Chapter 11, Chapter 13, Chapter 12

The "golden age" of doctoring was marked by: a. Escalating prices and overcharging to a degree previously unknown. b. Provider-structured insurance that paid for almost any mistakes. c. A proliferation of unnecessary tests, hospitalizations, prescriptions, and surgical operations. d. All of the above. e. None of the above.

All of the above

The decline in the status and autonomy of physicians is largely due to greater: a. Government regulation b. Corporations in the health care market c. Changes in the physician-patient relationship d. All of the above e. None of the above

All of the above

The _________________ are relatively inexpensive, require only two years of training, and yet place their graduates on the same career track as graduates of other programs. a. Associate degree programs. b. Hospital-based diploma schools. c. University baccalaureate programs. d. Post-baccalaureate advanced programs. e. Military nursing programs.

Associate degree programs

Freidson argues that it can be __________________ that physicians are dedicated to their patients. a. Guessed. b. Believed. c. Denied. d. Assumed. e. None of the above.

Assumed

Medicalization is a form of _______________ action. a. Socioeconomic. b. Individual. c. Collective. d. Physician-driven. e. None of the above.

Collective

25. Medical students shift from __________ to _____________ as part of a functional learning process fitted to the physician's role of maintaining an objective perspective of health and disease. a. Excitement; dejection. b. Defeatism; hopefulness. c. Optimism; to pessimism. d. Idealism; cynicism. e. None of the above.

d. Idealism; cynicism

15. One of the most significant guiding principles of the AMA has been its view of the physician as a(an) ___________________________. a. Academic force for change. b. Articulate, charismatic healer. c. Societal leader. d. Independent practitioner. e. All of the above.

d. Independent practitioner

Who are the key sources of medication information for the general public? a. Doctors/Physicians. b. Nurses. c. Pharmacists. d. Physician's Assistants. e. Midwives.

Pharmacists

6. Who defined the guidelines for analyzing the development of the medical profession in American society? a. Goode. b. Koch. c. Durkheim. d. Brown. e. Grant.

a. Goode

While opposition to midwifery by the medical profession continues, approximately how many states today license or register lay midwives? a. 12. b. 16. c. 20. d. 24. e. 28.

16

__________________ are composed of licensed physicians and osteopaths who determine if the services rendered are medically necessary, meet professional standards of quality, and are provided as efficiently and effectively as possible. a. PSROs. b. DRGs. c. HMOs. d. PPOs. e. AMAs.

PSROs

14. AMA local societies have the power to enforce conformity at their level because they determine: a. Dues. b. Membership qualifications. c. Participation in events. d. Membership size (maximum size of the AMA). e. None of the above.

b. Membership qualifications

Although this was not always the case, nursing students today tend to view their occupation as: a. Secondary to life goals of marriage and family. b. A career to be followed throughout their working lives. c. The pathway to better jobs in hospital administration. d. A second choice because they couldn't get into medical school. e. None of the above.

A career to be followed throughout their working lives

Registered nurses, especially those with baccalaureate degrees, have expanded their range of services to include: a. Hospital administration. b. Primary-care healing. c. Nurse anesthetists. d. Cardiovascular nurse specialists. e. All of the above.

All of the above

Which group may hold doctorates in their field? a. Nurses. b. Physical therapists. c. Pharmacists. d. Nutritionists. e. All of the above.

All of the above

The word "drug" is of _____________ origin. a. American. b. Arab. c. French. d. British. e. Chinese.

Arab

Which is NOT an important feature of a positive relationship for patients with their physician? a. High levels of trust. b. General satisfaction. c. Participation in decision-making. d. Gender matching. e. None of the above.

None of the above

10. Who was responsible for significant advancements in the germ theory of disease? a. Koch. b. Goode. c. Pasteur. d. Virchow. e. Grant.

c. Pasteur

9. The ____________ was founded in Philadelphia in 1847. a. American Medical Association. b. American College of Physicians. c. Health Care Workers, USA Chapter. d. Alliance of Physicians. e. All of the above.

a. American Medical Association

Mistakes and errors in medical practice, through neglect or ignorance, can sometimes be defended as: a. Cultural latitude. b. A difference of opinion. c. Accidental. d. Unintentional. e. None of the above.

