,Chapter 01: The Evolution of Nursing
Cooper: Foundation of Nursing, 9th Edition
MULTIPLE CHOICE
1. What is a nursing program considered when certified by a state agency?
a. Accredited
b. Approved
c. Provisional
d. Exemplified
ANS: B
Approved means certified by a state agency for having met minimum standards; accredited
means certified by the NLN for having met more complex standards. Provisional and
exemplified are not terms used in regard to nursing program certification.
DIF: Cognitive Level: Knowledge REF: p. 10 OBJ: 5
TOP: Nursing programs KEY: Nursing Process Step: N/A
MSC: NCLEX: N/A
2. Which of the following must the nurse recognize regarding the health care delivery system?
a. It includes all states.
b. It affects the illness of patients.
c. Insurance companies are not involved.
d. The major goal is to achieve optimal levels of health care.
ANS: D
The nurse must recognize that in the health care delivery system, the major goal is to achieve
optimal levels of health care. The health care system consists of a network of agencies,
facilities, and providers involved with health care in a specified geographic area. Insurance
companies do have involvement in the health care system. The illness of patients is not
necessarily affected by the health care system.
DIF: Cognitive Level: Comprehension REF: p. 12 OBJ: 7
TOP: Health care systems KEY: Nursing Process Step: N/A
MSC: NCLEX: N/A
3. What is required by the health care team to identify the needs of a patient and to design care to
meet those needs?
a. The Kardex
b. The health care provider’s order sheet
c. An individualized care plan
d. The nurse’s notes
ANS: C
An individualized care plan involves all health care workers and outlines care to meet the
needs of the individual patient. The Kardex, health care provider’s order sheet, and nurse’s
notes do not identify the needs of the patient nor are they designed to assist all members of the
health care team to meet those needs.
DIF: Cognitive Level: Comprehension REF: p. 13 OBJ: 8 | 9
, TOP: Care plan KEY: Nursing Process Step: Planning MSC: NCLEX: N/A
4. Patient care emphasis on wellness, rather than illness, begins as a result of:
a. increased education concerning causes of illness.
b. improved insurance payments.
c. decentralized care centers.
d. increased number of health care givers.
ANS: A
The acute awareness of preventive medicine has resulted in today’s emphasis on education
about issues such as smoking, heart disease, drug and alcohol abuse, weight control, and
mental health and wellness promotion activities. This preventive education has resulted in an
emphasis on wellness, rather than illness. Improved insurance payments, decentralized care
centers, and increased numbers of health care givers did not influence an emphasis on
wellness.
DIF: Cognitive Level: Comprehension REF: p. 12 OBJ: 4 | 8
TOP: Wellness KEY: Nursing Process Step: N/A MSC: NCLEX: N/A
5. What is the most effective process to ensure that the care plan is meeting the needs of the
patient?
a. Documentation
b. Communication
c. Evaluation
d. Planning
ANS: B
Communication is the primary essential component among the health care team to evaluate
and modify the care plan. Documentation, evaluation, and planning are not primary essential
components to ensure the care plan is meeting the needs of the patient.
DIF: Cognitive Level: Comprehension REF: p. 17 OBJ: 8
TOP: Communication KEY: Nursing Process Step: N/A
MSC: NCLEX: N/A
6. How does an interdisciplinary approach to patient treatment enhance care?
a. By improving efficiency of care
b. By reducing the number of caregivers
c. By preventing the fragmentation of patient care
d. By shortening hospital stay
ANS: C
An interdisciplinary approach prevents fragmentation of care. An interdisciplinary approach
does not improve the efficiency of care, reduce the number of caregivers, or shorten hospital
stay.
DIF: Cognitive Level: Comprehension REF: p. 16 OBJ: 8 | 9
TOP: Interdisciplinary approach KEY: Nursing Process Step: N/A
MSC: NCLEX: N/A
7. How may a newly licensed LPN/LVN practice?
a. Independently in a hospital setting
, b. With an experienced LPN/LVN
c. Under the supervision of a health care provider or RN
d. As a sole health care provider in a clinic setting
ANS: C
An LPN/LVN practices under the supervision of a health care provider, dentist, OD, or RN.
