[community Public Health] Chapter 3: The United State Health care System
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What is the main difference in the health care system in the United States between President Clintons vision in 1994 and today reality?
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Funding is totally centralized or decentralized.
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Oversight is a public or private responsibility.
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Health care team leadership is shared.
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Pharmaceuticals are purchased through a payer system.
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Explore the evolution and characteristics of the US Health Care System, focusing on key differences from past visions to current realities. Understand the dual system of private and public healthcare and assess its impact on community health.
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- 2.
A community/public health nurse is describing the American health care system to a group of immigrants. How would the nurse best describe this system?
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As a static, complex entity that the nurse must seek to understand
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As clearly the best in the world and envied by other countries
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As extremely effective, especially in high-technology care
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As being in the midst of ongoing change that offers real opportunities
Correct Answer
A. As being in the midst of ongoing change that offers real opportunitiesExplanation
The nurse would best describe the American health care system as being in the midst of ongoing change that offers real opportunities. This suggests that the system is dynamic and evolving, presenting possibilities for improvement and advancement.Rate this question:
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- 3.
A community/public health nursing faculty member discusses with students the significant changes in the U.S. health care system. Why is this information important to discuss with this population?
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Helps orient students to their options for health insurance
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Helps students understand health behaviors
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Helps students determine where they wish to seek employment
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Helps meet accreditation requirements for the curriculum
Correct Answer
A. Helps students understand health behaviorsExplanation
Understanding health behaviors is important for students in order to provide effective community/public health nursing care. By discussing the significant changes in the U.S. health care system, students can gain insight into how these changes impact health behaviors and the overall health of individuals and communities. This knowledge can help students develop strategies to promote healthy behaviors and prevent illness and disease. Additionally, understanding health behaviors is essential for students to effectively communicate and educate individuals and communities about health promotion and disease prevention.Rate this question:
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- 4.
A public health nurse is examining the effectiveness of a health care system. Which of the following data would be the most appropriate for the nurse to use?
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The number of resources expended by the system
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The health of the population served
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The number of noncitizens who seek health care in the system
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The typical cost of routine primary care
Correct Answer
A. The health of the population servedExplanation
The most appropriate data for the nurse to use in examining the effectiveness of a health care system would be the health of the population served. This data would provide insight into the overall impact and outcomes of the system on the health of the individuals it serves. By assessing the health of the population, the nurse can determine if the system is effectively meeting the needs of the community and achieving positive health outcomes.Rate this question:
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- 5.
Which of the following best describes the U.S. health care system?
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It is a mixture of social welfare and comprehensive care.
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It is decentralized and expensive.
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It is highly centralized and autocratic.
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It assures basic minimal care to everyone.
Correct Answer
A. It is decentralized and expensive.Explanation
The correct answer is "It is decentralized and expensive." This means that the U.S. health care system is not centrally controlled and instead operates through a variety of private and public entities. It also implies that health care in the U.S. is costly, often leading to financial burdens for individuals and families.Rate this question:
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- 6.
What are the two systems of health care that exist in the United States?
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Federal system for military personnel and community system for others
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Home-based care for wealthy and nursing home care for poor
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Hospitals for acute care and outpatient clinics for chronic care
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Private system for those who can pay and public system for some of the poor
Correct Answer
A. Private system for those who can pay and public system for some of the poorExplanation
The correct answer is private system for those who can pay and public system for some of the poor. This answer accurately describes the two systems of healthcare that exist in the United States. The private system refers to healthcare services that are provided by private insurance companies and healthcare providers, which individuals can access if they can afford to pay for it. The public system, on the other hand, refers to government-funded healthcare programs such as Medicaid and Medicare, which provide healthcare coverage for low-income individuals and certain vulnerable populations.Rate this question:
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- 7.
In comparison with other similar industrialized countries, the U.S. health care system results in
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Outcomes very similar to outcomes in other industrialized countries.
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Superb outcomes, perhaps because of the advanced research and technology.
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The highest life expectancy and lowest infant mortality.
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The lowest life expectancy and highest infant mortality.
Correct Answer
A. The lowest life expectancy and highest infant mortality.Explanation
The correct answer is "The lowest life expectancy and highest infant mortality." This answer suggests that the U.S. health care system performs poorly in terms of life expectancy and infant mortality compared to other similar industrialized countries. This could be due to various factors such as disparities in access to healthcare, high healthcare costs, and inadequate preventive care measures.Rate this question:
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- 8.
