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4) Teaching a diabetic patient about his diet
ANS: 3
Chapter number and title: 1, Nursing Past & Present
Chapter learning objective: Name and recognize the four purposes of nursing care.
Chapter page reference: p. 15
Heading: Nursing Practice: Caring for Clients
Integrated Processes: Nursing Process – Implementation
Client Need: Health Promotion and Maintenance
Cognitive level: Application [Applying]
Concept: Health Promotion
Difficulty: Moderate
Feedback
1 Illness-prevention activities focus on avoiding a specific disease. A food diary is
a health-promotion activity.
2 Although cancer is a disease, it is assumed that a person joining a support group
would already have the disease; therefore, this is not disease prevention but
treatment.
3 Administering immunization for HPV is an example of illness prevention.
4 Teaching a diabetic patient about diet is a treatment for diabetes; the patient
already has diabetes, so it cannot prevent diabetes.
PTS: 1 CON: Health Promotion
3. Which contribution of Florence Nightingale had an immediate impact on improving patients’
health?
1) Providing a clean environment
2) Improving nursing education
3) Changing the delivery of care in hospitals
4) Establishing nursing as a distinct profession
ANS: 1
Chapter learning objective: Name nine expanded roles for nursing.
Heading: Table 1-1 Roles and Functions of the Nurse
Integrated Processes: Caring
Client Need: Health Promotion and Maintenance
Cognitive level: Comprehension [Understanding]
Concept: Evidence-Based Practice
Difficulty: Easy
Feedback
1 Improved sanitation (a clean environment) greatly and immediately reduced the
rate of infection and mortality in hospitals.
2 This is an activity of Florence Nightingale that improved healthcare or nursing,
but the impact is long range, not immediate.

PTS: 1 CON: Evidence-Based Practice
4. Which aspect of the full-spectrum nursing role is essential for the nurse to do in order to
successfully carry out all the others?
1) Thinking and reasoning about the client’s care
2) Providing hands-on client care
3) Carrying out physician orders
4) Delegating to assistive personnel
ANS: 1
Chapter learning objective: Name and recognize the four purposes of nursing care.
Heading: Nursing Today: Full-Spectrum Nursing
Integrated Processes: Nursing Process
Client Need: Safe and Effective Care Environment: Management of Care
Cognitive level: Analysis [Analyzing]
Concept: Patient-Centered Care
Difficulty: Difficult
Feedback
1 A substantial portion of the nursing role involves using clinical judgment,
critical thinking, and problem solving, which directly affect the care the client
will actually receive.
2 Providing hands-on care is important; however, clinical judgment, critical
thinking, and problem-solving are essential to do it successfully.
3 Carrying out physician orders is a small part of a nurse’s role; it, too, requires
nursing assessment, planning, intervention, and evaluation.
4 Many simple nursing tasks are being delegated to nursing assistive personnel;
delegation requires careful analysis of patient status and the appropriateness of
support personnel to deliver care.
PTS: 1 CON: Patient-Centered Care
5. Which statement pertaining to Benner’s practice model for clinical competence is true?
1) Progression through the stages is constant, with most nurses reaching the proficient
stage.
2) Progression through the stages involves continual development of thinking and
technical skills.
3) The nurse must have experience in many areas before being considered an expert.
4) The nurse’s progress through the stages is determined by years of experience and
skills.
ANS: 2
Chapter learning objective: Discuss the transitions nursing education has undergone in the last
century.
Heading: Benner’s Model

