A nurse was preparing for a home visit to a family where the mother had just been discharged from trauma care after being hit by a drunk driver. The nurse
... [Show More] hoped the family was able to care for her. Which of the following comments from the husband would suggest an energized family?
a."I make most of the decisions so the kids don't notice much difference."
b."My daughter is pretty independent; she's active in both sports and theater."
c."My son is old enough to get a job and help pay all these medical bills."
d."My wife taught our daughter how to cook simple meals."
ANS: B
Pratt proposed the energized family as being an ideal family type that was most effective in meeting health needs. The energized family is characterized by active contact with a variety ofgroups and organizations (Boy Scouts, church, sports, theater), flexible role relationships (not if only the daughter is taught how to cook and only the son is expected to get a job), equal power structure (not if the husband makes all the decisions), and a high degree of autonomy by each member (kids know how to be flexible, because parents travel for business frequently).
Using the Neuman Systems Model, which of the following questions would the nurse ask a client to assess physiological health?
a."What helps you to cope with situations involving your wife's cancer?"
b."How has your child's illness affected the behavior of your other children?"
c."Tell me about any illnesses your other family members have."
d."Who do you turn to for support outside your immediate family?
ANS: C
Physiological health involves issues related to physical wellness or illness. Other components of health in Neuman's model include psychological health, sociocultural health, developmental health, and spiritual health.
A nurse is working with a family member to reduce his health risk. Which of the following recommendations would most likely be made by the nurse?
a."Be sure to take a 30-minute walk each day."
b."Call our office if you have any questions or concerns at all."
c."Come back in 2 weeks for follow-up on your surgery."
d."Continue to take the drug until it is gone, even if you're feeling better earlier."
ANS: A
The factors that determine or influence whether disease or other unhealthy results occur are called health risks. The major categories of risk include inherited biological risk, social and physical environmental risk, and behavioral risk. All the other options are treatment oriented rather than risk avoidance. Exercising for 30 minutes a day reduces the risk for many diseases
A nurse is appraising health risks. Which of the following questions would most likely be asked by the nurse?
a."Does your 4 year-old have a booster seat in the car?"
b."Have you noticed any physical problems as you go about your daily routine?"
c."What concerns do you have today?
d."Why did you decide to come in for a checkup?"
ANS: A
Health risk appraisal refers to the process of assessing for the presence of specific factors in each of the categories that have been identified as being associated with an increased likelihood of an illness, such as cancer, or an unhealthy event, such as an automobile accident
A nurse is conducting a health risk appraisal. Which of the following activities is the nurse assessing when using this tool?
a.Health promotion activities
b.Illness prevention activities
c.Risk reduction activities
d.Unhealthy activities
ANS: D
Health risk appraisal refers to the process of assessing for the presence of specific factors in each of the categories that have been identified as being associated with an increased likelihood of an illness, such as cancer, or an unhealthy event, such as an automobile accident.Therefore, the nurse would assess for unhealthy behavior and activities in the areas of biological and age-related risk, social and physical environment risk, and behavioral risk. Activities to promote health, prevent illness, or reduce risks would be advantageous, not risky
A nurse is implementing risk reduction interventions with a family. Which of the following questions is most important for the nurse to ask?
a."Did any of the hunters in your family kill a deer this year?"
b."How do you keep your rifles safe from curious children?"
c."Where do you shoot with your handguns?"
d."Where do you keep your rifles locked when it is not hunting season?"
ANS: C
Risk reduction is a complex process that requires knowledge of risks and families' perceptionsof the nature of the risk. In this situation the nurse was asking questions to determine the family's perception of risks associated with owning guns. If the family does not perceive the behavior (having guns in the house) as risky, but rather as necessary for food or sport, the nurse must first educate or persuade the family that others may be more comfortable if certain precautionary measures are taken (such as locks on the guns). Rifles are used for food and sport but handguns are often used in crimes and accidents resulting in death
A nurse is completing a health risk appraisal with a client. Which of the following comments would cause the nurse to probe further to determine if the family is in crisis?
a."I can't visit my husband in the hospital when I'm at work all day. How can I be sure he's all right?"
b."My husband always handled our finances. Now that he's gone, I'll have to learn how to do this."
c."I don't know what to do now that my husband is dead. There is no way I can go back to work and also take care of our three children."
d."What am I supposed to do now that everything we own is gone? Are there any agencies that can help me?"
ANS: C
A family crisis occurs when the family is not able to cope with an event and becomes disorganized or dysfunctional. When the demands of the situation exceed the resources of the family, a family crisis exists. In three of the options, the survivor is considering the problem and trying to learn how to cope or seek resources to cope. Only in this option is the person overwhelmed and unable to conceive of how to cope
A nurse has completed health risk appraisals with several different families. Which of the following families would be of most concern to the nurse?
a.An older couple who has just retired and sold their house, who talk about their new condo in a retirement community.
b.Newlyweds who have been saving their money, who want to discuss birth control and family planning in preparation for future pregnancies.
c.Parents who come with their child for his pre-kindergarten physical exam and want to be sure all the child's immunizations are up to date.
d.A woman who is very pleased with her new position at the hospital and wants to have her pre-employment exam and drug screen
ANS: A
Transitions (movement from one stage or condition to another) are times of potential risk for families. Age-related or life-event risks often occur during transitions from one developmentalstage to another. Transitions present new situations and demands for families. Moving from the family home to a smaller condo represents a major change in lifestyle. None of the other options represent major transitions. If the event is normative, or anticipated, it is possible for families to prepare for the event and its consequences.