A community health nurse is caring for a client who is not a veteran and has no funds for health care. Where would this client go to receive care?
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Local hospital
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Privately owned, for-profit hospital
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Proprietary hospital
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Publicly owned hospital
Correct Answer
A. Local hospitalExplanation
The client would go to a local hospital to receive care. Local hospitals typically provide care to all individuals regardless of their veteran status or ability to pay. These hospitals are funded by the local community and often have programs in place to assist individuals who cannot afford healthcare.Rate this question:
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- 9.
The federal government obtains its authority to be involved in health care from the
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Legislation that was passed giving the federal government that privilege.
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Regulation of interstate commerce and its responsibility to provide for the general welfare.
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Constitution, specifically allocating authority for health care to the federal government.
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States requesting the federal government, because of its taxing ability, to accept that responsibility.
Correct Answer
A. Regulation of interstate commerce and its responsibility to provide for the general welfare.Explanation
The federal government obtains its authority to be involved in health care from the regulation of interstate commerce and its responsibility to provide for the general welfare. This means that the federal government can regulate health care activities that cross state lines and can also provide for the well-being and welfare of its citizens by ensuring access to healthcare services. This authority is derived from the Constitution, which allocates authority for health care to the federal government.Rate this question:
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- 10.
Which federal agency is most involved in both direct and indirect health-related responsibilities?
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U.S. Department of Health and Human Services
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National Health Care Service Agency
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Public Health Service
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Veterans Administration Medical Services Branch
Correct Answer
A. U.S. Department of Health and Human ServicesExplanation
The U.S. Department of Health and Human Services is the correct answer because it is the federal agency that is most involved in both direct and indirect health-related responsibilities. This department is responsible for protecting the health of all Americans and providing essential human services. It oversees various agencies and programs, including the Centers for Disease Control and Prevention, the Food and Drug Administration, and the National Institutes of Health. Through its direct involvement in healthcare delivery and its indirect responsibilities in policymaking and regulation, the Department plays a crucial role in promoting and maintaining public health in the United States.Rate this question:
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- 11.
From where does the state obtain its authority to be involved in health care?
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Delegation from the federal level to the states
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Local governments requesting the state government accept that responsibility
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The Constitution, which reserved for states all powers not specifically given to the federal government
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The demand from citizens that a more regionalized authority be responsible
Correct Answer
A. The Constitution, which reserved for states all powers not specifically given to the federal governmentExplanation
The correct answer is The Constitution, which reserved for states all powers not specifically given to the federal government. The Constitution grants certain powers to the federal government, but any powers not explicitly given to the federal government are reserved for the states. This principle is known as federalism, and it allows states to have authority in various areas, including health care.Rate this question:
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- 12.
A community/public health nurse is speaking with a group of elderly citizens about how the state health agency operates as part of the state government. Which of the following information would likely be included?
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Every state health agency has a similar organizational structure and offers similar services to its citizens.
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Each state health agency has many different departments, commissions, agencies, and boards.
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Each state health agency depends primarily on federal funding and guidance in meeting health concerns.
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Every state health agency delegates authority or funds to local boards of health.
Correct Answer
A. Each state health agency has many different departments, commissions, agencies, and boards.Explanation
This option is the most likely to be included because it provides information about the organizational structure of state health agencies, indicating that they have multiple departments, commissions, agencies, and boards. This suggests that state health agencies are complex and have various components that work together to provide services to citizens.Rate this question:
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- 13.
A community member asks a community/public health nurse, How much progress has been made toward consolidating state health services into a single agency? Which of the following statements would be accurate for the nurse to make?
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Incredible progress; about half the states have done so.
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Little progress; no state has completely done so.
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Some progress; about one third of the states have done so.
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Successful progress; most states have done so.
Correct Answer
A. Little progress; no state has completely done so.Explanation
The accurate statement for the nurse to make is "Little progress; no state has completely done so." This means that there has been minimal progress in consolidating state health services into a single agency, and no state has fully achieved this goal.Rate this question:
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- 14.
A recently hired community/public health nurse is learning about the responsibilities of the local health department during orientation. Which of the following responsibilities would be discussed?
