Chapter 1. Nursing Past & Present

Multiple Choice
Identify the choice that best completes the statement or answers the question.

____	1.	What 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	

____	2.	Which of the following is an example of an illness prevention activity? Select all that apply.
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	

____	3.	Which of the following contributions 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	

____	4.	All of the following are aspects of the full-spectrum nursing role. Which one 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	

____	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.	

____	6.	Which of the following 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.	

____	7.	Nurses have the potential to be very influential in shaping healthcare policy. Which of the following factors 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.	

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

____	9.	The American Red Cross was established by
1)	Louisa May Alcott	
2)	Clara Barton	
3)	Dorothea Dix	
4)	Harriet Tubman	

____	10.	Which of the following 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	

____	11.	Which of the following 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	

____	12.	Which of the following 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.	

____	13.	Of the following, the biggest disadvantage of having nursing assistive personnel (NAP) help nurses is that the nurse
1)	Must know what aspects of care can legally and safely be delegated to the NAP	
2)	May rely too heavily on information gathered by the NAP when making patient care decisions	
3)	Is removed from many components of direct patient care that have been delegated to the NAP	
4)	Still maintains responsibility for the patient care given by the NAP	

____	14.	An older adult has type 1 diabetes. He 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 him?
1)	Acute care facility	
2)	Ambulatory care facility	
3)	Extended care facility	
4)	Assisted living facility	

____	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 can you infer that this nurse is following?
1)	Functional	
2)	Primary	
3)	Case method	
4)	Team	

____	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	

____	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	

____	18.	A patient who underwent a total abdominal hysterectomy is assisted out of bed as soon as her vital signs are stable. This intervention is most likely being directed by a
1)	Critical pathway	
2)	Nursing care plan	
3)	Case manager	
4)	Traditional care model	

____	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	

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

____	21.	An 80-year-old patient fell and fractured her hip and is in the hospital. Before the fall, she lived at home with her husband and managed their activities of daily living very well. The goal is for the patient to recover from the injury and return to her home. The hospital is ready to discharge her because she has exceeded the recommended length of stay in a hospital. However, she cannot walk or care for herself yet, and she will require lengthy physical therapy and further monitoring of her medications and her physical and mental status. To which type of facility should she be transferred?
1)	Nursing home	
2)	Rehabilitation center	
3)	Outpatient therapy center	
4)	None of these; she should receive home healthcare	

Multiple Response
Identify one or more choices that best complete the statement or answer the question.

____	22.	Which of the following 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	

____	23.	Which of the following nursing activities represent direct care? Choose all that apply.
1)	Bathing a patient	
2)	Administering a medication	
3)	Documenting an assessment	
4)	Making work assignments for the shift	

Matching

Match the nursing role listed on the left with the appropriate activity listed on the right. Each activity has only one correct answer.
1)	Planning the unit’s staffing schedule	
2)	Participating on a committee to develop a program to teach schoolchildren proper handwashing	
3)	Teaching the client about a scheduled test	
4)	Discussing new medication at a staff meeting	
5)	Discussing with the physician the client’s reasons for not wanting the recommended surgery.	

____	24.	Direct care provider

____	25.	Client advocate

____	26.	Manager

____	27.	Change agent

Match the event with the appropriate year. Each item has only one correct answer.
1)	Nursing programs become affiliated with religious groups	
2)	Start of public health nursing with the founding of the Henry Street Settlement	
3)	First formal nursing education in United States	
4)	First hospital	
5)	Establishment of the Army Nursing Service	
6)	Disassociation of nursing from religious orders	
7)	Florence Nightingale cared for the soldiers of the Crimean War	

____	28.	1st-century AD

____	29.	15th to 19th century

____	30.	1854

____	31.	1861

____	32.	1873

____	33.	1893

Match the nursing organization with its function in the nursing profession.
1)	Responsible for setting and maintaining nursing education standards	
2)	Developed Code for Nurses and the Standards of Clinical Nursing Practice	
3)	Responsible for publishing the journal, Image	
4)	Honor society for nursing	
5)	Represents nursing and promotes nursing leadership worldwide	

____	34.	American Nurses Association (ANA)

____	35.	National Student Nurses Association (NSNA)

____	36.	National League for Nursing (NLN)

____	37.	International Council of Nursing (ICN)

____	38.	Sigma Theta Tau International (STTI)

True/False
Indicate whether the statement is true or false.

