Giddens Chapter 3 Family Dynamics?
A client who had cranial surgery 5 days earlier to remove a brain tumor has a few cognitive deficits and does not seem to be progressing as quickly as the client or family had hoped. The nurse plans to implement which approach as most helpful to the client and family at this time? A. Emphasize progress in a realistic manner. B. Set high goals to give the client something to "aim for." C. Tell the family to be extremely optimistic with the client. D. Inform the client and family of standardized goals of care.
A
A patient has newly diagnosed hyperparathyroidism. What should the nurse expect to find during an assessment at the beginning of the nursing shift? A. Lethargy and constipation from hypercalcemia. B. Positive Trousseau's sign from hypercalcemia. C. Lethargy and constipation from hypocalcemia. D. Positive Trousseau's sign from hypocalcemia.
A
The nurse in a maternity unit is providing emotional support to a client and her significant other who are preparing to be discharged from the hospital after the birth of a dead fetus. Which statement made by the client indicates a component of the normal grieving process? A. "We want to attend a support group." B. "We never want to try to have a baby again." C. "We are going to try to adopt a child immediately." D. "We are okay, and we are going to try to have another baby immediately."
A
The nurse is assessing a family composed of a married couple with three children, one from the wife's previous marriage and two from the union of this couple. This couple would be considered what type of family? A. Married-blended family. B. Nuclear family. C. Same-sex family. D. Single-parent family.
A
Exemplars of negative/dysfunctional family dynamics include (Select all that apply): A. Codependency. B. Divorce/remarriage. C. Marital infidelity. D. Sibling rivalry. E. Traumatic injury of a family member.
A,C,D
A patient has a tumor that secretes excessive antidiuretic hormone (ADH). He is confused and lethagic. His partner wants to know how a change in blood sodium can cause these symptoms. What should the nurse teach the patient's partner? A. Decreased sodium in the blood causes the blood volume to decrease so that not enough oxygen reaches the brain. B. Decreased sodium in the blood causes brain cells to swell so that they do not work as effectively. C. Increased sodium in the blood causes the blood volume to increase so that too much oxygen reaches the brain. D. Increased sodium in the blood causes brain cells to shrivel so that they do not work as effectively.
B
A patient injured in an earthquake today when a wall fell on his legs received 9 units of blood an hour ago because he was hemorrhaging. Which laboratory value should the nurse check first when the report returns? A. Serum sodium. B. Serum potassium. C. Serum total calcium. D. Serum magnesium.
B
Members of the family of an unconscious client with increased intracranial pressure are talking at the client's bedside. They are discussing the client's condition and wondering whether the client will ever recover. The nurse intervenes on the basis of which interpretation? A. It is possible the client can hear the family. B. The family needs immediate crisis intervention. C. The client might have wanted a visit from the hospital chaplain. D. The family could benefit from a conference with the health care provider.
A
The nurse determines that the wife of an alcoholic client is benefiting from attending an Al-Anon group if the nurse hears the wife make which statement? A. "I no longer feel that I deserve the beatings my husband inflicts on me." B. "My attendance at the meetings has helped me to see that I provoke my husband's violence." C. "I enjoy attending the meetings because they get me out of the house and away from my husband." D. "I can tolerate my husband's destructive behaviors now that I know they are common among alcoholics."
A
The nurse is assessing learning needs for a patient who has coronary heart disease. The nurse finds that the patient has recently made dietary changes to decrease fat intake and has stopped smoking. The best initial response by the nurse at this time is: A. "You did an excellent job of changing your eating habits and quitting smoking. This is so important for your heart health. Nice work." B. "Although the changes you made are important, it is essential that you make other changes, too." C. "Which additional changes in your lifestyle would you like to implement at this time?" D. "Are you having any difficulty in maintaining the changes you have already made?"
A
The nurse is preparing to care for a newborn with respiratory distress syndrome. Which initial action should the nurse plan to best facilitate bonding between the newborn and the parents? A. Encourage the parents to touch their newborn. B. Identify specific caregiving tasks that may be assumed by the parents. C. Explain the equipment that is used and how it functions to assist the newborn. D. Give the parents pamphlets that will help them understand their newborn's condition.
A
The nurse planning to assess the structure of a family should ask which question? a. "Who lives with you in this home?" b. "Who does the grocery shopping?" c. "Who provides support in your family?" d. "How old are the members of your family?"
