,Chapter 1 – Marching to Lead in Policy
Question 1
A community hospital nurse learns that state legislators are considering budget cuts that
would reduce funding for home health programs. During a staff meeting, the nurse states,
“We cannot remain silent; we need to actively present the impact on vulnerable
populations.”
Which leadership action best demonstrates the nurse’s transition from passive
participation to active policy engagement?
A. Waiting for the nursing association to issue a public statement
B. Sharing personal frustrations with coworkers only
C. Writing an op-ed for the local newspaper describing patient outcomes
D. Ignoring the issue since decisions are made by legislators
✅ Correct Answer: C
Rationale: Actively engaging in policy involves taking steps to influence decision-
makers and the public. Writing an op-ed raises awareness, applies evidence, and positions
the nurse as a policy leader. Waiting, venting, or withdrawing reflects passivity.
Keywords: nurse advocacy, policy leadership, public engagement, passive vs. active
Question 2
Florence Nightingale used statistical evidence to demonstrate the relationship between
sanitation and soldier mortality during the Crimean War.
How does this historical example continue to guide nurses in policy leadership today?
A. By reminding nurses to avoid politics in order to maintain neutrality
B. By showing that clinical expertise alone ensures policy change
C. By illustrating how data can drive health reforms
D. By suggesting that only physicians should testify before policymakers
✅ Correct Answer: C
Rationale: Nightingale’s work exemplifies how evidence and data are powerful
advocacy tools. Modern nurses must combine data with clinical expertise to influence
reforms. Avoiding politics or deferring to other professions undermines nursing’s
leadership role.
Keywords: Nightingale, evidence-based advocacy, historical precedent, data in policy
,Question 3
A nurse working in an underserved rural clinic notices high rates of preventable
hospitalizations due to limited access to primary care.
Which action reflects professional responsibility in policy leadership?
A. Documenting patient cases privately without follow-up
B. Lobbying state officials for expanded funding of rural clinics
C. Avoiding involvement because advocacy is outside the nurse’s scope
D. Waiting until a physician group addresses the issue
✅ Correct Answer: B
Rationale: Advocacy is a professional responsibility for nurses, and engaging
policymakers to address systemic barriers reflects leadership. Passive documentation or
avoidance fails to fulfill professional obligations. Nurses do not require physician groups
to lead advocacy.
Keywords: professional responsibility, rural health, policy engagement, advocacy
Question 4
During a nursing conference, a panel discusses how nurses historically remained silent
during major health reforms. One nurse comments, “Staying quiet was respectful.”
How should today’s nurses interpret this history?
A. Silence preserved professional image and should continue
B. Passive roles limited nursing’s influence on health outcomes
C. Avoiding advocacy prevents conflict of interest
D. Policy engagement distracts from direct patient care
✅ Correct Answer: B
Rationale: Historically, silence reduced nursing’s impact on reforms. Current nursing
leadership must correct this by embracing active advocacy as integral to professional
responsibility. Avoiding advocacy diminishes influence.
Keywords: nursing history, passive participation, advocacy gap, professional growth
Question 5
,A hospital nurse is asked by a legislator for input on a bill addressing nurse-patient
staffing ratios.
Which response demonstrates active policy leadership?
A. Saying, “I’m just a bedside nurse; I don’t know enough.”
B. Providing personal and evidence-based insights on patient safety
C. Referring the legislator to a physician leader instead
D. Declining to comment because it is controversial
✅ Correct Answer: B
Rationale: Providing insights backed by evidence reflects leadership and advocacy,
showing nursing expertise in shaping safe staffing policy. Minimizing one’s role or
deferring undermines professional responsibility.
Keywords: staffing ratios, advocacy, leadership, evidence-based policy
Question 6
A nurse educator teaches students about contemporary nurse leaders who influenced
healthcare reform.
Which key message should be emphasized?
A. Nurses only influence policy through bedside care
B. Modern nurses must integrate professional expertise into advocacy
C. Nurses should avoid policy roles to prevent political bias
D. Policy leadership is limited to advanced practice nurses
✅ Correct Answer: B
Rationale: Policy leadership is expected of all nurses, regardless of role. Nursing
expertise must extend beyond bedside care into advocacy arenas. Avoiding policy
reduces professional impact.
Keywords: nurse leaders, professional expertise, advocacy integration, policy role
Question 7
A nurse attending a town hall meeting describes how Medicaid cuts affected patients’
access to insulin.
Which principle of professional responsibility is demonstrated?
A. Protecting only the interests of the nursing profession
,B. Using personal experience to remain neutral
C. Advocating for patient populations within a policy context
D. Avoiding systemic discussions in public forums
✅ Correct Answer: C
Rationale: Nurses advocate not only for their profession but also for health equity.
Speaking publicly about patient impact demonstrates professional responsibility in
policy.
