Chapter 2: Family-Centered Community-Based Care

The nurse is preparing a prenatal seminar for young mothers. Which type of information should the nurse gather to ensure success of the program? a. Who will be accompanying the mother b. Approximate education level of the participants c. Names of each of the participants d. Incomes of each of the participants

b. Approximate education level of the participants When teaching a group of clients, the nurse should seek demographic information, such as the education level of the participants, to help develop an appropriate teaching plan for the group. This is an impersonal group, so learning who is accompanying the mothers, their names, or their incomes is not appropriate.

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? a. "Family-centered care recognizes the health of the client." b. "Family-centered care is a component of health care." c. "Family-centered care recognizes the concept of family as the constant." d. "Family-centered care is one part of a system."

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

A pregnant woman who appears to be having contractions comes to the emergency department accompanied by her 10-year-old child. The woman does not speak the dominant language, but the child speaks both the parent's language and the dominant language. The nurse plans to use an interpreter to fully assess this client. Who would be the best interpreter? a. the child b. a nonmedical hospital staff member who speaks the woman's language c. a nurse on the medical-surgical floor who speaks the woman's and the dominant language d. an interpreter is not really needed

c. a nurse on the medical-surgical floor who speaks the woman's and the dominant language The nurse should not use children as interpreters because it could affect family relationships, proper understanding, and compliance with health care issues. Also, just because someone speaks the language does not mean he or she will make a good interpreter, especially if the speaker has no medical background. The nurse who speaks both languages would be a good choice. In this case an interpreter is definitely needed.

The nurse is educating the family of a 2-day old Chinese American boy with myelomeningocele about the disorder and its treatment. Which action involving an interpreter could jeopardize the family's trust in the health care providers? a. allowing too little time for the translation of health care terms b. using a person who is not a professional interpreter c. asking the interpreter questions not meant for the family d. using a relative to communicate with the parents

c. asking the interpreter questions not meant for the family Asking questions or having private conversations with the interpreter may make the family uncomfortable and destroy the nurse/client relationship. Translation takes longer than a same-language explanation, and the family may need additional to clarify terms; this must be considered so that the family is not rushed. Use of a nonprofessional may result in some inaccuracy in translating medical terminology but should not impact the trust of the family. Using a relative can upset the family relationships or cause legal problems but also does not affect trust with the healthcare providers.

The nurse is preparing to discuss birthing options with a 25-year-old female who is in a low-risk pregnancy with one older child. Which option will be best for the nurse to recommend for this client? a. Home setting b. Birthing center c. Hospital d. Any birthing settings

d. Any birthing settings When a woman is low-risk and has no known medical needs, birth location is the choice of the mother. Home births attended with certified nurse midwives are less likely to have complications and require interventions. Birthing centers are an option for an alternative birth setting, and hospitals are required birth locations for women with potential needs or complications. The nurse should present the advantages and disadvantages of each option and allow the client to make the decision.

A nurse is working in a community setting and is involved in case management. In which activity would the nurse most likely be involved? a. helping a grandmother to learn a procedure b. assessing the sanitary conditions of the home c. establishing eligibility for a Medicaid waiver d. scheduling speech and respiratory therapy services

d. scheduling speech and respiratory therapy services Case management focuses on coordinating health care services while balancing quality and cost outcomes. The nurse would be most likely involved with scheduling speech and respiratory services, ensuring these services are integrated into the client's plan of care in a coordinated manner. Helping a person learn a procedure or assessing the sanitary conditions of the home and establishing eligibility are not activities associated with case management.

Place the steps of planning and implementing home care in order from first to last. All options must be used. Obtain a copy of client's referral form. Wash the hands. Park in a well-lit area. Document all findings. Perform a physical examination. Assess the suitability of the family.

1. Assess the suitability of the family. 2. Obtain a copy of client's referral form. 3. Park in a well-lit area. 4. Wash the hands. 5. Perform a physical examination. 6. Document all findings. The correct order of steps when planning and implementing a home visit are as follows: 1) assess the suitability of the family; 2) obtain a copy of the client's referral form; 3) park in a well-lit area; 4) wash the hands; 5) perform a physical examination; 6) document all findings.

The nurse is preparing to teach a drug education class at a local elementary school. The nurse is focused on providing which type of care to the community? a. Primary prevention b. Secondary prevention c. Tertiary prevention d. Preventive care

a. Primary prevention Primary prevention is promotion of healthy activities and includes education concerning safety, diet, rest, exercise, and disease prevention. Secondary prevention focuses on health screening activities that aid in early diagnosis and encourage prompt treatment. Tertiary prevention focuses on rehabilitation and instruction on ways to prevent further injury or illness. "Preventive care" is not considered a specific category but is a general function that encompasses all three levels.

A nurse will conduct an information session for a group of parents who have children in elementary school. The session will focus on child growth and development. Which information about the parents would be important for the nurse to obtain before planning the session to promote the success of the session? Select all that apply. a. ages b. educational levels c. primary language(s) spoken d. cultural attitudes e. financial background

a. ages b. educational levels c. primary language(s) spoken d. cultural attitudes A successful group experience relies on the nurse being prepared before the session in addition to providing factual, unbiased information. It is important to know the needs of the target population to provide information to a group successfully. Important information about the group includes age, educational level, ethnic and gender mix, language barriers, cultural attitudes regarding receiving and acknowledging information, and any previous education the group has already had on the subject.

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: a. client education. b. client cooperation. c. early detection. d. rapid treatment.

a. client education. Client education is the cornerstone of all disease management programs. The more the client knows about his or her condition, the more willing he or she will be to cooperate with the treatment. Clients will also seek assistance if they are aware of the potential complications that can occur with a disease or disability, thus promoting the chances for early detection and rapid treatment.

Which factor is most critical to effective home care? a. commitment to home care from family and other essential people b. provision of care by an experienced nurse c. a health problem that is mild to moderate in nature d. the client's ability to get along with home care assistants

a. commitment to home care from family and other essential people Home care works best when a family is strongly committed to home care and well prepared to cooperate with health care providers.

