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WorksheetsW3 Test Bank Chapter Qs
Total questions: 145
Worksheet time: 1hrs 20mins
A nurse reviewed information before meeting with the community residents who were attending a program on healthful living. Which best describes the action by the nurse?
Disease prevention
Health promotion
Health improvement
Specific protection
A 50-year-old woman comes to the clinic for her first mammogram. Which best describes the action of this client?
Disease prevention
Health improvement
Health protection
Primary health promotion
Which is the best definition of health?
A goal and a resource for living
A lack of disease or illness
Complete state of well-being
Freedom from pain or discomfort
A nurse was becoming frustrated. She had given her client extensive information on his health problem, but the client continued to be noncompliant in making needed changes. Which principle had the nurse forgotten?
A person may have a higher priority than improving his or her health.
Information, while necessary, will not motivate people to change.
People need repetition over time to be able to absorb information.
Physicians, not nurses, are perceived as experts in health.
The nurse working with a client to change behavior to maximize health asked the client to bring his family to the next visit. Which best describes why the nurse wants the family to come with the client?
To analyze the family’s beliefs about health
To determine the family’s support of the client
To establish the family’s communication patterns
To evaluate the family’s approval of the proposed changes
A nurse is using the theory of reasoned action when working with a client to exercise on a regular basis. Which would be the easiest way for the nurse to determine if the client will engage in this activity?
The client’s intention to exercise regularly
The client’s perception of the threat of illness if he doesn’t exercise regularly
Society’s emphasis on the importance of regular exercise
The pros and cons of regular exercise
A nurse is using the theory of planned behavior when working with a client to change her behavior and improve her health. Which consideration should be made by the nurse?
If environmental limitations may prevent the person from acting
The availability of needed environmental supports for the client
The client’s belief about factors that may facilitate or impede the behavior
If the suggested behavior is actually the most effective approach
Some people believe that the air within their workplace makes them ill. Which premises support this belief?
They consistently feel worse on workdays and weeks without holidays.
There has been media coverage of “sick buildings” where there is very little air exchange with fresh air outside.
Research has demonstrated that some buildings emit poisonous vapors that make anyone who works there ill.
When a small group of persons begins to believe something, the others in the
larger group begin to believe it as well.
It is rumored that there is something in the workplace that is causing persons employed there to feel ill. Which action would be most appropriate for the nurse to take?
Ask researchers to set up a study to confirm the health hazard in the environment.
Assess the risk, including identifying any toxic substance.
Confirm the extent to which the illness resulted from intergroup agreement on the illness and cause.
Insist that the media not further spread stories of possible sick buildings until the truth of the situation can be studied.
Which risk factors are least subject to modification?
Choice of lifestyle behaviors
Environmental exposure
Nutritional options
Recreational activities
Which best describes why risk reduction is of such importance in the United States today?
Families suffer when family members die from avoidable causes.
Risk reduction activities will decrease insurance costs to individuals and their
employers.
The leading causes of death are all related to lifestyle choices.
Risk reduction can decrease the ongoing rise in national health care expenditures.
Which is the cause of most preventable deaths in the United States?
Alcohol
Drug addictions
Sexually transmitted diseases
Tobacco
A nurse is completing a health history with a client. Which question would be most important to include?
How many alcoholic drinks do you have in a day?
How many sexual partners have you had in the past month?
What nonprescription drugs do you take on a routine basis?
What kinds of tobacco do you use daily?
During a health history, the client looked confused and said, “But everybody drinks, like at parties and such. How much drinking do you think is too much?” Which would be most appropriate response by the nurse?
“Alcohol should be used only in moderation.”
“It’s okay as long as you don’t binge, and you eat food with your drinks.”
“Per day, no more than one drink for women and two drinks for men.”
“Total abstinence is the only healthy choice.”
Which best describes the reason why so many Americans are obese?
Culture requires eating at celebrations and holidays.
For many people, caloric intake is more than needed for their physical activity.
Physical education is no longer a required subject in most elementary and
secondary schools.
The expected portion size in restaurants has vastly increased over time.
Based on statistics, which group is probably more physically active?
A group of adults living in the southern U.S. states
A group of elderly mall walkers
A group of high school graduates employed in blue collar occupations
A group of highly paid college graduates
A young couple is searching for a home in a new neighborhood. Which neighborhood would most likely promote a healthy lifestyle?
One near a large active military base
One with excellent health facilities nearby
One with high walkability
One with superb recreational facilities
Which factors have a profound, if sometimes unrecognized, impact on one’s health? (Select all that apply.)
Adequate resources to allow easy access to health services
Interpersonal relationships with family and friends
Local, state, and national policies
Number and quality of health care providers within transportation range
Physical neighborhood where one works and lives
A nurse is using Pender’s model to explain what influences individuals to pursue health promotion activities. Which factors would be examined? (Select all that apply.)
A belief that one can change one’s behaviors
Environmental choices possible
Fear of negative consequences if action is not taken & the threat of an early death if behavior is not changed
The rewards one believes will result if action is taken
What one’s family and peers believe should be done
A nurse is using the Health Belief Model to help a client improve lifestyle choices. Which interventions would the nurse most likely implement? (Select all that apply.)
