Conceptual Foundations The Bridge Professional Nursing 6th Edition Friberg Creasia Test Bank

Chapter 03: Beyond Professional Socialization MULTIPLE CHOICE 1. An experienced nurse has accepted a new role in administration. Supervisors can best support this transition by assisting the nurse to a. learn the unspoken rules of the new role. b. manage time and other people effectively. c. obtain education regarding the new job. d. redefine the nurse’s professional identity. ANS: D A nurse changing roles would be expected to experience resocialization, in which the nurse needs to redefine his or her professional identity to fit the new role. Administrative support in adapting to the new role via socialization is crucial to a successful transition. Learning the unspoken rules of the new role might be important depending on the organizational culture in which the nurse has taken an administrative role, but it would not be the best choice. Managing time and other people effectively is not the best choice because there is no information here suggesting that part of the new role includes directly managing others. Obtaining information about the new job would be important, but it would not be the best choice. DIF: Cognitive Level: Apply TOP: Integrated Process: Caring MSC: NCLEX Client Needs: Safe and Effective Care Environment: Management of Care A nursing faculty member would judge that activities designed to foster socialization in students have been successful when the students a. are able to communicate in an effective manner with other health care providers. b. incorporate professional values, norms, and behaviors into their self-identities. c. learn the legal and ethical standards required to practice as a professional nurse. d. understand the complexities of their new, multifaceted role in health care today. ANS: B Students must incorporate the values, skills, behaviors, and norms appropriate to nursing into their self-identities in a process called socialization, which begins in nursing school and occurs again as nurses change roles or jobs. Professional and effective communication is a vital part of working in a multidisciplinary team, but it does not demonstrate socialization. Understanding legal and ethical standards is important to today’s nurses, but this is not the best choice for two reasons: First, simply learning the standards is not enough; one must act on them. Second, this is not all that is involved in the socialization process. Being able to understand the complexities of the nursing role today is something that the student will not truly understand until immersed in the first job. This is not directly related to socialization into a profession such as nursing. DIF: Cognitive Level: Evaluate TOP: Nursing Process: Evaluation MSC: NCLEX Client Needs: Safe and Effective Care Environment: Management of Care 2. 3. A nursing dean oversees an RN-BSN program and is evaluating whether or not program objectives have been met. The success of this program can be demonstrated when a. attitudes of the returning RN students are reinforced in their identities. b. graduates are proficient in new subjects learned during the program. c. RNs resocialize into the role of baccalaureate-prepared nurses. d. the nurses can articulate why having a BSN should be a requirement. ANS: C Socialization occurs at three important points in a nurse’s career: when a new graduate leaves the educational setting and begins work as a professional nurse; when an experienced nurse changes work settings; and when the nurse takes on new roles, such as returning to school. The hope is that graduates will leave school with changes in behaviors and attitudes that reflect their new status as baccalaureate-prepared nurses. It would be important for graduates to have a strong understanding of the subjects they encounter when they are back in school, but this choice is too narrow to support meeting broad goals. Nurses articulating that the BSN should be required is too narrow in focus to demonstrate that the program’s goals have been met. DIF: Cognitive Level: Evaluate TOP: Nursing Process: Evaluation MSC: NCLEX Client Needs: Safe and Effective Care Environment: Management of Care A nursing manager recognizes that a registered nurse has a strong sense of professional identity when which behavior is seen? a. Joins professional organizations and attends their conferences b. Participates in unit governance and on hospital-wide committees c. Reappraises own professionalism as new technologies and roles evolve d. Relies on historical meanings of professionalism to guide practice ANS: C As new technologies and roles develop, nurses must continually reappraise their professional identities and ensure congruent socialization with emerging trends. History does give background and context for socialization but is not as important as adapting to the current state of affairs. Joining organizations, attending conferences, and being active on committees are all part of socialization and one’s professional identity, but the larger scope of this concept revolves around maintaining a sound professional identity in the face of ongoing changes. DIF: Cognitive Level: Evaluate TOP: Nursing Process: Evaluation MSC: NCLEX Client Needs: Safe and Effective Care Environment: Management of Care A nursing faculty would determine that a student was developing a strong sense of professional identity when the student takes which action? a. Writes a paper describing nursing as being available to help patients and physicians b. Establishes a discussion group to debate interdisciplinary care activities c. Starts a letter writing campaign to boycott products advertised by “sexy nurses” d. Volunteers to serve the community at a free flu shot clinic for the uninsured ANS: C 4. 