____	39.	The nurse caring for a patient undergoing minor surgery as an outpatient provides the same type of care as for a hospitalized patient undergoing the same procedure.

Completion
Complete each statement.

	40.	____________________ is a health program, administered by the state and funded by federal and state governments to provide care for low-income people.

	41.	____________________ is a federal insurance-type program designed to fund healthcare for people age 65 years and older, the disabled, and those with end-stage renal disease from the high cost of healthcare.

Chapter 1. Nursing Past & Present
Answer Section

MULTIPLE CHOICE

	1.	ANS:	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 is critical, nurses provided healthcare to the sick and injured at the battle site. The physician's handmaiden was/is a nursing stereotype rather than an influence on nursing. Although there has been 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. Germ theory and sanitation helped to improve healthcare but did not shape nursing.

PTS:	1	DIF:	Moderate	REF:	pp. 9-10	
KEY:	Nursing process: N/A| Client need: N/A | Cognitive level: Recall	

	2.	ANS:	3
Administering immunization for HPV is an example of illness prevention. 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. Illness-prevention activities focus on avoiding a specific disease. A food diary is a health-promotion activity. Teaching a diabetic patient about diet is a treatment for diabetes; the patient already has diabetes, so it cannot prevent diabetes.

PTS:	1	DIF:	Moderate	
REF:	p. 18; high-level question, not directly stated in text	
KEY:	Nursing process: N/A | Client need: HPM | Cognitive level: Application

	3.	ANS:	1
Improved sanitation (a clean environment) greatly and immediately reduced the rate of infection and mortality in hospitals. The other responses are all activities of Florence Nightingale that improved healthcare or nursing, but the impact is long range, not immediate.

PTS:	1	DIF:	Easy	
REF:	V1, p. 3; student must infer from content | V1, p. 10; student must infer from content
KEY:	Nursing process: N/A | Client need: SECE | Cognitive level: Application

	4.	ANS:	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. Providing hands-on care is important; however, clinical judgment, critical thinking, and problem solving are essential to do it successfully. Carrying out physician orders is a small part of a nurse’s role; it, too, requires nursing assessment, planning, intervention, and evaluation. 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. Another way to analyze this question is that none of the options of providing hands-on care, carrying out physician orders, and delegating to assistive personnel is required for the nurse to think and reason about a client’s care; so the answer must be 1.

PTS:	1	DIF:	Difficult	REF:	p. 11	
KEY:	Nursing process: N/A | Client need: N/A | Cognitive level: Analysis

	5.	ANS:	2
Movement through the stages is not constant. Benner’s model is based on integration of knowledge, technical skill, and intuition in the development of clinical wisdom. The model does not mention experience in many areas. The model does not mention years of experience.

PTS:	1	DIF:	Moderate	REF:	p. 15	
KEY:	Nursing process: N/A | Client need: N/A | Cognitive level: Recall	

	6.	ANS:	2
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. 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. Although different nursing organizations have different definitions, they are similar in most ways. The different education pathways affect entry into practice, not the definition of nursing.

PTS:	1	DIF:	Moderate	REF:	p. 11; “How Is Nursing Defined?”
KEY:	Nursing process: N/A | Client need: N/A | Cognitive level: Analysis

	7.	ANS:	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. Serving the public, while positive, does not necessarily help nurses to be influential in establishing health policy. Independence from physicians, although positive, does not necessarily make nurses influential in establishing healthcare policy. Refuting negative media, although positive, does not necessarily make nurses influential in establishing healthcare policy.

