Medicare Plans Quiz

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Questions and Answers

What percentage of physician fees are reimbursed?

8% (correct)

15%

10%

Which part of Medicare is primarily responsible for inpatient hospital stays?

Part D

Part C

Part B

Part A (correct)

Which additional benefits does Medicare Advantage typically NOT provide?

Emergency room visits (correct)

Home health aide services

Vision exams

Wellness services

What is the typical out-of-pocket coverage arrangement for clients on traditional Medicare?

Obtain a secondary insurance plan Signup and view all the answers

What is the primary purpose of Medicare Advantage Plans?

To increase benefits and decrease co-payments Signup and view all the answers

What symptoms are indicative of acute angle-closure glaucoma?

Sudden onset of blurred vision and red eye Signup and view all the answers

Which of the following indicates a likely case of epiglottitis in a pediatric patient?

Stridor and use of accessory muscles for respiration Signup and view all the answers

What is a severe consequence of untreated acute angle-closure glaucoma?

Optic nerve damage leading to blindness Signup and view all the answers

Which symptom is NOT typically associated with epiglottitis?

Pharyngeal erythema Signup and view all the answers

What best characterizes the pupil appearance in acute angle-closure glaucoma?

Non-reactive to light and dilated Signup and view all the answers

In the context of pharyngitis, which symptom is primarily associated with the condition?

Difficulty in swallowing Signup and view all the answers

Which of the following is NOT a symptom of acute angle-closure glaucoma?

Severe throat pain Signup and view all the answers

What is a major risk if acute epiglottitis is left untreated?

Airway obstruction leading to respiratory distress Signup and view all the answers

What is a common sign indicating the presence of a cavity filled with purulent material in a sinus infection?

Inability to transilluminate the cavity Signup and view all the answers

Which symptom is specifically linked to ethmoid sinus problems?

Pain behind the eye and high on the nose Signup and view all the answers

What factors are used to confirm a diagnosis of sinusitis in a patient with a URI lasting at least 7 days?

Colored nasal drainage Signup and view all the answers

What is the first-line treatment for group A beta-hemolytic streptococcal pharyngitis in adults without known allergies to penicillin?

Penicillin V potassium 500mg PO twice daily Signup and view all the answers

What distinguishes acute sinusitis from chronic sinusitis based on duration?

Acute lasts up to 4 weeks Signup and view all the answers

Which of the following is a potential complication of a peritonsillar abscess?

Airway obstruction Signup and view all the answers

Which category of third-party payer does not typically cover medical expenses?

Personal savings Signup and view all the answers

How much are nurse practitioners reimbursed by CMS compared to physicians?

85% of the physician's fee Signup and view all the answers

What is a typical presentation of tonsillitis?

Inflammation of the tonsils Signup and view all the answers

What symptom in a patient with pharyngitis may indicate the need to check for infectious mononucleosis?

Fatigue, fever, and cervical lymphadenopathy Signup and view all the answers

What is the most appropriate treatment option for suspected Group A beta-hemolytic streptococcal pharyngitis in adults who have no known allergy to penicillin?

10-day course of penicillin V potassium Signup and view all the answers

Which symptom is most indicative of infectious mononucleosis?

Edematous enlarged tonsils with exudates Signup and view all the answers

What should be advised to a patient recovering from infectious mononucleosis regarding physical activities?

Avoid activities for 3-4 weeks due to risk for splenic rupture Signup and view all the answers

Which of the following is a differential diagnosis for hoarseness?

Papillomatosis Signup and view all the answers

What test would you perform to differentiate between conductive and sensorineural hearing loss?

Weber test Signup and view all the answers

What finding would suggest conductive hearing loss in a patient undergoing the Rinne test?

Bone conduction is greater than air conduction Signup and view all the answers

Which symptom is least likely associated with viral pharyngitis?

High fever Signup and view all the answers

Which of the following is NOT a common cause of hoarseness?

