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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A Reason: Contacting the healthcare provider is not the priority action because restraints should only be used as a last resort and not for staff convenience. The nurse manager should first ensure that the client's safety and dignity are respected.
Choice B Reason: This is the correct answer because restraints are not indicated for this situation and violate the client's rights. The nurse manager should educate the staff nurse about the ethical and legal implications of using restraints without proper justification and documentation.
Choice C Reason: Closing the door to the room is not a priority action because it does not address the issue of restraints. It also may isolate the client and increase her anxiety and distress.
Choice D Reason: Determining if the client has a PRN prescription for an antianxiety agent is not a priority action because it does not address the issue of restraints. It also may not be appropriate to medicate the client without assessing her condition and obtaining her consent.
Correct Answer is C
Explanation
Choice A Reason: Recording the patient's pulse volume distal to the IV site is a nursing assessment that requires clinical judgment and cannot be delegated to the UAP.
Choice B Reason: Reapplying cold compresses to the site of the extravasation is a nursing intervention that requires clinical judgment and cannot be delegated to the UAP.
Choice C Reason: Disposing of the IV tubing after the infusion is discontinued is a routine task that does not require clinical judgment and can be delegated to the UAP.
Choice D Reason: Teaching the patient about the need to keep the extremity elevated is a nursing intervention that requires clinical judgment and cannot be delegated to the UAP.
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