Health Promotion Throughout the Life Span, 8th Edition By Edelman A+

Description

1. Healthy People 2020 objectives provide a framework for:

a.	assessment.
b.	diagnosis.
c.	prevention.
d.	treatment.

ANS: C

The health promotion initiative named Healthy People 2010 provides a framework for prevention.

DIF: Cognitive Level: Remember (Knowledge) REF: p. 128

1. Which of the following best describes a primary prevention method for colon cancer?

a.	Hemoccult testing
b.	High fiber diet
c.	Colonoscopy
d.	Laparoscopy

ANS: B

Primary prevention includes generalized health promotion and specific protection from disease. Hemoccult and colonoscopy are forms of screening, not prevention. Eating a healthy diet high in fiber is a preventive measure.

DIF: Cognitive Level: Apply (Application) REF: pp. 128-129

1. Who authored the framework which provides the foundation for nursing assessment and diagnosis using the functional health patterns?

a.	Erikson
b.	Gordon
c.	Newman
d.	Nightingale

ANS: B

Gordon’s framework provides the foundation for most NANDA nursing diagnoses using the functional health pattern. Nurses use the framework to combine assessment skills with subjective and objective data to construct patterns.

DIF: Cognitive Level: Remember (Knowledge) REF: p. 129

1. Over the last week, a person has had finger stick glucose levels of 127, 132, 140, 138, 143, 145, and 140. This information allows the nurse to characterize the person’s function pattern by utilizing which area of focus?

a.	Age-developmental
b.	Functional
c.	Individual-environmental
d.	Pattern

ANS: D

Pattern focus implies that the nurse explores patterns or sequences of behavior over time. Pattern recognition occurs during information collection. Functional health patterns then provide structure to analyze factors.

DIF: Cognitive Level: Apply (Application) REF: p. 130

1. A nurse is using a functional focus to assess a person. Which of the following the nurse be evaluating?

a.	Visual acuity
b.	Pupil reactivity
c.	Ability to drive
d.	The red reflex

ANS: C

Functional focus refers to the individual’s performance level. Nurses assess how particular visual patterns affect lifestyle. The ability to drive would affect a person’s lifestyle and might require a change in how the person functions.

DIF: Cognitive Level: Analyze (Analysis) REF: p. 131

1. A nurse working with a Hispanic family is explaining the plan for managing a child’s asthma to the child’s mother, father, and grandmother. To whom should the nurse direct the education?

a.	Mother
b.	Father
c.	Grandmother
d.	Parents and grandmother

ANS: D

Culturally competent care is delivered with understanding of and sensitivity to cultural factors influencing health behaviors. Nurses provide culturally competent care when they identify and use cultural norms and values. In the Hispanic population, the male figure is usually the decision maker, and the family elders are highly respected. However, assumptions about cultural norms should not be made. As a result, the nurse should direct education to all three adults because they may all have an impact on the child’s health care needs.

DIF: Cognitive Level: Analyze (Analysis) REF: p. 131

1. A 27-year-old woman has not received a Pap test in years. This assessment finding identifies an alteration in which functional pattern?

a.	Health-perception–health-management pattern
b.	Elimination pattern
c.	Activity-rest pattern
d.	Self-perception–self-concept pattern

ANS: A

Assessment objectives for the health-perception–health-management pattern consist of obtaining data about perceptions, management, and preventive health practices. Exploring these values identifies potential health hazards. A 27-year-old woman should receive a Pap test every 2 years. Failing to do so could place her at risk for health problems; thus, this finding identifies an alteration in the health-perception–health-management pattern.

DIF: Cognitive Level: Apply (Application) REF: p. 131

1. A client is experiencing an alteration in the health-perception–health-management pattern and an alteration in the values-beliefs pattern. Which of the following best describes the behavior of this person?

a.	Never sees a physician
b.	Only sees a physician if not feeling well
c.	Sees a physician for screenings only
d.	Sees a physician for follow-up care of a chronic disease

ANS: B

Health beliefs and perceptions directly affect participation in care. Dimensions of assessment in the values-beliefs pattern include the individual’s values, beliefs, or goals that guide choices or decisions that are related to health. People who do not believe in health promotion activities will likely see a physician only when sick. Thus, someone with an alteration in the health-perception–health-management and values-beliefs patterns will likely only see a physician if not feeling well.