A difference of opinion

What is a gatekeeper? a. Typically, the government. b. A primary care physician who screens patients prior to referring them to a specialist. c. A physician who blocks the review of another physician in an attempt to protect him/her. d. None of the above. e. All of the above.

A primary care physician who screens patients prior to referring them to a specialist

The early approach to nursing training emphasized a code of behavior that idealized nurses as being: a. Responsible. b. Clean. c. Courageous. d. Obedient to the physician. e. All of the above.

All of the above

Which nursing program may qualify the student as a registered nurse (RN)? a. Hospital-based diploma schools. b. Two-year associate degree programs. c. University baccalaureate programs. d. All of the above. e. None of the above.

All of the above

13. In 2007, what percentage of all eligible physicians were members of the AMA? a. Less than 30%. b. 40%. c. 50%. d. 60%. e. Over 70%.

a. Less than 30%

____________________ were established in 1970 in conjunction with Medicaid and Medicare, to review and evaluate the medical care given to patients eligible to use these services. a. PSROs. b. DRGs. c. HMOs. d. PPOs. e. AMAs.

PSROs

Among the various occupational roles in the health field, _____________________ have the greatest prestige. a. Midwives. b. Physicians. c. Pharmacists. d. Administrators. e. None of the above.

Physicians

19. The Flexner Report was sponsored by the: a. American government. b. European government. c. Carnegie Foundation. d. National Institutes of Health. e. All of the above.

c. Carnegie Foundation

3. Recognition on the part of clients, outside agencies, and the wider society of the profession's claim to _____________________ is necessary if professional decisions are not to be reviewed by outside authorities. a. Professionalism. b. Dominance. c. Competence. d. Being service-oriented. e. None of the Above.

c. Competence

24. Medical schools have begun to employ which method to help decrease doubt and improve the application of medical knowledge? a. Clinical rotations. b. Koch's postulates. c. Evidence-based medicine. d. Grand rounds. e. None of the above.

c. Evidence-based medicine

__________________ are schedules of fees placing a ceiling on how much the government will pay for specific services rendered to Medicare patients by hospitals and doctors. a. PSROs. b. DRGs. c. HMOs. d. PPOs. e. AMAs.

DRGs

Lay midwives have remained in existence because they: a. Use special sterilization techniques. b. Act as emotional coaches for pregnant women. c. Deliver babies in the home. d. Move in with the patient during her third trimester. e. None of the above.

Deliver babies in the home

2. Once a professional group becomes established, Goode indicates that it begins to further consolidate its power by: a. Formalizing social relationships. b. Encouraging a service orientation. c. Developing associations that limit membership. d. Expanding practice scope. e. All of the above.

a. Formalizing social relationships

8. Most American medical practitioners in the period before the American Revolution were: a. Ship's surgeons. b. Apothecaries. c. Clergy. d. Trained in Europe. e. All of the above.

e. All of the above

The role of nursing in Western society was changed in the middle of the 19th century, through the insight and effort of: a. Louie Pasteur. b. Florence Nightingale. c. The Nursing Coalition of America. d. Universities. e. None of the above.

Florence Nightingale

Which type of program produces the fewest registered nurses today? a. Associate degree programs. b. Hospital-based diploma schools. c. University baccalaureate programs. d. Post-baccalaureate advanced programs. e. Military nursing programs.

Hospital-based diploma schools

About 75 percent of licensed registered and practical nurses in the United States work in: a. Doctors' offices. b. Public health agencies. c. Schools and industrial plants. d. Hospitals and nursing homes. e. None of the above.

Hospitals and nursing homes

During the late 19th and early 20th centuries, increasing numbers of women entered the labor market as a result of: a. Immigration. b. The women's rights movement. c. The depression. d. Boredom.

Immigration

What was one of the earliest forms of care available to women? a. Midwifery. b. Hospitalization. c. Home health care. d. Clinic care. e. None of the above.

Midwifery

Millman contended that _________________ errors resulted in unfavorable letters of recommendation for those seeking jobs and social isolation from other physicians in the hospital. a. Moral. b. Technical. c. Accidental. d. Real. e. Personal.

