Chapter 4: Health of the Individual, Family, and Community

The nursing student asks the instructor to explain what a community is. Which statement by the instructor would be inappropriate?

"Communities have few effects on the health of the individuals that live there."

the nurse is planning interventions to promote the health of a family with young children. Which family task does the nurse need to consider when planning interventions?

Coping with loss of energy and privacy

which theorist supports the developmental framework of family assessment?

Duvall

The nurse assesses a client who is postoperative day 1 following a total abdominal hysterectomy. Assessment data includes BP 150/88 Hg, HR 100/bpm, RR 22/min with a pain scale of 8 out of 1-10. The abdominal dressing in clean, dry, and intact. The client's orders indicate ambulation today. Which is the priority nursing action?

Medicare the client for pain

a nurse is assessing a client with stress-related problems. Which factor influences responses to stressors?

social support

The nurse is implementing care for several clients. Which client is the nurse helping to reach the highest level of Maslow's hierarchy of basic human needs?

the nurse provides privacy for the client and family during times of prayer.

Which statement is true regarding Friedman's theory of family-centered nursing care?

the role of the family is essential in every level of nursing care

The wife of a comatose client wishes to wash the client's hair. Washing the client's hair meets which basic human need?

physiologic

The wife of a comatose client wishes to wash the clients hair. Washing the clients hair meets which basic human need?

physiologic

the nurse is taking care of a client who is scheduled for a mastectomy. The client tells the nurse that the client is apprehensive about the operation and asks the nurse to read a passage from the Koran to help prepare the client for surgery. Which action by the nurse is the most appropriate?

read the Koran passage to the client.

A client will be hospitalized for at least three weeks following a serious automobile accident. How can the nurse best support this client's love and belonging needs during this hospitalization?

•allow family member to stay at bedside as much as possible •be caring in the provision and planning of care

The home health nurse is making an initial visit to a client's home. During the visit the nurse observed the mother cooking dinner, the father watching television with a child on the lap, and the grandmother in a rocking chair reading the Bible. The nurse recognizes this family structure as which of the following?

extended family

The nurse enters the client's room in the acute care unit immediately after the client experiences a generalized tonic-clonic type seizure in bed. What is the first action the nurse should take?

position the client in a side-lying position

Which intervention performed by the nurse is the most appropriate for assisting a client in meeting safety and security needs based on Maslow's hierarchy of needs?

providing the mother the phone number for poison control center

During the nurse's admission interview the client says, "I don't get too much rest because I am in nursing school and work full time to support myself and my kids." The nurse classifies this statement as an issue at which level of Maslow's basic needs?

psychologic

A nurse in the emergency department assesses a 3-year-old child with a fractured femur, a hematoma on the back of the head, and multiple 1-cm round scans and blisters on the upper back. The parents state that their child sustained the injuries by falling out of a high chair. What is the best action for the nurse to take?

report the suspected child abuse to Child Protective Services

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

The parents of a blended family have a baby boy age six months who is due for immunizations. The clinic closest to their home has recently closed, and they feel intimidated by the prospect of going to the large, university hospital near their home. Which of the following factors is the primary influence on this aspect of the family's health?

Community health care structure

The nurse is caring for an 85-year-old client hospitalized for dehydration. The nurse notices that the client is shivering and takes the client's temperature. The nurse notes an oral temperature of 97.8 degrees F. The client also reports being "chilly". Which nursing action is the most appropriate?

offer another blanket.

A 44-year-old client is being treated for dehydration in an acute care hospital. The nurse determines that the rehydration treatment is working by assessing which values?

urine output of 1500 mL in 24 hours

The nurse on an elective surgery floor receives a report that describes the client's abdominal wound dressing as having a moderate amount of yellowish and bloody drainage on it and a very foul smell. In planning for a dressing change, it is most important for the nurse to perform which action?

wash the nurse's hands before and after the dressing change

A nurse is applying for a position as a community-based nurse. Which type of assignments should this nurse choose to accept in this role?

•visiting a client recently discharged from the hospital •conducting an assessment on a family with a terminally ill child

The nurse is aware that basic client needs must be met before a client can focus on higher ones

grab bars are installed in a client bathroom to facilitate safe showering

A nurse is assisting a neurologist, who is assessing the norepinephrine level of a client who is reporting stress. Which function does norepinephrine perform?

heightens arousal and increases energy

Which are stressors that affect the health of the family?

inadequate childcare services

The nurse is assessing a family parented by a 60-year-old grandmother and three school-age grandchildren. The nurse is aware that which problem may occur in a single-parent family at a greater level than in other types of families?

increased financial concerns

A nurse is working as a part of a group to address factors within the community affecting the health of the families in that community. Which area would the nurse identify as playing a role in contributing to altered health status?

limited number of institutions providing health care, small number of recreational opportunities for adults and children, overlapping of industrial zones with residential zones

The community environment affects the well-being of the individual and the family. Which is the health responsibility of the family?

maintain a healthy lifestyle

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

setting up parenting classes

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

The nurse is assessing the communication style of the client. Communication is an example of which dimension of the individual?

