Chapter 19: Working with Families

A community health nurse is about to make the first home visit to a family based on a referral from the hospital where the high-risk infant was born to an adolescent mother about 6 days ago. The nurse plans to assess the family and home environment and provide anticipatory guidance. On arrival, the mother sleepily answers the door after the nurse rings the bell and knocks several times. The mother lets the nurse in but is not happy to see the nurse. She gets the infant and places him in the nurse's arms, then sits across the room and turns on the TV. Which response by the nurse would be most appropriate? A)"You must be very tired caring for a newborn baby." B)"I wasn't planning to hold the baby. You should hold him, you are the mother." C)"I need to talk to you, so please turn off the TV." D)"How do you feel being a mother at 17?"

A

A community health nurse is applying an interactional framework to assess a family's health. Which of the following would the nurse do? A)View them in terms of the family's internal relationships B)Look at them from a life-cycle perspective C)Evaluate the members' changing roles and tasks D)Assess them as a social system relating to other social systems

A

A community health nurse, visits an 81-year-old newly diagnosed insulin-dependent diabetic who lives alone. The nurse has visited the family three previous times and is visiting early in the morning to observe his client's insulin administration technique. The nurse finds the client depressed over his or her situation one morning. The nurse suggests that together they list positive points about his or her situation and discuss his or her feelings. This is an example of which of the following? A)Strengthening B)Data collection C)Goal-directed questioning D) Measuring family functioning

A

Which of the following things does a nurse who is traveling by automobile to make a home visit need? Select all that apply. A)A full gas tank and well-operating vehicle B)A map that includes the geographic location where the home visit will be made C)A cellular telephone D)A bus schedule E)Exact change

A,B,C

Which of the following are specific safety measures the nurse should apply when making a home visit? Select all that apply. A)Plan to reschedule the visit if you find a large group of people assembled between you and the client's door. B)Immediately leave the home when family members begin to physically fight with one another. C)Enter the residence before you determine that the family you are intending to visit does live there and is home. D)Travel only in pairs for all home visits. E)If someone approaches you and indicates that they want your nursing bag, throw your bag away from where you are and run in the opposite direction. F)Leave an itinerary of your planned travels, the telephone numbers of families you will attempt to visit and your cellular phone number at your base of operation.

A,B,E,F

A community health nurse arrives at a family's home. Which of the following would behaviors by the nurse would be nontherapeutic? A)Maintaining eye contact with the family members B)Paging through paperwork for information C)Sitting on the furniture near the family members D)Placing car keys in the nurse's carryall bag

B

A community health nurse determines that it is time for teaching a family about health promotion activities when they say which of the following? A)"Is there a place we can go for the medicine?" B)"It's time we do something about eating right." C)"When are you coming back to visit?" D)"Our grandchildren visit every summer."

B

The nurse educator knows that the nursing student has grasped the concept of self-evaluation when the nursing student makes which one of the following statements? A)It is important for the family to evaluate itself. B)It is important for the nurse's growth and effectiveness as a community health nurse. C)Evaluations by others are not helpful. D)Individuals can always see their own strengths or flaws.

B

Which of the following would a community health nurse use when conducting an outcome evaluation? A)Organization B)Family progress C)Timing D)Performance

B

Which one of the following is a principle that guides and enhances family nursing practice? A)The nurse should expect that the family will be normal and will not change. B)The nurse should start where the family is at the present time and not the ideal level of functioning. C)The nurse should focus on each family member individually. D)The nurse should evaluate the family based on consistency with traditional family patterns.

B

A community health nurse constructs an eco-map for a family based on the understanding that this tool is useful for which reason? A)Family relationships over three or more generations are depicted. B)The ecological system of a family's neighborhood is charted. C)It was originally devised to depict the complexity of the client's story. D)Directions for gathering data about neighborhoods are provided.

C

A community health nurse is attempting to empower a family to become independent. Which of the following would be most appropriate? A)Focus attention on the problem areas B)Do for the family what they cannot C)Emphasize the family's strengths D)Reinforce positive traits

C

During a home visit and assessment of an infant and new mother, the nurse determines that the infant looks healthy. The mother asks several questions and listens attentively. One question she asks is whether the nurse is going to visit her again. Which response would be most appropriate? A)"Your baby looks healthy. You should not have any further questions." B)"The agency limits the number of visits I can make; I will let you know." C)"I plan to visit again. What would you like to accomplish at the next visit." D)"I can come weekly for the next 16 weeks, and then a staff nurse will visit."

C

During a home visit, a client asks the community health nurse to take his or her shopping to purchase some of the food items he or she needs for his or her diet. Which response by the nurse would be most appropriate? A)"I can't, I'm going in a totally different direction." B)"You need to find some other way to get to the store." C)"I'll help you find a way to get to the store." D)"Use the foods you have in the house and shop next week."

C

When a community health nurse is conducting a family assessment on an assigned family, which of the following would be most appropriate? A)Use quantitative data only to maintain and preserve objectivity B)Interview one family member to avoid confusion and repeated information C)Use a checklist format, completing the tool in the family's presence D)Make several visits and accumulate data from all family members

D

When assessing a family, which of the following would lead the nurse to question the health of a family? A)Role relationships are inflexible. B)Coping is actively attempted. C)Family members communicate regularly. D)The family lacks regular links with the broader community.

D

When planning for a home visit, which of the following would be most helpful to ensure a successful home visit? A)Documentation in a timely manner B)Summarizing the main visit points C)Providing incidental teaching D)Scheduling an appropriate visit time

D

Which of the following would be most appropriate for the community health nurse to do first when planning an initial home visit to a family? A)Obtain the basic supplies that will be needed B)Gather appropriate educational materials C)Contact the family via telephone D)Review the referral information

D

Which one of the following has a negative influence on family health and individual health? A)The level at which a family functions significantly affects the individual's level of health. B)A healthy family fosters individual growth and sustains members during times of crisis. C)Family patterns dictate whether members participate in their own health care. D)Individuals can obstruct the family's health and families can obstruct individual family members' health.

D

While making a family health visit, an older relative who is visiting has been drinking and becomes verbally abusive and increasingly loud. Which action by the community health nurse would be best? A)Continue the visit with caution B)Suggest the relative go in another room and take a nap C)Ask the sober family members to take the visitor home D)Terminate the visit, making plans for another visit

D

A community health nurse is collecting data about the family's demographics. Which of the following would the nurse include? Select all that apply. A)Dietary patterns B)Housing C)Climate D)Socioeconomic status E)Education of members F)Ethnicity

D,E,F