Nursing: A Concept-Based Approach to Learning, 2e (Pearson)

Module 47 Health Policy

The Concept of Health Policy

1) A nurse educator is discussing the changes in the healthcare system with a group of nursing
students. The students ask why the cost of health care has increased so much in recent years.
What is the best response by the nurse?
A) "There are not enough technological advances."
B) "There is an increased use of alternative medicine."
C) "There is a decrease in chronic disease."
D) "Many people are forced to seek routine health care in the Emergency Department."
Answer: D
Explanation:
A) Many people in the United States do not have healthcare insurance. As a result, they seek
routine health care in the Emergency Department, contributing to the increase in the cost of
health care. Use of alternative medicine does not increase healthcare costs. Chronic disease is on
the rise. There are many technological advances in medicine, and they have increased the cost of
health care.
B) Many people in the United States do not have healthcare insurance. As a result, they seek
routine health care in the Emergency Department, contributing to the increase in the cost of
health care. Use of alternative medicine does not increase healthcare costs. Chronic disease is on
the rise. There are many technological advances in medicine, and they have increased the cost of
health care.
C) Many people in the United States do not have healthcare insurance. As a result, they seek
routine health care in the Emergency Department, contributing to the increase in the cost of
health care. Use of alternative medicine does not increase healthcare costs. Chronic disease is on
the rise. There are many technological advances in medicine, and they have increased the cost of
health care.
D) Many people in the United States do not have healthcare insurance. As a result, they seek
routine health care in the Emergency Department, contributing to the increase in the cost of
health care. Use of alternative medicine does not increase healthcare costs. Chronic disease is on
the rise. There are many technological advances in medicine, and they have increased the cost of
health care.
Page Ref: 2620
Cognitive Level: Applying
Client Need: Safe and Effective Care Environment
Nursing Process: Implementation
Learning Outcome: 1. Identify factors that influence the development of health policy in the
United States.

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2) A local health system has implemented a number of health promotion policies and plans to
prioritize health problems. The system must now evaluate the effectiveness of the interventions.
Which groups are stakeholders in this initiative and would be involved in this process?
A) Only consumers who were directly affected by the services provided
B) Consumers, community leaders, and politicians
C) Only hospital and clinic personnel who administered healthcare needs
D) Healthcare providers employed by other health systems
Answer: B
Explanation:
A) Community leaders, politicians, and consumers all would be stakeholders and would be
included in the evaluation process. Healthcare providers employed by other health systems
would not be stakeholders in this initiative and would not need to be included in the evaluation
process. Because policy changes are made by the health system, the hospital and clinic personnel
employed there would not evaluate the effectiveness of policy without participation by the
community. Consumers are part of the process, but would not be the only evaluation group.
B) Community leaders, politicians, and consumers all would be stakeholders and would be
included in the evaluation process. Healthcare providers employed by other health systems
would not be stakeholders in this initiative and would not need to be included in the evaluation
process. Because policy changes are made by the health system, the hospital and clinic personnel
employed there would not evaluate the effectiveness of policy without participation by the
community. Consumers are part of the process, but would not be the only evaluation group.
C) Community leaders, politicians, and consumers all would be stakeholders and would be
included in the evaluation process. Healthcare providers employed by other health systems
would not be stakeholders in this initiative and would not need to be included in the evaluation
process. Because policy changes are made by the health system, the hospital and clinic personnel
employed there would not evaluate the effectiveness of policy without participation by the
community. Consumers are part of the process, but would not be the only evaluation group.
D) Community leaders, politicians, and consumers all would be stakeholders and would be
included in the evaluation process. Healthcare providers employed by other health systems
would not be stakeholders in this initiative and would not need to be included in the evaluation
process. Because policy changes are made by the health system, the hospital and clinic personnel
employed there would not evaluate the effectiveness of policy without participation by the
community. Consumers are part of the process, but would not be the only evaluation group.
Page Ref: 2620
Cognitive Level: Applying
Client Need: Safe and Effective Care Environment
Nursing Process: Evaluation
Learning Outcome: 2. Describe processes by which health policies are developed, implemented,
evaluated, changed, and maintained.

