NURB 3030 Nursing as a Profession Exam 1

Code of Ethics for Nurses

- intended as a guide to practice ethical decision making - empowers nurses to maintain the focus on the patient as the center of health care.

Isabelle Hampton Robb (chapter 2)

-First university school of nursing -Nurses need theoretical foundation -Developed a grading policy to earn a diploma -Credited with founding the American Nurses Association and American Journal of Nursing

Baccalaureate Education (BSN) Today

-Provides college education and preparation for licensure, as well as advanced college education for established RNs -provide general education plus nursing courses -faculty qualifications are usually higher than the basic nursing programs (minimum masters degree) -graduates prepared to go into leadership roles & graduate programs, stresses independence of practice, assessment skills, and management abilities -career mobility

Associate Degree Education Today (ADN)

-developed in 1952 in response to post-WW2 nursing shortage -provides basic education for licensure -24 month curriculum -Focus on: nursing science & clinical nursing skills, decision making, leadership - popular because accessibility, low cost, part-time & evening study options, shorter duration of programs -often used as a step in progression to BSN or MSN

Diploma Education

-earliest type of nursing education -3 calendar years -hospital-based: cheap labor -declined in popularity until colleges/universities allowed college credits for courses

Master's Degree in Nursing (MSN)

-prepare for careers in research, nurse practitioner, clinical nurse specialists, educators, administrators, private practice, business consultants -typically 18-24 months if enrolled full-time -can be combined with other disciplines including: MSN/JD: nurse attorneys MSN/MBA: nurse administrators

Practical Nursing (LPN) (Chapter 4)

-program 9-12 months long -offered in hospitals, community colleges, trade schools, vocational schools -take NCLEX-PN after program -must be supervised by RN or MD -often practice outside of scope of practice, leaving them vulnerable

Educational Preparation for Nursing Practitioners and Assistants to nurses (1965):by the ANA

1. BSN should become the basic foundation for professional practice 2. controversial - fostered conflict & division within nursing 3. practicing nurses protested

What does the nursing lamp symbolize? Select all the apply. (chapter 2) 1. Life 2. Learning 3. Fire 4. Sacrifice 5. Caring

1. Life 2. Learning 5. Caring Rationale: The nursing lamp symbolizes the flame of LIFE that is extinguished by death, the light of LEARNING that pushes back the darkness of ignorance, and the CARING of Florence Nightingale and her nurses making their nighttime rounds in unlit British field hospitals.

Alonzo wants to become an RN and is trying to decide between an ADN program and a BSN program. Which of the following is an advantage of the ADN? Select all that apply. (Chapter 4) 1. Lower schooling costs 2. Earlier entry into the workforce 3. An easier form of the NCLEX-RN 4. Just as much prestige as a BSN 5. An emphasis on skills training

1. Lower schooling costs 2. Earlier entry into the workforce 5. An emphasis on skills training rationale: 1. Because the associate degree program is shorter that the BSN, costs are typically less. 2. Because the associate degree program is shorter than the BSN, graduates enter the work force sooner. 5. The ADN program includes less theoretical information and emphasizes skills training.

Ashley, an ADN, wants to pursue a degree that will allow her to provide advanced nursing care to the clients in the nursing home where she works. Given Ashley's interest and training, which of the following is her BEST option? (Chapter 4 ) 1. MSN nurse practitioner 2. PhD 3. EdD 4. DNP

1. MSN nurse practitioner rationale: Ashley can likely find an ADN to MSN program that will allow her to become a nurse practitioner.

What are the effects of having multiple paths to entering the nursing profession? Select all that apply. (Chapter 4) 1. More options are available to students. 2. More respect exists between nursing colleagues. 3. Multiple paths cause confusion among the public. 4. The NCLEX-RN becomes an equalizer. 5. Multiple paths cause confusion among nurses.

1. More options are available to students. 3. Multiple paths cause confusion among the public. 5. Multiple paths cause confusion among nurses. rationale: While having multiple paths to entering the nursing profession does provide more options for students, it also causes confusion in both the public, and among nurses about the level of training and scope of practice for each type of nurse. It tends to lead to division, not respect, among colleagues with different credentials. LPNs/LVNs do not take the NCLEX-RN.

