What are some of the areas that might be limited to patients under an mco?
Final answer:
Patients under an MCO might face limitations like a restricted choice in physicians and medical services, often called denial of care, which impacts access to certain exams, procedures, and prescription drugs. However, studies show that excluded services were typically of marginal value and political pressures may prevent exclusion of certain treatments due to increased government funding.
Explanation:
Under a managed care organization (MCO), several restrictions might limit the healthcare services available to patients. Firstly, MCOs, particularly health maintenance organizations (HMOs), may restrict patient choice in physicians, requiring them to only see doctors that are part of the HMO's approved network. If patients desire to see physicians outside this network, they likely will not be covered by the insurance. Secondly, MCOs often limit the types of medical exams and procedures that patients may undergo, a restriction known as denial of care. This may include limiting access to certain prescription drugs and favoring those that are approved by the HMO, even if another medication might be more effective according to the patient's doctor.
Studies such as those by Professors Jonathan Oberlander, Theodore Marmor, and Lawrence Jacobs have found that while there were concerns about access to certain medical services, in practice, services of marginal value were generally the ones excluded and patients sometimes received these services through other means. For instance, if a treatment for an uncovered illness was needed alongside a covered service, physicians could potentially provide both. Increased state government revenues also played a role in supporting the plans, making it harder politically to exclude treatments from coverage.
Despite the growth of MCOs and their popularity due to lower costs for employers, several issues remain, including the potential for racial/ethnic and gender bias in healthcare delivery, medical fraud, and difficulties in health insurance coverage.
The laboratory report for a patient taking clozapine (clozaril) shows a white blood cell count of 3000 mm3 and a granulocyte count of 1500 mm3. the nurse should: report the laboratory results to the health care provider.
The Answer is report the laboratory results to the health care provider. The reason behind this is these laboratory values specify the likelihood of agranulocytosis, a serious side effect of clozapine therapy. These outcomes must be immediately reported to the health care provider. The drug should be withdrawn since the health care provider will discontinue it. The health care provider may repeat the laboratory test, but, in the meantime, the drug should be withheld. Giving aspirin and forcing fluids are measures that are less important than stopping the administration of the drug.
List 5 responsibilities related to communication that you have to a patient
If you see a curb painted blue it designates:
A curb painted blue typically designates an area for disabled parking.
These specially marked parking spaces are reserved for people with disabilities who have a valid parking permit or placard. The blue color is an internationally recognized symbol used to signify accessibility for individuals with mobility challenges.
The purpose of such designated parking spaces is to provide easier access to buildings and facilities for people with disabilities, allowing them to park closer to their destinations and reducing the physical barriers they might face. These spaces are wider than regular parking spaces to accommodate wheelchair users and individuals with assistive devices.
By using the blue curb, authorities aim to ensure that parking spaces are allocated fairly and that those with disabilities can enjoy the same conveniences and opportunities as other members of the community.
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A person who feels deep within themselves, usually from early childhood, that they are of the opposite gender is given the diagnosis of
When faced with the victim you suspect has suffered an internal injury, one of the steps you should take
Alcohol _____ by making it difficult to anticipate driving situations.
a. makes driving less stressful
b. makes driving more exciting
c. increases your reaction time
d. increases your ability to react quickly to new conditions
Are sunglasses just as protective as safety glasses?
Sunglasses are not as just as protective as safety glasses. Regular prescription eyeglasses do not qualify as safety glasses unless they meet specific criteria. Safety glasses must conform to a higher standard of impact resistance than regular eyeglasses.OSHA has adopted safety eyeglasses standards established by the American National Standards Institute (ANSI).
Ground turkey must be cooked to an internal temperature of 165°F (74°C). Why must turkey be cooked to this minimum temperature?
The reason why ground turkey must be cooked to an internal temperature of 165°F (74°C) is because germs will survive at lower temperatures.
This temperature kills germs that may be in the meat.
The top five germs that cause illnesses from food eaten in the United States are: Norovirus, Salmonella, Clostridium perfringens, Campylobacter and Staphylococcus aureus (Staph).
Clara is depressed after losing her job. she has been complaining of a severe backache that is affecting her daily life. however, her physician has examined her and found that there is no medical cause for her condition. according to the symptoms displayed by clara, she is most likely to be suffering from:
Answer:
somatic symptom disorder
Explanation:
Somatic Symptom Disorder is a group of psychiatric disorders characterized by physical symptoms that suggest, but are not fully explained by, a physical disorder, and cause significant discomfort or interfere with social, occupational, or other functions. In this type of disorder the physical symptoms or their severity and duration cannot be explained by an underlying physical condition.
