nurs246 exam 2

The nurse desires to improve competency when caring for families within the LGBTQ+ community. Which first step should the nurse take to improve this competency?

evaluate personal background, beliefs, and biases

what does the family health nurse use to determine the most appropriate health promotion activities in a family with young children

the patterns of daily routines and family rituals

which action will the nurse take to promote well-being in a family with children? select all

-communicate with the family -understand the family's routines -encourage modeling positive behavior -support development of parenting skills

the nurse plans to assess routines that the family performs together. which information should the nurse collect from the family during this assessment? select all

-vacations -traditions -celebrations

during a health assessment a middle-aged gay man asks the nurse not to document his sexual preference because his primary health care provider is not aware. what should this request indicate to the nurse?

fear of not receiving required care

the parents of a child with muscular dystrophy have a negative view of the child's future and feel hopeless about future care needs. which view of the child is the family demonstrating

floundering

An interprofessional team meeting is scheduled to discuss the care needs for a client with a terminal illness. what should the nurse expect when participating in this meeting? select all

-client goals direct care -focus is on problem solving -client's family can be in attendance

the nurse is conducting an information session regarding factors that affect self-management of care. which statement by the nurse would have to be addressed as not being factual

"gender has an impact on self-management of care"

the nurse is working with a family whose parenting style has been identified as authoritarian. which of the following statements by the parent supports the identification of an authoritarian parenting style

"i need to be able to punish my child so they learn what is right and wrong"

a nurse is presenting information to their unit regarding the use of pronouns. which statement by the nurse would require further education?

"the correct pronoun is always discernible form how the person chooses to express their gender"

after giving birth to a newborn with a genetic disorder, the new mother asks when identification of genetic disorders can occur. how should the nurse respond? select all

-after birth -before conception -during an acute or chronic illness

the nurse notes that a family including a member with end-stage renal disease is feeling emotionally drained. on what should the nurse focus on when assessing this core process? select all

-attachment -commitment

bereavement care is a significant component of the hospice plan of care. which of the following statements about bereavement care are true? select all

-bereavement support can be provided to any close friend or family member of the patient -bereavement support continues to support the family after the death of the patient -bereavement care includes support and counseling from qualified bereavement experts -bereavement care may be a time when family members' suffering increases due to grief

preconception counseling is an intervention that includes providing information and support to couples before a pregnancy to promote health and reduce risks. what is the role of the nurse in preconception counseling? select all

-conduct a health risk assessment that includes fam history -assessment of lifestyle habits such as smoking, alcohol, street drug use -assessment of history of any specific genetic disorders -referral to a genetic specialist for a more extensive evaluation

the nurse plans to the SPICES tool during an assessment. which of the following are assessed with this tool? select all

-confusion -poor nutrition -sleep disorders -skin breakdown

the mother of a child with a chronic illness is exhausted and does not feel supported by other family members when providing the child with care. which instrumental support should the nurse recommend for this mother and family? select all

-create a schedule for meal preparation -assign chores for laundry and groceries -take turns providing the child with physical care

the nurse learns that a family has not planned a space for an expected infant. for which reason should the nurse assess the family about this lack of planning? select all

-denying that the birth is pending -a cultural belief that space planning occurs after the birth of a healthy infant -too busy with other responsibilities to allow time to plan for the baby's space

The hospice nurse learns that the spouse of a client with end-stage Alzheimer's disease has been the primary caregiver without assistance for the past 3 years. What are the risks to this spouse? Select all that apply.

-depression -ambivalence -lack of personal care -feelings of helplessness

The nurse helps the family decide whether a 13-year-old sibling should be present during the death of a younger brother. Which aspect should the nurse keep in mind when the family is making this decision? select all

-developmental age of the sibling -quality of the relationship between the children -cultural practices within the family regarding death and dying

the nurse is assessing a middle-aged gay man. the nurse knows that when assessing this patient, which of the following should be taken into consideration? select all

-earlier onset of physical disability -greater risk of cardiovascular disease -higher rate of chronic gastrointestinal problems

the nurse understands that which of the following interventions for a family will assist in health promotion? select all

-emphasizing the importance of family health on societal health -partnering with families with an optimistic view to improve health outcomes -strengthening the family mentors within the community -strengthening the family's ability to model and reflect on positive health practices -empowering families int heir ability to assess their own needs

the nurse is aware of several children adopted into same-sex families that are scheduled to participate in the community preschool program. what can the nurse do to facilitate the acceptance of these children's family structure into the preschool learning environment. select all

-ensure that teaching materials demonstrate diverse family structures -select materials that show both genders performing a variety of roles -instruct the preschool staff members on ways to reduce the stigma of these children

a key principle of palliative care is patient and family-centered care and the awareness that every person has the right to define their family. select all true statements that apply

