Chapter 4 Health of the Individual, Family, and Community

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."

The mother of three young children makes the following statements to the nurse working in community health. Drag and drop each statement in the order of priority from Maslow's basic priorities to Maslow's more complex priorities. Use all options.

"Sometimes we run out of food the day before I get paid." "There have been two murders in our neighborhood in the last year." "My teenage son is so quiet. He works and goes to school all the time and doesn't have time for friends." "I keep my kids' clothes clean, but we don't have money for the latest styles." "I try to get along with our neighbors, but they are from a strange culture with weird ideas."

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?

Which theorist supports the developmental framework of family assessment?

Duvall

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

Which are stressors that affect the health of the family?

Inadequate childcare services

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

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

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.

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

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

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.

A nurse is implementing interventions that focus on protecting a client from physical and emotional harm. Which category of needs is the nurse addressing?

Safety and security

The nurse provides the mother of a toddler with the phone number for the poison control center. Which level of Maslow's hierarchy of needs is the nurse addressing?

Safety and security needs

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

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

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.

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.

Which is the basic unit of human society?

Family

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

A nurse is working with a single-parent family. When planning the care for this family, which need should the nurse anticipate as being a priority concern?

Financial concerns

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

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

Sociocultural dimension

The nurse receives an 8-year-old client in the pediatric unit following a tonsillectomy. Which assessment finding requires immediate intervention by the nurse?

The client makes a rattling noise when breathing through the mouth

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

Been socialized in healthcare

A nurse is evaluating a child for new onset of bedwetting. Which nursing action is the priority?

Collect a urine sample for the prescribed urinalysis (UA).

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

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.

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 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

A nurse is developing a plan of care for a client to meet the client's safety and security needs. Which intervention would the nurse include? Select all that apply.

Using aseptic technique when providing wound care Teaching the client about what to expect with upcoming surgery Administering prescribed medication at the required time

What factors must the nurse consider when creating a holistic plan of care? (Select all that apply.)

The client's developmental life stage The client's emotional context The client's physiologic health condition

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

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

Which client requires priority intervention by a nurse providing care on a medical-surgical unit?

A postsurgical client who is feeling dizzy and has a heart rate of 45 beats/min

The nurse recognizes that the community affects the ability of individuals to meet basic human needs. Which example is not a characteristic of a healthy community?

The number of assaults increased 2% over the last year.

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

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

A home health nurse is visiting a family after the recent death of their matriarch. The nurse observes that the family is dressed in black, all of the mirrors are covered, and that the immediate family is sitting on square wooden boxes instead of chairs. The nurse asks what is happening, and is told, "We are Jewish, and the family is 'Sitting Shiva'." This family is fulfilling which family function?

affective and coping functions

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

Patient care dealing with nutrition and metabolism should include which factors? Select all that apply.

Knowledge about the value of the MyPlate diagram Understanding food preferences of clients from the Jewish community Information on the client's financial status related to meal provisions Ability of the client to prepare food at home

Which statements about the family unit are accurate? Select all that apply.

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.

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.

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."