That is, the patient feels the discomfort of a certain physical condition, such as Clara who has a severe back pain, however the doctor does not find a physical cause for these symptoms.
Effective team functioning is critical in ensuring the best performance. Which of these characteristics is critical in team leaders?
Effective team functioning requires leaders to establish a well-structured environment and adapt their leadership style to the team's needs. Leaders must balance structure and autonomy to accommodate various employee preferences and ensure team success.
Explanation:To ensure effective team functioning, it is critical for team leaders to embody certain characteristics that align with the needs of their team members. Leaders must provide a balance of structure and autonomy to cater to the diverse needs of their employees. As highlighted by research from Felfe & Schyns (2006), employees with a high need for leadership flourish in environments that offer clear responsibilities and minimal ambiguity. Therefore, a critical characteristic in team leaders is the ability to establish a well-structured environment for those who require it, while simultaneously supporting autonomy for more independent team members.
Understanding these dynamics can assist leaders in adopting the most suitable leadership style for their team. For instance, democratic leaders foster group participation and consensus, which is vital in some situations. Conversely, in scenarios where swift decision-making is essential, an authoritarian style may be more suitable. Team leaders must be adept at identifying the needs of their team and adjusting their management style accordingly to propel team success and employee satisfaction.
Using carbo-loading to increase the store of glycogen seems to benefit only those athletes who engage in aerobic activities that are?
Answer:
This can benefit athletes who perform aerobic activities lasting longer than 90 minutes.
Explanation:
Glycogen is a homopolysaccharide, which means that its molecule is composed of monomers of the same monosaccharide, in this case glucose. It is the main carbohydrate for energy storage in animal cells. In other words, we can say that glycogen is the way glucose is stored in the body for future energy needs.
Many athletes may be influenced to use a carbohydrate load to increase glycogen stores in the body. However, this extra glycogen reserve will only benefit athletes who perform aerobic activities lasting longer than 90 minutes, due to the extra energy expenditure that these activities impose.
The nurse researcher is using a nursing degree as a variable in a research study. the level of measurement most appropriate in this case is what?
A nurse is caring for a client who underwent a skin biopsy and has three stitches in place. this wound is healing by: first intention. fourth intention. third intention. second intention.
Answer:
Explanation:
first intention
Wounds with a small amount of tissue damage that are the result of procedures that use sterile technique and that are properly closed, such as with stitches, heal by first intention. Granulation tissue is generally not visible and scar formation is minimal. Second intention healing occurs in infected wounds or wounds with edges that aren't approximated. These wounds are usually packed with moist dressings. Third intention healing occurs with deep wounds that aren't sutured together, resulting in a deep, wide scar. There is no fourth intention of wound healing.
Give one reason why we cannot reuse boiling chips
During the first hour after a precipitous birth, the nurse should monitor a multiparous client for signs and symptoms of which complication?
Since russell's wife died, he has been eating the exact same thingâand a very small amount of itâfor breakfast and lunch every day. most nights, he skips dinner. sometimes he seems confused when his granddaughter calls to check in on him. based solely on this information, which diagnosis is most likely?
A 15-year-old female is diagnosed with prader-willi syndrome. this condition is an example of:
what body system does arteriosclerosis affect?
To a greater extent than other drugs, the effects of __________ depend on the specific personality and mental state of the user.
A. stimulantsB. depressantsC. hallucinogensD. antihistamines
To a greater extent than other drugs, the effects of hallucinogens depend on the specific personality and mental state of the user. Correct answer: C
Hallucinogens are drugs that alter perception and cause hallucinations, , and substantial subjective changes in thoughts and emotions. The most commonly abused hallucinogens are: LSD , Mescaline , Psilocybin....
When you see someone you have a crush on and your heart pounds, your hands get sweaty, and your cheeks feel hot, your ___________ is/are active?
Final answer:
When experiencing strong emotions such as attraction, the sympathetic nervous system and endocrine system are activated, causing physical reactions like a pounding heart and sweating. This is part of the fight-or-flight response, involving both physiological arousal and activation of brain areas related to emotion.
Explanation:
When you see someone you have a crush on and your heart pounds, your hands get sweaty, and your cheeks feel hot, your sympathetic nervous system and endocrine system are active. This response is similar to the fight-or-flight response, a term coined by Walter Cannon, which describes the physiological arousal that occurs in reaction to a perceived threat.
