PrepU 2 - Level 8

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The nurse is assessing a family with special health care needs. The nurse acts as an advocate by assisting the family with which activities? Select all that apply. A) Teaching about services that the child is eligible for B) Assisting the family to apply for Medicaid C) Taking the family to the Social Security office to apply for benefits D) Establishing eligibility for health care equipment E) Identifying inexpensive or free transportation

A) Teaching about services that the child is eligible for B) Assisting the family to apply for Medicaid D) Establishing eligibility for health care equipment E) Identifying inexpensive or free transportation The nurse is not responsible for taking the family to get services but can help to identify inexpensive methods of transportation. Establishing eligibility for health care equipment, helping with a Medicaid application, and teaching about other services the child is eligible to receive are all appropriate for the nurse to perform.

A nurse is caring for a client who has recently moved from her native Mexico. The nurse senses that the client misses her native country and asks her if she would like some burritos for lunch and perhaps watch the Mexican channel on television. The nurse is practicing: A) cultural blindness B) cultural competence C) cultural awareness D) cultural destructiveness

B) cultural competence Cultural competence is the capacity to work effectively and with people, integrating elements of their culture (e.g., vocabulary, values, attitudes, rules, norms, customs, etc.). Cultural blindness is when one does not see or believe there are cultural differences among people. Cultural awareness is being aware that we all live and function within a culture of our own and that our identity is shaped by it. Cultural destructiveness is making everyone fit the same cultural pattern.

The home health nurse is meeting with a client for the initial assessment in the home. Which location should the nurse prioritize for this assessment? A) Kitchen B) Living room C) Family room D) Bedroom

D) Bedroom Health interviewing and assessment is always conducted best in a private, quiet setting such as the bedroom. The kitchen, family room, and living room may not be appropriate due to the presence of other family members or other distractions such as television or computer.

The school nurse notes that a 10-year-old child has not had the required immunizations to attend classes. During discussion, the child states that his father lost his job and health insurance. What is the best action by the nurse? A) Have the student tell his parents that the school won't allow class attendance without required immunizations. B) Ask the student if there are any family members that might help with the expenses of immunizations. C) Inform the child that there is a free immunization clinic the following day at the health department. D) Contact the parents to inform them of the situation and community resources that can be utilized to obtain immunizations.

D) Contact the parents to inform them of the situation and community resources that can be utilized to obtain immunizations. Financial barriers, such as loss of a job and insurance benefits, can prevent obtaining health care. Contacting the parents would be necessary for a 10-year-old to ensure the information reaches the parents. Most communities have resources available for discounted or free immunizations.

The nurse is preparing to provide home care instructions to the family of a 2-year-old client recently placed on a ventilator. Which would be the priority consideration for the nurse? A) Family's available resources B) Health knowledge of the family C) Overall functioning of the family D) Identifying the primary caregiver

D) Identifying the primary caregiver The primary caregiver will have the most knowledge regarding the best strategies of care that will be most effective with the child. The primary caregiver will play an essential role in providing overall care to the child.

When orienting a new home health nurse on safety policies, which should the nurse include? A) Night and weekend visits are allowed with permission. B) Always carry your identification in your purse or wallet. C) If the client, family, or situation is hostile, call the police. D) Keep the agency informed of your visit schedule.

D) Keep the agency informed of your visit schedule The agency should always be informed of the nurses' visit schedule to assist in locating the nurse if he or she does not return on time. Any changes to the schedule should be communicated to the agency immediately.

A pregnant home care client calls the nurse and states that her husband just told her that he wants a divorce because he cannot deal with the stress of her being at home all the time. Which nursing diagnosis would the nurse assess for this client? A) Interrupted family process related to the need for home care B) Social isolation related to the need for home care C) Disabled family coping related to the need for home care D) Readiness for enhanced family coping related to increased time together due to home care

C) Disabled family coping related to the need for home care The nurse would assess that the client and spouse are currently experiencing disabled family coping related to the client's need for home care. It is important for the nurse to plan interventions that could assist the family in gaining coping skills and resources to better deal with the stress of the home care.