Difficulty: Easy
Feedback
1 Movement through the stages is not constant.
2 Benner’s model is based on integration of knowledge, technical skill, and
intuition in the development of clinical wisdom.
3 The model does not mention experience in many areas.
4 The model does not mention years of experience.
PTS: 1 CON: Evidence-Based Care
6. Which best explains why it is difficult for the profession to develop a definition of nursing?
1) There are too many different and conflicting images of nurses.
2) There are constant changes in healthcare and the activities of nurses.
3) There is disagreement among the different nursing organizations.
4) There are different education pathways and levels of practice.
ANS: 2
Chapter learning objective: Discuss the transitions that nursing education has undergone in the
last century.
Heading: How Is Nursing Defined?
Cognitive level: Analysis [Analyzing]
Concept: Professionalism
Difficulty: Difficult
Feedback
1 The conflicting images of nursing make it more important to develop a
definition; they may also make it more difficult but not to the extent that
constant change does.
2 Healthcare is constantly changing and with it come changes in where, how, and
what nursing care is delivered. Constant changes make it difficult to develop a
definition.
3 Although different nursing organizations have different definitions, they are
similar in most ways.
4 The different education pathways affect entry into practice, not the definition of
nursing.
PTS: 1 CON: Professionalism
7. Nurses have the potential to be very influential in shaping healthcare policy. Which factor
contributes most to nurses’ influence?
1) Nurses are the largest health professional group.
2) Nurses have a long history of serving the public.
3) Nurses have achieved some independence from physicians in recent years.

4) Political involvement has helped refute negative images portrayed in the media.
ANS: 1
Chapter learning objective: Discuss issues related to healthcare reform.
Heading: Influence of Nurses on Health Policy
Concept: Health Care System
Difficulty: Easy
Feedback
1 Nurses are trusted professionals and the largest health professional group. As
such, they have political power to effect changes. If nursing were a small group,
there would be little potential for power in shaping policies, even if all the other
answers were true.
2 Serving the public, although positive, does not necessarily help nurses to be
influential in establishing health policy.
3 Independence from physicians, although positive, does not necessarily make
nurses influential in establishing healthcare policy.
4 Refuting negative media, although positive, does not necessarily make nurses
influential in establishing healthcare policy.
PTS: 1 CON: Health Care System
8. Nursing was described as a distinct occupation in the sacred books of which faith?
1) Buddhism
2) Christianity
3) Hinduism
4) Judaism
ANS: 3
Chapter learning objective: Discuss the transitions that nursing education has undergone in the
last century.
Heading: Historical Context of Nursing
Cognitive level: Knowledge [Remembering]
Difficulty: Easy
Feedback
1 Nursing was not described as a distinct occupation in the sacred books of
Buddhism.
Christianity.
3 The Vedas, the sacred books of the Hindu faith, described Indian healthcare
practices and were the earliest writings of a distinct nursing occupation.

Judaism.
9. Which individual established the American Red Cross?
1) Louisa May Alcott
2) Clara Barton
3) Dorothea Dix
4) Harriet Tubman
ANS: 2
Chapter learning objective: Give four examples of influential nursing organizations.
Heading: Charitable Organizations
Cognitive level: Knowledge [Remembering]
Difficulty: Easy
Feedback
1 Louisa May Alcott was an American novelist who wrote Little Women in 1868.
2 Clara Barton was an American teacher, nurse, and humanitarian who organized
the American Red Cross after the Civil War.
3 Dorothea Dix was an American activist who acted on behalf of the indigent
population with mental illness. She was credited for establishing the first
psychiatric institution.
4 Harriet Tubman was an African American abolitionist and Union spy during the
Civil War. After escaping captivity, she set up a network of antislavery activists
known as the Underground Railroad.
10. Which is the most important reason to develop a definition of nursing?
1) Recruit more informed people into the nursing profession
2) Evaluate the degree of role satisfaction
3) Dispel the stereotypical images of nurses and nursing
4) Differentiate nursing activities from those of other health professionals
ANS: 4
Chapter learning objective: Define nursing in your own words.
Heading: How Is Nursing Defined?
Difficulty: Easy

