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Test Bank for Community and Public Health Nursing 6th Edition by Nies Chapter 10: Policy, Politics, Legislation, and Community Health Nursing Test Bank MULTIPLE CHOICE 1.. Which of th

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Test Bank for Community and Public Health

Nursing 6th Edition by Nies

Chapter 10: Policy, Politics, Legislation, and Community Health Nursing Test Bank

MULTIPLE CHOICE

1 Which of the following nurses fought to have American nursing controlled

by nurses rather than physicians?

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organizing relief efforts during the U.S Civil War Lillian Wald was the driving force behind the federal government’s development of the Children’s Bureau in 1912

DIF: Cognitive Level: Remember (Knowledge) REF: p 166

2 Which of the following nurses used political expertise to influence the

federal government to develop a Children’s Bureau?

DIF: Cognitive Level: Remember (Knowledge) REF: p 166

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3 Which of the following best describes the most important factor

in legislation?

a The amount of financing and lobbying behind

each choice

b The beliefs, attitudes, and values of the policy

c The preferences of the majority of American voters

d The president’s ongoing encouragement for one

particular choice

ANS: B

Public policy encompasses the choices made regarding goals, priorities, and how resources are allocated Policy choices reflect the values, beliefs, and attitudes of those designing the policy The influence of the president, preferences of Americans, and amount of financing related to the legislation are not as important as the

beliefs, attitudes, and values of the policy

DIF: Cognitive Level: Understand (Comprehension) REF: pp 166-167

4 Which of the following is accomplished through the use of public policy?

a Solutions to problems of public concern

are developed

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b A rational, logical problem-solving decision-making

The field of public policy involves the study of specific policy problems and

governmental responses to them Political scientists involved in the study of public policy attempt to devise solutions for problems of public concern The use of public policy may not involve the implementation of a logical problem-solving decision-making process Public policy addresses more than safety nets for vulnerable populations Additional principles besides economics and business management are applied through the use of public policy

DIF: Cognitive Level: Understand (Comprehension) REF: p 167

5 Which of the following best describes why it is so difficult to change

the paradigm of health care from disease orientation to promoting

health orientation?

a The belief exists that those without insurance could

obtain insurance if they worked hard enough

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b People find it difficult to agree on what the ideal

paradigm should be

c People realize the media have exaggerated the

problems that result from lack of insurance

d Serious reallocation of resources would have to occur

ANS: D

A shift in the paradigm would necessitate a substantial reallocation of resources because the vast majority of health spending is currently directed to medical care and biomedical research and reflects a viewpoint of health care as a commodity The allocation of resources has the most influence on creating a paradigm shift Individual opinions and the use of media do not play as great of role as where resources are spent

6 Which of the following best describes how the government

controls conditions that individuals cannot?

a Appeals to the common sense and good nature of the

citizens

b Establishes social mores that enable groups to control

individuals’ behaviors

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c Passes and enforces law

d Uses fear reinforced by police power

7 Which of the following statements best describes why the federal

government is unable to do whatever politicians currently in power want?

a The citizens would rise up in rebellion if actions

were outrageous

b The lack of funds to implement actions are seen

as unreasonable by a majority of voters

c Only the actions authorized by the Constitution are

legitimate

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d The states would rebel and withdraw from the union

ANS: C

The federal government is a government of limited powers, which means that, for

a federal action to be legitimate, it must be authorized Only those actions that are within the scope of the Constitution, the supreme law of the land, are authorized Power of the states and citizens is limited under the overall umbrella of the federal government Funding is also controlled through the powers of the federal

government

8 Which of the following is the basis for any American citizen to

feel comfortable expressing an opinion on a political issue?

a Amendments to the Constitution

b Articles of the Constitution of the United States

c Declaration of Independence

d Gettysburg Address

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ANS: A

Amendments to the Constitution, later known as the Bill of Rights, were added after the original Articles of the Constitution were ratified These amendments protect individuals’ rights and freedoms The Declaration of Independence

announced the freedom of America from the British Empire The Gettysburg

Address was a speech given by President Abraham Lincoln following the Civil War

9 Which of the following best describes who has the authority to act in

every area except those specifically mentioned in the Constitution?

a Any individual citizen

b Federal government

c Local government

d State government

ANS: D

Any powers not delegated to the federal government are reserved for the

states Thus, individual citizens, the federal government, and local governments are excluded

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10 Which of the following best describes how the local government is

provided authority?

a Through the ability to tax local residents to meet

local needs

b Through the people themselves who band together to

create the community

c Power delegated from the federal level to the local

11 Which of the following statements best describes how policies in the

private sector are different from policies in the public sector?

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a Private sector policies are slow, deliberate, and

reactive to events

b Private sector policies are determined by the opinions

and feelings of those employed in that sector

c Private sector policies are based on economics and

market trends

d Private sector policies are based on rational decision

making

ANS: C

Private policy is largely influenced by theories of economics and business

management, including consumerism and market trends Such policies can react quickly and are often proactive In comparison, public policies are slow and reactive, and economics is just one of many factors involved Public policies are determined by voting shifts, electoral realignment, and term limits

12 The president was sent a bill that he did not really like, but he would have been unpopular if he vetoed it, so he did nothing Which of the following best describes what will happen to the bill?

a The bill is dead

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b The bill returns to both houses to see if enough votes

can be obtained to pass the bill even without the

president signing the bill

c The bill becomes law

d The bill sits there until the president signs it or vetoes

it

ANS: C

A bill that has been passed by the legislature goes to the president The

president may sign it so it becomes law; however, if he neither signs nor vetoes

it, the bill becomes law by default

DIF: Cognitive Level: Apply (Application) REF: p 172

13 The forces for the proposed bill are roughly as persuasive, powerful, and well financed as the forces against the proposed bill Which of the following describes the most likely outcome?