Conduct an ongoing public information campaign to motivate people to take
action & emphasize how important it is to change behavior immediately..
Examine the individual’s perceptions of his or her health in relation to current lifestyle behavior choices.
Review how lifestyle changes can reduce risk and improve the client’s life.
Share statistics regarding the probability of health problems and their seriousness if action is not taken.
Use communication channels to send reminders of action currently needed.
A nurse was becoming frustrated. It had been 2 weeks, and although the client had verbalized that the best time of day to take a 15-minute walk was early in the morning, the client had not begun to exercise. Which principles of the Transtheoretical Model had the nurse forgotten? (Select all that apply.)
A decision to act always occurs before action begins.
Behavior change is difficult and takes time.
Continuing to stress to the client how important exercise is will help the client decide to exercise.
Discussing with the client why he or she is not yet exercising may help the client recognize his or her own resistance.
The nurse should offer some reward if the person exercises for at least a week. Verbalizing compassion for how difficult it is to change is a crucial intervention.
Which actions have been effective in reducing problems related to alcohol use? (Select all that apply.)
Abstinence education programs in elementary schools
Enforcement of ban on sales of alcohol to minors
Increased taxes on alcoholic beverages
Media campaigns that show unpleasant behaviors such as vomiting after drinking
Stringent laws on accurate labeling of alcoholic content in beverages & suggesting children be taught appropriate use of alcohol in the home
A nurse asks a client how she has been sleeping. Which best describes the rationale behind this question? (Select all that apply.)
Accidents and injury may occur with the sleep-deprived client at fault.
Interventions for sleep problems are primarily common sense.
Many adults report sleep problems or occasional lack of sleep.
Many important functions occur during sleep.
Nurses can determine whether the patient has a sleep disorder & a sleep assessment is easy and inexpensive to complete.
Which nurse fought to have American nursing controlled by nurses rather than physicians?
Clara Barton
Florence Nightingale
Lavinia Dock
Lillian Wald
Which nurse used political expertise to influence the federal government to develop a Children’s Bureau?
Clara Barton
Florence Nightingale
Lavinia Dock
Lillian Wald
Which best describes the most important factor in legislation?
The amount of financing and lobbying behind each choice
The beliefs, attitudes, and values of the policy
The preferences of the majority of American voters
The president’s ongoing encouragement for one particular choice
Which is accomplished through the use of public policy?
Solutions to problems of public concern are developed.
A rational, logical problem-solving decision-making process is implemented.
Public safety nets for vulnerable populations are created.
Economic and business management principles are applied.
Which best describes why it is so difficult to change the paradigm of health care from disease orientation to promoting health orientation?
The belief exists that those without insurance could obtain insurance if they
worked hard enough.
People find it difficult to agree on what the ideal paradigm should be.
People realize the media have exaggerated the problems that result from lack of insurance.
Serious reallocation of resources would have to occur.
Which best describes how the government controls conditions that individuals cannot?
Appeals to the common sense and good nature of the citizens
Establishes social mores that enable groups to control individuals’ behaviors
Passes and enforces law
Uses fear reinforced by police power
Which statement best describes why the federal government is unable to do whatever politicians currently in power want?
The citizens would rise up in rebellion if actions were outrageous.
The lack of funds to implement actions is seen as unreasonable by a majority of
voters.
Only the actions authorized by the Constitution are legitimate.
The states would rebel and withdraw from the union.
Which is the basis for any American citizen to feel comfortable expressing an opinion on a political issue?
Amendments to the Constitution
Articles of the Constitution of the United States
Declaration of Independence
Gettysburg Address
Which best describes who has the authority to act in every area except those specifically mentioned in the Constitution?
Any individual citizen
Federal government
Local government
State government
Which best describes how the local government is provided authority?
Through the ability to tax local residents to meet local needs
Through the people themselves who band together to create the community
Power delegated from the federal level to the local level
Power delegated from the states
Which statement best describes how policies in the private sector are different from policies in the public sector?
Private sector policies are slow, deliberate, and reactive to events.
Private sector policies are determined by the opinions and feelings of those
employed in that sector.
Private sector policies are based on economics and market trends.
Private sector policies are based on rational decision-making.
The president was sent a bill that he did not really like, but he would have been unpopular if he vetoed it, so he did nothing. Which best describes what will happen to the bill?
The bill is dead.
The bill returns to both houses to see if enough votes can be obtained to pass the bill even without the president signing the bill.
The bill becomes law.
The bill sits there until the president signs it or vetoes it.
The forces for the proposed bill are roughly as persuasive, powerful, and well financed as the forces against the proposed bill. Which describes the most likely outcome?
The bill will be debated through a public hearing.
The bill will fail.
The bill will pass.
The bill will remain in the legislature until one side or the other has a majority of votes.
Which statement best describes what happened to the hospitals built or expanded by Hill-Burton Act funds?
Many such hospitals have consolidated or closed.
Not needing to expand, hospitals have used the funds to upgrade their facilities.
They have continued to use such funds to expand.
When funding ceased, so did hospital expansion.
