, TESTBANK FOR Policy and Politics for Nurses and Other Health
Professionals Advocacy and Action Fourth Edition Nickitas
Important Notes
The file includes the complete test bank, organized chapter by chapter.
A sample of selected pages has been provided for preview.
All available appendices and Excel files (if included in the original resources) are
provided.
Quizzes, Midterm and final exams are included (if available in the original resources).
We continuously update our files to ensure you receive the latest and most accurate
editions.
New editions are added regularly – stay connected for updates!
⚠️Note on Answer Keys: If the answer key is not included within the chapter
questions, you will find the complete answers and solutions at the end of each
chapter.
✅ Why Buy From Us?
📚 Complete & organized chapter-by-chapter – no missing content, no guessing.
⚡ Instant digital delivery – get your file the moment you pay, no waiting.
📅 Always up to date – we track new editions so you always get the latest version.
💬 Friendly support – real humans ready to help, anytime you need us.
🔒 Safe & secure – thousands of satisfied students trust us every semester.
🛡️Our Guarantees
💰 Money-Back Guarantee: Not satisfied? We offer a full refund – no questions asked.
🔄 Wrong File? No Problem: Contact us and we will replace it immediately with the
correct version, free of charge.
⏰ 24/7 Support: We are always here – reach out anytime and expect a fast response.
,Nursing’s History of Advocacy and Action, 4e
Donna M. Nickitas, Donna J. Middaugh, and Veronica D. Feeg
Chapter Quiz
Chapter 1
CHAPTER 1
1. Examine the need of having a diverse healthcare workforce.
<Answer: A diverse healthcare workforce increases not only minority participation in the health
professions, but also the overall cultural competency of all patients. A report from the U.S.
Department of Health and Human Services (2006) indicates that improved patient satisfaction,
improved patient–nurse communication, and improved access to care for racial and ethnic
minority patients directly results from an increase in diversity among health professionals. This
is particularly beneficial when healthcare professionals are knowledgeable about their
backgrounds.>
<Subject: Nursing Strong, Chapter 1>
<Complexity: Medium>
<Bloom’s: Analyzing>
2. With regard to the makeup of the nursing workforce, what must the nursing profession do in
order to advance the composition of the future workforce?
<Answer: To successfully advance health care, the nursing profession must make significant strides
to change the composition of the future workforce. This will require greater efforts toward the
successful recruitment of underrepresented minority groups into nursing. A goal is to better
ensure that future nurses mirror the patient populations for which they will be providing care.>
<Subject: Nursing Strong, Chapter 1>
<Complexity: Medium>
<Bloom’s: Analyzing>
3. In the late 1800s and early 1900s, what plagued New York City school children?
<Answer: Trachoma, a contagious eye infection, plagued the New York City schoolchildren.>
<Subject: Advocacy and Public Health Nursing, Chapter 1>
<Complexity: Easy>
<Bloom’s: Remembering>
4. What were the conditions and issues that originally led nurses into the advocacy arena?
Copyright © 2025 by Jones & Bartlett Learning, LLC, an Ascend Learning Company
,Nursing’s History of Advocacy and Action, 4e
Donna M. Nickitas, Donna J. Middaugh, and Veronica D. Feeg
Chapter Quiz
Chapter 1
<Answer: Nurses sought legislation that would give definition to nursing practice long before
women had the right to vote. Nurses strongly advocated and educated others on the
importance of protecting the public, by demanding that nurses be professionally trained, and
were safe to practice. During this time period nurses faced the difficult task of convincing male
lawmakers to support nursing legislation. While nurses struggled for statewide nursing
registration, they had to “fight battles against long hours of work and opposition to nursing
education” (Lewenson, 1993, p. 171). In order to push legislation forward for the safety of the
public, some nurses began to support the work of the suffragist movement, and, therefore,
aligned themselves with the larger women’s movement of the early 1900s. Individual nursing
leaders, such as the public health pioneer Lillian Wald and nursing suffragist Lavinia Dock,
advocated for healthcare reforms in the community and in the legislative arena. These
professional organizations formed during this period in order to protect the public from
uneducated and untrained nurses, which in turn protected the public, and aided in development
