Health Insurance Chap 7 & Ess. Chap 5 & Pharm. Chap 23

Submit

9. Symptoms of corneal abrasion or ulcer include pain, redness, tearing, and sometimes visual impairment

True

False

10. Serious otitis media may be either acute or chronic

True

False

11. A referral is exactly the same as a consultation

True

False

Submit

15. Managed care has had little impact on healthcare in general in the united states

True

False

16. The purpose of a consultation is to obtain an expert opinion only and care of the patient is not relinquished to the consulting provider

True

False

17. One primary function of a managed care organization (MCO) is to establish a list of covered benefits tied to managed care rules

True

False

Submit

20. The internal lens of the eye is elastic and therefore can focus images both near and far

True

False

21. Keratitis is frequently caused by an infection of herpes simplex virus

True

False

22. Chronic open end glaucoma results from a malfunction of the drainage system which causes intraocular pressure to be raised

True

False

23. One advantage of an MCO is that it never has to be accredited

True

False

24. The only treatment that cures otosclerosis is a surgical procedure called stapedectomy

True

False

25. A cholesteatoma and mastoiditis can both be the result of a neglected otitis media

True

False

26. Macular degeneration is

Caused by degenerative changes in the retina

Usually related to aging

Both of the above

None of the above

27. This federal act, passed in 1996 is intended to improve the efficiency of healthcare delivery, reduce administrative cost and protect patient privacy

HCFA

HIPPA

EMTLA

COBRA

28. Sensorineural hearing loss that is caused by damage to the cochlea is irreversible, therefore prevention is essential

True

False

29. Glaucoma only occurs after age 60

True

False

30. Members of an HMO normally pay only a small fee (called a copayment) each time they visit their healthcare provider

True

False

31. A specific provider who oversees the total healthcare treatment of an individual enrolled in certain managed care plans is a

Participating provider

Primary care physician

Principal care provider

Treatment administrator

32. A relatively small out of pocket dollar amount that a member of a managed care plan typicallys pays up front is a

Copayment

Deductible

Premium

Compensation

33. An advantage of managed care organizations (MCOs) is that their aim is to keep their enrollees healthy which is commonly referred to as

Health options

Preventive care

All inclusive care

Defensive treatment

34. A request by a healthcare provider for his/her patient to be evaluated or treated by a specialist is a

Referral

Consultation

Confirmation

Preauthorization

35. Treatment of refractive errors of the eye might include

Laser surgery

Contact lenses

Eyeglasses

All of the above

36. Inflammatory infections of the hair follicles of the eyelid are called

Styes

Entropion

Keratitis

None of the above

37. Infection or inflammation in the semicircular canals is called

Cholesteatoma

Labyrinthitis

Otomycosis

Presbycusis

38. Which of the following might be prescribed to aid in smoking cessation

Doxepin (sinequan)

Naloxone(narcan)

Bupropion(zyban)

Buspirone (buspar)

39. A healthcare provider trained in a specific medical specialty is a

Specialist

Consultant

Counselor

Participating provider

40. With a point of service type HMO patients are allowed to go outside the plan and use any provider they choose

True

False

41. The middle ear is normally air filled

True

False

42. Toxic levels of lithium (lithane) may be associated with which of the following symptoms

Constipation and loss of appetite

Decreased urination and fever

Diarrhea and fine hand tremors

Increased appetite and sedation

43. The peripheral nervous system referes to the nervous structures outside of the

Brain

Central nervous system

Spine

Extremities

44. The formal term for a written complaint submitted by an individual covered by a special plan or policy is called a

Letter

Grievance

Complaint

Dispatch

45. A procedure required by most healthcare plans before a provider carries out specific procedures or treatment is a/an

Appeal

Grievance

Equalization

Preauthorization

46. One of the more popular types of MCO in this country is the preferred provider organization (PPO)

True

False

47. When reporting a craniectomy/craniotomy procedure it is common to also code _____ procedures

Grafting

Catheterization

Intubation

Excision

48. Weaning patients from selective serotonin re-uptake inhibitors (SSRIs) will reduce the likelihood of which of the following post treatment symptoms

Hypomanic episodes and increased energy

Anxiety and crying spells

Sedation and decreased appetite

Increased appetite and excessive thirst

49. An inflammation of the thin transparent membrane covering the visible portion of the sclera and lining the inside of the eyelids results in

