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The client is referred from the physician to a cardiologist for a cardiac catheterization to determine if the client has coronary artery disease. What type of care does the nurse understand that this is?
- A. Primary care
- B. Secondary care
- C. Tertiary care
- D. Acute care
Correct Answer: B
Rationale: Secondary care includes referrals to facilities for additional testing such as cardiac catheterization, consultation, and diagnosis as well as emergency and acute care interventions. This client falls into this category due to the referral to the cardiologist for the cardiac catheterization. The client does not fall into the acute care category. Primary care would include being seen by the client's primary physician. 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.
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The hospital is having a problem with healthcare-associated infections. A committee has been established to study the problem and make recommendations. The nurse working on the committee knows that this work addresses what?
- A. Inpatient quality indicators
- B. Prevention quality indicators
- C. National Patient Safety Goals
- D. Patient safety indicators
Correct Answer: C
Rationale: The Joint Commission has established National Patient Safety Goals that are updated annually. These safety goals have changed how patients are identified and prevent adverse effects. Some of the 2016 goals include reducing the risk of healthcare-associated infections. Patient safety indicators reflect the quality of care in hospitals but focus on potentially avoidable complications. Prevention indicators identify hospital admissions that could be avoided through high-quality outpatient care. Inpatient indicators reflect quality of care inside the hospital.
A client is brought into the emergency department by the rescue squad after involvement in a motorcycle accident with a severe spinal cord injury. As what type of illness does the nurse view this event?
- A. Terminal
- B. Acute
- C. Chronic
- D. Catastrophic
Correct Answer: D
Rationale: Illness refers to a state of being sick and can be viewed as catastrophic or a sudden, traumatic illness, which has occurred with this client. The client has suffered a traumatic accident with serious injury and would be classified as catastrophic. This event is not chronic, terminal, or acute.
The nurse is assisting with the development of a program to administer flu shots to a group of senior citizens. What type of prevention does this program reflect?
- A. Primary prevention
- B. Secondary prevention
- C. Tertiary prevention
- D. Prevalence
Correct Answer: A
Rationale: Primary prevention is prevention of the development of disease in a susceptible or potentially susceptible population and includes health promotion and immunization. Secondary prevention is the early diagnosis and treatment to shorten duration and severity of an illness, reduce contagion, and limit complications. Tertiary prevention is healthcare to limit the degree of disability or promote rehabilitation in chronic, irreversible diseases. Prevalence is the number of cases of a disease in a specific population during a specific period.
What does the nurse understand is the focus of healthcare when a client receives services from a health maintenance organization (HMO)?
- A. Avoiding coverage for needed services
- B. Health promotion and maintenance
- C. To offer discounted services to all patients
- D. High-quality service and contain cost
Correct Answer: B
Rationale: If the HMO does not require much high-cost care, providers make money; if members use many high-cost resources, providers lose money. This method of financing provides the strongest incentives for limiting use of expensive services and focusing healthcare on health maintenance and promotion. If services such as diagnostic testing are required, the HMO will cover this and not avoid payment. Services are not discounted for patients that are nonmembers or members. The goals of a physician hospital organization (PHO) are to maintain high-quality service and contain costs while fostering group contracts, collaboration, and capitation.
What method for financing healthcare is based on the ability to keep clients healthy and out of the hospital through periodic screening, health education, and preventive services?
- A. Managed care
- B. Preferred provider organization
- C. Health maintenance organization
- D. Point-of-service organization
Correct Answer: C
Rationale: Health maintenance organizations strive to keep their costs low and members out of the hospital through periodic screenings, health education, and preventive services. Managed care organizations are insurers who carefully plan and closely supervise the distribution of healthcare services. Preferred provider organizations are a community network of providers who are willing to discount their fees for service in exchange for a steady stream of referral customers. Point-of-service organizations involve a network of providers; clients select a primary care physician within the group who then serves as the gatekeeper for other healthcare services.