Moral

Nightingale incorporated the best attributes of the ___________________ and the ____________________ into her ideal nurse. a. Physician; nanny. b. Maid; physician. c. Sister; wife. d. Mother; housekeeper. e. None of the above.

Mother; housekeeper

18. In the developing American West, anyone who had ___________ could obtain a medical degree and practice medicine. a. Ambition. b. Money. c. Enthusiasm. d. Noble blood/heritage. e. All of the Above.

b. Money

12. With the founding of the American Medical Association (AMA) in Philadelphia, _____________ could mark the beginning of a new era in medicine. a. Nurses. b. Physicians. c. The government. d. Hospitals. e. None of the above.

b. Physicians

1. Which is a sociologically relevant characteristic noted by Goode in explaining professionalism? a. Professional titles and prestige. b. Prolonged training in a body of specialized knowledge. c. Entrance screening to only admit the most qualified. d. Being male dominated. e. All of the above.

b. Prolonged training in a body of specialized knowledge

28. Which is NOT an important factor in establishing prestige within the medical profession? a. Hospital affiliation. b. Race of the practitioner. c. Clientele. d. The inner fraternity. e. All are important factors.

b. Race of the practitioner

29. The "inner core" of physicians is divided into two major groups. Which of the following is one of these groups? a. Student elite. b. Practitioner elite. c. Administrative elite. d. Surgeon elite. e. None of the above.

c. Administrative elite

Which is NOT a feature of a free-standing emergency center? a. Open around 18-24 hours a day, 7 days a week. b. Attend to their patients with a minimum of waiting time. c. Treat cuts, broken bones, bruises, and minor ailments. d. Sometimes these are located in shopping centers or other convenient locations. e. All of the above are features.

All of the above are features

A major defect in the professional autonomy argument arises from the fact that the autonomy granted to the medical profession is granted _______________, on the assumption that it will resolve significant issues in favor of the public interest. a. Partially. b. Completely. c. Conditionally. d. Unconditionally. e. None of the above.

Conditionally

Public dissatisfaction with the medical profession in the United States is generally viewed as having ___________ and _______________ origins. a. Educational; economic b. Educational; social c. Economic; social d. Economic; ethnic. e. None of the above.

Economic; social

In many European languages, the word ___________________ not only refers to nuns but also generically identifies the nurse. a. Sister. b. Mother. c. Priestess. d. Angel. e. None of the above.

Sister

30. Which group exercises influence over medical work through its research productivity rather than focusing on individual diagnosis and treatment? a. Knowledge elite. b. Research elite. c. Policy elite. d. Management elite. e. None of the above.

a. Knowledge elite

20. The Flexner Report reviewed the state of: a. Medical education. b. The AMA. c. The professionalization of physicians. d. Infectious disease. e. None of the above.

a. Medical education

Other than a few consulting professions such as ________________, the occupations performing tasks of patient care are organized around the work of the physician, and are usually under the physician's direct control. a. Clinical psychology. b. Physical therapy. c. Pharmacy. d. Nursing. e. All of the above.

Clinical psychology

At the beginning of the 21st century we are witnessing that the dominance of medical profession is: a. Declining. b. Expanding. c. Increasing. d. Stagnating. e. None of the above.

Declining

Students of what program will be taught advanced clinical skills, collaboration with other health professionals to solve complex clinical problems, leadership, and other topics? a. Registered nurse. b. Nurse practitioner. c. Certified nurse's aide. d. Doctor of nursing practice. e. Licensed practical nurse.

Doctor of nursing practice

____________________ considerations have become a primary motivation among physicians, hospitals, and private health insurance companies. a. Economic. b. Social. c. Governmental. d. Insurance. e. All of the above.

Economic

What attracted corporations to health care delivery is the potential for: a. Improving health care. b. Helping people. c. Financial profit. d. All of the above. e. None of the above.

Financial profit

Support through planning grants and loan guarantees was provided to encourage the development of __________________; a form of prepaid group practice emphasizing preventative care. a. PSROs. b. DRGs. c. HMOs. d. SCHIPs. e. AMAs.

HMOs

Researchers find that many nurses are no longer willing to be treated as mere subordinates by physicians. Several reasons are offered for this change. What is NOT a reason for this change? a. Declining public esteem for doctors. b. Increased number of women doctors. c. The nursing shortage. d. Most nurses today are educated in academic settings. e. Increase in nursing salaries.