DIF: Cognitive Level: Apply (Application) REF: p. 131 | p. 142

1. When assessing a person’s nutritional-metabolic pattern, which objective finding would have implications for nursing intervention?

a.	The person’s 24-hour diet diary
b.	The person’s dentition
c.	The person’s food preferences
d.	The person’s financial status

ANS: B

Although all of the assessment parameters listed have implications for nursing diagnosis and planning for this client, the only objective measure is the client’s dentition. It is the only one that can be validated with a physical exam.

DIF: Cognitive Level: Apply (Application) REF: p. 134

1. When assessing a client’s activity-exercise pattern, which subjective finding has implications for nursing practice?

a.	A person’s decreased muscle tone
b.	A person’s amount of leisure time
c.	A person’s decreased range of motion
d.	A person’s use of a cane

ANS: B

Although all findings are important in assessing the activity-exercise pattern, the only subjective finding is the amount of leisure time that the person reports having. All others are objective findings and can be validated with a physical exam.

DIF: Cognitive Level: Apply (Application) REF: pp. 135-136

1. During a health history, a person reports getting 5 hours of sleep a night. What does this information indicate to the nurse?

a.	The person is not receiving enough sleep.
b.	The person is receiving adequate sleep.
c.	The nurse must determine where the person sleeps.
d.	The nurse must ask additional questions.

ANS: D

The single most important factor assessed in the sleep-rest pattern is probably the perception of adequacy of sleep and relaxation. The objective when assessing the sleep-rest pattern is to describe the effectiveness of the pattern from the person’s perspective. Wide variation in sleep time does not necessarily affect functional performance. Different individuals require different amounts of sleep. Thus, without further subjective data, the nurse is not able to make a diagnosis in this functional pattern.

DIF: Cognitive Level: Apply (Application) REF: p. 136

1. A nurse assesses the cognitive-perceptual pattern of a Type 1 diabetic client. Which finding has implications for the individual’s nursing plan of care?

a.	Decreased sense of hearing
b.	Decreased sense of smell
c.	Decreased sense of taste
d.	Decreased visual acuity

ANS: D

Assessment parameters in the cognitive-perceptual pattern include hearing, vision, smell, and taste. A person with Type 1 diabetes mellitus requires insulin injections. A decrease in visual acuity will make it difficult for the individual to draw up his or her medication and therefore will influence the nurse’s plan of care.

DIF: Cognitive Level: Analyze (Analysis) REF: p. 137

1. Which scenario indicates a potentially dysfunctional pattern?

a.	Adult with frequent urination
b.	Woman who lost her job
c.	Elderly person with blurred vision
d.	Overweight adult with a sweet tooth

ANS: B

A pattern is potentially dysfunctional when sufficient evidence exists or enough risk factors are present to indicate that a pattern of dysfunction will likely occur if interventions are not instituted. A dysfunctional pattern is a problem when it represents a deviation from established norms or from the individual’s previous condition or goal. The woman who lost her job indicates a potential dysfunction pattern because the stress of losing her job places her at risk for ineffective coping. The other scenarios are not potentially dysfunctional; by definition, they are dysfunctional.

DIF: Cognitive Level: Apply (Application) REF: p. 144

1. Which scenario represents a dysfunctional pattern?

a.	Sexually active teenager who does not use condoms
b.	Salesman who sleeps only 5 hours a night
c.	Single mother of three children
d.	Woman with a small extended family

ANS: A

A pattern is potentially dysfunctional when sufficient evidence exists or enough risk factors are present to indicate that a pattern of dysfunction will likely occur if interventions are not instituted. A dysfunctional pattern is a problem when it represents a deviation from established norms or the individual’s previous condition or goal. Dysfunctional patterns may be present in the absence of disease, and nursing care may be necessary for health promotion and maintenance. The teenager, although free of disease, is in need of health promotion and disease prevention strategies because her sexual behavior indicates a dysfunction in her sexuality-reproductive pattern that places her at risk for a sexually transmitted disease and pregnancy.

DIF: Cognitive Level: Apply (Application) REF: p. 144

1. A nurse is counseling a person with a dysfunctional sleep pattern. Which of the following recommendations would the nurse most likely give the person?

a.	Read in bed until he falls asleep.
b.	Avoid fluids after 7 PM.
c.	Exercise immediately before bedtime.
d.	Watch television in the recliner in the evening.

