Chapter 02: The Health Care Delivery System
1. The nurse is caring for a patient whose insurance coverage is Medicare. The nurse should
consider which information when planning care for this patient?
a. Capitation pro
...
Chapter 02: The Health Care Delivery System
1. The nurse is caring for a patient whose insurance coverage is Medicare. The nurse should
consider which information when planning care for this patient?
a. Capitation provides the hospital with a means of recovering variable charges.
b. The hospital will be paid for the full cost of the patient’s hospitalization.
c. Diagnosis-related groups (DRGs) provide a fixed reimbursement of cost.
d. Medicare will pay the national average for the patient’s condition.
ANS: C
2. A nurse is teaching the staff about managed care. Which information should the nurse include in
the teaching session?
a. Managed care insures full coverage of health care costs.
b. Managed care only assumes the financial risk involved.
c. Managed care allows providers to focus on illness care.
d. Managed care causes providers to focus on prevention.
ANS: D
3. A nurse is teaching a family about health care plans. Which information from the nurse indicates a
correct understanding of the Affordable Care Act?
a. A family can choose whether to have health insurance with no consequences.
b. Primary care physician payments from Medicaid services can equal Medicare.
c. Adult children up to age 26 are allowed coverage on the parent’s plan.
d. Private insurance companies can deny coverage for any reason.
ANS: C
4. A nurse is caring for a patient in the hospital. When should the nurse begin discharge planning?
a. When the patient is ready
b. Close to the time of discharge
c. Upon admission to the hospital
d. After an order is written/prescribed
ANS: C
5. The nurse is applying for a position with a home care organization that specializes in spinal cord
injury. In which type of health care facility does the nurse want to work?
a. Secondary acute
b. Continuing
c. Restorative
d. Tertiary
ANS: C
6. A nurse provides immunization to children and adults through the public health department. Which
type of health care is the nurse providing?
a. Primary care
b. Preventive care
c. Restorative care
d. Continuing care
ANS: B
7. A nurse is following the PDSA cycle for quality improvement. Which action will the nurse take for
the letter “A”?
a. Act
b. Alter
c. Assess
d. Approach
ANS: A
8. The nurse is trying to determine how well a certain health plan compares with other health plans.
To gather this type of data, which information will the nurse utilize?
a. Pew Health Professions Commission
b. Healthcare Effectiveness Data and Information Set (HEDIS)
c. American Nurses Credentialing Center (ANCC) Magnet Recognition Program
d. Hospital Consumer of Assessment of Healthcare Providers and Systems (HCAHPS)
ANS: B
9. An older adult patient has extensive wound care needs after discharge from the hospital. Which
facility should the nurse discuss with the patient?
a. Hospice
b. Respite care
c. Assisted living
d. Skilled nursing
ANS: D
10. A nurse working in a community hospital’s emergency department provides care to a patient
having chest pain. Which level of care is the nurse providing?
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