a The bill will be debated through a public hearing

b The bill will fail

c The bill will pass

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d The bill will remain in the legislature until one side

or the other has a majority of votes

ANS: B

It is far easier to defeat a bill than get one passed; therefore, the opposition always has the advantage

14 Which of the following statements best describe what happened to the hospitals built or expanded by Hill-Burton Act funds?

a Many such hospitals have consolidated or closed

b Not needing to expand, hospitals have used the funds

to upgrade their facilities

c They have continued to use such funds to expand

d When funding ceased, so did hospital expansion

ANS: A

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The Hill-Burton Act authorized federal assistance in construction of hospitals,

making hospitals more accessible However, with the high cost of health care and the decreasing lengths of stay and increasing use of primary care, many

hospitals are closing Because hospitals have closed, they are not further

expanding or upgrading facilities

15 An individual has been terminated from his job and has lost his health

insurance Which of the following federal laws allows him to continue his insurance benefits for a specified period of time?

a Health Insurance Portability and Accountability Act of

1996 (HIPAA)

b Family Support Act of 1988

c Health Maintenance Organization Act of 1973 (HMO)

d Consolidated Omnibus Budget Reconciliation Act of

1985 (COBRA)

ANS: D

An important requirement of COBRA focuses on the problem of the loss of insurance when a person loses his or her job With the growing number of unemployed, COBRA is even more important Employers who terminate an employee must continue benefits for the employee and dependents for a specified period of time if the employee had health benefits before the termination HIPPA offers protections for patient privacy and confidentiality The Family Support Act expanded coverage

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for poor women and children and required states to extend Medicaid coverage for

12 months to families who have increased earnings but are no longer receiving cash assistance The HMO Act provides grants for HMO development

16 Which of the following statements best describes an effect of the

Welfare Reform Act of 1996?

a Individuals who were required to obtain employment

lost their health coverage

b Many were happy to be off the government dole

and self-supporting

c Persons sought and obtained employment that often

included insurance benefits

d The food stamp program decreased in size

ANS: A

The law decreased the number of people on welfare and forced many individuals to take low-paying jobs, many of which did not offer health insurance Many individuals, particularly women and children, subsequently lost Medicaid coverage

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17 Which of the following best describes the history of the State Child Health Improvement Act (SCHIP) of 1997?

a The law included goals and programs but no funding

to achieve them

b The law received extensive support by both

Republicans and Democrats

c The law was extended, not renewed by the Bush

administration, and then renewed by the

Obama administration

d The law was passed by the majority of states but not

by the federal government

ANS: C

The law was extended several times, and then it was not renewed by the Bush administration In January 2009, the law was renewed again by the Obama administration

18 Which of the following best describes what happened after the Medicare Modernization Act of 2003 was enacted?

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a Additional restrictions in coverage were imposed

b Experimental treatments were approved

for reimbursement

c Reimbursement procedures became more efficient

d A prescription drug benefit was added

19 A nurse is employed by the state public health department Which of

the following activities would she most likely complete?

a Set up a flu shot clinic at a neighborhood church

b Lobby for health care reform to cover

more preventive services

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c Monitor the incidence of influenza in the state

d Serve as a volunteer for a state legislator’s campaign

ANS: C

One of the state health care functions is assessment of health needs based on

statewide data collection This could be done by monitoring the incidence of

influenza in the state Setting up a flu shot clinic would most likely be done at the local level, while lobbying for health care reform would most likely be done at the federal level Serving as a volunteer for a campaign may be something a nurse

would do, but would not be specifically related to employment by the state public health department

20 It has been proposed that a new, better approach to health care be tested with

a small group to evaluate its effectiveness Which of the following best

describes why this cannot be done?

a Any employment in the project would be only

temporary, so it would be difficult to find

professionals to staff the program

b It is challenging to find appropriate sites located in the

target area from which to offer the pilot project

service

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c No one wants to accept free services if they include

being a guinea pig in a research project

d Offering a service establishes a precedent and a sense

of entitlement, so it is difficult to discontinue the

program

ANS: D

Once a direct health care service is offered, it is difficult to discontinue it Existing programs create tradition by establishing vested interest and a sense of entitlement

21 Which of the following best describes the most crucial step in

policy formation?

a Convincing both political parties and independents to

support the proposed policy

b Defining the issue and placing it on the agenda

for possible action

c Determining who has vested interest in what

aspects of the policy

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d Trying to simplify the proposed legislation so the

public will support it

22 A nurse suggests to the students that they attend the local district nurses’ association meeting, where the nurse is an officer Which of the following provides the best rationale for this action?

a Meeting outside the clinical area allows for more

effective informal learning based on discussion

and interaction

b Role models are typically the major influence on

nurses choosing to become politically active

c Students are often given extra credit from their

instructor for such community involvement

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d Such groups want students to attend their meetings

to encourage them to join and to accept a committee

responsibility

ANS: B

Professional groups do not usually accept students into membership (especially since many students may want a different specialty practice) Nurses most often identify positive role models as the major influence that assisted them to become politically active Therefore, mentorship at the student level up to the expert level is important Providing extra credit should not be the motivator for students to learn from these role models The learning that occurs is a formal learning process

related to learning more about political advocacy and something that is difficult to demonstrate in a classroom environment

23 Which of the following statements best describes why nurses are not

more effective in creating political change?

a Nurses are not listened to by politicians

b Nurses are not perceived as leaders in the health care

field

c Nurses do not act or do not agree on what changes

are needed

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