ANS: B

Etiological factors of most dysfunctional patterns often lie within another pattern or patterns. Outcomes and plans are based on probable cause. Exercising before bed, watching television, and reading in bed are not considered appropriate sleep hygiene. Frequent urination may be the cause of his dysfunctional sleep pattern and, if so, avoiding fluids before bed would be an appropriate plan.

DIF: Cognitive Level: Analyze (Analysis) REF: p. 144

1. A nurse is caring for a person with a potential dysfunction in the health-perception–health-management pattern. Which of the following nursing interventions would most likely be performed?

a.	Arranging for home delivery of medication from the pharmacy
b.	Providing education regarding the dangers of smoking
c.	Instituting visiting nurse services for blood pressure checks
d.	Providing direct observed therapy for tuberculosis medications

ANS: B

Potential problems are risk states. Nursing interventions are directed toward risk reduction through education. Health promotion requires the individual to participate in his own care, and he cannot do this if he does not recognize his susceptibility to an impending health problem. Providing education addresses the risk and provides the person with information needed to change beliefs. The other options make the person a passive participant rather than an active one.

DIF: Cognitive Level: Apply (Application) REF: p. 144

1. The nurse has determined that a person has a dysfunction in the nutritional-metabolic pattern. Which action would be the next step for the nurse to take?

a.	Weigh the person.
b.	Set a goal weight with the person.
c.	Ask the person what her favorite foods are.
d.	Develop a plan for weight loss.

ANS: B

The individual’s goals and the determined diagnosis provide the basis for planning. Before developing a plan, a goal must be set. Clarity of the goals and diagnosis is critical to the development of an effective plan. In this case, the diagnosis has already been established and thus assessment of this pattern has occurred (weight, favorite foods). The next step before developing a plan is to set a goal weight with the client.

DIF: Cognitive Level: Apply (Application) REF: p. 145

1. A nurse weighs a person who has been diagnosed with a dysfunction in the nutritional-metabolic pattern. Which aspect of the nursing process is being performed?

a.	Assessment
b.	Implementation
c.	Planning
d.	Evaluation

ANS: D

The nursing process consists of assessment, diagnosis, planning, implementation, and evaluation. A person who has been diagnosed with a dysfunction has already been assessed. The process of analyzing changes experienced by a person after a plan has been implemented occurs in the evaluation phase. In this question, a weight will determine whether or not the person is moving toward her goals of weight loss.

DIF: Cognitive Level: Analyze (Analysis) REF: p. 145

1. A nurse administers the T-ACE test to a pregnant woman. The woman’s responses result in a score of 3. This score indicates that the woman:

a.	requires interventions for problem drinking.
b.	lacks evidence of problem drinking.
c.	requires interventions for sexually transmitted disease risks.
d.	lacks evidence of sexually transmitted disease risks.

ANS: A

The T-ACE provides a sensitive measure of alcohol-intake pattern in pregnant women. A score of 2 or more indicates evidence of problem drinking. This client had a score of 3, which would require an intervention for problem drinking.

DIF: Cognitive Level: Apply (Application) REF: p. 128 (Think About It Box)

1. A Hispanic mother tells the nurse that she has been using home remedies for her child’s asthma. Which home remedy might this mother be using?

a.	Acupuncture
b.	Cupping
c.	Hot tea
d.	Massage

ANS: C

In the Hispanic population, asthma is viewed as a cold disease (hot-cold imbalance) and thus is treated with warm therapies. Diet is often used to maintain equilibrium. Thus, warm tea added to the child’s diet might be used to restore equilibrium between hot and cold in this child who has asthma.

DIF: Cognitive Level: Apply (Application) REF: p. 133 (Box 6-2)

1. Which classification system fulfills needs that are exclusive to nursing?

a.	The International Classification of Nursing Practice (ICNP)
b.	The International Classification of Functioning, Disability, and Health (ICF)
c.	The International Nursing Diagnoses Classification (NANDA-I)
d.	The Nursing Diagnostic System (NDS)

ANS: C

The NANDA-I system includes diagnostic criteria, and related etiologies in addition to the description. The NANDA-I fulfills needs that are exclusive to nursing.

DIF: Cognitive Level: Remember (Knowledge) REF: p. 144 (Box 6-5)

1. Erikson’s task of autonomy vs. shame and doubt occurs during which stage of development?

a.	Infancy
b.	Early childhood
c.	Late childhood
d.	Early adolescence

ANS: B

Erikson’s task of autonomy vs. shame and doubt occurs during early childhood.

