ATI Fundamentals Study Guide 2025
with Complete Solutions
Medicare - ANSWER✔✔-for clients over age 65 and/or with permanent disabilities. premiums
applied as insurance program reimburses providers based on DRGs. Premiums applied as Managed
Care Organizations (MCOs) provide enrolled clients with comprehensive care overseen by a primary
care provider. Is federally funded.
Medicaid - ANSWER✔✔-for clients with low income. is federally funded and individual states
determine eligibility requirements.
Traditional Insurance - ANSWER✔✔-reimburses for services on fee-for-service basis.
Managed Care Organizations (MCOs) - ANSWER✔✔-comprehensive care is overseen by a primary
care provider & focuses on prevention and health promotion
Preferred Provider Organizations (PPOs) - ANSWER✔✔-client chooses from a list of contracted
providers. using non-contracted providers increases the client's out of pocket costs
Exclusive Provider Organizations (EPOs) - ANSWER✔✔-the client chooses from a list of
providers within a contracted organization
FOR STUDY PURPOSES ONLY COPYRIGHT © 2025 ALL RIGHTS RESERVED 1
,Long-Term Care Insurance - ANSWER✔✔-provides for long-term care expenses not covered by
Medicare
Preventive health care - ANSWER✔✔-focuses on educating and equipping clients to reduce and
control risk factors of disease. Examples include immunizations, stress management programs, and
seat belt use
Primary health care - ANSWER✔✔-emphasizes health promotion, and includes prenatal and well-
baby care, nutrition counseling, and disease control. is based on a sustained partnership between
client and provider. examples include office or clinic visits and scheduled school/work centered
screenings (vision, hearing, obesity)
Secondary health care - ANSWER✔✔-includes the diagnosis and treatment of emergency, acute
illness, or injury. examples include care given in hospital settings (inpatient and EDs), diagnostic
centers, or emergent care centers
Tertiary health care - ANSWER✔✔-involves the provision of specialized highly technical care.
examples include oncology centers and burn centers
Restorative health care - ANSWER✔✔-involves intermediate follow-up care for restoring health.
examples include home health care, rehab centers, and skilled nursing facilities
Continuing health care - ANSWER✔✔-designed to address long-term or chronic health care needs.
examples include hospice, adult day care, and in-home respite care
Health care regulatory agencies include: - ANSWER✔✔--US Dept of Health and Human Srvcs
-US FDA
FOR STUDY PURPOSES ONLY COPYRIGHT © 2025 ALL RIGHTS RESERVED 2
,-State and local public health agencies
-State licensing boards (to ensure providers & agencies comply with state regulations)
-the Joint Commission/JCAHO (set quality standards for accreditation of health care facilities)
-Professional Standards Review Organizations (PSROs)
-Utilization review committees (monitor for appropriate diagnosis and treatment of hospitalized
clients)
Clergy - ANSWER✔✔-Job: provide spiritual care to client (pastors, rabbis, priests)
Refer to when: the client requests communication or the family asks for prayer prior to client
undergoing a procedure
Registered dietitian - ANSWER✔✔-Job: assess, plan for, and educate the client reg. nutritional
needs; direct care of nutritional aids
Refer to when: ex- the client has low nutrient levels and/or experienced a recent unexplained weight
loss
Lab tech - ANSWER✔✔-Job: obtain specimens of the client's body fluids and perform the
necessary diagnostic tests
Refer to when: ex- the provider orders a CBC to be performed immediately
FOR STUDY PURPOSES ONLY COPYRIGHT © 2025 ALL RIGHTS RESERVED 3
, Occupational therapist - ANSWER✔✔-Job: assess and plan for the client to regain ADLs, esp
motor skills of the upper extremities; direct care of occupational therapy assistants
Refer to when: ex- client has difficulties using an eating utensil with dominate hand following a
stroke
Pharmacist - ANSWER✔✔-Job: provide & monitor meds for the client as prescribed by the
provider; supervises pharm techs in states in which the practice is allowed
Refer to when: client concerns over meds; dosage concerns; etc
Physical Therapist - ANSWER✔✔-Job: assess and plan for client to increase musculoskeletal
functions, esp of lower extremities, to maintain mobility; direct care of physical therapy assistants
Refer to when: ex- following a hip replacement, a client requires assistance learning to ambulate and
regain strength
Provider - ANSWER✔✔-Job: assess, diagnose, and treat cllient for disease and/or injury; includes
MDs, DOs, APNs, and PAs
Refer to when: ex- client experiences change in vital signs
Rad Tech - ANSWER✔✔-Job: position client and perform x-rays and other imaging procedures for
providers to review for diagnosis of disorders of various body parts
FOR STUDY PURPOSES ONLY COPYRIGHT © 2025 ALL RIGHTS RESERVED 4
with Complete Solutions
Medicare - ANSWER✔✔-for clients over age 65 and/or with permanent disabilities. premiums
applied as insurance program reimburses providers based on DRGs. Premiums applied as Managed
Care Organizations (MCOs) provide enrolled clients with comprehensive care overseen by a primary
care provider. Is federally funded.
