MCN - Unit 1 - Chapter 2: Family-Centered Community-Based Care

A couple had decided not to circumcise their newborn for nonreligious reasons. What is the appropriate response from the nurse? "OK, great. I will let the physician know." "What arrangements have you made outside the hospital?" "That's very unusual; tell me what has led you to this decision." "It's much better for the health of your newborn if you circumcise him."

"OK, great. I will let the physician know." The nurse should remain as nonjudgmental as possible when speaking with a client. There are many reasons why a couple may decide to leave their newborn uncircumcised. Both health benefits and risks are associated with circumcision. The nurse should respect the couple's decision.

An 11-year-old child is brought to the clinic by the parent who reports the child has had declining school performance and behavior issues since learning that the parents were divorcing. What is the most appropriate advice that the nurse can provide to the parent? "Remind your child that you are the stronger parent and will protect him more than your spouse." "Be sure to include your child in conversations about your upcoming financial struggles." "For stability, encourage your child to pick which parent he wishes to live with after the divorce." "Tell your child the divorce is not because of him and repeat this reminder as often as you can." "Encourage your child to read books about coping after divorce."

"Tell your child the divorce is not because of him and repeat this reminder as often as you can." Children suffer many emotions during the divorce of their parents, which may result in poor behavior and school concerns. Both parents are advised to remind the child often that they are not divorcing because of the child. The reinforcement of this message is of great importance. The parent would be advised to avoid taking the role of superior parent; avoid including the child in conversations about adult concerns (such as finances); and not to expect or ask the child to take sides. Reading about divorce may be helpful, but it is foundational to the child's ability to move forward in this process that the child not feel responsible for the divorce and that the child recognizes he is loved by both parents.

A group of nurses are developing a teaching program on adolescent parenting for a high school child development class. Which factor would be most important for the educators to know prior to beginning the class? The number of participants Previous knowledge about parenting Age and gender of participants Income level and socioeconomic status

Age and gender of participants In order for a class to be successful, the educator needs to know group dynamics and demographics prior to beginning the class. The adolescents' age and gender are very important facts to know. It is not as important to know how many students are coming, their socioeconomic status or their previous knowledge about parenting.

A nurse is working with a culturally diverse patient population. Which strategy would the nurse most likely use to assist in recognizing cultural influences on pain perception? Select all that apply. Appreciate that the meaning of pain varies among cultures. Appreciate that not all people communicate or express their level of pain in the same way. Recognize that communication of pain may not even be acceptable within a culture. Assume that everyone who is in pain will behave like they are in pain. Develop an awareness of personal values and beliefs. Use an assessment tool (e.g., rating scale from 0 to 10) to assist in measuring the pain. Remember that if someone is in enough pain, he or she will inform others.

Appreciate that the meaning of pain varies among cultures. Appreciate that not all people communicate or express their level of pain in the same way. Recognize that communication of pain may not even be acceptable within a culture. Develop an awareness of personal values and beliefs. Use an assessment tool (e.g., rating scale from 0 to 10) to assist in measuring the pain. Strategies to help recognize cultural influences on pain perception are to appreciate that the meaning of pain varies among cultures; appreciate that not all people communicate their level of pain the same way; recognize that communication of pain may not even be acceptable in a culture; develop an awareness of personal beliefs and your responses; and use an assessment tool to measure the degree of pain. The nurse should never assume that everyone will act like they are in pain, nor should he or she think that all people in pain will inform the nurse.

The nurse joins a work group focused on increasing the numbers of persons counseled about their health behaviors. Which action(s) will help the group achieve this goal? Select all that apply. Assessing the health learning needs of women, children, and their families Planning health care education in collaboration with clients and their families Providing health education at each client encounter Developing materials and programs that are culturally competent Providing bedside materials in the appropriate language

Assessing the health learning needs of women, children, and their families Planning health care education in collaboration with clients and their families Providing health education at each client encounter Developing materials and programs that are culturally competent Providing bedside materials in the appropriate language To increase the proportion of persons appropriately counseled about health behaviors, the work group will need to take multiple steps. They will assess health learning needs of women, children, and their families; plan health care education in collaboration with clients and their families; and provide health education at each client encounter. The work group will also need to take steps to provide culturally competent care. They will develop materials and programs that are culturally competent and provide bedside materials in the appropriate language.

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

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.

The home care nurse is visiting a client and family for the first time. Which initial action can the nurse take to build trust with the client and family? Inform the client who will have access to the medical record. Communicate in an organized and professional manner. Assist the client in making informed health care decisions. Validate the client's feelings of frustration and anger.

Communicate in an organized and professional manner. Communicating with the client in an organized and professional manner displays a level of competence by the nurse that promotes trust and respect. Next, the nurse will also want to inform the client who will have access to the medical record to build confidentiality and promote security.

The home care nurse visits a pregnant client who speaks very little of the dominant language. At this visit her spouse, who is fluent in the dominant language, is not present. Which intervention is most appropriate? Continue with the visit and call the spouse later. Cancel the visit and reschedule for another time. Wait at the client's home for the spouse to return. Call for a telephone interpreter and conduct the visit.

Call for a telephone interpreter and conduct the visit. The nurse should call for an interpreter to be used over the phone and continue with the visit. The nurse is not aware of a return time for the spouse and could potentially delay other visits on the schedule.

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

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 nurse is teaching a new mother about self-care measures. Which action would the nurse do as the final step in this process? Document the teaching and effectiveness. Reassess the teaching plan. Develop goals for the future. Reinforce positive behavioral changes.

Document the teaching and effectiveness. The steps of client and family education are similar to the steps of the nursing process: the nurse must assess, diagnosis, plan, implement, and evaluate. Part of the evaluation process is to document all actions taken and outcomes achieved.

The nurse is preparing to teach a class on cultural differences to a group of clients from the community. Which principle of culture will the nurse consider while planning the class information? Individuals are born with an understanding of their specific culture. Culture is always centered around religious activities and beliefs. Each generation learns about culture from family and the community. Culture is determined by one's own morals and personal beliefs.