DIF: Cognitive Level: Remember (Knowledge) REF: p. 139 (Table 6-3)

1. A young couple is deciding if they should get married and start a family. Which of Erikson’s life stages are they experiencing?

a.	Identity vs. role confusion
b.	Intimacy vs. isolation
c.	Generativity vs. stagnation
d.	Ego integrity vs. despair

ANS: B

During early adulthood individuals experience Erikson’s life stage of intimacy vs. isolation. Examples of life events in this stage include committing to a mate and family responsibilities and selecting a career. Identity vs. role confusion occurs during adolescence. Intimacy vs. isolation occurs during middle adulthood. Ego integrity vs. despair occurs during maturity.

DIF: Cognitive Level: Remember (Knowledge) REF: p. 139 (Table 6-3)

1. Which cultural group defines illness as a price that is being paid for the past or the future?

a.	African
b.	Native American
c.	Arabian
d.	Asian

ANS: B

American Indians define illness as a price that is being paid for the past or the future.

DIF: Cognitive Level: Remember (Knowledge) REF: p. 133 (Box 6-2)

1. A man is telling a nurse that he feels that his health is a gift from God. This statement most closely coincides with beliefs of which cultural group?

a.	African
b.	Alaska Native
c.	Asian
d.	Hispanic

ANS: D

Hispanics define health as a gift from God.

DIF: Cognitive Level: Apply (Application) REF: p. 133 (Box 6-2)

1. Which of the following is the leading cause of death among women?

a.	Accidents
b.	Cancer
c.	Coronary artery disease
d.	Stroke

ANS: C

The leading cause of death in women is coronary artery disease.

DIF: Cognitive Level: Remember (Knowledge) REF: p. 144 (Hot Topics Box)

MULTIPLE RESPONSE

1. A client who fails to take his insulin on a regular basis may have a conflict in which of the following functional health patterns? (select all that apply)

a.	Health-perception–health-management
b.	Cognitive-perceptual
c.	Elimination
d.	Values-beliefs

ANS: A, B, D

A problem in one area serves as a clue to dysfunction in other areas. Cognitive patterns include the ability of the individual to understand and follow directions, retain information, make decisions, solve problems, and use language appropriately. As a result, this person may not understand how to give himself the insulin properly. The values-beliefs pattern describes values including the individual’s spiritual values, beliefs, and goals. This person may not believe in the use of medications unless he is symptomatic. The health-perception–health-management pattern involves the individual’s health status and health practices used to reach the current level of health or wellness, with a focus on perceived health status and meaning of health to the individual. This person may not believe in health promotion and prevention. Thus, a person who fails to take his insulin on a regular basis may have a conflict in the health-perception–health-management, cognitive-perceptual, and values-beliefs patterns.

DIF: Cognitive Level: Apply (Application) REF: p. 131 | p. 137 | p. 142

1. Which individual is at risk for a dysfunction in elimination pattern? (select all that apply)

a.	46-year-old mother of two
b.	32-year-old African American man
c.	15-year-old girl
d.	72-year-old white woman

ANS: A, B, C, D

When evaluating elimination patterns, nurses must consider age, developmental level, and cultural considerations. A 46-year-old mother of two is at risk for urinary stress incontinence because of the two vaginal births; an older adult is at risk for urinary control problems; African Americans often have a diet low in fiber, which can lead to constipation; and teenagers, especially girls, may have problems with body image, leading to abuse of laxatives. Thus, all persons listed are at risk for a dysfunction in elimination patterns.

DIF: Cognitive Level: Analyze (Analysis) REF: p. 134

Chapter 07: Health Promotion and the Family

Edelman: Health Promotion Throughout the Life Span, 8th Edition

MULTIPLE CHOICE

1. A nurse is determining which family assessment tool would be best to implement with a family when planning home visits for health promotion. Which of the following criteria should the nurse use to evaluate these tools?

a.	The number of questions asked on the assessment tool
b.	The linkages of the assessment to Healthy People 2020
c.	The amount of involvement that the family has in completing the tool
d.	The capability of the tool to assess goals and outcomes

ANS: C

Useful health-promotion family assessments involve listening to families, engaging in participatory dialogue, recognizing patterns, and assessing family potential for active, positive change.