Increase in nursing salaries

This stage of socialization in the nursing student's education consisted of nursing students wanting to do things for patients within a secularized Christian-humanitarian ethic of care and kindness, consistent with the lay image of nursing: a. Initial innocence. b. Labeled recognition of incongruity. c. Psyching out. d. Role simulation. e. Provisional internalization.

Initial innocence

Nursing students begin to collectively articulate their disappointment and openly question their choice of becoming a nurse at what stage? a. Initial innocence. b. Labeled recognition of incongruity. c. Psyching out. d. Role simulation. e. Provisional internalization.

Labeled recognition of incongruity

_________________ refers to health care organizations that control the cost of health care by monitoring how doctors treat specific illnesses, limit referrals to specialists, and require authorization prior to hospitalization, among other measures. a. Health savings companies. b. Medicare and Medicaid. c. Health insurance. d. Managed care. e. None of the above.

Managed care

Nursing is ranked by sociologists as a distinctly ____________ class occupation. a. Working. b. Lower. c. Middle. d. Upper. e. None of the above.

Middle

Etiquette was a more important _________________ than accountability in undermining attempts at critical evaluation of physicians by physicians. a. Value. b. Belief. c. Norm. d. Opinion. e. All of the above.

Norm

_______________ allows nurses to develop, demonstrate, and communicate to physicians their superiority in certain important spheres of patient care. a. Medicalization. b. Nurse specialization. c. Nurse socialization. d. Nursing education. e. None of the above.

Nurse specialization

The central rule of the doctor-nurse game is to avoid: a. Administrator intervention in day-to- day activities. b. A shift in the balance of power. c. Medical errors. d. Open disagreement between the players. e. None of the above.

Open disagreement between the players

Millman contended that a "gentlemen's agreement" existed among the hospital physicians. What did this agreement allow for? a. Overlooking each other's mistakes. b. Not to discuss personal issues with physician's partners. c. Assisting in negotiating the highest pay possible for physicians. d. Doctors to be unreliable. e. Irresponsibility to patients.

Overlooking each other's mistakes

______________ typically have a bachelor's degree, experience in health care as a nurse or paramedic, and become qualified after completing a training program of approximately 26 months. a. Registered nurses. b. Physician assistants. c. Pharmacists. d. Midwives. e. None of the above.

Physician assistants

Technical knowledge employed in health occupations (other than "medicine") needs to be approved by: a. Occupational organizations (e.g., the AMA). b. The government. c. Patients. d. Physicians. e. None of the above

Physicians

What is a double agent? a. Physicians who look out for the interests of the patient and the interests of a managed care organization. b. Insurance agents who seem to be offering a great financial package, but are actually creating more profits for insurance companies. c. A physician who is also a patient. d. A nurse who reports on the mistakes of a physician who he/she works for. e. None of the above.

Physicians who look out for the interests of the patient and the interests of a managed care organization

_________________ are forced to spend time as "patient advocates," convincing various bureaucrats that more specialized and expensive care is warranted. a. Specialists. b. Physicians' assistants. c. Nurses. d. Primary care physicians. e. All of the above.

Primary care physicians

What is medicalization? a. Path by which a student becomes a medical professional. b. Process of turning commonly regarded normal human conditions into medical ailments. c. Process where a traditionally non-medical professional/occupational sphere becomes labeled as medical (e.g. insurance companies). d. None of the above. e. All of the above.

Process of turning commonly regarded normal human conditions into medical ailments

Which is NOT a term used to describe free-standing emergency centers? a. Docs-in- a-Box. b. 7-Eleven Medicine. c. Quick-fix facilities. d. None of the above are correct terms. e. All of the above are correct terms.

Quick-fix facilities

From the perspective of hospital administrators, _____________ can be used more economically in managerial and supervisory positions. a. Registered nurses. b. Licensed practical nurses. c. Nurses' aids d. Orderlies. e. All of the above.

Registered nurses

What situation has reduced public confidence in medicine more than any other single issue? a. Refusal to be regulated by an external body. b. Resistance to cost controls. c. Acceptance of HMOs and PPOs. d. Adoption of medical technology which does the doctor's work "for them." e. None of the above.

