Chapter 1. Nursing Past & Present

MULTIPLE CHOICE

	1.	Which is the most influential factor that has shaped the nursing profession?
1)	Physicians’ need for handmaidens	
2)	Societal need for healthcare outside the home	
3)	Military demand for nurses in the field	
4)	Germ theory influence on sanitation	

ANS:	3
Chapter number and title: 1, Nursing Past & Present
Chapter learning objective: Define nursing in your own words.
Chapter page reference: p. 7
Heading: Historical Context of Nursing 
Integrated Processes: Teaching and Learning 
Client Need: Safe and Effective Care Environment: Management of Care  
Cognitive level: Comprehension [Understanding]
Concept: Professionalism 
Difficulty: Easy

	Feedback	
1	The physician's handmaiden was/is a nursing stereotype rather than an influence on nursing. 	
2	Although there has been a need for healthcare outside the home throughout history, this has more influence on the development of hospitals than on nursing; this need provided one more setting for nursing work.	
3	Throughout the centuries, stability of the government has been related to the success of the military to protect or extend its domain. As the survival and well-being of soldiers are both critical, nurses provided healthcare to the sick and injured at the battle site.	
4	Germ theory and sanitation helped to improve healthcare but did not shape nursing.	

PTS:	1	CON:	Professionalism	

	2.	Which is an example of an illness-prevention activity?
1)	Encouraging the use of a food diary	
2)	Joining a cancer support group	
3)	Administering immunization for HPV	
4)	Teaching a diabetic patient about his diet	

ANS:	3
Chapter number and title: 1, Nursing Past & Present
Chapter learning objective: Name and recognize the four purposes of nursing care.
Chapter page reference: p. 15
Heading: Nursing Practice: Caring for Clients 
Integrated Processes: Nursing Process – Implementation 
Client Need: Health Promotion and Maintenance 
Cognitive level: Application [Applying]
Concept: Health Promotion 
Difficulty: Moderate 
	Feedback	
1	Illness-prevention activities focus on avoiding a specific disease. A food diary is a health-promotion activity.	
2	Although cancer is a disease, it is assumed that a person joining a support group would already have the disease; therefore, this is not disease prevention but treatment.	
3	Administering immunization for HPV is an example of illness prevention. 	
4	Teaching a diabetic patient about diet is a treatment for diabetes; the patient already has diabetes, so it cannot prevent diabetes.	

PTS:	1	CON:	Health Promotion	

	3.	Which contribution of Florence Nightingale had an immediate impact on improving patients’ health?
1)	Providing a clean environment	
2)	Improving nursing education	
3)	Changing the delivery of care in hospitals	
4)	Establishing nursing as a distinct profession	

ANS:	1
Chapter number and title: 1, Nursing Past & Present
Chapter learning objective: Name nine expanded roles for nursing.
Chapter page reference: p. 9
Heading: Table 1-1 Roles and Functions of the Nurse 
Integrated Processes: Caring 
Client Need: Health Promotion and Maintenance 
Cognitive level: Comprehension [Understanding]
Concept: Evidence-Based Practice 
Difficulty: Easy 
	Feedback	
1	Improved sanitation (a clean environment) greatly and immediately reduced the rate of infection and mortality in hospitals. 	
2	This is an activity of Florence Nightingale that improved healthcare or nursing, but the impact is long range, not immediate.	
3	This is an activity of Florence Nightingale that improved healthcare or nursing, but the impact is long range, not immediate.	
4	This is an activity of Florence Nightingale that improved healthcare or nursing, but the impact is long range, not immediate.	

PTS:	1	CON:	Evidence-Based Practice

	4.	Which aspect of the full-spectrum nursing role is essential for the nurse to do in order to successfully carry out all the others?
1)	Thinking and reasoning about the client’s care	
2)	Providing hands-on client care	
3)	Carrying out physician orders	
4)	Delegating to assistive personnel	

ANS:	1
Chapter number and title: 1, Nursing Past & Present
Chapter learning objective: Name and recognize the four purposes of nursing care.
Chapter page reference: p. 8
Heading: Nursing Today: Full-Spectrum Nursing 
Integrated Processes: Nursing Process 
Client Need: Safe and Effective Care Environment: Management of Care 
Cognitive level: Analysis [Analyzing]
Concept: Patient-Centered Care 
Difficulty: Difficult 
	Feedback	
1	A substantial portion of the nursing role involves using clinical judgment, critical thinking, and problem solving, which directly affect the care the client will actually receive. 	
2	Providing hands-on care is important; however, clinical judgment, critical thinking, and problem-solving are essential to do it successfully. 	
3	Carrying out physician orders is a small part of a nurse’s role; it, too, requires nursing assessment, planning, intervention, and evaluation. 	
4	Many simple nursing tasks are being delegated to nursing assistive personnel; delegation requires careful analysis of patient status and the appropriateness of support personnel to deliver care. 	