Which nursing action supports a 2020 National Health Goal that addresses cultural diversity? A) Focusing on actions to enhance disease prevention B) Reviewing actions to prevent accidents in the home environment C) Discussing breastfeeding with a pregnant client D) Analyzing the client's compliance with health promotion activities

C) Discussing breastfeeding with a pregnant client One 2020 National Health Goal for cultural diversity is to increase the proportion of mothers who breastfeed their babies in the early postpartum period from a baseline of 43.5% to a target of 60.6%. Actions to enhance disease prevention, prevent accidents, and comply with health promotion activities do not support the 2020 National Health Goals for cultural diversity.

The nurse is developing a plan of care for a child who will be in home care following a severe accident. The nurse notes that the client plays on several sports teams and is a member of the local church. Which would be the priority nursing diagnosis for this client? A) Readiness for enhanced coping skills B) Risk for interrupted family process C) Risk for delayed growth and development D) Risk for deficient knowledge

C) Risk for delayed growth and development The child is very active, which allows for normal growth and development. Without that interaction, this client may be at risk for delayed growth and development. The nurse should plan for interventions that would encourage some social interaction for the client

What could be the consequence of a nurse assigning a client to a staff member who is of the same culture as the client? A) Ensuring better care and understanding B) Helping in assessing client's cultural heritage C) Stereotyping D) Helping build nurse-client relationship

C) Stereotyping A nurse who thinks stereotypically may assign a client to a staff member who is of the same culture as the client because the nurse assumes that all people of that culture are alike. The nurse also may believe that clients with the same skin color have similar social situations. Because stereotypes are preconceived ideas unsupported by facts, they may not be real or accurate. They can be dangerous because they are dehumanizing and interfere with accepting others as unique individuals. Assigning a client to a staff member who is of the same culture as the client will not help in ensuring better care and understanding; assessing the client's cultural heritage; or building nurse-client relationships.

Which statement about time orientation most accurately exemplifies a person who is oriented in the present? A) The person is making plans to attend college in the next 2 years. B) The person is focused on preserving cultural traditions with minimal variation in practice. C) The person places a low priority toward saving money for college. D) The person focuses on what food to buy and prepare for a holiday celebration next month.

C) The person places a low priority toward saving money for college. Some cultures are oriented toward the past: they carefully preserve traditions, allowing only the slightest changes or variations in practices. Still others are oriented toward the present; saving money for college (a future-oriented action) might seem important to an American nurse but would not be a high priority in these cultures. Preparing for an upcoming celebration is a future-oriented focus.

The nurse is concluding her initial visit with a client at 28 weeks' gestation on bedrest for premature rupture of membranes. What information should the nurse consider when determining the timing of the next home visit? A) the location of the home B) client's type of health insurance C) amount of supervision and health education needed by the client D) the home visit schedule and needs of the agency to plan the visit

C) amount of supervision and health education needed by the client The nurse should complete an assessment on the client to include the amount of education and ability of the client to understand the health care provider's orders. The nurse should allow the agency to work with the insurance company, and the location of the home should not influence the decision of the nurse.

A pregnant woman with premature ruptured membranes is trying to decide whether home care might be the best option for her. Which advantage should the nurse mention to the client that is most pertinent to her condition? A) prevention of disruption of the family B) decreased exposure to infection C) lower cost for the health care delivery system D) prevention of social isolation

B) decreased exposure to infection There may be an advantage of placing women with premature ruptured membranes on home care rather than hospital care because of the decreased exposure to infection in their own homes compared to hospitals. Although prevention of disruption to the family and lower cost for the health care delivery system may be advantages, they are not the most pertinent to the client's condition. Home care would be more likely to cause social isolation than prevent it.

A nurse is reading a journal article about family-centered care. Which concept would the nurse expect to find as the fundamental core of this type of care? A) partnership with the clients B) open communication C) strengthening of family resources D) sharing of health care information

A) partnership with the clients At the heart of family-centered care is a commitment to working with clients as partners, which is a shift from a "doing to and doing for." Open communication and sharing of information are components of family-centered care that facilitate the partnership with the client. Strengthening of family resources is one of the desired outcomes of the client partnership in family-centered care.

