[community Public Health] Chapter 4: Financing For Health care: Context For Community/Public Health Nursing
![[community Public Health] Chapter 4: Financing For Health care: Context For Community/Public Health Nursing - Quiz](https://media.proprofs.com/images/QM/user_images/1826446/New%20Project%20(18)(29).webp "[community Public Health] Chapter 4: Financing For Health care: Context For Community/Public Health Nursing - Quiz")
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- 1.
What approach have nurses historically used when providing care and paying attention to costs?
- A.
Giving the best possible nursing care regardless of ability to pay
- B.
Giving whatever care the nurse has the expertise to give
- C.
Giving whatever care the patient could afford
- D.
Giving whatever care the patient desired and for which he or she was willing to pay
Correct Answer
A. Giving the best possible nursing care regardless of ability to payExplanation
Nurses historically have used the approach of giving the best possible nursing care regardless of a patient's ability to pay. This means that nurses prioritize providing high-quality care to all patients, regardless of their financial situation. The focus is on delivering optimal care and meeting the healthcare needs of patients, rather than being influenced by their ability to afford the services. This approach ensures that patients receive the necessary care and support, promoting equitable access to healthcare services.Rate this question:
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- 2.
Which of the following is true about access to care?
- A.
Care providers have always donated necessary services to make sure everyone received care.
- B.
Health care is rationed by the ability to pay.
- C.
Poverty-stricken patients received care from medical and nursing school students in teaching hospitals.
- D.
Universal access has always been a component of health care in America.
Correct Answer
B. Health care is rationed by the ability to pay.Explanation
Health care being rationed by the ability to pay means that access to care is limited to those who can afford it. This implies that individuals with lower income or those who are unable to pay for healthcare services may face difficulties in accessing the care they need. This statement suggests that the affordability of healthcare plays a significant role in determining who can receive necessary medical treatment and services.Rate this question:
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- 3.
A nurse educator teaches community/public health nursing students about how health care is financed in the United States. Why is it important that nursing students receive this information?
- A.
Nurses are expected to help patients find funding sources to pay for their care.
- B.
Nurses have to restrict their care to services that are financially reimbursed.
- C.
Health care organizations must charge patients for all supplies consumed while care is given.
- D.
 Health care organizations must notify patients of the exact cost of the nursing services rendered.
Correct Answer
B. Nurses have to restrict their care to services that are financially reimbursed.Explanation
It is important for nursing students to receive information on how healthcare is financed in the United States because nurses are expected to restrict their care to services that are financially reimbursed. This means that nurses need to be aware of the funding sources available to patients in order to provide appropriate care within the constraints of the healthcare system. Understanding healthcare financing allows nurses to navigate the complexities of insurance coverage and reimbursement, ensuring that patients receive the necessary care while also considering the financial aspects of healthcare delivery.Rate this question:
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- 4.
A nurse has chosen to provide home care services to a needy client even though there is no source of reimbursement for this care. What problem may result?
- A.
The nurse will be expected to provide this care to other clients.
- B.
The nurse may not be covered in case of a malpractice claim.
- C.
The agencies clients will start demanding that the staff provide free care.
- D.
The agencies clients will be at risk for being billed for the services provided.
Correct Answer
B. The nurse may not be covered in case of a malpractice claim.Explanation
If the nurse chooses to provide home care services to a needy client without a source of reimbursement, it means that there is no legal agreement or contract in place. Therefore, if any malpractice claim arises during the course of providing care, the nurse may not be covered by any insurance or liability protection. This could potentially expose the nurse to financial and legal consequences if a malpractice claim is filed against them.Rate this question:
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- 5.
A community/public health nurse is providing home care services to an elderly couple. They report that they believe they are spending more and more money on health care services and have limited funds available to meet their everyday living expenses. Which of the following offers the best explanation for their situation?
- A.
The proportion of the gross domestic product devoted to health care is increasing.
- B.
The health care costs are increasing for the elderly population.
- C.
The cost of living is increasing because of recent rapid inflation.
- D.
The cost of health care is increasing because more people are insured.
