Chapter 1: Historical Perspectives 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 which purpose?
1.	To understand the professional choices open to the student	
2.	To prevent making medication errors in practice	
3.	To determine in which geographic area it is best to practice	
4.	To reduce the cost of delivering quality health care	

____	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 which items?
1.	Pathogens and genetics	
2.	Evil spirits	
3.	Tides and planets	
4.	Plants and animals	

____	3.	Who is credited with making a written record of health-care practices and removing the mythical aspect of health care?
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.	Which is a crucial issue the nurse working in the late industrialization era would need to address 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.	The nurse demonstrates Florence Nightingale’s theory of nursing with which 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	

____	7.	Which 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	

____	8.	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	

____	9.	Which 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)	

____	10.	Which 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 health-care field.	

____	11.	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	

____	12.	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.	

____	13.	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	

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

____	14.	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	

____	15.	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 Perspectives and Current Trends
Answer Section

MULTIPLE CHOICE

	1.	ANS:	1
Chapter: Chapter 1 Historical Perspective and Current Trends
Objective: 1. Verbalize the importance of understanding the history of nursing. 
Page: 3
Heading: Introduction 
Integrated Processes: Communication and Documentation
Client Need: Safe, Effective Care Environment
Cognitive Level: Application [Applying]
Concept: Professionalism 
Difficulty: Moderate

	Feedback	
1	Understanding nursing history helps the nurse to better recognize the many choices available when choosing his or her own future path.	
2	Understanding nursing history does not prevent medication errors in practice. 	
3	Understanding nursing history does not determine which geographic area is the best place in which to practice. 	
4	Understanding nursing history does not reduce the cost of delivering quality health care.	

PTS:	1	CON:	Professionalism	

	2.	ANS:	2
Chapter: Chapter 1 Historical Perspective and Current Trends
Objective: 2. Identify the accomplishments of nurses during ancient times, the Dark Ages, and modern nursing. 
Page: 4
Heading: The Beginning of Nursing 
Integrated Processes: Nursing Process
Client Need: Psychosocial Integrity
Cognitive Level: Analysis [Analyzing]
Concept: Professionalism 
Difficulty: Difficult

	Feedback	
1	The belief that disease was caused by pathogens and genetics would not result in lighting fires or candles and making loud noises to ward off spirits. 	
2	A belief that disease was caused by evil spirits would result in lighting fires or candles and making loud noises to try to ward off the spirits.	
3	The belief that disease was caused by tides and planets would not result in lighting fires or candles and making loud noises to ward off spirits.	
4	The belief that disease was caused by plants and animals would not result in lighting fires or candles and making loud noises to ward off spirits.	

PTS:	1	CON:	Professionalism	

	3.	ANS:	3
Chapter: Chapter 1 Historical Perspective and Current Trends
Objective: 2. Identify the accomplishments of nurses during ancient times, the Dark Ages, and modern nursing.
Page: 4
Heading: The Beginning of Nursing 
Integrated Processes: Communication and Documentation
Client Need: Safe, Effective Care Environment
Cognitive Level: Comprehension [Understanding]
Concept: Professionalism 
Difficulty: Easy 
	Feedback	
1	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.	
2	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.	
3	Hippocrates wrote the first medical textbook, outlining current health-care practices, and removed the mythical belief that Apollo was responsible for health. 	
4	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	CON:	Professionalism	

	4.	ANS:	4
Chapter: Chapter 1 Historical Perspective and Current Trends
Objective: 2. Identify the accomplishments of nurses during ancient times, the Dark Ages, and modern nursing.
Page: 5
Heading: Dark Ages and Introduction of Christianity 
Integrated Processes: Communication and Documentation
Client Need: Safe, Effective Care Environment
Cognitive Level: Comprehension [Understanding]
Concept: Professionalism 
Difficulty: Easy 
	Feedback	
1	The Presbyterian Church did not serve as the first public health nurses who cared for the sick and poor. 	
2	The Salerno did not serve as the first public health nurses who cared for the sick and poor.	
3	The Jewish scholars did not serve as the first public health nurses who cared for the sick and poor.	
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	CON:	Professionalism	

	5.	ANS:	1
Chapter: Chapter 1 Historical Perspective and Current Trends
Objective: 2. Identify the accomplishments of nurses during ancient times, the Dark Ages, and modern nursing.
Page: 5
Heading: Era of Industrialization
Integrated Processes: Teaching/Learning
Client Need: Health Promotion and Maintenance
Cognitive Level: Analysis [Analyzing]
Concept: Leadership and Management 
Difficulty: Difficult 
	Feedback	
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.	
2	Reducing sedentary lifestyle promotes health; however, this was not a crucial issue in the late industrialization era. 	
3	Teaching the proper use of medications promotes health; however, this was not a crucial issue in the late industrialization era.	
4	Reducing the use of car seats promotes health; however, this was not a crucial issue in the late industrialization era.	

