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Conceptual Foundations 8th Edition Friberg
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,Chapter 01: A Brief History of the Professionalization of Nursing in the United States
Friberg: Conceptual Foundations: The Bridge to Professional Nursing, 8th Edition
MULTIPLE CHOICE
1. Historically, women were considered the obvious choice for nursing sick patients, because:
a. caring for others was an extension of their homemaker role.
b. early nurses were nuns, so the public was used to women in nursing.
c. men, who had education, were reluctant to try nursing.
d. women were often at home anyway, so caregiving was easy.
ANS: A
Women’s domestic role (as homemakers and mothers) was naturally associated with the
caregiving required in nursing. Although religious orders did play a role in health care, it was
the domestic duties of women that set the stage for their involvement in nursing. Widespread
education for men and women is a fairly new phenomenon and did not play a role in the early
history of nursing. Women did not care for sick or injured strangers in their homes, so being at
home was irrelevant.
2. Florence Nightingale’s views about trained nurses were most influenced by her:
a. experiences in wartime.
b. ideas about sanitation.
c. relationships with physicians.
d. view of education.
ANS: A
Nightingale’s experiences in wartime demonstrated to her that trained nurses were valuable in
decreasing morbidity and mortality among soldiers. Nightingale had revolutionary ideas about
hospital sanitation, but these are not credited with her advocacy of using trained nurses. Early
trained nurses were taught to follow the directions of the physician; collegial relationships
were not a part of health care practice in Nightingale’s day. Nightingale’s views of education
were influenced by her opinion on the value of trained nurses, not the other way around.
3. A nursing instructor explains to students that the major goal of the Society of Superintendents
of Training Schools for Nurses of the United States and Canada was to:
a. improve working conditions for students.
b. obtain legal recognition for the profession.
c. raise and standardize the training of nurses.
d. reverse discrimination in admissions policies.
ANS: C
The goals of the Society of Superintendents were “to promote fellowship of members, to
establish and maintain a universal standard of training, and to further the best interests of the
nursing profession.” Students were expected to work in apprenticeships during their education
in the hospital-based programs in existence at the time. Obtaining legal recognition for nurses
was the goal of the Nurses’ Associated Alumnae of the United States and Canada, later
renamed the American Nurses Association. Discrimination in nursing existed well into the
civil rights era and beyond, with men and women of color routinely being banned from
admission and employment.
,4. Today’s nurse understands that legal recognition for nurses was imperative to:
a. allow nurses to expand beyond the hospital setting.
b. lobby for better wages and working conditions.
c. protect the public from untrained nurses.
d. provide hospitals with accreditation requirements.
ANS: C
The goal of the Nurses’ Associated Alumnae of the United States and Canada (renamed the
American Nurses Association in 1912) was to protect the public from untrained nurses by
securing legal recognition for trained nurses. Graduate nurses predominantly worked as
private duty nurses up through the early 20th century. Wages remained low, and working
conditions remained long and arduous in hospitals (and seasonal for private duty nurses) until
hospitals began hiring more graduate nurses in the 1930s. Hospital accreditation is a recent
phenomenon, unattached to legal recognition for nurses.
5. Which patient would most likely have been cared for in a hospital in the 19th to early 20th
century?
a. Dying patient
b. Contagious patient
c. Homeless patient
d. Woman in labor
ANS: C
Hospitals were considered places for people who had no one else to care for them.
Most patients were cared for in their homes. A dying patient probably would have been cared
for at home. A patient with a communicable illness would have probably been confined to his
or her home. Women in labor typically had their children at home.
6. Lillian Wald’s contribution to nursing can best be described as the:
a. creation of community health nursing.
b. development of college-based nursing schools.
c. establishment of the Navy Nurse Corps.
d. foundation of maternal-child nursing.
ANS: A
Wald responded to the changing social conditions in the late 1800s by establishing the Henry
Street Settlement and Henry Street Visiting Nurse Services in response to the horrendous
health conditions she witnessed in New York City. Wald was not involved in establishing
college-based nursing programs. Wald was not involved in establishing the Navy Nurse
Corps. Wald was not involved in establishing maternal-child nursing as a specialty, although
she did care for many new mothers and their infants as part of her community nursing role.
