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Population And Community Health Nursing 6th EditionTest Bank

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Population And Community Health Nursing 6th EditionTest Bank

Population and Community Health Nursing, 6e (Clark)

Chapter 9 Political Strategies

1) After a natural disaster hits the community, a grassroots organization is formed to improve conditions post-recovery. The nurse joins the organization and volunteers to contact public officials about the organization’s concerns. This role is best described as:

  1. Politician.
  2. Activist.
  3. Citizen.
  4. Researcher.

Answer: 2

Explanation: 2. Though this is a role of citizen, through speaking out on policy issues and becoming acquainted with elected officials, the nurse is displaying the role of activist. Contacting public officials and joining relevant coalitions is a political activist role.

Nursing/Int.Conc: Nursing Process: Assessment

Client Need: Health Promotion and Maintenance

Cognitive Level: Analysis

Learning Outcome: 9-1

2) As part of a public hearing on amending health policy in the state, the nurse is asked to present identified health issues that directly impact the community and to assess the current health policy. In this role, the nurse is operating as a(n):

  1. Citizen.
  2. Activist.
  3. Politician.
  4. Researcher.

Answer: 4

Explanation: 4. In this situation, the nurse is acting as a researcher. As a population health expert, the nurse is qualified to publicly address the merits and drawbacks of health issues that affect a population and draws upon current research for presentation. Assessing a proposed health policy change for its effect on the population allows the nurse to assess its quality, integrity, and identification of issues as well as review decisions to ensure they reflect current knowledge. A citizen’s role is to stay informed, but by speaking as a population expert, the nurse goes beyond that role. In an activist role, the nurse would work for a specific outcome, but in this situation the nurse has been asked to present and comment on health issues. The nurse is not proposing legislative policy issues, so it is not a politician role.

Nursing/Int.Conc: Nursing Process: Evaluation

Client Need: Health Promotion and Maintenance

Cognitive Level: Application

Learning Outcome: 9-1

3) After working many years as a population nurse, the nurse seeks appointment to a statewide board that is in charge of developing strategies to improve health outcomes in the state. This role is best described as:

  1. Citizen.
  2. Activist.
  3. Politician.
  4. Researcher.

Answer: 3

Explanation: 3. The nurse can utilize experience as a population nurse to become a frontline policy maker by seeking appointment to a board that can develop and enforce health policy. This is the role of politician. The citizen role is one of an informed voter. The activist role addresses a role that seeks a definite outcome. The researcher role seeks to identify health policy issues, not policy formation or regulation.

Nursing/Int.Conc: Nursing Process: Planning

Client Need: Health Promotion and Maintenance

Cognitive Level: Application

Learning Outcome: 9-1

4) The nurse stays informed of events that impact the community by going to public forums to learn more about various issues. The nurse also joins the state nursing organization. In this role, the nurse is a(n):

  1. Citizen.
  2. Activist.
  3. Politician.
  4. Researcher.

Answer: 1

Explanation: 1. By staying informed and participating in public forums, the nurse is acting in the role of citizen. Joining politically active professional nursing organizations to participate in policy development is another activity of the citizen role. The activist role will consciously seek to ensure a set outcome. The politician role involves greater depth, such as seeking appointment to a regulatory body or seeking office to develop policy on the legislative level. The researcher role identifies issues and reviews decisions for quality, integrity, and objectivity based on the data of the policy decisions.

Nursing/Int.Conc: Nursing Process: Implementation

Client Need: Health Promotion and Maintenance

Cognitive Level: Application

Learning Outcome: 9-1

5) The nurse is a member of the state nursing organization, and is asked to speak before a state senate committee about a proposed bill to increase funding to outpatient mental health clinics to improve health outcomes for the mentally ill. Public policy development by this route is known as:

  1. Legislation.
  2. Administrative decision.
  3. Judicial decision.
  4. Regulation.

Answer: 1

Explanation: 1. A bill is proposed as part of the legislative process when a formally worded statement of public policy interest is needed to have legal enforcement behind it. Proposing a bill is an avenue for policy development as pending legislation. The nurse addressing a committee regarding the merits of the proposed legislation is engaging in the legislative process by providing the committee with input as to the respective merits or detractions of the legislation. Decisions, administrative or judicial, are made as additions to legislation either through executive orders or through the courts. Regulation addresses legislation implemented by regulatory agencies.

