480 ex 3

4. Family mental health services ideally occur in which of the following settings? a. clinic b. home c. school d. all of the above

d. all of the above

ANS: 1, 2, 3, 4 2. In which of the following educational programs are public health nurses likely to participate? 1. Tobacco use 2. Oral and dental health 3. Juvenile diabetes (type I diabetes) prevention 4. Injuries

1, 2, 4

16. Effective communication between the health care team and family members has been shown to: a. increase hospital costs from increased staff time spent talking to family members. b. decrease hospital costs from decreased staff time spent resolving conflict. c. increase hospital stays because of better communication with family members about their concern regarding early discharge. d. increase number of phone calls from family members because of comfort with the health care team.

b. decrease hospital costs from decreased staff time spent resolving conflict.

4. Asking a family about space arrangement for an expected baby helps the nurse to assess whether the family: a. is meeting the baby's basic needs. b. is accepting the reality of the expected baby. c. has fears about the survival of the baby. d. all the above.

b. is accepting the reality of the expected baby.

4. The three foundational competencies established for family caregiving in the Zerwekh Family Caregiving Model include: a. establishing rapport, completing an assessment, and designing mutually agreed-on hypotheses. b. locating the family, building trust, and building strength. c. assessment, diagnosis, and implementation of family care. d. engagement, assessment, and analysis.

b. locating the family, building trust, and building strength.

14. Postpartum depression is a concern to childbearing families because: a. most mothers recognize the symptoms. b. most mothers are reluctant to ask for professional help. c. most health care providers confuse postpartum depression with anxiety. d. most fathers and mothers become depressed together after the birth of a child.

b. most mothers are reluctant to ask for professional help.

3. Changes result in stress. The type of change found to be the most stressful in older adults is: a. normative change. b. non-normative change. c. neither normative nor non-normative change because older adults do not experience change. d. both normative and non-normative changes because they result in equal levels of stress.

b. non-normative change.

1. Early predecessors of childbearing family nurses were: a. childbirth educators. b. nurse midwives. c. nursery nurses. d. public health nurses.

b. nurse midwives.

3. The family child health nurse determines the most appropriate health-promotion activities in a family with young children through analysis of: a. children's health practices. b. patterns of parenting and family and child developmental tasks. c. parents' and grandparents' health beliefs. d. patterns of disease and illness reorganization task management.

b. patterns of parenting and family and child developmental tasks.

2. Family mental health nurses who are using systems theory to guide their practice would assess which of the following areas in families? a. differentiation of self, anxiety, and triangulation b. power, subsystems, and boundaries c. multigenerational trust, multigenerational loyalty, and other multigenerational family processes d. disconfirmation, disqualification, and double-bind messages

b. power, subsystems, and boundaries

6. Family needs during intensive care for a family member include all of the following except: a. family support. b. protection from information from physicians. c. regular visitation. d. family involvement in care.

b. protection from information from physicians.

6. Reorganization occurs in three stages, including all of the following except: a. disbelief in the reality of the change. b. reorganization of family tasks. c. frustration over not being able to cope in the old ways. d. accommodation with a new identity as parent and role expectations consistent with being parents.

b. reorganization of family tasks.

2. All of the following characteristics are likely to increase the degree of family stress associated with hospitalization except: a. sudden illness onset with no time to prepare. b. repeated family experiences with the illness. c. few sources of guidance for the family. d. significant disruption of family functioning as a result of the hospitalization.

b. repeated family experiences with the illness.

1. Which of the following factors has led to the growth of family nursing in medical-surgical settings? a. Consumer demands for unfragmented and holistic care b. Early hospital discharge c. Empirical evidence that families influence patient recovery d. All of the above

d. All of the above

9. What factors should be considered when determining hospital visiting policies? a. Patient preferences b. Family preferences c. Nursing care needs d. All of the above

d. All of the above

8. The two goals identified in Health People 2010 include: a. increase quality and years of a healthy life. b. eliminate health disparities. c. have universal medical insurance for all. d. a and b only.

d. a and b only

1. The fastest growing group of older adults in the United States currently is: a. adults aged 55 to 65 years. b. adults aged 65 to 75 years. c. adults aged 75 to 85 years. d. adults older than 85 years.

d. adults older than 85 years.

2. The overall, major task of parents, in our society, is to: a. help children learn to read. b. assist children in developing a spiritual belief guiding their daily tasks. c. socialize children into their schools and communities. d. all of the above

d. all of the above

3. Nurses can anticipate which of the following family reactions, as their family member is transferred from intensive care to the regular medical-surgical floor? a. ambivalence b. anxiety c. abandonment d. all of the above

d. all of the above

13. Risk to attachment includes: a. maternal depression. b. family stress. c. family violence. d. all of the above.

d. all of the above.

13. The amount of stress experienced by any one family because of the hospitalization of a family member varies depending on: a. the timing of the hospitalization. b. the availability of resources to the family. c. the extent of perceived or actual loss. d. all of the above.

d. all of the above.

8. The prevalence of grandparents raising grandchildren has increased in recent years because of: a. grandparents being younger and younger in age when compared with previous generations. b. women returning to work. c. increased numbers of mothers dying in child birth. d. increased numbers of parents being unable to parent their children because of substance abuse, incarceration, abuse and neglect, and

or death./ d. increased numbers of parents being unable to parent their children because of substance abuse, incarceration, abuse and neglect, and/or death.

2. The nurse is beginning the care of a 38-year-old adult mother of two who has just come to the ER with an acute asthma attack. The nurse is told that the patient's family is anxiously waiting to see him. Which of the following responses by the nurse reflect his understanding of the family's needs? Select all that apply 1. "I will go and answer the family's questions as soon as possible." 2. "If your mom is hospitalized, what does this mean for your family?" 3. "Don't worry, your mom will be better soon." 4. "I can see you are worried about your mother."

1, 2, 4

5. Which of the following demonstrate family-focused chronic care management? 1. Evidence-based 2. Episodic care 3. Needs of family unit met 4. Preventive

1, 2, 4

4. Which of the following are needs of family members who have a chronically ill family member? Select all 1. Care coordination 2. Constant supervision 3. Resilience 4. Some normalcy

1, 3, 4

8. You are caring for a 58-year-old woman who had a bilateral mastectomy 48 hours ago. When you meet the patient she tells you that her husband will not attend the discharge teaching meeting as planned. She also mentions that he has not been to the hospital since the surgery. Which of the following responses by the nurse practicing family-focused care is most appropriate? 1. "Can you tell me more about your family and how your hospitalization has affected them?" 2. "We may be able to reschedule the meeting—I'll check with the discharge planner." 3. "Did the admitting nurse create a genogram of your family?—it might help if I took a look at it." 4. "Will you be able to manage your care alone at home, or is there someone else I should call?"

1. "Can you tell me more about your family and how your hospitalization has affected them?"

