Health Policy and Ethics Study Guide Questions
Course Introduction
This course explores the fundamental principles of health policy and ethics, examining how public policy decisions impact healthcare systems, providers, and patient outcomes. Students will analyze key ethical theories and frameworks as they relate to health care, including issues of justice, equity, autonomy, and the allocation of scarce resources. The course covers current policy debates, government roles in health systems, regulatory environments, and the ethical dilemmas faced by healthcare professionals and policymakers. Through case studies and critical discussions, students will develop skills to assess and address ethical challenges and policy decisions that influence the health and well-being of communities at both local and global levels.
Recommended Textbook
Leading and Managing in Canadian Nursing 1st Canadian Edition by Patricia S. Yoder - Copy
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Page 2
Chapter 1: Leading, Managing, and Following
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Sample Questions
Q1) A grievance brought by a staff nurse against the unit manager requires mediation.At the first mediation session,the staff nurse repeatedly calls the unit manager's actions unfair,and the unit manager continues to reiterate the reasons for the actions.What would be the best course of action at this time?
A) Send the two disputants away to reach their own resolution.
B) Involve another staff nurse in the discussion so as to clarify issues.
C) Ask each party to examine her own motives and issues in the conflict.
D) Continue to listen as the parties repeat their thoughts and feelings about the conflict. Answer: C
Q2) Which category is unique to management but is not part of leadership?
A) Initiating change
B) Personal qualities
C) Developing people
D) Information management
Answer: D
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3
Chapter 2: Patient Focus
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Q1) Having access to information,evidence,and research is an important driver for quality and
A) nurse safety.
B) patient safety.
C) organizational policy development.
D) patient-centred care.
Answer: B
Q2) Approximately what percentage of Canadian hospital admissions can be expected to include an adverse event?
A) 5
B) 7.5
C) 10
D) 12.5
Answer: B
Q3) What is the focus in a culture of safety?
A) Employee safety
B) Investigating who is making health care errors
C) Effective systems and team work
D) Professional nursing standards and ethical codes
Answer: C
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Chapter 3: Developing the Role of Leader
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Sample Questions
Q1) A group of managers is meeting to discuss ideas related to the successful implementation of evidence-informed practice on their units.Siobhan has been asked by the director of care to assume leadership of these discussion groups.After two such sessions,Siobhan expresses disappointment to her mentor that the group seems disinterested in her ideas and that they are listening to Ken,who has much less experience with leadership.In discussing this with Siobhan,the mentor understands that leadership
A) is a designated role.
B) must be earned.
C) is more likely to be taken by someone who is more talkative.
D) rarely is taken over by someone with less experience.
Answer: B
Q2) In working with Sonia,her mentor suggests that it is really important for Sonia to engage in self-appraisal and to know her strengths.This observation is based on an understanding that
A) self-confidence is achieved automatically from leading.
B) self-confidence requires constant self-affirmation of strengths.
C) there is little external motivation and affirmation in leadership.
D) supervisors of leaders rarely provide feedback.
Answer: C
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Page 5
Chapter 4: Developing the Role of Manager
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Sample Questions
Q1) Whenever a staff nurse asks Sue,the nursing manager,about the best way to perform a new procedure,Sue immediately goes to the computer with the staff nurse and searches for online best practices related to the procedure in question.What is Sue demonstrating?
A) Lack of procedural knowledge
B) Role-modelling evidence-informed decision-making
C) Empowerment for the staff nurse to do this on her own, rather than involve the manager
D) The key role of informatics in the current health care system
Q2) As the manager of a unit with a high percentage of young professionals,you increase job satisfaction among this young staff by
A) providing high levels of job structure and task orientation.
B) developing schedules that are fair and observing contractual obligations.
C) utilizing skills in the staffing mix to optimize the delivery of patient care.
D) establishing opportunities to self-schedule.
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Chapter 5: Legal Issues
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Q1) With regard to nursing practice,nurse managers are held responsible for A) practising within legal guidelines established under provincial or territorial law and nurse practice acts.
