Answer is b. The provider is paid a fixed sum for the client on a monthly or yearly basis.

A health maintenance organization (HMO) is a type of health insurance that contracts with a network of providers and facilities to offer care at a discounted rate. The HMO pays the provider a fixed sum for each client, regardless of the services they use. This is called capitation³. The HMO also requires the client to have a primary care provider who coordinates their care and makes referrals to specialists².

a. This statement is wrong because it describes a co-payment, which is a fixed amount that the client pays for each service. Co-payments are usually low in HMOs, but they are not the main payment structure².
c. This statement is wrong because it describes a fee-for-service health care insurance program, which is the opposite of an HMO. In a fee-for-service program, the client pays the insurer for each service they use, and the insurer reimburses the provider. This gives the client more freedom to choose their provider, but it also increases the cost of health care¹.
d. This statement is wrong because it describes a co-insurance, which is a percentage of the total cost that the client pays for each service. Co-insurance is more common in preferred provider organizations (PPOs), which are another type of health insurance that offer more flexibility than HMOs, but also higher premiums

When caring for a client with terminal cancer who expresses a desire to discontinue enteral tube feedings, the nurse's priority is to ensure that the client's wishes are respected and appropriate steps are taken. The most suitable action is:

c) Explain the process for completing a living will.

A living will is a legal document that outlines a person's preferences regarding medical treatment in the event they are unable to communicate their wishes. In this situation, the client can express their desire to forgo enteral tube feedings through a living will, ensuring that their wishes are documented and legally recognized.

The other options may not be as appropriate:

a) Request the facility chaplain to visit the client:While spiritual and emotional support is important, the immediate concern is ensuring the client's autonomy in decision-making regarding medical interventions.

b) Ask the client to sign an informed consent form:Informed consent typically pertains to specific medical procedures, and discontinuing enteral tube feedings is more aligned with the broader context of advance care planning.

d) Complete an against medical advice form:This form is typically used when a patient refuses a recommended treatment against the medical team's advice. However, in this case, the client is expressing their own treatment preferences, and the focus should be on facilitating advance care planning and documentation.

When discussing electrical hazards with a client, the nurse should include the statement "You should limit your use of extension cords." Extension cords can be a tripping hazard and may cause electrical shocks or fires if used improperly. The nurse should also recommend using surge protectors and avoiding overloading electrical outlets. The client should be advised to unplug electrical items by pulling on the plug, not the cord, and to avoid using electrical items near water.

The correct answers are A, D, and E. Primary prevention activities aim to prevent the onset of disease or injury. Teaching a class about the risks of cigarette smoking and organizing a program to promote skateboard safety are examples of primary prevention activities. Lobbying for funding for health promotion efforts is also a primary prevention activity because it aims to prevent the occurrence of illness or injury in the community. Creating a plan of care for children who have a diagnosis of diabetes mellitus and recommending a seating arrangement for a child in a body cast are examples of secondary prevention activities, which aim to detect and treat health problems early to prevent complications.

. Tertiary prevention aims to prevent complications or further deterioration in individuals with existing health problems. Developing resources for victims of abuse is an example of tertiary prevention because it aims to prevent further harm to individuals who have already experienced violence. Presenting community education programs about stress management and urging community leaders to make nonviolence a priority are examples of primary prevention activities, which aim to prevent the occurrence of violence in the first place. Assessing for risk factors of intimate partner abuse during health examinations is an example of secondary prevention, which aims to detect violence early and intervene to prevent its progression.

The first step the nurse should take is to perform a needs assessment. This involves determining the specific needs of the older adults who will be served by the mobile meal program. The nurse should identify the target population and assess their nutritional needs, dietary restrictions, and food preferences. The nurse should also determine the availability of transportation for the delivery of meals and the potential need for volunteers. Once the needs assessment is complete, the nurse can begin to develop a plan for the program.

Inquiring about the availability of volunteers (choice B) and determining potential funding sources for the program (choice D) are important steps, but they should come after performing a needs assessment. Identifying alternative solutions (choice C) may be necessary at some point, but it is not the first step.

The host in the epidemiological triangle is the organism that harbors the disease. In the case of a mumps outbreak among school-age children, the host is the children themselves. The virus (choice C) is the agent that causes the disease, and the vaccine (choice D) is a means of preventing the disease. The school (choice A) is not the host, but it may be the environment where the disease is spreading.