5. Aiza is the wife of 52-year-old Hasan, who has been hospitalized for pneumonia. Aiza has spent the day by her husband's bedside and decides to leave his side to have dinner in the hospital cafeteria. When she returns to his room she finds Hasan is having difficulty breathing and notices that his oxygen saturation monitor is beeping and that the monitor is displaying 88% rather than the 94% it has been during the day. Aiza runs to get Hasan's nurse who is at a nearby computer charting. Which of the following statements made by Aiza best reflects the uncertainty of family illness? 1. "Please, you need to come to my husband's room—I'm afraid that he is dying." 2. "You need to come right now, I think that my husband needs some oxygen." 3. "This happened last time he was in the hospital for the flu—I think you need to check on him right away." 4. "I know I shouldn't have left for dinner—he gets so upset when I'm not at his side---he is probably having a hard time breathing because he is upset."

1. "Please, you need to come to my husband's room—I'm afraid that he is dying."

12. The nurse is trying to hold a family care conference as her 12-year old patient is being discharged home with a chronic illness. Which response by a family member indicates a need for the nurse to teach about family-focused nursing care? 1. "Why should I be here? It is my sister who is sick, not me." 2. "We need to make a plan for home care so I can still work." 3. "I can't believe how this illness is affecting the whole family." 4. "What kind of resources will be available to us?"

1. "Why should I be here? It is my sister who is sick, not me."

13. Some individuals and families are more likely to be insured than others. Which of the following people is most likely to be uninsured in the United States? 1. A middle-aged African American man working for a small rural company 2. An elderly woman whose husband recently passed away 3. A middle-aged Latino man who works for a large hospital 4. An infant American whose mother is on welfare

1. A middle-aged African American man working for a small rural company

11. Which of the following is an accurate statement about circular questions? 1. Circular questions often focus on family beliefs about acute illness. 2. Circular questions are primarily intended to commend family actions. 3. Circular questions may be open ended or yes-or-no questions. 4. The same circular questions should be used daily to ensure a consistent result.

1. Circular questions often focus on family beliefs about acute illness.

3. Which of the following statements indicate a nurse needs further education about family nursing using core family processes? 1. Core processes can provide a framework when family is the unit of care, rather than the individual with an illness. 2. Exploring core processes can help nurses find ways to empower and support families. 3. Core processes offers directions for family-focused nursing actions that intentionally include the family. 4. Core processes provide ways to approach family care that include both assessment and nursing actions.

1. Core processes can provide a framework when family is the unit of care, rather than the individual with an illness.

1. Family-focused care can assist a nurse to help a family achieve which of the following desired outcomes? Select all that apply 1. Decreased hospitalizations of the chronically ill member 2. Support of family resilience 3. Ambiguous loss 4. Realization of "courtesy stigma"

1. Decreased hospitalizations of the chronically ill member 2. Support of family resilience

7. Public health nurses work with families to address conditions that impact health, such as support systems, education, income, employment, transportation, access to health services, lifestyle choices, and home, work, and school environments. What are these conditions examples of? 1. Determinants 2. Personal issues 3. Cultural aspects 4. Community issues

1. Determinants

7. Family interventions in the core process of connections focus on which of the following? 1. Discussing a family genogram and ecomap 2. Completing a chronic sorrow assessment 3. Engaging a family in motivational interviewing 4. Facilitating family decision-making

1. Discussing a family genogram and ecomap

5. Family-focused nursing actions view a family within the larger social system. Which of the following statements reflect accurate understandings of this view of family nursing practice? 1. Effective nursing address the complexity of an individual's illness, as well as their family and social networks. 2. Nurses who practice in the hospital seldom need to address the patient's community networks. 3. Effective family nursing practice maintains a focus on the current situation. 4. Family nursing practice is based on one model of nursing care that places the family as the unit care.

1. Effective nursing address the complexity of an individual's illness, as well as their family and social networks.

8. A nurse is making a visit to the home of young female who was recently discharged from the hospital with a diagnosis of multiple sclerosis. She has two small children and they are all living in her parents' home for a period of time. Which of the following actions would be the most helpful for the nurse to provide intentional support for the family? 1. Explore with the family their perception of the most pressing need at this time. 2. Review all of the printed materials given to the woman while she was in the hospital. 3. Suggest that the family avoid discussing their concerns at this time until they are stronger. 4. Focus the teaching on the prescribed medications.

1. Explore with the family their perception of the most pressing need at this time.

3. A nurse aims to provide social support for a family to influence which of the following family outcomes? 1. Improved family health 2. Increased powerlessness in family members 3. Increased anxiety and depression in family member 4. Decreased problem solving in family members

1. Improved family health

2. The home health nurse visits a family for the first time. She meets a 40-year old woman and her 75-year old father, a 12-year old girl, and a 16-year old boy. She does not understand the language they speak in the home. The grandfather has limited mobility due to a stroke and appears confused. The nurse who learns to "think family" uses which of the following assessment practices? Select all that apply 1. Includes family members in client assessment. 2. Recognizes her own attitudes toward the family cultural practices. 3. Strives to understand the relationships of all family members and how each is affected by the client's illness. 4. Focuses her assessment on the grandfather because he is the only one who has an obvious illness.

1. Includes family members in client assessment. 2. Recognizes her own attitudes toward the family cultural practices. 3. Strives to understand the relationships of all family members and how each is affected by the client's illness.

1. Which of the following represents a barrier to the provision of family-focused nursing care in the acute care setting? 1. Nurse's beliefs that family members often interfere with the ability to provide quality care to the hospitalized family member 2. Family beliefs about the need to protect their hospitalized member by being involved with decisions about nursing care 3. Nurse's successful mastery of technology and electronic medical record allowing the nurse time to answer questions of family members 4. Nurse's focus on family involvement in discharge planning at the time of hospital Admission

1. Nurse's beliefs that family members often interfere with the ability to provide quality care to the hospitalized family member

2. Family support needs during an illness experience often require a nurse to: 1. Provide instructions that help the family understand the demands of an illness. 2. Develop a friendship with the family to provide continuity of care. 3. Resolve conflict by accentuating the individual family differences. 4. Make moral judgments of the family's actions.

1. Provide instructions that help the family understand the demands of an illness.

10. Vulnerable populations have limited access to health care compared to the rich. An example of upstream thinking to address this problem is: 1. Provide services to families through the use of a mobile van staffed with nurses and nurse practitioners. 2. Donate food and money to the local food bank. 3. Start a homeless shelter in your local community. 4. Work with families to help them recognize how they are responsible for their own problems.

1. Provide services to families through the use of a mobile van staffed with nurses and nurse practitioners.

13. Which of the following statements about the value of nurse-family meetings in the acute care setting is inaccurate? 1. Regular nurse-family meetings usually increase conflict between staff and family. 2. Regular family meetings help to improve care processes in the hospital. 3. Regular nurse-family meetings may enhance family decision-making. 4. Regular nurse-family meetings allow acknowledgement of family suffering.