An individual has been terminated from his job and has lost his health insurance. Which federal law allows him to continue his insurance benefits for a specified period of time?
Health Insurance Portability and Accountability Act of 1996 (HIPAA)
Family Support Act of 1988
Health Maintenance Organization Act of 1973 (HMO)
Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA)
Which statement best describes an effect of the Welfare Reform Act of 1996?
Individuals who were required to obtain employment lost their health coverage.
Many were happy to be off the government dole and self-supporting.
Persons sought and obtained employment that often included insurance benefits.
The food stamp program decreased in size.
Which best describes the history of the State Child Health Improvement Act (SCHIP) of 1997?
The law included goals and programs but no funding to achieve them.
The law received extensive support by both Republicans and Democrats.
The law was extended, not renewed by the Bush administration, and then renewed by the Obama administration.
The law was passed by the majority of states but not by the federal government.
Which best describes what happened after the Medicare Modernization Act of 2003 was enacted?
Additional restrictions in coverage were imposed.
Experimental treatments were approved for reimbursement.
Reimbursement procedures became more efficient.
A prescription drug benefit was added.
A nurse is employed by the state public health department. Which activity would she most likely complete?
Set up a flu shot clinic at a neighborhood church.
Lobby for health care reform to cover more preventive services.
Monitor the incidence of influenza in the state.
Serve as a volunteer for a state legislator’s campaign.
It has been proposed that a new, better approach to health care be tested with a small group to evaluate its effectiveness. Which best describes why this cannot be done?
Any employment in the project would be only temporary, so it would be difficult to find professionals to staff the program.
It is challenging to find appropriate sites located in the target area from which to offer the pilot project service.
No one wants to accept free services if they include being a guinea pig in a research project.
Offering a service establishes a precedent and a sense of entitlement, so it is difficult to discontinue the program.
Which best describes the most crucial step in policy formation?
Convincing both political parties and independents to support the proposed policy
Defining the issue and placing it on the agenda for possible action
Determining who has vested interest in what aspects of the policy
Trying to simplify the proposed legislation so the public will support it
A nurse suggests to the students that they attend the local district nurses’ association meeting, where the nurse is an officer. Which provides the best rationale for this action?
Meeting outside the clinical area allows for more effective informal learning based on discussion and interaction.
Role models are typically the major influence on nurses choosing to become politically active.
Students are often given extra credit from their instructor for such community involvement.
Such groups want students to attend their meetings to encourage them to join and to accept a committee responsibility.
Which statement best describes why nurses are not more effective in creating political change?
Nurses are not listened to by politicians.
Nurses are not perceived as leaders in the health care field.
Nurses do not act or do not agree on what changes are needed.
Nurses do not know how to negotiate, communicate, and collaborate to create change.
The local nursing association and the local medical association disagreed vehemently on advanced practice nursing reimbursement. Which best describes why the two groups agreed to join a coalition to send representatives to testify on a particular bill?
Although there was disagreement, both groups agreed to behave politely and professionally.
Both associations had formed a coalition to collaborate on a bill that would benefit patients.
Because the legislators had asked both groups to appear, the groups did not have a choice.
The two groups were sharing costs and expenses, but their testimony would give opposing viewpoints.
A nurse is employed by the state nursing association to serve as a lobbyist. Which would be the most crucial task to achieve?
Be seen as a reliable and credible source of accurate information
Convince colleagues in nursing to join their local nursing organization and write to encourage legislators to vote according to nurses’ goals
Offer to make large donations to the legislator who can forward nursing’s agenda
Visit every single legislator so the nurse is recognized in this role
A nurse represents the state professional association. Which action would the nurse complete in relation to legislation?
Be prepared to contribute to campaigns of legislators who vote consistently with nursing goals
Be prepared to confront verbally those on the opposite side of legislative issues
Be prepared to provide testimony and comment on relevant issues
Be prepared to visit schools of nursing to present about the current legislative issues
A nurse is unable to be actively involved in attending meetings at the state level. Which action would be most useful for the nurse?
Asking students to remain informed regarding proposed legislation
Communicating, with rationales, her stand on proposed legislation to legislators
Remaining uninvolved so incorrect information is not inadvertently given
Writing letters to the local newspaper asking nurses to become involved
A nurse states that he or she does not want to become involved in politics because of family, school, work, and other commitments. Which would be the best reply to this statement?
“Good for you. We should all stay out of such dirty game playing!”
“I am sorry to hear that but I do understand.”
“It doesn’t matter; politics have nothing to do with nursing practice.”
“It won’t take much time to join ANA and pay dues so their lobbyist can represent you.”
Which statement best describes why nurses should contribute whenever possible to their state nursing association political action committee (PAC)?
As PACs are a reality of political life, nursing needs to be heard.
Contributing money may result in a future political appointment.
Only money really has any influence on legislative votes.
PACs are being used to increase nursing salaries and working conditions.
Which best describes one of the strategic plan priorities for the Center of Disease Control’s (CDC) Strategic Framework?
Eliminate waste of health care resources
Eliminate health disparities
Improve health care access
Improve health security at home
A nurse would like to influence an internal private health policy. Which action should the nurse take?