Each generation learns about culture from family and the community. Culture is a shared, not individual, system of beliefs, values, and behavioral expectations that provide social structure for daily living. Culture includes the beliefs, habits, likes and dislikes, and customs and rituals learned from family and the community through a process called enculturation. Individuals are not born with a sense or awareness of culture. Some cultures are heavily centered on religious practices and customs, however, all are not.

An 8-year-old with cystic fibrosis has had a noted decline on the growth chart. Which nursing intervention is best for maintaining adequate nutrition? Provide high caloric meals to the client's liking. Delay pancreatic enzymes until food enters the small intestine. Encourage high calorie, high protein snacks. Limit sodium to a 2 gram sodium restricted diet

Encourage high calorie, high protein snacks. The best nursing intervention is a high calorie, high protein snack. Calories can be obtained from non-nutritious foods. It is not only that the client needs calories for energy, but nutrition needs to be present. Pancreatic enzymes aid in digestion so they need to be available for foods; thus they are given prior to ingestion. Sodium is encouraged due to the high sodium loss.

The nurse is preparing to provide home care instructions to the family of a 2-year-old client recently placed on a ventilator. Which would be the priority consideration for the nurse? Family's available resources Health knowledge of the family Overall functioning of the family Identifying the primary caregiver

Identifying the primary caregiver The primary caregiver will have the most knowledge regarding the best strategies of care that will be most effective with the child. The primary caregiver will play an essential role in providing overall care to the child.

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

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.

Which concept characterizes transcultural nursing? Performing health-related activities and restoring wellness Acknowledging that clients with the same skin have similar social situations Planning care compatible with the client's health belief system Influencing culture by specific conditions related to an environment

Planning care compatible with the client's health belief system Planning care compatible with the client's health belief system is a characteristic of transcultural nursing. Acknowledging that clients with the same skin color have similar social situations leads to stereotyping. Stereotyping can be dangerous because it is dehumanizing and also interferes in accepting others as unique individuals. Culture is influenced by specific conditions related to environment. Performing health-related activities and restoring wellness is an important aspect of nursing and does not only pertain to transcultural nursing.

The charge nurse overhears another nurse state, "I do not like caring for clients from a culture different from my own." Which action by the charge nurse is appropriate? Privately discuss the comment with the nurse. Assign the nurse to care for clients with the same culture. Report the nurse to the nurse manager. Recommend the nurse attend a cultural competence class.

Privately discuss the comment with the nurse. The change nurse would first discuss the overheard comment with the nurse to ensure the context of what was heard and to get a better understanding of how to help the nurse. It is not appropriate for the nurse to only be assigned clients of the same cultural background. Reporting the nurse to the nurse manager or referring the nurse to a class does not take care of the current situation, nor does the charge nurse have enough information at this time for these actions.

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

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.

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

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.

A clinical nurse specialist is conducting a review class for a group of nurses about cultural competence and cultural diversity. Which term reflects the view of the world and set of traditions of a specific social group passed down through generations? culture race values ethnicity

culture Culture consists of the world view and group of traditions shared by a social group and passed down through generations.

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 education program health screening program health system referral telephone consultation

health system referral The nurse is passing along information about the location of and services offered for the client, an example of a health system referral. Health education programs assist clients in making health-related decisions about self-care and use of resources. Health screening programs focus on detecting unrecognized or preclinical illness among individuals such as mammography. Telephone consultation involves listening and providing support, information or instruction given over the phone, and documenting the interaction.

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? type of dwelling the family lives in amount of money the household makes number of people in the immediate family if the family can deal with the stress of home care

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.

A child is being discharged from the hospital with prescriptions for home health care and durable medical equipment. The nurse is providing instructions for home care. Before teaching begins, what should the nurse determine first? readiness to learn method of teaching language barriers capacity to learn

readiness to learn In completing a learning assessment, the nurse should first determine the readiness to learn. The family may be emotionally overwhelmed with problems and cannot learn at the time the nurse wants to teach. Many families have been providing care for sometime already and need little instruction and tune out if the nurse tries to reteach. Others may feel since home health is being provided they do not need the nurse to teach them anything. Every family is individual. The capacity to learn, language barriers and methods of teaching should all be addressed in a learning needs assessment, but if the family is not ready to learn then these factors are not necessary to consider.

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 ensuring better care and understanding helping in assessing client's culture building a better nurse-client relationship

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 is working to develop cultural competence. Which aspect would the nurse need to incorporate as the foundation for this concept? Respect Knowledge Empathy Technical skill

Respect Cultural competence, or respecting cultural differences, allows the nurse to plan culturally competent care and to integrate cultural elements into care.

The nurse educator has completed a presentation on caring for babies born to mothers with a substance use disorder. Which statement by a participant would indicate the need for further education? "Babies born to mothers with a substance use disorder tend to be small for gestational age." "When a pregnant woman suffers from a substance use disorder, the child may suffer from withdrawal symptoms when born." "Mothers with a substance use disorder are at a higher risk for having a child with physical abnormalities." "Babies born to a mother with a substance use disorder don't have any difficulty eating."

"Babies born to a mother with a substance use disorder don't have any difficulty eating." Babies born to mothers with a substance use disorder tend to be small for gestational age. They may also suffer from withdrawal symptoms and are at a higher risk for both physical and mental abnormalities. They may also suffer from problems eating, such as a decreased ability to suck. Some of the problems of the baby may not be immediately apparent, because these problems can also encompass cognitive and skill-attainment delays.

The primary health care provider has recommended a client consult a nutritionist for specialized care. The nurse, by providing a list of referrals to the client, is providing which service? Client advocacy Community-based nursing Primary care Secondary prevention

Client advocacy Client advocacy is speaking or acting on behalf of clients to help them gain greater independence and to make the health care delivery system more responsive and relevant to their needs. Community-based nursing focuses on prevention and is directed toward persons and families within a community. Primary care is the direct action of the primary care provider. Secondary prevention involves health screening activities that aid in early diagnosis and encourage prompt treatment before long-term negative effects occur.

