Healthcare Systems and Policy
Exam Answer Key
Course Introduction
This course offers a comprehensive overview of healthcare systems and the policies that shape them, both in the United States and globally. Students will examine the organization, financing, and delivery of healthcare, exploring how various stakeholders including government agencies, private organizations, and consumers interact within these systems. The course also addresses the impact of policy decisions on healthcare quality, access, and cost, and encourages critical analysis of current policy debates and reforms. Through comparative analysis, students will develop an understanding of diverse healthcare models and learn to assess reform proposals to improve health outcomes and system efficiency.
Recommended Textbook
Nursing Today Transition and Trends 9th Edition by
JoAnn Zerwekh
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26 Chapters
654 Verified Questions
654 Flashcards
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Chapter 1: Role Transitions
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Sample Questions
Q1) A nurse is trying to avoid burnout.Which of the following actions is a valid way to achieve this?
A)Refusing to constantly work extra shifts
B)Withdrawing from peer support group
C)"Going native"
D)Changing jobs every 6 to 12 months
Answer: A
Q2) Which of the following actions by the graduate nurse is an inappropriate methodology to recover from reality shock?
A)Networking
B)Obtaining a mentor
C)Returning to school
D)Joining a support group
Answer: C
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Chapter 2: Personal Management: Time and Self-Care Strategies
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26 Verified Questions
26 Flashcards
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Sample Questions
Q1) The nurse understands stress-related illness when stating which of the following?
A)"Stress can cause insomnia."
B)"Stress is known to cause muscle and joint pain."
C)"Stress can cause headaches."
D)"Stress is not known to cause any health problems."
E)"Stress can cause gastrointestinal disturbances."
Answer: A,B,C,E
Q2) How can the student nurse increase studying efficiency?
A)Maintaining a supply of simple carbohydrates for a quick energy spurt
B)Alternating mental and physical activities to increase productivity
C)Working nonstop without breaks to focus concentration
D)Delegating tasks of household chores to family members
Answer: B
Q3) Which of the following is an example of a self-defeating belief?
A)I must always feel loved by everyone.
B)I am a caring person.
C)I will get through nursing school.
D)I am getting better.
Answer: A
Page 4
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Chapter 3: Mentorship, Preceptorship, and Nurse Residency Programs
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22 Verified Questions
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Sample Questions
Q1) A nursing student is in the mentoring process.Which action would occur if the nursing student were in the "Get out of the way phase"?
A)The nursing student would assess chest tubes with the mentor nearby for guidance.
B)The nursing student would assess chest tubes independently.
C)The nursing student would observe the mentor assessing chest tubes.
D)The nursing student would read the hospital policy on chest tubes.
Answer: B
Q2) You are a graduate nurse in search of a mentor.To find a good "match," what should you look for?
A)Choose an experienced nurse who is successful.
B)Look for things you and the potential mentor have in common.
C)Be very specific with the questions you ask of the possible mentor.
D)Be careful not to disclose too much personal information.
Answer: B
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5
Chapter 4: Employment Considerations: Opportunities,
Resumes, and Interviewing
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Sample Questions
Q1) Which of the following actions by the graduate nurse would not be advised during an interview campaign?
A)Plan three interviews in a day.
B)Identify a date to begin employment.
C)Ask questions about the interview process.
D)Research the prospective employer.
Q2) A graduate nurse has not heard from a prospective employer 3 days after submitting a resume.Which action should the graduate nurse take?
A)Call.
B)Write a letter.
C)Do nothing.
D)Contact another employment setting.
Q3) What actions should the graduate nurse take to assess an organization?
A)Talk to those who work in the organization of interest.
B)Read the organization's mission statement.
C)Evaluate the reputation of the leadership.
D)Listen to rumors about the organization.
E)Read and analyze the recruitment materials.
F)"I should list my age and marital status."
Page 6
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Chapter 5: Nclex-Rn and the New Graduate
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Sample Questions
Q1) What are helpful strategies for dealing with test anxiety?
A)Put as much time as possible into studying.
B)Practice relaxation techniques and positive thinking.