-every person has the right to decide who can be involved in their care planning -this philosophy aligns with the concept of chosen family, or family of choice -chosen families may include partners, spouses, friends, and biological and adopted children -chosen family members are not required to have biological connections with the patients to participate in care planning -the palliative care team prioritizes care of the patient and the family

the nurse suspects that a new mother is at risk for poor attachment with the newborn. what could be a reason for poor attachment? select all

-family violence -maternal depression

an older client seeks medical attention after being injured during a home invasion. which of the following should the nurse consider as reasons for this client's physical abuse? select all

-frailty -disability -low income -lack of social support

the nurse is presenting at a conference regarding a gender affirming approach to care. which statements by the nurse reflect an understanding of this approach? select all

-gender identity forms in response to interrelated factors -gender identity occurs on a spectrum -mental health issues can exist and could be a result of stigma and/or negative experiences

the nurse manager suggests that the nursing staff include an assessment of mental health for all clients who are of the LGBTQ+ community. why is the manager most likely making this suggestion. select all

-higher risk of substance abuse -greater risk for depression -high level of social stigma and discrimination that this community often experiences -the fact that suicide is a leading cause of death within this community

the nurse is preparing a presentation about the needs of family caregivers for a senate hearing on caring for people with chronic health problems. what should the nurse suggest as positive actions to improve the economic status of these caregivers? select all

-implement flextime -provide tax credit for caregiving -expand funding for the national family caregiver program -include the care of extended family members through the family and medical leave act

to provide optional palliative and end-of-life care, nurses need to be aware of their own assumptions and biases about dying and death. why is it important for the nurse to perform self-reflection? select all

-it may be difficult for the nurse to be with a patient or family who have different beliefs or values than they do -nurses may feel uncomfortable when they encounter dying and death, no matter how much expertise they have developed -it is important for nurses to explore personal attitudes and assumptions to understand how those might influence their attitudes toward dying and death -it is important for nurses to explore their beliefs and understanding of the human condition

the nurse learns that a gay man has waited more than 2 months before seeking treatment for a sexually transmitted infection. what should the nurse consider as a reason for this client to delay seeking treatment. select all

-lack of access to care -lack of insurance coverage -history of overt discrimination -negative experience with the healthcare system

the staff development trainer is preparing an educational program for nurses who provide palliative care. which suggestion should the trainer make to encourage a trusting relationship between nurse and family? select all

-maintain a nonjudgmental approach when providing care -listen to the family's experience with illness and suffering -acknowledge the strengths of the individual family members -demonstrate compassion by showing an understanding of the family's suffering

the nurse prepares to use the FAMILY tool to assess a client and family. which of the following will the nurse assess with this tool? select all

-members' needs -assistance needed -family involvement -integration into care plan

why is it important for acute care nurses to have gerontological nursing experience? select all

-older clients make up 25% of trauma cases -older clients are at risk for geriatric syndromes -older clients make up a high percentage of acute and critical care cases

the nurse prepares to assess an adolescent's sexual history. on which questions should the nurse focus when completing this assessment. select all

-partners -practices -protection -pregnancy prevention

the nurse is preparing a child and their family for a surgical procedure. the nurse understands the which of the following would be an appropriate approach with the child regarding the surgery? select all

-play with a blood pressure cuff with a child -show picture of an operating room to the child -use a doll with the child to demonstrate the use of a surgical mask

the nurse plans to use an empowerment model to plan care for a family who has a member with a chronic illness. which type of care will the nurse use to support this family? select all

-problem-based -strength-based -evidence-based -patient-centered

the nurse is providing interventions for a couple that is dealing with infertility. which of the following would be an appropriate intervention by the nurse? select all

-referring the couple to support groups -providing information related to cost and insurance coverage for treatment -facilitating communication between the couple -avoiding assigning blame to one partner or the other -encouraging the couple to engage in social support from friends

nurses play a critical role in. helping individuals and families find accurate information and access to resources on genetic risks. what are the nurse's responsibilities? select all

-reflect on their own beliefs and values -provide individuals and families with accurate information about genetic testing so they can make well-informed decisions -communicate factual info with family members when a genetic risk is present -conduct thorough risk assessment and genetic family histories as part of individual assessments -consider genetics and genomics as critical nursing knowledge no matter what setting the nurse works in

the nurse prepares to assess a family with a member who has a chronic illness. on what should the nurse focus during this assessment? select all

-sibling needs -core processes -economic restraints -developmental milestones

the nurse suspects that a client receiving palliative care is nearing end of life. what did the nurse assess to make this clinical determination? select all

-sleeping more often -refusing to eat -inability to swallow -talking with a deceased spouse

while providing care for a family, the nurse reviews the common reactions of siblings to a diabetes diagnosis. which statement is true regarding siblings of individuals with diabetes? select all

