Ch 4 Fundamental Health of individual and community

three general types of communities according to Archer

1. Emotional 2. Structural 3. Functional

risk factor for healthy family

1. psychosocial (turbulant parents, 2. environmental (poor neighborhood 3.chemical (alcholic,smoking

An adolescent confides in the school nurse that she is arguing daily with her mother, and she often wonders if her mother loves her. The school nurse recognizes that the student faces which of the following risk factors for altered family health?

A psychosocial risk factor Explanation: Conflicts between family members are considered psychosocial risk factors.

The nurse is explaining the expected developmental tasks of a typical family with adolescents. Which of the following would be incorrect for the nurse to include?

Adjustment to retirement Explanation: Developmental tasks for families with adolescents and young adults include balancing teenagers' freedom with responsibility, maintaining supportive home base, and strengthening marital relationships. Adjusting to retirement is a developmental task for families with older adults.

The nurse on the elective surgery floor receives a report that describes the client's abdominal wound dressing as having a moderate amount of yellowish and bloody drainage on it and a very foul smell. In planning for a dressing change, it is most important for the nurse to perform which action?

Wash her hands before and after the dressing change. Explanation: Physical safety and security means being protected from potential or actual harm. The abdominal dressing with a foul smell indicates the presence of bacteria. It is most important for the nurse to prevent the spread of infection to herself and others and to protect the client. Proper hand washing before and after the dressing change to prevent the spread of infection is a nursing activity that will meet these physical safety needs. Changing the abdominal dressing more frequently, applying extra gauze to absorb the wound drainage, or using sterile gloves to change the dressing will not prevent the spread of infection to other clients or staff.

Which client requires priority intervention when providing care on a medical-surgical unit?

a postsurgical client who is feeling dizzy with a heart rate of 45/bpm Explanation: According to Maslow, the first-level physiologic needs are the most important. They are the activities necessary to sustain life, such as breathing, circulation, and eating. Using Maslow and ABCs to help prioritize care of clients, the nurse needs to see the client experiencing acute problems with circulation and a heart rate of 45/bpm. All other client problems are not the priority at this time.

he nurse is assessing the communication style of the client. Communication is an example of which dimension of the individual?

Sociocultural dimension Explanation: Communication is essential for interaction with others and is an example of the sociocultural dimension. Housing and community are examples of the environmental dimension. The emotional dimension includes fear, sadness, loneliness, and acceptance of self.

A couple with adolescent children is most likely to focus on which of the following developmental tasks?

Strengthening marital relationships Explanation: The couple in a family with adolescents and young adults likely has a developmental task to strengthen marital relationships. Establishing a mutually satisfying marriage and coping with the loss of energy and privacy are tasks for a couple with young children. Adjusting to retirement is a developmental task for older adults.

You are the community-based nurse who acts as case-manager for a small town about 60 miles from a major health care centre. What is the most important factor of community-based nursing for you be knowledgeable about?

Community resources available to patients. Explanation: A community-based nurse must be knowledgeable about community resources available to patients as well as services provided by local agencies, eligibility requirements, and any possible charges for the services. The other answers are incorrect because they are not the most important factor for a community-based nurse to be knowledgeable about.

The nurse in the adolescent in-patient psychiatric unit is interviewing the family of a 16-year-old client admitted for depression and threatened suicide. What assessment information is most essential for the nurse in determining the affective and coping function of the family?

Family patterns of communication Explanation: The five major areas of family function are physical, economic, reproductive, affective and coping, and socialization. When assessing the family of a depressed client for affect and coping function, it is helpful for the nurse to be aware of the family's communication style. This information can help identify family difficulties and teaching points that could benefit the client and the family.

Mashlow's needs.

Level 1: Physiologic needs(food, elimination, pain,breathing, circulation) Level 2: Safety and security needs-(Environment) Level 3: Love and belonging needs aLevel 4: Self-esteem needs( Level 5: Self-actualization needs-intellectual&spiritual

The nurse is assessing the family structure of the client. The family household is comprised of two parents, three children, and one grandparent. The nurse recognizes that this is a(n):

Extended family. Explanation: An extended family is composed of family members, including aunts, uncles, and grandparents, who live in close geographic proximity to one another. A traditional family consists of two parents and their children. A blended family is formed when parents bring unrelated children from previous relationships together to form a new family. Individuals who choose to live together for a variety of reasons form a cohabiting family.

In conjunction with the client, the nurse has set the following client outcomes. Which client outcome reflects Maslow's level of self-esteem needs?

The client will verbalize feelings of increased confidence in performing a finger-stick blood sugar. Explanation: Identification of signs and symptoms of hypoglycemia will promote the safety of the client. Physical activity, such as ambulation, is essential for Maslow's physiologic needs. Social support that meets a transportation problem represents a solution to feeling love and belonging. Self-esteem is enhanced with feelings of increased confidence in skill performance.

