Chapter 1: Historical Perspective and Current Trends

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

____	1.	The nursing student predominantly uses knowledge about the history of nursing for what purpose?
1.	To understand the professional choices open to the student	
2.	To prevent making medication errors in practice	
3.	To determine what geographical area is the best place to practice	
4.	To reduce the cost of delivering quality healthcare	

____	2.	The nurse is working in an underdeveloped country and observes the natives lighting ritual fires and pounding on primitive drums around the sick person to promote recovery. The nurse interprets this behavior as indicating the natives believe illness results from what?
1.	Pathogens and genetics	
2.	Evil spirits	
3.	Tides and planets	
4.	Plants and animals	

____	3.	The person credited with making a written record of healthcare practices and removing the mythical aspect of healthcare is who?
1.	Hammurabi	
2.	Florence Nightingale	
3.	Hippocrates	
4.	Apollo	

____	4.	Who served as the first public health nurses, caring for the sick and the poor?
1.	The Presbyterian Church	
2.	Salerno	
3.	Jewish scholars	
4.	Convent deaconesses	

____	5.	What is a crucial issue the nurse working in the late industrialization era would need to address in order to promote health?
1.	Reducing spread of infection	
2.	Reducing sedentary lifestyle	
3.	Teaching proper use of medications	
4.	Teaching use of car seats	

____	6.	What types of skills would a nursing student learn while attending Kaiserworth Deaconess Institution in 1836?
1.	Administering immunizations	
2.	Assisting in surgery	
3.	Washing and changing bed linens	
4.	Developing a plan of care	

____	7.	The nurse demonstrates Florence Nightingale’s theory of nursing with what intervention?
1.	Respecting the patient’s culture and incorporating cultural needs in the plan of care	
2.	Promoting good health and treating those who are ill in a holistic manner	
3.	Understanding how to motivate people to practice a healthy lifestyle and reduce risks	
4.	Teaching other nurses how to deliver the highest quality of nursing care.	

____	8.	What action performed by the nurse directly resulted from the contribution made by Linda Richards?
1.	Using an antiseptic before administering an injection	
2.	Exploring the psychosocial needs of the patient	
3.	Documenting patient care in the medical record	
4.	Listening to a patient describe his or her condition	

____	9.	After graduating from nursing school, the graduate takes a licensure examination as the result of what nurse’s contribution?
1.	Florence Nightingale	
2.	Mary Adelaid Nutting	
3.	Lavinia L. Dock	
4.	Isabel Hampton Robb	

____	10.	In addition to caring for the sick, what other skills would the first LPN students learn when attending the Ballard School in New York in 1893?
1.	Political advocacy	
2.	Homemaking	
3.	Communication	
4.	Carpentry	

____	11.	The nurse responds to an alarm on a pulse oximeter and sees the patient’s oxygen saturation is reading 38%. The nurse observes the patient, noting a respiratory rate of 12 breaths per minute, pink mucous membranes, and easy regular respirations. The nurse concludes the pulse oximeter is not reading accurately. Whose theory of nursing is this nurse demonstrating?
1.	Annie Goodrich	
2.	Lillian D. Wald	
3.	Florence Nightingale	
4.	Linda Richards	

____	12.	What statement describes Florence Nightingale’s beliefs about nursing?
1.	Practicing nurses should be licensed.	
2.	Promotion of good health and treating the ill are nursing priorities.	
3.	Nurses could simultaneously have a career and a marriage.	
4.	Organisms cause infection.	

____	13.	What was Mary Eliza Mahoney’s contribution to nursing?
1.	She organized the first visiting nurse association.	
2.	She founded the American Journal of Nursing.	
3.	She founded the National League of Nursing.	
4.	She worked for the acceptance of African Americans into the nursing profession.	

____	14.	What professional organization was the first to focus on licensed practical nurses (LPNs)?
1.	National Association for Practical Nurse Education and Services (NAPNES)	
2.	National Federation of Licensed Practical Nurses (NFLPN)	
3.	National League for Nursing (NLN)	
4.	American Nurses Association (ANA)	

____	15.	What statement accurately describes the NFLPN?
1.	It represents both registered nurses (RNs) and LPNs.	
2.	It represents LPNs/LVNs only.	
3.	It is open to anyone interested in nursing.	
4.	It is open to anyone in the healthcare field.	

