Health Care Policy Practice Questions

Health Care Policy Practice Questions When describing a Medigap policy to an older adult patient, which statement by the nurse is most accurate? "Medigap is a government policy that pays some of your medical bills. Medigap is purchased by you privately to cover costs not covered by Medicare." "Medicare is a government policy that pays some of your medical bills. Medicaid is purchased by you privately to cover costs not covered by Medicare." "Medicare is a government policy that pays some of your medical bills. A Medigap policy is purchased by you privately to cover costs not covered by Medicare." "Medicaid is a government policy that pays some of your medical bills. Medicare is purchased by you privately to cover costs not covered by Medicare." - Correct Answer "Medicare is a government policy that pays some of your medical bills. A Medigap policy is purchased by you privately to cover costs not covered by Medicare." Medicare is a government policy that pays some of the patient's medical bills. A Medigap policy is purchased by the patient privately to cover costs not covered by Medicare. It is private health insurance designed to supplement Medicare coverage. If a patient cannot afford to purchase a Medigap policy, they may qualify for Medicaid, a government program for those with low income. Which statement most accurately describes health policy? "Health policy ensures that healthcare organizations will achieve their goals." "Health policy refers to actions taken by populations that consist of individuals who are in need of change." "Health policy ensures that individuals will reach their health-related objectives." "Health policy includes governmental actions that affect patients' abilities to reach healthcare goals." - Correct Answer "Health policy includes governmental actions that affect patients' abilities to reach healthcare goals." Health policy refers to actions and choices by government bodies and professional organizations that affect the ability of healthcare organizations and individuals in the healthcare system to reach their healthcare goals. Health policy does not guarantee achievement of goals and objectives. Which agency is responsible for administering a law once it has passed? The president An executive branch agency of the federal or state government A judicial branch agency of the federal or state government The federal or state senate - Correct Answer An executive branch agency of the federal or state government Once a law has been passed, the executive branch of the federal or state government is responsible for administering it. The judicial branch has the responsibility for enforcing a law. No one role is responsible for administering a law. The nurse has just been hired at a home care agency and is asked to choose an insurance plan. The nurse selects a consumer-driven healthcare plan (CDHP). Which statement describes this plan? Insurance designed to supplement Medicare coverage Employer-sponsored coverage that combines a private insurance plan with a health savings account (HSA) or health reimbursement account (HRA) An insurance plan that limits coverage to healthcare providers who contract with that specific health maintenance organization (HMO) A hybrid of a point-of-service (PPO) and a health maintenance organization (HMO) - Correct Answer Employer-sponsored coverage that combines a private insurance plan with a health savings account (HSA) or health reimbursement account (HRA) The CDHP is a type of employer-sponsored coverage that combines a private insurance plan with a health savings account (HSA) or health reimbursement account (HRA). A Medigap policy is private insurance designed to supplement Medicare. A health maintenance organization (HMO) is an insurance plan that limits coverage to healthcare providers who contract with that specific HMO. A point-of-service plan is a hybrid of a preferred provider organization (PPO) and an HMO. A graduate nurse is applying for licensure. Which agency will issue the nursing license? State agency County agency Local agency Federal agency - Correct Answer State agency State health agencies enforce regulations and may license healthcare facilities such as hospitals and long-term care facilities, as well as the state healthcare providers. Healthcare professionals are not licensed at a local, federal, or county level. A nurse is transferring from a county to a city health department. Which is a responsibility of a city health department? Waste disposal Retail food establishment safety Sanitation Sexual health - Correct Answer Sexual health City health departments may provide clinical, environmental, health promotion, and population-based services such as free clinics, sexual health, HIV/AIDS testing, and TB and dental clinics. County health departments are responsible for sanitation, retail food establishments, and waste disposal. The nurse is giving a presentation on the role and functions of specialty nursing practice organizations to a group of colleagues. Which statement is accurate for the nurse to include in the presentation regarding these organizations? "Specialty nursing practice organizations advance nursing practice in the affiliated specialty area." "Responsibilities of specialty nursing practice organizations include strengthening members' personal identities." "Examples of specialty nursing practice organizations include the American Nurses Association (ANA)." "A small number of nursing specialties are supported by a professional specialty practice organization." - Correct Answer "Specialty nursing practice organizations advance nursing practice in the affiliated specialty area." Most nursing specialties are supported by a professional specialty practice organization. These organizations advance nursing practice in