TLB-Chapter 4: The Health of the Individual, Family, and Community

A nurse working in an "Aging in Place" facility interviews a married couple in their late seventies. Based on Duvall's Developmental Tasks of Families, which developmental task would the nurse assess for this couple? A. Maintenance of a supportive home base B. Strength of the marital relationship C. Ability to cope with loss of energy and privacy D. Adjustment to retirement years

D. Adjustment to retirement years RATIONALE The developmental tasks of the family with older adults are to adjust to retirement and possibly to adjust to the loss of a spouse and loss of independent living.

Which are stressors that affect the health of the family? A. Many job opportunities with adequate income B. Family members who live in the same geographic location C. Public transportation present throughout the community D. Inadequate childcare services

D. Inadequate childcare services RATIONALE Inadequate childcare services is a major stressor for many families. Communities that offer many job opportunities tend to have low unemployment. Families that have adequate income to meet the needs of the family tend to have higher health. Public transportation facilitates access to health care. Other family members who live nearby are a source of support.

Which are examples of meeting self-actualization needs according to Maslow's hierarchy of needs? (Select all that apply.) A. A nurse attains a master's degree in nursing. B. A nurse refers a patient's spouse to an Al-Anon group meeting. C. A nurse takes a course in communication to better relate to clients. D. A nurse raises the side rails on the bed of a client at risk for falls. E. A nurse administers insulin to a client with diabetes mellitus. F. A nurse subscribes to several nursing journals.

A. A nurse attains a master's degree in nursing. C. A nurse takes a course in communication to better relate to clients. F. A nurse subscribes to several nursing journals.

An adolescent confides in the school nurse that the adolescent is arguing daily with her mother and often wonders whether her mother loves her. The school nurse recognizes that the student faces which of the following risk factors for altered family health? A. A psychosocial risk factor B. A lifestyle risk factor C. A developmental risk factor D. A biologic risk factor

A. A psychosocial risk factor RATIONALE Conflicts between family members are considered psychosocial risk factors. Lifestyle risk factors are habits or behaviors people choose to engage in such as smoking and exercise. Developmental risk factors are characterized by vulnerability to negative social and environmental influences, such as peers and underage drinking. Biological risk factors are related to genetics, the brain, health habits, and medical issues.

A nurse performs an assessment of a family consisting of a single mother, a grandmother, and two children. Which interview questions directed to the single mother could the nurse use to assess the affective and coping family function? Select all that apply. A. Who is the person you depend on for emotional support? B. Who is the breadwinner in your family? C. Do you plan on having any more children? D. Who keeps your family together in times of stress? E. What family traditions do you pass on to your children? F. Do you live in an environment that you consider safe?

A. Who is the person you depend on for emotional support? D. Who keeps your family together in times of stress?

The nurse caring for families in a free health care clinic identifies psychosocial risk for altered family health. Which example describes one of these risk factors? A. The family does not have dental care insurance or resources to pay for it B. Both parents work and leave a 12-year old child to care for his younger brother C. Both parents and their children are considerably overweight D. The youngest member of the family has cerebral palsy and needs assistance from community services

B. Both parents work and leave a 12-year old child to care for his younger brother RATIONALE inadequate childcare resources is a psychosocial risk factor. Not having access to dental care and obese family members are lifestyle risk factors. Having a family member with birth defects is a biologic risk factor.

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? A. Socialization B. Physical C. Reproductive D. Affective and coping

A. Socialization RATIONALE Through socialization, the family teaches; transmits beliefs, values, attitudes, and coping mechanisms; provides feedback; and guides problem solving. Incorporating religious beliefs, values, and attitudes is an example of socialization. Physical functions of the family include providing a safe, comfortable environment necessary for growth and development, rest, and recuperation. The reproductive function of the family is raising children. The affective and coping function of the family involves providing emotional comfort to family members.

The nurse is conducting a family assessment of a traditional family. Which assessment data cue describes the socioeconomic status of the family? A. The father is an engineer and the mother is an elementary school teacher. B. The family celebrates Hanukkah and Passover with special meals. C. The family consults their rabbi and synagogue members during times of stress. D. The family members vacation together every year at a beach resort.

A. The father is an engineer and the mother is an elementary school teacher. RATIONALE The occupations of the parents provide financial support for the family and contribute to the socioeconomic status of the family. Affiliation with a religious organization can be a source of social support during stressful times, which can promote adaptive coping for the family. Cultural and religious activities of the family define values and beliefs important to family members. Recreational activities, such as vacationing together, promote interaction of family members.

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? A. The parents have a tumultuous relationship, with frequent separations in the past. B. The mother has a history of heavy alcohol use. C. The family lives in a small apartment in a poor neighborhood with high crime rates. D. The family's electricity has been cut off at various times due to nonpayment.

A. The parents have a tumultuous relationship, with frequent separations in the past. RATIONALE Conflict is an example of a psychosocial risk factor. Chemical dependency is considered a lifestyle risk factor, whereas a lack of adequate housing is an environmental risk factor. Lack of electricity is an economic risk factor.