of standards for nursing education and practice.>
<Subject: Advocacy and Public Health Nursing, Chapter 1>
<Complexity: Medium>
<Bloom’s: Understanding>
5. In what ways are nurses positioned to be political advocates?
<Answer: Nurses have a unique position as political advocates, which can lead to system changes
that improve patient care, influence the implementation of health legislation, and conduct
ongoing scans of the political environmental. While functioning as leaders, administrators,
educators, and researchers, nurses repeatedly show the ability to manage complex processes, as
well as related data analytics around disparities, health outcomes, quality, and costs. In this
position, nurses advocate by bringing problems to the attention of the government, and seek
decisions and clarifications, in the form of programs, laws, regulations, the nation’s health.>
<Subject: History and Political Advocacy, Chapter 1>
<Complexity: Medium>
<Bloom’s: Analyzing>
6. As an interprofessional healthcare team, all professionals must “draw upon their moral
responsibility to respond to human suffering and become acknowledged participants in the
nation’s efforts to correct health disparity” (Harrison & Falco, 2005, p. 261). As a healthcare
professional, give your analysis of this quote and interpret its meaning with regard to the
current state of the American healthcare system.
<Answer: The answer, by nature, is subjective. The following points should be found within the
Copyright © 2025 by Jones & Bartlett Learning, LLC, an Ascend Learning Company
,Nursing’s History of Advocacy and Action, 4e
Donna M. Nickitas, Donna J. Middaugh, and Veronica D. Feeg
Chapter Quiz
Chapter 1
meaning of the response.
In order to achieve health equality for all, there must be a collaboration of many disciplines and
sectors, both inside and outside of nursing. Nurses must work to collaborate with other
healthcare professionals in order to address health disparities and health equity, within the
context of the social determinants of health. One of the greatest challenges in healthcare is
reducing spending. Interpreting healthcare reform from a nursing perspective enables nurses to
determine how to best distribute resources to individuals, families, and populations. Payment
and delivery reforms are extremely relevant to nurses, such as those working in primary care
and ambulatory settings. Nurses are in a position to advocate for better health, better health
care, and lower costs through improvement.>
<Subject: Nursing Strong, Chapter 1>
<Complexity: Hard>
<Bloom’s: Analyzing>
7. What does it mean to be engaged in advocacy as a nurse?
<Answer: Nurses who are engaged in advocacy are informed about policy and ways in which they
can influence nursing, healthcare, and public policy. The nurse has the ability to influence these
at the local, regional, national and global levels. This engagement requires the nurse to be
knowledgeable in sound evidence and to have a political strategy that allows for increased
understanding of the potential impact of linking the nursing workforce with the globalization of
health care, the implementation of health legislation, and the ongoing disparities in health care
and health outcomes. The demands for increased access to health care, and better outcomes
will require nursing to widen its influence in policy areas that address the health and healthcare
needs of underserved and minority populations.>
<Subject: Nurses as Advocates, Chapter 1>
<Complexity: Medium>
<Bloom’s: Understanding>
8. Why is it important to understand the role nurses and nursing have in the history of the
American healthcare system?
<Answer: The answer is subjective but should reflect the theme of the chapter.>
<Subject: Nurses as Advocates, Chapter 1>
<Complexity: Medium>
Copyright © 2025 by Jones & Bartlett Learning, LLC, an Ascend Learning Company
,Nursing’s History of Advocacy and Action, 4e
Donna M. Nickitas, Donna J. Middaugh, and Veronica D. Feeg
Chapter Quiz
Chapter 1
<Bloom’s: Analyzing>
9. Lillian Wald said “among the many opportunities for civic and altruistic work pressing on all
sides nurses having superior advantages in their practical training should not rest content with
being only nurses, but should use their talents wherever possible in reform and civic
movements.” Taking into consideration the time, what were the issues that led to a statement
such as this?
<Answer: Wald (1915) advocated bringing nurses to local schools in order to decrease truancy rates.