B) ensuring that nursing staff members under their supervision are currently licenced to practice.
C) referring all errors in nursing judgement to state discipline boards.
D) ensuring that physicians are properly licenced to provide care on patient care units.
Q2) The chart of a patient who has undergone abdominal surgery indicates that one set of vital signs were taken at 7 minutes after surgery; the next set were completed 10 hours after surgical.This level of assessment illustrates which element of malpractice?
A) Breach of duty owed the patient
B) Foreseeability
C) Causation
D) Injury or damage
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Chapter 6: Ethical Issues
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Q1) Which ethical principle is primarily involved in informed consent?
A) Veracity
B) Autonomy
C) Beneficence
D) Nonmaleficence
Q2) The nurse manager organizes interprofessional team meetings on a weekly basis.This action is demonstrating which aspect of relational ethics?
A) Embodied knowledge
B) Interdependent environment
C) Engaged interactions
D) Mutual respect
Q3) Autonomy is best promoted through which of the following,in taking a relational approach to autonomy?
A) Specific roles within the relationship
B) Social change
C) Protecting an individual's freedom of choice
D) The necessity of treating everyone fairly
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Chapter 7: Making Decisions and Solving Problems
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Q1) With regard to decision making,critical thinking,and problem solving,which of the following statements are accurate and valid points?
A) The professional decision maker approaches problem solving by beginning with an outcome already in mind.
B) Involvement in decision making is of little use unless you are an expert decision-maker.
C) Many models aid the nurse in improving his or her decision-making skills.
D) The nursing decision-maker who is successful recognizes that only those with similar experiences should be involved in decision making.
Q2) Which of the following is an intuitive decision-making model?
A) Fishbone model
B) SWOT model
C) Clinical judgement model
D) Bounded rationality model
Q3) Decisions are most likely to be of high quality in nursing situations when
A) team leaders make the crucial decisions.
B) individuals are advised of the problems.
C) group size is neither too small nor too large.
D) members are passively involved.
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Page 9
Chapter 8: Health Care Organizations
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Sample Questions
Q1) An arrangement has been made between an industry partner and a hospital for the industry partner to build a new hospital structure and then for the hospital to rent the space at an agreed rate over the useful life of the asset (usually decades).Proponents of this type of arrangement indicate that this partnership shifts the
A) risk of building delays to the industry partner.
B) organizational accountability for safety in the workplace.
C) burden of capital costs to the private sector.
D) efficiency to public rather than private enterprise.
Q2) An example of additional health care services is
A) dental cleaning and checkup.
B) annual Papanicolaou (Pap) smear.
C) childhood immunizations.
D) hospital room costs.
Q3) Which three provinces/territories provide nurses with unrestricted access to seek work and enable nearly seamless nurse mobility between them?
A) Nova Scotia, New Brunswick, and Prince Edward Island
B) Northwest Territories, Yukon, and Nunavut
C) Ontario, Manitoba, and Saskatchewan
D) Alberta, British Columbia, and Saskatchewan
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Page 10
Chapter 9: Understanding and Designing Organizational Structures
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Q1) In Valley Hospital,there is a great deal of discussion about the balance between hospital-wide budget decision-making and unit-based budget decision-making.This discussion represents
A) a search for the "sweet spot."
B) conflict between the values of nursing and those of the health care organization.
C) traditional organizational values.
D) differences between bureaucratic and nonlinear thinking.
Q2) A hospital and a nursing education program form a partnership to recruit more nurses to the region.This organizational structure is
A) being responsive to changes in the environment.
B) being bureaucratic.
C) creating permanent professional boundaries.
D) delineating structures for all decision-making.
Q3) A nurse manager understands that a matrix organizational structure
A) is a simplified organizational structure.
B) has both a functional manager and a service or product-line manager.
C) arranges departments strictly according to function.
D) promotes harmony in organizational decision-making.
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Chapter 10: Cultural Diversity in Health Care
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Sample Questions
Q1) During managers' meetings,Lindsay is surprised by the forthrightness of male managers.She finds that,during discussions,she would be more likely to say
A) "I wonder if we should consider changing our policy on performance appraisals? What do you think?"