To increase their power, what should nurses do? Select all the apply. 1. Network 2. Become politically active 3. Demonstrate professionalism 4. Join professional organizations 5. March in demonstrations

1. Network 2. Become politically active 3. Demonstrate professionalism 4. Join professional organizations Rationale: Marching in demonstrations can raise awareness of an issue, but it does NOT yield increased power.

What effect did the Renaissance have on the role of nursing? (chapter 2) 1. Nursing care fell to female religious orders as the number of male nursing orders decreased. 2. Nursing became more scientific because of the invention of the microscope and the thermometer. 3. Nursing became more secular, and faith in the teaching of the Catholic Church waivered. 4. Nursing in countries that broke away from the Catholic Church advanced swiftly.

1. Nursing care fell to female religious orders as the number of male nursing orders decreased.

3 documents that guide Nursing Practice

1. Nursing's Social Policy Statement 2. Nursing: Scope of Standards of Practice 3. The Code of Ethics for Nurses

Nursing: Scope and Standards of Practice

1. Outlines the expectations of the professional role within which all RNs must practice 2. Sets boundaries of our role 3. establishes minimum standards of care and levels of competencies 4. focuses on importance of collegiality

What was the status of organized medical care in the American colonies before they gained their independence? (chapter 2) 1. People were cared for at home; only five hospitals existed for the homeless and poor before the Revolutionary War. 2. Nurses trained in religious orders in Europe immigrated to the colonies in large numbers. 3. Hospitals were well known for their success in treating a variety of serious illnesses. 4. Benjamin Franklin organized and trained medical volunteers to aid the injured and sick during the Revolutionary War.

1. People were cared for at home; only five hospitals existed for the homeless and poor before the Revolutionary War. Rationale: Nurses did not emigrate from Europe in large numbers until AFTER the Revolutionary War. Hospitals were thought of as placed where people went to die, Franklin founded Pennsylvania Hospital in 1751, but there was no organized medical corps during the Revolutionary War.

Today there are 4 options for a nursing education: choose all that apply (Chapter 4) 1. Practical/vocational Program 2. Diploma school 3. Associate Degree Program (ADN -2 years) 4. Baccalaureate Degree Program (BSN - 4 years)

1. Practical/vocational Program 2. Diploma school 3. Associate Degree Program (ADN -2 years) 4. Baccalaureate Degree Program (BSN - 4 years)

Types of Power that nurses possess:

1. Referent power - someone will do what you want due to the power of the relationship you have with them 2. Expert power - based on the amount of knowledge or skill that a person has 3. Rewards power - ability to grant a reward for specific behaviors 4. Coercive power - opposite of rewards power; ability to withhold rewards, punish, etc. 5. Legitimate power - a legal right to make decisions for others 6. Collective power - a large group of individuals bound together is more powerful than one person

Analyze those traits defining a profession that nursing has attained

1. Specialized knowledge and autonomy -continuing education and research -High Intellectual Level (College)...... -Practitioners are relatively independent and control their own policies and activities (autonomy) -Each possess license to practice 2. Ethics/Standards - Services involve intellectual activities; Individual responsibility is a strong feature -Code of Ethics guides our decisions - professional organization (association) encourages/supports high standards of practice...the ANA - follow evidence-based practice 3. Service/altruism - Services provided are vital to humanity and welfare of society - motivated by service (altruism)

What effect did World War 2 have on the development of US Nursing? Select all that apply. (chapter 2) 1. The U.S. government commissioned nurses and paid them the same as men with the same rank. 2. Working with physicians and untrained personnel nurses initiated the concept of the healthcare team. 3. The nursing shortage immediately after WW2 led to ADNs outnumbering BSNs by the 1960s. 4. The number of BSN and graduate nursing programs exploded. 5. The image of the nursing profession was especially positive, in part because of the heroic portrayal of nurses in movies produced during the war.

1. The U.S. government commissioned nurses and paid them the same as men with the same rank. 2. Working with physicians and untrained personnel nurses initiated the concept of the healthcare team. 3. The nursing shortage immediately after WW2 led to ADNs outnumbering BSNs by the 1960s. 5. The image of the nursing profession was especially positive, in part because of the heroic portrayal of nurses in movies produced during the war.

Yolanda is doing research for a nursing paper on lung cancer, and she wonders if the website she's looking at is credible. What finding should make her suspicious of the content on the site? 1. There are no credentials listed after the authors' names. 2. The domain name of the site's web address ends in .edu. 3. The articles are from a current peer-reviewed journal 4. The study she's reading about was funded by the American Cancer Society.

