Chapter 4

A nurse is assessing a family with adolescents. The family consists of a father, mother, a 13-year-old son, a 14-year-old son from a previous marriage, and a 16-year-old daughter. Which statement by the parents would lead the nurse to suspect a potential risk factor for altered health with this family?

"Our 16-year-old just seems to butt heads with us at every turn." The statement about the daughter butting heads with the parents may suggest a conflict among family members and thus a risk factor for altered health. Being assertive (not aggressive), being able to problem-solve, and having open communication about sexually transmitted infections promote family health.

The nurse is admitting a 38-year-old client to the oncology unit whose religious background is different from the nurse's own. The nurse is assessing how the client's religion may affect the client's health care needs. Which question by the nurse is the best way to consider the client's religious practices in the plan of care?

"What can we do to help you meet any religious needs you may have?" The nurse should always respect the client's religious beliefs and ask whether the client has any religious needs that may affect health care. Comparing the client's beliefs with those of the nurse is inappropriate. Asking general questions about the client's religion would not identify other aspects of religion that might affect health care. A too-narrow focus on only dietary restrictions or specific medical treatments will not give the nurse enough information to develop an inclusive plan of care.

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 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 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, and spirit. A holistic plan of care seeks to balance and integrate the use of crisis medicine, advanced technology, and the mind, body, and spirit, which are incorporated though the use of the nursing process. Taking into account the cost of care is only one facet of a holistic picture. Connecting families, friends, and the environment is important, but mind, body, and spirit define holism. A holistic plan of care may provide a connection between medicine and nursing, but it does not define it.

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 Developmental tasks for families with adolescents and young adults include balancing teenagers' freedom with responsibility, maintaining supportive home base, and strengthening marital relationships. Adjusting to retirement is a developmental task for families with older adults.

What is an example of a community risk factor?

Children are kept inside on a sunny day due to a lack of recreational opportunities. A key component of the question is the term community. The most basic definition of a community is a specific population or group of people living in the same geographic area under similar regulations and having common values, interests, and needs. The only option above that addresses community is the one in which children are kept inside the home on a sunny summer day because of a lack of recreational opportunities. The other options are focused on individuals, which is not the direction of the question.

A community-based nurse acts as a case manager for a small town about 60 miles from a major healthcare center. What is the most important factor of community-based nursing for this nurse to be knowledgeable about?

Community resources available to clients A community-based nurse must be knowledgeable about community resources available to clients as well as services provided by local agencies, eligibility requirements, and any possible charges for the services. The other answers are incorrect because they are not the most important factor for a community-based nurse to be knowledgeable about.

A nurse is assessing a family and identifying where the family is in the family life cycle. During this assessment, the nurse applies Duvall's theory. Which theory forms the basis for Duvall's theory?

Erikson's theory of psychosocial development Duvall (1985) identified critical family developmental tasks and stages in a family life cycle. Duvall's theory, based on Erikson's theory of psychosocial development, states that all families have certain basic tasks for survival and continuity, as well as specific tasks related to developmental stages throughout the life of the family. Freud, Kohlberg, and Piaget are not associated with Duvall's theory.

The home health nurse is making an initial visit to a client's home. During the visit the nurse observes 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 extended family is composed of two parents, their children, and relatives (such as aunts or grandparents) living in the same household. The blended family is a family formed when parents bring unrelated children from previous relationships together. Single-parent families have only one parent, and the nuclear family consists of two parents and their children.

The nurse in the adolescent in-patient psychiatric unit is interviewing the family of a 16-year-old client admitted for depression and threatened suicide. What assessment information is most essential for the nurse in determining the affective and coping function of the family?

Family patterns of communication The five major areas of family function are physical, economic, reproductive, affective and coping, and socialization. When assessing the family of a depressed client for affect and coping function, it is helpful for the nurse to be aware of the family's communication style. This information can help identify family difficulties and teaching points that could benefit the client and the family.

The nurse is aware that basic client needs must be met before a client can focus on higher ones. According to Maslow's hierarchy of human needs, which example would be the highest priority for a client after physiologic needs have been met?

Grab bars are installed in a client bathroom to facilitate safe showering. According to Maslow, safety and security needs follow basic physiologic needs; therefore, grab bars in a bathroom helps ensure safety in the client's shower. Enrolling in an art class would meet love and belonging, self-esteem, or self-actualization needs. Arranging for a teenager to have friends visit would help in meeting love and belonging needs. Identifying strengths in a client demonstrates self-esteem needs.

A client is experiencing a stress response each time the family visits the room. What nursing intervention is most appropriate?

Limit the family visits to once daily 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.

A nurse is providing care to a client who is feeling lonely and isolated. In an effort to develop a trusting nurse-client relationship, the nurse exhibits a caring attitude, ensures the client's privacy, and spends time with the client to promote therapeutic communication. The nurse is meeting which category of client needs?

