LA#4 - Stanhope Chap 3 and 12 Flashcards Preview

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Flashcards in LA#4 - Stanhope Chap 3 and 12 Deck (48)
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1

While taking a family history, the community health nurse (CHN) finds out that the husband is a stepfather to the eldest child. This information should be documented as falling into which category?a.Family demographicsb.Family dynamicsc.Family functiond.Family system

AFamily demographics is the study of the structure of families and households and the family-related events, such as marriage and divorce, that alter the structure through their number, timing, and sequencing.

2

The CHN needs to conduct a family assessment for a family that lives in a commune, but is uncertain about how to proceed because family lines appear blurred. Which one of the following questions should the CHN ask to determine the structure of a family comprising a mother and a child?a.“How many children do you have, and who is the father of each of them?”b.“Is there a register of families that are members of this commune?”c.“Tell me about your significant other.”d.“Who are the members of your and your child’s family?”

DThe members of a family are self-defined. CHNs working with families should ask people who they consider to be their family and then include those members in health care planning.

3

Family functions and structures create unique challenges in family nursing. Which of the following is the primary reason for the existence of these challenges?a.The function and structure of families continue to change over time.b.Function and structure do not apply to all family units.c.Some clients do not have families.d.Traditional families are rare in today’s society.

AThe functions within families have evolved and changed over time. Some have become more important and others less so. Family structures also have changed over time. The structure–function theory perspective is a useful framework for assessing families and health. Illness of a family member results in the alteration of the family structure and function.

4

Historically, CHNs focused on the care of individuals while viewing the families of individuals as either background resources or possible stressors. Which view of the family did this traditional conceptualization take?a.Family as the clientb.Family as a component of societyc.Family as contextd.Family as a system

CFamily as the context, or structure, represents a traditional focus that places the individual first and the family second. This conceptualization views the family as either a resource or a stressor to individual health and illness.

5

A CHN researcher wants to know and better understand how the chronic illness of a child can affect a family’s communication patterns, relationships, role expectations, and role behaviours. Which of the following types of family nursing theory would best address the purpose of the CHN’s research?a.Developmental theoryb.Interactional theoryc.Structure–function theoryd.Systems theory

BAn interactional framework emphasizes interaction between and among family members and family communication patterns about health and illness behaviours appropriate for different roles.

6

Which one of the following nursing functions that identify family problems and strengths is the foundation for family nursing interventions?a.Assessmentb.Planc.Implementationd.Evaluation

AFamily nursing assessment is the cornerstone for family nursing interventions. With use of a systematic process, family problem areas are identified and family strengths are emphasized, thus laying the foundation for interventions. The CHN works in partnership with the client to promote health. Each family nursing assessment model and approach is unique and creates a database upon which to plan interventions.

7

Which of the following scenarios is an example of a normative event that can increase the risk for illness?a.A family is involved in a motor vehicle accident.b.A group of teens experiments with recreational drugs.c.A woman is pregnant with her first child.d.The family’s only earning member is laid off from work.

CCertain life events can increase the risk for illness and disability. Normative events are those events that are generally expected to occur at a particular stage of development or of the lifespan of a person. The normative event of the birth of a child, for example, requires considerable changes in family structures and roles. Furthermore, family functions are expanded from previous levels, requiring families to add new skills and establish additional resources.

8

When drawing a genogram, which one of the following will the CHN use to demonstrate a marital relationship between two individuals?a.A broken lineb.A dashed linec.A solid lined.Two parallel lines

CIn a genogram, marriage is indicated by a solid line between two individuals.

9

A CHN is preparing to terminate a visit with teenage parents and their new baby. During this phase of the home visit, which of the following actions will the CHN want to take?a.Determine the family’s willingness for home visits.b.Establish the purpose of the visit.c.Review important points of teaching discussed during the visit.d.Review the family record and reason for referral.

CDuring the termination phase, the CHN reviews the visit with the family and plans for future visits. The other options listed occur during the engagement phase.

10

A CHN has just signed as a witness to an agreement between a couple, in which they pledge not to yell at each other in the presence of their children. What is this approach to improving family health called?a.Contractingb.Crisis interventionc.Empowermentd.Strategic planning

AContracting, the making of an agreement between two or more parties, involves a shift in responsibility and control toward a shared effort by the clients and the professional as opposed to an effort by the professional alone. The premise of contracting is family control. It is assumed that when the family has legitimate control, their ability to make healthy choices is increased.

11

Which one of the following is the most important predictor of health?a.Biological riskb.Economic riskc.Life-event riskd.Health values

BEconomic risk is one of the foremost predictors of health and is determined by the relationship between family financial resources and the demands on those resources. Having adequate financial resources enables the family to purchase the necessary services and goods related to health, such as adequate housing, clothing, food, education, and health or illness care.