This was due to an increasing number of sick children who are sent home due to illness, many
were not able to access treatment. Wald’s advocacy included caring for those in rural settings,
and later the establishment of the American Red Cross Rural Nursing Service (later known as the
Town & Country). As Keeling and Lewenson wrote (2013), this organization “served as the point
of contact for families in rural communities where remoteness, isolation, and fewer physicians
and nurses created barriers to care.”
Advocacy took many forms during this time, and often ranged from participating in national
committees to ensuring that care was provided at local levels. The needs of the community
framed the work of the public health.>
<Subject: Advocacy and Public Health Nursing, Chapter 1>
<Complexity: Medium>
<Bloom’s: Analyzing>
10. From a nursing perspective, what is the benefit of being able to interpret healthcare reform?
<Answer: The benefit of being able to interpret healthcare reform is that nurses can then determine
the best way to distribute resources to those in need. The law stimulates payment and delivery
reforms, which are highly relevant to nurses, particularly those working in primary care and
ambulatory settings.
Nurses have a large impact on the way that resources are distributed and can create opportunities
for patients to become healthier, have greater access to health care, and pay less for medical
needs. improvement.>
<Subject: Nursing Strong, Chapter 1>
<Complexity: Medium>
<Bloom’s: Understanding>
Copyright © 2025 by Jones & Bartlett Learning, LLC, an Ascend Learning Company
,Nursing’s History of Advocacy and Action, 4e
Donna M. Nickitas
Test bank
Chapter 2
CHAPTER 2
1. Why is the concept of public purpose paradoxical? Why is the concept of public purpose
ambiguous?
<Answer: The concept of public purpose can be paradoxical because many of the same words can
represent multiple meanings. Duality of meaning may, in some cases, lead to agreement at the
highest possible expression of policy. However, it also can break down communication and
agreement when more detail is required. Take, for example, the concept of social equity. Does
the argument pertaining to social equity refer to the process by which goods or services are
provided, or the resulting outcomes? In education, for example, access is no longer considered
an adequate measure of success given the achievement gap among black, Hispanic, white, and
Asian students. It is ambiguous because there is no certainty that our actions will result in
predictable ends. Given the diversity of thought about how best to achieve a stated goal, there
is often no telling whether the outcome will be the one that was intended.>
<Subject: Policy Defined, Chapter 2>
<Complexity: Medium>
<Bloom’s: Understanding>
2. The very nature of federalism results in a fragmented system of governance. How does this
affect the ability to create a national health insurance program?
<Answer: Fragmentation can prevent the creation of national health insurance programs, as
evidenced by the problem of insurance regulation, a seemingly obscure problem. States have
regulatory authority over health insurance, but the Employee Retirement Income Security Act of
1975 supersedes state laws relating to benefit plans. This means businesses that self-insure for
employee health as part of their benefits program are exempt from state insurance regulations.
The significance of this dual regulatory system is that neither the states nor the federal
government can easily mandate employers to offer health benefits because neither governing
body has regulatory authority over all businesses in a particular area (Mariner, 1996). Unable to
create an employer mandate, the ACA mandated individuals to purchase health insurance
instead. The Supreme Court upheld the constitutionality of the mandate in June 2012 as well as
the penalty under the federal government’s power to collect taxes (Jost, 2012).>
<Subject: Federalism, Chapter 2>
<Complexity: Medium>
<Bloom’s: Understanding>
3. “Those who cannot afford their desired goods and services are not entitled to them.” In what
way does this statement relate to the current healthcare situation in America?