DIF: Cognitive Level: Apply (Application) REF: pp. 150-151

1. Which of the following best describes the nurse’s role in health promotion and disease prevention?

a.	Educating about home safety measures
b.	Identifying areas for family improvement
c.	Implementing the nursing process using a systems perspective
d.	Acting as a role model for the family

ANS: D

The nurse’s role in health promotion and disease prevention is best described as acting as a role model for the family. Implementing the nursing process, identifying areas for family improvement, and educating about home safety measures are all part of the nurse’s role but do not describe the comprehensive role of the nurse.

DIF: Cognitive Level: Remember (Knowledge) REF: pp. 151-152

1. Which of the following theories is an attempt to explain families as a set of interacting individuals with patterns of living that influence health decisions?

a.	Feminist theory
b.	Systems theory
c.	Developmental theory
d.	Resiliency theory

ANS: B

Systems theory is an attempt to explain patterns of living among the individuals who make up the family system.

DIF: Cognitive Level: Remember (Knowledge) REF: p. 151

1. A nurse is assessing how a family will transition and adapt after their youngest child leaves for college. By using this framework, which of the following perspectives is the nurse implementing?

a.	Risk-factor
b.	Structural-functional
c.	Open systems
d.	Developmental

ANS: D

Duvall and Miller identified stages of the family life cycle and critical family developmental tasks, through a developmental perspective. This conceptual model helps to anticipate family events and discusses how families complete basic family tasks as they transition through these events.

DIF: Cognitive Level: Apply (Application) REF: p. 152

1. Which of the following would be described as a family structural component?

a.	Income earner of the house
b.	Socialization for the family
c.	Immunization of infants
d.	Launching of children

ANS: A

Structural components of the family refer to family roles and relationships.

DIF: Cognitive Level: Apply (Application) REF: p. 152

1. A nurse is collecting data for a family assessment using Gordon’s functional health patterns. The nurse learns that the family has no books in the home to read to the preschool-age children. To which of the following functional health patterns does this information pertain?

a.	Roles-relationship
b.	Cognitive-perceptual
c.	Health-perception–health-management
d.	Self-perception–self-concept

ANS: B

The cognitive-perceptual pattern identified characteristics of language, cognitive skills, and perception that influence desired or required family activities. The availability of books in the home for preschool age children impacts this functional health pattern.

DIF: Cognitive Level: Analyze (Analysis) REF: p. 157

1. A nurse who is using Gordon’s functional health patterns is planning to assess its roles-relationships pattern. Which of the following questions would be most appropriate for the nurse to ask?

a.	What is the family’s philosophy of health?
b.	What does the family do to have fun?
c.	How are problems in the family resolved?
d.	Who decides when and how children go to sleep?

ANS: C

How problems in the family are resolved relates to assessment of the roles-relationships pattern. The family’s philosophy of health relates to the health perception-health management pattern. What the family does to have fun relates to the activity-exercise pattern. The decision concerning when and how children go to sleep relates to the sleep-rest pattern.

DIF: Cognitive Level: Analyze (Analysis) REF: pp. 158-159

1. A nurse is using a genogram to represent a family. Which of the following statements is accurate?

a.	A genogram identifies the genetic disorders of the family.
b.	A genogram includes information about the past two generations.
c.	A genogram can be used to make connections about family health patterns.
d.	A genogram begins with a circle in the center of the page.

ANS: C

A genogram shows a variety of family structures and highlights family health patterns, which can be used for anticipatory health guidance. Significant diseases and disorders of the family members are highlighted on the genogram. Data on at least three generations are reported on a genogram. The genogram uses a variety of symbols to demonstrate connections but does not begin with a circle in the center of the page.

DIF: Cognitive Level: Apply (Application) REF: p. 160

1. The ecomap of a client’s family has slashed lines drawn from the son to the family church. Based on this information, what conclusion can the nurse make?

a.	The son is deceased.
b.	The son is actively involved with the family church.
c.	The son has a stressful relationship with the church.
d.	The son has no relationship with the church.

ANS: C

Slashed lines on an ecomap signify stressful relationships.

DIF: Cognitive Level: Apply (Application) REF: p. 160

1. A client reports that her family will be moving because her husband is taking a new job in another state. She is very unhappy about the decision and doesn’t want to move. What action should the nurse take next?

a.	Assess the client’s and family’s coping mechanisms in handling stress.
b.	Encourage the client to act excited about the move.
c.	Talk to the husband to get his perspective on the move.
d.	Tell her that all families must cope with new situations from time to time.

