TEST BANK for United States Health Care System 3rd Edition by Anne Austin, Wetle-1

United States Health Care System 3rd Edition Austin Test Bank The U.S. Health Care System, 3e (Austin) Chapter 1 Health and Care in America 1) The medical model includes all of the following, EXCEPT A) illness and disease require treatment B) focus is diagnosis C) focus is on disease prevention D) focus is on treatment Answer: C 2) In the two decades following 2010, millions of Americans will reach age 65. This concerns the health care industry because A) men are living longer and will outpace women; thus, there will be a need for increased services for men B) of the exodus of experienced health care professionals C) the generation after the baby boomers will overwhelm the health care system D) there will be an increased need for geriatric care Answer: D 3) According to the 2014 National Health Interview Survey, who is more likely to suffer from poor health?

A) A person with a college degree B) A person who has graduated from high school C) An individual with a yearly income of $85,000 D) An individual with a yearly income of $20,000 Answer: C 4) The Centers for Disease Control and Prevention do all the following, EXCEPT A) survey Americans about their health B) collect health statistics C) report the leading causes of death D) monitor hospital compliance with HIPAA Answer: D 5) Focus areas of Healthy People 2020 and patterns of disease in the population direct research efforts. Research can be directed at all of the following, EXCEPT A) cure B) control C) prevention D) elimination Answer: D

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6) What was the leading cause of death in 2012?

A) Suicide B) Diabetes C) Heart disease D) Pneumonia/flu Answer: C 7) All of the following occupations are expected to increase by more than 40% by 2022, EXCEPT A) sonographers B) medical secretaries C) home care aides D) occupational therapy assistants Answer: B 8) Health care employment continues to grow for all of the following reasons, EXCEPT A) managing costs B) advances in medical technology C) aging population D) inability to automate many functions Answer: D 9) In 2013, the U.S. spent A) $2.5 billion B) $50 billion C) $2.9 trillion D) $50 trillion Answer: C

on health expenditures.

10) Which statement does NOT describe health care?

A) It accounts for the largest percentage of the gross domestic product.

B) It is one of the fastest growing industries in the United States.

C) It is the process of providing care to individuals to maintain and improve their physical and mental well-being.

D) It is an industry.

Answer: A 11) The study of disease and death in a population is called A) microbiology B) epidemiology C) anthropology D) sociology Answer: B

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12) Two parameters that usually result in an indication of excellent health are A) genetics and education B) genetics and income C) education and income D) profession and income Answer: C 13) All of the following are types of health care facilities, EXCEPT A) a physician's office B) an HMO C) a long-term-care facility D) a hospital Answer: B 14) Which is TRUE regarding long-term care?

A) Only those 65 and older are eligible.

B) The majority of care is provided in nursing homes.

C) In 2012, more than 4 trillion people received services.

D) All age groups are eligible for services.

Answer: D 15) The term LTC means providing health care services to an individual for more than A) 30 days B) 60 days C) 90 days D) 180 days Answer: C 16) All of the following are examples of locations where long-term care could take place, EXCEPT A) clinics B) hospitals C) rehabilitation centers D) adult day cares Answer: A 17) All of the following are examples of the role of public health, EXCEPT A) crosswalks on streets B) hard hat laws for construction workers C) prompt processing of insurance claims D) free immunization clinics Answer: C

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18) Mental illness A) is usually a chronic lifetime disease B) strikes one of every 10 adults C) is treated 90% of the time D) is readily available and inexpensive Answer: A 19) The three major places of employment for health care workers are A) hospitals, nursing and residential care facilities, and practitioners' offices B) practitioners' offices, dental offices, and public health facilities C) CDC, hospitals, and residential care facilities D) adult day care, hospitals, and practitioners' offices Answer: A 20) Health care policy addresses all of the following issues, EXCEPT A) cultural B) access C) costs D) quality Answer: A 21) The Patient Protection and Affordable Care Act A) helps increase the number of people who are uninsured B) allows the market to drive costs up C) seeks to improve health care delivery performance D) is surveying Americans about their health care utilization patterns Answer: C 22) Managed care can be described by all of the following, EXCEPT A) manages the patient's utilization of services B) manages the price paid for services C) has the objective of only providing those services that are necessary to contain costs D) maintains a sustainable noncompetitive advantage Answer: D 23) Sustainable competitive advantage is described by all of the following, EXCEPT it A) varies from business to business B) depends on the objectives the firm is trying to achieve C) helps a business maintain its position in the marketplace D) allows the market to drive costs up Answer: D

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24) The ability to stay in business for a health care facility is based on the facility's A) sustainable competitive advantage B) reimbursement rates C) business plan D) business viability Answer: A 25) Health care expenditures account for greater than 15% of the GDP. Answer: TRUE 26) Women are more likely to live in poverty than men.

Answer: TRUE 27) Competition is a component of a market economy.

Answer: TRUE 28) The patient is at the center of the health care industry.

Answer: TRUE 29) Less than half of health care workers provide direct patient care.

Answer: FALSE 30) The United States has a national health care system.

Answer: FALSE 31) Focus on the prevention of disease and the maintenance of well-being describes the model.

Answer: wellness 32) The population has more than doubled since 1990 and is younger than the total population.

Answer: Hispanic 33) Census data indicates that the United States has increased its Answer: ethnic

diversity.

34) Study of the nature, cause, control, and determinants of the frequency of disease, death, and disability in the human population is .

Answer: epidemiology 35) Name two trends that emerge from the demographic data about age and the impact on health care.

Answer: Responses will vary, but may include: Americans are living longer The record number of baby boomers reaching age 65

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36) Define health from the perspective of the wellness model.

Answer: Responses will vary but may include: the optimal functioning of each human being in his or her mind, body, and spirit 37) The Patient Protection and Affordable Care Act will impact many areas of health care.

Discuss the implications you anticipate for you, your family, and your fellow classmates, based on the information in this chapter.

Answer: Responses will vary, but may include: insurance mandated for all family members and by all employers cost of care is controlled, which decreases personal cost and potential tax burden quality of care is improved 38) Describe health care. List two viewpoints.

Answer: Health care is a set of delivery systems; health care is a set of related businesses.

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The U.S. Health Care System, 3e (Austin) Chapter 2 The Business Side of Health Care 1) A not-for-profit hospital is described by all of the following, EXCEPT it A) may focus on serving the poor B) is not focused on profits C) may lose money on many of its poor patients D) has a goal of making money Answer: D 2) Profit is A) money collected from patients and insurance companies for health care services rendered B) the price paid when an individual or business borrows money C) revenue minus costs D) lacking during times of prosperity Answer: C 3) A single physician in practice would be an example of a(n) A) sole proprietorship B) partnership C) corporation D) antitrust Answer: A 4) Shareholders may exist in which business ownership configuration?

A) Corporation B) Partnership C) Sole proprietorship D) Collaboration Answer: A 5) Marketing A) includes the product, price, promotion, and distribution to the customer B) uses technology to manage information C) creates the product or service D) tracks the flow of money in and out of a business Answer: A 6) Accounting A) creates the product or service B) tracks the flow of money in and out of a business C) uses technology to manage information D) includes the product, price, promotion, and distribution to the customer Answer: B

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7) Production A) uses technology to manage information B) tracks the flow of money in and out of a business C) includes the product, price, promotion, and distribution to the customer D) creates the product or service Answer: D 8) Information technology A) creates the product or service B) tracks the flow of money in and out of a business C) includes the product, price, promotion, and distribution to the customer D) uses technology to manage information Answer: D 9) A market economy is described by all of the following, EXCEPT it A) is also called a private system B) is called a free enterprise system C) has competition as its central feature D) is not concerned with profit Answer: D 10) Which economic principle influences the cost as well as the availability of goods and services?

A) Supply and demand B) Microeconomics C) Recession D) Macroeconomics Answer: A 11) All of the following are key economic indicators, EXCEPT A) tax rate B) unemployment rate C) inflation rate D) interest rate Answer: A 12) Prior to pursuing funding for a new imaging machine, the CFO assesses the economy, especially the prime rate. The CFO is concerned about the effect that the _ will have on the ultimate cost of the imaging machine.

A) loan B) credit C) inflation D) interest Answer: D

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13) An increase of the price level at any given time is called A) recovery B) interest C) inflation D) recession Answer: C 14) Which part of the economic cycle occurs with increasing inflation and interest rates?

A) Prosperity B) Recession C) Depression D) Recovery Answer: B 15) A decrease in unemployment and interest rates occurs during which portion of the economic cycle?

A) Prosperity B) Recession C) Depression D) Recovery Answer: A 16) Hospitals would be inclined to purchase major equipment during the _ A) prosperity B) recession C) depression D) recovery Answer: A

phase.

17) John Q. Public has been looking for a job for 2 months, to no avail. The country is likely in which economic period?

A) Recovery B) Unemployment C) Underemployment D) Recession Answer: D 18) Increasing GDP and decreasing interest, inflation, and unemployment rates are indicative of the scenario.

A) depression B) recession C) recovery D) prosperity Answer: D

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19) Consumers saving discretionary income, organizations holding off on building new facilities, and a persistent slow economy are indicative of a scenario.

A) recovery B) recession C) prosperity D) depression Answer: B 20) Individuals may have to do without health care during which business cycle scenario?

A) Prosperity B) Recession C) Depression D) Recovery Answer: C 21) The government's role in health care can be described as all of the following, EXCEPT A) payer B) regulator C) organizer D) provider Answer: C 22) Monopoly creation, price fixing, and price discrimination are prohibited by A) Medicare B) antitrust laws C) Medicaid D) The Joint Commission Answer: B 23) The Hill Burton Act A) is part of the Social Security Act B) prohibits referrals to clinical lab services where the provider has a financial interest C) involved the federal government funding construction of private facilities pursuant to a Certificate of Need D) provides for health insurance portability and protects the privacy of health records Answer: C 24) The Stark I law A) contains special provisions to protect laid-off workers and to encourage electronic records technology B) prohibits referrals to clinical lab services where the provider has a financial interest C) involved the federal government funding construction of private facilities pursuant to a Certificate of Need D) provides for health insurance portability and protects the privacy of health records Answer: B

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25) All of the following are a part of a SWOT analysis, EXCEPT A) evaluating opportunities B) identifying threats C) devising an action plan D) identifying weaknesses Answer: C 26) Which external environments impact the operation and design of health care businesses?

A) Economic and political-legal B) Technological and economic C) Organizational direction and political-legal D) Formal structure and economic Answer: A 27) Under code 62 of the North American Industry Classification System (NAICS), the government tracks the activities of the sector of the economy it calls health and social assistance.

Answer: TRUE 28) TJC accreditation is required for all health care facilities.

Answer: FALSE 29) TJC accreditation can substitute for Medicare and Medicaid federal certification.

Answer: TRUE 30) The Kefauver-Harris Drug Amendment tests safety and effectiveness of drugs.

Answer: TRUE 31) A new hospital system has moved into your three-hospital city. The other two hospitals in the city have been purchased by the new hospital system. The senior leadership of the remaining hospital completes a SWOT analysis during the annual strategic planning session. The new hospital system is an example of the opportunities portion of the SWOT analysis.

Answer: FALSE 32) The part of the management process is the manager's feedback loop.

Answer: control 33) A pharmaceutical company that holds a patent and sells the only drug for heartburn, is a .

Answer: monopoly 34) The person in charge of a hospital is the Answer: CEO

.

35) An environment where there are few sellers is a(n) Answer: oligopoly

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.

36) One of the objectives of health care laws is to Answer: ensure fair competition; protect the public

.