1. Regular nurse-family meetings usually increase conflict between staff and family.

5. A nurse who periodically asks himself "What makes me happy?" is engaging in which of the following processes? 1. Self-discovery that is helpful to building caring relationships 2. Egocentrism that threatens development of caring relationships 3. Self-indulgence important to developing resilience in nursing practice 4. Superficial assessment of his life

1. Self-discovery that is helpful to building caring relationships

6. A patient who is known to the nurse requests pain medication shortly after the physician leaves the room after discussing the patient's poor prognosis. The nurse enters the room to find the patient in tears. What would be the action on the part of the nurse that best conveys being with the patient? 1. Sitting on the bed to talk to the patient 2. Giving the pain medication as soon as possible 3. Encourage the patient to rest 4. Change the subject to distract the patient from worrying

1. Sitting on the bed to talk to the patient

9. Kathy is the parent of 13-year-old Meg, who has cerebral palsy. In the medical record, it is noted that in a previous hospitalization Kathy complained that Meg was forced to wear an oxygenation saturation monitor although the physician had said it was not needed. After you introduce yourself as the nurse, which of the following statements might best help build a positive nurse-family partnership? 1. "I understand that you were upset about the monitor during the last hospitalization, but every patient has to wear it." 2. "I know that you were upset during the last hospitalization. We will not use the monitor if the physician does not believe it is needed." 3. "Is there some way we can help Meg better comply with wearing the monitor during this hospitalization?" 4. "Parents are often upset during hospitalizations. Fatigue reduces your patience for hospital routine."

2. "I know that you were upset during the last hospitalization. We will not use the monitor if the physician does not believe it is needed."

10. A nurse is caring for a 62-year-old woman with respiratory failure who has an advance directive that indicates her wishes related to resuscitation. The woman has two adult children and a husband who express differing views about the directive. The nurse decides to lead a family meeting. Which of the following would be the best purposes of this particular family meeting? 1. Provide information that convinces the family to follow the health-care team's directions. 2. Assist individual family members to share individual beliefs and understandings. 3. Increase efficiency of the nurse by decreasing the number of questions. 4. Create an environment where prior stresses and conflicts can be resolved.

2. Assist individual family members to share individual beliefs and understandings.

2. Which of the following is a unique family intervention that will facilitate family-focused care? 1. Communicating with every family member 2. Commending strengths of the family unit 3. Contacting only the significant others for information 4. Interviewing all family members

2. Commending strengths of the family unit

4. Which of the following can be viewed as an accurate statement regarding the nurse-family communication related to support? 1. A nurse begins an assessment of needs by asking the family what types of support are needed. 2. Developing a trusting relationship with the family may help the nurse and family identify the types of support needed with discharge. 3. The nurse is usually the best judge of the types of support needed in the home. 4. A nurse focuses support on the ill family member, since the family most often has access to support.

2. Developing a trusting relationship with the family may help the nurse and family identify the types of support needed with discharge.

2. Which of the following concepts is important to the provision of family-centered nursing care in the acute care setting? 1. A planned hospitalization helps to clarify family roles and unifies families. 2. During hospitalization, families are often challenged by the need to make adjustments in family routines. 3. Deliberate adherence to typical family routines during hospitalization reduces the uncertainty experienced by family members. 4. Exposure to an ill family member in the acute care setting is stressful and family time should be limited.

2. During hospitalization, families are often challenged by the need to make adjustments in family routines.

10. Supporting families as they attempt to care for their family member has potential to improve the health of families and ultimately the nation's health. Which of the following statements related to this understanding is accurate? 1. Family members managing an illness in the family have similar needs when compared to the family member with the illness. 2. Family members might require support in the form of guidance, directions, teaching, and coaching. 3. The health of the individual with the illness is a priority for support when compared to the family's health. 4. Support that is obtained from a professional service such as a health-care provider is more important than community or family.

2. Family members might require support in the form of guidance, directions, teaching, and coaching.

Which of the following represents an intrinsic barrier to caring and learning ways to provide family care? 1. Understaffing 2. Fear of not knowing what to say to a family 3. Advances in technology 4. Cultural upbringing

2. Fear of not knowing what to say to a family

11. Health disparities are inequalities that exist when certain population groups do not benefit from the same health-promoting opportunities as do other population groups. An example of a health disparity is: 1. Unemployment rates are higher in the western United States. 2. Latino families have lower childhood immunization rates. 3. The high school dropout rates are higher for drug users. 4. African American nurses are more likely to work with AIDS patients and their family members.

2. Latino families have lower childhood immunization rates.

1. A nurse is making a visit to the home following a family member's discharge from the hospitalization. Which of the following data would be most helpful? 1. Identify potential areas of strengths in the family. 2. Plan for family care based on assessment of core processes. 3. View the priority of the home visit as the individual who was hospitalized. 4. Conduct a family assessment that remains focused on management of the symptoms.

2. Plan for family care based on assessment of core processes.

3. Providing women who may become pregnant with statewide safe eating guidelines for fish is an example of which of the following? 1. Obesity prevention 2. Primary health prevention 3. Secondary health prevention 4. Tertiary health prevention

2. Primary health prevention

2. A public health nurse is new to his position and wants to get an overview of the health issues in the county. Which of the following items would be least helpful in providing him information? 1. A windshield survey 2. The state health commissioner's blog 3. The statewide health assessment 4. The county vital statistics and county trends

2. The state health commissioner's blog

8. Which of the following situations reflects a time when doing for the patient takes priority over being with the patient? 1. A patient in active labor 2. When physical care is needed 3. A patient who takes a long time to feed herself 4. When the family member is doing the patient's dressing change incorrectly

2. When physical care is needed

14. Juanita was brought to the hospital by her daughter-in-law, Alejandra, who lives within a few miles of her in a remote area of the state. Juanita will be kept in a semi-private room for overnight observation and Alejandra plans to stay at Juanita's bedside for a couple of hours so she can find out what is going on before she leaves to check into a motel for the night. Juanita's nurse checks in on her patient and asks Alejandra what her relationship is to Juanita. Upon learning this information, what is the best response by the nurse? 1. "I'm afraid that, due to HIPPA regulations, we have a hospital policy that we can only share information about the patient with Juanita's extended family such as her husband or children." 2. "I'll need you to step out in the hallway so that I can talk to you about Juanita's medical Status, it's an issue of confidentiality and we need to protect personal health information." 3. "I'll need to check with Juanita to make sure it's okay if I discuss her medical status with you." 4. "I'm sorry, but due to HIPPA regulations, we can't have visitors stay at the bedside when the patient is not in a private room."

3. "I'll need to check with Juanita to make sure it's okay if I discuss her medical status with you."

6. Which of the following statements made by a nursing student indicates the need for further education about family-focused nursing? 1. "When family members are not well-supported during hospitalization, patients are often readmitted." 2. "Families that are well-supported by nurses during hospitalization are more satisfied with their care." 3. "While the individual patient is the focus during early hospitalization, the family should be included when things stabilize." 4. "When nurses exclude family members from patient care, suffering may be magnified."

3. "While the individual patient is the focus during early hospitalization, the family should be included when things stabilize."

5. A small rural community is struck by a natural disaster. What is the first thing that the public health nurses should do? 1. Go door-to-door to identify the injured. 2. Notify the American Red Cross. 3. Activate the emergency preparedness plan. 4. Begin triage of victims.

3. Activate the emergency preparedness plan.

9. Social justice implies that people deserve an equal chance for economic and political opportunities. To promote social justice, nurses can: 1. Talk to city council members about health risks of vulnerable populations. 2. Donate time and money to local homeless shelters and food banks. 3. Advocate for health policy changes that improve social and economic factors that impact health of vulnerable populations. 4. Refer health-care providers to Healthy People 2020 for information on health determinants.

3. Advocate for health policy changes that improve social and economic factors that impact health of vulnerable populations.