the affiliated specialty area and support practitioners and their patients. Responsibilities of specialty nursing practice organizations include strengthening members' professional identities. As opposed to being a specialty practice organization, the American Nurses Association (ANA) is the only full-service professional organization representing the nation's 3.1 million registered nurses. Which agency accredits all types of nursing education programs? The Accreditation Commission for Education in Nursing (ACEN) The Association of Specialized and Professional Accreditors (ASPA) The Commission on Collegiate Nursing Education (CCNE) The Commission for Nursing Education Accreditation (CNEA) - Correct Answer The Accreditation Commission for Education in Nursing (ACEN) The ACEN accredits all types of nursing education programs (clinical doctorate, master's degree, baccalaureate degree, associate degree, diploma, and practical nursing education programs). The CCNE accredits baccalaureate and graduate education programs. The CNEA issues standards for nursing programs. The ASPA maintains a Code of Good Practice for Accrediting Bodies. Which is the role of The Joint Commission in the creation of health policy? Oversees emergency services Leads infection prevention Influences the national quality and safety standards Monitors mortality and morbidity rates - Correct Answer Influences the national quality and safety standards The Joint Commission is an independent, nongovernmental organization whose work significantly influences national quality and safety standards and the advancement of healthcare policy. The Centers for Disease Control and Prevention maintains information regarding mortality and morbidity rates, and also leads infection prevention in the United States. Local agencies oversee emergency services. A 40-year-old patient with diabetes who is married and self-employed is searching for a new insurance plan. Which consideration about the different types of healthcare plans is most relevant to this patient? Individuals who are self-employed and have chronic health conditions may find it difficult to purchase health insurance through private insurers. A Medigap policy is private health insurance designed to supplement Medicare coverage. Benefits of group health insurance may include lower premium costs and better coverage for eligible employees and their families. Self-employment-based health insurance coverage is available to self-employed individuals as well as their spouses/domestic partners and dependents. - Correct Answer Individuals who are self-employed and have chronic health conditions may find it difficult to purchase health insurance through private insurers. Individuals who are self-employed and have chronic health conditions often experience difficulty trying to purchase health insurance through private insurers. A patient who is self-employed would not be eligible for group insurance (employment-sponsored insurance [ESI]), which is offered through one's employer or union. Self-employment-based health insurance coverage is available only to individuals who are self-employed, and only the policyholder is covered by the plan. A Medigap policy would only be appropriate for people age 65 or older who have worked in a Medicare-covered employment setting, younger people with disabilities, and people with end-stage renal disease or amyotrophic lateral sclerosis (ALS). The nurse is preparing a presentation about Supplemental Security Income (SSI). Which statement regarding how SSI differs from Medicaid should the nurse include? SSI is a federal program for blind and disabled persons to help pay for medical expenses. SSI is a federal and state program for aged, blind, and disabled persons to help pay basic needs such as food, clothing, and housing. SSI is a federal and state program for lower income people to help pay for basic needs such as food and housing. SSI is a state program for older adult patients that pays for their medical expenses. - Correct Answer SSI is a federal and state program for aged, blind, and disabled persons to help pay basic needs such as food, clothing, and housing. Supplemental Social Security Income (SSI) is a federal and state public assistance program designed to help the aged, blind, and disabled people with basic needs such as food, clothing, and housing. Medicaid is state funding to pay for medical expenses available to certain low-income individuals and families, older adult patients, and people with disabilities. Welfare, not SSI, helps low-income people with public assistance. The nurse leader is planning an in-service about healthcare policies that have direct effects on the nation's health. Which content is appropriate for inclusion in the presentation? The Administration for Children and Families and the Administration on Aging are mainly responsible for addressing healthcare financing issues. The primary role of the Centers for Medicare and Medicaid Services (CMS) is to oversee services for individuals throughout the lifespan. The Centers for Disease Control and Prevention (CDC) is governed by the National Institutes of Health (NIH). The Food and Drug Administration (FDA) is governed by the U.S. Department of Health and Human Services (DHHS) - Correct Answer The Food and Drug Administration (FDA) is governed by the U.S. Department of Health and Human Services (DHHS) The U.S. Department of Health and Human Services (DHHS) governs more than 300 divisions and programs, including the following: the National Institutes of Health (NIH), which provides health research and other health-related information; the Centers for Medicare and Medicaid Services (CMS), which addresses healthcare financing issues; and the Administration for Children and Families and the Administration on Aging, which oversee services