B) "Sean, your approach to appraisal is completely off track and does not reflect available evidence."
C) "The system that has been developed needs to be implemented. We have already spent enough time in discussion."
D) "Forget about change in this policy. It is fine as it is."
Q2) Monique,one of your registered nurses,tells you that she cannot understand why Jim,an Aboriginal patient,wants to have a smudge ceremony.Monique's response is based on her
A) cultural marginality.
B) circle of familiarity.
C) cultural understanding.
D) acculturation.
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Chapter 11: Power,Politics,and Influence
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Sample Questions
Q1) One day,at coffee,your co-worker suggests that you and she sit with unit members of the hospital research committee.She suggests that this would be an excellent way to get to know people who share her interest in research.Her actions are an example of A) mentorship.
B) politics.
C) networking. D) empowerment.
Q2) Nurses who engage in infighting,seek physician support against nursing colleagues,and avoid membership in nursing organizations
A) refuse to believe that they are acting like members of groups that suffer socioeconomic oppression.
B) do not understand how their failure to exercise power can limit the power of the whole profession.
C) purposefully choose to exercise their power in the workplace through indirect means. D) suffer from learned helplessness as a result of abuse by powerful nurse executives.
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13
Chapter 12: Caring,Communicating and Managing With Technology
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Q1) In an intensive care unit,you order new devices to measure heart rhythm and rate,respiratory rate,oxygen levels,and intracranial pressure.Which of the following do these devices involve?
A) Biomedical technology
B) Telecommunications
C) Retrieval of patient history information
D) The Internet
Q2) To improve outcomes on the stroke recovery unit,the unit manager leads an evidence-based practice (EBP)project.What is the goal of this project?
A) Enable detection of variations in clinical outcomes from well-researched standards that are supported by confirmatory evidence.
B) Obtain quick access to literature based on studies of patients who have experienced stroke and of their families.
C) Develop a list of articles that could be accessed to address clinical issues and problems in patients who have had a stroke.
D) Advance the development of staff members who are able to conduct independent nursing research on stroke outcomes.
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Chapter 13: Managing Costs and Budgets
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Q1) Which of the following is an example of an initiative that may reduce total health care costs?
A) Offering nurse practitioner-led clinics that educate parents about nonpharmacologic strategies for managing ear infections
B) Educating older adults about the comparative costs of medications that are prescribed to them
C) Lowering copayments for prescription drugs for older adults
D) Advocating for more readily available magnetic resonance imaging (MRI) services to ensure early diagnosis
Q2) A nurse manager discovers that the actual number of visits per patient in a home health service is 3.8 visits per day,whereas the standard is 5 visits per day.On the basis of this information,the nurse manager
A) concludes that the complexity of care in each visit has arisen.
B) concludes that patient volume has been decreased.
C) decides that more information is needed before a conclusion can be reached.
D) initiates a training session regarding the importance of ensuring that visits are made.
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Chapter 14: Care Delivery Strategies
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Sample Questions
Q1) When hiring a case manager for a rehabilitation setting,you are most likely to consider which of the following?
A) A registered nurse with a master's degree
B) A physiotherapist with a background in stroke rehabilitation
C) A social worker with a background in counselling
D) A health care provider with advanced background who is focused on patient and outcome
Q2) In comparing team and functional models of care,a nurse manager favours the team model.In particular,she finds that the team model
A) can be effective in recognizing individual strengths and backgrounds of staff members.
B) promotes autonomy and independence of the RN.
C) avoids conflict because of role clarity.
D) is efficient in delivering care to a large group of patients, with the use of a staffing mix.
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Chapter 15: Staffing and Scheduling
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Sample Questions
Q1) The difference between staffing and scheduling is that staffing
A) puts the right person in the right position.
B) puts the right person in the right time and place.
C) refers to the number of nursing hours per patient per day.
D) accounts for interpretation of benefits and compensation.
Q2) In the past year,you have noticed an increase in patient falls on your unit.In reading studies related to staffing and patient outcomes,you realize that you will need to plan for A) higher patient care hours.
