Growth and Development Across the Lifespan 3rd Edition by Leifer, Fleck Chatper 2

Multiple Choice
Identify the choice that best completes the statement or answers the question.

____	1.	Changes in health-care delivery systems have been influenced primarily by:
a.	institution of various systems to provide cost-effective health care.	
b.	governmental regulation of the cost of all health-care services.	
c.	the need to meet the health-care needs of an aging population.	
d.	development of medical technology that has reduced the incidence of illness.	

____	2.	The purpose of the state/national government program of Medicaid is to provide:
a.	immunizations for preschool children.	
b.	prescription drugs at a lower cost.	
c.	medical care on the basis of need or poverty.	
d.	community clinics for women and children.	

____	3.	A student is preparing a report on the history of the Women, Infants, and Children (WIC) program would acquire the most useful information from:
a.	Health, United States.	
b.	the Department of Health and Human Services.	
c.	the Federal Register.	
d.	the Centers for Disease Control and Prevention.	

____	4.	The Human Genome Project has the potential to reduce health-care costs by assisting health-care providers to:
a.	detect illnesses before they become chronic.	
b.	prevent chromosomal related illnesses.	
c.	identify the most effective drugs for specific diseases.	
d.	design low cost complementary and alternative medicine (CAM) remedies.	

____	5.	The Tax Equity Fiscal Responsibility Act of 1982 (TEFRA) established the development of:
a.	diagnosis-related groups (DRGs).	
b.	Medicaid access for the poor.	
c.	aid to families with dependent children.	
d.	maternal and child health services block grants.	

____	6.	The scope of practice for nursing is stipulated by the:
a.	American Nurses Association.	
b.	Board of Nurse Examiners.	
c.	Nursing Licensure Pact.	
d.	Nurse practice act.	

____	7.	The roles of the nurse have changed as a result of the national health-care focus on:
a.	illness prevention and health maintenance.	
b.	increased accountability to professional codes and international standards of care.	
c.	treatment of disease or disability.	
d.	planning for nationalized health care.	

____	8.	An informed consent form requires that:
a.	the patient is informed of all adverse problems of a procedure.	
b.	the nurse signs as a witness that the patient received the necessary information.	
c.	the nurse questions the patient to confirm that all aspects of treatment are understood.	
d.	the nurse documents that the consent has been signed.	

____	9.	A diagnosis-related group (DRG) is:
a.	a standard used by health-care facilities to determine charges for health-care services.	
b.	a medical condition classification system that determines what Medicare will pay for health-care services.	
c.	the method that health-care agencies use to decide what health-care services are needed for patients.	
d.	a system used by all insurance companies to determine what health-care services will be covered.	

____	10.	Prospective payment systems for health-care services:
a.	reimburse only preapproved treatments.	
b.	pay only health-care providers under contract with the system to provide the lowest-priced services.	
c.	require that health care be provided by preapproved health professionals.	
d.	provide payment based on flat predetermined rates regardless of actual cost.	

____	11.	To conform to the national trend in health care, health-care agencies of the future may need to depend on:
a.	accountants to implement cost-saving measures.	
b.	legislators to set limits on health-care funding.	
c.	nurses to plan and implement self-care education programs.	
d.	insurance companies to provide more coverage for high-technology procedures.	

____	12.	Standards of practice are the foundations for:
a.	plans of care.	
b.	insurance reimbursement.	
c.	licensure.	
d.	consumer protection laws.	

____	13.	The Health Insurance Portability and Accountability Act (HIPAA) provides for:
a.	health insurance for emergency treatment.	
b.	confidentiality of medical information.	
c.	payment for home health care.	
d.	medical care for single mothers and their children.	

____	14.	The Patient Protection and Affordable Care Act of 2010 caused controversy because it mandated:
a.	limited treatment for specified illnesses.	
b.	all recipients must have a picture identification card.	
c.	strict confidentiality of all medical records and medical communications.	
d.	health-care coverage for 32 million uninsured persons.	

Multiple Response
Identify one or more choices that best complete the statement or answer the question.