7. Which event eventually led to the creation of military nursing?
a. American Civil War
b. Spanish-American War
c. World War I
d. World War II
ANS: B
, During the Spanish-American War, trained nurses cared for soldiers suffering from yellow
fever. This convinced the military and Congress of the need for qualified nurses and set the
stage for the eventual creation of the Army Nurse Corps in 1901 and the Navy Nurse Corps in
1908. During the Civil War, both sides wanted women to care for injured and ill soldiers, but
these women were mostly untrained volunteers from the middle and upper classes. World War
I occurred after the creation of the Army Nurse Corps and the Navy Nurse Corps. World War
II occurred after the creation of the Army Nurse Corps and the Navy Nurse Corps.
8. A faculty nurse explaining the stratification in nursing roles seen today tells students that the
most important event leading to this development was:
a. desegregation in nursing.
b. limited nursing opportunities.
c. the Korean conflict.
d. World War II.
ANS: D
The United States’ involvement in World War II dramatically increased the demand for trained
nurses. To help fill this need, the American Red Cross and the Office of Civilian Defense co-
established a program to train nurse aides. The success of the program encouraged hospitals to
use employees with various levels of skill. Desegregation in nursing did come about in the
same era as stratification, but it was not instrumental in creating this differentiated practice.
Nursing opportunities were increasing throughout the 20th century. Role stratification was
already entrenched by the Korean conflict.
9. Discrimination against African-American nurses began to wane during:
a. Kennedy’s presidency.
b. the civil rights era.
c. the Vietnam War.
d. World War II.
ANS: D
World War II saw discrimination against African Americans begin to wane with the end of
segregation in the military Nurse Corps. At the end of World War II, many state nurses
associations ended their discrimination in membership as well; by 1952, all state nurses
associations had eliminated such discriminatory policies. Kennedy’s presidency, although
known for civil rights advancements, was not when discrimination began to end. The civil
rights era occurred at approximately the same time as the Kennedy era. The Vietnam War
occurred at the same time as Kennedy’s presidency and civil rights era.
10. Between the years 1950 and 1967, the number of nurses and assistive personnel rose
dramatically in part as a result of the influence of the:
a. Children’s Bureau.
b. Hill-Burton Act.
c. Nurse Training Act.
d. Social Security Act.
ANS: C
, The Nurse Training Act provided funding for nursing student education through scholarships,
loans, recruitment, school construction and maintenance, and special educational projects.
Until its passage, federal funding for nursing education was modest at best. The Children’s
Bureau was created in 1912 in response to concerns about women and children’s health. The
Hill-Burton Act provided federal funds for hospital construction and health care centers. The
Social Security Act of 1935 included financial aid for older adults and Title V health care
benefits for children with disabilities.
11. Mildred Montag’s major contribution to nursing is considered to be:
a. encouraging minority women and men to enter nursing.
b. establishing associate degree nursing programs.
c. fighting for improved wages and recognition for nurses.
d. paving the way for the military to use trained nurses.
ANS: B
In response to the severe nursing shortage in the post–World War II years, Montag proposed a
2-year nursing associate degree that would prepare technical nurses in community colleges.
Montag was not known for encouraging minorities and men to enter nursing. Montag’s major
accomplishment was not fighting for improved wages and recognition. Montag was not
involved in the military’s use of trained nurses.
12. Which nursing organizations are responsible for providing continuing education, establishing
practice standards, and offering certification examinations for their members?
a. Councils of nurse educators
b. National specialty organizations
c. State boards of nursing
d. State nurses associations
ANS: B
National specialty organizations, such as the American Association of Critical Care Nurses,
arose in response to the developing nursing specialties; these organizations offer continuing
education, practice standards, and certification exams for their members. Organizations that
consist of nurse educators would be primarily concerned with nursing education. State boards
of nursing are charged with the legal oversight of nursing in their respective states. State
nurses associations are often lobbying and marketing organizations for nursing within a
specific state and act as the state arms of the American Nurses Association.
13. What influence did Loretta Ford and Henry Silver have on the nursing profession?
a. Advocated for laws allowing autonomous practice
b. Created a major scholarship for nursing education
c. Designed the first doctoral nursing program
d. Opened the first nurse practitioner program
ANS: D
Loretta Ford and Henry Silver opened the first nurse practitioner program (in pediatrics) at the
University of Colorado in 1965. They did not advocate for laws allowing autonomous
practice, create a major scholarship, or design the first nursing doctoral program.
