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Chapter 1: Public Health and Nursing Practice
Multiple Choice
Identify the choice that best completes the statement or answers the question.
____ 1. Public health nurses (PHNs) know they must approach a public health issue with an understanding of the
related underlying risk factors to develop effective nursing interventions. They evaluate these risk factors
from two perspectives:
1. Disease; individual
2. Intervention; government
3. Epidemic; population
4. Individual; population
____ 2. A nursing student is studying public health. She learns that, according to C.E.A. Winslow’s definition, some
of the goals of public health include disease prevention, promoting health, control of communicable
infections, and __________________.
1. Risk assessment for disease
2. Promotion of primary care
3. Organization of medical and nursing services for the early diagnosis and preventive
treatment of disease
4. Governmental safety regulations
____ 3. If the international medical community was working to contain several worldwide pandemics, they would
look to the World Health Organization (WHO), which is:
1. The public health arm of the United Nations.
2. Working to improve health and well-being for the global population.
3. Working with nurses to promote public health interventions.
4. All of the above.
____ 4. The Institute of Medicine (IOM), now known as the Health and Medicine Division (HMD) of the National
Academies of Sciences, Engineering, and Medicine, stated in their report, The Future of the Public’s Health,
that there are three core functions that society carries out to collectively support the optimum conditions for
public health. Which one of the following is not one of these functions?
1. Prevention
2. Assessment
3. Policy development
4. Assurance
____ 5. With aging, there is an increased prevalence of both noncommunicable (chronic) and communicable disease
(NCD). The most pressing issue from a public health perspective based on this increase is:
1. An increased demand for long-term care
2. An increased need for further research
Copyright © 2020 F. A. Davis Company

3. Further exploration of the developmental stages related to aging
4. Decreased cost of medications.
____ 6. A PHN would like to use the Dahlgren-Whitehead model to help herself and other local practitioners
understand health in populations. She understands that the Dahlgren-Whitehead ecological model assumes
that:
1. There are multiple determinants of health, and thus multiple strategies are needed.
2. A population and environmental approach is essential.
3. Linkages and relationships are crucial.
4. All of the above.
____ 7. The PHN completed a community assessment and found that the obesity rate in one of the neighborhoods was
higher than the other neighborhoods in the county. She suspects that this is partially due to limited access to
full-service grocery stores and a lack of dedicated safe venues for exercise. Assuming her conclusion is
correct, what category or categories of determinants of health would these issues within the community fall
into?
1. Upstream determinants of health
2. Downstream determinants of health
3. Behavioral determinants of health
4. Genetic determinants of health
____ 8. Two PHNs working in a large urban community notice that community members are rarely engaged in the
process of planning interventions aimed at addressing a particular increase in a specific disease in the
community. For their next project, they include community collaboration as an essential component of the
development, implementation, and evaluation of the program. When questioned by others, they report that
there is evidence that community collaboration increases effectiveness and productivity, empowers the
participants, strengthens social engagement, and ______.
1. Decreases disease rates
2. Ensures accountability
3. Increases the availability of treatment for the targeted disease
4. Improves screening rates
____ 9. Which one of the following scenarios is not an example of community collaboration?
1. Local service groups working to organize disaster relief for tornado victims
2. A city council passing an ordinance to stop smoking in restaurants
3. An advocacy group working with the local churches to improve health care for the
indigent with mental health disorders
4. A school working with the local health department to start a school clinic
____ 10. Which layer of government is primarily responsible for issuing quarantines during a communicable disease
outbreak?
1. Federal
2. State
3. Local
4. All of the above
____ 11. As a PHN in a small local public health department, you understand that based on federal mandates your
public health department routinely performs all but which of the following?
1. Surveillance of disease at the local level
2. Investigation of disease outbreaks
3. Licensing of local hospitals
4. Quarantine

____ 12. The PHN recognizes that environmental science, epidemiology, biostatistics, biomedical sciences, and ____
form the foundational subjects of public health.
1. Economics
2. The humanities
3. Social and behavioral sciences
4. Anthropology
____ 13. As defined by the World Health Organization (WHO), an example of a health promotion intervention is ____
whereas a risk reduction/health protection intervention is ____.
1. Conducting a health fair; funding a school exercise program
2. Giving a free exercise class; conducting a flu vaccine outreach program
3. Providing flu medication free to older adults; a diet class for teenagers
4. Offering a tour of a hospital; a relaxation technique class
____ 14. From a health promotion perspective, how could an occupational health nurse advise a company to encourage
its employees to work towards good health?
1. Lower insurance premiums for employees who demonstrate good health habits
2. Have employee exercise classes or discounted health club memberships
3. Have incentives for healthy eating
4. All of the above
____ 15. Diversity refers to all of but which of these concepts?
1. Race
2. Culture
3. Ethnicity
4. Environment
Multiple Response
Identify one or more choices that best complete the statement or answer the question.
____ 16. Many of the emerging threats for public health are tied to increasing globalization. Which of the following
reflect these globalization threats? (Select all that apply.)
1. Greater disparities between rich and poor
2. Greater need for newer technology
3. Greater distribution of tobacco and alcohol
4. Emergence or re-emergence of communicable diseases
5. Increased need for improved transportation
____ 17. Several nurses who work in the emergency department of an urban hospital notice during the evening shift
that a number of children in a certain ethnic population have all come in presenting with similar symptoms.
The first step the nurses take to address the issue is which of the following? (Select all that apply.)
1. Increase antibiotic therapy availability
2. Identify characteristics of the disease
3. Group patients by diagnosis
4. Notify the public health department
5. Assess the environment of the patients
____ 18. The six standards of practice for public health nursing include which of the following? (Select all that
apply.)
1. Assessment
2. Population diagnosis and priorities

3. Outcomes identification
4. Planning
5. Mitigation
____ 19. Which of the following activities of PHNs reflect the PHN Core Competencies? (Select all that apply.)
1. Develop policy for handling a local quarantine.
2. Understand dietary restrictions when planning a program for new immigrants.
3. Create a financial plan for implementing a community level health intervention.
4. Develop a treatment plan for persons with a specific communicable disease.
5. Analyze data to determine rates of disease in the community.

