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The nurse is collecting data at the clinic from a new client who is being seen for an employee physical. The client informs the nurse that both parents have a history of high blood pressure, with one of them having a stroke at the age of 52 years. The nurse discusses diet and exercise programs that may benefit the client. What is the nurse displaying with this information?
- A. Early detection
- B. Health maintenance
- C. Health promotion
- D. Illness prevention
Correct Answer: D
Rationale: Illness prevention involves identifying risk factors such as family history of hypertension or diabetes and reducing the effects of risk factors on one's health. Early detection uses screening diagnostic tests and procedures to identify a disease process earlier, so that treatment may be initiated earlier and be more effective. Health maintenance refers to protecting one's current level of health by preventing illness or deterioration, such as by complying with medication regimens, being screened for diseases such as breast and colon cancers, or practicing safe sex. Health promotion refers to engaging in strategies to enhance health such as eating a diet high in grains and complex carbohydrates, exercising regularly, balancing work with leisure activities, and practicing stress-reduction techniques.
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The nurse has been asked to assist in gathering data regarding the incidence of falls in the hospital as part of a project that is geared toward identifying avoidable contributing factors and their effects. What type of quality indicators (QI) is this considered?
- A. Prevention QI
- B. Inpatient QI
- C. Client safety QI
- D. Pediatric QI
Correct Answer: C
Rationale: Client safety QIs reflect quality of care within hospitals but focus on potentially avoidable complications and adverse effects. Prevention QIs identify hospital admissions that could be avoided through high-quality outpatient care. Inpatient QIs reflect quality of care inside hospitals, including inpatient mortality for medical conditions and surgical events. The question does not indicate that client age is considered when gathering data, so Pediatric QIs would not be relevant here.
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.
A nurse is providing care for a client who has had a hip replacement and is going to be discharged in 2 days. The nurse has provided the client instructions for care after discharge. Which instruction would be considered accessing tertiary care?
- A. Begin physical therapy in 1 week.'
- B. Follow up with your primary health care provider in 2 days to discuss laboratory results.'
- C. Go to the outpatient laboratory for blood studies in 3 days.'
- D. Report to the emergency department for signs of infection, shortness of breath, or chest pain.'
Correct Answer: A
Rationale: Starting physical therapy, a type of rehabilitation, is a form of tertiary care. Tertiary care focuses on complex medical and surgical interventions, and specialized services such as cancer care and rehabilitative services. Encouraging the client to see a family health care provider would be promoting primary care. Sending the client for lab studies or instructing them to go to the emergency department would be directing the client to seek secondary care, which includes additional testing and emergency care.
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 72-year-old client who is hospitalized will be going on anticoagulant therapy and will require home healthcare nurses to visit once weekly to draw blood for coagulation studies. What coverage does the client have that will cover this service?
- A. Medicaid
- B. Medicare Part A
- C. Medicare Part B
- D. Medicare Part C
Correct Answer: B
Rationale: Medicare covers individuals who are 65 years of age or older, permanently disabled workers of any age with specific disabilities, and persons with end-stage renal disease. 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. Medicaid coverage is coverage for indigent patients that are unable to afford healthcare and qualify financially.