PTS:	1	CON:	Patient-Centered Care

	5.	Which statement pertaining to Benner’s practice model for clinical competence is true?
1)	Progression through the stages is constant, with most nurses reaching the proficient stage.	
2)	Progression through the stages involves continual development of thinking and technical skills.	
3)	The nurse must have experience in many areas before being considered an expert.	
4)	The nurse’s progress through the stages is determined by years of experience and skills.	

ANS:	2
Chapter number and title: 1, Nursing Past & Present
Chapter learning objective: Discuss the transitions nursing education has undergone in the last century.
Chapter page reference: p. 12
Heading: Benner’s Model 
Integrated Processes: Caring 
Client Need: Safe and Effective Care Environment: Management of Care 
Cognitive level: Comprehension [Understanding]
Concept: Evidence-Based Practice
Difficulty: Easy 
	Feedback	
1	Movement through the stages is not constant.	
2	Benner’s model is based on integration of knowledge, technical skill, and intuition in the development of clinical wisdom. 	
3	The model does not mention experience in many areas. 	
4	The model does not mention years of experience.	

PTS:	1	CON:	Evidence-Based Care	

	6.	Which best explains why it is difficult for the profession to develop a definition of nursing?
1)	There are too many different and conflicting images of nurses.	
2)	There are constant changes in healthcare and the activities of nurses.	
3)	There is disagreement among the different nursing organizations.	
4)	There are different education pathways and levels of practice.	

ANS:	2
Chapter number and title: 1, Nursing Past & Present
Chapter learning objective: Discuss the transitions that nursing education has undergone in the last century.
Chapter page reference: p. 8
Heading: How Is Nursing Defined? 
Integrated Processes: Caring 
Client Need: Safe and Effective Care Environment: Management of Care 
Cognitive level: Analysis [Analyzing]
Concept: Professionalism 
Difficulty: Difficult 
	Feedback	
1	The conflicting images of nursing make it more important to develop a definition; they may also make it more difficult but not to the extent that constant change does.	
2	Healthcare is constantly changing and with it come changes in where, how, and what nursing care is delivered. Constant changes make it difficult to develop a definition. 	
3	Although different nursing organizations have different definitions, they are similar in most ways.	
4	The different education pathways affect entry into practice, not the definition of nursing.	

PTS:	1	CON:	Professionalism	

	7.	Nurses have the potential to be very influential in shaping healthcare policy. Which factor contributes most to nurses’ influence?
1)	Nurses are the largest health professional group.	
2)	Nurses have a long history of serving the public.	
3)	Nurses have achieved some independence from physicians in recent years.	
4)	Political involvement has helped refute negative images portrayed in the media.	

ANS:	1
Chapter number and title: 1, Nursing Past & Present
Chapter learning objective: Discuss issues related to healthcare reform.
Chapter page reference: p. 24
Heading: Influence of Nurses on Health Policy 
Integrated Processes: Caring 
Client Need: Safe and Effective Care Environment: Management of Care 
Cognitive level: Comprehension [Understanding]
Concept: Health Care System 
Difficulty: Easy 
	Feedback	
1	Nurses are trusted professionals and the largest health professional group. As such, they have political power to effect changes. If nursing were a small group, there would be little potential for power in shaping policies, even if all the other answers were true. 	
2	Serving the public, although positive, does not necessarily help nurses to be influential in establishing health policy. 	
3	Independence from physicians, although positive, does not necessarily make nurses influential in establishing healthcare policy.	
4	Refuting negative media, although positive, does not necessarily make nurses influential in establishing healthcare policy.	

PTS:	1	CON:	Health Care System	

	8.	Nursing was described as a distinct occupation in the sacred books of which faith?
1)	Buddhism	
2)	Christianity	
3)	Hinduism	
4)	Judaism	

ANS:	3
Chapter number and title: 1, Nursing Past & Present
Chapter learning objective: Discuss the transitions that nursing education has undergone in the last century.
Chapter page reference: p. 6
Heading: Historical Context of Nursing
Integrated Processes: Caring 
Client Need: Safe and Effective Care Environment: Management of Care 
Cognitive level: Knowledge [Remembering]
Concept: Professionalism 
Difficulty: Easy 
	Feedback	
1	Nursing was not described as a distinct occupation in the sacred books of Buddhism. 	
2	Nursing was not described as a distinct occupation in the sacred books of Christianity. 	
3	The Vedas, the sacred books of the Hindu faith, described Indian healthcare practices and were the earliest writings of a distinct nursing occupation.	
4	Nursing was not described as a distinct occupation in the sacred books of Judaism. 	

