deWit's Fundamental Concepts and Skills for Nursing, 5th Edition practice questions study guide
Use these practice questions to test your understanding of this chapter. If you're preparing for quizzes, exams, or the NCLEX, the complete deWit's Fundamental Concepts and Skills for Nursing, 5th Edition practice question bank provides additional chapter-by-chapter practice covering the entire textbook.
Chapter 1 Summary
The Chapter 1: Nursing and the Health Care System exam covers the historical development of nursing, major nursing theories, professional roles and responsibilities, legal and ethical standards, evidence-based practice, educational pathways, and the structure of today's healthcare delivery system. Students should understand how nursing evolved from the work of pioneers such as Florence Nightingale, Dorothea Dix, Lillian Wald, and Mary Brewster, whose contributions shaped modern nursing practice, education, and community health.
The chapter also emphasizes the essential roles of nurses as caregivers, educators, collaborators, advocates, and managers. It introduces the fundamental concepts shared by nursing theories, including the relationship between the person, health, environment, and nursing, while highlighting Sister Calista Roy's Adaptation Model as an example of theory-based practice. Students should understand that nursing interventions are purposeful actions that promote, maintain, or restore health and that evidence-based practice uses the best available scientific research to guide clinical decision-making.
From a professional perspective, the chapter explains the legal scope of nursing practice under each state's Nurse Practice Act, the standards established for LPN/LVN practice, licensure through the NCLEX-PN, opportunities for certification, and educational pathways for career advancement.
Finally, the exam covers key aspects of the U.S. healthcare delivery system, including Diagnosis-Related Groups (DRGs), which were introduced to control healthcare costs and require accurate nursing documentation for reimbursement. Students should also understand the differences between Health Maintenance Organizations (HMOs) and Preferred Provider Organizations (PPOs), particularly how they influence patient referrals, provider choice, and access to healthcare services. Mastering these concepts provides the foundation for understanding professional nursing practice and succeeding on nursing examinations.
Chapter 1 introduces professional nursing roles, evidence-based practice, educational pathways and other essential concepts for nurses advancing their careers. If you're preparing for an LPN-to-RN bridge program, this LPN to RN Transition: Concepts and Change Theory Practice Questions Study Guide provides additional practice questions and detailed explanations to help you succeed.
Chapter 01: Nursing and the Health Care System Practice Questions
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 nurses dramatically reduced 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 education became more formalized through apprenticeships in 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, facilitate coping, and restore 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 caregiver, educator, collaborator, 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 common concepts concerning:
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, and health.
DIF: Cognitive Level: Comprehension REF: p. 4
OBJ: Theory #2
TOP: Nursing Theories
KEY: Nursing Process Step: N/A
MSC: NCLEX: N/A
5. Standards of care for the nursing practice of the LPN are established by the:
a. Boards of Nursing Examiners in each state.
b. National Council of States Boards of Nursing (NCSBN).
c. American Nurses Association (ANA).
d. National Federation of Licensed Practical Nurses.
ANS: D
The National Federation of Licensed Practical Nurses modified the standards published by the
ANA in 2015 to better fit the role of the LPN. In 2015 the American Nurses Association
(ANA) revised the Standards of Nursing Practice which contained 17 standards of national
practice of nursing, describing all facets of nursing practice: who, what, when, where, how.
DIF: Cognitive Level: Comprehension REF: p. 6
OBJ: Theory #2
TOP: Standards of Care
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 the application 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 in order to:
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 living in tenements.
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 patient’s needs to qualify the facility for Medicare reimbursement. Observant
assessment might also indicate another DRG classification and consequently more
reimbursement for the facility.
DIF: Cognitive Level: Comprehension REF: p. 10
OBJ: Theory #10
TOP: Managed Care
KEY: Nursing Process Step: N/A
MSC: NCLEX: N/A
11. If a member of a health maintenance organization (HMO) is having respiratory problems such
as fever, cough, and fatigue for several days and wants to see a specialist, the person is
required to go:
a. directly to an emergency room for treatment.
b. to any general practitioner of choice.
c. directly to a respiratory specialist.
d. to a primary care provider for a referral.
