What is Nux Vomica? State Board Questions From the Turn of the 20thCentury: An Era Gone By

  1. Have you ever wondered what the early NCLEX exams looked like? We will be exploring a sample of questions taken from a first edition Lippincott (1917 edition) nursing manual. They will give us a glimpse into a nurse's world at the turn of the century. I am excited about sharing this entry in the series “An Era Gone By” with you.

    What is Nux Vomica? State Board Questions From the Turn of the 20thCentury: An Era Gone By

    New England turned out the first formally trained nurse, Linda Richards in 1873 from New England Hospital for Women and Children Training School for Nurses. In 1873 the first nursing school in the U.S. was in New York at Bellevue Hospital that was grounded in Florence Nightingale's principles of nursing.

    Ida Jane Anderson was the first licensed nurse in 1904 out of Rochester. She was on the coattails of the Armstrong Act of 1903 when New York passed the required Registration of Nurses. Once the schools began to create a standard curriculum, regulation followed to become what we know in present day. Regulation and standardization help nursing to be professionalized and make sure that nursing students are taught according to standards that allow them to pass a state board exam.

    The content of state board exams are always being updated and it takes a long time to formulate one question. In the book, Lippincott's Nursing Manuals State Board Questions and Answers for Nurses by John Foote, M.D. we can find some questions that nurses in 1917 and after would have studied to pass their state boards.

    The book that I have the privilege to own, was once owned by an Edith Westhook. I found some typed notes she used to study along with a nurses' record she scribbled on from Philadelphia General Hospital. There was also a small envelope engraved "The Joseph Price Hospital 241 North 18th St. Philadelphia." I would love to have a conversation with Edith.

    Exam Question #1:

    "Name two preparations of nux vomica and give the dose of each. Answer -Tincture of nux vomica, dose to minims, extract of nux vomica, gr.⅙".

    This question gave me a headache, what is nux vomica? Nux vomica is a plant in which the seed is used as a supplement. Some of its uses are for heart and circulatory disorders, lung disease, Raynaud's disease, etc. This plant contains strychnine and has very ugly side effects such as anxiety, muscle spasms, convulsions, liver failure and death.

    Exam Question #2:

    "What is the dose of tincture of nux vomica and what is its action?

    Answer - Tincture of nux vomica is given in dosage from 8 to 15 minims. Its action is that of strychnia - a stimulant to the circulation, respiration and digestive organs, through its action on the spinal nerve centres" (yes, that is the spelling used in the book).

    Exam Question #3:

    "Describe method of giving hypodermatic injections.

    1. Scrub the skin well, preferably the outer part of the arm, with soap and water, followed by alcohol, or at least with alcohol alone, or paint the skin with ½ strength tincture of iodine.
    2. Place the needle in a tablespoon filled with water and boil it for two minutes over a flame from a stove or gas jet.
    3. Draw the hot water into the barrel of the syringe and return it several times to clean the syringe barrel. Boil the water again, fill the barrel with it, and empty excess from the spoon.
    4. Screw needle into syringe barrel, being careful to touch nothing but the base of the needle.
    5. Place a tablet in spoon, empty syringe on tablet, and draw solution again into the syringe.
    6. Hold syringe needle up and push piston until air is expelled from needle and a well formed drop appears at tip. PInch up a portion of cleaned skin which does not show any veins, insert the needle with a quick movement under the fold of raised skin, and expel the contents slowly, withdraw needle and gently massage the elevation produced. Wipe off puncture with alcohol.
    7. Rinse needle and syringe in water, followed by alcohol."

    Am I glad I don't have to worry about sanitizing a needle and the barrel of the syringe. Of course, there weren't the PPI standards we have today. Gloves are not spoken of, and needless to say, the chance of contamination was high with human error and shortcuts.

    We are very fortunate to live in the times that we do, and have the experience and information of all the nurses that come before us to implement into the standards we have now. If you want more early 1900 state board questions, tell me and I will share. I have a whole book of them!
    Last edit by Joe V on Jun 14
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    About Brenda F. Johnson, BSN, RN

    Joined: Oct '14; Posts: 231; Likes: 850
    RN at Gi Lab; from TN , US
    Specialty: 25 year(s) of experience in Gastrointestinal Nursing

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    16 Comments

  3. by   Buckeye.nurse
    This is amazing! More please
  4. by   Kitiger
    "We are very fortunate to live in the times that we do, and have the experience and information of all the nurses that come before us to implement into the standards we have now. If you want more early 1900 state board questions, tell me and I will share. I have a whole book of them!"

    Yes, I would love to hear more!
  5. by   klone
    Nux Vomica is still used as a homeopathic remedy. It used to be one of the components of the "Hyland's Kids' Kit" (not sure if that kit still exists).
  6. by   KatieMI
    Nux vomica is still used a lot on CAM, especially in aurvedic medicine. As the name says, it causes vomit which is supposed to "purge the body" of whatever thought to cause the disease. I'd seen liver failure caused by it once.
  7. by   Farawyn
    I LOVE THIS!!!

    My mom had a metal syringe in a case.
  8. by   amoLucia
    Love this kind of info!

    There is so much history out there that will soon be disappearing from our professional consciousness.

    Quicky quiz question. Anybody know who was the only nurse EVER EXECUTED for treason during war? Just for rendering nsg care to wounded soldiers regardless of their military affiliation.
  9. by   Brenda F. Johnson
    Quote from amoLucia
    Love this kind of info!

    There is so much history out there that will soon be disappearing from our professional consciousness.

    Quicky quiz question. Anybody know who was the only nurse EVER EXECUTED for treason during war? Just for rendering nsg care to wounded soldiers regardless of their military affiliation.
    Edith Cavell, right? I wrote an article on her. You can find it under my blog. Amazing story
  10. by   sevensonnets
    Brenda, you beat me to it. Edith Cavell during WWI.
  11. by   tnbutterfly
    Here is the article Brenda wrote about Edith Cavell

    Honoring Edith Cavell 101 Years Later
  12. by   dragonheart
    It would be interesting to research and share sativa and or indica treatment for ailments during that time period
  13. by   FSZ Student Nurse
    What a fun read! Thank you. Please do share more.

    I wonder which "Nursing Interventions" we use in 2018 will get chuckles from nurses (and nursing students) in 101 years...
  14. by   No Stars In My Eyes
    I have the entire course of a mail-order nurses-training course from 1936, presented in 53 Lessons, by The Chicago School of Nursing. Each lesson is followed by "Test Questions For Self-Examination". Then, every fourth lesson, "regular examination" questions are to be answered in writing and then mailed to the school for correction and grading. It doesn't seem that any clinical experiences were required by this course.

    Some interesting things from a list of "Don'ts:
    Don't bustle.
    Don't be fussy.
    Don't contradict your patient.
    Don't fail in being cheerful under all circumstances.
    Don't let your patient see that you are annoyed.
    Don't stir medicine with your finger.
    Don't taste either medicine or nourishment in the patient's presence. (HA!)

    I haven't gone through each lesson, but only skimmed certain parts. It is a real eye-opener!

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