Nursing A Concept Based Approach to Learning Volume II 2nd Ed - Test Bank

Nursing A Concept Based Approach to Learning Volume II 2nd Ed – Test Bank

 

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Nursing: A Concept-Based Approach to Learning, 2e (Pearson)

Module 26   Family

 

The Concept of Family

 

1) A nurse is caring for a 3-year-old female client who was admitted for dehydration. The child lives with her parents and maternal grandparents. In which type of family does this child reside?

1. A) Blended family
2. B) Extended
3. C) Two-career family
4. D) Traditional family

Answer:  B

Explanation:  A) In some cultures and as people live longer, more than two generations may live together in an extended setting. A two-career family is one where both partners are employed. A blended family occurs when existing family units join together to form new families. A traditional family is viewed as an autonomous unit in which both parents reside in the home.

1. B) In some cultures and as people live longer, more than two generations may live together in an extended setting. A two-career family is one where both partners are employed. A blended family occurs when existing family units join together to form new families. A traditional family is viewed as an autonomous unit in which both parents reside in the home.
2. C) In some cultures and as people live longer, more than two generations may live together in an extended setting. A two-career family is one where both partners are employed. A blended family occurs when existing family units join together to form new families. A traditional family is viewed as an autonomous unit in which both parents reside in the home.
3. D) In some cultures and as people live longer, more than two generations may live together in an extended setting. A two-career family is one where both partners are employed. A blended family occurs when existing family units join together to form new families. A traditional family is viewed as an autonomous unit in which both parents reside in the home.

Page Ref: 1709

Cognitive Level:  Analyzing

Client Need:  Health Promotion and Maintenance

Nursing Process:  Assessment

Learning Outcome:  1. Summarize the makeup of the family structure.

 

2) During a home visit, the nurse decides that care interventions are needed to address alcohol and substance abuse by family members. Which intervention(s) should the nurse consider when planning care for this family?

Select all that apply.

1. A) Suggest grief counseling.
2. B) Evaluate family members’ potential for being a danger to self or others.
3. C) Suggest engaging in educational activities.
4. D) Be alert to behaviors that indicate sibling jealousy.
5. E) Recommend community resources to assist with substance abuse behavior.

Answer:  B, E

Explanation:  A) For the family with alcohol or substance abuse, the nurse should evaluate family members’ potential for being a danger to self or others and recommend community resources to family members to help with substance abuse behaviors. Grief counseling would be appropriate for the family who has suffered a loss of a family member. Educational activities and being alert to sibling jealousy would be appropriate for the antepartum or postpartum family.

1. B) For the family with alcohol or substance abuse, the nurse should evaluate family members’ potential for being a danger to self or others and recommend community resources to family members to help with substance abuse behaviors. Grief counseling would be appropriate for the family who has suffered a loss of a family member. Educational activities and being alert to sibling jealousy would be appropriate for the antepartum or postpartum family.
2. C) For the family with alcohol or substance abuse, the nurse should evaluate family members’ potential for being a danger to self or others and recommend community resources to family members to help with substance abuse behaviors. Grief counseling would be appropriate for the family who has suffered a loss of a family member. Educational activities and being alert to sibling jealousy would be appropriate for the antepartum or postpartum family.
3. D) For the family with alcohol or substance abuse, the nurse should evaluate family members’ potential for being a danger to self or others and recommend community resources to family members to help with substance abuse behaviors. Grief counseling would be appropriate for the family who has suffered a loss of a family member. Educational activities and being alert to sibling jealousy would be appropriate for the antepartum or postpartum family.
4. E) For the family with alcohol or substance abuse, the nurse should evaluate family members’ potential for being a danger to self or others and recommend community resources to family members to help with substance abuse behaviors. Grief counseling would be appropriate for the family who has suffered a loss of a family member. Educational activities and being alert to sibling jealousy would be appropriate for the antepartum or postpartum family.

Page Ref: 1719

Cognitive Level:  Evaluating

Client Need:  Psychosocial Integrity

Nursing Process:  Planning

Learning Outcome:  2. Examine the relationship between family and other concepts/systems.

 

3) During a follow-up home visit, the nurse is evaluating the success of a family’s ability to use internal resources to cope with the illness of a family member. What does the nurse observe that indicates that internal resources are being accessed?

Select all that apply.

1. A) Next-door neighbor helping with family chores
2. B) Effective communication pattern
3. C) Skill in providing care to the ill family member
4. D) Church members stopping by with groceries
5. E) Center for Aging picking up the family member to take to a physician’s appointment

Answer:  B, C

Explanation:  A) External support systems promote coping and adaption and include friends, religious affiliations, and community resources. Internal resources include effective communication patterns and knowledge or skills to assist in the family problem-solving process.

1. B) External support systems promote coping and adaption and include friends, religious affiliations, and community resources. Internal resources include effective communication patterns and knowledge or skills to assist in the family problem-solving process.
2. C) External support systems promote coping and adaption and include friends, religious affiliations, and community resources. Internal resources include effective communication patterns and knowledge or skills to assist in the family problem-solving process.
3. D) External support systems promote coping and adaption and include friends, religious affiliations, and community resources. Internal resources include effective communication patterns and knowledge or skills to assist in the family problem-solving process.
4. E) External support systems promote coping and adaption and include friends, religious affiliations, and community resources. Internal resources include effective communication patterns and knowledge or skills to assist in the family problem-solving process.

Page Ref: 1719

Cognitive Level:  Analyzing

Client Need:  Psychosocial Integrity

Nursing Process:  Evaluation

Learning Outcome:  3. Identify commonly occurring alterations in families and their related therapies.

 

4) A pediatric home health care nurse is making an initial visit to assess the parenting style for a family in preparation for treating a child with drugs to reduce hyperactivity. Which approach should the nurse use for this assessment?

1. A) Ask the parents, “How do you handle situations that require limit setting?”
2. B) Ask the child, “What rule is hardest for you to obey?”
3. C) Observe the parent interacting with the child for 5 minutes.
4. D) Ask the parents, “What are the house rules?”

Answer:  A

Explanation:  A) Parental styles are best assessed while the family explains how it handles situations that require limit setting. A less complete picture of parenting style is obtained during a brief artificial observation. Asking the child which rule is hardest for him or her to follow will not give the nurse insight into parenting styles. Learning about rules is less helpful than is an explanation of enforcement efforts and success.

1. B) Parental styles are best assessed while the family explains how it handles situations that require limit setting. A less complete picture of parenting style is obtained during a brief artificial observation. Asking the child which rule is hardest for him or her to follow will not give the nurse insight into parenting styles. Learning about rules is less helpful than is an explanation of enforcement efforts and success.
2. C) Parental styles are best assessed while the family explains how it handles situations that require limit setting. A less complete picture of parenting style is obtained during a brief artificial observation. Asking the child which rule is hardest for him or her to follow will not give the nurse insight into parenting styles. Learning about rules is less helpful than is an explanation of enforcement efforts and success.
3. D) Parental styles are best assessed while the family explains how it handles situations that require limit setting. A less complete picture of parenting style is obtained during a brief artificial observation. Asking the child which rule is hardest for him or her to follow will not give the nurse insight into parenting styles. Learning about rules is less helpful than is an explanation of enforcement efforts and success.

