Chapter 01: Nursing and the Health Care System
Williams: deWit's Fundamental Concepts and Skills for Nursing, 5th Edition
MULTIPLE CHOICE
1. Florence Nightingale’s contributions to nursing practice and education:
a. are historically important but have no validity for nursing today.
b. were neither recognized nor appreciated in her own time.
c. were a major factor in reducing the death rate in the Crimean War.
d. were limited only to the care of severe traumatic wounds.
ANS: C
By improving sanitation, nutrition ventilation, and handwashing techniques, Florence Nightingale’s nu
the death rate from injuries in the Crimean War.
DIF: Cognitive Level: Knowledge REF: p. 2 OBJ: Theory #1
TOP: Nursing History KEY: Nursing Process Step: N/A
MSC: NCLEX: N/A
2. Early nursing education and care in the United States:
a. were directed at community health.
b. provided independence for women through education and employment.
c. were an educational model based in institutions of higher learning.
d. have continued to be entirely focused on hospital nursing.
ANS: B
Because of the influence of early nursing leaders, nursing education became more formalized through a
Nightingale schools that offered independence to women through education and employment.
DIF: Cognitive Level: Knowledge REF: p. 2 OBJ: Theory #4
TOP: Nursing History KEY: Nursing Process Step: N/A
MSC: NCLEX: N/A
3. In order to fulfill the common goals defined by nursing theorists (promote wellness, prevent illness, fac
health), the LPN must take on the roles of:
a. caregiver, educator, and collaborator.
b. nursing assistant, delegator, and environmental specialist.
c. medication dispenser, collaborator, and transporter.
d. dietitian, manager, and housekeeper.
ANS: A
In order for the LPN to apply the common goals of nursing, he or she must assume the roles of caregiv
manager, and advocate.
DIF: Cognitive Level: Comprehension REF: p. 3 OBJ: Theory #2
TOP: Art and Science of Nursing KEY: Nursing Process Step: N/A
MSC: NCLEX: N/A
4. Although nursing theories differ in their attempts to define nursing, all of them base their beliefs on co
a. self-actualization, fundamental needs, and belonging.
b. stress reduction, self-care, and a systems model.
c. curative care, restorative care, and terminal care.
d. human relationships, the environment, and health.
ANS: D
Although nursing theories differ, they all base their beliefs on human relationships, the environment, an
DIF: Cognitive Level: Comprehension REF: p. 4 OBJ: Theory #2
TOP: Nursing Theories KEY: Nursing Process Step: N/A
MSC: NCLEX: N/A
, 6. The LPN demonstrates an evidence-based practice by:
a. using a drug manual to check compatibility of drugs.
b. using scientific information to guide decision making.
c. using medical history of a patient to direct nursing interventions.
d. basing nursing care on advice from an experienced nurse.
ANS: B
The use of scientific information from high-quality research to guide nursing decisions is reflective of
evidence-based practice.
DIF: Cognitive Level: Knowledge REF: p. 7 OBJ: Theory #3
TOP: Evidence-Based Practice KEY: Nursing Process Step: N/A
MSC: NCLEX: N/A
7. Lillian Wald and Mary Brewster established the Henry Street Settlement Service in New York in 1893
a. offer a shelter to injured war veterans.
b. found a nursing apprenticeship.
c. provide health care to poor persons living in tenements.
d. offer better housing to low-income families.
ANS: C
Henry Street Settlement Service brought the provision of community health care to the poor people liv
DIF: Cognitive Level: Comprehension REF: p. 2 OBJ: Theory #4
TOP: Growth of Nursing KEY: Nursing Process Step: N/A
MSC: NCLEX: N/A
8. An educational pathway for an LPN/LVN refers to an LPN/LVN:
a. learning on the job and being promoted to a higher level of responsibility.
b. moving from a maternity unit to a more complicated surgical unit.
c. obtaining additional education to move from one level of nursing to another.
d. learning that advancement requires consistent work and commitment.
ANS: C
By broadening the educational base, an LPN/LVN may advance and build a nursing career.
DIF: Cognitive Level: Knowledge REF: p. 7 OBJ: Theory #7
TOP: Nursing Education Pathways KEY: Nursing Process Step: N/A
MSC: NCLEX: N/A
9. When diagnosis-related groups (DRGs) were established by Medicare in 1983, the purpose was to:
a. put patients with the same diagnosis on the same unit.
b. attempt to contain the costs of health care.
c. increase the availability of medical care to older adults.
d. identify a patient’s condition more quickly.
ANS: B
The purpose of instituting DRGs was to contain skyrocketing costs of health care.
DIF: Cognitive Level: Knowledge REF: p. 9 OBJ: Theory #10
TOP: Health Care Delivery KEY: Nursing Process Step: N/A
MSC: NCLEX: N/A
10. The advent of diagnosis-related groups (DRGs) required that nurses working in health care agencies:
a. record supportive documentation to confirm a patient’s need for care in order to
qualify for reimbursement.
b. use the DRG rather than their own observations for patient assessment.
c. be aware of the specific drugs related to the diagnosis.
d. acquire cross-training to make staffing more flexible.
