An older female client who was recently widowed has become increasingly confused and disoriented. Her family tells the healthcare provider's office nurse that it is imperative for their mother 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.
Healthcare costs are escalating because clients want to have diagnostic testing conducted in the hospital.
The client is grieving normally in response to her husband's death and hospitalization is not necessary.
Managed care providers have mandatory pre-certification requirements for hospitalization.
The Correct Answer is D
Choice A Reason: Managed healthcare plans do not pay for any in-hospital medical evaluations is not the best information for the nurse to provide this family. This statement is false and misleading. Managed healthcare plans may cover in-hospital medical evaluations if they are deemed medically necessary and authorized by the plan. The nurse should not discourage the family from seeking appropriate care for their mother based on inaccurate information.
Choice B Reason: Healthcare costs are escalating because clients want to have diagnostic testing conducted in the hospital is not the best information for the nurse to provide this family. This statement is irrelevant and insensitive. Healthcare costs are influenced by many factors, such as technology, inflation, regulation, and demand. The nurse should not blame the clients for wanting to have diagnostic testing done in the hospital, which may be essential for their health and well-being.
Choice C Reason: The client is grieving normally in response to her husband's death and hospitalization is not necessary is not the best information for the nurse to provide this family. This statement is presumptuous and dismissive. Grief is a complex and individual process that may affect people differently. The nurse should not assume that the client's confusion and disorientation are normal signs of grief, which may mask underlying medical conditions that require evaluation and treatment.
Choice D Reason: Managed care providers have mandatory pre-certification requirements for hospitalization is the best information for the nurse to provide this family. This statement is factual and helpful. Pre-certification is a process by which managed care providers review and approve proposed hospital admissions, procedures, or services before they are performed. The nurse should inform the family that they need to obtain pre-certification from their mother's plan before admitting her to the hospital, or they may face denial of coverage or higher out-of-pocket costs.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A) This action is not the best because it does not directly evaluate the PN's wound care skills in practice. A skill checklist may not reflect the current or actual abilities of the PN, especially if it is outdated or based on self-
reporting. The charge nurse should observe the PN's performance in person to ensure that she follows the proper procedures and protocols for sterile wound care.
B) This action is the best because it allows the charge nurse to verify the PN's wound care skills and provide feedback or guidance if needed. The charge nurse has a responsibility to ensure that the PN delivers safe and effective care to the clients on the unit. By watching the PN perform sterile wound care, the charge nurse can assess her competence, confidence, and compliance with standards of practice.
C) This action is not the best because it is disrespectful and discouraging to the PN. The charge nurse should not dismiss or undermine the PN's past experience, which may have contributed to her wound care skills. The charge nurse should acknowledge and appreciate the PN's expertise, but also verify her skill level through direct
observation.
D) This action is not the best because it exposes the client to potential harm and liability. The charge nurse should not delegate a task that requires assessment and evaluation to a PN without first confirming her skill level and competency. The charge nurse should also not ask the PN to perform a task while she is busy with other duties, as this may compromise the quality and safety of care.
Correct Answer is B
Explanation
Choice A Reason: This is not the first priority because it is not a life-threatening condition. The male adolescent may have gastroenteritis or food poisoning, which can cause dehydration and electrolyte imbalance. The nurse should monitor his vital signs and fluid intake, but he can wait for further assessment.
Choice B Reason: This is the first priority because it is a potential surgical emergency. The female client may have appendicitis, which can cause peritonitis and sepsis if left untreated. The nurse should assess her pain level, vital signs, and abdominal signs, and prepare her for diagnostic tests and possible surgery.
Choice C Reason: This is not the first priority because it is a chronic condition that does not require immediate intervention. The elderly client may have intermittent claudication, which is a symptom of peripheral arterial disease. The nurse should educate him on leg care and exercise, but he can wait for further assessment.
Choice D Reason: This is not the first priority because it is a common condition that can be treated with antibiotics. The child may have a bacterial infection, such as bronchitis or pneumonia, which can cause productive cough and fever. The nurse should auscultate his lungs and check his temperature, but he can wait for further assessment.
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