Question 1

A nursing instructor is teaching a group of nurses the various types of policies. The instructor recognizes that the class understands the information when they identify which result as an example of a regulatory health policy?

Accepted Answer

Regulatory health policy regulates or licenses services or people providing services in the community. Distributive health policy subsidizes nursing education, benefits the needy, and allocates resources among and between groups.

Question 2

A group of students are discussing the various types of policies and what they accomplish after a nurse has presented the information in an educational session. At the end of the discussion, the students will identify which outcome as the result of a distributive health policy?

Accepted Answer

Distributive health policy promotes nongovernmental activities that are thought to be beneficial to society as a whole. An example of a distributive policy is the Nurse Training Act, Title VIII of the Public Health Service Act, which was established in 1965 and provided federal subsidies for nursing education in an effort to address the need for a more nurses. Reporting of communicable diseases and arms control agreement are examples of regulatory health policy at the national and international levels respectively. Medicare is an example of a redistributive health policy.

Question 3

A nursing instructor has encouraged nursing students to research and formulate a health care policy to address a specific need that they feel will be beneficial and determine whom to contact to discuss the suggested policy with. Which group best understands the process?

Accepted Answer

Each jurisdiction has specific authority to implement various policies. Encouraging rezoning to allow a farmer's market and gardening is within the authority of the local level. Hunting regulations and policies fall within the jurisdiction of the state. Policies concerning Medicare are handled at the federal level, while Medicaid is handled at both the federal and state level.

Question 4

The public health nurse is aware that writing and implementing policies is a complex process. Before implementing a new federal policy, what should the nurse do first?

Accepted Answer

After policies are passed at the federal level, the state and/or local policy makers can modify the policies if it is felt to be warranted. The PHN needs to be aware of any state or local modifications to ensure that the law is being followed properly. The other choices would follow after the nurse understands the new policy.

Question 5

An instructor is discussing the basics of policy making with the class. Which statement by the students indicates understanding of what a policy is?

Accepted Answer

Health-making policy strategies would eliminate or increase the cost of those options that now result in health-damaging situations. It would provide new, easier opportunities, or reduce the cost of current options, in areas that now lack health-promoting resources. It would increase the cost of opportunities where health-promoting resources exist in deleterious excess.

Question 6

An instructor is leading a discussion with a group of student nurses about the history of public health nursing. The instructor recognizes that the students understand the material by which statement?

Accepted Answer

The concept of social justice is seen as the very foundation of public health nursing. Social marketing is the means to influence behavior of target populations for program development. Addressing social disparities or inequalities are one component of public health nursing. Advocacy involves pleading the case of another and pursuing influencing outcomes.

Question 7

A group of student nurses are discussing the various influences that play a part in making health policies. Which factors should the students recognize as being influential in the creation of health policies? Select all that apply.

Accepted Answer

Nurses need to provide input to policy circles through advocacy and leadership at decision-making tables. It is naive to believe that others will be persuaded by facts alone or that facts are given priority. Power is wielded by special interest groups, business, and industry. There are power struggles behind all legislation and health care regulation.

Question 8

A group of student nurses are preparing a class presentation to discuss how the United States compares to other countries in providing health care to the country's citizens. Which areas of concern will the students include in the discussion? Select all that apply.

Accepted Answer

Areas where the United States compares favorably to other countries includes cancer mortality, stroke mortality, control of blood pressure and cholesterol levels, suicide, elderly survival, and self-rated health. Burn injuries and tuberculosis are not included.

Question 9

A group of students are reviewing the history of how medical care has changed and evolved over the years. Some of these changes are related to various social changes and policies that have emphasized improving the situation or environment to improve the health of the community. Which result best relates to a social change leading to a health improvement during the first half of the 20th century?

Accepted Answer

Social policy changes in the first half of the 20th century (1900-1950) would include measures such as elimination of child labor, development of vaccines, clean water and sewage treatment, refrigeration and preservation of food, worker safety policies, development and use of antibiotics, and improved nutrition. The other choices occurred in the second half of the 20th century.

Question 10

A group of student nurses are questioning the benefits of joining a professional nursing organization during a class discussion. Which statements by the instructor will best address their concerns? Select all that apply.

Accepted Answer

Professional nursing organizations have elevated nursing professionalism, have given voice to the inequalities that affect our society, and have developed the paradigms that influence and affect public health. Despite nursing's early history of political activism and the fact that nurses are the largest group of health care providers in the United States, widespread political involvement has yet to be fully realized.

Question 11

A public health nurse is concerned about some specific issues that are occurring in the local community and would like to see positive changes occur to improve the situation. Which is the best way for any nurse to advocate for change and exert power?

Accepted Answer

A major way in which nurses have been successful with advocacy is through membership in their professional nursing organization. Influencing policy may be achieved by obtaining advanced education, running for a state congressional seat, or becoming a member of a local not-for-profit agency board of directors. Influencing policy is not the same as advocating.