Chronic ear infections Signup and view all the answers

Which condition is most likely to lead to sudden sensorineural hearing loss?

Acoustic neuroma Signup and view all the answers

What is the major viral cause of infectious mononucleosis?

Epstein-Barr virus Signup and view all the answers

What is the primary characteristic of conductive hearing loss in relation to bone and air conduction?

Bone conduction is greater than air conduction. Signup and view all the answers

Which of the following conditions can lead to conductive hearing loss?

Acute otitis media. Signup and view all the answers

What is the appropriate action for patients presenting with sudden sensorineural hearing loss?

Administration of corticosteroids. Signup and view all the answers

What is a common cause of tinnitus associated with hearing loss?

Presence of middle ear fluid. Signup and view all the answers

Bilateral, high-pitched tinnitus is typically associated with which condition?

Severe hypertension. Signup and view all the answers

What is a recommended strategy to help minimize symptoms of tinnitus?

Playing background music. Signup and view all the answers

Which common condition could mimic symptoms of ear pain in patients?

Sinus disease. Signup and view all the answers

In which test is a vibrating tuning fork used to distinguish types of hearing loss?

Weber test. Signup and view all the answers

Which is a potential outcome if a client experiences sudden sensorineural hearing loss?

Referral to an otorhinolaryngologist is necessary. Signup and view all the answers

What is a classic sign of acute otitis externa upon examination?

Pinna tenderness on traction. Signup and view all the answers

What is a significant dietary recommendation for individuals suffering from tinnitus?

Limit alcohol intake. Signup and view all the answers

What is a common management strategy for barotrauma of the auditory canal?

Use of nasal steroids. Signup and view all the answers

Which characteristic is associated with sensorineural hearing loss?

Can result from exposure to loud noises. Signup and view all the answers

What examination finding typically indicates acute otitis media?

Tympanic membrane is red and bulging. Signup and view all the answers

What is the main characteristic of the tympanic membrane in a diagnosis of acute otitis media?

Red and bulging with diminished light reflex Signup and view all the answers

Which symptom is most commonly associated with acute otitis externa?

Tenderness on traction of the pinna Signup and view all the answers

What is the typical treatment regimen for a healthy pediatric patient diagnosed with acute otitis media?

Amoxicillin 40–45 mg/kg/day in two divided doses for 10 days Signup and view all the answers

What finding is typically observed in a patient with allergic rhinitis during nasal examination?

Pale or violaceous turbinates Signup and view all the answers

What is a common symptom of Eustachian tube dysfunction?

Fluid build-up with pressure and muffled hearing Signup and view all the answers

Which sign indicates a higher likelihood of bacterial sinusitis following a URI?

Colored nasal drainage and facial pain Signup and view all the answers

What is the primary cause of rebound rhinitis?

Overuse of topical vasoconstrictive nasal sprays Signup and view all the answers

What is the recommended management for a perforated tympanic membrane?

Avoiding water exposure and using antibiotics Signup and view all the answers

During the assessment of sinusitis, what finding would typically suggest a cavity filled with purulent material?

Inability to transilluminate the maxillary sinus Signup and view all the answers

What is a significant symptom of viral rhinitis?

Watery rhinorrhea and nasal congestion Signup and view all the answers

What is a classic sign of acute otitis externa?

Pain on applying pressure over the tragus Signup and view all the answers

What symptom would indicate the need for more aggressive treatment in a patient with acute otitis media?

Hearing threshold change greater than 25 dB Signup and view all the answers

Which condition is characterized by nasal congestion without rhinorrhea after short-term use of topical decongestants?