Chapter 1: Public Health and Nursing Practice
Answer Section
MULTIPLE CHOICE
1. ANS: 4
Objective: 5. Identify the key roles and responsibilities of public health nurses (PHNs).
Page:
Heading: Introduction to Public Health
Integrated Processes: Nursing Process
Client Need: Physiological Integrity
Cognitive Level: Comprehension
Concept: Critical Thinking, Promoting Health
Difficulty: Easy
Feedback
1 The approach cannot be disease based because diseases can affect populations in
multiple locations, but the risk factors can be different.
2 Interventions occur after the public health event, and governments can only follow the
evidence of public health studies.
3 An epidemic is an occurrence of a disease and has the same limitations as a
disease-based approach.
4 PHNs assess risk for disease and other public health issues at both the individual level,
so that they can intervene on a one-to-one situational basis, as well as at the population
level to identify risk factors beyond the individual level and implement population-level
interventions.
PTS: 1 REF: 2 CON: Promoting Health | Critical Thinking

2. ANS: 3
Objective: 2. Describe public health in terms of current frameworks, community partnerships, and the concept
of population health.
Page:
Heading: Public Health Science and Practice
Client Needs: Health Promotion and Maintenance
Cognitive Level: Knowledge
Concept: Infection; Nursing Roles; Promoting Health
Difficulty: Easy
Feedback
1 Risk assessment is considered a part of disease prevention.
2 Promotion of primary care occurred through the Alma Ata World Health Organization
conference not Winslow’s definition.
3 Health-care providers are an essential component of public health.
4 The goal of public health is to guide governmental policy but not to create regulations.
PTS: 1 REF: 3 CON: Infection | Nursing Roles | Promoting Health

3. ANS: 4
Page:

Heading: Introduction to Public Health
Client Need: Safe and Effective Care Environment: Safety and Infection Control
Cognitive Level: Application [Applying]
Difficulty: Easy
Concept: Promoting Health; Health-Care System; Management; Safety
Difficulty: Easy
Feedback
1 The World Health Organization (WHO) is the “directing and coordinating authority for
health within the United Nations system”.
2 The WHO has the capability to monitor global epidemiological situations.
3 The WHO brings resources and knowledge to nurses who are working directly with
patients for them to make informed decisions.
4 The WHO is the public health arm of the United Nations and works toward both of the
previously mentioned goals.
PTS: 1 REF: 15-17

CON: Promoting Health | Health-Care System | Management | Safety
4. ANS: 1
Objective: 4. Explore the connection between environment, resource availability, and health.
Page:
Heading: Public Health Science and Practice
Integrated Processes: N/A
Client Need: Health Promotion and Maintenance
Concept: Assessment; Promoting Health
Difficulty: Easy
Feedback
1 Prevention is not considered a core function of public health, as assessment, policy
development, and assurance have prevention as an implied goal of each function.
2 Assessment focuses on analysis and collection of data, as well as the monitoring of
health problems and needs.
3 Policy development uses the acquired knowledge from assessments to create useful
public health policies.
4 Assurance creates trust in health-care agencies to provide necessary services that are in
line with public health goals.
PTS: 1 REF: 3 CON: Assessment | Promoting Health

5. ANS: 1
Page:
Heading: Introduction to Public Health > Public Health Frameworks: Challenges and Trends
Client Need: Safe and Effective Care Environment: Management of Care
Cognitive Level: Analysis
Concept: Immunity; Infection; Promoting Health
Difficulty: Easy
Feedback

1 As the percent of the population over the age of 65 increases, so does the prevalence of
chronic disease and the need for long-term care. From a population public health
perspective, decreased availability of care will result in increased morbidity and
mortality, and decreased quality of life.
2 An increased need for further research is important but is not the most pressing issue.
3 Further exploration of developmental stages related to aging might help in
understanding response to disease but is not the most pressing issue.
4 Decreased cost of medications will assist in access to treatment but is only one aspect
of long-term care needs.
PTS: 1 REF: 4 CON: Immunity | Infection | Promoting Health

6. ANS: 4
Page:
Client Need: Safe and Effective Care Environment: Management of Care
Cognitive Level: Analysis [Analyzing]
Concept: Evidence-Based Practice; Promoting Health
Difficulty: Moderate
Feedback
1 Location and social systems are two of many determinants in the ecology of a public
health problem.
2 This model asserts that the environment of the affected population is a key component
in assessing risk factors.
3 Social systems, families, and communities play a role in the health or lack of health for
an individual or a population.
4 The Dahlgren-Whitehead model is key to understanding the layers of influence and
relationships regarding population health and how important environment is to said
health. Thus, all of the answer choices together are correct.
PTS: 1 REF: 5 CON: Evidence-Based Practice | Promoting Health

7. ANS: 1
Objective: 3. Investigate determinants of health within the context of culture.
Page:
Concept: Promoting Health; Economics
Feedback
1 Upstream refers to determinants of health that include the physical as well as conditions
in the social environment creating poor health,
2 Downstream refers to the biological and behavioral bases for disease.
3 Genetic determinants of health occur at the individual biological level.
4 Behavioral determinants of health occur at the individual level.
PTS: 1 REF: 6 CON: Promoting Health | Economics