Build or join a private entrepreneurial practice to provide lower cost services to underserved groups
Participate in public discussions regarding quality and managed care
Support nursing research done that demonstrates positive clinical and economic outcomes
Write managed care organizations to request that nurses receive reimbursement for health services to clients
What was the poverty guideline for a family of four in mainland United States in 2024?
Below $24,600
Below $16,240
Below $32,150
Below $41,320
Which best describes the purposes of professional societies such as the American Nurses Association (ANA)? (Select all that apply.)
Providing control and oversight of the occupation
Creating licensing laws to control entry into the profession
Determining appropriate requirements for education into the profession
Establishing standards for practice & protecting the interests of the practitioners
Safeguarding the public trust
Which is one legally required to obey? (Select all that apply.)
Directions to a destination provided by a police officer & delegation of responsibility for a task by a physician
Court decisions related to legislative law
Executive decisions, such as your employer requirements
Laws passed by your state or the federal government
Rules and regulations from agencies, such as the state board of nursing
Which current issues are leading the World Health Organization (WHO) to reconsider its initial definition of health? (Select all that apply.)
Environmental issues such as industrial toxins or carcinogenic commercial products. Need to move from containment & treatment to social intervention
Global, not local, problems such as spread of antibiotic-resistant bacteria
Pressure from industrialized nations to emphasize chronic diseases rather than infectious diseases
Realization that government actions influence the basic human right of health
Worldwide pandemics such as human immunodeficiency virus (HIV) and swine
Which statements best describe a notable change of the Omnibus Budget Reconciliation Act? (Select all that apply.)
Legislated a funding increase for RN staffing
Changed from process evaluation to outcome evaluation when evaluating care
Established guidelines for the use of restraints
Created health maintenance organizations nationwide
Added prescription drug benefits for Medicaid recipients
Which were among the outcomes of the 1979 report Healthy People: The Surgeon General’s Report on Health Promotion and Disease Prevention? (Select all that apply.)
A national committee was established to have hearings and study the problem
further.
Increased funds were allocated for health planning and health care.
Many of the recommendations were adopted on the federal level.
The Health Objectives Planning Act of 1990 was passed.
The federal government began to identify and monitor national health care goals.
Which critical issues in health care were addressed by The Health Insurance Portability and Accountability Act (HIPAA) of 1996? (Select all that apply.)
Portability of insurance coverage
COBRA, maintaining coverage for those who lose their jobs
Insurance companies having a total monopoly in a certain geographic area
Insurance companies setting limits on coverage of longer than 12 months
Insurance companies charging seriously ill persons more than healthy persons
Which actions represent a shift in philosophy at the Centers for Disease Control and Prevention (CDC)? (Select all that apply.)
Collecting and analyzing health data & allocating resources to treat specific diseases
Improving health security around the world
Strengthening public health
Creating transaction-based relationships
Preventing the leading causes of injury and illness
Which best describes the principal factor behind ongoing legislation on the federal level related to health care?
Change is needed to reflect differences in health needs today.
Efforts must be put in place to control constantly increasing costs.
There is a need to focus on the population as a whole.
Technological breakthroughs should be expanded.
Which best describes the most common organization for receiving personal health care in the United States today?
A group of physicians all in a particular specialty group who share an office
Community health center that includes educational and social services
Fee for service by a physician in practice by himself or herself
Managed care organization with capitated payments to providers, both professionals and organizations
Which best describes how voluntary health agencies fit into the overall health care system?
They fill in the gaps between services offered by private and public health systems.
They primarily serve as sources of financial aid for the underserved.
They supplement the effort of the public health care system.
They support research, education, and services for particular groups of patients.
Which level of government primarily establishes regulations and provides funding for health care?
Federal government
Local health departments
Regional health districts
State health departments
Which federal agency is responsible for administering most of the federal health-related activities?
Centers for Disease Control and Prevention (CDC)
Department of Health and Human Services (HHS)
Health Resources and Services Administration (HRSA)
National Institutes of Health (NIH)
Which federal agency is responsible for the Women, Infants, and Children (WIC) program, food stamps, and school-based nutrition programs?
Aid to Dependent Children Department
Department of Agriculture
Department of Education
Department of Health and Human Services
Which best describes the approach to health care used by states?
Federal funding encourages experimentation in creating new programs.
Insurance regulations concerning reimbursement cross state lines.
Information about successful programs is known to legislators.
States frequently develop new programs as federal funds become available to pay for them.
Which has led to the more recent focus on cooperation between the state and the federal level in relation to public health?
The emphasis of Healthy People 2020
The ongoing continued restriction of financial resources
The new presidential administration’s goals
The threat of bioterrorism
Which health care provider organization is seeing an increase in the demand for their services?
Physician practice
Hospice service
Hospitals
Long-term care facilities
Which advanced nurse does not have advanced education in a clinical specialty?
Clinical nurse leader
Clinical nurse specialist
Nurse midwife
Nurse practitioner
Which best describes the effect of President Clinton’s Advisory Commission on Consumer Protection and Quality in the Health Care Industry report (1999)?