Nursing/Int.Conc: Nursing Process: Assessment

Client Need: Safe and Effective Care Environment

Cognitive Level: Application

Learning Outcome: 9-2

6) Amendments to the Nurse Practice Act in the state where the nurse is licensed now require that Advanced Practice Registered Nurses be board certified through a nationally recognized accrediting agency. Enforcement of this amendment is done through:

  1. Administrative decision.
  2. Legislation.
  3. Judicial decision.
  4. Regulation.

Answer: 4

Explanation: 4. Regulation addresses how policies are implemented. Regulatory agencies specify how policies are realized in actual behavior. The amendment to the Nurse Practice Act, while done through legislation, is then implemented through a regulatory agency. Administrative and judicial decisions are done by either an executive or judge.

Nursing/Int.Conc: Nursing Process: Implementation

Client Need: Safe and Effective Care Environment

Cognitive Level: Application

Learning Outcome: 9-2

7) An amendment to a state law that bans smoking in local music clubs and bars has generated much opposition from the restaurant industry, which cites that it will decrease their business and reduce a tax income to the state. The legislative session where this amendment was proposed expires and the amendment is dead. However, the governor signs an executive order that puts this ban into effect. The restaurant industry sues the state and the court rules in favor of the governor. In this situation, health policy has been developed through: (Select all that apply.)

  1. Legislation.
  2. Administrative decision.
  3. Judicial decision.
  4. Regulation.
  5. Special interest lobbying.

Answer: 2, 3

Explanation: 2. Though the amendment was proposed through legislation, when the legislative session ended, it rendered the amendment dead. An executive order, as long as it is not in contradiction to existing law, can be done by an executive office (the governor) to create policy. Judicial decisions reflect the court’s interpretation of laws, which in this case upheld the administrative decision made through executive order. Regulation is a rule or order with legal force to uphold a procedure following implementation that has not yet occurred. Special interest lobbying was not used in this process.

  1. Though the amendment was proposed through legislation, when the legislative session ended, it rendered the amendment dead. An executive order, as long as it is not in contradiction to existing law, can be done by an executive office (the governor) to create policy. Judicial decisions reflect the court’s interpretation of laws, which in this case upheld the administrative decision made through executive order. Regulation is a rule or order with legal force to uphold a procedure following implementation that has not yet occurred. Special interest lobbying was not used in this process.

Nursing/Int.Conc: Nursing Process: Implementation

Client Need: Health Promotion and Maintenance

Cognitive Level: Application

Learning Outcome: 9-2

8) The state medical board has proposed legislation to include physicians on the state board of nursing to interpret the Nurse Practice Act. Local nursing organizations have testified in public hearings opposing this measure. What aspect of policy development is this?

  1. Administrative decision.
  2. Legislation.
  3. Judicial decision.
  4. Regulation.

Answer: 4

Explanation: 4. When regulations deal with sensitive areas, the regulatory body involved may hold public hearings to solicit input. Including physicians on the state board of nursing to interpret the Nurse Practice Act would affect how nursing is practiced. Therefore nursing input is necessary to support the nursing position on the proposed regulations. Judicial or administrative decisions are not involved at this level, and while it is proposed legislation, it ultimately comes under the jurisdiction of the regulatory agency.

Nursing/Int.Conc: Nursing Process: Assessment

Client Need: Safe and Effective Care Environment

Cognitive Level: Application

Learning Outcome: 9-2

9) Activities and outcomes related to the evaluation aspect of policy development would include:

  1. Direction for future policy decisions based on implementation, performance, and impact from the policy.
  2. Impact of program performance with interpretation and resource acquisition.
  3. Policy statements with alternative development and coalition building.
  4. Policy agenda with support mobilization and problem definition.

Answer: 1

Explanation: 1. Evaluating policy development includes evaluating how well the policy is implemented and its performance and impact. Based on whether the implementation, performance, and impact are appropriate or not, the policy may also provide directions for future policy decision. Program performance with interpretation and resource acquisition is part of program implementation, which is not evaluation. Formulation of goals and programs addresses policy statements with alternative developments and coalition building. Setting the agenda involves defining the problem, which leads to a policy agenda.

