Professional Nursing: Concepts and Challenges 8th Edition Test Bank

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Chapter 01: Nursing in Today’s Evolving Health Care EnvironmentBlack: Professional Nursing: Concepts & Challenges, 8th EditionMULTIPLE CHOICE1.Which of the following could eventually change the historical status of nursing as afemale-dominated profession?a.More men graduating from baccalaureate and higher degree programsb.The proportion of men in nursing beginning to increasec.More male graduates of basic nursing programs entering the workplaced.Salary compensation increasing to attract more menANS:CFeedbackA“More men graduating from baccalaureate and higher degree programs” is notthe best answer because associate degree programs produce the most newgraduates.BThe percentage of men in nursing has increased 50% since 2000.CThe more men who enter the workplace as nurses, the less nursing will be seenas a female-dominated profession.DSalary rates do not appear to relate to the recruitment of men into nursing.DIF:Cognitive Level: ComprehensionREF:Page 22.The racial and ethnic composition of the nursing profession will change to more accuratelyreflect the population as a whole whena.theincreased numbers of racial and ethnic minorities enrolled in educationalprograms graduate and begin to practice.b.the number of Asians or Native Hawaiian-Pacific Islanders begins to increase.c.the percentage of African-American and Hispanic nurses decreases more than thepercentage of white nurses.d.the nonwhite portion of the general population decreases.ANS:AFeedbackAA larger percentage of minorities are enrolled in nursing educational programsthan previously.BAsians and Native Hawaiian-Pacific Islanders are over represented in nursingcompared to their percentage of the general population.CNot only would the percentage of African-American and Hispanic nurses need toincrease, the percentage of white nurses would have to decrease in order to moreaccurately reflect the population as a whole.DThe nonwhite portion of the general population is not likely to decrease.DIF:Cognitive Level: ComprehensionREF:Page 33.Which of the following is a correct statement about the registered nurse (RN) population?

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a.The racial/ethnic composition of RNs closely resembles that of the generalpopulation.b.The number of men entering nursing has decreased steadily over the last decade.c.The rate of aging of RNs has slowed for the first time in the past 30 years.d.The majority of employed RNs working full time must work a second position.ANS:CFeedbackAThe racial/ethnic composition of RNs is increasing, but does not approximatetheir percentage of the overall population.BThe number of men entering nursing is increasing.CThe average age of RNs in both 2004 and 2008 was 46. This is a result of thenumbers of RNs under 30 in the workforce.DAccording to 2008 data, only 12% of nurses working full time hold secondpositions.DIF:Cognitive Level: KnowledgeREF:Page 34.Which of the following best describes trends in nursing education?a.Numbers of RNs with bachelor’s and higher degrees are increasing.b.Numbers of RNs with associate degrees are decreasing.c.Foreign-born nurses practicing in the United States are seen as less knowledgeablebecause of their lesser educational preparation.d.Numbers of RNs with diploma educations are increasing.ANS:AFeedbackASlightly over 50% of RNs eventually obtain their bachelor’s of science innursing (BSN) or a higher nursing degree.BThe majority of nurses in this country get their initial nursing education inassociate degree in nursing (ADN) programs.CForeign-born nurses practicing in the United States may be viewed as lessknowledgeable by their peers because of language and cultural differences.DThe numbers of diploma-educated nurses are declining.DIF:Cognitive Level: KnowledgeREF:Page 45.Despite the variety of work settings available to the RN, data indicate that the primary worksite for RNs isa.ambulatory care settings.b.community health settings.c.long-term care facilities.d.acute care hospitals.ANS:DFeedbackAAmbulatory care settings account for about 10.5% of RNs’ places of