8. The public health nurse wanted to make the biggest impact on the families within the community. The best way to help the families would be to: 1. Visit the families more often. 2. Encourage other new graduates to become public health nurses. 3. Advocate for health policy focused on supporting families. 4. Refer the family to every resource within the community.

3. Advocate for health policy focused on supporting families.

6. After years of caregiving in the home, a family has recently moved their family member to a nursing home. Which of the following would be appropriate nursing actions at this time? 1. An assessment of the core process of celebration 2. Emphasize the family's opportunities, since the nursing home will replace the family member's caregiving responsibilities. 3. An assessment for ambiguous loss in the core process of cathexis 4. Use motivational interviewing techniques to guide family behavioral changes.

3. An assessment for ambiguous loss in the core process of cathexis

12. Improving the health of families will ultimately improve societal health. In order to improve the health of the nation, government must be invested in public health measures. Which of the following statements related to this understanding is accurate? 1. Government-funded programs, such as Medicare, Medicaid, and Veterans' benefits, ensure access to health-care services for U.S. citizens. 2. The state Children's Health Insurance Program (CHIP) ensures health insurance access to children age 18 and under across the country. 3. Approximately 41 million Americans are without health insurance. 4. Americans living in poverty are as healthy as Americans with middle or high incomes.

3. Approximately 41 million Americans are without health insurance.

1. Which of the following statements about the nursing practice of being with are accurate? Select all that apply. 1. Being with puts the nurse at risk for burn-out. 2. Being with adds more time to providing individual care. 3. Being with can be conveyed through tone of voice, eye contact, and body language. 4. Being with requires the nurse to have an open mind and understand a variety of perspectives.

3. Being with can be conveyed through tone of voice, eye contact, and body language. 4. Being with requires the nurse to have an open mind and understand a variety of perspectives.

5. Which of the following descriptions of the chronic illness experience is inaccurate? 1. Chronic illness may lead to a decreased life span. 2. Chronic illness modifies functional status. 3. Chronic illness often improves a family's quality of life. 4. Chronic illness makes use of family strengths.

3. Chronic illness often improves a family's quality of life.

9. A nurse is caring for a patient hospitalized with a new diagnosis of diabetes. A year later, a nurse is caring for the same patient, who has had repeated visits to the ambulatory clinic with no apparent efforts to make the lifestyle changes needed to manage blood sugars. Which of the following is an inaccurate statement about nursing actions? 1. Contacting patients and families when they return home to provide support may reduce hospital readmissions 2. Guiding family discussions that result in making plans for lifestyle changes can support adherence and family goal setting 3. Collaborating care between hospital, home, emergency room, and clinic is the sole responsibility of the nurse in the hospital setting 4. Continually reflecting on the support needs of the family managing a chronic illness may help nurses provide quality care

3. Collaborating care between hospital, home, emergency room, and clinic is the sole responsibility of the nurse in the hospital setting

2. Which of the following statements reflect an accurate understanding family core processes? 1. Core family processes focus on family structure 2. Core processes influence the health of family, rather than the individual 3. Core family processes can guide family nursing practices. 4. Nursing actions focused on family core processes focus on individual with an illness.

3. Core family processes can guide family nursing practices.

4. A nurse is caring for a patient with a terminal diagnosis of a brain tumor. The family and patient wish for him to be in their home during the end of his life. The family has decided hospice will become involved. Which of the following nursing actions address priority core processes at this time? 1. Determine the number of family members available to participate in care. 2. Helping the family determine the ways they will celebrate holidays after the death. 3. Discuss the communication patterns and emotional bonds of the family at this time and prior to the illness. 4. Identify the health routines of the family that need to be modified so family health can be regained.

3. Discuss the communication patterns and emotional bonds of the family at this time and prior to the illness.

6. Which of the following messages describe an effective individual-nurse-family communication model when a nurse aims to provide a family with social support? A family's ability to provide social support will be enhanced by: 1. Preserving the nurse's power in decision-making 2. Emphasizing the caregiving limitations of the family 3. Empowering a family 4. Insisting a family join a support group

3. Empowering a family

1. Which of the following statements about family-focused chronic illness case management is accurate? 1. Family-focused chronic illness case management focuses on the individual family member with the chronic illness. 2. Family-focused chronic illness case management begins with a nurse sharing advice with family members. 3. Family-focused chronic illness case management may lead to delayed or prevented complications. 4. Family-focused chronic illness case management determines certain family members with whom to communicate.

3. Family-focused chronic illness case management may lead to delayed or prevented complications.

10. You are a nurse caring for a patient who is having a GI bleed. You say to his wife: "It is so fortunate that you brought him to the emergency room. You were right in thinking that he needed immediate medical attention." This is a therapeutic statement for which of the following reasons? 1. It is an open-ended question that encourages conversation. 2. It is circular questioning that focuses on relationships. 3. It commends the family member and empowers them in the situation. 4. It makes the family member feel that she has been heard.

3. It commends the family member and empowers them in the situation.

7. The nurse notices that family members appear upset shortly after learning about the patient's poor prognosis from the physician. What would be the action on the part of the nurse that best conveys being with the family? 1. Tell the family you can see they would prefer to be by themselves. 2. Maintain a cheerful, upbeat attitude in the face of the family's distress. 3. Make eye contact and ask the family what is troubling them. 4. Ask the family if they want to talk to their minister.

3. Make eye contact and ask the family what is troubling them.

3. What can the nurse do to overcome extrinsic barriers to caring? 1. Employ active listening skills with individuals and families. 2. Ask the family to identify their most important goal for well-being. 3. Sign up for the hospital committee on obtaining Magnet status. 4. Maintain a journal on personal insights about family interactions.

3. Sign up for the hospital committee on obtaining Magnet status.

7. Which of the following statements accurately reflect understandings of evidence related to support and family nursing interventions? 1. Family nursing interventions seldom address emotional support. 2. Family nursing interventions fail to demonstrate positive health outcomes. 3. Social support influences health through multiple pathways. 4. Family nursing interventions focus support on the ill family member.

3. Social support influences health through multiple pathways.

12. A nurse is being attentive to the distress a family is experiencing with the admission of a family member to the intensive care unit. The nurse makes the statement, "I know this is a stressful time for you and your family. Would you like to come to your family member's room with me and I will explain equipment to you?" Which of the following is an accurate statement about the elements of this nursing action? 1. The critically ill patient is the recipient of this nursing action. 2. Characteristics of this settings is unrelated to this nursing action. 3. The anxiety and distress of the family is the focus of this nursing action. 4. All core processes need to be assessed at this time to gain a complete family assessment.

3. The anxiety and distress of the family is the focus of this nursing action.

7. Which of the following statements is the best rationale for allowing a family member to be present during cardiopulmonary resuscitation of another family member? 1. The inclusion of the family will improve the public image of nurses. 2. Inclusion of family members reduces the need for the nurse to constantly update them on patient progress. 3. The inclusion of family members reduces both patient and family distress. 4. The inclusion of family will improve the overall efficiency of the healthcare team.

3. The inclusion of family members reduces both patient and family distress.

6. What do pregnant women, migrant workers, elderly men, and refugees have in common? 1. They use disproportionately more health-care services than others. 2. They are more likely than most populations to have exposure to environmental lead. 3. They are considered vulnerable populations. 4. They are more likely than other populations to smoke cigarettes.

