Prep U Module 6 - Family

A young couple who have been married less than a year are having difficulty with adjusting to parenting. What is a contributing factor to this level of maladjustment?

Limited time in learning to be a marital partner

A home care nurse provides health education to parents regarding the care of their toddler. Which precaution should the nurse suggest the parents take to protect the toddler from drowning?

Avoid unattended baths for the toddler.

A child 4 years of age has a mother who is employed and works from home. To accomplish her daily work, she allows the child to watch television for 6 to 8 hours a day. Based upon this information, what nursing diagnosis would be applicable to this family?

Impaired Parenting associated with failure to provide stimuli for growth

According to Havighurst, learning behaviors are based upon developmental tasks. In assessing an adult patient, the nurse is aware that a common developmental task of middle adulthood includes:

assisting children to become responsible adults.

A nurse is caring for a small child with leukemia who will be hospitalized frequently for chemotherapy. What type of referral can the nurse make that will help the child and family through this time?

child life specialist

The child has been diagnosed with vulnerable child syndrome. Which statements by the child's parent are associated with the presence of this syndrome? Select all that apply.

"For the first few weeks of his life, he was so yellow I was afraid he would glow." "When she was a toddler she developed meningitis and the doctors told me they didn't think she'd make it." "She was born with a cleft lip and palate I was so afraid she wasn't getting enough formula."

Which statement by a relative indicates to the nurse that the teaching on the application of paste was effective?

"I will not apply the paste on hairy skin."

When attempting to facilitate spiritual support for a school-age child with a life-threatening disease and the child's family, which action would hinder the nurse-client relationship?

promoting the nurse's personal values and beliefs if the nurse considers the family's to be inappropriate

The nurse is conducting a screening for familial predisposition to cancer. Which element should the nurse note as a possible indication of hereditary cancer syndrome?

An aunt and uncle diagnosed with cancer

A client who recently gave birth to her third child expresses a desire to have her older two children come to the hospital for a visit. What should the nurse say in response to this request?

"As long as they are well, absolutely. Why don't we give you a dose of pain medication beforehand so that you will enjoy the visit?"

A nurse is assessing a 9-year-old child diagnosed with conduct disorder. Which advice should the nurse give the child's parents regarding treatment of the disorder?

"You will need to be involved in the therapeutic process for your child."

Discharge plans for a client with a mental health disorder include living with family members. The nurse learns that the family is no longer willing to allow the client to live with them. What is the nurse's most appropriate action?

Collaborate with other disciplines to revise the discharge plans.

The nurse is assessing the birth rates and death rates of the local municipality and comparing these rates to those of the nation and the world. Which type of nursing is this nurse practicing?

Community health nursing

The nurse is working with a client's family and social worker to select a home health care agency. Which question does the nurse state should be the family's priority when interviewing potential home health agencies?

Does the agency meet uniform standards for licensing, certification, and accreditation by state agencies and/or federal programs?

A client has designated a family member to make healthcare decisions for the client if the client is not able to do so. What type of advance directive is this considered?

Durable power of attorney (DPOA) for healthcare

A registered nurse is providing community-based health care for a client diagnosed with early onset dementia. Which strategy is best for the nurse to employ to facilitate the family participating in the client's care?

Encourage active participation of the client and family in health care decisions.

The family members of a dying client are finding it difficult to verbalize their feelings for and show tenderness to the client. Which intervention should a nurse perform in such a situation?

Encourage the family members to express their feelings and listen to them in their frank communication

The nurse is observing the parents and child during a health supervision visit. Which observation would alert the nurse to inquire and observe further?

The mother says, "Wait until we are finished with this doctor's visit and then I will take you to the bathroom."

A family brings the client to the emergency department in an unconscious state with a head injury. The client requires surgery to remove a blood clot. What would be the appropriate nursing intervention in keeping with the policy of informed consent prior to a surgical procedure?

The nurse confirms that the client's family has signed the consent form.

During a home health care visit, the nurse identifies a nursing diagnosis of Caregiver Role Strain for a parent who is caring for a child dependent on a ventilator. What subjective assessment data would support the nurse's diagnosis?