Page Ref: 1717

Cognitive Level:  Analyzing

Client Need:  Health Promotion and Maintenance

Nursing Process:  Assessment

Learning Outcome:  4. Differentiate common assessment procedures used to examine family health across the life span.

 

5) During a home visit, the nurse observes a family’s children acting out, shouting, and hitting each other when taking a small amount of food out of the refrigerator. The mother sits nearby yelling for the children to shut up while reaching for a cigarette. What should the nurse consider as being helpful for this family situation?

Select all that apply.

1. A) Suggesting ways to improve the family’s financial resources
2. B) Suggesting ways to improve the parent’s behavior
3. C) Contacting the authorities because of child abuse
4. D) Making a list of community resources to help this family cope
5. E) Creating a genogram

Answer:  A, B, D

Explanation:  A) Risk factors for family dysfunction may not always be evident. At times, the risk factors are masked by the absence of obvious problems. Stress can lead to many problems within a family, as the effects of unmanaged and unresolved stress can impact normal family functioning. Parental coping methods can also determine how their children will learn to handle stress, as children often model the actions of their parents. Stress in families results from numerous situations, including financial worry, job loss, marriage difficulties, and personal stress. Economic strain impacts individual well-being and physical health. Poverty-related stress can have a detrimental effect on the family unit by straining the parental relationship, leading to an increase in the stress level of any children in the family. Nurses can help alleviate some of this stress by facilitating connections with community resources that can help families meet their food, safety, and job-related needs. There is no evidence of child abuse. A genogram shows lines of birth descent through the generations and is part of the health history.

1. B) Risk factors for family dysfunction may not always be evident. At times, the risk factors are masked by the absence of obvious problems. Stress can lead to many problems within a family, as the effects of unmanaged and unresolved stress can impact normal family functioning. Parental coping methods can also determine how their children will learn to handle stress, as children often model the actions of their parents. Stress in families results from numerous situations, including financial worry, job loss, marriage difficulties, and personal stress. Economic strain impacts individual well-being and physical health. Poverty-related stress can have a detrimental effect on the family unit by straining the parental relationship, leading to an increase in the stress level of any children in the family. Nurses can help alleviate some of this stress by facilitating connections with community resources that can help families meet their food, safety, and job-related needs. There is no evidence of child abuse. A genogram shows lines of birth descent through the generations and is part of the health history.
2. C) Risk factors for family dysfunction may not always be evident. At times, the risk factors are masked by the absence of obvious problems. Stress can lead to many problems within a family, as the effects of unmanaged and unresolved stress can impact normal family functioning. Parental coping methods can also determine how their children will learn to handle stress, as children often model the actions of their parents. Stress in families results from numerous situations, including financial worry, job loss, marriage difficulties, and personal stress. Economic strain impacts individual well-being and physical health. Poverty-related stress can have a detrimental effect on the family unit by straining the parental relationship, leading to an increase in the stress level of any children in the family. Nurses can help alleviate some of this stress by facilitating connections with community resources that can help families meet their food, safety, and job-related needs. There is no evidence of child abuse. A genogram shows lines of birth descent through the generations and is part of the health history.
3. D) Risk factors for family dysfunction may not always be evident. At times, the risk factors are masked by the absence of obvious problems. Stress can lead to many problems within a family, as the effects of unmanaged and unresolved stress can impact normal family functioning. Parental coping methods can also determine how their children will learn to handle stress, as children often model the actions of their parents. Stress in families results from numerous situations, including financial worry, job loss, marriage difficulties, and personal stress. Economic strain impacts individual well-being and physical health. Poverty-related stress can have a detrimental effect on the family unit by straining the parental relationship, leading to an increase in the stress level of any children in the family. Nurses can help alleviate some of this stress by facilitating connections with community resources that can help families meet their food, safety, and job-related needs. There is no evidence of child abuse. A genogram shows lines of birth descent through the generations and is part of the health history.
4. E) Risk factors for family dysfunction may not always be evident. At times, the risk factors are masked by the absence of obvious problems. Stress can lead to many problems within a family, as the effects of unmanaged and unresolved stress can impact normal family functioning. Parental coping methods can also determine how their children will learn to handle stress, as children often model the actions of their parents. Stress in families results from numerous situations, including financial worry, job loss, marriage difficulties, and personal stress. Economic strain impacts individual well-being and physical health. Poverty-related stress can have a detrimental effect on the family unit by straining the parental relationship, leading to an increase in the stress level of any children in the family. Nurses can help alleviate some of this stress by facilitating connections with community resources that can help families meet their food, safety, and job-related needs. There is no evidence of child abuse. A genogram shows lines of birth descent through the generations and is part of the health history.

Page Ref: 1720

Cognitive Level:  Analyzing

Client Need:  Psychosocial Integrity

Nursing Process:  Planning

Learning Outcome:  5. Explain management of family health and prevention of stress.

 

6) While attending a community health fair, the nurse observes the children of one family walking quietly behind the father with their mother and periodically shyly asking the father questions. The father responds gruffly and continues walking while the children and mother scurry behind to keep up. What does this observation indicate to the nurse?

Select all that apply.

1. A) The father is in a hurry.
2. B) The father is the leader in the family.
3. C) The children are not to bother the father.
4. D) The children need discipline.
5. E) The mother’s role is to care for the children.

Answer:  B, C, E

Explanation:  A) This observation indicates a paternal family structure where the father makes the decisions for the family. The children appear fearful to ask the father a question, which is supported by the father’s gruff response and the father’s brisk walking. The mother is behind the father with the children, which could indicate that her role is child care. There is no evidence that these children need discipline or that the father is in a hurry.

1. B) This observation indicates a paternal family structure where the father makes the decisions for the family. The children appear fearful to ask the father a question, which is supported by the father’s gruff response and the father’s brisk walking. The mother is behind the father with the children, which could indicate that her role is child care. There is no evidence that these children need discipline or that the father is in a hurry.
2. C) This observation indicates a paternal family structure where the father makes the decisions for the family. The children appear fearful to ask the father a question, which is supported by the father’s gruff response and the father’s brisk walking. The mother is behind the father with the children, which could indicate that her role is child care. There is no evidence that these children need discipline or that the father is in a hurry.
3. D) This observation indicates a paternal family structure where the father makes the decisions for the family. The children appear fearful to ask the father a question, which is supported by the father’s gruff response and the father’s brisk walking. The mother is behind the father with the children, which could indicate that her role is child care. There is no evidence that these children need discipline or that the father is in a hurry.
4. E) This observation indicates a paternal family structure where the father makes the decisions for the family. The children appear fearful to ask the father a question, which is supported by the father’s gruff response and the father’s brisk walking. The mother is behind the father with the children, which could indicate that her role is child care. There is no evidence that these children need discipline or that the father is in a hurry.

