Question 1

A nurse is confused because a federal agency does not seem to be providing services according to the law.Another nurse explains that this can happen because
A)agencies do not work under any specific federal laws.
B)agency interpretation is needed to implement the law.
C)not all government agencies fall under specific laws.
D)there is considerable infighting among different agencies.

Accepted Answer

Agencies are charged with implementation of law according to their interpretation of the intent of the law,and agencies can change their procedures without revising the original law.Often,interpretation-and,hence,action-varies according to the personnel at the agency.
Agencies do work that falls under their jurisdiction according to law,whether that is at the state or federal level.
All government agencies fall under the auspices of some law.
Agencies have specific established functions and so would not be fighting among themselves over how each agency should do its job.

Question 2

A bill has passed both Houses.Before it gets sent to the president,it must be
A)approved by appropriate party chairs.
B)fully financed with appropriations.
C)registered as a pending law to sign.
D)resolved in conference committee.

Accepted Answer

After both Houses pass their version of a bill,a conference committee works on the bill to resolve any differences between the two versions that passed.
After a bill passes in both Houses,it does not go to the party chairs.The party chairs run the political party;the committee chairs set the legislative agenda.
Bills may be passed fully,partially,or not funded at all.
Bills that have passed do not need to be registered anywhere as pending laws.

Question 3

A nurse wants to see a bill passed that includes an increase in federal income taxes to fund it.A friend should encourage the nurse to
A)call the appropriate committee members.
B)provide information to the party secretary.
C)send a petition to the nurse's representative.
D)write a letter to the nurse's senator.

Accepted Answer

This answer is correct because all bills that call for increases in federal income tax must originate in the House of Representatives,and the nurse's representative could direct the petition or the nurse to the appropriate chairperson.
Committees can send forward ideas for bills,but only the House of Representatives can originate bills that call for increases in federal income tax.
The party secretary would not be the appropriate place to send this request because bills that call for increases in federal income tax must originate in the House of Representatives.
The Senate cannot originate bills that call for increases in federal income tax.

Question 4

Today's nurse understands that the mission of political action committees (PACs)has changed over the years to become more
A)invested in social and corporate agendas.
B)involved at the state rather than the national level.
C)fiscally responsible to the general population.
D)responsive to needs of underserved groups.

Accepted Answer

Originally intended to represent traditionally underrepresented groups,PACs now typically represent particular groups interested in specific issues.
PACs are active at both the national and state levels.
The lack of transparency in financial matters related to politics and to PACs has led to grass-roots advocacy regarding inappropriate financing.
Being responsive to needs of underserved groups was the original mission of PACs,but this has evolved to include specific groups of people with specific interests.

Question 5

The nurse studying the development of the American health care system understands that before the 1990s,health care funding was primarily
A)driven by fee-for-service costs.
B)from charitable organizations.
C)paid for by entitlement programs.
D)the responsibility of each state.

Accepted Answer

Before the involvement of the federal government in health care financing in the 1990s,physicians (and health care facilities)charged a fee for services,which was generally paid for either out of pocket by the individual or by private health insurance companies.
There has always been some charitable health care,but this has not been the primary method of payment.
Entitlement programs,such as Medicare,cover health care expenses for certain designated groups.
States are involved in some health care financing but certainly not the majority of it.

Question 6

A nurse working for a governmental agency is charged with establishing evaluation plans for the programs the agency oversees.To show the agency is meeting health-related objectives,the nurse would most likely compare the agency's outcomes to
A)benchmarks for health care at the local level.
B)budget guidelines imposed by Congress.
C)goals established in Healthy People 2020.
D)taxpayer satisfaction with health programs.

Accepted Answer

Healthy People is a blueprint to the nation's health,and many funding decisions are based on attempting to meet targets set forth in this document.
A federal agency would most likely look to national,not local,benchmarks when evaluating specific programs.
Staying within budget guidelines is important,but this does not give information about how well an agency is meeting health-related objectives.
Taxpayer satisfaction is certainly an important issue,but this would not allow evaluation on whether or not health-related goals have been met.