Which statement is true regarding Friedman's theory of family-centered nursing care? A. The role of the family is essential in every level of nursing practice. B. The family is composed of independent members who live and function individually. C. The focus on health should be directed at improving the health of the sickest member of the family. D. Illness of one family member strengthens the roles of the sick member in the family structure.

A. The role of the family is essential in every level of nursing practice. RATIONALE Friedman and associates identified the importance of family-centered nursing care, based on four rationales. First, the family is composed of interdependent members who affect one another. If some form of illness occurs in one member, all other members become part of the illness. Second, a strong relationship exists between the family and the health status of its members; therefore, the role of the family is essential in every level of nursing care. The third rationale is that the level of health of the family and, in turn, each member can be significantly improved through health-promotion activities. Finally, illness of one family member may suggest the possibility of the same problem in other members; through assessment and intervention, the nurse can assist in improving the health status of all members.

A nurse is practicing community based nursing in a mobile health clinic. What typically is the central focus of this type of nursing care? A. individual and family health care needs B. populations within the community C. local health care facilities D. families in crisis

A. individual and family health care needs

The nurse is prioritizing nursing care for a patient in a long-term care facility. Which examples of nursing interventions help meet physiologic needs? Select all that apply. A. Preventing falls in the facility B. Changing a patient's oxygen tank C. Providing materials for a patient who likes to draw D. Helping a patient eat his dinner E. Facilitating a visit from a spouse F. Referring a patient to a cancer support group

B. Changing a patient's oxygen tank D. Helping a patient eat his dinner RATIONALE Physiologic needs-oxygen, water, food, elimination, temperature, sexuality, physical activity, and rest- must at least be minimally met to maintain life.

A client says, "I live in a small community on the northwest side of the city." Why does the nurse consider it significant that the client reports living in a community rather than a neighborhood? A. Neighborhoods are, by definition, smaller units within a community. B. Community indicates people who share similar characteristics. C. Communities are defined by geography. D. Neighborhoods meet basic human needs, where communities do not.

B. Community indicates people who share similar characteristics. RATIONALE Communities are thought to contain persons who share similar characteristics, whether it be social interaction, cultural or ethnic ties, or geographic area. Communities may be larger or smaller that a geographic neighborhood and are not defined by geography. Communities exist because they meet basic human needs.

A nurse uses Maslow's hierarchy of basic needs to direct care for patients on an intensive care unit. For which nursing activities is this approach most useful? A. Making accurate nursing diagnoses B. Establishing priorities of care C. Communicating concerns more concisely D. Integrating science into nursing care

B. Establishing priorities of care RATIONALE Maslow's hierarchy of basic human needs is useful for establishing priorities of care.

A client is experiencing a stress response each time the family visits the room. What nursing intervention is most appropriate? A. tell the family they are causing too much stress B. limit the family visits to once daily C. explain that family visits and support are important D. do not intervene and allow the client to work out the family issue

B. limit the family visits to once daily RATIONALE When a person is experiencing a stressor, it is important for the nurse to reduce or eliminate the stress. In this case, it is appropriate to limit the family visiting time to allow the client to recover without experiencing a stress response. Telling the family they are causing the stress is not therapeutic. Telling the client that the family should be there invalidates the client's feelings. Doing nothing is not an appropriate response to decrease or remove the stressor.

The nurse caring for patients postoperatively uses careful hand hygiene a sterile techniques when handling patients. Which of Maslow's basic human needs is being met by this nurse? A. physiologic B. safety and security C. self-esteem D. love and belonging

B. safety and security by carrying out careful hand hygiene and using sterile technique, nurses provide safety from infection.

A visiting nurse working in a new community assessment. What assessment finding is indicative of a healthy community? A. It meets all the needs of its inhabitants B. It has mixed residential and industrial areas C. It offers access to health care services D. It consists of modern housing and condominiums

C. It offers access to health care services

The nurse is assessing the communication style of the client. Communication is an example of which dimension of the individual? A. Physical dimension B. Environmental dimension C. Sociocultural dimension D. Emotional dimension

C. Sociocultural dimension RATIONALE Communication is essential for interaction with others and is an example of the sociocultural dimension. The physical dimension incudes physiological health and nutrition. Housing and community are examples of the environmental dimension. The emotional dimension includes fear, sadness, loneliness, and acceptance of self.

A nurse caring for patients in a long term care facility uses available resources to help patients achieve Maslow's highest level of needs: self-actualization needs. Which statements accurately describe these needs? Select all that apply. A. Humans are born with a fully developed sense of self-actualization B. Self-actualization needs are met by depending on others for help C. The self-actualization process continues throughout life D. Loneliness and isolation occur when self-actualization needs are unmet E. A person achieves self-actualization by focusing on problems outside self F. Self-actualization needs may be met by creatively solving problems

C. The self-actualization process continues throughout life E. A person achieves self-actualization by focusing on problems outside self F. Self-actualization needs may be met by creatively solving problems

A nurse works with families in crisis at a community mental health care facility. What is the best broad definition of a family? A. a father, a mother, and children B. a group whose members are biologically related C. a unit that includes aunts, uncles, and cousins D. a group of people who live together and depend on each other for support

D. a group of people who live together and depend on each other for support RATIONALE The best definition is a group of people who live together and depend on each other for physical, emotional, or financial support