Sociocultural dimension

A couple with adolescent children is most likely to focus on which of the following developmental tasks?

Strengthening marital relationships

The nurse is conducting a family assessment of a traditional family. Which assessment data cue describes the socioeconomic status of the family?

The father is an engineer and the mother is an elementary school teacher.

The home health nurse is making an initial assessment visit to a family that consists of two parents and twin 3-year-old boys. During the interview, the nurse is most concerned if the client makes which statement?

The father states, "I don't discuss money matters with my wife because I don't want her to worry."

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 psychosocial risk factor

A nurse is caring for an adolescent who lost a leg in a motor vehicle accident. Which human need would the nurse most likely need the address?

Self-esteem needs

a nurse is caring for an adolescent who lost a leg in a motor vehicle accident. Which human need would the nurse most likely need to address?

Self-esteem needs

Nursing, as a profession, has long held the belief that providing nursing care to an individual patient means providing nursing care to the entire family. What does this mean when put into a holistic framework of patient care?

active participation by individuals and families in health promotion is integral to this framework of patient care

A nurse is caring for a client newly diagnosed with diabetes mellitus and developing a holistic plan of care. For this plan of care to be successful, it must what?

address the disease but also incorporate the mind, body, spirit

The nurse is caring for a client diagnosed terminal cancer who wishes to use meditation and prayer to be cured. What is the appropriate nursing action?

advocate for the client's choice

a client with persistent nausea is diagnosed with somatization. What is the appropriate nursing action when the client reports nausea?

sit with the client and ask them about their feelings

A nurse working with patients in a community is aware that which is a true statement related to environmental factors in that community?

barriers to accessing healthcare within a community may include lack of transportation

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?

community indicates the people who share similar characteristics

the nurse has developed a strong therapeutic relationship with an electrician who sustained severe burns while working on an industrial site. Which action by the nurse most directly addresses the client's self-actualization needs?

discussing the client's strengths and dialoguing about body image

which theorist supports the developmental framework of family assessment

duvall

Which community characteristics affect the health of individuals?

education programs, communication facilities, transportation services, recreation programs

A nurse is developing a plan of care for a client to meet the client's self-actualization needs. The nurse would focus on which area as most important?

emphasizing the client's strengths

A nurse is planning a seminar for the local community. Which topics are examples of health promotion discussions?

examples of a heart healthy diet, information of increasing activity and exercise

The nurse is assessing the family structure of the client. The family household comprises two parents, three children, and one grandparent. The nurse recognizes that this is a(n):

extended family

A community health nurse is providing care to several farming families in a rural community. Which concept would be most important for the nurse to integrate into the plans of care for these families?

family structures may change over time

A client comes to the health center for a follow-up visit. Assessment reveals that the client is experiencing problems ambulating and moving due to degenerative joint disease; in addition, the client is feeling isolated due to the limitations in mobility. The client also reports feeling anxious about the future related to mobility issues and being unable to fulfill the role as a major provider. Which need would the nurse identify as the priority?

mobility

The epidemiology nurse finds a lower occurrence of influenza cases in a section of a large metropolitan city. Further research reveals higher influenza immunization rates in that section of the city. The nurse determines which probable cause for this occurrence?

immunization have became a community norm

A school nurse is providing orientation to a nurse hired to provide care at a new elementary school opening in the district. The orienting nurse would ask for additional clarification about which statement made by the newly hired nurse?

"I would like to engage our dyadic nuclear families in activities to strengthen their parent-child bonds"

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 nurse is providing care for a client who experienced a stroke. Which nursing intervention reflects the tertiary level of prevention?

Provide care transition at discharge for speech therapy. Explanation: Tertiary prevention minimizes the consequences of a disorder through aggressive rehabilitation or appropriate management of the disease. An example is speech therapy to help restore ability.

the nurse performs an assessment of the client and family to have a better understanding of client and family needs. Which is an individual need?

safety

The nurse assists a postoperative client with ambulation. The nurse recognizes that assisting the client when performing this skill meets which of Maslow's Basic Human Needs?

safety and security

A client with persistent nausea is diagnosed with somatization. What is the appropriate nursing action when client reports nausea?

sit with the client and ask them about their feelings

In conjunction with the client, the nurse has set the following client outcomes. Which client outcome reflects Maslow's level of self-esteem needs?

the client will verbalize feelings of increased confidence in performing a finger-stick blood sugar

which statements about the family unit are accurate?

the family is a buffer between the needs of individual members and society, Duvall (1977) identified critical family developmental tasks and stages in the family life cycle, the nuclear family is composed of two parents and their children

the nurse on the elective surgery floor received a report that describes the client's abdominal wound dressing as having a moderate amount of yellowish and bloody drainage on it and a very foul smell. In planning for a dressing change, it is most important for the nurse to perform which action?

wash the nurse's hands before and after the dressing change