C)Use review books and tapes.
D)Focus on test-taking skills and emphasize facts less.
Q2) The graduate nurse is preparing to take the NCLEX-RN.Which blueprint category is interpreted as having the highest percentage of test items?
A)Safe,effective care environment
B)Physiologic integrity
C)Psychosocial integrity
D)Health promotion and maintenance
Q3) What is the best review strategy to use to prepare for the NCLEX-RN?
A)Spend about 8 hours a day on your days off until you take the examination.
B)Study for 4 hours a night while taking a 2-week review course.
C)Review basic nursing content 2 to 3 hours a day 3 days a week.
D)Study 10 hours on the day and evening before the examination.
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Page 7
Chapter 6: Historical Perspectives: Influences on the
Present
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Sample Questions
Q1) What was an important outcome of national events in the 21st century?
A)Nurses became more respected as experts in health care.
B)Disaster management and emergency preparedness emerged.
C)Pay for nurses increased to a sum equitable to education.
D)The HIV/AIDS epidemic impacted hospital nursing care.
Q2) The nurse has been studying the history of the nursing uniform and relates which information about the nurse's cap?
A)The nurse's cap evolved from battlefield uniforms.
B)The cap was designed to keep hair neatly in place.
C)Each educational institution had its own unique cap.
D)Men in nursing led to the cap's use declining.
E)Caps were very difficult and expensive to make.
Q3) Which action resulted from the command of George Washington during colonial times?
A)Women were banned from providing nursing care.
B)Women were hired to serve meals and provide care to the ill.
C)Men were hired to serve meals to the ill.
D)Most of the individuals in the large hospitals providing care were women.
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Chapter 7: Nursing Education
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Sample Questions
Q1) Which action by health care facilities shows implementation of the recommendations set by the Institute of Medicine?
A)Increase the cost of outpatient services.
B)Set up a reward system for nurses who receive their baccalaureate degree.
C)Encourage nurses to be lifelong learners.
D)Set up a valet system to better serve patients and visitors.
E)Implement measures that will offer assistance to nurses who are pursuing doctoral degrees.
Q2) Based on data,the nurse interprets which educational program as producing the most graduate nurses annually?
A)Diploma program
B)Associate's degree program
C)Baccalaureate program
D)Master's and doctoral programs
Q3) Select the following statement that describes the current student population.
A)The student population tends to be single.
B)The student population is younger than the age of 20 years.
C)The student population tends to be older.
D)The student population tends to be white.
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Page 9
Chapter 8: Nursing Theory
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Sample Questions
Q1) A nurse wishes to incorporate Dorothea Orem's theory into practice.Which action by the nurse encompasses this theory?
A)The nurse completes the AM care for a patient.
B)The patient gets dressed with help from the nurse aide.
C)The patient knows his or her own medication dosages and what time they are due.
D)The patient's spouse assumes all responsibility for the patient's medications.
Q2) Which of the following would correctly evaluate the effectiveness of Nightingale's actions to increase the health of the Crimean War soldiers?
A)Deaths continued to increase because of poor conditions.
B)Deaths declined because of increased cleanliness.
C)Death rates stayed consistent throughout the war.
D)Death rates reduced to zero.
Q3) Systems-oriented theorists include
A)Neuman,Roy,and Johnson.
B)Peplau,Watson,and Orlando.
C)Nightingale,Abdellah,and Orem.
D)Rogers,Newman,Rizzo,and Parse.
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Chapter 9: Image of Nursing: Influences on the Present
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Sample Questions
Q1) Which action would be consistent with the American Red Cross volunteer nurse?
A)Provide staffing for a local hospital.
B)Provide assistance after a tornado.
C)Teach first aid to a group of Girl Scouts.
D)Deliver clothing to flood victims.
E)Educate volunteers to assist in a local hospital.
Q2) A nurse wants to represent nursing in legislative activities.Which national nursing organization would be most important to join?
A)International Congress of Nursing
B)American Red Cross
C)American Academy of Nursing
D)American Nurses Association
Q3) Which of the following assesses how nurses can control their profession?
