Karen is a 31-year-old first-time mother who has just been diagnosed with postpartum depression
Which of the following nurses is most likely to determine whether Karen meets the inpatient admission criteria established by her health maintenance organization?
A) Quality assurance nurse
B) Discharge planner
C) Psychiatric home care nurse
D) Utilization review nurse
Ans: D
Utilization review nurses determine whether a client's clinical symptoms meet the appropriate psychiatric or medical necessity criteria or clinical guidelines, as developed by the insurance company or health care maintenance organization. This task is normally outside the scope of a quality assurance nurse, discharge planner, or psychiatric home care nurse.
You might also like to view...
You are performing a shift assessment as you begin caring for one of your patients. What is the most effective assessment technique for the lymph nodes of the neck?
A) Inspection B) Ausculation C) Palpation D) Percussion
Medical management of bronchiectasis may include what? (Mark all that apply.)
A) Physical therapy B) Antimicrobial therapy C) Isolation D) Chest physiotherapy E) Smoking cessation
The wife of an inpatient who is prescribed dexamethasone (Decadron) tells the nurse over the phone that she has developed a cold with a low-grade fever. What is the nurse's best advice at this time?
a. "If you come in to visit you must wear an isolation gown." b. "Hospital rules do not allow visitors with colds or fevers for any patients." c. "It would be best to speak with your husband by phone and stay home today." d. "You must take care of yourself so that you can take care of your husband when he comes home."
A major goal in all healthcare is the prevention of falls. What are examples of routine fall prevention measures that nurses must institute?
1 . Making sure wheelchairs are locked when the client is in bed 2 . Assisting with ambulation when needed 3 . Making sure spills are labeled with a sign and cleaned up within 1 hour 4 . Assessing clients and documenting in the client's record at least once every 24 hours A) 1, 2 B) 1, 3 C) 2, 4 D) 3, 4