Nursing/Int.Conc: Nursing Process: Evaluation

Client Need: Safe and Effective Care Environment

Cognitive Level: Application

Learning Outcome: 9-3

10) Compromise, negotiation, networking, and coalition building are essential activities in policy development while:

  1. Implementing the program as a result of the developed policy.
  2. Evaluating how well the policy has been implemented.
  3. Formulating the goals and programs to result from the policy.
  4. Setting the agenda to define the problem to be addressed by the policy.

Answer: 3

Explanation: 3. Formulating goals and programs for policy development involve compromise, negotiation, networking, and coalition building to collect the data, analyze it, and disseminate it. It involves groups working together toward a mutually acceptable and beneficial policy statement. Policy evaluation is the end stage of evaluation. Implementing the program occurs after formulating the goals of the program. The initial step in policy development is to set the agenda.

Nursing/Int.Conc: Nursing Process: Planning

Client Need: Safe and Effective Care Environment

Cognitive Level: Application

Learning Outcome: 9-3

11) A health policy is developed that allows for creating housing for homeless men during adverse weather, but no provision is made for homeless families. The evaluation criterion that would best reflect this policy inequity is:

  1. Cost.
  2. Equity.
  3. Feasibility.
  4. Appropriateness.

Answer: 2

Explanation: 2. The primary issue with creating homeless accommodations that serve only a male population is that of equity. Health policy needs to reflect equitable distribution of resources. While cost, feasibility, and appropriateness may factor into this, equity is the primary concern.

Nursing/Int.Conc: Nursing Process: Evaluation

Client Need: Safe and Effective Care Environment

Cognitive Level: Analysis

Learning Outcome: 9-4

12) A health policy proposed by the state Department of Health and Human Services addresses creating a charity health system in which all citizens can receive comprehensive preventive health care. While the health system is being debated in the legislature, which criteria for evaluation should be used to assess its potential effectiveness? (Select all that apply.)

  1. Cost.
  2. Feasibility.
  3. Resource needs.
  4. Location.
  5. Reimbursement guarantees from private insurance.

Answer: 1, 2, 3

Explanation: 1. Cost, feasibility, and resource needs are all evaluation criteria for health policy. Location is not an evaluation criterion for health policy. Reimbursement guarantees do not enter evaluation criteria when developing health policy.

  1. Cost, feasibility, and resource needs are all evaluation criteria for health policy. Location is not an evaluation criterion for health policy. Reimbursement guarantees do not enter evaluation criteria when developing health policy.
  2. Cost, feasibility, and resource needs are all evaluation criteria for health policy. Location is not an evaluation criterion for health policy. Reimbursement guarantees do not enter evaluation criteria when developing health policy.

Nursing/Int.Conc: Nursing Process: Evaluation

Client Need: Health Promotion and Maintenance

Cognitive Level: Analysis

Learning Outcome: 9-4

13) The local homeless shelter has a policy that requires that residents have documentation regarding their tuberculosis exposure. A member of the community states that this violates an individual’s right to privacy. What evaluation criterion would address this?

  1. Resource needs.
  2. Equity.
  3. Quality.
  4. Feasibility.

Answer: 3

Explanation: 3. Health care policies must safeguard individual rights and be capable of implementation or enforcement. Requiring a homeless shelter resident to provide proof of TB status safeguards the other residents and is a measure of the quality of the policy. Resource needs, equity, and feasibility are not addressed by this criterion.

Nursing/Int.Conc: Nursing Process: Evaluation

Client Need: Safe and Effective Care Environment

Cognitive Level: Analysis

Learning Outcome: 9-4

14) The most important criterion in evaluating health policy is its:

  1. Ability to be implemented.
  2. Ability to achieve the desired outcome on the target population.
  3. Equitable distribution of the health care resources.
  4. Effect on the target population.

Answer: 2

Explanation: 2. While all criteria listed are important, the most important is the ability for the policy to have the desired outcome on the target population. If the policy does not have the desired outcome, none of the other criteria listed have any importance.

