Chapter 01
1. A faculty nurse explaining the stratification in nursing roles seen today tells students that the most important
event leading to this development was [Multiple Choice]
a. desegregation in nursing.
b. limited nursing opportunities.
c. the Korean conflict.
d. World War II. ✔
ANS: D
The United States? involvement in World War II dramatically increased the demand for trained nurses. To help fill
this need, the American Red Cross and the Office of Civilian Defense co-established a program to train nurse
aides. The success of the program encouraged hospitals to use employees with various levels of
skill.Desegregation in nursing did come about in the same era as stratification, but it was not instrumental in
creating this differentiated practice.Nursing opportunities were increasing throughout the 20th century.Role
stratification was already entrenched by the Korean conflict.
2. What change is anticipated that will guide advanced practice nursing roles? [Multiple Choice]
a. Changes in federal funding for advanced education
b. Declining demand for advanced practice roles
c. Requirement of a doctor of nursing practice ✔
d. Third-party payer restrictions on this type of practice
ANS: C
If the American Association of Colleges of Nursing Board (AACN) leadership holds sway, the doctor of nursing
practice (DNP) will be the requisite preparation for all advanced practice nursing roles, including the NP, CNS,
certified nurse midwife, and certified registered nurse anesthetist (CRNA), in the near future. It is not anticipated
that there will be changes in federal funding for advanced education, a declining demand for advanced practice
roles, or third-party payer restrictions on this type of practice in such a way that will guide advanced practice
nursing roles as the requirement of a DNP will.
3. Social events surrounding the Great Depression that had a major impact on American?s emerging health care
system included (Select all that apply.) [Multiple Response]
a. Blue Cross was developed as a prepaid health insurance plan. ✔
b. large hospitals experienced increasing numbers of nonpaying patients. ✔
,c. many hospitals found their nursing schools too expensive to operate. ✔
d. nurses were hired in hospitals in increasing numbers. ✔
e. religious orders began supplying trained nurses, cutting the cost of nursing.
ANS: A, B, C, D
The development of Blue Cross helped hospitals? financial stability by providing patients who were able to pay for
care.Large hospitals, particularly those in cities, experienced more patients who needed medical care but were
unable to afford it because of the economic hardships of the Depression.A total of 570 training programs for
nurses were closed because of prohibitive costs during the decade of the Depression.As hospital care became
more sophisticated, more nurses were hired as staff. By 1941, more than 100,000 registered nurses were
employed in hospitals.Religious orders did not provide trained nurses to hospitals to decrease the cost of the
nursing staff.
4. When nursing registration laws were enacted, a ?registered nurse? was defined as someone who had (Select all
that apply.) [Multiple Response]
a. attended an acceptable nursing program. ✔
b. fit the definition of a professional nurse.
c. had not been convicted of any felonies.
d. passed a board evaluation examination. ✔
e. studied under a standardized curriculum.
ANS: A, D
One of the two criteria for being a registered nurse was having attended an acceptable nursing program.The
other criterion for being a registered nurse was having passed a board examination.A weakness of the early
registration laws was a lack of definition of professional nursing practice.Background checks were not part of the
early registry laws.Universal education standards were still lacking in 1903 when the first registry law was passed
in North Carolina.
5. Which nursing organizations are responsible for providing continuing education, establishing practice
standards, and offering certification examinations for their members? [Multiple Choice]
a. Councils of nurse educators
b. National specialty organizations ✔
c. State boards of nursing
d. State nurses associations
ANS: B
,National specialty organizations, such as the American Association of Critical Care Nurses, arose in response to
the developing nursing specialties; these organizations offer continuing education, practice standards, and
certification exams for their members.Organizations that consist of nurse educators would be primarily concerned
with nursing education.State boards of nursing are charged with the legal oversight of nursing in their respective
states.State nurses associations are often lobbying and marketing organizations for nursing within a specific state
and act as the state arms of the American Nurses Association.
6. Benefits of the apprenticeship model of nursing education included (Select all that apply.) [Multiple Response]
a. a well-trained graduate nursing hospital staff.
b. opportunities for further education in nursing.
c. providing a skilled but inexpensive workforce. ✔
d. providing working-class women employment. ✔
e. reforms in the care of sick and injured individuals. ✔
ANS: C, D, E
Nursing students provided the staffing for hospitals in exchange for their education.Nursing gave working-class
women employment alternatives to domestic or factory work.The use of skilled, trained nurses decreased
morbidity and mortality, and this benefit was evident in both civilian and military health care.Graduate nurses
were typically employed as private duty nurses and did not remain working in hospitals.Further education for
graduate nurses was rare; a postdiploma program was opened in 1899, but the first undergraduate college
nursing program was not opened until 1909.
