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1. CHAPTER 1

Managed care organizations are insurers that carefully plan and closely supervise the

distribution of healthcare services. What is one of the goals of managed care?

A) Preventing illness through screening and promotion of health activities

B) Improving training of healthcare professionals

C) Eliminating health disparities between segments of the population

D) Providing hospice or home hospice care

Ans: A

Feedback:

Preventing illness through screening and promotion of health activities is one of the

goals of managed care. Improved training of healthcare professionals is the priority for

international health and not the goal of managed care. Eliminating health disparities

between the segments of population is a goal of Healthy People 2020. Providing hospice

or home hospice care is only for terminally ill clients.

2. In an effort to cut costs, hospitals have instituted many changes. Which of these

cost-cutting factors is most likely to jeopardize the quality of care?

A) Using unlicensed assistive personnel

B) Increasing numbers of clients in hospitals

C) Not devoting enough time to the client

D) The rise of medical care costs in healthcare systems

Ans: A

Feedback:

Hospitals are using unlicensed assistive personnel to perform some duties practical and

registered nurses once provided. Many are concerned that the use of unlicensed assistive

personnel will jeopardize the quality of care. Increasing numbers of clients in hospitals,

not devoting enough time to the client, or the rise of medical costs are less likely to

jeopardize the quality of care.

3. Since losing his right leg years ago, Mr. Smith and his wife have formed a community

walking group to raise money for the homeless in his area. Which of the following has

contributed to him being viewed as “healthy”?

A) The client is married and is moving on.

B) The client is experiencing high quality of life within the limits of the physical

condition.

C) The client is facing various states of health and illness.

D) The client is physiologically and psychologically stable.

Ans: B

Feedback:

Clients adapt physically, emotionally, and socially, enabling them to maintain comfort,

stability, and self-expression. Clients with chronic illness can achieve a high level of

wellness and experience high quality of life. Marriage is an aspect of quality of life but

does not define the quality of the client's life. All clients experience various states of

health and illness.

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4. A 17-year-old client is having protected sex one to two times a week in a monogamous

relationship. What is the client participating in?

A) Health promotion

B) Health maintenance

C) Illness prevention

D) Wellness

Ans: B

Feedback:

Protecting one's current level of health by practicing safe sex to prevent illness is an

example of a health maintenance activity. Health promotion strategies are used to

enhance health, such as eating a diet high in fiber. Illness prevention includes

identifying risk factors such as hypertension. Wellness is the balance of total well-being.

5. A client complaining of bloody urine has scheduled an appointment with a family

practitioner. What type of care is the client receiving?

A) Tertiary

B) Secondary

C) Skilled nursing care

D) Primary

Ans: D

Feedback:

The first provider that clients contact about a health need provides primary care; this

person is typically a family practitioner or nurse practitioner. Secondary care includes

referrals to facilities for additional testing. Tertiary care focuses on more complex

medical and surgical intervention. Skilled nursing care occurs in facilities or units that

offer prolonged health maintenance or rehabilitative services.

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6. The hospital is having a problem with healthcare-associated infections. A committee has

been established to study the problem and make recommendations. The nurse working

on the committee knows that this work addresses what?

A) Inpatient quality indicators

B) Prevention quality indicators

C) National Patient Safety Goals

D) Patient safety indicators

Ans: C

Feedback:

The Joint Commission has established National Patient Safety Goals that are updated

annually. These safety goals have changed how patients are identified and prevent

adverse effects. Some of the 2012 goals include reducing the risk of

healthcare-associated infections. Patient safety indicators reflect the quality of care in

hospitals but focus on potentially avoidable complications. Prevention indicators

identify hospital admissions that could be avoided through high-quality outpatient care.

Inpatient indicators reflect quality of care inside the hospital.

7. After hip surgery, a client is admitted to the rehabilitation hospital. What type of care is

the client receiving?

A) Secondary

B) Tertiary

C) Rehabilitation

D) Primary

Ans: B

Feedback:

Hospitals where specialized technology is available provide tertiary care. Primary care

is the initial contact that a client has, such as an appointment with a family practitioner.

Secondary care includes referrals for additional testing. Rehabilitation is aimed at

restoring a person to his or her fullest ability.

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8. An older man has been sick for 3 weeks but will not seek medical help even though he

is able to get to the doctor's office. The client does not know what his insurance will

cover. The client has many medical bills from treatments not covered and does not want

to be faced with more. Why is this client waiting to obtain medical treatment?

A) Cost

B) Language

C) Accessibility

D) Culture

Ans: A

Feedback:

Many groups, such as ethnic minorities and older adults, are underserved; many do not

seek early services because they cannot afford to pay for them. Accessibility is not an

issue because the client is able to get to the office. No cultural or language barrier is

mentioned.

9. The Healthy People 2020 initiative targets the improvement of health for all. In addition

to eliminating health disparities, what are the broad goals of this plan?

A) Increasing technological innovations

B) Preventing treatable problems

C) Applying a systematic approach to health improvement

D) Increasing the quality and length of a healthy life

Ans: D

Feedback:

Two broad goals of the Healthy People 2020 initiative are to increase quality and years

of healthy life and eliminate health disparities. Healthy People 2020 initiatives will help

with treatable problems but will not prevent problems. The initiative does not apply a

systematic approach to health improvement or increase technological innovations.

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