Chapter 07: How Practical/Vocational Nursing Evolved: 1836 to Present My Nursing Test Banks

Chapter 07: How Practical/Vocational Nursing Evolved: 1836 to Present

Test Bank

MULTIPLE CHOICE

1. The first real school of nursing was located in

a.

Israel

b.

Greece.

c.

Italy.

d.

Germany.

ANS: D

The first real school of nursing was founded by the Lutheran Order of Deaconesses under the supervision of a German pastor, Theodor Fleidner, in Kaiserswerth, Germany. The other options are incorrect.

DIF: Cognitive Level: Knowledge REF: pp. 72-73, Table 7-1

OBJ: 1 TOP: History KEY: Nursing Process Step: N/A

MSC: NCLEX: N/A

2. The best reason for studying nursing history is to

a.

prepare for the NCLEX-PN examination.

b.

make nurses more professional.

c.

help nurses adapt to change.

d.

learn from nursings past mistakes.

ANS: C

Knowledge of the changes that have occurred in nursing prepares one to better understand and adapt to continuing changes. The other options have lesser degrees of validity.

DIF: Cognitive Level: Analysis REF: p. 71 OBJ: 1

TOP: Change in nursing KEY: Nursing Process Step: N/A

MSC: NCLEX: N/A

3. When was the first U.S. school of practical nursing founded?

a.

1830

b.

1853

c.

1892

d.

1902

ANS: C

The first class for formal training of practical nurses was offered in 1892 at the YWCA in Brooklyn, NY.

DIF: Cognitive Level: Knowledge REF: pp. 72-77, Table 7-1

OBJ: 3 TOP: Historyfirst PN school KEY: Nursing Process Step: N/A

MSC: NCLEX: N/A

4. In what year was practical nurse licensure utilized for the first time?

a.

1903

b.

1914

c.

1938

d.

1941

ANS: B

Mississippi law provided for practical nurse licensure in 1914.

DIF: Cognitive Level: Knowledge REF: p. 72, Table 7-1

OBJ: 4 TOP: Practical nurse licensure KEY: Nursing Process Step: N/A

MSC: NCLEX: N/A

5. The emergence of modern nursing is usually attributed to the influence of

a.

Florence Nightingale.

b.

Clara Barton.

c.

Lillian Wald.

d.

Sairy Gamp.

ANS: A

Miss Nightingales insistence that nurses be women of good character helped nursing emerge from its Dark Ages and elevated it to a respectable vocation. In addition, she established a school for nurse training and wrote several books on nursing. Although Barton and Wald are positive examples in nursing history, neither influenced nursing to the extent that Nightingale did. Sairy Gamp is a negative character associated with nursing history.

DIF: Cognitive Level: Comprehension REF: p. 73 OBJ: 2

TOP: Florence Nightingale KEY: Nursing Process Step: N/A

MSC: NCLEX: N/A

6. The first formal training for practical nurses focused on

a.

care for victims of war injuries.

b.

home care for children and people with chronic illness.

c.

training visiting nurses and public health nurses.

d.

creating nursing instructors for nursing programs.

ANS: B

The school at the Brooklyn YWCA placed the focus of training for practical nurses on home health care for patients with chronic illness, the aged, and children. The first program, created in 1892, was not affected by war. When visiting nurses and public health nurses went into the community, they were armed with their basic education, as described. Any trained nurse could teach in a practical nurse program at this point in time.

DIF: Cognitive Level: Knowledge REF: p. 77 OBJ: 1

TOP: History KEY: Nursing Process Step: N/A MSC: NCLEX: N/A

7. The event that had the greatest influence on the role of practical nurses in modern hospital nursing was

a.

the Crusades.

b.

the Industrial Revolution.

c.

the U.S. Civil War.

d.

World War II.

ANS: D

World War II and the shortage of nurses it created greatly expanded the practice sites available to practical nurses. In the face of the nursing shortage, hospitals gradually increased the responsibilities designated for the practical nurse. The other options had a lesser impact on modern hospital nursing.

DIF: Cognitive Level: Analysis REF: p. 80 OBJ: 2

TOP: PN role change KEY: Nursing Process Step: N/A

MSC: NCLEX: N/A

8. When in history was it first recommended that tasks of the RN and LPN be differentiated and that practical nurses should function under the supervision of registered nurses?

a.

1750-1760

b.

1826-1850

c.

1949-1950

d.

1965-1980

ANS: C

In 1949, the Joint Committee on Practical Nurses and Auxiliary Workers in Nursing Services recommended the title licensed practical nurse to differentiate between the tasks of PNs and LPNs; the joint committee also recommended that LPNs work under the supervision of RNs.

DIF: Cognitive Level: Comprehension REF: p. 81 OBJ: 2

TOP: LPN task differentiation KEY: Nursing Process Step: N/A

MSC: NCLEX: N/A

9. The role of self-defined practical nurses throughout history has been to

a.

care for the ill, injured, and dying and for birthing mothers.

b.

compete with physicians and surgeons.

c.

perform complex nursing skills independently.

d.

make contact with the gods on behalf of the ill person.