8. ANS: 2
Page:
Integrated Processes: Teaching/Learning
Concept: Nursing Roles; Communication; Collaboration
Difficulty: Easy
Feedback
1 Although decreased disease rate is a definite sign that the health population is
improving, community collaboration is a vehicle that brings participants together to
address health issues such as rates of disease. Community collaboration efforts are a
good way to achieve this.
2 Accountability among members of a community is improved when communities are
actively engaged in health programs.
3 Availability of treatment may not be an identified risk factor for the increase in the rate.
4 Improving screening rates may not be an identified risk factor for the increase in the
disease rate.
PTS: 1 REF: 6 CON: Nursing Roles | Communication | Collaboration

9. ANS: 2
Page:
Client Need: Communication and Documentation Cognitive Level: Application [Applying]
Concept: Promoting Health; Collaboration
Difficulty: Easy
Feedback
1 This collaboration benefits the community’s public health after a natural disaster.
2 Community collaboration can include advocating for change in regulations but does not
involve direct legislative activity that is the responsibility of governmental bodies.
3 A volunteer group can offer valuable services to enhance the lives of people suffering
from mental illness.
4 This community-based institution is an example of a social system that can work with a
health department to use each other’s strengths to produce a meaningful project.
PTS: 1 REF: 6 CON: Promoting Health | Collaboration

10. ANS: 3
Objective: 6. Identify the formal organization of public health services from a global to local level.
Page:
Heading: Introduction to Public Health > Public Health Organization and Management
Concept: Health-Care System, Regulation, Infection
Difficulty: Easy

Feedback
1 The Constitution did not provide for a national public health agency but rather assigned
that duty to the states. Although the Centers for Disease Control and Prevention (CDC)
provides ongoing research, sets guidelines, and offers support, quarantines are usually
the responsibility of local health departments.
2 State constitutions empower the states to establish state boards of health. Their duty is
to protect the citizens, but quarantines are mostly managed at the local level.
3 Quarantines are managed at the local level with assistance from the state if needed.
4 All levels of government are not needed or agile enough to handle local health crises.
PTS: 1 REF: 17 CON: Health-Care System | Regulations | Infection

11. ANS: 3
Objective: 6. Identify the formal organization of public health services from a global to local level.
Page:
Heading: Introduction to Public Health > Public Health Organization and Management
Integrated Processes: Communication and Documentation
Concept: Health-Care System, Regulations
Difficulty: Easy
Feedback
1 Local public health departments protect the health of the citizens that live in their
county, municipality, or township. In conjunction with the state public health
department and the Centers for Disease Control and Prevention, they conduct routine
surveillance to help identify an increase in disease.
2 Once there is a disease outbreak, local health departments participate in the outbreak
investigation in coordination with the state public health department and the Centers for
Disease Control and Prevention.
3 Hospitals are licensed by state and federal agencies, not local health departments.
4 Local public health department in coordination with the state public health department
and the Centers for Disease Control and Prevention implement and monitor quarantine
efforts in the event of communicable disease outbreak that warrants isolation of those
with the disease.
PTS: 1 REF: 19 CON: Regulations | Health-Care System

12. ANS: 3
Objective: 1. Identify how public health plays a central role in the practice of nursing across settings and
specialties.
Page:
Heading: Public Health as a Component of Nursing Practice Across Settings and Specialties > Health From a
Population Perspective
Concept: Evidence-Based Practice; Promoting Health
Feedback
1 Although economics could be a useful tool to assess the impact of a health program, it
is not considered one of the foundational subjects of public health.

2 The humanities are not considered one of the foundational subjects of public health.
3 Many branches of social and behavioral sciences are useful for analysis of public health
issues.
4 The study of man and his development is not considered one of the foundational
subjects of public health.
PTS: 1 REF: 2 CON: Evidence-Based Practice | Promoting Health

13. ANS: 2
Page:
Heading: Health Promotion, Risk Reduction, and Health Protection
Concept: Promoting Health
Difficulty: Easy
Feedback
1 Both of these options are health promotions because they create opportunities to
improve health through individual behavior change.
2 A health promotion intervention, such as an exercise class, creates an opportunity to
improve health through individual behavioral change, whereas a risk reduction
program, such as administering vaccinations, involves actions taken to reduce a
person’s risk for disease.
3 Free medication for the flu is a treatment program that occurs when disease is present
and not related to either health promotion or protection, and a diet class is a health
promotion program aimed at individual behavior change.
4 The hospital tour is educational but not related to health promotion or protection, and
the relaxation techniques class is health promotion exercise aimed at individual
behavior change.
PTS: 1 REF: 7 CON: Promoting Health

14. ANS: 4
Page:
Heading: Health Promotion, Risk Reduction, and Health Protection
Concept: Promoting Health; Nursing Roles
Feedback
1 Financial benefits or savings would promote behavioral change.
2 Health club memberships would facilitate the employees’ ability for change.
3 Encouraging a good diet through incentives would promote healthy behavior.
4 All of the options previously listed promote good health and reduce the risk for illness.
PTS: 1 REF: 15 CON: Promoting Health | Nursing Roles