Correct Answer
A. The proportion of the gross domestic product devoted to health care is increasing.Explanation
The best explanation for the elderly couple's situation is that the proportion of the gross domestic product devoted to health care is increasing. This means that a larger portion of the overall economy is being spent on health care services, which could result in higher costs for individuals. As a result, the couple may be experiencing increased expenses for health care services and limited funds available for their everyday living expenses. This explanation aligns with the information provided and offers a plausible reason for their financial situation.Rate this question:
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- 6.
Which of the following was true concerning the amounts paid by private funds and governmental funds in 2009?
- A.
Government spent 49%, and private funding accounted for 51%.
- B.
Government spent 75%, whereas private funding accounted for 25%.
- C.
Government spent 40%, whereas private funding accounted for 60%.
- D.
It is unknown what proportion of funds was governmental and what proportion was private.
Correct Answer
A. Government spent 49%, and private funding accounted for 51%.Explanation
In 2009, the government spent 49% of the funds, while private funding accounted for 51%. This means that the majority of the funds came from private sources rather than the government.Rate this question:
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- 7.
A community/public health nurse is examining how health care dollars are distributed in the United States. Which of the following information would the nurse find in the literature?
- A.
The majority of health care dollars are spent on health promotion activities.
- B.
The percentage of health care dollars spent on public health activities is increasing.
- C.
The percentage of health care dollars spent on health care advances is increasing.
- D.
The majority of health care dollars are spent on personal health care services.
Correct Answer
D. The majority of health care dollars are spent on personal health care services.Explanation
The nurse would find in the literature that the majority of health care dollars are spent on personal health care services. This means that the majority of the budget is allocated towards individual medical treatments and services, rather than health promotion activities, public health activities, or health care advances.Rate this question:
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- 8.
Which component of government is primarily responsible for health research spending?
- A.
The federal government, through the Centers for Disease Control and Prevention
- B.
The federal government, through the National Institutes of Health
- C.
State governments, through grants to state universities and research centers
- D.
State governments, through local public health departments in cooperation with local researchers
Correct Answer
B. The federal government, through the National Institutes of HealthExplanation
The National Institutes of Health (NIH) is a component of the federal government that is primarily responsible for health research spending. The NIH is one of the world's foremost medical research centers, and it is made up of 27 institutes and centers that conduct and support biomedical research. It provides grants and funding to universities, research centers, and individual researchers to advance scientific knowledge and improve public health. The CDC, although also a federal government agency, primarily focuses on disease prevention and control rather than research funding. State governments may provide some funding for health research, but the primary responsibility lies with the federal government through the NIH.Rate this question:
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- 9.
A community/public health nurse is working with vulnerable populations in the community. Which population would be most likely to not have health insurance?
- A.
Elderly persons who do not qualify for Social Security
- B.
Homeless persons who lack a permanent address
- C.
Working poor persons whose jobs lack health insurance as a benefit
- D.
Young families who have not yet saved enough to qualify
Correct Answer
C. Working poor persons whose jobs lack health insurance as a benefitExplanation
Working poor persons whose jobs lack health insurance as a benefit would be the most likely population to not have health insurance. This is because they are employed but their jobs do not provide health insurance as a benefit, making it difficult for them to afford coverage on their own. Elderly persons who do not qualify for Social Security, homeless persons who lack a permanent address, and young families who have not yet saved enough to qualify may also face challenges in obtaining health insurance, but the working poor population without job-related coverage is particularly vulnerable.Rate this question:
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- 10.
Self-payment of health care costs are
- A.
Almost never done because that is the purpose of health insurance.
- B.
Frequently done because many employers do not offer a health insurance benefit.
- C.
Frequently done by paying for ones own insurance to ensure coverage.
- D.
Usually done by paying co-payments and deductibles required by insurance.