PTS:	1	CON:	Professionalism	

	9.	Which individual established the American Red Cross?
1)	Louisa May Alcott	
2)	Clara Barton	
3)	Dorothea Dix	
4)	Harriet Tubman	

ANS:	2
Chapter number and title: 1, Nursing Past & Present
Chapter learning objective: Give four examples of influential nursing organizations.
Chapter page reference: p. 19
Heading: Charitable Organizations 
Integrated Processes: Caring 
Client Need: Safe and Effective Care Environment: Management of Care 
Cognitive level: Knowledge [Remembering]
Concept: Evidence-Based Practice 
Difficulty: Easy 
	Feedback	
1	Louisa May Alcott was an American novelist who wrote Little Women in 1868. 	
2	Clara Barton was an American teacher, nurse, and humanitarian who organized the American Red Cross after the Civil War.  	
3	Dorothea Dix was an American activist who acted on behalf of the indigent population with mental illness. She was credited for establishing the first psychiatric institution.	
4	Harriet Tubman was an African American abolitionist and Union spy during the Civil War. After escaping captivity, she set up a network of antislavery activists known as the Underground Railroad.	

PTS:	1	CON:	Evidence-Based Practice

	10.	Which is the most important reason to develop a definition of nursing?
1)	Recruit more informed people into the nursing profession	
2)	Evaluate the degree of role satisfaction	
3)	Dispel the stereotypical images of nurses and nursing	
4)	Differentiate nursing activities from those of other health professionals	

ANS:	4
Chapter number and title: 1, Nursing Past & Present
Chapter learning objective: Define nursing in your own words.
Chapter page reference: p. 8
Heading: How Is Nursing Defined? 
Integrated Processes: Caring 
Client Need: Safe and Effective Care Environment: Management of Care 
Cognitive level: Comprehension [Understanding]
Concept: Professionalism 
Difficulty: Easy 
	Feedback	
1	A definition of nursing would not be likely to increase the number of informed people recruited into nursing. 	
2	A definition of nursing would do little to improve the nurse’s role satisfaction. 	
3	Although a definition of nursing might contribute to fighting stereotypes of nursing, other, more powerful influences (e.g., media portrayals) exist to counteract it.	
4	Nursing organization leaders think it is important to develop a definition of nursing to bring value and understanding to the profession, differentiate nursing activities from those of other health professionals, and help student nurses understand what is expected of them. 	

PTS:	1	CON:	Professionalism	

	11.	Which provides evidence-based support for the contribution that advanced practice nurses (APNs. make within healthcare?
1)	Reduced usage of diagnostics using advanced technology	
2)	Decreased number of unnecessary visits to the emergency department	
3)	Improved patient compliance with prescribed treatments	
4)	Increased usage of complementary alternative therapies	

ANS:	3
Chapter number and title: 1, Nursing Past & Present
Chapter learning objective: Name nine expanded roles for nursing.
Chapter page reference: p. 22
Heading:  Expanded Career Roles for Nurses 
Integrated Processes: Nursing Process – Planning 
Client Need: Safe and Effective Care Environment: Management of Care  
Cognitive level: Comprehension [Understanding]
Concept: Evidence-Based Practice 
Difficulty: Easy 
	Feedback	
1	No well-known scientific studies support APNs’ effect on the use of advanced technology. 	
2	No well-known scientific studies support APNs’ effect on the frequency of emergency department visits. 	
3	Studies demonstrate that APNs have improved patient outcomes over those of physicians, including increased patient understanding and cooperation with treatments and decreased need for hospitalizations. 	
4	No well-known scientific studies support APNs’ effect on the use of alternative therapies.	

PTS:	1	CON:	Evidence-Based Practice

	12.	Which is an example of what traditional medicine and complementary and alternative medicine therapies have in common?
1)	Both can produce adverse effects in some patients.	
2)	Both use prescription medications.	
3)	Both are usually reimbursed by insurance programs.	
4)	Both are regulated by the FDA.	

ANS:	1
Chapter number and title: 1, Nursing Past & Present
Chapter learning objective: Delineate the forces and trends affecting contemporary nursing practice.
Chapter page reference: p. 22
Heading: What Are Some Trends in Nursing and Healthcare?  
Integrated Processes: Caring 
Client Need: Safe and Effective Care Environment: Management of Care 
Cognitive level: Comprehension [Understanding]
Concept: Evidence-Based Practice 
Difficulty: Easy 
	Feedback	
1	Both traditional and complementary therapies can produce adverse effects in some patients. 	
2	Many medications are derived from herbs, but the alternative treatments usually use the herbs, not prescription medication. 	
3	Insurance programs do not necessarily reimburse alternative treatments, because many are not supported by sound scientific research methodology. 	
4	Alternative medications are not regulated by the FDA.	

