Medicare Correct Answer: for clients over age 65 and/or with permanent disabilities. premiums applied as insurance program reimburses providers based on DRGs. Premiums applied as Managed Care Organizations (MCOs) provide enrolled clients with comprehensive care overseen by a primary care provider....
Capstone ATI Fundamentals Study Guide 2022
Medicare Correct Answer: for clients over age 65 and/or with permanent disabilities. premiums
applied as insurance program reimburses providers based on DRGs. Premiums applied as
Managed Care Organizations (MCOs) provide enrolled clients with comprehensive care
overseen by a primary care provider. Is federally funded.
Medicaid Correct Answer: for clients with low income. is federally funded and individual states
determine eligibility requirements.
Traditional Insurance Correct Answer: reimburses for services on fee-for-service basis.
Managed Care Organizations (MCOs) Correct Answer: comprehensive care is overseen by a
primary care provider & focuses on prevention and health promotion
Preferred Provider Organizations (PPOs) Correct Answer: client chooses from a list of
contracted providers. using non-contracted providers increases the client's out of pocket costs
Exclusive Provider Organizations (EPOs) Correct Answer: the client chooses from a list of
providers within a contracted organization
Long-Term Care Insurance Correct Answer: provides for long-term care expenses not covered
by Medicare
Preventive health care Correct Answer: focuses on educating and equipping clients to reduce
and control risk factors of disease. Examples include immunizations, stress management
programs, and seat belt use
Primary health care Correct Answer: emphasizes health promotion, and includes prenatal and
well-baby care, nutrition counseling, and disease control. is based on a sustained partnership
between client and provider. examples include office or clinic visits and scheduled school/work
centered screenings (vision, hearing, obesity)
Secondary health care Correct Answer: includes the diagnosis and treatment of emergency,
acute illness, or injury. examples include care given in hospital settings (inpatient and EDs),
diagnostic centers, or emergent care centers
Tertiary health care Correct Answer: involves the provision of specialized highly technical care.
examples include oncology centers and burn centers
Restorative health care Correct Answer: involves intermediate follow-up care for restoring
health. examples include home health care, rehab centers, and skilled nursing facilities
Continuing health care Correct Answer: designed to address long-term or chronic health care
needs. examples include hospice, adult day care, and in-home respite care
,Health care regulatory agencies include: Correct Answer: -US Dept of Health and Human Srvcs
-US FDA
-State and local public health agencies
-State licensing boards (to ensure providers & agencies comply with state regulations)
-the Joint Commission/JCAHO (set quality standards for accreditation of health care facilities)
-Professional Standards Review Organizations (PSROs)
-Utilization review committees (monitor for appropriate diagnosis and treatment of hospitalized
clients)
Clergy Correct Answer: Job: provide spiritual care to client (pastors, rabbis, priests)
Refer to when: the client requests communication or the family asks for prayer prior to client
undergoing a procedure
Registered dietitian Correct Answer: Job: assess, plan for, and educate the client reg. nutritional
needs; direct care of nutritional aids
Refer to when: ex- the client has low nutrient levels and/or experienced a recent unexplained
weight loss
Lab tech Correct Answer: Job: obtain specimens of the client's body fluids and perform the
necessary diagnostic tests
Refer to when: ex- the provider orders a CBC to be performed immediately
Occupational therapist Correct Answer: Job: assess and plan for the client to regain ADLs, esp
motor skills of the upper extremities; direct care of occupational therapy assistants
Refer to when: ex- client has difficulties using an eating utensil with dominate hand following a
stroke
Pharmacist Correct Answer: Job: provide & monitor meds for the client as prescribed by the
provider; supervises pharm techs in states in which the practice is allowed
Refer to when: client concerns over meds; dosage concerns; etc
Physical Therapist Correct Answer: Job: assess and plan for client to increase musculoskeletal
functions, esp of lower extremities, to maintain mobility; direct care of physical therapy
assistants
Refer to when: ex- following a hip replacement, a client requires assistance learning to ambulate
