Nurs 486 Final 164 Questions with Verified Answers,100% CORRECT

Nurs 486 Final 164 Questions with Verified Answers Why were there no incentives for physicians to control costs in healthcare? - CORRECT ANSWER they were the primary decision makers did as many tests as possible if ...

Nurs 486 Final 164 Questions with Verified Answers Why were there no incentives for physicians to control costs in healthcare? - CORRECT ANSWER they were the primary decision makers did as many tests as possible if there was any marginal benefit in the fee for service payment, the more tesys or procedures performed, the what - CORRECT ANSWER greater the physician's earnings because earning tied to procedures in fee for service, patients were insulated from the costs how - CORRECT ANSWER insurance was paying it all lack of what contributed to increased costs? - CORRECT ANSWER cost consciousness pts not aware of costs providers had no incentive to be concerned in 1983 the movement of Medicare shifted to what payment system? - CORRECT ANSWER prospective payment system (predetermined payment) based on DRGs, which was a common method of reimbursement based on what - CORRECT ANSWER predetermined fixed price-per-case diagnosis under DRGs, the hospital won't get reimbursed for what - CORRECT ANSWER going over pre-established prices the DRGs created a need for what? - CORRECT ANSWER nursing managers Brought physician reimbursement more in line with skills required & actual time spent on procedures Ex: when cataract surgery was new, it took longer and was more expensive - CORRECT ANSWER RBRVs now that its more routine and mainstream, RBRVs brought payment down • Individual or employer pays for premium • Copayment when patient sees physician • Must select primary care provider (in network physician) = GATE KEEPER • Can't go to any other physician/specialist w/o referral • Insurance won't give coverage if you do - CORRECT ANSWER HMO • Member pays premium for fixed percentage • There is a deductible and copayment • Can choose physician in network - DON'T HAVE TO HAVE A GATE KEEPER o Can choose anyone in their list w/o a referral • Might be able to get reimbursed out of network, but lower rate • May or may not pay for preventative care - CORRECT ANSWER PPO • Allows use of providers outside the plan's preferred list or network, but requires higher premiums and copayments for services - CORRECT ANSWER POS o Expands health insurance coverage to uninsured Americans while controlling costs and improving the quality of health care - CORRECT ANSWER patient protection and affordable care act encompasses skills and risk taking that businesspersons bring to health care organizations - CORRECT ANSWER entrepreneurship including all medical facilities and equipment available - CORRECT ANSWER capital what part of medicare is free? - CORRECT ANSWER the basic part largest Health insurane in the US - CORRECT ANSWER medicare Entitlement program based on age (65) or disability (kidney failure, terminal cancer) criteria rather than on need - CORRECT ANSWER medicare covers inpatient hospital services, skilled nursing facilities (SNFs), and home health benefits - CORRECT ANSWER medicare part A covers physician services - CORRECT ANSWER medicare part B what covers impoverished families - CORRECT ANSWER medicaid medicaid covers who? - CORRECT ANSWER disabled low income with children nursing home low income method of reimbursing providers based on the quality of care provided with an emphasis on disease prevention and reduction of complications - CORRECT ANSWER pay for performance what are never events? - CORRECT ANSWER where medicare no longer pays hospitals for the extra cost of treating preventable errors HAI injuries from falls wrong site surgery mismatched blood transfusions decrease duplication of services and reduce wasted health care resources - CORRECT ANSWER care coordination ensure that patients get effective treatment at the appropriate level of care • Makes sure patient isn't kept in hospital longer than should be or discharged before they should be discharged - CORRECT ANSWER case management manage and improve the health status of a defined patient population over the course of a disease - CORRECT ANSWER disease management demonstrate efficiency of care via measurable, effective outcomes - CORRECT ANSWER outcomes management A nurse is checking orders at the front desk when a visitor asks the room number of his father. The nurse leaves the chart open while looking up the room number on the computer, allowing the visitor to read the patient's recent x-ray film report. Which law would protect this client from others having access to his or her medical information? A. Health Insurance Portability and Accountability