A
The nurse finds that a patient has not been taking antihypertension medication as prescribed. How should the nurse proceed? (Select all that apply): A. Evaluate the teaching plan to determine if there is a need to reeducate the patient. B. Assess the patient's perceptions of and attitude toward the risks associated with not taking the antihypertensive medications. C. Review and reinforce the need to take the medication as prescribed. D. Ask the provider to prescribe a different medication because the patient does not want to take the currently prescribed medication. E. Explain to the patient that he or she could have a stroke or heart attack if he or she does not adhere to the treatment plan.
A,B,C
The nurse is assessing the extrinsic motivational levels of a patient following a knee replacement surgery. What behaviors would indicate that the patient is extrinsically motivated? (Select all that apply): A. Agrees to take blood thinners as prescribed because that is what the doctor has ordered. B. Verbalizes an understanding of taking blood thinners postoperatively to reduce the risk of clotting. C. Knows that exercise and physical therapy will help recovery to take place more quickly. D. Enjoys exercise and physical therapy and asks for pamphlets to learn about rehabilitation techniques.
A,B,C
Which of the following interventions should be included in a plan of care for a patient who had a stroke 30 days ago and is now in home care rehabilitation? (Select all that apply). A. Promoting independence and encouraging patient participation in activities of daily living (ADLs). B. Promoting rest and sleep. C. Promoting a diet rich in protein. D. Promoting exercise and ambulation. E. Assisting the patient with ADLs. F. Limiting visitors and social contacts.
A,B,D
A patient is being treated for tuberculosis (TB) with a standard four-drug regimen but continues to have positive sputum smears for acid-fast bacilli. Which actions should the nurse implement? (Select all that apply): A. Assist the patient with short-term goals and plan teaching according to these goals. B. Provide the patient with all the educational materials about drug-resistant TB. C. Refer the patient to a pulmonary specialist, who can assist the patient with the treatment regimen. D. Assist the patient in developing short-term goals that are realistic and attainable. E. Assist the patient with long-term goals and plan teaching according to these goals. F. Ask the patient whether medications have been taken as directed.
A,B,E,F
Exemplars of negative/dysfunctional family dynamics include (SATA): A. codependency B. divorce/remarriage C. marital infidelity D. sibling rivalry E. traumatic injury of a family member
A,C,D
The nurse is assessing a patient's ability to perform basic activities of daily living (BADLs). Which of the following activities are considered in the BADLs assessment? (Select all that apply): A. Feeding oneself. B. Preparing a meal. C. Balancing a checkbook. D. Walking. E. Toileting. F. Grocery shopping.
A,D,E
The nurse is incorporating motivational factors into the plan of care for a patient who has recently been diagnosed with congestive heart failure and is in a skilled nursing facility. What interventions would the nurse implement with this patient? (Select all that apply): A. Schedule a visit by another resident who has had congestive heart failure. B. Review diet and food choices using the food pyramid poster. C. Discuss the signs and symptoms of congestive heart failure. D. Encourage the patient to have the family assist in reaching the patient's health goals. E. Ask the patient about past experiences with lifestyle changes. F. Encourage the patient to keep a food diary and record weight losses and gains.
A,D,E,F
Instruments such as the Functional Activities Questionnaire (FAQ) for postoperative patients who are at home, the Minimum Data Set for Nursing Facility Resident Assessment and Care Screening (MDS) for nursing home patients, the Functional Status Scale (FSS) for children, and the Edmonton Functional Assessment Tool for cancer patients are used to assess activities of daily living (ADLs). The nurse needs to remember that a disadvantage of these instruments includes A. The efficacy and reliability of the instruments. B. The variations in assessments and responses may be subjective because of self-reporting of functional activities. C. The instruments do not show a true measure of ability because of a lack of interactivity during the assessments. D. The information contained in the instruments is insufficient to make a determination about functional status in these populations.
B
Jane and Janet have an established long-term relationship and are attending parenting classes in anticipation of finalizing the adoption of baby Joan. Jane and Janet would be considered as being in the family life cycle of A. Single young adult leaving home. B. New couple joining their families through marriage or living together. C. Families with young children. D. Launching children and moving on.
B
The geriatric nurse practitioner preparing to assess an 84-year-old whose daughter is concerned about her ability to live alone would complete a A. Developmental assessment. B. Functional assessment. C. Life experiences survey. D. Recent life changes questionnaire.
B
The mother of a 2-year-old asks the nurse about her child's cognitive development. The best response of the nurse is that her child A. Is beginning to think intuitively. B. Is using magical thinking. C. Can solve concrete problems. D. Is using abstract thinking.