Resistance to cost controls

What socialization stage was characterized by students performing so as to elicit favorable responses from the instructors? a. Initial innocence. b. Labeled recognition of incongruity. c. Psyching out. d. Role simulation. e. Provisional internalization.

Role simulation

What restricted the evaluation of work and discouraged the expression of criticism within physician circles? a. Rules of etiquette. b. Laws. c. Formal sanctions. d. Hospital guidelines. e. None of the above.

Rules of etiquette

Millman contended that __________________ errors could be forgiven and often had the result of motivating the offending physician to work harder, spend more time with patients, double-check procedures, and learn from the mistake. a. Moral. b. Technical. c. Accidental. d. Real. e. Personal.

Technical

Millman contended that _____________ errors, if they were made in "good faith," were less serious than ___________ errors. a. Technical; moral. b. Moral; technical. c. Accidental; real. d. Real; accidental. e. Accidental; personal.

Technical; moral

Which registered nurse (RN) program is intended to provide training not only in nursing skills and theory, but also to provide the background for becoming a nursing educator or leader? a. Associate degree programs. b. Hospital-based diploma schools. c. University baccalaureate programs. d. Post-baccalaureate advanced programs. e. Military nursing programs.

University baccalaureate programs

22. Physicians from a lower-class social origin were more likely than upper-class doctors to emphasize success values as reasons for going into medicine. Those physicians who were initially success-oriented became less so after commencing their practices, while the reverse occurred with those who were less success-oriented. This change occurs through: a. Socialization. b. Professionalization. c. Medicalization. d. Hazing. e. All of the above.

a. Socialization

16. President Bill Clinton referred to the AMA as just another ___________________. a. Special interest group. b. Lobbyist organization. c. Powerful force trying to shape American policy. d. Civil society group. e. None of the above.

a. Special interest group

7. Physicians in the United States used to lack: a. A service orientation. b. Lengthy training in specialized knowledge. c. Male dominance. d. The desire to help patients. e. All of the above.

b. Lengthy training in specialized knowledge

23. Renée Fox found that medical students at Cornell Medical School acquired two basic traits as a result of their medical training: the ability to be emotionally detached from the patient and to ___________________. a. Understand the limitations of medicine. b. Convey "bad news." c. Tolerate uncertainty. d. All of the above. e. None of the above.

c. Tolerate uncertainty

21. Oswald Hall pointed out that the decision to study medicine is largely ___________ in character: a. Biological. b. Humanitarian. c. Psychological. d. Social. e. None of the above.

d. Social

11. Who unveiled a general concept of disease based on cellular pathology? a. Koch. b. Goode. c. Pasteur. d. Virchow. e. Grant.

d. Virchow

17. American medical schools in the 1800s were known to have: a. Low standards. b. Poor facilities. c. Incentive programs (e.g., trips to Europe). d. Financially strong students. e. All of the above.

e. All of the above

26. What is a purpose of medical slang? a. Creating a sense of belonging. b. Establishing a unique identity. c. Providing a private means of communication. d. Creating opportunities for humor and wit. e. All of the above.

e. All of the above

27. Medical education is adjusting to new realities in medical practice. Changes include the transition in American health care delivery from: a. A system run by doctors to one shaped by the purchasers of care and the competition for profits. b. A decline in the public's trust in doctors to greater questioning and even distrust. c. A change in emphasis on specialization and subspecialization to primary care and prevention. d. Less hospital care to more outpatient care in homes and doctors' offices. e. All of the above.

e. All of the above

4. Which is NOT a feature of professionalism? a. The profession determines its own standards of education and training. b. The student professional goes through a more stringent socialization experience than the learner in other occupations. c. Professional practice is often legally recognized by some form of licensure. d. Licensing and admission boards are staffed by members of the profession. e. All of the above are features.

e. All of the above are features

5. Which is NOT a feature of professionalism? a. Most legislation concerned with the profession is shaped by that profession. b. As the occupation gains income, power, and prestige, it can demand high-caliber students. c. The practitioner is relatively free of lay evaluation and control. d. Members are strongly identified by their profession. e. All of the above are features.

e. All of the above are features