____	15.	The Omnibus Budget Reconciliation Act of 1981 provided money for the development of: (Select all that apply.)
a.	treatment centers for drug dependency.	
b.	skilled nursing facilities.	
c.	nursing schools.	
d.	home health agencies.	
e.	day care centers.	

____	16.	The Patient Bill of Rights ensures that all patients may: (Select all that apply.)
a.	select their health-care provider.	
b.	be assured of having a private room.	
c.	take part in treatment decisions.	
d.	expect confidentiality.	
e.	utilize channels for complaint.	

____	17.	Political action committees (PACs) can influence legislation by: (Select all that apply.)
a.	providing lobbying.	
b.	selecting candidates to run for office.	
c.	creating an awareness of the need for new legislation.	
d.	introducing legislation themselves.	
e.	contributing money to legislators.	

Completion
Complete each statement.

	18.	The nursing theorist that proposed a holistic view of health care in the 1960s was ___________ _____________.

	19.	The plan of care is the tool that directs patient care for a health care delivered by a _______________ team.

Growth and Development Across the Lifespan 3rd Edition by Leifer, Fleck Chatper 2
Answer Section

MULTIPLE CHOICE

	1.	ANS:	A
Increasing health-care costs have led to initiation of health-care delivery systems to contain cost while providing care. Cost control addressing national health goals, entitlements, use of available sources, and identification of changing health-care needs is the basic goal of these systems.

PTS:	1	DIF:	Cognitive Level: Comprehension	REF:	p. 26
OBJ:	5	TOP:	Health-care reform		KEY:	Nursing Process Step: NA
MSC:	NCLEX: NA		

	2.	ANS:	C
Medicaid is similar to a welfare program in which benefits are provided on the basis of need or poverty.

PTS:	1	DIF:	Cognitive Level: Comprehension	REF:	p. 22, Box 2-3
OBJ:	5	TOP:	Medicaid	KEY:	Nursing Process Step: NA
MSC:	NCLEX: NA		

	3.	ANS:	C
Federal legislation related to health care is recorded and published in the Federal Register.

PTS:	1	DIF:	Cognitive Level: Comprehension	REF:	p. 23
OBJ:	1	TOP:	Department of Health and Human Services	
KEY:	Nursing Process Step: NA	MSC:	NCLEX: NA		

	4.	ANS:	A
The Human Genome Project gives health-care providers the potential to detect illnesses before they become chronic.

PTS:	1	DIF:	Cognitive Level: Comprehension	REF:	p. 26
OBJ:	5	TOP:	Human Genome Project	KEY:	Nursing Process Step: NA
MSC:	NCLEX: NA		

	5.	ANS:	A
TEFRA amended the Social Security Act to establish the development of DRGs in 1982.

PTS:	1	DIF:	Cognitive Level: Knowledge	REF:	p. 24, Box 2.1
OBJ:	2	TOP:	Diagnosis-related groups	KEY:	Nursing Process Step: NA
MSC:	NCLEX: NA		

	6.	ANS:	D
Nurse practice acts of each state establish the scope of practice for nursing in that state.

PTS:	1	DIF:	Cognitive Level: Knowledge	REF:	p. 18
OBJ:	6	TOP:	Nurse Practice Acts		KEY:	Nursing Process Step: NA
MSC:	NCLEX: NA		

	7.	ANS:	A
Prevention and early intervention appear to be critical to reducing health-care costs and are at the heart of the objectives of Healthy People 2030.

PTS:	1	DIF:	Cognitive Level: Comprehension	REF:	p. 27
OBJ:	6	TOP:	Illness prevention		KEY:	Nursing Process Step: NA
MSC:	NCLEX: NA		

	8.	ANS:	B
The nurse is required to sign the informed consent form as witness that the patient received pertinent information. Extra documentation is not required.

PTS:	1	DIF:	Cognitive Level: Comprehension	REF:	p. 18
OBJ:	2	TOP:	Informed consent		KEY:	Nursing Process Step: NA
MSC:	NCLEX: NA		

	9.	ANS:	B
DRGs are a government-mandated program that radically changed the face of health care by establishing strict rules for reimbursement.