PTS:	1	CON:	Leadership and Management

	6.	ANS:	2
Chapter: Chapter 1 Historical Perspective and Current Trends
Objective: 3. List four modern nurses who significantly contributed to the history of nursing and identify a major contribution of each. 
Page: 7
Heading: Florence Nightingale 
Integrated Processes: Nursing Process
Client Need: Health Promotion and Maintenance
Cognitive Level: Application [Applying]
Concept: Professionalism 
Difficulty: Moderate 
	Feedback	
1	This is not a primary belief regarding the responsibility of nurses according to Nightingale. 	
2	Nightingale believed the nurse’s primary responsibilities included promoting health and treating the ill.	
3	This is not a primary belief regarding the responsibility of nurses according to Nightingale.	
4	This is not a primary belief regarding the responsibility of nurses according to Nightingale.	

PTS:	1	CON:	Professionalism	

	7.	ANS:	3
Chapter: Chapter 1 Historical Perspective and Current Trends
Objective: 3. List four modern nurses who significantly contributed to the history of nursing and identify a major contribution of each.
Page: 9
Heading: Linda Richards 
Integrated Processes: Communication and Documentation
Client Need: Safe, Effective Care Environment
Cognitive Level: Application [Applying]
Concept: Professionalism 
Difficulty: Moderate 
	Feedback	
1	This nursing action is not a reflection of Linda Richards. 	
2	This nursing action is not a reflection of Linda Richards.	
3	Linda Richards developed a system for recording details about patients and patient care. This system evolved into today’s documentation system.	
4	This nursing action is not a reflection of Linda Richards.	

PTS:	1	CON:	Professionalism	

	8.	ANS:	3
Chapter: Chapter 1 Historical Perspective and Current Trends
Objective: 3. List four modern nurses who significantly contributed to the history of nursing and identify a major contribution of each.
Page: 7
Heading: Florence Nightingale 
Integrated Processes: Communication and Documentation
Client Need: Safe, Effective Care Environment
Cognitive Level: Analysis [Analyzing]
Concept: Professionalism 
Difficulty: Difficult 
	Feedback	
1	The nurse is not demonstrating Goodrich’s theory of nursing. 	
2	The nurse is not demonstrating Wald’s theory of nursing.	
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.	
4	The nurse is not demonstrating Richards’s theory of nursing.	

PTS:	1	CON:	Professionalism	

	9.	ANS:	1
Chapter: Chapter 1 Historical Perspective and Current Trends
Objective: 5. Name two official membership organizations for LPNs concerned with practical nursing education and nursing practice. 
Page: 11
Heading: History of Licensed Practical and Vocational Nurse 
Integrated Processes: Teaching/Learning
Client Need: Safe, Effective Care Environment
Cognitive Level: Knowledge [Remembering]
Concept: Professionalism 
Difficulty: Easy 
	Feedback	
1	NAPNES was the first professional organization to focus on LPNs. NAPNES is very active today, with continuing education opportunities and publications for LPNs. 	
2	While NFLPN focuses on LPNs, they were not the first to do so.	
3	NLN and ANA focus on both RNs and LPNs.	
4	NLN and ANA focus on both RNs and LPNs.	

PTS:	1	CON:	Professionalism	

	10.	ANS:	2
Chapter: Chapter 1 Historical Perspective and Current Trends
Objective: 5. Name two official membership organizations for LPNs concerned with practical nursing education and nursing practice. 
Page: 11
Heading: History of Licensed Practical and Vocational Nurse 
Integrated Processes: Teaching/Learning
Client Need: Safe, Effective Care Environment
Cognitive Level: Knowledge [Remembering]
Concept: Professionalism 
Difficulty: Easy 
	Feedback	
1	This is not an accurate statement regarding NFLPN. 	
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.	
3	This is not an accurate statement regarding NFLPN.	
4	This is not an accurate statement regarding NFLPN.	

