Chapter 2: Family-Centered Community-Based Care (Prep U)
The nurse is caring for a child. The nurse is trying to ensure that the family's cultural practices are supported. Which statement by the nurse indicates a lack of understanding regarding cultural competence? "Since your child is only 8, I doubt that your child has any cultural practices we need to be aware of." "Is there a particular religion that we should note in your chart that may impact your care?" "Are there any dietary practices related to your culture that we should know about?" "Most cultures have certain practices that are important to them. We want to honor any that we can."
"Since your child is only 8, I doubt that your child has any cultural practices we need to be aware of." Typically, a child begins to understand his or her culture at approximately 5 years of age, so stating that the child does not have any cultural practices at the age of 8 is inaccurate. Diet, cultural practices, and religious practices related to culture are important for the nurse to know so that the nursing staff can support as many of these practices as possible.
A nurse is uncomfortable caring for a pregnant client who is married to her female life partner. The best advice another nurse can give her would include which statement? "Maybe it would be best if you don't care for this group of families and focus on caring for the classic husband and wife team." "If you can just put on your happy face and focus on the baby rather than the parents, you will be able to care for all families." "Spend some time self-reflecting why this family difference might be bothering you." "Maybe you should take another nursing course that focuses on cultural competencies; then you might have a better feeling caring for this family."
"Spend some time self-reflecting why this family difference might be bothering you." There are some major barriers for health care providers when caring for individuals who are different from them. One of these barriers is the potential for personal bias. This barrier can only be addressed through self-reflection, trying to understand why these differences might be bothersome, and setting those feelings aside while taking care of clients. A cultural nursing course might be beneficial, but it will not help in the meantime. Pretending to be okay with the family differences will not deal with the problem. Ignoring feelings by working only with traditional family units will not solve the problem in the long term.
The case manager is looking over the inpatient census on the floor to determine which client would be the best candidate for discharge with home health care follow-up. Which client would the case manager recommend to the practitioner for discharge? Adolescent who was admitted in sickle cell crisis yesterday and rates his pain as an 8/10. 10-year-old boy with an infected laceration on his leg who has been treated with IV antibiotics for 3 days. 3-day-old infant with a bilirubin level of 20 who is currently under phototherapy. 6-year-old asthmatic child who is wheezing and has an O2 saturation of 92%.
10-year-old boy with an infected laceration on his leg who has been treated with IV antibiotics for 3 days. The child with the infected laceration is on IV antibiotics and can safely be discharged to complete the medication at home with home health care. The 6-year-old is too unstable for discharge. The infant's bilirubin is too high for doing home health phototherapy and may need additional hydration. The adolescent is on sickle cell crisis and is not ready for discharge 1 day after admission.
What is the key nursing role when managing the health care of a child living with a foster family? Identifying any developmental delays. Advocating for the child and the services needed. Determining if the child has mental health needs. Securing proper educational placement.
Advocating for the child and the services needed. Advocating for the child is the overarching nursing role. Unmet health needs are likely. Advocacy gives the child a "voice" so that the wide range of health care needs often prevalent in foster children can be met. Determining the presence of mental health issues and developmental status as well as securing educational placement are specific issues among many that advocacy would address.
A woman is in the second stage of labor, 8-cm dilated and 90% effaced. She keeps very quiet without expressing any outward signs of pain. Which intervention by the nurse would be most appropriate in this situation? Monitor the woman to attempt to predict when it is time to push. Review the nursing goal to minimize the amount of pain with birth. Allow the woman to labor according to her cultural beliefs. Administer pain medication without asking the woman.
Allow the woman to labor according to her cultural beliefs. The way people respond to pain is an example of a trait that is heavily influenced by culture. Some women and children scream with pain; others remain stoic and quiet. Both are "proper" responses, just culturally different. The best nursing intervention is to allow the woman to labor the way that is best for her. Administering pain medication without permission is unacceptable nursing practice. The nurse will have to assess the woman frequently, especially noting if any blood is coming from the vagina and performing frequent vaginal exams to know when it is time to push. "A close watch" could mean just looking into the room frequently. In some cultures, being stoic is expected behavior, so minimizing the pain may not be the goal of the woman.
The nurse in a free clinic is caring for a 1-year-old girl and her single mother. Which nursing intervention would most likely be needed initially? Obtaining food stamps for the family. Discussing family beliefs. Providing a list of low-cost child care centers. Assessing the child's nutritional status.
