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,Chapter 01: Nursing and the Health Care System
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 #1
TOP: 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 nursing leaders,nursing education became more formalized
through apprenticeships in Nightingale schools that offered independence to women through
education and employment.
DIF: Cognitive Level: Knowledge REF: p. 2 OBJ: Theory #4
TOP: Nursing History KEY: Nursing Process Step: N/A MSC: NCLEX: N/A
3. 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: a. caregiver, educator, and collaborator.
b. nursing assistant, delegator, and environmental specialist.
c. medication dispenser, collaborator, and transporter.
d. dietitian, manager, and housekeeper.
ANS: A
In order for the LPN to apply the common goals of nursing, he or she must assume the roles
of caregiver, educator, collaborator, manager, and advocate.
DIF: Cognitive Level: Comprehension REF: p. 3 OBJ: Theory #2
TOP: Art and Science of Nursing KEY: Nursing Process Step: N/A MSC: NCLEX:
N/A
4. 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, the
, environment, and health.
DIF: Cognitive Level: Comprehension REF: p. 4 OBJ: Theory #2
TOP: Nursing Theories KEY: Nursing Process Step: N/A MSC: NCLEX: N/A
5. 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 the
ANA 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 #2
TOP: Standards of Care KEY: Nursing Process Step: N/A MSC: NCLEX: N/A
6. 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 is
reflective of the application of evidence-based practice.
DIF: Cognitive Level: Knowledge REF: p. 7 OBJ: Theory #3
TOP: Evidence-Based Practice KEY: Nursing Process Step: N/A MSC: NCLEX:
N/A
7. Lillian Wald and Mary Brewster established the Henry Street Settlement Service
in New York in 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 poor
people living in tenements.
DIF: Cognitive Level: Comprehension REF: p. 2 OBJ: Theory #4
TOP: Growth of Nursing KEY: Nursing Process Step: N/A MSC: NCLEX: N/A
8. 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 #7
TOP: Nursing Education Pathways KEY: Nursing Process Step: N/A MSC:
NCLEX: N/A
9. When diagnosis-related groups (DRGs) were established by Medicare in 1983, the
purpose was 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 #10
TOP: Health Care Delivery KEY: Nursing Process Step: N/A MSC: NCLEX: N/A
10. The advent of diagnosis-related groups (DRGs) required that nurses working in
health care agencies:
a. record supportive documentation to confirm a patient‘s need for care in order to qualify
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 #10
TOP: Managed Care KEY: Nursing Process Step: N/A MSC: NCLEX: N/A
11. If a member of a health maintenance organization (HMO) is having respiratory
problems such as 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 in
order for the HMO to pay for the care.
DIF: Cognitive Level: Comprehension REF: p. 10 OBJ: Theory #11
TOP: Managed Care KEY: Nursing Process Step: N/A MSC: NCLEX: N/A
12. An advantage of preferred provider organizations (PPOs) is that:
a. they make insurance coverage of employees less expensive to employers.
,Chapter 01: Nursing and the Health Care System
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 #1
TOP: 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 nursing leaders,nursing education became more formalized
through apprenticeships in Nightingale schools that offered independence to women through
education and employment.
DIF: Cognitive Level: Knowledge REF: p. 2 OBJ: Theory #4
TOP: Nursing History KEY: Nursing Process Step: N/A MSC: NCLEX: N/A
3. 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: a. caregiver, educator, and collaborator.
b. nursing assistant, delegator, and environmental specialist.
c. medication dispenser, collaborator, and transporter.
d. dietitian, manager, and housekeeper.
ANS: A
In order for the LPN to apply the common goals of nursing, he or she must assume the roles
of caregiver, educator, collaborator, manager, and advocate.
DIF: Cognitive Level: Comprehension REF: p. 3 OBJ: Theory #2
TOP: Art and Science of Nursing KEY: Nursing Process Step: N/A MSC: NCLEX:
N/A
4. 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, the
, environment, and health.
DIF: Cognitive Level: Comprehension REF: p. 4 OBJ: Theory #2
TOP: Nursing Theories KEY: Nursing Process Step: N/A MSC: NCLEX: N/A
5. 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 the
ANA 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 #2
TOP: Standards of Care KEY: Nursing Process Step: N/A MSC: NCLEX: N/A
6. 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 is
reflective of the application of evidence-based practice.
DIF: Cognitive Level: Knowledge REF: p. 7 OBJ: Theory #3
TOP: Evidence-Based Practice KEY: Nursing Process Step: N/A MSC: NCLEX:
N/A
7. Lillian Wald and Mary Brewster established the Henry Street Settlement Service
in New York in 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 poor
people living in tenements.
DIF: Cognitive Level: Comprehension REF: p. 2 OBJ: Theory #4
TOP: Growth of Nursing KEY: Nursing Process Step: N/A MSC: NCLEX: N/A
8. 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 #7
TOP: Nursing Education Pathways KEY: Nursing Process Step: N/A MSC:
NCLEX: N/A
9. When diagnosis-related groups (DRGs) were established by Medicare in 1983, the
purpose was 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 #10
TOP: Health Care Delivery KEY: Nursing Process Step: N/A MSC: NCLEX: N/A
10. The advent of diagnosis-related groups (DRGs) required that nurses working in
health care agencies:
a. record supportive documentation to confirm a patient‘s need for care in order to qualify
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 #10
TOP: Managed Care KEY: Nursing Process Step: N/A MSC: NCLEX: N/A
11. If a member of a health maintenance organization (HMO) is having respiratory
problems such as 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 in
order for the HMO to pay for the care.
DIF: Cognitive Level: Comprehension REF: p. 10 OBJ: Theory #11
TOP: Managed Care KEY: Nursing Process Step: N/A MSC: NCLEX: N/A
12. An advantage of preferred provider organizations (PPOs) is that:
a. they make insurance coverage of employees less expensive to employers.
