Nokea
Match the following Key Term(s) or italicized words from your text with the correct description: Point of service
- A. The federal government's health insurance program for people older than 65 years or those with certain disabilities or conditions
- B. A federally and state-funded health insurance program for individuals who are poor and medically indigent, pregnant women, individuals with disabilities, and children meeting income level requirements
- C. A system of health-care delivery aimed at managing the cost and quality of access to health care
- D. The insurance company that finances health care provided to a beneficiary
- E. A cost-containment program featuring a primary care physician (PCP) as the gatekeeper to eliminate unnecessary testing and procedures
- F. A classification of illnesses and diseases that is then used to determine the amount of money paid to a hospital by Medicare
- G. A group of health-care providers who contract with a health insurance company to provide services to a specific group of patients on a discounted basis
Correct Answer: F
Rationale: A POS plan allows patients to choose providers in or out of network with a primary care physician as gatekeeper.
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A 58-year-old patient is in an ICU step-down unit at an acute care hospital after having a cerebrovascular accident (stroke) with right-sided weakness. He is medically stable but needs assistance with all activities of daily living (ADLs). The doctors think he may be able to regain all his former level of function. The appropriate level of care at this point in the patient's progress is a(n)
- A. acute care hospital.
- B. long-term acute care hospital (LTACH).
- C. skilled nursing facility (SNF).
- D. rehabilitation facility.
Correct Answer: D
Rationale: A rehabilitation facility is appropriate for a patient needing intensive therapy to regain function after a stroke.
Primary care must be performed by an RN.
- A. TRUE
- B. FALSE
Correct Answer: B
Rationale: Primary care nursing can be performed by various nursing levels, not only RNs.
One important consideration in managing costs is making sure the patient is placed in which of the following?
- A. Appropriate level of care
- B. Managed care
- C. A health maintenance organization (HMO)
- D. Acute care hospital
Correct Answer: A
Rationale: Placing patients in the appropriate level of care ensures cost-effective treatment.
Fill in the blank with the correct Key Term(s) or italicized words from your text: When care is provided to a person without admitting him or her to a health-care facility, the person is referred to as a(n)
- A. Inpatient
- B. Outpatient
- C. Resident
- D. Client
Correct Answer: B
Rationale: An outpatient receives care without being admitted to a healthcare facility.
Match the following Key Term(s) or italicized words from your text with the correct description: Primary care physician
- A. The federal government's health insurance program for people older than 65 years or those with certain disabilities or conditions
- B. A federally and state-funded health insurance program for individuals who are poor and medically indigent, pregnant women, individuals with disabilities, and children meeting income level requirements
- C. A system of health-care delivery aimed at managing the cost and quality of access to health care
- D. The insurance company that finances health care provided to a beneficiary
- E. A cost-containment program featuring a primary care physician (PCP) as the gatekeeper to eliminate unnecessary testing and procedures
- F. A classification of illnesses and diseases that is then used to determine the amount of money paid to a hospital by Medicare
- G. The gatekeeper for access to medical services
Correct Answer: G
Rationale: The primary care physician controls access to medical services as a gatekeeper.