Copyright © 2025 by Jones & Bartlett Learning, LLC, an Ascend Learning Company
,Nursing’s History of Advocacy and Action, 4e
Donna M. Nickitas
Test bank
Chapter 2
<Answer: The answer is varied and can be subjective depending on the respondent’s background. A
portion of the response should include the general idea of the following text material:
What if, however, the service is essential to an individual’s welfare or the welfare of a society? In
these cases, the market is an inadequate distributive mechanism because competition puts
those with fewer resources at a disadvantage in terms of accessing services such as health
care.>
<Subject: Markets versus Government, Chapter 2>
<Complexity: Hard>
<Bloom’s: Analyzing>
4. Why do programs like Medicare tend to have greater political support?
<Answer: Medicare is universal entitlement, meaning it doesn’t use means testing to select who can
and cannot benefit from it. Medicare is available to nearly all Americans over age 65,
irrespective of their ability to pay. Since this means that nearly everyone can expect to benefit
from the program in their lifetime, nearly everyone has reason to support the program.>
<Subject: Policy Defined: A framework for Governmental Action, Chapter 2>
<Complexity: Medium>
<Bloom’s: Understanding>
5. In the 1930s scholars saw a radical shift from a system of dual federalism to __________
federalism brought on by the New Deal.
<Answer: cooperative>
<Subject: Policy Defined: A framework for Governmental Action, Chapter 2>
<Complexity: Easy>
<Bloom’s: Understanding>
6. Although nurses have not historically played a major role in initial development of policies, this
is beginning to change. What best explains why nurses are becoming more vocal in the
policymaking process?
Copyright © 2025 by Jones & Bartlett Learning, LLC, an Ascend Learning Company
,Nursing’s History of Advocacy and Action, 4e
Donna M. Nickitas
Test bank
Chapter 2
<Answer: The structure of the healthcare labor force is changing from a hierarchical pyramid with
physicians at the top to a team-based approach with greater input drawn from the expertise of
other professionals. Further, emergency policy responses to the COVID-19 pandemic provided
APNs with greater authority to meet demand for care, opening a window of opportunity for to
lobby for the continuation of those policies.>
<Subject: What Is at Stake for Nurses and Other Health Professionals? Chapter 2>
<Complexity: Medium>
<Bloom’s: Understanding>
7. Describe the three forms of health policy produced by each of the branches of government.
<Answer: The legislative branch enacts laws which create and fund health programs. The executive
branch implements laws by developing rules and regulations and may itself provide care or
purchase care from the private sector. The judicial branch interprets laws to preserve rights and
resolve disputes.>
<Subject: Governmental Intervention, Chapter 2>
<Complexity: Medium>
<Bloom’s: Analyzing>
8. Where does health policy live within the categories of foreign, economic, or social policy?
Explain why.
<Answer: Health policy can be found in the larger real of social policy. Generally, policy is often
rooted in social values and ideologies. Discussions on health policy typically begin with
recognition of the values and ideology that shape the healthcare system. Historically, American
health policy has shifted beliefs about access to care. Sometimes we have stridently pursued
health care as a right for all. Sometimes we have treated it as a privilege (Knowles, 1977). These
competing values (i.e., a right versus a privilege) are simultaneously and continually at work.>
<Subject: Policy Defined: A Framework for Governmental Action, Chapter 2>
<Complexity: Medium>
<Bloom’s: Understanding>
Copyright © 2025 by Jones & Bartlett Learning, LLC, an Ascend Learning Company
, Nursing’s History of Advocacy and Action, 4e
Donna M. Nickitas
Test bank
Chapter 2
9. Why do programs like Medicaid tend to have less political support?
<Answer: Programs like Medicaid tend to have less political support for a few reasons. First,
programs like Medicaid serve populations in need, who often have claims for services that can
be questionable. Second, the service level provided is often greater, and less expensive than
individuals who are right above the cutoff line for Medicaid services.>
<Subject: Policy Defined: A Framework for Governmental Action, Chapter 2>
<Complexity: Medium>
<Bloom’s: Understanding>
10. Legislation provides the broadest possible outline of a program. Why does legislation tend not
to clearly specify details?
<Answer: Fine-grained details are often opposed by one group or another, making consensus
difficult to achieve. By leaving details unspecified, legislation is more likely to pass, and the
details may be decided upon later by administering agencies.>
<Subject: Policy Adoption and Implementation, Chapter 2>
<Complexity: Easy>
<Bloom’s: Understanding>
Copyright © 2025 by Jones & Bartlett Learning, LLC, an Ascend Learning Company
Professionals Advocacy and Action Fourth Edition Nickitas
Important Notes
The file includes the complete test bank, organized chapter by chapter.
