Chapter 2 and Chapter 3 480

Which of the following is the best reason for a nurse to consider the family as a unit of care? a. The family is recognized as a unified whole. b. All family members are treated equally. c. Family members will receive care from other family members. d. The ill individual is given the best care possible.

ANS: A Feedback: a. The family as a whole influences the individual family member. b. Equality of treatment is not necessarily a goal of nursing care. c. Care provided by family members is situational and not predictable. d. No guarantee of the best care for the ill individual

How much greater is U.S. health-care spending compared to other nations? a. About 2.5 times as high b. About 4 times as high c. About 7.5 times as high d. About 10 times as high

ANS: A Rationale: The United States is one of the wealthiest nations in the world and spends more money on health care than anywhere else; health-care spending is about 2.5 times as high as other nations.

Which of the following assumptions about family will assist the nurse to plan and deliver meaningful care? Select any that apply. a. The nurse has limited information about family function. b. Individual family members seldom have only one problem at a time. c. Disease management may be influenced by family responsibilities. d. Family members are not able to prioritize activities related to health care.

ANS: A, B, C Rationale: Conducting a family assessment that includes function, other problems, and family roles will provide necessary information for developing goals for family members. Family members are able to prioritize, and when they do, compliance with treatments may not be possible.

Select all that apply. According to the WHO, a family health nurse: a. Possesses the usual knowledge expected of a competent nurse. b. Is a generalist with specialty knowledge of culture and family. c. Attempts to create a healthy family by addressing health problems. d. Only works with families in the community setting

ANS: A, B, C Rationale: Number 4 is not correct because a family health nurse coordinates care among the diverse settings where care is provided.

What do families desire from hospice care? a. Continuity of care. b. Comfort for the dying family member. c. Autonomy for family members. d. Case management

ANS: A, B, C, D Rationale: Continuity of care, comfort for the dying family member, autonomy for family members, and case management are all aspects of hospice care

Which of the following are reasons the United States has a growing health disadvantage when compared with peer countries? a. Uninsured segments of the population b. High poverty rates c. An efficient health-care delivery system d. Lack of care coordination

ANS: A, B, D Rationale: Uninsured people, high poverty rates, and lack of care coordination contribute to the growing health disadvantage of the United States, despite it being one of the wealthiest countries and spending more on health care compared to other nations. The U.S. health-care system is not efficient. There is much duplication, yet there are many gaps in care.

Which of the following factors influence societal health? a. Access to care providers b. Educational institutions c. Wealth distribution d. Respect of human rights

ANS: A, C, D Rationale: Access to care providers, distribution of wealth, and respect of human rights all influence the health of society. Educational institutions are not essential for health and wellness.

Which of the following may prevent illness? a. Adequate sleep b. Early diagnosis c. Stress management d. Adequate nutrition

ANS: A, C, D Rationale: Adequate sleep, nutrition, and stress management help to prevent illness. Early diagnosis of illness is important too, but it does not prevent illness.

Which of the following assumptions about the family perspective will guide nursing actions? a. Family members need full disclosure and clear explanations. b. Family members are usually afraid of being involved in care. c. Family confidence influences care giving. d. Family members have rights and can make choices.

ANS: A, C, D Rationale: Assumptions that may help to guide nursing actions include that family members need full disclosure and clear explanations, that their confidence influences care giving, and that they have rights and can make choices. Families are usually comfortable with other family members and want to be involved, but will need information that will enable their involvement.

Which of the following statements is most accurate concerning thinking family? A nurse who is thinking family: a. Recognizes only the family members who are present with the ill family member. b. Realizes that all persons receiving nursing care are interdependent with family members. c. Only considers the point of view of the ill family member. d. Believes that including the family will improve patient care.

ANS: B Feedback a. Family is family no matter where members reside. b. Interdependence is a characteristic of a functioning family. c. Family members have opinions that will influence health and illness. d. There is no guarantee that including family will improve care.

Which of the following statements describe the new patient/health-care consumer role? 1. Provide only the information asked for by the provider 2. Obtain information from a variety of sources 3. Engage in self-management of care 4. Assume providers will understand their needs a. 2 only b. 2 and 3 c. 1, 2 and 3 d. All of the above.

