HCAD Final Exam: Multiple Choice Questions and Answers, Exams of Nursing

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HCAD- Final Exam

Which best describes more than half the population of people served by community health centers? - Answer-They live in rural areas Documentation from a medical professional that a mother, her children, or both are at nutritional risk is a requirement for participation in which of the following programs? - Answer-WIC Which of the following works best when the health care team not only possesses clinical expertise but also considers patients' socioeconomic needs and provides coordination? - Answer-Patient engagement Which of the following trends are taking place in the United States today? Select all that apply. - Answer--The population is becoming older -The number of people of color is increasing -More people are living with chronic diseases Community risk includes which of the following? Select all that apply - Answer--Less access to parks and places to exercise -Less access to affordable healthy foods -Increased stress levels from low-wage jobs

Which of the following describe most patients who receive health care services from public hospitals? Select all that apply. - Answer--They are low income and uninsured -They suffer disproportionately from preventable chronic health problems -They lack a primary care provider Which of the following are eligible for Medicare? Select all that apply. - Answer--People aged 65 and older -Some people under 65 with qualifying disabilities -People with kidney failure requiring dialysis Strategies shown to help meet the needs of vulnerable populations include which of the following? Select all that apply. - Answer--Care coordination -Patient engagement -Integration of care "Dual eligibles" are those who - Answer-Qualify for both Medicare and Medicaid Critics who prefer less government involvement in the care of vulnerable populations point to which of the following to support their view? - Answer-The cost-ineffective nature of programs and services for the vulnerable Fragmentation in health care describes which of the following? - Answer-Care delivered by different providers who are not located with or near each other For every dollar the United States spends on health care, it spends an additional 90 cents on social services. For every dollar peer countries spend on health care, how much do they spend on social services? - Answer-Two dollars

In 2016, compensation for the 16.4 million jobs in the U.S. health care industry accounted for what percent of total health care spending? - Answer-Nearly 50% Which of the following is the largest health care occupation in the United States? - Answer-Registered nurses In what way can it be said that the expansion of insurance coverage under the ACA exacerbated the shortage of primary care providers? - Answer-The ACA led to a surge in demand for health services overall Financial incentives paid to health care organizations to encourage focus on models of care that increase quality at a reasonable cost are called - Answer-Performance-based payment programs Real-time two-way video communication and rapid transmission of electronic health records are encouraging improvements in which of the following? - Answer-Telemedicine Which of the following are expected to help solve shortages of primary care physicians? Select all that apply. - Answer--Integrated models of primary care delivery -Expanded roles for nonphysician health professionals Effective use of information technology Which of the following are arguments put forth by those who oppose increasing the education standards for health professionals? Select all that apply. - Answer--There is no evidence that higher educational requirements lead to better patient care -Higher levels of education increase costs for students and the health care system Which of the following is the stated purpose of scope-of-practice regulation and licensing? - Answer- Consumer protection

The establishment of fixed nurse-to-patient ratios and preferred shifts based on tenure are among the goals of - Answer-Health workers' unions Healthcare workforce planning in the United States is mostly left to - Answer-The private sector and local government agencies In hopes that allied health care students from rural areas will decide to stay and work in the area, many rural health care programs recruit and train such students in a strategy called - Answer-Grow your own Which of the following is the basic principle behind health insurance? - Answer-Pooled risks The largest share of total U.S. health care expenditures usually pays for which of the following? - Answer-Personal health care services provided to individuals Enrollment in Medicare has doubled since its passage, but annual expenditures have - Answer- Increased 40-fold Which of the following agencies operates the largest integrated health care system in the United States?

• Answer-Veterans Health Administration The Snyder Act of 1921 established a program of health services for which of the following? - Answer- Members of federally recognized Indian tribes and their descendants Which of the following is true of the workers' compensation program? - Answer-Employer and employee are expected to share the burden of loss from job-related injuries Which of the following requires employers to extend health insurance benefits to former employees for up to 18 months? - Answer-The Consolidated Omnibus Budget Reconciliation Act (COBRA)

