Chapter 15- Valuing the Political Process My Nursing Test Banks

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Chapter: Chapter 15: Valuing the Political Process

Multiple Choice

1. A nurse practicing in Alabama accepts a position in Connecticut. Which of the following would be the best resource to consult for a legal definition of nursing in that state?

A) American Association of Nurses

B) Nurse Practice Act

C) The American Journal of Nursing

D) National League for Nursing

Ans: B

Client Needs: A-1

Cognitive Level: Comprehension

Difficulty: Easy

Integrated Process: Communication and Documentation

Objective: 1

Page and Header: 530, Relevance of the Political Process for Nurses

Feedback: All of the philosophic discussions about the role of the nurse must return to the reality of the nurses role as legally defined in the states practice act. Nurse practice acts define the specific legal parameters for nursing practice in a state. The AAN, NLN, and nursing journals do not make these determinants.

2. A nurse attempts to become more involved in the political process. Which of the following statements accurately describes the political arena in which this nurse may become involved?

A) Nurses can be involved in the political process as individuals, but they are far more effective when working in groups.

B) Most traditional nursing organizations are government-mandated groups and therefore are deeply involved in political activity.

C) Political action committees are nonprofit organizations that are registered as political action groups and are free to try to affect the political process.

D) Nurses who testify for decision-making bodies must do so as an official representative of a nursing organization.

Ans: A

Client Needs: A-1

Cognitive Level: Analysis

Difficulty: Moderate

Integrated Process: Communication and Documentation

Objective: 2

Page and Header: 537, Group Action

Feedback: Legislators consider the views of individual constituents when making political decisions. However, the views of organized groups are more likely to influence a policymaker. Most traditional nursing organizations are nonprofit groups and therefore are limited in their political activity. PACs are registered as political action groups and are free to try to affect the political process. Nurses may testify as individuals.

3. Which of the following is an accurate representation of politics at the local level?

A) Once budgeted funds are allocated to an objective, more funds are made available for other projects.

B) Local budgets are generally mandated by federal agencies.

C) Support for community services may depend on whether knowledgeable nurses voice their advocacy.

D) Local political decision-making sessions are usually closed to the public.

Ans: C

Client Needs: A-1

Cognitive Level: Analysis

Difficulty: Moderate

Integrated Process: Communication and Documentation

Objective: 5

Page and Header: 546, Local Political Concerns

Feedback: In many communities, decisions about the allocation of federal money are made at the local level. Support for health-related community services may depend on whether those who are knowledgeable about the benefits of these services are willing to voice their advocacy in local decision-making bodies. When funds are allocated they are no longer available for other purposes and projects. The local political decision-making process is normally open to the public.

4. A nurse decides to become a member of NANDA-International (NANDAI). Which of the following areas of the nursing process is he or she most likely interested in developing?

A) Assessment

B) Diagnosis

C) Implementation

D) Evaluation

Ans: B

Client Needs: A-1

Cognitive Level: Comprehension

Difficulty: Easy

Integrated Process: Communication and Documentation

Objective: 8

Page and Header: 556, NANDA-I

Feedback: The purpose of NANDA-I is to work toward uniform terminology and definitions to be used in nursing diagnosis and to share ideas and information regarding this topic.

5. What is the main purpose of the National Council of State Boards of Nursing (NCSBN)?

A) Provide accreditation of baccalaureate and higher degree programs

B) Recognize those with superior ability and leadership potential, and those who have made important contributions to nursing

C) Provide a forum for the legal regulatory bodies to act together in the regulation of nursing practice for the protection of the public

D) Unite the interests of nursing with those of the community in support of excellence in nursing education

Ans: C

Client Needs: A-1

Cognitive Level: Comprehension

Difficulty: Moderate

Integrated Process: Communication and Documentation

Objective: 8

Page and Header: 555, National Council of State Boards of Nursing

Feedback: The purpose of the NCSBN is to provide a forum for the legal regulatory bodies (whatever their particular state titles might be) of all states, the District of Columbia, and the US territories to act together in the regulation of nursing practice for the protection of the public. It does not perform accreditation or leadership in education programs or acknowledge influential nurses.

6. A nurse has expressed her intention to draft a letter to her state senator but the nurses colleagues have characterized this effort as a waste of time and energy. Which of the following statements provides the most accurate rationale for nurses involvement in the political process?

A) Involvement in the political process can lead to the effective allocation of resources.

