A nurse is working with a case manager for a client who participates in a health maintenance organization. The nurse should identify that a health maintenance organization provides which of the following payment structures?

The provider is paid a fixed sum for the client on a monthly or yearly basis.

The provider bills the client directly for a predetermined percentage of the cost of services.

The client pays the insurer a percentage of the total costs for each service rendered by the provider.

The client is participating in a fee-for-service health care insurance program.

Answer and Explanation

The Correct Answer is A

A. In a health maintenance organization (HMO), providers typically receive a fixed sum (capitation) for each client enrolled, regardless of the services provided.
B. Billing the client directly for services rendered is more typical of fee-for-service or cost-sharing arrangements.
C. This option describes a cost-sharing model where the client pays a portion of the service costs, common in some insurance plans but not HMOs.
D. Fee-for-service insurance involves providers billing for each service provided, not typical in HMOs where payments are typically fixed.

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Correct Answer is ["A","D","E"]

Explanation

A. Flea bites are a common way the plague is transmitted, particularly in areas where the disease is endemic. The client's description of flea bites supports this mode of transmission.
B. While myalgia (muscle pain) can occur in many infectious diseases, it is a nonspecific symptom and does not specifically indicate the plague. Many other conditions can also present with muscle aches, so this symptom alone is not indicative of the plague.
C. A fever is common in many types of infections and is not specific to the plague. The presence of a fever alone does not distinguish the plague from other infectious diseases. It must be considered along with more specific symptoms and history.
D. Tender, inguinal lymphadenitis (swollen and painful lymph nodes) is a characteristic sign of bubonic plague, indicating infection and inflammation.
E. Recent travel to South Asia, where the plague is more prevalent, increases the likelihood of exposure to the pathogen. This travel history is a significant risk factor for infection.

A. Recommend the client seek out hospice services rather than seek treatment. B. Provide quiet time during visits for prayer or meditation. C. Initiate topics of conversation that avoid the client's health status. D. Place the client's name and medical condition on an online prayer chain.

Correct Answer is B

Explanation

A. The decision to seek hospice services should be guided by the client's preferences and needs.
B. Providing quiet time for prayer or meditation respects the client's spiritual and emotional needs.
C. Conversations should be client-centered and address their health status as appropriate.
D. Sharing personal health information should follow the client's consent and privacy preferences.

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A nurse is working with a case manager for a client who participates in a health maintenance organization. The nurse should identify that a health maintenance organization provides which of the following payment structures?

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Naxlex Comprehensive Predictor Exams

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Correct Answer is ["A","D","E"]

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