ANS: A

The family’s ability to cope with demands of everyday living determines its level of success. The nurse needs to assess how the family usually copes with stressful situations to find ways that might be available to the family now to cope with the current situation.

DIF: Cognitive Level: Analyze (Analysis) REF: p. 164

1. In a family in which the mother and the father differ on how to spend and save money, the parents are constantly arguing with each other. Which of the following interventions should the nurse include in the plan of care for this couple?

a.	Assist them to develop strategies that are congruent with their values.
b.	Allow each of them to defend his or her own values.
c.	Focus on outcomes that each wants to accomplish.
d.	Divert their attention to areas in which they are successful.

ANS: A

When strategies are used that are congruent with each individual’s values, the couple adjusts.

DIF: Cognitive Level: Apply (Application) REF: p. 166

1. A blended family has six children, ages 2, 4, 4, 5, 7, and 10. During a visit to the home, the nurse notices that the 7-year-old seems quiet and withdrawn, whereas the other children are playing loudly in the garage. Which of the following conclusions can the nurse make from this observation?

a.	This child has most likely been abused.
b.	This child is one of multiple children closely spaced in age.
c.	This family suffers from low self-esteem.
d.	This family provides harsh punishment for their children.

ANS: B

Risks associated with role relationships in blended families include multiple closely spaced children, which limits the parents’ time for interaction to meet individual children’s needs.

DIF: Cognitive Level: Apply (Application) REF: p. 167

1. The nurse is caring for a family who has 2-year-old twins. Which of the following health promotion advice would be included in the nurse’s plan of care for this couple?

a.	Wear bicycle helmets for safety.
b.	Use caution around the family swimming pool.
c.	Cross the street at using the crosswalks.
d.	Advocate for the day care to provide adequate socialization.

ANS: B

Two-year-olds are prone to wandering to where water is and could fall into a swimming pool without being noticed.

DIF: Cognitive Level: Apply (Application) REF: p. 167

1. A nurse is conducting a health promotion assessment for a family with a 9-month-old. Which of the following should be of most concern to the nurse?

a.	The age of the house in which the family lives
b.	Genetic diseases in the family
c.	Driving practices in the family
d.	Toilet training for the child

ANS: A

A typical 9-month-old is beginning to crawl. Houses built before 1974 may contain lead-based paint, to which a crawling baby might have access. Lead causes neurological damage and anemia.

DIF: Cognitive Level: Analyze (Analysis) REF: p. 167

1. A nurse is caring for a family with an adolescent child. Which of the following problems would the nurse anticipate that the family would report?

a.	Concerns about career decisions
b.	Concerns about exposure to environmental hazards
c.	Difficulty with parents finding fulfillment with raising the child
d.	Difficulty with open communication with the child

ANS: D

Open communication with parents is often difficult during the adolescent stage, partly because of the differing developmental tasks of adolescents and adults. Concerns about exposure to environmental hazards and parents finding fulfillment with raising the child typically are concerns with families with younger children. Concerns about career decisions are typically problematic for families with older children/young adults.

DIF: Cognitive Level: Apply (Application) REF: p. 168

1. The nurse is working with a middle-age married couple whose son has just graduated from college. Which developmental tasks would the nurse expect to find in this family?

a.	Attending activities for their son
b.	Strengthening their marital relationship for future family stages
c.	Acting as a launching center for their son
d.	Responding to the prospect of changing careers

ANS: C

Families with young adults act as launching centers for children ready to leave home.

DIF: Cognitive Level: Apply (Application) REF: pp. 168-169

1. A nurse has developed a family nursing diagnosis. Which of the following best describes the purpose of this action?

a.	Describes the strengths of the family
b.	Allows for creation of goals for the family
c.	Promotes behavioral change among family members
d.	Validates health problems with the family

ANS: D

Writing a family nursing diagnosis helps families promote health throughout the life cycle and prevents disease through decreasing risk-taking behaviors. Nurses derive diagnoses from assessed validated data. The nursing diagnosis describes and validates potential or actual health problems with families. The diagnosis provides direction for outcomes and interventions first identifying what the problem is.

DIF: Cognitive Level: Apply (Application) REF: p. 170

1. A home care nurse is planning an intervention with a family focusing on decreasing susceptibility. Which of the following nursing interventions would be most appropriate to implement?

a.	Education about building on current strengths of the family
b.	Education about hand hygiene
c.	Education about health care resources in the community
d.	Education about child safety seats

ANS: B

Four types of nursing interventions appear in health-promotion and disease-prevention planning: increasing knowledge and skills; increasing strengths; decreasing exposure; and decreasing susceptibility. Decreasing susceptibility means educating families about prevention principles. Examples include education about hand hygiene and how diseases are spread from person to person and by other factors in the environment.