-some siblings of children with a chronic illness feel pressure to be the good child -most siblings of children with a chronic illness feel shame-related embarrassment about their sibling -some siblings of children with a chronic illness experience an increased level of compassion -some siblings resent their sibling with a chronic illness because of increased responsibilities and less attention from parents

the nurse asks a family about space arrangements for an expected baby. what is the nurse assessing about the family at this time? select all

-the ability to meet the baby's basic needs -the fear about survival of the baby -the acceptance of the reality of having a baby -the ability to afford the financial obligations of a baby

palliative care can begin as soon as there is a diagnosis of a life-limiting illness. what principles of palliative care should guide nursing practice? select all

-the focus of palliative care is on supporting quality of life -education and support for the family is a high priority -the interprofessional team is there to support the patient and family -it is appropriate for palliative care to be delivered while curative treatments are also in place

the nurse is providing care to a mother suspected of having PPD. which of the following assessments does the nurse understand supports this diagnosis? select all

-the mother states she has been very sad over the last several weeks -the mother states she has difficulty sleeping -the mother states she has difficulty concentrating on daily tasks -the mother states she has no energy during the day

the nurse providing palliative care to a client with a terminal illness is experiencing moral distress. which situation most likely caused the nurse to experience this emotional response? select all

-the nurse continues to provide chemotherapy to the client upon the family's request -the nurse is unable to relieve dyspnea because of a fear of overmedicating the client -another health care provider suggested another course of treatment that "might do the trick" -the adult children want everything possible done yet the client is exhausted and wants it to end

the nurse is preparing to assess a family with small children. why should the nurse focus on the family transition points during this assessment? select all

-they represent a time when families are most likely to reorganize and change -they represent a time when individuals within the family are at greatest risk for illness -they represent a time when individuals within the family are most likely to change roles and related tasks

the nurse prepares an educational seminar about families for a community health fair. what should the nurse explain as the overall major function or task of parents? select all

-to help children learn to read -to provide food, shelter, and clothing -to socialize children into schools and the community -to assist children in developing spiritual beliefs to guide daily tasks

which phrase most accurately characterizes the purpose for family child health nurses to practice family-centered health care

form partnerships between families and nurses

a family learns that their newborn has a genetic anomaly. which statement best describes what genes control

functions of the human body at the cellular level

a school nurse working at a middle school recognizes that several students identify as LGBTQ+. which of the following should the school nurse keep in mind when assessing these students?

greater risk of teen pregnancy

the nurse learns that a disease is present in more than one generation of a family. what does this suggest to the nurse

the family may have either a biologically or environmentally based genetic disease or a combination of both

a frail older client does not have children. what should the nurse consider when planning this client's care

depend on formal services for assisstance

a mother of a child with asthma is confident about her ability to manage the child's care. the father is not as confident about his abilities to manage the child's asthma. which view of the child is the mother demonstrating

accommodating

the nurse is planning care for a family with a new baby. which reason should the nurse identify as a risk for conflict between the nurse and client during this time?

agreement between grandparents and the nurse

when planning interventions for a family with rheumatoid arthritis, it is essential that the nurse include which family member in the discussions regarding treatment options

all family members who are available

the family of a client nearing end of life asks if they can leave to get dinner. which client observation causes the nurse to suggest that they family wait a while longer before leaving the client

apneic periods of 15 to 30 seconds

the nurse plans to discuss an expectant client's decision regarding infant feeding. what is important for the nurse to do when considering feeding management for this family?

assist the parents to form a nurturing relationship surrounding the feeding of the infant

the nurse assesses a family's ability to transition to having a baby. to which concept is transition the most similar?

change

a family with a child diagnosed with cystic fibrosis has newly relocated to a community. which health trajectory will the nurse use as a guide for this family's care

chronicity

the nurse is preparing a unit-based in-service on genetic diseases. which key ethical concept should the nurse emphasize during this in-service

confidentiality

the nurse suspects that a family is experiencing ambivalence. to what does this term refer in the family

conflicting emotions regarding relationships with older adults

the spouse of a client nearing death is concerned because the client's breathing is "so noisy." how should the nurse refer to the client's respiratory status when talking with the spouse

congestion

the family of a client receiving palliative care for a terminal illness hesitate to call for the nurse because all staff seem to be too busy to address the client's needs. which action should the nurse take to improve the connection with the family

enter the room and stand or sit at the bedside to talk with the client and family

during a family conference, the nurse practitioner is leading a discussion with a family, which includes a 15 year old adolescent who often forgets to check his morning blood glucose. which questions would be the most appropriate for the nurse to ask

i understand that you are all concerned with checking blood sugars. is that right?

the nurse plans to attend a continuing education program for genetics. in which situations will the nurse use this knowledge

in all health care settings

the parents of a new baby are both 19 years old. which intervention should the nurse identify to help this family with realigning the intergenerational pattern?