Rebound rhinitis Signup and view all the answers

Study Notes

Fundoscopic Exam and Angle-Closure Glaucoma

Fundoscopic exam may reveal cupping, but evaluation can be challenging without experience.
Angle-closure glaucoma presents acutely with decreased/blurred vision, severe eye pain.
Symptoms often include frontal headache, nausea, vomiting, and seeing halos around light.
Affected pupils are non-reactive to light, partially dilated (4-6 mm).
Tearing and conjunctival redness can be present.
Increased intraocular pressure (IOP) is a result, and untreated, can lead to blindness.
Onset is sudden, with dramatic symptoms including blurred vision, redness, unilateral pain/pressure, headache, seeing halos, photophobia, peripheral, then central vision loss.
Nurse practitioners must assess vision loss upon presentation.
Sudden, severe IOP can cause optic nerve damage.

Epiglottitis

Epiglottitis involves severe throat pain, difficulty swallowing, copious oral secretions, respiratory difficulty, stridor, and fever, but without pharyngeal erythema.
In children, imminent airway obstruction may be indicated by stridor, restlessness, nasal flaring, and accessory muscle use.

Pharyngitis

Pharyngitis is inflammation of the pharynx causing discomfort, scratchiness, pain, and difficulty swallowing.
Symptoms like fatigue, fever, pharyngitis accompanied by cervical lymphadenopathy may be evaluated using a Monospot test, strep test, and throat culture.
Adults with no known allergies to penicillin, suspected of having Group A beta-hemolytic streptococcal pharyngitis, receive a 10-day course of penicillin V potassium (Pen-Vee K) or benzathine penicillin (Bicillin) as an alternative.

Ear Pain (Barotrauma)

Ear pain due to barotrauma (pressure changes) is often relieved using nasal steroids and oral decongestants.

Hoarseness (Dysphonia)

Hoarseness involves changes in voice pitch or quality (weak, scratchy, husky).
Causes include voice overuse, viruses, growths (cysts, papillomas, polyps, nodules), and GERD.
Laryngoscopy may be used for diagnosis.

Infectious Mononucleosis

Infectious mononucleosis is a viral infection, often caused by the Epstein-Barr virus (EBV); other viruses are possible.
Transmission occurs via shared saliva.
Common symptoms include extreme fatigue, low-grade fever, sore throat, bilaterally enlarged tonsils with erythema, swollen posterior cervical lymph nodes, swollen liver/spleen, rash, body aches, and mild nasal/throat erythema.
No specific antiviral therapy exists.
Antibiotics are usually not necessary unless a concurrent bacterial infection is present.
Amoxicillin/ampicillin can lead to a rash in clients with co-existing mononucleosis.
Client teaching: return to normal activities when fever and fatigue subside; avoid contact sports for 3-4 weeks; avoid sharing utensils/items. Mention urgency in seeking medical care for jaundice, abdominal pain, or bleeding

Hearing Loss

Sensorineural: Caused by loud noises, inner ear infections, familial disorders, aging, Meniere's disease, tumors, medications (e.g., aminoglycosides, aspirin, quinine), trauma, or diseases.
- Sudden sensorineural hearing loss requires referral to an ENT.
Conductive: Caused by presbycusis, serous otitis media, cerumen impaction.
- In conductive loss, bone conduction is better than air conduction.
- Cerumen impaction is a differential diagnosis for otitis externa.

Weber, Rinne, and Schwabach Tests

Used to differentiate conductive from sensorineural hearing loss.
Weber: Tuning fork on head; Equal hearing in both ears (normal); Louder in bad ear (conductive); Louder in good ear (sensorineural).
Rinne, Schwabach tests: Compare air and bone conduction.

Tinnitus

Tinnitus is a ringing or buzzing sound in one or both ears.
Potential causes include middle ear fluid (tympanometry, acoustic reflex/reflectometry).
Severe hypertension (diastolic over 120 mm Hg) can cause bilateral, high-pitched tinnitus; check orthostatics.
Minimize symptoms by masking noise with background music, reducing caffeine, alcohol, chocolate, salt, smoking, and ensuring adequate rest.
Encourage chewing gum/swallowing during airplane descent for eustachian tube opening and middle ear pressure equalization.
Severe tinnitus warrants screening for psychological disorders.

