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Chapter 02: The Contemporary Image of Professional Nursing

Cherry and Jacob: Contemporary Nursing: Issues, Trends, and Management, 8th
Edition

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
With an employment rate expected to increase by more than 15%, job production for nurses is
projected to grow faster than the average of all occupations (7%) until 2020.

DIF: Knowledge

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
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themselves.
d. Funding for nursing traineeships was eliminated.
ANS: B
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.

DIF: Comprehension

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
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.

DIF: Knowledge

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

DIF: Knowledge

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 to address the current
nursing shortage
d. Provided pediatric nursing training grants
ANS: C
This act provided nursing scholarships, public service announcements promoting nursing as a
career, faculty loan cancelation programs, geriatric training grants, and nurse retention and
safety enhancement grants.

DIF: Knowledge NURSINGKING.COM

6. What is the best way for the individual nurse to maintain the most effective professional
image?
a. Change out of their work attire before running errands
b. Renew membership in a nursing organization
c. Earning an advanced nursing degree
d. Developing effective nurse-physician relationships
ANS: B
Professional nurses recognize that their greatest benefit—and one of the most efficient and
powerful uses for their money—is less than 1% of their salary they spend for membership in
the ANA, the National League for Nursing, Sigma Theta Tau International, and their specialty
organization. They look forward to annual meetings because such meetings provide an
excellent opportunity to meet colleagues and discuss issues and practice innovations.

DIF: Application

7. What statement accurately describes Charles Dickens’ character Sairy Gamp?

a. The character was portrayed as a trained professional individual who put others
before self.
b. The character chose nursing because there were few other avenues for
employment.
c. The character was a prostitute who cared for the sick old men in the community.

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d. The character showed nurses to be at the forefront of the technology of that time.
ANS: B
Sairy Gamp endured nursing because of the lack of other opportunities.

DIF: Knowledge

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
c. Clara Maas, who found the cure for yellow fever during WWII
d. All military nurses for their service, bravery, and compassion
ANS: D
The statue the Spirit of Nursing was created to honor all military nurses.

DIF: Knowledge

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
what true nursing characteristic?
a. The skill and drive to assist doctors in caring for the wounded
b. That women possess the desire to serve one’s country that equals that of men
c. The ability of nurses to cope with the dreadfulness of war by using humor
d. The contributions of any nurse to the care of military personnel
ANS: C
The sitcom M*A*S*H did show humor as a coping mechanism for nurses in a war setting.
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DIF: Knowledge

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
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.

DIF: Comprehension

11. How can nurses best combat the nursing shortage?

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

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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
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 cancelation
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.

DIF: Application

12. What does the demographics of the 21st century nursing population indicate?
a. A typical nursing student is a second-degree student 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. 61% of nurses practice in hospitals.
ANS: D
Sixty-one percent of nurses practice in hospitals.

DIF: Comprehension

13. A nursing student asks, “I wonder if the reason that the nursing shortage is so severe is that
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registered nurses are unhappy with their jobs.” Which statement provides the answer provided
by the National Survey of Registered Nurses?
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: Comprehension

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14. A registered nurse is on break and checking e-mails. One e-mail 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 or 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 demonstrates poor ethical and legal
role-modeling as well as placing 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
Failing to report the image can result in discipline.

DIF: Comprehension

15. A nurse executive is concerned that the hospital’s mortality rate 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
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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

16. To best improve patient outcomes on an acute care hospital unit, which intervention should
the nursing staff advocate for?
a. Staffing only 8-hour shifts on the unit
b. Decreasing the number of patients cared for on any specific unit
c. Increasing salaries for experienced nurses
d. Increasing staffing on the evening shift
ANS: D

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The data clearly indicate that decreased nurse-patient ratios have been associated with higher
rates of mortality, shock, urinary tract infections, sepsis, hospital-acquired pneumonia, and
failure to rescue, especially among surgical patients.

DIF: Application

17. A physician reports 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
Investigating the situation to NURSINGKING.COM
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.

DIF: Application

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
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.

DIF: Application

MULTIPLE RESPONSE

1. According to current data what factors are most directly related to the nursing shortage?
(Select all that apply.)
a. Salaries of nurses are competitive with those of other professionals such as

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teachers.
b. Only 19% 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
Only 19% of nurses are minorities. RNs have one of the highest growth rates of employment
of all occupations.

DIF: Knowledge

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
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Recipients of BSN degrees represent the largest graduating educational profile. Nurses make
up the largest group of health care professionals.

DIF: Comprehension

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 black 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
Core solutions to the nursing shortage include providing incentives for minorities and men to
enter nursing. 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. Core solutions to the nursing shortage include developing ad
campaigns that target younger students.

DIF: Comprehension

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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
The campaign was designed to convey to the public that nurses are expert clinicians. A
strategically important part of the campaign raised consciousness among nurses of the
invisibility of nursing in the news media.

DIF: Comprehension

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