15. ANS: 4

Objective: 3. Investigate determinants of health within the context of culture.
Page:
Heading: Health Promotion, Risk Reduction, and Health Protection > The Context of Health
Concept: Diversity; Promoting Health
Feedback
1 Race continues to be used to identify groups and as a marker for diversity.
2 Culture refers to beliefs, values, and norms shared across a group of people and reflects
diverse world views.
3 Ethnicity reflects diversity in that specific groups differ based on geographic origin,
language and dialect, religious faith, folklore, and food preferences.
4 Environment is an important factor in understanding the context of health but is
separate from the concept of diversity.
PTS: 1 REF: 7 CON: Diversity | Promoting Health
MULTIPLE RESPONSE
16. ANS: 1, 3, 4
Objective: 1. Identify how public health plays a central role in the practice of nursing across settings and
specialties.
Page:
Cognitive Level: Comprehension [Understanding]
Concept: Addiction; Promoting Health; Economics; Infection
Difficulty: Easy
Feedback
1 Globalization has resulted in widening of disparity between low-income and high-income
countries especially in relation to food security and environmental degradation.
2 In public health, better strategies for managing health care and current resources are needed
more than newer technology.
3 The widespread availability of tobacco and alcohol increases the abuse of these substances and
the problems that accompany it.
4 Some of the diseases that have emerged or re-emerged as a result of globalization are HIV,
AIDS, severe acute respiratory syndrome, hepatitis, malaria, diphtheria, cholera, Ebola, and
Zika virus. There is a need for planning for these possible pandemics using limited resources.
5 Although improved transportation has resulted in increased globalization, further
improvements are not a public health threat.
PTS: 1 REF: 4 CON: Addiction | Promoting Health | Economics | Infection

17. ANS: 2, 3, 4, 5
Page:

Heading: Health Promotion, Risk Reduction, and Health Protection > Population-Focused Care Across
Settings and Nursing Specialties
Client Need: Physiological Integrity
Cognitive Level: Synthesis
Concept: Assessment; Critical Thinking
Difficulty: Easy
Feedback
1 Antibiotics may not be a necessary route of treatment for the diagnosis.
2 The first step is to note and compare symptoms, onset, and other information to ascertain whether
this is the same illness and if it is potentially due to a common cause.
3 Grouping the patients according to diagnosis will allow the health-care team to give better care
and help create a care map but would not be the first step.
4 Once the data on symptoms, onset, and other key information has been gathered, the next step is
to inform the public health department if warranted.
5 Evaluating the environment of the patients may create an understanding of why the illness
occurred and prevent a re-occurrence of the illness and would occur as part of the public health
department’s outbreak investigation, if one is warranted.
PTS: 1 REF: 9 | 10 CON: Infection | Assessment

18. ANS: 1, 2, 3, 4
Page:
Heading: Public Health Nursing as a Specialty > Public Health Nursing Scope and Standards of Practice
Client Need: N/A
Concept: Regulations; Nursing Roles
Difficulty: Easy
Feedback
1 The PHN collects comprehensive data pertinent to the health status of populations.
2 The PHN analyzes the assessment data to determine the diagnoses or issues.
3 The PHN identifies expected outcomes for a plan specific to the population or situation.
4 The PHN develops a plan that prescribes strategies and alternatives to attain expected outcomes.
5 Mitigation is a part of emergency preparedness and disaster management
PTS: 1 REF: 13 CON: Regulations | Nursing Roles

19. ANS: 1, 2, 3, 5
Page:
Heading: Public Health Nursing as a Specialty > Public Health Nursing Scope and Standards of Practice
Client Need: N/A
Concept: Infection; Nutrition; Diversity; Nursing Roles
Difficulty: Easy

Feedback
1 Policy development/program planning is an essential skill for a PHN.
2 To reach a population that might not receive adequate health care, cultural competency and
communication skills are needed to overcome any barriers.
3 Financial and management skills are needed to maintain the sustainability of programs.
4 Development of individual treatment plans is part of the basic skills of all nurses and does not
reflect a specific PHN competency.
5 One of the new challenges PHNs face is preparing the public for sudden, catastrophic health
events, such as bioterrorism.
PTS: 1 REF: 15 CON: Infection | Nutrition | Diversity | Nursing Roles