Feedback
1 A definition of nursing would not be likely to increase the number of informed
people recruited into nursing.
2 A definition of nursing would do little to improve the nurse’s role satisfaction.
3 Although a definition of nursing might contribute to fighting stereotypes of
nursing, other, more powerful influences (e.g., media portrayals) exist to
counteract it.
4 Nursing organization leaders think it is important to develop a definition of
nursing to bring value and understanding to the profession, differentiate nursing
activities from those of other health professionals, and help student nurses
understand what is expected of them.
11. Which provides evidence-based support for the contribution that advanced practice nurses
(APNs. make within healthcare?
1) Reduced usage of diagnostics using advanced technology
2) Decreased number of unnecessary visits to the emergency department
3) Improved patient compliance with prescribed treatments
4) Increased usage of complementary alternative therapies
ANS: 3
Heading: Expanded Career Roles for Nurses
Integrated Processes: Nursing Process – Planning
Difficulty: Easy
Feedback
1 No well-known scientific studies support APNs’ effect on the use of advanced
technology.
2 No well-known scientific studies support APNs’ effect on the frequency of
emergency department visits.
3 Studies demonstrate that APNs have improved patient outcomes over those of
physicians, including increased patient understanding and cooperation with
treatments and decreased need for hospitalizations.
4 No well-known scientific studies support APNs’ effect on the use of alternative
therapies.
12. Which is an example of what traditional medicine and complementary and alternative
medicine therapies have in common?
1) Both can produce adverse effects in some patients.
2) Both use prescription medications.
3) Both are usually reimbursed by insurance programs.

4) Both are regulated by the FDA.
ANS: 1
Chapter learning objective: Delineate the forces and trends affecting contemporary nursing
practice.
Heading: What Are Some Trends in Nursing and Healthcare?
Difficulty: Easy
Feedback
1 Both traditional and complementary therapies can produce adverse effects in
some patients.
2 Many medications are derived from herbs, but the alternative treatments usually
use the herbs, not prescription medication.
3 Insurance programs do not necessarily reimburse alternative treatments, because
many are not supported by sound scientific research methodology.
4 Alternative medications are not regulated by the FDA.
13. Which is the biggest disadvantage of having nursing assistive personnel (NAP) assist nurses
in practice?
1) Nurses must know what aspects of care can legally and safely be delegated to the
NAP.
2) Nurses may rely too heavily on information gathered by the NAP when making
patient care decisions.
3) Nurses are removed from many components of direct patient care that have been
delegated to the NAP.
4) Nurses still maintain responsibility for the patient care given by the NAP.
ANS: 2
practice.
Heading: Increased Use of Nursing Assistive Personnel
Concept: Collaboration
Difficulty: Easy
Feedback
1 All of the options may be disadvantages to using NAPs, but making decisions
based on another’s information is the greatest drawback because of the potential
for negatively affecting patient care. Treatment decisions based on incorrect
information may cause harm to the patient.

PTS: 1 CON: Collaboration
14. An older adult patient is diagnosed with type 1 diabetes mellitus (DM). The patient can
perform self-care activities but needs help with shopping and meal preparation as well as with
blood glucose monitoring and insulin administration. Which type of healthcare facility would
be most appropriate for this patient?
1) Acute care facility
2) Ambulatory care facility
3) Extended care facility
4) Assisted living facility
ANS: 4
Chapter learning objective: Describe the healthcare delivery system in the United States,
including sites for care, types of workers, regulation, and financing of healthcare.
Heading: Extended Care Facilities
Feedback
1 Acute care facilities focus on preventing illnesses and treating acute problems.
These facilities include physicians’ offices, clinics, and diagnostic centers.
2 Ambulatory care facilities provide outpatient care. Clients live at home or in
nonhospital settings and come to the site for care. Ambulatory care facilities
include private health and medical offices, clinics, surgery centers, and
outpatient therapy centers.
3 Extended care facilities typically provide long-term care, rehabilitation, wound
care, and ongoing monitoring of patient conditions.
4 Assisted living facilities are intended for those who are able to perform self-care
activities but who require assistance with meals, housekeeping, or medications.