DIF: Cognitive Level: Knowledge REF: p. 11 OBJ: 11
TOP: Vocational nursing KEY: Nursing Process Step: N/A
MSC: NCLEX: N/A
8. Whose influence on nursing practice in the 19th century was related to improvement of patient
environment as a method of health promotion?
a. Clara Barton
b. Linda Richards
c. Dorothea Dix
d. Florence Nightingale
ANS: D
The influence of Florence Nightingale was highly significant in the 19th century as she fought
for sanitary conditions, fresh air, and general improvement in the patient environment. Clara
Barton developed the American Red Cross in 1881. Linda Richards is known as the first
trained nurse in America, was responsible for the development of the first nursing and hospital
records, and is credited with the development of our present-day documentation system.
Dorothea Dix was the pioneer crusader for elevation of standards of care for the mentally ill
and superintendent of female nurses of the Union Army.
DIF: Cognitive Level: Knowledge REF: p. 17 OBJ: 2 | 4
TOP: Nursing leaders KEY: Nursing Process Step: N/A
MSC: NCLEX: N/A
9. What document identifies the roles and responsibilities of the LPN/LVN?
a. NLN Accreditation Standards
b. Nurse Practice Act
c. NAPNE Code
d. American Nurses’ Association Code
ANS: B
The LPN/LVN functions under the Nurse Practice Act. NLN Accreditation Standards, the
NAPNE Code, and the American Nurses’ Association Code do not identify the roles and
responsibilities of the LPN/LVN.
DIF: Cognitive Level: Knowledge REF: p. 12 | p. 14 OBJ: 11
TOP: Roles and responsibilities KEY: Nursing Process Step: N/A
MSC: NCLEX: N/A
10. What is a cost-effective delivery of care used by many hospitals that allows the LPN/LVN to
work with the RN to meet the needs of patients?
a.Focused nursing
b.Team nursing
c.Case management
d.Primary nursing
, ANS: C
Case management is a cost-effective method of care. Focused nursing, team nursing, and
primary nursing are not cost-effective methods of delivering care that allow the LPN/LVN to
work with the RN to meet patient needs.
DIF: Cognitive Level: Comprehension REF: p. 15 OBJ: 7 | 9
TOP: Patient care delivery systems KEY: Nursing Process Step: N/A
MSC: NCLEX: N/A
11. What is the title of the American Hospital Association’s 1972 document that outlines the
patient’s expectations to be treated with dignity and compassion?
a. Code of Ethics
b. Patient’s Bill of Rights
c. OBRA
d. Advance directives
ANS: B
Patient expectations are outlined by the Patient’s Bill of Rights. Patient expectations are not
outlined in the Code of Ethics, OBRA, or advance directives.
DIF: Cognitive Level: Knowledge REF: p. 16 OBJ: 4 | 8
TOP: Patient’s rights KEY: Nursing Process Step: N/A
MSC: NCLEX: N/A
12. The relationships among nursing, patients, health, and the environment are the basis for:
a. care plans.
b. nursing models.
c. health care provider’s orders.
d. evaluation of patient care.
ANS: B
Nursing models are theories based on the relationship between nursing, patients, health, and
environment. Care plans, health care provider’s orders, and evaluation of patient care are not
based on the relationships among nursing, patients, health, and environment.
DIF: Cognitive Level: Comprehension REF: p. 17 OBJ: 1
TOP: Nursing models KEY: Nursing Process Step: N/A
MSC: NCLEX: N/A
13. What system reduces the number of employees but still provides quality care for patients?
a. Team nursing
b. Cross-training
c. Use of critical pathways
d. Case management
ANS: B
Cross-training reduces the number of employees but does not alter the quality of patient care.
Team nursing, use of critical pathways, and case management do not reduce the number of
employees while continuing to provide quality care for patients.
DIF: Cognitive Level: Comprehension REF: p. 15 OBJ: 8
TOP: Patient care KEY: Nursing Process Step: N/A MSC: NCLEX: N/A
,14. What is the purpose of licensing laws for LPN/LVNs?
a. To limit the number of LPN/LVNs
b. Prevention of malpractice
c. Protection of the public from unqualified people
d. To increase revenue for the state board of nursing
ANS: C
The purpose of licensing laws for LPN/LVNs is to protect the public from unqualified health
care providers. Licensing laws’ purpose is not to limit the number of LPNs/LVNs, prevent
malpractice, or increase revenue for the state board of nursing.
DIF: Cognitive Level: Comprehension REF: p. 11 OBJ: 4 | 9 | 10
TOP: Licensure KEY: Nursing Process Step: N/A MSC: NCLEX: N/A
15. What premise is Maslow’s hierarchy of needs based on?
a. All needs are equally important.
b. Basic needs must be met before the next level of needs can be met.
c. Self-actualization is a primary need.
d. Individuals prioritize needs the same way.