A nurse has the Petty Family as a client, who consists of a wife, husband, and their 4-year-old daughter. The husband has been unemployed for 8 months, and they lost their apartment. The family has been staying in neighborhood shelters and, on occasion, with the husband's father for a night or two. When evaluating this family, the nurse identifies this family as which type?

A homeless family

You are the nurse caring for a patient newly diagnosed with diabetes and you are developing a holistic plan of care. You know that for this plan of care to be successful it must what?

Address the disease but also incorporate the mind, body, and spirit. Explanation: A holistic plan of care seeks to balance and integrate the use of crisis medicine, advanced technology along with the mind, body and spirit which are incorporated though the use of the nursing process. Option A is incorrect; taking into account the cost of care is only one facet of a holistic picture. Option B connecting families, friends and the environment is important but mind, body and spirit define holism. Option C is incorrect, a holistic plan of care may provide a connection between medicine and nursing but it does not define it.

The nurse assists a postoperative client with ambulation. The nurse recognizes that assisting the client when performing this skill meets which of Maslow's basic human needs?

Safety and security Explanation: Nurses carry out a wide variety of activities to meet patients' physical safety needs, such as moving and ambulating patients. Assisting the patient to ambulate ensures that the patient will not experience a fall.

A nurse is caring for an adolescent who lost a leg in a motor vehicle accident. Which human need would the nurse most likely need to address?

Self-esteem needs Explanation: The options listed are stages of Maslow's hierarch of needs. The adolescent would have issues and concerns in the self-esteem stage. Self-esteem needs would include fear, sadness, loneliness, and accepting self; all would be appropriate with this client. Love and belonging would focus on the sociocultural aspect and would include areas such as relationships with others, communications with others, support systems, being part of a community, and feeling loved by others. Safety and security would focus on the environmental aspect and would include areas such as housing and community/ neighborhood to name a few. Self-actualization needs are in the intellectual and spiritual dimension and would include areas such as thinking, learning, decision making, values, beliefs, and helping others.

A community is defined as a social group that may or may not share common geographic boundaries yet interact because of

Common interests Explanation: Community is defined as a social group, whose members may or may not share common geographic boundaries, yet who interact because of common interests or shared values to meet the needs within a larger society. A community assessment allows the nurse the opportunity to understand the community.

The core of the community is

Demographics Explanation: The core of a community includes demographic data, history of the community, and values and beliefs of the community.

The home health nurse is making an initial assessment visit to a family that consists of two parents and twin 3-year-old boys. During the interview, the nurse is most concerned if the client makes which statement?

The father states, "I don't discuss money matters with my wife because I don't want her to worry." Explanation: Effective and healthy families exhibit open communication among its members. Protecting the spouse from worry by not discussing money matters stifles communication and jeopardizes the family's affective and coping functions. It is appropriate for a father to provide emotional comfort to his son by allowing him to sit on his lap during the interview. Paying cash is an appropriate way to manage family finances. The mother is stating her personal belief about housework in a clear and open manner.

The nurse in the pediatric unit is caring for a 10-year-old boy admitted with dehydration and diarrhea after eating chicken contaminated with Salmonella bacteria. What action taken by the nurse would be the most effective in preventing the spread of the infectious microorganism?

Washing hands before and after providing the client care Explanation: Hand washing and sterile techniques are two significant measures to prevent the occurrence and transmission of infection in health care settings. Salmonella is spread through contaminated food and feces. There is no need to wear gloves to take the client's blood pressure and pulse. All soiled clothing should be placed in a sealed plastic bag before being sent home. The client ate contaminated chicken before he arrived at the hospital. There is no indication that the hospital food is contaminated.

A nurse is working at a community clinic that serves mostly families with young children. What would be a priority intervention for patients in this developmental stage? You Selected:

Setting up parenting classes Explanation: Duvall (1977) identified critical family developmental tasks and stages in a family life cycle. Duvall's theory, based on Erikson's theory of psychosocial development, states that all families have certain basic tasks for survival and continuity as well as specific tasks related to developmental stages throughout the life of the family. The question asks about a community clinic that serves mostly families with young children and the priority intervention for clients in this developmental stage. Setting up parenting classes is the only answer that address the stated developmental stage. Families with adolescents and young adults would be at the appropriate developmental stage for providing sex education and alcohol/drug information. The community clinic would not focus on screening for congenital defects.

The nurse is admitting a 38-year-old male client to the oncology unit whose religious background is different from her own. The nurse is assessing how the client's religion may affect his health care needs. Which question by the nurse is the best way to consider the client's religious practices in the plan of care?

"What can we do to help you meet any religious needs you may have?" Explanation: The nurse should always respect the client's religious beliefs and ask if he has any religious needs that may affect his health care. Comparing the client's beliefs to those of the nurse is inappropriate. Asking general questions about the client's religion would not identify other aspects of his religion that might affect his health care. A too narrow focus on only dietary restrictions or specific medical treatments will not give the nurse enough information to develop an inclusive plan of care.