A sample of selected pages has been provided for preview.
All available appendices and Excel files (if included in the original resources) are
provided.
Quizzes, Midterm and final exams are included (if available in the original resources).
We continuously update our files to ensure you receive the latest and most accurate
editions.
New editions are added regularly – stay connected for updates!
⚠️Note on Answer Keys: If the answer key is not included within the chapter
questions, you will find the complete answers and solutions at the end of each
chapter.
✅ Why Buy From Us?
📚 Complete & organized chapter-by-chapter – no missing content, no guessing.
⚡ Instant digital delivery – get your file the moment you pay, no waiting.
📅 Always up to date – we track new editions so you always get the latest version.
💬 Friendly support – real humans ready to help, anytime you need us.
🔒 Safe & secure – thousands of satisfied students trust us every semester.
🛡️Our Guarantees
💰 Money-Back Guarantee: Not satisfied? We offer a full refund – no questions asked.
🔄 Wrong File? No Problem: Contact us and we will replace it immediately with the
correct version, free of charge.
⏰ 24/7 Support: We are always here – reach out anytime and expect a fast response.
,Nursing’s History of Advocacy and Action, 4e
Donna M. Nickitas, Donna J. Middaugh, and Veronica D. Feeg
Chapter Quiz
Chapter 1
CHAPTER 1
1. Examine the need of having a diverse healthcare workforce.
<Answer: A diverse healthcare workforce increases not only minority participation in the health
professions, but also the overall cultural competency of all patients. A report from the U.S.
Department of Health and Human Services (2006) indicates that improved patient satisfaction,
improved patient–nurse communication, and improved access to care for racial and ethnic
minority patients directly results from an increase in diversity among health professionals. This
is particularly beneficial when healthcare professionals are knowledgeable about their
backgrounds.>
<Subject: Nursing Strong, Chapter 1>
<Complexity: Medium>
<Bloom’s: Analyzing>
2. With regard to the makeup of the nursing workforce, what must the nursing profession do in
order to advance the composition of the future workforce?
<Answer: To successfully advance health care, the nursing profession must make significant strides
to change the composition of the future workforce. This will require greater efforts toward the
successful recruitment of underrepresented minority groups into nursing. A goal is to better
ensure that future nurses mirror the patient populations for which they will be providing care.>
<Subject: Nursing Strong, Chapter 1>
<Complexity: Medium>
<Bloom’s: Analyzing>
3. In the late 1800s and early 1900s, what plagued New York City school children?
<Answer: Trachoma, a contagious eye infection, plagued the New York City schoolchildren.>
<Subject: Advocacy and Public Health Nursing, Chapter 1>
<Complexity: Easy>
<Bloom’s: Remembering>
4. What were the conditions and issues that originally led nurses into the advocacy arena?
Copyright © 2025 by Jones & Bartlett Learning, LLC, an Ascend Learning Company
,Nursing’s History of Advocacy and Action, 4e
Donna M. Nickitas, Donna J. Middaugh, and Veronica D. Feeg
Chapter Quiz
Chapter 1
<Answer: Nurses sought legislation that would give definition to nursing practice long before
women had the right to vote. Nurses strongly advocated and educated others on the
importance of protecting the public, by demanding that nurses be professionally trained, and
were safe to practice. During this time period nurses faced the difficult task of convincing male
lawmakers to support nursing legislation. While nurses struggled for statewide nursing
registration, they had to “fight battles against long hours of work and opposition to nursing
education” (Lewenson, 1993, p. 171). In order to push legislation forward for the safety of the
public, some nurses began to support the work of the suffragist movement, and, therefore,
aligned themselves with the larger women’s movement of the early 1900s. Individual nursing
leaders, such as the public health pioneer Lillian Wald and nursing suffragist Lavinia Dock,
advocated for healthcare reforms in the community and in the legislative arena. These
professional organizations formed during this period in order to protect the public from
uneducated and untrained nurses, which in turn protected the public, and aided in development
