ACTUAL QUESTIONS AND CORRECT
ANSWERS
Medicare - CORRECT ANSWERS 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 - CORRECT ANSWERS for clients with low income. is
federally funded and individual states determine eligibility requirements.
Traditional Insurance - CORRECT ANSWERS reimburses for services
on fee-for-service basis.
Managed Care Organizations (MCOs) - CORRECT ANSWERS
comprehensive care is overseen by a primary care provider & focuses on
prevention and health promotion
Preferred Provider Organizations (PPOs) - CORRECT ANSWERS client
chooses from a list of contracted providers. using non-contracted providers
increases the client's out of pocket costs
Exclusive Provider Organizations (EPOs) - CORRECT ANSWERS the
client chooses from a list of providers within a contracted organization
Long-Term Care Insurance - CORRECT ANSWERS provides for long-
term care expenses not covered by Medicare
,Preventive health care - CORRECT ANSWERS 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 - CORRECT ANSWERS 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 - CORRECT ANSWERS 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 - CORRECT ANSWERS involves the provision of
specialized highly technical care. examples include oncology centers and burn
centers
Restorative health care - CORRECT ANSWERS involves intermediate
follow-up care for restoring health. examples include home health care, rehab
centers, and skilled nursing facilities
Continuing health care - CORRECT ANSWERS 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: - CORRECT ANSWERS -US
Dept of Health and Human Srvcs
-US FDA
-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 - CORRECT ANSWERS 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 - CORRECT ANSWERS 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 - CORRECT ANSWERS 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
Occupational therapist - CORRECT ANSWERS 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 - CORRECT ANSWERS 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 - CORRECT ANSWERS 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 - CORRECT ANSWERS 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 - CORRECT ANSWERS Job: position client and perform x-
rays and other imaging procedures for providers to review for diagnosis of
disorders of various body parts
Refer to when: ex- provider orders x-ray of client's hip after a fall
Respiratory therapist - CORRECT ANSWERS Job: evaluate resp status
and provide prescribed resp treatments including O2 therapy, chest
physiotherapy, inhalation therapy, and artificial mechanical ventilation