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employment.BPublic health and community health settings account for 7.8% of employed RNs.CLong-term care facilities account for 5.3% of RNs’ places of employment.DStatistics show that 62.2% of RNs work in acute care hospitals.DIF:Cognitive Level: KnowledgeREF:Page 56.One important advantage of clinical ladder programs for hospital-based RNs is that theya.allow career advancement for nurses who choose to remain at the bedside.b.encourage nurses to move into management positions in which they can influencepatient care on a broader scale.c.encourage RNs to become politically active and guide the profession of nursing.d.provide training to staff nurses so they can move seamlessly across departments.ANS:AFeedbackAClinical ladder programs allow nurses to advance professionally while remainingat the bedside.BClinical ladder programs are designed to keep proficient nurses at the bedside.CEncouraging RNs to become politically active and guide the profession ofnursing is not the goal of clinical ladder programs.DClinical ladder programs are not designed to facilitate transfer betweendepartments.DIF:Cognitive Level: ComprehensionREF:Page 67.Which of the following statements is correct about community health nursing (CHN)?a.Prevention and community education are the cornerstones of CHN.b.Nursing care is rapidly moving from the home setting to the institutional setting.c.High-tech care such as ventilators and total parenteral nutrition cannot be handledin the home.d.Assessment skills are less important in CHN because patients are not acutely ill.ANS:AFeedbackAThe community health nurse provides educational programs in healthmaintenance, disease prevention, nutrition, and child care.BCare is moving into the home setting.CHome care is increasing in complexity.DCommunity health nurses must have excellent assessment skills as they do nothave the immediate backup that an acute care facility offers.DIF:Cognitive Level: ComprehensionREF:Page 98.Which of the following is most essential for the nurse entrepreneur to be successful?a.Ability to take direction wellb.Excellent time-management skillsc.Avoidance of risks

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d.A college degree in businessANS:BFeedbackANurse entrepreneurs must function autonomously.BNurse entrepreneurs must be well organized and efficient.CStarting a business involves risk.DA degree in business is not required to be a nurse entrepreneur.DIF:Cognitive Level: AnalysisREF:Page 169.The major benefit of serving as a military nurse isa.broader responsibilities and scope of practice than civilian nurses.b.working with entirely baccalaureate-prepared peers on active duty.c.serving as an officer on active duty or in the reserves.d.the financial support to seek advanced degrees.ANS:DFeedbackAAlthough military nurses do have broader responsibilities and scopes of practicethan civilian nurses do, this is not the major benefit.BAlthough military nurses do work with entirely baccalaureate-prepared peers onactive duty, this is not the major benefit.CAlthough military nurses serve as officers on active duty or in the reserves, thisis not the major benefit.DAdvanced education is supported by the military financially and also allows forpromotion in rank at an accelerated pace.DIF:Cognitive Level: ComprehensionREF:Page 1110.Which of the following statements explains why the school nurse of today is truly acommunity health nurse?a.The school nurse may be called on to care for a student’s family members inunderserved areas.b.The school nurse’s primary responsibility is centered on the well child.c.The school nurse’s primary responsibility is to maintain immunization records.d.The school nurse must be certified in CHN.ANS:AFeedbackAIn medically underserved areas a school nurse may be called on to care formembers of a child’s immediate family.BChronically ill, disabled, and physically challenged students are in regularclassrooms.CSchool nurses detect developmental problems; counsel and educate children,parents, and teachers; and maintain immunization records.DAlthough school nurses are considered community health nurses, certification in

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community health is not required.DIF:Cognitive Level: ComprehensionREF:Page 1211.What has been found about the outcomes of patients cared for in hospitals with a higherpercentage of BSN-prepared nurses as compared to patients in hospitals with a lowerpercentage of BSN-prepared nurses?a.Patient outcomes are more dependent on nurse-patient ratios.b.Outcomes were better in hospitals with more BSN-prepared nurses.c.Outcomes were similar in both types of hospitals.d.Medical patients had better outcomes, but surgical patients fared the same.ANS:BFeedbackANurse-patient ratio is an important determinant of patient care outcomes but hasnot been shown to be more or less important that the percentage ofBSN-prepared nurses providing direct patient care.BResearch by Aiken, et al. (2003) showed that patient outcomes were better inhospitals where higher percentages of BSN-prepared nurses were employed.CResearch by Aiken, et al. (2003) showed that patient outcomes were better inhospitals where higher percentages of BSN-prepared nurses were employed.DAiken, et al. (2003) studied orthopedic, general surgical, and vascular surgerypatients and found the outcomes were improved for these patients in hospitalswith a higher percentage of BSN-prepared nurses.DIF:Cognitive Level: KnowledgeREF:Page 712.Faith community nursing (FCN) was founded on which of the following premises?a.Nurses’ faith beliefs do not play a part in healing.b.The spiritual aspect takes precedence over the physical body in healing.c.Spiritual health is central to a person’s well-being.d.Faith community nurses must receive formal training as a minister or clergy.ANS:CFeedbackAThe nurse’s spiritual journey is believed to be an essential aspect of this nursingrole.BPatients are treated holistically under FCN.CFCN is based on the belief that spiritual health is central to well-being.DFaith community nurses do not need to have formal training as ministers.DIF:Cognitive Level: ComprehensionREF:Page 1513.One important advantage of the evolution of nursing informatics is thata.it allows any RN to become a certified informatics nurse.b.informatics nurses are best able to design systems with the needs and skills ofnurses who use them in mind.c.informatics nurses will reduce the need for direct caregivers to document care.