37) The Act encourages drug companies to produce drugs for rare diseases.

Answer: Orphan Drug 38) Explain a sole proprietorship Answer: Responses will vary but may include: In a sole proprietorship, one person owns the business.

The owner makes all the decisions, takes all the risks, and reaps all the rewards.

39) Name the four categories of health and social assistance under code 62.

Answer: The businesses in code 62 are divided into four categories: ambulatory health care services, hospitals, nursing and residential care facilities, and social assistance.

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The U.S. Health Care System, 3e (Austin) Chapter 3 The Payment Process: Insurance and Third-Party Payers 1) What is health insurance?

A) A PPO B) Shifting the risk of loss C) An HMO D) All of the above Answer: D 2) A third-party payer may be A) an insurance company B) a government agency C) a managed care organization D) all of the above Answer: D 3) The calculates risk and helps set premiums.

A) actuary B) government C) benefits manager D) employer Answer: A 4) John's recent physician's office visit was not paid by the insurance company. It was his first claim of the year. The claim totaled $200. The reason the claim was denied was likely related to John's A) copayment B) subscriber C) deductible D) premium Answer: C 5) A deductible is the A) portion of services paid by the patient B) amount paid by the patient before the third-party payer begins to pay C) fee paid by employers and employees to the insurance company D) negotiated payment for services between the payer and the provider Answer: B 6) The copayment is the A) fee paid by employers and employees to the insurance company B) negotiated payment for services between the payer and the provider C) portion of services paid by the patient D) amount paid by the patient before the third-party payer begins to pay Answer: C 1

7) Premiums are the A) portion of services paid by the patient B) amount paid by the patient before the third-party payer begins to pay C) negotiated payment for services between the payer and the provider D) fee paid by employers and employees to the insurance company Answer: D 8) A policy is A) a binding contract that describes all the terms of insurance B) the time in which employees can utilize benefits C) a time when employees can change providers D) a binding contract between the payer and the employee Answer: A 9) An enrollment period is the A) time when a policy lapses B) time when companies determine which policy pays C) time when employees can sign up for benefits D) all of the above E) none of the above Answer: C 10) Determining which third-party pays for services is known as A) explanation of benefits B) COBRA C) coordination of benefits D) ERISA Answer: C 11) A person who signs up for insurance coverage through an employer is a (an) A) actuary B) enrollee C) subscriber D) policy holder Answer: B 12) All of the following are true about the Healthcare Common Procedure Coding System (HCPCS), EXCEPT A) it consists of two levels B) the current procedural terminology (CPT) is for procedures and services performed by providers C) it involves indemnification D) the national codes (HCPCS level II codes) are for procedures, services, and supplies not found in CPT Answer: C

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13) Which of the following describes Blue Cross/Blue Shield?

A) A health insurance company B) A type of prepaid service C) Mostly are nonprofit organizations D) All of the above Answer: D 14) A method of reimbursing providers based on what other providers are paid for a particular service is known as the A) usual charge and reasonable cost plan.

B) usual, customary, and reasonable price C) universal charge and reimbursement plan D) ordinary and customary cost program Answer: B 15) A key function in a managed care model is A) gatekeeping B) prepayment C) processing fees D) indemnifying losses Answer: A 16) A payment method under which each patient receives a set dollar amount of services is known as the A) premium B) capitation C) copayment D) deductible Answer: B 17) An HMO contracts with more than one group practice for service in which arrangement?

A) Staff model HMO B) Network HMO C) IPA D) PPO Answer: B 18) Prepaid health plans A) are attractive to employers because they know in advance what the cost of providing health care will be B) all involve an IPO C) are attractive to the service provider because the number of patients is fixed and a certain revenue level is guaranteed D) relate to both A and C Answer: B

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19) A is a system where payment is made in advance of services being provided.

A) prepaid health plan B) preauthorization C) coordination of benefits D) copayment Answer: A 20) This organization negotiates and manages provider's contracts.

A) Staff model HMO B) PPO C) Network HMO D) IPA Answer: B 21) Which regulates portability, access, and mandated benefits at the federal level?

A) COBRA B) HIPAA C) EPO D) ERICA Answer: B 22) With EPOs, all of the following are true, EXCEPT A) patients must select their care providers from those in the network B) patients may choose their physician or hospital C) if the patient chooses to go outside the network, the services are not covered D) they are regulated by state insurance law Answer: B 23) A PPO A) is a delivery network B) does not receive premiums or assume financial risk C) decreases cost of service if a preferred provider is used D) represents all of the above Answer: D 24) All are true regarding regulation of third-party payers, EXCEPT A) insurers who sell any type of insurance are regulated B) only health insurance companies must be licensed C) the insurance commission is charged with regulatory authority D) regulation attempts to ensure policy holders receive the coverage they purchase Answer: B

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25) HIPAA regulates all of the following, EXCEPT A) portability B) coverage on a family plan until 26 years old C) access D) mandated benefits Answer: B 26) Employers must provide health insurance.

Answer: FALSE 27) Employers pay the entire insurance premium for their employees in most instances.

Answer: FALSE 28) Approximately 14 million people are without health insurance.

Answer: FALSE 29) Physicians are always independent contractors in third-party payer arrangements.

Answer: FALSE 30) Like hospitals, insurance companies must be licensed.

Answer: TRUE 31) According to the text, Answer: about 16

% of Americans under age 65 are uninsured.

32) insurance does not restrict a patient's choice of providers.

Answer: Indemnity 33) In a , the employer acts as the insurance company and pays for its employees' health care costs out of its own pocket.

Answer: self-insured plan 34) administer health care benefits and process claims for their clients.

Answer: Third-party administrators 35) A(n) Answer: HMO

is a type of prepaid health care plan.

36) Define the term third-party payer and describe the role of the insurance company as the third party in the patient-provider relationship.

Answer: Responses will vary, but should include that the patient contracts with the insurance company to pay the provider for services rendered to the patient.

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37) Explain the gatekeeping concept, and include an example of how it benefits the patient, payer, and provider.

Answer: Responses will vary, but should include: The patient can only access certain services from the primary care provider and can only obtain specialist and rehabilitative services if referred by the primary provider. This provides cost savings because only patients who are judged to need them have access to more expensive care.

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The U.S. Health Care System, 3e (Austin) Chapter 4 The Payment Process: Government Payment Programs 1) Hospitalization for a 70-year-old woman is likely covered by A) Medicaid Part B B) Medicaid Part A C) Medicare Part A D) Medicare Part B Answer: C 2) Medicare covers all of the following EXCEPT A) long-term care B) hospital care C) physician care D) hospice Answer: A 3) Medicare adopted(ing) managed care strategies.

A) is considering B) was one of the earliest to begin C) will not be D) was the first insurer that Answer: B 4) Medicaid is a A) state-funded, state-administered program B) federally-funded, federally-administered program C) state-funded, federally-administered program D) federally-funded, state-administered program Answer: D 5) Who may be eligible for Medicaid?

A) Older adults with large medical bills B) Pregnant women C) Disabled individuals D) All of the above Answer: D 6) Which people are most likely medically needy?

A) 35-year-old healthy mother of one B) 70-year-old nursing home resident C) 66-year-old retired corporate executive with controlled hypertension D) 2-year-old child with a genetic disorder who has two gainfully-employed parents Answer: B

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7) Which Medicaid benefit(s) must all states cover?

A) Dental services B) Physician services C) Pharmaceutical D) All of the above Answer: B 8) Medicaid eligibility is A) decided on the federal level B) decided on the state level C) the same for all states D) determined based on education Answer: B 9) Medicare is administered by A) CMS B) the states C) OPM D) FEHBP Answer: A 10) A physician office visit for a 9-year-old, whose mother makes minimum wage and cannot afford to pay her portion of her employer's health insurance plan, may be covered by A) Medicare Part B B) CHIP C) Medicaid D) Medicare Part A Answer: B 11) Which is TRUE regarding Medicaid?

A) It reimburses providers on a fee-for-service system.

B) It forces physicians to accept Medicaid patients.

C) Many providers feel Medicaid compensation is too high.

D) Reimbursements to providers was increased by 50%.

Answer: A 12) The category of Medicaid recipients who receive the largest amount of funding is A) the disabled B) the elderly C) adults D) children Answer: A

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13) Approximately how many children were enrolled in CHIP in 2012?

A) 1 million B) 8 million C) 36 million D) 43 million Answer: B 14) When providers feel that financial incentives are inadequate they may opt out of A) CHAMPUS B) CHIP C) Medicaid D) FEHBP Answer: C 15) All of the following are eligible for CHIP EXCEPT A) a 2-year-old B) an 18-year-old C) a 19-year-old D) an unborn child Answer: C 16) Susie Coder is a hospital inpatient coder. She is coding a complex Medicare record. She has to choose between two codes for the bill. Code A pays $3,400. Code B pays $9,700. The coding rules indicate that Susie should use code A. Susie uses code B. What is Susie guilty of?

A) Miscoding B) Hospital coding C) DRG coding D) Upcoding Answer: D 17) Which is (are) considered fraud?

A) A practitioner codes for a different procedure than was performed so the patient will be covered.

B) A physician makes a referral to an agency in which he has financial interest, and bills Medicaid.

C) A provider submits an insurance claim for a service that was never performed.

D) All of the above Answer: D 18) Penalties for fraud and abuse include A) substantial fines B) exclusion from Medicare C) imprisonment D) all of the above Answer: D

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19) All of the following describe the Affordable Care Act regarding fraud and abuse EXCEPT A) enhanced oversight of new providers B) required provider screening C) a sharing database across state and federal programs D) developed joint fraud strike forces Answer: D 20) The Office of Personnel Management administers which program for government workers?

A) Medicare B) FEHBP C) Medicaid D) CHIP Answer: B 21) Insurance for military personnel is A) Medicare B) Medicaid C) TRICARE D) CHAMPUS Answer: C 22) All are true about compliance programs EXCEPT A) all claims submitted for payment must have appropriate documentation B) providers should receive regular training to stay current with Medicare and Medicaid regulations C) they are mandatory under the Patient Protection and Affordable Care Act D) providers receive kickbacks for training courses Answer: D 23) Which are covered under the FEHBP? A) Federal employees B) Military families C) The medically needy D) Those with end-stage renal disease Answer: A 24) Which person may be eligible for workers' compensation?

A) Julie has an accident on her way to work.

B) Jan hurt herself while vacationing at the resort where she cooks.

C) Steve fell in the restaurant parking lot on his lunch break.

D) Scott, an RN, injured his back while transferring a patient.

Answer: D

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25) Workers' compensation is financed by A) employer and employee payments B) employer payments only C) employee and government payments D) employer and government payments Answer: B 26) An example of self-referral would be a patient who asks another provider for a referral to a specialist.

Answer: FALSE 27) Hospitals are the largest recipients of workers' compensation dollars.

Answer: FALSE 28) TRICARE is a provider of health care services.

Answer: FALSE 29) TRICARE has a variety of managed care options, such as HMOs, preferred providers, and fee-for-service.

Answer: TRUE 30) Worker's compensation programs provide the incentive of employers' premium rates dropping if they have low numbers of accidents.

Answer: TRUE 31) The disease that makes a person eligible for Medicare without being over 65 years old is .

Answer: end-stage renal disease 32) Medicare Part Answer: D

covers prescription drugs.

33) Medicare uses a to reimburse providers.

Answer: prospective payment system (PPS) 34) Financial gain from patient/service referrals is known as Answer: kickbacks 35) Define CHIP. Answer: Children's Health Insurance Program (CHIP) 36) List two groups eligible for the FEHBP. Answer: Federal employees Their families Retirees Survivors of federal employees 5

.