15. The nurse in the intensive care unit is providing care for only one patient, who was admitted
in septic shock. Based on this information, which care delivery model is the nurse
implementing?
1) Functional
2) Primary
3) Case method
4) Team
ANS: 3
Heading: What Models of Care Are Used to Provide Nursing Care?
Feedback
1 When the functional nursing model is employed, care is compartmentalized and
each task is assigned to a staff member with the appropriate knowledge and
skills.
2 In primary nursing, one nurse plans the care for a group of patients around the
clock. The primary nurse assesses the patient and develops the plan of care.
When that nurse is working, he or she provides care for those patients for whom
he or she is responsible. In his or her absence, the associate nurses deliver care.
Although the nurse in this case could possibly be a primary nurse, there are not
enough data to confidently infer that.
3 The nurse is following the case method model of nursing care. In this model,
one nurse cares for one patient during a single shift.
4 If the team nursing approach is utilized, a licensed nurse (RN or LVN) is paired
with a nursing assistant. The pair is then assigned to a group of patients.
16. Which healthcare worker should the nurse consult to counsel a patient about financial and
family stressors affecting healthcare?
1) Social worker
2) Occupational therapist
3) Physician’s assistant
4) Technologist
ANS: 1
Heading: Who Are the Members of the Interprofessional Healthcare Team?

Feedback
1 The social worker coordinates services and counsels patients about financial,
housing, marital, and family issues affecting healthcare.
2 The occupational therapist helps patients regain function and independence in
activities of daily living.
3 Physician’s assistants work under the physician’s direction to diagnose certain
diseases and injuries.
4 Technologists provide a variety of specific functions in hospitals, diagnostic
centers, and emergency care. For example, laboratory technologists aid in the
diagnosis and treatment of patients by examining blood, urine, tissue, and body
fluids. Radiology technologists perform x-rays and other diagnostic testing.
17. Which type of managed care allows patients the greatest choice of providers, medications, and
medical devices?
1) Health maintenance organization
2) Integrated delivery network
3) Preferred provider organization
4) Employment-based private insurance
ANS: 3
Heading: Managed Care
Feedback
1 Health maintenance organizations allow patients to choose a primary care
provider within the organization to coordinate their care. This type of program
will only reimburse medical care when patients have first obtained a referral
from their primary providers.
2 Integrated delivery networks combine providers, healthcare facilities,
pharmaceuticals, and services into one system, and patients must remain within
the system to receive care.
3 Preferred provider organizations are a form of managed care that allows patients
greater choice of providers, medications, and medical devices within the
designated list.
4 Employment-based private insurance is not a managed care organization.

18. A patient who underwent a total abdominal hysterectomy is assisted out of bed as soon as her
vital signs are stable. Which item is directing this intervention?
1) Critical pathway
2) Nursing care plan
3) Case manager
4) Traditional care model
ANS: 1
practice.
Heading: Work Redesign
Difficulty: Easy
Feedback
1 This patient’s care is most likely being directed by a critical pathway. A critical
pathway is a multidisciplinary approach to care that sequences interventions
over a length of stay for a given case type such as total abdominal hysterectomy.
Using this model, the patient can be assisted out of bed as soon as her vital signs
are stable.
2 The nursing care plan guides nursing care but cannot specify when the patient
can get out of bed postoperatively without a physician’s order.
3 When case management is used, care is coordinated by the case manager across
the healthcare setting, but the case manager does not direct each care
intervention.
4 Using the traditional model, the nurse would have to obtain a physician’s order
to assist the patient out of bed after surgery.
19. Which member of the healthcare team typically serves as the case manager?
1) Occupational therapist
2) Physician
3) Physician’s assistant
4) Registered nurse
ANS: 4
Heading: Table 1-1 Roles and Functions of the Nurse

Difficulty: Easy
Feedback
1 The occupational therapist, physician, and physician’s assistant all serve on the
healthcare team and take direction from the case manager.
4 Typically, registered nurses serve as case managers for patients with specific
diagnoses. Their role is coordinator of care across the healthcare system.
20. Which is considered a primary care service?
1) Providing wound care
2) Administering childhood immunizations
3) Providing drug rehabilitation
4) Outpatient hernia repair
ANS: 2
Heading: How Is Healthcare Categorized?
Difficulty: Easy
Feedback
1 Wound care is an example of a tertiary care service.
2 Primary care services focus on health promotion and disease prevention;
administering childhood immunizations is one such service.
3 Drug rehabilitation is an example of a tertiary care service.
4 Outpatient hernia repair surgery is an example of a secondary care service.
21. Which nursing activities represent direct care? Choose all that apply
1) Administering a medication
2) Documenting an assessment
3) Participating in a care conference
4) Making work assignments for the shift
ANS: 1