14. What change is anticipated that will guide advanced practice nursing roles?
a. Changes in federal funding for advanced education
b. Declining demand for advanced practice roles
, c. Requirement of a doctor of nursing practice
d. Third-party payer restrictions on this type of practice
ANS: C
If the American Association of Colleges of Nursing Board (AACN) leadership holds sway, the
doctor of nursing practice (DNP) will be the requisite preparation for all advanced practice
nursing roles, including the NP, CNS, certified nurse midwife, and certified registered nurse
anesthetist (CRNA), in the near future. It is not anticipated that there will be changes in
federal funding for advanced education, a declining demand for advanced practice roles, or
third-party payer restrictions on this type of practice in such a way that will guide advanced
practice nursing roles as the requirement of a DNP will.
MULTIPLE RESPONSE
1. Benefits of the apprenticeship model of nursing education included: (Select all that apply.)
a. a well-trained graduate nursing hospital staff.
b. opportunities for further education in nursing.
c. providing a skilled but inexpensive workforce.
d. providing working-class women employment.
e. reforms in the care of sick and injured individuals.
ANS: C, D, E
Nursing students provided the staffing for hospitals in exchange for their education. Nursing
gave working-class women employment alternatives to domestic or factory work. The use of
skilled, trained nurses decreased morbidity and mortality, and this benefit was evident in both
civilian and military health care. Graduate nurses were typically employed as private duty
nurses and did not remain working in hospitals. Further education for graduate nurses was
rare; a postdiploma program was opened in 1899, but the first undergraduate college nursing
program was not opened until 1909.
2. When nursing registration laws were enacted, a “registered nurse” was defined as someone
who had: (Select all that apply.)
a. attended an acceptable nursing program.
b. fit the definition of a professional nurse.
c. had not been convicted of any felonies.
d. passed a board evaluation examination.
e. studied under a standardized curriculum.
ANS: A, D
One of the two criteria for being a registered nurse was having attended an acceptable nursing
program. The other criterion for being a registered nurse was having passed a board
examination. A weakness of the early registration laws was a lack of definition of professional
nursing practice. Background checks were not part of the early registry laws. Universal
education standards were still lacking in 1903 when the first registry law was passed in North
Carolina.
3. Nurses in private duty positions faced several hardships, including: (Select all that apply.)
a. a shortage of nurses as schools limited enrollment.
b. a surplus of nurses starting in the mid-1920s.
c. employment that was sporadic and seasonal.
, d. opportunities primarily working with poorer families.
e. pay that continued to be lower than other jobs.
ANS: B, C, E
The increased enrollment in schools led to a surplus of graduate nurses. Because
communicable illnesses were often seen in the cooler months, employment for private duty
nurses was seasonal. According to the Geister report (1926), nurses made less money than
scrubwomen and worked in mostly short-term private duty cases. Schools were pressured to
increase enrollment as the hospital census began to rise for the first time. Only the middle to
upper class could afford to hire private duty nurses.
4. Community health nursing has been vital in shaping America’s health system and nursing in
general by providing: (Select all that apply.)
a. advocacy regarding matters of health and welfare.
b. autonomous nursing practice in patients’ homes.
c. means to check on patients’ compliance with treatment.
d. novel activities in health promotion and disease prevention.
e. treatment that didn’t rely on the patient’s ability to pay.
ANS: A, D
Community health nurses expanded nursing services to new areas, including school,
industrial, tuberculosis, and infant welfare nursing. They combined their training and
knowledge to educate the public and served as the backbone for the Maternal and Infant Act
of 1921. Community health nurses combined their training and knowledge to bring education
to the public to promote health and well-being. Private duty nurses had always been the
mainstay of nursing work; these nurses worked semi-autonomously in patients’ homes. A
system for determining compliance was not a part of the developing health care system in this
country. The use of community health nursing increased because of concern with the public’s
health, not the patient’s ability to pay.
5. Social events surrounding the Great Depression that had a major impact on American’s
emerging health care system included: (Select all that apply.)
a. Blue Cross was developed as a prepaid health insurance plan.
b. large hospitals experienced increasing numbers of nonpaying patients.
c. many hospitals found their nursing schools too expensive to operate.
d. nurses were hired in hospitals in increasing numbers.
e. religious orders began supplying trained nurses, cutting the cost of nursing.
ANS: A, B, C, D
The development of Blue Cross helped hospitals’ financial stability by providing patients who
were able to pay for care. Large hospitals, particularly those in cities, experienced more
patients who needed medical care but were unable to afford it because of the economic
hardships of the Depression. A total of 570 training programs for nurses were closed because
of prohibitive costs during the decade of the Depression. As hospital care became more
sophisticated, more nurses were hired as staff. By 1941, more than 100,000 registered nurses
were employed in hospitals. Religious orders did not provide trained nurses to hospitals to
decrease the cost of the nursing staff.