37) Describe workers' compensation. Include the rationale for its existence from an employer and employee perspective.

Answer: Responses will vary, but should include an explanation of workers' compensation as an insurance program that pays for health care related to work-related injuries.

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The U.S. Health Care System, 3e (Austin) Chapter 5 Health Care Providers: Physicians and Nurses 1) Which type of medicine is used with physicians who specialize in fighting disease, using proven, traditional treatment methods?

A) Alternative medicine B) Osteopathic medicine C) Chiropractic medicine D) Allopathic medicine Answer: D 2) Physicians who specialize in understanding the musculoskeletal system and providing holistic care, practice A) alternative medicine B) allopathic medicine C) osteopathic medicine D) homeopathic medicine Answer: C 3) The main area(s) of care for a primary care physician is A) internal medicine B) general and family practice C) pediatrics D) all of the above Answer: D 4) According to the Bureau of Labor Statistics, Physicians 2014—15, approximately A) 35% of physicians are women B) 12% of physicians are African American C) 5% of physicians are Asian D) 10% of physicians are Hispanic Answer: A 5) Emergency medicine physicians specialize in the diagnosis and treatment of A) diseases of the lungs B) changes in organs, tissues, and cells C) acute illness or injury D) diseases of the urinary system Answer: C 6) Psychiatrists specialize in the diagnosis and treatment of A) diseases and disorders of the stomach and intestines B) diseases and disorders of the mind C) changes in organs, tissues, and cells D) diseases of the brain and nervous system Answer: B 1

7) Pathologists specialize in A) diagnosing disease by studying changes in organs, tissues, and cells B) diseases and disorders of the heart and blood vessels C) diseases and disorders of the skin D) pregnancy, childbirth, and diseases of female reproductive organs Answer: A 8) Which type of specialist administers medication to provide loss of feeling before surgical procedures?

A) Anesthesiologist B) Ophthalmologist C) Radiologist D) Orthopedist Answer: A 9) Which type of surgery does an ophthalmic surgeon specialize in?

A) Eye B) Brain C) Heart D) Skeletal Answer: A 10) According to the 2012 Medical Group Management Association's Physician Compensation and Production Survey, the median net income for physicians per year in primary care is A) $159,478.00 B) $198,765.00 C) $220,942.00 D) $332,843.00 Answer: C 11) About A) 25 B) 50 C) 75 D) 90 Answer: B

percent of medical school applicants are accepted.

12) To practice medicine in most states, a physician must complete all of the following EXCEPT A) unpaid on-the-job training B) receive an undergraduate degree C) pass a licensing exam D) graduate from medical school Answer: A

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13) What are the licensure requirements for physicians?

A) Pass a medical licensing exam B) Complete at least 7 years of paid residency C) Obtain board certification D) All of the above Answer: A 14) Nurse Practice Acts A) contain the states' requirements for practice B) specify which educational, clinical, and licensure requirements are necessary to practice in a state C) are the same in all 50 states D) are waived in long-term care Answer: A 15) Nursing involves A) treating B) educating C) diagnosing D) all of the above Answer: D

patients.

16) The typical nurse is a A) white male B) minority male C) minority female D) white female Answer: D 17) Which health professional is predominantly responsible for assisting patients with feeding and hygiene?

A) CRNA B) RN C) CNA D) LPN Answer: C 18) What is the difference between an RN and an LPN? A) RNs, unlike LPNs, must pass a national licensure exam.

B) RNs, unlike LPNs, are encouraged to complete the BSN. C) RNs, unlike LPNs, are involved in client teaching.

D) RNs, unlike LPNs, are allowed to give injections.

Answer: B

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19) Which nursing professional specializes in anesthesia?

A) NP B) CNS C) CNM D) CRNA Answer: D 20) Which nursing profession specializes in a field such as oncology, neonatal care, or mental health?

A) NP B) RN C) CNM D) CNS Answer: D 21) Which are required at all levels of nursing?

A) Classroom instruction B) Supervised clinical experience C) Hospital diploma D) Both A and B Answer: D 22) The average salary of an RN who works in the hospital setting is approximately A) $45,000 B) $58,000 C) $67,000 D) $81,000 Answer: C 23) Nurses in which setting focus on disease prevention through community education?

A) Hospitals B) Public health agencies C) Long-term care facilities D) Medical offices Answer: B 24) In which setting does the RN generally hold a supervisory or administrative role?

A) Hospital B) Public health office C) Medical office D) Long-term care facility Answer: D

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25) According to the text, all of the following are issues for the medical profession EXCEPT A) quality of care B) access to care C) cost of care D) oversupply of physicians Answer: D 26) All of the following are serious concerns for health care professionals, EXCEPT A) cost B) burnout C) latex injuries D) LPN licensure Answer: D 27) Primary care physicians see patients for preventive care.

Answer: TRUE 28) A hospitalist is a physician employed by a hospital, who focuses on providing care to hospitalized patients.

Answer: TRUE 29) The nurse's role may include working with other professionals and referring the patient elsewhere for services.

Answer: TRUE 30) The USMLE is a two-step exam that replaced the three-part NBME and FLEX licensing exams.

Answer: FALSE 31) Continuing medical education credits are required by states, and physicians who do not complete them could lose their medical licenses.

Answer: TRUE 32) The average RN is 25 years old.

Answer: FALSE 33) NPs can prescribe medications in all 50 states (including controlled substances in 49).

Answer: TRUE 34) Physicians are able to diagnose and treat illnesses by obtaining a patient's medical and performing a exam.

Answer: history, physical 35) are physicians who treat a variety of conditions, as opposed to physicians who specialize in a specific type of patient or body system.

Answer: General or family practitioners 5

36) A state legislation that sets out the requirements for physician licensure in that state is called .

Answer: Medical Practice Act 37) A physician's post-formal education, paid training is called Answer: residency

.

38) In addition to the traditional role of direct patient care, nurses' roles have expanded to include and health promotion.

Answer: disease prevention 39) In order for a physician to retain their license, he or she must pay a renewal fee once per and complete 75 hours of continuing education every years.

Answer: year, 3 40) Once a nurse has finished the educational program requirements, the next step is to take the .

Answer: national registry exam (NCLEX).

41) Explain a physician's primary role.

Answer: Responses will vary, but should include: The role of physicians is to diagnose and treat the illnesses of their patients.

42) Briefly explain the difference between certification and licensure.

Answer: Responses will vary, but should include that certification involves graduating and receiving a college degree or official document attesting to a status or level of achievement.

Licensure involves passing a licensure exam and completing on-the-job training to receive a license in a particular field, practice, or profession, and generally requires continuing education to keep the license active.

43) Define "reciprocity agreement."

Answer: Responses will vary, but should include: An agreement between two states in which each accepts the professional licensing requirements of the other.

44) Identify and explain two issues facing the nursing profession.

Answer: Responses will vary, and could include professionalism, health risks, burnout, and changes in the health care industry.

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The U.S. Health Care System, 3e (Austin) Chapter 6 Other Clinical and Non-Clinical Health Care Providers 1) A medical assistant's duties may include A) ordering tests B) taking medical histories C) prescribing medications D) preparing laboratory specimens Answer: D 2) Which professional is responsible for cleaning the operating room following surgery?

A) Maintenance personnel B) Surgical technologist C) Medical assistant D) Physician assistant Answer: B 3) MRI technologists use A) radiation B) magnets and radio waves C) scanners D) high frequency sound waves Answer: B

to produce images.

4) CT technologists A) operate radiation detection equipment B) use topography scanners to take cross-sectional images of the body C) operate equipment that uses sound waves to produce images D) use ultrasound images to examine the heart Answer: B 5) Physicians performing balloon angioplasties may be assisted by A) diagnostic medical sonographers B) medical laboratory specialists C) cardiovascular technologists D) nuclear medicine technologists Answer: C 6) Tests using radiopharmaceuticals may be performed by A) diagnostic medical sonographers B) cardiovascular technologists C) medical imaging technologists D) nuclear medicine technologists Answer: D

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7) Clinical chemistry technologists A) analyze the chemical and hormonal contents of body fluids B) examine bacteria and other microorganisms C) focus on the human immune system D) examine cells for signs of cancer Answer: A 8) Molecular biology technologists A) examine blood B) perform genetic tests C) examine cells for signs of cancer D) focus on the human immune system Answer: B 9) Ultrasonography uses sound waves to generate an image to assess and diagnose medical conditions. The professionals who performs such tests are called A) imaging technologists B) nuclear technologists C) medical sonographers D) phlebotomists Answer: C 10) Which therapy professional works with patients experiencing breathing problems?

A) Recreational therapist B) Respiratory therapist C) Audiologist D) Speech-language pathologist Answer: B 11) Which occupation does NOT require a bachelor's degree?

A) Respiratory therapist B) Occupational therapist C) Physical therapist D) Recreational therapist Answer: A 12) Improving a patient's daily living skills is the responsibility of the A) recreational specialist B) occupational therapist C) physical therapist D) speech-language pathologist Answer: B

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13) A CTRS is a A) Certified Tumor Registry Specialist B) Certified Therapeutic Recreation Specialist C) Credentialed Therapist of Respiratory Service D) Certified Therapist of Respiratory Service Answer: B 14) Which pharmacy professional typically counts tablets and labels bottles?

A) Pharmacy technician B) Pharmacy aide C) Pharmacist D) Pharmacy technologist Answer: A 15) An EMT basic can A) administer intravenous fluids B) use defibrillators C) use advanced airway techniques D) transport patients by ambulance Answer: D 16) Which professional cleans teeth?

A) Dentist B) Dental hygienist C) Dental assistant D) Dental lab technician Answer: B 17) All of the following are true of optometrists EXCEPT they A) provide primary care B) prescribe corrective lenses C) perform eye surgery D) manage macular degeneration Answer: C 18) The practice of a chiropractor is focused on the A) spine B) foot C) eyes D) teeth Answer: A

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19) All of the following are true about podiatrists, EXCEPT A) they provide foot care B) they must graduate from an accredited college of podiatric medicine C) they must complete a hospital residency D) their average salaries are $200,000 Answer: D 20) Which eye care professional makes prescription eyeglasses?

A) Optometrist B) Ophthalmic lab technician C) Dispensing optician D) Ophthalmologist Answer: B 21) All of the following are true about dieticians, EXCEPT A) they provide medical nutrition therapy to patients B) a master's degree is required to practice C) they may be employed in wellness programs D) they may practice in educational settings Answer: B 22) Health administration is concerned with all of the following EXCEPT A) patient care B) profitability C) the local EMS system D) marketing Answer: C 23) Coders can obtain professional credentials through the A) American Coding Professionals Association B) American Health Information Management Association C) Master of Business Administration D) both A and B Answer: B 24) Coders would least likely be found in A) private billing practices B) government agencies C) medical clinics D) occupational therapy clinics Answer: D

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25) All of the following may be areas of practice for the professional in information technology, EXCEPT A) medical records management B) privacy officer C) medical coding D) medical transcription Answer: D 26) A coding specialist assigns codes or numbers to all the following, EXCEPT A) diagnoses B) services C) errors D) procedures Answer: C 27) Coders must have a strong background in all the following, EXCEPT A) etymology B) anatomy C) physiology D) medical terminology Answer: A 28) Medical transcriptionists can be found in all of the following settings, EXCEPT A) hospitals B) physicians' offices C) home businesses D) cardiovascular labs Answer: D 29) Physician assistants and medical assistants perform the same duties.

