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Chapter MULTIPLE CHOICE
1. Florence Nightingale’s contributions to nursing practice and education:
a. are historically important but have no validity for nursing today.
b. were neither recognized nor appreciated in her own time.
c. were a major factor in reducing the death rate in the Crimean War.
d. were limited only to the care of severe traumatic wounds.
ANS: C
By improving sanitation, nutrition ventilation, and handwashing techniques, Florence
Nightingale’s nurses dramatically reduced the death rate from injuries in the Crimean War.
DIF: Cognitive Level: Knowledge REF: p. 2 OBJ: Theory # TOP: Nursing History KEY: Nursing Process Step: N/A MSC: NCLEX: N/A
2. Early nursing education and care in the United States:
a. were directed at community health.
b. provided independence for women through education and employment.
c. were an educational model based in institutions of higher learning.
d. have continued to be entirely focused on hospital nursing.
ANS: B
Because of the influence of early nursing leaders, nursing education became more formalized
through apprenticeships in Nightingale schools that offered independence to women through
education and employment.
DIF: Cognitive Level: Knowledge REF: p. 2 OBJ: Theory # TOP: Nursing History KEY: Nursing Process Step: N/A MSC: NCLEX: N/A
3. In order to fulfill the common goals defined by nursing theorists (promote wellness, prevent
illness, facilitate coping, and restore health), the LPN must take on the roles of:
a. caregiver, educator, and collaborator.
b. nursing assistant, delegator, and environmental specialist.
c. medication dispenser, collaborator, and transporter.
d. dietitian, manager, and housekeeper.
ANS: A
In order for the LPN to apply the common goals of nursing, he or she must assume the roles of
caregiver, educator, collaborator, manager, and advocate.
DIF: Cognitive Level: Comprehension REF: p. 4 OBJ: Theory # TOP: Art and Science of Nursing KEY: Nursing Process Step: N/A MSC: NCLEX: N/A
ANS: D
The National Federation of Licensed Practical Nurses modified the standards published by the
ANA in 2004 to better fit the role of the LPN.
DIF: Cognitive Level: Comprehension REF: p. 5 OBJ: Theory # TOP: Standards of Care KEY: Nursing Process Step: N/A MSC: NCLEX: N/A
6. The LPN demonstrates an evidence-based practice by:
a. using a drug manual to check compatibility of drugs.
b. using scientific information to guide decision making.
c. using medical history of a patient to direct nursing interventions.
d. basing nursing care on advice from an experienced nurse.
ANS: B
The use of scientific information from high-quality research to guide nursing decisions is
reflective of the application of evidence-based practice.
DIF: Cognitive Level: Knowledge REF: p. 5 OBJ: Theory # TOP: Evidence Based Practice KEY: Nursing Process Step: N/A MSC: NCLEX: N/A
7. Lillian Wald and Mary Brewster established the Henry Street Settlement Service in New York
in 1893 in order to:
a. offer a shelter to injured war veterans.
b. found a nursing apprenticeship.
c. provide health care to poor persons living in tenements.
d. offer better housing to low-income families.
ANS: C
Henry Street Settlement Service brought the provision of community health care to the poor
people living in tenements.
DIF: Cognitive Level: Comprehension REF: p. 2 OBJ: Theory # TOP: Growth of Nursing KEY: Nursing Process Step: N/A MSC: NCLEX: N/A
8. An educational pathway for an LPN refers to an LPN:
a. learning on the job and being promoted to a higher level of responsibility.
b. moving from a maternity unit to a more complicated surgical unit.
c. obtaining additional education to move from one level of nursing to another.
d. learning that advancement requires consistent work and commitment.
ANS: C
By broadening the educational base, an LPN may advance and build a nursing career.
DIF: Cognitive Level: Knowledge REF: p. 6 OBJ: Theory #
d. acquire cross-training to make staffing more flexible.
ANS: A
DRGs required that nurses provide more supportive documentation of their assessments and
identified patient needs to qualify the facility for Medicare reimbursement. Observant assessment
might also indicate another DRG classification and consequently more reimbursement for the
facility.
DIF: Cognitive Level: Comprehension REF: p. 8 OBJ: Theory # TOP: Managed Care KEY: Nursing Process Step: N/A MSC: NCLEX: N/A
11. If a member of a health maintenance organization (HMO) is having respiratory problems such
as fever, cough, and fatigue for several days and wants to see a specialist, the person is required
to go:
a. directly to an emergency room for treatment.
b. to any general practitioner of choice.
c. directly to a respiratory specialist.
d. to a primary care physician for a referral.