PTS:	1	DIF:	Cognitive Level: Comprehension	REF:	p. 23
OBJ:	2	TOP:	Policy setting			KEY:	Nursing Process Step: NA
MSC:	NCLEX: NA		

	10.	ANS:	D
Prospective payment systems are part of the efforts of managed care organizations to standardize and control costs of health care.

PTS:	1	DIF:	Cognitive Level: Comprehension	REF:	p. 28
OBJ:	4	TOP:	Delivery of health care	KEY:	Nursing Process Step: NA
MSC:	NCLEX: NA		

	11.	ANS:	C
The focus of health care has changed from treatment to prevention. Health-care agencies may depend on self-care education to promote health and prevent disease as an effective cost-containment strategy. Nurses are ideally suited through education and experience to develop and implement these programs.

PTS:	1	DIF:	Cognitive Level: Comprehension	REF:	p. 27
OBJ:	6	TOP:	Self-care	KEY:	Nursing Process Step: NA
MSC:	NCLEX: NA		

	12.	ANS:	D
Standards of practice, which have evolved over the years, have been used as the foundation of laws relative to consumer protection.

PTS:	1	DIF:	Cognitive Level: Comprehension	REF:	p. 18
OBJ:	2	TOP:	Standards of care		KEY:	Nursing Process Step: NA
MSC:	NCLEX: NA		

	13.	ANS:	B
HIPAA provides for portability of health insurance, confidentiality of medical information, and coverage for preexisting conditions.

PTS:	1	DIF:	Cognitive Level: Comprehension	REF:	p. 24, Table 2.1
OBJ:	5	TOP:	Health Insurance Portability and Accountability Act (HIPAA)
KEY:	Nursing Process Step: NA	MSC:	NCLEX: NA		

	14.	ANS:	D
The Patient Protection and Affordable Care Act of 2010 mandated care to 32 million uninsured persons, which would be financed from Medicare payroll taxes.

PTS:	1	DIF:	Cognitive Level: Knowledge	REF:	p. 25, Table 2.1
OBJ:	5	TOP:	The Patient Protection and Affordable Care Act of 2010
KEY:	Nursing Process Step: NA	MSC:	NCLEX: NA		

MULTIPLE RESPONSE

	15.	ANS:	B, D
The Omnibus Budget Reconciliation Act of 1981 provided money for the development of various health-care projects such as nursing homes, skilled nursing facilities, and home health agencies.

PTS:	1	DIF:	Cognitive Level: Comprehension	REF:	p. 24
OBJ:	1	TOP:	Omnibus Budget Reconciliation Act		
KEY:	Nursing Process Step: NA	MSC:	NCLEX: NA		

	16.	ANS:	A, C, D, E
The Consumer Patient Bill of Rights assures patients that they may select their provider, take part in treatment decisions, expect confidentiality, use resources for complaint and appeal, be free from discrimination, and have access to emergency services.

PTS:	1	DIF:	Cognitive Level: Comprehension	REF:	p. 18
OBJ:	2	TOP:	Patient Bill of Rights		KEY:	Nursing Process Step: NA
MSC:	NCLEX: NA		

	17.	ANS:	A, C, E
PACs can influence legislation by contributing money to legislators and by providing lobbying services to create an awareness of the need for legislation.

PTS:	1	DIF:	Cognitive Level: Comprehension	REF:	p. 28
OBJ:	1	TOP:	Political action committees (PACs)		
KEY:	Nursing Process Step: NA	MSC:	NCLEX: NA		

COMPLETION

	18.	ANS:	
Martha Rogers
In the 1960s, Martha Rogers proposed a theory of holistic health care.

PTS:	1	DIF:	Cognitive Level: Knowledge	REF:	p. 27
OBJ:	6	TOP:	Holistic health care		KEY:	Nursing Process Step: NA
MSC:	NCLEX: NA		

	19.	ANS:	
multidisciplinary
The plan of care allows for the communication among the various team members to meet the individual patient’s health-care needs.

PTS:	1	DIF:	Cognitive Level: Comprehension	REF:	p. 17
OBJ:	3	TOP:	Plan of care	KEY:	Nursing Process Step: NA
MSC:	NCLEX: NA