B
The nurse is assessing a patient who has diabetic ketoacidosis. Her assessment reveals tachycardia, lethargy, and hyperventilation. Treatment for the ketoacidosis has been initiated. What should the nurse do about the hyperventilation? A. Request an order for pain medication and oxygen at 6 L/min. B. Lubricate the patient's lips and allow continued hyperventilation. C. Have the patient breathe into a paper bag to stop hyperventilating. D. Contact the physician immediately regarding this complication.
B
The nurse planning to assess the function of a family would ask A. Who lives with you? B. Who does the grocery shopping? C. Who are the members of your family? D. How old are the members of your family?
B
When providing nutritional education for a Mexican-American patient with newly diagnosed hypertension, the nurse notes that the patient is nodding "yes" to everything that is being said. With a better understanding of cultural interdependence, a nurse should immediately A. Write everything down for the patient to refer to later. B. Prompt the patient further to elicit additional questions or concerns. C. Call the recognized elder for this patient. D. Call the patient's oldest male relative for help with decision making.
B
You are working with a patient who has undergone transgender transformation to become a male. Western cultural masculine attributes to emphasize include A. Harmonious relationships, modesty, and caretaking. B. Achievement, material success, and recognition. C. Fitness, fidelity, and stamina. D. Generosity, sportsmanship, and leadership.
B
The home health nurse should assess a patient who has chronic diarrhea for which fluid and electrolyte imbalances? (Select all that apply). A. Extracellular fluid volume (ECV) excess. B. ECV deficit. C. Hypokalemia. D. Hyperkalemia. E. Hypocalcemia. F. Hypercalcemia.
B,C,E
The nurse is assessing a patient's ability to perform instrumental activities of daily living (IADLs). Which of the following activities are considered in the IADLs assessment? (Select all that apply): A. Feeding oneself. B. Preparing a meal. C. Balancing a checkbook. D. Walking. E. Toileting. F. Grocery shopping.
B,C,F
The nurse is assessing a patient's readiness to be discharged from the hospital following knee replacement surgery. Which of the following behaviors indicate a readiness to be discharged? (Select all that apply): A. The patient requests assistance with dressing. B. The patient demonstrates range-of-motion exercises. C. The patient asks to see the discharge folder to go over all the instructions. D. The patient complains of pain when performing range-of-motion exercises. E. The patient asks the nurse if he can take the day off from physical therapy to relax. F. The patient talks about going back to work and upcoming events at home.
B,C,F
A child uses 2- to 4-word sentences. The nurse interprets this data as expected development for a child the age of A. 2 months. B. 1 year. C. 2 years. D. 3 years.
C
A client diagnosed with terminal cancer says to the nurse, "I'm going to die, and I wish my family would stop hoping for a cure! I get so angry when they carry on like this. After all, I'm the one who's dying." Which response by the nurse is therapeutic? A. "Have you shared your feelings with your family?" B. "I think we should talk more about your anger with your family." C. "You're feeling angry that your family continues to hope for you to be cured?" D. "You are probably very depressed, which is understandable with such a diagnosis."
C
It is best for nurses to have a broad understanding of cultural influences on health care because of A. Disability entitlements. B. Requirements of the Health Insurance Portability and Accountability Act (HIPAA). C. Increasing global diversity. D. Litigious society.
C
The nurse caring for a patient would identify a need for additional interventions related to family dynamics when a. extended family offers to help. b. family members express concern. c. the ill member demands attention. d. memories are shared.
C
The nurse is instructing the caregiver of a child about reprimanding the child. The nurse recognizes that additional teaching is needed if the caregiver makes which statement to the child? A. "I like it when you obey." B. "I need you to listen to me." C. "You need to stop hitting your sister." D. "I don't like it when you hit your sister."
C
The nurse is triaging a hysterical patient in the emergency room. The patient is crying, has uncontrollable spasms, and is trembling and shouting. It is important to identify the manifestation of illness in order to effectively treat a patient. The nurse identifies this as a culture-bound syndrome called A. Shenjing shaijo. B. Loco de la cabeza. C. Ataque de nervios. D. Neurasthenia.
C
What is the priority intervention when developing a teaching plan for a patient newly diagnosed with high blood pressure? A. Teach the caregiver how to take the patient's blood pressure using a manual blood pressure cuff. B. Have the dietician meet with the patient and caregiver to discuss low-sodium dietary choices. C. Ask the patient and caregiver to select important information from a list of hypertension teaching topics. D. Provide written information about the treatment and complications of hypertension for the patient and caregiver.