Conjunctivitis

Choroiditis

Cornea abrasion

Lens distortion

50. Conjunctivitis can be caused by

A deterioration of the lens

Infection, irritation, allergies or chemicals

Hemorrhage behind the retina

A drooping of the upper eyelid

51. A cloudy or opaque area in the normally clear lens of the eye is called a

Stye

Detachment

Cataract

None of the above

52. Blepharoptosis can be ectropion or entropion

True

False

53. Patients on monoamine oxidase inhibitors (MAOIs) must observe which of the following dietary restrictions

Chocolate, nuts, and colas

Tomatoes, potatoes, and bell peppers

Chianti wine, aged cheese, and chicken liver

Sodium potassium and cholesterol

54. A healthcare delivery system that controls utilization and cost of services while providing enrollees access to quality cost effective healthcare is

Commercial care

Managed care

Systemized care

Preventive care

55. Under the federal HMO act an entity must have five characteristics to call itself an HMO

True

False

56. Precertification is a process people must go through to become eligible to join an HMO

True

False

57. The ears only function is hearing

True

False

58. The future of managed care is clear cut it is predicted that it will totally eliminate traditional healthcare in 10 years

True

False

59. A system designed to determine the medical necessity and appropriateness of a requested medical service or procedure is a/an

Appeal

Petition

Utilization review

Needs evaluation

60. Early symptoms of retinal detachment consist of

New floaters and light flashes

Purulent drainage

Redness of the eye and a gritty feeling

Ringing in the ears

61. Shunts are devices used to

Relieve pressure in the brain caused by fluid buildup

Monitor currents emanating from the brain

Decompress spinal nerves

None of the above

62. Symptoms of neoplasms of the ear commonly include

Progressive hearing loss and discharge from the ear

A visible mass or lesion

Facial paralysis

All of above

63. A procedure required by most healthcare plans before a provider carries out specific procedures or treatment is a/an

Appeal

Grievance

Equalization

Prequthorization

64. The cause of sensorineural deafness also referred to as occupational hearing loss includes

Loud noise

The aging process

The side effects of certain medication

All to the above

65. A multispeciality practice in which healthcare services are provided within the building complex owned by the health maintenance organization (HMO) is referred to as a/an

IPA

Staff model

Network model

Direct contact model

66. An independent not for profit organization that sets standards for healthcare in the united states and accredits most major hospitals is the

AMA

NUCC

Joint commission

NCQA

67. Which of the following medications would be prescribed for bipolar affective disorder

Haloperidol(haldol)

Fluoxetine (prozac)

Lithium (lithane)

Amitriptyline (elavil)

68. Extapyramidal side effects include which of the following

Dry mouth and blurred vision

Tremors and akathisia

Constipation and difficulty urinating

Increased saliva production and sedation

69. Chlorpromazine (thorazine) may cause which of the following side effects

Tachycardia

Respiratory depression

Hemorrhage

Gastric ulcers

70. For treating depression in the elderly which of the following medications would be useful because it does not cause over stimulation on days when depression does not occur

Phenelzine (nardil)

Tranylcypromine (parnate)

Imipramine (tofranil)

Amitriptyline (elavil)

71. A chronic disease of the inner ear marked by a recurring syndrome of vertigo, tinnitus, progressive hearing loss and a sensation of pressure in the ear is called

Cholesteatoma

Otosclerosis

Menieres disease

Mastoiditis

72. Fluphenazine (prolixin) is different from other tranquilizers in which of the following ways?

It can be administered through a transdermal patch

It has no side effects whatsoever

It can be given intramuscularly in long acting doses (one or two times per month)

It enhances agitation and psychotic behavior

73. The nurse should be sure to include which of the following facts in patient education about antidepressant agents

The onset of relief of symptoms is immediate

Certain foods must be avoided when taking any of the antidepressant agents

Therapeutic effect may not develop for several weeks

Alcohol and antihistamine drugs may be taken freely in combination with antidepressant agents

74. The insertion of a tympanostomy tube as a treatment for otitis media is called

Electronystagmography (ENG)

Myringotomy

Cryotherapy

Stapedectomy

75. The major risk with having a ruptured eardrum is infection in the inner ear

True

False

76. In the surgery of the skull base the _____ procedure is what is done to the lesion

Radical

Definitive

Approach

Intubation

77. Vision impairment as a result of old age and the loss of elasticity in the lens is called

Astigmatism

Emmetropia

Presbyopia

Diplopia

78. Ramelteon (rozerem) is indicated for which of the following sleep disturbances

Delayed onset

Early morning waking

Sleep apnea

Frequent awakenings

79. Neuroplasty is the

Injection of an anesthetic agent into a nerve

Decompression of intact nerves

Destruction of a nerve

All of the above

80. Individuals who are members of a managed care plan are commonly referred to as

Patients

Employees

Enrollees

Subscribers

81. Ankylosing of the stapes is called

Menieres disease

Otomycosis

Otosclerosis

Exotropia

82. Hyperopia myopia and presbyopia are refractive errors that result when the

Pressure within the anterior chamber of the eye is elevated

Eye is unable to focus light effectively

Tympanic membrane ruptures

Lens of the eye becomes cloudy

83. A group of healthcare providers working under one umbrella to provide medical services at a discount to the individuals who participate in the plan is referred to as a/an