PTS:	1	DIF:	Moderate	REF:	p. 21	
KEY:	Nursing process: N/A | Client need: N/A | Cognitive level: Analysis

	8.	ANS:	3
The Vedas, the sacred books of the Hindu faith, described Indian healthcare practices and were the earliest writings of a distinct nursing occupation.

PTS:	1	DIF:	Easy	REF:	p. 7	
KEY:	Nursing process: N/A | Client need: N/A | Cognitive level: Recall	

	9.	ANS:	2
Clara Barton was an American teacher, nurse, and humanitarian who organized the American Red Cross after the Civil War. Louisa May Alcott was an American novelist who wrote Little Women in 1868. 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. 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	DIF:	Easy	REF:	p. 10	
KEY:	Nursing process: N/A | Client need: N/A | Cognitive level: Recall	

	10.	ANS:	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. A definition of nursing would not be likely to increase the number of informed people recruited into nursing. A definition of nursing would do little to improve the nurse’s role satisfaction. Although a definition of nursing might contribute to fighting stereotypes of nursing, other, more powerful influences (e.g., media portrayals) exist to counteract it.

PTS:	1	DIF:	Easy	
REF:	V1, pp. 11–13; students must infer from content	
KEY:	Nursing process: N/A | Client need: N/A | Cognitive level: Recall	

	11.	ANS:	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. No well-known, scientific studies support APNs’ effect on the use of advanced technology. No well-known, scientific studies support APNs’ effect on the frequency of emergency department visits. No well-known, scientific studies support APNs’ effect on the use of alternative therapies.

PTS:	1	DIF:	Moderate	REF:	p. 20	
KEY:	Nursing process: N/A | Client need: N/A | Cognitive level: Recall	

	12.	ANS:	1
Both traditional and complementary therapies can produce adverse effects in some patients. Many medications are derived from herbs, but the alternative treatments usually use the herbs, not prescription medication. Insurance programs do not necessarily reimburse alternative treatments, because many are not supported by sound scientific research methodology. Alternative medications are not regulated by the FDA.

PTS:	1	DIF:	Moderate	REF:	p. 20	
KEY:	Nursing process: N/A | Client need: N/A | Cognitive level: Recall	

	13.	ANS:	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.

PTS:	1	DIF:	Difficult	REF:	p. 20–21; students must conclude from content
KEY:	Nursing process: N/A | Client need: N/A | Cognitive level: Analysis

	14.	ANS:	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. Acute care facilities focus on preventing illnesses and treating acute problems. These facilities include physicians’ offices, clinics, and diagnostic centers. 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. Extended care facilities typically provide long-term care, rehabilitation, wound care, and ongoing monitoring of patient conditions.

PTS:	1	DIF:	Easy	
REF:	p. 18 | ESG, Chapter 1, “Healthcare Delivery Systems—Expanded Discussion,” “Where is Healthcare Provided?”		
KEY:	Nursing process: N/A | Client need: SECE | Cognitive level: Application

	15.	ANS:	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. 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. In primary nursing, one nurse plans the care for a group of patients round-the-clock. The primary nurse assesses the patient and develops the plan of care. When he or she is working, he or she provides care for those patients that he or she is responsible for. 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. 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	DIF:	Moderate	
REF:	ESG, Chapter 1, “Healthcare Delivery Systems—Expanded Discussion,” “What Models of Care Are Used to Provide Nursing Care?”	
KEY:	Nursing process: Implementation | Client need: SECE | Cognitive level: Analysis

	16.	ANS:	1
The social worker coordinates services and counsels patients about financial, housing, marital, and family issues affecting healthcare. The occupational therapist helps patients regain function and independence for activities of daily living. Physician’s assistants work under the physician’s direction to diagnose certain diseases and injuries. 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	DIF:	Moderate	
REF:	ESG, Chapter 1, “Healthcare Delivery Systems—Expanded Discussion,” “What Healthcare Providers Will You Work With?”	
KEY:	Nursing process: Planning | Client need: SECE | Cognitive level: Comprehension

	17.	ANS:	3
Preferred provider organizations are a form of managed care that allows the patient a greater choice of providers, medications, and medical devices within the designated list. Health maintenance organizations allow the patient to choose a primary care provider within the organization to coordinate his care. This type of program will only reimburse medical care when the patient has first obtained a referral from the primary provider. Integrated delivery networks combine providers, healthcare facilities, pharmaceuticals, and services into one system, and the patient must remain within the system to receive care. Employment-based private insurance is not a managed care organization.