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3) A student nurse is completing a community assessment with a group of fellow students. The
student must research the location of the main healthcare facilities and the number of health
professionals in the community. Which would be the best source for this information?
A) Police department
B) Local health department
C) State census data
D) City health planning board
Answer: B
Explanation:
A) The local health department would be able to supply information about location of health
facilities, occupational health programs, numbers of health professionals, numbers of welfare
recipients, and so on. The police department has statistics regarding incidence of crime,
vandalism, and drug addiction. The city health planning board has information about health
needs and practices. The state census data describe population composition and characteristics.
B) The local health department would be able to supply information about location of health
facilities, occupational health programs, numbers of health professionals, numbers of welfare
recipients, and so on. The police department has statistics regarding incidence of crime,
vandalism, and drug addiction. The city health planning board has information about health
needs and practices. The state census data describe population composition and characteristics.
C) The local health department would be able to supply information about location of health
facilities, occupational health programs, numbers of health professionals, numbers of welfare
recipients, and so on. The police department has statistics regarding incidence of crime,
vandalism, and drug addiction. The city health planning board has information about health
needs and practices. The state census data describe population composition and characteristics.
D) The local health department would be able to supply information about location of health
facilities, occupational health programs, numbers of health professionals, numbers of welfare
recipients, and so on. The police department has statistics regarding incidence of crime,
vandalism, and drug addiction. The city health planning board has information about health
needs and practices. The state census data describe population composition and characteristics.
Page Ref: 2620
Cognitive Level: Understanding
Client Need: Safe and Effective Care Environment
Nursing Process: Assessment
Learning Outcome: 3. Identify regulatory agencies and accrediting bodies that develop,
administer, or implement health policy.

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4) A nurse educator is discussing the different entities that offer accreditation to healthcare
professional programs. Which types of programs can receive accreditation from the National
League of Nursing (NLN)?
Select all that apply.
A) Bachelor of Science in Nursing (BSN) programs
B) Licensed Vocational Nursing (LVN) programs
C) Medical Assisting programs
D) Licensed Practical Nursing (LPN) programs
E) Dental Assisting programs
Answer: A, B, D
Explanation:
A) The NLN accredits nursing programs at all levels, including BSN, LPN, and LVN programs.
Medical Assisting and Dental Assisting programs would not be eligible for NLN accreditation.
B) The NLN accredits nursing programs at all levels, including BSN, LPN, and LVN programs.
Medical Assisting and Dental Assisting programs would not be eligible for NLN accreditation.
C) The NLN accredits nursing programs at all levels, including BSN, LPN, and LVN programs.
Medical Assisting and Dental Assisting programs would not be eligible for NLN accreditation.
D) The NLN accredits nursing programs at all levels, including BSN, LPN, and LVN programs.
Medical Assisting and Dental Assisting programs would not be eligible for NLN accreditation.
E) The NLN accredits nursing programs at all levels, including BSN, LPN, and LVN programs.
Medical Assisting and Dental Assisting programs would not be eligible for NLN accreditation.
Page Ref: 2625
Cognitive Level: Applying
Client Need: Safe and Effective Care Environment
Nursing Process: Assessment
Learning Outcome: 4. Compare and contrast the scope and purpose of specific regulatory
agencies and accrediting bodies.

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5) A nursing student is talking to the instructor about developing professional behavior. In order
to access information that may be useful in developing professional demeanor, the instructor
recommends that the student do which of the following?
A) Join the America Nurses Association (ANA).
B) Join the National Student Nurses Association (NSNA).
C) Read the Nurse Practice Act.
D) Use the Internet to obtain information.
Answer: B
Explanation:
A) The NSNA is an organization specifically for student nurses with a goal of assisting the
student to foster their professionalism. Nurse practice acts do need to be read by students, but
they denote laws, not professionalism. The ANA is for members practicing nursing, not students,
although students may join. The NSNA focuses on students and is a better resource. The Internet
is good for obtaining information and for networking but is not necessarily a help to the student
who wishes to increase professionalism.
B) The NSNA is an organization specifically for student nurses with a goal of assisting the
student to foster their professionalism. Nurse practice acts do need to be read by students, but
they denote laws, not professionalism. The ANA is for members practicing nursing, not students,
although students may join. The NSNA focuses on students and is a better resource. The Internet
is good for obtaining information and for networking but is not necessarily a help to the student
who wishes to increase professionalism.
C) The NSNA is an organization specifically for student nurses with a goal of assisting the
student to foster their professionalism. Nurse practice acts do need to be read by students, but
they denote laws, not professionalism. The ANA is for members practicing nursing, not students,
although students may join. The NSNA focuses on students and is a better resource. The Internet
is good for obtaining information and for networking but is not necessarily a help to the student
who wishes to increase professionalism.
D) The NSNA is an organization specifically for student nurses with a goal of assisting the
student to foster their professionalism. Nurse practice acts do need to be read by students, but
they denote laws, not professionalism. The ANA is for members practicing nursing, not students,
although students may join. The NSNA focuses on students and is a better resource. The Internet
is good for obtaining information and for networking but is not necessarily a help to the student
who wishes to increase professionalism.
Page Ref: 2525
Cognitive Level: Applying
Client Need: Safe and Effective Care Environment
Nursing Process: Planning
Learning Outcome: 5. Discuss professional organizations that support nurses and the nursing
profession.