PTS:	1	CON:	Evidence-Based Practice

	13.	Which is the biggest disadvantage of having nursing assistive personnel (NAP) assist nurses in practice?
1)	Nurses must know what aspects of care can legally and safely be delegated to the NAP.	
2)	Nurses may rely too heavily on information gathered by the NAP when making patient care decisions.	
3)	Nurses are removed from many components of direct patient care that have been delegated to the NAP.	
4)	Nurses still maintain responsibility for the patient care given by the NAP.	

ANS:	2
Chapter number and title: 1, Nursing Past & Present
Chapter learning objective: Delineate the forces and trends affecting contemporary nursing practice.
Chapter page reference: p. 24
Heading: Increased Use of Nursing Assistive Personnel 
Integrated Processes: Nursing Process – Implementation 
Client Need: Safe and Effective Care Environment: Management of Care 
Cognitive level: Comprehension [Understanding]
Concept: Collaboration 
Difficulty: Easy  
	Feedback	
1	All of the options may be disadvantages to using NAPs, but making decisions based on another’s information is the greatest drawback because of the potential for negatively affecting patient care. Treatment decisions based on incorrect information may cause harm to the patient.	
2	All of the options may be disadvantages to using NAPs, but making decisions based on another’s information is the greatest drawback because of the potential for negatively affecting patient care. Treatment decisions based on incorrect information may cause harm to the patient.	
3	All of the options may be disadvantages to using NAPs, but making decisions based on another’s information is the greatest drawback because of the potential for negatively affecting patient care. Treatment decisions based on incorrect information may cause harm to the patient.	
4	All of the options may be disadvantages to using NAPs, but making decisions based on another’s information is the greatest drawback because of the potential for negatively affecting patient care. Treatment decisions based on incorrect information may cause harm to the patient.	

PTS:	1	CON:	Collaboration		

	14.	An older adult patient is diagnosed with type 1 diabetes mellitus (DM). The patient can perform self-care activities but needs help with shopping and meal preparation as well as with blood glucose monitoring and insulin administration. Which type of healthcare facility would be most appropriate for this patient?
1)	Acute care facility	
2)	Ambulatory care facility	
3)	Extended care facility	
4)	Assisted living facility	

ANS:	4
Chapter number and title: 1, Nursing Past & Present
Chapter learning objective: Describe the healthcare delivery system in the United States, including sites for care, types of workers, regulation, and financing of healthcare.
Chapter page reference: p. 16
Heading: Extended Care Facilities 
Integrated Processes: Nursing Process – Planning 
Client Need: Safe and Effective Care Environment: Management of Care
Cognitive level: Application [Applying]
Concept: Patient-Centered Care 
Difficulty: Moderate 
	Feedback	
1	Acute care facilities focus on preventing illnesses and treating acute problems. These facilities include physicians’ offices, clinics, and diagnostic centers. 	
2	Ambulatory care facilities provide outpatient care. Clients live at home or in nonhospital settings and come to the site for care. Ambulatory care facilities include private health and medical offices, clinics, surgery centers, and outpatient therapy centers. 	
3	Extended care facilities typically provide long-term care, rehabilitation, wound care, and ongoing monitoring of patient conditions.	
4	Assisted living facilities are intended for those who are able to perform self-care activities but who require assistance with meals, housekeeping, or medications. 	

PTS:	1	CON:	Patient-Centered Care

	15.	The nurse in the intensive care unit is providing care for only one patient, who was admitted in septic shock. Based on this information, which care delivery model is the nurse implementing?
1)	Functional	
2)	Primary	
3)	Case method	
4)	Team	

ANS:	3
Chapter number and title: 1, Nursing Past & Present
Chapter learning objective: Describe the healthcare delivery system in the United States, including sites for care, types of workers, regulation, and financing of healthcare.
Chapter page reference: p. 15
Heading: What Models of Care Are Used to Provide Nursing Care?   
Integrated Processes: Nursing Process – Planning 
Client Need: Safe and Effective Care Environment: Management of Care 
Cognitive level: Application [Applying]
Concept: Patient-Centered Care 
Difficulty: Moderate 
	Feedback	
1	When the functional nursing model is employed, care is compartmentalized and each task is assigned to a staff member with the appropriate knowledge and skills. 	
2	In primary nursing, one nurse plans the care for a group of patients around the clock. The primary nurse assesses the patient and develops the plan of care. When that nurse is working, he or she provides care for those patients for whom he or she is responsible. In his or her absence, the associate nurses deliver care. Although the nurse in this case could possibly be a primary nurse, there are not enough data to confidently infer that. 	
3	The nurse is following the case method model of nursing care. In this model, one nurse cares for one patient during a single shift. 	
4	If the team nursing approach is utilized, a licensed nurse (RN or LVN) is paired with a nursing assistant. The pair is then assigned to a group of patients.	

