Exam #3 Community Multiples only

Question 1

Because of county need, a school nurse was transferred from a new suburban school to a large inner-city school in an older low-income neighborhood. What changes in role might the nurse expect? Select all that apply.

Answer 1

b. Cooperating with the school meal program to be sure fruits and vegetables and other healthy choices are included

e.
Need for lead poisoning screening and education

Question 2

A school nurse brought a young boy back into a private office and asked him to remove his shirt. Fresh welts across his back were seen. Why might the nurse be concerned about the parents? Select all that apply.

Answer 2

c.
The parents were dealing with a lot of stress and lacked support.
d.
The parents were themselves abused as children.
e.
The parents may be substance abusers.

Question 3

What was unfortunate about the idea of private health insurance? Select all that apply.

Answer 3

a.
Because providers were paid for any service they gave, it was economically advantageous for them to give as much care as possible.
b.
Health care costs increased very rapidly.
c.
Health education and health promotion interventions were not included in the idea of health insurance.

e.
Patients wanted any and all care that might help, regardless of how expensive it was.
f.
There was no limit on what care could be sought and given.

Question 4

What did insurance companies do to decrease their constantly increasing costs? Select all that apply.

Answer 4

a.
Did not cover any illnesses that were diagnosed before the person (or his or her employer) purchased insurance
b.
Limited coverage to only certain services, eliminating any that were experimental, nontraditional, or too costly
c.
Only care requested by the patient’s primary physician was eligible for reimbursement.

e.
Required preapproval before expensive services were used
f.
Whenever possible, ceased coverage on any person who used an exorbitant number of services

Question 5

Of what can the American health care system be especially proud? Select all that apply.

Answer 5

a.
Availability and use of technological advances in equipment and procedures

e.
Laboratory and clinical research

Question 6

Why do many persons who have Medicare decide to purchase Medigap health insurance policies? Select all that apply.

Answer 6

c.
Patients have to pay a deductible (about $1000) when admitted as a hospital inpatient for care.

d.
Medicare Part A does not pay for physician services, hospital outpatient care, and medical equipment.

Question 7

What or who determines eligibility for Medicaid to pay for health care? Select all that apply.

Answer 7

b.
Baseline eligibility is established by the federal government, but states may be more lenient.
c.
Children in low-income families are eligible for free care.
d.
Eligibility depends on family size and total family income.

Question 8

What were the effects of Medicare and Medicaid? Select all that apply.

Answer 8

b.
A previously unseen rise in demand for services occurred.
c.
Many persons previously without access now receive health care.
d.
Medicare reimbursement rates became the standard for all insurance carriers.
e.
Now almost half of all health care costs in the United States are paid by government financing.

Question 9

What was one unfortunate consequence of using diagnosis-related groups (DRGs) to determine reimbursement? Select all that apply.

Answer 9

b.
Incentive was to undertreat and underuse health resources.

f.
Quality of care was no longer assured.

Question 10

Who may receive benefits under Medicare? Select all that apply.

Answer 10

c.
Persons with end-stage renal disease
d.
Those over 65 years of age if eligible for Social Security benefits

f.
Those with permanent disabilities

Question 11

The Omnibus Budget Reconciliation Act influenced funding and set up regulations. What were some of the notable changes that resulted? Select all that apply.

Answer 11

b.
Change from process to outcome in evaluating care
c.
Guidelines on use of restraints

e.
Prescription drug benefits for Medicaid recipients

Question 12

What were among the outcomes of the 1979 report Healthy People: The Surgeon General’s Report on Health Promotion and Disease Prevention? Select all that apply.

Answer 12

d.
The Health Objectives Planning Act of 1990 was passed.
e.
The federal government began to identify and monitor national health care goals.

Question 13

The Health Insurance Portability and Accountability Act of 1996 was passed to address what critical issues in health care? Select all that apply.

Answer 13

a.
Portability of insurance coverage

d.
Insurance companies setting limits on coverage of longer than 12 months

Question 14

Which functions are responsibilities of the states? Select all that apply.

Answer 14

a.
Delegating power to localities and holding them accountable for results

d.
Licensure of professional health care providers
e.
Overseeing all insurance programs
f.
Providing access to necessary health services

Question 15

Which activities by some managed care organizations (MCOs) are ethically questionable? Select all that apply.

Answer 15

d.
Financial incentive to physicians if some treatments are not given

f.
Requirements that only certain treatment options be discussed with patients

Question 16

What are some of the current state legislation acts limiting what managed care organizations (MCOs) are allowed to do? Select all that apply.