While interviewing a Chinese man about his son's health, the nurse notices that the man keeps his eyes focused on the floor. What is the best action by the nurse? Continue with the interview. Stop and ask the man to elaborate about his anxiety regarding his son's care. Ask the man if he would like to continue the interview at a different time. Ask the man if anything is wrong.

Continue with the interview. For some Chinese Americans, it is not culturally acceptable to make eye contact while conversing; this can be seen as a cultural norm for this man. Continuing with the interview is the best response so as not to make him feel uncomfortable.

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

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 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? Arrange for her to have the HPV vaccination. Send a referral to social work for adequate housing assessment. Suggest she have a Papanicolaou test. Discuss with her the need for folic acid supplementation.

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.

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? allowing too little time for the translation of health care terms using a person who is not a professional interpreter asking the interpreter questions not meant for the family using a relative to communicate with the parents

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.

While taking a health history, the nurse finds out that the pregnant woman of Japanese descent comes from a culture that does not eat meat. Which foods will indicate sufficient protein intake? Select all that apply. beans and rice eaten every day stir-fried carrots and beans regularly egg drop soup 2 to 3 times per week dried fruit for dessert apples as a snack daily

beans and rice eaten every day stir-fried carrots and beans regularly egg drop soup 2 to 3 times per week A typical Japanese diet, for example, includes many vegetables such as bean sprouts, broccoli, mushrooms, water chestnuts, and alfalfa. Adequate protein is ingested, however, by mixing sources of incomplete protein such as beans and rice. Neither dried fruit nor apples will not meet protein needs.

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 to learn about the client's hobbies to pick up tips to pass on to other clients who are on bed rest to build rapport with the client

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 nurse encourages both partners in a lesbian family to come into the examining room with the newborn during a well-baby check. What type of nursing is the nurse practicing? community nursing transcultural nursing ethnic nursing stereotyping nursing

transcultural nursing Transcultural nursing is care guided by cultural aspects and respects individual differences. Community nursing is nursing care that takes place for a group of people in a specific area. Ethnicity refers to the cultural group into which a person was born. Stereotyping means expecting a person to act in a characteristic way without regard to his or her individual traits.

The term used to guide the cultural aspects of nursing care and respect individual differences is: diversity nursing. ethnicity nursing. family nursing. transcultural nursing.

transcultural nursing. Transcultural nursing is the nursing care method that is guided by cultural aspects and respects individual differences.

A child is seen in the pediatric clinic for update of immunizations prior to starting middle school. During the intake process the nurse asks the parents if the family is involved in any neighborhood or community activities. The parents ask the nurse, "What does that have to do with immunizations?" What is an accurate response by the nurse? "Our physician just likes to know what activities his clients are involved in." "We collect this data for our community health department statistics." "Based on research, our physician feels that better connection to community leads to better health in many ways." "This is a standard question that we ask all of our clients' families prior to starting middle school."

"Based on research, our physician feels that better connection to community leads to better health in many ways." Evidence suggests that the higher education and greater social capital present in a neighborhood or community are associated with positive health behaviors, so collecting this information can help the physician to better evaluate clients.

A nurse is providing care to a postpartum woman, her partner, and their neonate and is assessing their preparedness for discharge. Which question(s) would be appropriate for the nurse to ask? Select all that apply. "Are you having any pain or cramping?" "How comfortable are you with feeding your neonate?" "Can you tell me who will be at home to help you out." "Tell me how you plan to get rest once you are at home." "Are you feeling overwhelmed and tired?"

"How comfortable are you with feeding your neonate?" "Can you tell me who will be at home to help you out." "Tell me how you plan to get rest once you are at home." The key to assessing a family's preparedness for their new role as parents and in caring for their new neonate is for the nurse to ask open-ended questions in a sensitive manner to identify gaps in knowledge and areas of concerns. The questions related to the level of comfort in feeding the neonate, support persons, and plans for rest are open-ended and allow the woman to share feelings and concerns as well as help in identifying areas of needed instruction. The questions related to pain, cramping, feelings of being overwhelmed, and fatigue are closed-ended questions that do not allow the woman to elaborate. In addition, they focus on the nurse's concerns and not the woman's concerns.

A nurse is teaching an 18-year-old client about circumcision care for her second baby. Which statement made by the nurse would be most appropriate to assess the client's learning ability? "I notice you're having problems with reading the information. Will you tell me about this?" "Is it difficult having two babies to care for with you being a teenager?" "Can I help fill out the forms for government financial assistance for your family?" "Since leaving high school, have you been able to find employment?"

"I notice you're having problems with reading the information. Will you tell me about this?" The American Medical Association reports that poor health literacy skills are a stronger predictor of health status than age, income, employment status, education level, or racial/ethnic group. Poor health literacy leads to increased complications and increased mortality. The fact that the client is 18 years old and in a low socioeconomic situation are predictors of poor health, but finding out about her literacy level is a priority. The other questions will not determine her literacy ability.

The parents of a pediatric client tell the home care nurse, "The doctor says there is nothing more they can do for our son's cancer and that he will die. We do not want him to know, so please do not tell him." Which response by the nurse is best? "I must be honest with your son if he asks me." "I will contact the pastor; it is important that he knows." "I will not say anything to your son, but I will contact the doctor." "I think that it is important that you have a conversation with your son."

"I will not say anything to your son, but I will contact the doctor." The client is a minor and the parents are responsible for making decisions related to medical care; therefore, the nurse should respect the parent's request to not notify the client of the prognosis. However, the nurse should contact the primary care provider to confirm the diagnosis and update the plan of care if necessary.

While reviewing a woman's compliance with prenatal care, a nurse notes that which comment made by the woman may be a result of poverty rather than a cultural difference? "I just don't understand why I have to give up alcohol when I am pregnant." "In my culture, many women crave pica foods throughout the pregnancy." "I can't rest in the afternoon since I work all day, and then I have to pick my children up from day care." "I wish I could afford fresh fruits for vitamin C because I just don't remember to take those prenatal vitamins."