Nursing/Int.Conc: Nursing Process: Evaluation

Client Need: Health Promotion and Maintenance

Cognitive Level: Application

Learning Outcome: 9-4

15) The population health nurse is preparing information to share during a state judicial hearing to support the statewide implementation of pedestrian crosswalk signs. Which secondary data should the nurse include for this presentation? (Select all that apply.)

  1. Number of pedestrian accidents over the last 3 months.
  2. Number of accidents involving motor vehicles to avoid bicyclists.
  3. Number of schools in the state located on busy commercial highways.
  4. Number of tickets for jaywalking issued to pedestrians over the last 3 months.
  5. Results of a state survey asking residents if pedestrian crosswalk signs should be installed.

Answer: 1, 5

Explanation: 1. Effective policy analysis requires collection, interpretation, and use of data. Secondary data is information from existing data sources such as statistics about the number of accidents and the results of a survey. For a pedestrian accident issue statistics about motor vehicles and bicycles would not be appropriate. The number of schools located on busy highways would help contribute to the argument for pedestrian signs; however, children are not the only pedestrians. The number of tickets issued to jaywalkers does not support the need for pedestrian crosswalk signs other than to potentially reduce the number of jaywalking tickets issued.

  1. Effective policy analysis requires collection, interpretation, and use of data. Secondary data is information from existing data sources such as statistics about the number of accidents and the results of a survey. For a pedestrian accident issue statistics about motor vehicles and bicycles would not be appropriate. The number of schools located on busy highways would help contribute to the argument for pedestrian signs; however, children are not the only pedestrians. The number of tickets issued to jaywalkers does not support the need for pedestrian crosswalk signs other than to potentially reduce the number of jaywalking tickets issued.

Nursing/Int.Conc: Nursing Process: Implementation

Client Need: Safe and Effective Care Environment

Cognitive Level: Application

Learning Outcome: 9-3

16) A city has adopted the policy of banning smoking in all public parks. When evaluating the policy, which issues should the nurse identify as potentially problematic? (Select all that apply.)

  1. Park maintenance crews will have less smoking debris to clean.
  2. Individuals who smoke may argue that their personal rights are being affected.
  3. The park employs two full-time and one part-time employee for 20 square miles.
  4. City dwellers will not be exposed to second-hand smoke while enjoying the park.
  5. Individuals who smoke will no longer utilize the services available through the park.

Answer: 2, 3, 5

Explanation: 2. Criteria for evaluating health policies include their adequacy in meeting the health needs of the public, safeguards for the rights of individuals, equitable allocation of resources, their capacity for implementation, and the effects of the policy on the target population. Potential issues with the policy include the individuals who smoke arguing that personal rights are being violated. Another issue would be the lack of employees available to enforce the policy. And lastly there is a potential loss of revenue if individuals who smoke no longer use the services available through the park. Having less debris to clean is an advantage to the policy. Reducing exposure to second-hand smoke is also an advantage to the policy.

  1. Criteria for evaluating health policies include their adequacy in meeting the health needs of the public, safeguards for the rights of individuals, equitable allocation of resources, their capacity for implementation, and the effects of the policy on the target population. Potential issues with the policy include the individuals who smoke arguing that personal rights are being violated. Another issue would be the lack of employees available to enforce the policy. And lastly there is a potential loss of revenue if individuals who smoke no longer use the services available through the park. Having less debris to clean is an advantage to the policy. Reducing exposure to second-hand smoke is also an advantage to the policy.
  2. Criteria for evaluating health policies include their adequacy in meeting the health needs of the public, safeguards for the rights of individuals, equitable allocation of resources, their capacity for implementation, and the effects of the policy on the target population. Potential issues with the policy include the individuals who smoke arguing that personal rights are being violated. Another issue would be the lack of employees available to enforce the policy. And lastly there is a potential loss of revenue if individuals who smoke no longer use the services available through the park. Having less debris to clean is an advantage to the policy. Reducing exposure to second-hand smoke is also an advantage to the policy.

Nursing/Int.Conc: Nursing Process: Assessment

Client Need: Health Promotion and Maintenance

Cognitive Level: Application

Learning Outcome: 9-4

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