Page Ref: 1716

Cognitive Level:  Analyzing

Client Need:  Psychosocial Integrity

Nursing Process:  Assessment

Learning Outcome:  6. Demonstrate the nursing process in providing culturally competent and caring interventions across the life span for individual members of a family.

 

7) The community nurse identifies that a family new to the community needs assistance with family dynamics and material resources. What should the nurse consider offering to the parents of this family to support their needs?

Select all that apply.

1. A) A list of free counseling services to assist with parental stress
2. B) Hours of the local health clinic
3. C) Location of the community library
4. D) Location of the community co-op food bank
5. E) Hours when the park is open

Answer:  A, B, D

Explanation:  A) When working with families, nurses will often need to collaborate with other healthcare professionals. For families in need of counseling, financial assistance may be available. When making these recommendations, nurses should be aware of some stigmas surrounding therapy and counseling, and work to assure families of the potential benefits of these modes of care. Families facing economic challenges should be made aware of community resources, including wellness clinics and food banks. The hours for the library and the park would not help the family with the issues that the nurse observed.

1. B) When working with families, nurses will often need to collaborate with other healthcare professionals. For families in need of counseling, financial assistance may be available. When making these recommendations, nurses should be aware of some stigmas surrounding therapy and counseling, and work to assure families of the potential benefits of these modes of care. Families facing economic challenges should be made aware of community resources, including wellness clinics and food banks. The hours for the library and the park would not help the family with the issues that the nurse observed.
2. C) When working with families, nurses will often need to collaborate with other healthcare professionals. For families in need of counseling, financial assistance may be available. When making these recommendations, nurses should be aware of some stigmas surrounding therapy and counseling, and work to assure families of the potential benefits of these modes of care. Families facing economic challenges should be made aware of community resources, including wellness clinics and food banks. The hours for the library and the park would not help the family with the issues that the nurse observed.
3. D) When working with families, nurses will often need to collaborate with other healthcare professionals. For families in need of counseling, financial assistance may be available. When making these recommendations, nurses should be aware of some stigmas surrounding therapy and counseling, and work to assure families of the potential benefits of these modes of care. Families facing economic challenges should be made aware of community resources, including wellness clinics and food banks. The hours for the library and the park would not help the family with the issues that the nurse observed.

 

1. E) When working with families, nurses will often need to collaborate with other healthcare professionals. For families in need of counseling, financial assistance may be available. When making these recommendations, nurses should be aware of some stigmas surrounding therapy and counseling, and work to assure families of the potential benefits of these modes of care. Families facing economic challenges should be made aware of community resources, including wellness clinics and food banks. The hours for the library and the park would not help the family with the issues that the nurse observed.

Page Ref: 1719

Cognitive Level:  Evaluating

Client Need:  Psychosocial Integrity

Nursing Process:  Planning

Learning Outcome:  7. Compare and contrast common independent and collaborative interventions for clients with alterations in family health.

 

Exemplar 26.1  Family Health Promotion

 

1) The nurse educator is teaching a group of students about health promotion and disease prevention. Which nursing activities promote health and health maintenance?

Select all that apply.

1. A) Helping a mother determine a daily feeding schedule for her infant
2. B) Teaching a school-age child how to use dental floss
3. C) Teaching parents how to perform pulmonary drainage and cupping on their ill child.
4. D) Treating a child diagnosed with pneumonia
5. E) Administering the flu vaccine for an infant who is 9 months of age

Answer:  A, B, E

Explanation:  A) Administration of flu vaccines, feeding schedules, and instruction to adolescents on dental floss usage are all health promotion and/or maintenance topics. Treatment of pneumonia would not be a topic for health promotion and maintenance, as pneumonia is an acute illness. Teaching parents how to perform pulmonary drainage and cupping on their ill child is not considered health promotion and maintenance, as it is treating an acute illness.

1. B) Administration of flu vaccines, feeding schedules, and instruction to adolescents on dental floss usage are all health promotion and/or maintenance topics. Treatment of pneumonia would not be a topic for health promotion and maintenance, as pneumonia is an acute illness. Teaching parents how to perform pulmonary drainage and cupping on their ill child is not considered health promotion and maintenance, as it is treating an acute illness.
2. C) Administration of flu vaccines, feeding schedules, and instruction to adolescents on dental floss usage are all health promotion and/or maintenance topics. Treatment of pneumonia would not be a topic for health promotion and maintenance, as pneumonia is an acute illness. Teaching parents how to perform pulmonary drainage and cupping on their ill child is not considered health promotion and maintenance, as it is treating an acute illness.
3. D) Administration of flu vaccines, feeding schedules, and instruction to adolescents on dental floss usage are all health promotion and/or maintenance topics. Treatment of pneumonia would not be a topic for health promotion and maintenance, as pneumonia is an acute illness. Teaching parents how to perform pulmonary drainage and cupping on their ill child is not considered health promotion and maintenance, as it is treating an acute illness.
4. E) Administration of flu vaccines, feeding schedules, and instruction to adolescents on dental floss usage are all health promotion and/or maintenance topics. Treatment of pneumonia would not be a topic for health promotion and maintenance, as pneumonia is an acute illness. Teaching parents how to perform pulmonary drainage and cupping on their ill child is not considered health promotion and maintenance, as it is treating an acute illness.

Page Ref: 1725

Cognitive Level:  Analyzing

Client Need:  Health Promotion and Maintenance

Nursing Process:  Implementation

Learning Outcome:  1. Describe the purpose and general goals of family health promotion.

 

2) The nurse is determining psychosocial risk factors for a family prior to planning care. Which assessment tool should the nurse use when initially screening families for these health risks?

1. A) The Friedman Family Assessment Tool
2. B) The Family Ecomap
3. C) The Home Observation for Measurement of the Environment (HOME)
4. D) The Family APGAR

Answer:  D

Explanation:  A) The Family APGAR is a quick five-item questionnaire that may be used as an initial screening tool for family assessment. All other choices are family assessment tools but are not appropriate for initial family assessments.

1. B) The Family APGAR is a quick five-item questionnaire that may be used as an initial screening tool for family assessment. All other choices are family assessment tools but are not appropriate for initial family assessments.
2. C) The Family APGAR is a quick five-item questionnaire that may be used as an initial screening tool for family assessment. All other choices are family assessment tools but are not appropriate for initial family assessments.
3. D) The Family APGAR is a quick five-item questionnaire that may be used as an initial screening tool for family assessment. All other choices are family assessment tools but are not appropriate for initial family assessments.

Page Ref: 1727

Cognitive Level:  Applying

Client Need:  Health Promotion and Maintenance

Nursing Process:  Assessment

Learning Outcome:  2. Identify risk factors and prevention methods associated with impaired family health processes.

 

3) The nurse has completed a family assessment and is planning care for a newly blended family. The children are having trouble adapting to the new situation. What is the primary goal for this family?

1. A) Improve family situations.
2. B) Work with other families.
3. C) Practice life skills.
4. D) Self-evaluate.

Answer:  A

Explanation:  A) The primary nursing goal for this family is to improve family situations. The nurse listens to all family members, acknowledges their difficulties, and affirms the strengths and resources they bring to the situation. Self-evaluation, practicing life skills, and working with other families may be included, but they are not the primary goal.