ANS: B
Maslow’s hierarchy of needs is based on the premise that basic needs must be met first. It is
not based on all needs being equally important or that individuals prioritize needs the same
way. Self-actualization is not a primary need according to Maslow.
DIF: Cognitive Level: Comprehension REF: p. 12 | p. 13 OBJ: 8
TOP: Maslow’s Hierarchy of Needs KEY: Nursing Process Step: N/A
MSC: NCLEX: N/A
16. What must the nurse realize when assessing physical and social environmental factors
affecting health and illness?
a. They affect one another.
b. They cause illness.
c. They cause patients to react similarly.
d. They can be separated.
ANS: A
Physical and social factors affect each other, cannot be separated, and cause each patient to
react in a unique manner. They do not necessarily cause illness or cause patients to react
similarly, and they cannot be separated.
DIF: Cognitive Level: Comprehension REF: p. 14 OBJ: 4 | 8
TOP: Environmental factors KEY: Nursing Process Step: Assessment
MSC: NCLEX: Health Promotion and Maintenance
17. What organization, established during World War II, provided nursing education and training?
a. Nightingale school
b. Cadet Nurse Corps
c. Public health department
d. Frontier Nursing Service
, ANS: B
The Cadet Nurse Corps was established during World War II to provide nursing education and
training. The Nightingale school, public health department, and Frontier Nursing Service are
not organizations established during World War II to provide nursing education and training.
DIF: Cognitive Level: Knowledge REF: p. 5 OBJ: 1 | 4
TOP: Nursing education KEY: Nursing Process Step: N/A
MSC: NCLEX: N/A
18. What is a modern educational advancement program for the LPN/LVN to enter RN education?
a. Repetition
b. Exclusion
c. Articulation
d. Coexistence
ANS: C
Most states have some type of articulation program in which the LPN/LVN can achieve
advanced standing in an RN program without having to enroll in the entire curriculum.
Repetition, exclusion, and coexistence do not refer to educational advancement.
DIF: Cognitive Level: Knowledge REF: p. 10 OBJ: 1 | 9
TOP: Nursing education KEY: Nursing Process Step: N/A
MSC: NCLEX: N/A
19. Where did Florence Nightingale’s original nursing education take place?
a. Saint Thomas
b. Kings College Hospital
c. Crimean Hospital
d. Kaiserswerth School
ANS: D
Florence Nightingale trained at Kaiserswerth School. Florence Nightingale’s original training
was not at Saint Thomas, Kings College Hospital, or Crimean Hospital.
DIF: Cognitive Level: Knowledge REF: p. 2 OBJ: 2
TOP: Nursing programs KEY: Nursing Process Step: N/A
MSC: NCLEX: N/A
20. What system of comprehensive patient care considers the physical, emotional, and social
environment and spiritual needs of a person?
a. Interdependent care
b. Holistic health care
c. Illness prevention care
d. Health promotion care
ANS: B
Holistic health care encompasses the physical, emotional, social, and spiritual aspects of the
patient.
DIF: Cognitive Level: Comprehension REF: p. 12 OBJ: 8
TOP: Health care KEY: Nursing Process Step: N/A MSC: NCLEX: N/A
,21. What official agency exists exclusively for LPN/LVN membership and promotes standards for
the LPN/LVN?
a. NFLPN
b. ANA
c. NLN
d. NAPNES
ANS: A
The NFLPN exists solely for the LPN/LVN. The other options have membership that includes
RNs and the lay public.
DIF: Cognitive Level: Knowledge REF: p. 10 OBJ: 5 | 6 | 9
TOP: Nursing organizations KEY: Nursing Process Step: N/A
MSC: NCLEX: N/A
22. What score does the graduate practical nurse require to be issued a license upon completion of
the computerized examination?
a. 70% or better
b. This is defined and set by each state
c. Designated as “pass”
d. Within the 75th percentile
ANS: C
Currently graduates of an approved vocational school are eligible to take the licensing
examination and be awarded a license with a score of “pass” that is recognized by all states.
DIF: Cognitive Level: Knowledge REF: p. 12 OBJ: 3
TOP: Licensure examination KEY: Nursing Process Step: N/A
MSC: NCLEX: N/A
23. What document, published in 1965 by the ANA, clearly defined two levels of nursing
practice?
a. Licensing standards
b. Position paper
c. Smith-Hughes Act
d. Nurse practice act
ANS: B
The ANA’s position paper of 1965 defined two levels of nursing: registered nurse and
technical nurse. Licensing standards, the Smith-Hughes Act, and the nurse practice act were
not documents defining two levels of nursing practice published in 1965.