"I wish I could afford fresh fruits for vitamin C because I just don't remember to take those prenatal vitamins." Many characteristic responses described as cultural limitations are actually the consequences of poverty (e.g., parents seeking medical care for their children late in the course of an illness or a woman not taking prenatal vitamins during pregnancy). Solving these problems may be a question of locating adequate financial resources and may not be related to cultural differences. Reducing alcohol intake may be an addiction problem. Many women work when they are pregnant and cannot take an afternoon rest. Working may or may not be due to poverty, so the nurse will have to ask additional questions before concluding the woman lives in poverty.

A preterm newborn is to be discharged home on oxygen therapy and tube feedings. Which statement by the parents would indicate that they need additional teaching and preparation for this transition? "We'll make sure that we have enough feeding solution to get through the weekend." "We know how to check to make sure the feeding tube isn't clogged." "Our parents are going to take turns helping out at night so that we can get some sleep." "Our insurance company will pay for all the equipment that we need for the treatments."

"Our insurance company will pay for all the equipment that we need for the treatments." High-risk newborn home care involves all family members working together to provide 24-hour care. Managing supplies, trouble-shooting potential problems, and ensuring support are crucial to providing home care. Parents or caregivers must investigate and then negotiate with insurers for reimbursement of medical equipment and supplies. Insurers do not always cover all items necessary for care.

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. "You are correct since the focus of these courses is on pain management." "There are many different topics included in prepared childbirth classes aside from pain management." "Preparation for labor and birth can enhance your experience and coping abilities." "You can learn tools to assist you in the labor process both before and after your epidural." "You are limiting your options by not considering attending the classes."

"There are many different topics included in prepared childbirth classes aside from pain management." "Preparation for labor and birth can enhance your experience and coping abilities." "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.

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? "This really isn't a worry as your mother's advice is not true." "This is a health promotion strategy recommended to avoid harm to the baby." "This is a belief from your mother's culture about what to avoid during pregnancy." "This belief of your mother's is not evidenced based."

"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.

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 home birth is probably the most expensive setting for childbirth." "There are very rigid screening procedures that must be followed." "A wide range of pain medications is readily available to the woman."

"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.

A pregnant woman arrives in the L & D unit following premature rupture of membranes along with her spouse, who insists on being present and demands only female nurses assess his wife. When obtaining history and assessment data, the spouse provides all the answers. What is the best approach for the nurse to handle this situation? Call security and then inform the spouse that staff members need to speak with the woman alone. Evaluate whether it is essential to stand up to the spouse or pacify him. Educate the spouse about his expected role in the birthing process. Act as an advocate for the woman who has a male-dominant partner.

Act as an advocate for the woman who has a male-dominant partner. In many cultures, the man is the dominant figure. In a strongly male-dominant culture, if approval for hospital admission or therapy is needed, the man would prefer to give this approval. Since the woman is a nondominant member of the family, the nurse may have to act as an advocate for her with a more dominant partner. Security would be viewed as a threat and not appropriate at this time. To gain information from the woman, the nurse may need to confront the spouse about his role in the birthing process. It is not appropriate to educate the spouse because this is a long-standing family environment, and this is not the time to try to change the family culture toward females.

The nurse in a community health clinic wishes to make the client intake form (above) more inclusive of LGBTQ+ clients and families. What element(s) of the form should the nurse consider changing? Select all that apply. Add preferred pronouns to the form. Include both biological sex and gender on the form. Change mother and father to "parent/guardian." Add preferred name to the form. Add allergy section to the form.

Add preferred pronouns to the form. Include both biological sex and gender on the form. Change mother and father to "parent/guardian." Add preferred name to the form. Adding preferred pronouns and preferred name to the form ensures that the client is called by the name and pronouns that they identify with. Using parent/guardian instead of mother and father provides space for same-sex parents. Including both biological sex and gender allows for more clear identification of health needs (for example, need for Papanicolaou [Pap] test for a transgender man). An allergy section may be added to the form, but this does not promote inclusive practice for LGBTQ+ clients.

A woman in active labor begins to recite a lullaby to "call the baby outside." Which action by the nurse caring for this woman is most appropriate at this time? Administer IV pain medication. Allow the client to perform a ritual. Ask the woman the importance of this lullaby to her culture. Ask the family to join in with the singing of this lullaby.

Allow the client to perform a ritual. The nurse can acknowledge and celebrate a client's culture without stereotyping by such actions as ensuring that the client has the opportunity to perform her cultural traditions during labor, such as reciting a lullaby to "call her child outside." There is no indication that pain medication is needed at this time. When one respects the culture, quizzing about the purpose or importance of reciting this lullaby is inappropriate.

A woman is in the second stage of labor, 8-cm dilated and 90% effaced. She keeps very quiet without expressing any outward signs of pain. Which intervention by the nurse would be most appropriate in this situation? Administer pain medication without asking the woman. Allow the woman to labor according to her cultural beliefs. Monitor the woman to attempt to predict when it is time to push. Review the nursing goal to minimize the amount of pain with birth.

Allow the woman to labor according to her cultural beliefs. The way people respond to pain is an example of a trait that is heavily influenced by culture. Some women and children scream with pain; others remain stoic and quiet. Both are "proper" responses, just culturally different. The best nursing intervention is to allow the woman to labor the way that is best for her. Administering pain medication without permission is unacceptable nursing practice. The nurse will have to assess the woman frequently, especially noting if any blood is coming from the vagina and performing frequent vaginal exams to know when it is time to push. "A close watch" could mean just looking into the room frequently. In some cultures, being stoic is expected behavior, so minimizing the pain may not be the goal of the woman.

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? Home setting Birthing center Hospital Any birthing settings

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 providing care to a group of childbearing families from a different culture at the local family health clinic. Which action should the nurse prioritize? Adapt to the practices of the family's culture. Determine similarities between both cultures. Assess personal feelings about that culture. Ask the family to explain their culture.