The nurse is preparing a prenatal seminar for young mothers. Which type of information should the nurse gather to ensure success of the program? A) Who will be accompanying the mother B) Approximate education level of the participants C) Names of each of the participants D) Incomes of each of the participants

B) Approximate education level of the participants When teaching a group of clients, the nurse should seek demographic information, such as the education level of the participants, to help develop an appropriate teaching plan for the group. This is an impersonal group, so learning who is accompanying the mothers, their names, or their incomes is not appropriate.

A preterm newborn is to be discharged home on oxygen therapy and tube feedings. Which statement by the parents would indicate that they need additional teaching and preparation for this transition? A) "We'll make sure that we have enough feeding solution to get through the weekend." B) "We know how to check to make sure the feeding tube isn't clogged." C) "Our parents are going to take turns helping out at night so that we can get some sleep." D) "Our insurance company will pay for all the equipment that we need for the treatments."

D) "Our insurance company will pay for all the equipment that we need for the treatments. High-risk newborn home care involves all family members working together to provide 24-hour care. Managing supplies, trouble-shooting potential problems, and ensuring support are crucial to providing home care. Parents or caregivers must investigate and then negotiate with insurers for reimbursement of medical equipment and supplies. Insurers do not always cover all items necessary for care.

The nurse has completed teaching on total parenteral nutrition therapy for the parents of a 3-year-old client who will be receiving therapy at home. Which statement by the mother indicates that reteaching is necessary? A) "We will check the blood glucose levels 4 times a day." B) "I will flush the infusion line with saline before starting the TPN." C) "The TPN will warm on the counter for 2 hours before being started." D) "She can still take her bubble baths every day just like normal."

D) "She can still take her bubble baths every day just like normal." The nurse should address with the mother the importance of no baths if the water line will rise above the catheter insertion site; this can lead to infection.

A pregnant woman in her first trimester has come to the clinic for a check-up. The woman mentions to the nurse that she would like to try some complementary and alternative medicine (CAM) therapies to control her nausea. When teaching the woman about these methods, which information would be important for the nurse to emphasize? Select all that apply. A) "Remember that just because it says the remedy is natural, it does not always mean it is safe." B) "It would be important for you to talk with your provider about what might be best for you." C) "Try using some ginger tea to help control the nausea you are having." D) "It is okay to try more than one remedy with another to get a better effect." E) "Check the package to make sure that all the ingredients and their amounts are listed."

A) "Remember that just because it says the remedy is natural, it does not always mean it is safe." B) "It would be important for you to talk with your provider about what might be best for you." E) "Check the package to make sure that all the ingredients and their amounts are listed." If clients are considering the use of or are using CAM therapies, it is important to instruct them to check with their health care providers before taking any substance, even if it is natural. In addition, the nurse should instruct the woman that natural does not necessarily mean that the product is safe and that she should check that the product package contains a list of all ingredients and the amounts of each. Although ginger tea may be used to treat nausea of pregnancy, most substances ingested cross the placenta and have the potential to reach the fetus. There is also the potential for harm if therapies are mixed. Therefore, the nurse should stress the need to discuss all remedies with the provider.

The nurse joins a work group focused on increasing the numbers of persons counseled about their health behaviors. Which action(s) will help the group achieve this goal? Select all that apply. A) Assessing the health learning needs of women, children, and their families B) Planning health care education in collaboration with clients and their families C) Providing health education at each client encounter D) Developing materials and programs that are culturally competent E) Providing bedside materials in the appropriate language

A) Assessing the health learning needs of women, children, and their families B) Planning health care education in collaboration with clients and their families C) Providing health education at each client encounter D) Developing materials and programs that are culturally competent E) Providing bedside materials in the appropriate language To increase the proportion of persons appropriately counseled about health behaviors, the work group will need to take multiple steps. They will assess health learning needs of women, children, and their families; plan health care education in collaboration with clients and their families; and provide health education at each client encounter. The work group will also need to take steps to provide culturally competent care. They will develop materials and programs that are culturally competent and provide bedside materials in the appropriate language.

