Test Bank For Health Promotion Throughout the Life Span 8th Edition Edelman

<< Test Bank For Infants Children and Adolescents 8th Edition Berk Meyers

Test Bank for Human Communication in Society, 4th Edition By Jess K. Alberts, Thomas K. >>

Product Code: 222
Availability: In Stock

Price: $24.99

Qty: - OR - Add to Wish List
Add to Compare

0 reviews | Write a review

Description Reviews (0)

Test Bank For Health Promotion Throughout the Life Span 8th Edition Edelman

Description

WITH ANSWERS

Health Promotion Throughout the Life Span 8th Edition Edelman

Chapter 01: Health Defined: Objectives for Promotion and Prevention

Edelman: Health Promotion Throughout the Life Span, 8th Edition

MULTIPLE CHOICE

Which model of health is most likely used by a person who does not believe in preventive health care?

a.	Clinical model
b.	Role performance model
c.	Adaptive model
d.	Eudaimonistic model

ANS: A

The clinical model of health views the absence of signs and symptoms of disease as indicative of health. People who use this model wait until they are very sick to seek care.

DIF: Cognitive Level: Remember (Knowledge) REF: p. 3

A person with chronic back pain is cared for by her primary care provider as well as receives acupuncture. Which model of health does this person likely favor?

a.	Clinical model
b.	Role performance model
c.	Adaptive model
d.	Eudaimonistic model

ANS: D

The eudaimonistic model embodies the interaction and interrelationships among physical, social, psychological, and spiritual aspects of life and the environment in goal attainment and creating meaning in life. Practitioners who practice the clinical model may not be enough for someone who believes in the eudaimonistic model. Those who believe in the eudaimonistic model often look for alternative providers of care.

DIF: Cognitive Level: Apply (Application) REF: p. 3

A state of physical, mental, spiritual, and social functioning that realizes a persons potential and is experienced within a developmental context is known as:

a.	growth and development.
b.	health.
c.	functioning.
d.	high-level wellness.

ANS: B

Health is defined as a state of physical, mental, spiritual, and social functioning that realizes a persons potential and is experienced within a developmental context.

DIF: Cognitive Level: Remember (Knowledge) REF: p. 5

Which of the following best describes a client who has an illness?

a.	Someone who has well-controlled diabetes
b.	Someone with hypercholesterolemia
c.	Someone with a headache
d.	Someone with coronary artery disease without angina

ANS: C

Someone with a headache represents a person with an illness. An illness is made up of the subjective experience of the individual and the physical manifestation of disease. It can be described as a response characterized by a mismatch between a persons needs and the resources available to meet those needs. A person can have a disease without feeling ill. The other choices represent disease.

DIF: Cognitive Level: Analyze (Analysis) REF: p. 6

Which US report is considered a landmark document in creating a global approach to health?

a.	The 1990 Health Objectives for the Nation: A Midcourse Review
b.	Healthy People 2020
c.	Healthy People 2000
d.	The U.S. Surgeon General Report

ANS: C

Healthy People 2000 and its Midcourse Review and 1995 Revisions were landmark documents in which a consortium of people representing national organizations worked with US Public Health Service officials to create a more global approach to health.

DIF: Cognitive Level: Remember (Knowledge) REF: p. 6

Which of the following represents a method of primary prevention?

a.	Informational session about healthy lifestyles
b.	Blood pressure screening
c.	Interventional cardiac catheterization
d.	Diagnostic cardiac catheterization

ANS: A

Primary prevention precedes disease or dysfunction. It includes health promotion and specific protection and encourages increased awareness; thus, education about healthy lifestyles fits this definition. Blood pressure screening does not prevent disease, but instead identifies it.

DIF: Cognitive Level: Apply (Application) REF: p. 11

Which of the following represents a method of secondary prevention?

a.	Selfbreast examination education
b.	Yearly mammograms
c.	Chemotherapy for advanced breast cancer
d.	Complete mastectomy for breast cancer

ANS: B

Screening is secondary prevention because the principal goal of screenings is to identify individuals in an early, detectable stage of the disease process. A mammogram is a screening tool for breast cancer and thus is considered a method of secondary prevention.