of standards for nursing education and practice.>
<Subject: Advocacy and Public Health Nursing, Chapter 1>
<Complexity: Medium>
<Bloom’s: Understanding>
5. In what ways are nurses positioned to be political advocates?
<Answer: Nurses have a unique position as political advocates, which can lead to system changes
that improve patient care, influence the implementation of health legislation, and conduct
ongoing scans of the political environmental. While functioning as leaders, administrators,
educators, and researchers, nurses repeatedly show the ability to manage complex processes, as
well as related data analytics around disparities, health outcomes, quality, and costs. In this
position, nurses advocate by bringing problems to the attention of the government, and seek
decisions and clarifications, in the form of programs, laws, regulations, the nation’s health.>
<Subject: History and Political Advocacy, Chapter 1>
<Complexity: Medium>
<Bloom’s: Analyzing>
6. As an interprofessional healthcare team, all professionals must “draw upon their moral
responsibility to respond to human suffering and become acknowledged participants in the
nation’s efforts to correct health disparity” (Harrison & Falco, 2005, p. 261). As a healthcare
professional, give your analysis of this quote and interpret its meaning with regard to the
current state of the American healthcare system.
<Answer: The answer, by nature, is subjective. The following points should be found within the
Copyright © 2025 by Jones & Bartlett Learning, LLC, an Ascend Learning Company
,Nursing’s History of Advocacy and Action, 4e
Donna M. Nickitas, Donna J. Middaugh, and Veronica D. Feeg
Chapter Quiz
Chapter 1
meaning of the response.
In order to achieve health equality for all, there must be a collaboration of many disciplines and
sectors, both inside and outside of nursing. Nurses must work to collaborate with other
healthcare professionals in order to address health disparities and health equity, within the
context of the social determinants of health. One of the greatest challenges in healthcare is
reducing spending. Interpreting healthcare reform from a nursing perspective enables nurses to
determine how to best distribute resources to individuals, families, and populations. Payment
and delivery reforms are extremely relevant to nurses, such as those working in primary care
and ambulatory settings. Nurses are in a position to advocate for better health, better health
care, and lower costs through improvement.>
<Subject: Nursing Strong, Chapter 1>
<Complexity: Hard>
<Bloom’s: Analyzing>
7. What does it mean to be engaged in advocacy as a nurse?
<Answer: Nurses who are engaged in advocacy are informed about policy and ways in which they
can influence nursing, healthcare, and public policy. The nurse has the ability to influence these
at the local, regional, national and global levels. This engagement requires the nurse to be
knowledgeable in sound evidence and to have a political strategy that allows for increased
understanding of the potential impact of linking the nursing workforce with the globalization of
health care, the implementation of health legislation, and the ongoing disparities in health care
and health outcomes. The demands for increased access to health care, and better outcomes
will require nursing to widen its influence in policy areas that address the health and healthcare
needs of underserved and minority populations.>
<Subject: Nurses as Advocates, Chapter 1>
<Complexity: Medium>
<Bloom’s: Understanding>
8. Why is it important to understand the role nurses and nursing have in the history of the
American healthcare system?
<Answer: The answer is subjective but should reflect the theme of the chapter.>
<Subject: Nurses as Advocates, Chapter 1>
<Complexity: Medium>
Copyright © 2025 by Jones & Bartlett Learning, LLC, an Ascend Learning Company
,Nursing’s History of Advocacy and Action, 4e
Donna M. Nickitas, Donna J. Middaugh, and Veronica D. Feeg
Chapter Quiz
Chapter 1
<Bloom’s: Analyzing>
9. Lillian Wald said “among the many opportunities for civic and altruistic work pressing on all
sides nurses having superior advantages in their practical training should not rest content with
being only nurses, but should use their talents wherever possible in reform and civic
movements.” Taking into consideration the time, what were the issues that led to a statement
such as this?
<Answer: Wald (1915) advocated bringing nurses to local schools in order to decrease truancy rates.