3. They are considered vulnerable populations.

9. Which of the following situations reflects a time when doing for the family takes priority over being with the family? 1. At the end of the shift when the nurse knows she will be leaving the family 2. When the family needs to work through the answer rather than being provided an answer 3. When the family doesn't understand what is happening to their ill member 4. When the nurse wants to persuade the family of her point of view

3. When the family doesn't understand what is happening to their ill member

3. Monica is a 55-year-old woman who has suffered from diabetes mellitus for 30 years. The nurse enters the room to check routine vital signs and sees that both Monica and her husband appear upset, they tell the nurse to leave. Which of the following responses by the nurse reflect an accurate understanding of family-focused chronic illness care? 1. "I need to take Monica's vital signs. You (husband) can return when I am done." 2. "I'm so pleased you understand your disease, Monica." 3. "Has your doctor talked with you about your future?" 4. "I will give you some more time to be alone. Let me know if you have questions."

4. "I will give you some more time to be alone. Let me know if you have questions."

4. The family of an 88-year-old man with an acute exacerbation of chronic obstructive lung disease is at his bedside. He is experiencing dyspnea and placement on a ventilator is suggested. The patient is DNR and does not want extreme measures taken, but is unable to speak for himself. One daughter supports placement on a ventilator while the other believes that it will only add to his suffering. Which of the following statements by a nurse might facilitate communication between these family members? 1. "Can you tell me if he has ever been on a ventilator before, and how he responded to it then?" 2. "Given this confusion, maybe we should discuss his DNR status, I can go get the information we have on file." 3. "I know that this is a difficult situation—perhaps you would like to talk with a clergy person to help in making the decision." 4. "I'm sure that it is difficult seeing your father like this, can we spend a few minutes talking about your concerns at this time?"

4. "I'm sure that it is difficult seeing your father like this, can we spend a few minutes talking about your concerns at this time?"

11. Which of the following statements by a nurse who is planning to being leading family meetings reflect a need for additional education before she conducts the meetings? 1. "I must be sure to provide plenty of time so I can listen to each of the family members." 2. "I plan to direct my attention to the family's identified strengths and concerns." 3. " It is important for me to help clarify each of the family member's beliefs." 4. "It is best if I wait to hold a meeting until the family asks for this action."

4. "It is best if I wait to hold a meeting until the family asks for this action."

1. Which of the following statements is inaccurate regarding social support for a family? 1. A nurse's educational support is often needed to provide a family with necessary informational support to manage the symptoms of an illness. 2. A family may need instrumental support as they begin to care for a family member with a limited mobility in their home. 3. A family may need assistance to provide emotional support when a family member is hospitalized with an acute illness. 4. A chronically ill individual must learn to not rely on a family for social support.

4. A chronically ill individual must learn to not rely on a family for social support.

5. A nurse is preparing discharge instructions for a patient who has been hospitalized with renal failure from diabetes. The patient's family plans to support the patient following discharge. Which of the following are likely sources of support for a family? 1. The nurse discharging the patient 2. The patient and family's work colleagues 3. Community networks 4. All of the above

4. All of the above

8. Mary is the mother of a six-year-old son, James, with cerebral palsy. James uses wheelchair to attend school. However, lately he has had a tutor in the home because of declining health. James is being seen in the clinic for possible pneumonia. Effective family focused nursing actions should focus on which of the following core processes? 1. Cathexis 2. Coordination 3. Caregiving 4. All of the above

4. All of the above

9. Which of the following statements reflect an understanding of family-focused nursing actions? A nurse who is implementing family-focused nursing actions: 1. Partners with a family 2. Assesses family core processes 3. Identifies both the strengths and the concerns of a family 4. All of the above

4. All of the above

11. Nurses that think family recognize that long-term stress and burdens may emerge when a family is giving care to an ill family member. Research findings have shown: 1. Nurses can provide various types of support that ease distress of caregiving. 2. A positive relationship between caregiving and depression. 3. A positive link between caregiving and physical health effects. 4. All of the above.

4. All of the above.

3. You are caring for an eight-year-old who is in the emergency room with need for a closed- reduction of an arm fracture. The on-call orthopedic physician will be performing the procedure using conscious sedation. You are about to move the child to a different room to start an IV when the child's father asks you if you think that they should be seeking a second opinion. Because you know that families often feel the need to protect loved ones during hospitalization, what would your first response be to the parent? 1. Help the parent seek a second opinion by providing the name of another orthopedic surgeon. 2. Tell the parent that a second opinion might be confusing for them and that the room is ready for them to begin the procedure. 3. Review the procedure with the parent and assure them of the skill of the physician doing the procedure. 4. Ask the parent what has prompted them to ask this question of you and how you can be of most help to them at this time.

4. Ask the parent what has prompted them to ask this question of you and how you can be of most help to them at this time.

10. Which of the following examples of nursing actions that demonstrate being with is inaccurate? 1. Being emotionally present to another 2. Seeking to understand another point of view 3. Learning what matters most to each patient and family 4. Assessing the patient's physical well-being

4. Assessing the patient's physical well-being

4. The primary role of the public health nurse (PHN) is which of the following? 1. Home visiting to provide companionship to the elderly 2. Delivery of acute care nursing services in the homes of children with cancer 3. Development of tertiary prevention plans for type 2 diabetics 4. Health promotion and disease prevention

4. Health promotion and disease prevention

12. When nurses are trying to determine whether patients and families need more information, they often ask, "Do you have any questions?" Which of the following statements best explains why this approach is flawed? 1. Patients and families will ask questions without being invited, and this approach is too direct. 2. This approach presumes that the family and patient are not on the healthcare team and may be condescending. 3. The question asks patients to share private information, which is a violation of HIPPA guidelines. 4. Patients and families often don't know enough about a situation to know what questions to ask.

4. Patients and families often don't know enough about a situation to know what questions to ask.

11. The nurse is teaching a class on family-focused care in critical care environments. Which response from a nursing student indicates a need for additional teaching? 1. Families need information and support. 2. Families want to be involved in caregiving activities. 3. It is important to ensure that the family can be with the patient. 4. The nurse should protect the family from getting too involved in the illness experience.

4. The nurse should protect the family from getting too involved in the illness experience.

1. Many factors help determine whether a family is involved in health promotion. Which of the following factors may influence promotion of a family's health? a. Type of family b. Quality of family interaction c. Developmental level of family d. All of the above

D. All the above

1. Which of the following issues would be of concern to public health nurses? Select all that apply 1. The number of school children with influenza 2. The number of premature births in the county 3. The county plans to build a medical waste incinerator 4. The lack of compliance with TB medications

all of them

3. Which of the following are family needs during chronic disease care coordination? Select all apply 1. Vigilance 2. Knowledge 3. Self-care 4. Counseling

all of them

4. Which of the following discourages family-focused chronic illness care? 1. "Thinking family" 2. Adequate nurse staffing 3. Time constraints 4. Human connections

3. Time constraints

1. According to the Family Health Model, the assessment of a family includes three major domains. What are these domains?

