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 C
Explanation
- A. Use of educational materials in written and video format. This is generally a positive approach, as it caters to different learning styles. Therefore, it's not a barrier.
- B. Reliance on written notes during the teaching session. While notes can be helpful, excessive reliance on them might indicate a lack of confidence or familiarity with the material. This could hinder effective communication and engagement with the family, thus, it is a barrier.
- C. Use of humor to deal with disruptive behavior. Using humor inappropriately, especially in a sensitive situation like teaching about HIV infection control, can be perceived as unprofessional and disrespectful. It can also minimize the seriousness of the topic and create a barrier to learning.
- D. Previous experience teaching, i.e. a teens' course. While experience is generally beneficial, it could be a barrier if the nurse assumes the family's learning needs are the same as teenagers. Furthermore, if the nurse does not adapt their teaching style, and materials to the new audience, it will be a barrier.
Correct Answer is D
Explanation
Spiritual care is an important aspect of care for patients with end-stage breast cancer. It can help improve their wellbeing and quality of life 1. Providing quiet time during visits for prayer or meditation can help meet the spiritual needs of the patient.
Choice Ais not correct because placing the client’s name and medical condition on an online prayer chain may violate their privacy.
Choice B is not correct because it is not within the scope of a faith community nurse to recommend hospice services over treatment.
Choice Cis not correct because avoiding the client’s health status may not address their emotional and spiritual needs.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.