The precise classification of clients according to the highest diagnosis-related group (DRG) has created a new role for nurses, known as a _____ nurse
a. case management
b. quality assurance
c. utilization review
d. cost-control
ANS: C
Correct: Hospital-based utilization review nurses review medical records to determine the most appropriate DRG for clients. Financial gains can be made through careful diagnosis of clients according to their highest potential DRG classification.
Incorrect:
a. A case management nurse coordinates the client's care throughout the course of an illness. Case managers generally do not perform direct care duties but assume a planning and evaluation role and collaborate with the interdisciplinary health care team to ensure that goals are met, quality is maintained, and progress toward discharge is made.
b. A quality assurance nurse facilitates client care delivery through quality monitoring and quality improvement initiatives.
d. A cost-control nurse is not a standard role in hospitals.
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