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6) A 67-year-old client has experienced an extended hospitalization due to a chronic illness. The
client asks the nurse how he will afford to pay for the hospitalization plus all the extremely
expensive drugs he now has to take. What is the most appropriate response by the nurse?
A) "I'll have someone from the business office come and talk to you about your bill."
B) "You need to focus on recovering and stop worrying about money."
C) "Much of your care will be covered by Medicare."
D) "Don't worry. I'm sure everything will work out okay."
Answer: C
Explanation:
A) The Medicare amendment to the Social Security Act provided a national and state health
insurance program for older adults. By the mid-1970s, virtually everyone over 65 years of age
was protected by hospital insurance under Part A. In 1988, Congress expanded Medicare to
include extremely expensive hospital care, "catastrophic care," and expensive drugs. Ignoring the
client's concerns by telling him not to worry is not therapeutic communication and does little, if
anything, to confront the client's concerns. Giving the concern to the business office is merely
"passing the buck." Nurses should have some knowledge about the payment sources of their
clients, especially those who have automatic coverage with Medicare because of their age.
B) The Medicare amendment to the Social Security Act provided a national and state health
insurance program for older adults. By the mid-1970s, virtually everyone over 65 years of age
was protected by hospital insurance under Part A. In 1988, Congress expanded Medicare to
include extremely expensive hospital care, "catastrophic care," and expensive drugs. Ignoring the
client's concerns by telling him not to worry is not therapeutic communication and does little, if
anything, to confront the client's concerns. Giving the concern to the business office is merely
"passing the buck." Nurses should have some knowledge about the payment sources of their
clients, especially those who have automatic coverage with Medicare because of their age.
C) The Medicare amendment to the Social Security Act provided a national and state health
insurance program for older adults. By the mid-1970s, virtually everyone over 65 years of age
was protected by hospital insurance under Part A. In 1988, Congress expanded Medicare to
include extremely expensive hospital care, "catastrophic care," and expensive drugs. Ignoring the
client's concerns by telling him not to worry is not therapeutic communication and does little, if
anything, to confront the client's concerns. Giving the concern to the business office is merely
"passing the buck." Nurses should have some knowledge about the payment sources of their
clients, especially those who have automatic coverage with Medicare because of their age.
D) The Medicare amendment to the Social Security Act provided a national and state health
insurance program for older adults. By the mid-1970s, virtually everyone over 65 years of age
was protected by hospital insurance under Part A. In 1988, Congress expanded Medicare to
include extremely expensive hospital care, "catastrophic care," and expensive drugs. Ignoring the
client's concerns by telling him not to worry is not therapeutic communication and does little, if
anything, to confront the client's concerns. Giving the concern to the business office is merely
"passing the buck." Nurses should have some knowledge about the payment sources of their
clients, especially those who have automatic coverage with Medicare because of their age.
Page Ref: 2627
Cognitive Level: Analyzing
Client Need: Psychosocial Integrity
Nursing Process: Implementation
Learning Outcome: 6. Summarize the types of healthcare reimbursement.

