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Nursing: A Concept-Based Approach to Learning Vol. 1 & 2, 3e (Pearson)
Module 7 Health, Wellness, and Illness
The Concept of Health, Wellness, Illness, and Injury
1) A nurse identifies the seven components of wellness as a useful tool in assessing health.
Which are some of the components of wellness? Select all that apply.
A) Physical
B) Environmental
C) Emotional
D) Financial
E) Spiritual
Answer: A, B, C, E
1
Copyright © 2019 Pearson Education, Inc.
Explanation: A) The physical component is the ability to carry out daily tasks, achieve fitness,
and generally practice positive lifestyle habits. The environmental component includes
influences such as food, water, and air. The emotional component is the ability to manage stress
and to express emotions appropriately. Finances are not one of the seven components of health.
The spiritual component is the belief in some force (nature, science, religion, or a higher power)
that serves to unite human beings and provide meaning and purpose to life.
B) The physical component is the ability to carry out daily tasks, achieve fitness, and generally
practice positive lifestyle habits. The environmental component includes influences such as food,
water, and air. The emotional component is the ability to manage stress and to express emotions
appropriately. Finances are not one of the seven components of health. The spiritual component
is the belief in some force (nature, science, religion, or a higher power) that serves to unite
human beings and provide meaning and purpose to life.
C) The physical component is the ability to carry out daily tasks, achieve fitness, and generally
D) The physical component is the ability to carry out daily tasks, achieve fitness, and generally
E) The physical component is the ability to carry out daily tasks, achieve fitness, and generally
Page Ref: 432-433
Cognitive Level: Remembering
Client Need/Sub: Health Promotion and Maintenance
Standards: QSEN Competencies: III.A.1. Demonstrate knowledge of basic scientific methods
and processes. | AACN Essential Competencies: IX.3. Implement holistic, patient-centered care
that reflects an understanding of human growth and development, pathophysiology,
pharmacology, medical management and nursing management across the health-illness
continuum, across lifespan, and in all healthcare settings. | NLN Competencies: Knowledge and
Science: Relationships between knowledge/science and quality and safe patient care. | Nursing
Process: Assessment
Learning Outcome: 7.1. Differentiate health, wellness, and the health continuum.
MNL LO: Analyze the concept of health, wellness, and illness and its application to nursing
care.
2
2) A nurse is preparing a workshop on the topics that are new to Healthy People 2020. Which of
the topic areas should the nurse plan to address? Select all that apply.
A) Adolescent Health
B) Genomics
C) Lesbian, Gay, Bisexual, and Transgender Health
D) Mental Health and Mental Disorders
E) Healthcare-Associated Infections
Answer: A, B, C, E
Explanation: A) Healthy People 2020 is organized into 42 topic areas with nearly 600 objectives
to improve health. Thirteen of these topics are new for Healthy People 2020. These topic areas
include: Adolescent Health; Genomics; Lesbian, Gay, Bisexual, and Transgender Health; and
Healthcare-Associated Infections. Mental Health and Mental Disorders is an old topic area.
B) Healthy People 2020 is organized into 42 topic areas with nearly 600 objectives to improve
health. Thirteen of these topics are new for Healthy People 2020. These topic areas include:
Adolescent Health; Genomics; Lesbian, Gay, Bisexual, and Transgender Health; and Healthcare-
Associated Infections. Mental Health and Mental Disorders is an old topic area.
C) Healthy People 2020 is organized into 42 topic areas with nearly 600 objectives to improve
D) Healthy People 2020 is organized into 42 topic areas with nearly 600 objectives to improve
E) Healthy People 2020 is organized into 42 topic areas with nearly 600 objectives to improve
Page Ref: 438
Process: Planning
Learning Outcome: 7.4. Describe the national vision of health promotion.
care.
3
3) The nurse is assessing a 24-year-old woman who recently found out she is pregnant. Which
factor would the nurse identify as the most likely source of a barrier to health promotion in this
client?
A) Age of the client
B) Presence of the client's mother during the appointment
C) Pregnancy occurred as a result of rape
D) First pregnancy (primigravida)
Answer: C
Explanation: A) The age of the mother, presence of the client's mother, and gravidity could all
be factors that promote a desire for health or cause the client to make unhealthy choices,
depending on the client's situation. However, most clients who are pregnant as a result of rape
will have both physical and emotional barriers to health promotion.
B) The age of the mother, presence of the client's mother, and gravidity could all be factors that
promote a desire for health or cause the client to make unhealthy choices, depending on the
client's situation. However, most clients who are pregnant as a result of rape will have both
physical and emotional barriers to health promotion.
C) The age of the mother, presence of the client's mother, and gravidity could all be factors that
D) The age of the mother, presence of the client's mother, and gravidity could all be factors that
Page Ref: 438
Cognitive Level: Applying
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of
patient-centered care: Patient/family/community preferences, values; Coordination and
integration of care; Information, communication, and education; Physical comfort and emotional
support; Involvement of family and friends Transition and continuity. | AACN Essential
Competencies: IX.7. Provide appropriate patient teaching that reflects developmental state, age,
culture, spirituality, patient preferences, and health literacy considerations to foster patient
engagement in their care. | NLN Competencies: Relationship Centered Care: Effective
communication. | Nursing Process: Evaluation
care.
4
4) While teaching a class on health status, the nurse educator reviews internal variables that
affect health status. Which internal variables are appropriate for the nurse to include in the class?
Select all that apply.
A) Gender
B) Diet
C) Exercise regimen
D) Developmental level
E) Age
Answer: A, D, E
Explanation: A) Internal variables are often described as non-modifiable because, for the most
part, they cannot be changed. Examples of internal variables include gender, developmental
level, and age. In contrast, external variables, such as diet and exercise, are easily modified for
most clients.
B) Internal variables are often described as non-modifiable because, for the most part, they
cannot be changed. Examples of internal variables include gender, developmental level, and age.
In contrast, external variables, such as diet and exercise, are easily modified for most clients.
C) Internal variables are often described as non-modifiable because, for the most part, they
D) Internal variables are often described as non-modifiable because, for the most part, they
E) Internal variables are often described as non-modifiable because, for the most part, they
Page Ref: 441
Process: Planning
Learning Outcome: 7.5. Differentiate variables influencing health choices.
care.
5
5) A nurse is teaching a couples' class at a local community center about building positive
relationships. Today's session is on learning skills to be open-minded and respectful to those with
opposing opinions. Based on this data, on which component of wellness is the nurse focusing
this session?
A) Physical
B) Social
C) Environment
D) Emotional
Answer: B
Explanation: A) The social component of wellness focuses on the ability to interact successfully
with people and within the environment of which each person is a part, to develop and maintain
intimacy with significant others, and to develop respect and tolerance for those with differing
opinions and beliefs. The physical, environmental, and emotional components focus on other life
skills.
B) The social component of wellness focuses on the ability to interact successfully with people
and within the environment of which each person is a part, to develop and maintain intimacy
with significant others, and to develop respect and tolerance for those with differing opinions and
beliefs. The physical, environmental, and emotional components focus on other life skills.
C) The social component of wellness focuses on the ability to interact successfully with people
D) The social component of wellness focuses on the ability to interact successfully with people
Page Ref: 433
Client Need/Sub: Psychosocial Integrity
Learning Outcome: 7.1. Differentiate health, wellness, and the health continuum.
care.
6
6) The nurse is providing teaching related to health promotion for a group of older adults.
Several individuals describe their current health status. Which client is most in need of additional
information related to health promotion?
A) A client who states that her daughter takes her to all of her medical appointments
B) A client who states she was recently diagnosed with Parkinson disease
C) A client who states that she walks five times a week at the community center to help prevent
osteoporosis
D) A client who states that her husband has been suffering from hypertension for the past 12
years
Answer: B
7
Explanation: A) Although all clients, regardless of age and health status, can benefit from
teaching about health promotion, individuals who have recently been diagnosed with a chronic
illness, such as Parkinson disease, will require additional teaching related to health promotion
that is specific to their condition. The other clients appear to have positive support systems or
social activities that help promote health related to their conditions, or they have considerable
experience dealing with health conditions of family members.
B) Although all clients, regardless of age and health status, can benefit from teaching about
health promotion, individuals who have recently been diagnosed with a chronic illness, such as
Parkinson disease, will require additional teaching related to health promotion that is specific to
their condition. The other clients appear to have positive support systems or social activities that
help promote health related to their conditions, or they have considerable experience dealing
with health conditions of family members.
C) Although all clients, regardless of age and health status, can benefit from teaching about
D) Although all clients, regardless of age and health status, can benefit from teaching about
Page Ref: 448
Cognitive Level: Analyzing
care.
8
7) The nurse conducts teaching for a client recently diagnosed with type 2 diabetes mellitus. At
the conclusion of the session, which client statement indicates that teaching has been effective?
A) "I will take medication for a week for this acute illness."
B) "I will have to take insulin for this disease every day for the rest of my life."
C) "This chronic disease will become worse and lead to death."
D) "I will have to make dietary changes to manage this chronic disease."
Answer: D
Explanation: A) The client is aware that dietary changes will be needed to manage this chronic
disease, indicating that the client understands the teaching the nurse provided. Not all clients
diagnosed with type 2 diabetes mellitus require medication, such as insulin, to manage the
disease process. Diabetes is chronic, not acute. Depending on the client's response to the disease,
the outcome may not become worse or lead to death.
B) The client is aware that dietary changes will be needed to manage this chronic disease,
indicating that the client understands the teaching the nurse provided. Not all clients diagnosed
with type 2 diabetes mellitus require medication, such as insulin, to manage the disease process.
Diabetes is chronic, not acute. Depending on the client's response to the disease, the outcome
may not become worse or lead to death.
C) The client is aware that dietary changes will be needed to manage this chronic disease,
D) The client is aware that dietary changes will be needed to manage this chronic disease,
Page Ref: 434—435
Cognitive Level: Evaluating
Process: Evaluation
Learning Outcome: 7.2. Explain illness and injury and their effects on clients and families.
care.
9
8) An occupational health nurse for a large corporation is planning programs to address health
problems identified in the Healthy People 2020 report. Which programs should the nurse include
for the company employees at the worksite? Select all that apply.
A) A blood disorder and blood safety education program
B) A seminar about the components of wellness
C) A cultural competence program related to LGBT health
D) An informational program about genomics
E) An education program about the importance of sleep health
Answer: A, B, C, E
10
Explanation: A) Healthy People 2020 identifies a variety of programs that can be used to
promote health at the worksite. Specific programs should address components that may affect
work productivity, safety, and cohesion among workers, and may include blood disorders,
wellness, LGBT health, and sleep health, among many others. Information about genomics is not
relevant to the worksite.
B) Healthy People 2020 identifies a variety of programs that can be used to promote health at the
worksite. Specific programs should address components that may affect work productivity,
safety, and cohesion among workers, and may include blood disorders, wellness, LGBT health,
and sleep health, among many others. Information about genomics is not relevant to the
worksite.
C) Healthy People 2020 identifies a variety of programs that can be used to promote health at the
worksite.
D) Healthy People 2020 identifies a variety of programs that can be used to promote health at the
worksite.
E) Healthy People 2020 identifies a variety of programs that can be used to promote health at the
worksite.
Page Ref: 437
care.
11
9) After conducting a physical assessment for an adult client, the nurse discusses the assessment
with a coworker and states that the client's beliefs and actions regarding common health practices
are unfamiliar to her. Based on this data, which action by the nurse is the most appropriate?
A) Repeat the assessment later in the day.
B) Determine the culture with which the client identifies.
C) Write a nursing diagnosis to address the unfamiliar beliefs and actions.
D) Communicate the findings to the healthcare team.
Answer: B
Explanation: A) A thorough assessment that includes assessment of cultural beliefs and
practices is needed before proceeding with other steps of the nursing process. Behavior that is
considered uncommon in one cultural context may be considered desirable in another. Repeating
the assessment will most likely result in the same incomplete data. Writing a nursing diagnosis or
communicating findings before investigating the client's culture would be premature.
B) A thorough assessment that includes assessment of cultural beliefs and practices is needed
before proceeding with other steps of the nursing process. Behavior that is considered
uncommon in one cultural context may be considered desirable in another. Repeating the
assessment will most likely result in the same incomplete data. Writing a nursing diagnosis or
C) A thorough assessment that includes assessment of cultural beliefs and practices is needed
D) A thorough assessment that includes assessment of cultural beliefs and practices is needed
Page Ref: 442
Client Need/Sub: Psychosocial Integrity
Learning Outcome: 7.5 Differentiate variables influencing health choices.
care.
12
10) For a client with chronic obstructive pulmonary disease (COPD), the nurse may provide
health promotion teaching about what other major health concept?
A) Safety
B) Elimination
C) Immunity
D) Development
Answer: A
Explanation: A) COPD often develops as a result of years of smoking, and one common therapy
is oxygen administration. The combination of smoking and oxygen increases the client's risk for
safety related to fire hazards. COPD does not commonly cause changes in elimination,
immunity, or development.
B) COPD often develops as a result of years of smoking, and one common therapy is oxygen
administration. The combination of smoking and oxygen increases the client's risk for safety
related to fire hazards. COPD does not commonly cause changes in elimination, immunity, or
development.
C) COPD often develops as a result of years of smoking, and one common therapy is oxygen
development.
D) COPD often develops as a result of years of smoking, and one common therapy is oxygen
development.
Page Ref: 435
Process: Implementation
Learning Outcome: 7.3. Outline the concepts related to health, wellness, illness, and injury.
care.
13
11) Which nursing intervention exemplifies the nurse working in a health promotion role? Select
all that apply.
A) Administering a prescribed antibiotic
B) Reinforcing desirable changes to the client's lifestyle
C) Administering vaccines to a well child
D) Administering an inhaler to a client with asthma
E) Obtaining a blood glucose sample on a client with hypoglycemia
Answer: B, C
Explanation: A) The nurse acting in a health promotion role is performing interventions to
prevent disease. Reinforcing desirable changes to the client's lifestyle and administering vaccines
to a well child exemplify health promotion. Administering an ordered antibiotic or inhaler to a
client and obtaining a blood glucose sample from a symptomatic client exemplify nursing
interventions that are in response to disease or illness.
B) The nurse acting in a health promotion role is performing interventions to prevent disease.
Reinforcing desirable changes to the client's lifestyle and administering vaccines to a well child
exemplify health promotion. Administering an ordered antibiotic or inhaler to a client and
obtaining a blood glucose sample from a symptomatic client exemplify nursing interventions that
are in response to disease or illness.
C) The nurse acting in a health promotion role is performing interventions to prevent disease.
D) The nurse acting in a health promotion role is performing interventions to prevent disease.
E) The nurse acting in a health promotion role is performing interventions to prevent disease.
Page Ref: 437-439
care.
14
12) A community health nurse is educating a group of clients on the difference between illness
and disease. Which statements are appropriate for the nurse to include in the educational session?
A) "An individual can have a disease and not feel ill."
B) "Illness is synonymous with disease."
C) "Illness is an alteration in body function, where disease is highly subjective."
D) "An individual can feel ill without disease."
E) "Illness and disease are never related to one another."
Answer: A, D
15
Explanation: A) Illness is a highly personal state in which the individual's physical, emotional,
intellectual, social, developmental, or spiritual functioning is diminished. It is not synonymous
with disease and may or may not be related to disease. One individual can have a disease, such as
a growth in the stomach, and not feel ill. Another individual can feel ill–that is, feel
uncomfortable–and yet have no discernible disease. Disease can be described as an alteration in
body functions that reduces the capacities or shortens the normal lifespan.
B) Illness is a highly personal state in which the individual's physical, emotional, intellectual,
social, developmental, or spiritual functioning is diminished. It is not synonymous with disease
and may or may not be related to disease. One individual can have a disease, such as a growth in
the stomach, and not feel ill. Another individual can feel ill–that is, feel uncomfortable–and yet
have no discernible disease. Disease can be described as an alteration in body functions that
reduces the capacities or shortens the normal lifespan.
C) Illness is a highly personal state in which the individual's physical, emotional, intellectual,
D) Illness is a highly personal state in which the individual's physical, emotional, intellectual,
E) Illness is a highly personal state in which the individual's physical, emotional, intellectual,
Page Ref: 434
Learning Outcome: 7.2. Explain illness and injury and their effects on clients and families.
care.
16
13) A critical nursing concept that a nurse uses with every client that allows the nurse to identify
habits of health and wellness and the effects of illness and injury is
A) assessment.
B) collaboration.
C) teaching and learning.
D) advocacy.
Answer: A
Explanation: A) As the first step in the nursing process, the nurse will use assessment with every
client to identify habits of health and wellness and the effects of illness and injury. Nurses will
use the concepts of collaboration, teaching and learning, and advocacy for many clients, but
these concepts do not help identify healthy habits or the effects of illness and injury.
B) As the first step in the nursing process, the nurse will use assessment with every client to
identify habits of health and wellness and the effects of illness and injury. Nurses will use the
concepts of collaboration, teaching and learning, and advocacy for many clients, but these
concepts do not help identify healthy habits or the effects of illness and injury.
C) As the first step in the nursing process, the nurse will use assessment with every client to
D) As the first step in the nursing process, the nurse will use assessment with every client to
Page Ref: 436
Client Need/Sub: Physiological Integrity: Basic Care and Comfort
Standards: QSEN Competencies: I.B.1 Elicit patient values, preferences and expressed needs as
part of clinical interview, implementation of care plan and evaluation of care. | AACN Essential
Competencies: IX.3. Implement holistic, patient-centered care that reflects an understanding of
human growth and development, pathophysiology, pharmacology, medical management and
nursing management across the health-illness continuum, across lifespan, and in all healthcare
settings. | NLN Competencies: Relationship Centered Care: Factors that contribute to or threaten
health. | Nursing Process: Assessment
Learning Outcome: 7.3. Outline the concepts related to health, wellness, illness, and injury.
care.
17
14) For many clients, health promotion requires nursing assessment of and implementation of
changes in
A) culture.
B) lifestyle.
C) spiritual beliefs.
D) socioeconomic status.
Answer: B
Explanation: A) Health promotion involves nursing assessment of a client's lifestyle and
implementation of needed changes to that lifestyle. Examples include assessing and
implementing changes in habits related to smoking, diet, and exercise. The nurse is responsible
for assessing culture, spiritual beliefs, and socioeconomic status and how those factors influence
health promotion, but the nurse is not responsible for promoting changes to those factors.
B) Health promotion involves nursing assessment of a client's lifestyle and implementation of
needed changes to that lifestyle. Examples include assessing and implementing changes in habits
related to smoking, diet, and exercise. The nurse is responsible for assessing culture, spiritual
beliefs, and socioeconomic status and how those factors influence health promotion, but the
nurse is not responsible for promoting changes to those factors.
C) Health promotion involves nursing assessment of a client's lifestyle and implementation of
D) Health promotion involves nursing assessment of a client's lifestyle and implementation of
Page Ref: 436, 444
Standards: QSEN Competencies: I.B.10 Engage patients or designated surrogates in active
partnerships that promote health, safety and well-being, and self-care management. | AACN
Essential Competencies: VII.4. Use behavioral change techniques to promote health and manage
illness. | NLN Competencies: Relationship Centered Care: Factors that contribute to or threaten
health. | Nursing Process: Assessment, Implementation
Learning Outcome: 7.6. Apply the nursing process to identify health promotion needs.
care.
18
15) A nursing diagnosis that indicates that a client wants to implement steps to promote health
and wellness usually includes the word(s)
A) impaired.
B) ineffective.
C) risk for.
D) readiness for.
Answer: D
Explanation: A) Nursing diagnoses that indicate that a client wants to implement steps to
promote health and wellness usually include the words "readiness for," such as readiness for
enhanced coping, readiness for enhanced health management, or readiness for enhanced
parenting. Diagnoses that include the words "impaired" or "ineffective" refer to a disease
process, and diagnoses that include the words "risk for" indicate that the client has an increased
probability of developing complications related to their condition.
B) Nursing diagnoses that indicate that a client wants to implement steps to promote health and
wellness usually include the words "readiness for," such as readiness for enhanced coping,
readiness for enhanced health management, or readiness for enhanced parenting. Diagnoses that
include the words "impaired" or "ineffective" refer to a disease process, and diagnoses that
include the words "risk for" indicate that the client has an increased probability of developing
complications related to their condition.
C) Nursing diagnoses that indicate that a client wants to implement steps to promote health and
D) Nursing diagnoses that indicate that a client wants to implement steps to promote health and
Page Ref: 445
Cognitive Level: Understanding
Standards: QSEN Competencies: I.B.10. Engage patients or designated surrogates in active
Essential Competencies: IX.3. Implement holistic, patient-centered care that reflects an
understanding of human growth and development, pathophysiology, pharmacology, medical
management and nursing management across the health-illness continuum, across lifespan, and
in all healthcare settings. | NLN Competencies: Relationship Centered Care: Factors that
contribute to or threaten health. | Nursing Process: Diagnosis
Learning Outcome: 7.6. Apply the nursing process to identify health promotion needs.
care.
19
Exemplar 7.A Physical Fitness and Exercise
1) Physical activity and exercise improve the functioning of many body systems. Exercise
improves what normal body function of the gastrointestinal system?
A) Use of fatty acids
B) Insulin responsiveness
C) Peristalsis
D) Metabolic rate
Answer: C
Explanation: A) Exercise increases peristalsis in the gastrointestinal system, improving
movement of substances through the GI tract and increasing elimination of fecal matter. Use of
fatty acids, insulin responsiveness, and metabolic rate all also improve with exercise, but they are
related to effects on the endocrine system, not the gastrointestinal system.
B) Exercise increases peristalsis in the gastrointestinal system, improving movement of
substances through the GI tract and increasing elimination of fecal matter. Use of fatty acids,
insulin responsiveness, and metabolic rate all also improve with exercise, but they are related to
effects on the endocrine system, not the gastrointestinal system.
C) Exercise increases peristalsis in the gastrointestinal system, improving movement of
D) Exercise increases peristalsis in the gastrointestinal system, improving movement of
Page Ref: 448