A)Discussing issues on their lunch break
B)Joining a professional organization
C)Through publishing documents
D)Being active in the state boards of nursing
E)Keeping issues to themselves
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Chapter 10: Nursing Management and Leadership
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30 Verified Questions
30 Flashcards
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Sample Questions
Q1) Which action by the nurse indicates placement in the unfreezing phase of Lewin's Change Theory?
A)The nurse reconsiders if he or she is resistant to change.
B)The nurse begins the process of implementing change.
C)The change has become routine.
D)The change is permanent.
Q2) The nurse understands that having a stand-up meeting versus the traditional (sitting at a conference table)meeting takes less time to come to a decision based on which of the following ideas?
A)Contingency-style leadership
B)Evidence-based management protocols and interventions
C)Autocratic management style
D)Presence of a clinical nurse leader (CNL)
Q3) A nurse manager is in the planning phase in a new job.Which actions show this?
A)Developing goals that reflect the mission and vision of the organization
B)Defining strategies to meet the mission and vision of the organization
C)Providing direction for staff to perform the work of the organization
D)Retaining accountability for all work completed by the staff
E)Planning for contingencies that may interfere with the work of the organization
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Page 12
Chapter 11: Building Nursing Management Skills
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Sample Questions
Q1) The nurse manager is in charge of a busy nursing unit.Today the nurse manager is planning to evaluate the work of nurses on the unit.Which of the following actions would help complete this task in an effective manner?
A)Provide feedback as necessary to staff.
B)Verify the tasks are being performed according to standards of practice.
C)Allow nurses to complete all tasks,even if performed incorrectly.
D)Provide directions with clear expectations of how the task is to be performed.
E)Evaluate the performance of the task by the staff.
Q2) A nurse is working with a nurse aide to care for a group of patients.Which of the following activities would be inappropriate to delegate to the nurse aide?
A)Providing discharge instructions to a patient
B)Refilling water containers
C)Obtaining a lift to help a patient out of a chair
D)Feeding a patient who is unable to feed himself
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13
Chapter 12: Effective Communication, Team Building, and
Inter-professional Practice
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Sample Questions
Q1) Dr.Jones asks you to give a medication to one of the patients,and you know the patient is allergic to it.When you point this out,Dr.Jones says,"Give the medication or I'll report this to your supervisor." What is the best assertive response?
A)Agree to give the medication and hope no one finds out.
B)Say,"I won't give the medication,and I don't care who you talk to about it."
C)Walk away and ignore Dr.Jones.
D)Say,"Perhaps you and I could talk this over with my supervisor together."
Q2) Which of the following actions by the nurse leader is most likely to lead to an effective meeting?
A)Creating an atmosphere in which people say very little
B)Sending out an agenda ahead of time
C)Creating well-designed overhead transparencies
D)Completing all the tasks of the group
Q3) Which statement made the by the nurse indicates understanding of how to control the grapevine?
A)"Grapevine rumors are generally true."
B)"Avoid face-to-face communication."
C)"Avoid spreading rumors."
D)"Keep rumors circulating."
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Chapter 13: Conflict Management
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Sample Questions
Q1) Of the following common areas of conflict between nurses and their patients and families,which does the nurse interpret as the most easily resolved?
A)Issues of concern about quality of care
B)Issues surrounding treatment decisions
C)Issues of family involvement
D)Issues about quality of parental care
Q2) What action(s)by the staff nurse is an effective way to deal with a sexual harassment issue in the workplace?
A)Tell the person to stop.
B)Tell your best friend about the incident.
C)File a formal grievance.
D)Explain the situation to your spouse.
E)Play along with the person and document the activities.
F)Threaten the person with a sexual harassment lawsuit.
Q3) Which action by the nurse has a potential for creating role conflict?
A)Arguing that the nurse on the next shift is responsible for weighing a patient
B)Failing to discuss differences with a coworker the nurse is angry with
C)Placing the nurse's personal achievement over that of coworkers
D)Trying to change another nurse's personality
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Page 15
Chapter 14: Delegation in the Clinical Setting
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Sample Questions
Q1) What should the nurse do to assess competence before delegating a task to an LPN?