6. The development of associate degree (AD) nursing programs has had which effect on nursing
today? (Select all that apply.)
a. A wider student pool has been able to study nursing.
, b. AD programs have helped ease the nursing shortage.
c. Hospitals have been influenced to close their training programs.
d. Social status for graduates of nursing programs has improved.
e. The public has suffered some confusion about nursing education.
ANS: A, B, C, E
Nontraditional students, such as mothers and older students, have found it convenient to study
nursing at community colleges. More nurses enter the profession via AD programs than
through baccalaureate and diploma programs combined. As college education for nurses
became more widespread and accepted, hospital directors became convinced to close their
expensive programs, lessening the burden of hiring a professional nursing staff. The public
and nursing suffer from confusion about the educational requirements for becoming a
registered nurse. AD programs do not necessarily contribute to the improved social status of
nurses.
7. Enrollment in college-based nursing programs was initially hindered by: (Select all that
apply.)
a. a lack of qualified applicants.
b. little social and financial support.
c. poorly trained faculty members.
d. restrictive admissions criteria.
ANS: A, B
Nursing education differed from medical education, which had seen a rise in stature as a result
of social support and financial endowments. Aspiring nurses found the time and monetary
commitment to be too great compared with diploma programs. Poorly trained faculty
members were not a factor in limited enrollment into college programs. Restrictive admissions
criteria were not a factor in limited enrollment into college programs.
8. Men in nursing in the early to mid-20th-century faced which barriers to practice and
education? (Select all that apply.)
a. Denial of professional status in the military
b. Frequent use of trained nurses as orderlies
c. Limited areas of health care in which to practice
d. Physical inability to perform delicate tasks
e. Societal bias that nursing was women’s work
ANS: A, B, C, E
Men in nursing faced multiple barriers, including denial of professional status in the military,
the frequent use of trained nurses as orderlies, limited employment opportunities (e.g., in
psychiatric care), and a societal belief that nursing was strictly women’s work. Men are
physically able to perform delicate tasks.
, Chapter 02: Academic Progression
Friberg: Conceptual Foundations: The Bridge to Professional Nursing, 8th Edition
MULTIPLE CHOICE
1. A faculty member explains to students that one concern of the American Nurses Association’s
1965 position statement designating the baccalaureate degree (BSN) as the educational entry
point for nursing is that:
a. diploma programs remain the most popular educational program for nurses.
b. it is difficult to monitor other programs for congruency with BSN programs.
c. multiple educational paths create confusion for the public and the profession.
d. some states are creating different licensure exams for different pathways.
ANS: C
The existence of multiple entry paths for nursing education is confusing both to the public and
to aspiring nursing students, who may have difficulty understanding and comprehending the
differences and what they mean. Diploma programs have declined sharply in number, with
only 47 programs remaining in the United States in 2013. The ANA does not monitor different
programs to evaluate congruency with BSN programs. States are not creating different
licensure examinations for graduates of different programs.
2. A hospital-based nursing administrator is responsible for the diploma nursing program
affiliated with that hospital. In deciding to keep the program open, the administrator develops
changes that address a major historical concern with this type of program. In doing so, the
administrator would most likely:
a. arrange for faculty from the local college to teach science courses.
b. limit the hours students are expected to work in the hospital.
c. lower the tuition rate and apply for increased federal student grants.
d. require nursing faculty to be doctorally prepared to remain on staff.
ANS: B
Diploma students were traditionally expected to staff the hospital with which their program
was affiliated, often to the detriment of their educational experiences. This exploitation was
described in several important studies of nursing education. Traditional diploma programs do
not offer college credit, no matter who teaches the courses. Diploma programs were expensive
to operate and expensive to students, and this had a part in their decreasing numbers. Federal
funding (through a variety of means) is available for individual students, and although it is
administered by institutions, it is not granted to the institution itself. Requiring doctorally
prepared faculty would not address an historic concern with diploma education.
3. In analyzing trends within the profession that are correlated to the rise in baccalaureate
nursing (BSN) programs, the nurse historian would outline that:
a. degree inflation is contributing to the demand for BSN programs.
b. increased social status and pay correspond to education at the college level.
c. men in nursing demand an increase in BSN programs compared with other
programs.
d. the rise in doctorally prepared nurses corresponds to an increase in BSN programs.
ANS: D
Conceptual Foundations 8th Edition Friberg
Important Notes
The file includes the complete test bank, organized chapter by chapter.
A sample of selected pages has been provided for preview.
All available appendices and Excel files (if included in the original resources) are
provided.
