REVIEW||DETAILED QUESTIONS
AND CORRECT VERIFIED
ANSWERS||LATEST EXAM 2025-
2026||ALREADY GRADED A+
Health Care Delivery Systems: regulatory agencies -Answer U.S. department of
health and human services
U.S. Food and Drug Administration
State and Local public health agencies
State licensing boards
The Joint Commision
Professional Standards Review Organizations
Utlilization Review Committees
State licensing boards -Answer Ensure that health care providers and agencies
comply with state regulations
The Joint Commission -Answer Sets quality standards for accreditation of health
care facilities
Professional standards review organizations (PSROs) -Answer review the quality,
quantity, and cost of hospital care
Utilization review committee -Answer monitor for appropriate diagnosis and
treatment of hospitalized clients
Public federally funded programs -Answer Medicare (Part A, B, C, D)
Medicaid
Affordable Care Act
State Children's Health Insurance Program
Medicare -Answer A federal program of health insurance for persons 65 years of
age and older and those with permanent disabilities
Medicare Part A -Answer Hospital stays, home health, hospice
,Medicare Part B -Answer Outpatient and provider services (voluntary and requires a
monthly premium)
Medicare Part C -Answer Medicare advantage plan, combo of part a and b and
sometimes d. covers all medical services that are needed
Medicare Part D -Answer Prescription drug coverage eligible, requires monthly
premium
Medicaid -Answer for clients with low income. is federally funded and individual
states determine eligibility requirements.
Patient Protection and Affordable Care Act of 2010 -Answer A federal law enacted in
2010 to expand health insurance coverage, by decreasing health care costs and
otherwise regulate the health insurance industry
State Children's Health Insurance Program -Answer Coverage for uninsured children
up to age 19
Private plans -Answer Traditional insurance reimburses for services on a fee for
service basis. Private plans include: MCOs, PPOs, EPOs, and Long term care
insurance
Managed Care Organization (MCO) -Answer primary care providers oversee
comprehensive care for enrolled clients and focus on prevention and health promotion
Preffered Provider Organization (PPO) -Answer clients choose from list of contracted
providers and hospitals; using none contracted providers increases out of pocket costs
Exclusive Provider Organization (EPO) -Answer clients choose from a list of
providers and hospitals within a contracted organization with no out-of-network
coverage
long-term care insurance -Answer A supplement for long-term care expenses
Medicare does not cover
Levels of health care -Answer preventative, primary, secondary, tertiary, restorative,
continuing
Preventative Health Care -Answer focuses on educating and equipping clients to
reduce and control risk factors for disease; examples: immunization, stress
management, occupational health, 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: 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: care given in hospital settings (inpatient and EDs),
diagnostic centers, or emergent care centers
Tertiary Health Care -Answer acute care, involves the provision of specialized and
highly technical care examples: intensive care, oncology centers, and burn centers
Restorative health care -Answer intermediate follow-up care for restoring health and
promoting self-care; examples: home health care, rehabilitation centers and skilled
nursing facilities
Continuing health care addresses -Answer long-term or chronic health care needs.
examples include: end-of-life care, palliative care, hospice, adult day care, and in-home
respite care
Interprofessional team (non-nursing) -Answer Spiritual support staff, registered
dietician, laboratory technician, occupational therapist, pharmacist, physical therapist,
provider, radiologic technologist, respiratory therapist, social worker, speech-language
pathologist
Nursing Personnel -Answer Registered Nurse (RN)
Licensed Practical Nurse (LPN)
Unlicensed Assistive Personnel (UAP)
-Certified Nurse Assistant (CNA)
-Certified Medical Assistant (CMA)
-Monitor Technician
Basic Principles of Ethics -Answer advocacy, responsibility, accountability,
confidentiality
Advocacy -Answer support and defend clients' health, wellness, safety, wishes, and
personal rights, including privacy
responsibility -Answer willingness to respect obligations and follow through on
promises
Accountability -Answer ability to Answer for one's own actions