FREE Chapter 02: The Contemporary Image of Professional Nursing

Chapter 02: The Contemporary Image of Professional Nursing

Test Bank

MULTIPLE CHOICE

1. Which item below correctly describes the U.S. Bureau of Labor Statistics predictions by 2020?

a.

Positions that historically required registered nurses will be filled by unlicensed personnel.

b.

The job growth rate for RNs will surpass job growth in all other occupations.

c.

The need for hospital nurses will dramatically decrease.

d.

Hospitals will finally achieve the required RN workforce.

ANS: B

Correct: In 2020, the United States is projected to have only 64% of the registered nursing workforce required to meet the demand for RNs.

Incorrect:

a. Unlicensed personnel will not be filling positions for nurses because this group does not have the education needed to provide such care.

c. The need for hospital nurses will dramatically increase, not decrease.

d. Hospitals will not have enough nurses as stated per statistics.

DIF: Knowledge REF: p. 23

2. What effect did the movie One Flew Over the Cuckoo’s Nest have on health care?

a.

Funding for mental health care increased, allowing the point of care to change from the community to standardized institutional care.

b.

The public and the nursing profession were made aware of the rights of vulnerable populations.

c.

Nurses were seen as advocates for individuals who cannot advocate for themselves.

d.

Funding for nursing traineeships was eliminated.

ANS: B

Correct: One Flew Over the Cuckoo’s Nest reminded us that all individuals have rights and that it is the responsibility of the public and health care professionals to ensure that these rights are protected.

Incorrect:

a. The context for the care of patients with mental disability did not change as a result of the movie.

c. One Flew Over the Cuckoo’s Nest portrayed nurses as the enforcers of the system.

d. Funding for nursing traineeships was not eliminated. Rather, the Nurse Training Act was established in 1964.

DIF: Comprehension REF: p. 25

3. Which nurse died after deliberately acquiring two bites from yellow fever carrier mosquitoes to enable her to provide care to soldiers with yellow fever during the Spanish-American War?

a.

Florence Nightingale

b.

Margaret Hoolihan

c.

Clara Maas

d.

Sairy Gamp

ANS: C

Correct: Clara Maas is noted as the nurse who deliberately acquired two bites from yellow fever carrier mosquitoes to enable her to provide care to soldiers with yellow fever.

Incorrect:

a. Florence Nightingale is the founder of professional nursing.

b. Margaret Hoolihan is a character on a TV show, not an actual nurse.

d. Sairy Gamp is a character in a Charles Dickens novel.

DIF: Knowledge REF: p. 25

4. A bronze statue of a nurse in battle fatigues who is obviously exhausted but demonstrates caring by holding a soldier’s head is an artistic representation of nurses who served in which war?

a.

World War I

b.

World War II

c.

Spanish-American War

d.

Vietnam War

ANS: D

Correct: This statue represents the caring provided by nurses during the Vietnam War.

Incorrect:

a. There is no statue that represents nursing during World War I.

b. There is no statue that represents nursing during World War II.

c. There is no statue that represents nursing during the Spanish-American War.

DIF: Knowledge REF: p. 25

5. What was the purpose of the Nurse Reinvestment Act of 2002?

a.

Provided disability insurance to RNs who contract a life-threatening illness while on duty

b.

Funded public service announcements that promote unlicensed caregivers as an alternative to professional nurses

c.

Focused on nurse retention and safety enhancement grants

d.

Provided pediatric nursing training grants

ANS: C

Correct: This act provided nursing scholarships, public service announcements promoting nursing as a career, faculty loan cancellation programs, geriatric training grants, and nurse retention and safety enhancement grants.

Incorrect:

a. This act does not provide disability insurance to RNs.

b. These funds do not promote unlicensed caregivers as an alternative to professional nurses.

d. This act provides for geriatric training grants, not pediatric training grants.

DIF: Knowledge REF: p. 23

6. Potential nursing students are concerned about choosing a profession with job security and ask the recruiter, “Because more people are choosing nursing, will I have a job in a few years?” The recruiter answer that by 2025, on the basis of the U.S. Bureau of Labor Statistics prediction:

a.

positions that have historically required RNs will be filled by foreign nurses.

b.

the nursing shortage will increase twofold, the largest shortage in almost 50 years.

c.

the need for hospital nurses will dramatically decrease as nurses reenter the profession.

d.

hospitals will finally achieve the required RN workforce, reducing the need for more RNs.