Answer: FALSE 30) Physician assistants can work without physician supervision.

Answer: FALSE 31) Neurosonographers scan the abdominal cavity to assess the gallbladder, bile ducts, kidneys, liver, pancreas, and spleen.

Answer: FALSE 32) Dental lab technicians examine specimens for bacteria and microorganisms.

Answer: FALSE 33) Physical therapy assistants must work under the supervision of a physical therapist.

Answer: TRUE 34) Physician assistants must be recertified every Answer: 10 5

years.

35) Nuclear medicine uses Answer: radioactive drugs

to diagnose and treat disease.

36) prepare tissue samples for pathologists.

Answer: Histology technicians 37) use exercise and massage to help patients with mobility.

Answer: Physical therapists 38) The must be thoroughly familiar with CPT and ICD-10-CM codes.

Answer: coding specialist 39) ensure the completeness and accuracy of the health information record, which contains a patient's personal, social, financial, and medical data.

Answer: Health information managers 40) Describe the physician assistant's role.

Answer: Responses will vary, but may include: Working under the supervision of a physician, the PA provides health care services to patients. Duties may include taking medical histories, examining patients, ordering tests and X-rays, diagnosing, and prescribing medications.

41) Explain the role of a surgical technologist.

Answer: Responses will vary, but should include two of the following factors: Assist the surgical team by preparing patients; preparing surgical instruments and equipment; passing instruments and supplies during surgery; transferring patients after surgery; and cleaning and restocking the operating room.

42) List the three EMT service levels.

Answer: EMT-Basic EMT-Intermediate EMT-Paramedic 43) Define health administration.

Answer: Responses will vary, but should include: Health administration is concerned about patient care, but also about profitability and other business issues. Professionals in this industry may be referred to as health administrators, health managers, or health executives, and they hold a variety of job titles.

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The U.S. Health Care System, 3e (Austin) Chapter 7 Offices, Clinics, and Hospitals 1) John goes to his physician's office for his annual physical. This is an example of A) acute care B) tertiary care C) secondary care D) primary care Answer: D 2) John is in an automobile accident and taken to the hospital by ambulance. This is an example of A) primary care B) acute care C) secondary care D) tertiary care Answer: B 3) Ambulatory care can be provided in which setting?

A) Home health agency B) Hospice C) Physician's office D) EMS office Answer: C 4) Acute care is described by all of the following, EXCEPT A) it is considered routine hospitalization and surgery B) it implies a level of urgency C) the patient needs access to health care services immediately D) based on the seriousness, the patient may be admitted to the hospital Answer: A 5) The traditional medical practice structure is A) a corporation B) independent C) a solo practice D) a partnership Answer: D 6) One advantage of an LLP is A) financial obligation limits B) ease of construction C) independence D) simplicity Answer: A

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7) What must a facility do to comply with the accreditation standards of The Joint Commission (TJC)?

A) Improve rural access.

B) Pass a site survey visit.

C) Review numerous performance measure.

D) Receive certification.

Answer: B 8) The health information record contains all of the following, EXCEPT the patient's A) personal data B) medical data C) social data D) complete work history Answer: D 9) Uses of the health information record include all of the following, EXCEPT A) data for research activities B) information for patient care C) data for public health monitoring D) data for fixing prices of care delivery with area physicians Answer: D 10) A group of several physicians who practice as a group is a A) partnership B) limited liability partnership C) group practice D) solo practice Answer: C 11) All of the following regarding group practice are true, EXCEPT A) it permits the provider to share the burden of providing care B) it limits a partner's liability C) it allows the provider to share facilities D) it allows the provider to share equipment Answer: B 12) Health care professionals carry malpractice insurance for all the following reasons, EXCEPT to A) fulfill a requirement by many health care organizations B) protect their personal assets C) protect them from financial loss D) fulfill a requirement of HIPAA Answer: D

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13) Which are strategies to increase a physician's revenue?

A) Capture more revenue per patient B) Control and decrease costs C) Increase the number of patients seen D) All of the above Answer: D 14) All of the following are true regarding antitrust laws, EXCEPT they A) prohibit monopolization B) increase competition in the marketplace C) eliminate customer choice D) prohibit businesses from working together to set prices Answer: C 15) All of the following are examples of public hospitals, EXCEPT A) Veteran's Administration hospitals.

B) state psychiatric hospitals C) county hospitals D) proprietary hospitals Answer: D 16) In a not-for-profit hospital A) shareholders own the business B) income tax must be paid C) expansion is financed with loans D) property tax is not paid Answer: D 17) Long-term care is anything greater than A) 7 days B) 21 days C) 30 days D) 60 days Answer: D 18) A typical hospital is organized in three main parts, which include A) governing board, medical staff, and management team B) governing board, nursing staff, and management staff C) nursing staff, medical staff, and ancillary staff D) governing board, medical staff, and stock holders Answer: A

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19) Institutional policy is set by A) state and federal regulations B) the governing board C) the administration D) the medical staff Answer: B 20) The medical staff A) ensures quality patient care B) sets the overall direction for the hospital C) delegates authority to operate the facility D) reports to the hospital administrator Answer: A 21) The CEO is hired by the A) governing board B) medical staff C) administration D) state Board of Health Answer: A 22) This hospital area is responsible for entering initial personal and insurance data.

A) Medical records B) Ancillary services C) Nursing D) Admitting department Answer: D 23) Dietary, social service, and pastoral care are part of A) general patient support B) administrative support C) nursing support D) facilities support Answer: A 24) Security and maintenance are part of A) facilities support B) nursing support C) general patient support D) administrative support Answer: A

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25) Buying imaging equipment is the responsibility of A) general patient support B) administrative support C) nursing support D) facilities support Answer: B 26) All of the following are utilization measures, EXCEPT A) average daily census B) rates of infection C) capacity D) average length of stay Answer: B 27) Measures considered when assessing quality include all of the following, EXCEPT A) volume of procedures B) average length of stay C) rates of infection D) error rates Answer: B 28) All of the following are departments responsible for business functions, EXCEPT A) receiving B) accounting and finance C) information services D) marketing Answer: A 29) What is outsourcing?

A) Buying goods or services from another provider rather than performing them by the business B) Measuring that indicates whether an organization is being used to its full capacity C) Measuring the quality of an organization D) Evaluating hospitals owed by non-government entities Answer: A 30) Quality is determined by reviewing A) staffing levels B) infection rates C) long-term survival rates D) all of the above Answer: D 31) The office manager is responsible for the practice's business affairs.

Answer: TRUE 32) Medicare provides one of the largest share of revenue for physician's offices.

Answer: TRUE 5

33) Malpractice premiums are decreasing.

Answer: FALSE 34) Not-for-profit hospitals do not have to pay income or property taxes.

Answer: TRUE 35) Board members are employees of the hospital.

Answer: FALSE 36) Physicians are hospital employees, as is everyone on the administrative side of the organizational chart.

Answer: FALSE 37) The level of Medicare and Medicaid reimbursement to hospitals is now based, in part, on patient satisfaction survey results.

Answer: TRUE 38) The federal law created to aid in the protection of patient privacy is Answer: HIPAA

.

39) hospitals are non-federal hospital facilities available to the public.

Answer: Community 40) Private hospitals that operate on a for-profit basis are sometimes known as hospitals.

Answer: proprietary 41) The administrative work of the medical staff is carried out by Answer: committees

_.

42) List two of the functions on the business side of a professional practice.

Answer: Responses will vary, but should include two of the following: bills, payroll, taxes, supplies, equipment, and compliance with laws and regulations.

43) Identify three types of hospitals and address the factors that make them unique.

Answer: Responses will vary, but should include three of the following: public, privately owned, not-for-profit and issues related to ownership, personal liability, income taxation, and ease of formation.

44) Name the two key committees in administration and explain the role of each.

Answer: Responses will vary, but should include: Key committees are the executive committee and the credentials committee; the executive committee governs the activities of the medical staff; and the credentials committee focuses on the standards that will be used to grant staff membership and applies those standards to new applicants.

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45) Define EMTLA and explain what they do.

Answer: The Emergency Medical Treatment and Labor Act (EMTALA) dictates policy in hospital emergency rooms.

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The U.S. Health Care System, 3e (Austin) Chapter 8 Aging in America 1) When Diane and Steve return from vacation, Steve's mom expresses her desire to get out more. Diane wants to return to work, as opposed to being a full-time caregiver for her mother-inlaw. Which care option should they explore, excluding total out-of-home care?

A) Adult day care B) Nursing home C) Assisted living D) ICF care Answer: A 2) Long-term (LTC) care is defined as A) care for the elderly B) care for the disabled C) health care services to an individual for more than 60 days D) health care services to an individual for more than 90 days Answer: D 3) A LTC system that would provide physical, social, mental health, and financial support would be considered A) aging in place B) spending down C) a continuum of care D) IADL Answer: C 4) All of the following are IADL, EXCEPT A) managing money B) grocery shopping C) bathing D) housekeeping Answer: C 5) Which person would most likely require LTC? A) An individual with multiple sclerosis who is able to dress himself using assistive devices B) An individual who is unable to drive and takes the bus to run errands C) An individual who depends on others to clean house, run errands, and manage finances D) An individual who is unable to make it to the bathroom and cannot dress himself Answer: D 6) ADLs are A) assessment of daily living B) assessment delivery location C) activities of daily living D) alternative delivery location Answer: C 1

7) All of the following are ADLs, EXCEPT A) dressing B) bathing C) toileting D) shopping Answer: D 8) The two impairments most likely to result in the need for residential long-term care are A) bathing and eating B) transferring and bathing C) continence control and transferring D) eating and continence control Answer: C 9) Unpaid long-term-care providers are primarily A) women B) men C) local hospital employees D) sons Answer: A 10) The most prevalent reason for home health care visits is A) chronic illness B) injury C) cardiovascular illness D) cancer Answer: C 11) All of the following are true about home health care, EXCEPT A) it is the fastest growing segment of LTC B) the industry is divided into two categories: Medicare certified and private C) it includes hospice care D) the number of clients is decreasing Answer: D 12) Which therapies are frequently given in the home?

A) Enteral nutrition B) Chemotherapy C) Renal dialysis D) All of the above Answer: D

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13) Diane and Steve care for Steve's elderly mother. They have planned a vacation to Disney World and cannot take Steve's mom. Which care option should they explore?

A) Nursing home B) Respite care C) Assisted living D) ICF care Answer: B 14) All of the following are settings in which LTC may take place, EXCEPT A) clinics B) hospitals C) adult day cares D) assisted living centers Answer: A 15) All of the following are categories of nursing home care, EXCEPT A) SNF B) ADF C) ECF D) ICF Answer: B 16) What is the majority population admitted to nursing homes?

A) Caucasian females B) Caucasian males C) Hispanic females D) Asian males Answer: A 17) The average age of all assisted living residents is A) greater than 70 but less than 80 years old B) greater than 100 years old C) greater than 60 but less than 70 years old D) greater than 80 but less than 100 years old Answer: D 18) Long-term care beyond 100 days is funded by all the following, EXCEPT A) Medicaid B) Medicare C) LTC insurance D) family members Answer: B

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19) Medicaid will cover LTC payment in which situation?

A) The individual has turned 65.

B) The individual is disabled.

C) The individual qualifies for LTC and meets Medicaid's income test.

D) The individual did not qualify for LTC insurance.

Answer: C 20) Staffing ratios in long-term care are A) greater than B) less than C) equal to Answer: B

_ (in) hospitals.