The parent states, "I cannot allow anyone else to help because they won't do it right."

A nurse is caring for an 18-month-old girl undergoing traction therapy in a rehabilitation unit. The nurse understands that the girl is in the second phase of separation anxiety when she observes what behavior?

The toddler is quiet, looks sad, and is disinterested in playing.

A nurse is caring for a 4-year-old child. The parents indicate that their child often reports that objects in the house are his friends. The parents are concerned because the child says that the grandfather clock in the hallway smiles and sings to him. Which response by the nurse is best?

"Attributing lifelike qualities to inanimate objects is quite normal at this age."

A family has been given the news that their expected child has a serious genetic condition. Which therapeutic communication technique(s) will be beneficial for the nurse to use when helping this family? Select all that apply.

"I know you have been given a large amount of information. I am interested in what you think." "I know this news has been hard. I am going to just sit with you and not talk while you begin to process your thoughts." "The health care provider suggested you seek genetic testing. Does this make you more upset?"

A 40-year-old client is admitted for a surgical biopsy of a suspicious lump in the left breast. The client is tearfully writing a letter to the client's two children and tells the nurse, "I want to leave this for my children in case anything goes wrong today." Which response by the nurse would be most therapeutic?

"In case anything goes wrong? What are your thoughts and feelings right now?"

The nurse is providing emotional support for the parent of a 12-year-old hospitalized child. The parent tearfully reports the child's younger sibling is acting out and always seems angry with both parents. What response by the nurse would be most beneficial?

"Is there any way you can spend the evening at home with your younger child instead of at the hospital?"

A nurse is teaching the parents of an infant about primary immunodeficiencies. Which statement verifies that the parents understand the teaching?

"The majority of primary immunodeficiencies are diagnosed in infancy."

The nurse has been working with the parents of a child with special needs about being able to recognize when stressors of parenting may become intensified. The nurse is confident that the parents will be able to identify stressors in the future when they make which statements? Select all that apply.

"We should be alert to our stress level when we go back to work." "When our child enters puberty it will probably be especially challenging." "It is going to be really difficult taking our child to school for the first time." "We know every time our child has to be admitted to the hospital it is very difficult for our entire family."

A surgeon completes a total laryngectomy. Postoperatively, the nurse explains to the patient's family that:

A permanent tracheal stoma would be necessary.

In viewing the stages of the family life cycle, those families in later life undergo which emotional transition?

Accepting the shifting of generational roles

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

An older adult client has received a terminal lung cancer diagnosis. The client's adult children are tearful and afraid to leave their parent's bedside. What type of grieving is this family most likely experiencing?

Anticipatory

When planning initial care for a 16-year-old client and the client's newborn, the nurse formulates a nursing diagnosis of "Risk for Impaired Attachment." What would be the nurse's most appropriate action to take next?

Assess the client's interactions with the newborn.

A nurse manager on a pediatric unit is making assignments for the day. The nurse's goals are atraumatic care for pediatric clients and minimizing parent-child separation. What method of care delivery should the nurse implement?

Assign a core primary nurse.

Why will it be necessary for the nurse to be very supportive of parents' attempts to feed the infant with recently repaired myelomeningocele?

Assuming the usual feeding position will be difficult.

The nurse teaches the client diagnosed with Huntington disease that it is transmitted as which type of genetic disorder?

Autosomal dominant

A parent is asking how to help the child deal with the peer ridicule at school in regards to enuresis. What is the best response by the nurse?

Demonstrate love and acceptance at home.

The home care nurse is providing care and education to a client who is pregnant for the first time. The client states, "I have no money or food. I don't know what I should do. I want to provide for my unborn child." The nurse refers the woman to the WIC program and a local food bank. This is an example of what aspect of community-based nursing?

Planning

In order to promote optimal response to therapy the nurse should discuss what the client and family? (Select all that apply.)