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“And now,” he said, “I must be up and doing, although it is past two
o’clock. I must bid my mother good-bye, and I foresee there will be
no time to do it when once I have reported, which I promised to do
within twenty-four hours. By starting now I can reach Ferry Farm to-
morrow morning, spend an hour with her, and return here at night; so
if you, captain, will have my horses brought, I will wake up my boy
Billy”—for, although Billy was quite George’s age, he remained ever
his “boy.”
Next morning at Ferry Farm, about ten o’clock, Betty, happening to
open the parlor door, ran directly into George’s arms, whom she
supposed to be forty-five miles off. Betty was speechless with
amazement.
“Don’t look as if you had seen a rattlesnake, Betty,” cried George,
giving her a very cruel pinch, “but run, like a good child as you are,
though flighty, and tell our mother that I am here.”
Before Betty could move a step in marched Madam Washington,
stately and beautiful as ever. And there were the three boys, all
handsome youths, but handsomer when they were not contrasted
with the elder brother; and then, quite gayly and as if he were a mere
lad, George plunged into his story, telling his mother that he was to
make the campaign with General Braddock as first aide-de-camp,
and trying to tell her about the officers’ letter, which he took from his
pocket, but, blushing very much, was going to return it, had not Betty
seized it as with an eagle’s claw.
“Betty,” cried George, stamping his foot, “give me back that letter!”
“No, indeed, George,” answered Betty, with calm disdain. “Do not put
on any of your grand airs with me. I have heard of this letter, and I
mean to read it aloud to our mother. And you may storm and stamp
and fume all you like—’tis not of the slightest consequence.”
So George, scowling and yet forced to laugh a little, had to listen to
all the compliments paid him read out in Betty’s rich, ringing young
voice, while his mother sat and glowed with pride, and his younger
brothers hurrahed after the manner of boys; and when Betty had got
through the letter her laughing face suddenly changed to a very
serious one, and she ran to George and kissed him all over his
cheeks, saying:
“Dear George, it makes me so happy that I both want to laugh and
cry—dear, dear brother!”
And George, with tender eyes, kissed Betty in return, so that she
knew how much he loved her.
When Madam Washington spoke it was in a voice strangely different
from her usually calm, musical tones. She had just got the idol of her
heart back from all his dangers, and she was loath to let him go
again, and told him so.
“But, mother,” answered George, after listening to her respectfully,
“when I started upon my campaign last year you told me that you
placed me in God’s keeping. The God to whom you commended me
then defended me from all harm, and I trust He will do so now. Do
not you?”
Madam Washington paused, and the rare tears stole down her
cheeks.
“You are right, my son,” she answered, presently. “I will not say
another word to detain you, but will once more give you into the
hands of the good God to take care of for me.”
That night, before twelve o’clock, George reported at Alexandria to
General Braddock as his aide.
On the 20th of April, near the time that George had set out the year
before, General Braddock began his march from Alexandria in
Virginia to the mountains of Pennsylvania, where the reduction of
Fort Duquesne was his first object. There were two magnificent
regiments of crack British troops and ten companies of Virginia
troops, hardy and seasoned, and in the highest spirits at the
prospect of their young commander being with them. They cheered
him vociferously when he appeared riding with General Braddock,
and made him blush furiously. But his face grew very long and
solemn when he saw the immense train of wagons to carry baggage
and stores which he knew were unnecessary, and the general at that
very moment was storming because there were not more.
“These,” he said, “were furnished by Mr. Franklin, Postmaster-
General of Pennsylvania, and he sends me only a hundred and fifty
at that.”
“A hundred too many,” was George’s thought.
The march was inconceivably slow. Never since George could
remember had he so much difficulty in restraining his temper as on
that celebrated march. As he said afterwards, “Every mole-hill had to
be levelled, and bridges built across every brook.” General Braddock
wished to march across the trackless wilderness of the Alleghanies
as he did across the flat plains of Flanders, and he spent his time in
constructing a great military road when he should have been pushing
ahead. So slow was their progress that in reaching Winchester
George was enabled to make a détour and go to Greenway Court for
a few hours. The delight of Lord Fairfax and Lance was extreme, but
in a burst of confidence George told them the actual state of affairs.
“What you tell me,” said the earl, gravely, “determines me to go to
the low country, for if this expedition results disastrously I can be of
more use at Williamsburg than here. But, my dear George, I am
concerned for you, because you look ill. You are positively gaunt,
and you look as if you had not eaten for a week.”
“Ill!” cried George, beginning to walk up and down the library, and
clinching and unclinching his lists nervously. “My lord, it is my heart
and soul that are ill. Can you think what it is to watch a general,
brave but obstinate, and blind to the last degree, rushing upon
disaster? Upon my soul, sir, those English officers think, I verily
believe, that the Indians are formed into regiments and battalions,
with a general staff and a commissary, and God knows what!” And
George raved a while longer before he left to ride back to
Winchester, with Billy riding after him. This outbreak was so unlike
George, he looked so strange, his once ruddy face was so pallid at
one moment and so violently flushed at another that the earl and
Lance each felt an unspoken dread that his strong body might give
way under the strain upon it.
George galloped back into Winchester that night. Both his horse and
Billy’s were dripping wet, and as he pulled his horse almost up on his