C
When reviewing the purposes of a family assessment, the nurse educator would identify a need for further teaching if the student responded that family assessment is used to gain an understanding of which aspect of the family? a. Development b. Function c. Political views d. Structure
C
Which diagnosis indicates that the nurse should assess the patient most carefully for development of metabolic acidosis? A. Type B chronic obstructive pulmonary disease (COPD) and pneumonia. B. Acute meningococcal meningitis. C. A pancreatic fistula that is draining. D. Severe hyperaldosteronism.
C
Which of the following statements made by a mother would raise concerns about a developmental delay? A. "My 3-month-old raises her head and chest when lying down." B. "My 7-month-old transfers blocks from one hand to the other." C. "My 7-month-old never seems to smile." D. "My 1-year-old seems shy or anxious with strangers."
C
Which of the following would be considered appropriate phrases for motivational cognitive theories? (Select all that apply): A. Theory of achievement motivation. B. Positively or negatively motivated to achieve a goal based upon one's perception of the ability or lack of ability to reach that goal. C. Five stages in the change process. D. Achievement, power, the need for affiliation, and avoidance motives influence individual behavior. E. Satisfaction strategies provide extrinsic and intrinsic reinforcement for effort.
C,E
The nurse is caring for an 85-year-old woman 6 weeks following a hysterectomy secondary to ovarian cancer. The patient will need chemotherapy and irradiation on an outpatient basis. Which of the following priorities would be seen as a barrier to healing and need to be considered when planning care for this patient? (Select all that apply): A. Can feed herself and prepare meals but cannot drive to the store. B. Lives on a fixed income and can balance her checkbook. C. Has stress incontinence. D. Was active at the senior center and now cannot participate in activities. E. Lives alone and has no nearby relatives. F. Has no transportation to the oncology clinic.
C,E,F
The nurse is preparing to care for a dying client, and several family members are at the client's bedside. Which therapeutic techniques should the nurse use when communicating with the family? Select all that apply. A. Discourage reminiscing. B. Make the decisions for the family. C. Encourage expression of feelings, concerns, and fears. D. Explain everything that is happening to all family members. E. Touch and hold the client's or family member's hand if appropriate. F. Be honest and let the client and family know they will not be abandoned by the nurse.
C,E,F
A nurse is discharging a hospitalized patient to the home care setting. What is the priority intervention for increasing adherence to the plan of care? A. Arrange a physical therapy visit before the patient is discharged from the hospital. B. Assess the patient's ability to perform activities of daily living before discharge. C. Have the patient demonstrate the learned skills at the end of the teaching session. D. Determine whether the patient has had home visits before and, if so, whether the experience was positive.
D
A patient has acute gastroenteritis with watery diarrhea. Which statement by this patient would indicate that the nurse's teaching has been effective? A. "I should drink a lot of tap water today." B. "I need to take more calcium tablets today." C. "I should avoid fruits with potassium in them." D. "I need to drink liquids with some sodium in them."
D
A patient is admitted to a long-term care facility. The nurse notes that the patient has a low literacy level. What is the priority intervention for this patient in regard to teaching? A. Determine the patient's motivation and readiness to learn. B. Assess what the patient knows about his or her health issues. C. Include the family in the orientation to the unit and in the teaching process. D. Determine the literacy level of the patient and tailor the teaching strategies accordingly.
D
A powerful determinant of one's identity is A. Biculturalism. B. Race. C. Assimilation. D. Ethnicity.
D
An exemplar of a social/emotional developmental delay is A. Developmental dyspraxia .B. Fragile X syndrome. C. Mental retardation. D. Separation anxiety disorder.
D
The most appropriate initial nursing intervention when the nurse notes dysfunctional interactions and lack of family support for a patient would be to a. enforce hospital visiting policies. b. monitor the dysfunctional interactions. c. notify the primary care provider. d. role model appropriate support.
D
The nurse identifies the family with a child graduating from college as being in which family life cycle? a. Single young adult leaving home b. New couple joins their families through marriage or living together c. Families with young children d. Launching children and moving on
D
The nurse in the postpartum unit is observing the mother-infant bonding process in a client. Which observation, if made by the nurse, indicates the potential for a maladaptive interaction? A. The mother is observed talking to the newborn. B. The mother performs cord care for the newborn. C. The mother verbalizes discomfort with the new role of motherhood. D. The mother requests that the nurse feed the newborn because she is feeling fatigued.
D
The nurse working with a family to prepare for discharge of the father after a stroke would help them to address the things they can control, such as A. Economic state of society. B. Genetic inheritance. C. Maturity of individuals. D. Psychological defenses.
D
Which factors would alert the nurse to negative/dysfunctional family dynamics? a. Aging of family members b. Chronic illness of a family member c. Disability of a family member d. Intimate partner violence
D