5. Nurses who have a strong sense of professional identity work to change perceptions that nurses and non-nurses carry about the profession. Starting a letter writing boycott campaign to protest the use of a negative stereotype of nurses to sell a product is an excellent example of this in action. Although nurses do assist in many different ways, a nurse with a strong professional identity will advocate for a more equitable role for nurses in health care. Establishing a discussion group does not reveal what the nursing student feels about interdisciplinary care and the role of nursing in these activities. Volunteering is a respected and desired activity, but it does not strongly suggest the student’s view of his or her professional identity. DIF: Cognitive Level: Evaluate TOP: Nursing Process: Evaluation MSC: NCLEX Client Needs: Safe and Effective Care Environment: Management of Care 6. A hospital director of nursing (DON) establishes a hospital-wide committee to process the Institute of Medicine (IOM) report “The Future of Nursing: Leading Change, Advancing Health” and to create unit-based activities that support its recommendations. A unit manager asks about the importance of the endeavor. What response by the DON is best? a. If nursing doesn’t change with the times, the future of the discipline is threatened. b. Nursing has to remodel itself according to the mandates of the report. c. Operationalizing the report allows nurses to drive health care reform. d. Patient safety will be adversely affected if nursing doesn’t transform itself. ANS: C The IOM has identified nurses as key leaders in driving the reform and work to be done to reshape health care delivery in the United States. It is important that all nurses become educated and knowledgeable about this report, understand its implications for the future of the discipline, identify ways that individual nurses can get involved in implementing the recommendations, and educate others on what needs to be done. The other options all have elements of truth to them, but the broad implication is that nursing must lead the reform of health care. DIF: Cognitive Level: Understand REF: 41 TOP: Integrated Process: Communication and Documentation MSC: NCLEX Client Needs: Safe and Effective Care Environment: Management of Care 7. A nurse manager is evaluating staff members for the strength of their professional identity and ability to contribute to the profession into the future. Which nurse best demonstrates these qualities? a. Consistently incorporates knowledge, judgment, and ethics into everyday situations b. Provides information on the latest research findings related to patient populations c. Serves as the research “champion” on the hospital unit–based council structure d. Uses evidence-based practice consistently when working with patients ANS: A A nurse who consistently incorporates knowledge, judgment, and ethics into everyday situations best demonstrates these qualities. Although providing information on the latest research findings, serving as the research “champion,” and using evidence-based practice consistently are important actions, they are not as strong as indicators of professional identity and the potential for future professional contributions as incorporating knowledge, judgment, and ethics into everyday situations. DIF: Cognitive Level: Evaluate TOP: Nursing Process: Evaluation MSC: NCLEX Client Needs: Safe and Effective Care Environment: Management of Care MULTIPLE RESPONSE 1. Which of the following does the nursing student learn about professional socialization? (Select all that apply.) a. Everyday experiences are vital for professional socialization. b. Interaction with peers can have a positive or negative effect. c. Knowledge, skills, and behaviors contribute to socialization. d. Norms and values are more important than skill to socialization. e. Socialization happens during a memorable event in time. ANS: A,B,C Professional socialization is the process and effect of repetitive, everyday experiences in which knowledge, skills, behaviors, norms, and values are reinforced through interaction with others. Interaction with peers can have both negative and positive effects and contribute to either a positive or negative socialization process. Socialization does not happen through one salient event but rather through continuous exposure. DIF: Cognitive Level: Remember REF: 40 TOP: Integrated Process: Teaching/Learning MSC: NCLEX Client Needs: Safe and Effective Care Environment: Management of Care The faculty member understands that nursing schools contribute strongly to the process of socialization in which ways? (Select all that apply.) a. Assisting students to commit to nursing values b. Developing students’ understanding of ethics c. Grading students on professional socialization d. Helping students develop professional identities e. Requiring participation in professional organizations ANS: A,B,D Nursing education is strong in ways of teaching that effectively assist students to develop a deep sense of professional identity, commit to the values of the profession, and act with ethical comportment. Grading behavior is part of providing feedback to enable students to gain a professional identity but is not a specific strength of education. Requiring participation in professional organizations does not specifically encourage the development of professional identity. DIF: Cognitive Level: Remember REF: 40 TOP: Integrated Process: Teaching/Learning MSC: NCLEX Client Needs: Safe and Effective Care Environment: Management of Care A nurse is giving a report to the hospital nursing counsel on the Institute of Medicine’s report: “The Future of Nursing: Leading Change, Advancing Health.” What broad goals does the nurse report on? (Select all that apply.) a. Credentialing will continue to be the best way to advance practice. b. Nurses should be allowed to practice to the extent of their capabilities. c. Nursing should be included as an equal partner in health care reform. 