Which of the following explains why a number of providers have stopped serving Medicare or Medicaid patients in recent years? - Answer-Payment rates have not kept up with health care costs Which of the following is an out-of-network health care provider? - Answer-A provider that does not negotiate rates with an insurer through a contract Which of the following ranks payers in order from highest amounts paid to lowest? - Answer-Private insurer, Medicare, Medicaid Which of the following are fixed monthly or annual payments for each person regardless of the amount and kind of services needed? - Answer-Capitated payments Which of the following is the third-leading cause of hospital deaths in the United States? - Answer- Medical errors Which of the following is used by the Centers for Medicare & Medicaid Services as a quality metric? - Answer-Readmission rates Which of the following are dimensions of quality according to the Institute of Medicine? Select all that apply. - Answer--Safety -Effectiveness -Efficiency -Equitable access Which of the following are the dimensions of quality care in the model proposed by Donabedian? Select all that apply. - Answer--Structures -Process -Outcomes

A study of public reporting in the health care industry found that about what percent of even the best reports needed substantial improvement and redesign? - Answer-80% The National Strategy for Quality Improvement was mandated by which of the following? - Answer-The Affordable Care Act (ACA) Which of the following is a disadvantage of social media such as Facebook, Yelp, and Twitter as tools of consumer engagement in the health care industry? - Answer-There is no credible third-party mediator in social media Despite being one step removed from the actual delivery of services, an increasing number of health care payers have begun to do which of the following? - Answer-Incorporate rates of hospital-acquired infections in their payment strategies Which of the following are benefits of having a governing board for a nonprofit organization? Select all that apply. - Answer--Increased energy and resources available to organization -More balanced view of the context of situations than a CEO -Keeping the organization focused on "the main thing" Which managerial function involves determination of goals and objectives? - Answer-Planning Which managerial function involves structuring resources to accomplish the work required to meet the objectives? - Answer-Organizing Which managerial function involves comparing actual results with objectives to enable mid-course corrections and provide a measure of success or failure? - Answer-Controlling According to Goleman, which of the following attributes is most important for effective managers? - Answer-High emotional intelligence

Which of the following is a "people skill" needed for managerial competency? - Answer-Empathy The new field of inquiry that is emerging to bring systematic data and information together to guide organizational improvement is which of the following? - Answer-Evidence-based management 6 stages of change - Answer--precontemplation: have not started thinking -contemplation: set a time frame, start thinking -preparation: plans to change + beings initial steps -action: active attempt made -maintenance: beyond 6 months -termination/relapse 5 A's - Answer--Ask -Advise -Asses -Assist -Arrange 5 C's for prioritizing quality - Answer--Capacity: Does the organization have the right mix of providers to meet tasks? -Consistency: Promote the use of evidence based research? -Capability: Do providers have the tools they need? -Culture: Org. needs a culture in which employees can speak up, safety, continuing edu + training -Candor: Relationship between provider and patient i.e. promoting patients to ask questions, open dialogue

What do boards do? - Answer--Select a CEO -Discuss, review, and approve strategic directions -Monitor performance of management in achieving agreed upon goals -Ensure that the organization operate responsibly and effectively -Act on policy recommendations and mobilize support -Provide a buffer for president/CEO -Ensure all resources will be available -Nominate suitable candidates and carry out effective systems Electronic health records - Answer-A longitudinal collection of electronic health information for and about persons -Track data over time -Identify patients who are due for preventative visits and screenings -Monitor how patients measure up to certain parameters -Improve overall quality of care in practice Health information technology (HIT) includes the use of which of the following to document and maintain health information? - Answer-Electronic health records Early attempts to apply IT solutions to health care delivery demonstrated the value of HIT, especially in - Answer-Improving patient safety By 2016, what percent of hospitals in the United States were using electronic health records? - Answer- 96% The Office of the National Coordinator for Health Information Technology (ONC) was established by - Answer-President George W. Bush

Which of the following are barriers to adopting HIT? Select all that apply. - Answer--High costs of initial acquisition and implementation -Lack of business incentives -Lack of interoperability Which of the following are among the functions of computerized provider order-entry systems? Select all that apply. - Answer--Accept physicians' orders for medications -Share instructions for patient care with other parts of the EHR system Which of the following are among the results of passage of the HITECH Act of 2009? Select all that apply.