Act of 1996 B. Patient Self-Determination Act of 1990 C. Emergency Medical Treatment and Active Labor - CORRECT ANSWER A While assisting in the labor room, a nurse is helping to stimulate a newborn infant who has a low Apgar score. The nurse stumbles, allowing the baby to fall to the floor, resulting in the infant's death. This situation is referred to as: A. Criminal negligence B. Sentinel event C. res ipsa loquitur D. A negligent act - CORRECT ANSWER B Laws written and enacted by legislative bodies Violations are criminal offenses and are punishable by fines or imprisonment - CORRECT ANSWER statutory law Occurs when one person or company has a duty of care toward another person or company, but fails to live up to that standard. - CORRECT ANSWER breach of duty Body of written opinions created by judges in federal and state appellate cases; also known as judge-made law and common law. - CORRECT ANSWER case law A category of law (tort law) that deals with conduct considered unacceptable. It is based on societal expectations regarding interpersonal conduct. Common causes of civil litigation include professional malpractice, negligence, and assault and battery. - CORRECT ANSWER civil law Law that is created through the decision of judges as opposed to laws enacted by legislative bodies (e.g., Congress). - CORRECT ANSWER common law A type of liability in which damages may be apportioned among two or more defendants in a malpractice case. The extent of liability depends on the defendant's relative contribution to the patient's injury. - CORRECT ANSWER comparative negligence A type of liability in which the plaintiff (patient), through his own negligence, contributed to the harm suffered. - CORRECT ANSWER contributory negligence Negligence that indicates "reckless and wanton" disregard for the safety, well-being, or life of an individual; behavior that demonstrates a complete disregard for another, such that death is likely. - CORRECT ANSWER criminal negligence Monetary compensation the court orders paid to a person who has sustained a loss or injury to his or her person or property through the misconduct (intentional or unintentional) of another. - CORRECT ANSWER damanges The individual who is named in a person's (plaintiff's) complaint as responsible for an injury; the person who the plaintiff claims committed a negligent act or malpractice. - CORRECT ANSWER defendent A process in which the patient's primary provider (physician or advanced practice nurse) gives the patient, and when applicable, family members, complete information about unanticipated adverse outcomes of treatment and care. - CORRECT ANSWER disclosure An instrument that authorizes another person to act as one's agent in decisions regarding health care if the person becomes incompetent to make his or her own decisions. - CORRECT ANSWER durable power of attorney for health care A failure of a planned action to be completed as intended or the use of a wrong plan to achieve a specific aim. - CORRECT ANSWER error A legal concept that means extreme carelessness showing willful or reckless disregard for the consequences to a person (patient). - CORRECT ANSWER gross negligence Legal doctrine by which a person is protected from a lawsuit for negligent acts or an institution is protected from a suit for the negligent acts of its employees. - CORRECT ANSWER immunity Being legally responsible for harm caused to another person or property as a result of one's actions; compensation for harm normally is paid in monetary damages. - CORRECT ANSWER libility Laws that establish the qualifications for obtaining and maintaining a license to perform particular services. Persons and institutions may be required to obtain a license to provide particular health care services. - CORRECT ANSWER liccensing laws Failure of a professional to meet the standard of conduct that a reasonable and prudent member of his or her profession would exercise in similar circumstances that result in harm. The professional's misconduct is unintentional. - CORRECT ANSWER malpractice Failure to act in a manner that an ordinary, prudent person (either a layperson or professional) would act in similar circumstances, resulting in harm. The failure to act in a reasonable and prudent manner is unintentional. - CORRECT ANSWER negligence The complaining person in a lawsuit; the person who claims he or she was injured by the acts of another. - CORRECT ANSWER plaintiff An injury caused by medical management rather than the patient's underlying condition. An adverse event attributable to error is a preventable adverse event. - CORRECT ANSWER preventable adverse event Monetary compensation awarded to an injured person (patient) that goes beyond that which is necessary