1. B) The primary nursing goal for this family is to improve family situations. The nurse listens to all family members, acknowledges their difficulties, and affirms the strengths and resources they bring to the situation. Self-evaluation, practicing life skills, and working with other families may be included, but they are not the primary goal.
2. C) The primary nursing goal for this family is to improve family situations. The nurse listens to all family members, acknowledges their difficulties, and affirms the strengths and resources they bring to the situation. Self-evaluation, practicing life skills, and working with other families may be included, but they are not the primary goal.
3. D) The primary nursing goal for this family is to improve family situations. The nurse listens to all family members, acknowledges their difficulties, and affirms the strengths and resources they bring to the situation. Self-evaluation, practicing life skills, and working with other families may be included, but they are not the primary goal.

Page Ref: 1726

Cognitive Level:  Analyzing

Client Need:  Psychosocial Integrity

Nursing Process:  Planning

Learning Outcome:  3. Illustrate the nursing process in application of culturally competent family health promotion strategies across the life span.

 

4) The nurse is observing a family counseling session that is focusing on the family members’ communication patterns. Which observation indicates that there are existing or potential problems with family communication?

1. A) All members are participating in the discussion equally.
2. B) A few of the members just sit and listen.
3. C) Disagreements are ignored by the family leader.
4. D) The verbal communication is congruent with the nonverbal messages.

Answer:  C

Explanation:  A) An authoritarian setting is one in which one or more members set firm, nonnegotiable limits and other members may be cautious in expressing their feelings because of power struggles, hostility, or anger. Nurses should pay special attention to who does the talking for the family, which members are silent, how disagreements are handled, and how well the members listen to one another and encourage the participation of others. Nonverbal communication is important because it gives valuable clues about what people are feeling. Even though some members are more vocal, at least all are participating in the discussion. Verbal communication should be congruent with nonverbal cues. Listening is an art, and not all members of a family need to speak in the same setting.

1. B) An authoritarian setting is one in which one or more members set firm, nonnegotiable limits and other members may be cautious in expressing their feelings because of power struggles, hostility, or anger. Nurses should pay special attention to who does the talking for the family, which members are silent, how disagreements are handled, and how well the members listen to one another and encourage the participation of others. Nonverbal communication is important because it gives valuable clues about what people are feeling. Even though some members are more vocal, at least all are participating in the discussion. Verbal communication should be congruent with nonverbal cues. Listening is an art, and not all members of a family need to speak in the same setting.
2. C) An authoritarian setting is one in which one or more members set firm, nonnegotiable limits and other members may be cautious in expressing their feelings because of power struggles, hostility, or anger. Nurses should pay special attention to who does the talking for the family, which members are silent, how disagreements are handled, and how well the members listen to one another and encourage the participation of others. Nonverbal communication is important because it gives valuable clues about what people are feeling. Even though some members are more vocal, at least all are participating in the discussion. Verbal communication should be congruent with nonverbal cues. Listening is an art, and not all members of a family need to speak in the same setting.

 

1. D) An authoritarian setting is one in which one or more members set firm, nonnegotiable limits and other members may be cautious in expressing their feelings because of power struggles, hostility, or anger. Nurses should pay special attention to who does the talking for the family, which members are silent, how disagreements are handled, and how well the members listen to one another and encourage the participation of others. Nonverbal communication is important because it gives valuable clues about what people are feeling. Even though some members are more vocal, at least all are participating in the discussion. Verbal communication should be congruent with nonverbal cues. Listening is an art, and not all members of a family need to speak in the same setting.

Page Ref: 1726

Cognitive Level:  Analyzing

Client Need:  Psychosocial Integrity

Nursing Process:  Evaluation

Learning Outcome:  5. Summarize therapies used by interdisciplinary teams in the collaborative promotion of family health.

 

5) A nurse is caring for family members who have recently lost their home and belongings in a fire. The family is staying with extended family in the area. What would be the most appropriate diagnosis for this family?

1. A) Readiness for Enhanced Family Processes
2. B) Dysfunctional Family Processes
3. C) Compromised Family Coping
4. D) Ineffective Individual Coping

Answer:  C

Explanation:  A) The family has experienced a devastating loss. The family’s ability to cope has been compromised and the nurse will also assess their external support systems. The family is not in a state of readiness yet. There is no evidence that the family is dysfunctional or that any family member is experiencing ineffective coping.

1. B) The family has experienced a devastating loss. The family’s ability to cope has been compromised and the nurse will also assess their external support systems. The family is not in a state of readiness yet. There is no evidence that the family is dysfunctional or that any family member is experiencing ineffective coping.
2. C) The family has experienced a devastating loss. The family’s ability to cope has been compromised and the nurse will also assess their external support systems. The family is not in a state of readiness yet. There is no evidence that the family is dysfunctional or that any family member is experiencing ineffective coping.
3. D) The family has experienced a devastating loss. The family’s ability to cope has been compromised and the nurse will also assess their external support systems. The family is not in a state of readiness yet. There is no evidence that the family is dysfunctional or that any family member is experiencing ineffective coping.

Page Ref: 1728

Cognitive Level:  Analyzing

Client Need:  Psychosocial Integrity

Nursing Process:  Planning

Learning Outcome:  4. Formulate priority nursing diagnoses appropriate for family health promotion.

6) A nurse in a busy outpatient pediatric clinic notes that a preschool-aged child who was due to be seen was a no-show. The child is not up to date on vaccinations. What should the nurse do?

1. A) Call the parents and encourage them to bring the child for recommended care.
2. B) Speak firmly with the parents about the importance of being compliant.
3. C) Notify the physician that the child’s immunizations are no longer up to date.
4. D) Plan to discuss the principles of health supervision at the next scheduled visit.

Answer:  A

Explanation:  A) The nurse in the pediatric healthcare setting is responsible for reviewing the health supervision of the child. Partnering with the parents and encouraging the parents to follow health-supervision guidelines are the best strategies to use. Speaking firmly with the parents about compliance will alienate the parents at this time. A discussion of the principles of health supervision without an intervention at this visit would mean a delay in needed health care for the child in this example. Discussing with the physician that the immunizations are not up to date is not necessary in an outpatient clinic. Immunizations are given per schedule.

1. B) The nurse in the pediatric healthcare setting is responsible for reviewing the health supervision of the child. Partnering with the parents and encouraging the parents to follow health-supervision guidelines are the best strategies to use. Speaking firmly with the parents about compliance will alienate the parents at this time. A discussion of the principles of health supervision without an intervention at this visit would mean a delay in needed health care for the child in this example. Discussing with the physician that the immunizations are not up to date is not necessary in an outpatient clinic. Immunizations are given per schedule.
2. C) The nurse in the pediatric healthcare setting is responsible for reviewing the health supervision of the child. Partnering with the parents and encouraging the parents to follow health-supervision guidelines are the best strategies to use. Speaking firmly with the parents about compliance will alienate the parents at this time. A discussion of the principles of health supervision without an intervention at this visit would mean a delay in needed health care for the child in this example. Discussing with the physician that the immunizations are not up to date is not necessary in an outpatient clinic. Immunizations are given per schedule.
3. D) The nurse in the pediatric healthcare setting is responsible for reviewing the health supervision of the child. Partnering with the parents and encouraging the parents to follow health-supervision guidelines are the best strategies to use. Speaking firmly with the parents about compliance will alienate the parents at this time. A discussion of the principles of health supervision without an intervention at this visit would mean a delay in needed health care for the child in this example. Discussing with the physician that the immunizations are not up to date is not necessary in an outpatient clinic. Immunizations are given per schedule.