for individuals throughout the lifespan. Divisions governed by the DHHS also include the Food and Drug Administration (FDA) and the Centers for Disease Control and Prevention (CDC). Which is a reason for a private agency to develop health policy? To represent the interests of healthcare providers only To represent the interests of healthcare organizations To represent the interest of nurse executives To represent the interests of nurses only - Correct Answer To represent the interests of healthcare organizations Private agencies may also develop health policy. Policies generated by private associations representing the interests of healthcare organizations, health professions, or health professions education associations are not established in law or regulation. Although healthcare providers and nurses are represented in these associations, they are not the sole beneficiaries of this advocacy. The nurse is attending an orientation before starting work for the state health department. Over which department or organization does the state health department have jurisdiction? The Centers for Disease Control and Prevention (CDC) The National Institutes of Health (NIH) The Office of the Surgeon General Vital Statistics - Correct Answer Vital Statistics A state health department may have jurisdiction over local health departments, vital statistics, and sanitarians. The CDC, NIH, and Office of the Surgeon General are all federal agencies. Which nongovernmental organizations have an influence on health policy? Children's groups Banks Teachers Health professions associations - Correct Answer Health professions associations Public health policy is subject to influence by nongovernmental healthcare organizations, health professions associations, education accreditation agencies, and private citizens. Teachers, banks, and children's groups have no influence on health policy. The nurse wants to join a professional organization that represents individual nurses. Which organization should the nurse consider? Sigma Theta Tau International (STTI) The National League for Nursing (NLN) The American Nurses Association (ANA) The National Student Nurses Association (NSNA) - Correct Answer Sigma Theta Tau International (STTI) The American Nurses Association represents registered nurses nationwide. The National League for Nursing's membership consists of nursing education programs, nursing faculty, and leaders in nursing education. Sigma Theta Tau membership is by invitation only. The National Student Nurses Association is for student nurses. The community health nurse is designing a presentation about societal factors that influence health policy. Which statement should the nurse include in the presentation? Considerations include whether or not current policy benefits meets the population's needs. Level of support for the proposed policy is not an influencing factor. Population-specific needs are too complex to be taken into consideration. Population size does not influence the development of health policy. - Correct Answer Considerations include whether or not current policy benefits meets the population's needs. Societal factors that influence health policy include population size, population-specific needs, degree to which current policy benefits the population's needs, and level of support for the proposed policy. For which reason does the American Nurses Association (ANA) write issue briefs? To express the association's opinion on how federal or state laws or proposed federal rules affect nurses and patients To revoke laws To express the association's opinion on how nurses fit into the regulatory landscape To express the association's opinion on how nurses feel about proposed federal rules - Correct Answer To express the association's opinion on how federal or state laws or proposed federal rules affect nurses and patients The ANA writes briefs to express the association's opinion on how federal or state laws or proposed federal rules affect nurses and patients. Additionally, they write position statements on specific issues related to bloodborne pathogens, consumer advocacy, drug and alcohol abuse, environmental health, and ethics and human rights. Which statement describes the mission of the International Council of Nurses (ICN)? The ICN provides legal assistance for nurses. The ICN advocates for nurses worldwide. The ICN provides a code of conduct for nurses, advancing the profession and influencing health policy. The ICN represents nursing worldwide, advancing the profession and influencing health policy. - Correct Answer The ICN represents nursing worldwide, advancing the profession and influencing health policy. The International Council of Nurses (ICN), which represents more than 16 million nurses worldwide, is the world's oldest organization for health professionals. It is a federation of more than 130 national nurses' associations with the mission to "represent nursing worldwide, advancing the profession and influencing health policy". The nurse should recognize that which action is an example of continuous analysis and evaluation of results related to health policy? Reviewing evidence indicating whether or not the policy effectively benefits the people it was intended to serve Health professions raising awareness about the impact of a particular healthcare law and lobbying for a new policy Legislators or leaders in executive-branch health agencies committing to solve a problem Regulations describing how the executive-branch agency will carry out healthcare law - Correct Answer Reviewing evidence indicating whether or not the policy effectively benefits the people it was intended to serve The four major stages in policymaking are agenda setting, government response, implementation, and evaluation. In each stage, formal and informal relationships