Chapter 01: Nursing and the Health Care
System
Williams: deWit's Fundamental Concepts
and Skills for Nursing, 5th Edition
MULTIPLE CHOICE
1. Florence Nightingale’s contributions to
nursing practice and education:
a. are historically important but have no
validity for nursing today.
b. were neither recognized nor appreciated
in her own time.
c. were a major factor in reducing the
death rate in the Crimean War.
d. were limited only to the care of severe
traumatic wounds.
ANS: C
By improving sanitation, nutrition
ventilation, and handwashing techniques, Florence Nightingale’s nurses dramatically
reduced the death rate from injuries in the Crimean War.
DIF: Cognitive Level: Knowledge REF: p. 2 OBJ:
Theory #1TOP: Nursing History KEY: Nursing Process Step:
N/A MSC: NCLEX: N/A
2. Early nursing education and care in the United States:
a. were directed at community health.
b. provided independence for women through education and employment.
c. were an educational model based in institutions of higher learning.
d. have continued to be entirely focused on hospital nursing.
ANS: B
Because of the influence of early nNuUrRs iSnIgNGleTaBd.eCrOs,Mnursing education became more
formalized through apprenticeships in Nightingale schools that offered independence to
women througheducation and employment.
DIF: Cognitive Level: Knowledge REF: p. 2 OBJ:
Theory #4TOP: Nursing History KEY: Nursing Process Step:
N/A MSC: NCLEX: N/
In order to fulfill the common goals defined by nursing theorists
(promote wellness, prevent illness, facilitate coping, and restore
health), the LPN must take on the roles of:
e. caregiver, educator, and collaborator.
f. nursing assistant, delegator, and environmental specialist.
g. medication dispenser, collaborator, and transporter.
h. dietitian, manager, and housekeeper.
ANS: A
In order for the LPN to apply the common goals of nursing, he or she must assume the
rolesof caregiver, educator, collaborator, manager, and advocate.
DIF: Cognitive Level: Comprehension REF: p. 3 OBJ:
, Theory #2TOP: Art and Science of Nursing KEY:
Nursing Process Step: N/A MSC: NCLEX: N/A
3. Although nursing theories differ in their attempts to define nursing, all of them
base their beliefs on common concepts concerning:
a. self-actualization, fundamental needs, and belonging.
b. stress reduction, self-care, and a systems model.
c. curative care, restorative care, and terminal care.
d. human relationships, the environment, and health.
ANS: D
Although nursing theories differ, they all base their beliefs on human
relationships, theenvironment, and health.
DIF: Cognitive Level: Comprehension REF: p. 4 OBJ:
Theory #2TOP: Nursing Theories KEY: Nursing Process Step:
N/A MSC: NCLEX: N/A
4. Standards of care for the nursing practice of the LPN are established by the:
a. Boards of Nursing Examiners in each state.
b. National Council of States Boards of Nursing (NCSBN).
c. American Nurses Association (ANA).
d. National Federation of Licensed Practical Nurses.
ANS: D
The National Federation of Licensed Practical Nurses modified the standards published
by theANA in 2015 to better fit the role of the LPN. In 2015 the American Nurses
Association (ANA) revised the Standards of Nursing Practice which contained 17
standards of national practice of nursing, describing all facets of nursing practice: who,
what, when, where, how.
DIF: Cognitive Level: Comprehension REF: p. 6 OBJ:
Theory #2TOP: Standards of Care KEY: Nursing Process Step:
N/A MSC: NCLEX: N/A
5. The LPN demonstrates an evidence-based practice by:
a. using a drug manual to check compatibility of drugs.
b. using scientific information to guide decision making.
c. using medical history of a patient to direct nursing interventions.
d. basing nursing care on advice from an experienced nurse.
ANS: B
The use of scientific information from high-quality research to guide nursing
decisions isreflective of the application of evidence-based practice.
DIF: Cognitive Level: Knowledge REF: p. 7 OBJ:
Theory #3TOP: Evidence-Based Practice KEY: Nursing Process Step:
N/A MSC: NCLEX: N/A
6. Lillian Wald and Mary Brewster established the Henry Street Settlement Service in New
Yorkin 1893 in order to:
a. offer a shelter to injured war veterans.
b. found a nursing apprenticeship.
c. provide health care to poor persons living in tenements.
d. offer better housing to low-income families.
ANS: C
, Henry Street Settlement Service brought the provision of community health care to the
poorpeople living in tenements.