Client Need/Sub: Physiological Integrity: Physiological Adaptation
Process: Assessment
Learning Outcome: 7.A.3. Analyze physical fitness and exercise as they relate to health,
wellness, illness, and injury. Outline the effects of exercise on body systems.
care.
20
2) A nurse is providing wellness teaching to a client who is interested in beginning an exercise
program to reduce certain health risks. The nurse determines that the client understands the
teaching when the client selects which health risks that can be reduced by regular exercise?
A) Liver disease
B) Type 2 diabetes
C) Cardiovascular disease
D) Falling
E) Renal disease
Answer: B, C, D
Explanation: A) Regular physical activity results in a decreased risk of cardiovascular disease,
type 2 diabetes, and falling. It does not decrease the risk of liver or renal disease.
B) Regular physical activity results in a decreased risk of cardiovascular disease, type 2 diabetes,
and falling. It does not decrease the risk of liver or renal disease.
C) Regular physical activity results in a decreased risk of cardiovascular disease, type 2 diabetes,
D) Regular physical activity results in a decreased risk of cardiovascular disease, type 2 diabetes,
E) Regular physical activity results in a decreased risk of cardiovascular disease, type 2 diabetes,
Page Ref: 448
Client Need/Sub: Physiological Integrity: Reduction of Risk Potential
Process: Evaluation
wellness, illness, and injury. Describe the benefits of physical fitness.
care.
21
3) The nurse is providing care to an older adult client who was recently diagnosed with early
osteoporosis. Which intervention is most appropriate for the nurse to implement with this client?
A) Providing the client with assisted range of motion exercising twice daily
B) Instituting an exercise plan that includes weight-bearing activities
C) Protecting the client's bones with strict bedrest
D) Increasing the amount of calcium in the client's diet
Answer: B
22
Explanation: A) Osteoporosis is a demineralization of the bone in which calcium leaves the
bone matrix. One causative factor is lack of weight-bearing activity. Weight bearing helps to
move calcium back into the bone, thereby strengthening it. A standard intervention for those
attempting to prevent or reverse osteoporosis is beginning an exercise plan that includes weight-
bearing activities. Additional calcium in the diet after osteoporosis has begun is not thought to be
effective. Strict bedrest may well make the osteoporosis worse because there is no weight-
bearing activity. Assisted range of motion exercises are not weight bearing and do not help delay
or reverse osteoporosis.
B) Osteoporosis is a demineralization of the bone in which calcium leaves the bone matrix. One
causative factor is lack of weight-bearing activity. Weight bearing helps to move calcium back
into the bone, thereby strengthening it. A standard intervention for those attempting to prevent or
reverse osteoporosis is beginning an exercise plan that includes weight-bearing activities.
Additional calcium in the diet after osteoporosis has begun is not thought to be effective. Strict
bedrest may well make the osteoporosis worse because there is no weight-bearing activity.
Assisted range of motion exercises are not weight bearing and do not help delay or reverse
osteoporosis.
C) Osteoporosis is a demineralization of the bone in which calcium leaves the bone matrix. One
osteoporosis.
D) Osteoporosis is a demineralization of the bone in which calcium leaves the bone matrix. One
osteoporosis.
Page Ref: 450
wellness, illness, and injury. Outline the effects of exercise on body systems.
care.
23
4) A school nurse is reviewing the physical activity for adolescent high school students. Which
student has met the outcome for physical activity set by the Centers for Disease Control and
Prevention (CDC)?
A) An 18-year-old who speed-walks 60 minutes once per week
B) A 16-year-old who lifts moderately heavy weights for 15 minutes 3 times per week
C) A 15-year-old who runs at a fast pace for 20 minutes 2 times per week
D) A 17-year-old who alternates aerobic activities for 60 minutes daily and lifts weights 2 times
per week
Answer: D
Explanation: A) The recommendations for physical activity for adolescents are 60 minutes of
physical activity almost every day, with vigorous activity at least 3 days per week and inclusion
of muscle strengthening activities. Only the adolescent who alternates aerobic activities for 60
minutes daily and lifts weights 2 times per week fits the referenced criteria.
B) The recommendations for physical activity for adolescents are 60 minutes of physical activity
almost every day, with vigorous activity at least 3 days per week and inclusion of muscle
strengthening activities. Only the adolescent who alternates aerobic activities for 60 minutes
daily and lifts weights 2 times per week fits the referenced criteria.
C) The recommendations for physical activity for adolescents are 60 minutes of physical activity
D) The recommendations for physical activity for adolescents are 60 minutes of physical activity
Page Ref: 451
wellness, illness, and injury. Summarize the recommendations for physical activity across the
lifespan.
care.
24
5) The pulmonary rehabilitation nurse is teaching a group of clients about both isotonic and
isometric exercises. At the conclusion of the session, which client statements indicate effective
teaching has occurred? Select all that apply.
A) "Isotonic exercises are also called dynamic exercises."
B) "Isotonic exercises are static movements."
C) "Isometric exercises involve exerting pressure against a solid object."
D) "Isotonic exercises produce a mild increase in heart rate and cardiac output, but no
appreciable increase in blood flow to other parts of the body."
E) "Isometric exercises are useful for endurance training."
Answer: A, C, E
Explanation: A) In isotonic exercises, which are dynamic exercises, the muscle shortens to
produce muscle contraction and active movement. Isometric exercises, which are static exercises,
involve exerting pressure against a solid object. Isometric exercises produce a mild increase in
heart rate and cardiac output, but no appreciable increase in blood flow to other parts of the
body. Isometric exercises are useful for endurance training.
B) In isotonic exercises, which are dynamic exercises, the muscle shortens to produce muscle
contraction and active movement. Isometric exercises, which are static exercises, involve
exerting pressure against a solid object. Isometric exercises produce a mild increase in heart rate
and cardiac output, but no appreciable increase in blood flow to other parts of the body.
Isometric exercises are useful for endurance training.
C) In isotonic exercises, which are dynamic exercises, the muscle shortens to produce muscle
D) In isotonic exercises, which are dynamic exercises, the muscle shortens to produce muscle
25
E) In isotonic exercises, which are dynamic exercises, the muscle shortens to produce muscle
Page Ref: 448
Process: Evaluation
wellness, illness, and injury. Contrast the types of exercise.
care.
6) A nurse is caring for a 50-year-old client performing aerobic exercise in the cardiac
rehabilitation office. The nurse calculates the client's target heart rate as ________-________.
Answer: 102 beats per minute (BPM); 145 beats per minute (BPM)
Explanation: Target heart rate can be obtained by an equation: (220 - client’s age) × 60% and
85%.
So 220 - 50 = 170. 170 × 0.60 = 102 BPM. 170 × 0.85 = 145 BPM.
Page Ref: 449
wellness, illness, and injury. Contrast the types of exercise.
care.
26
7) The nurse is planning physical fitness and exercise recommendations for a 27-year-old
pregnant woman at 16 weeks' gestation. The woman states that before becoming pregnant, she
ran 3.5 to 4 miles on four days per week at a pace of 11 minutes per mile. She enjoys competing
in 5K races and has a goal to complete a 10K race before the age of 30. Which exercise
recommendation should the nurse include for this client at this stage of her pregnancy?
A) Continue exercising the same amount of time, but decrease the intensity of the workout to a
jog or walk
B) Continue engaging in vigorous activity as much as possible, with a goal of at least 150
minutes of moderate to vigorous activity per week
C) Decrease the amount of exercise to 30 minutes three times per week, engaging in moderate to
vigorous activity
D) Increase the amount of exercise to 60 minutes on most days of the week, most of it aerobic
exercise
Answer: B
27
Explanation: A) Pregnant women should engage in at least 150 minutes of moderate physical
activity each week. They can engage in vigorous physical activity if that is already part of their
routine. The intensity of the workout may need to decrease as she progresses through the
pregnancy, but at 16 weeks' gestation, she should be able to continue her normal vigorous
exercise routine. Decreasing the amount of exercise is not recommended. Engaging in aerobic
exercise for 60 minutes on most days of the week is recommended for children ages 6 to 17
years, not pregnant women.
B) Pregnant women should engage in at least 150 minutes of moderate physical activity each
week. They can engage in vigorous physical activity if that is already part of their routine. The
intensity of the workout may need to decrease as she progresses through the pregnancy, but at 16
weeks' gestation, she should be able to continue her normal vigorous exercise routine.
Decreasing the amount of exercise is not recommended. Engaging in aerobic exercise for 60
minutes on most days of the week is recommended for children ages 6 to 17 years, not pregnant
women.
C) Pregnant women should engage in at least 150 minutes of moderate physical activity each
women.
D) Pregnant women should engage in at least 150 minutes of moderate physical activity each
women.
Page Ref: 451
Standards: QSEN Competencies: I.B.10. Engage patients or designated surrogates in active
Essential Competencies: IX.3. Implement holistic, patient-centered care that reflects an
understanding of human growth and development, pathophysiology, pharmacology, medical
management and nursing management across the health-illness continuum, across lifespan, and
in all healthcare settings. | NLN Competencies: Knowledge and Science: Relationships between
knowledge/science and quality and safe patient care. | Nursing Process: Planning
wellness, illness, and injury. Summarize the recommendations for physical activity across the
lifespan.
care.
28
Exemplar 7.B Oral Health
1) A young school-age child is seen in a pediatric clinic for a well-child checkup. The parent tells
the nurse that they live in the country and use well water. Based on this data, which statement by
the nurse is the priority when conducting client teaching?
A) "Your child will need to use a teeth whitener in the future because well water is your primary
water source."
B) "Your child will need to be placed on a fluoride supplement because your primary water
source is from a well."
C) "I will recommend some mouthwashes that are appropriate for clients who drink well water."
D) "It will be very important that your child does not eat sugary foods because you drink well
water."
Answer: B
29
Explanation: A) Teeth whitener or special mouthwashes are not required for a child who drinks
well water. Inquire about use of fluoride if the water supply is not fluoridated. Well water does
not contain fluoride. Refraining from sugary foods is not necessary just because the child's
primary drinking source is from a well. While the nurse may teach about the effect of sugary
foods on teeth, the priority would be to teach about fluoride, since this family's water supply
does not provide it.
B) Teeth whitener or special mouthwashes are not required for a child who drinks well water.
Inquire about use of fluoride if the water supply is not fluoridated. Well water does not contain
fluoride. Refraining from sugary foods is not necessary just because the child's primary drinking
source is from a well. While the nurse may teach about the effect of sugary foods on teeth, the
priority would be to teach about fluoride, since this family's water supply does not provide it.
C) Teeth whitener or special mouthwashes are not required for a child who drinks well water.
D) Teeth whitener or special mouthwashes are not required for a child who drinks well water.
Page Ref: 454
Learning Outcome: 7.B.3. Analyze oral health as it relates to health, wellness, illness, and
injury. Describe the significance of oral hygiene across the lifespan.
care.
30
2) The portion of the tooth that wears away, allowing dental decay, is the
A) pulp cavity.
B) enamel.
C) gingiva.
D) root.
Answer: B
Explanation: A) Enamel is a hard substance that covers the outside of the tooth to protect it from
damage and decay. Enamel wears away over time, allowing dental damage and decay in the form
of dental caries. The pulp cavity and root are also parts of the tooth, and they most often become
damaged after the enamel has worn away. Gingiva is another term for gums; the gums are not
part of the teeth but instead help cover the roots and hold the teeth in place.
B) Enamel is a hard substance that covers the outside of the tooth to protect it from damage and
decay. Enamel wears away over time, allowing dental damage and decay in the form of dental
caries. The pulp cavity and root are also parts of the tooth, and they most often become damaged
after the enamel has worn away. Gingiva is another term for gums; the gums are not part of the
teeth but instead help cover the roots and hold the teeth in place.
C) Enamel is a hard substance that covers the outside of the tooth to protect it from damage and
D) Enamel is a hard substance that covers the outside of the tooth to protect it from damage and
Page Ref: 453
Process: Assessment
Learning Outcome: 7.B.1. Describe the functions of the oral cavity and normal oral health.
care.
31
3) A nurse is caring for a client in the intensive care unit who is intubated and mechanically
ventilated. Upon assessment, the nurse notes the client has cheilosis. Based on this data, which is
the priority intervention for this client?
A) Checking for ill-fitting dentures
B) Suggesting an increase in fluid intake
C) Providing oral care
D) Lubricating the lips using an antimicrobial ointment
Answer: D
Explanation: A) Cheilosis is when the lips are cracked. The priority nursing intervention for this
client is to lubricate the lips with antimicrobial ointment to prevent infection. The nurse will also
provide oral care; however, the lip ointment takes priority. Checking for ill-fitting dentures is
appropriate for a client with reddened or excoriated mucosa. Suggesting an increase to the
client's fluid intake would be appropriate for a client with dry mucous membranes.
B) Cheilosis is when the lips are cracked. The priority nursing intervention for this client is to
lubricate the lips with antimicrobial ointment to prevent infection. The nurse will also provide
oral care; however, the lip ointment takes priority. Checking for ill-fitting dentures is appropriate
for a client with reddened or excoriated mucosa. Suggesting an increase to the client's fluid
intake would be appropriate for a client with dry mucous membranes.
C) Cheilosis is when the lips are cracked. The priority nursing intervention for this client is to
D) Cheilosis is when the lips are cracked. The priority nursing intervention for this client is to
Page Ref: 454
pharmacology, medical management, and nursing management across the health-illness
injury. Identify commonly occurring alterations in oral health.
care.
32
4) A nurse is caring for a client with glossitis secondary to nutritional deficiencies. Based on this
data, which is the priority focus of this client's care?
A) Upper lip
B) Upper teeth
C) Uvula
D) Tongue
Answer: D
Explanation: A) Glossitis is the inflammation of the tongue and does not involve the lips, teeth,
or uvula.
B) Glossitis is the inflammation of the tongue and does not involve the lips, teeth, or uvula.
C) Glossitis is the inflammation of the tongue and does not involve the lips, teeth, or uvula.
D) Glossitis is the inflammation of the tongue and does not involve the lips, teeth, or uvula.
Page Ref: 454
injury. Identify commonly occurring alterations in oral health.
care.
33
5) A pediatric nurse is caring for a toddler at a well-child clinic. When providing education
regarding the client's oral health, which topics are appropriate for the nurse to include? Select all
that apply.
A) Instructions on avoiding prolonged bottle feeding during naps and at bedtime.
B) Instructions on brushing the client's teeth once daily.
C) Hazards of fluoride use in tooth development.
D) Instructions on eliminating the client's milk consumption.
E) Instructing the parents that the client needs dental care prior to when the client begins to lose
the primary teeth.
Answer: A, E
Explanation: A) Many parents are unaware of the importance of dental health in very young
children. They may see their child's teeth as "baby teeth" and think they can put off dental visits
until the child begins to lose the primary teeth. Nurses working with parents of very young
children may need to help parents learn that care of primary teeth is essential to healthy
permanent teeth. The client's teeth should be brushed after meals. Prolonged bottle feeding
should be avoided because it can contribute to dental caries. The client does not need to
eliminate milk consumption. Fluoride should be used for those with non-fluoridated water and
does not pose a risk in tooth development.
B) Many parents are unaware of the importance of dental health in very young children. They
may see their child's teeth as "baby teeth" and think they can put off dental visits until the child
begins to lose the primary teeth. Nurses working with parents of very young children may need
to help parents learn that care of primary teeth is essential to healthy permanent teeth. The
client's teeth should be brushed after meals. Prolonged bottle feeding should be avoided because
it can contribute to dental caries. The client does not need to eliminate milk consumption.
Fluoride should be used for those with non-fluoridated water and does not pose a risk in tooth
development.
C) Many parents are unaware of the importance of dental health in very young children. They
development.
D) Many parents are unaware of the importance of dental health in very young children. They
development.
34
E) Many parents are unaware of the importance of dental health in very young children. They
development.
Page Ref: 454-455
care.
35
6) The nurse is working with a family that is new to the pediatric practice. In reviewing the
family's records, the nurse notes that the older children have a large number of dental caries.
Which topics will the nurse include when teaching the mother how to decrease the development
of dental caries in infants? Select all that apply.
A) Refraining from giving the infant a bottle for a prolonged time at bedtime
B) Giving the infant sugar water only at breakfast time
C) Wiping the infant's gums with soft moist gauze once or twice daily
D) Using a toothbrush as soon as the first tooth erupts
E) Using a topical anesthetic daily, beginning as soon as the first tooth begins to erupt
Answer: A, C
Explanation: A) Interventions appropriate for prevention of dental caries are wiping the gums
with a soft moist gauze and avoiding prolonged bottle feeding at bedtime. Foods high in sugar
should be avoided in the infant at all times. A toothbrush should not be used during infancy.
Topical anesthetic should not be applied daily.
B) Interventions appropriate for prevention of dental caries are wiping the gums with a soft moist
gauze and avoiding prolonged bottle feeding at bedtime. Foods high in sugar should be avoided
in the infant at all times. A toothbrush should not be used during infancy. Topical anesthetic
should not be applied daily.
C) Interventions appropriate for prevention of dental caries are wiping the gums with a soft moist
D) Interventions appropriate for prevention of dental caries are wiping the gums with a soft
moist gauze and avoiding prolonged bottle feeding at bedtime. Foods high in sugar should be
avoided in the infant at all times. A toothbrush should not be used during infancy. Topical
anesthetic should not be applied daily.
E) Interventions appropriate for prevention of dental caries are wiping the gums with a soft moist
Page Ref: 454-455
care.
36
7) The nurse is caring for a client in a long-term care facility. The client has some cognitive
impairment that interferes with the ability to independently complete activities of daily living.
The nurse has identified Self-Care Deficit as an appropriate nursing diagnosis for this client.
Based on this data, which expected outcome is the most appropriate for the nurse to include in
the plan of care?
A) The client will be able to name the staff that works on the day shift.
B) The client, with supervision, will brush teeth twice per day.
C) The client will eliminate safety hazards in the environment.
D) The nurse will stress the importance of adequate fluid intake.
Answer: B
37
Explanation: A) A client with cognitive impairment would be able to brush the teeth, but only
with supervision. The client would not voluntarily brush the teeth without prompting from the
staff. Cognitive impairment limits the client's ability to understand and comprehend; therefore,
stressing adequate fluid intake, naming the staff, and eliminating safety hazards are not within
the client's realm of understanding.
B) A client with cognitive impairment would be able to brush the teeth, but only with
supervision. The client would not voluntarily brush the teeth without prompting from the staff.
Cognitive impairment limits the client's ability to understand and comprehend; therefore,
C) A client with cognitive impairment would be able to brush the teeth, but only with
D) A client with cognitive impairment would be able to brush the teeth, but only with
Page Ref: 455-456
injury. Outline nursing management of oral health including identifying clients at risk and
promoting oral hygiene.
care.
38
Exemplar 7.C Normal Sleep-Rest Patterns
1) The nurse is caring for a client who is admitted to the hospital with a diagnosis of pneumonia.
The client is on a monitor, and vital signs are recorded from the monitor in order to leave the
client undisturbed during the night. The nurse observes that blood pressure, heart rate, and
respirations are below baseline for this client. Based on this data, which conclusion by the nurse
regarding the changes in vital signs is the most appropriate?
A) The client is about to have a cardiac arrest.
B) The client is in NREM sleep.
C) The client's metabolic rate has increased.
D) The client is in REM sleep.
Answer: B
Explanation: A) During NREM sleep, the client is relaxed, and body functions are decreased,
including vital signs and metabolic rate. REM sleep is characterized by increased body function
and elevated vital signs. A decrease in vital signs is normal during NREM sleep, and the client is
not necessarily at risk for cardiac arrest.
B) During NREM sleep, the client is relaxed, and body functions are decreased, including vital
signs and metabolic rate. REM sleep is characterized by increased body function and elevated
vital signs. A decrease in vital signs is normal during NREM sleep, and the client is not
necessarily at risk for cardiac arrest.
C) During NREM sleep, the client is relaxed, and body functions are decreased, including vital
D) During NREM sleep, the client is relaxed, and body functions are decreased, including vital
Page Ref: 459
Process: Evaluation
Learning Outcome: 7.C.1. Analyze sleep and rest as they relate to health, wellness, illness, and
injury. Describe the physiology and functions of sleep.
care.
39
2) A pediatric nurse is assigned telephone triage for the day at a pediatric clinic. The nurse
receives a phone call from the mother of a newborn. The mother states, "I am concerned about
my baby. When she first goes to sleep, her eyes dart around under her eyelids, she doesn't
breathe regularly, and she sometimes twitches." Based on this data, which response by the nurse
is the most appropriate?
A) "Please bring your baby in immediately for a checkup."
B) "You should ask the doctor about these symptoms at your next checkup."
C) "These are common behaviors in newborns and are normal."
D) "If your baby does this again, take her to the emergency department."
Answer: C
Explanation: A) These are indications of normal REM sleep in the newborn. The mother should
be reassured that this is normal. Having the mother wait until the next checkup unnecessarily
delays this reassurance. There is no need for an immediate trip to the clinic or to the emergency
department.
B) These are indications of normal REM sleep in the newborn. The mother should be reassured
that this is normal. Having the mother wait until the next checkup unnecessarily delays this
reassurance. There is no need for an immediate trip to the clinic or to the emergency department.
C) These are indications of normal REM sleep in the newborn. The mother should be reassured
D) These are indications of normal REM sleep in the newborn. The mother should be reassured
Page Ref: 459-460
injury. Describe variations in sleep patterns across the lifespan.
care.
40
3) When talking to a client about sleep patterns, one of the most important interventions the
nurse can suggest for clients who are having difficulty sleeping is to
A) eat a small snack before bedtime.
B) take an over-the-counter sleep aid such as melatonin.
C) set a routine time to go to bed and a routine time to get out of bed.
D) do a calming activity in bed before trying to sleep, such as reading a book.
Answer: C
Explanation: A) The most important change to make in a bedtime routine is to set a routine
mandatory time to go to bed and set a routine mandatory time to get out of bed. The client needs
to train his mind and body to expect to sleep on this schedule. Eating a small snack before bed
and using the bed for activities other than sleep and sex are not recommended to promote sleep.
Although taking an over-the-counter sleep aid may help promote sleep, it should not be a first-
line treatment recommendation.
B) The most important change to make in a bedtime routine is to set a routine mandatory time to
go to bed and set a routine mandatory time to get out of bed. The client needs to train his mind
and body to expect to sleep on this schedule. Eating a small snack before bed and using the bed
for activities other than sleep and sex are not recommended to promote sleep. Although taking an
over-the-counter sleep aid may help promote sleep, it should not be a first-line treatment
recommendation.
C) The most important change to make in a bedtime routine is to set a routine mandatory time to
recommendation.
D) The most important change to make in a bedtime routine is to set a routine mandatory time to
recommendation.
Page Ref: 462
Learning Outcome: 7.C.5. Plan interventions that promote normal sleep.
care.
41
4) A parent of an adolescent client expressed concern to the nurse regarding the adolescent's
sleeping habits. The parent states that the client wants to sleep all the time. The nurse believes
that the adolescent is experiencing sleep deprivation. During the assessment, which clinical
manifestations support this diagnosis? Select all that apply.
A) Consumption of caffeinated soda
B) Difficulty waking in the morning for school
C) Irritability and anxiety, especially on days with less sleep
D) Trouble initiating or persisting in projects, such as school assignments
E) Refusal to participate in sports activities
Answer: A, B, C, D
42
Explanation: A) High caffeine consumption is associated with a variety of teen health issues like
insomnia, which can lead to sleep deprivation. Sleep deprivation may cause the adolescent to
have trouble waking in the morning for school. Other symptoms include irritability, anxiety, and
problems associated with attention, memory, and decision making. Sports participation is not
correlated to sleep deprivation.
B) High caffeine consumption is associated with a variety of teen health issues like insomnia,
which can lead to sleep deprivation. Sleep deprivation may cause the adolescent to have trouble
waking in the morning for school. Other symptoms include irritability, anxiety, and problems
associated with attention, memory, and decision making. Sports participation is not correlated to
sleep deprivation.
C) High caffeine consumption is associated with a variety of teen health issues like insomnia,
sleep deprivation.
D) High caffeine consumption is associated with a variety of teen health issues like insomnia,
sleep deprivation.
E) High caffeine consumption is associated with a variety of teen health issues like insomnia,
sleep deprivation.
Page Ref: 460
Process: Assessment
care.
43
5) The nurse is caring for a 34-year-old client who is about to be discharged from the hospital.
The client asks the nurse for suggestions on how to improve the quality of sleep in order to wake
feeling refreshed in the morning. After reviewing the client's medical history, which suggestions
by the nurse are appropriate? Select all that apply.
A) Limiting the use of alcohol to early in the evening
B) Having a cup of tea before bed in order to enhance relaxation
C) Adjusting the room temperature to a comfortable level for sleep
D) Changing the time of aerobic exercise to 1 hour prior to sleep
E) Limiting cigarette smoking before bedtime
Answer: A, C, E
44
Explanation: A) Alcohol interferes with REM sleep, and its consumption should be limited to
well before bedtime. A comfortable room temperature will promote sleep. Nicotine is a stimulant
and may prevent the client from falling asleep. Exercise close to bedtime acts as a stimulant and
can cause the client to be unable to sleep. Tea contains caffeine, which is a stimulant. The nurse
could suggest non-caffeinated tea before bedtime unless this causes the client to wake during the
night to urinate.
B) Alcohol interferes with REM sleep, and its consumption should be limited to well before
bedtime. A comfortable room temperature will promote sleep. Nicotine is a stimulant and may
prevent the client from falling asleep. Exercise close to bedtime acts as a stimulant and can cause
the client to be unable to sleep. Tea contains caffeine, which is a stimulant. The nurse could
suggest non-caffeinated tea before bedtime unless this causes the client to wake during the night
to urinate.
C) Alcohol interferes with REM sleep, and its consumption should be limited to well before
to urinate.
D) Alcohol interferes with REM sleep, and its consumption should be limited to well before
to urinate.
E) Alcohol interferes with REM sleep, and its consumption should be limited to well before
to urinate.
Page Ref: 461—462
injury. Outline factors affecting sleep.
care.
45
6) The nurse working in the newborn nursery understands that a neonate has differences in
sleeping patterns and stages than an older child or an adult. Which statement related to sleep is
incorrect for a newborn?
A) A newborn will have an irregular sleep schedule with periods of 1-3 hours spent awake.
B) NREM sleep in a newborn is characterized by regular respirations, closed eyes, and the
absence of body and eye movements.
C) REM sleep occurs gradually in a newborn.
D) NREM sleep is also called quiet sleep during the newborn period.
Answer: C
Explanation: A) Unlike older children and adults, newborns enter REM sleep immediately.
Newborns sleep on an irregular schedule with periods of 1-3 hours spent awake. Rapid eye
movements are observable through closed lids, and the body movements and irregular
respirations may be observed. NREM sleep (also called quiet sleep during the newborn period) is
characterized by regular respirations, closed eyes, and the absence of body and eye movements.
B) Unlike older children and adults, newborns enter REM sleep immediately. Newborns sleep on
an irregular schedule with periods of 1-3 hours spent awake. Rapid eye movements are
observable through closed lids, and the body movements and irregular respirations may be
observed. NREM sleep (also called quiet sleep during the newborn period) is characterized by
regular respirations, closed eyes, and the absence of body and eye movements.
C) Unlike older children and adults, newborns enter REM sleep immediately. Newborns sleep on
D) Unlike older children and adults, newborns enter REM sleep immediately. Newborns sleep on
Page Ref: 460
Process: Assessment
care.
46
Another random document with
no related content on Scribd:
uses; and that according to the various purposes they are applied,
&c. Therefore, indeed, a Letter-Cutter should have a Forge set up,
as by Numb. 1. But some Letter-Cutters may seem to scorn to use a
Forge, as accounting it too hard Labour, and Ungenteel for
themselves to officiate at. Yet they all well know, that though they
may have a common Black-Smith perform their much and heavy
Work, that many times a Forge of their own at Hand would be very
commodious for them in several accidental little and light Jobs,
which (in a Train of Work) they must meet withal.
But if our Letter-Cutter will have no Forge, yet he must of necessity
accommodate himself with a Vice, Hand-Vice, Hammers, Files,
Small and Fine Files (commonly called Watch-makers Files) of these
he saves all, as they wear out, to smooth and burnish the Sides and
Face of his Letter with, as shall be shewed; Gravers, and Sculpters
of all sorts, an Anvil, or a Stake, an Oyl-stone, &c. And of these,
such as are suitable and sizable to the several Letters he is to Cut.
These, or many of these Tools, being described in Numb. 1. I refer
my Reader thither, and proceed to give an account of some Tools
peculiar to the Letter-Cutter, though not of particular use to the
Common Black-Smith.
Plate 10.
¶. 2. Of the Using-File.
This File is about nine or ten Inches long, and three or four Inches
broad, and three quarters of an Inch thick: The two broad sides must
be exactly flat and straight: And the one side is commonly cut with a
Bastard-Cut, the other with a Fine or Smooth Cut. (See Numb. 1.
Fol. 14, 15.) Its use is to Rub a piece of Steel, Iron, or Brass, &c. flat
and straight upon, as shall be shewed hereafter.
In chusing it, you must see it be exactly Flat and Straight all its
Length and Breadth: For if it in any part Belly out, or be Hollow
inwards, what is Rubbed upon it will be Hollow, Rubbing on the
Bellying part; and Bellying, Rubbing on the Hollow part. You must
also see that it be very Hard; and therefore the thickest Using-Files
are likeliest to prove best, because the thin commonly Warp in
Hardning.
¶. 3. Of the Flat-Gage.
The Flat-Gage is described in Plate 10. at A. It is made of a flat piece

of Box, or other Hard Wood. Its Length is three Inches and an half,
its Breadth two Inches and an half, and its Thickness one Inch and
an half. This is on the Flat, first made Square, but afterwards hath
one of its Corners (as h) a little rounded off, that it may the easier
comply with the Ball of the Hand. Out of one of its longest Sides, viz.
that not rounded off, is Cut through the thickness of it an exact
Square, whose one side b f, c g is about an Inch and three quarters
long; and its other side b d, c e about half an Inch long. The Depth of
these Sides and their Angle is exactly Square to the top and bottom
of the upper and under Superficies of the Flat-Gage.
Its Use is to hold a Rod of Steel, or Body of a Mold, &c. exactly
perpendicular to the Flat of the Using-File, that the end of it may rub
upon the Using-File, and be Filed away exactly Square, and that to
the Shank; as shall more at large be shewed in §. 2. ¶. 3.
¶. 4. Of the Sliding-Gage.
The Sliding-Gage is described in Plate 10. at Fig. B. It is a Tool

commonly used by Mathematical Instrument-Makers, and I have
found it of great use in Letter-Cutting, and making of Molds, &c. a a
the Beam, b the Tooth, c c the Sliding Socket, d d d d the Shoulder
of the Socket.
Its Use is to measure and set off Distances between the Sholder and
the Tooth, and to mark it off from the end, or else from the edge of
your Work.
I always use two or three of these Gages, that I need not remove the
Sholder when it is set to a Distance which I may have after-use for;
as shall in Working be shewed more fully.
¶. 5. Of the Face-Gages, marked C in Plate 10.
The Face-Gage is a Square Notch cut with a File into the edge of a
thin Plate of Steel, Iron, or Brass, the thickness of a piece of
common Latton, and the Notch about an English deep. There be
three of these Gages made, for the Letters to be cut on one Body;
but they may be all made upon one thin Plate, the readier to be
found, as at D. As first, for the Long Letters; Secondly, for the
Assending Letters; And Thirdly, for the Short-Letters. The Length of
these several Notches, or Gages, have their Proportions to the Body
they are cut to, and are as follows. We shall imagine (for in Practice
it cannot well be perform’d, unless in very large Bodies) that the
Length of the whole Body is divided into forty and two equal Parts.
The Gage for the Long-Letters are the length of the whole Body, viz.
forty and two equal Parts. The Gage for the Assending Letters,
Roman and Italica, are five Seventh Parts of the Body, viz. thirty
Parts of forty-two, and thirty and three Parts for English Face. The
Gage for the Short-Letters are three Seventh Parts of the whole
Body, viz. eighteen Parts of forty-two for the Roman and Italica, and
twenty two Parts for the English Face.
It may indeed be thought impossible to divide a Body into seven
equal Parts, and much more difficult to divide each of those seven
equal Parts into six equal Parts, which are forty-two, as aforesaid,
especially if the Body be but small; but yet it is possible with curious
Working: For seven thin Spaces may be Cast and Rubb’d to do it.
And for dividing each of the thin Spaces into six equal Parts, you
may Cast and Rub Full Point . to be of the thickness of one thin
Space, and one sixth part of a thin Space: And you may Cast and
Rub : to be the thickness of one thin Space, and two sixth parts of a
thin Space: And you may Cast and Rub , to be the thickness of one
thin Space, and three sixth parts of a thin Space: And you may Cast
and Rub - to be the thickness of one thin Space, and four sixth parts
of a thin Space: And you may Cast and Rub ; to be the thickness of
one thin Space, and five sixth parts of a thin Space.
The reason why I propose . to be Cast and Rubb’d one sixth part
thicker than a thin Space, is only that it may be readily distinguished
from : , - ; which are two sixth parts, three sixth parts, four sixth
parts, five sixth parts thicker than a thin Space. And for six sixth parts
thicker than a thin Space, two thin Spaces does it.
The manner of adjusting these several Sixth Parts of Thicknesses is
as follows. You may try if six . exactly agree, and be even with seven
thin Spaces; (or, which is all one, a Body) for then is each of those
six . one sixth part thicker than a thin Space, because it drives out a
thin Space in six thin Spaces. And you may try if six : be equal to a
Body and one thin Space; for then is each : two sixth parts thicker
than a thin Space. If six , be equal to nine thin Spaces, then each , is
three sixth parts of a thin Space thicker than a thin Space. If six - be
equal to ten thin Spaces, then each - is four sixth parts of a thin
Space thicker than a thin Space. If six ; be equal to eleven thin
Spaces, then each ; is five sixth parts of a thin Space thicker than a
thin Space.
Now, as aforesaid, a thin Space being one seventh part of the Body,
and the thin Space thus divided, you have the whole Body actually
divided into forty and two equal parts, as I have divided them in my
Drafts of Letters down the Sides, and in the Bottom-Line.
Though I have thus shewed how to divide a thin Space into six equal
Parts, yet when the Letter to be Cut proves of a small Body, the thin
Space divided into two equal Parts may serve: If it prove bigger, into
three or four equal Parts: And of the largest Bodies, they may be
divided into six, as aforesaid.
If now you would make a Gage for any number of thin Spaces and
Sixth Parts of a thin Space, you must take one thin Space less than
the number of thin Spaces proposed, and add . : , - ; according as
the number of sixth Parts of a thin Space require; and to those
complicated Thicknesses you may file a square Notch on the edge of
the thin Plate aforesaid, which shall be a standing Gage or Measure
for that number of thin Spaces and sixth Parts of a thin Space.
All the Exception against this way of Measuring is, that thin Spaces
cast in Metal may be subject to bow, and so their Thicknesses may
prove deceitful. But, in Answer to that, I say, you may, if you will,
Cast I for two thin Spaces thick, e for three thin Spaces thick, S for
four thin Spaces thick, L for five thin Spaces thick, D for six thin
Spaces thick, or any other Letters near these several Thicknesses,
as you think fit; only remember, or rather, make a Table of the
number of thin Spaces that each Letter on the Shank is Cast for. And
by complicating the Letters and Points, as aforesaid, you will have
any Thickness, either to make a Gage by, or to use otherwise.
On the other Edge of the Face-Gage you may file three other
Notches, of the same Width with those on the former Edge, for the
Long, the Assending, and Short-Letters. But though the two sides of
each of these Notches are parallel to each other, yet is not the third
side square to them, but hath the same Slope the Italick hath from
the Roman; as you may see in the Figure at b b b.
¶. 6. Of Italick, and other Standing Gages.

These Gages are to measure (as aforesaid) the Slope of the Italick
Stems, by applying the Top and Bottom of the Gage to the Top and
Bottom Lines of the Letters, and the other Side of the Gage to the
Stem: for when the Letter complies with these three sides of the
Gage that Letter hath its true Slope.
The manner of making these Gages (and indeed all other Angular
Gages) is thus.
Place one Point of a Pair of Steel Dividers upon the thin Plate
aforesaid, at the Point c or d (in Fig. D in Plate 10.) and with the
other Point describe a small fine Arch of a Circle; as, e f or g h. In
this Arch of the Circle must be set off on the Gage a 110 Degrees,
and on the Gage b 70 Degrees, and draw from the Centres c and d
two straight Lines through those numbers of Degrees: Then Filing
away the Plate between the two Lines, the Gages are finished.
To find the Measure of this, or any other number of Degrees, do
thus; Describe a Circle on a piece of Plate-Brass of any Radius (but
the larger the better) draw a straight Line exactly through the Centre
of this Circle, and another straight Line to cut this straight Line at
right Angles in the Centre, through the Circle; so shall the Circle be
divided into four Quadrants: Then fix one Foot of your Compasses
(being yet unstirr’d) in one of the Points where any of the straight
Lines cuts the Circle, and extend the moving Foot of your
Compasses where it will fall in the Circle, and make there a Mark,
which is 60 Degrees from the fixed Foot of the Compasses: Then fix
again one Foot of your Compasses in the Intersection of the straight
Line and Circle that is next the Mark that was made before, and
extend the moving Foot in the same Quadrant towards the straight
Line where you first pitch’d the Foot of your Compasses, and with
the moving Foot make another Mark in the Circle. These two Marks
divide the Quadrant into three equal Parts: The same way you may
divide the other three Quadrants; so shall the whole Circle be divided
into twelve equal Parts; and each of these twelve equal parts contain
an Arch of thirty Degrees: Then with your Dividers divide each of
these 30 Degrees into three equal Parts, and each of these three
equal Parts into two equal Parts, and each of these two equal Parts
into five equal Parts, so shall the Circle be divided into 360 equal
Parts, for your use.
To use it, describe on the Centre of the Circle an Arch of almost a
Semi-Circle: This Arch must be exactly of the same Radius with that
I prescribed to be made on the Gages a b, from e to f and from g to
h; then count in your Circle of Degrees from any Diametral Line 110
Degrees; and laying a straight Ruler on the Centre, and on the 110
Degrees aforesaid, make a small Mark through the small Arch; and
placing one Foot of your Compasses at the Intersection of the small
Arch, with the Diametral Line, open the other Foot to the Mark made
on the small Arch for 110 Degrees, and transfer that Distance to the
small Arch made on the Gage: Then through the Marks that the two
Points of your Compasses make in the small Arch on the Gage,
draw two straight Lines from the Centre c: and the Brass between
those two straight Lines being filed away, that Gage is made. In like
manner you may set off any other number of Degrees, for the
making of any other Gage.
In like manner, you may measure any Angle in the Drafts of Letters,
by describing a small Arch on the Angular Point, and an Arch of the
same Radius on the Centre of your divided Circle: For then, placing
one Foot of your Compasses at the Intersection of the small Arch
with either of the straight Lines proceeding from the Angle in the
Draft, and extending the other Foot to the Intersection of the small
Arch, with the other straight Line that proceeds from the Angle, you
have between the Feet of your Compasses, the Width of the Angle;
and by placing one Foot of your Compasses at the Intersection of
any of the straight Lines that proceed from the Centre of the divided
Circle, and the small Arch you made on it, and making a Mark where
the other Foot of your Compasses falls in the said small Arch, you
may, by a straight Ruler laid on the Centre of the divided Circle, and
the Mark on the small Arch, see in the Limb of the Circle the number
of Degrees contained between the Diametral, or straight Line and
the Mark.
If you have already a dividing-Plate of 360 Degrees, of a larger
Radius than the Arch on your Gage, you may save your self the
labour of dividing a Circle (as aforesaid,) and work by your dividing-
Plate as you were directed to do with the Circle that I shewed you to
divide.
In these Documents I have exposed my self to a double Censure;
First, of Geometricians: Secondly, of Letter-Cutters. Geometricians
will censure me for writing anew that which almost every young
Beginner knows: And Letter-Cutters will censure me for proposing a
Rule for that which they dare pretend they can do without Rule.
To the Geometricians I cross the Cudgels: yet I writ this not to them;
and I doubt I have written superfluously to Letter-Cutters, because I
think few of them either will or care to take pains to understand these
small Rudiments of Geometry. If they do, and be ingenious, they will
thank me for discovering this Help in their own Way, which few of
them know. For by this Rule they will not only make Letters truer, but
also quicker, and with less care; because they shall never need to
stamp their Counter-Punch in Lead, to see how it pleases them;
which they do many times, before they like their Counter-Punch, (be
it of A A V v W w V W, and several other Letters) and at last finish
their Counter-Punch but with a good Opinion they have that it may
do well, though they frequently see it does not in many Angular
Letters on different Bodies Cut by the same Hand. And were Letter-
Cutting brought to so common Practice as Joynery, Cabinet-making,
or Mathematical Instrument-making, every young Beginner should
then be taught by Rules, as they of these Trades are; because
Letter-Cutting depends as much upon Rule and Compass as any
other Trade does.
You may in other places, where you find most Convenience (as at i)
make a Square, which may stand you in stead for the Squaring the
Face and Stems of the Punch in Roman Letters, and also in many
other Uses.
And you may make Gages, as you were taught before to try the
Counter-Punches of Angular Letters; as, A K M N V X Y Z, Romans
and Italicks, Capitals and Lower-Case. But then, that you may know
each distinct Gage, you may engrave on the several respective
Gages, at the Angle, A A 4 &c. For by examining by the Drafts of
Letters, what Angle their Insides make, you may set that Angle off,
and make the Gage as you were taught before, in the Gage for the
Slope of Italicks.
¶. 7. Of the Liner.
The Liner is marked E in Plate 10. It is a thin Plate of Iron or Brass,

whose Draft is sufficient to express the Shape. The Use of it is on
the under-edge a b (which is about three Inches long) and is made
truly straight, and pretty sharp or fine; that being applied to the Face
of a Punch, or other piece of Work, it may shew whether it be
straight or no.
¶. 8. Of the Flat-Table.
The Flat-Table at F in Plate 10. The Figure is there sufficient. All its
Use is the Table F, for that is about one Inch and an half square, and
on its Superficies exactly straight and flat. It is made of Iron or Brass,
but Brass most proper. Its Use is to try if the Shank of a Punch be
exactly Perpendicular to its Face, when the Face is set upon the
Table; for if the Shank stand then directly upright to the Face of the
Table, and lean not to any side of it, it is concluded to be
perpendicular.
It hath several other Uses, which, when we come to Casting of
Letters, and Justifying of Matrices, shall be shewn.
¶. 9. Of the Tach.
The Tach is a piece of Hard Wood, (Box is very good) about three
Inches broad, six Inches long, and three quarters of an Inch thick.
About half its Length is fastned firm down upon the Work-Bench, and
its other half projects over the hither Edge of it. It hath three or four
Angular Notches on its Fore-end to rest and hold the Shank of a
Punch steady when the End of the Punch is screwed in the Hand-
Vice, and the Hand-Vice held in the left hand, while the Workman
Files or Graves on it with his Right Hand.
Instead of Fastning the Tach to the Bench, I Saw a square piece out
of the further half of the Tach, that it may not be too wide for the
Chaps of the Vice to take and screw that narrow End into the Chaps
of the Vice, because it should be less cumbersome to my Work-
Bench.
¶. 10. Of Furnishing the Work-Bench.
The Workman hath all his great Files placed in Leather Nooses, with
their Handles upwards, that he may readily distinguish the File he
wants from another File. These Nooses are nailed on a Board that
Cases the Wall on his Right Hand, and as near his Vice as
Convenience will admit, that he may the readier take any File he
wants.
He hath also on his Right Hand a Tin Pot, of about a Pint, with small
Files standing in it, with their Handles downwards, that their Blades
may be the readier seen. These small Files are called Watch-makers
Files, and the Letter-Cutter hath occasion to use these of all Shapes,
viz. Flat, Pillar, Square, Triangular, Round, Half-Round, Knife-Files,
&c.
He also provides a shallow square Box, of about five Inches long,
and three Inches broad, to lay his small Instruments in; as, his
Gages, his Liner, some common Punches, &c. This Box he places
before him, at the further side of the Work-Bench.
He also provides a good Oyl-Stone, to sharpen his Gravers and
Sculpters on. This he places at some distance from the Vice, on his
left hand.
§. 13. ¶. 1. Of Letter-Cutting.
The Letter-Cutter does either Forge his Steel-Punches, or procures
them to be forged; as I shewed, Numb. 1. Fol. 8, 9, 10. in Vol. I. &c.
But great care must be taken, that the Steel be sound, and free from
Veins of Iron, Cracks and Flaws, which may be discerned; as I
shewed in Numb. 3. Vol. I. For if there be any Veins of Iron in the
Steel, when the Letter is Cut and Temper’d, and you would Sink the
Punch into the Copper, it will batter there: Or it will Crack or Break if
there be Flaws.
If there be Iron in it, it must with the Chissel be split upon a good
Blood-Red-Heat in that place, and the Iron taken or wrought out; and
then with another, or more Welding Heat, or Heats, well doubled up,
and laboured together, till the Steel become a sound entire piece.
This Operation Smiths call Well Currying of the Steel.
If there be Flaws in it, you must also take good Welding Heats, so
hot, that the contiguous sides of the Flaws may almost Run: for then,
snatching it quickly out of the Fire, you may labour it together till it
become close and sound.
Mr. Robinson, a Black-Smith of Oxford, told me a way he uses that is
ingenious, and seems rational: For if he doubts the Steel may have
some small Flaws that he can scarce discern, he takes a good high
Blood-Red Heat of it, and then twists the Rod or Bar (as I shewed,
Numb. 3. Vol. I.) which Twisting winds the Flaws about the Body of
the Rod, and being thus equally disposed, more or less, into the Out-
sides of the Rod, according as the Position of the Flaw may be,
allows an equal Heat on all sides to be taken, because the Out-sides
heat faster than the Inside and therefore the Out-sides of the Steel
are not thus so subject to Burn, or Run, as if it should be kept in the
Fire till the Middle, or Inside of it should be ready to Run. And when
the Steel is thus well welded, and soundly laboured and wrought
together with proper Heats, he afterwards reduces it to Form.
Now, that I may be the better understood by my Reader as he reads
further, I have, in Plate 10. at Fig. G described the several Parts of
the Punch; which I here explain.
G The Face.
a a, b b The Thickness.
a b, a b The Heighth.
a c, b c, b c The Length of the Shank, about an Inch and
three quarters long.
c c c The Hammer-End.
This is no strict Length for the Shank, but a convenient Length; for
should the Letter Cut on the Face be small, and consequently, the
Shank so too, and the Shank much longer, and it (as seldom it is) not
Temper’d in the middle, it might, with Punching into Copper, bow in
the middle, either with the weight of the Hammer, or with light
reiterated Blows: And should it be much shorter, there might perhaps
Finger-room be wanting to manage and command it while it is
Punching into the Copper. But this Length is long enough for the
biggest Letters, and short enough for the smallest Letters.
The Heighth and Thickness cannot be assign’d in general, because
of the diversity of Bodies, and Thickness of Letters: Besides, some
Letters must be Cut on a broad Face of Steel, though, when it is Cut,
it is of the same Body; as all Letters are, to which Counter-Punches
are used; because the Striking the Counter-Punch into the Face of
the Punch will, if it have not strength enough to contain it, break or
crack one or more sides of the Punch, and so spoil it. But if the
Letter be wholly to be Cut, and not Counter-Punch’d, as I shall
hereafter hint in general what Letters are not, then the Face of the
Punch need be no bigger, or, at least, but a small matter bigger than
the Letter that is to be cut upon it.
Now, If the Letter be to be Counter-punch’d, the Face of the Punch
ought to be about twice the Heighth, and twice the Thickness of the
Face of the Counter-Punch; that so, when the Counter-Punch is
struck just on the middle of the Face of the Punch, a convenient
Substance, and consequently, Strength of Steel on all its Sides may
be contained to resist the Delitation, that the Sholder or Beard of the
Counter-Punch sinking into it, would else make.
If the Letter-Cutter be to Cut a whole Set of Punches of the same
Body of Roman and Italica, he provides about 240 or 260 of these
Punches, because so many will be used in the Roman and Italica
Capitals and Lower-Case, Double-Letters, Swash-Letters, Accented
Letters, Figures, Points, &c. But this number of Punches are to have
several Heighths and Thicknesses, though the Letters to be Cut on
them are all of the same Body.
What Heighth and Thickness is, I have shewed before in this §, but
not what Body is; therefore I shall here explain it.
By Body is meant, in Letter-Cutters, Founders and Printers
Language, the Side of the Space contained between the Top and
Bottom Line of a Long-Letter. As in the Draft of Letters, the divided
Line on the Left-Hand of A is divided into forty and two equal Parts;
and that Length is the Body, thus: J being an Ascending and
Descending Letter, viz. a long Letter, stands upon forty-two Parts,
and therefore fills the whole Body.
There is in common Use here in England, about eleven Bodies, as I
shewed in §. 2. ¶. 2. of this Volumne.
I told you even now, that all the Punches for the same Body must not
have the same Heighth and Thickness: For some are Long; as, J j Q,
and several others; as you may see in the Drafts of Letters: and
these Long-Letters stand upon the whole Heighth of the Body.
The Ascending and Descending Letters reach from the Foot-Line, up
to the Top-Line; as all the Capital Letters are Ascending Letters, and
so are many of the Lower-Case Letters; as, b d f, and several others.
The Descending Letters are of the same Length with the Ascending
Letters; as, g p q and several others. These are contained between
the Head-Line and the Bottom-Line. The Short Letters are contained
between the Head-Line and the Bottom-line. These are three
different Sizes of Heighth the Punches are made to, for Letters of the
same Body. But in proper place I shall handle this Subject more
large and distinctly.
And as there is three Heighths or Sizes to be considered in Letters
Cut to the same Body, so is there three Sizes to be considered, with
respect to the Thicknesses of all these Letters, when the Punches
are to be Forged: For some are m thick; by m thick is meant m
Quadrat thick, which is just so thick as the Body is high: Some are n
thick; that is to say, n Quadrat thick, viz. half so thick as the Body is
high: And some are Space thick; that is, one quarter so thick as the
Body is high; though Spaces are seldom Cast so thick, as shall be
shewed when we come to Casting: and therefore, for distinction
sake, we shall call these Spaces, Thick Spaces.
The first three Sizes fit exactly in Heighth to all the Letters of the
same Body; but the last three Sizes fit not exactly in Thickness to the
Letters of the same Body; for that some few among the Capitals are
more than m thick, some less than m thick, and more than n thick;
and some less than n thick, and more than Space thick; yet for
Forging the Punches, these three Sizes are only in general
Considered, with Exception had to Æ Æ Q, and most of the Swash-
Letters; which being too thick to stand on an m, must be Forged
thicker, according to the Workman’s Reason.
After the Workman has accounted the exact number of Letters he is
to Cut for one Set, he considers what number he shall use of each of
these several Sizes in the Roman, and of each of these several
Sizes in the Italick; (for the Punches of Romans and Italicks, if the
Body is large, are not to be Forged to the same shape, as shall be
shewed by and by) and makes of a piece of Wood one Pattern of the
several Sizes that he must have each number Forged to. Upon every
one of these Wooden Patterns I use to write with a Pen and Ink the
number of Punches to be Forged of that Size, lest afterwards I might
be troubled with Recollections.
I say (for Example) He considers how many long Letters are m thick,
how many Long-Letters are n thick, and how many Long-Letters are
Space thick, in the Roman; and also considers which of these must
be Counter-punch’d, and which not: For (as was said before) those
Letters that are to be Counter-punch’d are to have about twice the
Heighth and twice the Thickness of the Face of the Counter-Punch,
for the Reason aforesaid. But the Letters not to be Counter-punch’d
need no more Substance but what will just contain the Face of the
Letter; and makes of these three Sizes three Wooden Patterns, of
the exact Length, Heighth and Thickness that the Steel Punches are
to be Forged to.
He also counts how many are Ascendents and Descendents, m
thick, n thick, and Space thick; still considering how many of them
are to be Counter-punch’d, and how many not; and makes Wooden
Patterns for them.
The like he does for short-letters; and makes Wooden Patterns for
them, for Steel Punches to be Forged by.
And as he has made his Patterns for the Roman, so he makes
Patterns for the Italick Letters also; for the same shap’d Punches will
not serve for Italick, unless he should create a great deal more Work
to himself than he need do: For Italick Punches are not all to be
Forged with their sides square to one another, as the Romans are;
but only the highest and lowest sides must stand in Line with the
highest and lowest sides of the Roman; but the Right and Left-Hand
sides stand not parallel to the Stems of the Roman, but must make
an Angle of 20 Degrees with the Roman Stems: so that the Figure of
the Face of the Punch will become a Rhomboides, as it is called by
Geometricians, and the Figure of this Face is the Slope that the
Italick Letters have from the Roman, as in proper place shall be
further shewed. Now, should the Punches for these Letters be
Forged with each side square to one another, the Letter-Cutter would
be forced to spend a great deal of Time, and take great pains to File
away the superfluous Steel about the Face of the Letter when he
comes to the Finishing of it, especially in great Bodied Letters. Yet
are not all the Italick Letters to be Forged on the Slope; for the
Punches of some of them, as the m n, and many others, may have
all, or, at least, three of their sides, square to one another, though
their Stems have the common Slope, because the ends of their
Beaks and Tails lie in the same, perpendicular with the Outer Points
of the Bottom and Top of their Stems, as is shewed in the Drafts of
Letters.
Though I have treated thus much on the Forging of Punches, yet
must all what I have said be understood only for great Bodied
Punches; viz. from the Great-Primer, and upwards. But for smaller
Bodies; as English, and downwards, the Letter-Cutter generally, both
for Romans and Italicks, gets so many square Rods of Steel, Forged
out of about two or three Foot in Length, as may serve his purpose;
which Rods he elects as near his Body and Sizes as his Judgment
will serve him to do; and with the edge of a Half-round File, or a
Cold-Chissel, cuts them into so many Lengths as he wants Punches.
Nay, many of these Rods may serve for some of the small Letters in
some of the greater Bodies; and also, for many of their Counter-
Punches.
Having thus prepared your Punches, you must Neal them, as I
shewed in Numb. 3. Vol. I.
¶. 2. Of Counter-Punches.
The Counter-Punches for great Letters are to be Forged as the

Letter-Punches; but for the smaller Letters, they may be cut out of
Rods of Steel, as aforesaid. They must also be well Neal’d, as the
Punches. Then must one of the ends be Filed away on the outside
the Shank, to the exact shape of the inside of the Letter you intend to
Cut. For Example, If it be A you would Cut; This Counter-Punch is
easie to make, because it is a Triangle; and by measuring the Inside
of the Angle of A in the Draft of Letters, as you were taught, §. 12. ¶.
6. you may make on your Standing Gage-Plate a Gage for that
Angle: So that, let the Letter to be Cut be of what Body you will, from
the least, to the biggest Body, you have a Standing Gage for this
Counter-Punch, so oft as you may have occasion to Cut A.
The Counter-Punch of A ought to be Forged Triangularly, especially
towards the Punching End, and Tryed by the A-Gage, as you were
taught to use the Square, Numb. 3. Vol. I. Yet, for this and other
Triangular Punches, I commonly reserve my worn- out three square
Files, and make my Counter-Punch of a piece of one of them that
best fits the Body I am to Cut.
Having by your A-Gage fitted the Top-Angle and the Sides of this
Counter-Punch, you must adjust its Heighth by one of the three
Face-Gages mentioned in §. 12. ¶. 5. viz. by the Ascending Face-
Gage; for A is an Ascending Letter. By Adjusting, I do not mean, you
must make the Counter-Punch so high, as the Depth of the
Ascending Face-Gage; because in this Letter here is to be
considered the Top and the Footing, which strictly, as by the large
Draft of A, make both together five sixth Parts of a thin Space:
Therefore five sixth Parts must be abated in the Heighth of your
Counter-Punch, and it must be but four thin Spaces, and one sixth
part of a thin Space high, because the Top above the Counter-
Punch, and the Footing below, makes five sixth Parts of a thin
Space, as aforesaid.
Therefore, to measure off the Width of four thin Spaces and one
sixth Part of a thin Space, lay three thin Spaces, or, which is better,
the Letter e, which is three thin Spaces, as aforesaid; and . which is
one thin Space and one sixth part of a thin Space, upon one another;
for they make together, four thin Spaces, and one sixth part of a thin
Space; and the thickness of these two Measures shall be the
Heighth of the Counter-Punch, between the Footing and the Inner
Angle of A. And thus, by this Example, you may couple with proper
Measures either the whole forty-two, which is the whole Body, or any
number of its Parts, as I told you before.
This Measure of four thin Spaces and one sixth part of a thin Space
is not a Measure, perhaps, used more in the whole Set of Letters to
be Cut to the present Body, therefore you need not make a Standing
Gage for it; yet a present Gage you must have: Therefore use the
Sliding-Gage (described in §. 12. ¶. 4. and Plate 10. at B.) and move
the Socket c c on the Beam a a, till the Edge of the Sholder of the
Square of the Socket at the under-side of the Beam stands just the
Width of four thin Spaces and one sixth part of a thin Space, from
the Point of the Tooth b; which you may do by applying the Measure
aforesaid just to the Square and Point of the Tooth; for then if you
Screw down the Screw in the upper-side of the Sliding Socket, it will
fasten the Square at that distance from the Point of the Tooth. And
by again applying the side of the Square to the Foot of the Face of
the Counter-Punch, you may with the Tooth describe a small race,
which will be the exact Heighth of the Counter-Punch for A. But A
hath a Fine stroak within it, reaching from Side to Side, which by the
large Draft of A, you may find that the middle of this cross stroak is
two Thin Spaces above the bottom of this Counter-Punch; and with
your common Sliding-Gage measure that distance as before, and set
off that distance also on the Face of your Counter-Punch. Then with
the edge of a Fine Knife-File, File straight down in that race, about
the depth of a Thin Space, or somewhat more; So shall the Counter-
Punch for A be finisht. But you may if you will, take off the Edges or
Sholder round about the Face of the Counter-Punch, almost so deep
as you intend to strike it into the Punch: for then the Face of the
Counter-Punch being Filed more to a Point, will easier enter the
Punch than the broad Flat-Face. But note, That if it be a very Small
Bodied A you would make, the Edge of a Thin Knife-File may make
too wide a Groove: In this case you must take a peece of a well-
Temper’d broken Knife, and strike its Edge into the Face of the
Counter-Punch, as aforesaid.
¶. 3. Of Sinking the Counter-Punches.
Having thus finisht his Counter-Punch, he Hardens and Tempers it,

as was taught Numb. 3. fol. 57, 58. Vol. I. And having also Filed the
Face of his Punch he intends to cut his A upon, pretty Flat by guess,
he Screws the Punch upright, and hard into the Vice: And setting the
Face of his Counter-Punch as exactly as he can, on the middle of
the Face of his Punch, he, with an Hammer suitable to the Size of
his Counter-Punch, strikes upon the end of the Counter-Punch till he
have driven the Face of it about two Thin Spaces deep into the Face
of the Punch. So shall the Counter-Punch have done its Office.
But if the Letter to be Counter-Puncht be large, as Great-Primmer, or
upwards, I take a good high Blood-red Heat of it, and Screw it
quickly into the Vice; And having my Counter-Punch Hard, not
Temper’d, because the Heat of the Punch softens it too fast: And
also having before-hand the Counter-Punch Screwed into the Hand-
Vice with its Shank along the Chaps, I place the Face of the
Counter-Punch as before, on the middle of the Face of the Punch,
and with an Hammer drive it in, as before.
Taking the Punch out of the Vice, he goes about to Flat and
Smoothen the Face in earnest; for it had been to no purpose to Flat
and Smoothen it exactly before, because the Sinking of the Counter-
Punch into it, would have put it out of Flat again.
But before he Flats and Smoothens the Face of the Punch, He Files
by guess the superfluous Steel away about the Face of the Letter,
viz. so much, or near so much, as is not to be used when he comes
to finish up the Letter, as in this present Letter A, which standing
upon a Square Face on the Punch, meets in an Angle at the Top of
the Letter. Therefore the Sides of that Square must be Filed away to
an Angle at the Top of the Face of the Punch. But great care must be
taken, that he Files not more away than he should: For he considers
that the left-hand Stroak of A is a Fat Stroak, and that both the left-
hand and the right-hand Stroak too, have Footings, which he is
careful to leave Steel enough in their proper places for.
The reason why these are now Fil’d thus away, and not after the
Letter is finisht, is, Because in the Flatting the Face there is now a
less Body of Steel to File away, than if the whole Face of the Punch
had remain’d intire: For though the following ways are quick ways to
Flatten the Face, yet considering how tenderly you go to Work, and
with what Smooth Files this Work must be done, the riddance made
will be far less when a broad Face of Steel is to be Flatned, than
when only so much, or very little more than the Face of the Letter
only is to be Flatned.
To Flat and Smoothen the Face of the Punch, he uses the Flat-
Gage, (described §. 12. ¶. 3. and Plate 10. at A.) thus, He fits one
convex corner of the Shank of the Punch, into the Concave corner of
the Flat-Gage, and so applies his Flat-Gage-Punch and all to the
Face of the Using-File, and lets the Counter-Puncht end, viz. the
Face of the Punch Sink down to the Face of the Using-File: And then
keeping the convex Corner of the Shank of the Punch close and
steddy against the Concave corner of the Flat-Gage, and pressing
with one of his Fingers upon the then upper end of the Punch, viz.
the Hammer-end, he also at the same time, presses the lower end of
the Punch, viz. The Face against the Using-File, and thrusts the Flat-
Gage and Punch in it so oft forwards, till the extuberant Steel on the

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Page Ref: 448

The Flat-Gage is described in Plate 10. at A. It is made of a flat piece

The Sliding-Gage is described in Plate 10. at Fig. B. It is a Tool

¶. 5. Of the Face-Gages, marked C in Plate 10.

¶. 6. Of Italick, and other Standing Gages.

The Liner is marked E in Plate 10. It is a thin Plate of Iron or Brass,

¶. 10. Of Furnishing the Work-Bench.

The Counter-Punches for great Letters are to be Forged as the

¶. 3. Of Sinking the Counter-Punches.

Having thus finisht his Counter-Punch, he Hardens and Tempers it,

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