and regain strength
Provider Correct Answer: Job: assess, diagnose, and treat cllient for disease and/or injury;
includes MDs, DOs, APNs, and PAs
,Refer to when: ex- client experiences change in vital signs
Rad Tech Correct Answer: Job: position client and perform x-rays and other imaging procedures
for providers to review for diagnosis of disorders of various body parts
Refer to when: ex- provider orders x-ray of client's hip after a fall
Respiratory therapist Correct Answer: Job: evaluate resp status and provide prescribed resp
treatments including O2 therapy, chest physiotherapy, inhalation therapy, and artificial
mechanical ventilation
Refer to when: ex- client with resp disease experiences SOB and requests nebulizer treatment
that is ordered PRN
Social Worker Correct Answer: Job: work with client and client's family by coordinating
inpatient and community resources to meet psychosocial and environmental needs that are
necessary for recovery and/or discharge
Refer to when: ex- client dying of cancer wishes to go home but is unable to perform ADLs; the
spouse needs med equipment in the home to care for client
Speech therapist Correct Answer: Job: evaluate and make recommendations regarding the
functions of speech, language, and swallowing impacted by various client disorders or injuries;
teach client techniques and exercises to improve function when possible
Refer to when: ex- a client is having difficulty swallowing a regular diet after trauma to the head
and neck
Registered Nurse (RN) Correct Answer: -Functions under state nurse practice laws
-Perform assessments; establish nursing diagnoses, goals, and interventions; conducts ongoing
client evaluations
-Participate in developing interdisciplinary plans for client care
-Share best practices; continuing education
Licensed Practical Nurse (LPN) Correct Answer: -Works under supervision of the RN
-Collaborate with other team members
-Possess technical knowledge and skills
-Participate in the delivery of nursing care, using the nursing process as a framework
Unlicensed Assistive Personnel (UAP) Correct Answer: -Includes CNAs, CMAs, and non-
nursing personnel
-Work under direct supervision of an RN or LPN
-Specific tasks usually outlined in position description
-Tasks may including feeding clients, preparing meals, lifting, basic care, measuring & recording
vital signs, and ambulating clients
, The foundation of ethics is based on: Correct Answer: an expected behavior of a certain group
in relation to what is considered right and wrong; it is the study of conduct and character
Morals are: Correct Answer: the values and beliefs held by people that guide their behaviors and
decision making
Ethical theory examines: Correct Answer: the different principles, ideas, systems, and
philosophies used to make judgments about what is right/wrong and good/bad
Ethical principles Correct Answer: standards of what is right/wrong with regard to important
social values and norms
Autonomy Correct Answer: ability of client to make personal decisions, even when those
decisions may not be in the client's best interest
Beneficence Correct Answer: agreement that the care given is in the best interest of the client;
taking positive actions to help others
Fidelity Correct Answer: agreement to keep one's promise to the client about care that was
offered
Justice Correct Answer: fair treatment in matters related to physical and psychosocial care and
use of resources
Nonmaleficence Correct Answer: avoidance of harm or pain as much as possible when giving
treatments
Hospital's ethics committee Correct Answer: may meet to discuss/resolve unusual or complex
ethical issues; not a legal entity
Ethical dilemmas are: Correct Answer: problems about which more than one choice can be
made and the choice made is influenced by the values and beliefs of the decision makers
A problem is an ethical dilemma if: Correct Answer: -it cannot be solved solely by a review of
scientific data
-it involves a conflict between two moral imperatives
-the answer will have a profound effect on the situation/client
Steps in ethical decision making Correct Answer: -identify whether or not the issue is indeed an
ethical dilemma
-state the ethical dilemma including all surrounding issues and individuals involved
-list and analyze all possible options for resolving the dilemma and review implications of each
option
-select option that is in concert with the ethical principle applicable to this situation, the decision
maker's values and beliefs, and the profession's values set forth for client care; justify why
chosen over other options
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