Assessing the child's nutritional status. A single mother using a free clinic probably means that the two are living in poverty. The child could be malnourished. This would affect all aspects of the child's growth and development. Obtaining food stamps may be a partial solution to a nutritional problem if this is confirmed following assessment. Family beliefs are important but not the first concern. Good child care promotes healthy growth and development. This can be addressed later.
The nurse notes that a 5-year-old boy is approaching obesity. Which is the priority intervention? Asking about culturally related eating habits Screening the child for metabolic disorders Determining the activity level of the child Assessing the diet of the child and family
Assessing the diet of the child and family The greatest influence on the child's behaviors is the family. Therefore, habits of the family are likely to be those of the child. Evaluating the family diet is most important. Determining the activity level of the child ranks next in importance. Sedentary behaviors lead to weight gain. Asking about culturally related eating habits can produce some helpful, but limited, nutrition information. Screening the child for metabolic disorders would not be done unless there was other evidence that points to this possibility.
What is a key element of providing family-centered care? Communicate specific health information. Give only the health information that is necessary while providing care. Avoid cultural issues by providing care in a standardized fashion. Be in control of the way care is given.
Communicate specific health information. Key elements in the provision of family-centered care include demonstrating interpersonal sensitivity, providing general health information and being a valuable resource, communicating specific health information, and treating people respectfully. Giving as much control as possible to the client and his or her family is essential in family-centered care. The nurse should give all the health information, both good and bad, that the client or the family requests and be culturally sensitive to the client and the family.
While interviewing a Chinese man about his son's health, the nurse notices that the man keeps his eyes focused on the floor. What is the best action by the nurse? Ask the man if anything is wrong. Ask the man if he would like to continue the interview at a different time. Stop and ask the man to elaborate about his anxiety regarding his son's care. Continue with the interview.
Continue with the interview. For some Chinese Americans, it is not culturally acceptable to make eye contact while conversing; this can be seen as a cultural norm for this man. Continuing with the interview is the best response so as not to make him feel uncomfortable
A gay couple asks their health care provider about how they can begin a family. Which methods should be discussed to accomplish their goal of a family? Select all that apply. One or both partners can donate sperm to a surrogate gestational carrier.× The couple can find a female surrogate and then donate sperm to allow for artificial insemination.× Both partners can donate sperm and take the sperm to a fertility clinic for insemination.× The couple can buy an "egg" and mix it with their sperm and then take it to a fertility clinic for preservation until a surrogate can be chosen.× The nurse can give the couple a list of area adoption agencies that might be helpful to use to grow their family
Correct response: One or both partners can donate sperm to a surrogate gestational carrier.× The couple can find a female surrogate and then donate sperm to allow for artificial insemination.× The nurse can give the couple a list of area adoption agencies that might be helpful to use to grow their family. Male partners may use their own sperm and an egg donor; sometimes that egg donor carries the pregnancy as well. Other times, a third person is involved; this "gestational carrier," or surrogate, shares none of her genetic material with the baby but carries and delivers the baby. Additionally, adoption is a common course of action couples use to grow their families. Insemination is a specialty and must be done under sterile conditions. The couple cannot just drop off the sperm for insemination.
While performing a community assessment, a nurse notes a large increase in single-parent families. She performs some research and finds that the increasing numbers of single-parent families are related to which trends? Select all that apply. Mobility Changing attitudes toward children born out of wedlock Increasing divorce rate Changing adoption laws Advancing age of women getting married
Increasing divorce rate Changing attitudes toward children born out of wedlock Changing adoption laws The advancing age of women getting married or mobility has not been found to be related to the increase in single-parent families. The other choices are related to the increasing number of single-parent families.
The nursing instructor is teaching a session outlining the necessary skills of a community nurse. The instructor determines the session is successful when the students correctly choose which factor as the foundation of all nursing care? Case management Communication Teaching Nursing process
Nursing process The nursing process serves as the foundation of nursing care in the community, just as it does in a health care facility. Communication and teaching are parts of the nursing process. Case management is necessary to coordinate care and implement the nursing process.