ANS: D
Participants in an HMO must see their primary physician to receive a referral for a specialist in
order for the HMO to pay for the care.
DIF: Cognitive Level: Comprehension REF: p. 9 OBJ: Theory #
TOP: Managed Care KEY: Nursing Process Step: N/A MSC: NCLEX: N/A
12. An advantage of preferred provider organizations (PPOs) is that:
a. they make insurance coverage of employees less expensive to employers.
b. there are fewer physicians to choose from than in an HMO.
c. long-term relationships with physicians are more likely.
d. patients may go directly to a specialist for care.
ANS: A
The use of PPOs allows insurance companies to keep their premiums low and in turn makes
insurance coverage less expensive for the employers. There are usually more physicians from
which to choose than from a HMO, but long-term relationships between physician and patient
cannot be established easily. Patients still must see their primary physician before being referred
to other specialties.
DIF: Cognitive Level: Knowledge REF: p. 6 OBJ: Theory # TOP: Preferred Provider Organizations KEY: Nursing Process Step: N/A MSC: NCLEX: N/A
13. After passing the National Council Licensure Examination for Practical Nurses (NCLEX-
PN), the nurse is qualified to take an additional certification in the field of:
a. pharmacology.
b. care of infants and children.
15. Nurse Practice Acts define the legal scope of an LPN’s practice, which are written and
enforced by:
a. the American Nurses Association.
b. the National Council Licensure Examiners.
c. each state.
d. each health care agency.
ANS: C
Each state writes and enforces the Nurse Practice Act, which defines the legal scope of nursing
practice.
DIF: Cognitive Level: Comprehension REF: p. 5 OBJ: Theory # TOP: Nurse Practice Act KEY: Nursing Process Step: N/A MSC: NCLEX: N/A
16. Women volunteers were organized to give nursing care to the wounded soldiers during the
Civil War by:
a. Florence Nightingale.
b. Dorothea Dix.
c. Clara Barton.
d. Lillian Wald.
ANS: B
The Union government appointed Dorothea Dix, a social worker, to organize women volunteers
to provide nursing care for the soldiers during the Civil War.
DIF: Cognitive Level: Knowledge REF: p. 2 OBJ: Theory # TOP: Nursing History KEY: Nursing Process Step: N/A MSC: NCLEX: N/A
17. The nursing theory presented by Sister Calista Roy is based on:
a. reduction of stress.
b. achievement of maximum level of wellness.
c. relief of self-care deficit.
d. adaptation modes.
ANS: D
Adaptation modes (physiologic, psychological, sociologic, and independence) are the basis of the
nursing theory of Sister Calista Roy.
DIF: Cognitive Level: Knowledge REF: p. 4, Table 1- OBJ: Theory #2 TOP: Nursing Theories KEY: Nursing Process Step: N/A MSC: NCLEX: N/A
18. The founding of the Red Cross is attributed to:
DIF: Cognitive Level: Knowledge REF: p. 4, Table 1- OBJ: Theory #2 TOP: Nursing Theorists KEY: Nursing Process Step: N/A MSC: NCLEX: N/A
20. The nursing theory that uses seven behavioral subsystems in an adaptation model is:
a. Betty Neumann.
b. Sister Calista Roy.
c. Dorothy Johnson.
d. Patricia Benner.
ANS: C
Dorothy Johnson’s practice framework is based on seven behavioral subsystems in an adaptation
model.
DIF: Cognitive Level: Knowledge REF: p. 4, Table 1- OBJ: Theory #2 TOP: Nursing Theorists KEY: Nursing Process Step: N/A MSC: NCLEX: N/A
21. The Standards of Clinical Nursing Practice are designed to direct LPNs to:
a. advance their nursing career.
b. seek a scientific basis for their interventions.
c. deliver safe, knowledgeable care.
d. a leadership role.
ANS: C
The Standards of Clinical Nursing Practice are designed to guide the LPN to deliver safe,
knowledgeable care.
DIF: Cognitive Level: Knowledge REF: p. 5 OBJ: Theory # TOP: Nursing Standards KEY: Nursing Process Step: N/A MSC: NCLEX: Safe Effective Care Environment
22. A state’s Nurse Practice Act is designed to protect the:
a. physician.
b. nurse.
c. public.
d. hospital.