instruct on ways to move from dependence to independence

the nurse notes that a family has a high need for certainty about a possible genetic condition. what should the nurse expect this family to do?

learn about the genetic condition

the nurse notes that a transgender man has elevated liver enzymes and poor bone density. what should the nurse consider as a reason for these findings?

masculinizing hormone therapy

during a family assessment, the nurse learns that one parent is heterosexual and the other family member is bisexual of the opposite sex. how should the nurse document this family structure?

mixed-orientation

a female learns of a genetic predisposition to breast cancer. what should the nurse identify as being the first line of defense for this person

more frequent mammograms to detect early cell changes

the nurse plans care for a postpartum client arriving for a wellness visit. what should the nurse tell the client about postpartum depression?

most mothers are reluctant to ask for professional help

the nurse learns that a grandparent will be the guardian of a grandchild. which relationship is the strongest predictor of the grandparent-grandchild relationship

mother and grandparent

changes result in stress. which type of change is found to be the most stressful for an older adult

nonnormative

what age group should the nurse identify as the fastest growing group of older adults in the US

older than 85

the nurse notes that a large number of older clients are living longer. what could be the reason for this

overhospitilization and prescription drug use

during a home visit, the nurse learns that a family is experiencing a situational transition. which event most likely occurred in the family

parents filed for divorce

which principle should family nurses incorporate in their care to help a family with a child who has diabetes

patterns of illness and disease differ between families

the nurse prepares health promotion information for a family with a toddler. which intervention will the nurse recommend to the parents

placing medications in a locked cabinet

the nurse is working with a family where child maltreatment is the focus. the nurse understands that which of the following is the preferred approach when working with this family

prevention

the nurse is providing care for a family who has an intersex child. which action by the nurse would require and intervention?

providing information to the family prior to their readiness

according to Knafl and his colleagues' theory of normalization, families including a child with a chronic illness must perform which action to adopt a "normalcy lens"

recognize the ongoing processes of actively adapting to the child's evolving physical, emotional, and social needs and establishing new family routines

the nurse notes that a family with a child newly diagnosed with a chronic illness has no experience with the disease. therefore, required routines and family life are disorganized. which need is the family experiencing

reeducation

the nurse understands that which of the following would not be apart of the contextual aspect when addressing the social construction of family health

routine meetings

the nurse completes an instrumental activities of daily living with an older client. which activity will this assessment include

shopping

when should the nurse consider that a new mother is developing postpartum depression?

sitting in a dark room ignoring the baby after 6 months

the nurse notes that through genetic testing, a female carrier of an X-linked condition has on normal copy of the gene on the X chromosome and one mutated copy of the gene on the other X chromosome. what should this indicate to the nurse

sons will have a 50% chance of having the condition

the nurse is working with an adolescent individual who is undergoing the process of coming out as transgender. the nurse understands that which of the following would be the final stage in this process?

surgical affirmation

a client assigned to a student nurse for care dies shortly after the student completes morning care. what should the nurse do to support the student at this time

talk with the student about the experience and answer any questions

the female partner of a family is upset because the spouse will not talk about the inability to conceive. which response should the nurse make to this client?

talking about he problem can increase your spouse's anxiety about it

the nurse plans care to address the communication pattern within a family with a new infant. what intervention should the nurse select for this family?

teach how to recognize and respond to the baby's cues

the family of a client with a terminal illness hesitates to agree to palliative care because of not wanting to give up on a possible cure. how should the nurse respond while also including a principle of palliative care?

the client can continue to receive treatment intended to cure the disease

the nurse recieves information about the human genome project. which phrase does the nurse identify as accurately defining the human genome

the complete set of genetic material that makes an organism

a family in the community has an inherited genetic disorder. what should the nurse realize about this family and their associated family members?

the diagnosed family members may not want to discuss the genetic information with the rest of the family

although the nurse desires to use Duvall's family developmental theory to guide the care of a family, the nurse decides against it. which is the major reason for the nurse to make this decision?

the theory is based on traditional nuclear families and does not address diverse family structures

a participant in a community health program asks how genetic diseases occur. what should the nurse include about genetic diseases in response

they are diseases caused by biological and environmental factors that family members share

the nurse cares for a family who has a member with huntington's disease. what should the nurse realize about the other family members

they are likely to have various opinions about predictive testing

a married couple arrives for an appointment for genetic testing after discovery of genetic diseases in their family histories. what should the nurse explain about genetic conditions to this couple?

they can be attributed to a mutation in a gene

the nurse suspects that a family has closed boundaries. why will this family not be amenable to nursing interventions?

they reject influences from the outside environment

the nurse learns that the parents of a family are rarely at home and are not involved in the children's activities or interests. which type of parenting style is represented by this family

uninvolved

the nurse prepares material for a group of new staff members. how should the nurse describe family careers

unique events that occur in families that affect family development and processes