ANS: A
DRGs required that nurses provide more supportive documentation of their assessments and identified
Williams: deWit's Fundamental Concepts and Skills for Nursing, 5th Edition
MULTIPLE CHOICE
1. Florence Nightingale’s contributions to nursing practice and education:
a. are historically important but have no validity for nursing today.
b. were neither recognized nor appreciated in her own time.
c. were a major factor in reducing the death rate in the Crimean War.
d. were limited only to the care of severe traumatic wounds.
ANS: C
By improving sanitation, nutrition ventilation, and handwashing techniques, Florence Nightingale’s nu
the death rate from injuries in the Crimean War.
DIF: Cognitive Level: Knowledge REF: p. 2 OBJ: Theory #1
TOP: Nursing History KEY: Nursing Process Step: N/A
MSC: NCLEX: N/A
2. Early nursing education and care in the United States:
a. were directed at community health.
b. provided independence for women through education and employment.
c. were an educational model based in institutions of higher learning.
d. have continued to be entirely focused on hospital nursing.
ANS: B
Because of the influence of early nursing leaders, nursing education became more formalized through a
Nightingale schools that offered independence to women through education and employment.
DIF: Cognitive Level: Knowledge REF: p. 2 OBJ: Theory #4
TOP: Nursing History KEY: Nursing Process Step: N/A
MSC: NCLEX: N/A
3. In order to fulfill the common goals defined by nursing theorists (promote wellness, prevent illness, fac
health), the LPN must take on the roles of:
a. caregiver, educator, and collaborator.
b. nursing assistant, delegator, and environmental specialist.
c. medication dispenser, collaborator, and transporter.
d. dietitian, manager, and housekeeper.
ANS: A
In order for the LPN to apply the common goals of nursing, he or she must assume the roles of caregiv
manager, and advocate.
DIF: Cognitive Level: Comprehension REF: p. 3 OBJ: Theory #2
TOP: Art and Science of Nursing KEY: Nursing Process Step: N/A
MSC: NCLEX: N/A
4. Although nursing theories differ in their attempts to define nursing, all of them base their beliefs on co
a. self-actualization, fundamental needs, and belonging.
b. stress reduction, self-care, and a systems model.
c. curative care, restorative care, and terminal care.
d. human relationships, the environment, and health.
ANS: D
Although nursing theories differ, they all base their beliefs on human relationships, the environment, an
DIF: Cognitive Level: Comprehension REF: p. 4 OBJ: Theory #2
TOP: Nursing Theories KEY: Nursing Process Step: N/A
MSC: NCLEX: N/A
, 6. The LPN demonstrates an evidence-based practice by:
a. using a drug manual to check compatibility of drugs.
b. using scientific information to guide decision making.
c. using medical history of a patient to direct nursing interventions.
d. basing nursing care on advice from an experienced nurse.
ANS: B
The use of scientific information from high-quality research to guide nursing decisions is reflective of
evidence-based practice.
DIF: Cognitive Level: Knowledge REF: p. 7 OBJ: Theory #3
TOP: Evidence-Based Practice KEY: Nursing Process Step: N/A
MSC: NCLEX: N/A
7. Lillian Wald and Mary Brewster established the Henry Street Settlement Service in New York in 1893
a. offer a shelter to injured war veterans.
b. found a nursing apprenticeship.
c. provide health care to poor persons living in tenements.
d. offer better housing to low-income families.
ANS: C
Henry Street Settlement Service brought the provision of community health care to the poor people liv
DIF: Cognitive Level: Comprehension REF: p. 2 OBJ: Theory #4
TOP: Growth of Nursing KEY: Nursing Process Step: N/A
MSC: NCLEX: N/A
8. An educational pathway for an LPN/LVN refers to an LPN/LVN:
a. learning on the job and being promoted to a higher level of responsibility.
b. moving from a maternity unit to a more complicated surgical unit.
c. obtaining additional education to move from one level of nursing to another.
d. learning that advancement requires consistent work and commitment.
ANS: C
By broadening the educational base, an LPN/LVN may advance and build a nursing career.
DIF: Cognitive Level: Knowledge REF: p. 7 OBJ: Theory #7
TOP: Nursing Education Pathways KEY: Nursing Process Step: N/A
MSC: NCLEX: N/A
9. When diagnosis-related groups (DRGs) were established by Medicare in 1983, the purpose was to:
a. put patients with the same diagnosis on the same unit.
b. attempt to contain the costs of health care.
c. increase the availability of medical care to older adults.
d. identify a patient’s condition more quickly.
ANS: B
The purpose of instituting DRGs was to contain skyrocketing costs of health care.
DIF: Cognitive Level: Knowledge REF: p. 9 OBJ: Theory #10
TOP: Health Care Delivery KEY: Nursing Process Step: N/A
MSC: NCLEX: N/A
10. The advent of diagnosis-related groups (DRGs) required that nurses working in health care agencies:
a. record supportive documentation to confirm a patient’s need for care in order to
qualify for reimbursement.
b. use the DRG rather than their own observations for patient assessment.
c. be aware of the specific drugs related to the diagnosis.
d. acquire cross-training to make staffing more flexible.
ANS: A
DRGs required that nurses provide more supportive documentation of their assessments and identified