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? a. conducting a well-baby visit to start the child's immunizations b. assessing the postpartum client for potential complications c. evaluating the emotional well-being of the family d. initiating referrals to community services as needed

a. conducting a well-baby visit to start the child's immunizations Postpartum care in the home environment usually includes monitoring the physical and emotional well-being of the family members; identifying potential or developing complications for the mother and newborn; linking the family as needed to available community social services; and bridging the gap between discharge and ambulatory follow up for mothers and newborns. The nurse would not be conducting a well-baby visit to initiate immunizations. Rather, the nurse would assess the newborn and educate the postpartum woman about the need for a well-baby follow-up for her newborn.

A nurse is working in the community providing tertiary prevention. The nurse is most likely performing which activity? a. counseling clients who are experiencing long-term effects of intimate partner violence b. administering immunizations at a well-child clinic c. assisting with the performance of hearing examinations d. providing drug education programs for local elementary and middle schools

a. counseling clients who are experiencing long-term effects of intimate partner violence Tertiary prevention measures are supportive and restorative. For example, tertiary prevention efforts would focus on minimizing and managing the effects of a chronic illness such as cerebrovascular disease or the chronic effects of sexually transmitted infections (STIs), e.g., herpes, human immunodeficiency virus (HIV), and untreated syphilis. Another example would involve working with women who have suffered long-term consequences of intimate partner violence. Administering immunizations and providing drug education are examples of primary prevention. Assisting with hearing evaluations is an example of secondary prevention.

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. a. early and continuing risk assessment b. health promotion c. terminating employment while pregnant d. medical and psychosocial interventions e. follow-up

a. early and continuing risk assessment b. health promotion d. medical and psychosocial interventions e. follow-up Early prenatal care can improve pregnancy outcomes. Basic components of prenatal care are early and continuing risk assessment, health promotion, medical and psychosocial interventions, and follow-up. Not working while pregnant does not necessarily help. Keeping active usually provides a healthier lifestyle and in turn a better outcome.

The nurse is performing a community assessment to determine the needs of the community and provide educational programs. The community assessment should include which action? a. examining present systems to see whether they function adequately and have features unique to the community b. examining the problems of the community and what can be done to correct them c. examining the population of the community for illness and accessing resources to cure them d. examining what is working for other communities that can be used in the client's community

a. examining present systems to see whether they function adequately and have features unique to the community Community assessment consists of examining the various systems present in almost all communities to see whether they are functioning adequately as well as features unique to a client's community.

When giving family-centered care, the nurse recognizes the need to view which concept as the constant? a. family b. client c. individual d. none of the above

a. family Family-centered care recognizes the concept of the family as the constant. The health and functional abilities of the family affect the health of the client and other members of the family.

A nurse is reviewing employment opportunities in community-based nursing and decides that the ambulatory care setting would be the best fit. Which settings might the nurse choose? Select all that apply. a. family planning clinic b. assisted living c. prison d. outpatient surgery center e. health maintenance organization

a. family planning clinic d. outpatient surgery center e. health maintenance organization Ambulatory care settings include health maintenance organizations, day surgery centers, and family planning clinics. Assisted living is a long-term care setting; a prison is a health department service setting.

The experienced nurse has seen many changes in health care throughout the last few decades. One such change has been to move from acute care settings out into the community with an emphasis on which areas? Select all that apply. a. health promotion b. acute illnesses c. chronic illnesses d. illness prevention e. none of the above

a. health promotion d. illness prevention Health care delivery has moved from the acute care settings out into the community. Health care now has a focus on health promotion and illness prevention. Preventing acute and chronic illnesses is now seen as the goal, or as an outcome if the goal is not achieved. Thus, these are not seen as the focus of delivery of 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? a. immunizations b. Papanicolaou (Pap) tests c. cholesterol monitoring d. fecal occult blood testing

a. immunizations Primary prevention encompasses a vast array of areas, including nutrition, good hygiene, sanitation, immunizations, protection from ultraviolet rays, genetic counseling, bicycle helmets, handrails on bathtubs, drug education for school children, adequate shelter, smoking cessation, family planning, and the use of seat belts. Papanicolaou (Pap) tests, cholesterol monitoring, and fecal occult blood testing are examples of secondary prevention activities.

The nursing instructor is teaching a class on labor and birth. She lists the advantages of a home birth and then lists which disadvantages of home births? Select all that apply. a. limited availability of pain medication b. allows the woman to maintain control c. danger to mother if emergency arises d. danger to baby if emergency arises e. allows labor to progress normally

a. limited availability of pain medication c. danger to mother if emergency arises d. danger to baby if emergency arises Home birth is advantageous for many different reasons, including permitting the woman to maintain control as well as allowing for labor to progress normally without any interferences and unnecessary interventions. Disadvantages include the limited availability of pain medication and danger to the mother and baby if an emergency arises.

The nurse who is working with women, children, and families knows the importance of using good communication, both verbal and nonverbal. Which actions are examples of nonverbal communication? Select all that apply. a. nodding b. attending to others c. active listening d. speaking e. singing

a. nodding b. attending to others c. active listening Verbal communication is the spoken word, and it includes singing. Nodding, attending to others, and active listening are forms of nonverbal communication.

Nurses involved with community health nursing focus primarily on: a. preventing illnesses. b. collecting epidemiological information. c. providing nursing care in the local schools. d. providing staffing support in the local clinics.

a. preventing illnesses. Community health nursing focuses on preventing illness and improving the health of populations and communities. They address current and potential health needs, promote and preserve the health of the population, and are not limited to particular age groups or diagnoses.

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? a. stereotyping of the client b. ensuring better care and understanding c. helping in assessing client's culture d. building a better nurse-client relationship

a. stereotyping of the client A nurse who thinks stereotypically may assign a client to a staff member who is of the same culture as the client because the nurse assumes that all people of that culture are alike. The nurse also may believe that clients with the same skin color may react in the same manner in similar social situations. Because stereotypes are preconceived ideas unsupported by facts, they may not be real or accurate. In fact, they can be dangerous because they are dehumanizing and interfere with accepting others as unique individuals.

A nurse working at a child health clinic is involved in primary prevention activities. Which activity will the nurse perform in this role? a. teaching about healthy food choices b. performing hearing screenings c. reviewing laboratory test results d. assisting with physical therapy exercises after knee surgery

a. teaching about healthy food choices Primary prevention involves health-promoting activities to prevent the development of illness or injury, such as teaching about healthy food choices. This level of prevention includes giving information regarding safety, diet, rest, exercise, and disease prevention through immunizations and emphasizes the nursing roles of the educator and client advocate. Secondary prevention focuses on health screening activities that aid in early diagnosis and encourage prompt treatment before long-term negative effects arise, such as hearing screenings and reviewing laboratory test results. Tertiary prevention involves health-promoting activities that focus on rehabilitation, such as physical therapy exercises after surgery, and providing information to prevent further injury or illness.