Keywords: Medicaid, advocacy, professional responsibility, health equity
Question 8
A novice nurse asks, “Why should I care about politics? I became a nurse to help
patients, not argue with legislators.”
Which teaching response best reflects the chapter’s theme?
A. “Politics is separate from healthcare, so you can avoid it.”
B. “Engaging in policy is optional for nurses who want leadership roles.”
C. “Policy decisions directly affect patient care, so advocacy is part of nursing.”
D. “Only experienced nurses should consider policy involvement.”
✅ Correct Answer: C
Rationale: Policy and politics shape access, safety, and health outcomes. All nurses,
regardless of experience, share responsibility for advocacy. Avoidance neglects
professional duty.
Keywords: politics in nursing, advocacy, patient outcomes, professional duty
Question 9
A nurse learns that her state is debating legislation restricting advanced practice nurses’
prescribing authority.
What is the nurse’s most responsible policy leadership response?
A. Attend hearings and provide testimony about patient impact
B. Ignore the issue since it mainly affects nurse practitioners
C. Avoid participation to protect employment security
D. Depend on medical associations to lead the debate
, ✅ Correct Answer: A
Rationale: Advocacy for nursing scope of practice protects patient access to care and
demonstrates leadership. Ignoring or avoiding undermines both patients and the
profession.
Keywords: scope of practice, advanced practice, policy leadership, advocacy
Question 10
A nurse recalls how early nursing leaders were instrumental in establishing public health
programs.
How does this history shape current expectations of nurses in policy?
A. Nurses should focus solely on bedside tasks
B. Policy engagement is optional, not essential
C. Nurses are expected to continue shaping systems of care
D. Historical roles were unique and cannot be replicated
✅ Correct Answer: C
Rationale: The history of nursing advocacy reinforces today’s expectation for nurses to
lead systemic health reforms. Limiting to bedside tasks ignores this professional legacy.
Keywords: nursing history, public health programs, policy expectation, leadership
Question 11
A school nurse notices an increase in children missing school because families cannot
afford required immunizations.
Which policy action best demonstrates the nurse’s professional responsibility?
A. Documenting absenteeism in student records without further action
B. Contacting a local legislator to support state-funded immunization programs
C. Advising families to move to a district with better resources
D. Waiting for physicians to request policy changes
✅ Correct Answer: B
Rationale: Nurses are responsible for advocating for policy solutions that address
systemic barriers, such as lack of immunization access. Legislative advocacy
demonstrates active leadership. Documentation or avoidance reflects passivity.
Keywords: school nurse, immunizations, health policy, advocacy
Question 1
A community hospital nurse learns that state legislators are considering budget cuts that
would reduce funding for home health programs. During a staff meeting, the nurse states,
“We cannot remain silent; we need to actively present the impact on vulnerable
populations.”
Which leadership action best demonstrates the nurse’s transition from passive
participation to active policy engagement?
A. Waiting for the nursing association to issue a public statement
B. Sharing personal frustrations with coworkers only
C. Writing an op-ed for the local newspaper describing patient outcomes
D. Ignoring the issue since decisions are made by legislators
✅ Correct Answer: C
Rationale: Actively engaging in policy involves taking steps to influence decision-
makers and the public. Writing an op-ed raises awareness, applies evidence, and positions
the nurse as a policy leader. Waiting, venting, or withdrawing reflects passivity.
Keywords: nurse advocacy, policy leadership, public engagement, passive vs. active
Question 2
Florence Nightingale used statistical evidence to demonstrate the relationship between
sanitation and soldier mortality during the Crimean War.
How does this historical example continue to guide nurses in policy leadership today?
A. By reminding nurses to avoid politics in order to maintain neutrality
B. By showing that clinical expertise alone ensures policy change
C. By illustrating how data can drive health reforms
D. By suggesting that only physicians should testify before policymakers
✅ Correct Answer: C
Rationale: Nightingale’s work exemplifies how evidence and data are powerful
advocacy tools. Modern nurses must combine data with clinical expertise to influence
reforms. Avoiding politics or deferring to other professions undermines nursing’s
leadership role.
Keywords: Nightingale, evidence-based advocacy, historical precedent, data in policy
,Question 3
A nurse working in an underserved rural clinic notices high rates of preventable
hospitalizations due to limited access to primary care.
Which action reflects professional responsibility in policy leadership?
A. Documenting patient cases privately without follow-up
B. Lobbying state officials for expanded funding of rural clinics
C. Avoiding involvement because advocacy is outside the nurse’s scope
D. Waiting until a physician group addresses the issue
✅ Correct Answer: B
Rationale: Advocacy is a professional responsibility for nurses, and engaging
policymakers to address systemic barriers reflects leadership. Passive documentation or
avoidance fails to fulfill professional obligations. Nurses do not require physician groups
to lead advocacy.
Keywords: professional responsibility, rural health, policy engagement, advocacy
Question 4
During a nursing conference, a panel discusses how nurses historically remained silent
during major health reforms. One nurse comments, “Staying quiet was respectful.”
