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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 Which of the following nurses fought to have American nursing controlled by nurses rather than physicians? a Clara Barton b Florence Nightingale c Lavinia Dock d Lillian Wald ANS: C Lavinia Dock was a political activist who waged a campaign for legislation to allow nurses to control the nursing profession Florence Nightingale was the first nurse to exert political pressure on a government Clara Barton was responsible for 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 Which of the following nurses used political expertise to influence the federal government to develop a Children’s Bureau? a Clara Barton b Florence Nightingale c Lavinia Dock d Lillian Wald ANS: D Lillian Wald recognized the connection between social conditions and health She was a driving force behind the federal government’s development of the Children’s Bureau in 1912 Lavinia Dock was a political activist who waged a campaign for legislation to allow nurses to control the nursing profession Florence Nightingale was the first nurse to exert political pressure on a government Clara Barton was responsible for organizing relief efforts during the U.S Civil War DIF: Cognitive Level: Remember (Knowledge) REF: p 166 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 Which of the following is accomplished through the use of public policy? a Solutions to problems of public concern are developed b A rational, logical problem-solving decision-making process is implemented c Public safety nets for vulnerable populations are created d Economic and business management principles are applied ANS: A 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 decisionmaking 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 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 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 not play as great of role as where resources are spent DIF: Cognitive Level: Understand (Comprehension) REF: p 168 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 c Passes and enforces law d Uses fear reinforced by police power ANS: C Government regulates conditions that individuals cannot control and provides individual protection through a population-wide focus These tasks are accomplished through passage and enforcement of laws These laws control individuals’ behaviors, which may lead to the establishment of social mores and common sense related to the laws that have been established DIF: Cognitive Level: Understand (Comprehension) REF: p 169 Which of the following statements best describes why the federal government is unable to 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 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 DIF: Cognitive Level: Understand (Comprehension) REF: p 170 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 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 DIF: Cognitive Level: Understand (Comprehension) REF: p 170 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 DIF: Cognitive Level: Understand (Comprehension) REF: p 170 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 level d Power delegated from the states ANS: D States may delegate powers to the local government Which powers they delegate vary widely from state to state The federal government does not directly delegate power to the local level, this occurs through state government Taxation and creation of a community not provide the local government with authority DIF: Cognitive Level: Understand (Comprehension) REF: p 170 11 Which of the following statements best describes how policies in the private sector are different from policies in the public sector? 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 DIF: Cognitive Level: Understand (Comprehension) REF: p 171 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 presentations to schools may be useful, but it may be assumed that most nursing faculty can discuss legislative health issues Verbal confrontations are not always useful DIF: Cognitive Level: Apply (Application) REF: p 180 27 A nurse is unable to be actively involved in attending meetings at the state level Which of the following actions would be most useful for the nurse? a Asking students to remain informed regarding proposed legislation b Communicating, with rationales, her stand on proposed legislation to legislators c Remaining uninvolved so incorrect information is not inadvertently given d Writing letters to the local newspaper asking nurses to become involved ANS: B Grassroots cooperation can influence decisions A high number of communications from individual constituents via e-mail, telephone, or postal mail have great influence DIF: Cognitive Level: Apply (Application) REF: p 180 28 A nurse states that he or she does not want to become involved in politics because of family, school, work, and other commitments Which of the following would be the best reply to this statement? a “Good for you We should all stay out of such dirty game playing!” b “I am sorry to hear that but I understand.” c “It doesn’t matter; politics have nothing to with nursing practice.” d “It won’t take much time to join ANA and pay dues so their lobbyist can represent you.” ANS: D Some of the nursing organizations have full-time lobbyists who work in Congress, including the American Nurses Association (ANA) These lobbyists help represent the interests of nurses and society Politics play a major role in nursing practice and nurses should be encouraged to participate in organizations, even if it is through paying dues, so that their voice can be represented DIF: Cognitive Level: Apply (Application) REF: p 180 29 Which of the following statements best describes why nurses should contribute whenever possible to their state nursing association political action committee (PAC)? a As PACs are a reality of political life, nursing needs to be heard b Contributing money may result in a future political appointment c Only money really has any influence on legislative votes d PACs are being used to increase nursing salaries and working conditions ANS: A Because PACs are a reality of political