A pregnant woman reports she does not see the value in attending prepared childbirth classes because she plans to have an epidural to manage the discomfort from the contractions. What information should be included in responses by the nurse? Select all that apply. a. "You are correct since the focus of these courses is on pain management." b. "There are many different topics included in prepared childbirth classes aside from pain management." c. "Preparation for labor and birth can enhance your experience and coping abilities." d. "You can learn tools to assist you in the labor process both before and after your epidural." e. "You are limiting your options by not considering attending the classes."

b. "There are many different topics included in prepared childbirth classes aside from pain management." c. "Preparation for labor and birth can enhance your experience and coping abilities." d. "You can learn tools to assist you in the labor process both before and after your epidural." Prepared childbirth education courses provide information for prospective and expecting parents. The information in prepared childbirth education is not limited to pain management. Courses can include other topics such as potential procedures during the labor process, newborn care and postpartum care. Education and an accompanying understanding of the labor and birth experience can improve the coping skills of the mother and her partner. Advising the woman that she is limiting her options is argumentative and not appropriately stated.

A nurse is planning the discharge of a newborn to parents recently immigrated from Syria. Which action best indicates that the nurse provides culturally sensitive care? a. The nurse approaches the clients in a nonjudgmental way in an attempt to change the clients' cultural beliefs to the unit's beliefs. b. The nurse researches the clients' cultural characteristics and beliefs. c. The nurse encourages the continuation of cultural practices in their home setting. d. The nurse strives to keep the clients' cultural background from influencing their health needs.

b. The nurse researches the clients' cultural characteristics and beliefs. Nurses must research and understand the cultural characteristics, values, and beliefs of the various people to whom they deliver care. To provide culturally appropriate care to diverse populations, nurses need to know, understand, and respect culturally influenced health behaviors.

A nurse is working on developing cultural competence. Which actions would reflect that the nurse is attaining cultural skills? Select all that apply. a. recognition that client's culture does not affect his or her health status b. examination of personal biases toward other cultures c. assessment of each client's unique cultural values and beliefs d. acting as an advocate for social justice to eliminate health disparities e. adaptation of care practices that ignore client's values and beliefs

b. examination of personal biases toward other cultures c. assessment of each client's unique cultural values and beliefs d. acting as an advocate for social justice to eliminate health disparities An attainment of cultural skills would allow the nurse to assess each client's unique cultural values, beliefs, and practices without depending solely on written facts about specific cultural groups; the nurse could also advocate for social justice to eliminate health disparities in diverse populations. Recognition of the effect of culture on health status and examination of personal biases occur with cultural awareness is part of this process. Adapting care practices occurs with step 4, cultural encounter.

A homeless client diagnosed with human papillomavirus (HPV) is seen in the maternity clinic requesting a pregnancy test. Which nursing action would be the best example of the secondary level of prevention? a. Arrange for her to have the HPV vaccination. b. Send a referral to social work for adequate housing assessment. c. Suggest she have a Papanicolaou test. d. Discuss with her the need for folic acid supplementation.

c. Suggest she have a Papanicolaou test. Secondary prevention is the early detection and treatment of adverse health conditions and is aimed at halting the disease. Health screenings are the mainstay of secondary prevention. Papanicolaou tests are at this level of prevention. Primary prevention encompasses immunizations, and as she is already infected with HPV, the vaccine would not be effective. The referral for social work and the use of folic acid supplements while pregnant are examples of primary prevention.

A nurse is developing a plan of care for a client of Muslim faith. Which action demonstrates an understanding of providing culturally competent care? a. The client is asked to encourage family members to bring in special foods. b. The client's traditional healing and health practices will be assessed for implementation. c. The client is asked if there are any meal preferences to be included in the care plan. d. The client will be referred to the hospital chaplain for spiritual support.

c. The client is asked if there are any meal preferences to be included in the care plan. It is important for all nurses to incorporate the client's traditional healing and health practices with conventional medicine. Some clients may prefer certain foods or drinks when they are ill. Diets may be different and need to be considered during the process of determining the appropriate course of treatment. Family members may not be able to bring in foods necessary for the client. Nurses should be competent in their ability to provide care to diverse populations without referrals.

A community-based nurse has a different set of skills than those of counterparts who work in a hospital. Community-based nurses also face unique issues and challenges. What is one of the unique aspects of community-based nursing? a. teamwork b. disease-oriented c. autonomous action d. less holistic focus

c. autonomous action Community-based nursing practice is autonomous. There are often no other members of the health care team to consult, or no members within the area to consult with. Teamwork is important in community-based nursing, but it is not a unique aspect of this type of nursing. Disease orientation is the medical model of health care. Community-based nursing takes in all aspects of the client, including community aspects such as education—not just the disease process. Therefore, it is more holistic rather than less holistic.

The nurse is caring for a pregnant woman and her family who are immigrants. Which intervention would be the priority for helping to achieve a successful outcome? a. inquiring about the family's ability to buy medicine b. asking how they got to the appointment c. communicating using understandable terms d. referring them to state and local aid programs

c. communicating using understandable terms Communicating using understandable terms, whether that means using an interpreter or speaking slowly and using simple terms, will greatly affect the success of the care provided. Inquiring about their financial situation, assessing transportation issues, and helping them access aid programs are secondary to the need for effective communication.

A young client who has herpes comes to the clinic regularly for treatment and counseling. This is an example of which level of prevention? a. primary b. secondary c. tertiary d. all of the above

c. tertiary Tertiary prevention is designed to reduce or limit the progression of a disease or disability. Tertiary prevention measures are supportive and restorative. They focus on minimizing and managing the effects of a chronic illness such as a sexually transmitted infection.