Answer 16

primary care provider
b.
Allowing patients to go to the emergency department without first telephoning for approval
c.
Allowing new mothers to stay in hospital longer than 24 hours if needed

e.
Requiring the MCO to accept any provider who meets plan requirements and is willing to accept the contract

Question 17

Which activities would be a responsibility of local health departments? Select all that apply.

Answer 17

b.
Determining the safety of residents’ wells

d.
Providing free health screenings
e.
Providing health education programs on proper nutrition
f.
Inspecting restaurants

Question 18

In what ways are complementary and alternative therapies different from traditional health care? Select all that apply.

Answer 18

d.
Providers vary in training and licensure.
e.
Reimbursement is often unavailable.

Question 19

What current activities are consistent with the conclusions of the report Crossing the Quality Chasm? Select all that apply.

Answer 19

a.
Focus on evidence-based practice

c.
Increased attention to patients’ needs for health education and self-management

e.
Move to information technology (electronic medical records and data management)

Question 20

What were the conclusions when Congress asked for a report on the federal government’s quality enhancement process on the care the federal government gave? Select all that apply.

Answer 20

a.
A clear responsibility at the federal level is to lead by example.

c.
Federally sponsored education and training programs have a strong impact.

f.
Writing regulations influences nonfederal health care providers and organizations.

Question 21

What are the purposes of professional societies such as the American Nurses Association? Select all that apply.

Answer 21

a.
Control and oversight of the occupation

d.
Establishing standards for practice
e.
Protecting the interests of the practitioners
f.
Safeguarding the public trust

Question 22

What are new national health goals as seen in Healthy People 2020? Select all that apply.

Answer 22

b.
Create social and physical environments that promote good health

d.
Eliminate preventable disease, disability, injury, and premature death

f.
Promote healthy behaviors at every stage of life

Question 23

Which of the following are you legally required to obey? Select all that apply.

Answer 23

b.
Court decisions related to legislative law

e.
Laws passed by your state or the federal government
f.
Rules and regulations from agencies such as the state board of nursing

Question 24

What current issues are leading the World Health Organization (WHO) to reconsider its initial definition of health? Select all that apply.

Answer 24

a.
Environmental issues such as industrial toxins or carcinogenic commercial products
b.
Global, not local, problems such as spread of antibiotic-resistant bacteria
c.
Need to move from containment and treatment to social intervention

e.
Realization that government actions influence the basic human right of health
f.
Worldwide pandemics such as human immunodeficiency virus (HIV) and swine flu, which require a different approach

Question 25

Which actions represent a shift in philosophy at the Centers for Disease Control and Prevention? Select all that apply.

Answer 25

b.
Creating integrated health information systems

d.
Encouraging partnerships and strategic alliances

f.
Levering resources to steer the larger health system

Question 26

What are some problems with U.S. water quality today? Select all that apply.

Answer 26

b.
Many aquifers are contaminated with pesticides and fertilizers.
c.
More than 42 million Americans drink untreated water.
d.
Sediment from construction, agriculture, and deforestation is often present.
e.
Underground water, if contaminated, can’t be cleansed.

Question 27

What have been the foci of international nursing research? Select all that apply.

Answer 27

a.
Development of home care or transition from hospital to home
b.
Diverse clinical experiences
c.
Educational exchange programs for students and faculty

Question 28

Why was the Vaccine Adverse Event Reporting System legislated into being? Select all that apply.

Answer 28

c.
To determine whether changes should be made in procedures or biological agents

e.
To provide assistance to families who experience a vaccine-related injury

Question 29

What variables create differences from school to school regarding the health services that are available? Select all that apply.

Answer 29

a.
Community resources

c.
School leadership preferences
d.
State legislative requirements
e.
Students’ needs

Question 30

How can schools determine what their school health education priorities should include? Select all that apply.

Answer 30

a.
Provide opportunities for students to practice decision-making skills
b.
Choose priorities according to which behaviors lead to avoidable problems
c.
Make priorities consistent with the six topics identified by Healthy People 2020

Question 31

What screenings are typically administered in the school setting? Select all that apply.

Answer 31

a.
Blood pressure

d.
Height and weight
e.
Scoliosis
f.
Visual and hearing acuity

Question 32

You are a community health nurse assigned to cover a school health office when the school’s nurse is ill. A child is waiting for your arrival saying a particular medication is needed. What can you expect to find in your temporary office? Select all that apply.

Answer 32

a.
A nursing policy book with standing orders and nursing protocols
b.
A locked cabinet with medications clearly labeled with student name, as well as typical medication information (e.g., name, dose)

e.
Written request from a health care provider for that student to receive that medication
f.
Written request from the student’s parents for the specific medication to be administered