We continuously update our files to ensure you receive the latest and most accurate
editions.
New editions are added regularly – stay connected for updates!
Purchase Guarantee
If you believe you have purchased the wrong file, don’t worry. Contact us anytime and we
will gladly replace it with the correct version.
Contact Email:
,Chapter 01: A Brief History of the Professionalization of Nursing in the United States
Friberg: Conceptual Foundations: The Bridge to Professional Nursing, 8th Edition
MULTIPLE CHOICE
1. Historically, women were considered the obvious choice for nursing sick patients, because:
a. caring for others was an extension of their homemaker role.
b. early nurses were nuns, so the public was used to women in nursing.
c. men, who had education, were reluctant to try nursing.
d. women were often at home anyway, so caregiving was easy.
ANS: A
Women’s domestic role (as homemakers and mothers) was naturally associated with the
caregiving required in nursing. Although religious orders did play a role in health care, it was
the domestic duties of women that set the stage for their involvement in nursing. Widespread
education for men and women is a fairly new phenomenon and did not play a role in the early
history of nursing. Women did not care for sick or injured strangers in their homes, so being at
home was irrelevant.
2. Florence Nightingale’s views about trained nurses were most influenced by her:
a. experiences in wartime.
b. ideas about sanitation.
c. relationships with physicians.
d. view of education.
ANS: A
Nightingale’s experiences in wartime demonstrated to her that trained nurses were valuable in
decreasing morbidity and mortality among soldiers. Nightingale had revolutionary ideas about
hospital sanitation, but these are not credited with her advocacy of using trained nurses. Early
trained nurses were taught to follow the directions of the physician; collegial relationships
were not a part of health care practice in Nightingale’s day. Nightingale’s views of education
were influenced by her opinion on the value of trained nurses, not the other way around.
3. A nursing instructor explains to students that the major goal of the Society of Superintendents
of Training Schools for Nurses of the United States and Canada was to:
a. improve working conditions for students.
b. obtain legal recognition for the profession.
c. raise and standardize the training of nurses.
d. reverse discrimination in admissions policies.
ANS: C
The goals of the Society of Superintendents were “to promote fellowship of members, to
establish and maintain a universal standard of training, and to further the best interests of the
nursing profession.” Students were expected to work in apprenticeships during their education
in the hospital-based programs in existence at the time. Obtaining legal recognition for nurses
was the goal of the Nurses’ Associated Alumnae of the United States and Canada, later
renamed the American Nurses Association. Discrimination in nursing existed well into the
civil rights era and beyond, with men and women of color routinely being banned from
admission and employment.
,4. Today’s nurse understands that legal recognition for nurses was imperative to:
a. allow nurses to expand beyond the hospital setting.
b. lobby for better wages and working conditions.
c. protect the public from untrained nurses.
d. provide hospitals with accreditation requirements.
ANS: C
The goal of the Nurses’ Associated Alumnae of the United States and Canada (renamed the
American Nurses Association in 1912) was to protect the public from untrained nurses by
securing legal recognition for trained nurses. Graduate nurses predominantly worked as
private duty nurses up through the early 20th century. Wages remained low, and working
conditions remained long and arduous in hospitals (and seasonal for private duty nurses) until
hospitals began hiring more graduate nurses in the 1930s. Hospital accreditation is a recent
phenomenon, unattached to legal recognition for nurses.
5. Which patient would most likely have been cared for in a hospital in the 19th to early 20th
century?
a. Dying patient
b. Contagious patient
c. Homeless patient
d. Woman in labor
ANS: C
Hospitals were considered places for people who had no one else to care for them.
Most patients were cared for in their homes. A dying patient probably would have been cared
for at home. A patient with a communicable illness would have probably been confined to his
or her home. Women in labor typically had their children at home.
6. Lillian Wald’s contribution to nursing can best be described as the:
a. creation of community health nursing.
b. development of college-based nursing schools.
c. establishment of the Navy Nurse Corps.
d. foundation of maternal-child nursing.
ANS: A
Wald responded to the changing social conditions in the late 1800s by establishing the Henry
Street Settlement and Henry Street Visiting Nurse Services in response to the horrendous
health conditions she witnessed in New York City. Wald was not involved in establishing
college-based nursing programs. Wald was not involved in establishing the Navy Nurse
Corps. Wald was not involved in establishing maternal-child nursing as a specialty, although
she did care for many new mothers and their infants as part of her community nursing role.