DIF: Cognitive Level: Apply (Application) REF: p. 15

Which of the following represents a method of tertiary prevention?

a.	Drunk driving campaign
b.	Road blocks for drunk driving
c.	Emergency surgery for head trauma after a motor vehicle accident
d.	Physical and occupational therapy after a motor vehicle accident with head trauma

ANS: D

Physical therapy and occupational therapy are considered tertiary prevention. Tertiary prevention occurs when a defect or disability is permanent and irreversible. It involves minimizing the effect of disease and disability. The objective of tertiary prevention is to maximize remaining capacities.

DIF: Cognitive Level: Apply (Application) REF: p. 15

In reviewing a persons medical claims, a nurse realizes that the individual with moderate persistent asthma has had several emergency department visits and is not on inhaled steroids as recommended by the NHLBI asthma management guidelines. The nurse discusses this with the persons primary care provider. In this scenario, the nurse is acting as a(n):

a.	advocate.
b.	care manager.
c.	consultant.
d.	educator.

ANS: B

Care managers act to prevent duplication of service and reduce cost. Care managers base recommendation on reliable data sources such as evidence-based practices and protocols.

DIF: Cognitive Level: Apply (Application) REF: p. 15

During a home visit, a nurse assists an individual to complete an application for disability services. The nurse is acting as a(n):

a.	advocate.
b.	care manager.
c.	consultant.
d.	educator.

ANS: A

The advocacy role of the nurse helps individuals obtain what they are entitled to receive from the health care system, tries to make the system more responsive to individuals community needs, and assists individuals in developing skills to advocate for themselves.

DIF: Cognitive Level: Apply (Application) REF: p. 15

During a home visit, a nurse discusses the dangers of smoking with an individual. In this scenario the nurse is acting as a(n):

a.	advocate.
b.	care manager.
c.	consultant.
d.	educator.

ANS: D

Health education is a primary prevention technique available to avoid major causes of disease. Teaching can range from a chance remark to a planned lesson.

DIF: Cognitive Level: Apply (Application) REF: p. 16

A nurse is asked to provide an expert opinion about the development of an education program for newly diagnosed diabetics. In this scenario, the nurse is acting as a(n):

a.	advocate.
b.	care manager.
c.	consultant.
d.	educator.

ANS: C

Nurses with a specialized area of expertise provide education about health promotion and disease prevention to individuals and groups as consultants.

DIF: Cognitive Level: Apply (Application) REF: p. 16

A nurse is planning to deliver an educational program to individuals with diabetes. Which of the following should be the initial action taken by the nurse to ensure the success of the program?

a.	Assess the motivation level of the individuals
b.	Assess the knowledge level of the individuals
c.	Establish teacher-learner goals with the individuals
d.	Establish multiple teaching sessions with the individuals

ANS: B

Selection of the methods most likely to succeed involves the establishment of teacher-learner goals. Thus, the first step by the nurse should be establishment of goals.

DIF: Cognitive Level: Analyze (Analysis) REF: p. 16

The conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individuals is known as:

a.	health-related quality of life.
b.	evidence-based practice.
c.	a Healthy People 2010 goal.
d.	the ecological model of health.

ANS: B

Evidence-based practice is defined as the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individuals.

DIF: Cognitive Level: Remember (Knowledge) REF: p. 16

Which research methodology should be used to address the question, What is the difference in the infection rates between individuals who receive twice-a-day dressing changes versus once-a-day dressing changes?

a.	Evidence-based practice research
b.	Qualitative research
c.	Quantitative research
d.	Clinical judgment research

ANS: C

Quantitative research studies describe situations, correlate different variables related to care, or test causal relationships among variables related to care. Evidence-based practice research and clinical judgment research are not research methodologies; they are used to answer clinical questions.

DIF: Cognitive Level: Apply (Application) REF: p. 16

The question, What is the experience of teenagers who lose a sibling to cancer? can best be answered by using which research methodology?

a.	Evidence-based practice research
b.	Qualitative research
c.	Quantitative research
d.	Clinical judgment research

ANS: B

Qualitative research studies describe phenomena or define the historical nature, cultural relevance, or philosophical basis of aspects of nursing care. Evidence-based practice research and clinical judgment research are not research methodologies; they are used to answer clinical questions.