Created improvement in both physician and nurse educational programs
Demonstrated the incredible influence on health care made by the insurance
industry
Increased national interest in improving health care and seeking reform
Stimulated the Institute of Medicine to explore quality in more depth
Which best describes one of the current goals for the HHS?
Mandate minimum nurse to patient staffing ratios
Decrease medical malpractice claims
Monitor for health care fraud and abuse
Advance scientific knowledge and innovation
Who primarily provides care for military personnel, their families, and veterans, as well as Native Americans?
Federal government
Local health departments
Regional health districts
State health departments
Which accurately describes the impact that the ACA had on expanding Medicaid?
There was no impact as Medicaid is funded by state governments.
Each state determined if they would accept the federal expansion of Medicaid.
Program enrollment decreased as less money was invested in Medicaid.
The cases of fraud and abuse within the Medicaid system rose.
Which statement best describes the significance of the Health Plan Effectiveness Data and Information Set (HEDIS)?
Data are publicized so consumers can make informed decisions about where to go
for care.
Data are used to measure performance in the accreditation of managed care organizations (MCOs).
Obvious improvement in the provision of health care has resulted from requiring
health care providers to collect and analyze such data.
Physicians and other health care providers can publicize the data to market their
services to new clients.
Which statement about the Agency for Healthcare Research and Quality (AHRQ) is accurate?
The AHRQ provides funding for medical and nursing research studies.
The AHRQ implements strategies to eliminate health disparities across the country.
The AHRQ works to improve the safety of the health care system by publishing clinical guidelines.
The AHRQ is a division of the Institute of Medicine.
Which report states that nurses should practice to the full extent of their education and training?
Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care
Keeping Patients Safe: Transforming the Work Environment
Priority Areas for National Action
The Future of Nursing
Which best describes a health disparity that exists in the United States?
Caucasians have higher rates of mortality than minority groups.
Caucasians have increased access to see specialist physicians.
Minority groups have increased access to government insurance options.
Minority groups have a higher prevalence of chronic conditions than Caucasians.
Which functions are responsibilities of the states? (Select all that apply.)
Delegating power to localities and holding them accountable for results
Creating managed health organizations to decrease state health care costs & Establishing and managing local health departments
Licensure of professional health care providers
Overseeing all insurance programs
Providing access to necessary health services
Which activities would be a responsibility of local health departments? (Select all that apply.)
Ensuring quality of nursing education programs
Determining the safety of residents’ wells
Establishing requirements for professionals to maintain their licensure
Providing free health screenings and health education programs on proper nutrition
Inspecting restaurants
Which best describes how complementary and alternative therapies differ from traditional health care? (Select all that apply.)
Alternative therapies have been documented as ineffective. Alternative therapies lack any research related to their effectiveness.
Complementary medicine is expanding because of paid media coverage.
Nurses rarely are involved in complementary or alternative therapies.
Providers vary in training and licensure.
Reimbursement is often unavailable.
Which would be offered as part of the community health services of a local health department? (Select all that apply.)
Immunization programs
Food inspection programs and Community-based mental health programs
Health promotion education
School-based clinics
Maternal-child programs
Which would most likely be found in a patients’ bill of rights? (Select all that apply.)
A statement about guaranteeing confidentiality
A statement about how to create a living will and a statement about who will be the payer of the services provided
A statement about who has access to the client’s medical information
A statement about completing the patient satisfaction survey
A statement about patient autonomy when making decisions
Which describes why a health care agency would want to achieve accreditation? (Select all that apply.)
Accreditation assesses the quality of services and care of the organization.
Accreditation requires achievement of certain minimum standards.
Accreditation instills public confidence in the health care agency.
Accreditation is necessary in order to be reimbursed for services provided.
Accreditation provides a means for an organization to get outcomes data.
Which is the best definition of economics?
Assets that can be traded for different assets
Income and outgo of monies
Science of allocation of resources
Study of goods, services, talents, and transportation
A client living in the 1920s received health care services. Which would have been the most likely form of payment?
Patients paid out of their pockets for whatever care the provider charged.
Public health employees gave care to those who needed it.
There was little health care to be had, regardless of a person’s wealth.
Workers who belonged to a union had their bills paid by insurance.
Which statement best describes what happened to health care providers during the Great Depression?
The amount of charity care greatly increased.
Both hospitals and physicians went bankrupt.
Government funding was legislated to assist those in need.
Public health greatly expanded to care for those in need.
Why did employers decide to offer health insurance as an employee benefit?
Hospitals and physicians quit offering charity care to those who could not pay.
Society was focused on not having to pay for doctor visits and other needed health benefits.
Teachers were role models for unions to demand insurance as a benefit.
To obtain and retain the limited number of persons available to work when government rules prohibited raising wages, insurance was offered.
Which best describes a flaw of indemnity plans?
Blue Cross and Blue Shield had a great idea, but they went bankrupt.
Cost sharing was expected of Blue Cross and Blue Shield enrollees.
Enrollees could not choose their provider or manage their own care.
Plans lacked any incentives to contain costs.
Which best describes the first government step in trying to stop constantly rising costs?
Insurance companies were told to cease adding new members to their plan.
Payment reimbursement was based on diagnosis and client characteristics rather than on treatment given.