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d.benefits of informatics advancements include improved patient safety andincreased variability of care.ANS:BFeedbackAAlthough all nurses may use informatics, a nurse specializing in informaticsshould have a BSN and additional knowledge and experience in the field ofinformatics.BInformatics nurses understand how the information needs to be used and how tomake the systems work for the nurses.CDirect caregivers will still need to document the care provided.DBenefits do include improved patient safety, but decreased variability of care isexpected with informatics systems.DIF:Cognitive Level: ComprehensionREF:Page 1614.Which of the following nursing roles is not considered an advanced practice role?a.Certified nurse-midwife (CNM)b.Community health nursec.Certified nurse practitioner (CNP)d.Clinical nurse specialist (CNS)ANS:BFeedbackAA CNM is an advanced practice role.BThe community health nurse is not an advanced practice role.CCNP is an advanced practice role.DCNS is an advanced practice role.DIF:Cognitive Level: ComprehensionREF:Page 1815.NPs are advanced practice nurses whoa.are required to have physician collaboration or supervision.b.function under a set of universal advanced practitioner laws.c.cannot receive direct reimbursement for their services.d.can diagnose and treat common and chronic conditions.ANS:DFeedbackAThe laws governing the practice of NPs vary from state to state, including thedegree of supervision required and how they may be reimbursed for theirservices.BThe laws governing the practice of NPs vary from state to state, including thedegree of supervision required and how they may be reimbursed for theirservices.CThe laws governing the practice of NPs vary from state to state, including thedegree of supervision required and how they may be reimbursed for their

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services.DNPs are prepared to handle a wide range of basic health problems.DIF:Cognitive Level: ComprehensionREF:Page 1916.The clinical nurse leader (CNL) is a recently proposed role. The responsibilities of the personin this role include which of the following?a.Oversee and manage care delivery in specific settings.b.Manage and streamline operations in multiple nursing units.c.Replace the outdated CNS role.d.Provide daily care to a specific subset of patients with similar needs.ANS:AFeedbackAThe CNL roleis intended to provide the highest quality of nursing care byhaving master’s-prepared nurses involved in the care of a distinct group ofpatients.BThe CNL role was not intended as a managerial or administrative role.CThe CNS role is not outdated, and some controversy exists because some CNSsview this new role as possibly disenfranchising them.DCNLs may on occasion provide direct patient care, but not on a daily basis.DIF:Cognitive Level: KnowledgeREF:Page 18MULTIPLE RESPONSE1.Hospice and palliative care nursing is a rapidly developing specialty in nursing. Which factshave contributed to this growth? (Select all that apply.)a.End-of-life care is largely the responsibility of nurses.b.End-of-life needs are expected to increase with the aging population.c.Nursing curricula have prepared nurses to deal effectively with dying patients andtheir families.d.Palliative care is a new focus of advanced practice nurses.e.Hospice and palliative care nurses work in a variety of settings.ANS:A, B, EFeedbackCorrect“End-of-life care is largely the responsibility of nurses” is correct becausepalliative care reflects the holistic philosophy of nursing, and comfort andrelief have always been nursing responsibilities. “End-of-life needs areexpected to increase with the aging population” is correct because as thepopulation ages there will be a greater demand for end-of-life care as thenumber of individuals needing care increases. “Hospice and palliative carenurses work in a variety of settings” is correct because palliative care takesplace in hospitals, homes, hospices, skilled nursing homes, etc.Incorrect“Nursing curricula have prepared nurses to deal effectively with dyingpatients and their families” is incorrect because nursing educationalprograms have not prepared nurses well as the content related to