The nursing instructor is teaching a session on the increase of health care costs associated with the advancement of modern technology. The instructor determines the session is successful when the students correctly choose which focus of community-based health care that has been implemented to combat the increased cost? Preventing disease and its sequelae Keeping clients with chronic illnesses in their homes Providing care for the client as an individual Tracking reportable diseases
Preventing disease and its sequelae Community-based nursing focuses on prevention and is directed toward persons and families within a community. Community-based nursing is holistic in nature and provides care for the client as part of a family and community, not just as an individual. It strives to keep clients with chronic illnesses in their homes, but that is not the focus of the care provided. A function of community-based nursing is reporting and tracking reportable diseases; again, that is not the focus of community-based nursing.
A nursing student asks the instructor why nurses focus on assessing sociocultural aspects of clients. Which response from the nurse is most accurate? Such assessment can reveal why people take certain preventive or treatment measures related to their health. Assessment of sociocultural components makes nurses better equipped to work in diverse settings. This assessment is necessary to pinpoint genetic risks in people. Nurses should strive to understand all dimensions of the client, even those that seem less important.
Such assessment can reveal why people take certain preventive or treatment measures related to their health. Assessing sociocultural status, ethnicity, and cultural beliefs of families and clients can reveal why people take the type of preventive health measures that they do or seek a particular type of care for illness. While the other answers might be partially correct, they do not represent the best answer for this question.
A homeless client diagnosed with human papillomavirus (HPV) is seen in the maternity clinic requesting a pregnancy test. Which nursing action would be the best example of the secondary level of prevention? Arrange for her to have the HPV vaccination. Discuss with her the need for folic acid supplementation. Suggest she have a Papanicolaou (Pap) smear. Send a referral to social work for adequate housing assessment.
Suggest she have a Papanicolaou (Pap) smear. Secondary prevention is the early detection and treatment of adverse health conditions and is aimed at halting the disease. Health screenings are the mainstay of secondary prevention. Papanicolaou (Pap) smears are at this level of prevention. Primary prevention encompasses immunizations, and as she is already infected with HPV, the vaccine would not be effective. The referral for social work and the use of folic acid supplements while pregnant are examples of primary prevention.
A nurse is addressing a group of women on the issue of women's health during their reproductive years. Which reason does the nurse provide regarding the need for comprehensive, community-centered care to women during this time period? Women have more health problems during their reproductive years. Women's health care needs change with their reproductive goals. A woman's immune system weakens immediately after birth. Increased stress causes more health problems during their reproductive years.
Women's health care needs change with their reproductive goals. The nurse should inform the women that comprehensive community-centered care should be given to women during their reproductive years. This is because as their reproductive goals change, their health care needs change as well. A woman's immune system does not weaken immediately after birth. Similarly, women do not have more health problems specifically during their reproductive years, nor are they more susceptible to stress during their reproductive years.
The nurse is concluding her initial visit with a client at 28 weeks' gestation on bedrest for premature rupture of membranes. What information should the nurse consider when determining the timing of the next home visit? amount of supervision and health education needed by the client the home visit schedule and needs of the agency to plan the visit client's type of health insurance the location of the home
amount of supervision and health education needed by the client The nurse should complete an assessment on the client to include the amount of education and ability of the client to understand the health care provider's orders. The nurse should allow the agency to work with the insurance company, and the location of the home should not influence the decision of the nurse.
When a woman is admitted to the labor-and-delivery unit, her husband says he is going to work and asks you to call when the baby is born. Your best response to this husband would be to tell him he is missing out on the opportunity of a lifetime by leaving. tell him that all fathers now stay with their wives during labor. ask him if he knows that he can stay with his wife during labor. insist he stay with his wife during labor because she will need his support.
ask him if he knows that he can stay with his wife during labor. Respect for cultural values is important for developing effective nurse-client relationships.
A community-based nurse has a different set of skills than those of counterparts who work in a hospital. Community-based nurses also face unique issues and challenges. What is one of the unique aspects of community-based nursing? less holistic focus disease-oriented teamwork autonomous action
autonomous action Community-based nursing practice is autonomous. There are often no other members of the health care team to consult, or no members within the area to consult with. Teamwork is important in community-based nursing, but it is not a unique aspect of this type of nursing. Disease orientation is the medical model of health care. Community-based nursing takes in all aspects of the client, including community aspects such as education—not just the disease process. Therefore, it is more holistic rather than less holistic.