7. Which event eventually led to the creation of military nursing?
a. American Civil War
b. Spanish-American War
c. World War I
d. World War II
ANS: B
, During the Spanish-American War, trained nurses cared for soldiers suffering from yellow
fever. This convinced the military and Congress of the need for qualified nurses and set the
stage for the eventual creation of the Army Nurse Corps in 1901 and the Navy Nurse Corps in
1908. During the Civil War, both sides wanted women to care for injured and ill soldiers, but
these women were mostly untrained volunteers from the middle and upper classes. World War
I occurred after the creation of the Army Nurse Corps and the Navy Nurse Corps. World War
II occurred after the creation of the Army Nurse Corps and the Navy Nurse Corps.
8. A faculty nurse explaining the stratification in nursing roles seen today tells students that the
most important event leading to this development was:
a. desegregation in nursing.
b. limited nursing opportunities.
c. the Korean conflict.
d. World War II.
ANS: D
The United States’ involvement in World War II dramatically increased the demand for trained
nurses. To help fill this need, the American Red Cross and the Office of Civilian Defense co-
established a program to train nurse aides. The success of the program encouraged hospitals to
use employees with various levels of skill. Desegregation in nursing did come about in the
same era as stratification, but it was not instrumental in creating this differentiated practice.
Nursing opportunities were increasing throughout the 20th century. Role stratification was
already entrenched by the Korean conflict.
9. Discrimination against African-American nurses began to wane during:
a. Kennedy’s presidency.
b. the civil rights era.
c. the Vietnam War.
d. World War II.
ANS: D
World War II saw discrimination against African Americans begin to wane with the end of
segregation in the military Nurse Corps. At the end of World War II, many state nurses
associations ended their discrimination in membership as well; by 1952, all state nurses
associations had eliminated such discriminatory policies. Kennedy’s presidency, although
known for civil rights advancements, was not when discrimination began to end. The civil
rights era occurred at approximately the same time as the Kennedy era. The Vietnam War
occurred at the same time as Kennedy’s presidency and civil rights era.
10. Between the years 1950 and 1967, the number of nurses and assistive personnel rose
dramatically in part as a result of the influence of the:
a. Children’s Bureau.
b. Hill-Burton Act.
c. Nurse Training Act.
d. Social Security Act.
ANS: C
, The Nurse Training Act provided funding for nursing student education through scholarships,
loans, recruitment, school construction and maintenance, and special educational projects.
Until its passage, federal funding for nursing education was modest at best. The Children’s
Bureau was created in 1912 in response to concerns about women and children’s health. The
Hill-Burton Act provided federal funds for hospital construction and health care centers. The
Social Security Act of 1935 included financial aid for older adults and Title V health care
benefits for children with disabilities.
11. Mildred Montag’s major contribution to nursing is considered to be:
a. encouraging minority women and men to enter nursing.
b. establishing associate degree nursing programs.
c. fighting for improved wages and recognition for nurses.
d. paving the way for the military to use trained nurses.
ANS: B
In response to the severe nursing shortage in the post–World War II years, Montag proposed a
2-year nursing associate degree that would prepare technical nurses in community colleges.
Montag was not known for encouraging minorities and men to enter nursing. Montag’s major
accomplishment was not fighting for improved wages and recognition. Montag was not
involved in the military’s use of trained nurses.
12. Which nursing organizations are responsible for providing continuing education, establishing
practice standards, and offering certification examinations for their members?
a. Councils of nurse educators
b. National specialty organizations
c. State boards of nursing
d. State nurses associations
ANS: B
National specialty organizations, such as the American Association of Critical Care Nurses,
arose in response to the developing nursing specialties; these organizations offer continuing
education, practice standards, and certification exams for their members. Organizations that
consist of nurse educators would be primarily concerned with nursing education. State boards
of nursing are charged with the legal oversight of nursing in their respective states. State
nurses associations are often lobbying and marketing organizations for nursing within a
specific state and act as the state arms of the American Nurses Association.
13. What influence did Loretta Ford and Henry Silver have on the nursing profession?
a. Advocated for laws allowing autonomous practice
b. Created a major scholarship for nursing education
c. Designed the first doctoral nursing program
d. Opened the first nurse practitioner program
ANS: D
Loretta Ford and Henry Silver opened the first nurse practitioner program (in pediatrics) at the
University of Colorado in 1965. They did not advocate for laws allowing autonomous
practice, create a major scholarship, or design the first nursing doctoral program.