Physicians were limited to a maximum amount that would be paid for any
particular service.
Reimbursement was based on prospective payment, that is, in advance of
admittance for care.
Which statement best describes the message that public health leaders are trying to emphasize to the public?
Assume responsibility for your own health by choosing healthy behaviors
Have a primary physician and get yearly checkups
Obtain immunizations and screenings when they are offered
Support legislative efforts to improve our medical care system
Which action would be the least expensive approach to treating chronic diseases?
Choose healthy lifestyle behaviors to retain health
Continue media campaigns encouraging early detection and treatment
Encourage patients to seek care at a local neighborhood health clinic
Suggest self-therapies that have been demonstrated to be effective
Which best describes how having health insurance has affected lifestyle behaviors?
Health promotion disease prevention programs are attended because they are reimbursable.
Health education is widespread because insurance companies promote such
education.
Medications and medical treatment are relied on for cure.
Screening is widespread because of insurance sponsorship.
Which best describes why so many Americans continue to engage in unhealthy behaviors?
Americans are not knowledgeable on how to change their behavior.
Americans believe that most illnesses can be cured with insurance footing the bill.
Health is not a concern to most Americans.
Most Americans do not know which behaviors are unhealthy.
Which conclusion can be drawn from reviewing how health care costs are spread over a person’s lifetime?
Health care expenditures increase with age.
Premature newborns incur more costs than other children from birth through adulthood.
The majority of cost is incurred during middle age when chronic diseases strike.
Persons aged 85 years and above spend the most money on health care.
Which was a major change after Medicare began a prescription drug benefit?
Number of prescriptions ordered by physicians decreased
Medications increased without affecting patient care outcomes
U.S. expenditures on drugs approached the same level as that of other industrialized nations
Use of drugs and their cost immediately increased
Which best describes a current trend related to health care services?
Nonprofit organizations are assuming responsibilities for service from for-profit organizations.
Health care organizations are offering services low in cost and higher in reimbursement.
Ways to minimize reimbursement using current procedural terminology (CPT) codes have been created.
Postponing computerized medical record programs increases profitability.
Which action would help decrease the total health care costs in the United States?
Consolidate major health care facilities while expanding neighborhood primary
care clinics
Continue the move to computer-based medical records and other efficiencies in informatics
Decrease current fraud and abuse
Streamline and make more consistent all documents needed for third-party reimbursement
Which statement best describes a major event that occurred in the 1960s that affected health care?
The amount of charity care by health care providers greatly increased.
Hospitals began to voluntarily pay taxes to the communities where they were
located.
Legislation greatly expanded funds available to train physicians, nurses, and other health care providers.
The Social Security Act was amended to create Medicare and Medicaid legislation.
Which best describes how the federal government determines which projects are awarded special funding for health care?
Those that are consistent with societal priorities, such as Healthy People 2030
Those that are supported by legislators
Those that are written by health care organizations that have special needs
Those that are consistent with the state’s long-term health goals
Which best describes what happens when a health care organization receives federal funding for a special health care need?
Other groups see the project and write grants wanting similar projects in their geographic area.
Participants continue to demand the services, so local funding has to be readjusted
to continue the care.
esearch is done to demonstrate whether or not the intervention was successful
and should be replicated.
When funds cease, so does the health care; therefore, continuity is lacking.
Which best describes the health care services that are provided by philanthropic groups?
Direct care to patients with problems related to the group’s primary interest area
Legislative lobbying for increased funding for their special interests
Informational and research activities
Special services such as housing, transportation, or appearance aids
Which best describes what was done by large industrial giants to stop the constant increase in their costs for health insurance for their employees?
Assembled their own health care programs
Established health promotion programs that employees were required to attend
Signed only certain providers to give care at a reduced rate in exchange for so many new patients
Suggested that employees seek only the most necessary services
Which best describes what physicians did to compete with new competition from health maintenance organizations (HMOs)?
Accepted employment directly under the insurance company
Organized preferred provider organizations (PPOs) to negotiate with insurance companies
Created private practices with colleagues within hospital medical complexes
Decided to strike and refused to work in the new HMOs
Which best describes how the government was successful at containing costs?
The original legislation for Medicare and Medicaid had built-in cost controls.
Certificate-of-need requirements restricted provider overtreatment.
Utilization review determined appropriateness of care.
Prospective payments were based on diagnosis-related groups (DRGs).
Peer standard review organizations were effective watchdogs.
Which best describes how hospitals initially coped when Medicare reimbursement became based on diagnosis-related groups (DRGs)?
Charged more for patients whose care was paid by insurance
Decreased nursing staff to cut labor costs
Lobbied politicians to increase Medicare reimbursement to reflect actual costs
Refused to accept Medicare patients
Which statement best summarizes all of the changes resulting from attempts to control costs?
Conflict between providers, patients, employer, and insurance plans raged.
Costs were controlled, at least temporarily.
Demand for health care drastically dropped.
Most employers discontinued their insurance plans for employees.
Which best describes how providers can legally improve their profit under the current reimbursement process?