Correct Answer
D. Usually done by paying co-payments and deductibles required by insurance.Explanation
The correct answer is usually done by paying co-payments and deductibles required by insurance. This is because even with health insurance, individuals are often responsible for paying certain out-of-pocket costs, such as co-payments and deductibles. These costs help to share the financial burden between the individual and the insurance provider. While self-payment of healthcare costs can be done in certain situations, it is more common for individuals to contribute to their healthcare expenses through co-payments and deductibles when using insurance.Rate this question:
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- 11.
A community/public health nurse is visiting a nuclear family. Both of the parents are employed full-time, have a moderate income, and have health insurance. Which of the following is the most likely source of their health insurance?
- A.
Employer-paid insurance
- B.
Federal government subsidized health insurance
- C.
Medicare/Medicaid program
- D.
Private-paid insurance
Correct Answer
A. Employer-paid insuranceExplanation
The most likely source of their health insurance is employer-paid insurance. This is because both parents are employed full-time, indicating that they likely receive health insurance benefits through their employer. Additionally, the fact that they have a moderate income suggests that they may not qualify for government subsidized health insurance or Medicare/Medicaid programs. Private-paid insurance is also a possibility, but employer-paid insurance is generally more common for individuals who have access to it through their employment.Rate this question:
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- 12.
A companies chief executive officer (CEO) discusses potential ways to control employee health care costs with the organizations occupational health nurse. Which of the following recommendations would the nurse be most likely to suggest?
- A.
Suggest employees exercise and stop smoking to retain their employment.
- B.
Encourage the use of generic prescriptions and outpatient services.
- C.
Consider layoffs to decrease the number of employees who receive insurance.
- D.
Reward employees who have limited health care expenses.
Correct Answer
B. Encourage the use of generic prescriptions and outpatient services.Explanation
The nurse would most likely suggest encouraging the use of generic prescriptions and outpatient services as a way to control employee healthcare costs. This recommendation can help reduce the expenses associated with medications and hospital visits, which are often more expensive than generic prescriptions and outpatient services. By promoting the use of these cost-effective options, the company can lower healthcare costs without negatively impacting employee health or job security.Rate this question:
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- 13.
A community/public health nurse is discussing insurance options with a healthy, young adult client who has recently lost her job. Why would the client most likely not be receptive to obtaining privately paid health insurance?
- A.
Health care services can be obtained at a local free clinic.
- B.
She prefers to spend her money on higher priority needs than insurance.
- C.
The monthly premiums are just too high to be affordable.
- D.
She has no need for insurance because she is young and healthy.
Correct Answer
C. The monthly premiums are just too high to be affordable.Explanation
The client would most likely not be receptive to obtaining privately paid health insurance because the monthly premiums are too expensive for her to afford. This implies that the client does not have the financial means to pay for the insurance, making it an impractical option for her.Rate this question:
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- 14.
Why was the Health Insurance Portability and Accountability Act (HIPAA) not successful at making insurance more available?
- A.
It provided for medical savings accounts, which were not what people wanted.
- B.
It focused primarily on protecting the confidentiality of patient records, not insurance.
- C.
It was repealed shortly after its passage.
- D.
It did not limit what companies could charge for the insurance.
Correct Answer
D. It did not limit what companies could charge for the insurance.Explanation
The Health Insurance Portability and Accountability Act (HIPAA) was not successful at making insurance more available because it did not limit what companies could charge for the insurance. Although HIPAA focused on protecting the confidentiality of patient records, it did not address the issue of insurance affordability. Without any limitations on insurance costs, companies were free to charge high premiums, making insurance less accessible for many individuals.Rate this question:
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- 15.
A community/public health nurse is working with a low-income family that has children and is uninsured. What recommendation made by the nurse would assist the children in obtaining health care?
- A.
Visit a free clinic at the health department.
- B.
Apply for Medicare.
- C.
Apply for the Children Health Insurance Program (CHIP).
- D.
Visit the local pediatricians office.
Correct Answer
C. Apply for the Children Health Insurance Program (CHIP).Explanation
The nurse's recommendation to apply for the Children Health Insurance Program (CHIP) would assist the children in obtaining health care. CHIP is a government-funded program that provides low-cost or free health insurance for children in low-income families. This program would ensure that the children have access to necessary medical services and treatments, despite being uninsured.Rate this question:
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- 16.