haunches Billy said, in a queer voice:
“Hi, Marse George, d’yar blood on yo’ bridle. You rid dat boss hard,
sho’ nough!”
“Hold your tongue!” shouted George, in a tone that Billy had never
heard from him before; and then, in the next minute, he said,
confusedly, “I did not mean to speak so, but my head is in a whirl; I
think I must be ill.”
And as he spoke he reeled in his saddle, and would have fallen had
not Billy run forward and caught him. He staggered into the house
where he had lodgings, and got into his bed, and by midnight he was
raving with fever.
Billy had sense enough to go for Dr. Craik, George’s old
acquaintance, who had volunteered as surgeon to General
Braddock’s staff. He was a bright-eyed, determined-looking man, still
young, but skilled in his profession. By morning the fever was
reduced, and Dr. Craik was giving orders about the treatment as he
sat by George’s bedside, for the army was to resume its march that
day.
“Your attack is sharp,” said the doctor, “but you have an iron
constitution, and with ordinary care you will soon be well.”
George, pale and haggard, but without fever, listened to the doctor’s
directions with a half-smile. The troops were already on the move;
outside could be heard the steady tramp of feet, the thunder of
horses’ hoofs, the roll of artillery-wagons, and the commotion of an
army on the move. In a few moments the doctor left him, saying:
“I think you will shortly be able to rejoin the army, Colonel
Washington.”
“I think so, too,” answered George.
As soon as the doctor was out of the room George turned to Billy
and said:
“Help me on with my clothes, and as soon as the troops are well out
of the town fetch the horses.”
When the soldiers halted at noon, General Braddock, sitting under a
tree by the road-side, was asking Dr. Craik’s opinion of the time that
Colonel Washington could rejoin, when around the corner of a huge
bowlder rode George with Billy behind him. He was very pale, but he
could sit his horse. He could not but laugh at the doctor’s angry face,
but said deprecatingly to him:
“I would have fretted myself more ill had I remained at Winchester,
for I am not by nature patient, and I have been ill so little that I do not
know how to be ill.”
“I see you don’t,” was the doctor’s dry reply.
For four days George kept up with the army, and managed, in spite
of burning fevers, of a horrible weakness and weariness, of
sleepless nights racked with pain, to ride his horse. On the fifth he
was compelled to take to a covered wagon. There, on a rough bed,
with Billy holding his burning head, he was jolted along for ten days
more, each day more agonizing than the one before. In that terrible
time master and man seemed to have changed places. It was
George who was fretful and unreasonable and wildly irritable, while
Billy, the useless, the lazy, the incorrigible, nursed him with a
patience, a tenderness, a strange intelligence that amazed all who
saw it, and was even dimly felt by George. The black boy seemed
able to do altogether without sleep. At every hour of the day and
night he was awake and alert, ready to do anything for the poor
sufferer. As the days passed on, and George grew steadily worse,
the doctor began to look troubled. In his master’s presence Billy
showed no sign of fear, but he would every day follow Dr. Craik when
he left, and ask him, with an ashy face:
“Marse doctor, is Marse George gwi’ die?”
“I hope not. He is young and strong, and God is good.”
“Ef he die, an’ I go home, what I gwi’ say when mistis come out and
say, ‘Billy, wh’yar yo’ Marse George?’” And at that Billy would throw
himself on the ground in a paroxysm of grief that was piteous to see.
The doctor carefully concealed from the soldiers George’s real
condition. But after four or five days of agony a change set in, and
within the week George was able to sit up and even ride a little. The
wagons had kept with the rear division of the army, but George knew
that General Braddock, with twelve hundred picked men, had gone
ahead and must be near Fort Duquesne. On the fourteenth day, in
the evening, when the doctor came he found his patient walking
about. He was frightfully thin and pale, but youth and strength and
good habits were beginning to assert themselves. He was getting
well.
“Doctor,” said he, “this place is about fifteen miles from Fort
Duquesne. I know it well, and from this hour I emancipate myself
from you. This day I shall report for duty.”
The next morning, the 9th of July, 1755, dawned beautifully, and the
first long lances of light revealed a splendid sight on the banks of the
Monongahela. On one side flowed the great river in majestic beauty.
Following the shores was a kind of natural esplanade, while a little
way off the rich woods, within which dwelt forever a purple twilight,
overhung this charming open space. And along this open space
marched, in exquisite precision, two thousand of England’s crack
troops—cavalry, infantry, and artillery—and a thousand bronzed
Virginia soldiery to the music of the fife and drum. Often in after-
years George Washington was heard to say that the most beautiful
sight his eyes ever rested on was the sight of Braddock’s army at
sunrise on that day of blood. Officers and men were in the highest
spirits; they expected within a few hours to be in sight of Fort
Duquesne, where glory, as they thought, awaited their coming. Even
George’s apprehensions of the imprudence of this mode of attack
were soothed. He rode by General Braddock’s side, and was by far
the most conspicuous figure there for grace and nobility. His illness
seemed to have departed in a night, and he was the same erect,
soldierly form, fairly dwarfing every one contrasted with him. As the
general and his first aide rode together, General Braddock said,
confidently:
“Colonel Washington, in spite of your warning, see how far we have
come upon our way without disaster. The danger of an attack by
Indians is now passed, and we have but to march a few miles more
and glory is ours.”
Scarcely were the words out of his mouth when there was one sharp
crack of a gun, followed by a fierce volley, and fifty men dropped in
their tracks. But there was no enemy visible. The shots were like a
bolt of lightning from a clear sky.