ANS: A

History has seen people called attendants, midwives, and self-proclaimed nurses who had special skills in helping those who were ill. These self-proclaimed nurses were the original home health nurses and visiting nurses, who cared for patients who were ill, injured, or dying and for mothers who were giving birth. The other options were never considered roles of the practical nurse.

DIF: Cognitive Level: Comprehension REF: p. 77 OBJ: 1

TOP: Role of self-proclaimed nurses KEY: Nursing Process Step: N/A

MSC: NCLEX: N/A

10. The event that had the most profound influence in changing practical/vocational nursing was the

a.

depression of the 1930s, when nurses worked for room and board in lieu of salary.

b.

postWorld War II movement of practical/vocational nurses into hospital positions.

c.

American Medical Association (AMA) proposal to develop registered care technicians as new health care workers.

d.

first computer-adaptive test for practical/vocational nursing graduates.

ANS: B

The nursing shortage following World War II was responsible for hospitals hiring practical/vocational nurses and for the gradual expansion of the role of the practical/vocational nurse. None of the other options offered had the same degree of influence as World War II and the subsequent nursing shortage.

DIF: Cognitive Level: Analysis REF: p. 80 OBJ: 2

TOP: History KEY: Nursing Process Step: N/A MSC: NCLEX: N/A

11. When permitted by the state Nurse Practice Act, under what conditions can the LPN/LVN perform complex nursing skills not taught in the basic educational program?

a.

When ordered to do so by the attending physician

b.

When the task is delegated to a competent LPN/LVN by a supervising RN

c.

When the LPN/LVN has graduated from a nursing program accredited by the National League for Nursing

d.

When the state of practice has declared a severe nursing shortage

ANS: B

Delegation, if allowed by the Nurse Practice Act of the state, can take place if the RN teaches the skill, observes a return demonstration, documents the teaching/learning process in the LPN/LVNs file, and provides ongoing direct supervision. LPN/LVNs are under the direct supervision of professional nurses. Accreditation of the school does not confer the right to accept delegation. Nursing shortages cannot dictate the acceptability of delegation.

DIF: Cognitive Level: Comprehension REF: p. 71|p. 81 OBJ: 2

TOP: Delegation KEY: Nursing Process Step: N/A MSC: NCLEX: N/A

12. A major reason for LPN/LVN graduates to join nursing organizations is that membership

a.

keeps one updated on issues that affect practical nursing.

b.

enhances ones standing among registered nurses.

c.

provides an opportunity to draft legislation for health care workers.

d.

encourages practical nurses to expand their social horizons.

ANS: A

Membership in a nursing organization provides access to information relevant to the standing, as well as the practice, of nursing. Proposed changes in the Nurse Practice Act can be disseminated. and the organization can use its collective power to support or call for defeat of such measures. The greater the membership in an organization, the greater the political power the group has. The other options are not considered major reasons for belonging to a nursing organization.

DIF: Cognitive Level: Analysis REF: p. 85 OBJ: 5

TOP: Political action KEY: Nursing Process Step: N/A

MSC: NCLEX: N/A

13. Which statement best explains the entry into practice controversy?

a.

Nursing shortages would be relieved if all nurses entered into practice as LPN/LVNs.

b.

The return to self-proclaimed nurses would save scarce health care dollars.

c.

Entry into practice refers to discerning the educational level most appropriate for entry into the practice of nursing: ADN, BSN, MSN.

d.

After graduation, all professional and vocational nurses should enter practice by serving a 1-year internship in a hospital setting.

ANS: C

Entry into practice, originally advanced by the ANA, refers to the movement to establish two levels of nursing. More recently it has become a question of determining the most appropriate entry into practice for professional nurses: the ADN, BSN, or masters level of preparation. The other options are not related to entry into practice.

DIF: Cognitive Level: Comprehension REF: p. 85 OBJ: 5

TOP: Entry into practice KEY: Nursing Process Step: N/A

MSC: NCLEX: N/A

14. The outcome that can be predicted for the latest nurse education proposal is that

a.

LPN/LVN education will be extended to 2 years.

b.

LPN/LVN licensure will be abandoned.

c.

the LPN/LVN will be the lower level for entry into practice.

d.

the outcome cannot be determined at this time.

ANS: D

No single concrete proposal has been advanced for debate; thus, one cannot determine the probable effect on LPN/LVN training and education.

DIF: Cognitive Level: Analysis REF: p. 85 OBJ: 5

TOP: Education KEY: Nursing Process Step: N/A MSC: NCLEX: N/A

15. Which was the first state to pass a law licensing practical nurses?

a.

Alabama

b.

California

c.

New York

d.

Mississippi

ANS: D

Mississippi was the first state to pass a law licensing practical nurses.

DIF: Cognitive Level: Knowledge REF: p. 72|p. 78, Table 7-1

OBJ: 2 TOP: Nursing history KEY: Nursing Process Step: N/A

MSC: NCLEX: N/A

16. The first chapter of the American Red Cross was established by

a.