____	16.	What organizations represent only LPNs/LVNs?
1.	ANA and NLN	
2.	NFLPN and NLN	
3.	NAPNES and NFLPN	
4.	NAPNES and ANA	

____	17.	The nurse working in mental health nursing honors what historical nurse for working to improve care of the mentally ill?
1.	Clara Barton	
2.	Florence Nightingale	
3.	Dorothea Dix	
4.	Lillian D. Wald	

____	18.	What is the difference between the LPN and LVN nursing title?
1.	LPNs have a longer educational program than LVNs.	
2.	LVNs and LPNs have the same duties and skills, just different titles.	
3.	LVNs are able to perform venipuncture and LPNs cannot.	
4.	LPNs are working toward an RN license while LVNs are not.	

____	19.	What mythical god was believed to promote healthcare in ancient times?
1.	Apollo	
2.	Zeus	
3.	Isis	
4.	Ares	

____	20.	What factor has had the greatest impact on the current nursing shortage?
1.	Later age of women having children	
2.	Fewer women being born	
3.	Overall unemployment rate	
4.	More employment options for women	

____	21.	What health condition is classified as a World Health Organization priority and a focus of health promotion for nurses?
1.	HIV	
2.	MRSA	
3.	Natural disasters	
4.	Terrorism	

____	22.	What trend in healthcare has only existed for the past decade and has changed nursing education to prepare student nurses for practice after graduation?
1.	Technology	
2.	Cultural diversity	
3.	HIV	
4.	Nursing shortage	

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

____	23.	What factors are contributing to the nursing shortage? (Select all that apply.)
1.	Increased demand for nurses	
2.	Shortage of nursing faculty	
3.	Lack of nursing organizations	
4.	Nurses leaving the profession due to poor working conditions	
5.	Not enough interest in nursing	

____	24.	The newly licensed LPN joins a professional organization for what benefits? (Select all that apply.)
1.	Opportunities to maintain current nursing knowledge	
2.	Most facilities mandate membership before hiring a nurse.	
3.	Organizations offer a way for the LPN’s voice to be heard regarding concerns.	
4.	They advocate for the LPN in professional matters.	
5.	It is a requirement for licensure in most states.	

____	25.	In order to deliver the safest possible care, the nurse needs to understand what? (Select all that apply.)
1.	How to perform the procedure correctly	
2.	Why the procedure is being performed	
3.	How the procedure will affect the patient	
4.	The cost of performing the procedure	
5.	The equipment needed to perform the procedure	

Chapter 1: Historical Perspective and Current Trends
Answer Section

MULTIPLE CHOICE

	1.	ANS:	1
Understanding nursing history helps the nurse to better recognize the many choices available when choosing their own future path.

PTS:	1	REF:	Chapter: 1	OBJ:	Objective: 1	
KEY:	Content Area: History | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying

	2.	ANS:	2
A belief that disease was caused by evil spirits would result in lighting fires or candles and making loud noise to try to ward off the spirits.

PTS:	1	REF:	Chapter: 1	OBJ:	Objective: 2	
KEY:	Content Area: History | Integrated Processes: Nursing Process | Client Need: Psychosocial Integrity | Cognitive Level: Analyzing	

	3.	ANS:	3
Hippocrates wrote the first medical textbook, outlining current healthcare practices and removed the mythical belief that Apollo was responsible for health. Hammurabi wrote a code of laws to protect the patient and define legal limitations of caregivers, Florence Nightingale introduced modern nursing during the Crimean War, and Apollo was a mythical God who was believed to control health and wellness.

PTS:	1	REF:	Chapter: 1	OBJ:	Objective: 2	
KEY:	Content Area: History | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding

	4.	ANS:	4
Deaconesses from local convents acted as the first public health nurses, providing care for the sick and the poor based on the Christian belief in the importance of caring for one another.

PTS:	1	REF:	Chapter: 1	OBJ:	Objective: 2	
KEY:	Content Area: History | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding

	5.	ANS:	1
Many deaths resulted from communicable diseases and lack of cleanliness in hospitals, so the nurse’s priority concern with health promotion would be reducing the spread of infection.