21) The sandwich generation are A) adults who are caring for both their children and parents B) teens who have preschool and adult siblings C) adults who are caring for their parents D) adults who are caring for their parents and grandparents Answer: A 22) Medical power of attorney refers to A) an individual who is able to select the proper attorney for a malpractice case B) an individual given health care decision power for another person who is deemed incapable of making decisions C) an automatic power, which any caregiver has for the care decisions of another D) a power only the Veteran's Administration may grant Answer: B 23) Which of the following is NOT an ethical or political issue related to LTC? A) Resource allocation B) Guardianship C) End-of-life care D) DVA Answer: D 24) Utilization statistics show that a person uses the most care in the last life.

A) 24 B) 12 C) 6 D) 3 Answer: C

4

months of

25) What percent of LTC is provided by friends and family members?

A) 20% B) 40% C) 60% D) 80% Answer: D 26) Which services will Medicare pay for?

A) Unskilled care B) Long-term home health care C) Acute care D) All of the above Answer: C 27) The Department of Veterans Affairs (DVA) is the largest integrated delivery system.

Answer: TRUE 28) DVA is one of the leading educational and research organizations for chronic and aging care.

Answer: TRUE 29) Adult day care provides socialization and rehabilitation.

Answer: TRUE 30) Assisted living facilities utilize the same model of care as hospitals and SNFs. Answer: FALSE 31) The amount of money that families in the low- to middle-income ranges inherit has been decreasing over the last decades, in part related to spending down of assets to provide LTC. Answer: TRUE 32) The ideal long-term-care system utilizes a model.

Answer: holistic

approach, as opposed to the medical

33) is any method of delivering nutrition that is not by mouth, such as by an intravenous line or by a direct tube into the stomach or intestine.

Answer: Parenteral nutrition 34) Mary lives in an apartment complex. She has a small one-bedroom apartment with a small kitchen and living area. She eats in the community dining room at least once a day. Mary lives in a(n) .

Answer: independent living center or assisted living center 35) Differentiate between an ADL and IADL. Answer: Responses will vary, but should include: ADLs are personal care/needs; IADLs are care/management of the person's environment.

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36) Name three primary disease processes that affect the elderly, causing a need for assistance in ADLs and IADLs. Answer: Responses will vary, but should include: The primary disease processes that affect this population and cause the need for assistance in the ADLs and IADLs are arthritis, complications of high blood pressure (e.g., stroke, heart disease), diabetes, pulmonary disease, cancers, fractures, and cognitive impairment from Alzheimer's or other dementias.

37) Define continuum of care.

Answer: Responses will vary, but should include: The philosophy that the health care system should facilitate an individual's care from complete independence to dependence.

38) Define aging in place.

Answer: Responses will vary, but should include: A philosophy that allows the aging person or couple to stay in their living situation while growing older with increasing levels of personal and medical assistance, as needed. These are adult living communities where the range is from individual homes to a skilled-nursing facility in one complex.

39) Describe the health care power of attorney. What are the advantages and disadvantages of this legal document to the patient and to the health care community?

Answer: Responses will vary, but should include: Gives another authority to make decisions on the patient's behalf.

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The U.S. Health Care System, 3e (Austin) Chapter 9 Mental Health Services: A Combination of Systems 1) The discovery of a biochemical basis for some of the major categories of mental illness led to all of the following changes, EXCEPT A) changes from residential care to outpatient talk therapy B) changes from physical or somatic treatments to treatments relying on drug therapy C) changes from treatments relying on drug therapy to somatic and physical treatments D) changes from the institutional model of care to a general delivery and business model Answer: C 2) A diagnosis of mental illness is determined A) solely through measurable parameters B) solely through functional ability C) through a combination of objective and subjective data D) through response to prior treatment Answer: C 3) All of the following describe mental illnesses, EXCEPT A) alterations in thinking B) alterations in behavior C) alterations in liver function D) alterations in mood Answer: C 4) Mental illness, including drug abuse, affects A) less than 10% B) greater than 20% C) greater than 30% D) less than 20% Answer: A

of the U.S. population.

5) All of the following are true regarding mental illness, EXCEPT A) around 45% of adults suffer from substance abuse B) around 80% do not receive treatment C) most are a chronic lifetime disease D) it strikes one in every five adults Answer: A 6) Among the public payers of mental health care, A) Medicaid B) Medicare C) state and local agencies D) Department of Veterans Affairs Answer: A

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pays the most.

7) Which is TRUE regarding mental health services?

A) Less than one-half of adults with a mental health disorder receive services.

B) Direct state funding of mental health care has increased.

C) Medicaid funding of mental health care has grown.

D) Generally, the same providers are used for treatment of mental illness and substance abuse.

Answer: C 8) Because of its substantial role in financing mental health services, influence in designing mental health service delivery.

A) Medicaid B) Medicare C) Blue Cross/Blue Shield D) private insurance Answer: A

has significant

9) Which of the following is NOT a category of human resource components in mental health care?

A) Specialty mental health sector B) Home health sector C) General medical/primary care sector D) Human services sector Answer: B 10) Which of the following is NOT a type of treatment for mental illness?

A) Psychotherapy B) Ablation C) Drug therapy D) Electroshock therapy Answer: B 11) Which is part of the specialty mental health sector?

A) Alcoholics Anonymous B) Prison-based services C) Psychiatrist D) Primary care physician Answer: C 12) Which of the following is NOT true about the human services sector?

A) They assesses, diagnose, and treat childhood mental illness and cognitive disorders.

B) Self-help groups play a major role for this group.

C) Social services and school-based counseling belong to this sector.

D) Religious counselors belong to this sector.

Answer: B

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13) Which era focused on prevention and scientific orientation?

A) Moral era B) Mental hygiene era C) Community mental health era D) Current community support era Answer: B 14) Human restorative treatment was the focus of which mental illness treatment period?

A) Mental hygiene era B) Community mental health era C) Current community support era D) Moral treatment era Answer: D 15) The state care acts A) centralize the care into one or two state mental hospitals that cared for thousands of residents at a time B) called for an expansion of neuropathology in mental hospitals C) called for bringing mental health services to the public in their communities D) investigated the results of consumer-operated program outcomes for people with mental illness Answer: A 16) All the following are major causes of disability for women, EXCEPT A) depression B) bipolar disease C) schizophrenia D) obsessive compulsive disorder Answer: D 17) This medical disorder involves the body, mood, and thoughts.

A) Alzheimer's B) Schizophrenia C) Depression D) Anxiety disorder Answer: C 18) Deinstitutionalization of people committed to psychiatric hospitals and changes in psychiatric treatment led to all of the following, EXCEPT A) self-help programs B) drop-in centers C) case-management services D) fewer treatment options Answer: D

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19) All of the following are examples of mental disorders, EXCEPT A) Alzheimer's B) schizophrenia C) anorexia D) Parkinson's Answer: D 20) All the following are true regarding suicide, EXCEPT A) men attempt suicide three times more often than women B) there are approximately 25 suicide attempts for every death C) ninety percent suffer from substance abuse or a diagnosable depressive disorder D) in 2006, the highest rates occurred in white men over the age of 85 Answer: A 21) Hallucinations are characteristic of A) schizophrenia B) anxiety disorders C) Alzheimer's D) depression Answer: A 22) Which is TRUE regarding schizophrenia?

A) It appears in men in their late teens or early twenties.

B) Over fifty thousand new cases are diagnosed each year.

C) If one twin exhibits symptoms, the other twin will not become symptomatic.

D) Affects four times more women than men.

Answer: A 23) Feelings of dread, fear, and apprehension are indicative of A) anxiety disorders B) depression C) schizophrenia D) Alzheimer's Answer: A 24) Hyperventilation and tachycardia often accompany A) panic disorder B) generalized anxiety disorder C) posttraumatic stress disorder D) obsessive-compulsive disorder Answer: A

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25) All the following are true regarding posttraumatic stress disorder, EXCEPT it A) involves frequent occurrence of flashbacks B) generally manifests within 3 months of a terrifying event C) affects ten times more men than women D) is accompanied by depression, substance abuse, and anxiety Answer: C 26) Which disorder is predominantly associated with children?

A) Attention-deficit/hyperactivity disorder B) Posttraumatic stress disorder C) Schizophrenia D) Generalized anxiety disorder Answer: A 27) Which of the following is NOT a possible risk factor for mental illness?

A) Family history B) Lack of social support C) Inability to read D) Strong support system Answer: D 28) Which of the following is NOT an ethical issue in mental health?

A) Confidentiality B) Access C) Economics D) Ageism Answer: D 29) More U.S. adults suffer from substance abuse than from mental illness.

Answer: FALSE 30) The parity of payment to consumers is a major goal of mental health legislation.

Answer: TRUE 31) Historically, mentally ill people were considered possessed by evil spirits.

Answer: TRUE 32) The movie One Flew over the Cuckoo's Nest was a dramatic portrayal of the state's response to the state care acts.

Answer: TRUE 33) Racism is a barrier to a person accessing mental health services.

Answer: TRUE 34) Mental illness, like physical illness, is defined the same way by every culture.

Answer: FALSE 5

35) calls for equity in mental health and general health coverage.

Answer: Parity 36) The major sector that assesses, diagnoses, and treats childhood mental illness and cognitive disorders is the _.

Answer: human services sector 37) is a major concern of patients with mental illness because of the stigma and possible occupational repercussions if the condition were known.

Answer: Confidentiality 38) List three of the identified mental health treatment types identified in the text.

Answer: Answers will vary, but should include three of the following: self-help, psychotherapy, talk therapy, behavioral therapy, drug therapy, or device therapy.

39) List three of the identified mental health care settings.

Answer: Answers will vary, but should include three of the following: home care, communitybased residential care, day care, sheltered work setting, outpatient facilities, private psychiatric and recovery institutions, public emergency facilities, or public long-term-care facilities 40) Discuss issues related to children and mental health.

Answer: Responses will vary, but should address the following: Diagnosis, care delivery systems, care givers, and therapies.

41) Explain some of the factors that result in the underutilization of mental health services.

Answer: Responses will vary, but should include systemic, economic, stigma, and cultural factors.

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The U.S. Health Care System, 3e (Austin) Chapter 10 The Public Health System: The Government's Role 1) Public health focuses on A) prevention issues B) curative medical care C) foundation support D) environmental health Answer: A 2) The Act for the Relief of Sick and Disabled Seamen A) established the Massachusetts public health agency B) required the quarantine of sailors with a contagious disease C) provided funds for the Report of the Sanitary Commission of Massachusetts D) taxed the salaries of sailors to build and staff hospitals to care for soldiers Answer: D 3) The Act for the Relief of Sick and Disabled Seamen also resulted in the A) creation of a public health lab in every state B) U.S. Public Health Service C) creation of the Institute of Medicine D) creation of a health department in every state Answer: B 4) Which of these became America's blueprint for the development of public health systems?

A) The World Health Organization B) The Philadelphia epidemic C) Report of the Sanitary Commission of Massachusetts D) Act for the Relief of Sick and Disabled Seamen Answer: C 5) Which is a key function of public health?

A) Policy development B) Assurance of the public's health C) Assessment of the community's health D) All of the above Answer: A 6) Epidemiology is all the following, EXCEPT A) it is the study of the history of a disease B) it determines where a disease came from C) it is the continuous search for and documentation of disease D) it determines of the frequency of disease Answer: C

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7) Surveillance is A) the study of disease distribution throughout society B) determining if there is more or less of a disease than in the past C) the continuous search for and documentation of disease in public health D) the study of the number of deaths from disease Answer: C 8) Monitoring is A) the study and review of drug resistant diseases B) the regular review of disease data to determine changes in disease levels C) the review of the determinants of skin diseases and disorders D) the study of determinants of the frequency of disability Answer: B 9) This area of public health collects data on the number of sexually transmitted diseases.