DIF: Cognitive Level: Apply (Application) REF: p. 16

A nurse who uses findings from a randomized, controlled trial on the care of Foley catheters to change practice at an institution is practicing:

a.	evidence-based medicine.
b.	qualitative research.
c.	quantitative research.
d.	clinical judgment.

ANS: A

The practice of evidence-based medicine means integrating individual clinical expertise with the best available external clinical evidence from systematic research.

DIF: Cognitive Level: Apply (Application) REF: p. 16

Which of the following is most influenced by the social and economic environment of a community?

a.	Social health policies
b.	Quality of care
c.	Evidence-based practice
d.	Practice guidelines

ANS: A

Social policies concerning health are influenced by the social and economic environment of a population. Analysis of population trends and projections is necessary to help health professionals determine changing needs.

DIF: Cognitive Level: Remember (Knowledge) REF: p. 17

A major cause of death in the early twentieth century was:

a.	cancer.
b.	cerebrovascular disease.
c.	heart disease.
d.	infections.

ANS: D

Infections and acute disease were the major causes of death in the early part of the twentieth century.

DIF: Cognitive Level: Remember (Knowledge) REF: p. 17

A mainstay of therapy for the management of chronic diseases is:

a.	lifestyle changes.
b.	occupational and physical therapy.
c.	medications.
d.	surgery.

ANS: A

The application of complex technology is not only costly but contributes minimally to improvement of health. One needs to focus on the cause of disease. The needs of a person with chronic disease are related to and affected by the individuals biochemical functioning, genetics, environment, and personal choices.

DIF: Cognitive Level: Apply (Application) REF: p. 17

Which of the following demonstrates a nurse taking action to promote health and prevent disease?

a.	Making a home visit to a person who is recovering from a heart attack
b.	Administering medications to a cardiac client in the hospital
c.	Providing cardiopulmonary resuscitation during a heart attack
d.	Educating a person about the advantages of a heart-healthy diet during a home visit

ANS: D

Solutions for health promotion are focused on individual and government involvement. To promote health and wellness, an emphasis must be placed on primary prevention. This is often related to actions such as education that influence lifestyle choices. In the preceding example, educating a person about the advantages of a heart-healthy diet during a home visit serves to influence lifestyle choices.

DIF: Cognitive Level: Apply (Application) REF: p. 17

Which factor may have the most influence in changing the health behavior of a single, adult woman who smokes and is the care provider for her mother, her own children, and granddaughter?

a.	Education regarding effects of smoking on her health
b.	The satisfaction that she will not contribute to secondhand smoke
c.	The availability of a weekly support group
d.	A gift card for $10 to a local grocery store for every week she is smoke free

ANS: D

Motivational factors play a role in influencing attitudinal changes. A financial incentive is an example of a motivating factor. For this woman, who is financially responsible for the health and well-being of other individuals, finances will likely play a significant role in motivating her actions. Remember that education regarding the benefits of not smoking is not enough. Thus, the $10 gift card may have the most influence in changing her health behavior.

DIF: Cognitive Level: Analyze (Analysis) REF: p. 14 (Box 1-6) | p. 18

An example of a Hispanic American nurse promoting cultural competency is:

a.	providing translation services for all Hispanic Americans.
b.	focusing on episodic care of illnesses with Hispanic Americans.
c.	taking a class about the Hispanic American culture.
d.	providing care for all Hispanic American persons in her clinic.

ANS: C

Nurses must be aware of their beliefs, values, and customs. They should not assume that their perspective is correct and shared by others. Additionally, they should avoid stereotyping. Broadening ones educational base regarding cultural beliefs is a way to develop and thus promote cultural competency.

DIF: Cognitive Level: Apply (Application) REF: p. 17 (Box 1-2)

The devaluing of beliefs, values, and customs of others is known as:

a.	ethnocentrism.
b.	racism.
c.	cultural competency.
d.	empathy.

ANS: B

Racism is defined as the devaluing of beliefs, values, and customs of others.

DIF: Cognitive Level: Remember (Knowledge) REF: p. 7 (Box 1-2)

Building a partnership with an obese individual who is trying to lose weight requires the nurse to:

a.	schedule a day to exercise with the individual.
b.	go grocery shopping for the individual.
c.	learn about the methods of weight loss.
d.	give the individual a weight loss goal.