PTS:	1	REF:	Chapter: 1	OBJ:	Objective: 2	
KEY:	Content Area: History | Integrated Processes: Teaching/Learning | Client Need: Health Promotion and Maintenance | Cognitive Level: Analyzing		

	6.	ANS:	3
Washing and changing bed linens, mopping floors, and housekeeping tasks were included as part of the nurse’s education. Immunizations did not exist at that time in history, and surgery was uncommon and very primitive with frequent poor outcomes. Thus assistants were rarely required and not part of nursing school. Plan of care considerations were not used until after the mid 1900s.

PTS:	1	REF:	Chapter: 1	OBJ:	Objective: 2	
KEY:	Content Area: History | Integrated Processes: Teaching/Learning | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding	

	7.	ANS:	2
Nightingale believed the nurse’s primary responsibilities included promoting health and treating the ill.

PTS:	1	REF:	Chapter: 1	OBJ:	Objective: 3	
KEY:	Content Area: History | Integrated Processes: Nursing Process | Client Need: Health Promotion and Maintenance | Cognitive Level: Applying

	8.	ANS:	3
Linda Richards developed a system for recording details about patients and patient care. This system evolved into today’s documentation system.

PTS:	1	REF:	Chapter: 1	OBJ:	Objective: 3	
KEY:	Content Area: History | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying

	9.	ANS:	4
Isabel Hampton Robb fought for licensing examinations and registration to protect patients from incompetent nurses, in order to raise the standard of the profession.

PTS:	1	REF:	Chapter: 1	OBJ:	Objective: 3	
KEY:	Content Area: History | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying	

	10.	ANS:	2
LPN students learned homemaking skills, because much of the patient care they provided was within the patient’s home.

PTS:	1	REF:	Chapter: 1	OBJ:	Objective: 4	
KEY:	Content Area: History | Integrated Processes: Teaching/Learning | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding	

	11.	ANS:	3
Florence Nightingale promoted treating the patient based on the patient’s individual needs rather than treating the disease or, in this case, the machinery.

PTS:	1	REF:	Chapter: 1	OBJ:	Objective: 3	
KEY:	Content Area: History | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Analyzing

	12.	ANS:	2
One of Florence Nightingale’s strongest beliefs was that promoting good health and treating the ill were nursing priorities. Throughout her career, Nightingale implemented changes in the nursing practice to enhance the health of all who were ill.

PTS:	1	REF:	Chapter: 1	OBJ:	Objective: 3	
KEY:	Content Area: History | Integrated Processes: Nursing Process | Client Need: Health Promotion and Maintenance | Cognitive Level: Understanding	

	13.	ANS:	4
Mary Eliza Mahoney was the first African American nurse in the United States. She spent her life working for the acceptance of African Americans into the nursing profession, and was also the organizer and the first president of the National Association for Colored Graduate Nurses.

PTS:	1	REF:	Chapter: 1	OBJ:	Objective: 3	
KEY:	Content Area: History | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding

	14.	ANS:	1
NAPNES was the first professional organization to focus on LPNs. NAPNES is very active today, with continuing education opportunities and publications for LPNs. While NFLPN focuses on LPNs, they were not the first to do so. NLN and ANA focus on both RNs and LPNs.

PTS:	1	REF:	Chapter: 1	OBJ:	Objective: 5	
KEY:	Content Area: Nursing Organizations | Integrated Processes: Teaching/Learning | Client Need: Safe, Effective Care Environment | Cognitive Level: Remembering

	15.	ANS:	2
The NFLPN is considered the official membership organization for the licensed practical nurse/licensed vocational nurse (LPN/LVN); therefore, only the LPN/LVN may join this organization.

PTS:	1	REF:	Chapter: 1	OBJ:	Objective: 5	
KEY:	Content Area: Nursing Organizations | Integrated Processes: Teaching/Learning | Client Need: Safe, Effective Care Environment | Cognitive Level: Remembering

	16.	ANS:	3
The two vocational LPN organizations are the National Federation for Licensed Practical Nurses (NFLPN) and the National Association for Practical Nurse Education and Service (NAPNES). Both the ANA and the NLN focus on both RNs and LPNs.