“The Indians,” said George, in a perfectly composed voice, reining
up his horse.
“I see no Indians,” cried General Braddock, excitedly. “There is
disorder in the ranks; have them closed up at once, and march in
double time. We will soon find the enemy.”
But the firing from the invisible foe again broke forth, this time fiercer
and more murderous than before. General Braddock, riding to the
head of the first regiment, which had begun to waver, shouted the
order for them to reform and fire. The veteran troops, as coolly as if
on parade, closed up their ranks, and gave a volley, but it was as if
fired in the air. They saw no enemy to fire at. Meanwhile the Virginia
troops, after the first staggering effect of a terrific musketry fire
poured into them by an unseen enemy, suddenly broke ranks, and,
each man running for a tree, they took possession of the skirts of the
woods. On seeing this General Braddock galloped up to George.
“Colonel Washington,” he cried, violently, “your Virginia troops are
insubordinate! They have scattered themselves through the woods,
and I desire them formed again in columns of fours to advance.”
“Sir,” answered George, in agony, “the ravines are full of Indians—
many hundreds of them. They can slaughter us at their pleasure if
we form in the open. The Virginians know how to fight them.”
“You are an inexperienced soldier, sir, and therefore I excuse you.
But look at my English veterans—see how they behave—and I
desire the Virginians to do the same.”
At that moment George’s horse fell upon his knees, and the next he
rolled over, shot through the heart. The English regiments had
closed up manfully, after receiving several destructive volleys,
returning the fire of their assailants without seeing them and without
producing the smallest effect. But suddenly the spectacle of half their
men dead or wounded on the ground, the galloping about of
riderless horses, the shrieks of agony that filled the air, seemed to
unman them. They broke and ran in every direction. In vain General
Braddock rode up to them, actually riding over them, waving his
sword and calling to them to halt.
The men who had faced the legions of Europe were panic-stricken
by this dreadful unseen foe, and fled, only to be shot down in their
tracks. To make it more terrible, the officers were singled out for
slaughter, and out of eighty-six officers in a very little while twenty-six
were killed and thirty-seven wounded. General Braddock himself had
his horse shot under him, and as he rolled on the ground a cry of
pain was wrung from him by two musket-balls that pierced his body.
Of his three aides, two lay weltering in their blood, and George alone
was at his side helping him to rise.
Rash and obstinate as General Braddock might be, he did not lack
for courage, and in that awful time he was determined to fight to the
last.
“Get me another horse,” he said, with difficulty, to George. “Are you,
too, wounded?”
“No, general, but I have had two horses shot under me. Here is my
third one—mount!” And by the exertion of an almost superhuman
strength he raised General Braddock’s bulky figure from the ground
and placed him in the saddle.
“I am badly wounded,” said General Braddock, as he reeled slightly;
“but I can sit my horse yet. Your Virginians are doing nobly, but they
should form in columns.”
Besotted to the end, but seeing that the Virginians alone were
standing their ground, General Braddock did not give a positive
order, and George did not feel obliged to obey this murderous
mistake. But General Braddock, after a gasp or two, turned a livid
face towards George.
“Colonel Washington, the command is yours. I am more seriously
wounded than I thought.” He swayed forward, and but for George
would have fallen from his horse.
The panic was now at its height. Men, horses, wagons, all piled
together in a terrible mêlée, made for the rear; but there, again, they
were met by a hail of bullets. Staggered, they rushed back, only to
be again mowed down by the hidden enemy. The few officers left
commanded, begged, and entreated the men to stand firm; but they,
who had faced death upon a hundred fields, were now so mad with
fear that they were incapable of obedience. George, who had
managed to have General Braddock carried to the rear with the aid
of Dr. Craik, had got another horse, and riding from one end of the
bloody field to the other, did all that mortal man could do to rally the
panic-stricken men, but it was in vain. His clothes were riddled with
bullets, but in the midst of the carnage around him he was
unharmed, and rode over the field like the embodied spirit of battle.
The Virginians alone, cool and determined, fought steadily and sold
their lives dearly, although picked off one by one. At last, after hours
of panic, flight, and slaughter, George succeeded in bringing off the
remnant of the Virginians, and, overtaking the fleeing mob of regular
troops some miles from the scene of the conflict, got them across the
ford of the Monongahela. They were safe from pursuit, for the
handful of Frenchmen could not persuade their Indian allies to leave
the plunder of the battle-field for the pursuit of the enemy. The first
thing that George did was to send immediately for wagons, which
had been left behind, to transport the wounded. General Braddock,
still alive but suffering agonies from his wounds, was carried on
horseback, then in a cart, and at last, the jolting being intolerable, on
a litter upon the shoulders of four sturdy backwoodsmen. But he was
marked for death. On the third day of this terrible retreat, towards
sunset, he sank into a lethargy. George, who had spent every
moment possible by his side, turned to Dr. Craik, who shook his
head significantly—there was no hope. As George dismounted and
walked by the side of the litter, the better to hear any words the dying
soldier might utter, General Braddock roused a little.
“Colonel Washington,” he said, in a feeble voice, “I am satisfied with
your conduct. We have had bad fortune—very bad fortune; but”—
here his mind began to wander—“yonder is the smoke rising from
the chimneys; we shall soon be home and at rest. Good-night,
Colonel Washington—”
“GEORGE DID ALL THAT MORTAL MAN COULD DO”

