Chapter 02: The History of Public Health and Public and Community Health Nursing Stanhope: Foundations for Population Health in Community/Public Health Nursing, 5th EditionMULTIPLE CHOICE

1. A nurse is considering applying for a position as a public health nurse. Which of the following would be a reason this position would be appealing?
   1. Its autonomy and independence
   2. Its focus on acute care and immediately visible outcomes
   3. Its collaboration with other healthcare professionals
   4. It’s flexibility and higher wages

   ANS: APublic health nursing is known for its autonomy and independence. In many instances, there are limited other healthcare professionals and staff with whom to interact. In-patient acute care nurses focus on acute care with outcomes known fairly quickly. Acute care nurses collaborate frequently with other health care professionals. Depending on the position there may be more flexibility, but typically public health nurses do not receive higher wages.

2. The Elizabethan Poor Law of 1601 is similar to which current law?
   1. Welfare
   2. Food stamps
   3. Medicaid
   4. Medicare

   ANS: C NURSINGTB.COMThe Elizabethan Poor Law guaranteed medical care for poor, blind, and “lame” individuals, similar to Medicaid. Welfare and food stamps do not provide for medical care. Medicare provides medical care to primarily the elderly population.

3. How did the Industrial Revolution result in previous caregiving approaches, such as care by families, friends, and neighbors, becoming inadequate?
   1. Economic and political wars resulted in frequent deaths and injuries.
   2. Incredible plagues consistently and constantly swept the European continent.
   3. Migration and urbanization resulted in increased demand for care.
   4. Caregivers could easily find other employment, so they demanded to be paid.

   ANS: CCare became inadequate because of the social changes in Europe, with great advances in transportation, communication, and other technologies. The increased mobility led to migration and urbanization, which in turn led to increased need for care. The Industrial Revolution was a time of great advances in technology, transportation, and communication, not a time of economic and political unrest or a time when incredible plagues occurred in Europe. Caregivers during this period were typically poorly educated and untrained, so there was not an issue related to wages or employment.

4. A colonist is working in the public health sector in early colonial America. Which of the following activities would have likely been completed?

a. Establishing schools of nursing

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2. Developing vaccines to administer to large numbers of people
3. Collecting vital statistics and improving sanitation
4. Developing public housing and almshouses

ANS: Collecting vital statistics and improving sanitation are examples of activities from early colonial America. Establishing schools of nursing, developing vaccines to administer to large numbers of people, and developing public housing and almshouses all happened after the colonial period.

5. Why did American citizens become interested in establishing government-sponsored boards of health?
   1. They were afraid of infectious diseases such as yellow fever.
   2. The government could force the poverty-stricken to accept care.
   3. Such boards could tax and thereby ensure adequate funds to pay for care.
   4. Such a system would allow for accurate records of births and deaths.

   ANS: A threat of disease, especially yellow fever, led to public interest in establishing government-sponsored, or official, boards of health. The threat of disease was the impetus for the creation of the boards of establishing boards of health. The primary interest of the boards of health was to provide public health services for the entire population and not only those who were poverty-stricken. The primary purpose of the boards of health was not to collect accurate vital statistics or receive tax dollars rather its purpose was to ensure the health of the population.

6. A nurse was employed by the Marine Hospital Service in 1800. Which of the following

1. Setting policy on quarantine legislation for immigrants
2. Establishing hospital-based programs to care for the sick at home
3. Identifying and improving environmental conditions
4. Providing health care for merchant seamen

ANS: Providing health care to seamen was an early effort by the federal government to improve public health. The purpose of the Marine Hospital Service was to secure its maritime trade and seacoast cities. Quarantine legislation was enacted by legislation during this period, but the nurse would not have been responsible for setting these policies. Nursing care for clients in the home began in the first half of the 1800s through a variety of agencies including the Ladies’ Benevolent Society of Charleston South Carolina. Identifying and improving environmental conditions was a focus of the public boards of health, not necessarily specifically the role of the nurse.7. What was the outcome of the Shattuck Report?

1. Efforts to control alcohol and drug abuse, as well as tobacco use, were initiated.
2. Environmental sanitation efforts became an immediate priority.
3. Guidelines for modern public health organizations were eventually developed.
4. Local and state governments established boards of health after its publication.

ANS: C

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It took 19 years for the first of Shattuck’s recommendations to be implemented, but his report was the first effort to create a modern public health organization. This report called for broad changes to improve the public’s health to take place; however, these changes did not happen immediately after publication. They took 19 years to be implemented in the first state of Massachusetts. The report included the establishment of a state health department and local health boards in every town, sanitary surveys, and food, drug, and communicable disease control, but none of these changes happened quickly.

8. Which of the following nurses is famous for creating public health nursing in the United States?
   1. Florence Nightingale
   2. Frances Root
   3. Lillian Wald
   4. Mrs. Solomon Loeb

   ANS: Lillian Wald established the Henry Street Settlement and later emerged as the established leader of public health nursing during its early decades. Mrs. Solomon Loeb was a wealthy layperson who assisted Mary Brewster in the establishment of the Henry Street Nurses Settlement. Francis Root was the first trained nurse in the United States who was salaried as a visiting nurse. Florence Nightingale had many accomplishments, but none of these occurred in the United States.

9. Which of the following would have been the focus of a school nurse in the early 20th century?
   1. Investigating causes of absenteeism
   2. Teaching school as well as being a nurse
   3. Promoting nursing as an autonomous practice

ANS: Early school nursing focused on investigating causes of absenteeism. Providing medical treatment was the responsibility of physicians. School nurses did not teach in the schools nor were they part of an autonomous practice during this period.

10. A nurse is reviewing the original work of the National Organization for Public Health Nursing. Which of the following accomplishments of today was started within this organization?
    1. Requiring that public health nurses have a baccalaureate degree in nursing
    2. Standardizing public health nursing education
    3. Developing Public Health Nursing Competencies
    4. Opening the Henry Street Settlement

    ANS: The National Organization for Public Health Nursing sought to improve the educational and services standards of public health nursing. The Henry Street Settlement was already in existence and was opened by Lillian Wald and Mary Brewster. The baccalaureate degree in nursing has not developed yet. Public health nursing competencies were developed by the Quad Council.