University of San Francisco - NURS 320

Chapter 08: Economic Influences Test Bank

MULTIPLE CHOICE

1)A nurse is discussing how health care rationing occurs in the United States. Which of the following would most likely be discussed as the criterion that is used to ration health care?

1. 1. Clinic operating hours
   2. Ability to pay for services
   3. Availability of local provider services
   4. Transportation availability

2. Which of the following must a nurse be knowledgeable about to make decisions regarding the most cost-effective way to allocate health care resources?

1. 1. Insurance resources
   2. Health care rationing
   3. Health economics
   4. Medical technology

3. Which of the following individuals would most likely experience a barrier when accessing health care?
   1. A 40-year-old female who speaks English
   2. A 25-year-old female with health insurance
   3. A 50-year-old male with hypertension
   4. A 30-year-old male who is unemployed

4. Which person is most likely to be uninsured?
   1. An 82-year-old woman with chronic medical problems
   2. A 2-year-old whose mother is on welfare
   3. A 50-year-old business man who works for a large corporation
   4. A 32-year-old man who works part-time at a small business

5. Which of the following is most closely correlated with poor health?
   1. Age and gender (i.e., older males)
   2. Low socioeconomic status
   3. Minority race status
   4. High-risk lifestyle behaviors

6. A pregnant teenager has approached a nurse asking about ways to improve the health outcomes for her and her unborn child. Which of the following statements would be most appropriate for the nurse to make?
   1. “Don’t drop out of school.”
   2. “Sign up for childbirth classes.”
   3. “Sign up for the WIC program.”
   4. “Take your prenatal vitamins daily.”

7. A nurse is providing care to a child whose parents do not receive health insurance as an employee benefit and who do not have the financial resources to pay for health care out of pocket. Which of the following resources should the nurse recommend to the family?
   1. A managed care organization
   2. An emergency department
   3. Medicaid
   4. Medicare

8. Which of the following best explains how the government inadvertently encourages low-income persons to use emergency departments as their primary care provider?
   1. A huge amount of paperwork is required when Medicaid clients go to a physician’s office.
   2. Government regulations require Medicaid clients to use emergency departments when their primary health care provider is unavailable.
   3. Legally, emergency departments must see clients even if clients can’t pay.
   4. Physicians’ limited office hours make them unavailable during evenings and weekends.

9. Of the four main factors that affect health, which is the least important?
   1. Environment
   2. Human biology
   3. Lifestyle choices
   4. Health care system

10. A nurse is trying to maximize the quality of life of her clients while reducing health care costs. Which of the following actions would most likely be completed by the nurse?
    1. Assisting in cast application for a client who was injured in a skateboard incident

1. 2. Irrigating the eyes of a client splashed with chemicals
   3. Restoring a normal cardiac rhythm following cardiopulmonary resuscitation of a client with a heart condition
   4. Teaching a high school boy about sexually transmitted infections and proper condom application

11. Which of the following caused health care providers to begin to focus on individual infections and trauma in the 1900s in the United States?
    1. Education of health care providers moved into universities.
    2. People finally had enough money to pay for medical care.
    3. The improved outcomes of hospital care were recognized.
    4. Advances were made in safe water, sewage disposal, and pasteurization of milk.

12. Which of the following accurately describes a challenge that will be faced by health care

providers in the twenty-first century?

1. 1. Lack of available space to provide care for clients in hospitals
   2. Emergence of new and old communicable and infectious diseases
   3. New guidelines for chronic disease management
   4. Increased use of technology leading to a decreased need for health care workers

13. Which of the following demographic factors is expected to have the greatest influence on national health care spending?
    1. The aging population
    2. Use of diagnosis-related groups to determine reimbursement

1. 3. Insurance reform
   4. An increasing number of people without health insurance

14. Which of the following groups pays the largest amount for health care in the United States today?
    1. Consumers
    2. Federal and state government
    3. Insurance companies and other third-party payers
    4. Hospitals and health care providers

15. Which of the following services would be covered under Medicare Part A?
    1. Blood draw to assess PT/INR
    2. Physical therapy visit      
    3. Stay in skilled nursing facility
    4. Transportation by an ambulance

16. A Medicare recipient has elected to pay a monthly premium for Medicare that will cover expenses such as laboratory services and equipment. Which of the following best describes this part of Medicare?
    1. Part A
    2. Part B
    3. Part C
    4. Part D

17. Which of the following criterion is now used for deciding the amount of the reimbursement before care is provided?
    1. A proportion of actual cost arbitrarily decided by the Medicare panel
    2. The federal budget constraints for the current fiscal year
    3. Hospital and health care provider feedback and political persuasion
    4. Prospective payment scale based on the medical diagnosis

18. Which of the following payment systems tries to keep clients healthy through education and health promotion, with the goal of reducing the need for professional health care intervention and therefore also lowering cost?
    1. Managed care plan
    2. Fee-for-service payment
    3. Prospective reimbursement
    4. Retrospective reimbursement

19. Which of the following terms describes when a nurse practitioner receives a set monthly payment to take care of a group of clients regardless of the services needed and provided?
    1. Capitation
    2. Fee for service
    3. Rationing
    4. Retrospective reimbursement

20. A client expresses concern that health care coverage based on capitation may have negative side effects. Which of the following would most likely be a consequence of capitation?
    1. Coercing clients to attend health promotion education classes
    2. Encouraging clients to seek care elsewhere
    3. Increasing the number of interventions to maximize payment
    4. Neglecting to order certain tests or treatment to minimize cost to the provider

21. A public health nurse is counseling a client who is trying to determine if a health maintenance organization (HMO) or preferred provider organization (PPO) will provide the better health care coverage. Which of the following best describes one main difference between these two types of coverage?
    1. HMOs provide comprehensive care to members for a fixed fee.
    2. PPOs designate providers that members can choose.
    3. PPOs provide one model of care delivery.
    4. HMOs provide financial incentives to encourage members to select HMO providers.

22. A nurse is implementing a primary prevention strategy focusing on economics within the community. Which of the following intervention nurse most likely completing?
    1. Applying for a grant to establish a day care center to serve dependent older adult clients living with working families
    2. Persuading legislators to pass a bill offering health care financial aid to families at risk
    3. Screening cocaine addicts for financial assistance eligibility for drug treatment
    4. Referring clients with renal failure to apply for Medicare

MULTIPLE RESPONSE

1. In which of the following situations would the federal government provide money through tax relief for private enterprise? (Select all that apply.)
   1. A business pays for part of health insurance premiums for its employees
   2. A business purchases gifts for its employees to award them for their service
   3. An employer provides health screenings and immunizations
   4. An employer requests reimbursement for employee transportation costs

2. Which of the following best explains why clients who have Medicaid have poor health outcomes? (Select all that apply.)
   1. Clients may have preexisting conditions not covered by insurance.
   2. Many physicians won’t accept Medicaid clients.
   3. Medicaid won’t pay for certain medical interventions.
   4. Medicaid recipients are noncompliant with their health care providers’ recommendations.

3. A nurse would like to help members of the community focus on receiving primary preventive health care services. Which of the following interventions should be implemented by the nurse? (Select all that apply.)
   1. Publicize data on success of health promotion efforts, including cost savings.
   2. Lobby for decreased reimbursement for secondary and tertiary care services.
   3. Establish standards for appropriate screenings at specific intervals.
   4. Encourage members of the military service to engage in appropriate healthy lifestyle behaviors.