HMO

FFS

AMA

PPO

84. In the surgery of skull base the __________ procedure is the method used to obtain exposure of the lesion

Radical

Definitive

Approach

Intubation

85. The initials that indicate a shunting procedure are

CPC

SCP

CSF

SFP

86. Placement of sharp objects into the ear canal an explosion a severe middle ear infection or a blow to the ear could result in

Otosclerosis

Cholesteatoma

Mastoiditis

A ruptured tympanic membrane

87. What procedure is often performed with a laminectomy

Discectomy

Corpectomy

Arthrodesis

Creation of a shunt

88. Which of the following statement(s) is (are) true about nystagmus

It is usually treated with warm compresses

It is also known as strabismus

It necessitates a complete neurologic evaluation when acquired

All of the above statements are true

89. Which of the following statements is true about chronic open angle glaucoma

It is caused by a decrease in intraocular pressure

It produces symptoms at the onset

It rarely progresses

It is the most treatable cause of blindness

90. This is the most commonly known neuroplastic procedure

Surgery of skull base

Craniectomy

Cisternal cervical puncture

Carpal tunnel

91. A private nonprofit organization that accredits healthcare plans based on evaluation of the quality of care given to plan members is the

AMA

NUCC

Joint commission

NCQA

92. The sensor receptive cells in the retina that function best in dim light and enable night vision are the

Iris

Pupil

Rods

Cones

93. A type of HMO whereby services are provided by outpatient networks composed of individual healthcare providers who supply all necessary patient care is a/an

IPA

Network model

Point of service

Direct contact model

94. A major cause of blindness in the united states is

Eye trauma

Retinal detachment

Strabismus

Glaucoma

95. Causes of conductive hearing loss might include

Otosclerosis, impacted cerumen, and otitis media

Impacted cerumen otitis media and sensorineural damage

Both of the above

None of the above

96. A defect in the _____ results in difficulty in visual detection of color and fine detail

Lens

Cones

Rods

Cones and rods

97. During skull based surgery if one surgeon performs the approach and a second physician performs the definitive procedure and a third physician performs the closure what modifier is appended to the definitive procedure code

-62 co surgeons

-66 team surgeons

-80 assistant surgeon

No modifier is used

98. Venlafaxine hydrocholoride (effexor) is different from other medications in its class in which of the following ways? select all that apply

It has an increased incidence of extrapyramidal side effects

It is tolerated well by all patients including the elderly

It is available in transdermal patches

It has a short onset of action

It has a strong sedative effect

Submit

Health Insurance Chap 7 & Ess. Chap 5 & Pharm. Chap 23

1. With many MCOs the enrollee typically pays a small fee upfront when visiting his/her PCP called a ________________

2.

What first name or nickname would you like us to use?

2. A "hybird" type of managed care (also called an open ended HMO) that allows patients to use either their HMO provider or go outside the plan and use a provider of their choices is a/ an _______________

3. A request by a healthcare provider for a patient under his/her care to be treated by another provider usually a specialist is a _______ (hint total care is often transferred)

4. When a patient is sent to another provider (often a specialist) with the intent of rendering an expert opinion only this is a ___________consultation (hint total care is not transferred)

5. MCOs tend to focus on ____________ care, or keeping the patient well thus avoiding expensive treatment later on

6. __________________ pertains to medical necessity and appropriateness only and does not in all instances guarantee payment

7. A process used by health insurance companies to control health care costs similar to prequthorization is

8. The ________________ model HMO is similar to an IPA except the organization contracts directly with individual providers

9. Symptoms of corneal abrasion or ulcer include pain, redness, tearing, and sometimes visual impairment

10. Serious otitis media may be either acute or chronic

11. A referral is exactly the same as a consultation

12. A specific provider who oversees the entire care and treatment of a patient in an HMO is called a

13. The private not for profit organization that is dedicated to improving healthcare quality and is frequently referred to as the managed care "watch dog" is ___________

14. HMOs normally do not have _____________ or plan limits

15. Managed care has had little impact on healthcare in general in the united states

16. The purpose of a consultation is to obtain an expert opinion only and care of the patient is not relinquished to the consulting provider

17. One primary function of a managed care organization (MCO) is to establish a list of covered benefits tied to managed care rules

18. A predominant standard setting nonprofit organization that evaluates and accredits healthcare organizations in the united states is the ______________