Which action by the nurse in a community clinic would best meet a family's need of physical sustenance? A) Enrolling the pregnant mother in a WIC program B) Offering parenting classes to teenage mothers C) Holding monthly educational sessions on nutrition D) Providing weekly exercise classes for the neighborhood families

A) Enrolling the pregnant mother in a WIC program Physical sustenance deals with meeting the basic needs of food, clothing, shelter and protection from harm of each family member. By enrolling the pregnant mother in WIC, her physical needs of nutrition are addressed. Parenting classes, nutrition classes, and exercise classes are all good ideas but do not directly address physical sustenance.

To be effective, a community health nurse needs to recognize which factors as being important to families in making health care decisions? Select all that apply. A) Family financial resources B) Cultural influences C) Priorities of the family D) Health care provider values E) Lack of understanding of health situation

A) Family financial resources B) Cultural influences C) Priorities of the family. E) Lack of understanding of health situation A community nurse must understand what is going on with the families being caref for to understand how to assist them in accessing health care. Having a clear understanding of the family's finances, cultural beliefs and priorities, and ensuring they understand the situation is the nurse's responsibility. Health care provider values are not a part of the decision-making process for families.

While performing a community assessment, a nurse notes a large increase in single-parent families. She performs some research and finds that the increasing numbers of single-parent families are related to which trends? Select all that apply. A) Increasing divorce rate B) Advancing age of women getting married C) Changing attitudes toward children born out of wedlock D) Changing adoption laws E) Mobility

A) Increasing divorce rate C) Changing attitudes toward children born out of wedlock D) Changing adoption laws The advancing age of women getting married or mobility has not been found to be related to the increase in single-parent families. The other choices are related to the increasing number of single-parent families.

A home care client who is 30 weeks' gestation with triplets reports to the nurse that she is having increasing difficulty getting out of bed to perform hygiene or elimination. Which is the most appropriate intervention? A) Request a hospital bed for the home B) Have her use a bed pan at home C) Transfer her to direct care status D) Reevaluate her ability to continue home care

A) Request a hospital bed for the home The nurse can request a hospital bed for the home care client. This will allow the client to adjust the bed to various heights and positions that may make it easier to get out of bed when needed. The client's condition does not warrant direct care status.

The home care nurse's primary responsibility is teaching the pregnant client diagnosed with cervical insufficiency. This client also has a history of several spontaneous abortions (miscarriages). Which teaching interventions should the nurse discuss with the client? Select all that apply. A) Restrict sexual activity B) Monitor for uterine contractions C) Gain 3 to 4 pounds per week D) Watch for vaginal bleeding E) Look for discharge indicating infection

A) Restrict sexual activity B) Monitor for uterine contractions D) Watch for vaginal bleeding E) Look for discharge indicating infection To reduce the chance of preterm labor the client with an cervical insufficiency will likely undergo a cervical cerclage. The nurse should instruct the client to monitor for uterine contractions, vaginal bleeding, and signs of infections. The client should also be instructed to restrict sexual activity during this time. The nurse should encourage the client to gain only a health amount of weight during pregnancy as large amounts of weight can increase pressure on the abdomen.

A nursing student asks the instructor why nurses focus on assessing sociocultural aspects of clients. Which response from the nurse is most accurate? A) Such assessment can reveal why people take certain preventive or treatment measures related to their health. B) This assessment is necessary to pinpoint genetic risks in people. C) Assessment of sociocultural components makes nurses better equipped to work in diverse settings. D) Nurses should strive to understand all dimensions of the client, even those that seem less important.

A) Such assessment can reveal why people take certain preventive or treatment measures related to their health. Assessing sociocultural status, ethnicity, and cultural beliefs of families and clients can reveal why people take the type of preventive health measures that they do or seek a particular type of care for illness. While the other answers might be partially correct, they do not represent the best answer for this question.