Assess personal feelings about that culture. The first step is for the nurse to assess personal feelings about the culture. The nurse needs to develop cultural awareness, engage in self-exploration beyond one's own culture, see clients from different cultures, and examine personal biases and prejudices toward other cultures. Once this occurs, the nurse can learn a great deal about the culture to gain cultural knowledge and become familiar with similarities and differences between one's own culture and the family's culture. The nurse would adapt nursing care to address the practices of the family's culture to provide culturally competent care. The nurse could also ask the family about specifics that they follow in their family unit.

An expectant client asks the childbirth educator about the advantages of going to a birthing center for delivery. Which are the nurse's best responses? Select all that apply. Birthing centers are a good option for every pregnant client who wants this alternative. Birth centers are designed to be more home-like and comfortable with fewer interventions. Birth centers focus on pregnancy as a state of wellness and on women and families as a whole. The rate of cesarean delivery for clients who deliver in a birth center is less than for those who deliver in hospitals. Care is usually provided by midwives for pregnant clients with lower risk of complications. Birth centers have transfer agreements with local hospitals if complications occur.

Birth centers are designed to be more home-like and comfortable with fewer interventions. Birth centers focus on pregnancy as a state of wellness and on women and families as a whole. The rate of cesarean delivery for clients who deliver in a birth center is less than for those who deliver in hospitals. Care is usually provided by midwives for pregnant clients with lower risk of complications. Birth centers have transfer agreements with local hospitals if complications occur. Approximately 0.3% of births occur in independent birth centers, most of which are freestanding and not located in a hospital. Midwives attend most of these births. Birth centers are designed to be more home-like and comfortable and cater to women with low-risk pregnancies. Approximately 85% of women who are pregnant are eligible to deliver in a birth center rather than a hospital. Birth centers have standing transfer agreements with hospitals, and approximately 16% of women, 82% of whom are primigravidas, or infants are transferred to the hospital from the birthing center before, during, or after the birth. Birth centers focus on pregnancy as a state of wellness and on women and families as a whole. The rate of cesarean delivery for women choosing to deliver in a birth center is approximately one fifth that of women who deliver in hospitals, and neonate morbidity and mortality rates are equivalent to those of low-risk deliveries in hospitals.

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? Birthing centers allow the client to eat and move around during labor. Birthing centers allow the client to give birth in any position. Birthing centers do not always have pediatricians on staff if the newborn has special needs. Birthing centers limit the number of friends and family who can attend the birth.

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.

Today, families come in a variety of structures. Which statement best describes a blended family? All the adult relatives living in the household participate in raising the children and grandchildren. Both adults are custodial parents and bring their children to the family structure. The parents choose to legally take into their family structure a child who is not a biological child to either parent. Custodial parents live together and raise one parent's children as one family.

Both adults are custodial parents and bring their children to the family structure. The stepfamily consists of a custodial parent and children and a new spouse. If both partners in the marriage bring children from a previous marriage into the household, the family is usually termed a blended family. If there are adult relatives living in the household along with the parents and their children, it is termed an extended family. When parents legally take a non-biologic child into their home and raise it as their biologic child it is an adoptive family. When one or both of the adults in the household are custodial and they live together, raising their children as one family, it is termed a cohabitation family.

A woman arrives to the unit in active labor with her spouse and 7-year-old child. The woman and her spouse do not speak the dominant language, but the child does. Which action(s) by the nurse is appropriate? Select all that apply. Call the interpreter or use the interpreter phone. Ask the woman's child to translate until the interpreter arrives. Ask another nurse to switch assignments with you because the nurse speaks the woman's language. Use hand gestures to communicate until the interpreter phone is working. Speak very slowly in dominant language, and use pictures.

Call the interpreter or use the interpreter phone. Ask another nurse to switch assignments with you because the nurse speaks the woman's language. Use hand gestures to communicate until the interpreter phone is working. Culturally competent care includes attempting to overcome language barriers. However, it is not acceptable to have a child be responsible for translating pertinent medical information. This may also be unacceptable in some other cultures. The nurse should switch assignments with someone who speaks the client's language fluently or wait until interpreter services are available. Speaking loudly or slowly in a language the client does not speak is not an acceptable way to communicate. This may be seen as rude and insensitive.

The nurse is caring for a 7-year-old boy and his family, who are immigrants. Which intervention will most significantly affect the success of the care provided? Communicating with sensitivity using understandable terms Inquiring about common health problems in their home country Asking about transportation to the appointment Referring them to state and local aid programs

Communicating with sensitivity using understandable terms Being understood is essential to the provision of all nursing care. An interpreter may be needed. Speaking slowly and using simple terms is also useful. Inquiring about common health problems in their home country, asking about transportation, and helping them access aid programs are all secondary to and dependent upon effective communication.

The school nurse notes that a 10-year-old child has not had the required immunizations to attend classes. During discussion, the child states that his father lost his job and health insurance. What is the best action by the nurse? Have the student tell his parents that the school won't allow class attendance without required immunizations. Ask the student if there are any family members that might help with the expenses of immunizations. Contact the parents to inform them of the situation and community resources that can be utilized to obtain immunizations. Inform the child that there is a free immunization clinic the following day at the health department.

Contact the parents to inform them of the situation and community resources that can be utilized to obtain immunizations. Financial barriers, such as loss of a job and insurance benefits, can prevent obtaining health care. Contacting the parents would be necessary for a 10-year-old to ensure the information reaches the parents. Most communities have resources available for discounted or free immunizations.

A home care nurse is visiting a pregnant client from the Arab culture. During the health history the husband frequently answers questions for the client. How should the nurse respond? Continue with the health history. Stop the interview. Ask the husband to leave. Specifically ask the client to answer.

Continue with the health history. In being culturally aware the nurse will recognize that the client and her husband come from a culture that is a patriarchal structure. The nurse should continue with the health history.

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? Ask questions about the histories of those present. Use posters that everyone in the group can read. Tell the participants about the nurse's background. Know the needs of the audience.

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.

A community-based nurse is assessing the needs of a family of four, which includes a physically challenged 9-year-old. Which activity would the nurse prioritize to be an advocate for this family? Ensure case history is complete for all family members. Establish eligibility for assistive devices for child. Ensure the client follows physical therapy recommendations. Train the school nurse on the needs of the child.

