Author Question: Which appropriately describes the difference in nursing practice before and after the Social ... (Read 30 times)

2125004343 · **on:** Jul 8, 2018

Which appropriately describes the difference in nursing practice before and after the Social Security Act Amendments of 1983?

1. Nursing practice changed from focusing mostly on the client to focusing more on
efficiency.
2. Nursing administrators finally were able to bill Medicare for nursing services.
3. Nurses at the beside had to discharge clients even if they were unstable.
4. Nursing practice did not change; only reimbursement for hospital services
changed.

Question 2

If a nurse wishes to become certified as having expertise in a particular area of nursing, which action is the nurse's first priority?

1. Work in the area for at least 5 years.
2. Arrange to take the certification exam.
3. Determine the specific requirements.
4. Obtain a letter of recommendation.

Sassygurl126 · **Reply #1 on:** Jul 8, 2018

Answer to Question 1

Answer: 1

Rationale: The Social Security Act Amendments of 1983 formed diagnosis-related groups in an effort to control rising health care costs. Clients were grouped according to their diagnosis, and facilities were paid based on the allotted services for that diagnostic group. Since facilities got paid the same regardless of services provided, nurses were urged to closely adhere to the timeline in the plan of care. Nursing has never been able to charge Medicare for inpatient services of the nursing staff. If clients were unstable, nurses were not asked to discharge them anyway, but were asked to keep to the allotted timeline as closely as possible. Nursing practice changed in that nurses were asked to increase efficiency while still providing quality care. In a sense, nurses were asked to do more with less time and fewer resources.

Answer to Question 2

Answer: 3

Rationale: The nurse should always assess before acting, as specified by the nursing process. Therefore, determining the specific requirements should be the first action, as each area might vary slightly. Some certifications might require a specific period of time working in the specialty, but the nurse must be actively practicing in the specialty in order to sit for the exam. Once requirements are met, the nurse can arrange to take the exam. Few if any stipulate that the nurse must present a letter of recommendation to sit for the exam.