With regard to the effectiveness of the Medicare program, it can accurately be said that the program
- A.
Ensured that elderly persons received appropriate care.
- B.
Helped reduce health care costs.
- C.
Prevented elderly persons from suffering any major financial hardships.
- D.
Improved access to health care services for eligible persons.
Correct Answer
D. Improved access to health care services for eligible persons.Explanation
The correct answer is "Improved access to health care services for eligible persons." This is because the Medicare program was designed to provide health care coverage for elderly individuals and certain disabled individuals. By offering this coverage, Medicare has improved access to health care services for those who are eligible, ensuring that they can receive the medical care they need.Rate this question:
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- 17.
How are the funds obtained to pay for the Medicare program?
- A.
A Medicare tax paid by all employees who pay Social Security tax
- B.
A tax on wages paid by employer and employee
- C.
Money from the federal income tax paid by all citizens
- D.
Social security funds paid by employer and employee
Correct Answer
B. A tax on wages paid by employer and employeeExplanation
The funds to pay for the Medicare program are obtained through a tax on wages paid by both the employer and the employee. This means that a portion of the wages earned by employees is deducted and paid towards funding the Medicare program. The tax is levied on both the employer and the employee to ensure that the burden is shared between them. This tax revenue is then used to finance the Medicare program and provide healthcare benefits to eligible individuals.Rate this question:
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- 18.
Research has demonstrated that which of the following relationships is true with regard to paying for care?
- A.
The higher the co-payment, the less health care the person seeks.
- B.
The higher the co-payment, the more the patient thinks the care was worth the cost.
- C.
The lower the co-payment, the more compliant patients become with the suggested treatment.
- D.
The lower the co-payment, the more patients feel they can always get the care later.
Correct Answer
A. The higher the co-payment, the less health care the person seeks.Explanation
Research has shown that when the co-payment for care is higher, individuals tend to seek less health care. This is because higher co-payments act as a financial barrier, making individuals think twice before seeking care. They may avoid seeking care for minor ailments or delay necessary treatments due to the increased cost. Therefore, the higher the co-payment, the less likely individuals are to seek health care.Rate this question:
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- 19.
The primary criticism that may truthfully be made of the Medicare program is that it
- A.
Does not meet the most serious medical needs of the population it serves.
- B.
Has inadequate controls on the amounts paid to health care providers.
- C.
Has not sufficiently reduced taxpayer cost.
- D.
Lacks adequate funding, and Medicare taxes continue to increase.
Correct Answer
A. Does not meet the most serious medical needs of the population it serves.Explanation
The primary criticism of the Medicare program is that it does not meet the most serious medical needs of the population it serves. This means that the program may not adequately cover or provide necessary medical services for individuals with severe health conditions. This criticism suggests that there may be gaps or limitations in the coverage and services offered by Medicare, potentially leaving some individuals without the necessary care they require.Rate this question:
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- 20.
An elderly client reports that he has been told that he needs to spend down in order to be eligible for Medicaid. He is confused about what he needs to do in order to accomplish this task. Which of the following statements is the best response from the community/public health nurse?
- A.
You will have to spend your own money to pay for the Medicaid premiums.
- B.
You will have to spend your own funds until you are eligible for Medicare.
- C.
You will have to exhaust most of your assets before receiving benefits.
- D.
You will have to meet a certain deductible amount before receiving benefits.
Correct Answer
C. You will have to exhaust most of your assets before receiving benefits.Explanation
The best response from the community/public health nurse is that the elderly client will have to exhaust most of their assets before receiving benefits. This means that in order to be eligible for Medicaid, the client will need to spend down their assets until they meet the eligibility requirements. This could include spending their own funds on medical expenses or other eligible expenses until they reach the asset limit set by Medicaid. Once they have depleted most of their assets, they will then be able to receive benefits from Medicaid.Rate this question:
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- 21.
For which of the following clients will care not be reimbursed by Medicare?
- A.
A terminally ill client who is receiving hospice care
- B.