Accept more patients and work more hours so former high income is retained
Order the cheapest generic medications and treatments possible
Convince patients that they do not want expensive treatments
Practice conservatively to earn an incentive payment
Which best describes why large employers would decide to self-insure?
To claim to offer more benefits to employees
To have more control over health care providers
To be more effective at keeping employees happy
To reduce administrative costs charged by insurance companies
When was the idea of national health care insurance first debated in the United States?
Clinton’s 1992 presidential campaign as he attempted to achieve such a plan
During President Johnson’s administration when Medicare and Medicaid were instituted in the 1960s
President Franklin Roosevelt’s attempt to include health insurance in Social Security legislation in the 1930s
President Theodore Roosevelt advocated such national medical coverage in 1916
Which statement best describes why nurses should be knowledgeable about health care funding?
To be able to be an effective employee for insurance companies
To be knowledgeable when media asks for opinions on some new legislation
To better serve as patient advocates in policy making for funding that provides appropriate care for the greatest good
To know how to write nursing notes that reflect higher reimbursement possibilities
Which best describes a carve-out service?
A particular service that is offered only by a designated provider or group.
A particular procedure that receives limited reimbursement.
A particular treatment is not allowed within a particular diagnosis.
A particular prescription drug that is only available to those with certain conditions.
Which statements best describe what was unfortunate about the original private health insurance plans that were developed? (Select all that apply.)
Because providers were paid for any service they gave, it was economically advantageous for them to give as much care as possible.
Health care costs increased very rapidly.
Health education and health promotion interventions were not included in the idea
of health insurance.
Patients wanted any and all care that might help, regardless of how expensive it
was.
There was no limit on what care could be sought and given.
Which best describes the effects of Medicare and Medicaid? (Select all that apply.)
All persons who were temporarily disabled now receive free care & public health education was now financed.
A previously unseen rise in demand for services occurred.
Many persons previously without access now receive health care.
Medicare reimbursement rates became the standard for all insurance carriers.
Indemnity insurance plans were offered.
Which best describes what insurance companies did to decrease their constantly increasing costs? (Select all that apply.)
Did not cover any illnesses that were diagnosed before the person (or his or her
employer) purchased insurance
Limited coverage to only certain services, eliminating any that were experimental, nontraditional, or too costly
Reimbursed only the care that was requested by the patient’s primary physician
Required preapproval before expensive services were used
Ceased coverage on any person who used an exorbitant number of services,
whenever possible
Which best describes the strengths of the American health care system? (Select all that apply.)
Offering the availability and use of technological advances in equipment and procedures
Having the ability to overcome concerns regarding access and rationing & creating the best patient care outcomes
Providing the highest quality of life among any industrialized nation
Having the lowest maternal and infant mortality rate among industrialized nations
Leading the world in laboratory and clinical research
Who may receive benefits under Medicare? (Select all that apply.)
Federal employees and persons aged 55 to 65 years who have bought into the system
Those who are dependents of elderly grandparents, usually because their parents are in prison as a result of drug abuse
Persons with end-stage renal disease
Those over 65 years of age, if eligible for Social Security benefits
Those with permanent disabilities
Which best describes how eligibility for Medicaid services is determined? (Select all that apply.)
Anyone over age 65 years who is eligible for Social Security benefits may apply
for Medicaid.
Baseline eligibility is established by the federal government, but states may be
more lenient.
Children in low-income families may be eligible for free care.
Eligibility depends on family size and total family income.
Federal government establishes eligibility and gives funds to the states in reimbursement for this care.
Which statements best describe an unfortunate consequence of using diagnosis-related groups (DRGs) to determine reimbursement? (Select all that apply.)
The incentive was to undertreat and underuse health resources.
Health care providers had to accept losses for each patient treated.
Insurance companies had to greatly increase their funding from employers & health care providers learned to cheat the system.
Health care providers refused to accept more patients whose reimbursement was based on DRGs.
High quality of care was no longer assured.
Which statement best describes the relationship between the environment and health?
Because of the large number of variables involved, the relationship between environment & health cannot be researched.
Because the environment has such long-term effects on health, research findings are not yet available.
Research shows that a healthy environment has limited impact on one’s health.
Research shows that a healthy environment increases quality of life and years of healthy living.
When using an environmental perspective, which would be the most important question for a nurse to ask when assessing potential health problems?
“Can you tell me how you have been feeling?”
“Can you tell me what you do at work?”
“What brings you here today?”
“What problems have you been having?”
How does critical theory differ from other nursing theories such as the Health Belief Model or Orem’s self-care deficit theory?
Critical theory can be used by professionals other than nurses.
Critical theory focuses on oppression and facilitates group action.
Critical theory is not directly related to health promotion.
Critical theory confronts changing an individual’s beliefs.
Which statement best describes why environmental health is more challenging than other variables related to an individual’s health?
Environmental health affects susceptible individuals more than groups.
Environmental health demands that individuals be willing to change their beliefs.
Environmental health is dependent on social neighborhoods, as well as geography.
Environmental health requires social, economic, and political changes to improve.
Which nursing action would be the most helpful to the community’s long-term health?