Love and belonging People who believe that their love and belonging needs are unmet often feel lonely and isolated. The nurse addresses this by establishing a nurse-client relationship based on mutual understanding and trust (by demonstrating caring, encouraging communication, and respecting privacy). Physiologic needs are the most basic in the hierarchy of needs and the most essential to life. Safety and security needs have both physical and emotional components: physical safety and security means being protected from potential or actual harm; emotional safety and security involves trusting others and being free of fear, anxiety, and apprehension. Self-esteem needs include the need for a person to feel good about himself or herself, to feel pride and a sense of accomplishment, and to believe that others also respect and appreciate those accomplishments.

A family that consists of two homosexual parents and three children living in the same house is an example of which type of family?

Nuclear The nuclear family is also known as the traditional family and is composed of two parents and their children. The parents might be heterosexual or homosexual, are often married or in a committed relationship. An extended family includes aunts, uncles, and grandparents. A blended family is also a traditional family formed when parents bring unrelated children from previous relationships together to form a new family. A single-parent family involves one parent and may be the result of marital separation or divorce, the death of a spouse, or the parent never having been married.

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°F (36.6°C). The client also reports being "chilly." Which nursing action is most appropriate?

Offer the client an extra blanket. Thermoregulation is a physiological need. The human body functions within a narrow temperature range with an oral temperature of 97.5 to 99.5°F (36 to 38°C). Homeostatic mechanisms and adaptive responses, such as shivering (to increase body temperature) or sweating (to reduce body temperature), help to maintain body temperature. Offering the client a blanket is appropriate because the external body covering will increase the client's low body temperature. Notifying the physician is not necessary because the temperature is within normal range. A normal or low temperature is not an indicator of dehydration, so increasing the intake of oral fluids is not necessary. A normal or low temperature is not an indication of respiratory distress, so an assessment of the client's respiratory rate is not necessary.

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 scabs 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. The physical function of the family is to provide a safe environment necessary for growth and development. The child's injuries (a fractured femur with head injury and 1-cm round scabs and blisters on the upper back) suggest physical abuse by slamming the child into a wall while holding on to his leg, along with cigarette burns. All suspected cases of abuse must be reported to the appropriate agency or authority. Failure to report suspected child abuse is considered nursing negligence. Documenting "suspected abuse" in the client's record is inappropriate. Only the objective physical findings and observations should be documented. Referring the family for follow-up care to social services does not satisfy the legal obligation to report the suspected crime of child abuse to the proper authorities. Asking the physician to question the parents about the suspected abuse can jeopardize the child's safety by alienating the parents and creating distrust between the parents and the healthcare providers.

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 Somatization is manifesting an emotional stress through a physical disorder. Treating the nausea with an antiemetic will not get at the root cause of the emotional issue. Contacting the primary care provider is not appropriate, as the diagnosis of somatization is present. Explaining that the physical symptoms are all in the client's head is not therapeutic. Sitting with the client to explore what is really going on is most appropriate nursing response.

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

Sociocultural dimension 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.

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. Identification of signs and symptoms of hypoglycemia will promote the safety of the client. Physical activity, such as ambulation, is essential for Maslow's physiologic needs. Social support that meets a transportation problem represents a solution to feeling love and belonging. Self-esteem is enhanced with feelings of increased confidence in skill performance.

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 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.

The nurse on the 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. Physical safety and security mean being protected from potential or actual harm. The abdominal dressing with a foul smell indicates the presence of bacteria. It is most important for the nurse to prevent the spread of infection to the nurse and others and to protect the client. Proper hand washing before and after the dressing change to prevent the spread of infection is a nursing activity that will meet these physical safety needs. Changing the abdominal dressing more frequently, applying extra gauze to absorb the wound drainage, or using sterile gloves to change the dressing will not prevent the spread of infection to other clients or staff.

Which theorist supports the developmental framework of family assessment?

Duvall Duvall supports the developmental framework of family function. Minuchin, Satir, and Bowen are nurses whose family nursing theory is based on systems theory.

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 Tasks that the family does not complete at any one developmental stage can produce chronic difficulties as the family struggles to master tasks at the next stage. The couple is struggling due to them only being together married for less than a year and the difficulty of a having a child in this short time frame. Nothing in the stem alludes to the couple having issues with the stress of education, job, and parenting nor economic difficulties or involvement with significant others.

Which are stressors that affect the health of the family?

Inadequate childcare services 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.

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?

The parents have a tumultuous relationship, with frequent separations in the past. 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.

A nursing student's parents are both physicians. The nursing instructor may feel the student has

Been socialized in healthcare Socialization happens by the process of living and experiencing in family and society. If the student comes from a family of healthcare professionals, this too is part of the socialization process.

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 type of factor is the primary influence on this aspect of the family's health?