A teenage client has been airlifted to a large urban hospital for emergent care. The nurse will illustrate family-centered care by prioritizing which actions? Select all that apply. A) The health care team gives the client and family regular updates. B) The client is encouraged to make his or her own health care decisions. C) The family is assisted with travel plans to be able to stay with the client. D) The client and family are able to communicate their potential fears to nurses and health care providers. E) Family is encouraged to bring visitors during visiting hours.

A) The health care team gives the client and family regular updates. C) The family is assisted with travel plans to be able to stay with the client. D) The client and family are able to communicate their potential fears to nurses and health care providers. Family-centered care refers to the collaborative partnership among the individual, family, and caregivers, and thus the family should receive regular updates and also the assistance with travel plans to visit their child. It is an approach in which clients and their families are considered integral components of the health care decision-making-not just the client. It is based on collaboration among everyone in the client's life and the health care professional. Family members' visits, support, and their need to communicate with one another goes well beyond the health care provider's brief time with them, such as during their child's illness. Encouraging the family to bring visitors would not be a priority for the nurse.

While taking a health history, the nurse finds out that the pregnant woman of Japanese descent comes from a culture that does not eat meat. Which foods will indicate sufficient protein intake? Select all that apply. A) beans and rice eaten every day B) stir-fried carrots and beans regularly C) egg drop soup 2 to 3 times per week D) dried fruit for dessert E) apples as a snack daily

A) beans and rice eaten every day B) stir-fried carrots and beans regularly C) egg drop soup 2 to 3 times per week A typical Japanese diet, for example, includes many vegetables such as bean sprouts, broccoli, mushrooms, water chestnuts, and alfalfa. Adequate protein is ingested, however, by mixing sources of incomplete protein such as beans and rice. Neither dried fruit nor apples will not meet protein needs.

A pregnant client is being discharged. The nurse is educating the client about the advantages of continuing her treatment at home. Which advantages would the nurse include? Select all that apply. A) increased individual teaching B) lifestyle assessments C) increased health care costs D) increased self-care E) value influence from nurse

A) increased individual teaching B) lifestyle assessments D) increased self-care The home care setting allows the nurse to spend time with the individual and the family in a private environment in which teaching can occur. This also allows for a lifestyle assessment to better understand ways in which to promote healthy behaviors, not simply those related to pregnancy. Home care also increases the ability of the client to perform self-care that may have otherwise been done by others (for the client) in the acute care setting. The home care setting decreases health care costs and allows the nurse to better asses the values and priority of the client and family.

The nurse is assessing a pregnant woman's health literacy during a prenatal visit. Which factors would the nurse identify as impacting the woman's health literacy? Select all that apply. A) lack of familiarity with the information B) complexity of information C) woman's employment status D) last grade completed in school E) woman's level of emotional distress

A) lack of familiarity with the information B) complexity of information C) woman's employment status Health literacy refers to the ability to read, understand, and use health care information. When new or unfamiliar information is presented or when emotional distress is present, reading ability and understanding are reduced. The last grade completed in school does not equate with reading ability. In addition, appearance, verbal ability, employment status, and educational level cannot reveal persons who do not read well.

The nurse is assessing a child brought to the emergency department with a badly abscessed ingrown toenail that could have been avoided with early treatment. When assessing for potential barriers to health care, the nurse should address which possible factors? Select all that apply. A) the family's current health care insurance status B) the family's cultural beliefs about health and illness C) the family's spirituality and religion D) the child's genetic risk factors for disease E) the child's previous experiences in the health care system

A) the family's current health care insurance status B) the family's cultural beliefs about health and illness C) the family's spirituality and religion E) the child's previous experiences in the health care system There are numerous potential barriers to health care in varied domains, including spirituality, finances, culture, and previous experience. Genetics have a major effect on health and illness but are not considered to be an independent barrier to health care.

When working with a woman and newborn being discharged with a prescription for a liquid antibiotic to be given to the infant 3 times a day, which directions are most appropriate? A) "Give the medicine precisely at 08:00, 14:00, and 18:00 to maintain blood levels." B) "Give the medicine 3 times a day, spreading it out to work with your schedule." C) "Give the medicine first thing in the morning, right before bedtime, and then the third dose sometime in the afternoon." D) "Since you work, give two doses in the morning and one dose in the evening."

