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Health Care in America

51. What financial benefit does a small rural hospital reap by qualifying for the designation, Critical Access Hospital? 
It can receive specific federal grants for serving vulnerable populations 
It can use its beds for either acute care or long-term care as needed 
It can increase its profitability by receiving special payments for emergency services 
It can receive cost-plus reimbursement under Medicare Part A 
52. Which principle of ethics requires caregivers to involve the patient in medical decision making? 
Paternalism 
Fidelity 
Beneficence 
Autonomy 
53. What is the main drawback of a living will? 
It cannot cover all possible situations 
The patient’s agent may not act in the patient’s best interest 
The person formulating a living will must have a court appointed 
guardian 
It becomes invalid when the patient becomes incompetent 
54. To participate in Medicare and Medicaid, a health care facility must be 
conditioned 
accredited 
certified 
licensed 
55. Which entity oversees the licensure of health care facilities? 
The Joint Commission 
Federal government 
State government 
Local county or city government

56. Institutional theory predicts that 
for-profit and nonprofit organizations will imitate each other when faced with similar regulatory and legal constraints 
as an enterprise increases in size, its unit overhead costs would 
decrease 
as a hospital increases in size, its economies of scale dissipate 
in competitive markets, both for-profit and nonprofit organizations 
would deliver certain essential community benefits 
57. Under this method, a primary care physician decides whether or not to refer a patient to a specialist. 
Preauthorization 
Prospective uti I ization review 
Disease management 
Closed-panel utiIization 
58. When an MCO adopts capitation as the primary method of payment, which service is likely to be carved out? 
Surgery 
Gatekeeping 
Mental health 
Primary care 
59. Which HMO model is likely to require heavy capital outlays to expand into new markets? 
Staff model 
Group model 
Network model 
IPA model 
60. PPOs were created by __ in response to HMOs’ growing market share. 
physicians 
insurance companies 
hospitals 
independent contractors

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61. Which of these organizations was specifically created to bring management expertise to physician group practices? 
Virtual organizations 
Physician-hospital organizations 
Provider-sponsored organizations 
Management services organizations 
62. Where two organizations cease to exist, and a new corporation is formed: 
Acquisition 
Merger 
Joint venture 
Alliance 
63. Regional health systems are often: 
horizontally integrated 
vertically integrated 
formed into virtual organizations 
formed into alliances 
64. requires that any health care need is recognized, evaluated, and addressed. 
long-term care 
health care 
individual care 
total care 
65. What is the primary goal of long-term care? 
help patients with increased pain 
cure deadly diseases 
preventing institutionalization 
providing socialization

66. This type of clinical category for long-term care is non-medical care provided to support and requires no active medical treatments. 
personal care 
nursing care 
custodial care 
subacute care 
67. What is the most common cause of mental retardation in America? 
Down’s syndrome 
autism 
spina bifida 
epilepsy 
68. The prevalence of HIV in the population has: 
increased 
decreased 
stayed the same 
none of the above 
69. Which law created two categories for nursing home certification purposes? 
Nursing Home Reform Act 
Medical Advancement Act 
Nursing Home Alternatives Act 
None of the above 
70. Who is the primary payer for health care services for the elderly? 
Medicaid 
Medicare 
private insurance 
none of the above 
71. What was the sixth leading cause of death for Hispanic males in 2003? 
heart disease 
malnutrition 
diabetes 
homicide

72. What factor has been found to be associated with the highest injury-related mortality rate among Indian children? 
cultural 
prenatal care 
social 
poverty 
73. Most medically uninsured adults are employed but are not covered because: 
their employer does not offer health benefits 
they do not work enough hours to qualify for health benefits 
they cannot afford the premium 
all of the above. 
74. Education and psychotherapy for children with HIV is an example of: 
heatlh-related support services 
population-based community health services 
personal medical and preventive services 
none of the above 
75. Who is the principal user of the health care system? 
men 
children 
elderly 
women 
76. What is defined as a “high-impact” area? 
areas with over 3,000 rural health clinics 
areas that serve at least 4,000 migrant workers for at least two months per year. 
areas that serve at least 12,000 community members per year 
none of the above.

77. Which type of patient is most likely to experience disability and more severe medical illnesses? 
diabetic 
cancer 
depressed 
elderly 
78. All of the following are factors effecting the growth in health spending EXCEPT: 
uninsured patients 
hospital services 
prescription drugs 
physician services 
79. What is partly responsible for the surplus of specialists in the US? 
greater access to financial aid 
technology 
increased population 
none of the above 
80. Defensive medicine leads to: 
decreased cesarean sections 
legal risks 
unnecessary tests and services 
none of the above 
8l. What was the most sweeping price-control initiative for Medicare? 
Economic Stabilization Program 
Balanced Budget Act 
Omnibus Budge Reconciliation 
none of the above

82. What is NOT an implication for access to health and health care delivery? 
access to medical care is one of the key determinants of health 
measures of access reflect changes across the board 
access is increasingly linked to quality of care 
access is a significant benchmark in assessing effectiveness 
83. Which main type of access refers to the type, site, and purpose of health services? 
potential 
realized 
equitable 
inequitable 
84. What do proponents believe regarding clinical practice guidelines? 
it reduces utilization 
decreases scientific research 
it promotes lower costs and better outcomes 
increases technology 
85. When public policy pertains to or influences the pursuit of health they become: 
health policy 
population policy 
prevention policy 
none of the above 
86. A problem associated with government involvement in US Health Is: 
escalating costs 
bureaucratic inflexibility 
excessive regulation 
all of the above

87. An insurance risk pool: 
helps people acquire private insurance otherwise unavailable 
helps insurance companies decrease their costs 
helps employers obtain insurance for their employees 
none of the above 
88. All BUT which of the following presidents is mentioned in the text as contributing major changes in health policies: 
President Lyndon Johnson 
President John Kennedy 
President Harry Truman 
President Bill Clinton 
89. Which branch of government is the most active in policymaking? 
executive 
judicial 
legislative 
none of the above 
90. Which group have policies been created to provide access to health care? 
elderly 
poor children 
poor adults 
all of the above 
9l. What is the third main concern of health care policy? 
cost 
research 
qualify of care 
technology 
92. The majority of employers currently offer: 
long-term plan 
defined benefit plan 
deductible health plan 
none of the above

93. The greatest challenge in insurance is: 
maintaining a balance between healthy and sick enrollees 
maintaining a balance between young and elder enrollees 
maintaining a balance between premium and nonpremium enrollees 
none of the above 
94. What is a disadvantage of managed competition? 
the medical infrastructure fluctuates 
increased government bureaucracy 
it cannot guarantee that everyone would have equal access to care 
all of the above 
95. Infectious diseases and health care must be viewed from a 
perspective. 
cost 
cultural 
global 
multi-faceted 
96. What is a strategy used to deal with nurse shortages? 
investments in training 
improvement in work environments 
opening new schools 
all of the above 
97. What approach will be used in order to improve quality and productivity? 
collaborative team approach 
collaboration 
cross-training 
all of the above

98. What is the goal of evidence-based medicine? 
increase the amount of patients 
increase the availabilty of prescription medicine 
increase the value of medicine 
none of the above 
99. What type of integration is represented by a chain of nursing homes? 
Ve integration 
Network 
Horizontal integration 
Diversification 
100. Where a new corporation created by two partnering organizations remains independent: 
Acquisition 
Merger 
Joint venture 
Alliance

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