A) Surveillance B) Monitoring C) Epidemiology D) Reporting Answer: A 10) Money granted by the national government to a state government with few restrictions on its spending is a A) categorical grant B) block grant C) government loan D) relative risk loan Answer: B 11) The number of new cases of a disease or event is called the A) prevalence B) incidence C) risk D) mortality Answer: B 12) Which is an example of mortality?

A) Cancer accounted for 10,000 deaths in 2008.

B) There were 20 reported cases of HIV in Webster County.

C) A smoker is more likely to get cancer than a nonsmoker.

D) Ten new cases of TB were discovered in the state of Nebraska.

Answer: A

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of the disease.

13) The total number of infected people over a given period of time is known as A) mortality B) incidence C) prevalence D) risk Answer: C 14) Morbidity is the A) number of new cases of a disease or event B) number of cases of a specific disease in a specific period of time per unit of population C) number of people who have died from a given disease or event D) total number of infected/affected people (cases) over a given period of time Answer: B 15) Epidemiologists investigate all of the following, EXCEPT A) where a disease outbreak occurred B) who is affected by a disease C) how a disease affected a victim D) the genetic material of a bacterium Answer: D 16) State departments are required by law to report all of the following, EXCEPT A) the number of people with a specific disease B) child abuse and neglect C) the names of people with HIV D) the number of people who are disabled Answer: C 17) The principal agency responsible for protecting the nation's health is the A) Centers for Disease Control and Prevention B) Food and Drug Administration C) Department of Health and Human Services D) Health Resources and Services Administration Answer: C 18) This agency maintains national health statistics.

A) Food and Drug Administration B) Department of Health and Human Services C) Health Resources and Services Administration D) Centers for Disease Control and Prevention Answer: D

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19) This agency provides health care for 25% of Americans.

A) Department of Health and Human Services B) Centers for Medicare and Medicaid Services C) Health Resources and Services Administration D) Food and Drug Administration Answer: B 20) This agency works to provide health care to people who live in areas where health care is not readily available.

A) Centers for Disease Control and Prevention B) Department of Health and Human Services C) Health Resources and Services Administration D) Centers for Medicare and Medicaid Services Answer: C 21) The CDC works with community organizations and state health department to do all the following, EXCEPT A) monitor disease B) prevent disease outbreaks C) assure the safety of medications D) operate health promotion programs Answer: C 22) The FDA A) assures the safety of food B) assures the safety of cosmetics C) assures the safety of medication D) all of the above Answer: D 23) Responsibilities of state departments of health include all of the following, EXCEPT A) conducting inspections of restaurants and factories B) assuring the safety of foods, cosmetics, and medications nationally C) carrying out national and state mandates designed to protect health D) conducting the planning and evaluation of health programs Answer: B 24) Licensing boards are responsible for all the following, EXCEPT A) making sure that laboratories are using proper techniques B) evaluating restaurants for safe food handling and cleanliness C) ensuring that factories have strong pollution control measures D) making sure schools have violence protection measures in place Answer: D

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25) Functions of county and city health departments do NOT include A) adult and child immunizations B) communicable disease control C) raising funds for the American Cancer Society D) community assessment Answer: C 26) Foundations are NOT A) not-for-profit organizations B) groups that raise funds to support a cause of their choice C) groups that distribute funding to other community-based organizations in support of their work D) groups that provide direct medical care Answer: D 27) Public health has a curative focus.

Answer: FALSE 28) Requiring hard hats falls within the public health domain.

Answer: TRUE 29) Leper colonies were part of the early days of public health.

Answer: TRUE 30) The nation's capital was moved from Philadelphia because of a public health issue.

Answer: TRUE 31) The Institute of Medicine report entitled, "The Future of Public Health" identified key functions of public health.

Answer: three 32) health departments can serve an individual county, city, or region.

Answer: Local 33) are the policymaking bodies for a state's department of health.

Answer: Boards of health 34) Improved sanitation and clean water have helped control many diseases, such as and .

Answer: cholera; typhoid 35) Define and explain the concept of public health.

Answer: Responses will vary, but should include: Public health involves the well-being of all of us as we live together in neighborhoods, communities, states, and countries. It is anything and everything that relates to helping us collectively experience "a state of complete physical, mental and social well-being." It touches nearly every aspect of our lives.

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36) Explain how the government's role in health has expanded and what led to this expansion.

Answer: Responses will vary, but should include; During the Great Depression, the federal government was expected to take action. Since then, the federal government's role in health has expanded. Two sections of the Constitution have been interpreted as allowing the federal government to intervene in the nation's health. The first is the ability to tax people to provide for the "general welfare." This allows for the collection of money to be used in support of health programs. In fact, today, the government's main role in public health is financial support of public health programs. Second, the federal government has the ability to regulate commerce.

Only the government can enforce policies that limit the personal and property rights of individuals or businesses. This power allows for the regulation of restaurants, sewage and water companies, product and drug safety, and other businesses that sell products to consumers.

37) List three of the state health department's responsibilities.

Answer: Answers will vary, but should include three of the following: Carrying out national and state mandates designed to protect health Managing environmental education and personal health services Collecting, analyzing, and disseminating information on threats to the community's health Responding to statewide health crises, such as hepatitis and flu outbreaks Setting policies and standards for health care and medical professionals Conducting, planning, and evaluation of health programs Conducting inspections of restaurants and factories 38) Identify and explain two of the Centers for Disease Control and Prevention's achievements that have resulted in increased longevity for Americans.

Answer: Responses will vary, but must include two of the following: Vaccination Safer workplaces Healthier mothers and babies Control of infectious diseases Coronary heart disease and stroke prevention programs Safer and healthier food Family planning Motor vehicle safety Fluoridation of drinking water Recognition of tobacco as a health hazard 39) Name three foundations that work to improve individuals' health.

Answer: Red Cross, March of Dimes, American Cancer Society

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The U.S. Health Care System, 3e (Austin) Chapter 11 Medical Technology, Pharmaceuticals, and Pharmacological Research 1) Medical technology is A) the research, production, marketing, and dispensing of bioactive agents for therapeutic purposes B) a means to collect and store, analyze, and display health care data C) the primary reason health care is so expensive D) therapeutic and diagnostic devices used by health professionals to prevent, treat, and medically assist and diagnose illness Answer: D 2) Pharmaceuticals are A) the primary reason health care is so expensive B) bioactive agents for therapeutic purposes C) therapeutic and diagnostic devices used by health professionals to prevent, treat, and medically assist and diagnose illness D) a means to collect and store, analyze, and display health care data Answer: B 3) The medical technology industry reinvests A) 3 B) 5 C) 11 D) 20 Answer: C

% of sales in research and development.

4) The medical technology industry employs about A) 281,000 B) 423,000 C) 591,000 D) 725,000 Answer: A

people.

5) The last 20 years have seen medical advances in all the following, EXCEPT A) medical devices B) medical imaging C) genetic mapping D) maximally invasive surgery Answer: D 6) Fiber optics, microwave, and cryotherapy are used in A) laparoscopic surgery B) mapping C) genetic therapy D) minimally invasive surgery Answer: D 1

7) A CT scan is a A) process used to read the implanted microchip of lost felines B) computerized axial tomography C) compound access tomograph D) computerized access tomography Answer: B 8) Genetic testing may result in A) genetic discrimination B) lower insurance rates C) decrease in abortion D) higher divorce rates Answer: A 9) In the following statement, which is NOT true? Faulty genes can be correct through .

A) gene replacement B) selective reverse mutation C) electrocautery D) gene swapping Answer: C 10) Gene therapy is currently approved for the treatment of A) mental disorders B) contagious diseases C) genetic disorders D) non-curable diseases Answer: D 11) Gene recombination is A) the swapping an abnormal gene for a normal gene B) stem cell therapy C) the introduction of a vector virus D) a translocation of genetic material Answer: A 12) Use of this technology has resulted in decreased hospital days.

A) Robotics B) Antibiotics C) Radiology D) Laparoscopic surgery Answer: D

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13) Cost/benefit analysis compares the costs of A) drugs versus devices B) a treatment to the benefits C) insurance to its benefits D) genetic mapping to its benefits Answer: B 14) Medications that consumers can buy for themselves without a prescription are A) generic drugs B) over-the-counter drugs C) investigational drugs D) disease-specific drugs Answer: B 15) What percentage of office visits involve drug therapy?

A) 10% B) 35% C) 75% D) 90% Answer: D 16) Which percent of individuals have used three or more prescription drugs within the last 30 days?

A) 11% B) 21% C) 48% D) 75% Answer: B 17) Which legislation required labeling of drugs and food additives?

A) 1959 Kefauver Senate hearings B) 1962 Amendment to the Food, Drug, and Cosmetic Act C) Food and Drug Act of 1906 D) Food, Drug, and Cosmetic Act of 1938 Answer: C 18) Which legislation required drug safety testing?

A) 1962 Amendment to the Food, Drug, and Cosmetic Act B) Food, Drug, and Cosmetic Act of 1938 C) Food and Drug Act of 1906 D) 1959 Kefauver Senate hearings Answer: B

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19) Which phase of drug testing determines whether the drug produced the desired effect?

A) Phase IV B) Phase II C) Phase I D) Phase III Answer: B 20) In which testing phase is the safety and effectiveness of the drug compared to both the standard treatment and placebos?

A) Phase II B) Phase I C) Phase III D) Phase IV Answer: C 21) Blind randomized trials are A) new tools which scientists can use to examine millions of compounds a year to screen for good ideas or drug leads B) phase I research studies C) phase II research studies D) studies where volunteers do not know whether they are receiving the drug, a placebo, or standard treatment Answer: D 22) All of the following are true about an IND, EXCEPT A) it is submitted to begin clinical tests on human subjects B) it takes several years to get approval to test on human subjects C) IND stands for investigational new drug application D) if it is approved, phase I testing begins Answer: B 23) Which is TRUE regarding gene sequencing?

A) It helps scientists screen for good ideas or prescription drug leads.

B) It is the treatment of disease using normal or altered genes to replace or enhance nonfunctional or missing genes.

C) It is the process of determining the individual arrangement of nucleotides that compose a given gene.

D) A and C Answer: D 24) All of the following are ways a new drug is marketed in the United States, EXCEPT A) medical journals and conference reporting B) asking the FDA to advertise the drug C) marketing by drug representatives of pharmaceutical companies D) reaching patients directly by paid advertising Answer: B 4

25) In direct-to-consumer advertising, the FDA requires all the following, EXCEPT A) information on comparable generic drugs B) claims must be supported by substantial evidence C) information must reflect a balance of risks and benefits D) consistency with approved labeling Answer: A 26) What do many patient advocates believe should occur regarding drugs for AIDs, malaria, and TB? A) Patents should be cancelled.

B) Patents should be required.

C) Price of the drugs should be increased.

D) These drugs should be free.

Answer: A 27) HIV/AIDS drugs cost around A) $5,000 per year B) $20,000 per year C) $40,000 per year D) $100,000 per year Answer: D 28) Magnetic resonance imaging creates images using electrons instead of X-rays. Patient care is improved by reducing the time and discomfort a patient experiences being immobile and confined for a conventional CT scan.

Answer: FALSE 29) An example of cost/benefit analysis is the research that led to the conclusion that the cost of treating childhood earaches has increased in the last two decades, with no significant change in outcomes.

