chapter 2 maternity
A nurse is providing care to a client and actively involves the client's family members in the care planning and implementation, dealing with the client and family as a unit. The nurse is engaging in which of the following? a) Family-centered care b) Holistic care c) Community-based care d) Culturally competent care
family centered care
eing a community-based nurse means that you have a different set of skills than those of your counterparts who work in a hospital. As a community-based nurse you also face unique issues and challenges. What is one of the unique aspects of community-based nursing? a) Disease-oriented b) Less holistic c) Teamwork d) Autonomous
Autonomous
The nurse caring for children in the community setting knows that the number of grandparents raising grandchildren is on the rise. a) True b) False
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Which behavior suggests that a family is a well one? a) A father wishes the family was able to spend more time together. b) A mother is angry that the father never helps with housework. c) A brother is so jealous of his new sister that he hides her clothes. d) A mother states she has grown up since giving birth to her children.
A mother states she has grown up since giving birth to her children.
The nurse interviews a family that consists of a husband and wife who have both previously been in a marital relationship and who are living with two children. The children are the biological children of the mother and were born before the remarriage. This family situation is termed a(n): a) Blended family b) Binuclear family c) Nuclear family d) Extended family
Blended family
The nurse is assessing a family in which the parents are going through a divorce. There are three siblings in the family: a 4-year-old girl, a 10-year-old boy, and a 15-year-old girl. Which of the following is an important framework for the nurse to use when assessing the response of each child to the divorce? a) Family systems b) Crisis intervention c) Developmental stages d) Life cycle
Developmental stages
A nursing instructor is teaching a class about families and their functions. The instructor determines that the teaching was successful when the class identifies which of the following as true? a) Reproduction remains an important function of all families. b) Couples today are more concerned about unplanned pregnancies. c) Family members usually share the funds that some members earn. d) It is primarily the older members who teach the younger members in a family.
Family members usually share the funds that some members earn.
The nurse is teaching a 6-year-old girl and her mother about home care for an eye infection. Which of the communication techniques would be least effective with this child? a) Talking directly to the child even though the mother makes comments b) Asking permission to touch the child before doing so c) Listening attentively to the child while giving time to finish thoughts and ideas d) Standing beside the child when doing the teaching
Standing beside the child when doing the teaching
A family is getting divorced and is asking about what is best for the children. How should the nurse approach this question? a) The nurse should make a follow-up call to see what the family's decision was. b) The nurse should direct the information towards the mother. c) The nurse should encourage the father to be involved in the care of the children. d) The nurse should give them his or her personal contact number for future help.
The nurse should encourage the father to be involved in the care of the children.
A gay couple is considering adopting a newborn and they want to know the long-term outcomes for children in gay families. What is the best response by the nurse? a) This type of adoption is not recommended for a newborn. b) Their social relationships are usually more strained. c) Their psychological health is similar to children of heterosexual parents. d) There is lack of evidence on how this will impact the children.
Their psychological health is similar to children of heterosexual parents.
One type of medicine a patient on home care receives could be given with any of the following schedules. Which of the following would be most effective in helping compliance?
Three times a day at 10 am, 2 pm, and 10 pm
As part of an education program for pregnant women and their partners, the nurse describes the various settings available for childbirth. The nurse determines that the program was successful when the group relates which of the following about home births? a) "A wide range of pain medications is readily available to the woman." b) "There are very rigid screening procedures that must be followed." c) "A home birth is probably the most expensive setting for childbirth." d) "Women giving birth at home have control over every part of labor."
Women giving birth at home have control over every part of labor."
A nurse is educating a client about a care plan. Which of the following statements would be appropriate to assess whether the client is learning? a) "Did you graduate from high school; how many years of schooling did you have?" b) "Do you have someone in your family who would understand this information?" c) "Would you prefer that the doctor give you more detailed medical information?" d) "Many people have trouble remembering information; is this a problem for you?"
"Many people have trouble remembering information; is this a problem for you?"
