pg. 1 Test Bank For Medical Surgical Nursing 5th Edition By Holly K. Stromberg, All Chapters 1-49 | Latest Update 2024
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Chapter 01: Caring for Medical-Surgical Patients
deWit: Medical-Surgical Nursing: Concepts & Practice, 5th Edition
MULTIPLE CHOICE
The nurse is educating a patient that is a member of a health maintenance organization (HMO). Which informationshould the nurse include?
- Seek the opinion of an alternate health care
- Obtain insurance approval for medical
- Provide detailed documentation of all care
- Wait at least 6 months to see a specialist.
provider.
services prior to treatment.
received for his condition.
ANS: B
Most HMOs require preprocedure authorization for treatment. Patients are not required to seek a second opinion, providedocumentation of care, or wait a specific time period before visiting a specialist.
PTS: 1 DIF: Cognitive Level: 9
Application REF:
OBJ: 9 TOP: Charge Nurse/Manager KEY: Nursing Process Step: Implementation MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
The nurse compares the characteristics of a health maintenance organization (HMO) and a preferred providerorganization (PPO). Which information should the nurse include about HMOs?
- HMOs require a set fee of each
- HMOs allow the member to select his
- HMOs permit admission to any facility
- HMOs offer unlimited diagnostic tests
member monthly.
health care provider.
the member prefers.
and treatments.
ANS: A
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HMOs require a set fee from each member monthly (capitation). The patient will be treated by the HMO staff in HMO-approvedfacilities. Excessive use of diagnostic tests and treatments is discouraged by the HMO.
PTS: 1 DIF: Cognitive Level: 9
Application REF:
OBJ: 9 TOP: Managed Care KEY: Nursing Process Step: Implementation MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
A patient asks the nurse what Medicare Part A covers. Which response is correct?
- Medicare Part A covers inpatient
- Medicare Part A covers
- Medicare Part A covers outpatient
- Medicare Part A covers ambulance
hospital costs.
reimbursement to the physician.
hospital services.
transportation.
ANS: A
Medicare Part A covers inpatient hospital expenses, drugs, x-rays, laboratory work, and intensive care. Medicare Part B pays thephysician, ambulance transport, and outpatient services.
PTS: 1 DIF: Cognitive Level: REF 7, Box Comprehension : 1-4 OBJ: 9 TOP: Government-Sponsored Health Insurance KEY: Nursing Process Step: Implementation MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
Which is the main cost-containment component of diagnosis-related groups (DRGs)?
- Hospitals focus only on the specific diagnosis.
- Hospitals treat and discharge patients quickly.
- Reduced cost drugs are ordered for specific diagnoses.
- Diagnostic group classification streamlines care.
ANS: B 3 / 4
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DRGs are a prospective payment plan in which hospitals receive a flat fee for each patient’s diagnostic category regardless of the length of time in the hospital. If hospitals can treat and discharge patients before the allotted time, hospitals get to keep the excess payment; cost is contained, and the patient is discharged sooner.
PTS: 1 DIF: Cognitive Level: REF 8 Comprehension
:
OBJ: 9 TOP: Government-Sponsored Health Insurance KEY: Nursing Process Step: Implementation MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care
The nurse is assessing a group of patients. Which patient would most likely qualify for Medicaid?
- A 35-year-old unemployed single mother with diabetes
- A 70-year-old Medicare recipient with retirement income who
- An 80-year-old blind woman living in her own home who has
- A 67-year-old stroke victim with Medicare Part A and an income
needs to be in a long-term care facility
inadequate private insurance
from investments
ANS: A
Medicaid is a joint effort of federal and state governments geared primarily for low- income people with no insurance.
PTS: 1 DIF: Cognitive Level:
Application REF: 8, Box 1-5
OBJ: 9 TOP: Government-Sponsored Health Insurance–Medicaid KEY: Nursing Process Step: Assessment MSC: NCLEX: Safe, Effective Care
Environment: Coordinated Care
Which area is the major focus of Healthy People 2020 and the primary mechanism through which to improve the healthof Americans in the second decade of the century?
- Research funding
- Health information distribution
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