1. There are no credentials listed after the authors' names. -Rationale: a source that does not list the authors' credentials is suspicious

core competencies

1. provide patient-centered care 2. Work in interdisciplinary teams 3. Employ evidence-based practice 4. Apply quality improvement principles 5. Utilize informatics

Which qualities are characteristic of a profession? Select all that apply. 1. specialized body of knowledge 2. High level of individual responsibility 3. potential for high pay 4. relatively high degree of autonomy 5. a code of ethics

1. specialized body of knowledge 2. High level of individual responsibility 4. relatively high degree of autonomy 5. a code of ethics According to the Characteristic Theory of Identifying a profession, the potential for high pay is NOT one of the key characteristics.

"Famous Trio" of first US nursing schools in

1872

Carla tells her supervisor that she wants to become an advanced practice nurse. Which statements of Carla's indicates a need for more information? (Chapter 4) 1. "When I am certified, I will be able to write some prescriptions" 2. "When I finish my MSN, I will be an advanced practice nurse" 3. "When I am an advanced practice nurse, I will continue to care for clients." 4. "Training as an advanced practice nurse is specialized."

2. "When I finish my MSN, I will be an advanced practice nurse" rationale: Advanced practice nurses receive specialized training, care for clients, and have some prescriptive authority. Receiving an MSN does NOT certify a person as an advanced practice nurse

For decades, Homans sign was used to assess for the presence of deep vein thrombosis (DVT) in the lower leg. However, after many studies called into question the risks involved with and the diagnostic value of Homans sign, it has fallen out of favor. What is this an example of? 1. Accustomed practice 2. Evidence-based practice 3. Specialized body of knowledge 4. A nursing intervention

2. Evidence based practice Rationale: Evidence based practice is nursing practice that is continually updated and refined with the latest research findings

An APRN discusses the possible causes of a clients' abnormal laboratory work with the client's physician. What source of power is the APRN demonstrating? 1. referent 2. expert 3. rewards 4. coercive

2. Expert power is power derived from knowledge, skill, expertise.

Reggie is doing online research for his nursing fundamentals class. In the article he's reading, several links that he has clicked on have shown the message, "Page not found." What should Reggie do next? 1. Stop clicking the links and keep reading 2. Find a more up-to-date source for his information 3. Write an angry email to the site's administrator 4. Click more links to see if they work

2. Find a more up-to-date source for his information Rationale: Having several links yield the message "page not found" indicates that the source is likely out of date. Reggie should not waste time clicking or reading further or contacting the site administrator. He should find a more current source.

Place the steps of developing an evidence-based practice in the order they should occur. 1. Evaluate effectiveness of current practice 2. Identify the goal of the intervention 3. Develop a plan to implement new findings 4. Train staff to use the new intervention 5. Search for practices that are demonstrably more effective

2. Identify the goal of the intervention \/\/\/\/\/\/\/ 1. Evaluate effectiveness of current practice \/\/\/\/\/\/\/ 5. Search for practices that are demonstrably more effective \/\/\/\/\/\/\/ 3. Develop a plan to implement new findings \/\/\/\/\/\/\/ 4. Train staff to use the new intervention

Which Institute of Medicine (IOM) competency is demonstrated by the nurse and the respiratory therapist coordinating care of a client hospitalized with an exacerbation of COPD? (Chapter 4) 1. Client-centered care 2. Interdisciplinary teamwork 3. Evidence-based practice 4. Quality improvement

2. Interdisciplinary teamwork has the goal of promoting communication about and coordination of client care among the various disciplines or departments caring for a client, such as social work, respiratory therapy, physical therapy, and home health.

Which of the following nursing leaders is best known for her work outside the field of nursing? (chapter 2) 1. Annie W. Goodrich 2. Loretta C. Ford 3. Lavinia Lloyd Dock 4. Lillian Wald

3. Lavinia Lloyd Dock Rationale: Lavinia Lloyd Dock lobbied for 20 years to secure the right to vote for American women.

What main concerns do nursing educators have about the DNP degree? (CH 4) 1. The DNP program is not as rigorous as the PhD program. 2. The DNP program will divert students from MSN programs. 3. The DNP program is a practice degree, not a teaching or administration degree. 4. The DNP program will cost significantly more than a PhD program.