Answer: TRUE 30) Once a drug has been approved to market, it can only be recalled by the pharmaceutical company.

Answer: FALSE 31) Claritin, Lipitor, and Viagra are examples of drugs advertised in popular print and television media.

Answer: TRUE 32) Answer:

is safely being used to remove tumors of the liver, heart, kidney, and more.

RFA or radio frequency ablation

33) percent of people have used at least one prescription drug.

Answer: 48%

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34) This drug was the catalyst for the 1962 Amendment to the Food, Drug, and Cosmetic Act of 1938.

Answer: Thalidomide 35) In , thousands of people participate in new drug testing.

Answer: Phase III 36) are not advertised.

Answer: Generic drugs 37) Describe the Human Genome Project and identify two positive outcomes and two controversial aspects of the project.

Answer: Responses will vary, but should identify the project as one that involves genetic research and assists in the identification of genetic data. The data can be used to identify and treat disorders. This data can also be used in bioethical, legal, and social ways to discriminate.

38) List the three questions that must be answered during clinical drug trials for new drugs.

Answer: Is the drug safe? Does it work? Is it better than the standard treatment already in place?

39) Explain one ethical issue in pharmaceuticals.

Answer: Responses will vary, but should identify that the research should be available to everyone, following the model of the Human Genome Project. The pricing of drugs that only have a very limited market for distribution for people with rare diseases is another area of concern.

40) Name the two largest "free" categories brought about by the Affordable Care Act. Answer: Common preventive medicine and oral contraceptives are the largest "free" categories.

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The U.S. Health Care System, 3e (Austin) Chapter 12 Health Care Research and Prevention 1) In 2009, the influenza virus that was spreading around the world was the A) H1N1 B) H7N7 C) Asian flu (H2N2) D) Hong Kong flu (H3N2) Answer: A 2) Curative describes research designed to A) identify a disease definitively B) prevent a disease from spreading C) keep a disease from occurring D) eliminate a disease Answer: D 3) Control describes research designed to A) find a cure for a disease B) identify a disease definitively C) keep a disease from occurring D) decrease the symptoms/severity of a disease Answer: D 4) Prevention describes research designed to A) keep a disease from occurring B) decrease the symptoms/severity of a disease C) eliminate a disease D) identify a disease definitively Answer: A 5) All of the following are examples of curative research, EXCEPT A) correction of a congenital heart abnormality B) reducing the symptoms of menopause C) removal of a tumor D) hysterectomy Answer: B 6) All of the following are examples of control therapy, EXCEPT A) chemotherapy B) thyroid hormone C) immunization D) heart medication Answer: C

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7) All of the following are phases of prevention research, EXCEPT A) determining health disparities B) determining what diseases and conditions affect the population C) determining the predisposing factors that put a person at risk for disease D) identifying the causative agent for the disease Answer: A 8) All of the following are part of the government's role in prevention, EXCEPT A) research B) funding C) informing D) marketing products Answer: D 9) All of the following are true about the NIH, EXCEPT A) it has 25 different centers B) it controls a research budget of $30 billion/year C) it has 75 buildings on 300 acres D) it only approves prevention research Answer: D 10) The federal government's expenditures for health care research equals about billion a year.

A) $60 B) $10 C) $75 D) $30 Answer: D 11) CDC stands for A) Centers for Disease Control and Prevention B) Communicable Disease Center C) Center for Disease Control D) Communicable Disease Control Center Answer: A 12) Which of the following is NOT a center of the NIH? A) National Cancer Institute B) National Human Genome Research Institute C) National Heart Association D) National Institute on Aging Answer: C

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13) Which is NOT a department of DHHS? A) National Eye Institute B) National Institutes of Health C) Food and Drug Administration D) Indian Health Services Answer: A 14) What must a person do if they receive an NIH grant?

A) Report to the NINR each year.

B) Submit a budget every year.

C) Take the NINR research training course.

D) Write grants for researchers.

Answer: B 15) Which of the following is NOT true about NIH research grants?

A) The NIH receives 3,000 grant applications quarterly.

B) The smallest grants are $50,000.

C) The largest grants may be millions of dollars.

D) The standard grant is for 5 years.

Answer: A 16) In 2013 the life expectancy in the U.S. was approximately A) 85 years B) 79 years C) 67 years D) 90 years Answer: B 17) The leading cause of death in the U.S. in 2013 was A) stroke B) heart disease C) cancer D) accidents Answer: B 18) Cigarette smoking is responsible for A) 156,000 B) 480,000 C) 610,000 D) 750,000 Answer: B

deaths per year.

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19) All of the following are smoking cessation treatments found to be effective, EXCEPT A) counseling B) prescription non-nicotine medication C) surgical intervention D) over-the-counter and prescription nicotine replacement products Answer: C 20) Approximately A) 12 B) 23 C) 42 D) 75 Answer: C 21) An estimated exposure.

A) 22,000 B) 30,000 C) 41,000 D) 49,000 Answer: C

million people in the United States smoke cigarettes.

of tobacco-related deaths are the result of secondhand smoke

22) The leading causes of death among women are related to all the following, EXCEPT A) alcoholism B) smoking C) obesity D) hypertension Answer: A 23) Which of the following is NOT true about women's health?

A) In most states, 85% of women under 65 have health insurance.

B) Only 17 states provide poor women with safe abortion procedures.

C) Thirty percent of women over 18 have a pap smear every 3 years.

D) Sixty-seven percent of women over 40 have a mammogram every 2 years.

Answer: C 24) The need for increased access to reproductive health care is demonstrated by A) neurologically-impaired babies B) increased maternal diabetes C) high rates of unintended pregnancies D) all of the above Answer: D

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25) All of the following is true regarding the workplace, EXCEPT A) employers may offer up to 50 percent reductions in health coverage costs as an incentive for participation in wellness programs B) chronic diseases cost employers about $93 billion in health insurance claims C) so far, small companies have been more likely to implement wellness programs than large companies D) employees may receive monetary incentives for participation in "walk" and "talk" programs Answer: C 26) WELCOA estimates that for every $1 spent on wellness programs, the employer saves in health insurance costs.

A) $1 B) $3 C) $5 D) $7 Answer: B 27) Which website provides information on food and nutrition?

A) www.cdc.gov/workplacehealthpromotion/organizations/index.htm B) www.acefitness.org/default.aspx C) www.choosemyplate.gov/ D) http://www.nia.nih.gov/alzheimers Answer: C 28) The government, universities, and private industries finance health care research.

Answer: TRUE 29) Control research can focus on the use of pharmaceuticals, such as antibiotics, that eliminate disease.

Answer: FALSE 30) Cancer was the second leading cause of death in the U.S. in 2013.

Answer: TRUE 31) Women's health is one of the areas in which the least progress has been made toward the Healthy People 2020 goals.

Answer: TRUE 32) The NIH tracks American health behavior.

Answer: FALSE 33) Health-related quality of life (HRQOL) integrates both and health dimensions so that health is no longer the opposite of disease and death, but a concept that stands for well-being.

Answer: physical, mental

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34) A parent wanting to research her child's health should visit the website of Answer: www.kidshealth.org

.

35) List two reasons for health care research.

Answer: Identify causes of disease Identify ways to control disease symptoms Identify ways to prevent disease conditions 36) Describe the government research grant process.

Answer: Complete research training course, if applicable Write grant Apply to one of 25 NIH centers Applications screened by NIH grant screeners Receive approval Submit quarterly report and annual budget Reapply after 5 years, if necessary 37) List 4 of the 12 agencies of the DHHS. Answer: Answers will vary, but should include four of the following: FDA CDC NIH IHS AHRQ HRSA ACF AOA CMS ATSDR SAMHSA PSC 38) List 3 of the 10 leading causes of death in the United States, according to 2001 CDC data.

Answer: Answers will vary, but should include three of the following: Heart disease Cancer Chronic lower respiratory diseases Accidents (unintentional injuries) Stroke (cerebrovascular disease) Alzheimer's disease: Diabetes Influenza and pneumonia Nephritis, nephrotic syndrome, and nephrosis Intentional self-harm (suicide)

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39) List the two broad health goals from Healthy People 2020.

Answer: The first goal is to increase the quality and years of healthy life, and the second is to eliminate health disparities.

40) Access to care is responsible for many of the health issues discussed in this chapter. Define this issue.

Answer: Answers will vary, but should include income and education as major predictors of access.

41) List the website that employers can visit to obtain assistance in creating programs that study their health care data, and survey employees to decide which programs would be most valuable.Answer: www.cdc.gov/workplacehealthpromotion/organizations/index.htm

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The U.S. Health Care System, 3e (Austin) Chapter 13 Cultural Competency, Health Literacy, and Health Care Ethics 1) Subcultures are A) persons who evaluate others' customs according to values of their own cultural group B) groups that share many elements of mainstream culture but maintain distinctive customs and lifestyles C) clusters of minorities D) individuals with health illiteracy Answer: B 2) All of the following are ethnic minority groups in the U.S., EXCEPT A) Asian B) Native American/Alaskan Native C) Caucasian D) Hispanic/Latina Answer: C 3) Which of the following is NOT an aspect of culture that impacts health care?

A) Language B) Sexuality C) Grief response D) Leisure practices Answer: D 4) All of the following may be more likely for patients of different cultures and languages regarding health issues, EXCEPT they may be A) calm and relaxed B) anxious C) worried D) confused Answer: A 5) Which relates to the American cultural value of freedom?

A) Americans expect to be comfortable.

B) Americans resent any limitation on their right to smoke or drink.

C) Americans expect technology to change rapidly.

D) Even when not at work, Americans expect people to be "busy."

Answer: B 6) Autonomy means A) self-rule B) do no harm C) everyone is equal D) justice Answer: A 1

7) Paternalism means A) justice B) do no harm C) father knows best D) everyone is equal Answer: C 8) All of the following are true about codes of ethics, EXCEPT A) they are based on ethical principles B) health care professionals are held to a higher ethical standard than nonprofessionals C) they demand a certain standard of behavior D) few professions have them Answer: D 9) The three policy drivers of health care include all of the following, EXCEPT A) cost B) compassion C) quality D) access Answer: B 10) All of the following are principles of professional behavior, EXCEPT A) confidentiality B) transparency C) veracity D) compassion Answer: B 11) In Rights theory, health care is described as a A) basic human and citizen right B) resource to be allocated where it will do the most good C) right for only the few D) resource for only the most disadvantaged Answer: A 12) All the following is true regarding the Swedish health system, EXCEPT A) three-fourths more money is spent on health care per person than the United States B) the maternal and infant mortality is the lowest in the world C) it does not allow unequal treatment on the basis of wealth or income shares D) it is a wholly nationalized system Answer: D

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13) All of following are cultural values in America, EXCEPT A) group superiority B) humanitarianism C) science and technology D) equal health care for all Answer: D 14) Health literacy affects all the following, EXCEPT A) level of access to health care B) the incidences of certain diseases C) the number and type of immunizations D) the licensing requirements to become an advocate Answer: D 15) Research suggests that those who are not health literate experience almost on hospitalizations than their health literate counterparts.

A) 15 B) 30 C) 40 D) 50 Answer: C

% more

16) Prior to the Affordable Care Act, the only people with a right to health care were A) newborns B) preschoolers C) young adults D) the 65+ age group Answer: D 17) Kantian theory A) tells people they ought to treat others as they want to be treated themselves B) views health care as a basic right C) implies that health care resources should be allocated where they will do the most good D) states that each person is to have an equal right to basic liberties Answer: A 18) The delivery of health care is ethically special because of all of the following, EXCEPT A) it has the overarching goal of reducing pain and suffering B) it influences the opportunities a person has in society C) it has historical, religious, and moral connotation D) medical technology companies often make large profits Answer: D

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19) The life expectancy in Sweden is A) 85 years B) 81 years C) 67 years D) 77 years Answer: B 20) The mortality rate for mothers and infants in the U.S. is ranked A) 1st B) 7th C) 13th D) 20th Answer: C

_ in the world.