Question 7

An elected member of Congress wishes to arrange discussion of a new bill related to heart disease during February,which has been declared National Heart Month.Which action by the legislator would most likely lead to this happening as desired?
A)Arrange the dates for discussion with the party whip's secretary.
B)Hire a lobbyist to present the proposed bill and timeline for debate.
C)Meet with the appropriate committee chairperson to make the request.
D)Reserve rooms in chambers for public discussion and debate on the issue.

Accepted Answer

Committee chairpersons develop the calendar for discussion of issues;this would be the appropriate avenue for this idea.
The party whip is the minority leader and does not set the agenda.
A lobbyist might be very helpful in getting bills passed,but the lobbyist would most likely not have any influence on the timing of debate.
Public discussion is not the same thing as legislative debate.

Question 8

A nursing dean wishes to establish a center to study the feasibility of creating a curriculum based on community-based nursing.To acquire funding,the dean would most likely apply to the
A)National Institutes of Health.
B)Pew Charitable Trusts.
C)state board of nursing.
D)Surgeon General's office.

Accepted Answer

The Pew Charitable Trusts is a philanthropic foundation that supplies grants for health care demonstration projects,research studies,and training and education of health care professionals.
The National Institutes of Health do provide funding for health-related projects,but most are research studies.
The state board of nursing is involved in regulation of nursing practice,not funding studies.
The Surgeon General's office works to ensure health programs that affect the nation as a whole are effective.

Question 9

A nurse is worried about an upcoming judicial appointment.A co-worker explains that the nurse can voice opinions about such matters best by
A)calling the majority party's leadership.
B)phoning the nurse's House member.
C)sending a petition to the president.
D)writing to the senator from that state.

Accepted Answer

The Senate has the primary responsibility for such political appointments as judges,ambassadors,the surgeon general,cabinet members,and federal agency directors.The nurse should write (or call)the senators from his or her state.
The majority party's leadership would not necessarily be involved in a judicial appointment.
The House of Representatives does not have primary responsibility for judicial appointments.
The president nominates people for judicial appointments but does not get them appointed.

Question 10

A congresswoman is explaining that she occasionally votes for bills that need,but do not contain,provisions for funding because
A)appropriations bills are usually considered in specific years.
B)once the bill has passed,it is often easier to find funding for it.
C)she can support the cause without having to find money for it.
D)there isn't enough money left in the budget for some issues.

Accepted Answer

Congressional representatives often vote for bills that do not contain funding so they can be seen as supporting the cause without having to provide funding.
Authorization bills for funding programs,if present,usually pass around the time the original bill passed,and the first authorization bill for a program is often named for the program it funds.
Bills are not usually passed in the hope that funding can be found at a later date.
It certainly may be true that there is not enough money left in the budget,but it is not the reason that this is done as a practice.

Question 11

A nurse studying the intersection of politics and health care describes the relationship best by saying that
A)hiring lobbyists is the most effective way to communicate ideas.
B)only national organizations really have a voice in health care.
C)politics provides a means for differing voices to be heard.
D)voting in elections is the primary way to influence policy.

Accepted Answer

Through the political process,individuals,groups,agencies,and government entities have a voice in developing our health care system via regulations,establishing outcomes,and developing policy.
Lobbyists can be an effective tool,but they are expensive,and in the case of issues that are very popular with the general public,they may not be necessary at all.
Everyone has a voice in our national health care system.
There are multiple avenues for influencing health care policy;voting is one but is not necessarily the primary method.

Question 12

An undergraduate nursing dean is expecting a site visit from the school's accrediting agency.To ensure that the school meets the agency's objectives for accreditation,it would be most important that the dean would assess whether course work provided opportunities for students in
A)different types of health care organizations and levels of care.
B)mastering basic science concepts as they apply to nursing care.
C)providing charitable care through nurse-run clinics and offices.
D)working with community-based clients and regional health needs.