If a nurse encounters a client with a suspected bioterrorism-related illness, the first action should be to don personal protective equipment (PPE). This includes a mask, gloves, gown, and eye protection. Moving the client to a quarantine area (choice A) may be necessary, but it should come after the nurse has taken steps to protect themselves and others. Reporting the client's condition to the Federal Bureau of Investigation (FBI) (choice B) is not the nurse's responsibility, but they should report the illness to their supervisor or public health department.

When reviewing home safety precautions with a client who is to begin radioactive iodine therapy, the nurse should emphasize the importance of using a toilet that is not used by others in the family. The client should also flush the toilet several times after use and clean it with household bleach. The nurse should advise the client to use disposable plates, cups, and utensils and to avoid close contact with others, especially pregnant women and children. The client should also avoid sharing towels, linens, and other personal items. Waiting one week after treatment to use a laxative (choice A) and using cloth handkerchiefs instead of tissues (choice B) are not relevant to home safety precautions for this client. Allowing the granddaughter to visit for four hours daily (choice C) may be unsafe, as the client may still be emitting radiation.

The correct answer is choice B. When caring for clients from different cultural backgrounds, it is important to be respectful and non-judgmental. In this situation, the nurse should ask the family to describe how they hope the treatments will affect their health. This will allow the nurse to gain a better understanding of the family's beliefs and values regarding health and illness. The nurse should avoid making assumptions or judgments about the family's beliefs and should not criticize or dismiss the folk healer. Alternative medicine practices (choice A) can be dangerous in some cases, but it is not appropriate to make a blanket statement that they should be avoided. Suggesting that folk medicine works by providing a placebo effect (choice C) is not respectful of the family's beliefs and is dismissive of their cultural practices. Referring the family to a medical practitioner (choice D) may not be appropriate if the family has a strong belief in folk medicine practices.

implementing a disaster triage plan with a local medical facility. Disaster preparedness efforts involve planning and coordinating actions to reduce the impact of a disaster on a community. One of the key components of disaster planning is triage, which is the process of sorting and prioritizing patients based on the severity of their injuries or illnesses. In the event of a disaster, the implementation of a disaster triage plan with a local medical facility is crucial to ensure that resources are allocated efficiently and effectively. The plan should include guidelines for identifying and prioritizing patients, allocating medical resources, and communicating with other agencies.

The correct answer is choice A, providing health services at work sites. Migrant populations often face barriers to healthcare access, such as language and cultural differences, lack of insurance, and transportation issues. Providing health services at work sites can help overcome these barriers and improve healthcare access for this population. Work site health services can include health education, health screenings, immunizations, and treatment for acute and chronic conditions. By providing these services on-site, nurses can reach more individuals in the migrant population and help prevent health problems from becoming more severe.

The correct answer is choice C, "Describe the place where you are currently living." When discussing discharge plans with a client, the first step is to assess the client's living situation to ensure that they will be able to safely manage their health condition at home. In this case, the client requires a special bed at home due to their pressure injury. By asking the client to describe their living situation, the case manager can determine if the client's home is suitable for their needs or if they require additional assistance or resources. Once the client's living situation has been assessed, the case manager can then discuss options for obtaining necessary supplies and provide education on how to manage the pressure injury.

, providing a smoking cessation class. Secondary prevention activities focus on early detection and treatment of disease or injury to prevent further complications. A smoking cessation class falls under this category because it aims to prevent further harm from smoking-related illnesses. Encouraging a pregnant client to participate in prenatal care (choice A) is an example of primary prevention, which aims to prevent the development of a disease or injury in the first place. Referring a client who is recovering from a substance use disorder to a social service program (choice C) is an example of tertiary prevention, which focuses on preventing complications or disabilities from an existing disease or injury. Advocating for laws that prohibit texting while driving (choice D) is an example of primary prevention, as it aims to prevent accidents from occurring in the first place.

The correct answer is choice A, activate the alarm. In the event of a fire, the first priority is to ensure the safety of all individuals in the facility. Activating the alarm alerts other staff members and the fire department, which can help to prevent the spread of the fire and ensure that everyone is safely evacuated. Attempting to extinguish the fire (choice D) should only be done if it is safe to do so and if the nurse has been trained in the proper use of fire extinguishers. Shutting the doors and windows of the room (choice B) can help to contain the fire, but it is not the first priority. Moving the client to another location (choice C) should only be done if it is safe to do so and if the client is not in immediate danger.