Answer: context, structure, and function

7. Family health promotion can be defined as: a. having medical bills less than $1000.00 per year. b. achieving maximum family well-being. c. living longer than the life expectancy. d. having a quality and dignified death.

B. achieving max family well-being

5. According to Zerwekh, two nursing competencies used with high-risk families include: a. persuading and saving the children. b. avoidance and safety for the nurse. c. encouragement and support. d. assessment and diagnosis.

a. persuading and saving the children.

2. Visiting home nurses is a fairly new phenomenon, only in existence since 1976. a. True b. False

b. False

11. Recent research has repeatedly demonstrated that: a. family involvement in the care of hospitalized patients increases the cost of care. b. family involvement in the care of hospitalized patients improves outcomes. c. family involvement in the care of hospitalized patients interferes with the care of the patient and causes poor outcomes. d. family involvement in the care of hospitalized patients is too stressful on families and should be discouraged.

b. family involvement in the care of hospitalized patients improves outcomes.

14. The approximate percentage of older adults (older than 65 years) living in a family setting versus living alone or with nonrelated adults is: a. 5 percent. b. 25 percent. c. 50 percent. d. 75 percent.

c. 50 percent.

For questions 7 through 9, using the Core Public Health Function Model, match the assessment activities to the individual, family, or community. 7. Analyze data on and needs of specific populations or geographic area. a. Individual b. Family c. Community

c. Community

7. When planning interventions for the family with rheumatoid arthritis at the stage of launching children, it is essential that the nurse includes which family member(s) in the discussions regarding treatment options? a. The mother as primary caregiver b. The child with the illness c. The father as the breadwinner d. All family members who are available

d. All family members who are available

7. Role ambiguity can occur for nurses when caring for a critically ill patient because of: a. nurse's role as professional versus friend with family members. b. nurse's role as biomedical professional versus social and psychological professional. c. nurse's role as sharing diagnostic information versus avoiding conflict with physicians. d. all of the above.

d. all of the above.

1. The public health nurse is writing the annual service plan for her agency. Which of the following data would be most helpful to her? 1. A recent community needs assessment 2. A list of the county board members 3. The names and contact information for the physicians in the county 4. The most recent hospital census data

1. A recent community needs assessment

2. Which of the following represents an extrinsic barrier to caring and learning ways to provide family care? 1. An attitude that caring is innate and cannot be learned 2. An assumption that family care takes too much time 3. Fear of becoming too involved with the individual or family 4. An expectation to meet workplace outcomes

4. An expectation to meet workplace outcomes

4. Which of the following personal strengths enhance caring relationships? 1. Willingness to engage in regular self-reflection 2. Being an early adopter of technology 3. Efficiency in completing a variety of nursing tasks 4. Paying attention to finishing tasks in a timely manner

1. Willingness to engage in regular self-reflection

11. Family rituals can be described as: a. receptive behaviors or activities between two or more family members that occur with regularity in the day-to-day activities of daily living. b. the process of family members learning to do things together. c. the family keeping the family heritage, respect for the family history, and learning from the conflicts of members from the previous generation. d. the process of getting back together again after conflict.

A. receptive behaviors or activities between two or more family members that occur with regularity in the day-to-day activities of daily living.

1. Match the following terms with their definitions: a. Palliative care b. Terminal care c. Life support d. End-of-life care e. Hospice care i. Care that focuses on management of symptoms to relieve suffering during the last few days or weeks of life when it becomes apparent that the patient is in a state of decline and cure is not possible. ii. Care that focuses on improving the quality of life of patients and families facing the problems associated with life-limiting illness, to help them live well through prevention and relief of suffering by early identification and excellent assessment and treatment of pain and other symptoms whether physical, psychosocial, or spiritual (World Health Organization, 2006). iii. Care that includes extraordinary medical measures to prolong or sustain life. iv. Care that focuses on providing support to people in the final phase of a terminal illness, with the focus being on comfort and quality of life, rather than cure. v. Care that focuses on the end of life when a steady decline is expected. Professionals tend to refer to end-of-life care, whereas family members tend to refer care for a terminal illness or terminal care.

Answers: a = ii b = i c = iii d = v e = iv

12. An example of an external influence on family health promotion is: a. sibling subsystems. b. marital dyad. c. child care. d. chronic illness.

C. child care

6. The role of the nurse, when promoting health, is to assist families in: a. attaining health. b. maintaining health. c. regaining health. d. all of the above.

D. All the above

10. According to the Models of Family Health Promotion, healthy behaviors are learned: a. lifelong efforts to sustain or improve quality of life. b. lifelong efforts to nurture family members. c. lifelong efforts to strengthen the family as a unit. d. all of the above e. a and c only

D. all of the above

5. Family health is an evolving understanding of behaviors that positively affect the quality of life and longevity of life. In combination with biologist, psychologist, family scientist, religious leaders, and nurses, the development of health-promoting behaviors has been primarily developed by: a. economists. b. physicians. c. politicians. d. anthropologists.

D. anthropologists

9. The traits of a healthy family include all of the following except: a. shares responsibility among members. b. adaptable to transitions and change. c. communicates and listens effectively to all members. d. is a member of an organized religion.

D. is a member of an organized religion

15. Postpartum depression affects: a. 10 to 15 percent of all childbearing women. b. 35 to 50 percent of all childbearing women. c. 50 to 75 percent of all childbearing women. d. 75 to 85 percent of all childbearing women.

a. 10 to 15 percent of all childbearing women.

13. The approximate percentage of older adults (older than 65 years) currently residing in nursing homes is: a. 5 percent. b. 25 percent. c. 50 percent. d. 75 percent.

a. 5 percent.

9. Develop a nursing diagnosis for the individual that describes a problem or potential problems, cause, and contributing factors. a. Individual b. Family c. Community

a. Individual

6. While providing care for a family, the nurse reviews common reactions by siblings to the diagnosis of diabetes in their older brother. Which statement is not true regarding siblings of individuals with diabetes? a. Most siblings of children with a chronic illness develop behavior problems. b. Some siblings will wish they had the chronic illness too. c. Positive outcomes of siblings of children with chronic illnesses include an increased level of compassion. d. It is not uncommon for siblings to resent the child with the chronic illness because of increased responsibilities and parents being spread thinner, which results in less attention.

a. Most siblings of children with a chronic illness develop behavior problems.

1. An aggregate of people can best be described as: a. a group of people with similar characteristics. b. a group of people with the same illness. c. a group of people struggling with anger and violence. d. a group of vulnerable people.

a. a group of people with similar characteristics.

10. In 2003, Morbidity and Mortality Weekly Report reported that: a. a majority of adults older than 65 years have at least one chronic illness. b. a majority of adults older than 85 years have one chronic illness. c. a majority of adults between ages 65 and 85 are healthy, and report not having any chronic illnesses. d. a minority of adults older than 85 years have more than one chronic illness.

a. a majority of adults older than 65 years have at least one chronic illness.

5. A family who is willing to discuss withdrawal of treatment, has little hope for their family member's recovery, understands the severity of their dying family member's condition, has good communication with other family members, uses facts and family wishes to make decisions, and is able to identify a time and date to withdraw treatment describes: a. a progressive family. b. an accommodating family. c. a maintaining family. d. a struggling family.

a. a progressive family.