ANS: C

Nurses must work with individuals to determine what they are willing to do to lose weight. To do this successfully, nurses must know what options are available to the individuals for weight loss. Once nurses learn about the methods of weight loss, they can then develop goals for weight loss with the individual.

DIF: Cognitive Level: Apply (Application) REF: p. 8 (Box 1-3)

Assuming that an individuals own perspective is correct and shared by others is known as:

a.	ethnocentrism.
b.	racism.
c.	cultural competency.
d.	empathy.

ANS: A

Assuming that an individuals own perspective is correct and shared by others is known as ethnocentrism.

DIF: Cognitive Level: Remember (Knowledge) REF: p. 8 (Box 1-2)

MULTIPLE RESPONSE

Which of the following investment themes has been identified by the National Institute of Nursing Research? (select all that apply)

a.	Interprofessional collaboration
b.	Improving quality of life
c.	End-of-life care
d.	Increasing physical activity among Americans

ANS: B, C

The National Institute of Nursing Research has identified five themes that promote health and prevent disease, improve quality of life through symptom management, and support palliative and end-of-life care, innovation, and nurse scientists.

DIF: Cognitive Level: Remember (Knowledge) REF: p. 16

Which interventions address both the National Institute of Nursing Research themes and the overall goals of the Healthy People 2020 leading health indicators? (select all that apply)

a.	Establishing a new park with a well-lit track
b.	Establishing a smoking cessation campaign
c.	Providing reduced-cost transportation passes to senior citizens
d.	Providing free condoms at all federally funded health clinics

ANS: A, B, D

Establishing a new park with a well-lit track, establishing a smoking cessation campaign, and providing free condoms at all federally funded health clinics all address the National Institute of Nursing Research themes and the Healthy People 2020 leading health indicators. A park, smoking cessation campaign, and free condoms address the themes of promoting health and preventing disease and the goal of increasing quality and years of healthy life. Providing reduced-cost transportation passes to senior citizens may indirectly affect the health of this population; however, it is not directly related to the themes of the National Institute of Research (promote health and prevent disease, improve quality of life through symptom management, and support palliative and end-of-life care, innovation, and nurse scientists) or the overall goals of Healthy People 2020 (increase quality and years of healthy life and eliminate health disparities).

DIF: Cognitive Level: Analyze (Analysis) REF: p. 7 | p. 16

Chapter 03: Health Policy and the Delivery System

Edelman: Health Promotion Throughout the Life Span, 8th Edition

MULTIPLE CHOICE

Which addition to a community best demonstrates the concept of the Healthy People 2020 report?

a.	New cardiothoracic intensive care unit at a major hospital
b.	New rehabilitation center
c.	New recreational health center
d.	New childrens hospital

ANS: C

The Healthy People 2020 report promotes health care, not illness care. A hospital, ICU, and rehabilitation center emphasize episodic care after an illness. The recreation health center serves to preserve health in the community and helps meet the goals of the Healthy People 2020 report.

DIF: Cognitive Level: Apply (Application) REF: p. 47 | p. 47 (Box 3-1)

Which nurse is at risk of making a medical error?

a.	Working overtime
b.	Works in a hospital that advocates multidisciplinary care
c.	Caring for four clients during the shift
d.	Attends regular continuing education programs

ANS: A

Health care systems are the basic cause of medical errors. Organizational and workforce management, work design, and organizational culture are problem areas that contribute to medical errors. Poor management leads to increased nurse turnover, the need for increased client-to-nurse ratios, increased need for overtime, and decreased number of nurses, all of which can lead to medical errors. A nurse working overtime is at risk of making a medical error.

DIF: Cognitive Level: Apply (Application) REF: p. 50

What is the most effective policy a staff nurse can implement to help decrease medical errors on the unit?

a.	Forgo opportunities for continuing education so the unit is never understaffed.
b.	Foster a collaborative working environment on the unit.
c.	Check all medications a minimum of three times before administering them.
d.	Develop a policy that mandates the firing of any nurse who commits an error.

ANS: B

Health care systems are the basic cause of medical errors. Organizational and workforce management, work design, and organizational culture are problem areas that contribute to medical errors. Creating a collaborative working environment helps improve organizational culture, thereby reducing the chance of medical errors.

DIF: Cognitive Level: Apply (Application) REF: p. 50

The person known as the father of British and American public health is:

a.	Lillian Wald.
b.	Edwin Chadwick.
c.	Lemuel Shattuck.
d.	Paul Ehrlich.

ANS: B

Edwin Chadwick is known as the father of British and American public health.

DIF: Cognitive Level: Remember (Knowledge) REF: p. 51

A community health nurse most effectively preserves the health of a person with tuberculosis (TB) and the community by:

a.	administering and reading the purified protein derivative (PPD) of all close contacts
b.	providing direct observed therapy (DOT) for the individual with TB
c.	isolating the person because it is likely drug resistant
d.	telling the person to wear a mask when leaving the home

ANS: B

Community health nursing practice promotes, preserves, and maintains the health of populations and the effect of their health status on that of the community as a whole through care provided to individuals, families, and groups. Thus, the most effective strategy of treating the individual and preventing the spread of TB is to provide DOT.

DIF: Cognitive Level: Analyze (Analysis) REF: p. 52

A community planning committee is working on the development of a community nursing center. Which of the following essential components should be included in this center?

a.	Physician as medical director
b.	Interdisciplinary staff
c.	Nurse as chief manager
d.	Partnership with an academic institution

ANS: C

The essential components of a community nursing center include a nurse as chief manager, a nursing staff that is accountable and responsible for care and professional practice, and nurses as the primary providers of care.

DIF: Cognitive Level: Apply (Application) REF: p. 54

Considering the provider and client perspective, which of the following is the most autonomous form of insurance?

a.	Fee-for-service plan
b.	Health maintenance organization (HMO)
c.	Preferred provider organization (PPO)
d.	Independent practice association (IPA)

ANS: A

In the fee-for-service plan, a provider provides a service and bills the individuals insurance company. The individual is also allowed to choose his or her provider.

DIF: Cognitive Level: Apply (Application) REF: p. 55

Which could result in a change in a nurse practitioners practice?

a.	Holding a masters degree or higher
b.	Moving to another state when she gets married
c.	Caring for Medicare clients
d.	Changing to another office within the same practice

ANS: B

Nurse practitioners generally hold masters degrees or higher. The nurse practice act within their states may be more comprehensive than the institutions for which they work. Legislation exists for reimbursement of nurse practitioners by Medicare. However, practice acts and prescriptive authority vary from state to state and thus influence practice patterns.

DIF: Cognitive Level: Apply (Application) REF: p. 55 | p. 70

Which health care provider represents a primary care provider?

a.	Psychiatric advanced practice nurse
b.	Clinical nurse specialist
c.	Pediatric nurse practitioner
d.	Acute care nurse practitioner

ANS: C

A primary care provider serves as a gatekeeper, coordinating care of individuals by determining the need for referrals and procedures. A primary care provider can be a physician, physicians assistant, or advanced practice nurse in a primary care setting. The primary care provider provides basic and routine care usually in an office or a clinic. A pediatric nurse practitioner is an example of a primary care provider.

DIF: Cognitive Level: Apply (Application) REF: p. 55 | p. 56 (Box 3-5)

Which form of managed care restricts providers to caring for individuals who are members of their organization?

a.	Fee-for-service plan
b.	Health maintenance organization (HMO)
c.	Preferred provider organization (PPO)
d.	Independent practice association (IPA)

ANS: B

The traditional HMO was a group or staff model in which a group of physicians and some specialty services provided care to its members. Providers generally spent all their time serving members of the HMO. Fee-for-service, IPAs, and PPOs are not restricted to serving clients for any one organization.

DIF: Cognitive Level: Remember (Knowledge) REF: p. 55

A Medicare client reports to the home care nurse that he is receiving care through an accountable care organization (ACO). Which of the following considerations should be made when delivering care to this individual?

a.	The individual must see a primary care provider before being referred to a specialist.
b.	The focus of care is prevention and management of individuals with chronic disease.
c.	The individual has paid a membership fee to be part of this organization.
d.	The focus of care is to conserve money in a health savings account.

ANS: B

The focus of care of accountable care organizations (ACOs) is to focus on prevention and management of individuals with chronic disease out of the hospital. In an ACO, physicians accept the responsibility for the quality of care provided and overall costs of delivering care to a defined population of patients. Accountable care organizations are composed of physicians, specialists, and hospitals, so a specialist will be able to be seen within the ACO. Individuals who are part of concierge care pay a membership fee in return for enhanced health care services or amenities. Health savings accounts are used in conjunction with high deductible health insurance plans and are not related to the use of ACOs.

DIF: Cognitive Level: Apply (Application) REF: pp. 56-57

An individual states that his family has insurance, but that paying for routine medical costs is very expensive because most routine services are paid for out of pocket. Which type of insurance plan does this individual most likely have?

a.	High deductible health insurance plan (HDHP)
b.	Point-of-service plan (POS)
c.	Health maintenance organization (HMO)
d.	Preferred provider organization (PPO)

ANS: A

High deductible health insurance plans (HDHPs) are structured in a way similar to traditional managed care plans and fee-for-service plans but have a very high annual out-of-pocket deductible. Thus, a family with this type of insurance will pay out-of-pocket until they reach the deductible, which may make receiving health services expensive for them. Point-of-service plans allow members, for an additional fee and higher copayment, to use providers outside of the HMO network. Health maintenance organizations (HMOs) deliver comprehensive health maintenance and treatment services for a group of enrolled individuals who prepay a fixed fee. Preferred provider organizations (PPOs) have a preselected list of providers who have agreed to provide health services for those enrolled in the plan.

DIF: Cognitive Level: Apply (Application) REF: p. 58

Which of the following is a health plan consisting of hospitals and physician providers providing health care services to plan members (usually at discounted rates) in return for expedited claims payment?

a.	Health maintenance organization (HMO)
b.	Health savings account (HSA)
c.	Preferred provider organization (PPO)
d.	Independent practice association (IPA)

ANS: C

A health plan consisting of hospitals and physician providers providing health care services to plan members (usually at discounted rates) in return for expedited claims payment is known as a preferred provider organization (PPO).

DIF: Cognitive Level: Remember (Knowledge) REF: p. 58 | p. 56 (Box 3-5)

Two working adults do not have access to health insurance for their family from their employers and do not meet the financial criteria for Medicaid. For which of the following federal programs may the children in this family be eligible?

a.	Medicare
b.	Civilian Health Medical Program for Uniformed Services (CHAMPUS)
c.	State Childrens Health Insurance Program (SCHIP)
d.	Veterans Administration Program

ANS: C

The State Childrens Health Insurance Program is a public state insurance program established to provide insurance to uninsured children whose family is typically described as the working poor and do not meet Medicaid requirements. In this case, both parents work but do not have access to insurance through their employers. Additionally, they do not meet the financial Medicaid requirement.

DIF: Cognitive Level: Apply (Application) REF: p. 60

A nurse complies with the Patient Self-Determination Act when asking:

a.	a person upon admission to the hospital if he or she has an advanced directive
b.	the family in the recovery room if the client has an advanced directive
c.	a person before discharge from the hospital if he or she has an advance directive
d.	the family about an advanced directive after the person has been intubated

ANS: A

The Patient Self-Determination Act is designed to increase individual involvement in decisions about life-sustaining treatments. The nurse must ensure that advanced directives are available to physicians at the time the medical decision is being made. Therefore, the nurse complies with the act when she asks a person upon admission to the hospital if he or she has an advanced directive.

DIF: Cognitive Level: Apply (Application) REF: p. 64

A nurse discussing the care of a person on the surgical unit following gastric bypass surgery with a friend is in violation of the:

a.	Patient Self-Determination Act
b.	Health Insurance Portability and Accountability Act of 1996
c.	Americans with Disabilities Act
d.	Civil Rights Act

ANS: B

The Health Insurance Portability and Accountability Act of 1996 (HIPAA) is a federal privacy standard that requires safeguards to protect the security and confidentiality of health information. Disclosures without individual authorization are allowed only to public health authorities authorized by law to collect and receive information for the purpose of preventing or controlling disease, injury, or disability.