The correct answer is choice C, "An increase in client falls at home." A quality improvement committee is responsible for identifying and addressing areas in need of improvement in client care. Among home health clients, falls are a common cause of injury, which can lead to hospitalizations or even death. Therefore, it is essential to address this issue by examining the data and identifying trends to establish interventions to prevent falls. The committee can evaluate whether proper assessments have been completed, including a home safety evaluation, medication review, and the use of mobility aids, to prevent falls. The committee can also review the use of interventions, such as physical therapy or occupational therapy, to improve mobility and strength, and education for clients, caregivers, and family members to promote safety in the home environment. By addressing the increase in client falls, the committee can improve the quality of care provided to home health clients and reduce the risk of falls and injuries.

The correct answer is choice B, "Avoid direct sunlight between 10 am and 4 pm." Skin cancer is a prevalent form of cancer, and the primary prevention strategies include avoiding exposure to ultraviolet (UV) radiation. The nurse's statement emphasizes the importance of avoiding the sun's peak intensity, which is between 10 am and 4 pm, to reduce exposure to UV radiation. This primary prevention strategy is effective in reducing the risk of skin cancer, especially for individuals with fair skin, a history of sunburn, or a family history of skin cancer. It is also important to encourage individuals to wear protective clothing, apply sunscreen with a minimum sun protection factor (SPF) of 30, and avoid indoor tanning to further reduce exposure to UV radiation.

The correct answer is choice A, "Seizures." Manifestations of alcohol withdrawal can vary depending on the severity of the addiction, the duration and frequency of alcohol consumption, and the presence of other medical conditions. Seizures are a common manifestation of alcohol withdrawal, which can occur within 6 to 48 hours after the last drink. Other manifestations of alcohol withdrawal include tremors, anxiety, sweating, nausea and vomiting, tachycardia, hypertension, and hallucinations. These manifestations can be severe and life-threatening, especially if not managed appropriately. It is essential to monitor clients with alcohol withdrawal closely, administer medications as ordered, and ensure that clients receive appropriate medical care to prevent complications and promote recovery.

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Cultural variances in the expression of pain can impact the assessment and management of pain. It is important to recognize and respect these cultural differences to provide culturally sensitive care. Puerto Rican cultural practices consider the expression of pain as a private matter, and individuals may not express their pain openly, as it may be viewed as a weakness or shameful. In contrast, Native American cultural practices often consider pain as a sign of strength, and individuals may express pain openly to receive validation and support from their community. Chinese cultural practices emphasize the importance of stoicism, and individuals may endure pain to prevent family dishonor. Middle Eastern cultural practices may consider pain as a test of faith, and individuals may hide their pain from close family members to avoid burdening them. By understanding these cultural variances, nurses can assess pain more effectively and develop culturally sensitive pain management plans.

Secondary prevention strategies aim to prevent complications and reduce the impact of a disaster on individuals' health and wellbeing. In the aftermath of a disaster, individuals may experience a range of physical and emotional health needs, including injuries, infectious diseases, and mental health issues.

The correct answer is choice A, "Are you having any thoughts about hurting yourself?" This is the most important question to ask because it assesses the client's risk for suicide, which is a potential complication of depression. The nurse should ask this question before exploring other issues related to the client's depression. If the client expresses suicidal thoughts or intent, the nurse should initiate appropriate interventions to ensure the client's safety.

The correct answer is choice B, "Educate children at a day care center about nutrition and exercise." Primary prevention strategies aim to prevent the occurrence of a health problem before it happens. Educating children about healthy eating habits and regular exercise can help prevent obesity from developing in the first place. This is a more effective strategy than simply measuring the BMI of older adults, distributing health-risk appraisal questionnaires, or encouraging enrollment in weight-reduction programs.

The correct answer is choice B, "Immunizing the clients against influenza." This is the priority for the nurse to include because older adults are at increased risk for complications from influenza. Immunization against influenza can help prevent serious illness and death in this population. While exercise, a low-fat diet, and dental examinations are important health promotion strategies for older adults, they are not as high a priority as influenza immunization.

It is important to identify the client's spoken dialect before contacting an interpreter because there are many different dialects within a single language, and the interpreter needs to be able to understand and communicate effectively with the client. Using professional terminology may not be effective if the client does not understand the language in the first place, and relying on the client's daughter to communicate information about the procedure may not be reliable or appropriate.

The correct answer is choice B, "Gonorrhea." Gonorrhea is a reportable infectious condition that must be reported to the Centers for Disease Control and Prevention (CDC). While genital herpes simplex virus, bacterial vaginosis, and human papillomavirus are also sexually transmitted infections, they are not reportable to the CDC. It is important to report cases of gonorrhea to the CDC for surveillance and control purposes.