Chapter 4: Health of the Individual, Family, and Community
The nursing student asks the instructor to explain what a community is. Which statement by the instructor would be inappropriate?
"Communities have few effects on the health of the individuals that live there."
The nurse is admitting a 38-year-old male client to the oncology unit whose religious background is different from her own. The nurse is assessing how the client's religion may affect his health care needs. Which question by the nurse is the best way to consider the client's religious practices in the plan of care?
"What can we do to help you meet any religious needs you may have?"
The nurse is explaining the expected developmental tasks of a typical family with adolescents. Which of the following would be incorrect for the nurse to include?
Adjustment to retirement
The parents of a blended family have a baby boy age six months who is due for immunizations. The clinic closest to their home has recently closed, and they feel intimidated by the prospect of going to the large, university hospital near their home. Which of the following factors is the primary influence on this aspect of the family's health?
Community health care structure
Which nursing diagnosis is the priority according to Maslow's hierarchy of basic needs?
Constipation related to decreased mobility
The nurse is planning interventions to promote the health of a family with young children. Which family task does the nurse need to consider when planning interventions?
Coping with loss of energy and privacy
A community health nurse is providing care to several farming families in a rural community. Which of the following would be most important for the nurse to integrate into the plans of care for these families?
Family structures may change over time.
The nurse is assessing a family parented by a 60-year-old grandmother and her three school-age grandchildren. The nurse is aware that which problem may occur in a single-parent family at a greater level than in other types of families?
Increased financial concerns
A family that consists of two homosexual parents and three children living in the same house is an example of which type of family?
Nuclear
The nurse enters the client's room in the acute care unit immediately after he experiences a generalized tonic-clonic type seizure in bed. What is the first action the nurse should take?
Position the client in a side-lying position.
The nurse is taking care of a female client who is scheduled for a mastectomy. The client tells the nurse that she is apprehensive about the operation and asks the nurse to read a passage from the Koran to help her prepare herself for surgery. Which action by the nurse is the most appropriate?
Read the Koran passage to the client.
A 44-year-old female client is being treated for dehydration in an acute care hospital. The nurse determines that the rehydration treatment is working by assessing which of the following values?
Urine output of 1500 ml in 24 hours
The nurse receives a client assignment. Which client should the nurse see first?
client admitted with pneumonia, who is restless and diaphoretic with an oxygen saturation of 90%
A new graduate nurse asks a nurse manager working at the community health center, "I've heard people talk about community health nursing and community-based nursing. Is there a difference?" Which response by the nurse manager would be appropriate?
"Community health nursing involves care for entire populations whereas community-based nursing focuses on individuals and families in that population."
A nurse is planning education on self-administration of insulin to the client and his family members. The client asks the nurse why the family members are also included in the teaching. What should the nurse's response be?
"Family members are equally involved in planning and implementation of care."
A nurse working with patients in a community is aware that which of the following is a true statement related to environmental factors in that community?
Barriers to accessing health care within a community may include lack of transportation
A client says, "I live in a small community on the northwest side of the city." Why does the nurse consider it significant that the client reports living in a community rather than a neighborhood?
Community indicates people who share similar characteristics.
A nurse is developing a plan of care for a client to meet the client's self-actualization needs. The nurse would focus on which area as most important?
Emphasizing the client's strengths
The epidemiology nurse finds a lower occurrence of influenza cases in a section of a large metropolitan city. Further research reveals higher influenza immunization rates in that section of the city. The nurse determines which probable cause for this occurrence?
Immunization has become a community norm.
A couple with adolescent children is most likely to focus on which of the following developmental tasks?
Strengthening marital relationships
In conjunction with the client, the nurse has set the following client outcomes. Which client outcome reflects Maslow's level of self-esteem needs?