Establish eligibility for assistive devices for child. Client advocacy is acting on behalf of the client. Making calls to arrange for special equipment is one role of a nurse who is acting on behalf of the client. A case history would be taken at the initial visit to the treatment center by the attending nurse. The client's progress in physical therapy is to be noted by the therapist or PT assistant. The community-based nurse should not have to train the school nurse but would share the needs of the child so that the school nurse is prepared to provide appropriate care.

A 4-year-old adopted child has begun to ask questions about when she was born. Which suggestions by the clinic nurse would be considered the most appropriate answer for this child related to her birth? Select all that apply. Explain to the child that she grew inside another woman, but after the birth she was given to her adoptive mom and dad to raise. Tell the child that her biological mom could not care for her after birth because she was HIV positive. Inform the child that her biological mom was in prison and would not be able to care for her for a long time. Explain that her biological mom could not care for her so she was given away. Avoid criticizing the biological parents but reinforce how much the adoptive mom and dad love them.

Explain to the child that she grew inside another woman, but after the birth she was given to her adoptive mom and dad to raise. Avoid criticizing the biological parents but reinforce how much the adoptive mom and dad love them. At least by 4 years, children are old enough to fully understand the story of their adoption: they grew inside the body of another woman who, because she could not care for them after they were born, gave them to the adopting parents to raise and love. It is important for parents not to criticize a birth mother as part of the explanation because children need to know, for their own self-esteem, that their birth parents were good people and they were capable of being loved by them, but things just did not work out that way. At age 4, children do not understand HIV status, not being able to provide for the needs of an infant, or prison terms.

The nurse is working with a same-sex couple, both of whom have children from previous relationships. Although the couple have no plans of marrying, they view their relationship as monogamous and long-term. Which family structure would apply to this family? Select all that apply. Gay or lesbian family Cohabitation family Blended family Extended family Foster family

Gay or lesbian family Cohabitation family Blended family As the members of the couple in this scenario are of the same sex, this is a gay or lesbian family. As the couple is not married, it is a cohabitation family. And as they each have children from previous relationships, it is a blended family. It is not an extended family, as it does not include extended family relations, such as grandmothers, grandfathers, aunts, uncles, cousins, or grandchildren. It is not a foster family, as the children are related biologically to at least one of the parents.

The nurse is providing an educational program for the staff working at a homeless shelter. The program is focused on the impact of homelessness on children. What information should be included in the presentation? Select all that apply. Homeless children are at an increased risk for sexual abuse. A short period of uncertain housing is not detrimental as long as the family are able to remain available. Homeless children are at risk for developing chronic health problems. Acute health conditions are increased in homeless children. Having space in a shelter will neutralize the health risks to the homeless child.

Homeless children are at an increased risk for sexual abuse. Homeless children are at risk for developing chronic health problems. Acute health conditions are increased in homeless children. Homelessness is a psychological and physiological stressor on the family unit. Children who are homeless are at an increase risk for both acute and chronic health concerns. Even when homeless families have beds in shelter settings these children and their parents are still at an elevated risk for health problems. Incidence of sexual abuse is increased in homeless children. Although the family unit may remain together, this does not minimize the overall risk of homelessness.

When orienting a new home health nurse on safety policies, which should the nurse include? Night and weekend visits are allowed with permission. Always carry your identification in your purse or wallet. If the client, family, or situation is hostile, call the police. Keep the agency informed of your visit schedule.

Keep the agency informed of your visit schedule. The agency should always be informed of the nurses' visit schedule to assist in locating the nurse if he or she does not return on time. Any changes to the schedule should be communicated to the agency immediately.

A labor and birth nurse is admitting an adolescent client with her mother. The client appears to be upset, and the nurse wants to find out why. How should the nurse proceed? Select all that apply. Ask another nurse to sit in and participate. Make note of the client's and parent's nonverbal expressions. Maintain eye contact throughout the discussion. Stand opposite the family and lean slightly back during the discussion. During the discussion maintain an open posture, with arms uncrossed.

Make note of the client's and parent's nonverbal expressions. Maintain eye contact throughout the discussion. During the discussion maintain an open posture, with arms uncrossed. Guidelines for appropriate nonverbal communication include maintaining a relaxed and open posture, with the arms uncrossed. The nurse should sit opposite the family and lean forward slightly, maintaining eye contact. The nurse should also note the child's or parent's posture, eye contact, and facial expressions. Asking another nurse to sit in on the discussion will not enhance the client-nurse relationship.

A woman has presented to the clinic with her sick school-aged child. The child's mother reports she rarely has enough money to meet the health care needs of her chronically ill child. What information should be provided to the woman? Medicaid is a federal program designed to meet the specific needs of children. Medicaid is a state assistance program that provides health care for all children under the age of 13. Medicare may be available to help with the health care needs of indigent children. Medicaid may be available to low-income parents and their children.

Medicaid may be available to low-income parents and their children. Medicaid is a joint federal and state program that provides health insurance to low-income parents and their children. It is state-administered, and each state has its own set of guidelines.

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? Communication Nursing process Teaching Case management

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 home care nurse is planning care for a 29-week gestation client pregnant with triplets on bed rest to reduce the chance for preterm labor. Which tasks can the nurse delegate to the home care assistant? Select all that apply. Assess fetal heart rates Prepare lunch for the client. Teach about signs of preterm labor. Assist the client with a bed bath. Pick up the client's kids from school.

Prepare lunch for the client. Assist the client with a bed bath. The nurse can delegate tasks that address personal care, assisting with ambulation and feeding clients. The assessment of fetal heart rates and teaching activities are beyond the scope of practice for the home care assistant. It is not appropriate for the home care assistant to pick up the client's children from school.

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? Primary prevention Secondary prevention Tertiary prevention Preventive care

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.

An Islamic woman is in active labor and informs the nurse that she is fasting during the day since it is Ramadan. What would the nurse assess for in this woman related to her cultural ritual? Fasting will be able to continue since laboring women are not allowed to eat at this time. Respect this woman's faith, but also assess for dehydration and hypoglycemia. Ask the family to bring in traditional foods during the evening hours so the woman can receive some nourishment. Call the health care provider for a prescription for IV fluids to keep her hydrated as she labors.