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Meeting the demands of the local citizens
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Implementing programs as directed by the state health commissioner
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Addressing needs that have been delegated by state health agencies
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Assuring that services are provided to meet the needs of vulnerable populations
Correct Answer
A. Addressing needs that have been delegated by state health agenciesExplanation
The responsibilities of the local health department would include addressing needs that have been delegated by state health agencies. This means that the local health department would be responsible for carrying out specific tasks and initiatives that have been assigned to them by the state health agencies. This could include implementing programs, providing services, and meeting the needs of vulnerable populations based on the directives and priorities set by the state health agencies.Rate this question:
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- 15.
Which of the following is considered to be a responsibility of an insurance company?
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Establishing guidelines for employees in hospitals
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Establishing the rules of medical practice
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Managing third-party reimbursement
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Purchasing and managing hospitals and extended care facilities
Correct Answer
A. Managing third-party reimbursementExplanation
Managing third-party reimbursement is considered to be a responsibility of an insurance company. This involves handling the process of reimbursing healthcare providers for services rendered to policyholders. Insurance companies negotiate contracts with healthcare providers, determine the reimbursement rates, and process and approve claims for payment. They are responsible for ensuring that the claims are accurate, appropriate, and compliant with the terms of the insurance policy. By managing third-party reimbursement, insurance companies play a crucial role in facilitating the financial transactions between healthcare providers and policyholders.Rate this question:
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- 16.
A community/public health nurse is caring for a client who has a health insurance plan which offers a looser organizational structure and has no requirement for primary care physician approval before seeing a specialist. Which type of health insurance does this client most likely have?
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Health care network
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Health maintenance organization
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Point of service plan
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Preferred provider organization
Correct Answer
A. Preferred provider organizationExplanation
This client most likely has a preferred provider organization (PPO) health insurance plan. PPO plans typically have a looser organizational structure and do not require primary care physician approval before seeing a specialist. In a PPO plan, clients have the flexibility to see any healthcare provider they choose, although they may receive greater benefits if they use providers within the plan's network.Rate this question:
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- 17.
A client has been informed that his health care plan will be changing to a managed care model. How would the nurse best explain the goal of this model?
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Managed care decreases consumer use of outpatient health care.
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Managed care ensures maximum value received from resources used.
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Managed care decreases patient satisfaction.
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Managed care ensures provider satisfaction.
Correct Answer
A. Managed care ensures maximum value received from resources used.Explanation
Managed care is a model that aims to ensure maximum value received from the resources used in healthcare. This means that the goal of managed care is to optimize the use of resources, such as medical treatments and services, to provide the best possible outcomes for patients while minimizing unnecessary costs. By implementing managed care, healthcare providers can prioritize cost-effective and evidence-based practices, ultimately improving the overall quality and efficiency of healthcare delivery.Rate this question:
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- 18.
A client has recently changed health insurance plans and is now part of a health maintenance organization (HMO). How might the nurse best explain how HMOs operate?
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HMOs provide creative ways to ensure hospitals can decrease their daily census.
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HMOs employ a group of nurses who focus on health education programs.
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HMOs encourage physicians to focus on health promotion and self-care.
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HMOs organize a network of providers who offer services for a predetermined fee
Correct Answer
A. HMOs organize a network of providers who offer services for a predetermined feeExplanation
HMOs operate by organizing a network of healthcare providers who offer services for a predetermined fee. This means that the client will have access to a specific group of healthcare providers who have agreed to provide services within the HMO network. The client will typically pay a fixed fee, such as a monthly premium, in exchange for this access. This arrangement helps to control costs and ensure that the client receives care within the designated network of providers.Rate this question:
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- 19.
A client has a point-of-service health care plan. Why would the community/public health nurse need to consult this clients physician?
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The physician is the budget officer, who makes decisions about the cost of care.
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The physician is a collaborator, who is the leader of the health care team.
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The physician is the expert medical diagnostician, who decides on interventions.
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The physician is the primary care gatekeeper, who determines appropriate referrals.
Correct Answer
A. The physician is the primary care gatekeeper, who determines appropriate referrals.Explanation
The community/public health nurse would need to consult this client's physician because the physician is the primary care gatekeeper who determines appropriate referrals. This means that the physician has the authority to decide whether the client needs to be referred to other healthcare professionals or specialists for further evaluation or treatment. The nurse may need to consult the physician to discuss the client's health condition and determine if any referrals are necessary for the client's comprehensive care.Rate this question:
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- 20.
A nurse is employed by the American Heart Association. What feature of this type of organization is unique?
