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Page 1 of 165 Agenda Comparison Grid & Fact Sheet / Talking Points Brief Assignment (Part 1 & 2) | Walden University | Health Policy and Advocacy Question 1 According to John Kingdon's Multiple Streams Framework, the three streams that must converge for a policy to reach the government agenda are: A) Problem, Policy, and Politics B) Budget, Personnel, and Operations C) Research, Evidence, and Evaluation D) House, Senate, and President E) Local, State, and Federal Correct Answer: A Page 2 of 165 Rationale: Kingdon's model: Problem stream (recognition of issue), Policy stream (solutions/alternatives), Politics stream (political will). Convergence creates a policy window. Question 2 Scenario: A nurse advocate notices that a rise in opioid overdoses has received media attention, a new evidence-based prescribing guideline has been published, and a senator has announced support for funding addiction treatment. According to Kingdon, this represents: A) A policy window B) A political stalemate C) A problem without solution D) A failed agenda E) A disregard for evidence Correct Answer: A Page 4 of 165 Question 4 The "problem stream" in Kingdon's framework includes: A) Indicators, focusing events, and feedback about existing programs B) Proposed legislation C) Election results D) Interest group lobbying E) Budget allocations Correct Answer: A Rationale: Problem stream: data indicators (e.g., rising mortality), focusing events (crises), and feedback from current programs. Page 5 of 165 Question 5 Which of the following is an example of a "focusing event" that can propel a health issue onto the policy agenda? A) A routine annual report B) A mass shooting or infectious disease outbreak C) A minor administrative change D) A regular budget hearing E) A staff meeting Correct Answer: B Rationale: Focusing events are sudden, harmful events that draw public and political attention (e.g., COVID-19, opioid crisis, school shootings). Question 6 Scenario: A new drug with life-threatening side effects has been linked to several deaths. The FDA has known for a year but Page 7 of 165 A) A literal window in a legislator's office B) A brief opportunity for advocates to push their solutions when streams converge C) A permanent opening for any policy D) A window of time when budgets are approved E) A physical location for policy meetings Correct Answer: B Rationale: Policy window is a temporary opportunity for action, often when problem, policy, and politics align. Question 8 Which of the following is a key component of the "politics stream"? A) Feasible technical solutions B) National mood, election results, partisan balance, interest group campaigns Page 8 of 165 C) Statistical data on problem magnitude D) Program evaluation results E) Clinical trial outcomes Correct Answer: B Rationale: Politics stream includes public opinion, electoral shifts, power dynamics, and advocacy group influence. Question 9 In agenda setting, "venue shopping" means: A) Choosing a restaurant for lunch B) Advocates selecting the most favorable government body or jurisdiction to hear their issue C) Avoiding all government venues D) Shopping for policy textbooks E) Renting a conference room Page 10 of 165 Rationale: Presenting to multiple committees increases chances of favorable hearing — venue shopping. Question 11 The concept of "policy subsystem" refers to: A) A computer system for policy tracking B) The network of actors (agencies, interest groups, experts) involved in a specific policy area C) A subordinate policy D) A failed policy E) A personal opinion Correct Answer: B Rationale: Policy subsystems (or iron triangles, issue networks) include legislators, bureaucrats, advocates, and experts. Page 11 of 165 Question 12 Which of the following is a characteristic of the "punctuated equilibrium" theory of agenda setting? A) Policy changes only slowly and steadily B) Long periods of stability interrupted by sudden, dramatic policy shifts C) Policy never changes D) Only incremental changes occur E) Random changes without pattern Correct Answer: B Rationale: Punctuated equilibrium: policy remains stable for long periods, then rapid change when attention shifts. Question 13 A "policy entrepreneur" in the problem stream might use which strategy? Page 13 of 165 D) Interest group funding E) Lobbyist registration Correct Answer: A Rationale: Policy stream involves development and refinement of potential solutions by experts and analysts. Question 15 Scenario: A health policy advocate wants to propose a new funding mechanism for community health centers. Before the policy window opens, she meets with policy analysts to develop a detailed white paper. This work occurs in the: A) Problem stream B) Policy stream C) Politics stream D) Implementation stream E) Evaluation stream Page 14 of 165 Correct Answer: B Rationale: Developing specific solutions (white paper) is policy stream work. Question 16 Which of the following is NOT a factor in the politics stream? A) National mood B) Changes in administration C) Partisan composition of legislature D) Efficacy of a clinical treatment (that's policy stream) E) Interest group mobilization Correct Answer: D Rationale: Clinical efficacy belongs to policy stream (solutions). Politics stream is about power, elections, public sentiment. Page 16 of 165 A) The problem is resolved B) Political attention shifts to another issue or the political landscape changes C) Advocates stop working D) A law is passed E) Budgets are approved Correct Answer: B Rationale: Windows close when streams diverge — e.g., new election, crisis fades, or solution no longer feasible. Question 19 Scenario: After a mass casualty shooting, gun control advocates push for legislation, but the legislature is controlled by opponents of gun control. According to Kingdon, the politics stream is: A) Favorable B) Unfavorable (blocked) Page 17 of 165 C) Irrelevant D) Fully open E) The only stream that matters Correct Answer: B Rationale: Even with problem (shooting) and policy (proposals), unfavorable political composition prevents convergence. Question 20 The "garbage can model" of agenda setting suggests that: A) All policies are garbage B) Problems, solutions, and decision-makers randomly mix; solutions may seek problems C) Only experts decide D) Public opinion is irrelevant E) Policies are always rational Page 19 of 165 Rationale: Crises (focusing events) or major political shifts (new president, majority change) open windows. Question 22 Which of the following is an example of "indicators" in the problem stream? A) A senator's speech B) Rising infant mortality rates C) A lobbyist's donation D) A think tank report E) A campaign advertisement Correct Answer: B Rationale: Indicators are measurable data showing problem magnitude (e.g., mortality rates, survey results). Page 20 of 165 Question 23 "Feedback" in the problem stream refers to: A) Comments on a draft bill B) Information from existing programs about their performance or unintended consequences C) Election results D) Poll results E) Media reactions Correct Answer: B Rationale: Feedback from current policies can reveal problems needing attention (e.g., Medicare cost overruns). Question 24 Scenario: A nurse policy advocate wants to put nurse staffing on the state legislative agenda. She identifies that a recent hospital- acquired complication rate has increased (indicator), a state 