When performing an initial home care assessment, the nurse evaluates material resources (e.g., hospital beds, oxygen, fetal home monitors) as well as which resource? a. type of dwelling the family lives in b. amount of money the household makes c. number of people in the immediate family d. if the family can deal with the stress of home care

d. if the family can deal with the stress of home care On the first home care visit, the nurse must perform a thorough history and physical examination of the client as well as assess the resources of the family and whether they will be able to care for the client at home. Resources include not only material objects (e.g., hospital beds, oxygen, fetal monitors) but also whether the family can deal with the chronic stress of home care.

Which information is true of home care as a whole? a. It is decreasing because many new care measures are too technical for use in the home. b. It is increasing because new technology makes so many procedures available in the home. c. It is decreasing because the overall incidence of children's illnesses is decreasing in number. d. The amount of care remains even because only a limited number of nurses are available to give care.

b. It is increasing because new technology makes so many procedures available in the home. Home care is expanding because it can offer advantages to both caregivers and consumers. New technology makes it successful.

A client receiving home care is on bed rest. She says to the nurse, "I feel so useless like this. I'm not used to being so inactive." What response from the nurse might help the client to better cope with her situation? a. "Are there hobbies you enjoy that you can do while resting that you never get a chance to do otherwise?" b. "Think about how much faster you'll recover by following directions." c. "Let me talk to the primary care provider to see if the restrictions can be eased back at all." d. "I would love the opportunity to sit back and relax. Take advantage of this while you can."

a. "Are there hobbies you enjoy that you can do while resting that you never get a chance to do otherwise?" Women and children on bed rest react in several ways, but many report feeling "tied down," "like a prisoner," and "as if I'm missing out." One solution to help them cope with the stress of the experience is for them to keep busy or use their time to learn a new skill. Most women can name activities they would like to do but have never had time to begin to do. For example, if a woman likes to read but does not always have the time, bed rest at home may provide an ideal time for her to catch up on her reading.

A young couple is preparing to leave the hospital and go home after the birth of their baby. While preparing their care plan, the nurse can demonstrate recognition of their cultural differences by asking: a. "Do you have any treatment preferences you would like me to include in the care plan?" b. "Do you understand why the treatment plan must be followed carefully?" c. "Do you agree to do exactly as the primary care provider is asking?" d. "If you have any difficulties, do you remember whom to call?"

a. "Do you have any treatment preferences you would like me to include in the care plan?" It is important for all nurses to incorporate the client's traditional healing and health practices with conventional medicine. Showing respect for the client's beliefs and practices will improve communication and effectiveness of the care plan. The differences and needs of the client must be considered when developing the plan.

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. a. "Just remember that if it says 'natural,' it doesn't always mean it is safe." b. "If you use any other therapies, be sure to tell any health care providers about them." c. "You should be okay to use any therapy as long you check it out thoroughly on the internet." d. "Most therapies are safe because they have undergone some very strict scientific testing." e. "Even if you use these therapies, make sure that you get medical care if you become sick."

a. "Just remember that if it says 'natural,' it doesn't always mean it is safe." b. "If you use any other therapies, be sure to tell any health care providers about them." e. "Even if you use these therapies, make sure that you get medical care if you become sick." If clients are considering the use of or are using CAM therapies, suggest they check with their health care provider before taking any "natural" substance. Offer clients the following instructions: keep in mind that "natural" does not necessarily mean "safe"; seek medical care when ill; always inform the health care provider if you are taking herbs or other therapies. Although carefully researching a therapy is important, the internet may or may not have reputable information. Additionally, most therapies have not undergone rigorous scientific testing.

What is a key element of providing family-centered care? a. Communicate specific health information. b. Be in control of the way care is given. c. Give only the health information that is necessary while providing care. d. Avoid cultural issues by providing care in a standardized fashion.

a. Communicate specific health information. Key elements in the provision of family-centered care include demonstrating interpersonal sensitivity, providing general health information and being a valuable resource, communicating specific health information, and treating people respectfully. Giving as much control as possible to the client and his or her family is essential in family-centered care. The nurse should give all the health information, both good and bad, that the client or the family requests and be culturally sensitive to the client and the family.

A couple is trying to decide where they want to have their baby: at home, a birthing center, or the hospital. Which statement would indicate to the nurse that the couple needs more information to decide? a. "My mom had me at home, so I can have this baby at home as well." b. "Okay, we understand this is a low-risk birth." c. "We live just five miles from the hospital, so we would have time to get to the hospital if needed." d. "We understand the situation can change, and we need to have a plan B in place."

a. "My mom had me at home, so I can have this baby at home as well." The couple needs to realize that each pregnancy is unique and must be considered on its own merits. This decision should be based on considering the woman's preferences, her risk status, her financial status, and her distance from a hospital. Client safety is paramount, but at the same time nurses must protect the woman's right to select birth options. Nurses should promote family-centered care in all maternity settings.

A pregnant woman in her first trimester has come to the clinic for a check-up. The woman mentions to the nurse that she would like to try some complementary and alternative medicine (CAM) therapies to control her nausea. When teaching the woman about these methods, which information would be important for the nurse to emphasize? Select all that apply. a. "Remember that just because it says the remedy is natural, it does not always mean it is safe." b. "It would be important for you to talk with your provider about what might be best for you." c. "Try using some ginger tea to help control the nausea you are having." d. "It is okay to try more than one remedy with another to get a better effect." e. "Check the package to make sure that all the ingredients and their amounts are listed."

a. "Remember that just because it says the remedy is natural, it does not always mean it is safe." b. "It would be important for you to talk with your provider about what might be best for you." e. "Check the package to make sure that all the ingredients and their amounts are listed." If clients are considering the use of or are using CAM therapies, it is important to instruct them to check with their health care providers before taking any substance, even if it is natural. In addition, the nurse should instruct the woman that natural does not necessarily mean that the product is safe and that she should check that the product package contains a list of all ingredients and the amounts of each. Although ginger tea may be used to treat nausea of pregnancy, most substances ingested cross the placenta and have the potential to reach the fetus. There is also the potential for harm if therapies are mixed. Therefore, the nurse should stress the need to discuss all remedies with the provider.

x A young couple desires to use aromatherapy during the labor and birth of their child. The nurse realizes more education is needed after they make which statement? a. "We will just use whichever smells the best at that moment." b. "We will ask our primary care provider for suggestions." c. "We understand some oils should not be used during pregnancy." d. "We should be careful about mixing oils."

a. "We will just use whichever smells the best at that moment." Aromatherapy can be used to reduce discomfort during birth; however, it is important that the couple understand that some oils are contraindicated due to the effects they may have on the uterus during this time and can interfere with the delivery. Discussing their options with the care provider and being careful about mixing are important before the delivery to ensure the safety of the mother and infant.