PTS:	1	DIF:	Easy	
REF:	ESG, Chapter 1, “Healthcare Delivery Systems—Expanded Discussion,” “How Do Healthcare Policy and Reform Efforts Affect Care?”	
KEY:	Nursing process: N/A | Client need: SECE | Cognitive level: Analysis

	18.	ANS:	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. Using the traditional model, the nurse would have to obtain a physician’s order to assist the patient out of bed after surgery. The nursing care plan guides nursing care but cannot specify when the patient can get out of bed postoperatively without a physician’s order. 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.

PTS:	1	DIF:	Moderate	
REF:	ESG, Chapter 1, “Healthcare Delivery Systems—Expanded Discussion,” “Issues Related to Healthcare Reform”	
KEY:	Nursing process: Planning | Client need: SECE | Cognitive level: Application

	19.	ANS:	4
Typically, registered nurses serve as case managers for patients with specific diagnoses. Their role is coordinator of care across the healthcare system. The occupational therapist, physician, and physician’s assistant all serve on the healthcare team and take direction from the case manager.

PTS:	1	DIF:	Easy	
REF:	ESG, Chapter 1, “Healthcare Delivery Systems—Expanded Discussion,” “What Healthcare Providers Will You Work With?”	
KEY:	Nursing process: N/A | Client need: SECE | Cognitive level: Recall

	20.	ANS:	2
Primary care services focus on health promotion and disease prevention; administering childhood immunizations is one such service. Providing wound care and drug rehabilitation are examples of tertiary care services. Outpatient hernia repair surgery is an example of a secondary care service.

PTS:	1	DIF:	Moderate	
REF:	ESG, Chapter 1, “Healthcare Delivery Systems—Expanded Discussion,” “Categories of Healthcare?”	
KEY:	Nursing process: N/A | Client need: SECE | Cognitive level: Application

	21.	ANS:	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 to get skilled care until she is able to return home. A nursing home provides custodial care for people, like this patient, 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. This patient cannot ambulate or perform activities of daily living, so outpatient therapy and home care would not be appropriate.

PTS:	1	DIF:	Moderate	REF:	p. 18	
KEY:	Nursing process: Implementation | Client need: SECE | Cognitive level: Application

MULTIPLE RESPONSE

	22.	ANS:	1, 4
Health promotion includes strategies that promote positive lifestyle changes. Disinfecting an abraded knee is a treatment/intervention for an injury. Administering a vaccination is a disease-prevention and treatment activity.

PTS:	1	DIF:	Moderate	
REF:	p. 18; high-level question, not directly stated in text	
KEY:	Nursing process: N/A | Client need: HPM | Cognitive level: Application

	23.	ANS:	1, 2
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). 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	DIF:	Easy	REF:	p. 17	
KEY:	Nursing process: Implementation | Client need: SECE | Cognitive level: Comprehension

MATCHING

	24.	ANS:	3	PTS:	1	DIF:	Moderate	
REF:	p. 13; must recognize examples not provided in content	
KEY:	Nursing process: N/A | Client need: N/A | Cognitive level: Application

	25.	ANS:	5	PTS:	1	DIF:	Moderate	
REF:	p. 13; must recognize examples not provided in content	
KEY:	Nursing process: N/A | Client need: N/A | Cognitive level: Application

	26.	ANS:	1	PTS:	1	DIF:	Moderate	
REF:	p. 13; must recognize examples not provided in content	
KEY:	Nursing process: N/A | Client need: N/A | Cognitive level: Application

