Deck 20: Family Health

Question 1

Each evening, a newly disabled man becomes angry when his wife, just home from her new full-time job, does not have dinner on the table at 6 PM. Which of the following actions would be most appropriate for the nurse to take?

A) Allow the wife to express her frustration and anger to you
B) Explain to the husband that he is going to have to begin learning how to cook
C) Help all family members recognize that long-time roles are being changed and change is uncomfortable for everyone
D) Suggest to the children who are old enough that they prepare some simple meals during the week with the mother doing the fancy cooking only on weekends

Answer 1

Help all family members recognize that long-time roles are being changed and change is uncomfortable for everyone

Question 2

Which of the following best describes why a nurse would ask about the meals of all family members, rather than focus on a nutritional history for the post-myocardial infarction patient?

A) It is assumed that all family members eat the same food at the same time each day.
B) Lifestyle choices among family members are usually consistent.
C) Many parents eat whatever their children don't rather than throw away good food, so the nurse should know what the children eat.
D) The nurse was afraid to assume that whoever cooked would only prepare one meal for everyone to share.

Answer 2

Lifestyle choices among family members are usually consistent.

Question 3

Which of the following questions is crucial to ask very early in a family interview?

A) "Do you see any way this problem could have been avoided-so future problems could be prevented?"
B) "What do you all, as a famil,y hope to achieve during your time with me?"
C) "What would you like me to do for you today?"
D) "Would you like to know my perception of what our goals together should be?"

Answer 3

"What do you all, as a famil,y hope to achieve during your time with me?"

Question 4

A young son was so physically fidgety that his mother was seriously embarrassed by his inability to be quiet and involved in the interview. Which of the following comments by the nurse would be the most helpful?

A) "Isn't it marvelous how much energy your son has?"
B) "Is there something your son could be doing for you that would use some of that energy?"
C) "Is your son always so fidgety? Have you discussed his behavior with his pediatrician?"
D) "Why don't you let your son go to his room until we're finished?"

Question 5

A nurse is completing a first assessment interview with a family after entering the family's apartment for the first time. Which of the following would be crucial for the nurse to remember?

A) Analyze the power relationships before focusing on needed information
B) Be on best behavior with manners and courtesy, starting with a self-introduction
C) Determine as soon as possible who makes decisions within the family
D) Evaluate the safety of the immediate environment for self and the family

Question 6

Beyond gathering needed information for future interventions, which of the following purposes is served when the nurse interviews the family?

A) Assessing the safety of the immediate environment before further planning can be done
B) Establishing a process for the nurse and the family to make decisions
C) Engaging in focused planned conversation, which has healing potential in itself
D) Focusing on giving compliments to make the family feel good about themselves

Question 7

Which of the following statements best describes how a family can meet the needs of society?

A) By living and existing in the wider community
B) By meeting the needs of the individual family members
C) Through procreation and socialization
D) Through productivity seen in employment positions

Question 8

Which of the following best describes what proportion of children live in a single-parent family?

A) Fewer than 10%
B) 11%-15%
C) 16%-20%
D) 21%-26%
E) More than 30%

Question 9

A 36-year-old woman had diabetes diagnosed at a free health-screening program at a large employer. Which of the following should be emphasized by the nurse when helping the woman make an appointment at the diabetic clinic for follow-up testing and treatment?

A) "Bring a food diary of everything you've eaten for one week with you to the appointment to help with future meal planning."
B) "It's really not that hard to learn how to inject insulin, and it really doesn't hurt."
C) "Please encourage all your family members, including your parents, to be tested for diabetes as well."
D) "They'll teach you how to manage your meals and medications to stay healthy."

Question 10

The current school year is now over, and the school health nurse spends time summarizing the records of all the children who had come into the school health office during the past school year. Which of the following best explains the rationale for this action?

A) Because analysis can help establish priorities for future health programs
B) Because annual reports are expected by the school board
C) Because it's very personally rewarding to see all the help one has given throughout the year
D) Because the nurse has to justify the school health office budget for each year

Question 11

A nurse was teaching a class on good hygiene at a local day care center when one child volunteered, "I have two mommies." Which of the following would be the most appropriate response by the nurse?

A) "Don't tell anyone; that's a secret."
B) "That's nice-why did you share that?"
C) "Yes, some children have two mommies, some have a mommy and a daddy, and some just have daddies. Some people only have one grown-up to love them."
D) "Which mommy is your real mommy?"

Question 12

A nurse needed to help a child who was not behaving consistently with the requirements of the new preschool program that began that fall. Which of the following actions would be most appropriate for the nurse to perform?

A) Meet with the child each day to let the child have a safe play environment without the regular program frustrations
B) Meet with the child's parents to discuss how their parenting may need to change to help improve their child's behavior at school
C) Meet with the child's teacher to brainstorm ways to help the child cope with school requirements
D) Point out to the child that if behavior doesn't improve, the child won't be able to play with all the other children at the school

Question 13

A man had been in an extended-care facility for five weeks and was now home. His wife tells the nurse, "He's trying to take up where he left off but we've adapted to not having him home. He keeps thinking things will be just as they were when he left, but they aren't." Which of the following would be the most appropriate response by the nurse?

A) "Are the changes making him uncomfortable or are the rest of you uncomfortable?"
B) "Do you want me to talk to him and try to explain?"
C) "How can we make things as they were before he left?"
D) "You all adapted to running the house without him; it will be challenging now to adapt back."

Question 14

A family came in to discuss a problem with one of their children. Which of the following family behaviors would be concerning to the nurse?

A) Each family member made supportive comments about each other.
B) Every Sunday the family attends religious services together.
C) Family members made humorous comments about their life together.
D) The family seemed to rather quickly determine priorities for action.
E) The family wanted the nurse to decide what they should do.

Question 15

Which of the following is a major barrier to a nurse caring for the family as a whole?

A) Families often don't want to know what is wrong with their loved one.
B) Nurses don't know how to care for families.
C) Reimbursement is paid only for services given to an individual.
D) The family often isn't available when the nurse is giving care.

Question 16

When making a home visit, a nurse is usually expected to focus attention on the ill family member. But whom would the nurse possibly focus on instead?

A) The children who are being affected by the stress of the situation
B) The ill family member's primary caregiver
C) The spouse of the ill family member
D) The neighbors of the family who may be able to help

Question 17

Which of the following best describes what is meant by cohabitation?

A) A living arrangement in which one adult is employed and the other is unemployed
B) A living arrangement in which an unmarried couple in a long-term relationship lives together
C) A living arrangement between two members of the same sex
D) A living arrangement between two single mothers with children

Question 18

Which of the following are examples of the internal structure of the family?

A) Ethnicity and race
B) Extended family members
C) Gender and rank order of birth
D) Social class and religion

Question 19

Record data demonstrated that there were a very large number of children in the school district whose insurance plan was the Children's Health Insurance Program (CHIP). Which of the following conclusions would be accurate for the nurse to make?

A) There are a large number of parents who know how to abuse government programs.
B) There are a large number of homeless families.
C) There are a large number of unemployed poverty-stricken families.
D) There are a large number of working, low-income parents.

Question 20

Which of the following definitions of family would be the most useful for the nurse practicing in the community?

A) A group of persons with shared convictions
B) A social unit interacting with the larger society
C) People descended from a common ancestor
D) Persons related either by blood or by legal contract (marriage)
E) Whoever the family says is in their family

Question 21

A nurse was creating an ecomap for a family, which consisted of a 3-year-old girl, an 8-year-old boy, and their mother. Which of the following questions would be useful for the nurse to ask?

A) "Are you involved with any groups or resources in the community?"
B) "Can you tell me about your extended family wherever they live?"
C) "Have you thought about what would happen if you needed help?"
D) "What were the causes of death for your older family members?"

Question 22

Which of the following is an appropriate conclusion to draw from research based on network therapy theory?

A) Nurses can help at-risk populations access or build support systems.
B) Problems in our health care system are worsened by specialization and fragmentation.
C) Social class places limitations on access to health care.
D) The family is culturally anchored in American beliefs.