ANS: D
Participants in an HMO must see their primary provider to receive a referral for a specialist in
order for the HMO to pay for the care.
DIF: Cognitive Level: Comprehension REF: p. 10
OBJ: Theory #11
TOP: Managed Care
KEY: Nursing Process Step: N/A
MSC: NCLEX: N/A
12. An advantage of preferred provider organizations (PPOs) is that:
a. they make insurance coverage of employees less expensive to employers.
b. there are fewer physicians to choose from than in an HMO.
c. long-term relationships with physicians are more likely.
d. patients may go directly to a specialist for care.
ANS: A
The use of PPOs allows insurance companies to keep their premiums low and in turn makes
insurance coverage less expensive for the employers. There are usually more physicians from
which to choose than from an HMO, but long-term relationships between physician and
patient cannot be established easily. Patients still must see their primary physician before
being referred to other specialties.
DIF: Cognitive Level: Knowledge
REF: p. 11
OBJ: Theory #11
TOP: Preferred Provider Organizations KEY: Nursing Process Step: N/A
MSC: NCLEX: N/A
13. After passing the National Council Licensure Examination for Practical Nurses (NCLEX PN),
the nurse is qualified to take an additional certification in the field of:
a. pharmacology.
b. care of infants and children.
c. operating room technology.
d. community health.
ANS: A
After becoming an LPN, the nurse may apply for additional certification in pharmacology or
long-term care.
DIF: Cognitive Level: Knowledge
REF: p. 7
OBJ: Theory #6
TOP: Educational Opportunities
KEY: Nursing Process Step: N/A
MSC: NCLEX: N/A
14. Nursing interventions are best defined as activities that:
a. are taken to improve the patient’s health.
b. involve researching methods to maintain asepsis.
c. include the family in nursing care.
d. review guidelines for handling infectious wastes.
ANS: A
Interventions are actions taken to improve, maintain, or restore health.
DIF: Cognitive Level: Comprehension REF: p. 3
OBJ: Theory #2
TOP: Art and Science of Nursing
KEY: Nursing Process Step: Planning
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Detection of Disease
15. Nurse Practice Acts define the legal scope of an LPN’s practice, which are written and
enforced by:
a. American Nurses Association.
b. National Council Licensure Examiners.
c. each state.
d. each health care agency.
ANS: C
Each state writes and enforces the Nurse Practice Act, which defines the legal scope of
nursing practice.
DIF: Cognitive Level: Comprehension REF: p. 6
OBJ: Theory #3
TOP: Nurse Practice Act
KEY: Nursing Process Step: N/A
MSC: NCLEX: N/A
16. Women volunteers were organized to give nursing care to the wounded soldiers during the
Civil War by:
a. Florence Nightingale.
b. Dorothea Dix.
c. Clara Barton.
d. Lillian Wald.
ANS: B
The Union government appointed Dorothea Dix, a social worker, to organize women
volunteers to provide nursing care for the soldiers during the Civil War.
DIF: Cognitive Level: Knowledge
REF: p. 2
OBJ: Theory #4
TOP: Nursing History
KEY: Nursing Process Step: N/A
MSC: NCLEX: N/A
17. The nursing theory presented by Sister Calista Roy is based on:
a. reduction of stress.
b. achievement of maximum level of wellness.
c. relief of self-care deficit.
d. adaptation modes.
ANS: D
Adaptation modes (physiological, psychological, sociological, and independence) are the
basis of the nursing theory of Sister Calista Roy.
DIF: Cognitive Level: Knowledge
REF: p. 5|Table 1-1
OBJ: Theory #2 TOP: Nursing Theory
KEY: Nursing Process Step: N/A
MSC: NCLEX: N/A
0
1968