7. A nursing instructor explains to students that the major goal of the Society of Superintendents of Training
Schools for Nurses of the United States and Canada was to [Multiple Choice]
a. improve working conditions for students.
b. obtain legal recognition for the profession.
c. raise and standardize the training of nurses. ✔
d. reverse discrimination in admissions policies.
ANS: C
The goals of the Society of Superintendents were ?to promote fellowship of members, to establish and maintain a
universal standard of training, and to further the best interests of the nursing profession.? Students were
expected to work in apprenticeships during their education in the hospital-based programs in existence at the
time.Obtaining legal recognition for nurses was the goal of the Nurses? Associated Alumnae of the United States
and Canada, later renamed the American Nurses Association.Discrimination in nursing existed well into the civil
rights era and beyond, with men and women of color routinely being banned from admission and employment.
, 8. Men in nursing in the early to mid-20th century faced which barriers to practice and education? (Select all that
apply.) [Multiple Response]
a. Denial of professional status in the military ✔
b. Frequent use of trained nurses as orderlies ✔
c. Limited areas of health care in which to practice ✔
d. Physical inability to perform delicate tasks
e. Societal bias that nursing was women’s work ✔
ANS: A, B, C, E
Men in nursing faced multiple barriers, including denial of professional status in the military, the frequent use of
trained nurses as orderlies, limited employment opportunities (e.g., in psychiatric care), and a societal belief that
nursing was strictly women?s work. Men are physically able to perform delicate tasks.
9. The development of associate degree (AD) nursing programs has had which effect on nursing today? (Select all
that apply.) [Multiple Response]
a. A wider student pool has been able to study nursing. ✔
b. AD programs have helped ease the nursing shortage. ✔
c. Hospitals have been influenced to close their training programs. ✔
d. Social status for graduates of nursing programs has improved.
e. The public has suffered some confusion about nursing education. ✔
ANS: A, B, C, E
Nontraditional students, such as mothers and older students, have found it convenient to study nursing at
community colleges.More nurses enter the profession via AD programs than through baccalaureate and diploma
programs combined.As college education for nurses became more widespread and accepted, hospital directors
became convinced to close their expensive programs, lessening the burden of hiring a professional nursing
staff.The public and nursing suffer from confusion about the educational requirements for becoming a registered
nurse.AD programs do not necessarily contribute to the improved social status of nurses.
10. Which event eventually led to the creation of military nursing? [Multiple Choice]
a. American Civil War
b. Spanish-American War ✔
c. World War I
d. World War II
1. A faculty nurse explaining the stratification in nursing roles seen today tells students that the most important
event leading to this development was [Multiple Choice]
a. desegregation in nursing.
b. limited nursing opportunities.
c. the Korean conflict.
d. World War II. ✔
ANS: D
The United States? involvement in World War II dramatically increased the demand for trained nurses. To help fill
this need, the American Red Cross and the Office of Civilian Defense co-established a program to train nurse
aides. The success of the program encouraged hospitals to use employees with various levels of
skill.Desegregation in nursing did come about in the same era as stratification, but it was not instrumental in
creating this differentiated practice.Nursing opportunities were increasing throughout the 20th century.Role
stratification was already entrenched by the Korean conflict.
2. What change is anticipated that will guide advanced practice nursing roles? [Multiple Choice]
a. Changes in federal funding for advanced education
b. Declining demand for advanced practice roles
c. Requirement of a doctor of nursing practice ✔
d. Third-party payer restrictions on this type of practice
ANS: C
If the American Association of Colleges of Nursing Board (AACN) leadership holds sway, the doctor of nursing
practice (DNP) will be the requisite preparation for all advanced practice nursing roles, including the NP, CNS,
certified nurse midwife, and certified registered nurse anesthetist (CRNA), in the near future. It is not anticipated
that there will be changes in federal funding for advanced education, a declining demand for advanced practice
roles, or third-party payer restrictions on this type of practice in such a way that will guide advanced practice
nursing roles as the requirement of a DNP will.
3. Social events surrounding the Great Depression that had a major impact on American?s emerging health care
system included (Select all that apply.) [Multiple Response]
a. Blue Cross was developed as a prepaid health insurance plan. ✔
b. large hospitals experienced increasing numbers of nonpaying patients. ✔
,c. many hospitals found their nursing schools too expensive to operate. ✔
d. nurses were hired in hospitals in increasing numbers. ✔
e. religious orders began supplying trained nurses, cutting the cost of nursing.
ANS: A, B, C, D
The development of Blue Cross helped hospitals? financial stability by providing patients who were able to pay for
care.Large hospitals, particularly those in cities, experienced more patients who needed medical care but were
unable to afford it because of the economic hardships of the Depression.A total of 570 training programs for
nurses were closed because of prohibitive costs during the decade of the Depression.As hospital care became
more sophisticated, more nurses were hired as staff. By 1941, more than 100,000 registered nurses were
employed in hospitals.Religious orders did not provide trained nurses to hospitals to decrease the cost of the
nursing staff.