Careful assessment, diagnosis, planning, & giving care to individual patients &
their families
Dialogue with community members concerning what health issues are of
importance in that community
Focusing on family health through school-based neighborhood clinics
Helping the community create political change through organization, use of media, legislative lobbying, & mass demonstrations
Which best explains why it is difficult to get others interested in environmental health?
Environmental problems just are not interesting or dramatic.
It’s difficult to get media interested.
People respond more to an acute crisis than chronic environmental problems.
People respond more to an individual asking for help than a community asking for help.
What would be an appropriate term for intoxicated drivers, secondhand smoke, urban crowding, noise, and mechanization?
Risks of living style
Risks in the built environment
Personal health risks
Modern day health risks
What is meant by discriminatory land use?
Backlash against companies that do not protect the environment
Daily insults to people who live in a particular community
Locating industrial hazards in low-income communities
Political recognition that companies support a safe environment
t has been learned that a particular industry has vastly polluted the surrounding neighborhood. Which action would most likely be taken by those living in the neighborhood?
Band together to shut the industry down
Nothing, because of family ties and cost of relocation
mmediately move to a different neighborhood
Seek legal reimbursement for the hazard exposure
Which statement supports why it is believed that the risks of various employment positions are inaccurate?
Companies refuse to share employee injury information.
Because factories reimburse employees directly, the injury is not reported.
Individuals assume it is a personal problem, not an employment issue.
Most employment positions do not have known risks.
Why are health care providers concerned over such social issues as mass transit, clean power, and the farming industry?
Because air pollutants are contributors to asthma and other health problems.
Clean power would reduce the pollution that results from burning of high-sulfur coal.
Manure runoff from industrial farming is polluting water and killing fish throughout the United States.
Mass transit would remove the problem of so many Americans being killed or injured by drunken or impaired drivers.
Which statement best describes what has happened to air quality since the United States outlawed the use of chlorofluorocarbons, halons, and carbon tetrachloride?
Air quality immediately improved.
Air quality is slowly improving.
Little change occurred because these chemicals remain in the atmosphere.
Nothing has happened because other countries worldwide continue to extensively use these products.
Which is the leading cause of lung cancer among nonsmokers?
Secondhand smoke
Living near a nuclear power plant
Exposure to pesticides
Radon gas
Which best describes a food desert?
The inability to store foods at an acceptable temperature
The inability to have healthy foods at home
A neighborhood with little to no access to healthy foods
A neighborhood that has experienced a recent food-borne illness
Which issue exists from communities using solid waste landfills to dispose of trash from private residences?
Landfills are too wasteful, as solid waste can be burned to produce energy.
Methane gas may move through the soil to cause fire or explosions nearby.
There is an ongoing need to purchase more land as landfills eventually fill up.
People do not use landfills but dump their garbage anywhere they will not be seen.
Which is a direct result of global warming?
Decreased prevalence of infectious diseases
Increased water pollution from soil erosion
Decreased protection from the ozone layer
Increased number of parasites and insects
Which conclusion can be drawn concerning efforts to decrease environmental pollution?
The Environmental Protection Agency (EPA) sets priorities for environmental
problems and funds action.
Federal policies have been weakened, and enforcement lacks funding.
Federal recycling mandates have decreased waste products.
Legislation is increasingly being passed to force companies to lower toxic waste emissions.
In a community presentation about asthma, a nurse explained the causes of asthma in children, how to observe for “triggers” that lead to an attack, and how to use an inhaler. Which statement best identifies what was omitted from this presentation?
The nurse did not ask the attendees to disclose if any of them smoke around children.
The nurse did not address actions that should be taken to improve air quality and only focused on the treatment of asthma.
The nurse did not address the need to avoid exposure to others who may have a communicable disease.
The nurse did not review the genetic components related to asthma in families.
The local stream was full of trash. The Boy Scouts had a cleanup day so they could again canoe on the stream. Which action should be taken by nurses in the local community?
Hold a dialogue with community members about the problem and its effects
Fight for stronger “do not trash” laws and harsher penalties
Lecture community organizations about the value of safe water for recreation
Put all personal trash in appropriate trash receptacles
Which action should be taken by a small community group who hopes to accomplish goals against a large powerful corporation?
Appeal to the chief executive officer’s conscience
Ask the corporation’s employees to encourage change
Begin legal action to force the corporation to change
Form coalitions with other groups that have similar goals
How does participatory action research differ from other research methods?
Participatory action research does not use a control group.
Participatory action research does not require randomization.
Participatory action research is not based on a predetermined hypothesis.
Participatory action research poses solutions to the problem.
Which strategy should a nurse use to remember what should be included in a health history?
Always use a preprinted form
Depend on education to learn this
Depend on experience to know what to ask
Memorize the I PREPARE mnemonic
Which describe a problem with the U.S. water quality today? (Select all that apply.)
Many aquifers are contaminated with pesticides and fertilizers.
More than 45 million Americans drink untreated water
Sediment from construction, agriculture, and deforestation is often present.
Underground water, if contaminated, cannot be cleansed.
Water-related diseases (cholera, typhoid, dysentery) frequently occur.
Which have been identified as part of the core environmental health competencies? (Select all that apply.)
Assessment
Policy development
Management
Advocacy
Communication