DIF: Cognitive Level: Knowledge REF: p. 11 OBJ: 3 | 4 | 9
TOP: Position paper KEY: Nursing Process Step: N/A
MSC: NCLEX: N/A
24. What is the wellness/illness continuum defined as?
a. A concept that never changes
b. The range of a person’s total health
c. A continuum influenced only by one’s physical condition
d. An idea that focuses strictly on an individual’s social well-being
, ANS: B
The wellness/illness continuum is defined as the range of a person’s total health. This
continuum is ever changing, and it is influenced by the individual’s physical condition, mental
condition, and social well-being.
DIF: Cognitive Level: Comprehension REF: p. 12 OBJ: 8
TOP: Wellness/illness continuum KEY: Nursing Process Step: N/A
MSC: NCLEX: N/A
25. According to Maslow’s hierarchy of needs, what is an individual’s most basic need?
a. Safety and security
b. Love/belongingness
c. Physiologic
d. Self-actualization
e. Esteem
ANS: C
Abraham Maslow believed that an individual’s behavior is formed by the individual’s
attempts to meet essential human needs, which he identified as physiologic, safety and
security, love and belongingness, and esteem and self-actualization.
DIF: Cognitive Level: Comprehension REF: p. 12 | p. 13 OBJ: 8
TOP: Maslow’s Hierarchy of Needs KEY: Nursing Process Step: N/A
MSC: NCLEX: N/A
MULTIPLE RESPONSE
1. Florence Nightingale established a nursing school at Saint Thomas Hospital in London. What
was it characterized by? (Select all that apply.)
a. Allowing all applicants who applied to be enrolled
b. Offering formal and practical educational experiences
c. Keeping records of students’ progress
d. Focusing on sanitation and hygiene
e. Retaining a registry of all graduates
ANS: B, C, D, E
The nursing school established by Florence Nightingale rigorously screened its applicants.
The curriculum, which included both formal education and practical experiences, was focused
on hygiene and sanitation. The school kept records of the students’ progress during their
school years, and also kept a registry of the graduates.
DIF: Cognitive Level: Comprehension REF: p. 3 OBJ: 1 | 2
TOP: School established by Florence Nightingale KEY: Nursing Process Step: N/A
MSC: NCLEX: N/A
COMPLETION
1. Primitive medical interventions were based on the belief that illness was caused by the
presence of spirits.
ANS:
, evil
Illness was thought to be caused by the inhabitation of the body by evil spirits. Medical
interventions were designed to drive out the evil spirits by introducing good spirits.
DIF: Cognitive Level: Comprehension REF: p. 1 OBJ: 1
TOP: Primitive health care KEY: Nursing Process Step: N/A
MSC: NCLEX: N/A
2. During early civilization men performed witchcraft and rituals to induce the
bad spirits to leave the body of the ailing person.
ANS:
medicine
Medicine men performed witchcraft and rituals to induce the bad spirits to leave the body of
the ailing person during early civilization.
DIF: Cognitive Level: Knowledge REF: p. 2 OBJ: 1
TOP: Primitive health care KEY: Nursing Process Step: N/A
MSC: NCLEX: N/A
3. The National Council of State Boards of Nursing (NCSBN) performs a job analysis every
years to determine the scope of practice of LPN/LVNs.
ANS:
3
three
The National Council of State Boards of Nursing performs a job analysis every 3 years to
measure the scope of practice for LPN/LVNs.
DIF: Cognitive Level: Knowledge REF: p. 18 OBJ: 6 | 9
TOP: National Council analysis KEY: Nursing Process Step: N/A
MSC: NCLEX: N/A
4. Graduates of the first school for training the practical nurse were referred to as
nurses.
ANS:
attendant
The first school for training the practical nurse started in Brooklyn, New York, in 1892 and
was conducted under the auspices of the Young Women’s Christian Association (YWCA). The
Ballard School, as it was known, was approximately 3 months in duration and trained its
students to care for the chronically ill, invalids, children, and the elderly. The main emphasis
was on home care and included cooking, nutrition, basic science, and basic procedures.
Graduates of this program were referred to as attendant nurses.
DIF: Cognitive Level: Knowledge REF: p. 9 OBJ: 1
TOP: Attendant nurses KEY: Nursing Process Step: N/A