4. When nursing registration laws were enacted, a ?registered nurse? was defined as someone who had (Select all
that apply.) [Multiple Response]
a. attended an acceptable nursing program. ✔
b. fit the definition of a professional nurse.
c. had not been convicted of any felonies.
d. passed a board evaluation examination. ✔
e. studied under a standardized curriculum.
ANS: A, D
One of the two criteria for being a registered nurse was having attended an acceptable nursing program.The
other criterion for being a registered nurse was having passed a board examination.A weakness of the early
registration laws was a lack of definition of professional nursing practice.Background checks were not part of the
early registry laws.Universal education standards were still lacking in 1903 when the first registry law was passed
in North Carolina.
5. Which nursing organizations are responsible for providing continuing education, establishing practice
standards, and offering certification examinations for their members? [Multiple Choice]
a. Councils of nurse educators
b. National specialty organizations ✔
c. State boards of nursing
d. State nurses associations
ANS: B
,National specialty organizations, such as the American Association of Critical Care Nurses, arose in response to
the developing nursing specialties; these organizations offer continuing education, practice standards, and
certification exams for their members.Organizations that consist of nurse educators would be primarily concerned
with nursing education.State boards of nursing are charged with the legal oversight of nursing in their respective
states.State nurses associations are often lobbying and marketing organizations for nursing within a specific state
and act as the state arms of the American Nurses Association.
6. Benefits of the apprenticeship model of nursing education included (Select all that apply.) [Multiple Response]
a. a well-trained graduate nursing hospital staff.
b. opportunities for further education in nursing.
c. providing a skilled but inexpensive workforce. ✔
d. providing working-class women employment. ✔
e. reforms in the care of sick and injured individuals. ✔
ANS: C, D, E
Nursing students provided the staffing for hospitals in exchange for their education.Nursing gave working-class
women employment alternatives to domestic or factory work.The use of skilled, trained nurses decreased
morbidity and mortality, and this benefit was evident in both civilian and military health care.Graduate nurses
were typically employed as private duty nurses and did not remain working in hospitals.Further education for
graduate nurses was rare; a postdiploma program was opened in 1899, but the first undergraduate college
nursing program was not opened until 1909.
7. A nursing instructor explains to students that the major goal of the Society of Superintendents of Training
Schools for Nurses of the United States and Canada was to [Multiple Choice]
a. improve working conditions for students.
b. obtain legal recognition for the profession.
c. raise and standardize the training of nurses. ✔
d. reverse discrimination in admissions policies.
ANS: C
The goals of the Society of Superintendents were ?to promote fellowship of members, to establish and maintain a
universal standard of training, and to further the best interests of the nursing profession.? Students were
expected to work in apprenticeships during their education in the hospital-based programs in existence at the
time.Obtaining legal recognition for nurses was the goal of the Nurses? Associated Alumnae of the United States
and Canada, later renamed the American Nurses Association.Discrimination in nursing existed well into the civil
rights era and beyond, with men and women of color routinely being banned from admission and employment.
, 8. Men in nursing in the early to mid-20th century faced which barriers to practice and education? (Select all that
apply.) [Multiple Response]
a. Denial of professional status in the military ✔
b. Frequent use of trained nurses as orderlies ✔
c. Limited areas of health care in which to practice ✔
d. Physical inability to perform delicate tasks
e. Societal bias that nursing was women’s work ✔
ANS: A, B, C, E
Men in nursing faced multiple barriers, including denial of professional status in the military, the frequent use of
trained nurses as orderlies, limited employment opportunities (e.g., in psychiatric care), and a societal belief that
nursing was strictly women?s work. Men are physically able to perform delicate tasks.
9. The development of associate degree (AD) nursing programs has had which effect on nursing today? (Select all
that apply.) [Multiple Response]
a. A wider student pool has been able to study nursing. ✔
b. AD programs have helped ease the nursing shortage. ✔
c. Hospitals have been influenced to close their training programs. ✔
d. Social status for graduates of nursing programs has improved.
e. The public has suffered some confusion about nursing education. ✔
ANS: A, B, C, E
Nontraditional students, such as mothers and older students, have found it convenient to study nursing at
community colleges.More nurses enter the profession via AD programs than through baccalaureate and diploma
programs combined.As college education for nurses became more widespread and accepted, hospital directors
became convinced to close their expensive programs, lessening the burden of hiring a professional nursing
staff.The public and nursing suffer from confusion about the educational requirements for becoming a registered
nurse.AD programs do not necessarily contribute to the improved social status of nurses.
10. Which event eventually led to the creation of military nursing? [Multiple Choice]
a. American Civil War
b. Spanish-American War ✔
c. World War I
d. World War II