Which of the following best describes a normative life event that can increase the risk for illness?
a.A family is involved in a motor vehicle crash.
b.A group of teens experiment with recreational drugs.
c.A woman is pregnant with her first child.
d.The family wage earner is laid off from his job
ANS: C
Life events can increase the risk for illness and disability. Normative events are those that are generally expected to occur at a particular stage of development or of the life span. Although pregnancy is a normal condition, it carries risks such as the development of eclampsia or more minor health problems such as constipation and hemorrhoids. Additionally,pregnancy (and the birth that follows) will alter family dynamics and may increase risk for psychological stressors. The events listed in the other options are not normative life events
A nurse is drawing a genogram. Which of the following would the nurse use to demonstrate a marriage relationship between two individuals?
a.A broken line
b.A dashed line
c.A solid line
d.Two parallel lines
ANS: C
Marriage is indicated by a solid line on a genogram
Which of the following best describes the use of genomic health care?
a.Assists with understanding family relationships
b.Assists with determining familial health risks
c.Useful in learning about environmental risk factors
d.Useful in detecting risk for developing cancer
ANS: B
Genomic health care can give health care providers the tools that they need to use a person's unique genomic information to design and prescribe the most effective treatment for each person and to help clients and families understand some of their health risks that are influenced by their genetic make-up. When nurses obtain a family history and learn about the illnesses and causes of death of biologically related family members, they can then learn aboutshared genes, environment and lifestyle behaviors that can increase a person's risks for the same diseases that other family members experienced. Genomic health care is broader than detecting risk for developing cancer
Which of the following families is at high risk for health problems?
a.A man agrees that he needs to eat better and exercise more but also expresses how busy he is at his job.
b.A man knows that his grandfather, father, and older brother all died of cardiac
disease.
c.A man is currently unemployed and despairs about finding a position.
d.A man expresses disappointment that, having been laid off as an executive, his new position pays only about two thirds of his original salary
ANS: C
A person who is unemployed and despairing of finding employment is at serious economic risk, which is one of the foremost predictors of health problems. Economic risk is determined by the relationship between family financial resources and the demands on those resources. Having adequate financial resources means that a family is able to purchase the necessary services and goods related to health, such as adequate housing, clothing, food, education, and health or illness care.
A home health nurse who is visiting a family for the first time asks, "Could we review your extended family and other persons or groups with whom you interact each week?" Which of the following provides the best rationale for the nurse asking this question?
a.To assess the family's environment and social resources and risks
b.To communicate with relevant others as needed
c.To determine financial assets available to the family in case of serious need
d.To understand the extended family relationships
ANS: A
The question by the nurse indicates that she is trying to obtain an ecomap. Ecomaps can provide information about relationships that the family has with others (such as relatives and neighbors), the family's connections with other social units (such as church, school, work, clubs, and organizations), and the flow of energy, positive or negative, in the family. An ecomap represents the family's interactions with other groups and organizations. Environmental or social risk and resources can be assessed from an ecomap
Which of the following clients would cause the nurse the most concern?
a.The client who is currently unemployed but actively seeking a position and frequently walking from one interview to another
b.The client who is not employed but spending time at the gym keeping fit and studying the benefits of organic natural uncooked foods
c.The client who is employed and often works 12 hours a day without moving from the computer desk
d.The client who is employed but always leaves promptly at 5:00 to pick up the children from the day care center
ANS: C
Personal health habits continue to contribute to the major causes of morbidity and mortality. The pattern of personal health habits and behavioral risk defines individual and family lifestyle risk. The client who doesn't move from the computer desk is creating great stress andstrain on personal physiology and needs to be educated on the benefits of exercise and the risks of cumulative trauma on the body. Multiple health benefits of regular physical activity have been identified; regular physical exercise is effective in promoting and maintaining health and preventing disease
An occupational health nurse is developing an educational program to address the importance of healthy personal health habits. Which of the following topics would be most important for the nurse to address?
a.Avoidance of alcohol
b.Regular physical exercise
c.Daily consumption of calcium-rich foods
d.Monthly self-breast and testicular exams
ANS: B
Many family health risks can be reduced by careful attention to diet, exercise, and stress management. Regular physical exercise is effective in promoting and maintaining health and in preventing disease. Physical activity can help to prevent obesity, diabetes, heart disease, cancer, osteoporosis, and depression. Avoidance of alcohol and daily consumption of calcium-rich foods are not recommendations for improving personal health habits
A home health nurse is about to visit a family at their home. However, the nurse is feeling uncomfortable about getting out of her car because a group of young adults across the street are drinking and fighting among themselves. Which of the following actions should be taken by the nurse?
a.Call the agency and ask what she should do.
b.Call the family, explain the situation, and try to reschedule.
c.Fulfill the nurse's commitment to the family and enter the home quickly.
d.Drive away and notify the family from a safer location
ANS: D
Personal safety is an issue. Home visits are generally very safe; however, as with all worksites, the possibility of violence exists. Therefore, the nurse needs to use caution. If a reasonable question exists about the safety of making a visit, the nurse should not make the visit [Show Less]