B) "Give the medicine 3 times a day, spreading it out to work with your schedule." In some cultures, the use of time contrasts greatly—being late for appointments is a sign of respect (giving the person you are meeting time to organize and be prepared for your arrival). Women who do not have a strict time orientation may have difficulty following a strict medical regimen. It is most important for the nurse to stress that the medication should be taken 3 times a day and not necessarily at specific times.

The home care nurse has taught the pregnant home care client how to complete several self-assessment parameters. Which statement by the client indicates that teaching has been successful? A) "I will measure for fundal height from the top of my pubic bone to the bottom of my umbilicus." B) "I will sit or lie down for two hours and count how many times the baby kicks, looking for at least 10 per two hours." C) "I will get all of my house cleaning done and then take my blood pressure using the wrist monitor." D) "I need to drink a sugary drink, wait 2 hours, and then prick my finger to test my blood glucose on a daily basis."

B) "I will sit or lie down for two hours and count how many times the baby kicks, looking for at least 10 per two hours." To assess for fetal movements, the client will need to sit or lie down to be able to feel fetal kicks, movements, or rolls during a 2-hour period. This should be done during the same time every day, in which the fetus is the most active. The nurse should instruct the client to keep a log of fetal movement and track the amount of time to reach 10 movements.

The mother of a child who has been diagnosed with a chronic lung condition has asked what the implications are for her child's future. After providing education to the parent, which statements indicate the need for additional teaching? Select all that apply. A) "This may cause my child to experience issues in school." B) "Since this condition is not related to my child's level of intelligence, it will not impact her performance in school." C) "Social maturity is not likely to be impacted with a chronic lung condition." D) "There is no way to know specifically how this will impact my child's developmental progression." E) "Sadly, this diagnosis can have a far-reaching impact on my child's future in many areas."

B) "Since this condition is not related to my child's level of intelligence, it will not impact her performance in school." C) "Social maturity is not likely to be impacted with a chronic lung condition." The diagnosis of a chronic condition can have broad implications. The impact will affect areas other than those specifically related to the disease. Areas of impact may include but are not limited to school, social maturity, and developmental delays.

Today, families come in a variety of structures. Which statement best describes a blended family? A) All the adult relatives living in the household participate in raising the children and grandchildren. B) Both adults are custodial parents and bring their children to the family structure. C) The parents choose to legally take into their family structure a child who is not a biological child to either parent. D) Custodial parents live together and raise one parent's children as one family.

B) Both adults are custodial parents and bring their children to the family structure. The stepfamily consists of a custodial parent and children and a new spouse. If both partners in the marriage bring children from a previous marriage into the household, the family is usually termed a blended family. If there are adult relatives living in the household along with the parents and their children, it is termed an extended family. When parents legally take a non-biologic child into their home and raise it as their biologic child it is an adoptive family. When one or both of the adults in the household are custodial and they live together, raising their children as one family, it is termed a cohabitation family.

A high school senior has just received a positive pregnancy test. She confides to the high school nurse her plans to attend college. The student is confused and conflicted about whether to have an abortion (elective termination of pregnancy), have the baby and put it up for adoption, or keep the baby. She expresses concern about how she could afford to care for an infant on a low-wage job. Which NANDA would be the most appropriate for this situation? A) Dysfunctional family process B) Impaired parenting C) Readiness for enhanced relationship D) Ineffective childbearing process

B) Impaired parenting Nursing diagnoses formulated for families and the community generally relate to the family's ability to handle stress and to provide a positive environment for the growth and development of the members. Impaired parenting related to unplanned pregnancy is the best response in this scenario. Dysfunctional family process deals with family relationships. Readiness for enhanced relationship relates to quality of functioning in socially expected behavior patterns. Ineffective childbearing process relates to reproduction problems.