ANS: B

Correct: According to the U.S. Bureau of Labor Statistics, the nursing shortage is predicted to be twice as large as any previous shortage since Medicare and Medicaid in 1965.

Incorrect:

a. The number of foreign nurses arriving in the United States is not sufficient to cure the shortage, and a large number of these nurses are unsuccessful on the NCLEX-RN®, resulting in an inability of foreign RNs to practice.

c. Although slightly more than half of all nurses practice in hospitals, 84.8% of its licensed members are currently in nursing practice. Thus, reentering RNs will not dramatically reduce the shortage.

d. Even by 2025, it is projected that the United States will need 260,000 more RNs than will be available.

DIF: Comprehension REF: p. 23

7. Charles Dickens’ character Sairy Gamp:

a.

portrayed nurses as trained professional individuals who put others before themselves.

b.

chose nursing because she had no other avenue for employment.

c.

was a prostitute who took advantage of sick old men.

d.

characterized nurses as being at the forefront of technology and autonomy.

ANS: B

Correct: Sairy Gamp endured nursing because of the lack of other opportunities.

Incorrect:

a. Sairy Gamp did not portray a professional image of nursing, but that of an untrained caregiver who profited from the sick and dying.

c. Sairy Gamp was a nurse who used her position to take advantage of her patients.

d. Dickens’ portrayal of a nurse does not suggest that the nurse is at the forefront of technology and autonomy.

DIF: Knowledge REF: pp. 23-24

8. What does the Spirit of Nursing statue honor?

a.

Florence Nightingale’s accomplishments in public health

b.

Edith Cavell’s attempt to help the victims of the Tuskegee experiment seek treatment

c.

Clara Maas, who found the cure for yellow fever during WWII

d.

All military nurses for their bravery and compassion

ANS: D

Correct: The statue the Spirit of Nursing was created to honor all military nurses.

Incorrect:

a. The statue does not seek to honor Florence Nightingale.

b. Nurse Rivers was the nurse who attempted to help the victims of the Tuskegee experiment.

c. The statue does not honor Clara Maas, and Clara Maas did not find the cure for yellow fever.

DIF: Knowledge REF: p. 24

9. Although the media portrayed nursing in a negative light in M*A*S*H through the character of a promiscuous, uncaring nurse, it also provided Americans with a promising glimpse of:

a.

nurses who can be promiscuous and still help doctors.

b.

the fact that caring is not as important as the desire to serve one’s country.

c.

the ability of nurses to cope with the dreadfulness of war by using humor.

d.

the contributions of male military nurses.

ANS: C

Correct: The sitcom M*A*S*H did show humor as a coping mechanism for nurses in a war setting.

Incorrect:

a. M*A*S*H’s portrayal of promiscuous nurses has no merit because nurses assist physicians.

b. The sitcom addressed both factors as part of the nurse’s role in the military.

d. No male nurses were portrayed in the sitcom.

DIF: Knowledge REF: p. 25

10. With the crisis in health care and the nursing shortage, why is the image of nursing still important?

a.

Nursing care is often delivered during a time of uncertainty, and the image of nurses during this time can reinforce trust in the nurse-patient relationship.

b.

Physicians have a distinctive body of knowledge that identifies them as professionals, whereas nursing has yet to develop a unique body of knowledge on which to base practice.

c.

Nurses must present a unified image if they hope to ever establish nursing as a profession.

d.

The dynamic state of today’s health care requires nurses to move from a caring image to one of technologic competence.

ANS: A

Correct: A person who seeks health care is entering a world of uncertainty. The nurse provides continuity and compassion and stabilizes the environment of the patient.

Incorrect:

b. Nursing has a unique body of knowledge.

c. Nursing is a profession. Unification will enhance the professional goals for nursing.

d. Caring will always be part of the nursing image, and nurses have already moved into the technologic realm.

DIF: Comprehension REF: pp. 22-23

11. Nurses can combat the nursing shortage by:

a.

joining unions, which influence employers to provide incentives such as pay raises and free child care, thus encouraging the large percentage of nonworking nurses to return to the workforce.

b.

demanding that the requirements of the qualifying examination for foreign nurses should be reduced, so they are eligible to sit for the licensure examination.

c.

working more hours with a higher nurse/patient ratio.

d.

advocating for funds to pay for nursing education and a safer work environment.