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Assisting with access to health care services
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Promoting the use of inexpensive health care providers
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Using creative approaches to solve health problems
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Providing professional education to health care providers
Correct Answer
A. Using creative approaches to solve health problemsExplanation
The unique feature of the American Heart Association is using creative approaches to solve health problems. This sets them apart from other organizations as they focus on finding innovative solutions to address health issues. They may utilize unconventional methods, technologies, or strategies to tackle these problems in a more effective and efficient manner. This approach allows them to constantly adapt and improve their efforts in promoting heart health and preventing cardiovascular diseases.Rate this question:
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- 21.
How do nurses differ from most other professional health care providers?
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Nurses are committed to caring for others.
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Nurses are heavily involved in ongoing research programs.
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Nurses are primarily employees of an organization.
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Nurses do not expect a fair salary because nurses are primarily women.
Correct Answer
A. Nurses are primarily employees of an organization.Explanation
Nurses differ from most other professional health care providers because they are primarily employees of an organization. This means that they work within a specific healthcare facility, such as a hospital or clinic, and are employed by that organization. Other healthcare providers, such as doctors or therapists, may have their own private practices or work independently. Being employees of an organization can impact the way nurses provide care and the structure of their work environment.Rate this question:
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- 22.
What was the primary reason public health lost power and influence in the 1960s?
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Continued to emphasize prevention rather than hospital care
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Forgot voters would rather pay for care from a private physician
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Had significantly reduced many life-threatening health problems
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Lobbyists were unable to influence legislators
Correct Answer
A. Had significantly reduced many life-threatening health problemsExplanation
In the 1960s, public health lost power and influence primarily because it had already made significant progress in reducing many life-threatening health problems. As a result, the urgency and perceived importance of public health initiatives decreased, leading to a decline in its power and influence.Rate this question:
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- 23.
Before 1965 most consumers and health care providers were not concerned about health care costs because
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Insurance companies were not worried about making a profit.
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Many employees had such low co-pays and deductibles.
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Expenses were paid by insurance reimbursement for employees who received insurance as a fringe benefit.
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Physicians were receiving adequate reimbursements in a timely manner when they submitted claims correctly.
Correct Answer
A. Expenses were paid by insurance reimbursement for employees who received insurance as a fringe benefit.Explanation
Before 1965, most consumers and healthcare providers were not concerned about healthcare costs because expenses were paid by insurance reimbursement for employees who received insurance as a fringe benefit. This means that individuals did not have to directly bear the cost of healthcare services as it was covered by their insurance plans. Therefore, there was less incentive for consumers and healthcare providers to be concerned about the costs involved.Rate this question:
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- 24.
What was the most costly category of health care in the 1960s, which drastically increased after Medicare and Medicaid began?
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Drugs and medical supplies
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Hospital care
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Physician services
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Public health
Correct Answer
A. Hospital careExplanation
After the introduction of Medicare and Medicaid in the 1960s, the most costly category of health care was hospital care. This can be attributed to the fact that these government programs provided coverage for hospital stays and medical procedures, leading to an increase in the utilization of hospital services. As a result, the demand for hospital care rose significantly, leading to higher costs in this category of health care.Rate this question:
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- 25.
A community/public health nurse working in the 1990s wanted to improve the health of the community. According to economists, sociologists, and political activists, what was the best method to improve poor health?
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Decrease poverty levels.
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Increase funding to health care on the state level.
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Increase the number of outpatient clinics for site-focused care.
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Decrease the number of specialty physicians.
Correct Answer
A. Decrease poverty levels.Explanation
Decreasing poverty levels is considered the best method to improve poor health according to economists, sociologists, and political activists. Poverty is often associated with limited access to healthcare, unhealthy living conditions, and inadequate nutrition, all of which contribute to poor health outcomes. By addressing poverty and improving socioeconomic conditions, it is believed that overall health in the community can be improved. Increasing funding to health care, increasing the number of outpatient clinics, or decreasing the number of specialty physicians may have some impact on health, but addressing poverty is seen as a more effective and comprehensive approach.Rate this question:
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- 26.
A community/public health nurse educated a community group about the development of the national goals. Which of the following information would the nurse have included in this presentation?
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Action plans are focused on changing lifestyles to reduce risks and prevent problems.
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The goals emphasize improvement of health education in elementary and high schools.
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The goals emphasize increasing the number of students in the health care professions.
