Ch. 2: Family-Centered Community-Based Care

After teaching a group of nursing students about family-centered care, which statement made by the students would best indicate that the teaching was successful?

"Family-centered care recognizes the concept of family as the constant."

As part of an education program for pregnant women and their partners, the nurse illustrates the various settings available for birth. The nurse determines that the program was successful when the group correctly chooses which statement about home births?

"Women giving birth at home have control over every part of labor."

A nurse is visiting the home of a mother and her newborn. The woman's family members are present when the nurse arrives. What is the nurse's best approach to the situation?

Assess the family members' interactions with the newborn and one another.

A first-time mother is at home on the third day after birth and has bleeding, painful nipples after breastfeeding. She calls the hospital to speak to her postpartum nurse. What is the best plan the nurse can implement for this client?

Arrange for a home visit from a lactation consultant.

During a prenatal visit, a nurse suspects that a client is using complementary and alternative medicine (CAM). Based on a review of the client's medical record, the nurse determines that the primary care provider is unaware of the client's action. Which action by the nurse would be most appropriate?

Have the client tell the primary care provider about this therapy.

Which information is true of home care as a whole?

It is increasing because new technology makes so many procedures available in the home.

The nursing instructor is teaching a session on the increase of health care costs associated with the advancement of modern technology. The instructor determines the session is successful when the students correctly choose which focus of community-based health care that has been implemented to combat the increased cost?

Preventing disease and its sequelae

A nurse is developing a plan of care for a client of Muslim faith. Which action demonstrates an understanding of providing culturally competent care?

The client is asked if there are any meal preferences to be included in the care plan.

A nurse has moved into a new community and will begin practicing at the local health department. Why is it important for this nurse to become familiar with the community where the nurse will work?

The health of a community influences the health of its individuals.

The emergency nurse is providing care for a pregnant woman admitted with a broken femur, blackened eye, and multiple contusions. She admits her partner is abusive. Which activity would be considered at the tertiary level of prevention?

The nurse contacts the crisis social worker for assistance.

A nurse is addressing a group of women on the issue of women's health during their reproductive years. Which reason does the nurse provide regarding the need for comprehensive, community-centered care to women during this time period?

Women's health care needs change with their reproductive goals.

A community health nurse is actively involved in various community projects. The nurse is providing a secondary prevention activity by organizing which event?

a skin cancer screening fair

Community-based health care has unique challenges for the nurse. Which skill must the nurse have to handle these challenges?

assessment

A primary care provider writes a prescription for home visits daily for a postpartum woman. The nurse is to perform dressing changes on an infected cesarean birth incision and administer ceftriaxone 1 gm IV. What type of care will the nurse be providing in the home?

skilled home nursing care

A nurse is caring for a Turkish American client. The nurse understands that there could be major cultural differences between herself and the client. The nurse contemplates assigning this client to a staff member who is of the same culture as the client. What is a potential consequence?

stereotyping of the client

A woman comes to the community clinic for a visit. During the visit, the client tells the nurse that she is thinking about using some complementary and alternative measures to deal with illness. Which suggestions by the nurse would be appropriate? Select all that apply.

"Just remember that if it says 'natural,' it doesn't always mean it is safe." "If you use any other therapies, be sure to tell any health care providers about them." "Even if you use these therapies, make sure that you get medical care if you become sick."

The nurse is assessing a child of a different cultural background. Which nursing action should the nurse prioritize when providing nursing care?

Ask the family for input into their care based on their cultural beliefs.

When discussing a health concern with a woman at the local community clinic, the nurse recognizes that the cornerstone of all disease management programs is:

client education.

Which factor is most critical to effective home care?

commitment to home care from family and other essential people

A pregnant client is questioning the nurse about the advantages of the various health care options. When providing information about home care and births, which factor should the nurse point out as an advantage?

Families can be better kept intact.

A nursing instructor is teaching a group of nursing students about the various options available to provide nursing care in a community. The instructor determines the session is successful when the students correctly choose which action as the primary focus of home care nursing?

Provide direct client care.

An oncology nurse is preparing a plan of care for a young father newly diagnosed with lung cancer. What action would be the nurse's priority?

Teach the family how to navigate the health care system.

The community health nurse is seeing a mother and newborn for the first home visit. Which information best indicates an understanding of visiting clients in their home?

The home visit is a way of monitoring the well-being of all family members.

The nurse is providing care to a client who comes to the clinic for a follow-up visit. Which skill would be most important for the nurse to use when communicating with the client?

active listening

A nurse is making a home visit to a postpartum client. Which action would be inappropriate for the nurse to perform when making the visit?

conducting a well-baby visit to start the child's immunizations

A nurse is working in the community providing tertiary prevention. The nurse is most likely performing which activity?

counseling clients who are experiencing long-term effects of intimate partner violence

The nurse reinforces to the client that prenatal care is associated with improved pregnancy outcomes. Which basic components of good prenatal care should the nurse describe for the client? Select all that apply.

early and continuing risk assessment health promotion medical and psychosocial interventions follow-up

During a prenatal visit, a client tells the nurse, "I just started some herbal remedies and haven't told my doctor yet." Which action by the nurse would be most appropriate?

encouraging the client to let the primary care provider know

When giving family-centered care, the nurse recognizes the need to view which concept as the constant?

family

The nurse is participating in a poisoning prevention program. This activity is an example of which type of community-based nursing intervention?

health education program

A nurse is providing care to a client who has undergone a mastectomy. The nurse provides the woman with information about where to obtain a breast prosthesis. This is an example of which type of community-based nursing intervention?

health system referral

A primary care provider tells a pregnant woman with slightly elevated blood pressure to return home on bed rest until her next scheduled checkup. This is an example of which type of care?

home care

A nurse is working at a community women's health clinic. The nurse is involved in primary prevention activities. Which activity would the nurse be performing?

immunizations

A nurse is reading a journal article comparing community-based nursing with nursing in the acute care setting. Which factor would the nurse most likely find as being associated with community-based nursing?

making decisions in isolation

The nursing instructor is teaching a session outlining the necessary skills of a community nurse. The instructor determines the session is successful when the students correctly choose which factor as the foundation of all nursing care?

nursing process

A nurse working in the neonatal intensive care unit assists a family during the discharge of the premature newborn. What would the nurse prioritize in assessing the family's preparedness to care for the newborn? Select all that apply.

the family's knowledge of newborn care the mother's and the family's concerns the family's available support system

The client who gives birth at a hospital can expect a shorter hospital stay after a normal birth. This is mainly due to which factor?

the recent reforms in health care financing

A nurse is providing home care to a pregnant woman who is on bed rest. The woman has two other children. During her assessment, the nurse asks the woman how she occupies her time. What is the best rationale for asking this question?

to ensure that the woman is not engaging in activities that would disrupt her rest