While interviewing a client, a nurse assesses the client's reaction to health care and determines that the reaction reflects the client's preferred ways of acting based on traditions. Which term would the nurse use to document this information? cultural values ethnicity race culture
cultural values Culture is a view of the world and a set of traditions that a specific social group uses and transmits to the next generation. Cultural values are preferred ways of acting based on those traditions. Ethnicity refers to the cultural group into which a person was born, although the term is sometimes used in a narrower context to mean only race. Race refers to a category of people who share a socially recognized physical characteristic. The term is rarely used today as the research on the human genome shows no basic differences in structure among people.
A family that regularly takes in foster children is visiting the junior high school nurse to inform the staff that there will be a new 8th grade foster child beginning school the following week. The school nurse should monitor this new student for which psychosocial response to being moved to the foster care system? refusal to complete required immunizations high level of insecurity aggressive behavior as the child acts out feelings eating disorders like anorexia nervosa
high level of insecurity Theoretically, foster home placement is temporary until children can be returned to their own parents. Unfortunately, if return does not become possible, children may be raised to adulthood in a series of foster care families. Such children can experience a high level of insecurity, concerned that they will have to soon move again. Aggressiveness and eating disorders should be assessed, but these responses are not the priority for most foster children. Immunization completion is not a psychosocial response to being a foster child.
To assess the sociocultural aspects of the family of an adolescent being seen in an ambulatory clinic, the nurse would try to find out more about: the adolescent's education level. his mother's attitude toward citizenship. his family structure. his mother's occupation.
his family structure. Family structure is a characteristic strongly influenced by culture and ethnicity.
When caring for woman who speaks a different language than one's own, the nurse must ask for an interpreter before having the client sign which forms to ensure clarity can be confirmed? Select all that apply. smoking cessation policy end-of-life care consent to blood transfusions surgical permit dietary preferences
surgical permit end-of-life care consent to blood transfusions When caring for clients who speak a different dialect or language, the nurse should always ask them to repeat instruction to be certain it was interpreted correctly. The nurse should repeat what the client said so he or she can confirm understanding the nurse correctly. The nurse should not be reluctant to ask for an interpreter to help clarify forms, such as consent for blood transfusion, informed consent for surgery, or wishes regarding right-to-life care, as necessary. Dietary preferences and smoking cessation policy are not as important as the other forms that result in invasive procedures.
A nurse encourages both partners in a lesbian family to come into the examining room with the newborn during a well-baby check. What type of nursing is the nurse practicing? community nursing transcultural nursing ethnic nursing stereotyping nursing
transcultural nursing Transcultural nursing is care guided by cultural aspects and respects individual differences. Community nursing is nursing care that takes place for a group of people in a specific area. Ethnicity refers to the cultural group into which a person was born. Stereotyping means expecting a person to act in a characteristic way without regard to his or her individual traits.
A pregnant client is questioning the nurse about the advantages of the various health care options. When providing information about home care and births, which factor should the nurse point out as an advantage? Women can rest more efficiently. It allows for better control of diet and exercise. Families can be better kept intact. Although it is more costly, it is more satisfying.
Families can be better kept intact. The main advantages of home care are cost-effectiveness and the ability to keep a family intact during extended therapy. Women may not necessarily rest more efficiently, as some women might not have the necessary assistance to help with routine activities. Controlling diet and exercise is also not a major focus of home care for the client.
Which information is true of home care as a whole? The amount of care remains even because only a limited number of nurses are available to give care. It is decreasing because many new care measures are too technical for use in the home. It is increasing because new technology makes so many procedures available in the home. It is decreasing because the overall incidence of children's illnesses is decreasing in number.
It is increasing because new technology makes so many procedures available in the home. Home care is expanding because it can offer advantages to both caregivers and consumers. New technology makes it successful.
The nurse is preparing to teach a drug education class at a local elementary school. The nurse is focused on providing which type of care to the community? Tertiary prevention Preventive care Secondary prevention Primary prevention
Primary prevention Primary prevention is promotion of healthy activities and includes education concerning safety, diet, rest, exercise, and disease prevention. Secondary prevention focuses on health screening activities that aid in early diagnosis and encourage prompt treatment. Tertiary prevention focuses on rehabilitation and instruction on ways to prevent further injury or illness. "Preventive care" is not considered a specific category but is a general function that encompasses all three levels.