Respect this woman's faith, but also assess for dehydration and hypoglycemia. Knowing which religion a family practices can help the nurse locate the correct religious support person if one is needed. It helps in planning care if the nurse knows a woman wants a time set aside daily for private prayer or if she intends to fast, such as during Ramadan. The nurse should respect the woman's faith; however, the nurse should also assess hydration status and for hypoglycemia since she is fasting yet working hard to give birth to the infant. Most women in labor can drink fluids throughout the labor process. Asking the family to supply foods may be appropriate but also may be inappropriate if the woman is the one that cooks for the family. Hydration in the form of IV fluids may be considered inappropriate since the culture is for fasting from fluids and food.

Which intervention best demonstrates the L & D nurse is respectful of a client who is deaf and in early labor? Write down information on a piece of paper that the client can keep. Seek assistance from another health care professional who can converse in sign language. Utilize the labor coach so he or she can interpret and relay information to the client. Utilize hand signals like in charades to try to communicate important pieces of information.

Seek assistance from another health care professional who can converse in sign language. Cultural differences occur across not only different ethnic backgrounds but also different sociodemographic groups. A parent who has been deaf since birth, for example, expects her deaf culture to be respected by having health care professionals locate a sign language interpreter for her while she is in labor. If an interpreter cannot be located, writing down questions and answers is an alternative, assuming the parent has the ability to read and comprehend while dealing with labor contractions. Use of friends and family members is not considered to be the best option since many family/friends find it difficult to interpret medical terms. Hand signals can help in an emergency; however, it not the best way to interpret questions/comments from a laboring woman who is deaf.

A nursing instructor is teaching a class on the levels of preventive care. The instructor determines the class is successful when the students correctly choose which activity as a tertiary level? Teaching signs and symptoms of infection to a postoperative client Teaching a family about proper child restraint systems Showing a mother how to diaper her newborn Teaching a family how to monitor blood pressures

Teaching signs and symptoms of infection to a postoperative client A tertiary level intervention is one taken to prevent further illness or injury associated with an existing problem, such as teaching the signs and symptoms of an infection after surgery. Primary prevention involves teaching individuals necessary skills to prevent injury or disease, such as the proper use of child restraints and how to diaper a newborn. Secondary prevention involves health-screening activities that aid in early diagnoses and encourage prompt treatment before long term negative effects arise, such as monitoring blood pressure in family members who may be prehypertensive.

A nursing student asks the instructor why nurses focus on assessing sociocultural aspects of clients. Which response from the nurse is most accurate? Such assessment can reveal why people take certain preventive or treatment measures related to their health. This assessment is necessary to pinpoint genetic risks in people. Assessment of sociocultural components makes nurses better equipped to work in diverse settings. Nurses should strive to understand all dimensions of the client, even those that seem less important.

Such assessment can reveal why people take certain preventive or treatment measures related to their health. Assessing sociocultural status, ethnicity, and cultural beliefs of families and clients can reveal why people take the type of preventive health measures that they do or seek a particular type of care for illness. While the other answers might be partially correct, they do not represent the best answer for this question.

The nurse is caring for a child who has recently been placed in foster care. When providing care which findings would consistent with this recent change in the child's care providers? Select all that apply. The child has a series of bruises in various stages of healing. The child reports living with her mother and having no relationship with her father. The child has frequent nightmares and difficultly sleeping. The child is uncomfortable when the lights are out in the room. The child voices interest in the activities on the nursing unit.

The child has a series of bruises in various stages of healing. The child has frequent nightmares and difficultly sleeping. The child is uncomfortable when the lights are out in the room. Children may be placed in foster care due to abuse, neglect, abandonment or inability to meet the child's needs. These children may suffer from physical or mental health issues such as posttraumatic stress disorder (PTSD), anxiety, and feelings of worthlessness. Bruises in various states of healing may signal a history of physical abuse. Having divorced parents, a single parent, or living with an extended family does not increase the child's risk for being placed in foster care. Difficulty sleeping, nightmares or requesting the lights be left on may be seen in children with PTSD.

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 to encourage family members to bring in special foods. The client's traditional healing and health practices will be assessed for implementation. The client is asked if there are any meal preferences to be included in the care plan. The client will be referred to the hospital chaplain for spiritual support.

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 nurse is completing a home visit for an ill child. The mother of the child appears physically exhausted, the house is in disarray, and the young sibling is misbehaving. Which outcome evaluation by the nurse is most appropriate? Care of the client is appropriate; mother has developed home monitoring skills. The client is able to maintain interactions with others outside of the home. The family has not adjusted appropriately to the home care of the client. Younger sibling is in need of growth and development activities.

The family has not adjusted appropriately to the home care of the client. The nurse would recognize that the family has not appropriately adjusted to providing home care for the ill child. The nurse should re-evaluate to see if additional resources are needed, such as a routine home health nurse or respite services for the client. The nurse should assess the family for levels of support and provide community resources.

The home care nurse visited a newly assigned primigravida client with preeclampsia. When conducting the assessment and teaching, the client continued to cry and state she was in disbelief this was happening to her. When should the nurse schedule the second visit with the client? In seven days; the order was for once a week. The next day; the client is not coping well. In three days; this is a halfway point in the week. In five days; this will allow the client to adjust.

The next day; the client is not coping well. The client is in a state of disbelief regarding the diagnosis. The nurse will need to assess to see if the teaching that was conducted was retained and to evaluate whether this client is an appropriate client for home care.

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? The nurse recognizes that Muslim clients do not have an interest in food. The nurse becomes familiar with the Muslim client's meal practices. The nurse recognizes that Muslim clients prefer rest, which encourages appetite. A referral will be made to the dietitian to assess the Muslim client's preferences.

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.