A client who is hospitalized for pneumonia
- C.
A client who requires intermittent skilled home health care
- D.
A client who needs long-term care in a nursing home
Correct Answer
D. A client who needs long-term care in a nursing homeExplanation
Medicare does not typically cover long-term care in a nursing home. Medicare primarily covers short-term stays in skilled nursing facilities for specific medical conditions, such as after a hospitalization. Long-term care in a nursing home is usually paid for by the individual or through Medicaid, a joint federal and state program for low-income individuals. Therefore, care for a client who needs long-term care in a nursing home would not be reimbursed by Medicare.Rate this question:
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- 22.
What is the main problem with Medicare Part D?
- A.
The plan allows elderly persons to purchase medications from certain mail-order companies.
- B.
The plan covers generic, not brand-name, drugs.
- C.
Medicare recipients are confused by what the plan will or will not cover.
- D.
There is a coverage gap in which recipients have to pay full cost of drugs.
Correct Answer
D. There is a coverage gap in which recipients have to pay full cost of drugs.Explanation
The main problem with Medicare Part D is that there is a coverage gap in which recipients have to pay the full cost of drugs. This means that after a certain amount of drug costs have been reached, the recipients are responsible for paying for their medications until they reach catastrophic coverage. This coverage gap, also known as the "donut hole," can be financially burdensome for elderly individuals who rely on Medicare for their prescription drug coverage.Rate this question:
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- 23.
What is notable about Medicare Advantage?
- A.
Because it is a new program, no one has yet seen any problems with this aspect of Medicare.
- B.
Insurance salespeople have been very careful in explaining this program to elderly persons.
- C.
More insurance companies are marketing such plans to elderly persons.
- D.
Unless the elderly person is very healthy, the plan may cost more than the original Medicare.
Correct Answer
D. Unless the elderly person is very healthy, the plan may cost more than the original Medicare.Explanation
The notable aspect about Medicare Advantage is that the plan may cost more than the original Medicare, unless the elderly person is very healthy. This suggests that there is a potential for increased expenses for individuals who choose Medicare Advantage, especially if they have health issues.Rate this question:
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- 24.
Of the following, persons, who is most likely to receive Medicaid benefits if the family income is below the poverty level?
- A.
A 16-year-old child
- B.
A pregnant woman with a 3-year-old child
- C.
A single-parent family
- D.
A two-parent family in which the father is unemployed
Correct Answer
B. A pregnant woman with a 3-year-old childExplanation
A pregnant woman with a 3-year-old child is most likely to receive Medicaid benefits if the family income is below the poverty level. Medicaid is a government program that provides health insurance for low-income individuals and families. Pregnant women and young children are considered a priority population for Medicaid coverage, as they have specific healthcare needs and require access to prenatal care and early childhood healthcare services. Therefore, the pregnant woman with a 3-year-old child is the most likely candidate to receive Medicaid benefits in this scenario.Rate this question:
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- 25.
Of the following persons, who is most likely not to receive benefits under Medicaid, regardless of financial status?
- A.
A 3-year-old child
- B.
A 21-year-old pregnant woman
- C.
A single-parent family
- D.
A two-parent family ANS: D
Correct Answer
D. A two-parent family ANS: DExplanation
A two-parent family is most likely not to receive benefits under Medicaid, regardless of financial status. Medicaid is a government program that provides healthcare coverage to low-income individuals and families. However, eligibility for Medicaid is based on income and other factors such as family size. A two-parent family is more likely to have a higher income compared to a single-parent family or a 21-year-old pregnant woman, which may disqualify them from receiving Medicaid benefits. Therefore, a two-parent family is the least likely to receive benefits under Medicaid.Rate this question:
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- 26.
Which of the following populations accounts for the majority of the cost in the Medicaid program?
- A.
Children younger than 5
- B.
Elderly persons
- C.
Low-income families
- D.