• Answer--Growth in the adoption of electronic health records -Establishment of a discretionary fund for reducing barriers to the adoption and use of HIT -Founding of the Beacon Community Program to demonstrate HIT's role in patient-centered care Consumers were given the right to review and obtain a copy of their protected health information through which legislation? - Answer-Health Insurance Portability and Accountability Act (HIPAA) One of the earliest initiatives to allow patients to download their own health data on an electronic portal was conducted by which of the following? - Answer-Veterans Health Administration One successful application of consumer-facing IT has allowed providers to do which of the following? - Answer-Remotely monitor glucose levels of diabetic patients Mobile medical software and devices that support clinical decision-making fall under the jurisdiction of which of the following? - Answer-Food and Drug Administration (FDA) Which of the following looks at a patient's past use of services, past behavioral choices, and existing health needs to forecast his or her future use of health care? - Answer-Predictive analytics

Which of the following is currently the key driver of potential change in the health care system? - Answer-Emerging technology and medical know-how Which technology has the potential to help overcome the body's tendency to reject transplants? - Answer-Stem-cell technology Which of the following are potential applications of stem-cell research? Select all that apply. - Answer-- Growing specific organs -Overcoming the body's tendency to reject transplants -Testing treatment interventions to find the most effective ones One of the decisions the public will have to make about the adoption of new medical technologies is - Answer-Whether to make them available to everyone or only to those who can pay for them Which of the following are examples of disruptive innovation in health care? Select all that apply. - Answer--Patient access to providers via email and telehealth tools -Apps that help people manage chronic conditions -Insurance companies that focus on prevention-oriented services Which of the following is increasingly a focus of the U.S. health care system? - Answer-Helping people live healthy lifestyles to reduce their need for care The rapid spread of urgent care centers is an example of which of the following? - Answer-Disruptive innovation One predictable result of the aging of the U.S. population is that - Answer-The government's overall cost for Medicare will increase

Which of the following is one of the most critical requirements for achieving an improved health care system in the United States? - Answer-Motivated and well-trained leadership Identify the six key forces health care workers should keep in mind when developing forecasts for the future. - Answer--New knowledge and technology -Income disparities -The potential of creating and more vibrant culture of health -An aging population -Integration, consolidation, and other changes in now care delivery is organized -Disruptive innovation Which of the following causes more preventable deaths and diseases than any other behavioral risk factor? - Answer-Tobacco use Which of the following are the four leading behavioral risk factors that lead to death? Select all that apply. - Answer--Tobacco Use -Alcohol Abuse -Sedentary Life -Unhealthy Diet Mark, a friend of yours, has recently begun talking about quitting smoking. He has spoken with his doctor and is gathering information from some of his friends who have successfully quit. He plans on actually quitting in about 3 months, right after the holiday season. Which stage of the stages-of-change model of health behavior change is Mark currently in? - Answer-Contemplation Approximately what percentage of American adults are either overweight or obese? - Answer-70% Describe the parallel shifts that have taken place during the past 30 years in understanding what the essential targets need to be for successful interventions (a) to increase patients' adherence to

recommended prevention-oriented health behavior and (b) to increase providers' use of recommended clinical preventive behavior change interventions. - Answer--Social ecological models- integrate behavioral science with clinical and public health approaches, -emphasize that there is multiple levels of influence: Interpersonal factors, social factors, organizational community factors, broader environmental influences, and public policies -ecological model- proposes that educational and clinical interventions should be implemented to improve, reinforces things, access to safe places to walk and run With reference to McKinlay's population-based intervention model, outline possible coordinated "downstream," "midstream," and "upstream" strategies for: (a) curbing binge drinking on a college campus, - Answer-Downstream strategies include group and individual counseling and self-help programs. Midstream strategies could be holding prevention activities on campus or community-based interventions focused on defined at risk populations. Upstream strategies are national public education or policies reducing access to alcohol. Describe early behavior change efforts in the 1970s and 1980s, including the methods used, theories implemented, and the results. - Answer-1970s and 80's relied primarily on public education campaigns and individually oriented health education interventions. They were guided by the health belief model, theory of reasoned actions and theory of planned behavior. Sought to raise awareness of the harms of unhealthy behavior vs benefits of behavior change. Doctor patient relationship was seen as a unique and powerful context for effective health education. Both population-level and individual clinical health education efforts achieved initial success.