Question 23

A mother says to the nurse, "I know I should be feeling an empty nest sadness now that our youngest has left for college-but mainly I'm dying to turn his room into my craft room. Do you think that's normal for a mom? I really do love my kids." Which of the following would be the most appropriate response by the nurse?

A) "Hmm, that is unusual. Would you like me to make an appointment with a psychologist for you?"
B) "Maybe you've always wanted to be an artist and now you can, so enjoy the feeling-and the room!"
C) "You're probably trying to put a positive spin on the situation to keep feelings of sadness at bay."
D) "Very normal; you've launched your family and now you can devote attention to your own life and preferences-such as crafts."
E) "Would you like to talk about how you feel?"

Question 24

A family agreed to bring all the children in to the clinic at one time to begin to catch up on the children's immunizations, but they didn't keep their appointment. Which of the following conclusions by the nurse would be most accurate?

A) Obtaining immunizations might have been the nurse's goal, not the family's.
B) Some barrier or restraint interfered with the family's ability to come.
C) The family had other, more important priorities.
D) The nurse didn't adequately emphasize the importance of obtaining immunizations.

Question 25

The nurse has started to complete a family health tree. Which of the following questions would be most helpful as the nurse works with the family to promote their health?

A) "Can you tell me the cause of death of your older relatives back several generations?"
B) "Do you know of any chronic health problems any of your relatives or their spouses have had?"
C) "What concerns do you have about your family's health?"
D) "What do your family members do to keep in shape and handle stress?"

Question 26

Which of the following theoretical approaches would be most useful to the nurse who wants to improve patient-provider communication and address the gap between what providers discuss and what families want to know about?

A) Ecological framework
B) Network therapy theory
C) The Kentucky Partnership model
D) Transaction model

Question 27

Which of the following factors make family nursing particularly challenging? (Select all that apply.)

A) The health care system primarily focuses on care of individuals.
B) Insurance reimbursement focuses on illness care and treatment of individuals.
C) Family members are not always consistent in what they tell the nurse.
D) More variables to be considered when completing an assessment
E) Number of chronic comorbidities
F) Most theories focus on intervention with individuals.

Question 28

A nurse asked of a family, "Could each of you tell me what you typically do during the week?" Which of the following would the nurse most likely say to follow up such an open-ended question?

A) "Could you tell me about what you do at your job?"
B) "Do you believe those choices are the best use of your free time?"
C) "How do you feel about those activities?"
D) "Is there anything you would like to do differently?"

Question 29

What has research suggested is a barrier to college students eating healthy?

A) Lack of access to an exercise facility
B) Lack of access to a primary care provider
C) Lack of knowledge of the benefits of healthy eating
D) Lack of knowledge related to food preparation

Question 30

Which of the following best describe why it is crucial that nurses who focus on the care of individual patients also be able to work with families? (Select all that apply.)

A) Anytime a person is ill, his or her whole family is affected.
B) By understanding the family, understanding of the individual is improved.
C) Families often are very demanding if they feel their loved one isn't receiving the best care possible.
D) Individuals depend on their families for care and support.
E) Most important decisions are made by families as a whole, not individuals.
F) Risks caused by genetics or environment affect the whole family, not just the individual.

Question 31

A nurse asked a family if they'd work with her to create a family genogram. The mother asked, "Why would you want to know so much about our family?" Which of the following would be the most appropriate response by the nurse?

A) "A genogram helps you see how some problems run in families. Your children will need to know this."
B) "If you're willing to share, we can discuss family history and possibly some hereditary health issues."
C) "Please be assured you don't have to answer any question you don't want to answer."
D) "Why would you want to keep your family members secret? Is there some problem?"

Question 32

Which of the following best describes an unexpected result of the decrease in funding to traditional public and private forms of health care?

A) Emergency departments where patients can't be turned away are overwhelmed with patients needing nonemergency care.
B) Grants are increasingly being requested to pay for care.
C) More people don't receive needed health care in a timely manner.
D) Programs are developed as a result of community efforts.