to compensate for losses (e.g., the ability to function, death, income) and is intended to punish the wrongdoer. - CORRECT ANSWER punitive damages Legal doctrine applicable to cases in which the provider (e.g., the physician) had exclusive control of events that resulted in the patient's injury; the injury would not have occurred ordinarily without a negligent act; a Latin phrase meaning "the thing speaks for itself." - CORRECT ANSWER res ipsa loquitur Legal doctrine that holds an employer indirectly responsible for the negligent acts of employees carried out within the scope of employment; a Latin phrase meaning "let the master answer." - CORRECT ANSWER respondeat superior Process of identifying, analyzing, and controlling risks posed to patients; involves human factor and incident analysis, changes in systems operations, and loss control and prevention. - CORRECT ANSWER risk management As defined by The Joint Commission, an unintended adverse outcome that results in death, paralysis, coma, or other major permanent loss of function. Examples of sentinel events include patient suicide while in a licensed health care facility, surgical procedure on the wrong organ or body side, or a patient fall. - CORRECT ANSWER sentinel event In civil cases, the legal criteria against which the nurse's (and physician's) conduct is compared to determine whether a negligent act or malpractice occurred; commonly defined as the knowledge and skill that an ordinary, reasonably prudent person would possess and exercise in the same or similar circumstances. - CORRECT ANSWER standard of care Law enacted by a legislative body; separate from judge-made or common law. - CORRECT ANSWER statute or statutory law A legal doctrine, sometimes referred to as absolute liability, which can be imposed on a person or entity (e.g., a hospital) without proof of carelessness or negligence. - CORRECT ANSWER strict liability Legal doctrine in which a person or institution is liable for the negligent acts of another because of a special relationship between the two parties; a substituted liability. - CORRECT ANSWER vicarious liability violation of a law or statue is punishable how? - CORRECT ANSWER criminal charges is ignorance of the law a defnese when a nurse violates a health care statute? - CORRECT ANSWER no is the principal set of rules and regulations issued by federal agencies regarding public health - CORRECT ANSWER title 42 Have a major effect on nursing care—mandate a minimum standard of care in all settings that receive federal funds (Medicare, Medicaid) - CORRECT ANSWER federal statues makes it an offense to submit a false claim to the government for payment of health care services - CORRECT ANSWER federal false claims act the person who reports a false or fradulent clain i known as what - CORRECT ANSWER whistle blowercan get 15-25% if the case is won enacted in 1986 to prohibit the refusal of care for indigent and uninsured patients seeking medical assistance in an ED - CORRECT ANSWER emergency medical treatment and active labor law COBRA 42 the emergency medical treatment and active labor law prohibits what? - CORRECT ANSWER the transfer of unstable patients, including women in labor, from one facility to another the EMTALA is also applied to whawt? - CORRECT ANSWER non emergency facilities such as urgent care clinic prohibits discrimination against persons with disabilities by removing barriers that might prevent the same opportunities available to persons without disabilities - CORRECT ANSWER americans with diabilities act of 1990 requires federally funded hospitals (Medicare, Medicaid) to inform adult patients in writing about their right to make treatment choices and to ask patients if they have a living will or durable power of attorney - CORRECT ANSWER patient self determination act of 1990 ): ensures confidentiality of a patient's medical records; sets guidelines for maintaining the privacy of health data - CORRECT ANSWER HIPAA allows certain disclosures of patient safety data - CORRECT ANSWER The Patient Safety and Quality Improvement Act: The law permits a provider to disclose nonidentifiable patient data to a qualified patient safety organization (PSO) for the purpose of analyzing medical errors. - CORRECT ANSWER patient safety and quality improvement act prohibits an accrediation body such as THC from taking any action against a provider who reports patient safety data to an approved PSO what is an example of a state statute? - CORRECT ANSWER NPA what are pentalies that may be imposed by the licensing boards who have the atuthoirty to hear and decide cases against nurses - CORRECT ANSWER issuing a formal reprimand establishing a period of probation levying fines limiting suspending