B) safer facilities.
C) institution of a patient classification system.
D) an increased number of RN positions.
Q3) What does a nurse staffing plan take into account?
A) Specific nurse-to-patient ratios per shift
B) Participation of nurses in projecting staffing needs
C) Compensation and benefits for each level of staff
D) The occupancy load of a unit
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17
Chapter 16: Selecting, developing, and Evaluating Staff
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Sample Questions
Q1) Marcia,a nurse manager,discusses her concerns about the hospital's employee appraisal system with her work group,noting that all that it includes is one rating scale and that it means nothing unless the manager is effective in her job.Marcia's concerns reflect which best practices associated with performance appraisal?
A) Rating scales are too generalized to be considered valid or reliable.
B) The effectiveness of any appraisal system is tied directly to the skills and communication abilities of the manager.
C) BARSs are considered superior to simple rating scales in terms of performance appraisal.
D) Rating scales need to be designed by users to be well accepted.
Q2) On your unit,despite efforts to build a strong sense of team,conflict between some of the staff is ongoing.Nonetheless,you want to proceed with developing a systematic and effective performance appraisal system.Which of the following approaches would be most appropriate for you to implement?
A) Peer review
B) A combination of tools
C) Anecdotal notes
D) Rating scale
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Chapter 17: Strategic Planning and Goal Setting
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Q1) After a year,staff members at Pacific Hospital are frustrated,and the implementation of evidence-informed practice has gone poorly.In responding to this situation,the strategic planning team at Pacific Hospital
A) recommends that the mission, objectives, and goals of the hospital be reassessed.
B) revises the goal statements in the strategic plan.
C) consults an external team on preparation of materials on evidence-informed practice.
D) holds focus groups with staff to determine what kinds of issues, challenges, and obstacles have occurred in implementation.
Q2) Construction of properly worded and written objectives most often begin with which word?
A) "Illustrate"
B) "Demonstrate"
C) "To"
D) "Develop"
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Chapter 18: Leading Change
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Q1) Which of the following are examples of application of the Leadership Rounding Tool (Studer,2009)?
A) "What is working well for you during bedside reporting?"
B) "What has not worked for you today?"
C) "Is there someone on your team who deserves special recognition for her efforts in the implementation?"
D) "Did you have a good vacation?"
Q2) Elizabeth is an example of
A) an early adopter.
B) the late majority.
C) a laggard.
D) a rejector.
Q3) When goals/outcomes are somewhat unclear in early preparation for a complex change,the manager and the change management team develop several acceptable goals/outcomes.This change in management approach is termed
A) unfreezing.
B) nonlinear.
C) cybernetic.
D) linear.
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Page 20
Chapter 19: Building Teams Through Communication and Partnerships
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Sample Questions
Q1) Trust is an important aspect of helping relationships,therapeutic communications,and the positive communications model.Which statement does not involve or operationally define trust?
A) Trust can be described as a belief that although the nurse is capable of helping in times of distress, the nurse is unlikely do so.
B) Trust is the basis by which leaders facilitate the activities and progress of a team.
C) Trust is critical in teams and interdisciplinary teams.
D) Trust is an important aspect of interpersonal relationships.
Q2) The nurse manager used a mediator to help resolve conflicts on the unit.During the mediation process,the nurse manager saw signs of potential team building.One key concept of an effective team is A) conflict.
B) task clarity.
C) commitment.
D) a designated leader.
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Chapter 20: Collective Nursing Advocacy
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Q1) Nurses on the dialysis unit notice that changes in labelling of fluids have caused several alarming instances in which fluids were almost administered incorrectly.They take this concern to the unit manager.As an advocate of nurse autonomy,the most appropriate response in this situation would be which of the following?
A) Ensure that the nurses are aware of the reasons for the change and how the decision was made about the new labels.
B) Discuss concerns about the labels and develop potential solutions that take into account changes that can be made at the local level and those that need system intervention.
C) Suggest that the staff wait until they have become more familiar with the labels before taking further action.