B) Political action increases the status and influence of the nursing profession as a whole.

C) Involvement in the political process demonstrates responsibility and accountability by nurses.

D) Political involvement by nurses increases the influence of women in society and in government.

Ans: A

Client Needs: A-1

Cognitive Level: Analysis

Difficulty: Difficult

Integrated Process: Communication and Documentation

Objective: 1

Page and Header: 530, Relevance of the Political Process for Nurses

Feedback: With many voices competing to be heard in the decision-making circles of any nation, the person who understands power and politics, and who participates in this process, is the one most likely to obtain the resources needed to accomplish desired ends. Political involvement is not primarily motivated by the desire to increase the status of nurses and/or women and it is not simply an activity performed out of obligation or responsibility.

7. A nurse has become aware of sweeping changes that are proposed for the state budget which may have ramifications for the funding of the inner-city clinic where the nurse provides care. In order to influence the decision-making process the nurse should first

A) tell clients of the clinic that their healthcare is in jeopardy.

B) clearly communicate her views on the matter to the appropriate legislators.

C) examine the systems and processes at the clinic to see where efficiency could be improved.

D) approach the media with examples of the way that funding changes will hurt patient and client outcomes.

Ans: B

Client Needs: A-1

Cognitive Level: Application

Difficulty: Moderate

Integrated Process: Communication and Documentation

Objective: 2

Page and Header: 531, Display 15.1

Feedback: One of the most basic, and important, ways to influence the political process is to explicitly communicate ones views to the government leaders who determine policy. Examining the efficiency of the clinic is a useful exercise but not one that is likely to influence political decisions. It is likely premature and alarmist to go to the media or begin telling clients that their care is in jeopardy.

Multiple Selection

8. The federal government operates in the healthcare field in complex ways that involve dozens of agencies. Which of the following groups are examples of the involvement of the federal government in healthcare? (Select all that apply.)

A) Centers for Disease Control and Prevention (CDC)

B) Department of Health and Human Services (HHS)

C) National Institutes of Health (NIH)

D) Center for Medical & Medicare Services (CMS)

E) National League of Nursing (NLN)

Ans: A, B, C, D

Client Needs: A-1

Cognitive Level: Knowledge

Difficulty: Difficult

Integrated Process: Communication and Documentation

Objective: 3

Page and Header: 542, Federal Agencies Related to Healthcare

Feedback: The Department of Health and Human Services (HHS) is a cabinet-level administrative unit of the federal government with four major service divisions and many different sections. The Public Health Service includes the Centers for Disease Control and Prevention (CDC). The National Institutes of Health (NIH), the Food and Drug Administration, the Health Resources Administration, and the Center for Medical & Medicare Services (CMS) are all part of HHS. The NLN is not a department or agency affiliated with the federal government.

Multiple Choice

9. A group of nurses have organized with the purpose of promoting an amendment to the nurse practice act that governs the profession. This group should direct their efforts toward what level of government?

A) Local

B) State

C) Federal

D) Regional

Ans: B

Client Needs: A-1

Cognitive Level: Application

Difficulty: Moderate

Integrated Process: Communication and Documentation

Objective: 4

Page and Header: 545, State Legislative Concerns

Feedback: Nurse practice acts are pieces of legislation that exist at the state level.

10. A nurse has initiated a letter-writing campaign in an effort to increase the funding for school nursing programs in local high schools. A colleague of the nurse, however, has pointed out that the monies for such programs originate with the federal government. Which of the following statements best describes the relationship between federal funding and local healthcare programs?

A) Federal funding is made available only in cases where the local tax base is insufficient to fund programs.

B) Local contributions to health promotion programs are matched by the Department of Health and Human Services.

C) Decisions around the allocation for federal funding are often made at the local level.

D) Federal representatives control budgets at a local level but are obliged to consider input from local residents.

Ans: C

Client Needs: A-1

Cognitive Level: Analysis

Difficulty: Difficult

Integrated Process: Communication and Documentation

Objective: 5

Page and Header: 546, Local Political Concerns

Feedback: In many communities, decisions about the allocation of federal money are made at the local level. Recent congressional actions have leaned toward enhancing state and local control through creating large block grants where priorities would be decided locally. Federal funding is not dependent on a lack of local funding and the DHHS does not normally match local funding. Local budgets are not normally under the direction of federal officials.

