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CULINARY ARTS EXAM #3 QUESTIONS AND ANSWERS
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CULINARY ARTS EXAM #3 QUESTIONS AND ANSWERS
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CULINARY ARTS EXAM #3 QUESTIONSAND ANSWERS
An older adult client was admitted to the hospital with the condition classified as
"pneumonia." Reimbursement for care was based on a predetermined fixed price. What
is this classification system referred to as?
a. Diagnosis-related groups (DRGs)
b. Subjective symptom management
c. Acuity classification system
d. Organized managed care - Answer-ANS: A
The precise classification of clients according to the highest diagnosis-related group
(DRG) has created a new role for nurses, known as a _____ nurse.
a. case management
b. quality assurance
c. utilization review
d. cost-control - Answer-ANS: C
Diagnosis-related groups (DRGs) have attempted to reduce health care costs by
decreasing what component of care?
a. Hospital admission rates
b. Length of hospital stay
c. Outpatient services
d. Specialty groups - Answer-ANS: B
When reviewing the literature on the effects of Medicaid on health care for the poor,
what common problem would the nurse researcher find?
a. Less access than even the uninsured
b. Receive many unnecessary treatments
c. A lack of consistent providers
d. An abuse of preventive services - Answer-ANS: C
Lack of insurance, uninsured populations, and uncompensated care are covered by
charging more to those who can pay. What term is used to refer to this practice?
a. Charity
b. Cost shifting
c. Price sharing
d. Governmental reimbursement - Answer-ANS: B
,A contractual agreement between the insurer and the provider in which covered
members are encouraged to use specific health care providers in return for reduced
rates is referred to as which type of arrangement?
a. Health maintenance organization
b. Preferred provider organization
c. Fee-for-service arrangement
d. Philanthropic agency - Answer-ANS: B
In the triad of health care, which would be considered the third-party payer?
a. Client
b. Health care provider
c. Insurance company
d. Government agency that sets reimbursement rules for services - Answer-ANS: C
A physician bills the insurance company for a computed tomography (CT) scan,
laboratory tests, chest x-ray, and an extended visit and receives revenue for each
procedure billed. This type of payment system is a _____ payment system.
a. prospective
b. retrospective
c. diagnosis-related group
d. capitated - Answer-ANS: B
A client is admitted with chest pain. A series of diagnostic tests are ordered, and the
client undergoes coronary artery bypass grafting. The cost of care for this client is
increased because of a four-pack-per-day smoking history that resulted in extension of
the client's intensive care unit (ICU) stay by 3 days because of respiratory problems.
The case manager realizes that under the terms of the diagnosis-related group (DRG)
payment system for this diagnosis that the client's past history and present care needs
will have what affect on reimbursement?
a. The cost of caring for this client was $5000 greater than the DRG reimbursement fee,
and the hospital will be allowed to collect the additional fees from the insurance
company.
b. Although the cost of care for this client was greater than the DRG reimbursement
amount, the hospital will be reimbursed only at the set fee.
c. The client will be required to pay bac - Answer-ANS: B
A young mother has detected a lump in her breast, and because she lives at the poverty
level, she is covered under Medicaid. What is the most likely consequence of this
woman's situation?
a. She will participate in mammography screening more often than individuals covered
by private insurance.
, b. She has both a designated primary care provider and a specialist as sources of care.
c. She will wait to seek care increasing her risk of being diagnosed with advanced
breast cancer.
d. She has decreased access to health care when compared with the uninsured. -
Answer-ANS: C
A client who is reading a newspaper asks, "This article about health care states that
many providers of health care lack effectiveness. What is the difference between
effectiveness and efficiency?" The nurse best responses with what statement?
a. Effective means performing the correct test or intervention whereas efficiency refers
to the wise use of supplies and resources for the desired outcome.
b. Effective refers to competence in clinical practice and efficiency describes quick
completion of the task.
c. Efficiency means wasting and meeting a minimum standard and effectiveness refers
to taking all the time needed to exceed expectations.
d. Efficiency refers to speed and effectiveness refers to the usefulness of the
implementation. - Answer-ANS: A
A nurse is offered several health care plans as part of employee benefits. Which plan is
based on a monthly fee per participant and offers a range of preventive, diagnostic, and
treatment services?
a. Prospective payment system
b. Retrospective payment system
c. Single-payer system
d. Capitation - Answer-ANS: D
At a local health fair, an individual asks about the difference between universal health
care and a single-payer system. The nurse explains the difference based on what fact?
a. With universal health, one universal payer, usually the government, pays all
expenses for health care.
b. Single-payer systems offer health care only to eligible persons based on income.
c. Single-payer systems rely on insurance companies to pay predetermined fees for
services.
d. With universal health, one payer is responsible for all health care costs, providing
health care to all citizens. - Answer-ANS: D
An elderly person, age 80, is finding it difficult to live alone and the family is considering
long-term care. The elderly person is reasonably healthy, with only normal aging
declines, and maintains a healthy appetite. All medications are administered orally and
require only minimal assistance. She is financially secure with an income based on
retirement from both the military and factory from her deceased husband and herself.
The family contacts long-term care and is given what information, based on this
patient's situation?
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