ANS: D

Correct: Advocating for funds to pay for nursing education and a safer work environment is a positive strategy, as can be seen by results attained after the Reinvestment Act P.L. 107-205 provided $20 million for nursing scholarships, public service announcements, faculty loan cancellation programs, geriatric training grants, and nurse retention and safety enhancement grants. This is the best defense against the nursing shortage. Nursing graduates in many states have increased in number, and enrollment in nursing schools is also on the rise.

Incorrect:

a. Unions are not the answer to the nursing shortage. This approach would make access to health care more difficult, and the nursing shortage would only increase because efforts to attract nurses from younger generations would be reduced by the fact that funding for exposure to nursing would most likely decrease.

b. Lowering standards would increase the chance for errors, cause patient care standards to become lower, and harm the image of nursing.

c. As the acuity level of patients increases, the nurse/patient ratio should be lowered. Facts reveal that lower nurse/patient ratios reduce errors and decrease mortality rates.

DIF: Application REF: p. 23

12. The demographics of the twenty-first century nursing population indicate that:

a.

individuals entering nursing are second-degree students who average 45 years of age.

b.

more white nurses enter and obtain graduate degrees than any other ethnic group.

c.

the highest level of nursing education for most RNs is an associate degree.

d.

the majority of nurses practice in hospitals.

ANS: D

Correct: Fifty-six percent of nurses practice in hospitals.

Incorrect:

a. There is an influx of new graduates less than age 30, which has slowed the aging of the profession.

b. More African-Americans are entering graduate school.

c. The highest level of nursing education is most often the baccalaureate degree.

DIF: Comprehension REF: p. 28

13. A nursing student asks, “I wonder if the reason that the nursing shortage is so severe is that registered nurses are unhappy with their jobs.” To research the answer, the National Survey of Registered Nurses was reviewed and found:

a.

registered nurses change employers every year to prevent burnout and to keep the nursing shortage from increasing.

b.

nursing faculty are aging or leaving academia due to increased work demands and generational difference from students.

c.

practicing registered nurses are satisfied with their job and most remain with same employer they worked for the previous year.

d.

registered nurses were the least satisfied with their job of all health care providers.

ANS: C

According to the latest National Sample Survey of Registered Nurses (NSSR), 79.8% of practicing RNs were satisfied with their job and 88.4% were with the same employer as they had been in the preceding year (U.S. Department of Health and Human Services, 2010). Among all RNs, nursing faculty are the most satisfied (86.6%).

DIF: Application REF: pp. 27-28

14. A registered nurse is on break and checking emails. One email contains a picture of a celebrity who is a patient in the hospital, and on the same floor, where the nurse works. Included with the photo is a message, “check out my Facebook,” which contains additional photographs of the patient. The nurse immediately deletes the picture to prevent having to report the “friend” to supervisors. Based on the action of the nurse who received the message, which statement is correct?

a.

The nurse is not at risk for having his/her license suspended since removing the photos made them temporary and invisible to all others.

b.

Because the nurse did not send the message and immediately deleted the photo, there is no risk for discipline.

c.

Failing to report receiving the message places the nurse at risk for discipline.

d.

Because the patient is on the same floor as the one on which the nurse works, the information can be ethically and legally shared.

ANS: C

Correct: Failing to report the image can result in discipline.

Incorrect:

a. Removing a posting or a picture from a website does not make it unavailable because it is retrievable.

b. Nurses who have received patient pictures and not immediately reported the problem have been subject to the same discipline as nurses who sent the pictures.

d. Information posted on social media can be viewed by others who are not providing health care—even the public.

DIF: Application REF: p. 26

15. A nurse executive is concerned that the mortality rate in his/her hospital exceeds the national average and searches the literature finding Aiken’s 2011 Survey on the effects of nurse staffing and education on mortality, including work environment. If Aiken’s recommendations are followed, which change would be most effective?

a.

Increasing staffing ratios to include more nurses of all levels of educational preparation on all shifts

b.

Employing bachelor’s prepared nurses who participate in interprofessional rounds with attending physicians where their voices are heard

c.

Ensuring nurse managers and administrators have at minimum a Master’s degree

d.

