Question 1

Which of the following best describes what is being discussed in relation to concerns over patients' safety and nurse fatigue?

Accepted Answer

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.

Question 2

Which of the following best describes the new national health goals as seen in Healthy People 2020? (Select all that apply.)

Accepted Answer

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.

Question 3

Which of the following statements best describes why nurses are not more effective in creating political change?

Accepted Answer

Nurses know how to communicate, collaborate, negotiate, and serve as leaders who can make themselves heard. However, the various nursing subgroups do not agree on public policies.

Question 4

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.)

Accepted Answer

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.

Question 5

Which of the following statements best describes a notable change of the Omnibus Budget Reconciliation Act? (Select all that apply.)

Accepted Answer

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 loansand scholarships for full-time study.

Question 6

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?

Accepted Answer

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.

Question 7

A nurse is employed by the state nursing association to serve as a lobbyist. Which of the following would be the most crucial task to achieve?

Accepted Answer

An individual who establishes a reputation as a reliable and accurate resource as a lobbyist has substantial influence. Certainly, it is also useful to convince colleagues to join nursing organizations and write legislators or contribute to campaigns of legislators supportive of nursing goals. Legislators rely on lobbyists to educate them on issues. The official must trust the lobbyists to give accurate (though predictably biased) information, which is timely and up to date.

Question 8

A nurse represents the state professional association. Which of the following actions would the nurse complete in relation to legislation?

Accepted Answer

Although a nurse might do any of the above, the most effective is to provide testimony and comment on issues of importance to nursing. Contributing is dependent on the financial resources of the nurse. Legislators often appreciate volunteer hours spent on campaign tasks as much as sums of money. Giving 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.

Question 9

Which of the following is one legally required to obey? (Select all that apply.)

Accepted Answer

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.

Question 10

The local nursing association and the local medical association disagreed vehemently on advanced practice nursing reimbursement. Which of the following best describes why the two groups agreed to join a coalition to send representatives to testify on a particular bill?

Accepted Answer

When two or more groups join to maximize resources, increasing their influence and improving their chances of success in achieving a common goal, it is a coalition. Professional groups often form coalitions to advance their shared interests.

Question 11

Which of the following statements best describes why nurses should contribute whenever possible to their state nursing association political action committee (PAC)?

Accepted Answer

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.

Question 12

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.)

Accepted Answer

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.

Question 13

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?

Accepted Answer

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.

Question 14

A nurse would like to influence an internal private health policy. Which of the following actions should the nurse take?

Accepted Answer

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.

Question 15

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?

Accepted Answer

Grassroots cooperation can influence decisions. A high number of communications from individual constituents via e-mail, telephone, or postal mail have great influence.

Question 16

Which of the following actions represent a shift in philosophy at the Centers for Disease Control and Prevention (CDC)? (Select all that apply.)

Accepted Answer

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.

Question 17

Which of the following current issues are leading the World Health Organization (WHO) to reconsider its initial definition of health? (Select all that apply.)

Accepted Answer

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.

Question 18

Which of the following best describes the purposes of professional societies such as the American Nurses Association (ANA)? (Select all that apply.)

Accepted Answer

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.

Question 19

Which of the following best describes the most crucial step in policy formation?

Accepted Answer

How an issue is defined determines what the possible approaches to resolution might be. With all the demands on legislators' time, it is difficult for an issue to be seen as important enough to have action taken. Defining the issue as crucially important and worthy of a place on the agenda for possible action is the most critical step.

Question 20

What was the poverty guideline for a family of four in mainland United States in 2013?

Accepted Answer

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.

Quiz 10: Policy, Politics, Legislation, and Community Health Nursing