PTS:	1	REF:	Chapter: 1	OBJ:	Objective: 5	
KEY:	Content Area: Nursing Organizations | Integrated Processes: Teaching/Learning | Client Need: Safe, Effective Care Environment | Cognitive Level: Remembering

	17.	ANS:	3
Dorothea Dix championed the development of psychiatric hospitals, and her work also brought about improvement for prisoners in jails.

PTS:	1	REF:	Chapter: 1	OBJ:	Objective: 3	
KEY:	Content Area: History | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying	

	18.	ANS:	2
Both LPNs and licensed vocational nurses (LVNs) are legally recognized and practice in diverse healthcare settings today. LVN education predominantly takes place in California and Texas, whereas LPN education is common in other geographic areas of the country.

PTS:	1	REF:	Chapter: 1	OBJ:	Objective: 4	
KEY:	Content Area: Role of LPN | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding	

	19.	ANS:	1
The primitive healthcare that was available was provided by males, except for the midwives, and was promoted by a belief in Apollo, the mythical Greek healer.

PTS:	1	REF:	Chapter: 1	OBJ:	Objective: 2	
KEY:	Content Area: History | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Remembering

	20.	ANS:	4
One reality of the nursing shortage is that the 21st century woman has more employment options than women had previously.

PTS:	1	REF:	Chapter: 1	OBJ:	Objective: 6	
KEY:	Content Area: Trends | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Analyzing	

	21.	ANS:	1
The prevention and treatment of HIV is a World Health Organization priority. While MRSA is a focus of health promotion for nurses, it is the CDC that is focusing on reducing occurrence. The World Health Organization has not set natural disasters as a priority because they cannot be controlled, and it is not focused on reducing terrorism; nurses respond to terrorist events when they occur, but it is not a source of health promotion.

PTS:	1	REF:	Chapter: 1	OBJ:	Objective: 6	
KEY:	Content Area: Trends | Integrated Processes: Caring | Client Need: Health Promotion and Maintenance | Cognitive Level: Remembering

	22.	ANS:	1
The use of technology in healthcare has increased dramatically over the last decade, and has become a major consideration in nursing education.

PTS:	1	REF:	Chapter: 1	OBJ:	Objective: 6	
KEY:	Content Area: Trends | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Analyzing	

MULTIPLE RESPONSE

	23.	ANS:	1, 2, 4
Aging Baby Boomers, people living longer, and the increasing complexity of healthcare have all increased the demand for nurses. Insufficient nursing faculty results in turning potential nursing students away from nursing programs because there aren’t enough educated faculty to teach them. Mandatory overtime, working holidays and weekends, long hours without breaks, and other working conditions can cause nurses to leave the profession. There is no lack of nursing organizations and this does not contribute to the nursing shortage, and there is no lack of interest in nursing but not everyone is designed to be a nurse.

PTS:	1	REF:	Chapter: 1	OBJ:	Objective: 6	
KEY:	Content Area: Trends | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding

	24.	ANS:	1, 3, 4
Professional organizations provide lifelong learning opportunities for the LPN in the form of journals, seminars, and annual meetings. They also provide the LPN a voice for concerns and opinions, and they serve as an advocate for LPNs at the state and national level. Membership in a nursing organization is not usually a requirement for employment, but it can serve as a favorable indicator that the nurse is maintaining current knowledge. While ongoing education is required by some boards of nursing for licensure, there is no requirement the nurse belong to an organization.

PTS:	1	REF:	Chapter: 1	OBJ:	Objective: 6	
KEY:	Content Area: Trends | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding

	25.	ANS:	1, 2, 3, 5
Understanding how to perform the procedure correctly is important if the nurse is to maintain safety. The nurse should never perform any procedure without understanding why it is being performed and what outcome is desired. The nurse is responsible for teaching the patient what to expect before the procedure is begun, so the nurse must understand how the procedure will impact the patient. The nurse will gather the equipment required to perform the procedure, therefore  needs to know what will and what might be needed. The nurse is not responsible for knowing the cost of the procedure.

PTS:	1	REF:	Chapter: 1	OBJ:	Objective: 6	
KEY:	Content Area: QSEN | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying