Question 1

After assessment and discussion with a family,a nurse had a list of 12 areas of need,none of which involved life-threatening issues.Which of the following needs should the nurse address first?

Accepted Answer

When working with families,the need that assumes top priority (after life-threatening emergencies)is the need that the family itself identifies as most important.

Question 2

The community/public health nurse asks a married couple to review important family events.What is the nurse accomplishing through this review?

Accepted Answer

A chronology,or time line,of family events is often useful in helping people see relationships between events and behavior changes.This allows the couple the opportunity to examine how they have interacted with each other during these events (their behavior and the associated event).

Question 3

The nurse used multiple assessment tools to gather data on the family,which resulted in the nurse's feeling overwhelmed.What action should the nurse take next?

Accepted Answer

The information must be integrated and analyzed before decisions about the plan of care can be made.Once the information is summarized and targets of care are identified,the process of intervention is clearer for the nurse and the family.Asking others for input might be helpful,but the nurse is still the one who performed the observation and assessment and should be able to draw conclusions.

Question 4

A community/public health nurse is conducting a family assessment.Which source of data would be most helpful?

Accepted Answer

Sources of data can include,but should not be limited to,charts and written health records,biologic data such as blood pressure measurements or specimens,telephone calls and conversations with other health care team members,information from social service agencies involved with the family,and environmental and community information.However,the most accurate and complete information can be obtained only by observing and interviewing the family itself.

Question 5

A mother was very upset and said to a nurse,"My mother would never have allowed such behavior.I punish the baby for doing it,and she just does it again." What conclusion can the nurse make from this interaction?

Accepted Answer

Families meeting normal growth and developmental challenges often benefit from health-promotion and illness-prevention education or supportive contact as family members master behaviors appropriate for their new stage of life.Mothers cannot know appropriate childhood behaviors without an opportunity to know reasonable expectations according to the child's age and development.On the basis of the statement by the mother,it cannot be assumed that the mother is abusing her baby.

Question 6

What is the primary goal of case management of families?

Accepted Answer

Although nurses try to be cost-effective and to communicate,counsel,or teach,as well as coordinate care,the ultimate goal of case management is to maximize the family's self-care capabilities.

Question 7

A home health nurse was making an initial visit to an elderly man.As the nurse began the assessment,the man's wife gave all of the information requested.Which of the following actions should the nurse take next?

Accepted Answer

Having heard from only the wife,the nurse must attempt to validate the information with the husband or recognize that all information was from only one perspective.

Question 8

A community/public health nurse is working with a family whose members are experiencing an incredible amount of stress.Which source of social support should the nurse encourage the family to use?

Accepted Answer

The nurse should first mobilize social support from inside the family or from informal support networks such as friends,neighbors,and religious communities with which the family was already involved.These relationships are more likely to be long lasting and to be the most culturally appropriate.

Question 9

A nurse met with a client before hospital discharge to make arrangements to visit the client at home.Why would the nurse visit the client's home when the assessment could be completed while the client is still in the hospital?

Accepted Answer

Meeting families in their own environment is preferable because the nurse can observe firsthand the physical and environmental conditions,as well as the way family members act with each other in their home.

Question 10

A community/public health nurse is visiting a family for the first time.Which of the following should be the priority action for the nurse?

Accepted Answer

Although all of the options are important aspects of planning care,the nurse's ability to establish a relationship in which the family's rights and strengths are respected is more important than any other task.

Question 11

The teenage mother admitted to the nurse that sometimes she was sorry she had the baby,and all she wanted was to be able to sleep all night.Which of the following is the most appropriate action for the nurse to take?

Accepted Answer

It may help the mother to know that this situation is something all new mothers face and that her feelings are normal.Explaining normal growth and development for infants,not toddlers-including an expectation of when the baby might sleep through the night-would be most appropriate at this time.This would emphasize that the baby will eventually sleep through the night and the mother's sleep will no longer be interrupted.In other words,there is hope.Suggesting that the grandmother provide assistance may be helpful,but it will not allow the teenager to recognize that these feelings are normal.Calling Child Protective Services is not appropriate.