Community health care structure The size, location, and services of health care offerings in a geographical area are components of the community health care structure and its influence on health. Family functioning, lifestyle, and economic considerations are not primary influences on the family's actions.

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 people who share similar characteristics. 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 new graduate nurse asks a nurse manager working at the community health center, "I've heard people talk about community health nursing and community-based nursing. Is there a difference?" Which response by the nurse manager would be appropriate?

"Community health nursing involves care for entire populations whereas community-based nursing focuses on individuals and families in that population." In contrast to community health nursing, which focuses on whole populations within a community, community-based nursing is centered on the health care needs of individuals and families. Nurses practicing community-based nursing provide interventions to manage acute or chronic health problems, promote health, and facilitate self-care. Nursing care provided within a community must be culturally competent and family centered.

Place the following examples of interventions to meet human needs in order from the most basic, high-priority needs to the lower-priority needs based on Maslow's hierarchy. Use all options.

- A nurse provides nutrition for a client through a feeding tube. - A nurse places a No Smoking sign on the door of a client who is receiving oxygen. - A nurse includes family members in the care of a client. - A nurse helps a client focus on the client's strengths following a diagnosis of breast cancer. - A nurse prepares a room for a clerical visit requested by a client. Maslow's hierarchy provides a framework for nursing assessment and for understanding the needs of clients at all levels, so that interventions to meet priority needs become a part of the plan of care. A nurse would first prioritize the nutritional needs of the client. This is Level 1, physiological needs. The next task to be prioritized would be placing a No Smoking sign on the door of a client who is receiving oxygen. This is Level 2, safety and security needs. The next task would be including family members in the care of the client. This is Level 3, love and belonging needs. The next task would be helping a client focus on the client's strengths following a diagnosis of breast cancer. This is Level 4, self-esteem needs. The last task would be preparing a room for a clerical visit requested by the client. This is Level 5, self-actualization needs.

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 Maintaining a healthy lifestyle is the health responsibility of the family. Providing educational, health care, and recreational services is the responsibility of the community.

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?

Physiologic Rest is a basic physiologic need, because it allows time for the body to rejuvenate and be free of stress. Lack of sleep and rest may become a safety issue if not addressed. Love and belonging is related to acceptance in a group. Self-esteem is related to how one sees one's self.

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

Provide care transition at discharge for speech therapy 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. Blood pressure and mental status exams are examples of secondary prevention associated with the acute stroke. Discussing family history is also secondary prevention in terms of assessing for further risk factors.

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

Safety Safety is an individual need and a part of Maslow's hierarchy. Educational, socialization, and political needs are provided by the family.

The nurse is conducting a home assessment and suggests that the client's family remove scatter rugs from the home and increase the lighting. Which basic human need is being addressed by the nurse's suggestions?

Safety and security Making changes in the home environment, such as removing scatter rugs and increasing lighting, promotes the safety of the family members. Physiologic needs include basic bodily functions, such as oxygen, water, and food. Self-esteem needs include the need for an individual to feel good about himself or herself, to feel pride and a sense of accomplishment, and to believe that others also respect and appreciate those accomplishments. Self-actualization includes the need for individuals to reach their full potential through development of their unique capabilities.

The nurse is assessing the family structure of the client and determines it is an extended family. Which family represents an extended family?

Two parents, three children, and one grandparent An extended family is composed of family members, including aunts, uncles, and grandparents, who live in close geographic proximity to one another. A traditional family consists of two parents and their children. A blended family is formed when parents bring unrelated children from previous relationships together to form a new family. Individuals who choose to live together for a variety of reasons form a cohabiting family.

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

Setting up parenting classes Duvall (1977) identified critical family developmental tasks and stages in a family life cycle. Duvall's theory, based on Erikson's theory of psychosocial development, states that all families have certain basic tasks for survival and continuity as well as specific tasks related to developmental stages throughout the life of the family. The question asks about a community clinic that serves mostly families with young children and the priority intervention for clients in this developmental stage. Setting up parenting classes is the only answer that addresses the stated developmental stage. Families with adolescents and young adults would be at the appropriate developmental stage for providing sex education and alcohol/drug information. The community clinic would not focus on screening for congenital defects.

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

Social support A person's response to stressors depends on social support, intensity of the stressor, number of stressors, duration of the stressor, physical health status, life experiences, coping strategies, personal beliefs, attitudes, and values. A person's response to stressors is independent of education, eating habits, economic status, or personal hygiene.

A nurse is working as 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? Select all that apply.