A home care nurse is planning care for a 29-week gestation client pregnant with triplets on bed rest to reduce the chance for preterm labor. Which tasks can the nurse delegate to the home care assistant? Select all that apply. A) Assess fetal heart rates B) Prepare lunch for the client. C) Teach about signs of preterm labor. D) Assist the client with a bed bath. E) Pick up the client's kids from school

B) Prepare lunch for the client. D) Assist the client with a bed bath The nurse can delegate tasks that address personal care, assisting with ambulation and feeding clients. The assessment of fetal heart rates and teaching activities are beyond the scope of practice for the home care assistant. It is not appropriate for the home care assistant to pick up the client's children from school.

A school nurse informs parents that a screening for lice will be conducted on all first graders the following week. Which type of prevention is this nurse conducting? A) Primary prevention B) Secondary prevention C) Tertiary prevention D) It is not a preventive measure

B) Secondary prevention Primary prevention is health-promoting activities that help prevent the development of illness or injury. Secondary prevention is health-screening activities that aid in early diagnosis and encourage prompt treatment before long-term negative effects arise. Tertiary prevention is health-promoting activities that focus on rehabilitation and teaching to prevent further injury or illness and occurs in special settings. Screening is a preventive measure.

The camp nurse is reviewing the health information of the participants at a school-age summer camp for children with diabetes. What topic would be most appropriate for this group of campers? A) Weight control measures B) Self-administration of insulin C) Long-term effects of diabetes D) Latest trends in medication delivery

B) Self-administration of insulin School-age children need to learn self-administration of insulin, along with how to check their blood sugar. Although weight control and diet are important, as are peer relationships and being current in available resources, they are not as important for the child's health as learning how to be independent in their insulin administration.

A nurse is planning the discharge of a newborn to parents recently immigrated from Syria. Which action best indicates that the nurse provides culturally sensitive care? A) The nurse approaches the clients in a nonjudgmental way in an attempt to change the clients' cultural beliefs to the unit's beliefs. B) The nurse researches the clients' cultural characteristics and beliefs. C) The nurse encourages the continuation of cultural practices in their home setting. D) The nurse strives to keep the clients' cultural background from influencing their health needs.

B) The nurse researches the clients' cultural characteristics and beliefs. Nurses must research and understand the cultural characteristics, values, and beliefs of the various people to whom they deliver care. To provide culturally appropriate care to diverse populations, nurses need to know, understand, and respect culturally influenced health behaviors.

A group of nurses are developing a teaching program on adolescent parenting for a high school child development class. Which factor would be most important for the educators to know prior to beginning the class? A) The number of participants B) Previous knowledge about parenting C) Age and gender of participants D) Income level and socioeconomic status

C) Age and gender of participants In order for a class to be successful, the educator needs to know group dynamics and demographics prior to beginning the class. The adolescents' age and gender are very important facts to know. It is not as important to know how many students are coming, their socioeconomic status or their previous knowledge about parenting.

The primary health care provider has recommended a client consult a nutritionist for specialized care. The nurse, by providing a list of referrals to the client, is providing which service? A) Community-based nursing B) Primary care C) Client advocacy D) Secondary prevention

C) Client advocacy Client advocacy is speaking or acting on behalf of clients to help them gain greater independence and to make the health care delivery system more responsive and relevant to their needs. Community-based nursing focuses on prevention and is directed toward persons and families within a community. Primary care is the direct action of the primary care provider. Secondary prevention involves health screening activities that aid in early diagnosis and encourage prompt treatment before long-term negative effects occur.

The nurse is completing the social assessment of a client who reports the family members consist of herself, her boyfriend, their daughter, and his son. The nurse determines this family represents which family structure? A) Nuclear family B) Blended family C) Cohabitation family D) Adoptive family

C) Cohabitation family A cohabitation family includes parents who are not married along with their children or children from previous relationships. A blended family includes a couple who are married and each bring children from a previous relationship. The stepfamily consists of a custodial parent and children and a new spouse. The nuclear family consists of a man, a woman, and their children, either biologic or adopted. The adoptive family consists of the parents and children who not biologically theirs but accepted into the family as if they were.