As part of an education program for pregnant women and their partners, the nurse illustrates the various settings available for birth. The nurse determines that the program was successful when the group correctly chooses which statement about home births? a. "Women giving birth at home have control over every part of labor." b. "A home birth is probably the most expensive setting for childbirth." c. "There are very rigid screening procedures that must be followed." d. "A wide range of pain medications is readily available to the woman."

a. "Women giving birth at home have control over every part of labor." Home births permit the woman to maintain control over every aspect affecting the woman's labor, such as positioning, attire, and support persons present. A home birth involves the least amount of cost. Home births are recommended for pregnant women considered to be at low risk for complications. Some birthing centers may have very rigid screening criteria. The availability for pain medication is limited for home births.

Advocacy for the client is an important aspect of community-based nursing. What is one way a nurse can advocate for a pediatric client? a. Assist the family to apply for Medicaid or other forms of health care reimbursement. b. Report a new case of whooping cough to the county health authorities. c. Arrange for educational events for the local hospital staff. d. Assure a young mother that the nurse will not report the suspicious bruises on her toddler to social services.

a. Assist the family to apply for Medicaid or other forms of health care reimbursement. The nurse working in a community setting may often develop a long-standing relationship with families because of the continuous nature of client contact in an outpatient, school, or other setting. This type of relationship may allow the nurse to advocate for the client on a broader scale in health and welfare issues. Examples of interventions include helping the family apply for Medicaid or other forms of health care reimbursement. Reporting new cases of whooping cough is done to state authorities, not county authorities, and is not considered advocating for a client. Arranging educational events for the local hospital staff is not a community-based function. Assuring a mother that the bruises on her toddler will not be reported to social services—when it is mandated that any suspected case of child violence be reported—is not advocating for the child.

Which action should a nurse perform to avoid disrupting family routine when visiting to provide home care? a. Avoid coming during mealtimes. b. Keep all client information confidential during the visit. c. Obtain directions to the home. d. Greet the client and any other family members present at the door.

a. Avoid coming during mealtimes. To avoid disrupting family routines, try not to visit at prayer times or mealtimes unless observing family interaction or assessing a client's typical meal is necessary. The other answers, although they are valid guidelines for home visits, would not help the nurse avoid disrupting a family routine.

An ill child will be cared for at home by the parents. What resources will be most advantageous for this family? a. effective support people from the family or community to offer help b. financial assistance to buy medications c. visits from the nurse daily d. social service referral

a. effective support people from the family or community to offer help Home care is most successful when support people from the family or community offer help. Otherwise, parents and children can experience loneliness and low self-esteem that interfere with their ability to remain on continuous bed rest or continue with a medical regimen.

A nurse is providing preoperative instructions to a client undergoing an emergency cesarean birth. Which actions follow appropriate communication guidelines? Select all that apply. a. During the instructions, the nurse uses open-ended questions. b. The conversation is redirected while maintaining its focus. c. The client's feelings are addressed. d. The nurse does not acknowledge the emotions in the situation. e. The family's words are used to describe the necessary information. f. Only the correct medical terms are used when explaining the cesarean birth.

a. During the instructions, the nurse uses open-ended questions. b. The conversation is redirected while maintaining its focus. c. The client's feelings are addressed. e. The family's words are used to describe the necessary information. Good verbal communication skills are necessary. General guidelines for appropriate verbal communication include the following: Use open-ended questions that do not restrict the clients' answers; redirect the conversation to maintain focus; use reflection to clarify the parents' feelings; paraphrase the child's or parent's feelings to demonstrate empathy; acknowledge emotion; and demonstrate active listening by using the child's or family's own words.

A nurse is preparing to teach insulin administration to an adolescent newly diagnosed with diabetes. Which strategy(ies) will the nurse use to assist the adolescent's learning? Select all that apply. a. Go slow and repeat information often. b. Use plain nonmedical language to explain procedures. c. Deliver the material in an educational lecture format. d. Teach the prioritized information. e. Use the accurate medical terms in the presentation.

a. Go slow and repeat information often. b. Use plain nonmedical language to explain procedures. d. Teach the prioritized information. Techniques that can help improve learning include: slow down and repeat information often; repeat important information at least four or five times; speak in conversational style using plain, nonmedical language; group information and teach it in small amounts using logical steps; and prioritize information first. Teach using an interactive, "hands-on" approach.

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? a. Have the client tell the primary care provider about this therapy. b. Reprimand the client for using anything during pregnancy. c. Record the suspicions in the client's medical record. d. Have the client show the nurse what she is using.

a. Have the client tell the primary care provider about this therapy. The nurse should always encourage clients to discuss the use of any unprescribed therapy with their primary care provider, as some therapies are contraindicated and may increase the risk of harm to the mother and infant. Some CAM substances are harmful during pregnancy and must be avoided. It is also important that clients research reputable sources for their information. Some substances will cross the placenta and have the potential to reach the fetus. It is extremely important that the nurse remain reflective, nonjudgmental, and open-minded about CAM. Action needs to be taken. Recording the suspicion is not enough.

The nurse takes on many roles, especially in the community setting. One important role of the nurse in the community is educator. Client and family education allows for which actions? Select all that apply. a. allows families and clients to make informed decisions b. ensures the presence of basic health care skills c. promotes recognition of problem situations and their appropriate responses d. causes families and clients to feel helpless and powerless e. allows for questions to be answered

a. allows families and clients to make informed decisions b. ensures the presence of basic health care skills c. promotes recognition of problem situations and their appropriate responses e. allows for questions to be answered Overall, client and family education allows clients and families to make informed decisions, ensures the presence of basic health care skills, promotes recognition of problem situations, promotes appropriate responses to problems, and allows for questions to be answered. Through client education, clients can overcome feelings of helplessness and powerlessness and gain the confidence to be active members in their plan of care.