	27.	ANS:	2	PTS:	1	DIF:	Moderate	
REF:	p. 13; must recognize examples not provided in content	
KEY:	Nursing process: N/A | Client need: N/A | Cognitive level: Application

	28.	ANS:	4	PTS:	1	DIF:	Difficult	
REF:	pp. 6–11; must recognize examples not provided in content		
KEY:	Nursing process: N/A | Client need: N/A | Cognitive level: Recall	

	29.	ANS:	6	PTS:	1	DIF:	Difficult	
REF:	pp. 6–11; must recognize examples not provided in content		
KEY:	Nursing process: N/A | Client need: N/A | Cognitive level: Recall	

	30.	ANS:	7	PTS:	1	DIF:	Difficult	
REF:	pp. 6–11; must recognize examples not provided in content		
KEY:	Nursing process: N/A | Client need: N/A | Cognitive level: Recall	

	31.	ANS:	5	PTS:	1	DIF:	Difficult	
REF:	pp. 6–11; must recognize examples not provided in content		
KEY:	Nursing process: N/A | Client need: N/A | Cognitive level: Recall	

	32.	ANS:	3	PTS:	1	DIF:	Difficult	
REF:	pp. 6–11; must recognize examples not provided in content		
KEY:	Nursing process: N/A | Client need: N/A | Cognitive level: Recall	

	33.	ANS:	2	PTS:	1	DIF:	Difficult	
REF:	pp. 6–11; must recognize examples not provided in content		
KEY:	Nursing process: N/A | Client need: N/A | Cognitive level: Recall	

	34.	ANS:	2	PTS:	1	DIF:	Moderate	REF:	p. 17
KEY:	Nursing process: N/A | Client need: N/A | Cognitive level: Recall	

	35.	ANS:	3	PTS:	1	DIF:	Moderate	REF:	p. 17
KEY:	Nursing process: N/A | Client need: N/A | Cognitive level: Recall	

	36.	ANS:	1	PTS:	1	DIF:	Moderate	REF:	p. 17
KEY:	Nursing process: N/A | Client need: N/A | Cognitive level: Recall	

	37.	ANS:	5	PTS:	1	DIF:	Moderate	REF:	p. 17
KEY:	Nursing process: N/A | Client need: N/A | Cognitive level: Recall	

	38.	ANS:	4	PTS:	1	DIF:	Moderate	REF:	p. 17
KEY:	Nursing process: N/A | Client need: N/A | Cognitive level: Recall	

TRUE/FALSE

	39.	ANS:	T
The nurse caring for a patient receiving care after outpatient surgery provides the same type of care as with the hospitalized patient. The only difference is that the outpatient spends fewer than 24 hours in the facility.

PTS:	1	DIF:	Easy	
REF:	p. 18; students must draw conclusion from content	
KEY:	Nursing process: Implementation | Client need: SECE | Cognitive level: Recall

COMPLETION

	40.	ANS:	
Medicaid 
Medicaid is a health program run by the state and funded by the federal and state governments. It is intended to provide preventative and acute healthcare for individuals without ability to pay for services, particularly pregnant women and children.

PTS:	1	DIF:	Moderate	
REF:	ESG, Chapter 1, “Healthcare Delivery Systems—Expanded Discussion,” “How Is Healthcare Financed?”		
KEY:	Nursing process: N/A | Client need: SECE | Cognitive level: Recall

	41.	ANS:	
Medicare
Medicare is a federal insurance program created by Title XVIII of Social Security Act of 1965. This Act was designed to protect people age 65 years and older from the high cost of healthcare. In 1972, the program was expanded to cover disabled workers as well as people with end-stage renal disease.

PTS:	1	DIF:	Moderate	
REF:	ESG, Chapter 1, “Healthcare Delivery Systems—Expanded Discussion,” “How Is Healthcare Financed?”		
KEY:	Nursing process: N/A | Client need: SECE | Cognitive level: Recall