2. 3. d. The nursing workforce is encouraged to attain higher levels of education. e. Workforce data collection needs infrastructure to enable meaningful use. ANS: B,C,D,E The IOM’s report’s key messages and related recommendations affirm and encourage professional nurses to practice fully, achieve higher levels of education, become full partners in providing and reforming health care, and develop an infrastructure for workforce data collection. Credentialing is not one of the key recommendations. DIF: Cognitive Level: Remember REF: 41 TOP: Integrated Process: Communication and Documentation MSC: NCLEX Client Needs: Safe and Effective Care Environment: Management of Care 4. An astute practitioner recognizes that the dynamic process of nursing includes which possibilities? (Select all that apply.) a. Engaged stakeholder: speaking up and establishing leadership within the system b. Expert learner: engaging in lifelong learning and synthesizing learning into practice c. Innovation catalyst: developing new technologies and conducting research d. Interprofessional collaborator: being an advocate to promote systems-level change e. Reflective practitioner: reflecting on whether or not new knowledge is relevant ANS: A,B,D The engaged stakeholder will no longer remain silent and accept others’ expectations but will develop leadership skills to position them to serve as advocates and change agents. The expert learner engages in lifelong learning and takes the time to synthesize new learning into practice. The interprofessional collaborator is an advocate for patients, families, and communities and for systems-level change. The innovation catalyst rejects old ways of thinking and doing to see, do, and be in the profession of nursing. The reflective practitioner is able to think systematically about actions and responses in a manner that allows transformed perspective and reframing for determination of future actions and response. DIF: Cognitive Level: Understand REF: 41 TOP: Integrated Process: Teaching/Learning MSC: NCLEX Client Needs: Safe and Effective Care Environment: Management of Care Chapter 06: Health Policy and Planning and the Nursing Practice Environment MULTIPLE CHOICE 1. The nurse studying the development of the American health care system understands that before the 1990s, health care funding was primarily a. driven by fee-for-service costs. b. from charitable organizations. c. paid for by entitlement programs. d. the responsibility of each state. ANS: A Before the involvement of the federal government in health care financing in the 1990s, physicians (and health care facilities) charged a fee for services, which was generally paid for either out of pocket by the individual or by private health insurance companies. There has always been some charitable health care, but this has not been the primary method of payment. Entitlement programs, such as Medicare, cover health care expenses for certain designated groups. States are involved in some health care financing but certainly not the majority of it. 2. A nurse studying the intersection of politics and health care describes the relationship best by saying that a. hiring lobbyists is the most effective way to communicate ideas. b. only national organizations really have a voice in health care. c. politics provides a means for differing voices to be heard. d. voting in elections is the primary way to influence policy. ANS: C Through the political process, individuals, groups, agencies, and government entities have a voice in developing our health care system via regulations, establishing outcomes, and developing policy. Lobbyists can be an effective tool, but they are expensive, and in the case of issues that are very popular with the general public, they may not be necessary at all. Everyone has a voice in our national health care system. There are multiple avenues for influencing health care policy; voting is one but is not necessarily the primary method. DIF: Cognitive Level: Apply TOP: Integrated Process: Teaching/Learning MSC: NCLEX Client Needs: N/A A politically savvy nurse is explaining to co-workers that a plank in a political party’s platform refers to the a. documents that will be voted on. b. financing arm of the convention. c. party’s stand on specific issues. d. supporters of various programs. 