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 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 healthcare insurance program.
The provider is paid a fixed sum for the client on a monthly or yearly basis.
The Correct Answer is D
In a health maintenance organization (HMO), the provider is paid a set amount of money for each client enrolled in the program. This payment structure is known as capitation.
The provider is responsible for providing all necessary healthcare services to the client within the confines of the capitated payment.
The client is not required to pay the provider directly for any services rendered within the HMO network.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Bending at the waist to lift heavy objects can increase the risk of back injury, even when wearing a back brace. The nurse should advise this worker to bend at the knees and keep the back straight when lifting heavy objects. The worker who is standing with a wide base of support when pulling a cart toward himself is using proper body mechanics, which helps reduce the risk of injury.
The worker who is 7-weeks postoperative following rotator cuff surgery and is labeling boxes should avoid lifting heavy objects or performing tasks that require excessive use of the affected arm. The worker who is standing in place for extended periods and rests one foot on a box may experience fatigue or discomfort, but is not necessarily at an increased risk for injury.
Correct Answer is C
Explanation
Personal protective equipment should be used to prevent the spread of a suspected bioterrorism-related illness to others. The nurse should also contact the appropriate authorities, such as the local health department or Centers for Disease Control and Prevention (CDC), for guidance on how to proceed.
Option a, moving the client to a quarantine area, is not appropriate without guidance from the appropriate authorities.
Option b, reporting the client's condition to the Federal Bureau of Investigation, is not appropriate as the nurse should report the condition to the appropriate public health authorities, such as the local health department or CDC.
Option d, disinfecting contaminated areas of skin with isopropyl alcohol, is not appropriate as this action does not provide adequate protection against a bioterrorism-related illness.
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