Leadership

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
In 2020 the United States is projected to have only 64% of the registered nursing workforce required to meet the demand for RNs.
Unlicensed personnel will not be filling positions for nurses because this group does not have the education needed to provide such care.
The need for hospital nurses will dramatically increase, not decrease.
Hospitals will not have enough nurses as stated per statistics.

DIF: Knowledge REF: Page 28

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 right 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.
The context for the care of patients with mental disability did not change as a
One Flew Over the Cuckoo’s Nest portrayed nurses as the enforcers of the system.
Funding for nursing traineeships was not eliminated. Rather, the Nurse Training Act was established in 1964.

DIF: Comprehension REF: Page 30

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.
Florence Nightingale is the founder of professional nursing.
Margaret Hoolihan is a character on a TV show, not an actual nurse.
Sairy Gamp is a character in a Charles Dickens novel.

DIF: Knowledge REF: Page 30

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.
There is no statue that represents nursing during World War I.
There is no statue that represents nursing during World War II.
There is no statue that represents nursing during the Spanish-American War.

DIF: Knowledge REF: Page 31

5. What is the purpose of the Nurse Reinvestment Act of 2002?
a.
Provides disability insurance to RNs who contract a life-threatening illness while on duty
b.
Funds public service announcements that promote unlicensed caregivers as an alternative to professional nurses
c.
Focuses on nurse retention and safety enhancement grants
d.
Provides pediatric nursing training grants

ANS: C
This act funded $20 million to provide nursing scholarships, public service announcements promoting nursing as a career, faculty loan cancellation programs, geriatric training grants, and nurse retention and safety enhancement grants.
This act does not provide disability insurance to RNs.
These funds do not promote unlicensed caregivers as an alternative to professional nurses.
This act provides for geriatric training grants, not pediatric training grants.

DIF: Knowledge REF: Page 28

6. Potential nursing students are concerned about choosing a profession with job security and ask, “Because more people are choosing nursing, will I have a job in a few years?” The nurse answers, on the basis of the U.S. Bureau of Labor Statistics prediction, that by 2020,
a.
positions that have historically required RNs will be filled by foreign nurses.
b.
the total number of RNs will not meet the demand for the workforce number required.
c.
the need for hospital nurses will dramatically decrease.
d.
hospitals will finally achieve the required RN workforce.

ANS: B
According to the U.S. Bureau of Labor Statistics, the nursing profession is predicted to have only 64% of the RN workforce required to meet demands.
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.
More than half of all nurses practice in hospitals, and it has not been indicated that this will change.
Even by 2020, it is projected that the United States will achieve only 64% of the needed nursing workforce.

DIF: Comprehension REF: Page 28

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
Sairy Gamp endured nursing because of the lack of other opportunities.
Sairy Gamp did not portray a professional image of nursing, but that of an untrained caregiver who profited from the sick and dying.
Sairy Gamp was a nurse who used her position to take advantage of her patients. Dicken’s portrayal of a nurse does not suggest that the nurse is at the forefront of technology and autonomy.

DIF: Knowledge REF: Page 29

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
The statue the Spirit of Nursing was created to honor all military nurses.
The statue does not seek to honor Florence Nightingale.
Nurse Rivers was the nurse who attempted to help the victims of the Tuskegee experiment.
The statue does not honor Clara Maas, and Clara Maas did not find the cure for yellow fever.

DIF: Knowledge REF: Page 29

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
The sitcom M*A*S*H did show humor as a coping mechanism for nurses in a war setting.
M*A*S*H’s portrayal of promiscuous nurses has no merit because nurses assist physicians.
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: Page 30

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 move nursing to 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.
Nursing has a unique body of knowledge.
Nursing is a profession. Unification will enhance the professional goals for nursing.
Caring will always be part of the nursing image and nurses have already moved into the technologic realm.