The client will verbalize feelings of increased confidence in performing a finger-stick blood
Which client requires priority intervention when providing care on a medical-surgical unit?
a postsurgical client who is feeling dizzy with a heart rate of 45/bpm
Nursing, as a profession, has long held the belief that providing nursing care to an individual patient means providing nursing care to the entire family. What does this mean when put into a holistic framework of patient care?
Active participation by individuals and families in health promotion is integral to this framework of patient care.
The nurse has developed a strong therapeutic partnership with a 44-year-old electrician who suffered severe burns while working on an industrial site. Which of the nurse's following actions most directly addresses the patient's self-actualization needs?
Discussing the patient's strengths and dialoguing with him about his body image
A nurse is assessing a family and identifying where the family is in the family life cycle. During this assessment, the nurse applies Duvall's theory. Which theory forms the basis for Duvall's theory?
Erikson's theory of psychosocial development
The nurse is assessing the family structure of the client. The family household is comprised of two parents, three children, and one grandparent. The nurse recognizes that this is a(n):
Extended family.
The nurse is aware that basic client needs must be met before a client can focus on higher ones. According to Maslow's hierarchy of human needs, which example would be the highest priority for a client after physiologic needs have been met?
Grab bars are installed in a client bathroom to facilitate safe showering.
A nurse is developing a plan of care for a client to meet the client's self-actualization needs. The nurse would focus on which area as most important?
Emphasizing the client's strengths
The community environment affects the well-being of the individual and the family. Which of the following is the health responsibility of the family?
Maintain a healthy lifestyle
The nurse is conducting a family assessment of a traditional family. Which assessment data cue describes the socioeconomic status of the family?
The father is an engineer and the mother is an elementary school teacher.
Which of the following theorists supports the developmental framework of family assessment?
Duvall
The nurse assesses a client who is postoperative day 1 following a total abdominal hysterectomy. Assessment data includes BP 150/88 mm Hg, HR 100/bpm, RR 22/min with a pain scale of 8 out of 1-10. The abdominal dressing in clean, dry, and intact. The client's orders indicate ambulation today. Which is the priority nursing action?
Medicate the client for pain.
The nurse provides the mother of a toddler with the phone number for the Poison Control Centre. Which level of Maslow's hierarchy of needs is the nurse addressing?
Safety and security needs
A couple with adolescent children is most likely to focus on which of the following developmental tasks?
Strengthening marital relationships
Which intervention performed by the nurse is most appropriate for assisting a client in meeting safety and security needs based on Maslow's Hierarchy of Needs?
Providing the mother the phone number for the Poison Control Center
A nurse is caring for an adolescent who lost a leg in a motor vehicle accident. Which human need would the nurse most likely need to address?
Self-esteem needs
The nurse is assessing a family parented by a 60-year-old grandmother and her three school-age grandchildren. The nurse is aware that which problem may occur in a single-parent family at a greater level than in other types of families?
Increased financial concerns
The nurse recognizes that many factors place the family at increased risk for altered health. Which items represent lifestyle risk factors for altered family health? Select all that apply.
Ingestion of high fat foods Smoking by parents Inadequate dental hygiene
The home health nurse is making an initial assessment visit to a family that consists of two parents and twin 3-year-old boys. During the interview, the nurse is most concerned if the client makes which statement?
The father states, "I don't discuss money matters with my wife because I don't want her to
A nurse is providing care to a client who is feeling lonely and isolated. In an effort to develop a trusting nurse-client relationship, the nurse exhibits a caring attitude, ensures the client's privacy, and spends time with the client to promote therapeutic communication. The nurse is meeting which category of client needs?
Love and belonging
The nurse performs an assessment of the client and the family to have a better understanding of client and family needs. Which of the following is an individual need?
Safety
A client is admitted to the emergency department following a tornado in which multiple people were killed or injured. The nurse applies direct pressure to an open wound on the client's thigh while assuring the client that the weather has cleared. Which of Maslow's basic human needs is the nurse addressing with the actions? Select all that apply.
Physiologic Safety and security