Module 11 Flashcards
T/F: Preferred provider organizations (PPOs) are prepaid, group-managed care plans that allow subscribers to receive all medical services through a group of affiliated providers.
FALSE
A program of palliative and supportive care that provides physical, psychological, social, and spiritual care for dying people is known as ______________ service.
hospice
A hospital designated with ___________status has been recognized for quality patient care, nursing excellence, and innovations in professional nursing practice.
magnet
T/F: The United States spends more per person on health care than any other nation in the world
TRUE
The Patient Protection and Affordable Care Act, beginning in 2014, will provide __________ or subsidized coverage to qualifying people with incomes up to 400% of poverty
medicare
A strategy to reduce health care costs is __________, a system that gives providers of care a fixed amount of money per enrollee.
capitation
T/F: Fifty years ago, half of the doctors in the United States practiced primary care, but today fewer than one in three do.
TRUE
T/F: The government estimates that by 2021, 20% of the U.S. gross domestic product will be allocated to health care.
TRUE
Immunizations and health risk screenings are examples of a __________ level of health care
primary
T/F: Managed care systems always allow patients to choose their own health care providers.
FALSE
According to Kübler-Ross, in the _____________ stage of dying, the patient goes through a period of grief before death.
depression
While hospice care focuses on the needs of the dying, ___________ care is appropriate across the spectrum of disease and illness.
palliative
T/F: Perceived loss is felt by the person and can be recognized by others.
FALSE
T/F: The Patient Self-Determination Act of 1990 required all hospitals to conform to a standard, uniform set of advance directives
FALSE
Patient Self-Determination Act of 1990 requires all hospitals to inform patients about advance directives.
During _____________ loss, a person displays loss and grief behaviors for a loss that has yet to take place.
anticipatory
T/F: Terminal weaning is the gradual withdrawal of mechanical ventilation from a patient with a terminal illness or an irreversible condition with a poor prognosis.
TRUE
Death is defined as the irreversible cessation of all functions of circulatory and ______________ functions, or irreversible cessation of all functions of the entire brain, including the brainstem.
respiratory
A ___________ power of attorney appoints an agent whom the person trusts to make decisions in the event of subsequent incapacity
durable
T/F: Active euthanasia is defined as withdrawing medical treatment with the intention of causing the patient’s death.
FALSE
passive euthenasia
T/F: During Engel’s stage of grief known as idealization, there is often an exaggeration of the good qualities that the deceased person possessed
TRUE
A nursing diagnosis related specifically to spirituality would be __________, a subjective state in which a person sees limited or no alternatives or personal choices available and is unable to mobilize energy on one’s behalf.
hopelessness
T/F: Members of the religion Jesus Christ of Latter Day Saints (Mormons) believe in divine healing through the “laying on of hands.”
TRUE
Closely related to spirituality, faith, and religion, ______ is the ingredient in life responsible for a positive outlook even in life’s bleakest moments.
hope
T/F: An emergency department nurse is aware that those who practice the religion of Jehovah’s Witnesses will not accept blood transfusions.
TRUE
T/F: Faith is a confident belief in something for which there is no material evidence or proof
TRUE
The religion known as _____________ teaches that there are “Four Noble Truths” that indicate the range of “suffering,” its “origin,” its “cessation,” and the “way” that leads to its cessation.
Buddhism
T/F: Spirituality is anything that pertains to a person’s relationship with a nonmaterial life force or higher power.
TRUE
The nursing diagnosis of spiritual _________ can be used to describe the impaired ability to experience and integrate meaning and purpose in life through one’s connectedness with such things such as self, others, art, and music.
distress
An atheist is a person who denies the existence of a higher power; an _________ is one who holds that nothing can be known about the existence of a higher power.
agnostic
T/F: Nurses always have the moral right to withdraw from administering care that violates their personal moral code.
TRUE
The client’s spouse says to the nurse, “It’s been really tough this last month caring for my spouse. Even though I have an aide who comes in to help for a couple of hours a week, I’m just spent, physically and emotionally.” A referral for which service would be appropriate?
Respite care
When conducting an education program for a group preparing for retirement, the nurse would include information about applying for Social Security benefits and Medicare insurance. The nurse would include in the education that Medicare is a federally funded insurance program which bases the fee for payment on what?
Correct response:
A prospective payment plan based on a predetermined fixed cost
Which is the main focus of care for a school nurse?
Community care
Explanation:
A nurse employed as a school nurse is considered to be working in community-based care. School nurses provide many different services, including maintaining immunization records, providing emergency care for physical and mental disorders, administering prescribed medications, conducting routine health screenings (e.g., vision, hearing, scoliosis), and providing health information and education.
The nurse shares with the health care team the need for a client, diagnosed with cancer and receiving chemotherapy, to attend an adult child’s wedding. What discussion does the nurse have with the health care team to advocate for the client attending the wedding?
To affirm that the decision is consistent with client goals
Which is the acute care setting for people who are too ill to care for themselves at home, are severely injured, or require surgery?
Hospitals
Which six trends in health care reflect the Institute of Medicine’s (IOM) focus?