develop between stakeholders both inside and outside of government. Reviewing evidence to support the efficacy of the policy constitutes evaluation. Legislators or leaders in executive-branch health agencies committing to solving a problem represents government response. Creation of regulations to describe how an executive-branch agency will carry out a healthcare law constitutes implementation. An association of health professions raising awareness about the impact of a particular healthcare law and lobbying for a new policy constitutes agenda setting. A home health nurse is caring for a patient who requires an appointment with a specialty provider. The patient's health insurance is an employer-provided health maintenance organization (HMO). Based on the patient's insurance, which is the first step for the nurse to take to ensure that this patient is seen by the specialist? Discussing the patient's options with the insurance company Calling the specialist directly to make an appointment Calling the primary healthcare provider for a referral to the specialist Discussing the patient's options with the case manager - Correct Answer Calling the primary healthcare provider for a referral to the specialist Health maintenance organization (HMO) participants must choose a primary care provider (PCP). The PCP serves as the gatekeeper to care, referring the patient to in-network hospitals and specialists when needed. Therefore, the nurse would need to call the PCP to get a referral for the specialist in order for the visit to be covered under the patient's insurance policy. The case manager would not be involved in this process. Because the nurse knows that the patient has an HMO, it is not necessary to call the insurance company regarding the patient's options. The nurse case manager is reviewing Medicare coverage rules with a patient. Which patient statement indicates correct understanding of the teaching? "Prescription drug coverage is available through Medicare." "Medicare covers the cost of hearing aids." "Medicare covers my routine dental care." "Medicare covers the costs of long-term care." - Correct Answer "Prescription drug coverage is available through Medicare." Medicare Part D offers prescription drug coverage. Services that are not covered by Medicare include long-term care, routine dental care, and hearing aids and the exams for fitting them. Which is the only international health agency with legal authority? Project Hope Private voluntary organizations (PVOs) The United Nations (UN) The World Health Organization (WHO) - Correct Answer The World Health Organization (WHO) The premier international health organization is the World Health Organization (WHO), which is an intergovernmental agency related to the UN and the only international health organization with legal authority. Project Hope provides essential medicine and supplies, volunteers, medical training, and disaster response. Nongovernmental agencies such as PVOs are independent of any government. A nurse is working for a local health department in the child care center sanitation program. On which heath-promotion programs should the nurse be expected to work? Poison control Bicycle safety Infant car seats Hand sanitation - Correct Answer Hand sanitation Proper hand sanitation in the child care setting is an important task to prevent the spread of infection. In the child care setting, car seats, bicycle helmets, and poison control are important issues, but they do not directly relate to sanitation. The nurse researcher is preparing a webinar about the history of nursing research. Which statement should be included? "Membership in the National League for Nursing is by invitation only to baccalaureate and graduate nursing students." "Membership in the American Association of Colleges of Nursing is by invitation only to baccalaureate and graduate nursing students." "Membership in Sigma Theta Tau International is by invitation only to baccalaureate and graduate nursing students." "Membership in the American Nurses Association is by invitation only to baccalaureate and graduate nursing students." - Correct Answer "Membership in Sigma Theta Tau International is by invitation only to baccalaureate and graduate nursing students." Sigma Theta Tau International (STTI) is the second largest nursing organization in the United States. Membership is by invitation to baccalaureate and graduate nursing students who demonstrate excellence in scholarship and to nurse leaders who exhibit exceptional achievements in nursing. The National League for Nursing, the American Nurses Association, and the American Association of Colleges of Nursing do not invite their members to join. The staff nurse asks the nursing supervisor, "Which regulatory agency requires hospitals to have personal protective equipment (PPE) ready for us to use when we need it?" Which response is correct? "The National Institutes of Health" "The Agency for Healthcare Research and Quality" "The Centers for Disease Control and Prevention" "The Occupational Safety and Health Administration." - Correct Answer "The Occupational Safety and Health Administration." Part of the mission of the Occupational Safety and Health Administration (OSHA) is to help employers fulfill their responsibilities to their employees related to creating safe, healthful workplace environments, and reducing or eliminating workplace hazards. OSHA standards include ensuring that employees have and use personal protective equipment (PPE) when required for safety and health. Research conducted or evaluated by the National Institutes of Health, the Agency for Healthcare Research and Quality, and the Centers for Disease Control and Prevention may inform OSHA regulations and standards, but these agencies do not oversee health and safety in workplace environments.