14. What change is anticipated that will guide advanced practice nursing roles?
a. Changes in federal funding for advanced education
b. Declining demand for advanced practice roles
, c. Requirement of a doctor of nursing practice
d. Third-party payer restrictions on this type of practice
ANS: C
If the American Association of Colleges of Nursing Board (AACN) leadership holds sway, the
doctor of nursing practice (DNP) will be the requisite preparation for all advanced practice
nursing roles, including the NP, CNS, certified nurse midwife, and certified registered nurse
anesthetist (CRNA), in the near future. It is not anticipated that there will be changes in
federal funding for advanced education, a declining demand for advanced practice roles, or
third-party payer restrictions on this type of practice in such a way that will guide advanced
practice nursing roles as the requirement of a DNP will.
MULTIPLE RESPONSE
1. Benefits of the apprenticeship model of nursing education included: (Select all that apply.)
a. a well-trained graduate nursing hospital staff.
b. opportunities for further education in nursing.
c. providing a skilled but inexpensive workforce.
d. providing working-class women employment.
e. reforms in the care of sick and injured individuals.
ANS: C, D, E
Nursing students provided the staffing for hospitals in exchange for their education. Nursing
gave working-class women employment alternatives to domestic or factory work. The use of
skilled, trained nurses decreased morbidity and mortality, and this benefit was evident in both
civilian and military health care. Graduate nurses were typically employed as private duty
nurses and did not remain working in hospitals. Further education for graduate nurses was
rare; a postdiploma program was opened in 1899, but the first undergraduate college nursing
program was not opened until 1909.
2. When nursing registration laws were enacted, a “registered nurse” was defined as someone
who had: (Select all that apply.)
a. attended an acceptable nursing program.
b. fit the definition of a professional nurse.
c. had not been convicted of any felonies.
d. passed a board evaluation examination.
e. studied under a standardized curriculum.
ANS: A, D
One of the two criteria for being a registered nurse was having attended an acceptable nursing
program. The other criterion for being a registered nurse was having passed a board
examination. A weakness of the early registration laws was a lack of definition of professional
nursing practice. Background checks were not part of the early registry laws. Universal
education standards were still lacking in 1903 when the first registry law was passed in North
Carolina.
3. Nurses in private duty positions faced several hardships, including: (Select all that apply.)
a. a shortage of nurses as schools limited enrollment.
b. a surplus of nurses starting in the mid-1920s.
c. employment that was sporadic and seasonal.
, d. opportunities primarily working with poorer families.
e. pay that continued to be lower than other jobs.
ANS: B, C, E
The increased enrollment in schools led to a surplus of graduate nurses. Because
communicable illnesses were often seen in the cooler months, employment for private duty
nurses was seasonal. According to the Geister report (1926), nurses made less money than
scrubwomen and worked in mostly short-term private duty cases. Schools were pressured to
increase enrollment as the hospital census began to rise for the first time. Only the middle to
upper class could afford to hire private duty nurses.
4. Community health nursing has been vital in shaping America’s health system and nursing in
general by providing: (Select all that apply.)
a. advocacy regarding matters of health and welfare.
b. autonomous nursing practice in patients’ homes.
c. means to check on patients’ compliance with treatment.
d. novel activities in health promotion and disease prevention.
e. treatment that didn’t rely on the patient’s ability to pay.
ANS: A, D
Community health nurses expanded nursing services to new areas, including school,
industrial, tuberculosis, and infant welfare nursing. They combined their training and
knowledge to educate the public and served as the backbone for the Maternal and Infant Act
of 1921. Community health nurses combined their training and knowledge to bring education
to the public to promote health and well-being. Private duty nurses had always been the
mainstay of nursing work; these nurses worked semi-autonomously in patients’ homes. A
system for determining compliance was not a part of the developing health care system in this
country. The use of community health nursing increased because of concern with the public’s
health, not the patient’s ability to pay.
5. Social events surrounding the Great Depression that had a major impact on American’s
emerging health care system included: (Select all that apply.)
a. Blue Cross was developed as a prepaid health insurance plan.
b. large hospitals experienced increasing numbers of nonpaying patients.
c. many hospitals found their nursing schools too expensive to operate.
d. nurses were hired in hospitals in increasing numbers.
e. religious orders began supplying trained nurses, cutting the cost of nursing.
ANS: A, B, C, D
The development of Blue Cross helped hospitals’ financial stability by providing patients who
were able to pay for care. Large hospitals, particularly those in cities, experienced more
patients who needed medical care but were unable to afford it because of the economic
hardships of the Depression. A total of 570 training programs for nurses were closed because
of prohibitive costs during the decade of the Depression. As hospital care became more
sophisticated, more nurses were hired as staff. By 1941, more than 100,000 registered nurses
were employed in hospitals. Religious orders did not provide trained nurses to hospitals to
decrease the cost of the nursing staff.
