And Answers
Quiz :An older adult client was admitted to the hospital with the condition
classified as "pneumonia." Reimbursement was based on a predetermined
fixed price. This classification system is referred to as: - Answer :a. diagnosis-
related groups (DRGs).
Quiz :The precise classification of clients according to the highest diagnosis-
related group (DRG) has created a new role for nurses, known as a _____
nurse. - Answer :c. utilization review
Quiz :Diagnosis-related groups (DRGs) have attempted to reduce health care
costs by decreasing: - Answer :b. length of hospital stay.
Quiz :When reviewing the literature on the effects of Medicaid on health care
for the poor, the nurse researcher found that the poor: - Answer :c. lack
consistent providers.
Quiz :Lack of insurance, uninsured populations, and uncompensated care are
covered by charging more to those who can pay. This practice is referred to as:
- Answer :b. cost shifting.
Quiz :A contractual agreement between the insurer and the provider in which
covered members are encouraged to use specific healthcare providers in
return for reduced rates is which type of arrangement? - Answer :b. Preferred
provider organization
Quiz :In the triad of health care, which would be considered the third-party
payer? - Answer :c. Insurance company
Quiz :A physician bills the insurance company for a computed tomography
(CT) scan, laboratory tests, chest x-ray, and an extended visit and receives
revenue for each procedure billed. This type of payment system is a _____
payment system. - Answer :b. retrospective
Quiz :A client is admitted with chest pain. A series of diagnostic tests are
ordered, and the client undergoes coronary artery bypass grafting. The cost of
care for this client is increased because of a four-pack-per-day smoking history
that resulted in extension of the client's intensive care unit (ICU) stay by 3 days
, because of respiratory problems. The case manager realizes that under the
terms of the diagnosis-related group (DRG) payment system for this diagnosis:
- Answer :b. although the cost of care for this client was greater than the DRG
reimbursement amount, the hospital will be reimbursed only at the set fee.
Quiz :A young mother has detected a lump in her breast, and because she lives
at the poverty level, she is covered under Medicaid. This individual: -
Answer :c. will more likely wait to seek care and will require hospitalization for
a mastectomy, which could have been avoided if care had been sought earlier.
Quiz :A client who is reading a newspaper asks, "This article about health care
states that many providers of health care lack effectiveness. What is the
difference between effectiveness and efficiency?" The nurse explains that: -
Answer :a. effective means performing the correct test or intervention
whereas efficiency refers to the wise use of supplies and resources for the
desired outcome.
Quiz :A nurse is offered several health care plans as part of employee benefits.
Which plan is based on a monthly fee per participant and offers a range of
preventive, diagnostic, and treatment services? - Answer :d. Capitation
Quiz :In February 2010, Congress passed legislation to support universal health
care for all Americans. At a local health fair, an individual asks about the
difference between universal health care and a single payer system. The nurse
explains the difference is that: - Answer :d. with universal health, one payer is
responsible for all health care costs, providing health care to all citizens.
Quiz :An elderly person, age 80, is finding it difficult to live alone and the
family is considering long-term care. The elderly person is reasonably healthy,
with only normal aging declines, and maintains a healthy appetite. All
medications are administered orally and require only minimal assistance. She is
financially secure with an income based on retirement from both the military
and factory from her deceased husband and herself. The family contacts long-
term care and is told that, based on this patient's information: - Answer :c.
Medicare will pay for home health services should these additional services
meet the needs of the individual.
Quiz :Certain groups of individuals are opposed to the Patient Protection and
Affordable Care Act (PPACA) based on religious beliefs that prohibit
circumcision and blood transfusions. These individuals believe the PPACA is