This was due to an increasing number of sick children who are sent home due to illness, many
were not able to access treatment. Wald’s advocacy included caring for those in rural settings,
and later the establishment of the American Red Cross Rural Nursing Service (later known as the
Town & Country). As Keeling and Lewenson wrote (2013), this organization “served as the point
of contact for families in rural communities where remoteness, isolation, and fewer physicians
and nurses created barriers to care.”
Advocacy took many forms during this time, and often ranged from participating in national
committees to ensuring that care was provided at local levels. The needs of the community
framed the work of the public health.>
<Subject: Advocacy and Public Health Nursing, Chapter 1>
<Complexity: Medium>
<Bloom’s: Analyzing>
10. From a nursing perspective, what is the benefit of being able to interpret healthcare reform?
<Answer: The benefit of being able to interpret healthcare reform is that nurses can then determine
the best way to distribute resources to those in need. The law stimulates payment and delivery
reforms, which are highly relevant to nurses, particularly those working in primary care and
ambulatory settings.
Nurses have a large impact on the way that resources are distributed and can create opportunities
for patients to become healthier, have greater access to health care, and pay less for medical
needs. improvement.>
<Subject: Nursing Strong, Chapter 1>
<Complexity: Medium>
<Bloom’s: Understanding>
Copyright © 2025 by Jones & Bartlett Learning, LLC, an Ascend Learning Company
,Nursing’s History of Advocacy and Action, 4e
Donna M. Nickitas
Test bank
Chapter 2
CHAPTER 2
1. Why is the concept of public purpose paradoxical? Why is the concept of public purpose
ambiguous?
<Answer: The concept of public purpose can be paradoxical because many of the same words can
represent multiple meanings. Duality of meaning may, in some cases, lead to agreement at the
highest possible expression of policy. However, it also can break down communication and
agreement when more detail is required. Take, for example, the concept of social equity. Does
the argument pertaining to social equity refer to the process by which goods or services are
provided, or the resulting outcomes? In education, for example, access is no longer considered
an adequate measure of success given the achievement gap among black, Hispanic, white, and
Asian students. It is ambiguous because there is no certainty that our actions will result in
predictable ends. Given the diversity of thought about how best to achieve a stated goal, there
is often no telling whether the outcome will be the one that was intended.>
<Subject: Policy Defined, Chapter 2>
<Complexity: Medium>
<Bloom’s: Understanding>
2. The very nature of federalism results in a fragmented system of governance. How does this
affect the ability to create a national health insurance program?
<Answer: Fragmentation can prevent the creation of national health insurance programs, as
evidenced by the problem of insurance regulation, a seemingly obscure problem. States have
regulatory authority over health insurance, but the Employee Retirement Income Security Act of
1975 supersedes state laws relating to benefit plans. This means businesses that self-insure for
employee health as part of their benefits program are exempt from state insurance regulations.
The significance of this dual regulatory system is that neither the states nor the federal
government can easily mandate employers to offer health benefits because neither governing
body has regulatory authority over all businesses in a particular area (Mariner, 1996). Unable to
create an employer mandate, the ACA mandated individuals to purchase health insurance
instead. The Supreme Court upheld the constitutionality of the mandate in June 2012 as well as
the penalty under the federal government’s power to collect taxes (Jost, 2012).>
<Subject: Federalism, Chapter 2>
<Complexity: Medium>
<Bloom’s: Understanding>
3. “Those who cannot afford their desired goods and services are not entitled to them.” In what
way does this statement relate to the current healthcare situation in America?