DIF: Cognitive Level: Comprehension REF: p. 2 OBJ:
Theory #4TOP: Growth of Nursing KEY: Nursing Process Step:
N/A MSC: NCLEX: N/A
7. An educational pathway for an LPN/LVN refers to an LPN/LVN:
a. learning on the job and being promoted to a higher level of responsibility.
b. moving from a maternity unit to a more complicated surgical unit.
c. obtaining additional education to move from one level of nursing to another.
d. learning that advancement requires consistent work and commitment.
ANS: C
By broadening the educational base, an LPN/LVN may advance and build a nursing
career.
DIF: Cognitive Level: Knowledge REF: p. 7 OBJ:
Theory #7TOP: Nursing Education Pathways KEY:
Nursing Process Step: N/A MSC: NCLEX: N/A
8. When diagnosis-related groups (DRGs) were established by Medicare in 1983, the
purposewas to:
a. put patients with the same diagnosis on the same unit.
b. attempt to contain the costs of health care.
c. increase the availability of medical care to older adults.
d. identify a patient’s condition more quickly.
ANS: B
The purpose of instituting DRGs was to contain skyrocketing costs of health care.
DIF: Cognitive Level: Knowledge REF: p. 9 OBJ:
Theory #10TOP: Health Care Delivery KEY: Nursing Process Step: N/A
MSC: NCLEX: N/A
9. The advent of diagnosis-related groups (DRGs) required that nurses working in
health careagencies:
a. record supportive documentation to confirm a patient’s need for care in
order toqualify for reimbursement.
b. use the DRG rather than their own observations for patient assessment.
c. be aware of the specific drugs related to the diagnosis.
d. acquire cross-training to make staffing more flexible.
ANS: A
DRGs required that nurses provide more supportive documentation of their
assessments and identified patient’s needs to qualify the facility for Medicare
reimbursement. Observant assessment might also indicate another DRG classification
and consequently more reimbursement for the facility.
DIF: Cognitive Level: Comprehension REF: p. 10 OBJ:
Theory #10TOP: Managed Care KEY: Nursing Process Step: N/A
MSC: NCLEX: N/A
10. If a member of a health maintenance organization (HMO) is having respiratory
problems suchas fever, cough, and fatigue for several days and wants to see a specialist,
the person is required to go:
a. directly to an emergency room for treatment.
b. to any general practitioner of choice.
, c. directly to a respiratory specialist.
d. to a primary care provider for a referral.
ANS: D
Participants in an HMO must see their primary provider to receive a referral for a
specialist inorder for the HMO to pay for the care.
DIF: Cognitive Level: Comprehension REF: p. 10 OBJ:
Theory #11TOP: Managed Care KEY: Nursing Process Step: N/A
MSC: NCLEX: N/A
11. An advantage of preferred provider organizations (PPOs) is that:
a. they make insurance coverage of employees less expensive to employers.
b. there are fewer physicians to choose from than in an HMO.
c. long-term relationships with physicians are more likely.
d. patients may go directly to a specialist for care.
ANS: A
The use of PPOs allows insurance companies to keep their premiums low and in turn
makes insurance coverage less expensive for the employers. There are usually more
physicians fromwhich to choose than from an HMO, but long-term relationships
between physician and patient cannot be established easily. Patients still must see their
primary physician before being referred to other specialties.
DIF: Cognitive Level: Knowledge REF: p. 11 OBJ:
Theory #11TOP: Preferred Provider Organizations KEY:
Nursing Process Step: N/A MSC: NCLEX: N/A
12. After passing the National Council Licensure Examination for Practical Nurses
(NCLEX PN),the nurse is qualified to take an additional certification in the field of:
a. pharmacology.
b. care of infants and children.
c. operating room technology.
d. community health.
ANS: A
After becoming an LPN, the nurse may apply for additional certification in
pharmacology or long-term care.
DIF: Cognitive Level: Knowledge REF: p. 7 OBJ:
Theory #6TOP: Educational Opportunities KEY: Nursing Process Step:
N/A MSC: NCLEX: N/A
13. Nursing interventions are best defined as activities that:
a. are taken to improve the patient’s health.
b. involve researching methods to maintain asepsis.
c. include the family in nursing care.
d. review guidelines for handling infectious wastes.
ANS: A
Interventions are actions taken to improve, maintain, or restore health.