3. DIF: Cognitive Level: Remember REF: 89 TOP: Integrated Process: Teaching/Learning MSC: NCLEX Client Needs: N/A ANS: C The party’s stands on specific issues are called planks, which come together to form a platform, which represents the consensus of party delegates on specific issues of importance to the party leaders. The party votes on issues during the political conventions, which then become the basis of arguments made during a political race. The financing means of the convention is not known as a plank. The supporters of various programs are not known as planks. DIF: Cognitive Level: Understand REF: 90 TOP: Integrated Process: Teaching/Learning MSC: NCLEX Client Needs: N/A 4. Today’s nurse understands that the mission of political action committees (PACs) has changed over the years to become more a. invested in social and corporate agendas. b. involved at the state rather than the national level. c. fiscally responsible to the general population. d. responsive to needs of underserved groups. ANS: A Originally intended to represent traditionally underrepresented groups, PACs now typically represent particular groups interested in specific issues. PACs are active at both the national and state levels. The lack of transparency in financial matters related to politics and to PACs has led to grass- roots advocacy regarding inappropriate financing. Being responsive to needs of underserved groups was the original mission of PACs, but this has evolved to include specific groups of people with specific interests. DIF: Cognitive Level: Understand REF: 90 | 92 TOP: Integrated Process: Teaching/Learning MSC: NCLEX Client Needs: N/A 5. A nurse wishing to give money to a national political party without designating it for a specific purpose is donating what is called __________ money. a. hard b. soft c. unencumbered d. unrestricted ANS: B Soft money is money donated to a national political party without a designated purpose. Hard money is given to specific campaigns. The term unencumbered money was not discussed in the chapter. The term unrestricted money was not discussed in the chapter. DIF: Cognitive Level: Remember REF: 92 TOP: Integrated or Nursing Process: N/A MSC: NCLEX Client Needs: N/A 6. A nurse wishes to encourage people to vote and energize those who feel strongly about a particular political issue. The nurse would best accomplish this by a. donating money to a political action committee (PAC). b. joining the office staff of an involved lobbyist. c. serving on a national candidate’s platform staff. d. volunteering for a related 527 political group. ANS: D A 527 political group is usually involved in voter mobilization, issue advocacy, and other political activities that do not call for endorsing a particular candidate. PACs typically work to raise money, assist in campaigns, and lobby on behalf of special interest groups. Lobbyists work for special interest groups, often as part of a PAC. Serving on the platform staff or on a convention staff would not be involved with “get out the vote” campaigns. DIF: Cognitive Level: Apply TOP: Integrated Process: Communication and Documentation MSC: NCLEX Client Needs: N/A 7. An elected member of Congress wishes to arrange discussion of a new bill related to heart disease during February, which has been declared National Heart Month. Which action by the legislator would most likely lead to this happening as desired? a. Arrange the dates for discussion with the party whip’s secretary. b. Hire a lobbyist to present the proposed bill and timeline for debate. c. Meet with the appropriate committee chairperson to make the request. d. Reserve rooms in chambers for public discussion and debate on the issue. ANS: C Committee chairpersons develop the calendar for discussion of issues; this would be the appropriate avenue for this idea. The party whip is the minority leader and does not set the agenda. A lobbyist might be very helpful in getting bills passed, but the lobbyist would most likely not have any influence on the timing of debate. Public discussion is not the same thing as legislative debate. DIF: Cognitive Level: Apply TOP: Integrated Process: Communication and Documentation MSC: NCLEX Client Needs: N/A 8. A bill has passed both Houses. Before it gets sent to the president, it must be a. approved by appropriate party chairs. b. fully financed with appropriations. c. registered as a pending law to sign. d. resolved in conference committee. ANS: D After both Houses pass their version of a bill, a conference committee works on the bill to resolve any differences between the two versions that passed. After a bill passes in both Houses, it does not go to the party chairs. The party chairs run the political party; the committee chairs set the legislative agenda. Bills may be passed fully, partially, or not funded at all. Bills that have passed do not need to be registered anywhere as pending laws. DIF: Cognitive Level: Remember REF: 95 TOP: Integrated or Nursing Process: N/A MSC: NCLEX Client Needs: N/A 9. A nurse wants to see a bill passed that includes an increase in federal income taxes to fund it. A friend should encourage the nurse to a. call the appropriate committee members. b. provide information to the party secretary. c. send a petition to the nurse’s representative. d. write a letter to the nurse’s senator. ANS: C This answer is correct because all bills that call for increases in federal income tax must originate in the House of Representatives, and the nurse’s representative could direct the petition or the nurse to the appropriate chairperson. Committees can send forward ideas for bills, but only the House of Representatives can originate bills that call for increases in federal income tax. The party secretary would not be the appropriate place to send this request because bills that call for increases in federal income tax must originate in the House of Representatives. The Senate cannot originate bills that call for increases in federal income tax. DIF: Cognitive Level: Apply TOP: Integrated Process: Communication and Documentation MSC: NCLEX Client Needs: N/A A nurse is worried about an upcoming judicial appointment. A co-worker