Page Ref: 1729

Cognitive Level:  Applying

Client Need:  Health Promotion and Maintenance

Nursing Process:  Implementation

Learning Outcome:  6. Plan evidence-based health promotion strategies for families in collaboration with other members of the healthcare team.

 

7) The community nurse is planning a wellness seminar for families in an urban community. Which resources should the nurse consider obtaining to support these families’ needs?

Select all that apply.

1. A) Emergency first responder personnel
2. B) Information about community healthcare providers
3. C) Individuals who provide mental health services
4. D) Law enforcement officials
5. E) Nutritionists

Answer:  B, C, E

Explanation:  A) Wellness promotion is an essential aspect of family health and focuses on increasing healthy behaviors and optimizing lifestyle choices. Educating clients and facilitating appropriate referrals to nutritionists and community service providers will not only improve the family’s quality of life, but also reduce the risk of illness. Depending on the needs of the client, nurses may collaborate with a variety of healthcare providers and professionals, including physicians, counselors, social workers, and mental health specialists. Ambulance first responders and law enforcement personnel will not necessarily support the goal of the wellness program.

1. B) Wellness promotion is an essential aspect of family health and focuses on increasing healthy behaviors and optimizing lifestyle choices. Educating clients and facilitating appropriate referrals to nutritionists and community service providers will not only improve the family’s quality of life, but also reduce the risk of illness. Depending on the needs of the client, nurses may collaborate with a variety of healthcare providers and professionals, including physicians, counselors, social workers, and mental health specialists. Ambulance first responders and law enforcement personnel will not necessarily support the goal of the wellness program.
2. C) Wellness promotion is an essential aspect of family health and focuses on increasing healthy behaviors and optimizing lifestyle choices. Educating clients and facilitating appropriate referrals to nutritionists and community service providers will not only improve the family’s quality of life, but also reduce the risk of illness. Depending on the needs of the client, nurses may collaborate with a variety of healthcare providers and professionals, including physicians, counselors, social workers, and mental health specialists. Ambulance first responders and law enforcement personnel will not necessarily support the goal of the wellness program.
3. D) Wellness promotion is an essential aspect of family health and focuses on increasing healthy behaviors and optimizing lifestyle choices. Educating clients and facilitating appropriate referrals to nutritionists and community service providers will not only improve the family’s quality of life, but also reduce the risk of illness. Depending on the needs of the client, nurses may collaborate with a variety of healthcare providers and professionals, including physicians, counselors, social workers, and mental health specialists. Ambulance first responders and law enforcement personnel will not necessarily support the goal of the wellness program.

 

1. E) Wellness promotion is an essential aspect of family health and focuses on increasing healthy behaviors and optimizing lifestyle choices. Educating clients and facilitating appropriate referrals to nutritionists and community service providers will not only improve the family’s quality of life, but also reduce the risk of illness. Depending on the needs of the client, nurses may collaborate with a variety of healthcare providers and professionals, including physicians, counselors, social workers, and mental health specialists. Ambulance first responders and law enforcement personnel will not necessarily support the goal of the wellness program.

Page Ref: 1725

Cognitive Level:  Evaluating

Client Need:  Health Promotion and Maintenance

Nursing Process:  Planning

Learning Outcome:  5. Summarize therapies used by interdisciplinary teams in the collaborative promotion of family health.

 

8) The nurse is evaluating the success of wellness care provided to a new family in the community. Which observations indicate that care has been successful?

Select all that apply.

1. A) The children are observed eating donuts for breakfast.
2. B) All family members have up-to-date immunizations.
3. C) The family spends every Saturday afternoon participating in physical activities.
4. D) The youngest child squints when reading school work.
5. E) The oldest child does not wash his hands before eating.

Answer:  B, C

Explanation:  A) Evaluation of care is based on the family’s progress toward goals and outcomes mutually determined by the family and nurse. Examples of achieved outcomes include the following: family members demonstrate more frequent engagement in activities that involve the entire family unit, each family member is up to date with all vaccinations, and individual family members report a decrease in or cessation of behaviors associated with adverse health conditions and disease. Eating donuts for breakfast could indicate poor nutrition. Squinting when reading indicates the need for a vision assessment. And not washing hands before eating could lead to the ingestion of a microorganism that could cause disease.

1. B) Evaluation of care is based on the family’s progress toward goals and outcomes mutually determined by the family and nurse. Examples of achieved outcomes include the following: family members demonstrate more frequent engagement in activities that involve the entire family unit, each family member is up to date with all vaccinations, and individual family members report a decrease in or cessation of behaviors associated with adverse health conditions and disease. Eating donuts for breakfast could indicate poor nutrition. Squinting when reading indicates the need for a vision assessment. And not washing hands before eating could lead to the ingestion of a microorganism that could cause disease.
2. C) Evaluation of care is based on the family’s progress toward goals and outcomes mutually determined by the family and nurse. Examples of achieved outcomes include the following: family members demonstrate more frequent engagement in activities that involve the entire family unit, each family member is up to date with all vaccinations, and individual family members report a decrease in or cessation of behaviors associated with adverse health conditions and disease. Eating donuts for breakfast could indicate poor nutrition. Squinting when reading indicates the need for a vision assessment. And not washing hands before eating could lead to the ingestion of a microorganism that could cause disease.
3. D) Evaluation of care is based on the family’s progress toward goals and outcomes mutually determined by the family and nurse. Examples of achieved outcomes include the following: family members demonstrate more frequent engagement in activities that involve the entire family unit, each family member is up to date with all vaccinations, and individual family members report a decrease in or cessation of behaviors associated with adverse health conditions and disease. Eating donuts for breakfast could indicate poor nutrition. Squinting when reading indicates the need for a vision assessment. And not washing hands before eating could lead to the ingestion of a microorganism that could cause disease.

 

1. E) Evaluation of care is based on the family’s progress toward goals and outcomes mutually determined by the family and nurse. Examples of achieved outcomes include the following: family members demonstrate more frequent engagement in activities that involve the entire family unit, each family member is up to date with all vaccinations, and individual family members report a decrease in or cessation of behaviors associated with adverse health conditions and disease. Eating donuts for breakfast could indicate poor nutrition. Squinting when reading indicates the need for a vision assessment. And not washing hands before eating could lead to the ingestion of a microorganism that could cause disease.