The nurse is teaching students about the benefits of complementary and alternative medicine (CAM). What are examples of CAM? Select all that apply. a. aromatherapy b. therapeutic touch c. acupressure d. medication therapy e. guided imagery

a. aromatherapy b. therapeutic touch c. acupressure e. guided imagery CAM is used widely by people in all areas of the community and is used more often by women than men. Some examples include aromatherapy, homeopathy, acupressure, feng shui, guided imagery, reflexology, therapeutic touch, herbal medicine, and spiritual healing.

The nurse who works in the community understands the importance of becoming culturally competent. Which of the following are steps to gain cultural competence? Select all that apply. a. cultural self-awareness b. cultural knowledge c. replacing one's own cultural identity d. cultural skills e. cultural encounters

a. cultural self-awareness b. cultural knowledge d. cultural skills e. cultural encounters Nurses working in the community need to develop cultural competence. Steps to gaining cultural competence include cultural self-awareness, cultural knowledge, cultural skills, and cultural encounters. Cultural competence does not mean replacing one's own cultural identity with another, ignoring the variability within cultural groups, or even appreciating the cultures being served. Instead, nurses skilled at cultural competence show a respect for difference, an eagerness to learn, and a willingness to accept multiple views of the world.

A pregnant woman with premature ruptured membranes is trying to decide whether home care might be the best option for her. Which advantage should the nurse mention to the client that is most pertinent to her condition? a. decreased exposure to infection b. prevention of disruption of the family c. lower cost for the health care delivery system d. prevention of social isolation

a. decreased exposure to infection There may be an advantage of placing women with premature ruptured membranes on home care rather than hospital care because of the decreased exposure to infection in their own homes compared to hospitals. Although prevention of disruption to the family and lower cost for the health care delivery system may be advantages, they are not the most pertinent to the client's condition. Home care would be more likely to cause social isolation than prevent it.

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? a. encouraging the client to let the primary care provider know b. scolding the client for jeopardizing herself and baby c. documenting the statement in the client's medical record d. asking her about the remedy to ensure she is using it correctly

a. encouraging the client to let the primary care provider know The nurse should always encourage clients to discuss the use of any unprescribed therapy with their primary care provider, as some therapies are contraindicated and may increase the risk of harm to the mother and infant. Some CAM substances are harmful during pregnancy and must be avoided. It is also important that clients research reputable sources for the information. Some substances will cross the placenta and have the potential to reach the fetus. It is extremely important that the nurse remain reflective, nonjudgmental, and open-minded about CAM. The nurse needs to do more than just document the information.

The nursing student demonstrates an understanding of what is included in postpartum home visits when the student identifies which actions? Select all that apply. a. monitoring the physical and emotional well-being of the family members b. administering all of the newborn vaccinations c. identifying potential or developing complications for the mother and newborn d. bridging the gap between discharge and ambulatory follow-up for mothers and their newborns e. performing any home cleaning that the mother cannot perform

a. monitoring the physical and emotional well-being of the family members c. identifying potential or developing complications for the mother and newborn d. bridging the gap between discharge and ambulatory follow-up for mothers and their newborns Home visits give the nurse an opportunity to assess the family's adaptation and dynamics and the home environment. Postpartum care includes monitoring the physical and emotional well-being of the family members, identifying potential or developing complications for the mother and newborn, and bridging the gap between discharge and ambulatory follow-up for mothers and their newborns. Administering all of the newborn vaccinations is not feasible as they are numerous and are scheduled at different intervals and are not given in the home but instead in a primary care provider's office or clinic. The nurse does not perform any home cleaning for the family.

A nurse is presenting a program for a group of nurses new to providing home care to women and their families. After presenting the information, the nurse determines that additional discussion is needed when the group identifies which action as a nursing responsibility in the home? a. prescribing needed medications b. providing direct client care c. performing client education d. advocating for the client's needs

a. prescribing needed medications Home care focuses on minimizing the effects of the illness or disability along with providing the client with the means to care for the illness or disability at home. Nurses in the home care setting are direct care providers, educators, advocates, and case managers.

The nurse is instructing a young woman who wants to get pregnant on the use of folic acid supplement three months before and three months after conception. This is an example of which level of prevention? a. primary b. secondary c. tertiary e. all of the above

a. primary Taking folic acid is an example of primary prevention. Taking it three months before and at least three months after conception will help prevent neural tube defects such as anencephaly and spina bifida.

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? a. to ensure that the woman is not engaging in activities that would disrupt her rest b. to learn about the client's hobbies c. to pick up tips to pass on to other clients who are on bed rest d. to build rapport with the client

a. to ensure that the woman is not engaging in activities that would disrupt her rest If bed rest is required, ask how the client occupies her time. A woman is not really resting if she is concerned about her family or finances, is caring for older children, or is so bored that she is frequently turning or sitting up. The other answers are legitimate reasons for asking the question but are not the best rationale for it.

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? a. Tell the client to have someone inspect her nipples to see if she is right. b. Arrange for a home visit from a lactation consultant. c. Advise the client to nurse less frequently and pump between feedings. d. Suggest to the client that she should change her brand of body wash.

b. Arrange for a home visit from a lactation consultant. This client needs a skilled lactation consultant to personally assess this situation. Suggesting remedies without further assessment constitutes improper nursing care. An unskilled friend can miss signs of infection and does not have the evidence-based practice knowledge needed to best help this client.

How can the nurse assist with achieving National Health Goals when caring for a woman with placental previa at 28 weeks' gestation who is on bed rest? a. Inform the client that if she continues to get out of bed, she will lose the baby. b. Educate the client on the benefits of bed rest for the pregnancy and access community resources to assist her with compliance. c. Inform the mother that she must have someone come into the home to live with her until after the baby is born. d. Educate the mother that she will need to be in the hospital for the duration of the pregnancy if she is not compliant with care at home.

b. Educate the client on the benefits of bed rest for the pregnancy and access community resources to assist her with compliance. National Health Goals are concerned with reducing complications of pregnancy, both by better monitoring and preventing complications during pregnancy. Nurses can help the nation achieve these goals by helping women better accept and adhere to home care if it is advised during pregnancy.

Which statement is not an advantage of home care? a. It prevents extensive disruption of the family unit. b. It can increase self-confidence because it allows sick people to rest while others take care of them. c. Families can be better assessed in their own environment than in an agency because family interactions, values, and priorities are more obvious than in a health care setting. d. Home visits provide a private, one-on-one opportunity for health teaching.

b. It can increase self-confidence because it allows sick people to rest while others take care of them. Home care can increase a woman's or child's self-confidence because it allows for more self-care and often more control of circumstances. The other statements are true.

