The nurse is working with a case manager for a client who participates in a health maintenance organization.
The nurse should identify which of the following payment structures?
The provider is paid a fixed sum for the client on a monthly or yearly basis.
The client is participating in a fee-for-service healthcare insurance program. 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.
None of the above (This option is necessary because there are only three options provided in the original question).
The Correct Answer is A
The provider is paid a fixed sum for the client on a monthly or yearly basis. This payment structure is known as capitation. In a health maintenance organization (HMO), the provider is paid a fixed amount per enrolled member per month or year, regardless of the services provided.
Choice B is not the answer because it describes a fee-for-service healthcare insurance program, which is different from an HMO.
Choice C is not the answer because it describes a co-insurance payment structure, which is also different from an HMO.
Choice D is not the answer because it states that none of the above choices are correct.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
During the response phase of a disaster, community health nurses play an integral role in meeting the national preparedness goal. They assist in mobilizing necessary resources and support the coordination of care, giving special attention to vulnerable groups12. Establishing a location to perform client triage is an important part of this process.
Choice B is not correct because developing an evacuation plan for the community is part of the preparedness phase, not the response phase.
Choice C is not correct because creating a checklist of needed supplies for each type of disaster is also part of the preparedness phase.
Choice D is not correct because conducting community disaster drills is also part of the preparedness phase.
Correct Answer is B
Explanation
This statement indicates that the client is using rationalization as a coping mechanism by justifying their obesity with a seemingly logical reason 1.
Choice A, “I have difficulty resisting the items in vending machines,” does not indicate rationalization as it is a statement of fact.
Choice C, “I know you don’t like me because I am obese,” indicates the use of projection as a coping mechanism by attributing their own feelings to someone else.
Choice D, “I have lots of health problems from being obese,” does not indicate rationalization as it is a statement of fact.
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