Encouraging all unlicensed assistive personnel to attend educational programs to be certified

ANS: B

Aiken (2011) found that simply increasing the number of RNs was not the only answer to reduce mortality. Increasing the number of BSN-prepared nurses along with developing a positive work environment had the most impact on reducing mortality. The impact on reducing mortality by increasing the educational level of nurse managers/administrators and certified unlicensed assistive personnel was not documented.

DIF: Application REF: p. 29

16. A student nurse signs the nurses’ notes in the patient’s record as, Mary Smith, RN (pending graduation 2015). According to the International Council of Nurses, which individual can use the title “nurse”?

a.

Any student nurse who has completed at least 50% of the education program in which he or she is enrolled

b.

Any graduate of an accredited nursing program who has taken the NCLEX-RN® and is waiting on test results

c.

The nursing assistant who is assigned by the registered nurse to “help out” by performing health histories on newly admitted stable patients

d.

An individual who has successfully passed the NCLEX-RN®

ANS: D

Correct: According to the International Council of Nurses, the title “nurse” is reserved for the registered nurse. Only an individual who has passed the NCLEX-RN can use the title.

Incorrect:

a. A student nurse should not use the title “nurse,” rather should indicate that he or she is a student nurse and sign accordingly.

b. Until an individual is notified that he/she has passed the NCLEX-RN®, the title “nurse” is not used.

c. The nursing assistant who accepts the “role” of the registered nurse may not use the title and is practicing outside the bounds of the role of certified UAP.

DIF: Application REF: p. 29

17. A physician complains to administration that the nurse working last evening is unethical, based on observing the nurse educate the patient about a new medication ordered. The physician demanded the nurse be reprimanded and reminded that only physicians have the educational background to teach patients about new medications. Which comment and action by the administrator would be most effective in changing nurse-physician relationships in this instance?

a.

Inform the nurse, “You will be suspended for 3 days for going beyond your job description,” and enforce the 3-day suspension because the physician did not write the order to “teach the patient about the new medication”

b.

Advise the physician that only nurses can teach patients about medications; the physician’s role is to only prescribe. No action will be taken against the nurse.

c.

After investigating the situation, thank the physician while also providing information that patient education related to medication is within the scope of practice of registered nurses. Share the physician’s concern and administrator’s response with the nurse so both parties are aware of the resolution of the concerns.

d.

Contact the patient’s family and ask, “Do you prefer that all teaching related to medications be performed by the physician rather than the nurse” to determine what action to take.

ANS: C

Correct: Investigating the situation to provide evidence is the first step. Once the facts are known, action can be taken. In this instance, including the ethics committee would help ensure an unbiased decision.

Incorrect:

a. The nurse should not be suspended unless an error occurred.

b. Both physicians and nurses are prepared to teach patients.

d. The patient’s family should not be involved at this point. The scope of practice of the RN allows for patient teaching.

DIF: Application REF: pp. 29-30

18. Which nurse best portrays nursing as a “knowledge worker”?

a.

Nurse in matched scrubs with lab coat, hair back, small stud earrings

b.

Nurse in mismatched scrubs, no lab coat, large hoop earrings

c.

Nurse in white uniform with apron with no jewelry/hair back

d.

Nurse with nose ring and eyebrow piercing with starched white uniform and cap

ANS: A

Correct: Nursing scrubs have become a popular alternative to the traditional white uniform; clean wrinkle free matching scrubs presented a professional image. Small stud earrings reduce risk of injury to nurse when caring for confused or combative patients.

Incorrect:

b. Mismatched scrubs may be interpreted as someone who doesn’t take an interest in the profession or lacks time management.

c. White uniforms have been replaced by scrubs in most healthcare facilities. The apron was used by student nurses from the past who also were restricted from wearing jewelry. Having the hair pulled back continues today to adhere to infection control policies that prevent hair from entering sterile fields or falling in patients personal space. Many feel the white uniform is associated with a time when nurses had less voice in patient care and were “handmaidens” to physicians.

d. Caps were discontinued due to infection control. Most healthcare agencies prohibit nurses from visible piercing other than one small stud earring per ear.