D) Tell the staff that you will notify the pharmacy about these concerns and leave it up to the pharmacy to decide what should be done.
Q2) Health care inequities frequently arise from
A) failure of organizational structures to adhere to shared governance.
B) social determinants of health.
C) lack of commitment to health.
D) inability to pay for health services.
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Chapter 21: Managing Quality and Risk
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Q1) The nurse gives an inaccurate dose of medication to a patient.After assessment of the patient,the nurse completes an incident report.The nurse notifies the nursing supervisor of the medication error and calls the physician to report the occurrence.The nurse who administered the inaccurate medication understands that
A) the error will result in suspension.
B) an incident report is optional for an event that does not result in injury.
C) the error will be documented in her personnel file.
D) risk management programs are not designed to assign blame.
Q2) The chief executive officer asks the nurse manager of the telemetry unit to justify the disproportionately high number of registered nurses on the telemetry unit.The nurse manager explains that nursing research has validated which statement about a low nurse-to-patient ratio?
A) "It promotes teamwork among health care providers."
B) "It increases adverse events."
C) "It improves outcomes."
D) "It contributes to duplication of services."
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Chapter 22: Translating Research Into Practice
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Q1) Which of the following would be most effective in implementing the findings of Dobbins,Ciliska,Estabrooks,et al.(2005)on treating problems associated with bowel motility?
A) Face-to-face lecture by a nurse practitioner
B) Workshop for surgical nurses that involves discussion of case studies and application of evidence
C) Discussion of the findings on the bulletin boards at the workstation
D) Education of unit opinion leaders regarding the evidence presented in the studies
Q2) Which of the following has been identified as a significant factor in moving EBP into patient care?
A) Strong utilization models
B) Development of stronger opinion leaders
C) Technology
D) Support by other disciplines
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24
Chapter 23: Understanding and Resolving Conflict
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Q1) When a nurse decides to walk away from a patient conflict situation and document the situation,the outcome as depicted by Thomas's (1992)conflict stages can be considered to be
A) compromising.
B) confronting.
C) constructive.
D) destructive.
Q2) Jane has transferred from the intensive care unit to the critical care unit.She is very set in the way she makes assignments and encourages her new peers to adopt this method without sharing the rationale for why it is better.This is a good example of a process and procedure that creates ________ conflict.
A) organizational
B) intrapersonal
C) interpersonal
D) disruptive
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Chapter 24: Managing Personalpersonnel Problems
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Q1) Incivility is a disruptive behaviour or communication that creates negativity in the environment and interferes with quality of patient care and safety.The manager can implement steps that help to alleviate uncivil behaviour on a unit.Which of the following would not be an appropriate first step?
A) Suspending the staff member from work
B) Providing written admonishment that is discussed and placed in the employee's file
C) Providing verbal admonishment
D) Terminating the staff member
Q2) All of the following are grounds for immediate dismissal except
A) failing to pursue further medical help for a patient, after which the patient dies.
B) selling narcotics obtained from the unit supply of narcotics.
C) restraining a patient in bed for 7 hours, unsupervised, as punishment for hitting a staff member.
D) grabbing the unit manager and threatening further physical harm after a poor performance appraisal.
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Chapter 25: Workplace Violence and Incivility
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Q1) Caroline asks family members to leave while she cares for the 16-year-old victim of a recent car accident.The father screams at her and tells her that she has no right to ask his family to leave,and that if she continues to do so,he will "throw her out of the room." Caroline is shaken and tells her head nurse,who tells her that this kind of thing is just part of the job.The guidance of the head nurse
A) is reasonable. No physical violence was involved. B) is related to why incidents of violence in health care probably underreported. C) acknowledges the deep distress and fear of the family.
D) acknowledges the concern of the nurse.
Q2) Many inaccurately believe workplace violence to be related specifically to A) verbal abuse. B) physical injury.
C) incivility.
D) harassment.
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Chapter 26: Practising and Leading in Interdisciplinary Settings
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Q1) The unit manager is working in a large metropolitan facility and is told that two unregulated care providers are to be assigned to work with her.Delegation begins with A) acknowledging the arrival of the second unregulated care provider on the unit.