3. The DNP program is a practice degree, not a teaching or administration degree. rationale: The DNP program is just as rigorous as a PhD program and costs about the same. While the DNP may divert some students from MSN programs, the greater concern is that nursing faculty with DNPs, not PhDs, do not have the training required for teaching or administering nursing programs.

Which historical thread explains the evolution of health-care providers from shamans & priests to nurses and physicians? (chapter 2) 1. The value place in individual life 2. The role of women in society 3. The beliefs about the causes of illness 4. The effects of large-scale war on society

3. The beliefs about the causes of illness Rationale: Before the development of scientific understanding of illness and disease, the most common explanation for these conditions was evil spirits or angry gods. So, the most suitable remedy was to enlist a holy man to cast out the spirits or appease the gods. As scientific knowledge during and after the Renaissance, physicians rather than priests became the preferred health-care providers.

Which factor was primarily responsible for the shift away from diploma schools of nursing? (Chapter 4) 1. The costs to hospitals of running diploma schools became to high. 2. Nurses trained in diploma schools were NOT as proficient as others. 3. Women were no longer limited in the types of professions they could choose. 4. Accreditation standards were developed that diploma schools could not or would not meet.

4. Accreditation standards were developed that diploma schools could not or would not meet. rationale: In order to standardize outcome criteria and course curricula, the National League for Nursing became responsible for accrediting schools of nursing

Some states require that APRNs practice under the license of a physician. What area of the nursing profession is being limited by these regulations? 1. Specialized body of knowledge 2. Public service and altruistic activities 3. A code of ethics that guides members in their practice 4. Autonomy and independence of practice

4. Autonomy and independence of practice Rationale: Requiring an APRN to practice under a physician's license rather than his or her own license is a limit on the APRN's autonomy and independence of practice. APRNs are still guided by a code of ethics, required to have a specialized body of knowledge, and encouraged to engage in public service.

Which statement BEST describes the relationship between the IOM competencies and the QSEN competencies? (Chapter 4) 1. The IOM competencies were based on a medical model, the QSEN competencies were based on a nursing model. 2. Only the IOM competencies address safety; the QSEN competencies do not. 3. Only the competencies are included in up-to-date nursing textbooks. 4. The IOM competencies were used to create the QSEN competencies to guide the development of nursing curricula.

4. The IOM competencies were used to create the QSEN competencies to guide the development of nursing curricula. rationale: The IOM competencies, which were based on a medical model, were used to create the QSEN competencies. The QSEN competencies include the competency of safety and are used to guide the development of nursing curricula.

Place the events in the development of nursing in the Christian church in the order in which they occurred. (chapter 2) 1. Monks and nuns, often with little training, cared for the poor and the sick. 2. After the Protestant Reformation, nursing care in countries that broke away from the Catholic Church fell into disarray. 3. During the Crusades, Knights Hospitallers cared for those who became sick or were wounded in battle. 4. Wealthy Roman women who had converted to Christianity established hospital-like institutions.

4. Wealthy Roman women who had converted to Christianity established hospital-like institutions. 1. Monks and nuns, often with little training, cared for the poor and the sick. 3. During the Crusades, Knights Hospitallers cared for those who became sick or were wounded in battle. 2. After the Protestant Reformation, nursing care in countries that broke away from the Catholic Church fell into disarray.

Whose scope of practice is NOT regulated by the state board of nursing? 1. registered nurse 2. licensed practical nurse 3. case manager 4. physician assistant

4. physician assistant is NOT Rationale: All levels of nursing practice from LPN to APRN and case manager are regulated by the state board of nursing

Margaret Sanger (chapter 2)

American leader of the movement to legalize birth control during the early 1900's. As a nurse in the poor sections of New York City, she had seen the suffering caused by unwanted pregnancy. Founded the first birth control clinic in the U.S. and the American Birth Control League, which later became Planned Parenthood.