Medicaid - ANSWER✔✔-for clients with low income. is federally funded and individual states
determine eligibility requirements.
Traditional Insurance - ANSWER✔✔-reimburses for services on fee-for-service basis.
Managed Care Organizations (MCOs) - ANSWER✔✔-comprehensive care is overseen by a primary
care provider & focuses on prevention and health promotion
Preferred Provider Organizations (PPOs) - ANSWER✔✔-client chooses from a list of contracted
providers. using non-contracted providers increases the client's out of pocket costs
Exclusive Provider Organizations (EPOs) - ANSWER✔✔-the client chooses from a list of
providers within a contracted organization
FOR STUDY PURPOSES ONLY COPYRIGHT © 2025 ALL RIGHTS RESERVED 1
,Long-Term Care Insurance - ANSWER✔✔-provides for long-term care expenses not covered by
Medicare
Preventive health care - ANSWER✔✔-focuses on educating and equipping clients to reduce and
control risk factors of disease. Examples include immunizations, stress management programs, and
seat belt use
Primary health care - ANSWER✔✔-emphasizes health promotion, and includes prenatal and well-
baby care, nutrition counseling, and disease control. is based on a sustained partnership between
client and provider. examples include office or clinic visits and scheduled school/work centered
screenings (vision, hearing, obesity)
Secondary health care - ANSWER✔✔-includes the diagnosis and treatment of emergency, acute
illness, or injury. examples include care given in hospital settings (inpatient and EDs), diagnostic
centers, or emergent care centers
Tertiary health care - ANSWER✔✔-involves the provision of specialized highly technical care.
examples include oncology centers and burn centers
Restorative health care - ANSWER✔✔-involves intermediate follow-up care for restoring health.
examples include home health care, rehab centers, and skilled nursing facilities
Continuing health care - ANSWER✔✔-designed to address long-term or chronic health care needs.
examples include hospice, adult day care, and in-home respite care
Health care regulatory agencies include: - ANSWER✔✔--US Dept of Health and Human Srvcs
-US FDA
FOR STUDY PURPOSES ONLY COPYRIGHT © 2025 ALL RIGHTS RESERVED 2
,-State and local public health agencies
-State licensing boards (to ensure providers & agencies comply with state regulations)
-the Joint Commission/JCAHO (set quality standards for accreditation of health care facilities)
-Professional Standards Review Organizations (PSROs)
-Utilization review committees (monitor for appropriate diagnosis and treatment of hospitalized
clients)
Clergy - ANSWER✔✔-Job: provide spiritual care to client (pastors, rabbis, priests)
Refer to when: the client requests communication or the family asks for prayer prior to client
undergoing a procedure
Registered dietitian - ANSWER✔✔-Job: assess, plan for, and educate the client reg. nutritional
needs; direct care of nutritional aids
Refer to when: ex- the client has low nutrient levels and/or experienced a recent unexplained weight
loss
Lab tech - ANSWER✔✔-Job: obtain specimens of the client's body fluids and perform the
necessary diagnostic tests
Refer to when: ex- the provider orders a CBC to be performed immediately
FOR STUDY PURPOSES ONLY COPYRIGHT © 2025 ALL RIGHTS RESERVED 3
, Occupational therapist - ANSWER✔✔-Job: assess and plan for the client to regain ADLs, esp
motor skills of the upper extremities; direct care of occupational therapy assistants
Refer to when: ex- client has difficulties using an eating utensil with dominate hand following a
stroke
Pharmacist - ANSWER✔✔-Job: provide & monitor meds for the client as prescribed by the
provider; supervises pharm techs in states in which the practice is allowed
Refer to when: client concerns over meds; dosage concerns; etc
Physical Therapist - ANSWER✔✔-Job: assess and plan for client to increase musculoskeletal
functions, esp of lower extremities, to maintain mobility; direct care of physical therapy assistants
Refer to when: ex- following a hip replacement, a client requires assistance learning to ambulate and
regain strength
Provider - ANSWER✔✔-Job: assess, diagnose, and treat cllient for disease and/or injury; includes
MDs, DOs, APNs, and PAs
Refer to when: ex- client experiences change in vital signs
Rad Tech - ANSWER✔✔-Job: position client and perform x-rays and other imaging procedures for
providers to review for diagnosis of disorders of various body parts
FOR STUDY PURPOSES ONLY COPYRIGHT © 2025 ALL RIGHTS RESERVED 4
