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 C

Explanation

A. The local Red Cross chapter typically handles emergency and disaster relief, not the reporting of infectious diseases.
B. The hospital infection control department may collect data on infectious diseases but does not directly report to the CDC.
C. The state health department is responsible for collecting and voluntarily reporting cases of Lyme disease and other reportable diseases to the Centers for Disease Control and Prevention (CDC).
D. The Office of the Surgeon General focuses on public health initiatives and education, not the direct reporting of specific disease cases.

A. I can receive care in the hospital or at home." B. "I will need to have private insurance because Medicare does not cover hospice services." C. "I can discontinue hospice care whenever I want." D. "I will receive care from a variety of interprofessional team members." E. "My provider will recommend that I enter hospice care when I have 1 year left to live."

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

Explanation

A. Hospice care can be provided in various settings, including hospitals and homes.
B. Medicare covers hospice services, so private insurance for hospice care is not necessary.
C. Patients have the right to discontinue hospice care at any time.
D. Hospice care involves a team approach, including different healthcare professionals.
E. The statement about the provider recommending hospice care with 1 year left to live is incorrect; hospice care can be recommended based on other criteria, not necessarily a specific timeframe.

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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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse working in an infectious disease clinic is caring for a client who has a new diagnosis of Lyme disease. Which of the following agencies is responsible for voluntarily reporting cases of this disease to the Centers for Disease Control and Prevention?

Correct Answer is C

Explanation

A nurse is teaching a client who has a terminal illness about hospice care. Which of the following statements by the client indicates an understanding of the teaching? (Select all that apply.)

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

Explanation

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