Chapter 2- The Health Care Delivery System

Diagnosis-related groups (DRGs) provide a fixed reimbursement of cost.

The nurse is caring for a patient whose insurance coverage is Medicare. The nurse should

consider which information when planning care for this patient?

The patient-centered medical home model

A nurse is teaching the staff about integrated health care systems. Which model of care should

the nurse include in the teaching about seam-less care delivery?

Adult children up to age 26 are allowed coverage on the parent's plan.

A nurse is teaching a family about health care plans. Which information from the nurse

indicates a correct understanding of the Affordable Care Act?

Upon admission to the hospital.

A nurse is caring for a patient in the hospital. When should the nurse begin discharge

planning?

Restorative

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?

Preventive care

A nurse provides immunization to children and adults through the public health department.

Which type of health care is the nurse providing?

Omnibus Budget Reconciliation Act

In order to receive payment for care provided, nursing centers must comply with requirements

outlined in what federal legislation?

The Outcome and Assessment Information Set (OASIS)

The nurse is trying to determine risk factors unique to home care patients. What resource

should the nurse access?

Skilled nursing

An older-adult patient has extensive wound care needs after discharge from the hospital.

Which facility should the nurse discuss with the patient?

Tertiary care

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?

Coordination of health care services

A nurse is teaching about the primary focus of community wellness. Which information

should the nurse include in the teaching session?

Performance scores

A nurse is using research findings to improve clinical practice and improved care delivery.

Which technique is the nurse using?

Staff identifies the wait time in the emergency department is too long.

Which finding indicates the best quality improvement process?

Education

A nurse is providing home care to a home-bound patient treated with intravenous (IV) therapy

and enteral nutrition. What is the home health nurse's primary objective after providing

necessary care?

―Technology use has to be combined with nursing judgment.‖

A nurse hears a co-worker state that anybody could be a nurse since it is so automated with

infusion devices and electronic monitoring; technology is doing the work. What is the nurse's

best response?

Nursing center

A nurse is completing a minimum data set. Which area is the nurse working?

-Professional standards review organizations

-Prospective payment systems

-Diagnosis-related groups

Which government-instituted programs should the nurse include in a teaching session about

controlling health care costs? (Select all that apply.)

-Use informatics

-Apply quality improvement.

-Use evidence-based practice.

A nurse is teaching the staff about the Institute of Medicine competencies. Which examples

indicate the staff has a correct understanding of the teaching? (Select all that apply.)

-Hospital readmission rates

-Nursing hours per patient day

-Patient falls/falls with injuries

A nurse is evaluating care based upon the nursing quality indicators. Which areas should the

nurse evaluate? (Select all that apply.)

-Empirical quality results

-Structural empowerment

-Transformational leadership

-Exemplary professional practice

A nurse is working in a health care organization that has achieved Magnet status. Which

components are indicators of this status? (Select all that apply.)

Attending a review course in preparation for a certification examination

Which activity performed by a nurse is related to maintaining competency in nursing practice?

-Providing prenatal teaching on nutrition to a pregnant woman during the first trimester

-Assessing the nutritional status of older adults who come to the community center for lunch

-Teaching a class to parents at the local elementary school about the importance of immunizations

Which of the following are examples of a nurse participating in primary care activities? (Select all that apply.)

Magnet® is a special designation for hospitals that achieve excellence in nursing practice.

Which of the following statements is true regarding Magnet® status recognition for a hospital?

Performing endotracheal suctioning for a patient on a ventilator in the medical ICU

The nurse is working in a tertiary care setting. Which activity does the nurse perform while providing tertiary care?

Patient will be able to walk 200 feet without shortness of breath.

A nurse is providing restorative care to a patient following an extended hospitalization for an acute illness. Which of the following is the most appropriate outcome for this patient's restorative care?

-The focus is holistic.

-The system coordinates a continuum of services.

-Members of the health care team link electronically to use the EHR to share the patient's health care record.

Which of the following describe characteristics of an integrated health care system? (Select all that apply.)

-The level of support parents offer when the student completes homework

-The level of violence in the family's neighborhood

-The cultural values about education held by the family

The school nurse has been following a 9-year-old student who has shown behavioral problems in class. The student acts out and does not follow teacher instructions. The nurse plans to meet with the student's family to learn more about social determinants of health that might be affecting the student. Which of the following potential social determinants should the nurse assess? (Select all that apply.)

Timing of referral

A nurse is assigned to care for an 82-year-old patient who will be transferred from the hospital to a rehabilitation center. The patient and her husband have selected the rehabilitation center closest to their home. The nurse learns that the patient will be discharged in 3 days and decides to make the referral on the day of discharge. The nurse reviews the recommendations for physical therapy and applies the information to fall prevention strategies in the hospital. What discharge planning action by the nurse has not been addressed correctly?

-Ineffective communication among providers

-Lack of role clarity among health care team members

Which of the following are common barriers to effective discharge planning? (Select all that apply.)

-Improved patient satisfaction

-Reduction in patient falls

-Reduction in patient use of nurse call system

A nurse newly hired at a community hospital learns about intentional hourly rounding during orientation. Which of the following are known evidence-based outcomes from intentional rounding? (Select all that apply.)