Term
| Those who are uninsured often seek heath care services when they are _____, thus requiring more costly services. |
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Definition
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Term
| Values of the nursing profession are rooted in helping persons to ___,___, or ____ _____, ____ illness and find comfort and ______ |
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Definition
| regain, maintain, or improve health; prevent illness; and find comfort and dignity |
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Term
| The federal government, the biggest consumer of health care which paid for Medicare and Medicaid, created ____ ___ ___ ___ to review the quality, quantity, and cost of hospital care |
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Definition
| professional standards review organizations (PSROs) |
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Term
| Medicare-qualified hospitals had physician-supervised ____ _____ ____to review the admissions, diagnostic testing, and treatments provided by physicians who cared for clients receiving Medicare. |
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Definition
| utilization review (UR) committees |
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Term
| One of the most significant factors that influenced payment for health care was the ___ ___ ___Established by Congress in 1983 |
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Definition
| prospective payment system (PPS). |
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Term
| The term ___ ___ describes health care systems in which there is administrative control over primary health care services for a defined client population. |
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Definition
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Term
| Larger health care systems have developed ____ _____ ____ that include a set of providers and services organized to deliver a continuum of care to a population of clients at a capitated cost in a particular setting |
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Definition
| integrated delivery networks (IDNs) |
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Term
| One that limits an enrollee's choice to a list of “preferred” hospitals, physicians, and providers. An enrollee pays more out-of-pocket expenses for using a provider not on the list. |
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Definition
| PPO Preferred provider organization |
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Term
| Provides comprehensive preventive and treatment services to a specific group of voluntarily enrolled persons. Structures include a variety of models: staff model, group model, network model, independent practice |
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Definition
| Managed care organization (MCO) |
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Term
| Program same as MCO but designed to cover health care costs of senior citizens. |
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Definition
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| One that limits an enrollee's choice to providers belonging to one organization. Sometimes able to use outside providers at additional expense. |
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Definition
| Exclusive provider organization (EPO) |
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Term
| a financially funded national health insurance program in the United States for people 65 years and older. |
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Definition
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Term
| Federally funded, state-operated program that provides: (1) health insurance to low-income families; (2) health assistance to low-income people with long-term care (LTC) disabilities |
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Definition
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Term
| Traditional fee-for-service plan. Payment computed after client receives services on basis of number of services used. |
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Definition
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Term
| Supplemental insurance for coverage of long-term care services. Policies provide a set amount of dollars for an unlimited time or for as little as 2 years. |
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Definition
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Term
| Activities that protect people from becoming ill because of actual or potential health threats |
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Definition
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Term
| Activities that develop human attitudes and behaviors to maintain or enhance well-being |
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Definition
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Term
| Organization that provides or contracts for specific health care services (e.g., hospital care, prescription medications) |
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Definition
| Managed care organization |
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Term
| Provision of integrated, accessible health care services by health care professionals who address a majority of personal health care needs, develop partnerships with clients, and care for families and communities |
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Definition
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Term
| Combination of primary and public health care that is accessible to individuals and families in a community and provided at an affordable cost |
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Definition
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Term
| vHealth-promoting behaviors or activities that reduce the occurrence of an illness |
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Definition
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Term
| Community and interdisciplinary care aimed at preventing disease and promoting health |
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Definition
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Term
| Early diagnosis and treatment of illness (e.g., screening for hypertension) |
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Definition
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Term
| Care that prevents further progression of disease |
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Definition
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Term
| 5 examples of Primary Care (Health Promotion) |
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Definition
Prenatal care
Well-baby care
Nutrition counseling
Family planning
Exercise classes |
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Term
| 5 examples of preventive care |
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Definition
Blood pressure and cancer screening
Immunizations
Poison control information
Mental health counseling and crisis prevention
Community legislation (seat belts, air bags, bike helmets) |
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Term
| 3 examples of secondary acute care |
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Definition
Emergency care
Acute medical-surgical care
Radiological procedures |
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Term
| 2 examples of tertiary care |
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Definition
Intensive care
Subacute care |
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Term
| 4 examples of restorative care |
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Definition
Cardiovascular and pulmonary rehabilitation
Sports medicine
Spinal cord injury programs
Home care |
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Term
| 2 examples of continuing care |
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Definition
Assisted living