A)Ask if the LPN has previous experience performing the task.
B)Ask if the LPN is willing to perform the task.
C)Ask another nurse if the LPN is competent.
D)Assume the LPN is competent due to her years of service.
Q2) An experienced nursing assistant could be assigned by the nurse to do which of the following?
A)Help teach new diabetic clients to give themselves injections.
B)Report on quality and quantity of urine,and adjust drip rate on continuous bladder irrigation.
C)Assist the client to obtain a clean-catch urine specimen.
D)Chart the dietary intake of a client with an eating disorder.
Q3) To optimally use the level of preparation of the LPN who previously worked in an emergency department,which task should the registered nurse delegate to the LPN?
A)Transporting a patient to the laboratory
B)Assisting with a thoracentesis
C)Restocking and counting the sterile supplies
D)Passing afternoon nutrition supplements and waters
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Chapter 15: The Health Care Organization and Patterns of Nursing Care Delivery
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Sample Questions
Q1) The nurse understands cost containment when stating which of the following? Major elements of the law that support cost containment include
A)"increased governmental regulation of insurers."
B)"less use of technology."
C)"increasing incentives for coordination of care."
D)"emphasis on physician-centered care."
E)"decreasing consumer out-of-pocket costs."
Q2) Which statement regarding characteristics of clinical pathways shows the nurse's lack of understanding?
A)"Clinical pathways focus on patient outcomes."
B)"Clinical pathways use a timeline with sequenced interventions."
C)"Clinical pathways collaborate efforts by health care professionals."
D)"Clinical pathways involve nurse-centered orientation."
Q3) A chief nursing officer wants to create a healthy work environment.What action by the CNO would be best to accomplish this goal?
A)Use a nursing theory to support the environment and nursing care.
B)Send unit managers to frequent leadership development workshops.
C)Be a nursing advocate and make most nursing decisions him/herself.
D)Offer bonuses for high-performing nurses and ancillary staff.
Page 17
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Chapter 16: Economics in the Health Care Delivery System
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Sample Questions
Q1) The nurse has an adequate understanding of capital budget when stating
A)"A capital budget is part of the expected expenses of the unit."
B)"A capital budget is used to purchase or replace equipment costing more than $5000."
C)"A capital budget is used to pay for nurses to work in the hospital."
D)"A capital budget is used to purchase lunch for employees."
Q2) Which statement by the nurse shows understanding of the Rand Health Insurance Experiment?
A)"When consumers were required to pay a 25% co-payment,there was a considerable decline in the use of health care services."
B)"There was an increase in the use of health care services when consumers were required to make a co-payment."
C)"If the health care cost is being paid by insurance companies,the consumer is not concerned about the cost."
D)"The implementation of the Oregon Health Policy for reimbursement of the cost of health care services led to the Rand Health Insurance Experiment."
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18
Chapter 17: Political Action in Nursing
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Sample Questions
Q1) A nurse has recently moved from one state to another and wishes to write lawmakers to urge them to vote against a change in the Nurse Practice Act that would replace individual licensure with institutional licensure.Which lawmakers should the nurse contact?
A)The city council members
B)The county (parish)legislators
C)The state legislators from the district
D)The federal legislators from the district
Q2) The nurses at Community General Hospital are concerned about violence involving children in their community.They wish to propose to the city government that drug-free and weapon-free zones and corridors be instituted near each school.The nurses send liaisons to the city school board and the parent-teacher association to ask them to join the effort.What is the term for this type of strategy?
A)Forming a coalition
B)Displaying legitimate power
C)Collective bargaining
D)Seeking compromise
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19
Chapter 18: Collective Bargaining: Traditional Unionand
Nontraditional
Approaches
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Sample Questions
Q1) A nurse has an adequate understanding of traditional collective bargaining when making which of the following statements?
A)"The goal of traditional collective bargaining is to win something that is controlled by another."
B)"The goal of traditional collective bargaining is to win something that another person has worked for."
