A nurse has just explained to a newly admitted patient that the ...

[stevenposner]

A nurse has just explained to a newly admitted patient that the token economy system is employed on the unit. The patient announces, I have a PhD, and I'll be damned if I participate in a barter exchange for my human rights..
 
  An appropriate response from the nurse would be: a. Well, according to the unit rules you have just lost four tokens for swearing, and you haven't even earned any yet. That makes your score a negative four..
  b. Being a PhD, I'm sure you are familiar with being held responsible for your actions. That's the policy on this unit, and you now have minus four tokens..
  c. It seems as if you're having difficulty being here. Are you saying that you feel you don't have to abide by the same policies for living on this unit because you are well educated?
  d. Well-educated individuals usually have no need to swear. You have now lost four tokens. We'll talk when you are able to be more polite..

Question 2

A patient asks a nurse, How do managed care systems control costs? The nurse should reply that the HMO's cost saving strategies include using: (Select all that apply.)
 
  a. utilization reviews.
  b. case management.
  c. easy repayment plans.
  d. preadmission certifications.
  e. inexpensive health care plans.

[SamMuagrove]

Answer to Question 1

C
The most therapeutic communication is the one in which the nurse expresses empathy for the patient and asks the patient to reflect on his or her thinking. In this way, the nurse seeks to determine whether the patient is able to think critically about his or her situation and response and how it appears to others. This eliminates any countertransference in the nurse's behavior. Lecturing the patient will only stimulate more angry behavior. The nurse's goal ought to be to facilitate the patient's expression of feelings so that the patient can begin to reflect and eventually problem solve effectively.

Answer to Question 2

A, B, D
Preadmission certification ensures the proper treatment setting; utilization review evaluates the appropriateness and necessity of services; and case management focuses on desirable outcomes, appropriate lengths of stay, and efficient use of resources. Each of these helps control costs. The remaining options are not suggested by HMOs. The correct response does not respond to the patient in an effective way.

[stevenposner]

TY

[SamMuagrove]

Happy to Help