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end-of-life issues and palliative care has been limited. “Palliative care is anew focus of advanced practice nurses” is incorrect because palliative carehas been a focus of many nurses, not just advanced practice nurses.DIF:Cognitive Level: ComprehensionREF:Page 142.CNSs may (Select all that apply.)a.manage an inpatient nursing unit.b.develop educational programs for nursing staff.c.conduct practice outcomes research.d.prescribe medications for common illnesses.e.attend or assist in the delivery of low-risk newborns.ANS:A, B, CFeedbackCorrectCNSs are prepared with an advanced nursing degree and the skills tofunction ina variety of settings and functional roles.IncorrectCNSs do not have prescribing authority. CNMs attend or assist at thedelivery of low-risk newborns.DIF:Cognitive Level: ComprehensionREF:Page 19

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Chapter 02: The History and Social Contexts of NursingBlack: Professional Nursing: Concepts & Challenges, 8th EditionMULTIPLE CHOICE1.Which early nursing leader founded the first training school for nurses that would laterbecome a model for early nursing education?a.Dorothea Dixb.Florence Nightingalec.Clara Bartond.Mary Ann BickerdykeANS:BFeedbackADorothea Dix is best known as an advocate for the mentally ill, and she created abrief training program at two New York hospitals for women who wished toserve as nurses in the Civil War.BFlorence Nightingale founded the first training school for nurses at St. Thomas’sHospital in London in 1806. This became the model for nursing education in theUnited States.CClara Barton is known for founding the American Red Cross.DMary Ann Bickerdyke is best known for nursing services during the Civil War.DIF:Cognitive Level: KnowledgeREF:Page 262.Who was the first educated African-American professional nurse?a.Linda Richardsb.Phoebe Pemberc.Sojourner Truthd.Mary Eliza MahoneyANS:DFeedbackALinda Richards was the first trained nurse in the United States.BPhoebe Pember was one of the first women placed in charge of a hospital.CSojourner Truth was a famous abolitionist who served as a nurse for the Unionforces in the Civil War.DMary Eliza Mahoney was the first African-American professional nurse; she waseducated at the New England Hospital for Women and Children.DIF:Cognitive Level: KnowledgeREF:Page 283.To which early nursing leader is attributed the founding of the American Red Cross?a.Clara Bartonb.Dorothea Dixc.Florence Nightingaled.Lavinia Lloyd Dock

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ANS:AFeedbackAFounding the American Red Cross is attributed to Clara Barton.BDorothea Dix was superintendent of women nurses of the Union Army.CFlorence Nightingale was an English pioneer in nursing.DLavinia Lloyd Dock was influential in forming the National League for Nursing(NLN).DIF:Cognitive Level: KnowledgeREF:Page 284.What were some of the application requirements of nursing education programs in the 1900s?a.Male, intelligent, strongb.Female, sensitive, subservientc.Female, docile, from poor backgroundd.Male, high breeding, independentANS:BFeedbackAMen were not thought to be sensitive enough for nursing.BSensitivity, breeding, intelligence, ladylike behavior, and submission to authoritywere highly desired personal traits for nursing students.CHigh breeding was desirable for nursing education program applicants.DMen were not desired nursing education program applicants.DIF:Cognitive Level: KnowledgeREF:Page 285.Which of the following statements best describes how the Chicago World’s Fair of 1893became a pivotal point in the history of nursing education in the United States?a.Florence Nightingale’s work on sanitation and its relationship to mortality rateswas finally recognized.b.The organization today known as the NLN was formed to address issues in nursingeducation.c.The American Nurses Association (ANA) was formed to oversee nursingeducation in the United States.d.The International Council of Nurses (ICN) was formed to enhance collaborationbetween practicing nurses and educators.ANS:BFeedbackAFlorence Nightingale’s paper was on scientific training of nurses.BSeveral influential nursing leaders met at the Chicago World’s Fair and startedthe National League for Nursing Education—the precursor to the NLN.CThe NLN, not the ANA, was formed to oversee nursing education in the UnitedStates.DThe ICN was not founded until 1899 and is not involved in U.S. education ofnurses.