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? a. Communication b. Nursing process c. Teaching d. Case management

b. Nursing process The nursing process serves as the foundation of nursing care in the community, just as it does in a health care facility. Communication and teaching are parts of the nursing process. Case management is necessary to coordinate care and implement the nursing process.

A school nurse informs parents that a screening for lice will be conducted on all first graders the following week. Which type of prevention is this nurse conducting? a. Primary prevention b. Secondary prevention c. Tertiary prevention d. It is not a preventive measure.

b. Secondary prevention Primary prevention is health-promoting activities that help prevent the development of illness or injury. Secondary prevention is health-screening activities that aid in early diagnosis and encourage prompt treatment before long-term negative effects arise. Tertiary prevention is health-promoting activities that focus on rehabilitation and teaching to prevent further injury or illness and occurs in special settings. Screening is a preventive measure.

The obstetrical nurse notes that a Muslim client has not been eating any of the meals supplied to her. Which actions performed by the nurse best demonstrate cultural competence? a. The nurse recognizes that Muslim clients do not have an interest in food. b. The nurse becomes familiar with the Muslim client's meal practices. c. The nurse recognizes that Muslim clients prefer rest, which encourages appetite. d. A referral will be made to the dietitian to assess the Muslim client's preferences.

b. The nurse becomes familiar with the Muslim client's meal practices. The steps to developing cultural competence is to acquire cultural knowledge about the group. Nurses can obtain this knowledge by reading about different cultures, attending continuing education courses on different cultures, accessing websites, and attending cultural diversity conferences. It is not true that after delivery Muslim clients have no interest in food nor is it true that rest will encourage appetite. A referral is not always necessary, as the nurse should be able to coordinate foods that the client will eat after discussing with the client.

A client with hypertension tells the nurse about wanting to use an herbal substance to lower blood pressure instead of taking the antihypertensive medication. The nurse should: a. tell the client that if choosing to use the herbal substance, check the blood pressure daily. b. advise the client to speak with the health care provider about combining herbal substances with the prescribed medication. c. tell the client that using herbal substances is dangerous and should not be done. d. show the client how to take blood pressure so the client can monitor it closely.

b. advise the client to speak with the health care provider about combining herbal substances with the prescribed medication. The nurse should ensure that the client speaks with the health care provider. Clients who are being treated with conventional medication therapy should be advised about using herbal substances because they may lead to unknown interaction effects.

A pregnant teen at 32 weeks' gestation is receiving home care because of elevated blood pressure. She has been prescribed bed rest and a low-sodium diet. Because this is the client's first pregnancy, what other information is a priority that the nurse should include in her teaching? a. name choices for the baby b. birth education c. birth control options d. importance of continuing her education

b. birth education A home care visit can provide many opportunities for one-on-one teaching. An important part of teaching for a pregnant woman is providing birth education because a woman on bed rest cannot attend formal classes.

Nursing students are learning about using a family-centered approach to achieve positive outcomes. This family-centered care refers to which action? a. preventing illness and improving health of populations b. collaborating among the individual, family, and caregivers to determine goals, share information, offer support and formulate plans for health care c. providing care to a large population or potential at-risk clients d. none of the above

b. collaborating among the individual, family, and caregivers to determine goals, share information, offer support and formulate plans for health care Family-centered care refers to the collaborative partnership among the individual, family, and caregivers to determine goals, share information, offer support, and formulate plans for health care. Community health nursing focuses on preventing illness and improving the health of populations and communities. In community-based care, the community is the unit of service and the providers are concerned for the clients who seek service, but also with the larger population of potential or at-risk clients.

At a prenatal class, the nurse is told by a client that her mother advises her not raise her hands above her head during pregnancy in order to avoid umbilical cord problems. What is the nurse's best response? a. "This really isn't a worry as your mother's advice is not true." b. "This is a health promotion strategy recommended to avoid harm to the baby." c. "This is a belief from your mother's culture about what to avoid during pregnancy." d. "This belief of your mother's is not evidenced based."

c. "This is a belief from your mother's culture about what to avoid during pregnancy." Using a family-centered approach is associated with positive outcomes. Communication between the health care team and the family is also improved, leading to greater satisfaction for both health care providers and health care consumers (families). It is important for nurses to remain neutral to all they hear and see in order to enhance trust and maintain open communication lines with all family. Dismissing her mother's advice in a negative way will not enhance the nurse-client relationship. It is a cultural belief that harm would come to the fetus by a pregnant woman raising her arms over her head during pregnancy.

A 40-year-old pregnant client tells her nurse that she would like to give birth in a birthing center because she wants several friends and family members to be there and will have more freedom at the center. What would be the most important factor for the nurse to point out when discussing this option with the client? a. Birthing centers allow the client to eat and move around during labor. b. Birthing centers allow the client to give birth in any position. c. Birthing centers do not always have pediatricians on staff if the newborn has special needs. d. Birthing centers limit the number of friends and family who can attend the birth.

c. Birthing centers do not always have pediatricians on staff if the newborn has special needs. With this particular client, the nurse should point out that many birthing centers do not have pediatricians on site. The nurse should include all information related to birthing centers, such as the freedom to eat, move around, and give birth in any position so that the client can make the best decision. Birthing centers do not limit the number of friends and family who can attend the birth.

A nursing instructor is teaching the class about community-based nursing. The instructor determines the session is successful when the students correctly choose which activity as an example of tertiary prevention? a. Caring for new mothers and infants in a maternity clinic b. Identifying a child with pediculosis in an elementary school c. Ensuring the client attends physical therapy after orthopedic surgery d. Reviewing dietary habits with parents of a slightly anemic child

c. Ensuring the client attends physical therapy after orthopedic surgery Tertiary prevention focuses on rehabilitation activities and would be the focus of a nurse in an orthopedic clinic, aligning with the needs of the clients in that clinic. Orthopedic clients are typically recovering from injury or surgery and are in need of rehabilitation such as physical therapy. Secondary prevention includes health screening activities that aid in early diagnosis and encourage prompt treatment, such as screening for head lice in schools and reviewing dietary habits in individuals who are experiencing anemia. Primary prevention includes health promoting activities to prevent the development of illness or injury, such as new mothers bringing their infants to the clinic for follow-up well-child appointments.