ANS: B Feedback a. Not the only descriptor of the new patient/consumer listed. b. Both 2 and 3 describe the new patient/consumer. c. Providing minimal information will not assist with problem solving. d. Includes incorrect descriptors of patient/consumer.

Which of the following is not a domain of the Family Health Model? a. Structure b. Interaction c. Function d. Context

ANS: B Rationale: Interaction will occur between family members but is not a domain of model.

What percent of U.S. adults are overweight or obese? a. Less than 25% b. 34% c. 40% d. More than 50%

ANS: B Rationale: The obesity crisis is of great concern. According to the Centers for Disease Control and Prevention (2011), about 33.8% of U.S. adults are overweight or obese.

The Institute for Patient- and Family-Centered Care proposes which of the following desired changes in the way health care is provided to individuals and their families? Select all that apply. Each health encounter should: a. Include all family members. b. Enhance individual and family strengths. c. Build the confidence and competence of family members. d. Discourage care giving by family members.

ANS: B, C Rationale: a. Family members cannot always be present but can still be involved. b. This will assist family members with health maintenance and promotion. c. May lead to behaviors that promote and maintain health. d. Care giving by family members is often necessary and desired.

Which of the following increase risk for illness? a. Physical activity b. Tobacco use c. Sedentary lifestyle d. Poverty

ANS: B, C, D Rationale: Tobacco use and a sedentary lifestyle are high-risk behaviors; socioeconomic status also correlates with increased risk for illness

Select all that apply. A family is a group of people a. Living together. b. Related by blood. c. Connected emotionally. d. Committed to each other. e. Who call themselves family.

ANS: B, C, D, E Rationale: A family does not need to physically live together and may not be connected by blood or emotion.

Which of the following is not a priority of the Affordable Care Act's quality improvement strategy? a. New health-care delivery models. b. Families engaged as partners in care. c. Less emphasis on preventive care. d. Use of best practices.

ANS: C Feedback a. New health-care delivery models, families engaged as partners in care, and use of best practices are all priorities of the Affordable Health Care Act's quality improvement strategy. b. New health-care delivery models, families engaged as partners in care, and use of best practices are all priorities of the Affordable Health Care Act's quality improvement strategy. c. Rather than less emphasis on preventive care, a priority is to promote the most effective prevention and treatment practices for leading causes of mortality. d. New health-care delivery models, families engaged as partners in care, and use of best practices are all priorities of the Affordable Health Care Act's quality improvement strategy.

An ____ point of view encourages one to see connections between society and individual or societal health. a. Educated b. Ecumenical c. Ecological d. Environmental

ANS: C Rationale: An ecological point of view encourages one to see connections between society and individual or societal health.

Which of the following actions by the nurse demonstrate the nurse is thinking family? Susan, a nurse who thinks family: a. Introduces herself to each of her patients in the acute-care setting. b. Ensures that family members are not in the room when procedures are done. c. Practices active listening with all her patients' visitors. d. Commends family members for their positive interactions with her patients.

ANS: C, D Rationale: Thinking family is demonstrated by actively listening to patients' visitors and commending family members for their positive interactions with patients. Introducing oneself to each patient and ensuring that family members are not in the room when procedures are done only shows concern for the individual, not for the family.

Which of the following does not contribute to the high costs of medical care in the last year of life? a. Caring for severe illness b. Functional impairment c. Nursing home expenditures d. Over-prescribing practices

ANS: D Rationale: According to Hogan (2001), caring for severe illness, functional impairment, and nursing home expenditures contribute to the high cost of medical care in the last year of life.

Consider the following statements: Statement A. When physicians discuss end-of-life with cancer patients, their health-care costs are much higher in the last week of life. Statement B. Many dying persons never get referred to hospice care. a. Both statements A and B are true. b. Both statements A and B are false. c. Statement A is true and statement B is false. d. Statement A is false and statement B is true.

ANS: D Rationale: According to Zhang et al. (2009), costs are much lower when physicians discuss end-of-life care with their patients. Yet many dying persons are never referred to hospice. More than a third of those referred only spend seven days enrolled, although many would benefit greatly from aspects of care management lasting longer (Jennings, Ryndes, D'Onofrio, & Baily, 2010).