DIF: Cognitive Level: Comprehension REF: p. 3 OBJ:
Theory #2TOP: Art and Science of Nursing KEY:
Nursing Process Step: Planning
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Detection of Disease
14. Nurse Practice Acts define the legal scope of an LPN’s practice, which are
System
Williams: deWit's Fundamental Concepts
and Skills for Nursing, 5th Edition
MULTIPLE CHOICE
1. Florence Nightingale’s contributions to
nursing practice and education:
a. are historically important but have no
validity for nursing today.
b. were neither recognized nor appreciated
in her own time.
c. were a major factor in reducing the
death rate in the Crimean War.
d. were limited only to the care of severe
traumatic wounds.
ANS: C
By improving sanitation, nutrition
ventilation, and handwashing techniques, Florence Nightingale’s nurses dramatically
reduced the death rate from injuries in the Crimean War.
DIF: Cognitive Level: Knowledge REF: p. 2 OBJ:
Theory #1TOP: Nursing History KEY: Nursing Process Step:
N/A MSC: NCLEX: N/A
2. Early nursing education and care in the United States:
a. were directed at community health.
b. provided independence for women through education and employment.
c. were an educational model based in institutions of higher learning.
d. have continued to be entirely focused on hospital nursing.
ANS: B
Because of the influence of early nNuUrRs iSnIgNGleTaBd.eCrOs,Mnursing education became more
formalized through apprenticeships in Nightingale schools that offered independence to
women througheducation and employment.
DIF: Cognitive Level: Knowledge REF: p. 2 OBJ:
Theory #4TOP: Nursing History KEY: Nursing Process Step:
N/A MSC: NCLEX: N/
In order to fulfill the common goals defined by nursing theorists
(promote wellness, prevent illness, facilitate coping, and restore
health), the LPN must take on the roles of:
e. caregiver, educator, and collaborator.
f. nursing assistant, delegator, and environmental specialist.
g. medication dispenser, collaborator, and transporter.
h. dietitian, manager, and housekeeper.
ANS: A
In order for the LPN to apply the common goals of nursing, he or she must assume the
rolesof caregiver, educator, collaborator, manager, and advocate.
DIF: Cognitive Level: Comprehension REF: p. 3 OBJ:
, Theory #2TOP: Art and Science of Nursing KEY:
Nursing Process Step: N/A MSC: NCLEX: N/A
3. Although nursing theories differ in their attempts to define nursing, all of them
base their beliefs on common concepts concerning:
a. self-actualization, fundamental needs, and belonging.
b. stress reduction, self-care, and a systems model.
c. curative care, restorative care, and terminal care.
d. human relationships, the environment, and health.
ANS: D
Although nursing theories differ, they all base their beliefs on human
relationships, theenvironment, and health.
DIF: Cognitive Level: Comprehension REF: p. 4 OBJ:
Theory #2TOP: Nursing Theories KEY: Nursing Process Step:
N/A MSC: NCLEX: N/A
4. Standards of care for the nursing practice of the LPN are established by the:
a. Boards of Nursing Examiners in each state.
b. National Council of States Boards of Nursing (NCSBN).
c. American Nurses Association (ANA).
d. National Federation of Licensed Practical Nurses.
ANS: D
The National Federation of Licensed Practical Nurses modified the standards published
by theANA in 2015 to better fit the role of the LPN. In 2015 the American Nurses
Association (ANA) revised the Standards of Nursing Practice which contained 17
standards of national practice of nursing, describing all facets of nursing practice: who,
what, when, where, how.
DIF: Cognitive Level: Comprehension REF: p. 6 OBJ:
Theory #2TOP: Standards of Care KEY: Nursing Process Step:
N/A MSC: NCLEX: N/A
5. The LPN demonstrates an evidence-based practice by:
a. using a drug manual to check compatibility of drugs.
b. using scientific information to guide decision making.
c. using medical history of a patient to direct nursing interventions.
d. basing nursing care on advice from an experienced nurse.
ANS: B
The use of scientific information from high-quality research to guide nursing
decisions isreflective of the application of evidence-based practice.
DIF: Cognitive Level: Knowledge REF: p. 7 OBJ:
Theory #3TOP: Evidence-Based Practice KEY: Nursing Process Step:
N/A MSC: NCLEX: N/A
6. Lillian Wald and Mary Brewster established the Henry Street Settlement Service in New
Yorkin 1893 in order to:
a. offer a shelter to injured war veterans.
b. found a nursing apprenticeship.
c. provide health care to poor persons living in tenements.
d. offer better housing to low-income families.
ANS: C
, Henry Street Settlement Service brought the provision of community health care to the
poorpeople living in tenements.