C)"The goal of traditional collective bargaining is to give all power to the nurse."
D)"The goal of traditional collective bargaining is to give all power to the organization."
Q2) The nurse believes that an adequate understanding of arbitration through the traditional collective bargaining unit has been obtained.Which of the following statements supports this belief?
A)"Arbitration is a management technique to discharge an employee."
B)"Arbitration is useful to resolve conflicts having a basis in the labor-management contract."
C)"Arbitration is always used before the formal grievance process."
D)"Arbitration is a process used to establish nursing standards."
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Page 20
Chapter 19: Ethical Issues
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Sample Questions
Q1) The nurse is educating a coworker on the ethical principle of beneficence.The nurse judges the teaching to be effective when her coworker states
A)"Beneficence involves allowing patient to make their own health care decisions."
B)"Beneficence is the duty to actively do good for patients."
C)"Beneficence is the duty to do no harm."
D)"Beneficence involves treating all patients equally."
Q2) A nurse is educating a nurse aide on patient confidentiality.The nurse believes the teaching to be effective when the nurse aide states that confidentiality will be maintained by a nurse who believes in and values the ethical principle of A)veracity.
B)autonomy.
C)justice.
D)fidelity.
Q3) The ethical principle of autonomy is not applicable in which patient situation?
A)The patient does not speak or understand the English language.
B)The patient is unaware of who or where he or she is.
C)The patient has been in a long-term care facility for 10 years.
D)The patient has values that conflict with the caregiver's values.
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Chapter 20: Legal Issues
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Sample Questions
Q1) A nurse has just administered a medication when suddenly realizing that more medication was given than was ordered.Which action should the nurse take?
A)Call the patient's provider,and report the error.
B)Say nothing about the medication error,and continue to monitor the patient.
C)Document the dose that was supposed to be given in the medical record.
D)Document the amount given in the medical record,but keep the error quiet.
Q2) What action might be taken on a nurse who commits an infraction of the Nurse Practice Act?
A)The nurse is subject to discipline by a court of law.
B)The nurse is subject to discipline by the state board of nursing.
C)The nurse is subject to discipline by the state nurses association.
D)The nurse is subject to discipline by the National League for Nursing.
Q3) A nurse tells a patient,"If you don't stop getting out of that chair,I'm going to put some restraints on you." What may this nurse be accused of?
A)False imprisonment
B)Defamation
C)Invasion of privacy
D)Malpractice
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Chapter 21: Cultural and Spiritual Awareness
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Sample Questions
Q1) The nurse is creating a plan of care for a patient.Which would be important for the nurse to consider before implementing the plan?
A)The patient's lifestyle
B)The patient's insurance coverage
C)The patient's value system
D)The patient's religious beliefs
E)The patient's ability to pay for services
Q2) In what culture are older adults respected and unquestioned?
A)Asian
B)African American
C)Hispanic
D)Native American
Q3) A nurse is caring for a patient experiencing spiritual distress.What nursing intervention would be appropriate for this patient?
A)Asking the patient to reserve prayer for the hospital chaplain
B)Placing the patient by the nurses' station because it will be distracting
C)Developing a trusting relationship with the patient
D)Allowing the patient's roommate to have visitors late into the night
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23
Chapter 22: Quality Patient Care
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Sample Questions
Q1) A nurse is educating students on the history of quality improvement.The teaching has been effective when one of the students states that,historically,quality improvement focused on
A)"controlling process by inspection so that errors were prevented."
B)"quality improvement did not begin until recently."
C)"proactive approaches to lessen errors."
D)"error prevention strategies."
Q2) A nurse is a team member assisting with the define-measure-analyze-improve-control (DMAIC)process.Which action would the nurse take during the define phase?
A)Identify the stakeholders.
B)Agree on the key performance indicators.
C)Identify gaps between performance and goals.
D)Identify those responsible for data collection.
Q3) Which of the following statements by the nurse indicates an understanding of Quality and Safety for Nurses (QSEN)?
A)"QSEN helps prepare future nurses for improving patient safety."