Accepted Answer

The two agencies that accredit schools of nursing (the National League for Nursing Accreditation Commission and the Commission on Collegiate Nursing Education)require undergraduate nursing programs to tailor their curricula to local and regional health care needs.Having the ability to work within several different types of agencies providing multiple levels of care is a good skill but is not one of the specific requirements of the two accreditation agencies.
Students do need a mastery of basic science skills in order to advance to more sophisticated concepts,but this is not a specific requirement of the accreditation agencies.
Nurse-run clinics are an increasingly used method of providing care and educating students,but they are not a specific requirement of accreditation agencies.

Question 13

A nurse wishes to encourage people to vote and energize those who feel strongly about a particular political issue.The nurse would best accomplish this by
A)donating money to a political action committee (PAC).
B)joining the office staff of an involved lobbyist.
C)serving on a national candidate's platform staff.
D)volunteering for a related 527 political group.

Accepted Answer

A 527 political group is usually involved in voter mobilization,issue advocacy,and other political activities that do not call for endorsing a particular candidate.
PACs typically work to raise money,assist in campaigns,and lobby on behalf of special interest groups.
Lobbyists work for special interest groups,often as part of a PAC.
Serving on the platform staff or on a convention staff would not be involved with "get out the vote" campaigns.

Question 14

A voter is angry that his or her congressman voted for a bill that contained an amendment unrelated to the bill without knowing about the amendment.The congressman explains that this occurs because
A)aides do not have time to fully read bills and inform congressional members.
B)amendments sometimes are added at the last minute.
C)representatives do not get copies of full bills before they vote on them.
D)there simply is not enough time to understand each bill.

Accepted Answer

Amendments are sometimes added at the last minute in order to get a specific congressional member to vote for the bill.Other legislators may not be aware of the addition of such "pork barrel" legislation to the bill and may vote for (or against)the bill without knowing that they are voting on specific projects.
Aides do read bills and give reports to their congressional members,but members should not rely totally on the aides to understand bills.
Representatives do get the bills before voting on them;however,to gain the vote of specific congressional members,"pork barrel" legislation (for special "pet" projects)is often added to the bill at the last moment (and some members may not be aware of this).
Congressional members should take the time to fully understand the contents of each bill before voting.

Question 15

Bills that include funding requests are known as __________ bills.
A)authorization
B)finalized
C)funded
D)supplemental

Accepted Answer

Bills that contain requests for funding are known as authorization bills.
A finalized bill might be one that has passed both houses and has been resolved in conference committee,but the chapter does not discuss finalized bills.
A program or mandate gets its funding via authorization bills.
A supplemental bill might be used to provide funding for emergencies that were not anticipated and therefore not funded.

Question 16

A nursing manager is concerned about staffing levels and their impact on patient safety.What action by the nurse would have the best chance of influencing this issue?
A)Call senators from the state,explaining the need for staffing laws.
B)Donate money to the American Nurses Association for lobbying.
C)Organize a petition drive calling for a city ordinance on staffing.
D)Work with the state nurses association on related state legislation.

Accepted Answer

The nurse should work with the state nurses association in that state because state legislatures typically are the level of government to regulate nursing working environments,including staffing levels.
Mandatory staffing issues are typically taken up at the state level.
The American Nurses Association is a strong force to join,but staffing levels are typically mandated at the state level.
A city ordinance would not be an effective way to ensure safe staffing levels.

Question 17

A nurse does not understand why the U.S.Department of Health and Human Services (USDHHS)cannot allocate more money for public health efforts.Another nurse explains that money for public health and other expenditures is limited because the majority of the USDHHS budget must fund
A)any program deemed in need of funding.
B)initiatives according to Healthy People 2020.
C)Medicare and other legislated programs.
D)United Nations health and wellness plans.

Accepted Answer

About two thirds of the budget of the USDHHS goes to fund Medicare and other entitlement programs,leaving a minority of funds for other items.
Only about one third of USDHHS's budget is discretionary;the remainder goes to fund other legislated programs.
Healthy People 2020 does focus on the health care priorities of the nation,but budgetary expenditures from USDHHS for these initiatives are limited because of fixed spending on entitlements.
The USDHHS budget does not fund United Nations plans.