PTS:	1	CON:	Patient-Centered Care

	16.	Which healthcare worker should the nurse consult to counsel a patient about financial and family stressors affecting healthcare?
1)	Social worker	
2)	Occupational therapist	
3)	Physician’s assistant	
4)	Technologist	

ANS:	1
Chapter number and title: 1, Nursing Past & Present
Chapter learning objective: Describe the healthcare delivery system in the United States, including sites for care, types of workers, regulation, and financing of healthcare.
Chapter page reference: p. 17
Heading: Who Are the Members of the Interprofessional Healthcare Team? 
Integrated Processes: Nursing Process – Planning 
Client Need: Safe and Effective Care Environment: Management of Care 
Cognitive level: Application [Applying]
Concept: Collaboration 
Difficulty: Moderate 
	Feedback	
1	The social worker coordinates services and counsels patients about financial, housing, marital, and family issues affecting healthcare. 	
2	The occupational therapist helps patients regain function and independence in activities of daily living. 	
3	Physician’s assistants work under the physician’s direction to diagnose certain diseases and injuries. 	
4	Technologists provide a variety of specific functions in hospitals, diagnostic centers, and emergency care. For example, laboratory technologists aid in the diagnosis and treatment of patients by examining blood, urine, tissue, and body fluids. Radiology technologists perform x-rays and other diagnostic testing.	

PTS:	1	CON:	Collaboration		

	17.	Which type of managed care allows patients the greatest choice of providers, medications, and medical devices?
1)	Health maintenance organization	
2)	Integrated delivery network	
3)	Preferred provider organization	
4)	Employment-based private insurance	

ANS:	3
Chapter number and title: 1, Nursing Past & Present
Chapter learning objective: Describe the healthcare delivery system in the United States, including sites for care, types of workers, regulation, and financing of healthcare.
Chapter page reference: p. 19
Heading: Managed Care 
Integrated Processes: Nursing Process – Planning 
Client Need: Safe and Effective Care Environment: Management of Care 
Cognitive level: Application [Applying]
Concept: Patient-Centered Care 
Difficulty: Moderate 
	Feedback	
1	Health maintenance organizations allow patients to choose a primary care provider within the organization to coordinate their care. This type of program will only reimburse medical care when patients have first obtained a referral from their primary providers. 	
2	Integrated delivery networks combine providers, healthcare facilities, pharmaceuticals, and services into one system, and patients must remain within the system to receive care. 	
3	Preferred provider organizations are a form of managed care that allows patients greater choice of providers, medications, and medical devices within the designated list. 	
4	Employment-based private insurance is not a managed care organization.	

PTS:	1	CON:	Patient-Centered Care

	18.	A patient who underwent a total abdominal hysterectomy is assisted out of bed as soon as her vital signs are stable. Which item is directing this intervention?
1)	Critical pathway	
2)	Nursing care plan	
3)	Case manager	
4)	Traditional care model	

ANS:	1
Chapter number and title: 1, Nursing Past & Present
Chapter learning objective: Delineate the forces and trends affecting contemporary nursing practice.
Chapter page reference: p. 20
Heading: Work Redesign
Integrated Processes: Nursing Process – Implementation 
Client Need: Safe and Effective Care Environment: Management of Care 
Cognitive level: Comprehension [Understanding]
Concept: Health Care System 
Difficulty: Easy 
	Feedback	
1	This patient’s care is most likely being directed by a critical pathway. A critical pathway is a multidisciplinary approach to care that sequences interventions over a length of stay for a given case type such as total abdominal hysterectomy. Using this model, the patient can be assisted out of bed as soon as her vital signs are stable. 	
2	The nursing care plan guides nursing care but cannot specify when the patient can get out of bed postoperatively without a physician’s order. 	
3	When case management is used, care is coordinated by the case manager across the healthcare setting, but the case manager does not direct each care intervention.	
4	Using the traditional model, the nurse would have to obtain a physician’s order to assist the patient out of bed after surgery.	

PTS:	1	CON:	Health Care System	

	19.	Which member of the healthcare team typically serves as the case manager?
1)	Occupational therapist	
2)	Physician	
3)	Physician’s assistant	
4)	Registered nurse	

ANS:	4
Chapter number and title: 1, Nursing Past & Present
Chapter learning objective: Name nine expanded roles for nursing.
Chapter page reference: p. 9
Heading: Table 1-1 Roles and Functions of the Nurse 
Integrated Processes: Caring 
Client Need: Safe and Effective Care Environment: Management of Care 
Cognitive level: Comprehension [Understanding]
Concept: Collaboration 
Difficulty: Easy 
	Feedback	
1	The occupational therapist, physician, and physician’s assistant all serve on the healthcare team and take direction from the case manager.	
2	The occupational therapist, physician, and physician’s assistant all serve on the healthcare team and take direction from the case manager.	
3	The occupational therapist, physician, and physician’s assistant all serve on the healthcare team and take direction from the case manager.	
4	Typically, registered nurses serve as case managers for patients with specific diagnoses. Their role is coordinator of care across the healthcare system. 	