6. The development of associate degree (AD) nursing programs has had which effect on nursing
today? (Select all that apply.)
a. A wider student pool has been able to study nursing.
, b. AD programs have helped ease the nursing shortage.
c. Hospitals have been influenced to close their training programs.
d. Social status for graduates of nursing programs has improved.
e. The public has suffered some confusion about nursing education.
ANS: A, B, C, E
Nontraditional students, such as mothers and older students, have found it convenient to study
nursing at community colleges. More nurses enter the profession via AD programs than
through baccalaureate and diploma programs combined. As college education for nurses
became more widespread and accepted, hospital directors became convinced to close their
expensive programs, lessening the burden of hiring a professional nursing staff. The public
and nursing suffer from confusion about the educational requirements for becoming a
registered nurse. AD programs do not necessarily contribute to the improved social status of
nurses.
7. Enrollment in college-based nursing programs was initially hindered by: (Select all that
apply.)
a. a lack of qualified applicants.
b. little social and financial support.
c. poorly trained faculty members.
d. restrictive admissions criteria.
ANS: A, B
Nursing education differed from medical education, which had seen a rise in stature as a result
of social support and financial endowments. Aspiring nurses found the time and monetary
commitment to be too great compared with diploma programs. Poorly trained faculty
members were not a factor in limited enrollment into college programs. Restrictive admissions
criteria were not a factor in limited enrollment into college programs.
8. Men in nursing in the early to mid-20th-century faced which barriers to practice and
education? (Select all that apply.)
a. Denial of professional status in the military
b. Frequent use of trained nurses as orderlies
c. Limited areas of health care in which to practice
d. Physical inability to perform delicate tasks
e. Societal bias that nursing was women’s work
ANS: A, B, C, E
Men in nursing faced multiple barriers, including denial of professional status in the military,
the frequent use of trained nurses as orderlies, limited employment opportunities (e.g., in
psychiatric care), and a societal belief that nursing was strictly women’s work. Men are
physically able to perform delicate tasks.
, Chapter 02: Academic Progression
Friberg: Conceptual Foundations: The Bridge to Professional Nursing, 8th Edition
MULTIPLE CHOICE
1. A faculty member explains to students that one concern of the American Nurses Association’s
1965 position statement designating the baccalaureate degree (BSN) as the educational entry
point for nursing is that:
a. diploma programs remain the most popular educational program for nurses.
b. it is difficult to monitor other programs for congruency with BSN programs.
c. multiple educational paths create confusion for the public and the profession.
d. some states are creating different licensure exams for different pathways.
ANS: C
The existence of multiple entry paths for nursing education is confusing both to the public and
to aspiring nursing students, who may have difficulty understanding and comprehending the
differences and what they mean. Diploma programs have declined sharply in number, with
only 47 programs remaining in the United States in 2013. The ANA does not monitor different
programs to evaluate congruency with BSN programs. States are not creating different
licensure examinations for graduates of different programs.
2. A hospital-based nursing administrator is responsible for the diploma nursing program
affiliated with that hospital. In deciding to keep the program open, the administrator develops
changes that address a major historical concern with this type of program. In doing so, the
administrator would most likely:
a. arrange for faculty from the local college to teach science courses.
b. limit the hours students are expected to work in the hospital.
c. lower the tuition rate and apply for increased federal student grants.
d. require nursing faculty to be doctorally prepared to remain on staff.
ANS: B
Diploma students were traditionally expected to staff the hospital with which their program
was affiliated, often to the detriment of their educational experiences. This exploitation was
described in several important studies of nursing education. Traditional diploma programs do
not offer college credit, no matter who teaches the courses. Diploma programs were expensive
to operate and expensive to students, and this had a part in their decreasing numbers. Federal
funding (through a variety of means) is available for individual students, and although it is
administered by institutions, it is not granted to the institution itself. Requiring doctorally
prepared faculty would not address an historic concern with diploma education.
3. In analyzing trends within the profession that are correlated to the rise in baccalaureate
nursing (BSN) programs, the nurse historian would outline that:
a. degree inflation is contributing to the demand for BSN programs.
b. increased social status and pay correspond to education at the college level.
c. men in nursing demand an increase in BSN programs compared with other
programs.
d. the rise in doctorally prepared nurses corresponds to an increase in BSN programs.
ANS: D