Question 12

A nursing instructor is discussing the importance of each nurse, especially public health nurses to become involved in political activism. Which statement by a nursing student would indicate that the teaching was successful?

Accepted Answer

A professional nursing association such as the ANA builds a collective voice for nurses. Despite nursing's early history of political activism and the fact that nurses are the largest group of health care providers in the United States, widespread political involvement has yet to be realized. Nursing also is not thought of as a major player in Washington when discussing health care policy.

Question 13

A group of student nurses are observing a committee discussion on a health care-based policy. As the students watch the process, they recognize that power and empowerment are demonstrated by which actions? Select all that apply.

Accepted Answer

Power is the ability to act or produce an effect and possess control, authority, or influence over others. Empowerment is a process of assisting communities to come together to express their values and ideas to those outside the community. If power is the ability to control, predict, and participate in one's environment, then empowerment is the process whereby individuals and communities take power and transform their lives. Professionals hold the power and authority by virtue of their place in the bureaucracy. Nurses have a responsibility to ensure community participation in issues affecting them, and they must continually examine the relationship and position they hold within these communities. The legislators recognize that they represent the people, and if they do only what they want and ignore the voice of the community, they can be replaced at the next election.

Question 14

A community health nurse working in the community has developed a great relationship with the clients. This nurse understands that the power and empowerment are best achieved by which concept?

Accepted Answer

The various definitions of empowerment and the expansion of the definition of health, which now includes the social, political, and economic determinants of health, have changed our thinking on how best to interact with the communities we serve. This also suggests a change in the relationship between professionals and communities; a change from the customary hierarchical client/provider relationship, exerting authority over the client, or allowing the client to have complete autonomy to one of a partnership.

Question 15

A nursing instructor is discussing potential future changes in health care and encouraging the students to get involved and be a part of the process to influence policy development. Which actions should the instructor emphasize? Select all that apply.

Accepted Answer

The four key messages from The Future of Nursing: Leading Change, Advancing Health include the following:
1. Nurses should practice to the full extent of their education and training.
2. Nurses should achieve higher levels of education and training through an improved education system that promotes seamless academic progression.
3. Nurses should be full partners, with physicians and other health professionals, in redesigning health care in the United States.
4. Effective workforce planning and policy making require better data collection and an improved information infrastructure.
It is not yet true that most nurses are already involved in the regulatory framework development.

Question 16

A public health nurse has noted a sharp increase in clients from the same area presenting with similar symptoms that appear to be environmentally related. What is the best response from the nurse while utilizing the Kingdon's framework to tackle this issue?

Accepted Answer

The Kingdon's framework allows the nurse to examine a current issue in real time and determine if a window of opportunity exists or if one could be created. This helps the PHN, or public health organization, to prioritize its time and resources and focus policy efforts where they can be most effective. The other choices would be followed if it is decided that now is the appropriate time to pursue a policy change.

Question 17

A public health nurse has accepted a position in a new public health district clinic in a previously underserved area. Identify the nursing priority.

Accepted Answer

The initial priority is to determine which issues need immediate attention and address those needs. Hiring of support staff would be the responsible of the office manager, which may or may not be the PHN. Establishing relationships with the community and policy makers would come after the nurse understands what the current concerns are for the community.

Question 18

The public health nurse is preparing a community educational presentation to describe the ACA and its various benefits. Which points will the nurse include in the presentation? Select all that apply.

Accepted Answer

The ACA has the goal of providing health insurance coverage for all citizens in the United States. Employers have been given the option to provide insurance or contribute to the marketplace option to provide insurance for their employees. Subsidies are available only for low-income families or individuals. Its focus is not for Health Saving Accounts. It does not create one central insurance provider but maintains several companies that continue to provide insurance. It does, however, mandate how those companies will and will not provide insurance.

Question 19

The public health nurse recognizes that the ACA has provided guideline that can have a positive effect on the local community. Which activity mandated by the ACA can the nurse implement to assist the local population?

Accepted Answer

There are seven strategic priority areas that are indicated by ACA. They include healthy eating, tobacco-free living, preventing drug abuse and excessive alcohol use, active living, mental and emotional well-being, reproductive and sexual health, and injury- and violence-free living. These priority areas are concentrated on preventing health problems. Expanding services at a local clinic, providing birth centers, and working with food banks are activities that would address specific health concerns.

Question 20

The public health nurse recognizes that communication is an essential element in the policy-making process. The nurse identifies which method as one of the best formats to utilize to communicate with policy makers?

Accepted Answer

Common methods of generating a conversation with legislators is by e-mail, phone, or in person. The other choices may help the nurse collecting information concerning issues and how the politician may relate to health care issues but are not the best methods for establishing and maintaining an open communication line.

Quiz 13: Policy Making and Advocacy