,NU 180 EXAM 3 Nursing and Healthcare II Questions And Answers
2026/2027 Galen College
Q1. Which federal law established a health insurance marketplace
for individuals to obtain health coverage?
A) Medicare Modernization Act
B) Affordable Care Act
C) Emergency Medical Treatment and Labor Act
D) Nurse Practice Act
Correct Answer: B) Affordable Care Act
Rationale: The Affordable Care Act created mechanisms including health
insurance marketplaces to expand access to health coverage.
Q2. Which are two major methods used to finance healthcare
services?
A) Fee-for-service and capitation
B) Deductibles and premiums
C) Coinsurance and copayments
D) Medicare and Medicaid
Correct Answer: A) Fee-for-service and capitation
Rationale: Fee-for-service pays providers based on individual services, while
capitation provides a predetermined payment for each enrolled patient.
**Q3. Which payment method reimburses a healthcare provider for each
service provided?
A) Capitation
B) Fee-for-service
C) Prospective payment
D) Bundled payment only
Correct Answer: B) Fee-for-service
Rationale: Under fee-for-service, providers receive payment for individual
healthcare services delivered.
**Q4. Which payment method provides a predetermined amount per patient
for a defined period of care?
A) Fee-for-service
B) Capitation
, C) Deductible
D) Coinsurance
Correct Answer: B) Capitation
Rationale: Capitation provides a fixed payment per enrolled patient,
regardless of the number of services used.
**Q5. Which healthcare payment system determines a predetermined
amount that a hospital will receive for a patient's hospitalization?
A) Prospective payment system
B) Fee-for-service
C) Copayment
D) Deductible
Correct Answer: A) Prospective payment system
Rationale: A prospective payment system establishes payment in advance
for a defined episode of hospital care.
**Q6. What effect can the prospective payment system have on hospitals?
A) It encourages efficient use of healthcare resources
B) It guarantees payment for every service provided
C) It eliminates the need for cost control
D) It prevents hospitals from discharging patients
Correct Answer: A) It encourages efficient use of healthcare resources
Rationale: Because payment is predetermined, healthcare organizations
have an incentive to manage resources efficiently.
**Q7. What is a deductible?
A) A fixed amount paid for each office visit
B) The amount an insured person pays before the insurance plan begins
sharing certain costs
C) The percentage paid after the deductible
D) The monthly insurance premium
Correct Answer: B) The amount an insured person pays before the insurance
plan begins sharing certain costs
Rationale: A deductible is the amount the patient is responsible for paying
before the insurance plan begins paying its share of covered expenses
according to the policy.
2026/2027 Galen College
Q1. Which federal law established a health insurance marketplace
for individuals to obtain health coverage?
A) Medicare Modernization Act
B) Affordable Care Act
C) Emergency Medical Treatment and Labor Act
D) Nurse Practice Act
Correct Answer: B) Affordable Care Act
Rationale: The Affordable Care Act created mechanisms including health
insurance marketplaces to expand access to health coverage.
Q2. Which are two major methods used to finance healthcare
services?
A) Fee-for-service and capitation
B) Deductibles and premiums
C) Coinsurance and copayments
D) Medicare and Medicaid
Correct Answer: A) Fee-for-service and capitation
Rationale: Fee-for-service pays providers based on individual services, while
capitation provides a predetermined payment for each enrolled patient.
**Q3. Which payment method reimburses a healthcare provider for each
service provided?
A) Capitation
B) Fee-for-service
C) Prospective payment
D) Bundled payment only
Correct Answer: B) Fee-for-service
Rationale: Under fee-for-service, providers receive payment for individual
healthcare services delivered.
**Q4. Which payment method provides a predetermined amount per patient
for a defined period of care?
A) Fee-for-service
B) Capitation
, C) Deductible
D) Coinsurance
Correct Answer: B) Capitation
Rationale: Capitation provides a fixed payment per enrolled patient,
regardless of the number of services used.
**Q5. Which healthcare payment system determines a predetermined
amount that a hospital will receive for a patient's hospitalization?
A) Prospective payment system
B) Fee-for-service
C) Copayment
D) Deductible
Correct Answer: A) Prospective payment system
Rationale: A prospective payment system establishes payment in advance
for a defined episode of hospital care.
**Q6. What effect can the prospective payment system have on hospitals?
A) It encourages efficient use of healthcare resources
B) It guarantees payment for every service provided
C) It eliminates the need for cost control
D) It prevents hospitals from discharging patients
Correct Answer: A) It encourages efficient use of healthcare resources
Rationale: Because payment is predetermined, healthcare organizations
have an incentive to manage resources efficiently.
**Q7. What is a deductible?
A) A fixed amount paid for each office visit
B) The amount an insured person pays before the insurance plan begins
sharing certain costs
C) The percentage paid after the deductible
D) The monthly insurance premium
Correct Answer: B) The amount an insured person pays before the insurance
plan begins sharing certain costs
Rationale: A deductible is the amount the patient is responsible for paying
before the insurance plan begins paying its share of covered expenses
according to the policy.
