Question 1

Which observation indicates to the nurse that a family is not functioning in a healthy way?&#10;A) The family pays cash for health care.&#10;B) The father comforts his crying daughter.&#10;C) The mother states, &#34;This family couldn't function without me.&#34;&#10;D) The father does not share his concerns so his wife will not worry about them.

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?&#10;A) A mother is angry that the father never helps with housework.&#10;B) A brother is so jealous of his new sister that he hides her clothes.&#10;C) A father wishes the family was able to spend more time together.&#10;D) A mother states she has grown up since giving birth to her children.

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.)

A) Religion
B) Age span
C) Health care
D) Recreation
E) Environment

Health care
Environment

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?&#10;A) Discuss adequate dental care.&#10;B) Explain the need for the toddlers to have socialization with other children.&#10;C) Remind the mother that the toddlers need regularly scheduled vaccinations.&#10;D) Stress the importance of home safety and prevention of accidental poisoning.

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?

A) "I'll be careful that no guest smokes."
B) "I'll be certain he doesn't get too tired."
C) "His brother can help him open presents."
D) "I'm baking a cake and we'll have candles."

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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?&#10;A) The family could buy her a television set.&#10;B) Her father could purchase her a cell phone.&#10;C) The family might install an intercom system.&#10;D) The family could have dinner together in the same room.

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?&#10;A) &#34;I can take the three pills together at one time.&#34;&#10;B) &#34;I will take one pill before breakfast, before lunch, and before dinner.&#34;&#10;C) &#34;I can take one pill when I have symptoms and save the others for later.&#34;&#10;D) &#34;I will take the pill when I get up in the morning and before I go to bed.&#34;

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?&#10;A) Hopelessness related to prolonged home care&#10;B) Health-seeking behaviors related to home care&#10;C) Readiness for enhanced coping related to home care&#10;D) Compromised coping related to difficulty of home care

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?

A) "You should soak both hands to get them clean."
B) "You need to stay in bed while your hand soaks."
C) "Would you like to sit in the chair or stay in bed to soak your hand?"
D) "I know your favorite show is on right now, but we need to soak your hand now."

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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.)

A) Health teaching
B) Monitoring vital signs
C) Bathing and washing hair
D) Monitoring fetal heart rate
E) Administering medication

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?&#10;A) Bedroom, where it is quiet and private&#10;B) Kitchen, so other family members can participate&#10;C) Porch, so the nurse does not have to enter the home&#10;D) Living room, so as to not interrupt television viewing

Accepted Answer

The answer of The nurse is preparing to obtain a...

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?&#10;A) The device is sitting on the kitchen table.&#10;B) The patient cannot locate the device during a routine home visit.&#10;C) The patient has two rhythm strips to share with the nurse during the home visit.&#10;D) The patient has a log with the date, time, and number of fetal heart beats counted.

Accepted Answer

The answer of The nurse instructs a patient who is...

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?&#10;A) Get up every hour and get a drink from the refrigerator.&#10;B) Keep a pitcher of fluid readily available on a bedside table.&#10;C) Drink cool liquids and avoid hot liquids because they increase thirst.&#10;D) Drink the eight glasses before the spouse leaves for work in the morning.

Accepted Answer

The answer of The nurse instructs a pregnant patient who...

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.)&#10;A) Keeping the car doors unlocked&#10;B) Keeping the gas tank of the car full&#10;C) Parking the car in a well-lighted area&#10;D) Using a map to avoid getting lost in a strange neighborhood&#10;E) Informing the agency of the estimated arrival time and expected return

Accepted Answer

The answer of The nurse is preparing to make a...

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.)&#10;A) Never take medication in front of children.&#10;B) Use a reminder sheet and cross off when a medication has been taken.&#10;C) Drink a full glass of water with pills to ensure they reach the stomach.&#10;D) Keep all medication in a safe place above the height for a child to reach.&#10;E) Place medication doses in empty candy or mint containers to reduce waste.

Accepted Answer

The answer of During a home visit, the nurse begins...

Deck 4: Home Care and the Childbearing and Childrearing Family