revoking license who was the firt to enact a law in january 2004 that mandates the establishment of minimum nurse/patient ratios in acute care facilities? - CORRECT ANSWER california research indicates that improved nure patient ratios are associated with what - CORRECT ANSWER lower failure to rescue rates lower inpatient mortaility rates Laws mandating reporting of specific health problems and suspected or confirmed abuse - CORRECT ANSWER child abuse prevention and treatment act and reporting statues health care professionals mut report the following under penalty of fine or improsonment for failing to do o for the child abuse prevention and treatment act and reporting statues - CORRECT ANSWER infant/child abuse dependent elder abuse specified communicable disease all facilities that provide health care services must comply with what - CORRECT ANSWER licensing laws Should be used along with Standards of Quality Practice to guide nurses - CORRECT ANSWER american nurses association standards of professional performance Created through cases heard and decided in federal and state appellate courts—also known as decisional or judge-made law - CORRECT ANSWER common law body of written opinions about nursing practice - CORRECT ANSWER nursing case law failure to act in a reasonable and prudent manner - CORRECT ANSWER negligence special type of negligence; that is, the failure of a professional, a person with specialized education and training, to act in a reasonable and prudent manner - CORRECT ANSWER malpractice negligence and malpractice are what law - CORRECT ANSWER civil law what are elements essential to prove negligence or malpractice? - CORRECT ANSWER Nurse owed patient a special duty of care based on the establishment of a nurse-patient relationship Nurse breached duty to the patient or client The patient suffered actual harm or damage Proximate cause or a causal connection has been established between the standard of care provided by the nurse and the patient's injury what are most frequent allegation of nursing negligence? - CORRECT ANSWER failure to ensure pt safety improper tx or negligent performance of tx failure to monitor pt and report significant finding med errors failure to follow agency's policies and procedures Applies when the negligent act clearly lies within the range of a jury's common knowledge and experience to determine the standard of care—"the thing that speaks for itself" - CORRECT ANSWER negligence and the doctrine of res ipsa loquitur Reckless act that reflects a conscious disregard for the patient's welfare Court may award special damages meant to punish the nurse for the outrageous conduct; these are referred to as punitive damages - CORRECT ANSWER gross negligence Constitutes a crime—the act is deemed so reckless that it results in serious injury or death to the patient - CORRECT ANSWER criminal negligence when can the nurse use the defense "following physician's orders"? - CORRECT ANSWER never what defense against claimss of negligence? nursing care rendered in a life-threatening emergency may breach the standard of care required under normal circumstances - CORRECT ANSWER emergency situation who are shielded from personal responsibility for damages in malpractice cases - CORRECT ANSWER employed by federal or state facilities limits a nurse's liability or shields the nurse from malpractice for rendering emergency assistance outside the employment setting - CORRECT ANSWER good samaritan immunity the central role of nurses to prvent patient harm - CORRECT ANSWER ANA code of ethic and american medical asocation's code of medical ethics Establish time limits within which a person may initiate a lawsuit Time limits vary depending on state laws and a variety of case circumstances - CORRECT ANSWER statutes of limitation in malpractice cases when errors occur in practice, studies confirm that what results in less severe ramifications for clinicans and facilities? - CORRECT ANSWER telling the family and pt about the mistake Asserts that every person is responsible for the wrong or injury done to another as the result of carelessness - CORRECT ANSWER liability Requires nurse to assume responsibility for patient harm or injury that is a result of negligent acts Nurse cannot be relieved of liability by another professional, such as a physician or nurse manager Damages can be levied against current assets and future earnings - CORRECT ANSWER personal liability nurses have the legal duty to refuse specific tasks that they cannot perfom safetly and competenly but should consider what - CORRECT ANSWER negotiation and compromise with the supervisor when is a nurse not allowed to render services? - CORRECT ANSWER if the requisite knowledge to act competently