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Action plans are focused on aligning salaries for professionals among the health care disciplines.
Correct Answer
A. Action plans are focused on changing lifestyles to reduce risks and prevent problems.Explanation
The nurse would have included information about action plans being focused on changing lifestyles to reduce risks and prevent problems in the presentation. This is because action plans are an important component of achieving national health goals, and they typically involve interventions and strategies aimed at promoting healthy behaviors and reducing the prevalence of risk factors for various health problems. By emphasizing the importance of lifestyle changes, the nurse would have highlighted the role of individual behavior in improving health outcomes and preventing diseases.Rate this question:
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- 27.
What was one consequence of the Omnibus Budget Reconciliation Act of 1981?
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There was a demand for local governments to give more free care.
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There was a rise in the number of uninsured Americans.
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An incredible increase in taxes occurred on different products and services.
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Emergency department services expanded as people postponed seeing physicians.
Correct Answer
A. There was a rise in the number of uninsured Americans.Explanation
The Omnibus Budget Reconciliation Act of 1981 had the consequence of causing a rise in the number of uninsured Americans. This act made significant cuts to federal funding for Medicaid, which resulted in reduced access to healthcare for low-income individuals and families. As a result, many Americans who were previously covered by Medicaid became uninsured, leading to an increase in the overall number of uninsured individuals in the country.Rate this question:
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- 28.
A conflict exists between an insurance company and a physician. Which of the following is most likely the root cause of this conflict?
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Contribution of the client
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Distribution of power
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Compensation of the provider
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Regulation of finances
Correct Answer
A. Distribution of powerExplanation
The most likely root cause of the conflict between an insurance company and a physician is the distribution of power. This suggests that there is a disagreement or imbalance in the authority and control within the relationship between the two parties. It could be that the insurance company is exerting too much control over the physician's decisions or that there is a dispute over the allocation of power and decision-making responsibilities. This conflict may arise from differing perspectives on how power should be distributed and exercised in the context of their professional relationship.Rate this question:
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- 29.
A nurse is providing care for a client in a hospital. In which of the following situations would the hospital no longer receive Medicare reimbursement?
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Consulting with a physician if an advanced practice nurse is available
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Providing inpatient care if procedures could be done on an outpatient basis
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Prescribing trade name drugs when generic alternatives are available
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Treating a urinary tract infection that occurred during hospitalization
Correct Answer
A. Treating a urinary tract infection that occurred during hospitalizationExplanation
If a hospital is treating a urinary tract infection that occurred during hospitalization, it may no longer receive Medicare reimbursement. This is because Medicare reimbursement is typically provided for the treatment of conditions that were present upon admission to the hospital, rather than conditions that develop during the hospital stay. Therefore, treating a urinary tract infection that occurred during hospitalization would not be eligible for Medicare reimbursement.Rate this question:
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- 30.
A nurse has referred a client to the managed care service provided by the hospital. What is the purpose of this referral?
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To confirm that care options chosen are the least expensive possible
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To coordinate the care provided by professional specialists
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To keep the focus on the individual patients unique needs
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To review care to eliminate unnecessary services
Correct Answer
A. To review care to eliminate unnecessary servicesExplanation
The purpose of referring a client to the managed care service provided by the hospital is to review the care being provided and eliminate any unnecessary services. This ensures that the client is receiving the most appropriate and cost-effective care, while also avoiding any unnecessary medical interventions or treatments. By reviewing the care plan, the managed care service can identify any services that may not be beneficial or essential to the client's needs, thereby optimizing the care provided.Rate this question:
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- 31.
A community/public health nurse discusses the current health care system with a class of finance students. A student asks why the U.S. government has not moved to a single-payer system. Which of the following statements would be an appropriate response by the nurse?
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Drug companies report that they would go bankrupt if such a plan were implemented.
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It has been demonstrated that administrative costs would greatly increase.
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It would be difficult to implement and more expensive than our current approach.
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The political influence held by those with a strong interest in maintaining the current system has prevented this change.
Correct Answer
A. The political influence held by those with a strong interest in maintaining the current system has prevented this change.Explanation
The nurse would respond that the political influence held by those with a strong interest in maintaining the current system has prevented the change to a single-payer system. This implies that there are powerful individuals or groups who benefit from the current system and have the ability to prevent any major changes from occurring.Rate this question:
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Jul 17, 2023Quiz Edited by
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May 05, 2020Quiz Created by
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