Heading: Who Are the Recipients of Nursing Care?
Difficulty: Easy
Feedback
1 Direct care involves personal interaction between the nurse and clients (e.g.,
giving medications, dressing a wound, or teaching a client about medicines or
care).
2 Nurses deliver indirect care when they work on behalf of an individual, group,
family, or community to improve their health status (e.g., restocking the code
blue cart [an emergency cart], ordering unit supplies, or arranging unit staffing).
22. An 80-year-old patient fell and fractured her hip and is in the hospital. Before the fall, the
patient lived at home with her spouse and managed their activities of daily living (ADLs) very
well. The hospital is ready to discharge the patient because the recommended length of stay in
a hospital has been exceeded. However, she cannot walk or perform ADLs independently. She
requires lengthy physical therapy and further monitoring of medications and both physical and
mental status. To which type of facility should the patient be transferred?
1) Nursing home
2) Rehabilitation center
3) Outpatient therapy center
4) None of these; she should receive home healthcare
ANS: 2
Heading: Extended Care Facilities
Feedback
1 A nursing home provides custodial care for those people who cannot live on
their own but who are not sick enough to require hospitalization. It provides a
room, custodial care, and opportunity for recreation.
2 A skilled nursing facility primarily provides skilled nursing care for patients

who can be expected to improve with treatment. For example, a patient who no
longer needs hospitalization may transfer to a skilled nursing facility, such as a
rehabilitation center, to get skilled care until able to return home.
3 This patient cannot ambulate or perform ADLs, so outpatient therapy and home
care would not be appropriate.
4 This patient cannot ambulate or perform ADLs, so outpatient therapy and home
care would not be appropriate.
23. A high school graduate desires to become a registered nurse in order to work in a community
setting. In which type of program should this student enroll?
1) RN-BSN
2) Associate degree
3) Diploma program
4) Baccalaureate degree
ANS: 4
Chapter learning objective: Differentiate between the various forms of nursing education.
Heading: How Do Nurses’ Educational Paths Differ?
Difficulty: Easy
Feedback
1 Nurses who have already received basic nursing education, passed the
NCLEX-RN®
examination, and now desire to earn a baccalaureate degree
would enter an RN-BSN program.
2 Associate program nurses are prepared to provide direct patient care.
3 Diploma program nurses are prepared to provide direct patient care.
4 Baccalaureate degree nurses are prepared to address complex clinical situations,
provide direct patient care, work in community care, apply research findings,
and enter graduate education.
24. A practicing registered nurse wants to become a staff development educator. Which type of
education should this nurse investigate?
1) Master’s degree
2) Doctoral degree
3) Baccalaureate degree
4) Continuing education
ANS: 1

Difficulty: Easy
Feedback
1 Master’s degree programs prepare RNs to function in a more independent and
autonomous role, such as nurse educator.
2 Baccalaureate and master’s degrees are required before entrance to a doctoral
program. Courses of study in doctoral programs include practice or research.
3 Baccalaureate degree nurses are prepared to address complex clinical situations,
provide direct patient care, work in community care, apply research findings,
and enter graduate education.
4 Continuing education courses do not prepare nurses for a particular role.
25. In preparation for relocating to another state the nurse contacts the state board of nursing to
obtain the necessary transfer of nursing license. Where will the nurse learn about continuing
education requirements for the new state of practice?
1) State board of nursing
2) The Joint Commission
3) School of original nursing education
4) Human resource department at new place of employment
ANS: 1
Difficulty: Easy
Feedback
1 The state board of nursing notifies nurses about continuing education
requirements and will notify nurses of any changes in the requirements.
2 The Joint Commission is a regulatory body that does not license nurses.
3 The school of original nursing education will not notify registered nurses about
continuing education requirements for licensure.
4 The Human Resources department at the new place of employment will not
notify or track continuing education requirements for the nursing staff.
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