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DIF:Cognitive Level: ComprehensionREF:Page 296.Which early nursing organization is credited with first recommending state registration fornurses?a.ICNb.NLNc.ANAd.National Association of Colored Graduate NursesANS:AFeedbackAThe ICN was formed to unite all nursing organizations. The topic of the firstmeeting was registration for nurses by each country and state.BThe NLN was formed to oversee nursing education in the United States.CThe ANA was formed to enhance collaboration between practicing nurses andeducators.DThe National Association of Colored Graduate Nurses was formed to developleadership among African-American nurses.DIF:Cognitive Level: KnowledgeREF:Page 327.Which of the following nursing leaders, because of her work in the Henry StreetSettlement, isconsidered the founder of public health nursing?a.Margaret Sangerb.Clara Bartonc.Lillian Waldd.Lavinia Lloyd DockANS:CFeedbackAMargaret Sanger is known for her work on birth control with immigrant womenfrom the Lower East Side of New York City.BClara Barton founded the American Red Cross.CLillian Wald founded the Henry Street Settlement, the first formalized publichealth nursing project.DLavinia Lloyd Dock was instrumental in the formation of the NLN.DIF:Cognitive Level: KnowledgeREF:Page 308.Despite the caring efforts of early public health nurses in the Henry Street Settlement, racialdisparity left many people underserved. Which of the following African-American publichealth nurses was instrumental in providing excellent nursing care to underserved familiesdespite these social challenges?a.Jessie Sleet Scalesb.Margaret Sangerc.Lavinia Lloyd Dockd.Anita M. McGee

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ANS:AFeedbackAJessie Sleet Scales established the Stillman House, a part of the Henry StreetSettlement that provided care to African Americans.BMargaret Sanger worked to provide immigrant women on the Lower East Sideof NewYork City with birth control information.CLavinia Lloyd Dock founded the NLN.DAnita M. McGee was a physician appointed as head of the Hospital Corps, whorecruited nurses for the Spanish-American War of 1898.DIF:Cognitive Level: ComprehensionREF:Page 319.Which one of the following events occurring during the first decade of the 20th centurybrought sweeping changes to nursing?a.It was required that all practicing nurses be licensed.b.Permissive licensing laws allowed registered nurses (RNs) to practice without alicense if they registered with the state.c.All states required a standardized licensing examination.d.Nurses had to pass a licensing examination to use the title RN.ANS:DFeedbackAPracticing nurses did not have to be licensed but could not use the title RN.BPermissive licensing laws required all nurses using the title RN to be licensed.CLicensing examinations were not standardized until 1950.DLicensure laws were passed that required all people using the title of RN to belicensed.DIF:Cognitive Level: ComprehensionREF:Page 3210.What was the most significant impact on the profession of nursing made by MaryBreckenridge in her role as a frontier nurse?a.She demonstrated that nurses could provide primary care in rural settings.b.She demonstrated that female nurses could protect themselves in unsettled ruralenvironments.c.She demonstrated that nurses were capable of teaching new mothers to care forbabies.d.She demonstrated that nurses could provide care to many clients despitegeographic boundaries.ANS:AFeedbackAMary Breckenridge established frontier nursing services. She provided primarycare to women and babies and demonstrated that nurses could provide primarycare.BSafety was not the primary impact of the success of frontier nursing.CAlthough she was a nurse-midwife, this was not the most significant impact.