DIF: Cognitive Level: Analyze (Analysis) REF: p. 171

1. A nurse is making a final home visit with a family to evaluate the nursing care plan. Which of the following actions would the nurse most likely complete during this visit?

a.	Obtain vital signs from all members of the family.
b.	Ask the family members to state the goals that were previously developed.
c.	Collect data similar to that which was collected at the initial visit for comparison.
d.	Educate about the importance of using role relationships to create a healthy family.

ANS: C

The purpose of evaluation is to determine how the family has responded to the planned interventions and whether these interventions were successful. The family’s baseline data are used as comparative criteria in evaluation; thus, it would be worthwhile to collect data similar to that collected at the initial visit to see if any changes have occurred. The nurse reassesses the situation and compares the new information with that on the original assessment to determine whether change has occurred.

DIF: Cognitive Level: Analyze (Analysis) REF: p. 172

1. A nurse is planning a home visit for a family. Which of the following actions would be most appropriate for the nurse to take?

a.	Study information regarding the family from agency records and other sources.
b.	Make a contract with the family that states specific goals and objectives.
c.	Identify how the home visit will be financed.
d.	Understand the situation from the family’s perspective.

ANS: A

Part of planning the home visit is studying information regarding the family from agency records, referral forms, and other sources. Making a contract, identifying how the visit will be financed, and understanding the situation from the family’s perspective are all part of the process of making the visit.

DIF: Cognitive Level: Apply (Application) REF: p. 151 (Box 7-1)

1. A nurse is providing follow-up care for a family who has recently had a baby. Which of the following topics should the nurse anticipate discussing with the family?

a.	Type 1 diabetes
b.	Fetal alcohol syndrome
c.	Communicable diseases
d.	SIDS

ANS: D

Families in the beginning childbearing stage need education about the risk of SIDS for their infant. After the birth of the child, it is most likely that they do not need education about fetal alcohol syndrome, unless there were issues with alcohol use during the prenatal period. Discussion about communicable diseases and potentially Type 1 diabetes would be more common with families with school-aged children.

DIF: Cognitive Level: Apply (Application) REF: p. 154 (Table 7-1)

MULTIPLE RESPONSE

1. A home health nurse is admitting a 54-year-old man for services following a coronary artery bypass graft (CABG). As part of the initial visit the nurse completes a family assessment. What is the purpose of this nursing action? (select all that apply)

a.	Allows for health promotion and disease prevention appraisal
b.	Allows for inclusion of family members in decision-making
c.	Allows for data collection necessary for comparison to Healthy People 2020
d.	Allows for development of patient-centered care

ANS: A, B

Families provide the structure for many health promotion practices; therefore, family assessment informs health promotion and disease prevention appraisal. Additionally, health providers are encouraged to include families in decision-making and encouraging their presence and participation in all aspects of care from acute care to health promotion. Thus, it is important to have assessed the family so that the family can be included in the care process.

DIF: Cognitive Level: Apply (Application) REF: p. 150

1. A nurse is providing care for a family in the community. Which of the following characteristics would the nurse assess to determine the health of the family? (select all that apply)

a.	Developmental stage of each family member
b.	Coping mechanisms of each family member
c.	Potential risk factors within the family
d.	Maintenance of trust within the family

ANS: B, C, D

Coping mechanisms of each family member, potential risk factors within the family, and maintenance of trust within the family are all necessary characteristics for the nurse to assess when determining the health of a family. When assessing a family, the nurse will consider the developmental stage of the family before considering the developmental stage of each of the individual family members.

DIF: Cognitive Level: Apply (Application) REF: p. 152 (Box 7-2)

1. A nurse is conducting an environmental assessment as part of a family assessment. Which of the following would the nurse assess? (select all that apply)

a.	Garbage collection in the neighborhood
b.	Convenience stores in the neighborhood
c.	Safety of the home
d.	Climate of the home

ANS: A, B, C, D

The family environment is made up of the home, neighborhood, and community. Thus, aspects of the community as well as aspects of the home environment need to be analyzed during this assessment.

DIF: Cognitive Level: Apply (Application) REF: p. 165