is lacking Triage of staff and equipment Supervision of subordinates Delegation of patient care tasks Reporting of team member performance deficits Supporting or invoking the chain of command process when indicated who are held to this liability - CORRECT ANSWER team leaders/managers Inadequate training Failure to periodically reevaluate staff competencies Failure to discipline or terminate unsafe workers Negligence in developing appropriate policies and procedures Failure to uphold institutional licensing laws and state and federal statutes who are held to this liability - CORRECT ANSWER nurse mangers and administrators what is vicarious liability - CORRECT ANSWER employer liability Track incidents and accidents in the facility Assist in the development of policies and procedures to improve practice Provide knowledge about federal and state laws, licensing laws, and health care case law - CORRECT ANSWER risk managment systems Direct violation of a person's legal rights Plaintiff does not have to prove that the nurse breached a special duty or was negligent Consequences include fines and punitive damages, but may rise to the level of criminal acts - CORRECT ANSWER intentional torts defamation caused by written word - CORRECT ANSWER libel defamation caused by spoken word - CORRECT ANSWER slander Nurse's behavior is so outrageous that it leads to the patient's emotional shock - CORRECT ANSWER intentional influction of emotional distres an offense against society that is defined through written criminal statutes or codes - CORRECT ANSWER crime crime is punishable by what - CORRECT ANSWER fines imprisonment death in some states Illegal practice of medicine Failing to report child abuse Falsification of medical records Assault and battery and physical abuse of patients are uually what offenses - CORRECT ANSWER misdemeanor what offensess are drug trafficking fraud in billing services for medicare patients theft rape murder - CORRECT ANSWER felony if a student gets sued, what is it usually filed under? - CORRECT ANSWER ordinary negligence rather than professional malpractie Interprofessional approach to EOL care Aggressive pain and symptom control Spiritual and psychological care Patient and family are the unit of care Symptom control rather than curative treatment The disease is considered end stage with progression to death - CORRECT ANSWER hospice supports the best quality of life during the time of diagnosis, treatment, and life with serious illness - CORRECT ANSWER palliative care unlike hospice, palliative patients can receive what - CORRECT ANSWER curative tx what care is an approach that improves quality of life of pts and families facing problems associated with life-threatening illnes - CORRECT ANSWER palliative care how is quality of life improved in palliative care? - CORRECT ANSWER through the prevention and relief of suffering by means of early identification of pain or other physical, psychological, and spiritual problems what for palliative care nurses: Provides age-appropriate culturally, ethically, and spiritually sensitive care and support Maintains a safe environment Educates patients/family to identify appropriate settings and treatment options Assures continuity of care and safe transitions to the next appropriate setting Coordinates care across settings and among caregivers Manages information and protects confidentiality Communicates promptly and effectively - CORRECT ANSWER HPNA standard sof practice for palliative care nurses with inital diagnosis, palliative care can help guide what - CORRECT ANSWER therapy what is an option of care with disease progression to an end stage condition - CORRECT ANSWER hospice as aggressive therapies are no longer effective and comfort care increases, what can be introduced? - CORRECT ANSWER hospice care and breavement services what i a general tool that identifies functional decline and scores it - CORRECT ANSWER palliative performance scale what is appropriate for pts with a cancer diagnosis for prognosstication tools - CORRECT ANSWER karnofsky scale what is prognostication based on - CORRECT ANSWER lab findings and diagnostic test results after gathering data for prognostication, what is imperative - CORRECT ANSWER a meeting with the pt and family hope for what - CORRECT ANSWER a cure more time no pain a good death what are the two roads to death - CORRECT ANSWER peaceful difficult which road to death pt begins sleeping more and being less and less responsibe - CORRECT ANSWER peaceful what road to death one of restlessness with increased confusion and frequently with hallucinations - CORRECT ANSWER difficult what are triggers to palliative care consult? - CORRECT ANSWER asking "would i be surprised if this