Copyright © 2025 by Jones & Bartlett Learning, LLC, an Ascend Learning Company
,Nursing’s History of Advocacy and Action, 4e
Donna M. Nickitas
Test bank
Chapter 2
<Answer: The answer is varied and can be subjective depending on the respondent’s background. A
portion of the response should include the general idea of the following text material:
What if, however, the service is essential to an individual’s welfare or the welfare of a society? In
these cases, the market is an inadequate distributive mechanism because competition puts
those with fewer resources at a disadvantage in terms of accessing services such as health
care.>
<Subject: Markets versus Government, Chapter 2>
<Complexity: Hard>
<Bloom’s: Analyzing>
4. Why do programs like Medicare tend to have greater political support?
<Answer: Medicare is universal entitlement, meaning it doesn’t use means testing to select who can
and cannot benefit from it. Medicare is available to nearly all Americans over age 65,
irrespective of their ability to pay. Since this means that nearly everyone can expect to benefit
from the program in their lifetime, nearly everyone has reason to support the program.>
<Subject: Policy Defined: A framework for Governmental Action, Chapter 2>
<Complexity: Medium>
<Bloom’s: Understanding>
5. In the 1930s scholars saw a radical shift from a system of dual federalism to __________
federalism brought on by the New Deal.
<Answer: cooperative>
<Subject: Policy Defined: A framework for Governmental Action, Chapter 2>
<Complexity: Easy>
<Bloom’s: Understanding>
6. Although nurses have not historically played a major role in initial development of policies, this
is beginning to change. What best explains why nurses are becoming more vocal in the
policymaking process?
Copyright © 2025 by Jones & Bartlett Learning, LLC, an Ascend Learning Company
,Nursing’s History of Advocacy and Action, 4e
Donna M. Nickitas
Test bank
Chapter 2
<Answer: The structure of the healthcare labor force is changing from a hierarchical pyramid with
physicians at the top to a team-based approach with greater input drawn from the expertise of
other professionals. Further, emergency policy responses to the COVID-19 pandemic provided
APNs with greater authority to meet demand for care, opening a window of opportunity for to
lobby for the continuation of those policies.>
<Subject: What Is at Stake for Nurses and Other Health Professionals? Chapter 2>
<Complexity: Medium>
<Bloom’s: Understanding>
7. Describe the three forms of health policy produced by each of the branches of government.
<Answer: The legislative branch enacts laws which create and fund health programs. The executive
branch implements laws by developing rules and regulations and may itself provide care or
purchase care from the private sector. The judicial branch interprets laws to preserve rights and
resolve disputes.>
<Subject: Governmental Intervention, Chapter 2>
<Complexity: Medium>
<Bloom’s: Analyzing>
8. Where does health policy live within the categories of foreign, economic, or social policy?
Explain why.
<Answer: Health policy can be found in the larger real of social policy. Generally, policy is often
rooted in social values and ideologies. Discussions on health policy typically begin with
recognition of the values and ideology that shape the healthcare system. Historically, American
health policy has shifted beliefs about access to care. Sometimes we have stridently pursued
health care as a right for all. Sometimes we have treated it as a privilege (Knowles, 1977). These
competing values (i.e., a right versus a privilege) are simultaneously and continually at work.>
<Subject: Policy Defined: A Framework for Governmental Action, Chapter 2>
<Complexity: Medium>
<Bloom’s: Understanding>
Copyright © 2025 by Jones & Bartlett Learning, LLC, an Ascend Learning Company
, Nursing’s History of Advocacy and Action, 4e
Donna M. Nickitas
Test bank
Chapter 2
9. Why do programs like Medicaid tend to have less political support?
<Answer: Programs like Medicaid tend to have less political support for a few reasons. First,
programs like Medicaid serve populations in need, who often have claims for services that can
be questionable. Second, the service level provided is often greater, and less expensive than
individuals who are right above the cutoff line for Medicaid services.>
<Subject: Policy Defined: A Framework for Governmental Action, Chapter 2>
<Complexity: Medium>
<Bloom’s: Understanding>
10. Legislation provides the broadest possible outline of a program. Why does legislation tend not
to clearly specify details?
<Answer: Fine-grained details are often opposed by one group or another, making consensus
difficult to achieve. By leaving details unspecified, legislation is more likely to pass, and the
details may be decided upon later by administering agencies.>
<Subject: Policy Adoption and Implementation, Chapter 2>
<Complexity: Easy>
<Bloom’s: Understanding>
Copyright © 2025 by Jones & Bartlett Learning, LLC, an Ascend Learning Company