PTS:	1	CON:	Collaboration		

	20.	Which is considered a primary care service?
1)	Providing wound care	
2)	Administering childhood immunizations	
3)	Providing drug rehabilitation	
4)	Outpatient hernia repair	

ANS:	2
Chapter number and title: 1, Nursing Past & Present
Chapter learning objective: Describe the healthcare delivery system in the United States, including sites for care, types of workers, regulation, and financing of healthcare.
Chapter page reference: p. 17
Heading: How Is Healthcare Categorized? 
Integrated Processes: Nursing Process – Implementation 
Client Need: Safe and Effective Care Environment: Management of Care 
Cognitive level: Comprehension [Understanding]
Concept: Health Care System 
Difficulty: Easy 
	Feedback	
1	Wound care is an example of a tertiary care service.	
2	Primary care services focus on health promotion and disease prevention; administering childhood immunizations is one such service. 	
3	Drug rehabilitation is an example of a tertiary care service.	
4	Outpatient hernia repair surgery is an example of a secondary care service.	

PTS:	1	CON:	Health Care System	

	21.	Which nursing activities represent direct care? Choose all that apply
1)	Administering a medication	
2)	Documenting an assessment	
3)	Participating in a care conference	
4)	Making work assignments for the shift	

ANS:	1
Chapter number and title: 1, Nursing Past & Present
Chapter learning objective: Name nine expanded roles for nursing.
Chapter page reference: p. 15
Heading: Who Are the Recipients of Nursing Care? 
Integrated Processes: Nursing Process – Implementation 
Client Need: Safe and Effective Care Environment: Management of Care 
Cognitive level: Comprehension [Understanding]
Concept: Professionalism 
Difficulty: Easy 
	Feedback	
1	Direct care involves personal interaction between the nurse and clients (e.g., giving medications, dressing a wound, or teaching a client about medicines or care). 	
2	Nurses deliver indirect care when they work on behalf of an individual, group, family, or community to improve their health status (e.g., restocking the code blue cart [an emergency cart], ordering unit supplies, or arranging unit staffing).	
3	Nurses deliver indirect care when they work on behalf of an individual, group, family, or community to improve their health status (e.g., restocking the code blue cart [an emergency cart], ordering unit supplies, or arranging unit staffing).	
4	Nurses deliver indirect care when they work on behalf of an individual, group, family, or community to improve their health status (e.g., restocking the code blue cart [an emergency cart], ordering unit supplies, or arranging unit staffing).	

PTS:	1	CON:	Professionalism	

	22.	An 80-year-old patient fell and fractured her hip and is in the hospital. Before the fall, the patient lived at home with her spouse and managed their activities of daily living (ADLs) very well. The hospital is ready to discharge the patient because the recommended length of stay in a hospital has been exceeded. However, she cannot walk or perform ADLs independently. She requires lengthy physical therapy and further monitoring of medications and both physical and mental status. To which type of facility should the patient be transferred?
1)	Nursing home	
2)	Rehabilitation center	
3)	Outpatient therapy center	
4)	None of these; she should receive home healthcare	

ANS:	2
Chapter number and title: 1, Nursing Past & Present 
Chapter learning objective: Describe the healthcare delivery system in the United States, including sites for care, types of workers, regulation, and financing of healthcare.
Chapter page reference: p. 16
Heading: Extended Care Facilities 
Integrated Processes: Nursing Process – Planning 
Client Need: Safe and Effective Care Environment: Management of Care 
Cognitive level: Application [Applying]
Concept: Patient-Centered Care 
Difficulty: Moderate 
	Feedback	
1	A nursing home provides custodial care for those people who cannot live on their own but who are not sick enough to require hospitalization. It provides a room, custodial care, and opportunity for recreation.	
2	A skilled nursing facility primarily provides skilled nursing care for patients who can be expected to improve with treatment. For example, a patient who no longer needs hospitalization may transfer to a skilled nursing facility, such as a rehabilitation center, to get skilled care until able to return home. 	
3	This patient cannot ambulate or perform ADLs, so outpatient therapy and home care would not be appropriate.	
4	This patient cannot ambulate or perform ADLs, so outpatient therapy and home care would not be appropriate.	