During this response, your body is preparing you to either fight the threat or flee from it, prompting various reactions such as increased heart rate, dilated pupils, and perspiration. This reaction also occurs when you experience strong emotions like fear or attraction, activating areas in your brain associated with rewards and emotions, like the caudate nucleus and ventral tegmental area.
Now that you have reviewed normal blood flow, why does a patient with left-sided heart failure have a low systolic blood pressure?
The heart's pumping action moves oxygen-rich blood as it travels from the lungs to the left atrium, then on to the left ventricle, which pumps it to the rest of the body. The left ventricle supplies most of the heart's pumping power, so it's larger than the other chambers and essential for normal function. In left-sided or left ventricular (LV) heart failure, the left side of the heart must work harder to pump the same amount of blood.
A twenty-one-year-old female presents to your clinic complaining of shortness of breath and a nonproductive nocturnal cough. she states she used to feel this way only with extreme exercise, but lately, she has felt this way continuously. she denies any other upper respiratory symptoms, chest pain, gastrointestinal symptoms, or urinary tract symptoms. her past medical history is significant only for seasonal allergies, for which she takes a nasal steroid spray but is otherwise on no other medications. she has had no surgeries. her mother has allergies and eczema, and her father has high blood pressure. she is the only child. she denies smoking and illegal drug use but drinks three to four alcoholic beverages per weekend. on examination, she is in no acute distress and her vital signs are: t 98.6, bp 120/80, pulse 80, and respirations 20. her head, eyes, ears, nose, and throat examinations are essentially normal. inspection of her anterior and posterior chest shows no abnormalities. on auscultation of her chest, there is decreased air movement and high-pitched whistling on expiration in all lobes. percussion reveals resonant lungs. what is your diagnosis?
In order for pests to feel comfortable and survive well in a food facility they need access to _____.
Pests in a food facility need access to food, water, shelter, and space to thrive. Managing these resources and enhancing ecosystem diversity can effectively control pest populations. Understanding pest distribution patterns can inform strategic pest management decisions.
In order for pests to feel comfortable and survive well in a food facility, they need access to several key resources such as food, water, shelter, and sufficient space. Controlling access to these necessities can greatly reduce pest problems. By creating a healthy environment in agricultural settings, one can prevent the introduction and proliferation of pests through methods such as selecting resilient cultivars, removing infested plant debris, and choosing plants that are well-suited for the local conditions. Additionally, it is crucial to maintain a diverse ecosystem with a variety of predators that can naturally manage pest populations.
Landscape diversity plays a significant role in pest control. The presence of multiple enemies of pests increases the complexity of the ecosystem, which in turn enhances the effectiveness of pest-suppressing organisms. Moreover, understanding the distribution patterns of pests can inform growers and researchers about the nutritional requirements and the behavioral traits of pests, which is key for developing strategic pest management practices.
Mrs. anderson presents with an itchy rash which is raised and appears and disappears in various locations. each lesion lasts for many minutes. what most likely accounts for this rash?
A person who uses sunscreen prior to going out in the sun would be said to be exercising
Statutes are legislation passed by legislative bodies on the _______ levels. A. local B. federal and state C. federal, state, and local D. state and local
Statutes are legislation passed by legislative bodies on the federal, state, and local levels.
Explanation:
The correct answer is C. federal, state, and local.
Statutes are legislation that is passed by legislative bodies on all levels: federal, state, and local. These legislative bodies include the federal government, state legislatures, and city councils.
For example, in the United States, the federal government passes federal statutes, state legislatures pass state statutes, and city councils pass local statutes.
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A nurse is caring for 70-year-old patient who is undergoing anticholinergic drug therapy. the nurse should assess for which condition when caring for this elderly patient?
used to direct the coder to the correct codes and the sequence of codes for conditions that may be preset with each other
WITH used to direct the coder to the correct codes and the sequence of codes for conditions that may be preset with each other. WITH may be used by the physician to acknowledge two conditions exist but the physician may also use other phrases such as associated with or due to and the ICD-10-CM phrase of WITH also applies in the alphabetic index or in the tabular list in an instructional note. Alphabetic index is the term WITH will appear immediately following the main term. Tabular list is the term WITH appearing in a code title means that two conditions must be present in the patient to use that particular code.
Why should
you practice good sleep hygiene