PTS:	1	CON:	Professionalism	

	11.	ANS:	3
Chapter: Chapter 1 Historical Perspective and Current Trends
Objective: 3. List four modern nurses who significantly contributed to the history of nursing and identify a major contribution of each. 
Page: 8
Heading: Dorothea Dix 
Integrated Processes: Caring
Client Need: Safe, Effective Care Environment
Cognitive Level: Application [Applying]
Concept: Professionalism 
Difficulty: Moderate 
	Feedback	
1	The nurse who works in mental health does not honor the beliefs of Clara Barton. 	
2	The nurse who works in mental health does not honor the beliefs of Florence Nightingale. 	
3	Dorothea Dix championed the development of psychiatric hospitals, and her work also brought about improvement for prisoners in jails.	
4	The nurse who works in mental health does not honor the beliefs of Lillian D. Wald. 	

PTS:	1	CON:	Professionalism	

	12.	ANS:	2
Chapter: Chapter 1 Historical Perspective and Current Trends
Objective: 4. Discuss the role of LPN and the evolution of the role historically. 
Page: 3
Heading: History of Licensed Practical and Vocational Nurse 
Integrated Processes: Caring
Client Need: Safe, Effective Care Environment
Cognitive Level: Comprehension [Understanding]
Concept: Professionalism 
Difficulty: Easy 
	Feedback	
1	This is not an accurate statement regarding the difference between the LPN and LVN nursing title. 	
2	Both LPNs and licensed vocational nurses (LVNs) are legally recognized and practice in diverse health-care settings today. LVN education predominantly takes place in California and Texas, whereas LPN education is common in other geographic areas of the country.	
3	This is not an accurate statement regarding the difference between the LPN and LVN nursing title.	
4	This is not an accurate statement regarding the difference between the LPN and LVN nursing title.	

PTS:	1	CON:	Professionalism	

	13.	ANS:	4
Chapter: Chapter 1 Historical Perspective and Current Trends
Objective: 6. Discuss three current trends and issues that affect the practice of LPNs. 
Page: 13
Heading: Current Trends and Issues
Integrated Processes: Caring
Client Need: Safe, Effective Care Environment
Cognitive Level: Analysis [Analyzing]
Concept: Health-Care System 
Difficulty: Difficult 
	Feedback	
1	Age of pregnancy does not have the greatest impact on the current nursing shortage. 	
2	A decrease in the number of women born does not have the greatest impact on the nursing shortage. 	
3	The overall unemployment rate does not have the greatest impact on the current nursing shortage. 	
4	One reality of the nursing shortage is that the 21st century woman has more employment options than women had previously.	

PTS:	1	CON:	Health-Care System	

MULTIPLE RESPONSE

	14.	ANS:	1, 2, 4
Chapter: Chapter 1 Historical Perspective and Current Trends
Objective: 6. Discuss three current trends and issues that affect the practice of LPNs. 
Page: 13
Heading: Current Trends and Issues 
Integrated Processes: Caring
Client Need: Safe, Effective Care Environment
Cognitive Level: Comprehension [Understanding]
Concept: Health-Care System 
Difficulty: Moderate 

	Feedback	
1.	Aging baby boomers, people living longer, and the increasing complexity of health care 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. 	
2. 	Aging baby boomers, people living longer, and the increasing complexity of health care 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. 	
3. 	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.	
4. 	Aging baby boomers, people living longer, and the increasing complexity of health care 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. 	
5.	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	CON:	Health-Care System	

	15.	ANS:	1, 2, 3, 5
Chapter: Chapter 1 Historical Perspective and Current Trends
Objective: 6. Discuss three current trends and issues that affect the practice of LPNs. 
Page: 15
Heading: Current Trends and Issues 
Integrated Processes: Caring
Client Need: Safe, Effective Care Environment
Cognitive Level: Application [Applying]
Concept: Health-Care System 
Difficulty: Moderate 

	Feedback	
1.	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, the nurse needs to know what will and what might be needed. 	
2. 	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, the nurse needs to know what will and what might be needed.	
3. 	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, the nurse needs to know what will and what might be needed.	
4. 	The nurse is not responsible for knowing the cost of the procedure.	
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, the nurse needs to know what will and what might be needed.	

PTS:	1	CON:	Health-Care System