Psychiatric and older adult day care |
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Term
| In settings where clients receive ____and _____ care, such as schools, physician offices, occupational health clinics, and nursing centers, health promotion is a major theme |
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Definition
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Term
| ______ care focuses on health services provided on an individual basis, whereas ____ ____ care focuses on improved health outcomes for an entire population |
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Definition
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Term
| A hospital is an example of what kind of care? |
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Definition
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Term
| Hospitalized clients are acutely ill and need comprehensive and specialized _____ health care. Larger hospitals also offer professional staff from a variety of specialties such as social service, respiratory therapy, physical and occupational therapy, and speech therapy |
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Definition
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Term
| Because of the need to contain costs, many hospitals use a_____ _____model of care. In this model, a case manager, who is usually a nurse or a social worker, coordinates the efforts of all disciplines to achieve the most efficient and appropriate plan of care for the clien |
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Definition
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Term
| Nurses play a large role in _______ planning in the hospital where continuity of care is important. |
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Definition
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Term
| . A____ ____ is a multidisciplinary treatment plan that outlines the treatments or interventions clients need to have while in the hospital for a specific condition or procedure. |
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Definition
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Term
| The goal of ____ _____ is to help individuals regain maximal functional status and to enhance quality of life through promotion of independence and self-care |
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Definition
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Term
| ___ ____ is the provision of medically related professional and paraprofessional services and equipment to clients and families in their homes for health maintenance, education, illness prevention, diagnosis and treatment of disease, palliation, and rehabilitation |
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Definition
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Term
| ______ restores a person to the fullest physical, mental, social, vocational, and economic potential possible |
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Definition
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Term
| An____ _____ facility provides intermediate medical, nursing, or custodial care for clients recovering from acute illness or clients with chronic illnesses or disabilities. |
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Definition
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Term
• Make appropriate referrals to optimize independence; older adult clients often need help with medication administration, home maintenance, dental care, and transportation.
• Help clients interpret medical bills and apply for free or reduced-cost medication programs.
These are examples of |
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Definition
| advocating for the client |
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Term
| A _______ is a system of family-centered care that allows clients to live and remain at home with comfort, independence, and dignity while easing the pains of terminal illness. |
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Definition
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Term
| _____ _____ outcomes are client outcomes that are directly related to nursing care. They have a major effect on client safety and quality of care |
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Definition
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Term
| emphasizes outcomes that nursing interventions most affect. However, all health care disciplines can use this system. |
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Definition
| Outcomes Classification (NOC) |
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Term
| he _____ _____ Credentialing Center (ANCC) has established a Magnet Recognition Program to recognize health care organizations that achieve excellence in nursing practice ( |
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Definition
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Term
1. Which of the following is the biggest consumer of health care?
1.Hospitals
2.Businesses
3.Federal government
4.Private insurance companies |
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Definition
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Term
2. Which of the following was most significant in influencing competition in health care costs?
1.Medicare and Medicaid
2.Diagnosis-related groups
3.Managed care organizations
4.Prospective payment system |
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Definition
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Term
3. A nurse is working in an acute care hospital that uses a case management model. Which of the following activities should the nurse communicate with the case manager? (Select all that apply.)
1.Management of a client transfer to the x-ray department
2.Coordination of a client transfer to the step-down rehabilitation unit
3.Obtaining permission to bring in special food to a client by the family
4.Follow-up after a client's discharge to evaluate whether needs have been mets |
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Definition
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Term
4. Which of the following clients need to be in an extended care facility with skilled nursing? (Select all that apply.)
1. A client who had a stroke, can talk, and has lost bowel and bladder control
2. A severely brain injured client on a ventilator with intravenous medications
3. A client with Alzheimer's disease who is abusive, combative, and a threat to self and others
4. A young child who recently had a spinal cord injury and is living with quadriplegia and needs to learn a new way of life |
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Definition
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Term
5. Which of the following statements is true about evidence-based practice? (Select all that apply.) Evidence-based practice:
1.Is based only on the results of research
2.Assists nurses with meeting standards of practice
3.Helps nurses solve dilemmas in the clinical setting
4.Requires nurses to review and critique research and practice findings |
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Definition
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Term
6. Which of the following are population-based interventions for hypertension? (Select all that apply.)
1.Providing education to five clients to prevent hypertension
2.Obtaining a medication prescription and follow-up appointment
3.Identifying the prevalence of hypertension by age, race, and sex
4.Discovering the subpopulation with the highest rate of untreated hypertension |
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Definition
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Term
| 7. A client is receiving health care by a health care provider who is a salaried employee. Which type of managed care organization (MCO) does the client belong to? (Select all that apply.) |
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Definition
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