The community health nurse is seeing a mother and newborn for the first home visit. Which information best indicates an understanding of visiting clients in their home? The home visit is a way of monitoring the well-being of all family members. The home visits are much more cost-effective than office visits. The home visits are essential only for those clients in high risk situations. The home visit places the newborn at risk of acquiring an infection from the nurse.
The home visit is a way of monitoring the well-being of all family members. Home visits offer services similar to those offered at a scheduled clinic visit, but they also give the nurse an opportunity to assess the family's adaptation and dynamics and the home environment. The other statements do not indicate the best understanding of home visits.
The camp nurse is reviewing the health information of the participants at a school-age summer camp for children with diabetes. What topic would be most appropriate for this group of campers? Weight control measures Latest trends in medication delivery Self-administration of insulin Long-term effects of diabetes
Self-administration of insulin School-age children need to learn self-administration of insulin, along with how to check their blood sugar. Although weight control and diet are important, as are peer relationships and being current in available resources, they are not as important for the child's health as learning how to be independent in their insulin administration.
A family with two new foster children in the school system has made an appointment to visit with the school nurse concerning the placement of these two children. The family shares with the nurse that the children's parents are both addicted to drugs and no longer able to provide for the children's basic needs. During this session, the school nurse should ascertain which vital piece of information related to the health care needs of the children? How long will the children be living with the foster parents? Who has legal responsibility to sign for health care for the children? Are the biological parents allowed to pick the children up from school? Do the children have any allergies to drugs or food items?
Who has legal responsibility to sign for health care for the children? Most foster parents are as concerned with health care as biologic parents and can be depended on to follow health care instructions conscientiously. When caring for children from foster homes, be certain to determine who has legal responsibility to sign for health care for the child (a foster parent may or may not have this responsibility). If children are removed from their biological parents, it is highly doubtful the biological parents can pick them up from school. The medical reports from the foster system should provide a list of allergies, if known. How long the children will live with these foster parents will not affect the care provided by the school nurse.
A nurse is providing care to a client who has undergone a mastectomy. The nurse provides the woman with information about where to obtain a breast prosthesis. This is an example of which type of community-based nursing intervention? health system referral health screening program health education program telephone consultation
health system referral The nurse is passing along information about the location of and services offered for the client, an example of a health system referral. Health education programs assist clients in making health-related decisions about self-care and use of resources. Health screening programs focus on detecting unrecognized or preclinical illness among individuals such as mammography. Telephone consultation involves listening and providing support, information or instruction given over the phone, and documenting the interaction.
A laboring client, 2 cm dilated and 50% effaced, is screaming in pain. The nurse caring for this client recognizes this woman's response to pain should be documented using which label? lack of pain control low pain threshold inappropriate response to pain high pain tolerance
low pain threshold A person's response to pain is both individually and culturally determined. The pain threshold is the point at which the individual reports a stimulus is painful. Pain tolerance is the point at which an individual withdraws from a stimulus. Lack of pain control and inappropriate response to pain reflects the nurse's individual bias.
A couple had decided not to circumcise their newborn for nonreligious reasons. What is the appropriate response from the nurse? "That's very unusual; tell me what has led you to this decision." "What arrangements have you made outside the hospital?" "OK, great. I will let the physician know." "It's much better for the health of your newborn if you circumcise him."
"OK, great. I will let the physician know." The nurse should remain as nonjudgmental as possible when speaking with a client. There are many reasons why a couple may decide to leave their newborn uncircumcised. Both health benefits and risks are associated with circumcision. The nurse should respect the couple's decision.
As part of an education program for pregnant women and their partners, the nurse illustrates the various settings available for birth. The nurse determines that the program was successful when the group correctly chooses which statement about home births? "A home birth is probably the most expensive setting for childbirth." "A wide range of pain medications is readily available to the woman." "There are very rigid screening procedures that must be followed." "Women giving birth at home have control over every part of labor."
"Women giving birth at home have control over every part of labor." Home births permit the woman to maintain control over every aspect affecting the woman's labor, such as positioning, attire, and support persons present. A home birth involves the least amount of cost. Home births are recommended for pregnant women considered to be at low risk for complications. Some birthing centers may have very rigid screening criteria. The availability for pain medication is limited for home births.