B) providing clear directions to both unregulated care providers.
C) matching tasks with qualified persons.
D) receiving reports from the prior shift.
Q2) In some provinces,a restricted activities or controlled acts model is currently in place.A main distinction between this model and the model of licensure that is still used in most other provinces is that
A) each health care provider is registered to conduct specific tasks.
B) specific acts are licenced.
C) acts cannot be shared among health care providers unless they are registered.
D) nurses are bound by exclusive scopes of practice.
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Chapter 27: Role Transition
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Q1) Samia finds a mentor,Amy,who has been in the role of unit manager for 3 years and has a similar interest in clinical excellence.During their frequent meetings,Amy provides assistance with learning aspects of the manager's role,including technical aspects,such as how to interpret budget printouts and to achieve budget outcomes.The success of Amy's coaching depends on
A) clarity of Amy's information.
B) organizational support for the mentor relationship.
C) the congruence of Amy's beliefs with Samia's beliefs.
D) willingness of Samia to receive feedback.
Q2) Sue,a newly graduated registered nurse,has been on the orthopedic unit for about 6 months and is reconciling discrepancies between what she thought her role was in relation to peer performance appraisal and what it actually is.This is an example of role A) discrepancy.
B) ambiguity.
C) integration.
D) stabilization.
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Chapter 28: Self-Management: Stress and Time
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Q1) The chief nursing officer listens to nurse managers verbalize their feelings of internal stress.One common source of internal stress seems to be
A) the death of a loved one.
B) perfectionism.
C) getting married.
D) losing a job.
Q2) A staff nurse approaches the unit manager and indicates to her that because of her father's death in the previous month,she is now finding it very difficult to do her work effectively.This would be considered which type of stress?
A) Internal source
B) Familial
C) Burnout
D) External
Q3) Sources of occupational stress in nursing include all except which of the following?
A) Authoritarian leadership
B) Concern about moral wrongdoing by colleagues
C) Multiple changes in a short time
D) Job insecurity
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Chapter 29: Managing Your Career
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Q1) A functional résumé focuses on
A) experience and skills obtained in positions.
B) positions held and specific roles in the positions.
C) academic qualifications and achievements.
D) relating skills and experience to qualifications in a specific position.
Q2) During performance appraisal interviews,Joanna's nurse manager notices Joanna's excitement when she talks about how she has helped patients on a rehabilitation unit understand the complexities of their regimens.When Joanna's nurse manager asks her about her career path plans,Joanna says that she wants to become a nurse administrator.The best response to Joanna would be
A) "Nursing administration is rewarding. What experiences would help you along this path?"
B) "You do not appear excited about nursing administration. Unless you are excited by that career path, I wouldn't advise going in that direction."
C) "You seem to find teaching others very rewarding. Have you considered that as a possible career path?"
D) "You are too inexperienced to consider administration. Work for a few years, and then consider administration."
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Chapter 30: Thriving for the Future
Available Study Resources on Quizplus for this Chatper
24 Verified Questions
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Sample Questions
Q1) Jadzia is a school nurse in a large urban high school.She observes the numbers of students smoking and understands the usefulness of increased evidence of acute and chronic disorders related to smoking.After involving teachers,parents,students,and the community,she implements a smoking cessation program.Her program reflects which strength of connected leadership?
A) Quest for meaning
B) Authenticity and accountability
C) Thinking for the long term, acting for the short term
D) Leadership through expectation
Q2) Which of the following strategies is most important in developing a strong vision?
A) Seeking out evidence to support trends and innovative thinking
B) Spending time with others to discuss ideas
C) Setting up focus groups to provide information on current realities
D) Being honest and open about what the person thinks for the future
Q3) The Canadian Nurses Association`s vision for 2020 includes
A) focusing the delivery system on health care providers.
B) rapidly accelerating the adoption of promising technologies.
C) concentrating the delivery of health care on institutions.
D) integrating medical knowledge related to care of acutely ill patients.
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