life, nurses need to recognize their power and support those that are committed to electing candidates sympathetic to health care issues The contribution of money will support the current nursing practice initiatives which will change as nursing practice changes These contributions will most likely not have any relationship to a future political appointment Legislative votes are influenced by a variety of factors and are not limited only to money DIF: Cognitive Level: Understand (Comprehension) REF: p 180 30 Which of the following best describes what is being discussed in relation to concerns over patients’ safety and nurse fatigue? a All hospitals are now required to report errors made that are a result of low nurse staffing b The Centers for Disease Control and Prevention (CDC) is monitoring the incidence of medical errors caused by nurse understaffing c The Registered Nurse Safe Staffing Act was passed by Congress in 2013 d Legislation has been suggested that staffing systems require the input of direct care registered nurses ANS: D The Registered Nurse Safe Staffing Act of 2013 was introduced in Congress to address concerns of inadequate and inappropriate staffing, which threatens patients’ safety and the nurses’ health The act would encourage development of staffing systems that require the input of direct care registered nurses, as well as protection for RNs who speak out about patient care issues This suggested legislation has not been acted on The CDC is not involved in monitoring medical errors caused by nurse understaffing Hospitals are not required to report errors that occur due to nurse understaffing DIF: Cognitive Level: Understand (Comprehension) REF: pp 182-183 31 A nurse would like to influence an internal private health policy Which of the following actions should the nurse take? a Build or join a private entrepreneurial practice to provide lower cost services to underserved groups b Participate in public discussions regarding quality and managed care c Support nursing research done that demonstrates positive clinical and economic outcomes d Write managed care organizations to request that nurses receive reimbursement for health services to clients ANS: C Internal nursing action is from within the agency, such as holding an important management position Nurses can support and use nursing research that demonstrates positive clinical and economic outcomes Such action also serves to validate the importance of nursing within the health system External strategies can include participation in discussions regarding aspects of care or seeking employment in entrepreneurial practices DIF: Cognitive Level: Apply (Application) REF: p 184 32 What was the poverty guideline for a family of four in mainland United States in 2013? a Below $23,550 b Below $25,250 c Below $28,550 d Below $32,250 ANS: A A four-person household must make less than $23,550 to be considered under the poverty guideline according to the U.S Department of Health and Human Services DIF: Cognitive Level: Understand (Comprehension) REF: p 174 MULTIPLE RESPONSE Which of the following best describes the purposes of professional societies such as the American Nurses Association (ANA)? (Select all that apply.) a Providing control and oversight of the occupation b Creating licensing laws to control entry into the profession c Determining appropriate requirements for education into the profession d Establishing standards for practice e Protecting the interests of the practitioners f Safeguarding the public trust ANS: A, D, E, F Professional societies seek to further a particular profession, the interests of persons engaged in that profession, and the public interest Their roles are to maintain control and oversight of the occupation—such as by writing standards for practice—as well as safeguarding the public trust Licensure and educational standards are responsibilities of individual states DIF: Cognitive Level: Understand (Comprehension) REF: pp 167-168 Which of the following is one legally required to obey? (Select all that apply.) a Directions to a destination provided by a police officer b Court decisions related to legislative law c Delegation of responsibility for a task by a physician d Executive decisions, such as your employer requirements e Laws passed by your state or the federal government f Rules and regulations from agencies, such as the state board of nursing ANS: B, E, F Laws that all must obey include legislative law, regulatory agency rules and regulations, and judiciary rulings regarding the law Although physicians may delegate a task, a physician cannot delegate responsibility DIF: Cognitive Level: Understand (Comprehension) REF: p 167 Which of the following current issues are leading the World Health Organization (WHO) to reconsider its initial definition of health? (Select all that apply.) a Environmental issues such as industrial toxins or carcinogenic commercial products b Global, not local, problems such as spread of antibiotic-resistant bacteria c Need to move from containment and treatment to social intervention d Pressure from industrialized nations to emphasize chronic diseases rather than infectious diseases e Realization that government actions influence the basic human right of health f Worldwide pandemics such as human immunodeficiency virus (HIV) and swine flu, which require a different approach ANS: A, B, C, E, F WHO is refocusing as it attempts to deal with environmental issues of nuclear contamination and industrial toxins, and the exploration of carcinogenic commercial products (such as tobacco) Globally, WHO is trying to eliminate antibiotic-resistant bacteria and the HIV pandemic HIV has changed the paradigm from traditional containment and treatment to a more comprehensive approach of social intervention There is a realization that health is a basic human right and health problems are linked to government action and affect human rights The WHO is not emphasizing the chronic diseases faced by industrialized nations DIF: Cognitive Level: Understand (Comprehension) REF: p 168 Which of the following best describes the new national health goals as seen in Healthy People 2020? (Select all