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CHAPTER1:
ANSWERS AND RATIONALES
1. Which change represents the primary impetus for the end of the era of the female lay
healer?
1. Perception of health promotion as an obligation
2. Development of a clinical nurse specialist position statement
3. Foundation of the American Association of Nurse-Midwives
4. Emergence of a medical establishment
Page: 4
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1. This is incorrect. Lay healers traditionally viewed their role as being a function
of their community obligations; however, the emerging medical
establishment viewed healing as a commodity. The emergence of a male
medical establishment represents the primary impetus for the end of the era
of the female lay healer.
2. This is incorrect. The American Nurses Association (ANA) position statement
on educational requirements for the clinical nurse specialist (CNS) was
developed in 1965; the ANA’s position statement on the role of the CNS was
issued in 1976. The emergence of a male medical establishment represents
the primary impetus for the end of the era of the female lay healer.
3. This is incorrect. The American Association of Nurse-Midwives (AANM) was
founded in 1928. The emergence of a male medical establishment represents
the primary impetus for the end of the era of the female lay healer.
4. This is correct. The emergence of a male medical establishment represents
the primary impetus for the end of the era of the female lay healer. Whereas
lay healers viewed their role as being a function of their community
obligations, the emerging medical establishment viewed healing as a
commodity. The era of the female lay healer began and ended in the 19th
century. The American Association of Nurse-Midwives (AANM) was founded
in 1928. The American Nurses Association (ANA) position statement on
educational requirements for the clinical nurse specialist (CNS) was developed
in 1965; the ANA’s position statement on the role of the CNS was issued in
1976.
2. The beginning of modern nursing is traditionally considered to have begun with which
event?
1. Establishment of the first school of nursing
2. Incorporation of midwifery by the lay healer
3. Establishment of the Frontier Nursing Service (FNS)
4. Creation of the American Association of Nurse-Midwives (AANM)
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Answer: 1
Pages: 4–5
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1. This is correct. Traditionally, modern nursing is considered to have begun in
1873, when the first three U.S. training schools for nurses opened. The role of
the lay healer as a midwife is documented to have occurred in the 19th
century, before the establishment of schools of nursing. The Frontier Nursing
Service (FNS), which provided nurse-midwifery services, was established in
1925. In 1928, the Kentucky State Association of Midwives, which was an
outgrowth of the FNS, became the American Association of Nurse-Midwives
(AANM).
2. This is incorrect. The role of the lay healer as a midwife is documented to
have occurred in the 19th century, before the establishment of schools of
nursing. Traditionally, modern nursing is considered to have begun in 1873,
when the first three U.S. training schools for nurses opened.
3. This is incorrect. The Frontier Nursing Service (FNS), which provided nurse-
midwifery services, was established in 1925. Traditionally, modern nursing is
considered to have begun in 1873, when the first three U.S. training schools
for nurses opened.
4. This is incorrect. In 1928, the Kentucky State Association of Midwives, which
was an outgrowth of the FNS, became the American Association of Nurse-
Midwives (AANM). Modern nursing is considered to have begun in 1873, at
which time the first three U.S. training schools for nurses opened.
3. In 1910, which factors most significantly influenced the midwifery profession? Select
all that apply.
1. Strict licensing requirements
2. Negative public perception
3. Dedicated funding for training
4. Poor maternal-child outcomes
5. Mandatory professional supervision
Answer: 2, 4
Pages: 6–7
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1. This is incorrect. In 1910, the midwifery profession was significantly
influenced by poor maternal-child outcomes and a public perception as
unprofessional. Though legislation ultimately was passed to tighten
requirements related to licensing and supervision of midwives, in the early
20th century, midwives were largely unregulated and generally perceived as
unprofessional.
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2. This is correct. In 1910, the midwifery profession was significantly influenced
by poor maternal-child outcomes and a public perception as unprofessional.
At that time, approximately 50% of all U.S. births were reportedly attended by
midwives. However, especially with regard to perinatal health indicators, the
national population’s general health was poor. Unfavorable outcomes among
both mothers and infants were attributed to midwives who, at that time,
were largely unregulated and generally perceived as unprofessional. Poor
maternal-child outcomes, negative perceptions of midwives, obstetricians’
targeted efforts to take control of the birthing process, and a movement away
from home births prompted major changes. Legislation was passed to tighten
requirements related to licensing and supervision of midwives. One aim of
the Sheppard-Towner Maternity and Infancy Act involved allotting funds to
train public health nurses in midwifery; however, the bill lapsed in 1929.
3. This is incorrect. Goals of the Sheppard-Towner Maternity and Infancy Act
included allocating funds to train public health nurses in midwifery, but the
bill lapsed in 1929. In 1910, poor maternal-child outcomes and a public
perception as unprofessional significantly influenced the midwifery
profession.
4. This is correct. In 1910, the midwifery profession was significantly influenced
by poor maternal-child outcomes and a public perception as unprofessional.
At that time, approximately 50% of all U.S. births were reportedly attended by
midwives. However, especially with regard to perinatal health indicators, the
national population’s general health was poor. Unfavorable outcomes among
both mothers and infants were attributed to midwives who, at that time,
were largely unregulated and generally perceived as unprofessional. Poor
maternal-child outcomes, negative perceptions of midwives, obstetricians’
targeted efforts to take control of the birthing process, and a movement away
from home births prompted major changes. Legislation was passed to tighten
requirements related to licensing and supervision of midwives. One aim of
the Sheppard-Towner Maternity and Infancy Act involved allotting funds to
train public health nurses in midwifery; however, the bill lapsed in 1929.
5. This is incorrect. In 1910, the midwifery profession was largely unregulated.
Factors that influenced the profession included poor maternal-child outcomes
and a public perception as unprofessional.
4. Which advanced practice nursing role is unique in that the practitioners view their
role as comprising a combination of two distinct disciplines?
1. Nurse practitioner
2. Certified registered nurse anesthetist
3. Clinical nurse specialist
4. Certified nurse-midwife
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