21) Countries that meet the test for justice and fairness for their health care systems include all of the following, EXCEPT A) Great Britain B) United States C) France D) Japan Answer: B 22) All of the following are cues suggesting that a patient has low health literacy status, EXCEPT A) registration and other forms may be filled out incompletely or incorrectly B) patients hand written material to a relative or other person C) patients give excuses when asked to read something D) patients complete all forms correctly, but have many questions Answer: D 23) All of the following are true about the REALM, EXCEPT it A) stands for Rapid Estimate of Adult Literacy in Medicine B) asks patients to read medical terms C) is used to assess cultural competency D) has been used to assess health literacy among many different patient populations Answer: C 24) Groups who are perceived to be minorities or those affected by cultural competency and health literacy issues include all of the following, EXCEPT A) men B) women C) children D) elders Answer: A

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25) The federal government became the largest broker of health care in the world when A) Medicare and Medicaid were established in 1965 B) the health care code of ethics was adopted C) Kantian theory was adopted by the U.S. congress D) the Indian Health service was brought into the NIH Answer: A 26) According to the theory of justice who is least advantaged?

A) Women B) Men C) Children D) Minorities Answer: A 27) All the following are reasons why women are disadvantaged in health care, EXCEPT A) information about the dangers of drugs have been withheld from women B) women's issues in old age have very low research priority C) the median income of women is still less by far than that for men D) women make up 30% of the population and receive only 50% its benefits Answer: D 28) John Rawls is one of the most influential philosophers in the field of health care.

Answer: TRUE 29) Cultural competence is the ability to recognize the ethnic group of an individual.

Answer: FALSE 30) Ethnocentricity can lead to conflicts in health care.

Answer: TRUE 31) A core value identified by Robin Williams is efficiency.

Answer: TRUE 32) Beneficence requires us to contribute positively to the welfare of others–do good, not evil.

Answer: TRUE 33) In theory, health care is viewed as a basic human and citizen right.

Answer: rights 34) theory revolves around the idea that health care resources should be allocated where they will do the most good.

Answer: Utilitarian 35) includes communicating in a manner that is linguistically and culturally appropriate.

Answer: Competency 5

36) requires health care providers not to inflict harm intentionally or simply put–at least do no harm.

Answer: Nonmaleficence 37) Discuss Kantian theory and its application in health care ethics.

Answer: Responses will vary, but should include: Kantian theory tells people they ought to treat others as they want to be treated themselves. Furthermore, people should never be treated as a means to an end. In other words, do not use people for your own benefit.

38) Discuss the elements in a professional code of ethics.

Answer: Elements include: health professionals held to a higher standard certain standards of behavior veracity confidentiality compassion integrity trustworthiness wisdom 39) List three core values of American culture.

Answer: Answers will vary, but should include three of the following: individualism freedom democracy equality achievement and success efficiency and practicality progress science and technology material comfort activity and work humanitarianism group superiority

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40) List four aspects of culture that impact health care.

Answer: Answers will vary, but should include four of the following: language time orientation family practices childbirth practices child-rearing practices food habits sexuality beliefs about health and illness beliefs about aging death practices pain response grief response touch and privacy 41) List two tips for talking to patients of different cultures and languages.

Answer: Answers will vary, but should include two of the following: Avoid using technical words or jargon Avoid unnecessary detail Avoid acronyms Use the teach-back method Use pictures Talk to family members 42) Define cultural competence.

Answer: Cultural competence is the ability of health organizations and practitioners to recognize cultural beliefs, values, attitudes, traditions, language preferences, and health practices of specific cultural groups and to apply that knowledge to produce positive health outcomes.

43) Define health literacy.

Answer: Health literacy is the degree to which individuals have the capacity to obtain, process, and understand basic information and services needed to make appropriate decisions about their health.

44) Name two websites to assess your own family's health literacy or learn about health care around the world.

Answer: Responses will vary, but should include two of the following: http://www.minorityhealth.hhs.gov http://www11.georgetown.edu/research/gucchd/nccc/foundations/frameworks http://bioethics.od.nih.gov/culturalcomp https://www.ihs.gov/healthcommunications/ www.cia.gov/library/publications/theworldfactbook/rankorder/2091rank.html http://www.oecd.org/infobycountry

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The U.S. Health Care System, 3e (Austin) Chapter 14 International Health Care 1) Which of the following is NOT considered a health indicator?

A) Life expectancy B) Income C) Spending on health care D) Infant and maternal mortality Answer: B 2) The oldest national health care system is in A) the United States B) Canada C) Germany D) the United Kingdom Answer: D 3) A single payer system is described by all of the following, EXCEPT A) it is the financing of the costs of delivering universal care B) the entire population is covered C) a single insurance pool is used to pay costs D) this is the system in the U.S. Answer: D 4) Which country does NOT have a single payer system?

A) India B) New Zealand C) Taiwan D) Cuba Answer: A 5) Which country does NOT have a variant of the single payer system?

A) Australia B) France C) Germany D) Spain Answer: A 6) All of the following describe the market economy model EXCEPT A) the price and distribution of goods is determined by supply and demand B) all health care costs are billed to a single agency C) the price of care increases as demand increases D) services tend to be concentrated in areas of high population Answer: B

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7) Which does NOT describe the Japanese health care system?

A) It is a mixed model.

B) There is mandatory insurance.

C) The delivery model is a private market model.

D) The system is the same as that in Scandinavia.

Answer: D 8) The United States health care system is described as a A) single payer system B) variation of the single payer system C) market economy model D) mixed model Answer: C 9) Which does NOT describe how the market economy model works?

A) Health care is treated like a product.

B) Costs rise very rapidly.

C) There is great disparity in compensation between levels of providers.

D) Costs are usually contained.

Answer: D 10) Which system of care in Mexico covers wage earners, state employees, and the military?

A) Public B) Comprehensive C) Private.

D) Universal Answer: A 11) All of the following are positive advances that have occurred within the Mexican health care system, EXCEPT A) catastrophic health cost has been reduced by 9% B) life expectancy is now 90 C) malaria cases have dropped D) Mexican children now receive the same vaccinations as Canadian children Answer: B 12) Mexico spends about A) $8400 B) $4000 C) $2200 D) $877 Answer: D

per capita in health care expenditures.

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13) Which country has the highest infant mortality for every 1000 births?

A) United States B) Japan C) India D) Mexico Answer: C 14) The country with the highest maternal mortality rate has which type of health care system?

A) Market/single payer/universal B) Universal/private C) Market/public/universal D) Private traditional government Answer: D 15) What percentage of citizens are covered for health care in India?

A) 0% B) 50% C) 80% D) 100% Answer: A 16) What is India's life expectancy?

A) 53.4 years B) 63.7 years C) 80.2 years D) 83.2 years Answer: B 17) Mexico was in the world spotlight in 2009 because of A) the Avian flu B) the Olympics C) the pandemic H1N1 flu outbreak D) their exceptionally low infant mortality rate Answer: C 18) In Mexico, health care is delivered by all of the following, EXCEPT A) public institutions B) state and federal governments C) Ayurvedic practitioners D) private hospitals Answer: C

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19) The first hospital in Mexico was founded in _ A) 1610 B) 1791 C) 1854 D) 1901 Answer: B

.

20) The purpose of the Mexican Social Security Institute was to provide A) public health to poor Mexican citizens B) public health to all Mexican citizens C) benefits to retired and disabled individuals D) a source of revenue for the Mexican government Answer: A 21) The medical system in Mexico is a three-part system that includes all the following EXCEPT A) comprehensive B) private C) public D) universal Answer: A 22) Which system of care in Mexico caters to the wealthy and tourists?

A) Public B) Comprehensive C) Private D) Universal Answer: C 23) Which of the following does NOT describe the Canadian health care delivery system?

A) It is described as a mixed system.

B) It is possible to have completely private health care.

C) The vast majority of care is provided through a single payer model.

D) It is described as a market economy model.

Answer: D 24) The early French settlers founded Catholic hospitals in the A) 1600s B) 1700s C) 1800s D) 1900s Answer: C

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25) Which link should a person choose when planning a trip to Canada for health care services?

A) http://www.hc-sc.gc.ca B) http://content.healthaffairs.org/cgi/content/full/24/6/1467 C) http://www.indianhealthcare.in D) http://www.india.gov.in/citizen/health/health.php Answer: A 26) A) 25 B) 75 C) 50 D) 80 Answer: B

% of health care in Canada is funded publicly and delivered privately.

27) Which is NOT a role of the Canadian federal government?

A) Pay for dentistry B) Provide funds to deliver services to the provinces C) Deliver services to special groups, such as veterans and First Nations and Inuit people D) Provide public health, health promotion programs, and health care research Answer: A 28) India has A) 7 B) 23 C) 58 D) 100 Answer: A

physicians per 10,000 people.

29) Which country's health care system is seen as a model for U.S. health care reform?

A) India B) Japan C) Canada D) Mexico Answer: C 30) All of the following are true regarding traditional medicine, EXCEPT A) it is three times more expensive than Western systems B) diet, socialization, and food for the mind are as important as the medications C) it comprises knowledge systems that developed over generations D) it can be found around the world Answer: A

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31) Which is NOT true about the Ayurvedic system?

A) The diagnosis considers a person's physical and mental state, and position within society.

B) It is built on the balance of three humors.

C) Health or illness depends on eating the proper amount of food in each food group.

D) Treatments include massage and spiritual guidance.

Answer: C 32) The infant mortality rate in the United States is lower than that in Germany.

Answer: FALSE 33) One hundred percent of U.S. citizens have health care coverage.

Answer: FALSE 34) The Canadian system blends universal health coverage with private sector fee-for-service.

Answer: TRUE 35) Vata and Pitta are humors in the Ayurvedic system.

Answer: TRUE 36) India is becoming a major destination for medical tourism.

Answer: TRUE 37) Spending in Mexico for health care is about Answer: half

of what is spent in the United States.

38) The Ayurvedic system believes that health or illness depends on the of a balanced state.

Answer: presence; absence

or

39) Discuss the elements of the market economy model.

Answer: Responses will vary, but should include: health care determined by supply and demand; the price of care increases as demand increases; and/or services tend to be concentrated in areas of high population; little incentive to treat or do research on a low-demand disease.

40) Canada spends about how much per capita on health care?

Answer: approximately $4,045 U.S. 41) has a population of over one billion.

Answer: India 42) List two reasons why people seek health care in foreign countries.

Answer: lower cost and higher quality 43) About what percentage of Mexicans are uninsured?

Answer: 40%

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44) Describe the health care system of Canada.

Answer: Responses will vary, but should include: the combination system of both universal and private coverage; individual insurance available for out-of-pocket; and/or delivery private with the government fixing fees.

45) List two forms of traditional medicine practices in India.

Answer: Ayurveda Unani Siddha Yoga Naturopathy Homeopathy 46) List two links that would be helpful for a person traveling to a foreign country for a health care need.

Answer: Responses will vary, but should include: http://www.hc-sc.gc.ca, http://content.healthaffairs.org/cgi/content/full/24/6/1467 http://www.indianhealthcare.in http://www. india.gov.in/citizen/health/health.php http://www.who.int/countries/can

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