DIF: Comprehension REF: Pages 29-30

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
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.
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.
Lowering standards would increase the chance for errors, cause patient care standards to become lower, and harm the image of nursing.
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: Page 30

12. Today’s demographics of the RN population indicate that:
a.
nurses entering the workforce do so within 2 years of completing high school.
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
56% of nurses practice in hospitals.
The youngest professionals, those with a BSN, enter at age 26.
More African-Americans are entering graduate school.
The highest level of nursing education is the baccalaureate degree.

DIF: Comprehension REF: Page 34

13. The 2008 Gallop Poll ranked the four most ethical professionals in the following descending order:
a. Firemen
b. High school teachers
c. Physicians
d. Nurses
e. Pharmacists

a.
A, B, C, D
b.
A, D, B, E
c.
E, D, C, B
d.
D, E, B, C

ANS: D
Only in 2001 did firemen rank higher than the other four professions. In the 2008 Gallop Poll nurses ranked first (84%); second, pharmacists (70%); third, high school teachers (65%); and fourth were physicians (64%).

DIF: Comprehension REF: Page 33

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 10.6% of nurses are minorities.
c.
overall, nurses are satisfied with their jobs but leave the profession because of fear of contracting fatal diseases.
d.
over the next decade, more than half of RNs in the United States will retire.
e.
staff nurses are returning to school to obtain certificates to teach nursing.

ANS: B, D
Only 10% of nurses are minorities.
Nurses are older, with a mean age of 46.8 years.
Salaries are not a problem related to the nursing shortage. Most facilities are willing to increase salaries and benefits for nurses.
It has not been documented that nurses are afraid of contracting a fatal disease. Nurses take precautions to reduce this risk.
There is a shortage of nursing faculty, and graduate education is required rather than certificates to teach nursing.

DIF: Knowledge REF: Page 34

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 are educated to attain an associate degree than a baccalaureate degree or diploma.
b.
Because of the push 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 second largest health care professional group, second only to medical doctors.
f.
Job satisfaction is high among nurses, despite long hours, high nurse/patient ratios, and lower pay than is often earned by individuals with less education.
g.
Even with the popularity of nursing as a career, the nation faces a severe deficit of RNs now and even more so in the future.

ANS: F, G
A recent job satisfaction survey found that 78% of RNs were happy with their jobs. Increasing awareness of nursing as a profession has enhanced enrollment in nursing schools and has promoted interest among high school students
Recipients of BSN degrees are younger and represent the largest graduating educational profile.
More than half of all nurses practice in acute care hospitals.
Nurse practitioners constitute the majority of advanced practice nurses (APRNs).
Minority nurses are more likely to enter graduate school than white nurses.
Nurses make up the largest group of health care professionals.

DIF: Comprehension REF: Pages 28, 34

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
Providing incentives for minorities and men to enter nursing speaks to the core of solutions to the nursing shortage.
Obtaining grant funding to increase the number of faculty members and scholarship availability for students entering baccalaureate nursing programs speaks to the core of solutions to the nursing shortage.
Developing ad campaigns that target younger students speaks to the core of solutions to the nursing shortage.
Determining why few African-American women enter graduate school would not result in a greater number of nurses entering and staying in practice.
Job satisfaction among nurses is currently high.

DIF: Comprehension REF: Pages 28, 33, 34

ANS: B, C, E
Providing incentives for minorities and men to enter nursing speaks to the core of solutions to the nursing shortage.
Obtaining grant funding to increase the number of faculty members and scholarship availability for students entering baccalaureate nursing programs speaks to the core of solutions to the nursing shortage.
Developing ad campaigns that target younger students speaks to the core of solutions to the nursing shortage.
Determining why few African-American women enter graduate school would not result in a greater number of nurses entering and staying in practice.
Job satisfaction among nurses is currently high.
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.
Lower nurse/patient ratios are needed.
It was not a focus of the campaign to let the public know that nurses are caring.
The campaign did not focus on the financial aspects of being a nurse.
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