Evaluate why nursing has failed to attain some of the traits that define a profession

Autonomy & Independence of Practice Professional Identity & Development

Stillman House (chapter 2)

Branch of the Henry Street Settlement serving "colored people"

Surgical procedures and midwifery documented as early as 1500 BC in __________ (chapter 2)

Egypt

Hippocrates (chapter 2)

Father of medicine concerned with ethical standards for physicians - Hippocratic oath

British woman labeled "Lady with the lamp" (chapter 2)

Florence Nightingale

Who was credited with the first educational system for nurses? (chapter 4)

Florence Nightingale

Who wrote Notes on Nursing: What it is and what is not? (chapter 2)

Florence Nightingale

______________ invaded the hospital run by the British Army with 37 of her best educated nurses and made massive changes in health outcomes. (chapter 2)

Florence Nightingale

Lillian Wald (chapter 2)

Founder of Henry Street Settlement House in NY and Founder of Public Health Nursing

Florence Nightingale (chapter 2)

Founder of modern nursing entered nursing at 30 founded the first training school for nurses in London in 1860

______________pushed for nursing education a the university level at a time when there were hardly any women in college. (chapter 2)

Hampton Robb

In what way did Hippocrates' beliefs about illness & medicine differ from those of other ancient Greek physician-priests? (chapter 2)

Hippocrates believed in treating the whole client, not just in appeasing the gods. =Hippocrates diagnosed illness on the basis of symptoms & treated the mind, body, spirit, and environment of the client

Challenges in Nursing Education

Inability of nursing programs to produce enough nurses to meet society's need as a result of several causes, including: -Lack of capacity in nursing schools -Faculty shortages due to retirement and low salaries Need to incorporate QSEN (Quality and Safety Education for Nurses) into all nursing education Need to transform nursing education for complex US health care needs -increased technological demands -need for multicultural practitioners -Cost-effectiveness of care should be emphasized -Increase the number of advanced practice nurses

______________ conceived and nurtured the role of advanced practice nurse (APN) despite strong objections from her physician colleagues. (chapter 2)

Loretta Ford -credited with founding the nurse practitioner (NP) practice

Who affirmed BSN as minimal educational level?

National League for Nursing in 1982

4 Advanced Practice Nursing (APN) categories

Nurse Practitioner (NP) Clinical Nurse Specialist (CNS) Certified Nurse Midwife (CNM) Certified Registered Nurse Anesthetist (CRNA)

Clara Barton (chapter 2)

Nurse during the Civil War; founder of the American Red Cross

The _______________ program prepares doctoral students to conduct the research that supports evidence-based nursing practice. (Chapter 4)

PhD rationale: PhD programs in nursing require the statistics courses and research-design courses and graduates will rely on to conduct the research that supports future evidence-based practice.

________________ is the ability or capacity to exert influence over another person or group of persons.

Power -Rationale: Power is the ability to get other people to do things even when they do not want to do them

Correlate the concept of power with its important characteristics

Power is best defined as the ability or capacity to exert influence over another person or group of persons -strong, positive attitude -highly motivated

Compare the three approaches to defining a profession

Process approach- determining where nursing is on the continuum line. Power Approach- how much independence of practice does this occupation have, how much power does this occupation control? Trait Approach- Common characteristics: high intellect, responsibility and accountability, specialized body of knowledge, higher education, public service and valued over financial gain, high degree of autonomy code of ethics, professional competency.

First American women to volunteer in nursing during the American Civil War: (chapter 2)

Sojourner Truth Harriet Tubman

Nursing's Social Policy Statement

This summarizes the nature of the social contract between the members of the nursing profession and society.

Dorothea Dix (chapter 2)

Union Army Superintendent of Women Nurses, champion for mental health

First BSN was in 1909 at the: (Chapter 4)

University of Minnesota

First baccalaureate nursing program

University of Minnesota in 1909

Baccalaureate Degree in Nursing

a degree from a 4-year nursing program in a higher education institution focus on: liberal arts, nursing science & clinical nursing skills, communication, decision-making, leadership, care patients in a variety of settings

collective power

a large group of individuals bound together is more powerful than one person

legitimate power

a legal right to make decisions for others

rewards power

ability to grant a reward for specific behaviors

In addition to their development of central heating, baths, and advanced systems for sewage disposal, the ancient Romans maintained the good health of citizens with ____________, which supplied clean water. (chapter 2)

aqueducts Rationale - Aqueducts to supply clean water and an advanced disposal system that kept sewage out of the clean water supply were essential to keeping the large population of Roman cities healthy.

expert power

based on the amount of knowledge or skill that a person has

Brown Report (1948)

by the Carnegie Foundation, recommended that basic schools of nursing be placed in universities and colleges