The teacher suspects that there is some big change occurring in the household of one of her students. Which student may be demonstrating behaviors consistent with a separation or divorce in the family unit? A teenager who is popular and the star football player turns in their homework late. A diabetic school-aged child who's blood glucose levels have been relatively high this week. A kindergarten student who complains of a headache about every day. A teenager who usually gets the highest grade on tests now is barely passing the class.
A teenager who usually gets the highest grade on tests now is barely passing the class. Although there are thoughts that boys generally have more emotional trauma from divorce than girls, boys and girls react differently to the divorce of their parents. All children may manifest their feelings with physical symptoms or by a change in behavior. Their school performance may suffer. Popular, busy students may turn in late work when they have too many activities taking up study time. Young children should have their eye sight tested if they complain frequently with headaches. This is not a normal complaint for young children. Young diabetic patients frequently have fluctuation in their blood glucose levels based on diet, exercise, or hormonal changes.
The nurse is preparing to discuss birthing options with a 25-year-old female who is in a low-risk pregnancy with one older child. Which option will be best for the nurse to recommend for this client? Birthing center Hospital Any birthing settings Home setting
Any birthing settings When a woman is low-risk and has no known medical needs, birth location is the choice of the mother. Home births attended with certified nurse midwives are less likely to have complications and require interventions. Birthing centers are an option for an alternative birth setting, and hospitals are required birth locations for women with potential needs or complications. The nurse should present the advantages and disadvantages of each option and allow the client to make the decision.
A group of student nursing students have been assigned to do a community assessment for the neighborhoods near the college. Which of the following questions should be asked/answered in the report on the community? Select all that apply. Are the children being exposed to a large HIV population? Are there environmental risks present like air pollution, busy roads where children cross going to school, etc. Are the schools and health clinics handicapped accessible? Do the children get exposed to prostitutes standing on the corners of the streets? Will the family have access to public transportation if they do not have an automobile?
Are there environmental risks present like air pollution, busy roads where children cross going to school, etc. Are the schools and health clinics handicapped accessible? Will the family have access to public transportation if they do not have an automobile? When assessing the environment, the students should ask: Are environmental risks present, such as air pollution? Busy highways? Train yards? Pools of water where drowning could occur? Could hypothermia be a problem? When looking at health care, the students should ask: ? Is it handicapped accessible? When looking into transportation, the students should ask: Is there public transportation? Will family members have access to it if they become physically challenged? Lower assessments for Exposure to HIV positive people and prostitutes are not a priority when doing a community assessment unless it impacts the general health of the whole community.
You see a 3-year-old girl in an ambulatory clinic because she has a bad cold. Her mother tells you the girl's problem was caused by her being affected by "mal ojo." What would be the best action? Ask her mother what symptoms her daughter is experiencing. Explain there is nothing to do for illnesses caused by evil spirits. Tell her mother this is not a legitimate illness. Teach her mother that colds are caused by viruses.
Ask her mother what symptoms her daughter is experiencing. Respecting cultural values is important for effective nurse-client relationships.
A nurse is visiting the home of a mother and her newborn. The woman's family members are present when the nurse arrives. What is the nurse's best approach to the situation? Reschedule the assessment visit for another time without family present. Ask the family to leave to meet to perform the assessments privately. Assess the family members' interactions with the newborn and one another. Do brief maternal and infant assessments with the family members present.
Assess the family members' interactions with the newborn and one another. The philosophy of family-centered care recognizes the family as the constant. The health and functioning of the family affect the health of the client and other members of the family. Family members support one another well beyond the health care provider's brief time with them, such as during the birth process or during a child's illness.
Advocacy for the client is an important aspect of community-based nursing. What is one way a nurse can advocate for a pediatric client? Assist the family to apply for Medicaid or other forms of health care reimbursement. Report a new case of whooping cough to the county health authorities. Arrange for educational events for the local hospital staff. Assure a young mother that the nurse will not report the suspicious bruises on her toddler to social services.
Assist the family to apply for Medicaid or other forms of health care reimbursement. The nurse working in a community setting may often develop a long-standing relationship with families because of the continuous nature of client contact in an outpatient, school, or other setting. This type of relationship may allow the nurse to advocate for the client on a broader scale in health and welfare issues. Examples of interventions include helping the family apply for Medicaid or other forms of health care reimbursement. Reporting new cases of whooping cough is done to state authorities, not county authorities, and is not considered advocating for a client. Arranging educational events for the local hospital staff is not a community-based function. Assuring a mother that the bruises on her toddler will not be reported to social services—when it is mandated that any suspected case of child violence be reported—is not advocating for the child.