Single pregnant women
Correct Answer
B. Elderly personsExplanation
Elderly persons account for the majority of the cost in the Medicaid program. This is because the elderly often have more complex and expensive healthcare needs due to age-related conditions and chronic illnesses. They may require long-term care services, such as nursing home care or home health aides, which can be costly. Additionally, the elderly population is growing as the baby boomer generation ages, further contributing to the higher cost burden on the Medicaid program.Rate this question:
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- 27.
The major method used to reduce costs to third-party payers has been to
- A.
Change the eligibility requirements.
- B.
Convert reimbursement to a retrospective payment plan.
- C.
Require all clients to choose a managed care plan for reimbursement.
- D.
Set fee schedules to restrict increases in provider payment.
Correct Answer
A. Change the eligibility requirements.Explanation
Changing the eligibility requirements is the major method used to reduce costs to third-party payers. By altering the criteria for who is eligible for reimbursement, payers can limit the number of individuals who qualify for coverage, thus reducing their overall costs. This approach allows payers to control expenses by only covering those who meet the newly established requirements, potentially excluding some individuals who previously would have been eligible for reimbursement.Rate this question:
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- 28.
A community/public health nurses states that the United States has an integrated health care system. What is meant by this statement?
- A.
The larger for-profit managed care organizations are absorbing smaller organizations so that eventually only three to five large companies will exist.
- B.
Large organizations are trying to own or control a complete range of health care facilities to meet all health care needs of their enrolles.
- C.
Large managed care organizations are employing attorneys as employees to ensure that no malpractice suit against them can be successful.
- D.
Physicians are choosing to become employees to avoid paying for malpractice insurance and therefore are being absorbed into hospital systems.
Correct Answer
B. Large organizations are trying to own or control a complete range of health care facilities to meet all health care needs of their enrolles. -
- 29.
Which of the following statements most accurately summarizes the current view of health care in the United States?
- A.
The government should allow Americans to receive the health care they can afford.
- B.
The government should trust the free market system.
- C.
The government should assume responsibility for providing basic care to all.
- D.
The government should provide basic care to those who cannot care for themselves.
Correct Answer
D. The government should provide basic care to those who cannot care for themselves.Explanation
The answer "The government should provide basic care to those who cannot care for themselves" accurately summarizes the current view of health care in the United States. This statement reflects the belief that the government has a responsibility to ensure that individuals who are unable to afford or access healthcare are still provided with basic care. It implies a belief in the importance of social safety nets and the role of the government in addressing healthcare disparities and ensuring access to healthcare for all citizens.Rate this question:
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- 30.
As part of the orientation program at a local public health department, the newly hired nurse learns about the resources that are available in the community. What is the reason for including this information?
- A.
So that the nurse is able to advise clients on how to obtain food stamps
- B.
So that the nurse is able to determine who is eligible for certain services
- C.
So that the nurse will be able to include other departments in providing care
- D.
So that the nurse will be able to refer clients to the appropriate resources
Correct Answer
D. So that the nurse will be able to refer clients to the appropriate resourcesExplanation
The reason for including information about available resources in the community is so that the nurse will be able to refer clients to the appropriate resources. This is important because the nurse may come across clients who are in need of specific services or assistance, such as food stamps, and by having knowledge of the resources available in the community, the nurse can provide the necessary information and support to help the clients access the help they need.Rate this question:
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- 31.
Which of the following actions demonstrates the community/public health nurse advocating for the community?
- A.
Encouraging the media to run personal interest stories on needy clients
- B.
Becoming an active member of a professional nursing organization
- C.
Offering to organize a fundraising campaign for needy families
- D.
Suggesting appropriate agencies where families can receive services
Correct Answer
B. Becoming an active member of a professional nursing organizationExplanation
Becoming an active member of a professional nursing organization demonstrates the community/public health nurse advocating for the community because it shows their commitment to advancing the profession and improving healthcare outcomes for the community. By actively participating in a professional nursing organization, the nurse can collaborate with other healthcare professionals, share knowledge and resources, and work together towards addressing community health needs and promoting positive change.Rate this question:
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Current Version
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May 26, 2023Quiz Edited by
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May 05, 2020Quiz Created by
Draconisnightman
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