Barotrauma Relief

Barotrauma (middle ear pressure) relief can be achieved with nasal steroids and oral decongestants.

Acute Otitis Media/Ear Infection

Usually viral (e.g., flu, URI).
Diagnosis: red, bulging tympanic membrane; diminished/absent light reflex; decreased mobility.
Treatment for healthy children with mild symptoms and no recent antibiotics: amoxicillin (40-50 mg/kg/day PO).
Follow-up within 48-72 hours; or several days after completion of treatment.

Acute Otitis Externa (AOE)

Outer ear infection, ("swimmer's ear").
Characterized by pain on traction of pinna and/or pressure on tragus.
Erythematous ear canal. Often history of recent swimming.
Important to dry the ear.

Otitis Media with Effusion

Fluid in the middle ear without infection.

Eustachian Tube Dysfunction (ETD)

Fluid buildup in eustachian tube, potentially due to allergies, sinusitis, URIs, enlarged adenoids, pregnancy, air travel, or scuba diving.
Symptoms: pain, muffled hearing, fullness, tinnitus, popping, vertigo.

Allergic Rhinitis

IgE-mediated hypersensitivity response to airborne irritants (pollen, dust, mold, animal dander).
Affects eyes, nose, sinuses, throat, bronchi.
Seasonal or year-round.
Symptoms: sneezing, runny nose, red, watery, itchy eyes.
Diagnosis is clinical; examine nasal mucosa for pallor, pale bluish hue, turbinate edema.
Clear rhinorrhea and postnasal drip may be observed.
Avoidance of triggers is key to symptom management.

Viral Rhinitis

Watery rhinorrhea, nasal congestion, "nasal" speech, and mouth breathing are common.
Rebound rhinitis: congestion without rhinorrhea, from decongestant overuse; improves within 2-3 weeks after discontinuation.

Sinusitis

Sinus infection - may lead to invasive complications (mastoiditis, meningitis).
Ethmoid sinus pain: behind eye, high on nose.
Maxillary sinus pain: cheek area.
Inability to transilluminate sinus cavity suggests pus buildup.
Diagnosis: URI for 7+ days; 2+ signs/symptoms (colored discharge, poor decongestant response, facial/sinus pain, headache).

Hoarseness/Dysphonia

Voice changes (weak, scratchy, husky).
Causes: voice misuse, viruses, and growths (cysts, papillomas, polyps, nodules), GERD.

Tonsillitis/Pharyngitis

Tonsillitis/pharyngitis inflammation of tonsils and pharynx.
Pharyngitis symptoms with swollen cervical lymph nodes require testing for strep, mono, other conditions.

Peritonsillar Abscess

Acute pharyngeal infection, usually unilateral.
Symptoms: severe unilateral sore throat, pain swallowing, fever, ear pain, asymmetric cervical adenopathy, trismus, muffled voice.
May show a toxic appearance such as poor eye contact, irritability, drooling, severe halitosis, tonsillar erythema, and exudates.
Requires immediate referral to the emergency department due to potential airway compromise or sepsis.

Third-Party Payers

Medicare, Medicaid, indemnity insurance companies, managed care organizations, workers' compensation, veterans' administration, auto liability.
Third-party payers reimburse on behalf of insurance recipients/beneficiaries.

NP Reimbursement by CMS

NPs are reimbursed at 85% of physician fees.

Medicare Benefits

Part A: Inpatient, skilled nursing, hospice, and home care.
Part B: Outpatient, provider visits, surgery, labs, medical equipment, preventive exams.
Part C (Medicare Advantage): Offers added benefits and lower co-payments; includes traditional Medicare benefits.
Part D: Prescription drugs.
Clients will frequently seek secondary insurance to cover 20% co-pays.

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Description

Test your knowledge about Medicare plans, including reimbursement percentages, inpatient coverage, and the typical benefits of Medicare Advantage. This quiz will help you understand the key aspects and arrangements of traditional Medicare and its alternatives.