Clara Barton.

b.

Sairy Gamp.

c.

Dorothea Lynde Dix.

d.

Florence Nightingale.

ANS: A

Clara Barton established the first chapter of the American Red Cross. Sairy Gamp was a fictional character in Charles Dickens novel Martin Chuzzlewit. Dorothea Lynde Dix was appointed superintendent of nurses and organized a corps of female nurses during the Civil War. Florence Nightingale nursed wounded soldiers during the Crimean War.

DIF: Cognitive Level: Knowledge REF: p. 72|p. 77, Table 7-1

OBJ: 1 TOP: Nursing history KEY: Nursing Process Step: N/A

MSC: NCLEX: N/A

COMPLETION

1. After licensing, the LPN/LVN is permitted to perform complex nursing skills as delegated by the registered nurse (RN) and allowed by the ____________________.

ANS:

Nurse Practice Act

After licensing, the LPN/LVN is permitted to perform complex nursing skills as delegated by the registered nurse (RN) and allowed by the Nurse Practice Act.

DIF: Cognitive Level: Knowledge REF: p. 71 OBJ: 1

TOP: Modern practical nurses KEY: Nursing Process Step: N/A

MSC: NCLEX: N/A

MULTIPLE RESPONSE

1. Which of the following are major concerns associated with the present nursing shortage? (Select all that apply.)

a.

Patient safety

b.

High patient acuity

c.

High nurse-to-patient ratios

d.

High stress among nurses

e.

High recruitment incentives

ANS: A, B, C, D

Patient safety is a concern, because errors are more common when nurse-to-patient ratios are high. Patients in hospitals are sicker than previously. High patient acuity requires increasingly skilled nurses, and the high-acuity patient requires more nursing time; neither may be available during a nursing shortage. Errors increase when one nurse has a patient load that is so large that care is rushed. Nurses leave the workforce as a result of high stress; this worsens the shortage. High recruitment incentives are not considered major concerns associated with the shortage of nurses.

DIF: Cognitive Level: Analysis REF: p. 85 OBJ: 5

TOP: Present nursing shortage KEY: Nursing Process Step: N/A

MSC: NCLEX: N/A

2. Practical nurses are referred to as those who, from the beginning of time, chose (or were appointed) to care for individuals who were ill, injured, dying, or having babies. Names used to designate this person have included which of the following? (Select all that apply.)

a.

Midwife

b.

Attendant

c.

Trained nurse

d.

Practical nurse

e.

Self-proclaimed nurse

f.

Babysitter

ANS: A, B, C, D, E

Practical nurses have had a varied and colorful evolution. Practical nurses are referred to in a broad sense as those who, from the beginning of time, chose (or were appointed) to care for individuals who were ill, injured, dying, or having babies. Names used to designate this person have included midwife, attendant, trained nurse, practical nurse, and self-proclaimed nurse.

DIF: Cognitive Level: Comprehension REF: p. 74|pp. 77-79|p. 81

OBJ: 1 TOP: Nursing History KEY: Nursing Process Step: N/A

MSC: NCLEX: N/A

3. After licensing, the LPN/LVN is permitted to perform complex nursing skills as delegated by the registered nurse (RN) and allowed by the Nurse Practice Act. Delegation is allowed as long as which requirements are met? (Select all that apply.)

a.

An RN is willing to teach the skill.

b.

An RN observes the return demonstration.

c.

An RN delegates complex patients to the LPN/LVN.

d.

An RN delegates formulating nursing diagnoses to the LPN/LVN.

e.

An RN documents the teaching or learning process for the LPN/LVNs file in the place of employment.

ANS: A, B, E

After licensing, the LPN/LVN is permitted to perform complex nursing skills as delegated by the registered nurse (RN) and allowed by the Nurse Practice Act. Delegation is allowed as long as (1) an RN is willing to teach the skill; (2) an RN observes the return demonstration; and (3) an RN documents the teaching or learning process for the LPN/LVNs file in the place of employment. In addition, most Nurse Practice Acts call for direct supervision by RNs for all complex nursing tasks delegated by them.

DIF: Cognitive Level: Comprehension REF: p. 71|p. 77 OBJ: 1

TOP: Modern practical nurses KEY: Nursing Process Step: Implementation

MSC: NCLEX: N/A

4. Which individuals made significant contributions to nursing? (Select all that apply.)

a.

Lillian Wald

b.

Linda Richards

c.

Sairy Gamp

d.

Betsy Prig

e.

Mary Mahoney

ANS: A, B, E

Wald organized the first visiting nurse service for the poor. Linda Richards was Americas first professionally trained nurse; she organized other training schools. Mary Mahoney was the first African-American graduate nurse. Gamp and Prigg were Dickens characters who portrayed nurses as scoundrels and women of ill repute.

DIF: Cognitive Level: Comprehension REF: p. 77|pp. 85-86, Table 7-2

OBJ: 2 TOP: History KEY: Nursing Process Step: N/A

MSC: NCLEX: N/A

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