The nurse is providing home care for a 6-year-old girl with multiple medical challenges. Which of the following activities would be considered the tertiary level of prevention? a) Teaching parents to administer albuterol b) Reminding parent to give a full course of antibiotics c) Giving a DTaP vaccination at the proper interval d) Arranging for a physical therapy session
Arranging for a physical therapy session Explanation: The tertiary level of prevention involves restorative, rehabilitative, or quality of life care such as arranging for a physical therapy session. Teaching parents to administer albuterol and reminding a parent to give the full course of antibiotics as prescribed are part of the secondary level of prevention, which focuses on diagnosis and treatment of illness. Giving a DTaP vaccination at the proper interval is an example of the primary level of prevention, which centers on health promotion and illness
When caring for childbearing families from cultures different from one's own, which of the following must be accomplished first? a) Assess personal feelings about that culture b) Adapt to the practices of the family's culture c) Learn as much as possible about that culture d) Determine similarities between both cultures
Assess personal feelings about that culture
The nurse is educating a 16-year-old girl who has just been diagnosed with acute myelogenous leukemia. Which of the following statements best demonstrates therapeutic communication? a) Using medical terms when describing the disease b) Talking about clothing and the stores where she shops c) Discussing the treatment plan in detail for the next few weeks d) Assessing the adolescent's emotional status in private
Assessing the adolescent's emotional status in private
A nurse has just learned that one of her patients, a 40-year-old woman, has gone through a divorce. She has full custody of her 16-year-old son and 5-year-old daughter. The mother was the primary wage earner in the marriage and will be continuing to work after the divorce. Which of the following should be the priority for the nurse? a) Assessing the son for emotional trauma b) Assessing the daughter for emotional trauma c) Educating the mother on community financial supports d) Educating the mother on the risks of domestic abuse
Assessing the son for emotional trauma
Advocacy for your client is an important aspect of community-based nursing. What is one way a community-based nurse can advocate for a child that is her client? a) Assisting the family to apply for Medicaid or other forms of health care reimbursement b) Arranging for educational events for the local hospital staff c) Assuring a young mother that you will not report the suspicious bruises on her toddler to social services d) Reporting a new case of whooping cough to the county health authorities
Assisting the family to apply for Medicaid or other forms of health care reimbursement
Historically the structure of a family in our society was the nuclear family with a man, a woman and their children who shared a common household. Today, families come in a variety of structures. Two of these structures are the stepfamily and the blended family. What differentiates a blended family from a stepfamily? a) Custodial parents live together and raise their children as one family b) Both adults are custodial parents and bring their children to the family structure instead of just one custodial parent and their children c) The parents choose to legally take into their family structure a child who is not biologically their child and to raise it as if it were biologically their child d) All the adult relatives living in the household participate in raising the children
Both adults are custodial parents and bring their children to the family structure instead of just one custodial parent and their children
Students are reviewing information about family structures and functions. They demonstrate understanding of the information when they identify which of the following as true? a) Married couples in families with children have been increasing since the year 2000. b) The functions of a family in each family are identical. c) Despite changes in family structure, the nuclear family is still prominent. d) The intergenerational family is the traditional U.S. family structure
Despite changes in family structure, the nuclear family is still prominent
A woman with a high-risk pregnancy is on bed rest and is receiving home care from a nurse. The mother expresses anxiety over the possibility of losing the baby, as she has lost a previous pregnancy. She says that receiving visits from her friends and family while at home reduce her anxiety. Which of the following would be the most appropriate outcome criterion pertaining to the home care of this patient? a) Client is able to travel safely from the home to the hospital b) Client is able to receive frequent visits from friends and family c) Client is able to maintain an appropriate weight during pregnancy d) Client is able manage pain effectively during labor at the hospital
Client is able to receive frequent visits from friends and family
The nurse is providing a secondary prevention activity when a) Teaching a group of adolescents about sexually transmitted diseases b) Conducting a skin cancer screening fair c) Showing a patient proper application of a colostomy device d) Instructing a group of senior citizens on use of the Internet
Conducting a skin cancer screening fair
A pregnant woman with a premature ruptured membrane is trying to decide whether home care might be the best option for her. Which of the following is an advantage the nurse should mention to her that is most pertinent to her condition? a) Prevention of disruption of the family b) Prevention of social isolation c) Lower cost for the health care delivery system d) Decreased exposure to infection
Decreased exposure to infection
A pregnant woman with a premature ruptured membrane is trying to decide whether home care might be the best option for her. Which of the following is an advantage the nurse should mention to her that is most pertinent to her condition? a) Prevention of social isolation b) Decreased exposure to infection c) Prevention of disruption of the family d) Lower cost for the health care delivery system
Decreased exposure to infection
The nurse is caring for a 4-year-old boy with Ewing sarcoma who is scheduled for a computed axial tomography (CAT) scan tomorrow. Which of the following is the best example of therapeutic communication? a) Telling him he will get a shot when he wakes up tomorrow morning b) Describing what it is like to get a CAT scan using words he understands c) Telling him how cool he looks in his baseball cap and pajamas d) Using family-familiar words and soft words when possible
Describing what it is like to get a CAT scan using words he understands
The nurse is teaching the student nurse how to communicate effectively with children. Which one of the following methods would the nurse recommend? a) Direct questions and explanations to the child. b) If possible, communicate with the child apart from the parent. c) Position self above the child's level to denote authority. d) Use the medical terms for body parts and medical care.