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DDemonstrating that nurses could provide care to many clients despite geographicboundaries was not the most significant impact made by Mary Breckenridge.DIF:Cognitive Level: ComprehensionREF:Page 3311.Which ofthe following trends in health care delivery that began in the second half of the 20thcentury continues today?a.Widespread use of team nursing to address the nursing shortageb.Massive movement of nurses out of acute care and into home carec.Advent of primary care to replace specialized cared.Provision of care to the poor, elderly, and disabled through Medicare and MedicaidANS:DFeedbackATeam nursing is rarely used today.BMore nurses work in acute care today than in home care.CAfter World War II, specialization became popular.DTwo amendments to the Social Security Act in 1965 designed to ensure access tohealth care for elderly, poor, and disabled Americans were the establishment ofMedicare and Medicaid.DIF:Cognitive Level: ComprehensionREF:Page 3412.A recent trend in nursing has been an increase in the number of men and women with degreesin other fields or other careers applying to nursing programs. What is the single mostimportant reason for this trend?a.Nursing as a career has gained increased status and prestige.b.Nursing salaries have outpaced many other fields.c.A nursing career provides both job security and meaningful employment.d.Working conditions in nursing have improved.ANS:CFeedbackAWhile true, nursing’s increased status and prestige is not a significant factor inthe trend of people choosing it as a second career.BSalary is not a major factor.CThe current appeal to men and women with degrees in other fields is that nursingcan provide job opportunities, economic security, and the opportunity to helpothers.DWorking conditions are not identified as a reason for choosing a second career innursing.DIF:Cognitive Level: KnowledgeREF:Page 4013.What specialty of nursing was considered well suited for men at a time when other areas wereexcluding men from practicing?a.Obstetric nursingb.Pediatric nursing

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c.Psychiatric nursingd.Nurse educatorANS:CFeedbackAObstetric nursing was not considered an appropriate area for men in nursing.BPediatric nursing was not considered an appropriate area for men in nursing.CPsychiatric nursing was considered well suited for men because it requiredphysical stamina and strength.DEducation was not a specialty considered well suited for men in nursing.DIF:Cognitive Level: KnowledgeREF:Page 3814.When surveyed, what is the primary reason given by men for entering nursing?a.To make a differenceb.High salariesc.Flexible schedulesd.Opportunity for travelANS:AFeedbackAMen who want to make a difference in peoples’ lives find nursing an appealingcareer choiceBEconomic and job security are important factors for men entering nursing, butmore significant is the opportunity to make a difference in peoples’ lives.CFlexible schedules, where provided, are an attractive incentive for employment,but that is not as significant as being able to make a difference in peoples’ lives.DOpportunity for travel is available for travel and military nurses, otherwise it isnot an important aspect of nursing as a career.DIF:Cognitive Level: KnowledgeREF:Page 3915.What was the purpose of the Hill-Burton Act?a.It established funding for the construction of hospitals.b.It provided women in the service with military rank.c.It established and funded the Frontier Nursing Service.d.It created the Cadet Nurse Corps.ANS:AFeedbackAThe 1946 Hill-Burton Act provided funding for the construction of hospitals.BCongress passed a bill in 1920 that allowed women to hold military rank.CThe Frontier Nursing Service, originally known as the Kentucky Committee forMothers and Babies, was established by Mary Breckinridge.DThe Cadet Nurse Corps was an alliance between military and collegiate nursingprograms to train nurses and was funded by Congress.

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DIF:Cognitive Level: KnowledgeREF:Page 3416.When surveyed, which profession was chosen by the general public as highest in honesty andethics?a.Physicianb.Pharmacistc.Nursed.AttorneyANS:CFeedbackAPhysicians were not ranked over nurses.BPharmacists were not ranked over nurses.CGallup polls from 1999 to 2010 rated nursing as the top profession in honestyand ethics.DAttorneys were not ranked over nurses in honesty and ethics.DIF:Cognitive Level: KnowledgeREF:Page 4117.In 2002 which major American corporation partnered with nursing to design a mediacampaign to promote the image of nursing?a.Johnson & Johnsonb.Baxterc.Microsoftd.Wal-MartANS:AFeedbackAIn 2003 Johnson & Johnson began a $20 million campaign—Campaign forNursing’s Future—to enhance the image of nursing, to recruit new nurses andeducators, and to retain nurses.BBaxter did not launch a media campaign to promote the image of nursing.CMicrosoft did not launch a media campaign to promote the image of nursing.DWal-Mart did not launch a media campaign to promote the image of nursing.DIF:Cognitive Level: KnowledgeREF:Page 4118.A shift in population growth is expected to place stress on nursing resources. Whichage-group is expected to experience the greatest population growth in the next decade?a.Older than 85 years of ageb.75 to 85 years of agec.35 to 65 years of aged.18 to 35 years of ageANS:AFeedbackAPeople older than 85 years, known as the “very old,” represent the

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