The men with the litter stopped. George, with an overburdened
heart, watched the last gasp of a rash but brave and honorable
soldier, and presently gently closed his eyes. That night the body of
General Braddock, wrapped in his military cloak, was buried under a
great oak-tree in the woods by the side of the highway, and before
daylight the mournful march was resumed.
The news of the disaster had preceded them, and when George,
attended only by Captain Vanbraam and a few of his Virginia officers,
rode into Williamsburg on an August evening, it was with the
heaviest heart he had ever carried in his bosom. But by one of those
strange paradoxes, ever existing in the careers of men of destiny,
the events that had brought ruin to others only served to exalt him
personally. His gallant conduct in battle, his miraculous escape, his
bringing off of the survivors, especially among the Virginia troops,
and the knowledge which had come about that had his advice been
heeded the terrible disaster would not have taken place—all
conspired to make him still more of a popular hero. Not only his own
men adored him, and pointed out that he had saved all that could be
saved on that dreadful day, but the British troops as well saw that the
glory was his, and the return march was one long ovation to the one
officer who came out of the fight with a greater reputation than when
he entered it. Everywhere crowds met him with acclamations and
with tears. The streets of the quaint little town of Williamsburg were
filled with people on this summer evening, who followed the party of
officers, with George at their head, to the palace. George responded
to the shouts for him by bowing gracefully from side to side.
Arrived at the palace he dismounted, and, just as the sentry at the
main door presented arms to him, he saw a party coming out, and
they were the persons he most desired to see in the world and least
expected. First came the Earl of Fairfax with Madam Washington,
whom he was about to hand down the steps and into his coach,
which had not yet driven up. Behind them demurely walked Betty,
and behind Betty came Lance, carrying the mantles of the two
ladies.
The earl and Madam Washington, engaged in earnest conversation,
did not catch sight of George until Betty had rushed forward, and
crying out in rapture, “George, dear George!” they saw the brother
and sister clasped in each other’s arms.
Madam Washington stood quite still, dumfounded with joy, until
George, kissing her hand tenderly, made her realize that it was
indeed he, her best beloved, saved from almost universal destruction
and standing before her. She, the calmest, the stateliest of women,
trembled, and had to lean upon him for support; the earl grasped his
hand; Lance was in waiting. George was as overcome with joy as
they were.
“But I must ask at once to see the governor,” said he, after the first
rapture of meeting was over. “You, my lord, must go with me, for I
want friends near me when I tell the story of sorrow and disaster.”
Four days afterwards, the House of Burgesses being in session,
Colonel Washington was summoned by the Speaker to read his
report of the campaign before it, and to be formally designated as
commander-in-chief of the forces. The facts were already known, but
it was thought well, in order to arouse the people to the sense of
their danger, and to provide means for carrying on the war in
defence of their frontiers, that Colonel Washington should make a
public report, and should publicly receive the appointment of
commander-in-chief of the next expedition. The House of Burgesses,
then as ever, proudly insistent of its rights, had given the governor to
understand that they would give him neither money nor supplies
unless their favorite soldier should have the command in the next
campaign—and, indeed, the attitude of the officers and soldiery
made this absolutely necessary. Even the governor had realized this,
and, disheartened by the failure of his much-heralded regulars, was
in a submissive mood, and these haughty colonial legislators, of
whose republican principles Governor Dinwiddie already complained
much, took this opportunity to prove that without their co-operation
but little could be done.
The large hall of the House of Burgesses, but dimly lighted by small
diamond-paned windows, was filled with the leading men of the
colony, including Lord Fairfax. Ladies had been admitted to the floor,
and among them sat in majestic beauty Madam Washington, and
next to her sat Betty, palpitating, trembling, blushing, and with proud,
bright eyes awaited the entrance of her “darling George,” as she
called him, although often reproved for her extravagance by her
mother.
At last George entered this august assembly. His handsome head
was uncovered, showing his fair hair. He wore a glittering uniform,
and his sword, given him by Lord Fairfax, hung at his side. He
carried himself with that splendid and noble air that was always his
characteristic, and, quietly seating himself, awaited the interrogatory
of the president. When this was made he rose respectfully and
began to read from manuscript the sad story of Braddock’s
campaign. It was brief, but every sentence thrilled all who heard it.
When he said, in describing the terrible story of the 9th of July, “The
officers in general behaved with incomparable bravery, for which
they suffered, upwards of sixty being killed or wounded,” a kind of
groan ran through the great assemblage; and when he added, in a
voice shaken with emotion, “The Virginia companies behaved like
men and died like soldiers; for, I believe, out of three companies on
the ground that day scarce thirty men were left alive,” sobs were
heard, and many persons, both men and women, burst into tears.
His report being ended, the president of the House of Burgesses
arose and addressed him:
“Colonel Washington: We have listened to your account of the late
campaign with feelings of the deepest and most poignant sorrow, but
without abandoning in any way our intention to maintain our lawful
frontiers against our enemies. It has been determined to raise
sixteen companies in this colony for offensive and defensive warfare,
and by the appointment of his excellency the governor, in deference
to the will of the people and the desire of the soldiers, you are
hereby appointed, by this commission from his excellency the
governor, which I hold in my hand, commander-in-chief of all the
forces now raised or to be raised by this colony, reposing special
confidence in your patriotism, valor, conduct, and fidelity. And you
are hereby invested with power and authority to act as you shall
think for the good of the service.
“And we hereby strictly charge all officers and soldiers under your
command to be obedient to your orders and diligent in the exercise
of their several duties.
“And we also enjoin and require you to be careful in executing the
great trust reposed in you, by causing strict discipline and order to be
observed in the army, and that the soldiers be duly exercised and
provided with all necessaries.
“And you are to regulate your conduct in every respect by the rules
and discipline of war, and punctually to observe and follow such
orders and directions as you shall receive from his excellency the
governor and this or other House of Burgesses, or committee of the
House of Burgesses.”
A storm of applause broke forth, and George stood silent, trembling
and abashed, with a noble diffidence. He raised one hand in
deprecation, and it was taken to mean that he would speak, and a
solemn hush fell upon the assembly. But in the perfect silence he felt
himself unable to utter a word, or even to lift his eyes from the floor.
The president sat in a listening attitude for a whole minute, then he
said:
“Sit down, Colonel Washington. Your modesty is equal to your valor,
and both are above comparison. Your life would not have been
spared, as if by a miracle, had not the All-wise Ruler of the heavens
and the earth designed that you should fulfil your great destiny; and
one day, believe me, you shall be called the prop, the stay, and the
glory of your country.”
THE END
FOOTNOTES:
[A] In Washington’s will he mentions “my man
William, calling himself William Lee,” and gives
him his freedom, along with the other slaves, and
an annuity besides: “and this I give him as a
testimony of my sense of his attachment to me,
and for his faithful services during the
Revolutionary War.”
[B] Washington, in his journal, speaks of the
Indian firing at him at short range, but says
nothing of his preventing his companion from
killing the would-be murderer. But his companion
expressly says that he would have killed the
Indian on the spot had not Washington forbidden
him. The Indians became very superstitious
about Washington’s immunity from bullets,
especially after Braddock’s defeat. In that battle
he was the target for the best marksmen among
them, and not only escaped without a scratch,
although two horses were killed under him and
his clothes riddled with bullets, but he was the
only officer of Braddock’s military family who
survived.
[C] This letter, which is printed in full in Marshall’s
Life of Washington, was among the highest
personal compliments ever paid Washington. The
signers were seasoned soldiers, addressing a
young man of twenty-three, under whom they
had made a campaign of frightful hardship ending
in disaster. They were to be ordered to resume
operations in the spring, and it was to this young
man that these officers appealed, believing him to
be essential to the proper conduct of the
campaign.
By JAMES BARNES
A LOYAL TRAITOR. A Story of the War of 1812.
Illustrated. Post 8vo, Cloth, Ornamental, $1 50.
A vigorous romance it is, full of life and adventure.—
N. Y. Herald.
A stirring story.... The several characters are finely
balanced and well drawn, and are admirably
interwoven to give reasonableness and
completeness in every chapter.—Chicago Inter-
Ocean.
We turn with a feeling of relief to Mr. Barnes’s
breezy and Marryat-like story of the American
privateersman.... This is all genuine romance, with a
wide horizon and many changes of scene.... Mr.
Barnes has done his work well.—N. Y. Times.
An excellent and intensely interesting story of
romance and adventure.—Brooklyn Standard-Union.
The book has freshness, animation, and strong
story-interest.—Outlook, N. Y.
A quick-moving, picturesque story. The daring
Yankee sailor of that naval war, his life above deck
and below, in battle and in cruise, his dialect and
yarns, are all quaintly reproduced in a series of vivid
scenes.—Philadelphia Record.
FOR KING OR COUNTRY. A Story of the American

Revolution. Illustrated. Post 8vo, Cloth, Ornamental, $1
50.
NAVAL ACTIONS OF THE WAR OF 1812. Illustrated. 8vo,

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NEW YORK AND LONDON
HARPER & BROTHERS, Publishers
☞ The above works are for sale by all booksellers, or will
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receipt of the price.
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