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?

Accepted Answer

Roles refer to established patterns of behavior for a family. It takes other family members to keep a person in a particular role. Traditional roles are being challenged and are evolving with economic changes. Formal roles may come into conflict with roles set by family members. The husband has major life changes to which to adjust, as do all the other family members. His anger is a symptom of the painfulness of major life changes. The nurse can help the family members recognize the problem in preparation for addressing the issues.

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?

Accepted Answer

The family remains the focus because families experience similar risk factors (i.e., physiological, behavioral, and environmental). Family health practices influence lifestyle habits among family members. Consequently, although family members may or may not eat together, they will have a tendency to make similar choices.

Question 3

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

Accepted Answer

Therapeutic questions are key questions that the nurse uses to facilitate the interview. One important basic theme is to determine the family's expectations of the interview or home visit.

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?

Accepted Answer

Sending the son to his room might be seen as punitive and would remove him from being informed about interventions planned and decisions made. A compliment reinforces family strengths and tends to further progress toward open trusting relationships. The comment took a flaw (physically fidgeting) and reframed it as an asset (high energy).

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?

Accepted Answer

Manners are common social behaviors that set the tone for the interview and begin the development of a therapeutic relationship. The nurse introduces himself or herself by name and title and always addresses the client and family members by name (i.e., Mr., Mrs., or Ms., unless otherwise directed by client).

Question 6

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

Accepted Answer

The second key element in the interview is the therapeutic conversation. This type of conversation is focused and planned and engages the family. The nurse must listen and remember that even one sentence has the potential to heal or help a family member. Every encounter, whether brief or extended, has "healing potential."

Question 7

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

Accepted Answer

The family fulfills two important purposes. The first is to meet the needs of society, and the second is to meet the needs of individual family members. The family meets the needs of society through procreation and socialization of family members.

Question 8

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

Accepted Answer

In 2012, 34% of all U.S. children lived in single-parent homes.

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?

Accepted Answer

Although the nurse might make any of these comments, it is particularly important that the rest of the family also get tested. Any problem that affects one or more family members probably affects other family members and the family as a whole. Commonalities in risk factors and diseases shared by family members can lead to case finding within the family. Because families often choose similar foods and engage in similar lifestyle behaviors, they all are at similar risk for problems such as diabetes. The earlier the diagnosis and treatment, the more likely it is that secondary problems can be avoided.

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?

Accepted Answer

Community health nurses (CHNs) are employed in ambulatory care centers, occupational health and school sites, housing complexes, day care programs, residential treatment and substance abuse programs, and other official and nonofficial agencies. At each of these sites, CHNs meet families and can assess and intervene at the family and community levels.
The challenge is to focus not only on individual students but extend practice to the whole school community of children. Fiscal constraints hold the nurse accountable for the best delegation of scarce resources. In times of limited budgets, the school health nurse, on the basis of the most frequent problems presented in the office, can draw conclusions as to what are the major health needs of children in the community. On the basis of those conclusions, health programs can be planned to maximize health promotion and disease prevention in the school.

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?

Accepted Answer

The Human Rights Campaign (2009) urges that health professions acknowledge all types of families including gay, lesbian, and even grandparents as heads of family.

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?

Accepted Answer

The teacher can be assumed to be an expert in dealing with small children. If the problem is defined as a child not behaving within expectations, the most effective approach would be to discuss with the parents how to help the child. Systems theory provides direction in understanding how health care providers can expand family capacity by changing parenting and therefore changing child behaviors.

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?

Accepted Answer

Family functional assessment, or how family members behave toward one another, is divided into two categories. The first is instrumental functioning, which refers to routine activities of daily living. This area takes on important meaning for the family when one member of the family becomes ill or disabled and changes were made. When the family member is better, the family must again adapt to changes, even if the change is to return to the original mode of functioning. It will help the family to be able to recognize the problem; labeling it makes it more manageable.

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?

Accepted Answer

Traits of a healthy family include open communication, ability to establish priorities, being supportive of each other, sharing a religious core, having a sense of humor, and knowing when to seek help. However, healthy families also engage in decision making and do not want others to make decisions for them.

Question 15

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

Accepted Answer

As a result of the current era of cost containment, constraints on the community health nurse will increase. Reimbursement is almost entirely calculated for services rendered to the individual and thus is a major constraint toward moving toward planning care for the family as a unit.

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?

Accepted Answer

Changes in family patterns, fears, emotional responses, and expectations of individual family members can be assessed in the family interview. Special needs of the primary caretaker (i.e., often the spouse, daughter, or daughter-in-law) must be assessed.

Question 17

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

Accepted Answer

The most comprehensive definition of cohabitation is a living arrangement in which an unmarried couple live together in a long-term relationship that resembles a marriage. One of the key aspects of this definition is the long-term relationship which is not mentioned in the other definitions.

Question 18

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

Accepted Answer

Internal structure of the family refers to such items as family composition, gender, rank order (by age and sex), subsystems through which the family functions, and boundaries or who is in and who is not in the family system. Extended family members are part of the external structure.

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?

Accepted Answer

CHIP has greatly increased access to health care for many low-income children. The majority of these children live in families with 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?

Accepted Answer

Although some believe even these definitions are too narrow, the widest definitions are "the members of the family are self-defined" and "the family is who they say they are."

Quiz 20: Family Health