Karen is a 31-year-old first-time mother who has just been ...

[fox]

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

Question 2

Despite his family members' concerns, a patient has been discharged home after a recent suicide attempt and a diagnosis of major depression.
 
  Which of the following phenomena has been identified as contributing to reduced lengths of hospital stays in recent years?
 
  A) Increased federal and state funding for psychiatric home care
  B) Pressures to reduce health care costs associated with inpatient care
  C) Improved pharmacological treatments for major depression
  D) Research suggesting that inpatient psychiatric treatment is less effective than previously believed

[mmj22343]

Answer to Question 1

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.

Answer to Question 2

Ans: B
There is tremendous pressure to reduce the escalating costs of health care, a trend that has often resulted in early discharge and reduced average lengths of stay. This trend toward shorter inpatient courses of care is not a result of the ineffectiveness of inpatient care or improved drug treatments and publically funded programs.