Chapter 03: US and Global Health Care
Stanhope: Foundations for Population Health in Community/Public Health Nursing,
MULTIPLE CHOICE
1. A public health agency is planning to implement the electronic health record. (Which is a benefit of th
a. Facilitation of interprofessional care
b. Improved client compliance with medical regimens
c. Cost savings to the agency
d. Compliance with JCAHO standards
ANS: A
The electronic medical record facilitates interprofessional care in chronic disease management and coo
24-hour availability of records with downloaded laboratory results and up-to-date assessments; incorpo
reminders for prevention, screening, and management of chronic disease; improvement of quality mea
increased client safety; and decline in medication errors. There is no evidence that an electronic health
compliance with medical regimens. Electronic health records can increase costs to an agency. JCAHO
health agencies.
2. Which statement best describes the cost of health care in the United States?
a. Health care costs are kept low, and the indicators of health are among the best
worldwide.
b. Health care costs are low which has resulted in poor health outcomes.
c. Health care costs are the highest in the world, but the indicators of health are not
the best worldwide.
d. Health care costs and indicators of health are the highest in the world.
ANS: C
Health care costs in the United States are the highest in the world and comprise the greatest percentage
product, the indicators of what constitutes good health do not document that Americans are really getti
Health care costs are not low in comparison to the rest of the world. The health outcomes in the United
comparison to other countries who spend less money on health care.
3. A nurse is explaining the health care system in the United States to a group of health care providers vis
How would the nurse best describe the current health care system?
a. “It is a logical, rational approach to meeting expressed needs while still trying to
control costs.”
b. “It is a centralized system that provides care in hospitals.”
c. “It is divided primarily into two components: private health care and public health
care.”
d. “It is the best in the world with outstanding research and high-technology care
available to all.”
ANS: C
Health care in the United States consists of a private or personal care system and a public health system
two. The United States health care system is one of the most expensive systems in the world that does
controlling costs. Care is provided through an enormous range of facilities and providers, including ho
dentists’ offices, nursing homes, mental health facilities, ambulatory care centers, and freestanding clin
research and high-technology care in the United States, the health care outcomes of the country do not
disparities exist among multiple populations making this system not available to all.
4. Which statement best describes ideal primary health care?
a. Based on a multidisciplinary group of health care providers that work as a team
b. Essential care available to all community members, which encourages
self-management
c. Focused on health promotion and disease prevention for everyone enrolled in the
health center
d. Local efforts to meet the Declaration of Alma Ata principles
, lOMoAR cP SD |12827 373
5. How does managed care (MC) attempt to control costs of care?
a. By encouraging families to use the point of service list of individual practice
associates
b. By requiring families to choose a care provider from the MC network and not
allowing access to other services without their provider’s permission
c. By moving Medicaid-eligible families onto state Medicare enrollment
d. By refusing permission for families to use urgent care or emergency department
services
ANS: B
Managed care is a system in which care is delivered by a specific network of providers. Each provider
controls access to other providers and services. Cost is reduced because members cannot use specialist
care without permission from their primary-care providers. Thus, those enrolled in Medicaid managed
help keep costs down for government (and for taxpayers). Managed care provides care through a speci
agree to comply with the care approaches established through a case management approach, not throug
individual practice associates. Medicaid and Medicare programs are not interchangeable, these program
populations. Managed care does not refuse permission for certain services such as urgent care or emerg
case management approach is used to control costs.
6. An 80-year-old woman comes to the community health care facility with a large bag of medications. S
longer afford these medications because her only income is Social Security. Which statement is the be
a. “Let’s go through these medications and see which ones we can delete.”
b. “You can get these medicines at this clinic for free.”
c. “Let’s see if we can get some help from Medicare to help you pay for these
medications.”
d. “These medications are important. Do your best to pay for them.”
ANS: C
This elderly patient probably is eligible for benefits through Medicare Part D. Medicare Part D has bee
cover the cost of prescriptions. The role of the nurse would not be to delete medications for the patient
it out on her own. Because of the age of the patient, the nurse should see if options exist under the Med
into receiving the medications for free as there may be other barriers which limit the abilities to get the
discounted cost.
7. A nurse is determining which health care services must be offered at a local public health clinic. Whic
for the nurse to consider?
a. Data available from the most recent community assessment
b. Suggestions from community members about what is needed
c. Recommendations from Healthy People 2020
d. Services mandated by the state government
ANS: D
At the local level, health departments provide care that is mandated by state and federal regulations. D
recent community assessment, suggestions from community members about need, and recommendatio
2020 could all be used. However, funding for these types of programs may not be available. The servic
state
government will be funded and allow the clinic to be able to provide these services.
8. A public health nurse is working with a low-income population in Massachusetts. Which of the follow
nurse make about this population?
a. They have difficulty accessing health care due to a shortage of primary-care
providers.
b. They most likely receive health insurance through Medicare.
c. They are unable to access health care due to the implementation of the Affordable
Care Act.
d. They have access to affordable health care insurance.
ANS: D
Massachusetts began an experiment in health reform in 2006. Two years after health reform legislation
2.6% were uninsured, the lowest percentage ever recorded in any state. The shortage of primary care p
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