12. Frail individuals are at greatest risk for: a. adverse outcomes with changes. b. conflicts with family members. c. community or family care. d. lung cancer.

a. adverse outcomes with changes.

15. The older adult without a spouse who is most likely to live with a child is: a. an older adult who had a reciprocal relationship with a child across their adult life span. b. an older adult with three or more chronic illnesses. c. an older adult suffering from medication or alcohol addiction, or both. d. all of the above.

a. an older adult who had a reciprocal relationship with a child across their adult life span.

4. Family involvement in discharge planning should include: a. assessment of family capabilities. b. legal advice or a lawyer present at every discharge meeting. c. a written statement by the family of what they expect from the health care team. d. an advance directive.

a. assessment of family capabilities.

2. The most important cause of the increased number of older adults in U.S. society is attributed to: a. biomedical advances have increased the life expectancy of adults in the United States. b. decreased birth rates have increased the access to health care resources by older adults. c. increased family care of older adults has increased longevity. d. increased social and community support of older adults has increased longevity.

a. biomedical advances have increased the life expectancy of adults in the United States.

11. A risk for conflict between nurses and clients during childbearing can arise from: a. different advice from family members versus nurses. b. agreement between grandparents and nurses. c. agreement between fathers and mothers. d. acute illness occurring in the pregnant mother.

a. different advice from family members versus nurses.

3. Nancy is an advanced practice nurse practicing family nursing in a community mental health center. She is developing a health-promotion program for the community. Health promotion seeks to: a. increase positive coping abilities and counteract harmful conditions that may produce disability. b. provide early diagnosis and treatment, and prompt referral as necessary. c. assist the client and the family to resume the highest level of productivity in all aspects of daily living. d. assist the client and the family to cope with residual disability that warrants continued assistance.

a. increase positive coping abilities and counteract harmful conditions that may produce disability.

5. A growing trend in the care of individuals with mental illness is: a. the use of family members as caregivers. b. the use of wrap-around services in all communities. c. the use of multigenerational assessments in all settings. d. the decrease in the use of psychotropic medications in the treatment of mental illness.

a. the use of family members as caregivers.

6. Two overlying or encompassing competencies included in the Zerwekh Family Caregiving Model include: a. timing and detecting. b. persisting and futuring. c. implementing and evaluating. d. encouraging and supporting.

a. timing and detecting.

9. Chronic illnesses that are present at birth are more likely to be genetic than are chronic illnesses diagnosed later in life. a. True b. False

b. False

8. Evaluate the family's living environment, looking specifically at support, relationships, and other factors that might have a significant impact on family health outcomes. a. Individual b. Family c. Community

b. Family

10. Which of the following is not an advantage to having families present when nurses and physicians carry out resuscitative efforts? a. Families have assurance that the patient is dying. b. Less nursing staff time is needed for giving explanations because the family has witnessed activities firsthand. c. It helps the family accept the reality of death. d. It provides the family with an opportunity to say what they need to say while there is still a chance the patient can hear.

b. Less nursing staff time is needed for giving explanations because the family has witnessed activities firsthand.

12. Illness or injury requiring hospitalization is considered: a. a normative event for most families. b. a non-normative event for most families. c. neither a normative nor non-normative event for most families. d. both a normative and a non-normative event for most families.

b. a non-normative event for most families.

11. Frailty is a term used to describe: a. older adults with osteoporosis. b. a syndrome characterized by functional decline, anorexia, weight loss, impaired mobility, falls, fatigue, wasting, and decreased ability to cope. c. a syndrome characterized by decreased muscle tone, weakness, and anemia. d. all adults who have reached 85 years or older.

b. a syndrome characterized by functional decline, anorexia, weight loss, impaired mobility, falls, fatigue, wasting, and decreased ability to cope.

10. Health promotion can best be described as: a. activities that protect families from actual or potential diseases and disabilities and their consequences. b. activities that improve or maintain the well-being of people. c. activities that teach families to resolve conflicts. d. activities that help families identify their strengths and trust their own decisions.

b. activities that improve or maintain the well-being of people.

12. When considering feeding management for childbearing families, it is important to: a. inform all mothers that they should breast-feed. b. assist all parents in forming a nurturing relationship surrounding feeding of an infant. c. encourage fathers to leave feeding up to mothers, because mothers are naturally better at breast- and bottle-feeding of an infant. d. encourage mothers to bottle-feed their infants to guarantee proper nutrients are provided to the infant.

b. assist all parents in forming a nurturing relationship surrounding feeding of an infant.

5. The concept of transition is similar to the concept of: a. communication. b. change. c. system. d. stress

b. change.

5. Ambivalence refers to: a. the family's ability to maintain a stable level of balance in the midst of changes. b. the family's conflicting emotions regarding relationships with older adults, often including sense of care and nurturing, accomplishment, and love mixed with feelings of anger, role overload, and guilt. c. the family's ability to avoid stress over time. d. the family's ability to maintain harmony with extended family members over time.

b. the family's conflicting emotions regarding relationships with older adults, often including sense of care and nurturing, accomplishment, and love mixed with feelings of anger, role overload, and guilt.

4. The "sandwich generation" refers to: a. the group of Americans who rely on sandwiches for nutrition rather than cooked meals. b. the group of women caught in caring for their children and their aging parents at the same time. c. the group of men caught caring for their biological children and stepchildren at the same time. d. the group of older adults caught caring for their aging spouse and their grandchildren at the same time.

b. the group of women caught in caring for their children and their aging parents at the same time.

6. Which of these principles should family nurses incorporate in their care to help a family with a child who has diabetes? a. Patterns of illness are usually predictable in families. b. Protection is paramount in each interaction. c. Patterns of illness and disease differ in different families. d. Reorganization of family routines is discouraged.

c. Patterns of illness and disease differ in different families.

8. According to Knafl and colleagues' theory of normalization, families with a child with a chronic illness must do which of the following to adopt a "normalcy lens"? a. Actively deny aspects of the illness that are unpleasant or burdensome. b. Focus attention equally on "normal" siblings and the child with the chronic illness. c. Recognize the ongoing processes of actively adapting to the child's evolving physical, emotional, and social needs, and establishing new family routines. d. Advocate for the child to ensure that he or she is "mainstreamed" because it provides the best hope for the child's development.

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

7. Use of the FAMILY assessment tool helps the nurse to: a. assess the family's perception of change as a positive challenge that can be managed. b. assess the family's perception that a situation is hopeless and beyond their ability to manage. c. assess the family's involvement in care and current needs for resources and interventions. d. assess the family's acceptance for residential care for their older relative.

c. assess the family's involvement in care and current needs for resources and interventions.

3. The primary focus of the Zerwekh Family Caregiving Model is to: a. help family members prevent acute and chronic illnesses. b. assist families in identifying strengths within each member. c. assist families in developing the ability of members to take charge of their lives and make their own decisions. d. assist family members in better utilizing the health care system.

c. assist families in developing the ability of members to take charge of their lives and make their own decisions.

10. Financial concerns during childbearing can be caused by all of the following except: a. increased expenses. b. decreased income. c. decreased nonmonetary resources. d. increased use of savings.

c. decreased nonmonetary resources.