explains that the nurse can voice opinions about such matters best by a. calling the majority party’s leadership. b. phoning the nurse’s House member. c. sending a petition to the president. d. writing to the senator from that state. ANS: D The Senate has the primary responsibility for such political appointments as judges, ambassadors, the surgeon general, cabinet members, and federal agency directors. The nurse should write (or call) the senators from his or her state. The majority party’s leadership would not necessarily be involved in a judicial appointment. The House of Representatives does not have primary responsibility for judicial appointments. The president nominates people for judicial appointments but does not get them appointed. DIF: Cognitive Level: Apply TOP: Integrated Process: Teaching/Learning MSC: NCLEX Client Needs: N/A A nursing manager is concerned about staffing levels and their impact on patient safety. What action by the nurse would have the best chance of influencing this issue? a. Call senators from the state, explaining the need for staffing laws. b. Donate money to the American Nurses Association for lobbying. c. Organize a petition drive calling for a city ordinance on staffing. d. Work with the state nurses association on related state legislation. ANS: D The nurse should work with the state nurses association in that state because state legislatures typically are the level of government to regulate nursing working environments, including staffing levels. Mandatory staffing issues are typically taken up at the state level. 10. 11. The American Nurses Association is a strong force to join, but staffing levels are typically mandated at the state level. A city ordinance would not be an effective way to ensure safe staffing levels. DIF: Cognitive Level: Apply TOP: Integrated Process: Communication and Documentation MSC: NCLEX Client Needs: Safe and Effective Care Environment: Management of Care 12. Bills that include funding requests are known as __________ bills. a. authorization b. finalized c. funded d. supplemental ANS: A Bills that contain requests for funding are known as authorization bills. A finalized bill might be one that has passed both houses and has been resolved in conference committee, but the chapter does not discuss finalized bills. A program or mandate gets its funding via authorization bills. A supplemental bill might be used to provide funding for emergencies that were not anticipated and therefore not funded. DIF: Cognitive Level: Remember REF: 97 TOP: Integrated or Nursing Process: N/A MSC: NCLEX Client Needs: N/A 13. A congresswoman is explaining that she occasionally votes for bills that need, but do not contain, provisions for funding because a. appropriations bills are usually considered in specific years. b. once the bill has passed, it is often easier to find funding for it. c. she can support the cause without having to find money for it. d. there isn’t enough money left in the budget for some issues. ANS: C Congressional representatives often vote for bills that do not contain funding so they can be seen as supporting the cause without having to provide funding. Authorization bills for funding programs, if present, usually pass around the time the original bill passed, and the first authorization bill for a program is often named for the program it funds. Bills are not usually passed in the hope that funding can be found at a later date. It certainly may be true that there is not enough money left in the budget, but it is not the reason that this is done as a practice. DIF: Cognitive Level: Understand REF: 97 TOP: Integrated Process: Communication and Documentation MSC: NCLEX Client Needs: N/A 14. A voter is angry that his or her congressman voted for a bill that contained an amendment unrelated to the bill without knowing about the amendment. The congressman explains that this occurs because a. aides do not have time to fully read bills and inform congressional members. b. amendments sometimes are added at the last minute. c. representatives do not get copies of full bills before they vote on them. d. there simply is not enough time to understand each bill. ANS: B Amendments are sometimes added at the last minute in order to get a specific congressional member to vote for the bill. Other legislators may not be aware of the addition of such “pork barrel” legislation to the bill and may vote for (or against) the bill without knowing that they are voting on specific projects. Aides do read bills and give reports to their congressional members, but members should not rely totally on the aides to understand bills. Representatives do get the bills before voting on them; however, to gain the vote of specific congressional members, “pork barrel” legislation (for special “pet” projects) is often added to the bill at the last moment (and some members may not be aware of this). Congressional members should take the time to fully understand the contents of each bill before voting. DIF: Cognitive Level: Understand REF: 98 TOP: Integrated or Nursing Process: N/A MSC: NCLEX Client Needs: N/A 15. A nurse does not understand why the U.S. Department of Health and Human Services (USDHHS) cannot allocate more money for public health efforts. Another nurse explains that money for public health and other expenditures is limited because the majority of the USDHHS budget must fund a. any program deemed in need of funding. b. initiatives according to Healthy People 2020. c. Medicare and other legislated programs. d. United Nations health and wellness plans. ANS: C About two thirds of the budget of the USDHHS goes to fund Medicare and other entitlement programs, leaving a minority of funds for other items. Only about one third of USDHHS’s budget is discretionary; the remainder goes to fund other legislated programs. Healthy People 2020 does focus on the health care priorities of the nation, but budgetary expenditures from USDHHS for these initiatives are limited because of fixed spending on entitlements. The USDHHS budget does not fund United Nations plans. DIF: Cognitive Level: Understand REF: 99 TOP: Integrated Process: Teaching/Learning MSC: NCLEX Client Needs: N/A 16. A nurse understands that the first major government involvement in health care occurred with passage of the __________ Act. a. Brady b. Hill-Burton c. Nurse Reinvestment d. Social Security ANS: D The Social Security Act of 1935 was the first incursion of the federal government in health care and provided grants to the states for specific health programs. The Brady Act (1993) concerned gun control and the prevention of handgun violence. The Hill-Burton Act (1946) concerned building hospitals and improving their physical capabilities. The Nurse Reinvestment Act (2008) is a training act funded as a discretionary health care expenditure. DIF: Cognitive Level: Remember REF: 99 TOP: Integrated Process: Teaching/Learning MSC: NCLEX Client Needs: N/A 17. A nurse is confused because a federal agency does not seem to be providing services according to the law. Another nurse explains that this can happen because a. agencies do not work under any specific federal laws. b. agency interpretation is needed to implement the law. c. not all government agencies fall under specific laws. d. there is considerable infighting among different agencies. ANS: B Agencies are charged with implementation of law according to their interpretation of the intent of the law, and agencies can change their procedures without revising the original law. Often, interpretation—and, hence, action—varies according to the personnel at the agency. Agencies do work that falls under their jurisdiction according to law, whether that is at the state or federal level. All government agencies fall under the auspices of some law. Agencies have specific established functions and so would not be fighting among themselves over how each agency should do its job. DIF: Cognitive Level: Understand REF: 99 TOP: Integrated Process: Teaching/Learning MSC: NCLEX Client Needs: N/A 18. A nurse working for a governmental agency is charged with establishing evaluation plans for the programs the agency oversees. To show the agency is meeting health-related objectives, the nurse would most likely compare the agency’s outcomes to a. benchmarks for health care at the local level. b. budget guidelines imposed by Congress. c. goals established in Healthy People 2020. d. taxpayer satisfaction with health programs. ANS: C Healthy People is a blueprint to the nation’s health, and many funding decisions are based on attempting to meet targets set forth in this document. A federal agency would most likely look to national, not local, benchmarks when evaluating specific programs. Staying within budget guidelines is important, but this does not give information about how well an agency is meeting health-related objectives. Taxpayer satisfaction is certainly an important issue, but this would not allow evaluation on whether or not health-related goals have been met. DIF: Cognitive Level: Evaluate TOP: Nursing Process: Evaluation MSC: NCLEX Client Needs: N/A 19. A nursing dean wishes to establish a center to study the feasibility of creating a curriculum based on community-based nursing. To acquire funding, the dean would most likely apply to the a. National Institutes of Health. b. Pew Charitable Trusts. c. state board of nursing. d. Surgeon General’s office. ANS: B The Pew Charitable Trusts is a philanthropic foundation that supplies grants for health care demonstration projects, research studies, and training and education of health care professionals. The National Institutes of Health do provide funding for health-related projects, but most are research studies. The state board of nursing is involved in regulation of nursing practice, not funding studies. The Surgeon General’s office works to ensure health programs that affect the nation as a whole are effective. DIF: Cognitive Level: Apply TOP: Nursing Process: Implementation MSC: NCLEX Client Needs: N/A An undergraduate nursing dean is expecting a site visit from the school’s accrediting agency. To ensure that the school meets the agency’s objectives for accreditation, it would be most important that the dean would assess whether course work provided opportunities for students in a. different types of health care organizations and levels of care. b. mastering basic science concepts as they apply to nursing care. c. providing charitable care through nurse-run clinics and offices. d. working with community-based clients and regional health needs. ANS: D The two agencies that accredit schools of nursing (the National League for Nursing Accreditation Commission and the Commission on Collegiate Nursing Education) require undergraduate nursing programs to tailor their curricula to local and regional health care needs. Having the ability to work within several different types of agencies providing multiple levels of care is a good skill but is not one of the specific requirements of the two accreditation agencies. Students do need a mastery of basic science skills in order to advance to more sophisticated concepts, but this is not a specific requirement of the accreditation agencies. Nurse-run clinics are an increasingly used method of providing care and educating students, but they are not a specific requirement of accreditation agencies. DIF: Cognitive Level: Evaluate TOP: Nursing Process: Evaluation MSC: NCLEX Client Needs: N/A A nurse has been investigating how health care policy is made and believes that the system is too complicated and difficult to navigate. Which statement best justifies this position? Health care policy is a. created at many governmental levels and affected by multiple variables. b. enacted mostly by federal law, which requires compromise by both parties. c. funded by appropriations bills, making additional policies hard to enact. 