Chapter 20: Family-Centered Home Care

Chapter 20: Family-Centered Home Care

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. Home care is being considered for a young child who is ventilator-dependent. Which factor is most important in deciding whether home care is appropriate?

a.	Level of parents’ education
b.	Presence of two parents in the home
c.	Preparation and training of family
d.	Family’s ability to assume all health care costs

 

 

ANS:  C

One of the essential elements is the family’s training and preparation. The family must be able to demonstrate all aspects of care for the child. In many areas, it cannot be guaranteed that nursing care will be available on a continual basis, and the family will have to care for the child. The amount of formal education reached by the parents is not the important issue. The determinant is the family’s ability to care adequately for the child in the home. At least two family members should learn and demonstrate all aspects of the child’s care in the hospital, but it does not have to be two parents. Few families can assume all health care costs. Creative financial planning, including negotiating arrangements with the insurance company and/or public programs, may be required.

 

PTS:   1                    DIF:    Cognitive Level: Analyze                REF:   598-599

TOP:   Integrated Process: Nursing Process: Implementation

MSC:  Area of Client Needs: Safe and Effective Care Environment: Safety and Infection Control

 

2. The home health nurse asks a child’s mother many questions as part of the assessment. The mother answers many questions, then stops and says, “I don’t know why you ask me all this. Who gets to know this information?” The nurse should take which action?

a.	Determine why the mother is so suspicious.
b.	Determine what the mother does not want to tell.
c.	Explain who will have access to the information.
d.	Explain that everything is confidential and that no one else will know what is said.

 

 

ANS:  C

Communication with the family should not be invasive. The nurse needs to explain the importance of collecting the information, its applicability to the child’s care, and who will have access to the information. The mother is not being suspicious and is not necessarily withholding important information. She has a right to understand how the information she provides will be used. The nurse will need to share, through both oral and written communication, clinically relevant information with other involved health professionals.

 

PTS:   1                    DIF:    Cognitive Level: Apply                   REF:   604

TOP:   Integrated Process: Communication and Documentation

MSC:  Area of Client Needs: Safe and Effective Care Environment: Management of Care

 

3. When communicating with other professionals, it is important for home care nurses to:

a.	ask others what they want to know.
b.	share everything known about the family.
c.	restrict communication to clinically relevant information.
d.	recognize that confidentiality is not possible.

 

 

ANS:  C

The nurse will need to share, through both oral and written communication, clinically relevant information with other involved health professionals. Asking others what they want to know and sharing everything known about the family is inappropriate. Patients have a right to confidentiality. The nurse is not permitted to share information about clients, except clinically relevant information that pertains to the child’s care. Confidentiality permits the disclosure of information to other health professionals on a need-to-know basis.

 

PTS:   1                    DIF:    Cognitive Level: Apply                   REF:   604

TOP:   Integrated Process: Communication and Documentation

MSC:  Area of Client Needs: Safe and Effective Care Environment: Management of Care

 

4. The home health nurse is caring for a child who requires complex care. The family expresses frustration related to obtaining accurate information about their child’s illness and its management. Which is the best action for the nurse?

a.	Determine why family is easily frustrated.
b.	Refer family to child’s primary care practitioner.
c.	Clarify family’s request, and provide information they want.
d.	Answer only questions that family needs to know about.

 

 

ANS:  C

The philosophic basis for family-centered practice is the recognition that the family is the constant in the child’s life. It is essential and appropriate that the family have complete and accurate information about their child’s illness and management. The nurse may first have to clarify what information the family believes has not been communicated. The family’s frustration arises from their perception that they are not receiving information pertinent to their child’s care. Referring the family to the child’s primary care practitioner does not help the family. The home health nurse should have access to the necessary information. Questions about what they need and want to know concerning their child’s care should be addressed.

 

PTS:   1                    DIF:    Cognitive Level: Apply                   REF:   605

TOP:   Integrated Process: Communication and Documentation

MSC:  Area of Client Needs: Safe and Effective Care Environment: Management of Care