Direct questions and explanations to the child.
The nurse is providing care for a 2-year-old girl with a chronic respiratory disease present since birth. Which of the following would be of least help in working effectively with the parents? a) Maintain complete honesty with the parents. b) Expect parents to perform procedures precisely as taught. c) Provide positive feedback to mother and father for care and parenting well done. d) Consider parents equal partners in care.
Expect parents to perform procedures precisely as taught.
A married couple has 3-year-old twins. They own a dog. The father's mother lives with them. The father is a professor; the mother has resigned from her position as a legal secretary to be the children's primary caregiver. Which type of family does this represent? a) Extended b) Cohabiting c) Nuclear d) Blended
Extended
An elderly woman brings her 10-year-old granddaughter to the doctor's office for a vaccination. The nurse learns that the elderly woman lives with her daughter, son-in-law, and three grandchildren. What type of family is this? a) Nuclear family b) Blended family c) Adoptive family d) Extended family
Extended family
Assessment of an adult client reveals that he lives with his wife and three children. The client's father-in-law lives in an in-law suite attached to the client's home. The client's parents live about a block away and visit the family often. The nurse interprets this as which type of family? a) Single-parent b) Blended c) Nuclear d) Extended family
Extended family
The functions of the family are important in preserving our society with its beliefs, norms, and values. There are five major functions of the family unit; what is one of them? a) Assimilating the child into the national culture rather then the cultural heritage of the family b) Protection from violence in the media and the environment c) Giving and teaching emotional support d) Addresses meaning in a lifestyle
Giving and teaching emotional support
A nurse is trying to reduce a mother's anxiety about her child being in the hospital. Which would be the best way to accomplish this? a) Include the mother in the medical decision making. b) Let the mother know you will relay any messages she has for the doctor. c) Address all the mother's concerns promptly. d) Tell the mother about the tests being performed.
Include the mother in the medical decision making.
The nurse is performing a cultural assessment of an Asian family who have a child hospitalized for leukemia. What is the best technique for providing culturally competent care for this family? a) Research the culture and base care on findings. b) Just ask the family about their culture and listen. c) Ask other Asians to explain their culture. d) Hire an interpreter to explain the family culture.
Just ask the family about their culture and listen.