DIF: Application REF: pp. 28-29

MULTIPLE RESPONSE

1. According to current data related to the nursing shortage: (Select all that apply.)

a.

salaries of nurses are competitive with those of other professionals such as teachers.

b.

only 16.8% of nurses are minorities.

c.

overall, nurses are satisfied with their jobs but leave the profession because of fear of contracting fatal diseases.

d.

the employment opportunities for nurses continue to be strong.

e.

staff nurses are returning to school to obtain certificates to teach nursing.

ANS: B, D

Correct:

b. Only 16.8% of nurses are minorities.

d. RNs have one of the highest growth rates of employment of all occupations.

Incorrect:

a. Salaries are not a problem related to the nursing shortage. Most facilities are willing to increase salaries and benefits for nurses.

c. It has not been documented that nurses are afraid of contracting a fatal disease. Nurses take precautions to reduce this risk.

e. There is a shortage of nursing faculty, and graduate education is required rather than certificates to teach nursing.

DIF: Knowledge REF: p. 23 | p. 28

2. A group of new graduate nurses is asked to speak to a group of politicians to describe the current state of professional nursing and how best to alleviate the nursing shortage. Which statements accurately portray professional nursing today and tomorrow? (Select all that apply.)

a.

More RNs attain a bachelor’s degree than an associate degree or diploma.

b.

Because of pressure to shorten length of stay in hospitals, more RNs practice in outpatient settings and home health than in acute care settings.

c.

The most popular advanced practice specialty is nurse anesthesia.

d.

White nurses are more likely to enter graduate school than nurses from other ethnic groups.

e.

Nursing represents the largest health care professional group, followed by medical doctors.

ANS: A, E

Correct:

a. Recipients of BSN degrees represent the largest graduating educational profile (47.2%).

e. Nurses make up the largest group of health care professionals.

Incorrect:

b. Slightly more than half of all nurses practice in acute care hospitals.

c. Nurse practitioners constitute the majority of advanced practice nurses (APRNs).

d. Minority nurses are more likely to enter graduate school than white nurses.

DIF: Comprehension REF: p. 28

3. Which actions would result in a greater number of nurses entering and staying in practice, given today’s state of nursing? (Select all that apply.)

a.

Determine why few African-American women enter graduate school.

b.

Provide incentives for minorities and men to enter nursing.

c.

Obtain grant funding to increase the number of faculty members and scholarship availability for students entering baccalaureate nursing programs.

d.

Survey nurses to determine why their job satisfaction is lower than that of other health care professions.

e.

Develop ad campaigns that target younger students.

ANS: B, C, E

Correct:

b. Core solutions to the nursing shortage include providing incentives for minorities and men to enter nursing.

c. Core solutions to the nursing shortage include obtaining grant funding to increase the number of faculty members and scholarship availability for students entering baccalaureate nursing programs.

e. Core solutions to the nursing shortage include developing ad campaigns that target younger students.

Incorrect:

a. Determining why few African-American women enter graduate school would not result in a greater number of nurses entering and staying in practice.

d. Job satisfaction among nurses is currently high.

DIF: Comprehension REF: p. 23

4. The Nurses of America’s media campaign raised awareness of which aspects of nursing? (Select all that apply.)

a.

Nurses are expert clinicians.

b.

A higher nurse/patient ratio is needed.

c.

Nurses are invisible in the news media.

d.

Nurses are caring.

e.

Nurses are well paid.

ANS: A, C

Correct:

a. The campaign was designed to convey to the public that nurses are expert clinicians.

c. A strategically important part of the campaign raised consciousness among nurses of the invisibility of nursing in the news media.

Incorrect:

b. Lower nurse/patient ratios are needed.

d. It was not a focus of the campaign to let the public know that nurses are caring.

e. The campaign did not focus on the financial aspects of being a nurse.

DIF: Comprehension REF: pp. 27-28

OTHER

1. Place the five most ethical professionals in descending order, according to the 2011 Gallop Poll ranking. Put a comma and space between each answer choice (for example: a, b, c, d).

a.   Police officers

b.   High school teachers

c.   Medical doctors

d.   Nurses

e.   Pharmacists

ANS:

d, e, c, b, a

Only in 2001 did firemen rank higher than the other four professions. In the 2011 Gallup poll on ethical professions, 84% of the public rated nurses as the most ethical; followed by pharmacists (73%), medical doctors (70%) high school teachers (62%), and police officer (54%).

DIF: Comprehension REF: p. 27