Purpose of drug therapy Tolerance will develop to adverse reactions Adverse reactions that can occur with drug therapy Which adverse reactions to report to the physician

Which provides the most appropriate example of neglect according to the definition of the term?

Rejecting a 3-year-old who cries and seek affection after falling

A nursing instructor is teaching a class about the basic functions of families. The instructor determines the class is successful when the students correctly choose which statement as a basic function of the family?

Reproduction remains an important function of many families.

During a home care visit to a home-bound older client, the client's spouse, who is the caregiver, verbalizes anger, fatigue, and sleeplessness. Which recommendations by the nurse would be most effective in relieving caregiver role strain?

Respite care

The parents of a young adult diagnosed with schizophrenia are providing care for the client in their home. During a home visit, the parents state, "It's been so difficult taking care of our child. We need a break. But our child needs constant supervision." Which would be appropriate for the nurse to suggest?

Respite residential care

A 1-year-old child with an abdominal wound is undergoing a dressing change. The child's parent is at the bedside. Which action would the nurse instruct the parent to do?

Talk to the child in a quiet, soothing voice.

The nurse conducts a wellness visit for a pediatric client. Which findings could indicate an increased risk for child abuse and the potential need for an additional assessment? Select all that apply.

The child is diagnosed with a developmental delay. The child has bruises in various degrees of healing on the buttock and upper legs.

A nurse is working with a dying client and the client's family. Which communication technique is most important to use?

Use active listening and silence when communicating.

A nurse is teaching parents about Internet safety for children. Which action(s) is a recommended guideline for Internet use? Select all that apply.

Use filtering software to block objectionable information. Investigate any public chat rooms used by the children. Be alert for downloaded files with suffixes that indicate images or pictures.

The nurse is proving discharge instructions for a client with a new arrhythmia. Which statement should the nurse include?

Your family and friends may want to take a CPR class.

During assessment for a child with cystic fibrosis who is new to the practice, the nurse notes that the father keeps asking about costs and if there is a "cheaper" way of providing the care that the child needs without compromising health. For example, instead of buying prepackaged normal saline for breathing treatments, he asks if they can boil water (and containers with lids) and add the salt to the water in proper portions. When documenting this assessment, the nurse would identify the father as playing which role in the family based on the aforementioned questions?

allocation of resources

A client who is newly diagnosed with hypertension is going to be starting antihypertensive medicine. What is one of the main things the client and the client's spouse should watch for?

dizziness

The parents of three children ages 4, 7, and 11 years are interested in fostering spiritual development in their children. The nurse informs the parents that the development of a child's spirituality is best accomplished by:

educating through parental behaviors.

The nurse has asked the client for a family history. This nursing assessment is the first step in which aspect of genetic counseling?

establishing a pedigree

The nurse is teaching discipline strategies to the parents of a 14-year-old girl. Which topic is an example of positive reinforcement discipline?

taking a chore away from her for a week

A nurse is assessing a family with adolescents. The family consists of a father, mother, a 13-year-old son, a 14-year-old son from a previous marriage, and a 16-year-old daughter. Which statement by the parents would lead the nurse to suspect a potential risk factor for altered health with this family?

"Our 16-year-old just seems to butt heads with us at every turn."

On the first postoperative day, a 4-year-old child who was hospitalized for an emergency appendectomy has begun to cry relentlessly, will not let the nurse touch him or her, and keeps asking for the parent. The pediatric nurse is aware that this client is in which stage of separation?

protest

Two previously divorced people are getting married and becoming a blended family. They each have two children from prior marriages. They have met with a family counselor to discuss potential problems of blended families and ways to deal with the problems. Which potential problem will likely occur at some early point in the marriage?

rivalry for attention of a parent

The nurse is working with a family that has indicated a desire to learn better communication skills. The nurse role-plays assertive communication techniques with each family member. The role-play is an example of which type of family intervention?

Behavioral

A 68-year-old parent is the sole care provider for a 39-year-old child who has a diagnosis of bipolar disorder. The 39-year-old has been experiencing worsening of the illness over several years. The nurse should recognize that the parent is at risk for what?

