Nokea
In an effort to cut costs, hospitals have instituted many changes. Which of these cost-cutting factors is most likely to jeopardize the quality of care?
- A. Using unlicensed assistive personnel
- B. Increasing numbers of clients in hospitals
- C. Not devoting enough time to the client
- D. The rise of medical care costs in healthcare systems
Correct Answer: A
Rationale: Hospitals are using unlicensed assistive personnel to perform some duties practical and registered nurses once provided. Many are concerned that the use of unlicensed assistive personnel will jeopardize the quality of care. Increasing numbers of clients in hospitals, not devoting enough time to the client, or the rise of medical costs are less likely to jeopardize the quality of care.
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A client with chronic obstructive pulmonary disease visits a local long-term care facility once a week to lead a bingo game for the residents. How does the nurse determine that this client is achieving a high level of wellness?
- A. The client enjoys the activity that the nurse provides to the clients.
- B. The client finds satisfaction in socialization with the residents.
- C. The client is achieving a high quality of life within the limits of the illness.
- D. The client needs to feel a part of a group setting.
Correct Answer: C
Rationale: Clients with chronic illness can achieve a high level of wellness if they can experience a high quality of life within the limits of that illness. By engaging in a personal and social activity weekly, this client would be considered healthy. Although the client may enjoy the activity, find satisfaction in socialization, or need to feel a part of a group, choosing to take part in an activity that promotes a high quality of life within the limits of the client's illness is what demonstrates wellness to the nurse.
A 17-year-old client is having protected sex one to two times a week in a monogamous relationship. What is the client participating in?
- A. Health promotion
- B. Health maintenance
- C. Illness prevention
- D. Wellness
Correct Answer: B
Rationale: Protecting one's current level of health by practicing safe sex to prevent illness is an example of a health maintenance activity. Health promotion strategies are used to enhance health, such as eating a diet high in fiber. Illness prevention includes identifying risk factors such as hypertension. Wellness is the balance of total well-being.
A client with terminal cancer is being referred to hospice services to assist with care of the client and the family in the home environment. What type of care does the nurse determine this is?
- A. Primary care
- B. Secondary care
- C. Tertiary care
- D. Acute care
Correct Answer: C
Rationale: Tertiary care focuses more on complex medical and surgical interventions, cancer care, rehabilitative services, long-term care such as burn care, and palliative and hospice care. This client is terminally ill and being referred for hospice service. Secondary care includes referrals to facilities for additional testing such as cardiac catheterization, consultation, and diagnosis as well as emergency and acute care interventions. The client does not fall into the acute care category. Primary care would include being seen by the client's primary physician.
A 65-year-old client is prescribed multiple medications for diabetes, hypertension, and angina and is going to the pharmacy to have the prescriptions filled. What coverage will the client use to assist with financial coverage of the medication?
- A. Medicare Part A
- B. Medicare Part B
- C. Medicare Part C
- D. Medicare Part D
Correct Answer: D
Rationale: Medicare Part D is Medicare Prescription Drug Coverage and helps to cover and possibly reduce prescription drug costs and protect against catastrophic drug expenses. Medicare Part A covers hospital care, skilled care, hospice, and home health services. Medicare Part B covers medically necessary services such as physician services that are not covered under Part A. Medicare Part C is the Medicare Advantage Plan and includes Parts A and B.
Since losing a leg years ago, the client and their spouse have formed a community walking group to raise money for the homeless in their area. Which of the following has contributed to the client being viewed as 'healthy'?
- A. The client is married and is moving on.
- B. The client is experiencing high quality of life within the limits of the physical condition.
- C. The client is facing various states of health and illness.
- D. The client is physiologically and psychologically stable.
Correct Answer: B
Rationale: Clients adapt physically, emotionally, and socially, enabling them to maintain comfort, stability, and self-expression. Clients with chronic illness can achieve a high level of wellness and experience high quality of life. Marriage is an aspect that contributes to quality of life but does not by itself define the quality of the client's life. All clients experience various states of health and illness.