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PMHNP Boards Exam Questions and Answers 100% Solved
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PMHNP Boards Exam Questions and Answers 100% Solved Medicare Part A Coverage - Hospital insurance that covers inpatient and most skilled care. Mandatory copays for hospital days 21-150, getting higher with each period of time. Medicare Part A Eligibility - >65 in social security automatic e...

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  • October 22, 2024
  • 41
  • 2024/2025
  • Exam (elaborations)
  • Questions & answers

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  • PMHNP
  • PMHNP

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©JOSHCLAY 2024/2025. YEAR PUBLISHED 2024.

PMHNP Boards Exam Questions and

Answers 100% Solved


Medicare Part A Coverage - ✔✔Hospital insurance that covers inpatient

and most skilled care. Mandatory copays for hospital days 21-150, getting

higher with each period of time.

Medicare Part A Eligibility - ✔✔>65 in social security automatic enrollment

Medicare Part A Cost - ✔✔No cost if automatically qualified. 30-39 work

quarters: ~$250/mo <30 work quarters: ~$450/mo

Medicare Part B Coverage - ✔✔Supplemental medical insurance.

Outpatient services, care, physical/speech therapy, some home health

care, medical equipment

Medicare Part B Eligibility - ✔✔Voluntary if >65

Medicare Part B Cost - ✔✔Deducted from monthly social security check.

*Enroll 3 months before 65th birthday or 4 months after, otherwise

increased costs to enroll*

,©JOSHCLAY 2024/2025. YEAR PUBLISHED 2024.

Medicare Part C - ✔✔Medicare Advantage. Get all their medical services

through that plan.

Medicare Part D coverage - ✔✔Prescription drug coverage

Medicare Part D Cost - ✔✔Varies depending on how extensive drug benefit

is. Different plans have different benefits.

Medigap Plans - ✔✔Fill gaps in coverage that occur with Medicare

Medicare Advantage Plan - ✔✔Will likely eliminate need for medigap

insurance?

Medicaid Eligibility - ✔✔Automatic coverage not guaranteed except for

poor pregnant women and children. States can refuse to cover adults/head

of households who lose Temporary Assistance to Needy Families d/t

refusal to work. Generally covers poor people.

Medicaid funding - ✔✔Federal + state. States determine how much they

want to pay in, different states have different qualities of Medicaid

HMO - ✔✔Four components: Enrolled population, prepayment of

premiums, coverage of comprehensive medical svcs, centralization of

medical and hospital svcs

,©JOSHCLAY 2024/2025. YEAR PUBLISHED 2024.

Closed-panel HMO - ✔✔Specific providers identified by plan to provide the

medical services to members. Staff can be salaried by HMO or an

agency/group contracted by the HMO.

Open-panel HMO - ✔✔Network HMO, Individual Practice Association,

Point of Service Plans

Network HMO - ✔✔HMO contracts with more than one group of practices

Individual Practice Association - ✔✔Insurance coverage. Contract with an

association of physicians to provide services to members

Point of Service (POS) and Preferred Provider Organizations (PPOs) -

✔✔Insurance coverage. Patients allowed to self-refer to specialist but pay

higher premium to do so. POS requires PCP is gatekeeper but pt can see a

provider outside of HMO for more $$. PPOs contract to a selected group of

participating providers and give discount for using a selected group of

providers. Financial risk held by insurer in PPO, held by providers in POS

Managed indemnity - ✔✔Traditional model insurance coverage.. Pre-

certification, catastrophic case management, minimal contract arrangement

with providers. Provider groups and health plans can use quality control,

utilization review, bundling of services, incentives for health behaviors.

, ©JOSHCLAY 2024/2025. YEAR PUBLISHED 2024.

MUST seek National Committee on Quality Assurance (NCQA)

accreditation

Licensure - ✔✔Member of profession is granted ability to practice

Accreditation - ✔✔Formal review and approval by a recognized agency of

educational degree or certification programs in nursing or nursing-related

programs.

Certification - ✔✔Tests knowledge, skills, abilities for entry into practice.

Formal recognition of the knowledge, skills, and experience

demonstrated by the achievement of standards identified by the profession

Education - ✔✔Formal preparation of APRNs in graduate degree-granting

or postgraduate

certificate programs

Factors facilitating NP growth - ✔✔Demand for svcs, acceptance of role,

emphasis on integrated healthcare svcs, emergence of PMHNP and

decreasing stigmatization

Factors constraining NP growth - ✔✔Growth competition, reimbursement

struggles, overlapping scopes with other NPs, concerns about

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