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7) A student nurse will be attending clinical at the local health department. The student nurse is
aware that which potential programs are offered by local health departments?
Select all that apply.
A) Injury prevention campaigns
B) Lead poisoning prevention efforts
C) Nutritional programs
D) Disease prevention efforts
E) Workplace safety inspections
Answer: A, B, C, D
Explanation:
A) Local health departments oversee a variety of health policies and the respective regulations.
Typical programs include injury prevention campaigns; lead poisoning prevention efforts; and
making safety equipment such as smoke detectors, children's bicycle helmets, and infant car
seats available to families at no cost. Local departments of health usually administer the Women,
Infants, and Children (WIC) supplemental nutrition program, which provides food assistance to
pregnant women and children under age 5 who are at risk for malnutrition. The Occupational
Safety and Health Administration (OSHA) is a federal agency that works to ensure the health
and safety of Americans in the workplace. It provides training, outreach, and education to
employers and employees, and encourages improvement of workplace safety and health.
B) Local health departments oversee a variety of health policies and the respective regulations.
Typical programs include injury prevention campaigns; lead poisoning prevention efforts; and
making safety equipment such as smoke detectors, children's bicycle helmets, and infant car
seats available to families at no cost. Local departments of health usually administer the Women,
Infants, and Children (WIC) supplemental nutrition program, which provides food assistance to
pregnant women and children under age 5 who are at risk for malnutrition. The Occupational
Safety and Health Administration (OSHA) is a federal agency that works to ensure the health
and safety of Americans in the workplace. It provides training, outreach, and education to
employers and employees, and encourages improvement of workplace safety and health.
C) Local health departments oversee a variety of health policies and the respective regulations.
Typical programs include injury prevention campaigns; lead poisoning prevention efforts; and
making safety equipment such as smoke detectors, children's bicycle helmets, and infant car
seats available to families at no cost. Local departments of health usually administer the Women,
Infants, and Children (WIC) supplemental nutrition program, which provides food assistance to
pregnant women and children under age 5 who are at risk for malnutrition. The Occupational
Safety and Health Administration (OSHA) is a federal agency that works to ensure the health
and safety of Americans in the workplace. It provides training, outreach, and education to
employers and employees, and encourages improvement of workplace safety and health.
D) Local health departments oversee a variety of health policies and the respective regulations.
Typical programs include injury prevention campaigns; lead poisoning prevention efforts; and
making safety equipment such as smoke detectors, children's bicycle helmets, and infant car
seats available to families at no cost. Local departments of health usually administer the Women,
Infants, and Children (WIC) supplemental nutrition program, which provides food assistance to
pregnant women and children under age 5 who are at risk for malnutrition. The Occupational
Safety and Health Administration (OSHA) is a federal agency that works to ensure the health
and safety of Americans in the workplace. It provides training, outreach, and education to
employers and employees, and encourages improvement of workplace safety and health.

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Copyright © 2015 Pearson Education, Inc.
E) Local health departments oversee a variety of health policies and the respective regulations.
Typical programs include injury prevention campaigns; lead poisoning prevention efforts; and
making safety equipment such as smoke detectors, children's bicycle helmets, and infant car
seats available to families at no cost. Local departments of health usually administer the Women,
Infants, and Children (WIC) supplemental nutrition program, which provides food assistance to
pregnant women and children under age 5 who are at risk for malnutrition. The Occupational
Safety and Health Administration (OSHA) is a federal agency that works to ensure the health
and safety of Americans in the workplace. It provides training, outreach, and education to
employers and employees, and encourages improvement of workplace safety and health.
Page Ref: 2624
Cognitive Level: Understanding
Client Need: Safe and Effective Care Environment
Client Need Sub: Safety and Infection Control
Nursing Process: Teaching and Learning
Learning Outcome: 4. Compare and contrast the scope and purpose of specific regulatory
agencies and accrediting bodies.