DIF: Cognitive Level: Apply (Application) REF: p. 64

Which is a violation of the Health Insurance Portability and Accountability Act of 1996?

a.	Nurse reporting a case of TB to the health department
b.	Nurse reporting a case of child abuse to the Department of Human Services
c.	Nurse discussing the persons case with his or her physician
d.	Nurse discussing the persons case with his or her school nurse

ANS: D

DIF: Cognitive Level: Apply (Application) REF: p. 64

Which nurse is functioning as a care manager?

a.	Nurse working with a family to coordinate care after their child experiences a second hospitalization for an asthma exacerbation
b.	Nurse providing asthma education in the office setting to a child with moderate, persistent asthma
c.	Nurse administering the appropriate antiinflammatory medication to a child admitted to the hospital with an asthma exacerbation
d.	Nurse making a home visit for a respiratory assessment to a child following an admission for an asthma exacerbation

ANS: A

Care managers help determine what medical care is necessary, monitor care, and arrange for individuals to receive the most cost-effective care in the most appropriate settings. They must collaborate with providers and with the client/family. Care managers are especially helpful following a client after discharge and clients with complex needs. A nurse working with a family to coordinate service after a hospitalization is a good example of services provided by a care manager.

DIF: Cognitive Level: Apply (Application) REF: p. 71

A pregnant woman with two toddlers living at less than 135% of the federal poverty level would be eligible for:

a.	Medicare Part A
b.	Medicare Part B
c.	Medicaid
d.	State Childrens Health Insurance Program (SCHIP)

ANS: C

State Medicaid programs must cover all pregnant women and children up to 6 years of age with a family income of less than 133% of the federal poverty level. States Childrens Health Insurance Program provides insurance coverage to children whose family income is below 200% of the federal poverty level or whose income is 50% higher than the states Medicaid eligibility threshold. In this case, the woman is pregnant, her children are under the age of 6, and they meet the financial criteria for Medicaid but not SCHIP.

DIF: Cognitive Level: Apply (Application) REF: pp. 74-75

Which of the following is a major factor limiting health care services in the United States?

a.	Lack of nurses
b.	Lack of health care facilities
c.	Lack of funding
d.	Lack of client interest in health promotion

ANS: C

The lack of nurses may prevent health care providers from offering health promotional education activities. The cost of health care and prescription drugs is a major limitation to health care services. The United States has the highest proportion of population with no health insurance, thereby limiting health care services available to Americans.

DIF: Cognitive Level: Remember (Knowledge) REF: pp. 75-76

Which person is at highest risk for being uninsured?

a.	68-year-old retired mailman
b.	48-year-old on renal dialysis
c.	2-year-old whose parents work but do not have benefits through their employers
d.	27-year-old who attends college and works part time in a small pizza parlor

ANS: D

Young adults (27 years of age or older) are not eligible to be covered under their parents insurance. Medicare is available for those over the age of 65 and for people who require dialysis. Medicaid and SCHIP are available for children whose families meet the financial requirements. This child would likely meet criteria for either Medicaid or SCHIP because the parents are considered working poor. Because health care insurance is so expensive, it would be difficult for a 27-year-old to afford his or her own plan. Young adults often go without insurance because of the high costs.

DIF: Cognitive Level: Apply (Application) REF: pp. 75-76

Adoption of a Canadian-style health care system in the United States has the potential to:

a.	decrease waiting times for tests and procedures.
b.	create further health disparities.
c.	increase the number of HMOs.
d.	increase the amount of funding available for health care.

ANS: B

Canadians with private health insurance and higher incomes have access to greater health care services and more expedient health care. This translates to a two-tier system of health care, which can contribute to health disparities in health care access and quality.

DIF: Cognitive Level: Analyze (Analysis) REF: p. 77

A system used to evaluate the necessity, appropriateness, and efficiency of the use of the health care system, the purpose of which is to lower costs by discouraging unnecessary treatments, is known as:

a.	managed care
b.	gate keeping
c.	utilization review
d.	capitation

ANS: C

A system used to evaluate the necessity, appropriateness, and efficiency of the use of the health care system, the purpose of which is to lower costs by discouraging unnecessary treatments, is known as utilization review.

DIF: Cognitive Level: Remember (Knowledge) REF: p. 56 (Box 3-5)