The nurse is conducting a postpartum home visit. Which action would not necessarily be a responsibility of a visit? Identifying potential complications Linking the family to community services as needed Conducting a well-baby visit to start the child's immunizations Evaluating the emotional well-being of the family
Conducting a well-baby visit to start the child's immunizations Postpartum care in the home environment usually includes monitoring the physical and emotional well-being of the family members; identifying potential or developing complications for the mother and newborn; linking the family as needed to available community social services; and bridging the gap between discharge and ambulatory follow up for mothers and newborns.
The nurse is preparing to teach a class on cultural differences to a group of clients from the community. Which principle of culture will the nurse consider while planning the class information? Each generation learns about culture from family and the community. Culture is always centered around religious activities and beliefs. Culture is determined by one's own morals and personal beliefs. Individuals are born with an understanding of their specific culture.
Each generation learns about culture from family and the community. Culture is a shared, not individual, system of beliefs, values, and behavioral expectations that provide social structure for daily living. Culture includes the beliefs, habits, likes and dislikes, and customs and rituals learned from family and the community through a process called enculturation. Individuals are not born with a sense or awareness of culture. Some cultures are heavily centered on religious practices and customs, however, all are not.
A nursing instructor is teaching the class about community-based nursing. The instructor determines the session is successful when the students correctly choose which activity as an example of tertiary prevention? Caring for new mothers and infants in a maternity clinic Ensuring the client attends physical therapy after orthopedic surgery Reviewing dietary habits with parents of a slightly anemic child Identifying a child with pediculosis in an elementary school
Ensuring the client attends physical therapy after orthopedic surgery Tertiary prevention focuses on rehabilitation activities and would be the focus of a nurse in an orthopedic clinic, aligning with the needs of the clients in that clinic. Orthopedic clients are typically recovering from injury or surgery and are in need of rehabilitation such as physical therapy. Secondary prevention includes health screening activities that aid in early diagnosis and encourage prompt treatment, such as screening for head lice in schools and reviewing dietary habits in individuals who are experiencing anemia. Primary prevention includes health promoting activities to prevent the development of illness or injury, such as new mothers bringing their infants to the clinic for follow-up well-child appointments.
A community-based nurse is assessing the needs of a family of four, which includes a physically challenged 9-year-old. Which activity would the nurse prioritize to be an advocate for this family? Ensure the client follows physical therapy recommendations. Establish eligibility for assistive devices for child. Ensure case history is complete for all family members. Train the school nurse on the needs of the child.
Establish eligibility for assistive devices for child. Client advocacy is acting on behalf of the client. Making calls to arrange for special equipment is one role of a nurse who is acting on behalf of the client. A case history would be taken at the initial visit to the treatment center by the attending nurse. The client's progress in physical therapy is to be noted by the therapist or PT assistant. The community-based nurse should not have to train the school nurse but would share the needs of the child so that the school nurse is prepared to provide appropriate care.
A 4-year-old adopted child has begun to ask questions about when she was born. Which suggestions by the clinic nurse would be considered the most appropriate answer for this child related to her birth? Select all that apply. Inform the child that her biological mom was in prison and would not be able to care for her for a long time. Explain to the child that she grew inside another woman, but after the birth she was given to her adoptive mom and dad to raise. Tell the child that her biological mom could not care for her after birth because she was HIV positive. Explain that her biological mom could not care for her so she was given away. Avoid criticizing the biological parents but reinforce how much the adoptive mom and dad love them.
Explain to the child that she grew inside another woman, but after the birth she was given to her adoptive mom and dad to raise. Avoid criticizing the biological parents but reinforce how much the adoptive mom and dad love them. At least by 4 years, children are old enough to fully understand the story of their adoption: they grew inside the body of another woman who, because she could not care for them after they were born, gave them to the adopting parents to raise and love. It is important for parents not to criticize a birth mother as part of the explanation because children need to know, for their own self-esteem, that their birth parents were good people and they were capable of being loved by them, but things just did not work out that way. At age 4, children do not understand HIV status, not being able to provide for the needs of an infant, or prison terms.