A nurse is planning to provide home care to a family. The nurse assesses the client's community based on which rationale? a. It allows the nurse to treat many people at once. b. It facilitates the nurse's exposure to different cultures. c. It can reveal if there are aspects about a community that contributed to an illness. d. It can help the nurse find resources that the client may need during recuperation.

c. It can reveal if there are aspects about a community that contributed to an illness. Community assessment can reveal if there are aspects about a community that contributed to an illness (and therefore need to be corrected) and determine whether the person will be able to return to the community without extra help and counseling after recovering from an illness.

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? a. Provide care based on insurance coverage. b. Teach and supervise caregivers. c. Provide direct client care. d. Act as a liaison between health care provider and family.

c. Provide direct client care. The primary focus of home care nursing is to provide direct care. Teaching and supervising caregivers and acting as a liaison between the health care provider and family are additional functions of the home care nurse that support the direct care. The nurse should be aware of potential insurance restrictions so that other options may be explored if insurance will not cover specific treatments or medications that the health care provider has determined essential to the client. In these instances, the nurse can then act as the advocate to help find the necessary resources the client may need.

A public health nurse is preparing to visit the home of teenage parents with a new infant. Which action would be the priority? a. Determine the family's willingness for home visits. b. Prepare a schedule of follow-up visits. c. Review previous home visits to validate interventions. d. Review the family record to assess if the visit is necessary.

c. Review previous home visits to validate interventions. It is essential to review previous interventions to eliminate unsuccessful ones. Checking with previous home visit narratives will validate interventions. It would be necessary to communicate with previous nurses to ask questions and clarify. The other actions would not be the priority.

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? a. The nurse may not like it and choose to move before settling too deeply in the community. b. The workplace may implement alternate methods of treatment than the ones the nurse is used to employing. c. The health of a community influences the health of its individuals. d. It is not necessary for the nurse to become familiar with the community prior to treating the individuals there.

c. The health of a community influences the health of its individuals. Because the health of a community influences the health of its individuals, it is important for the nurse to become acquainted with the community in which he or she practices. Community assessment can reveal aspects of a community that may have contributed to an illness and help determine whether a person will be able to return to the community without extra help and counseling after recovering from an illness.

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? a. The home visit places the newborn at risk of acquiring an infection from the nurse. b. The home visits are much more cost-effective than office visits. c. The home visit is a way of monitoring the well-being of all family members. d. The home visits are essential only for those clients in high-risk situations.

c. The home visit is a way of monitoring the well-being of all family members. Home visits offer services similar to those offered at a scheduled clinic visit, but they also give the nurse an opportunity to assess the family's adaptation and dynamics and the home environment. The other statements do not indicate the best understanding of home visits.

The 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? a. The nurse discusses with the client how to avoid her partner's triggers. b. The nurse asks the client to enroll in a self-defense class. c. The nurse contacts the crisis social worker for assistance. d. The nurse refers the client for an orthopedic assessment.

c. The nurse contacts the crisis social worker for assistance. Tertiary prevention is designed to reduce or limit the progression of a permanent, irreversible disease or disability. Contacting a crisis social worker for immediate assistance is an example of tertiary care. The purpose of tertiary prevention is to restore individuals to their maximum potential. Tertiary prevention measures are supportive and restorative. When working with women who have suffered long-term consequences of violence, client education is the cornerstone of all disease management programs. The focus of the nurse would be to maximize the woman's strengths through education, to help her recover from the trauma and loss, and to build support systems. The other options are not examples of tertiary prevention.

The nurse is asked to present an educational event to the local Junior League. While planning for the event, what is most important for the nurse to do? a. Ask questions about the histories of those present. b. Use posters that everyone in the group can read. c. Tell the participants about the nurse's background. d. Know the needs of the audience.

d. Know the needs of the audience. To teach a group successfully, it is important to know the needs of the target population and to have the appropriate teaching skills, strategies, and resources. Asking questions about the histories of those who will be attending the event comes under the category of the targeted group's demographics. While it is important to have these facts, it is not most important for the nurse to know. Using posters that everyone can read is part of the presentation strategy of the nurse, but it is not most important. Telling those present at the event a brief synopsis of the nurse's background is usually done by whomever introduces the nurse as the speaker. It is not usually an activity the nurse does herself or himself.

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? a. Providing care for the client as an individual b. Tracking reportable diseases c. Keeping clients with chronic illnesses in their homes d. Preventing disease and its sequelae

d. Preventing disease and its sequelae Community-based nursing focuses on prevention and is directed toward persons and families within a community. Community-based nursing is holistic in nature and provides care for the client as part of a family and community, not just as an individual. It strives to keep clients with chronic illnesses in their homes, but that is not the focus of the care provided. A function of community-based nursing is reporting and tracking reportable diseases; again, that is not the focus of community-based nursing.

The nurse is caring for several clients in the prenatal clinic. Which action by the nurse demonstrates cultural competency? a. The nurse reminds the clients the clinic is not open on Sundays. b. The nurse requests that non-family members wait in the waiting room while the client is evaluated. c. The nurse informs each client of the clinic hours, phone number, and after-hours emergency number. d. The nurse asks each client about dietary restrictions and preferences during the postpartum period.

d. The nurse asks each client about dietary restrictions and preferences during the postpartum period. Providing culturally competent nursing care involves seeking to understand the impact the client's culture will have on the client's beliefs, values, care, and actions. Because each culture varies, the nurse must ask the client for specific needs and wishes as they relate to the upcoming birth/postpartum stay in the hospital or home. Giving the clinic information to each client should be done regardless of culture. Asking non-family members to wait in the waiting room may go against some cultural beliefs concerning who is important to the client; the nurse should assess this first.

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? a. Women have more health problems during their reproductive years. b. Increased stress causes more health problems during their reproductive years. c. A woman's immune system weakens immediately after birth. d. Women's health care needs change with their reproductive goals.

d. Women's health care needs change with their reproductive goals. The nurse should inform the women that comprehensive community-centered care should be given to women during their reproductive years. This is because as their reproductive goals change, their health care needs change as well. A woman's immune system does not weaken immediately after birth. Similarly, women do not have more health problems specifically during their reproductive years, nor are they more susceptible to stress during their reproductive years.