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8) A newly licensed nurse has been hired at a local hospital and completed the hospital
orientation program. The newly licensed nurse would be aware that which regulatory agency
works to ensure the health and safety of Americans in the workplace?
A) Department of Health and Human Services (DHHS)
B) National Institutes of Health (NIH)
C) Occupational Safety and Health Administration (OSHA)
D) Centers for Medicare and Medicaid Services (CMS)
Answer: C
Explanation:
A) OSHA works to ensure the health and safety of Americans in the workplace. The DHHS is
the federal government's principal agency for the protection of the health of all Americans and
the provision of essential human services for those least able to care for themselves. The NIH is a
branch of the DHHS that is responsible for health research and the provision of health-related
information. The CMS is responsible for healthcare financing.
B) OSHA works to ensure the health and safety of Americans in the workplace. The DHHS is
the federal government's principal agency for the protection of the health of all Americans and
the provision of essential human services for those least able to care for themselves. The NIH is a
branch of the DHHS that is responsible for health research and the provision of health-related
information. The CMS is responsible for healthcare financing.
C) OSHA works to ensure the health and safety of Americans in the workplace. The DHHS is
the federal government's principal agency for the protection of the health of all Americans and
the provision of essential human services for those least able to care for themselves. The NIH is a
branch of the DHHS that is responsible for health research and the provision of health-related
information. The CMS is responsible for healthcare financing.
D) OSHA works to ensure the health and safety of Americans in the workplace. The DHHS is
the federal government's principal agency for the protection of the health of all Americans and
the provision of essential human services for those least able to care for themselves. The NIH is a
branch of the DHHS that is responsible for health research and the provision of health-related
information. The CMS is responsible for healthcare financing.
Page Ref: 2623
Cognitive Level: Understanding
Client Need: Safe and Effective Care Environment
Client Need Sub: Safety and Infection Control
Nursing Process: Teaching and Learning
Learning Outcome: 3. Identify regulatory agencies and accrediting bodies that develop,
administer, or implement health policy.

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9) A nursing student is preparing to compose a paper. She has chosen to research an organization
that promotes excellence in all levels of nursing education. The nursing student would research
which organization?
A) National League for Nursing (NLN)
B) National Student Nurses Association (NSNA)
C) American Nurses Association (ANA)
D) American Association of Colleges of Nursing (AACN)
Answer: A
Explanation:
A) The NLN was the first nursing organization in the United States and was founded in 1893.
Part of the mission of the NLN is to promote excellence in nursing education to build a strong
and diverse nursing workforce. The NSNA is a nonprofit organization that mentors nursing
students who are preparing for initial licensing as a registered nurse. The ANA fosters high
standards of nursing practice, promotes the rights of nurses in the workplace, projects a positive
and realistic view of nursing, and lobbies Congress and regulatory agencies on healthcare issues
affecting nurses and the public. The AACN is the national voice for America's baccalaureate and
graduate nursing education programs.
B) The NLN was the first nursing organization in the United States and was founded in 1893.
Part of the mission of the NLN is to promote excellence in nursing education to build a strong
and diverse nursing workforce. The NSNA is a nonprofit organization that mentors nursing
students who are preparing for initial licensing as a registered nurse. The ANA fosters high
standards of nursing practice, promotes the rights of nurses in the workplace, projects a positive
and realistic view of nursing, and lobbies Congress and regulatory agencies on healthcare issues
affecting nurses and the public. The AACN is the national voice for America's baccalaureate and
graduate nursing education programs.
C) The NLN was the first nursing organization in the United States and was founded in 1893.
Part of the mission of the NLN is to promote excellence in nursing education to build a strong
and diverse nursing workforce. The NSNA is a nonprofit organization that mentors nursing
students who are preparing for initial licensing as a registered nurse. The ANA fosters high
standards of nursing practice, promotes the rights of nurses in the workplace, projects a positive
and realistic view of nursing, and lobbies Congress and regulatory agencies on healthcare issues
affecting nurses and the public. The AACN is the national voice for America's baccalaureate and
graduate nursing education programs.

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D) The NLN was the first nursing organization in the United States and was founded in 1893.
Part of the mission of the NLN is to promote excellence in nursing education to build a strong
and diverse nursing workforce. The NSNA is a nonprofit organization that mentors nursing
students who are preparing for initial licensing as a registered nurse. The ANA fosters high
standards of nursing practice, promotes the rights of nurses in the workplace, projects a positive
and realistic view of nursing, and lobbies Congress and regulatory agencies on healthcare issues
affecting nurses and the public. The AACN is the national voice for America's baccalaureate and
graduate nursing education programs.
Page Ref: 2625
Cognitive Level: Understanding
Client Need: Safe and Effective Care Environment
Client Need Sub: Management of Care
Nursing Process: Teaching and Learning
Learning Outcome: 5. Discuss professional organizations that support nurses and the nursing
profession.

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