B)"QSEN helps prepare future nurses for working mandatory overtime."
C)"QSEN helps train nurses in the clinical setting."
D)"QSEN provides nurses with strategies for passing the NCLEX exam."
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Chapter 23: Nursing Informatics
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Sample Questions
Q1) A nurse manager is lecturing staff nurses on the barriers to the full integration of health information technology.The nurse manager judges the teaching to be effective when a staff nurse states
A)"Barriers include lack of standardization across care areas."
B)"A barrier to the full integration is funding."
C)"Currently there are no barriers."
D)"A current barrier is privacy laws."
E)"Barriers to full integration are not likely to be overcome."
Q2) The nurse understands the benefits of Computerized Provider Order Entry (CPOE)when stating
A)"CPOE does not change the process of patient care."
B)"CPOE averts problems with handwritten orders."
C)"CPOE benefits only the nurses in the health care system."
D)"CPOE benefits only the pharmacists in the health care system."
Q3) Which action can the nurse take to evaluate an Internet resource?
A)Assume that the resource is credible if it is on an Internet page.
B)Determine if the resource provides evidence for claims made.
C)Assess the popularity of the resource.
D)Determine the date the resource was published;older material is more reliable.
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Page 25
Chapter 24: Using Evidence-Based Practice and Nursing Research
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Sample Questions
Q1) Which statement by the nursing professor shows understanding of the major function of the National Institute of Nursing Research?
A)"Serves as a major source of federal grants to fund nursing research"
B)"Provides direction to nurses interested in research utilization"
C)"Collects data about the major nursing schools in the country"
D)"Provides money to fund the education of nurses"
Q2) Which statement by the nurse demonstrates understanding of a barrier-free practice environment?
A)"Too few studies reported in the literature relating to the identified problem"
B)"Obtaining consensus to implement a new approach to resolve the care problem"
C)"Staff suggesting there is too little time to learn a new approach to the care problem"
D)"Staff asking,'Why fix it if it isn't broken?'"
Q3) Which step is inconsistent with the nurse's knowledge of research utilization?
A)Assessing patient care
B)Planning for the patient's needs
C)Implementing a plan of care
D)Guessing the extent of care needed
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Page 26
Chapter 25: Workplace Issues
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Sample Questions
Q1) The Occupational Safety and Health Administration (OSHA)provides guidelines to protect health care workers from needlesticks.Which action by the nurse manager shows the use of the guidelines in practice?
A)Purchasing safety devices
B)Providing a safe working environment
C)Working with the local health department
D)Establishing guidelines for safe nursing practice
Q2) What action can the nurse take to reduce the risk of repetitive motion disorders?
A)Avoid frequent position changes.
B)Frequently alternate between standing and sitting.
C)Have a good understanding of ergonomic principles.
D)Engage in routine stretching of shoulders,neck,arms,hands,and fingers.
E)Attend training on how to reduce injury.
Q3) Which statement by the nurse indicates an adequate understanding of violence in the health care setting?
A)"Violence is a new problem."
B)"Violence can occur anytime and anywhere."
C)"Violence is a problem in the acute care setting."
D)"Violence occurs mostly in mental health settings."
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Page 27
Chapter 26: Emergency Preparedness
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Sample Questions
Q1) The nurse interprets which of the following to be a Level III disaster?
A)Car accident
B)Train derailment
C)Hurricane
D)Tsunami
E)House fire
F)Tornado
Q2) An emergency department nurse should suspect a possible bioterrorist agent if,during the Fourth of July weekend,the nurse notices which of the following?
A)Three patients arrive complaining of abrupt onset of severe myalgia,fever,sore throat,and headache.
B)Four patients,all from the same family picnic,arrive complaining of abdominal pain and nausea,vomiting,and diarrhea.
C)Two patients arrive from the local lake complaining of tiredness,weakness,dizziness,muscle cramps,and headache.
D)Two patients arrive from a local concert with superficial burns on the faces,necks,arms,and legs and complaining of pain in these areas.They are tachycardic and appear dehydrated.
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