Page Ref: 1729

Cognitive Level:  Analyzing

Client Need:  Health Promotion and Maintenance

Nursing Process:  Evaluation

Learning Outcome:  7. Evaluate expected outcomes related to family health promotion.

 

Exemplar 26.2  Family Response to Health Alterations

 

1) The nurse is assigned to a child in a spica cast for a fractured femur suffered in an automobile accident. The child’s father was driving the car, which was totaled. In assessing the family, the nurse learns that the father just recently lost his job and the mother has been working through a “temp” agency. Which nursing diagnosis is most appropriate for this family?

1. A) Disabled Family Coping related to the effects of multiple simultaneous stressors
2. B) Interrupted Family Processes related to child with a significant disability requiring alteration in family functioning
3. C) Caregiver Role Strain related to a child with a disability and the associated financial burden
4. D) Impaired Social Interaction (parent and child) related to the lack of family or respite support

Answer:  A

Explanation:  A) Disabled Family Coping related to the effects of multiple simultaneous stressors best fits the multiple crises to which this family is responding. Lack of family or respite support was not mentioned in the scenario. The spica cast might result in an alteration in family functioning; however, fractures generally are not considered a significant long-term disability. The need for a spica cast is not considered a newly acquired disability.

1. B) Disabled Family Coping related to the effects of multiple simultaneous stressors best fits the multiple crises to which this family is responding. Lack of family or respite support was not mentioned in the scenario. The spica cast might result in an alteration in family functioning; however, fractures generally are not considered a significant long-term disability. The need for a spica cast is not considered a newly acquired disability.
2. C) Disabled Family Coping related to the effects of multiple simultaneous stressors best fits the multiple crises to which this family is responding. Lack of family or respite support was not mentioned in the scenario. The spica cast might result in an alteration in family functioning; however, fractures generally are not considered a significant long-term disability. The need for a spica cast is not considered a newly acquired disability.
3. D) Disabled Family Coping related to the effects of multiple simultaneous stressors best fits the multiple crises to which this family is responding. Lack of family or respite support was not mentioned in the scenario. The spica cast might result in an alteration in family functioning; however, fractures generally are not considered a significant long-term disability. The need for a spica cast is not considered a newly acquired disability.

Page Ref: 1737

Cognitive Level:  Analyzing

Client Need:  Psychosocial Integrity

Nursing Process:  Planning

Learning Outcome:  4. Formulate priority nursing diagnoses appropriate for a family’s response to health alterations.

 

2) A client with a bipolar disorder arrives at the Emergency Department disheveled, arguing with family members. The nurse recognizes that the family is suffering from an objective family burden. To what is this burden related?

1. A) The client’s symptomatic behaviors
2. B) Family conflict
3. C) Anger
4. D) Caregiving problems

Answer:  A

Explanation:  A) The objective family burden is related to the actual, identifiable family problems associated with an individual’s mental illness. One burden the family must manage relates to symptomatic behaviors. Deficit behaviors of their loved ones–such as lack of motivation, difficulty in completing tasks, isolation from others, inability to manage money, poor grooming and personal care, and poor eating and sleeping behavior–can be of great concern to families. Intrusive or acting-out behaviors–such as lack of consideration for others, excessive arguing, conflicts with neighbors and friends, damaging material possessions, inappropriate sexual behavior, suicide attempts, substance abuse, and violent outbursts–are very disturbing to family members. The family may be experiencing caregiving problems, fear, or family conflict, but these arise from the client’s symptomatic behaviors.

1. B) The objective family burden is related to the actual, identifiable family problems associated with an individual’s mental illness. One burden the family must manage relates to symptomatic behaviors. Deficit behaviors of their loved ones–such as lack of motivation, difficulty in completing tasks, isolation from others, inability to manage money, poor grooming and personal care, and poor eating and sleeping behavior–can be of great concern to families. Intrusive or acting-out behaviors–such as lack of consideration for others, excessive arguing, conflicts with neighbors and friends, damaging material possessions, inappropriate sexual behavior, suicide attempts, substance abuse, and violent outbursts–are very disturbing to family members. The family may be experiencing caregiving problems, fear, or family conflict, but these arise from the client’s symptomatic behaviors.
2. C) The objective family burden is related to the actual, identifiable family problems associated with an individual’s mental illness. One burden the family must manage relates to symptomatic behaviors. Deficit behaviors of their loved ones–such as lack of motivation, difficulty in completing tasks, isolation from others, inability to manage money, poor grooming and personal care, and poor eating and sleeping behavior–can be of great concern to families. Intrusive or acting-out behaviors–such as lack of consideration for others, excessive arguing, conflicts with neighbors and friends, damaging material possessions, inappropriate sexual behavior, suicide attempts, substance abuse, and violent outbursts–are very disturbing to family members. The family may be experiencing caregiving problems, fear, or family conflict, but these arise from the client’s symptomatic behaviors.

 

1. D) The objective family burden is related to the actual, identifiable family problems associated with an individual’s mental illness. One burden the family must manage relates to symptomatic behaviors. Deficit behaviors of their loved ones–such as lack of motivation, difficulty in completing tasks, isolation from others, inability to manage money, poor grooming and personal care, and poor eating and sleeping behavior–can be of great concern to families. Intrusive or acting-out behaviors–such as lack of consideration for others, excessive arguing, conflicts with neighbors and friends, damaging material possessions, inappropriate sexual behavior, suicide attempts, substance abuse, and violent outbursts–are very disturbing to family members. The family may be experiencing caregiving problems, fear, or family conflict, but these arise from the client’s symptomatic behaviors.

Page Ref: 1731

Cognitive Level:  Analyzing

Client Need:  Psychosocial Integrity

Nursing Process:  Assessment

Learning Outcome:  2. Identify risk factors and prevention methods associated with a family’s response to health alterations.

 

3) The nurse is caring for a woman who was involved in a car accident. The client’s husband was killed in the accident. The couple has two teenage children. Which statement explains how this tragedy will be approached by the family?

1. A) The family feels that their place in the community has been eliminated.
2. B) Family members may become detached from extended family.
3. C) Family disorganization may occur.
4. D) The family may withdraw into seclusion during the grief process.

Answer:  C

Explanation:  A) The death of a family member often has a profound effect on the whole family–especially if the deceased, as in this situation, was the head of the family. Family disorganization would be common, but as the family begins to recover, a new sense of normalcy develops and the family reintegrates its roles and functions. Families need support from extended family members, their community, and spiritual advisers. The other options are not considered normal patterns of family grieving, and the nurse should be alert for problems that may develop if these are present.