11. In 2010, the Quality and Affordable Care Act was passed, beginning the process of providing health coverage for all legal residents of the United States. This legislation has numerous ramifications for nurses, including

A) the replacement of most general practice physicians with nurse practitioners.

B) the creation of incentives for advanced practice nursing education.

C) the creation of a common scope of practice for practical (vocational) nurses and registered nurses.

D) the establishment of mandatory overtime for nurses in acute care settings.

Ans: B

Client Needs: A-1

Cognitive Level: Comprehension

Difficulty: Moderate

Integrated Process: Communication and Documentation

Objective: 3

Page and Header: 546, Federal Healthcare Reform Legislation

Feedback: The Quality and Affordable Care Act creates incentives for nurses to seek advanced education. This legislation does not create a uniform scope of practice for PNs and RNs or advocate the elimination of general practice physicians. As well, the act does not establish mandatory overtime for nurses.

12. A nursing student has expressed exasperation at the bewildering number and variety of nursing organizations that exist in the United States. Why are there so many nursing organizations?

A) The nursing profession itself is large, diverse, and complex.

B) Nursing has long been defined by competing political interests.

C) Nursing is governed by a combination of local, state, and federal laws.

D) The nursing profession has traditionally been influenced by the interests of other political organizations.

Ans: A

Client Needs: A-1

Cognitive Level: Comprehension

Difficulty: Moderate

Integrated Process: Communication and Documentation

Objective: 6

Page and Header: 549, Nursing Organizations of Today

Feedback: The existence of a large number of diverse organizations for nurses is, in many ways, a reflection of nursing itself. The profession offers a wide variety of employment opportunities to its members, with distinct and varied contributions and interests in healthcare. When nurses become committed to a particular specialty group, they have a tendency to want to advance the purposes and interests of the people working in that area. This variety and diversity is reflected in the number of nursing organizations. It is not necessarily a result of competition, outside influences, or the variety of legislation that affects nursing practice.

13. After many years of providing bedside care in a variety of settings, a nurse has become involved in the leadership of the American Nurses Foundation (ANF). In this role, the nurse will be primarily involved in

A) supporting nursing research.

B) enhancing the public perception of the nursing profession.

C) advancing the scope of practice for registered nurses.

D) lobbying for improved wages and benefits.

Ans: A

Client Needs: A-1

Cognitive Level: Application

Difficulty: Moderate

Integrated Process: Communication and Documentation

Objective: 7

Page and Header: 552, American Nurses Foundation

Feedback: The ANF is a tax-exempt, nonprofit corporation that exists for the purpose of supporting research related to nursing. It is not primarily involved in promoting the image of nursing, lobbying for wages and benefits, or determining the scope of practice.

14. During his baccalaureate program in nursing, Mark became passionate about excellence in nursing education. Now that he has graduated and begun acting as a preceptor for nursing students, he wishes to become politically involved in issues relating to nursing education. What nursing organization should Mark most likely join?

A) American Nurses Foundation (ANF)

B) National Council of State Boards of Nursing, Inc. (NCSBN)

C) NANDA-International (NANDA-I)

D) National League for Nursing (NLN)

Ans: D

Client Needs: A-1

Cognitive Level: Application

Difficulty: Moderate

Integrated Process: Communication and Documentation

Objective: 9

Page and Header: 553, Activities and Services

Feedback: The NLN seeks to unite the interests of nursing with those of the community in support of excellence in nursing education. The NCSBN, ANF, and NANDA-I are not primarily focused on matters relating to nursing education.

15. The Quality and Affordable Care Act of 2010 addresses a large variety of issues and policies related to the provision of healthcare in the United States. Which of the following situations is most likely to be affected by the provisions of this act?

A) A new resident of a small town has been unable to find a family physician who is accepting new patients.

B) A citizen has been falsifying documents and tax returns in order to qualify for Medicare.

C) A man is engaged in a dispute with his health maintenance organization (HMO) over reimbursement for an emergency procedure.

D) A woman is unsure where to bring her daughter for an annual influenza vaccination.

Ans: B

Client Needs: A-1

Cognitive Level: Analysis

Difficulty: Difficult

Integrated Process: Communication and Documentation

Objective: 3

Page and Header: 546, Federal Healthcare Reform Legislation

Feedback: The Quality and Affordable Care Act addresses the Medicare and Medicaid programs, aiming to increase availability and eliminate waste and fraud. The act does not directly address the functioning of HMOs or the availability of specific aspects of care.

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