As a community health nurse you are asked to present an educational event to the local Junior League. While planning for the event, what is most important for you, the nurse, to do? a) Tell the participants about the nurse's background b) Use posters that everyone in the group can read c) Know the needs of the audience d) Ask questions about the histories of those present
Know the needs of the audience
A family of a mother, father, and a 6-year-old boy was recently enlarged to include a new baby sister. What type of family does this represent? a) Extended b) Dysphasic c) Single unit d) Nuclear
Nuclear
After talking at length with the single mother of a malnourished child, the nurse determines that the child's poor nutrition is a result of improper care of the child by an older sibling while the mother is working. This determination is an example of which step of the nursing process? a) Nursing diagnosis b) Assessment c) Implementation d) Outcome identification and planning
Nursing diagnosis
A nurse is providing home care to several families who live in a community with limited resources. Which of the following is an example of how the nurse can best "nurse the community"? a) Read a recent journal article on prevention of staph infections in hospitals b) Obtain a Master's degree in a nursing field of interest c) Organize a free flu vaccination in the community d) Attend a leadership training workshop
Organize a free flu vaccination in the community
A child has just been diagnosed with lead poisoning. The child's father admits that the home they live in has old, with flaking paint on the walls because they cannot afford to remove it. A failure in which wellness behavior has led to this child's condition? a) Division of labor b) Allocation of resources c) Physical maintenance d) Socialization of family members
Physical maintenance
Modern health care has seen many technological advances. While improving many aspects of health care these advances have been a part of the reason for the increases in the cost of health care and the necessity of finding alternative health care approaches. These alternative approaches have different foci and goals than traditional health care. Community-based health care is one of these alternative approaches. What is the focus of community-based health care? a) Tracking reportable diseases b) Keeping clients with chronic illnesses in their homes c) Providing care for the client as an individual d) Preventing disease and its sequelae
Preventing disease and its sequelae
The nurse is teaching the parents of a newborn with a metabolic problem about the disorder and its treatment. Which of the following is the least effective teaching technique? a) Providing a print handout for the parent to read and asking for questions b) Using the food pyramid diagram to teach necessary nutrition alterations c) Explaining the disorder in common terms d) Discussing how to handle a possible emergency situat
Providing a print handout for the parent to read and asking for questions
A newborn is being discharged from the hospital. What information would be important to give the parents to help them identify a medical home? a) Referral to local pediatric specialists b) Information about pediatric urgent care facilities c) Resources of local pediatricians' offices d) Education about what is appropriate emergency room use
Resources of local pediatricians' offices
Community care settings for the pediatric client are as varied in their settings as they are in their functions. Much of the care of the pediatric client has been shifted from the hospital setting to a community setting suitable for the care being provided. Which community care setting is appropriate for assessing vision and hearing in children? a) Schools b) Vision and hearing centers c) Pediatric acute care clinics d) Pediatric rehabilitation centers
Schools
A nurse is assigned to perform a blood pressure evaluation on a pregnant patient. This type of care is referred to as a) Tertiary prevention b) Secondary prevention c) It is not prevention because the problem did occur. d) Primary prevention
Secondary prevention
A nurse is caring for a client who has frequent visitors. The client informs the nurse that he belongs to a communal family. Which is the most likely characteristic of a communal family? a) Several people living together and sharing work b) Unmarried individuals living together c) Intimate partners of the same sex living together d) Children living with paid caregivers temporarily
Several people living together and sharing work
Because of high divorce rates and separations in recent years, there has been a significant increase in the family structure termed a) Single-parent b) Extended c) Communal d) Foster child
Single-parent
The nurse is incorporating nonverbal communication with verbal communication when explaining the treatment plan for a child with juvenile diabetes. Which of the following should the nurse do to communicate effectively with this family? a) Sit opposite the family and lean forward slightly. b) Relax; maintain an open posture, with the arms crossed. c) Speak a verbal yes or no; do not use head nods. d) Use eye contact sparingly to avoid embarrassment.
Sit opposite the family and lean forward slightly.
An example of an intervention taken on the tertiary prevention level of care is a) Teaching a family about proper child restraint systems b) Teaching cardiopulmonary resuscitation to a group of lifeguards c) Teaching signs and symptoms of infection to a postoperative patient d) Showing a mother how to diaper her newborn
Teaching signs and symptoms of infection to a postoperative patient
A nurse in a woman's shelter is counseling a client who has been a victim of abuse. What type of prevention is this treatment? a) Community-based b) Primary c) Secondary d) Tertiary
Tertiary
The nurse is assessing the learning needs for a 12-year-old boy with a chronic health condition and his parents. Which of the following aspects would be least pertinent to a learning needs assessment?
The family belongs to a mainline traditional faith community
Assessment of a client reveals that he is part of a nuclear family. The nurse interprets this as which of the following? a) Each family member exerts similar influence on the other person. b) The family includes a married adult man, his wife, and their children. c) The family members share a common belief or bond. d) Family members live together in one household.
The family includes a married adult man, his wife, and their children.
The nurse uses family-centered care to care for children in a pediatric office. Upon what concept is family-centered care based? a) The wishes of the family should direct the nursing care plan for the child. b) The child must be prepared to be his or her own source of strength during times of crisis. c) The care provider is the constant in the child's life and the primary source of strength. d) The family is the constant in the child's life and the primary source of strength.
