An older adult client who was recently widowed has become increasingly confused and disoriented. The family tells the healthcare provider's office nurse that it is imperative for their parent to be admitted to the hospital for medical evaluation. The client is a member of a managed healthcare plan. Which information is best for the nurse to provide this family?
Managed healthcare plans do not pay for any in-hospital medical evaluations.
The client is grieving normally in response to the loss of a spouse and hospitalization is not necessary.
Managed care providers have mandatory precertification requirements for hospitalization.
Healthcare costs are escalating because clients want to have diagnostic testing conducted in the hospital.
The Correct Answer is C
Choice A rationale: This statement is inaccurate. Managed healthcare plans typically cover in-hospital medical evaluations, but the decision may be subject to precertification requirements.
Choice B rationale: While grief is a natural response to the loss of a spouse, the client's confusion and disorientation warrant a medical evaluation, and this option dismisses the family's concerns.
Choice C rationale: Managed care providers often have mandatory precertification requirements for hospitalization. Informing the family about this requirement is important for them to navigate the process effectively.
Choice D rationale: This statement does not provide relevant information about the managed healthcare plan's policies or the client's current condition.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["D"]
Explanation
- Choice A Rationale: This choice is not optimal because the PN has the skills necessary to assist with the thoracentesis, a procedure that requires clinical judgment and skill, which the UAP does not possess. The RN is also needed to obtain the report from the ED due to the complexity of unstable angina, which requires advanced knowledge and assessment skills.
- Choice B Rationale: This option incorrectly assigns the UAP to prepare the room, which is within their scope, but fails to utilize the PN's skills effectively. The PN should be involved in more complex tasks such as assisting with procedures or obtaining detailed reports, rather than the UAP.
- Choice C Rationale: This choice is inappropriate because it assigns the UAP to assist with the thoracentesis, a task they are not trained for and is outside their scope of practice. The RN should be involved in the more complex care of obtaining the report, and the PN should assist with the thoracentesis.
- Choice D Rationale: This is the correct choice because it utilizes all staff members according to their scope of practice and skills. The PN assists with the thoracentesis, a task they are qualified for, the RN obtains the report on the new admission, which requires advanced knowledge, and the UAP prepares the room, a task that fits their role.
- Choice E Rationale: As there is no Choice E provided in the question, no rationale can be given for this option. It is important to follow the instructions and options given in the scenario to provide accurate and relevant information.
Correct Answer is D
Explanation
Choice A rationale: It is the role of the heathcare provider to provide the patient with explanation for the procedure and ensure their understanding.
Choice B rationale: Postponing the procedure may not be necessary if the client's concerns can be adequately addressed through communication and education. Choice C rationale: Calling the client's next of kin for verbal consent is not appropriate in this situation, as the client is capable of providing informed consent once concerns are addressed.
Choice D rationale: Notifying the healthcare provider isnecessary as it is their role to obtain informed consent. They should also address any patient specific concerns
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