19. A _____________________ is used in managed care plans to reduce unnecessary inpatient/outpatient services

20. The internal lens of the eye is elastic and therefore can focus images both near and far

21. Keratitis is frequently caused by an infection of herpes simplex virus

22. Chronic open end glaucoma results from a malfunction of the drainage system which causes intraocular pressure to be raised

23. One advantage of an MCO is that it never has to be accredited

24. The only treatment that cures otosclerosis is a surgical procedure called stapedectomy

25. A cholesteatoma and mastoiditis can both be the result of a neglected otitis media

26. Macular degeneration is

27. This federal act, passed in 1996 is intended to improve the efficiency of healthcare delivery, reduce administrative cost and protect patient privacy

28. Sensorineural hearing loss that is caused by damage to the cochlea is irreversible, therefore prevention is essential

29. Glaucoma only occurs after age 60

30. Members of an HMO normally pay only a small fee (called a copayment) each time they visit their healthcare provider

31. A specific provider who oversees the total healthcare treatment of an individual enrolled in certain managed care plans is a

32. A relatively small out of pocket dollar amount that a member of a managed care plan typicallys pays up front is a

33. An advantage of managed care organizations (MCOs) is that their aim is to keep their enrollees healthy which is commonly referred to as

34. A request by a healthcare provider for his/her patient to be evaluated or treated by a specialist is a

35. Treatment of refractive errors of the eye might include

36. Inflammatory infections of the hair follicles of the eyelid are called

37. Infection or inflammation in the semicircular canals is called

38. Which of the following might be prescribed to aid in smoking cessation

39. A healthcare provider trained in a specific medical specialty is a

40. With a point of service type HMO patients are allowed to go outside the plan and use any provider they choose

41. The middle ear is normally air filled

42. Toxic levels of lithium (lithane) may be associated with which of the following symptoms

43. The peripheral nervous system referes to the nervous structures outside of the

44. The formal term for a written complaint submitted by an individual covered by a special plan or policy is called a

45. A procedure required by most healthcare plans before a provider carries out specific procedures or treatment is a/an

46. One of the more popular types of MCO in this country is the preferred provider organization (PPO)

47. When reporting a craniectomy/craniotomy procedure it is common to also code _____ procedures

48. Weaning patients from selective serotonin re-uptake inhibitors (SSRIs) will reduce the likelihood of which of the following post treatment symptoms

49. An inflammation of the thin transparent membrane covering the visible portion of the sclera and lining the inside of the eyelids results in

50. Conjunctivitis can be caused by

51. A cloudy or opaque area in the normally clear lens of the eye is called a

52. Blepharoptosis can be ectropion or entropion

53. Patients on monoamine oxidase inhibitors (MAOIs) must observe which of the following dietary restrictions

54. A healthcare delivery system that controls utilization and cost of services while providing enrollees access to quality cost effective healthcare is

55. Under the federal HMO act an entity must have five characteristics to call itself an HMO

56. Precertification is a process people must go through to become eligible to join an HMO

57. The ears only function is hearing

58. The future of managed care is clear cut it is predicted that it will totally eliminate traditional healthcare in 10 years

59. A system designed to determine the medical necessity and appropriateness of a requested medical service or procedure is a/an

60. Early symptoms of retinal detachment consist of

61. Shunts are devices used to

62. Symptoms of neoplasms of the ear commonly include

63. A procedure required by most healthcare plans before a provider carries out specific procedures or treatment is a/an

64. The cause of sensorineural deafness also referred to as occupational hearing loss includes

65. A multispeciality practice in which healthcare services are provided within the building complex owned by the health maintenance organization (HMO) is referred to as a/an

66. An independent not for profit organization that sets standards for healthcare in the united states and accredits most major hospitals is the

67. Which of the following medications would be prescribed for bipolar affective disorder

68. Extapyramidal side effects include which of the following

69. Chlorpromazine (thorazine) may cause which of the following side effects

70. For treating depression in the elderly which of the following medications would be useful because it does not cause over stimulation on days when depression does not occur

71. A chronic disease of the inner ear marked by a recurring syndrome of vertigo, tinnitus, progressive hearing loss and a sensation of pressure in the ear is called

72. Fluphenazine (prolixin) is different from other tranquilizers in which of the following ways?

73. The nurse should be sure to include which of the following facts in patient education about antidepressant agents

74. The insertion of a tympanostomy tube as a treatment for otitis media is called

75. The major risk with having a ruptured eardrum is infection in the inner ear

76. In the surgery of the skull base the _____ procedure is what is done to the lesion

77. Vision impairment as a result of old age and the loss of elasticity in the lens is called