Question 1

Which observation indicates to the nurse that a family is not functioning in a healthy way?

Accepted Answer

Health family functioning includes communication with each other and identifying and sharing feelings about the home situation. The family paying cash for health care does not support a family that is not functioning in a healthy way. The father comforting his crying daughter demonstrates healthy family functioning. The mother who believes the family could not function without could be a statement of frustration or evidence that the family needs her to maintain healthy functioning.

Question 2

During a home visit, the nurse determines that a family is functioning in a healthy manner. Which behavior did the nurse observe to make this determination?

Accepted Answer

A family that is supportive of all family members and provides an environment conducive to each member's continued growth and development is more likely to be able to manage home care. The mother's statement about growing up after giving birth demonstrates growth. The mother that is angry because of no help with housework is demonstrating unrealistic expectations of family members. A brother that hides clothes is not successfully dealing with the stresses within the family. The father wishing the family had more time together might be overwhelmed with the home situation.

Question 3

A pregnant patient experiencing exacerbation of asthma is prescribed home care. The nurse is planning to assess the patient's community for resources. On which areas will the nurse focus this assessment? (Select all that apply.)

Accepted Answer

For a patient with asthma, the community areas that the nurse should assess include environment and access to health care. The environment could exacerbate the patient's symptoms and health care could influence the patient's ability to obtain help if necessary. Religion, age span, and recreation will not necessarily impact the maintenance of the patient's asthma.

Question 4

The nurse is completing the health histories for twin toddlers. Which statement should the nurse make to the mother that focuses on the 2020 National Health Goals?

Accepted Answer

The 2020 National Health Goal applicable to this situation is to reduce or eliminate vaccine-preventable diseases such as measles, pertussis, and varicella. Dental care, socialization, and home safety are not 2020 National Health Goals.

Question 5

A preschooler, receiving home oxygen therapy, is excited about an upcoming birthday. Which statement by the patient's mother indicates that additional teaching on the safety of home oxygen therapy is needed for the occasion?

Accepted Answer

During the home visit, the nurse should have instructed the mother on home safety with oxygen therapy. This includes knowing not to light candles near oxygen for a birthday. The statement about no guests smoking indicates that teaching has been effective. The statements about fatigue and having help with presents do not evaluate the effectiveness of teaching on home oxygen safety.

Question 6

During a home care visit, the nurse learns that a pregnant adolescent is concerned about being lonely at home. What should the nurse suggest to help with this problem?

Accepted Answer

To combat the feelings of loneliness and support the family structure, the family can plan to have one meal a day together, such as dinner, in the same room. A cell phone, intercom system, or television set may or may not help the adolescent with feelings of loneliness.

Question 7

The nurse is assessing a patient for potential home care. Which patient statement indicates that the patient will be able to take a medication that is prescribed for three times a day?

Accepted Answer

The nurse is assessing if a patient is able to properly take a medication that is prescribed three doses per day. The statement that the patient will take one dose before breakfast, lunch, and dinner is evidence that the patient will be able to safely take the medication. Taking three pills together, taking a pill with symptoms, and taking a pill in the morning and at night indicates that the patient will not be able to adhere to the prescribed medication schedule.

Question 8

A parent caring for an ill child at home states that at first it was difficult but now has adjusted to the situation. Which would be the most appropriate nursing diagnosis for this family?

Accepted Answer

Home care of a child can place a heavy burden on a family as the stress of being responsible for an ill child's daily health status can have a negative impact on a parent's self-esteem. The statement that the mother has adjusted to the situation indicates readiness for enhanced coping. The mother is not demonstrating hopelessness,
health-seeking behaviors, or compromised coping.

Question 9

The nurse is explaining to a school-age child the need to soak the hands twice a day to help with an infection. Which teaching should the nurse provide that would be appropriate for the patient's cognitive level?

Accepted Answer

Before anyone can be cared for at home, teaching will be required so the family understands the illness and principles of care. Because the patient is a school-age child, the nurse should provide choices so that the patient has a sense of control over the situation. Soaking both hands may or may not be medically necessary. Telling the patient to stay in bed or soaking the hands now does not provide the patient with a sense of control and may lead to resistance or nonadherence to medical treatment.

Question 10

A patient who is at 30 weeks gestation is prescribed bed rest and home care. Which skills should the nurse anticipate providing when making the home care visits with the patient? (Select all that apply.)

Accepted Answer

Nursing care is considered skilled home nursing care if it includes primary health care provider-prescribed procedures such as dressing changes, administration of medication, health teaching, or observation of a woman status through monitoring vital signs or fetal heart rate. Bathing and washing hair is not considered skilled nursing care.

Question 11

The nurse is preparing to obtain a health history from a patient with preeclampsia who is at home. In which area should the nurse conduct the assessment?

Accepted Answer

The nurse should provide privacy and confidentiality when obtaining the health history and performing a physical examination. The nurse should identify a private location such as the bedroom. The kitchen, porch, and living room are not private areas for this assessment.

Question 12

The nurse instructs a patient who is at 28 weeks gestation on the correct use of the fetal heart monitor at home. Which observation indicates that teaching has been effective?

Accepted Answer

Fetal heart rate monitoring can be taught to the patient including how to record the findings. The patient that has a log with the date, time, and number of fetal heart beats counted indicates that teaching has been effective. Fetal heart monitoring should be conducted in the reclining position and the device should not be on the kitchen table. The patient who is unable to locate the device is not performing the assessment as instructed. The patient who has two rhythm strips to share with the nurse may or may not be performing the assessment as instructed.

Question 13

The nurse instructs a pregnant patient who is at home on bed rest to drink at least eight glasses of fluid each day. What would be the best method to encourage the patient to drink this amount?

Accepted Answer

All women during pregnancy should drink six to eight full glasses of fluid a day to obtain adequate fluid for effective kidney function and placental exchange. The patient on bed rest should have a supply of fluid close to the bed such as a water pitcher so this can be done easily. Getting up every hour does not support bed rest. Drinking eight glasses of fluid before the spouse leaves for work does not ensure adequate hydration during the day. The temperature of the liquids is inconsequential. Hot liquids do not necessarily increase thirst.

Question 14

The nurse is preparing to make a home visit to admit a new patient to services. Which actions should the nurse take to ensure personal safety? (Select all that apply.)

Accepted Answer

Safety tips for making home care visits include keeping the gas tank full, park in a well-lighted area, using a map to avoid getting lost, and informing the agency of the estimated arrival time and expected return. The nurse should keep the car doors locked for safety.

Question 15

During a home visit, the nurse begins teaching on medication safety in the home. What should the nurse include in these instructions? (Select all that apply.)

Accepted Answer

Instructions for medication safety in the home should include never taking medication in front of children, using a reminder sheet to keep track of medication doses, drinking a full glass of water with medication doses, and keeping all medication in a safe place above the height for a child to reach. Medications should not be placed in empty candy or mint containers because children might think that these items are candy and might accidentally ingest someone else's prescribed medication. This could lead to an accidental poisoning in the home.

Quiz 4: Home Care and the Childbearing and Childrearing Family