How should today’s nurses interpret this history?
A. Silence preserved professional image and should continue
B. Passive roles limited nursing’s influence on health outcomes
C. Avoiding advocacy prevents conflict of interest
D. Policy engagement distracts from direct patient care
✅ Correct Answer: B
Rationale: Historically, silence reduced nursing’s impact on reforms. Current nursing
leadership must correct this by embracing active advocacy as integral to professional
responsibility. Avoiding advocacy diminishes influence.
Keywords: nursing history, passive participation, advocacy gap, professional growth
Question 5
,A hospital nurse is asked by a legislator for input on a bill addressing nurse-patient
staffing ratios.
Which response demonstrates active policy leadership?
A. Saying, “I’m just a bedside nurse; I don’t know enough.”
B. Providing personal and evidence-based insights on patient safety
C. Referring the legislator to a physician leader instead
D. Declining to comment because it is controversial
✅ Correct Answer: B
Rationale: Providing insights backed by evidence reflects leadership and advocacy,
showing nursing expertise in shaping safe staffing policy. Minimizing one’s role or
deferring undermines professional responsibility.
Keywords: staffing ratios, advocacy, leadership, evidence-based policy
Question 6
A nurse educator teaches students about contemporary nurse leaders who influenced
healthcare reform.
Which key message should be emphasized?
A. Nurses only influence policy through bedside care
B. Modern nurses must integrate professional expertise into advocacy
C. Nurses should avoid policy roles to prevent political bias
D. Policy leadership is limited to advanced practice nurses
✅ Correct Answer: B
Rationale: Policy leadership is expected of all nurses, regardless of role. Nursing
expertise must extend beyond bedside care into advocacy arenas. Avoiding policy
reduces professional impact.
Keywords: nurse leaders, professional expertise, advocacy integration, policy role
Question 7
A nurse attending a town hall meeting describes how Medicaid cuts affected patients’
access to insulin.
Which principle of professional responsibility is demonstrated?
A. Protecting only the interests of the nursing profession
,B. Using personal experience to remain neutral
C. Advocating for patient populations within a policy context
D. Avoiding systemic discussions in public forums
✅ Correct Answer: C
Rationale: Nurses advocate not only for their profession but also for health equity.
Speaking publicly about patient impact demonstrates professional responsibility in
policy.
Keywords: Medicaid, advocacy, professional responsibility, health equity
Question 8
A novice nurse asks, “Why should I care about politics? I became a nurse to help
patients, not argue with legislators.”
Which teaching response best reflects the chapter’s theme?
A. “Politics is separate from healthcare, so you can avoid it.”
B. “Engaging in policy is optional for nurses who want leadership roles.”
C. “Policy decisions directly affect patient care, so advocacy is part of nursing.”
D. “Only experienced nurses should consider policy involvement.”
✅ Correct Answer: C
Rationale: Policy and politics shape access, safety, and health outcomes. All nurses,
regardless of experience, share responsibility for advocacy. Avoidance neglects
professional duty.
Keywords: politics in nursing, advocacy, patient outcomes, professional duty
Question 9
A nurse learns that her state is debating legislation restricting advanced practice nurses’
prescribing authority.
What is the nurse’s most responsible policy leadership response?
A. Attend hearings and provide testimony about patient impact
B. Ignore the issue since it mainly affects nurse practitioners
C. Avoid participation to protect employment security
D. Depend on medical associations to lead the debate
, ✅ Correct Answer: A
Rationale: Advocacy for nursing scope of practice protects patient access to care and
demonstrates leadership. Ignoring or avoiding undermines both patients and the
profession.
Keywords: scope of practice, advanced practice, policy leadership, advocacy
Question 10
A nurse recalls how early nursing leaders were instrumental in establishing public health
programs.
How does this history shape current expectations of nurses in policy?
A. Nurses should focus solely on bedside tasks
B. Policy engagement is optional, not essential
C. Nurses are expected to continue shaping systems of care
D. Historical roles were unique and cannot be replicated
✅ Correct Answer: C
Rationale: The history of nursing advocacy reinforces today’s expectation for nurses to
lead systemic health reforms. Limiting to bedside tasks ignores this professional legacy.
Keywords: nursing history, public health programs, policy expectation, leadership
Question 11
A school nurse notices an increase in children missing school because families cannot
afford required immunizations.
Which policy action best demonstrates the nurse’s professional responsibility?
A. Documenting absenteeism in student records without further action
B. Contacting a local legislator to support state-funded immunization programs
C. Advising families to move to a district with better resources
D. Waiting for physicians to request policy changes
✅ Correct Answer: B
Rationale: Nurses are responsible for advocating for policy solutions that address
systemic barriers, such as lack of immunization access. Legislative advocacy
demonstrates active leadership. Documentation or avoidance reflects passivity.
Keywords: school nurse, immunizations, health policy, advocacy