The nurse is educating the family of a 2-day old Chinese American boy with myelomeningocele about the disorder and its treatment. Which action involving an interpreter could jeopardize the family's trust in the health care providers? A) allowing too little time for the translation of health care terms B) using a person who is not a professional interpreter C) asking the interpreter questions not meant for the family D) using a relative to communicate with the parents

C) asking the interpreter questions not meant for the family Asking questions or having private conversations with the interpreter may make the family uncomfortable and destroy the nurse/client relationship. Translation takes longer than a same-language explanation, and the family may need additional to clarify terms; this must be considered so that the family is not rushed. Use of a nonprofessional may result in some inaccuracy in translating medical terminology but should not impact the trust of the family. Using a relative can upset the family relationships or cause legal problems but also does not affect trust with the healthcare providers.

The nurse is asked to present an educational event to the local Junior League. While planning for the event, what is most important for the nurse to do? A) Ask questions about the histories of those present. B) Use posters that everyone in the group can read. C) Tell the participants about the nurse's background. D) Know the needs of the audience.

D) Know the needs of the audience. To teach a group successfully, it is important to know the needs of the target population and to have the appropriate teaching skills, strategies, and resources. Asking questions about the histories of those who will be attending the event comes under the category of the targeted group's demographics. While it is important to have these facts, it is not most important for the nurse to know. Using posters that everyone can read is part of the presentation strategy of the nurse, but it is not most important. Telling those present at the event a brief synopsis of the nurse's background is usually done by whomever introduces the nurse as the speaker. It is not usually an activity the nurse does herself or himself.

A nurse is assessing an adolescent in a clinic with both parents accompanying the child. The nurse questions whether the family is functioning in a healthy way after noting which action? A) The father comforts his crying daughter. B) The mother states, "This family couldn't function without me." C) The family pays cash for health care. D) The father does not share his concerns with his wife.

D) The father does not share his concerns with his wife. Effective families demonstrate a great deal of communication among family members. If one parent does not share with the other, it is difficult for the family to function as a unit. The father comforting his daughter demonstrates the father's love and caring attitude toward his child. Paying for health care with cash does not automatically indicate there is a problem. The mother sharing that the family could not function without her is also not an automatic indicator of a dysfunctional family; each family member has his or her own role and responsibilities that help the family function as a unit.

A nurse is addressing a group of women on the issue of women's health during their reproductive years. Which reason does the nurse provide regarding the need for comprehensive, community-centered care to women during this time period? A) Women have more health problems during their reproductive years. B) Increased stress causes more health problems during their reproductive years. C) A woman's immune system weakens immediately after birth. D) Women's health care needs change with their reproductive goals.

D) Women's health care needs change with their reproductive goals. The nurse should inform the women that comprehensive community-centered care should be given to women during their reproductive years. This is because as their reproductive goals change, their health care needs change as well. A woman's immune system does not weaken immediately after birth. Similarly, women do not have more health problems specifically during their reproductive years, nor are they more susceptible to stress during their reproductive years.

A woman in labor has brought a butcher knife with her and insists on putting it under her hospital mattress to "cut the labor pain." Your best response to this practice would be to: A) teach her to use chest breathing with contractions. B) educate her about the cause of labor pain. C) tell her that she cannot keep the knife because it is a lethal weapon. D) allow her to keep the knife under her mattress during labor.

D) allow her to keep the knife under her mattress during labor. Respect for cultural values is important for developing effective nurse-client relationships.

A nurse is working in a community setting and is involved in case management. In which activity would the nurse most likely be involved? A) helping a grandmother to learn a procedure B) assessing the sanitary conditions of the home C) establishing eligibility for a Medicaid waiver D) scheduling speech and respiratory therapy services

D) scheduling speech and respiratory therapy services Case management focuses on coordinating health care services while balancing quality and cost outcomes. The nurse would be most likely involved with scheduling speech and respiratory services, ensuring these services are integrated into the client's plan of care in a coordinated manner. Helping a person learn a procedure or assessing the sanitary conditions of the home and establishing eligibility are not activities associated with case management.


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