DIF: Cognitive Level: Comprehension REF: p. 2 OBJ:
Theory #4TOP: Growth of Nursing KEY: Nursing Process Step:
N/A MSC: NCLEX: N/A
7. An educational pathway for an LPN/LVN refers to an LPN/LVN:
a. learning on the job and being promoted to a higher level of responsibility.
b. moving from a maternity unit to a more complicated surgical unit.
c. obtaining additional education to move from one level of nursing to another.
d. learning that advancement requires consistent work and commitment.
ANS: C
By broadening the educational base, an LPN/LVN may advance and build a nursing
career.
DIF: Cognitive Level: Knowledge REF: p. 7 OBJ:
Theory #7TOP: Nursing Education Pathways KEY:
Nursing Process Step: N/A MSC: NCLEX: N/A
8. When diagnosis-related groups (DRGs) were established by Medicare in 1983, the
purposewas to:
a. put patients with the same diagnosis on the same unit.
b. attempt to contain the costs of health care.
c. increase the availability of medical care to older adults.
d. identify a patient’s condition more quickly.
ANS: B
The purpose of instituting DRGs was to contain skyrocketing costs of health care.
DIF: Cognitive Level: Knowledge REF: p. 9 OBJ:
Theory #10TOP: Health Care Delivery KEY: Nursing Process Step: N/A
MSC: NCLEX: N/A
9. The advent of diagnosis-related groups (DRGs) required that nurses working in
health careagencies:
a. record supportive documentation to confirm a patient’s need for care in
order toqualify for reimbursement.
b. use the DRG rather than their own observations for patient assessment.
c. be aware of the specific drugs related to the diagnosis.
d. acquire cross-training to make staffing more flexible.
ANS: A
DRGs required that nurses provide more supportive documentation of their
assessments and identified patient’s needs to qualify the facility for Medicare
reimbursement. Observant assessment might also indicate another DRG classification
and consequently more reimbursement for the facility.
DIF: Cognitive Level: Comprehension REF: p. 10 OBJ:
Theory #10TOP: Managed Care KEY: Nursing Process Step: N/A
MSC: NCLEX: N/A
10. If a member of a health maintenance organization (HMO) is having respiratory
problems suchas fever, cough, and fatigue for several days and wants to see a specialist,
the person is required to go:
a. directly to an emergency room for treatment.
b. to any general practitioner of choice.
, c. directly to a respiratory specialist.
d. to a primary care provider for a referral.
ANS: D
Participants in an HMO must see their primary provider to receive a referral for a
specialist inorder for the HMO to pay for the care.
DIF: Cognitive Level: Comprehension REF: p. 10 OBJ:
Theory #11TOP: Managed Care KEY: Nursing Process Step: N/A
MSC: NCLEX: N/A
11. An advantage of preferred provider organizations (PPOs) is that:
a. they make insurance coverage of employees less expensive to employers.
b. there are fewer physicians to choose from than in an HMO.
c. long-term relationships with physicians are more likely.
d. patients may go directly to a specialist for care.
ANS: A
The use of PPOs allows insurance companies to keep their premiums low and in turn
makes insurance coverage less expensive for the employers. There are usually more
physicians fromwhich to choose than from an HMO, but long-term relationships
between physician and patient cannot be established easily. Patients still must see their
primary physician before being referred to other specialties.
DIF: Cognitive Level: Knowledge REF: p. 11 OBJ:
Theory #11TOP: Preferred Provider Organizations KEY:
Nursing Process Step: N/A MSC: NCLEX: N/A
12. After passing the National Council Licensure Examination for Practical Nurses
(NCLEX PN),the nurse is qualified to take an additional certification in the field of:
a. pharmacology.
b. care of infants and children.
c. operating room technology.
d. community health.
ANS: A
After becoming an LPN, the nurse may apply for additional certification in
pharmacology or long-term care.
DIF: Cognitive Level: Knowledge REF: p. 7 OBJ:
Theory #6TOP: Educational Opportunities KEY: Nursing Process Step:
N/A MSC: NCLEX: N/A
13. Nursing interventions are best defined as activities that:
a. are taken to improve the patient’s health.
b. involve researching methods to maintain asepsis.
c. include the family in nursing care.
d. review guidelines for handling infectious wastes.
ANS: A
Interventions are actions taken to improve, maintain, or restore health.
DIF: Cognitive Level: Comprehension REF: p. 3 OBJ:
Theory #2TOP: Art and Science of Nursing KEY:
Nursing Process Step: Planning
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Detection of Disease
14. Nurse Practice Acts define the legal scope of an LPN’s practice, which are