PTS:	1	CON:	Patient-Centered Care

	23.	A high school graduate desires to become a registered nurse in order to work in a community setting. In which type of program should this student enroll?
1)	RN-BSN	
2)	Associate degree	
3)	Diploma program	
4)	Baccalaureate degree	

ANS:	4
Chapter number and title: 1, Nursing Past & Present
Chapter learning objective: Differentiate between the various forms of nursing education.
Chapter page reference: p. 11
Heading: How Do Nurses’ Educational Paths Differ?
Integrated Processes: Nursing Process
Client Need: Safe and Effective Care Environment: Management of Care
Cognitive level: Application [Applying]
Concept: Professionalism
Difficulty: Easy
	Feedback	
1	Nurses who have already received basic nursing education, passed the NCLEX-RN® examination, and now desire to earn a baccalaureate degree would enter an RN-BSN program. 	
2	Associate program nurses are prepared to provide direct patient care.	
3	Diploma program nurses are prepared to provide direct patient care.	
4	Baccalaureate degree nurses are prepared to address complex clinical situations, provide direct patient care, work in community care, apply research findings, and enter graduate education.	

PTS:	1	CON:	Professionalism	

	24.	A practicing registered nurse wants to become a staff development educator. Which type of education should this nurse investigate?
1)	Master’s degree	
2)	Doctoral degree	
3)	Baccalaureate degree	
4)	Continuing education	

ANS:	1
Chapter number and title: 1, Nursing Past & Present
Chapter learning objective: Differentiate between the various forms of nursing education.
Chapter page reference: p. 11
Heading: How Do Nurses’ Educational Paths Differ?
Integrated Processes: Nursing Process
Client Need: Safe and Effective Care Environment: Management of Care
Cognitive level: Application [Applying]
Concept: Professionalism
Difficulty: Easy
	Feedback	
1	Master’s degree programs prepare RNs to function in a more independent and autonomous role, such as nurse educator.	
2	Baccalaureate and master’s degrees are required before entrance to a doctoral program. Courses of study in doctoral programs include practice or research.	
3	Baccalaureate degree nurses are prepared to address complex clinical situations, provide direct patient care, work in community care, apply research findings, and enter graduate education.	
4	Continuing education courses do not prepare nurses for a particular role. 	

PTS:	1	CON:	Professionalism	

	25.	In preparation for relocating to another state the nurse contacts the state board of nursing to obtain the necessary transfer of nursing license. Where will the nurse learn about continuing education requirements for the new state of practice?
1)	State board of nursing	
2)	The Joint Commission	
3)	School of original nursing education	
4)	Human resource department at new place of employment	

ANS:	1
Chapter number and title: 1, Nursing Past & Present
Chapter learning objective: Differentiate between the various forms of nursing education.
Chapter page reference: p. 11
Heading: How Do Nurses’ Educational Paths Differ?
Integrated Processes: Nursing Process
Client Need: Safe and Effective Care Environment: Management of Care
Cognitive level: Application [Applying]
Concept: Professionalism
Difficulty: Easy
	Feedback	
1	The state board of nursing notifies nurses about continuing education requirements and will notify nurses of any changes in the requirements. 	
2	The Joint Commission is a regulatory body that does not license nurses. 	
3	The school of original nursing education will not notify registered nurses about continuing education requirements for licensure. 	
4	The Human Resources department at the new place of employment will not notify or track continuing education requirements for the nursing staff. 	

PTS:	1	CON:	Professionalism	

MULTIPLE RESPONSE

	26.	Which are examples of a health-promotion activity? Select all that apply.
1)	Helping a client develop a plan for a low-fat, low-cholesterol diet	
2)	Disinfecting an abraded knee after a child falls off a bicycle	
3)	Administering a tetanus vaccination after an injury from a car accident	
4)	Distributing educational brochures about the benefits of exercise	
5)	Administering a measles, mumps, rubella (MMR) immunization to a toddler at 15 months of age	

ANS:	1, 4, 5
Chapter number and title: 1, Nursing Past & Present 
Chapter learning objective: Discuss issues related to healthcare reform.
Chapter page reference: p. 18
Heading: Nursing and Health Promotion 
Integrated Processes: Nursing Process – Implementation 
Client Need: Health Promotion and Maintenance 
Cognitive level: Comprehension [Understanding]
Concept: Health Promotion 
Difficulty: Moderate 

	Feedback	
1. 	This is correct. Health promotion includes strategies that promote positive lifestyle changes, such a developing a healthy diet.	
2. 	This is incorrect. Disinfecting an abraded knee is a treatment/intervention for an injury.	
3. 	This is incorrect. Administering a vaccination is a disease-prevention and treatment activity.	
4. 	This is correct. Health promotion includes strategies that promote positive lifestyle changes.	
5. 	This is correct. Primary care focuses on health promotion and disease prevention. Activities include health education and immunizations for infectious diseases.	