3. A nurse is working with parents of a child with sickle cell disease. The nurse would help the family create normality by: a. completing all physical care. b. ignoring family weaknesses and strengths. c. encouraging parents to reorganize family routines. d. focusing on the disease and its treatments.

c. encouraging parents to reorganize family routines.

4. Family child health nurses practice family-centered health care, which is most accurately characterized as: a. fostering partnerships between members of different families. b. providing consistently high-quality care for all families. c. forming partnerships between families and nurses. d. viewing the nurse as the constant in family and child health.

c. forming partnerships between families and nurses.

14. The media in the United States has: a. had a positive influence on the health of children. b. had a positive influence on the health of young adults. c. had a negative influence on the health of children and adults. d. had no affect on the health of adults and children.

c. had a negative influence on the health of children and adults.

1. Which of the following recent trends has influenced both the client's treatment needs and the system of care delivery in family mental health nursing? a. Freudian psychoanalytic movement, deinstitutionalization b. downward turn in the economic market, consumer advocacy c. health care reform, shortened length of hospital stay, more manageable medication protocols d. Freudian psychoanalytic movement

c. health care reform, shortened length of hospital stay, more manageable medication protocols

6. Use of the SPICE assessment tool is a good method to assess: a. level of illness and related hardships. b. level of normative and non-normative changes. c. level of disability and hardship experienced by an older adult. d. all of the above.

c. level of disability and hardship experienced by an older adult.

13. The majority of health promotion policies for the United States in the past were directed toward: a. minority groups. b. those living at or below poverty levels. c. the middle and upper classes. d. older adults.

c. middle and upper class

11. Barriers identified that limit access to care in our society include all of the following except: a. lack of access to information. b. lack of health insurance for all families. c. social policy that supports family-centered care instead of individual care. d. lack of transportation to health care facilities, especially for the poor and homeless in rural areas.

c. social policy that supports family-centered care instead of individual care.

3. A nurse is working with parents of a 6-year-old child who is dying of cancer. The nurse would help the family decide whether the 13-year-old sibling should be present during the death. Important aspects to consider when making this decision include all of the following except: a. the developmental age of the sibling. b. the quality of relationship between the two children. c. the hospital visiting hour policies. d. the cultural practices within the family regarding death and dying.

c. the hospital visiting hour policies.

7. The biggest criticism with using Duvall's Family Development Theory is: a. the theory does not use the life span approach. b. the theory does not include family life before having children. c. the theory was based on traditional nuclear families and is difficult to apply to new, diverse family structures. d. the theory is based on individuals rather than families.

c. the theory was based on traditional nuclear families and is difficult to apply to new, diverse family structures.

15. The needs of families with a family member facing a life-threatening illness or injury include all of the following except: a. questions answered honestly. b. to know the facts of the condition. c. to not be called at home. d. to receive understandable explanations.

c. to not be called at home.

7. Families are described as coping within their daily patterns after the diagnosis of a chronic illness within their family. Which description best describes a floundering family? a. A family that considers the chronic condition "normal" and family members feel confident in their care. b. A family that is managing the care of the chronic condition well, but with great difficulty and feelings of being burdened. c. A family that is experiencing conflict over illness management. d. A family that is experiencing confusion and overall negativity or uncertainty as to how to manage the chronic illness.

d. A family that is experiencing confusion and overall negativity or uncertainty as to how to manage the chronic illness.

9. Nurses assess whether families are planning space for an upcoming birth. Reasons families may not have planned space include which of the following? a. Families may be too busy with other responsibilities to allow time for planning space for the infant. b. Families may be denying that the birth is impending. c. Families may have a cultural belief that planning for space should not occur until after the birth of a healthy infant. d. All of the above.

d. All of the above.

14. Two thirds of family members reported which of the following symptoms when their ill family member was in the intensive care unit? a. Relief that care was obtained on time b. Depression c. Anxiety d. Both b & c

d. Both b & c

5. During a family conference, the nurse practitioner is leading a discussion with the Smith family, which includes a 15-year-old youth who often "forgets" to check his morning blood sugar. Which of these questions from the nurse would be most appropriate initially? a. Why would a person neglect his body? b. Some teens act out. Mr. Smith, do you think that is the problem? c. Can I tell you about the dangers of high blood sugar levels? d. I understand that you are all concerned with checking blood sugars. Is that right?

d. I understand that you are all concerned with checking blood sugars. Is that right?

5. During a family conference, the hospice nurse learns that the wife of a 74-year-old man with end-stage Alzheimer disease has been caring for her husband without assistance for the last 3 years. What are the risks to this wife? a. feelings of helplessness b. depression c. lack of personal health care d. all of the above

d. all of the above

1. Transition points within families are important for nurses to assess because: a. they represent a time when individuals within the family are at greatest risk for illness. b. they represent a time when individuals within the family are most likely to change roles and related tasks. c. they represent a time when families are most likely to reorganize and change. d. all of the above.

d. all of the above.

2. The best theory to guide childbearing family nursing is: a. Family Systems Theory. b. communication theory. c. change theory. d. all of the above.

d. all of the above.

8. Childbearing families can be positively influenced by: a. family nursing care. b. social support networks. c. experiences with the infant. d. all of the above.

d. all of the above.

9. Important roles of a gerontological nurse include: a. effective communication to assist family members in setting goals. b. ability to make meaningful referrals to community resources. c. ability to evaluate ethical components to care of older adults. d. all of the above.

d. all of the above.

15. Family empowerment is a process, outcome, and intervention. Nurses working toward assisting families in becoming more empowered need to focus on: a. providing information. b. providing encouragement and support. c. using specific strategies or interventions shown to increase family strength. d. all of the above.

d. all the above

17. Cultural affiliation: a. does not impact family nursing care of the hospitalized patient because the basic needs of families do not change across cultures. b. impacts family nursing care of the hospitalized patient because family beliefs and practices around hospitalization vary across cultures. c. should be assessed by nurses and interventions adapted accordingly. d. b & c only

d. b & c only

10. When assessing the process of change within a family with chronic illnesses, the areas of concern include: a. health maintenance. b. family tasks. c. language and symbolic interaction. d. control.

d. control.

18. When talking with families about end-of-life issues, the nurse should: a. refer all questions and discussions to the physician. b. help the family interpret what the patient meant in the advance directives c. limit discussions to decisions about CPR. d. help the family understand probable outcomes of decisions.

d. help the family understand probable outcomes of decisions.

2. The nurse conducting a family assessment would focus on all of the following except: a. family structure. b. family beliefs. c. family coping strategies. d. individual financial resources.

d. individual financial resources.

8. Families find communication from nurses most helpful when communication is: a. brief. b. vague to avoid conflict with other health care providers. c. limited to superficial topics as technical care is what families really need nurses for. d. sensitive and honest.

d. sensitive and honest.

3. Families with closed boundaries are often not accessible to nursing interventions because: a. these families do not have children. b. these families are unstable. c. these families have family members who do not interact with each other. d. these families reject influences from the outside environment.

d. these families reject influences from the outside environment.

5. Family careers can be best described as: a. normative events that occur in all families. b. predictable developmental stages that occur in most families in the United States. c. parents' occupation across the life span from marriage to old age. d. unique events that occur in families that impact family development and processes.

d. unique events that occur in families that impact family development and processes.