The family is the constant in the child's life and the primary source of strength
Children in foster care have a disproportionately higher incidence of pediatric acute and chronic conditions. a) False b) True
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On assessing the family, which of the following actions would lead you to suspect that the family is not functioning in a healthy way? a) The father does not share his concerns so his wife will not worry about them. b) The father comforts his crying daughter. c) The mother states, "This family couldn't function without me." d) The family pays cash for health care.
The father does not share his concerns so his wife will not worry about them.
Providing certain aspects of health care in the home has reduced the cost of such care. This reduced cost is most beneficial for a) The community b) Doctors' offices c) The health care plan d) The hospital
The health care plan
After evaluating a patient on home care, it is most important for the visiting nurse to determine a) Whether the patient can return to work b) What questions the family has c) Whether the patient needs to be readmitted to the hospital d) If the patient has enough supplies to last until the next visit by the nurse
Whether the patient needs to be readmitted to the hospital
The best setting in which to secure a health history in a home would be the a) kitchen, so other family members can participate. b) bedroom, where it is quiet and private. c) porch, so you do not have to enter the home. d) living room, so you do not interrupt television viewing.
bedroom, where it is quiet and private.
A pregnant teenager is not certain that she will like home care because she is afraid she will feel lonely. You suggest that a) her father buy a cell phone. b) the family buy her a television set. c) everyone could eat together. d) the family install an intercom system.
everyone could eat together.
A physician orders a pregnant woman with slightly elevated blood pressure to return home on bed rest until her next scheduled check-up. This is an example of which type of care? a) skilled home care b) hospice care c) home care d) community care
home care
A boy you care for tells you that his mother is a psychologist while his father is unemployed. His mother is the one who reminds him to take his medicine and also comforts his sister when she cries. Analyzing this description of his parents' roles, you would conclude that his a) father is the health supervisor and nurturer. b) father is the peacemaker. c) mother is the provider and nurturer. d) mother is the decision maker.
mother is the provider and nurturer.
A nurse is changing roles in her job such that she will now be primarily providing home care to children rather than seeing them in a health care facility. She knows that she will need which of the following skills or traits when working in this new environment? (Select all that apply.) a) Ability to work in a highly structured environment b) Acute care nursing skills c) Ability to teach family members how to give care d) Ability to encourage frustrated family members e) Skill in helping children adapt to a new environment f) Great flexibility
• Acute care nursing skills • Great flexibility • Ability to teach family members how to give care • Ability to encourage frustrated family members
The pediatric nurse must assess the roles each family member plays in order to prevent role overload and ensure that family functions are fulfilled. Which of the following are examples of formal family roles? Select all that apply. a) Homemaker b) Raising the children c) Mediator d) Breadwinner e) Easing family tensions f) Providing humor
• Breadwinner • Homemaker • Raising the children
A mother brings her 10-year old daughter, Shanaya to the clinic for a check up. The mother confides to the nurse that Shanaya was adopted as a baby, but they never told her. The mother asks the nurse what she should tell her daughter about the adoption. When responding to the mother, the nurse would suggest that the mother include which information when disclosing the adoption to Shanaya? Select all that apply. a) Explaining the adoptive parents motivation for adoption b) Acknowledging the important role of the birth parents in the creation of the child c) Acknowledging that there are happy and sad feelings associated with adoption d) Describing the specifics of the adoption story
• Explaining the adoptive parents motivation for adoption • Acknowledging the important role of the birth parents in the creation of the child • Acknowledging that there are happy and sad feelings associated with adoption • Describing the specifics of the adoption story
The nurse is working with a same-sex couple, both of whom have children from previous relationships. Although the couple are not married and have no plans of marrying, they view their relationship as monogamous and long-term. Which of the following family types would apply to this family? (Select all that apply.) a) Dyad family b) Extended family c) Cohabitation family d) Foster family e) Gay or lesbian family f) Blended family
• Gay or lesbian family • Cohabitation family • Blended family
A student nurse is preparing a presentation on the functions of a family. What information should the student include? Select all that apply. a) Provide support and security for family members b) Provide nurturing c) Economic provisions of care d) Socialization e) Family functions do not change over time
• Provide support and security for family members • Provide nurturing • Economic provisions of care • Socialization