PTS:	1	CON:	Health Promotion	

	27.	The nurse registers to attend an in-service education program. What should the nurse expect this program to provide? Select all that apply.
1)	Review of new policies	
2)	Introduction to new equipment	
3)	Credit toward a professional nursing degree	
4)	Continuing education hours for license renewal	
5)	Enhancement of competency in knowledge, skills, and attitudes	

ANS:	1, 2, 5
Chapter number and title: 1, Nursing Past & Present
Chapter learning objective: Differentiate between the various forms of nursing education.
Chapter page reference: p.11
Heading: How Do Nurses’ Educational Paths Differ?
Integrated Processes: Nursing Process 
Client Need: Safe and Effective Care Environment: Management of Care
Cognitive level: Application [Applying]
Concept: Professionalism
Difficulty: Moderate 

	Feedback	
1. 	In-service education is institution specific and provides information about policy changes.	
2. 	In-service education is institution specific and provides information about the use of new equipment. 	
3. 	In-service education does not provide credit toward a professional nursing degree.	
4. 	In-service education does not count toward meeting the continuing education requirement for licensure or renewal. 	
5. 	In-service education is designed to enhance continuing competence in knowledge, skills, and attitudes.	

PTS:	1	CON:	Professionalism	

	28.	The nurse manager prepares information on the regulations of nursing practice for a group of new nursing employees. Which information should the manager include in this presentation? Select all that apply.
1)	Laws	
2)	Standards of practice	
3)	Facility policies and procedures	
4)	The Joint Commission regulations	
5)	Professional organization guidelines	

ANS:	1, 2, 5
Chapter number and title: 1, Nursing Past & Present
Chapter learning objective: Explain how nursing practice is regulated.
Chapter page reference: p. 13
Heading: How Is Nursing Practice Regulated?
Integrated Processes: Teaching and Learning
Client Need: Safe and Effective Care Environment: Management of Care
Cognitive level: Application [Applying]
Concept: Professionalism
Difficulty: Easy

	Feedback	
1. 	Laws regulate the practice of nursing	
2. 	Standards of practice regulate the practice of nursing	
3. 	Facility policies and procedures do not regulate the practice of nursing.	
4. 	The Joint Commission regulations are not used to regulate the practice of nursing. 	
5. 	Guidelines from professional organizations regulate the practice of nursing	

PTS:	1	CON:	Professionalism	

	29.	The nursing instructor provides a program on the state board of nursing for students preparing to graduate from a school of nursing. What should the instructor emphasize about the role of the state boards of nursing? Select all that apply.
1)	Approve nursing education programs	
2)	Define the scope of practice for nursing	
3)	Develop rules and regulations for nursing practice	
4)	Provide guidance on knowledge, skills, and attitudes	
5)	Publish statements of duties for competent performance	

ANS:	1, 2, 3
Chapter number and title: 1, Nursing Past & Present
Chapter learning objective: Explain how nursing practice is regulated.
Chapter page reference: p. 13
Heading: How Is Nursing Practice Regulated?
Integrated Processes: Teaching and Learning
Client Need: Safe and Effective Care Environment: Management of Care
Cognitive level: Application [Applying]
Concept: Professionalism
Difficulty: Easy

	Feedback	
1. 	Each state board of nursing is responsible for approving nursing education programs. 	
2. 	Each state board of nursing is responsible for defining the scope of practice for nursing. 	
3. 	Each state board of nursing is responsible for developing rules and regulations for guidance to nurses. 	
4. 	Standards provide a guide to the knowledge, skills, and attitudes (KSAs) that nurses must incorporate into their practice to provide safe, quality care.	
5. 	Standards are authoritative statements of the duties that all registered nurses, regardless of role, population, or specialty, are expected to perform competently.	

PTS:	1	CON:	Professionalism	

	30.	The nurse reviews standards of professional practice every 3 to 4 months. Why does the nurse complete this review? Select all that apply.
1)	Judge own performance	
2)	Develop an improvement plan	
3)	Incorporate into evaluation tools	
4)	Educate the public about nursing	
5)	Understand employer expectations	

ANS:	1, 2, 5
Chapter number and title: 1, Nursing Past & Present
Chapter learning objective: Explain how nursing practice is regulated.
Chapter page reference: p. 13
Heading: How Is Nursing Practice Regulated?
Integrated Processes: Nursing Process
Client Need: Safe and Effective Care Environment: Management of Care
Cognitive level: Application [Applying]
Concept: Professionalism
Difficulty: Moderate

	Feedback	
1. 	Practicing nurses use the standards to judge their own performance. 	
2. 	Practicing nurses use the standards to develop an improvement plan.	
3. 	Employers may incorporate the standards into annual employee evaluation tools.	
4. 	Professional organizations use the standards to educate the public about nursing. 	
5. 	Practicing nurses use the standards to understand employers’ expectations. 	

PTS:	1	CON:	Professionalism