Compassion fatigue

The school nurse is caring for a child newly diagnosed with special needs and determines the child needs an individualized education plan (IEP). Which action by the school nurse is appropriate?

Contact the child's parents and teacher for a meeting.

Which are stressors that affect the health of the family?

Inadequate childcare services

The nurse is caring for a terminally ill client in the intensive care unit that is on life support measures. The family members are opposed in their decision to take the client off of life support. What option does the nurse discuss with the nurse manager?

Contact the ethics committee for their input.

The nurse is caring for a preschool-age child in the hospital with severe developmental delays. The parents have three other younger children at home and both parents work full-time outside the home. The family has just moved to this area. Which nursing diagnosis would be the highest priority in regard to the parents at this time?

Risk for caregiver role strain

A nurse is working at a community clinic that serves mostly families with young children. What would be a priority intervention for clients in this developmental stage?

Setting up parenting classes

Parents raising two school-aged children incorporate their religious beliefs into the family's daily life. The family's beliefs regarding religion include dietary considerations, worship practices, attitudes, and values. This is an example of which function of the family?

Socialization

Which feature would most likely predispose an adult to engage in family violence?

The adult was physically abused as a child

When educating families on fire safety, it is important to:

have a meeting place outside the home.

A nurse is assessing a 7-year-old child in a school. The nurse suspects that the child has an insecure relationship with the parents. Which statement said by the child would have led the nurse to this conclusion?

"Please don't tell my mom anything we've talked about."

An adolescent's parent states not knowing what to do with the adolescent. The parent reports the teenager is taking two or three showers a day when not that long ago the parent could barely get the teen to take a shower at all. What should the nurse's reply be to the parent?

"Reinforce the family rules but also allow the adolescent to develop one's own routine."

The nurse is preparing a client to be discharged from the surgical unit following abdominal surgery. Which intervention will the nurse use to ensure the client's adherence to proper wound care techniques?

Include family members or other caregivers in the education.

The nurse is caring for a 7-year-old child with diurnal enuresis. When discussing home treatment of this problem with the parents, what is the best advice for the nurse to give?

Follow a schedule for the child to urinate.

A concerned client tells the nurse that her husband, who was very excited about the baby before its birth, is apparently happy but seems to be afraid of caring for the baby. What suggestion should the nurse give to the client's husband to resolve the issue?

Hold the baby frequently.

A family assessment of a father, mother, and four children has suggested the presence of several risk factors. Which aspect of the family's structure and function would be considered a psychosocial risk factor?

The parents have a tumultuous relationship, with frequent separations in the past.

Assessment of genetic predisposition supports asking a client who is exhibiting symptoms of a delusional disorder what?

Whether any family members have been diagnosed with schizophrenia

The nurse is assessing a family to determine if they have access to adequate health care. Which statement accurately describes how certain families are affected by common barriers to health care?

White, non-Hispanic children overall are more likely than Black and Hispanic children to be in very good or excellent health.

The nurse is assessing an infant girl at her first well-baby visit. The nurse also observes the actions of the 6-year-old brother and parents who share that she was the best anniversary present they received this year. Which type of family will the nurse conclude these individuals represent?

immediate

The school nurse is conducting health assessments for a group of children. Which of the following situations encountered by the nurse raises suspicion of child neglect?

A child reports of constant hunger.

The mother of a pediatric client being discharged confides to the nurse that her husband is abusive and she is afraid to return home. What is the nurse's most appropriate action?

Coordinate with the case manager to make a safe discharge plan.

According to Wright & Leahey (2005), which family function incorporates the use of power and decision making about resources?

Management

Which is a typical characteristic of parents of clients diagnosed with anorexia nervosa?

Overprotective of their children

The nurse promotes the self-concept of the parents of an infant age 6 months admitted to the hospital with a fever and dehydration by:

allowing the parents to participate in the infant's care.

A nurse is completing a genetic map of a client's family. The client has brown eyes and his wife has blue eyes. Both the son and the daughter have brown eyes. Which of the following is the same in both children?

Phenotype