20. 21. d. politicized with the current administration’s party views taking priority. ANS: A Health care policy can be developed by federal or state law; by federal, state, or local rules and regulations; or by think tanks and philanthropic organizations. Policy is affected by funding decisions, public opinion, the economy, demographics, technology, and many other factors. This creates a system that is very complex and difficult for the average person to navigate. Policy is not only enacted by federal law but can be enacted at the state level and created by agencies and organizations. Funding does occur through appropriations bills, but this is not the reason the system is complicated. This statement is true; however, this viewpoint is too narrow to explain the complexity of the entire system. DIF: Cognitive Level: Analyze TOP: Integrated Process: Communication and Documentation MSC: NCLEX Client Needs: N/A 22. A nurse is explaining to a co-worker that the Patient Self-Determination Act, the Ryan White Act, and the McKinney Homelessness Act are all examples of a. bills that were passed without matching appropriations bills. b. health care policies and regulations created in the 1990s. c. laws that were enacted after involvement of philanthropies. d. the only times nurses will ever make differences in legislation. ANS: B The 1990s were a very prolific time for health care laws and regulations. These bills were all passed during that decade. The McKinney bill was partially funded, the Ryan White Act was a funding bill, and the chapter does not describe funding for the Patient Self-Determination Act. Philanthropies may or may not have been instrumental in getting some of these bills passed; the chapter provides no information on this. Nurses can make a difference in any legislation that is proposed, debated, or passed. DIF: Cognitive Level: Understand REF: 105 TOP: Integrated Process: Teaching/Learning MSC: NCLEX Client Needs: N/A 23. A nurse is able to correlate Medicare regulations with which major trend in health care? Medicare has influenced decisions regarding a. creation of policies related to genetic privacy acts. b. inclusion of women and children in research studies. c. purchasing prescription drugs from foreign countries. d. reimbursement through capitated cost agreements. ANS: D Care provided under capitated costs are the major way in which health care is paid for by third parties and is a direct result of the diagnostic-related groups, which were the cost agreements negotiated under Medicare rules. Genetic privacy is an issue, resulting in the Genetic Information Nondiscrimination Act of 2008, but this is not a major trend influenced by Medicare. Inclusion of women and children into research studies has been a topic of national prominence lately, but it has not been influenced by Medicare regulations. Medicare regulations have not required prescriptions to be purchased in foreign countries. DIF: Cognitive Level: Apply TOP: Integrated Process: Teaching/Learning MSC: NCLEX Client Needs: N/A 24. A chief nursing officer (CNO) wishes to demonstrate to the community that the quality of nursing in his or her particular hospital meets or exceeds professional standards. The best method for demonstrating this would be for the CNO to a. advertise nurse–patient ratios. b. apply for magnet hospital status. c. hire advanced practice nurses. d. publish complication rates. ANS: B Applying for and receiving magnet hospital status from the American Nurses Association shows a facility meets or exceeds eight standards of care and can be used to publicize the quality of nursing services in that facility. Advertising nurse–patient ratios would give the public some information about nursing quality, but many individuals would not understand the implications of specific nurse–patient ratios. Hiring more advanced practice nurses would not specifically demonstrate that the hospital had met or exceeded professional standards. Publishing complication rates for specific procedures or populations of patients would be valuable information to some consumers, but this often reflects medical care more than nursing care. DIF: Cognitive Level: Apply TOP: Nursing Process: Implementation MSC: NCLEX Client Needs: N/A 25. A nursing school dean is looking for external funding for an innovative program that recruits underemployed sectors of the workforce into nursing. Which action by the dean would most likely result in gaining external funding for this new program? a. Apply for federal grants through the Department of Health and Human Services Bureau of Health Professions (DHHS BHP). b. Contact governmental agencies to gain scholarship money for specific students. c. Negotiate with a local hospital to sponsor, or fund, education for some students. d. Work with the Alumni Association