Question 36·Hard·Central Ideas and Details
The following text is adapted from Florence Nightingale’s 1863 essay Notes on Hospitals.
It may appear a strange principle to lay down as our first requirement in a hospital—that it should do the sick no harm. Yet this negative must be secured before any positive good is possible. To speak of comfort, skilled attendance, or the newest remedies while the wards themselves propagate disease is merely to polish the chain that still binds the patient. The very classification of hospitals, therefore, ought to begin by excluding whatever maintains the illness they profess to cure.
Which choice best states Nightingale’s central claim about hospitals?
For “central claim” questions, identify the sentence where the author states a principle, requirement, or main assertion (often flagged by wording like “first requirement” or a strong general statement). Paraphrase that claim in your own words, then choose the option that matches your paraphrase without reversing priorities, overstating the author’s point, or introducing a new focus.
Hints
Locate the main requirement
Reread the first sentence. Nightingale calls something the “first requirement in a hospital.” What is that requirement, in her own words?
Focus on the contrast words
Look closely at the sentence that mentions “this negative must be secured before any positive good is possible.” What has to happen before anything else? What does that tell you about her priority for hospitals?
Eliminate ideas that reverse or exaggerate the passage
Check each choice against the passage. Cross out any option that (1) puts comfort/remedies ahead of preventing harm, (2) changes what “classification” refers to, or (3) makes an extreme claim the author never states (for example, that hospitals should generally be avoided).
Step-by-step Explanation
Identify what the question is asking
The question asks for Nightingale’s central claim about hospitals. That means you need the main argument or key point she is making in this short passage, not a minor detail.
Find where the author states the main requirement
Look at the beginning of the passage:
It may appear a strange principle to lay down as our first requirement in a hospital—that it should do the sick no harm.
She clearly labels this as the “first requirement” of a hospital, which strongly signals her central claim.
Use the “negative” vs. “positive good” contrast to confirm the claim
Nightingale adds:
Yet this negative must be secured before any positive good is possible.
She means that preventing harm (the “negative”) must come before comforts, skilled attendance, or new remedies (the “positive good”). She reinforces this by saying that talking about comforts/remedies is pointless if the wards themselves spread disease.
Match the claim to the best answer choice
The correct choice must say that hospitals should first ensure they do not harm patients, and then pursue other benefits.
- Choice 1 reverses Nightingale’s priority by elevating comforts/remedies even if there is risk.
- Choice 3 misreads the point about “classification”: Nightingale says classification should begin by excluding what maintains illness, not by grouping hospitals by what comforts/treatments they offer.
- Choice 4 goes beyond the passage by claiming hospitals should generally be avoided.
Therefore, the correct answer is: They must prevent harm to patients before striving for any additional benefits.