“The system should be safe, effective, efficient, patient centered, timely, and equitable.”
A client is being prepared for discharge from the hospital after an exacerbation of heart failure. The client needs assessment of cardiac status, instruction in medications and diet therapy as well as exercises to increase endurance and stamina. The client also needs assistance with self-care, both in performing it now and learning how to adapt to the limitations to maintain independence. The client also lives alone with an older adult, frail spouse. In addition to the client’s physician, which members of the interdisciplinary team would need to be involved? Select all that apply.
Nurse Physical therapist Occupational therapist Unlicensed assistive personnel Social worker Explanation: Based on the client's condition, the following members would be involved: nurse to assess cardiac status and teach about medications and diet; physical therapist to assist with exercises; occupational therapist to assist with self-care adaptations; unlicensed assistive personnel to assist with self-care now; and social worker to assist with supportive services for the couple since the spouse is elderly and frail.
The nurse is caring for several clients with chronic conditions that need to be evaluated for long-term care. After evaluating each client, the nurse determines which client is most appropriate to receive long-term care?
A client who suffered a stroke who has mobility issues and problems completing activities of daily living (ADLs).
A client is admitted to the facility after fracturing a hip. The client has undergone surgery to repair the fracture and is receiving services to promote healing of the surgical site and regain mobility. Which discussion should the nurse have with a member of the interdisciplinary team member to promote the goal of regaining mobility?
Speak with the physical therapist about exercises to strengthen muscles.
Which statement is true when comparing home care with acute care?
The nurse is the guest in the client’s home.
A nurse has an older adult home care client who lives alone with no family nearby. On a recent visit, the nurse notices that his clothes are very loose, and he has difficulty letting the nurse leave when the visit is ending. After talking with him, the nurse learns that he has not been cooking for himself and he can’t get to the grocery store easily. What service could the nurse suggest as an immediate response until a long-term plan can be formed?
Enroll the client in Meals on Wheels.
The nurse is a member of the multidisciplinary team in a large primary healthcare setting. The nurse understands that which healthcare team member is responsible for a client’s swallow evaluation following a cerebral vascular accident?
Speech pathologist/therapist
Which client would a nurse correctly refer to Medicare services?
A 66-year-old client with diabetes
Explanation:
Medicare is a federal health care plan for individuals over the age of 65. An individual with a disability might be referred to Medicare, but other federal organizations must be involved for this to occur.
A nurse working for a home health agency is scheduled to evaluate a client with worsening heart failure to determine whether the client is a candidate for the new “Hospital at Home” program. Which statement accurately reflects an outcome for this program?
Correct response:
Clients in the “Hospital at Home” program have been found to require shorter lengths of stay than when admitted to the acute care setting.
Explanation:
Clients who receive care in their own homes, surrounded by familiar family and friends, have been found to recover more quickly than those in inpatient acute care settings
The growth in home health care is largely attributed to which factor?
Early discharge of clients from the hospital setting
Nurses in various health care settings provide services to prevent the fragmentation of care that is occurring as a health care trend in today’s society. What role of the nurse is most important in preventing this effect?
Coordinator of care
The implementation of diagnosis-related groups (DRGs) by Medicare in 1983 affected hospitals in which way?
Medicare pays only the amount of money preassigned to a treatment for a diagnosis.
The nurse understands that a diagnostic-related group is one of the reimbursement strategies in a prospective payment system. The diagnostic-related group is a part of which health care system?
Medicare
A nurse demonstrates understanding of Healthy People 2030 by supporting which statement?
A client’s health is affected by social, economic, and political factors.
A hospitalized client with advanced metastatic lung cancer states, “I want to go home. I don’t have much time left. I want to be with my family.” Which type of care referral by the nurse is most appropriate?
Hospice
A client diagnosed with a terminal illness is displaying periods of depression and anger alternating with acceptance. The client’s spouse is concerned about the client’s labile mood. When talking with the client’s spouse, which statement made by the nurse best addresses principles of loss and grieving?
“Not everyone experiences grief in the same way and your loved one needs our support.”
The nurse is preparing a presentation on preparing children for death. What information should the nurse include? Select all that apply.
Encourage expression of feelings.
Provide for stability and safety.
Talk openly about death and the feelings associated with it.
A nurse completing admission paperwork asks the client about having an advanced directive. The client states, “I do not know, what is an advanced directive?” What is the nurse’s best response?
“It is a written document that identifies a person’s preferences regarding which medical interventions to use in the event of a terminal condition.”
A client with a terminal illness is overheard by the nurse saying, “If I promise never to smoke another cigarette in my life, please let me recover from this lung cancer.” How will the nurse document this stage of grief according to the Kübler-Ross model?
bargaining
A client is informed about the results of a biopsy, which indicate a malignant tumor that has spread. The client states, “Well once you remove the tumor, I will be just fine.” What stage of the grief process does the nurse identify the client is experiencing?
denial
The wife of a client who has been diagnosed with a terminal illness asks the nurse about the differences between palliative care and hospice care. Which information would the nurse most likely include in the response?
Hospice care is provided for clients who have 6 months or less to live; palliative care is provided at any time during illness.