- Small number of recreational opportunities for adults and children - Limited number of institutions providing health care - Overlapping of industrial zones with residential zones Many community factors affect the health of residents. A healthy community enables people to maintain a high quality of life and productivity. For example, a healthy community offers access to health care services for all members of the community; has roads, schools, playgrounds, and other services to meet needs of the people in the community; and maintains a safe and healthy environment. Factors within the community that can affect health include the number and availability of health care institutions and services; zoning regulations separating residential and industrial areas; as well as air and water pollution and recreational opportunities. Limited numbers and availability of these would be considered risk factors for altered health. A high, not low, incidence of crime would be a risk factor for altered health.

In the implementation of effective client care, the nurse should

Assess the client's family dynamics and community. Understanding family dynamics and the community context assists nurses in planning appropriate care for clients.

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 To help meet a client's self-actualization needs, the nurse focuses on the person's strengths and possibilities rather than on problems. Reducing fear would assist in meeting the client's safety and security needs. Promoting socialization would aid in meeting the client's love and belonging needs.

A client comes to the health center for a follow-up visit. Assessment reveals that the client is experiencing problems ambulating and moving about 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 the mobility issues and being unable to fulfill the role as the major provider. Which need would the nurse identify as the priority?

Mobility Although all of the needs listed need to be addressed, the nurse would identify mobility issues as the priority need based on Maslow's hierarchy. In addition to it being a physiologic need, it also appears to be the underlying issue related to the client's other needs. Addressing mobility may have a positive impact on the client's other needs.

Which intervention performed by the nurse is 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 the poison control center The nurse is meeting safety needs by providing a mother with the phone number for the poison control center. Cutting up food and opening drink containers for the client would meet the most basic need for food. The nurse seeking input from the client regarding preferences for a snack is showing respect to the individual and meeting self-esteem needs. When assisting the client to validate feelings regarding treatment options, the nurse is acknowledging the uniqueness of the client and respecting the client's knowledge and feelings in solving problems to attain self-actualization.

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

Self-esteem needs The options listed are stages of Maslow's hierarchy of needs. The adolescent would have issues and concerns in the self-esteem stage. Self-esteem needs would include fear, sadness, loneliness, and accepting self; all would be appropriate with this client. Love and belonging would focus on the sociocultural aspect and would include areas such as relationships with others, communication with others, support systems, being part of a community, and feeling loved by others. Safety and security would focus on the environmental aspect and would include areas such as housing and community/ neighborhood to name a few. Self-actualization needs are in the intellectual and spiritual dimension and would include areas such as thinking, learning, decision making, values, beliefs, and helping others.

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 practice. 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 caring for a 78-year-old client who has been hospitalized following a stroke. Which nursing action has the highest priority for this client?

Measuring the client's intake and output during recovery According to Maslow's hierarchy of basic human needs, physiologic (Level 1) needs, such as maintaining fluid balance, are of the highest priority, so measuring the client's intake and output during recovery is the nursing priority in this case. Ensuring that the client has family and friends visit addresses a Level 3 (love and belonging) need. Helping the client fill out an advanced directive form addresses a Level 4 (self-esteem) need. Finding a safe environment for the client on discharge addresses a Level 2 need (safety and security).

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. Active participation by individuals and families in health promotion supports the self-care model historically embraced by the nursing profession. This model is congruent with the philosophy that seeks to balance and integrate the use of traditional medicine and advanced technology with the influence of the mind and spirit on healing. Families are not always caretakers when the patient is not acutely ill; it is not necessary for the nurse, patient and the patient's family to integrate the physical and emotional environment of the patient. It is necessary for the patient to integrate their physical and emotional environment. The holistic framework of patient care is not a model that is congruent with the philosophy of traditional patriarchal medicine.

The nurse assesses a client who is postoperative day 1 following a total abdominal hysterectomy. Assessment data includes blood pressure (BP) 150/88 mm Hg, heart rate (HR) 100 beats/min, respiratory rate (RR) 22 breaths/min with a pain scale of 8 on a scale of 1 to 10. The abdominal dressing is clean, dry, and intact. The client's prescriptions indicate ambulation today. Which is the priority nursing action?

Medicate the client for pain as prescribed by the health care provider. The nurse is likely to use Maslow's hierarchy of needs as a tool for setting priorities for client care. Using this tool, the nurse considers the client's physical needs, such as managing pain, as a priority in this situation. The nurse addresses other needs, such as assisting the client with ambulation, after the client's health condition stabilizes. There is no need to contact the health care provider about condition unless vital signs do not improve following the management of the client's pain. Removing the abdominal dressing is not indicated.

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 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 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. The nurse who provides privacy for the client and family during times of prayer is helping the client to reach self-actualization, the highest level on the hierarchy. The most basic level in the hierarchy, physiologic need of physical activity, would be addressed when the nurse teaches the son how to perform passive range of motion. By teaching the daughter how to do the client's finger-stick blood glucose level check, the nurse is meeting the client's physical safety needs. The nurse facilitates meeting the love and belonging needs of the client when allowing the family to sit quietly at the bedside after visiting hours.