to find corporate or individual sponsors. ANS: A The largest source of external funding for nursing education is through the DHHS BHP. This funding is generally for programs, not individual students. There are governmental agencies that provide some student scholarships; however, the question specifically asked about program funding. Hospitals do sometimes sponsor students who are already employees of theirs, but this question asked about program funding. Corporate or individual sponsors are important sources of funding for most institutions, but the largest source of external funding for nursing education is the federal government. DIF: Cognitive Level: Apply TOP: Nursing Process: Implementation 26. The nurse researcher explains to a co-worker that the priority in funding for research today is research studies that examine a. effectiveness of care as evidenced by specified outcomes. b. how standards improve the cost effectiveness of therapies. c. if local standards of care measure up to national standards. d. ways to determine whether health disparities are being addressed. ANS: A Outcomes research is a priority in health care research today. Meeting outcomes demonstrates effective and accountable practice and, in fact, is a required element of research. Using standards of care may improve cost effectiveness of therapies, but determining this is not as important as determining whether care meets stated outcomes. Local standards of care should, for the most part, be reflective of national standards. Health disparities are important, especially as addressed in Healthy People 2010, but determining whether these had been addressed would be a form of outcomes research, which is too narrow in scope to be the correct answer. MSC: NCLEX Client Needs: N/A DIF: Cognitive Level: Understand REF: 112 TOP: Integrated Process: Teaching/Learning MULTIPLE RESPONSE MSC: NCLEX Client Needs: N/A 1. An individual is an ardent supporter of a specific candidate in a federal election. This person wants to contribute $2800 to the candidate’s campaign. How can the individual make this kind of contribution? The individual can give (Select all that apply.) a. $2600 to the candidate and $200 to the national party. b. all of it to the candidate of choice without restriction. c. half to the candidate and the other half to the national party. d. the entire amount to the national party without restriction. ANS: A,C,D In 2013 and 2014, individuals were restricted to giving $2600 to an individual candidate and $32,400 to a national party, so this contribution would maximize the donation to the specific candidate and use the remainder toward a contribution to the national party. A person can give up to $2600 to an individual candidate and up to $32,400 to a national party, so splitting it in half would be possible. A person can make a donation of up to $32,400 to a national political party, so one option would be to give it all to the national party and assume that some of it is being used for the candidate the individual favors. This probably is not the best option, but it is a possible choice. Because the individual restriction on donations to specific candidates is $2600, the person cannot give all of it to the particular candidate favored. DIF: Cognitive Level: Apply TOP: Integrated Process: Communication and Documentation MSC: NCLEX Client Needs: N/A A student nurse understands that state nurse practice acts delineate (Select all that apply.) a. eligibility for licensure. b. national accreditation standards. 2. c. required educational preparation. d. rules for members of compacts. e. scope of practice for nurses. ANS: A,C,E Eligibility for licensure is explained in the individual state nurse practice acts. The required educational preparation nurses must obtain is included in state nurse practice acts. The scope of practice for nurses is outlined within each state’s nurse practice act. Nursing students have to graduate from a program approved by the state board of nursing, but this program does not have to have national accreditation. State compacts allow nurses who have licenses in one member state to practice nursing in the other member states without having to get another license. Rules for these compacts are not included in the state nurse practice acts. These compacts were developed by the National Council of State Boards of Nursing. DIF: Cognitive Level: Understand REF: 108 TOP: Integrated Process: Teaching/Learning MSC: NCLEX Client Needs: Safe and Effective Care Environment: Management of Care 3. A nurse is concerned about an upcoming debate on a proposed state health care policy change. What actions can the nurse take in order to have his or her voice heard on this issue? (Select all that apply.) a. Contact legislators by phone to express opinions. b. Encourage nursing experts to testify at hearings. c. Gather information and speak at the hearings. d. Run for election to governmental office. e. Write letters to supportive state representatives. ANS: A,B,C,E Nurses have many avenues for becoming politically active and ensuring that their voices are heard. To influence the outcome of this proposed change, the nurse can contact legislators by phone, encourage experts to testify, speak at hearings, and write letters. Running for office will allow the nurse great political involvement but will not affect the outcome of a policy change soon to be debated. DIF: Cognitive Level: Apply TOP: Integrated Process: Communication and Documentation MSC: NCLEX Client Needs: Safe and Effective Care Environment: Management of Care