Question 12

A community/public health nurse is teaching a family about how to care for an ill member of the family.Upon which family member should the nurse focus on teaching?

Accepted Answer

For maximum effectiveness,the nurse should teach the strongest member,who is most able to change.That member may be able to delegate some responsibilities to others in the family.

Question 13

Why do community/public health nurses focus on families?

Accepted Answer

When a nurse cares for a family,nursing practice is directed toward maximizing the health and well-being of all individuals within a family system.Improving the health of a family improves the health of a community.

Question 14

A family had just moved to the city when the illness struck the father.The wife had always been a stay-at-home mother with the three young children.The nurse developed a list of short-term resources for the family.Which of the following actions should the nurse take next?

Accepted Answer

Many families have a need for multiple resources;identifying the one or two that are most helpful to the need will help both the nurse and the family.The entire list may well be overwhelming to the family when the family is already stressed and perhaps less able to make good decisions.Feeding the family and getting them settled will reduce their stress enough that they can then consider what would be most helpful.

Question 15

A nurse asked quite a few questions about what each family member did during the day,including school,work,and recreation outside the home.What was the nurse accomplishing by asking these questions?

Accepted Answer

An eco-map can be used to help discover the interactions between the family and the outside environment.The family's relationships with significant community resources,activities,and agencies are diagrammed.It helps family members visualize how relationships with external systems are affecting their state of well-being.

Question 16

When a client's wife asked whether the nurse would like a tour of the yard and her gardens,the nurse agreed immediately.Considering the limited time the nurse had to spend with the family,why did the nurse agree to tour the gardens?

Accepted Answer

Data about the family's physical environment,such as the presence of accident hazards,screens,plumbing,and cooking facilities,help the nurse (1)plan care that matches or supplements family resources and (2)identify potential health problems.The nurse may also be able to complete the other things suggested as responses;however,the main reason why the nurse is touring the garden is to identify potential hazards.An environmental assessment is not used for completing a genogram.

Question 17

A nurse is assigned to care for a client who has just been discharged from the hospital.What should be the nurse's priority assessment after discovering that other family members desperately need health care as well?

Accepted Answer

Typically,one member of the family is identified as the client who is to be the recipient of nursing care.This client may have an identified health problem,a chronic illness,or a potential problem.Adequate identification and collection of information about the client's response to these actual or potential health problems is the first priority in family assessment.

Question 18

A community/public health nurse is providing care in the home of a family with children.The father returned from the physician during the nurse's visit and reported that the physician wanted several diagnostic tests performed.The father believed that the physician had looked quite serious.Which of the following actions would be most appropriate for the nurse?

Accepted Answer

Because the father is confronting a possibly serious illness,he is in the early phase of diagnosis,which necessitates preparation and cooperation with diagnostic testing.Both the father and the family as a whole will have to deal with anxiety and uncertainty.The nurse can help the family deal with anxiety and uncertainty by helping them to mobilize support while they await the diagnosis.

Question 19

The father of a family was told he had metastatic pancreatic cancer too advanced for any treatment.Which of the following is the most appropriate intervention for the nurse?

Accepted Answer

Families who are dealing with illness and loss may encounter experiences in which nothing that they do will make the situation better.For example,a family may confront an irreversible loss,and no actions will rectify the situation.In these circumstances,both the nurse and the family often resolve the situation by searching for some meaning within what has happened.

Question 20

After a family and a nurse discussed the family needs,they began to discuss what each member of the family might be willing to contribute.Which of the following would be the most important variable in determining the probable success of the plan?

Accepted Answer

Because families act as systems,an action applied to one member will influence the other members.The most useful care plan will develop from the wishes of the family members who will be responsible for implementing it.However,every assessment should include identifying the most functional and most willing members because they will be the ones to follow through.

Quiz 13: Family Case Management