Which intervention best demonstrates the L & D nurse is respectful of a client who is deaf and in early labor? Utilize hand signals like in charades to try to communicate important pieces of information. Write down information on a piece of paper that the client can keep. Utilize the labor coach so he or she can interpret and relay information to the client. Seek assistance from another health care professional who can converse in sign language.
Seek assistance from another health care professional who can converse in sign language. Cultural differences occur across not only different ethnic backgrounds but also different sociodemographic groups. A parent who has been deaf since birth, for example, expects her deaf culture to be respected by having health care professionals locate a sign language interpreter for her while she is in labor. If an interpreter cannot be located, writing down questions and answers is an alternative, assuming the parent has the ability to read and comprehend while dealing with labor contractions. Use of friends and family members is not considered to be the best option since many family/friends find it difficult to interpret medical terms. Hand signals can help in an emergency; however, it not the best way to interpret questions/comments from a laboring woman who is deaf.
A woman who is from the Philippines becomes upset when the nurse brings in an interpreter, rather than using her cousin as the translator. Which would be the best reason for using an official interpreter in this case? There may be cultural limitations that change how the information is being interpreted by the family. There is no additional cost to the client when a professional interpreter is utilized. The woman was unable to pronounce the words the nurse had written down on a sheet of paper. Many English words have double meanings when clients try to make sense of what is being communicated.
There may be cultural limitations that change how the information is being interpreted by the family. It is unacceptable to have a family member serve as an interpreter. There may be cultural limitations that change how the information the nurse is stating is being interpreted for a parent or partner. Additionally, the medical terminology used in the health care system is best translated by a trained professional interpreter.
A clinical nurse specialist is conducting a review class for a group of nurses about cultural competence and cultural diversity. Which term reflects the view of the world and set of traditions of a specific social group passed down through generations? race values ethnicity culture
culture Culture consists of the world view and group of traditions shared by a social group and passed down through generations.
A primary care provider tells a pregnant woman with slightly elevated blood pressure to return home on bed rest until her next scheduled checkup. This is an example of which type of care? skilled home care home care hospice care community care
home care This is an example of home care, or care of persons in their own home. Hospice care relates to end-of-life care and care of those with chronic illnesses who are not expected to get any better. Skilled care requires treatments such as administering IV medications, enteral feedings, and dressing changes. Community care relates to care of individuals and/or groups of people living in a specific geographical area.
A client originally from China is admitted to a medical floor right when lunch trays are being delivered. When the client expresses hunger, the nurse tells the client that the nurse will order some rice for lunch. What is the nurse practicing when telling the client this? prejudice ethnocentrism stereotyping assimilation
stereotyping Stereotyping means expecting a person to act in a characteristic way without regard to his or her individual traits. In this case, the nurse expects that all Chinese people like rice. Prejudice is believing that some people matter less than others based on their physical or cultural traits. Assimilation means that people have adopted the values of the dominant culture. Ethnocentrism is the belief that one's own culture is superior to all others.
A nurse is caring for a Turkish American client. The nurse understands that there could be major cultural differences between herself and the client. The nurse contemplates assigning this client to a staff member who is of the same culture as the client. What is a potential consequence? building a better nurse-client relationship helping in assessing client's culture ensuring better care and understanding stereotyping of the client
stereotyping of the client A nurse who thinks stereotypically may assign a client to a staff member who is of the same culture as the client because the nurse assumes that all people of that culture are alike. The nurse also may believe that clients with the same skin color may react in the same manner in similar social situations. Because stereotypes are preconceived ideas unsupported by facts, they may not be real or accurate. In fact, they can be dangerous because they are dehumanizing and interfere with accepting others as unique individuals.
A laboring woman has brought her partner as her support person who is dressed in feminine attire, but when she speaks, it is clear to the nurse that the support person has a male voice. When documenting about the client's support person, which term would be most appropriate? gender dysphoria male who likes to dress like a woman drag queen transgender
transgender A transgender person is an individual whose gender identity does not match the sex assigned at birth. Gender dysphoria is the realization one's physical sex and gender are mismatched, which can cause a lot of stress and anxiety. There is no data that supports the partner is experiencing anxiety. Drag queen is a slang, inappropriate term. The term "male who likes to dress like a woman" is making a judgment statement and not appropriate in a medical document.