1. B) The death of a family member often has a profound effect on the whole family–especially if the deceased, as in this situation, was the head of the family. Family disorganization would be common, but as the family begins to recover, a new sense of normalcy develops and the family reintegrates its roles and functions. Families need support from extended family members, their community, and spiritual advisers. The other options are not considered normal patterns of family grieving, and the nurse should be alert for problems that may develop if these are present.
2. C) The death of a family member often has a profound effect on the whole family–especially if the deceased, as in this situation, was the head of the family. Family disorganization would be common, but as the family begins to recover, a new sense of normalcy develops and the family reintegrates its roles and functions. Families need support from extended family members, their community, and spiritual advisers. The other options are not considered normal patterns of family grieving, and the nurse should be alert for problems that may develop if these are present.
3. D) The death of a family member often has a profound effect on the whole family–especially if the deceased, as in this situation, was the head of the family. Family disorganization would be common, but as the family begins to recover, a new sense of normalcy develops and the family reintegrates its roles and functions. Families need support from extended family members, their community, and spiritual advisers. The other options are not considered normal patterns of family grieving, and the nurse should be alert for problems that may develop if these are present.

Page Ref: 1719

Cognitive Level:  Analyzing

Client Need:  Psychosocial Integrity

Nursing Process:  Assessment

Learning Outcome:  1. Describe the factors that influence a family’s response to health alterations.

 

4) The nurse is caring for a client who is hospitalized with pneumonia. What will the nurse assess when determining the impact of the illness on the family?

Select all that apply.

1. A) The duration of the illness
2. B) The effect of the illness on future family functioning
3. C) The cause of the illness
4. D) The meaning of the illness to the family
5. E) The financial impact of the illness

Answer:  A, B, D, E

Explanation:  A) The impact on the family is assessed by the duration of the illness as well as its effect on the family finances and functioning. Other factors include residual effects of the illness, meaning of the illness to the family, and its significance to family systems. The cause of the illness is not a factor that determines the impact on the family.

1. B) The impact on the family is assessed by the duration of the illness as well as its effect on the family finances and functioning. Other factors include residual effects of the illness, meaning of the illness to the family, and its significance to family systems. The cause of the illness is not a factor that determines the impact on the family.
2. C) The impact on the family is assessed by the duration of the illness as well as its effect on the family finances and functioning. Other factors include residual effects of the illness, meaning of the illness to the family, and its significance to family systems. The cause of the illness is not a factor that determines the impact on the family.
3. D) The impact on the family is assessed by the duration of the illness as well as its effect on the family finances and functioning. Other factors include residual effects of the illness, meaning of the illness to the family, and its significance to family systems. The cause of the illness is not a factor that determines the impact on the family.
4. E) The impact on the family is assessed by the duration of the illness as well as its effect on the family finances and functioning. Other factors include residual effects of the illness, meaning of the illness to the family, and its significance to family systems. The cause of the illness is not a factor that determines the impact on the family.

Page Ref: 1730

Cognitive Level:  Applying

Client Need:  Health Promotion and Maintenance

Nursing Process:  Assessment

Learning Outcome:  1. Describe the factors that influence a family’s response to health alterations.

 

5) A client being treated for newly diagnosed schizophrenia will be discharged to the family home. The family is developing an image of the disease process and expectations of mental health professionals and has reached Stage 2 of family recovery. Which concepts are included in this stage of recovery?

Select all that apply.

1. A) Coping
2. B) Problem solving
3. C) Acceptance
4. D) Recognition
5. E) Personal and political advocacy

Answer:  B, C, D

Explanation:  A) Stage 2 of family recovery is one of recognition and acceptance. As it becomes more evident that there is a significant problem, the family begins to search for reasons and solutions by gathering available information. Families begin to develop their own image of the disease process and expectations of mental health professionals. Many families also hope for what was in the past and for what might be in the future. Personal and political advocacy occurs in the final stage of recovery. Coping and competence occur in Stage 3.

3. B) Stage 2 of family recovery is one of recognition and acceptance. As it becomes more evident that there is a significant problem, the family begins to search for reasons and solutions by gathering available information. Families begin to develop their own image of the disease process and expectations of mental health professionals. Many families also hope for what was in the past and for what might be in the future. Personal and political advocacy occurs in the final stage of recovery. Coping and competence occur in Stage 3.
4. C) Stage 2 of family recovery is one of recognition and acceptance. As it becomes more evident that there is a significant problem, the family begins to search for reasons and solutions by gathering available information. Families begin to develop their own image of the disease process and expectations of mental health professionals. Many families also hope for what was in the past and for what might be in the future. Personal and political advocacy occurs in the final stage of recovery. Coping and competence occur in Stage 3.
5. D) Stage 2 of family recovery is one of recognition and acceptance. As it becomes more evident that there is a significant problem, the family begins to search for reasons and solutions by gathering available information. Families begin to develop their own image of the disease process and expectations of mental health professionals. Many families also hope for what was in the past and for what might be in the future. Personal and political advocacy occurs in the final stage of recovery. Coping and competence occur in Stage 3.
6. E) Stage 2 of family recovery is one of recognition and acceptance. As it becomes more evident that there is a significant problem, the family begins to search for reasons and solutions by gathering available information. Families begin to develop their own image of the disease process and expectations of mental health professionals. Many families also hope for what was in the past and for what might be in the future. Personal and political advocacy occurs in the final stage of recovery. Coping and competence occur in Stage 3.

Page Ref: 1732

Cognitive Level:  Analyzing

Client Need:  Psychosocial Integrity

Nursing Process:  Assessment

Learning Outcome:  7. Evaluate expected outcomes for a family responding to health alterations.

6) The nurse is discussing hospice care with the family of a client dying of cancer. The spouse asks the nurse if Medicare will continue to pay if the client lives longer than 6 months. What should the nurse respond to the spouse?

1. A) “I will call someone in the finance office to come speak with you about your question.”
2. B) “Are you concerned about paying for your spouse’s health care?”
3. C) “It is unlikely your husband will live past 6 months.”
4. D) “Please ask the doctor to explain the role of hospice before discharge.”

Answer:  B

Explanation:  A) The nurse is responsible for explaining resources that the client and family will need for ongoing care. Finding someone to explain the hospice benefit is the best response for the nurse to make. The nurse should not question the spouse’s concern about paying for health care. The nurse has no way of knowing how long the client will live. The physician will most likely not have the most current information regarding the hospice benefit. The best individual to explain this benefit would be someone from the finance department.

1. B) The nurse is responsible for explaining resources that the client and family will need for ongoing care. Finding someone to explain the hospice benefit is the best response for the nurse to make. The nurse should not question the spouse’s concern about paying for health care. The nurse has no way of knowing how long the client will live. The physician will most likely not have the most current information regarding the hospice benefit. The best individual to explain this benefit would be someone from the finance department.
2. C) The nurse is responsible for explaining resources that the client and family will need for ongoing care. Finding someone to explain the hospice benefit is the best response for the nurse to make. The nurse should not question the spouse’s concern about paying for health care. The nurse has no way of knowing how long the client will live. The physician will most likely not have the most current information regarding the hospice benefit. The best individual to explain this benefit would be someone from the finance department.
3. D) The nurse is responsible for explaining resources that the client and family will need for ongoing care. Finding someone to explain the hospice benefit is the best response for the nurse to make. The nurse should not question the spouse’s concern about paying for health care. The nurse has no way of knowing how long the client will live. The physician will most likely not have the most current information regarding the hospice benefit. The best individual to explain this benefit would be someone from the finance department.