patient died within 6 months to a year?" and getting a positive response pt with multifaced care such as a vent, feedings, assistance with functional needs a pts place of residence is a long-term care facility age of pt cognitive impairment metastic cancer current or past enrollment in hospice pt without an advnace care plan what is the end of life nursing education consortium core curriculum? - CORRECT ANSWER nursing care at the end of life pain management symptom management ethical/legal issues cultural consideratioins communication loss/grief/bereavement final hours what is the task force of organizations striving to improve care? including american academy of hopice and palliative medicine center to advance palliative care hospice and palliative care nurses association national hospice and palliative care organization - CORRECT ANSWER nation consensus project which domain of national consensus project structure and processes of care - CORRECT ANSWER domain 1 which domain of national consensus project addresses physical aspects of care - CORRECT ANSWER domain 2 which domain of national consensus project psychological and psychiatric aspectw of care - CORRECT ANSWER domain 3 which domain of national consensus project social aspects of care - CORRECT ANSWER domain 4 which domain of national consensus project spiritual, religious, and existential aspects of care - CORRECT ANSWER domain 5 which domain of national consensus project cultural aspects of care - CORRECT ANSWER domain 6 which domain of national consensus project care of the patient at the end of life - CORRECT ANSWER domain 7 which domain of national consensus project ethical and legal aspects of care - CORRECT ANSWER domain 8 in the palliative care model, who is the unit of care? and who defines family? - CORRECT ANSWER family patient the role of the nurse as what is vital to the care of the pt and their families in the palliative care model - CORRECT ANSWER advocate palliative care futher caries an important focus to special populations such as what? - CORRECT ANSWER vulnerable prisoner substane abuser palliative care is for what - CORRECT ANSWER all life-threatening illneses what is integral to high quality palliative care - CORRECT ANSWER interprofessional care of the pt/family what provokes or exacerbates distress disturbs coping and adjustment augments a sense of culnerability interferes with ability to eat, sleep, think, and interact with others correlated with fatiuge in cancer pts - CORRECT ANSWER unrelieved pain what are benefits to palliative care? - CORRECT ANSWER relief of suffering optimization of function promotion of healing and comfort fostering of appropriate hope genuine coordination of care at timess of transsitions between health care providers giving family time to explore and prepare for hospice a state of severe distress associated with events that threaten the intactness of a person - CORRECT ANSWER suffering the experience of a person - CORRECT ANSWER suffering the relief of suffering is central to the work of what - CORRECT ANSWER palliative care what are strategies for family caregivers? - CORRECT ANSWER set realistic goals have difficult discussions find help negotiate expectations what are barriers to palliative care - CORRECT ANSWER lack of a general understanding limited numbers of palliative care trained professionals payment for aplliative care services communication barriers related to patient safety and independence treating the pt for the familys sake withholding/withdrawing food/fluid all are what - CORRECT ANSWER challenges to palliative care what are areas of expertise for hospice and palliative care nurses? - CORRECT ANSWER clinical judgement advocacy and ethic professionalism collaboratoin systems thinking cultural competence facilitator of learning communication the genralist level palliative care nurse needs what - CORRECT ANSWER CHPN certified hopice palliative nurse the palliative nurse admin needs what - CORRECT ANSWER CHPA certified hospice palliatice administrator the advanced level palliative nurse needs what? - CORRECT ANSWER ACHPN advanced certified hospice palliative nurse what is voluntary certification in which nurse gets recognition for high quality palliative care available through the joing commission - CORRECT ANSWER institutional certification the national hospice and palliative care organization committed to the improvement of multiple areas of quality including what? - CORRECT ANSWER pt centered measures related to management of pain within 48 hr of admision avoiding unwanted hospitalizations avoiding unwanted CPR pt safety what is the naitons leading resource for palliative care program development? - CORRECT ANSWER center to advance palliative care