In 290 BC The Romans created the aqueduct which is a: (chapter 2)

clean water supply

Health Care in Ancient Times believed that _________ caused illness. (chapter 2)

evil spirits -health care was combined with religion

In 400 BC Hippocrates changed medical practices in Greece. This Emphasized _______________. Famous for emphasizing medical ethics (chapter 2)

holistic care

Which of these nursing leaders helped develop the American Journal of Nursing? (chapter 2) 1. Florence Nightingale 2. Isabel Adams Hampton Robb 3. Lillian Wald 4. Lavinia Lloyd Dock

isabel Adams Hampton Robb -believed in nurses having a strong academic & theoretical background for their practice

"graying" of the workforce

many starting second careers as nurses; this has slowed due to increasing #s of younger graduates

Continuing Education in Nursing

non-degree seeking ways to maintain expertise in nursing "life-long learning" -pursued by individual nurses -take place in variety of settings and available in many formats ANCC is responsible for standards of CE, accreditation of CE programs, transferability of CE from state to state and guidelines Nationwide need is for mandatory CE as a prerequisite for license renewal (required in all but 12 states and us territories) State requirements vary

The "earliest" nurses were: (chapter 2)

nuns

coercive power

opposite of rewards power; ability to withhold rewards, punish, etc

referent power

power that comes from subordinates' and coworkers' respect, admiration, and loyalty someone will do what you want due to the power of the relationship you have with them

Doctoral Education in Nursing

prepare for teaching as faculty in universities, administrators in nursing schools or large medical centers, researchers, and advanced practitioners divided into two categories: research focus (PhD) or Practice Focus (ND, DNP)

What was invented during the Renaissance (1300s AD)? (chapter 2)

the thermometer and microscope were invented. Many more "orders" of nursing nuns emerged

Nursing school

where every answer is correct; but you're still probably wrong

How can nurses increase their power?

•BE UNIFIED!! •Be politically active •Be accountable for our actions •Be PROFESSIONAL •Network with other nurses

Nurse Practitioner (NP)

•By 2015 all NPs were have a DNP •Amount of autonomy varies by state law --28 states: SBON has sole authority over NP practice --14 states: NPs have some supervision by MDs --8 states: MDs must supervise NP practice --37 states: NPs have prescriptive authority with some MD supervision --13 states: NPs have independent prescriptive authority •ANP, FNP, PNP, WHNP, NNNP, ACNP, GNP, PMHNP •Qualified to handle a wide range of health problems

Certified Registered Nurse Anesthetist (CRNA)

•MSN required; usually a 2-3 year long program •Work with MD anesthesiologists or independently •Research has shown no difference in care quality between MDs and CRNAs

Certified Nurse Midwife (CNM)

•Master's degree required as of 2010 •Provide well-woman care, assist with childbirth in birthing centers, home deliveries, or in hospitals •Research has shown comparable outcomes, lower costs, higher satisfactions in birthings attended by CNMs •Have prescriptive authority in all 50 states

Clinical Nurse Specialist (CNS)

•Master's or Doctorally prepared •Serve as experts in specialty areas, administrator positions •Usually do not have prescriptive authority •***Many want to combine CNS and NP into one role

Clinical Nurse Leader

•New credential as of 2008; still being piloted and researched •Master's-prepared nurses who manage care delivery •Not intended to be administrators •Nurse managers directly providing and overseeing care "at the bedside"

Barriers to Professionalism

•Variability in educational preparation --Professional versus technical nursing --Differing levels of education for RNs •Gender issues --Lack of balance between men and women --Persistent devaluing of "women's work" •Historical influences --Historical connections with religion and military...unquestioning obedience •External and internal conflicts --Conflicts with medicine....aim for collaboration NOT competition --Fragmentation between nursing subgroups

occupation

•a group of jobs usually found throughout an industry or work environment

job

•a group of positions that can be carried by an individual

position

•a group of tasks assigned to one individual

professional

•a person who belongs to and practices a profession.

profession

•a type of occupation that requires prolonged prep, formal qualifications, and meets higher level criteria

Professionalism

•demonstration of high-level of personal, ethical and kill characteristics of a member of a profession

What age and years were plagues, smallpox, leprosy, etc. present while Rome was still advancing care for the sick and poor? (chapter 2)

◦The Dark Ages (500-1000 AD)