ANS: C
Nurse Practice Acts are designed to protect the public.
DIF: Cognitive Level: Knowledge REF: p. 6 OBJ: Theory # TOP: Nurse Practice Act KEY: Nursing Process Step: N/A MSC: NCLEX: N/A
ANS: A
Tertiary health care includes extended care, chronic disease management, medical homes, in-
home personal care, and hospice care.
DIF: Cognitive Level: Comprehension REF: p. 9, Box 1- OBJ: Theory #8 TOP: Health Care Services KEY: Nursing Process Step: N/A MSC: NCLEX: N/A COMPLETION
25. Preferred provider organizations (PPOs) use __________ to finance their services and pay the
physical cost of the service.
ANS:
capitated cost
The capitated cost is the set fee that is paid to the network for each patient enrolled to finance its
services.
DIF: Cognitive Level: Knowledge REF: p. 9 OBJ: Theory # TOP: Capitated Cost KEY: Nursing Process Step: N/A MSC: NCLEX: N/A
26. In the United States, the Young Women’s Christian Association (YMCA) in New York opened
The __________ School, the first practical nursing school.
ANS:
Ballard
In 1892, the YMCA opened The Ballard School, a 3-month course in practical nursing that was
the first school of practical nursing.
DIF: Cognitive Level: Knowledge REF: p. 2 OBJ: Theory # TOP: Ballard School KEY: Nursing Process Step: N/A MSC: NCLEX: N/A
27. Such health services as surgical procedures, restorative care, and home health care would be
classified as __________ care.
ANS:
secondary
Surgical procedures, restorative care, and home health are part of the many services classified as
secondary care.
DIF: Cognitive Level: Comprehension REF: p. 9, Box 1- OBJ: Theory #10 TOP: Health Care Services KEY: Nursing Process Step: N/A MSC: NCLEX: N/A MULTIPLE RESPONSE
28. Characteristics of primary nursing include which of the following? ( Select all that apply. )
a. Elimination of fragmentation of care between shifts
b. Evolved in the mid-1950s
c. Planning and direction performed by one nurse
d. Ancillary workers used to increase productivity
e. The care plan covering the entire day
f. Associate nurses taking over care and planning when the primary nurse is off duty
ANS: A, C, D, E, F
Primary care reduces fragmentation of care between shifts. Care is planned by one nurse to cover
a 24-hour period using ancillary workers to increase productivity. An associate nurse may take
on direction of care in the absence of the primary nurse.
DIF: Cognitive Level: Knowledge REF: p. 8 OBJ: Theory # TOP: Nursing Care Delivery KEY: Nursing Process Step: N/A
b. assisting a patient to complete his or her bath.
c. assigning patient care tasks to certified nursing assistants.
d. requesting the housecleaning staff to mop the floor of a patient’s room.
e. instructing the unit secretary to page a physician to the floor.
ANS: C, D, E
Delegation under the scope of the practice of an LPN is the assignment of a certified nursing
assistant to certain nursing care or other non-medical staff to aspects of patient care.
DIF: Cognitive Level: Comprehension REF: p. 4 OBJ: Theory # TOP: Art and Science of Nursing KEY: Nursing Process Step: N/A MSC: NCLEX: N/A
31. During the Civil War, nursing schools offered education to women both in England and in the
United States. The schools in the United States differed from those in Europe because in U.S.
schools: ( Select all that apply. )
a. students worked without pay.
b. the core curriculum was the same.
c. instruction was presented by physicians at the bedside.
d. the educational focus was on nursing care.
e. classes were held separately from the clinical experience.
ANS: A, C
In the United States, the students staffed the hospital and worked without pay. There were no
formal classes; education was achieved through work. There was no set curriculum, and content
varied depending on the type of cases present in the hospital. Instruction was done at the bedside
by the physician and therefore came from a medical viewpoint.
Chapter 2 MULTIPLE CHOICE
1. The nurse is aware that any description of health would include the concept that:
a. health is the absence of illness, and illness is the presence of chronic disease.
b. culture, education, and socioeconomic status influence one’s definition of health or illness.
c. illness is a biologic malfunction, and health is biologic soundness.
d. lifestyle factors are the major determinant of health or illness.
ANS: B
The concept of health is influenced by culture, education, and socioeconomic factors.
DIF: Cognitive Level: Comprehension REF: p. 15 OBJ: Theory #
