A nurse is scheduling a client for surgery.
Which of the following actions should the nurse take to obtain precertification for the client to have surgery?
Inform the client of the need to pre-pay for the consent of authorization.
Contact the client's insurance carrier to obtain authorization.
Notify the provider to obtain approval for the surgery.
Witness the client sign the surgical consent form.
The Correct Answer is B
Choice A rationale:
The nurse should not inform the client of the need to pre-pay for the consent of authorization. Precertification for surgery is related to obtaining approval from the client's insurance provider and not about pre-payment.
Choice B rationale:
Contacting the client's insurance carrier to obtain authorization is the correct action to take when obtaining precertification for surgery. Many insurance companies require pre-authorization for surgical procedures to ensure coverage and to confirm that the procedure is medically necessary. This step is essential to prevent financial burdens on the client and ensure they have coverage for the surgery.
Choice C rationale:
Notifying the provider to obtain approval for the surgery is not the nurse's responsibility in the context of precertification. The primary responsibility lies with obtaining approval from the client's insurance carrier.
Choice D rationale:
Witnessing the client sign the surgical consent form is an essential step in the surgical preparation process but is not the same as obtaining precertification. Precertification involves confirming insurance coverage and approval for the surgery, which is the responsibility of the insurance carrier, not the client's consent.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale:
The National Student Nurses Association is primarily focused on students and recent graduates. While it can be an excellent organization for student nurses, it may not provide opportunities for a nurse looking to become involved in nursing on a national level beyond their student years.
Choice B rationale:
The National Academy of Medicine is an organization that focuses on health policy and research. While it is a prestigious organization, it is not specifically a nursing organization, and its focus may not align with the goals of a nurse seeking to become more involved in nursing on a national level.
Choice C rationale:
The American Nurses Association (ANA) is a national organization specifically dedicated to advancing the nursing profession. It offers various opportunities for nurses to get involved in national-level nursing advocacy, policy development, and professional growth. Joining the ANA is a suitable choice for a nurse looking to make a national impact in the field of nursing.
Choice D rationale:
The National League for Nursing (NLN) is an organization that primarily focuses on nursing education. While it plays a crucial role in the field of nursing, its focus is more on education and may not align with a nurse's goal to become involved in nursing on a national level from a broader perspective.
Correct Answer is A
Explanation
Choice B rationale:
The statement "The ACA is primarily for individuals requiring tertiary care" is not accurate. The Affordable Care Act (ACA) is designed to improve access to healthcare for a broad range of individuals, not just those in need of tertiary care. It aims to make healthcare coverage more affordable and accessible for all, regardless of the level of care needed.
Choice C rationale:
The statement "Individuals must qualify to participate in ACA insurance coverage" is correct to some extent. Individuals must meet certain eligibility criteria to enroll in ACA insurance plans, such as being a U.S. citizen or lawfully present, but it does not capture the full scope of the ACA's purpose. The primary goal of the ACA is to expand access to healthcare and reduce disparities, not just limited to qualification requirements.
Choice D rationale:
The statement "Individuals with pre-existing conditions are not eligible for ACA coverage" is incorrect. One of the significant achievements of the ACA is that it prohibits insurance companies from denying coverage to individuals with pre-existing conditions. In fact, the ACA has provisions to protect individuals with pre-existing conditions and ensure their access to insurance coverage.
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