Which statement about time orientation most accurately exemplifies a person who is oriented in the present? × The person is making plans to attend college in the next 2 years. × The person is focused on preserving cultural traditions with minimal variation in practice. × The person places a low priority toward saving money for college. × The person focuses on what food to buy and prepare for a holiday celebration next month. ×

The person places a low priority toward saving money for college. Some cultures are oriented toward the past: they carefully preserve traditions, allowing only the slightest changes or variations in practices. Still others are oriented toward the present; saving money for college (a future-oriented action) might seem important to an American nurse but would not be a high priority in these cultures. Preparing for an upcoming celebration is a future-oriented focus.

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 sexually transmitted infection (STI) education internet instruction for older adults application of a colostomy device

a skin cancer screening fair Secondary prevention measures are those taken to screen for diseases (such as skin cancer screening), delayed development according to criteria, or use of medication. Primary prevention involves health promotion activities to prevent the development of illness or injury. This level of prevention includes giving information which could include teaching older adults how to use the internet to find reliable information concerning various diseases, or providing STI education to prevent the spread of the disease. Tertiary prevention includes health promotion activities that focus on rehabilitation and that provide information to prevent further injury or illness, such as teaching a client how to properly apply a colostomy device.

A woman in labor has brought a butcher knife with her and insists on putting it under her hospital mattress to "cut the labor pain." Your best response to this practice would be to: teach her to use chest breathing with contractions. educate her about the cause of labor pain. tell her that she cannot keep the knife because it is a lethal weapon. allow her to keep the knife under her mattress during labor.

allow her to keep the knife under her mattress during labor. Respect for cultural values is important for developing effective nurse-client relationships.

The nurse is concluding her initial visit with a client at 28 weeks' gestation on bedrest for premature rupture of membranes. What information should the nurse consider when determining the timing of the next home visit? the location of the home client's type of health insurance amount of supervision and health education needed by the client the home visit schedule and needs of the agency to plan the visit

amount of supervision and health education needed by the client The nurse should complete an assessment on the client to include the amount of education and ability of the client to understand the health care provider's orders. The nurse should allow the agency to work with the insurance company, and the location of the home should not influence the decision of the nurse.

When a woman is admitted to the labor-and-delivery unit, her husband says he is going to work and asks you to call when the baby is born. Your best response to this husband would be to ask him if he knows that he can stay with his wife during labor. tell him that all fathers now stay with their wives during labor. tell him he is missing out on the opportunity of a lifetime by leaving. insist he stay with his wife during labor because she will need his support.

ask him if he knows that he can stay with his wife during labor. Respect for cultural values is important for developing effective nurse-client relationships.

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? teamwork disease-oriented autonomous action less holistic focus

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.

While interviewing a client, a nurse assesses the client's reaction to health care and determines that the reaction reflects the client's preferred ways of acting based on traditions. Which term would the nurse use to document this information? culture cultural values ethnicity race

cultural values Culture is a view of the world and a set of traditions that a specific social group uses and transmits to the next generation. Cultural values are preferred ways of acting based on those traditions. Ethnicity refers to the cultural group into which a person was born, although the term is sometimes used in a narrower context to mean only race. Race refers to a category of people who share a socially recognized physical characteristic. The term is rarely used today as the research on the human genome shows no basic differences in structure among people.

A nurse is reviewing a journal article that describes a view of the world and a set of traditions that a specific social group uses and transmits to the next generation. The nurse is reading an article about which concept? culture cultural values ethnicity ancestry group

culture Culture is a view of the world and a set of traditions that a specific social group uses and transmits to the next generation. Cultural values are preferred ways of acting based on those traditions. Ethnicity refers to the cultural group into which a person was born, although the term is sometimes used in a narrower context to mean only race. An ancestry group would be what a person identifies as one's heritage or lineage group.

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 Papanicolaou (Pap) tests cholesterol monitoring fecal occult blood testing

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.

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? decreased exposure to infection prevention of disruption of the family lower cost for the health care delivery system prevention of social isolation

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.

The nurse is assessing a pregnant woman's health literacy during a prenatal visit. Which factors would the nurse identify as impacting the woman's health literacy? Select all that apply. lack of familiarity with the information complexity of information woman's employment status last grade completed in school woman's level of emotional distress

lack of familiarity with the information complexity of information woman's level of emotional distress Health literacy refers to the ability to read, understand, and use health care information. When new or unfamiliar information is presented or when emotional distress is present, reading ability and understanding are reduced. The last grade completed in school does not equate with reading ability. In addition, appearance, verbal ability, employment status, and educational level cannot reveal persons who do not read well.

A woman who just gave birth tells the obstetrical nurse that her mother has noticed that so much has changed in maternity care in recent years. One change she could likely be referring to is: infections are prevented as births happen in highly advanced, sterile rooms. the family is now allowed to visit at prescribed visiting hours. the newborn stays in a newborn nursery for care to allow the mother to rest. newborns stay at the mother's bedside as long the infant is well.

newborns stay at the mother's bedside as long the infant is well. There has been increased access to care for all women (regardless of their ability to pay) and many hospital redesigns of labor, birth, and recovery rooms and postpartum spaces aimed at keeping families together during the birth experience and minimizing interruptions. Rooming-in and liberal visiting policies allow parents and other family members to participate in the child's care. Births happen in birthing suites/rooms as opposed to sterile birth rooms. Family is allowed to visit at most times of the day and night. Rooming in with the newborn is considered standard care now.

A nurse working in a busy urban family clinic has noted a high percentage of single mothers. What should the nurses in this clinic be prepared to offer these single mothers? financial planning for college accounts for each child support when a problem related to childrearing occurs contraceptive advice to prevent future pregnancies organizational and time management skills

support when a problem related to childrearing occurs Single-parent families may not have even one other adult to offer them support. Single parents have difficulty working full-time plus taking total care of young children. Trying to fulfill several central roles (mother and father) is not only time-consuming but also mentally and physically exhausting and, in many instances, not rewarded. This causes families to look more and more to health care providers, especially nurses, for guidance when a problem with pregnancy or childrearing occurs. Nurses are not educated to offer financial guidance or time management strategies to these families. The health care provider for the clinic can best address contraceptive advice if the parent is asking these questions.