that apply.) a Achieve a plan for universal basic health care for citizens b Create social and physical environments that promote good health c Eliminate health disparities d Eliminate preventable disease, disability, injury, and premature death e Achieve health equity f Promote healthy behaviors at every stage of life ANS: B, D, F Building on previous iterations, the updated 2020 version has four “over-arching goals” for 2020: (1) attain high quality, longer lives free of preventable disease, disability, injury, and premature death; (2) achieve health equity, eliminate disparities, and improve the health of all age groups; (3) create social and physical environments that promote good health for all; and (4) promote quality of life, health development, and health behaviors across all life stages Achieving a plan for universal basic health care for citizens, eliminating health care disparities, and achieving health equity are not seen as national health goals in Healthy People 2020 DIF: Cognitive Level: Understand (Comprehension) REF: p 168 Which of the following statements best describes a notable change of the Omnibus Budget Reconciliation Act? (Select all that apply.) a Legislated a funding increase for RN staffing b Changed from process evaluation to outcome evaluation when evaluating care c Established guidelines for the use of restraints d Created health maintenance organizations nationwide e Added prescription drug benefits for Medicaid recipients f Required all states to review certificates of need before agencies could expand ANS: B, C, E The Budget Reconciliation Act influenced funding and set up guidelines and regulations about several issues including a move from process to outcome evaluation, use of restraints, and prescription drugs for Medicaid recipients The Health Maintenance Organization Act of 1973 established health maintenance organizations The National Health Planning and Resources Act of 1974 required health care facilities to obtain prior approval from the state for expansion in the form of a certificate of need The Nurse Training Act in 1964 provided funds for nursing school construction and loans and scholarships for full-time study DIF: Cognitive Level: Understand (Comprehension) REF: p 175 Which of the following were among the outcomes of the 1979 report Healthy People: The Surgeon General’s Report on Health Promotion and Disease Prevention? (Select all that apply.) a A national committee was established to have hearings and study the problem further b Increased funds were allocated for health planning and health care c Many of the recommendations were adopted on the federal level d The Health Objectives Planning Act of 1990 was passed e The federal government began to identify and monitor national health care goals f The president addressed the American people about the need for health care reform ANS: D, E The federal government began to take a direct approach in identifying and monitoring national health care goals after the Surgeon General’s report The Healthy Objectives Planning Act of 1990 was passed Healthy People 2000, Healthy People 2010, and Healthy People 2020 are continuing the efforts The establishment of a national committee, increased funding for health planning and health care, adoption of recommendations at the federal level, and the need for health care reform were not outcomes of the 1979 report DIF: Cognitive Level: Understand (Comprehension) REF: p 175 Which of the following critical issues in health care were addressed by The Health Insurance Portability and Accountability Act (HIPAA) of 1996? (Select all that apply.) a Portability of insurance coverage b COBRA, maintaining coverage for those who lose their jobs c Insurance companies having a total monopoly in a certain geographic area d Insurance companies setting limits on coverage of longer than 12 months e Insurance companies charging seriously ill persons more than healthy persons f Insurance companies paying the same for mental health coverage as for physical illnesses ANS: A, D The HIPAA of 1996 addressed insurance issues Critical were the portability of coverage and preexisting conditions Insurers cannot set limits on coverage longer than 12 months COBRA was established through the Consolidated Omnibus Budget Reconciliation Act of 1985 The McCarren-Ferguson Act of 1945 gave states the exclusive right to regulate health insurance plans The Mental Health Parity and Addictions Equity Act of 2008 mandated that insurance companies must provide the same coverage for mental health as for physical illness Health Care Reform legislation prevents insurance companies from charging seriously ill persons more than healthy persons DIF: Cognitive Level: Understand (Comprehension) REF: p 175 Which of the following actions represent a shift in philosophy at the Centers for Disease Control and Prevention (CDC)? (Select all that apply.) a Collecting and analyzing health data b Creating integrated health information systems c Allocating resources to treat specific diseases d Encouraging partnerships and strategic alliances e Creating transaction-based relationships f Leveraging resources to steer the larger health system ANS: B, D, F Rather than allocating resources, resources will be leveraged to influence the larger health system Rather than collecting and analyzing health data, they now are creating integrated health information systems Rather than transaction-based relationships, they now encourage partnerships and strategic alliances DIF: Cognitive Level: Understand (Comprehension) REF: p 168 ... the efforts The establishment of a national committee, increased funding for health planning and health care, adoption of recommendations at the federal level, and the need for health care reform... regulate health insurance plans The Mental Health Parity and Addictions Equity Act of 2008 mandated that insurance companies must provide the same coverage for mental health as for physical illness Health. .. basic health care for citizens, eliminating health care disparities, and achieving health equity are not seen as national health goals in Healthy People 2020 DIF: Cognitive Level: Understand (Comprehension)