Question 18

A nurse understands that the first major government involvement in health care occurred with passage of the __________ Act.
A)Brady
B)Hill-Burton
C)Nurse Reinvestment
D)Social Security

Accepted Answer

The Social Security Act of 1935 was the first incursion of the federal government in health care and provided grants to the states for specific health programs.
The Brady Act (1993)concerned gun control and the prevention of handgun violence.
The Hill-Burton Act (1946)concerned building hospitals and improving their physical capabilities.
The Nurse Reinvestment Act (2008)is a training act funded as a discretionary health care expenditure.

Question 19

A politically savvy nurse is explaining to co-workers that a plank in a political party's platform refers to the
A)documents that will be voted on.
B)financing arm of the convention.
C)party's stand on specific issues.
D)supporters of various programs.

Accepted Answer

The party's stands on specific issues are called planks,which come together to form a platform,which represents the consensus of party delegates on specific issues of importance to the party leaders.
The party votes on issues during the political conventions,which then become the basis of arguments made during a political race.
The financing means of the convention is not known as a plank.
The supporters of various programs are not known as planks.

Question 20

A nurse wishing to give money to a national political party without designating it for a specific purpose is donating what is called __________ money.
A)hard
B)soft
C)unencumbered
D)unrestricted

Accepted Answer

Soft money is money donated to a national political party without a designated purpose.
Hard money is given to specific campaigns.
The term unencumbered money was not discussed in the chapter.
The term unrestricted money was not discussed in the chapter.

Quiz 6: Health Policy and Planning and the Nursing Practice Environment

A nurse is confused because a federal agency does not seem to be providing services according to the law.Another nurse explains that this can happen because

A bill has passed both Houses.Before it gets sent to the president,it must be

A nurse wants to see a bill passed that includes an increase in federal income taxes to fund it.A friend should encourage the nurse to

Today's nurse understands that the mission of political action committees (PACs) has changed over the years to become more

The nurse studying the development of the American health care system understands that before the 1990s,health care funding was primarily

A nurse working for a governmental agency is charged with establishing evaluation plans for the programs the agency oversees.To show the agency is meeting health-related objectives,the nurse would most likely compare the agency's outcomes to

An elected member of Congress wishes to arrange discussion of a new bill related to heart disease during February,which has been declared National Heart Month.Which action by the legislator would most likely lead to this happening as desired?

A nursing dean wishes to establish a center to study the feasibility of creating a curriculum based on community-based nursing.To acquire funding,the dean would most likely apply to the

A nurse is worried about an upcoming judicial appointment.A co-worker explains that the nurse can voice opinions about such matters best by

A congresswoman is explaining that she occasionally votes for bills that need,but do not contain,provisions for funding because

A nurse studying the intersection of politics and health care describes the relationship best by saying that

An undergraduate nursing dean is expecting a site visit from the school's accrediting agency.To ensure that the school meets the agency's objectives for accreditation,it would be most important that the dean would assess whether course work provided opportunities for students in

A nurse wishes to encourage people to vote and energize those who feel strongly about a particular political issue.The nurse would best accomplish this by

A voter is angry that his or her congressman voted for a bill that contained an amendment unrelated to the bill without knowing about the amendment.The congressman explains that this occurs because

Bills that include funding requests are known as __________ bills.

A nursing manager is concerned about staffing levels and their impact on patient safety.What action by the nurse would have the best chance of influencing this issue?

A nurse does not understand why the U.S.Department of Health and Human Services (USDHHS) cannot allocate more money for public health efforts.Another nurse explains that money for public health and other expenditures is limited because the majority of the USDHHS budget must fund

A nurse understands that the first major government involvement in health care occurred with passage of the __________ Act.

A politically savvy nurse is explaining to co-workers that a plank in a political party's platform refers to the

A nurse wishing to give money to a national political party without designating it for a specific purpose is donating what is called __________ money.