Page Ref: 1736

Cognitive Level:  Applying

Client Need:  Psychosocial Integrity

Nursing Process:  Implementation

Learning Outcome:  3. Illustrate the nursing process in providing culturally competent care across the life span to families responding to health alterations.

 

7) The nurse is determining the type of support the family of a client with newly diagnosed mood disorder is going to need. Which type(s) of support should the nurse consider to help this family?

Select all that apply.

1. A) Financial
2. B) Professional
3. C) Friend
4. D) Family
5. E) Spiritual

Answer:  B, C, D, E

Explanation:  A) Supportive relationships build and sustain courage, helping families make the best of their difficult lives. There are four main types of support when working through trying situations: professional, friend, family, and spiritual. Professional support may come from any one or a number of professionals in the community who exhibit a nonblaming and respectful attitude toward families, and who provide information on how to respond to symptoms and help in locating community resources, such as housing or vocational training. Friend support comes from nonfamily members, such as close friends and coworkers. Friend support is most valued when the concern is genuine and stigma is minimized. Family support often comes in the form of tangible assistance, such as respite care for family members and physical presence in times of crisis. Many families find emotional strength from their religious faith. They find spiritual support as they search for meaning through relationships and feeling connected with others. Financial is not an identified type of support for families in this situation.

1. B) Supportive relationships build and sustain courage, helping families make the best of their difficult lives. There are four main types of support when working through trying situations: professional, friend, family, and spiritual. Professional support may come from any one or a number of professionals in the community who exhibit a nonblaming and respectful attitude toward families, and who provide information on how to respond to symptoms and help in locating community resources, such as housing or vocational training. Friend support comes from nonfamily members, such as close friends and coworkers. Friend support is most valued when the concern is genuine and stigma is minimized. Family support often comes in the form of tangible assistance, such as respite care for family members and physical presence in times of crisis. Many families find emotional strength from their religious faith. They find spiritual support as they search for meaning through relationships and feeling connected with others. Financial is not an identified type of support for families in this situation.
2. C) Supportive relationships build and sustain courage, helping families make the best of their difficult lives. There are four main types of support when working through trying situations: professional, friend, family, and spiritual. Professional support may come from any one or a number of professionals in the community who exhibit a nonblaming and respectful attitude toward families, and who provide information on how to respond to symptoms and help in locating community resources, such as housing or vocational training. Friend support comes from nonfamily members, such as close friends and coworkers. Friend support is most valued when the concern is genuine and stigma is minimized. Family support often comes in the form of tangible assistance, such as respite care for family members and physical presence in times of crisis. Many families find emotional strength from their religious faith. They find spiritual support as they search for meaning through relationships and feeling connected with others. Financial is not an identified type of support for families in this situation.

 

1. D) Supportive relationships build and sustain courage, helping families make the best of their difficult lives. There are four main types of support when working through trying situations: professional, friend, family, and spiritual. Professional support may come from any one or a number of professionals in the community who exhibit a nonblaming and respectful attitude toward families, and who provide information on how to respond to symptoms and help in locating community resources, such as housing or vocational training. Friend support comes from nonfamily members, such as close friends and coworkers. Friend support is most valued when the concern is genuine and stigma is minimized. Family support often comes in the form of tangible assistance, such as respite care for family members and physical presence in times of crisis. Many families find emotional strength from their religious faith. They find spiritual support as they search for meaning through relationships and feeling connected with others. Financial is not an identified type of support for families in this situation.
2. E) Supportive relationships build and sustain courage, helping families make the best of their difficult lives. There are four main types of support when working through trying situations: professional, friend, family, and spiritual. Professional support may come from any one or a number of professionals in the community who exhibit a nonblaming and respectful attitude toward families, and who provide information on how to respond to symptoms and help in locating community resources, such as housing or vocational training. Friend support comes from nonfamily members, such as close friends and coworkers. Friend support is most valued when the concern is genuine and stigma is minimized. Family support often comes in the form of tangible assistance, such as respite care for family members and physical presence in times of crisis. Many families find emotional strength from their religious faith. They find spiritual support as they search for meaning through relationships and feeling connected with others. Financial is not an identified type of support for families in this situation.

Page Ref: 1736

Cognitive Level:  Evaluating

Client Need:  Psychosocial Integrity

Nursing Process:  Planning

Learning Outcome:  5. Summarize therapies used by interdisciplinary teams in the collaborative care of a family responding to health alterations.

 

8) The nurse is creating a plan of care for the family of a client with a terminal illness. What aspects of this family’s care should the nurse emphasize when creating this plan?

Select all that apply.

1. A) Instructing on medication administration
2. B) Guiding to determine realistic goals
3. C) Identifying strategies to enhance family functioning
4. D) Suggesting that cultural practices be minimized at this time
5. E) Focusing on the client’s health needs as a priority

Answer:  B, C

Explanation:  A) Nursing care includes assisting the family with planning realistic goals/outcomes and strategies that enhance family functioning, such as improving communication skills, and identifying and utilizing support systems. Teaching medication administration is an intervention that would support the assimilation of the ill client back into the home and family environment. This action may or may not be needed at this time. The nursing care should incorporate cultural practices and not minimize them. The family’s needs are as important as those of the family and need to be addressed by the nurse.

1. B) Nursing care includes assisting the family with planning realistic goals/outcomes and strategies that enhance family functioning, such as improving communication skills, and identifying and utilizing support systems. Teaching medication administration is an intervention that would support the assimilation of the ill client back into the home and family environment. This action may or may not be needed at this time. The nursing care should incorporate cultural practices and not minimize them. The family’s needs are as important as those of the family and need to be addressed by the nurse.
2. C) Nursing care includes assisting the family with planning realistic goals/outcomes and strategies that enhance family functioning, such as improving communication skills, and identifying and utilizing support systems. Teaching medication administration is an intervention that would support the assimilation of the ill client back into the home and family environment. This action may or may not be needed at this time. The nursing care should incorporate cultural practices and not minimize them. The family’s needs are as important as those of the family and need to be addressed by the nurse.
3. D) Nursing care includes assisting the family with planning realistic goals/outcomes and strategies that enhance family functioning, such as improving communication skills, and identifying and utilizing support systems. Teaching medication administration is an intervention that would support the assimilation of the ill client back into the home and family environment. This action may or may not be needed at this time. The nursing care should incorporate cultural practices and not minimize them. The family’s needs are as important as those of the family and need to be addressed by the nurse.

 

1. E) Nursing care includes assisting the family with planning realistic goals/outcomes and strategies that enhance family functioning, such as improving communication skills, and identifying and utilizing support systems. Teaching medication administration is an intervention that would support the assimilation of the ill client back into the home and family environment. This action may or may not be needed at this time. The nursing care should incorporate cultural practices and not minimize them. The family’s needs are as important as those of the family and need to be addressed by the nurse.

Page Ref: 1736

Cognitive Level:  Analyzing

Client Need:  Psychosocial Integrity

Nursing Process:  Planning

Learning Outcome:  6. Plan evidence-based care for a family responding to health alterations in collaboration with other members of the healthcare team.