12

Which of the following actions by the CHN has the most potential to empower the family of a mother with newly diagnosed breast cancer?a.Applying for emergency financial assistance on the family’s behalfb.Arranging for community members to assist with child carec.Recommending that the mother join a cancer support groupd.Teaching the family how to navigate the health care system

DDefinitions of empowerment reflect three factors involved in a family seeking help: (1) access and control over needed resources, (2) decision-making and problem-solving abilities, and (3) the ability to communicate and to obtain needed resources. Applying for emergency financial assistance and arranging for community members to assist with child care are enabling interventions. Recommending that the mother join a cancer support group, although certainly helpful for coping, is not a component of empowerment.

13

The CHN conducting a health risk appraisal assesses which one of the following?a.Health promotion activitiesb.Illness prevention activitiesc.Risk reduction activitiesd.Unhealthy events

DHealth risk appraisal refers to the process of assessing and analyzing in order to identify specific factors in each of the categories associated with an increased likelihood of development of an illness, such as cancer, or an unhealthy event, such as a motor vehicle accident.

14

During which of the following phases should documentation of home visits take place?a.Engagement phaseb.In-home phasec.Termination phased.Postvisit phase

DEven after a CHN has concluded a home visit and left the client’s home, the responsibility for the visit is not complete until the interaction has been recorded. Documentation of the visit is a basic requirement for legal and clinical purposes. It is important that the recording be current, dated, and signed.

15

In a predominantly poor community, where eating clay (pica) is a common practice, through which of the following actions can the CHN intervene at the tertiary prevention level?a.Helping the clients obtain extra welfare money, after explaining that clay, although filling, does not provide necessary nutrientsb.Initiating early intervention in the school system through education programs designed to focus on healthy food choicesc.Conducting laboratory testing and physical assessments to identify nutritional deficits resulting from pica and the lack of regular food intaked.Surveying families to determine the presence and extent of pica

ATertiary prevention is undertaken to prevent additional health problems when a problem has already occurred. Initiating early intervention to focus on healthy food choices in the school system is an example of primary prevention. Laboratory testing to identify nutritional deficits and surveying families to determine presence of pica are screening activities to determine if problem behaviour is present and to identify it in the early phases. Screening activities are representative of secondary prevention.

16

Which of the following categories is addressed by the developmental assessment aspect of the Calgary Family Assessment Model (CFAM)?a.Family life-cycle stagesb.Instrumental and expressive functionsc.Activities of everyday livingd.Family strengths

AWithin the CFAM, developmental assessment contains family life-cycle stages, tasks usually achieved in relation to life-cycle stages, and attachments for the family.

17

Which of the following best describes the concept of public health?a.A population health approach designed to prevent disease, promote health, and protect populationsb.Health care provision offered in primary and secondary institutions or in clients’ homesc.Provision of health care services in institutions located in the community but outside the hospitald.Use of the nursing process and evidence-informed practice to meet the objectives for community health improvement

AIn Canada, public health takes a population health approach to protecting and promoting health and preventing disease for all Canadians. Public health nurses (PHNs) work with many partners, both within the public health unit or health authority (e.g., nutritionists, epidemiologists, dental hygienists, health inspectors) and external to the health unit (e.g., community coalitions for heart health, cancer screening, diabetes, and obesity prevention; school and hospital administrators; regional planners; social service and child-care workers; lobbyists for health issues such as antismoking legislation and homelessness).

18

The increasing complexity of societal needs and rapid changes in public health no longer allow adequate time for on-the-job training and education. As a result, which of the following is the current minimum level of educational preparation for a military nurse?a.Training as a registered practical nurseb.Training as a registered nursec.A baccalaureate degree in nursingd.A master of science degree in nursing

CEducational preparation for military nurses should be at least a baccalaureate degree.

19

Which of the following is a core competency required of PHNs?a.Advanced knowledge in the use of high-technology diagnosticsb.Familiarity with current life-support technologyc.Highly tuned skills for assessment of critically ill clientsd.Skill in developing policy and planning programs to improve health

DSkill in developing policy and planning programs to improve health is part of the set of core public health competencies, which are divided into the following eight domains: 1) Public Health and Nursing Sciences; 2) Assessment and Analysis; 3) Policy and Program Planning, Implementation, and Evaluation; 4) Partnerships, Collaboration, and Advocacy; 5) Diversity and Inclusiveness; 6) Communication; 7) Leadership and Professional Responsibility; and 8) Accountability. The other competencies listed are better suited to nurses who work in tertiary facilities, such as hospitals.

20

A public health administrator is in the process of hiring a new PHN. Which of the following statements by a potential employee would raise the greatest concern for the employer?a.“I like to be the only person working on a project because individual team members have their own ideas and plans, and the resulting debate slows progress.”b.“I prefer to work in teams because no single person has too much responsibility and the burden is shared.”c.“Teamwork is better than work done by individuals because teamwork incorporates different perspectives.”d.“Whether teamwork is better than work done by individuals depends on the nature of the work being performed.”

AWorking in collaborative partnerships is an essential role of public health nursing. Partnerships and collaboration among groups are much more powerful in making changes than are the individual client and the PHN working separately. Part of the reason for this is that multiple perspectives are examined in the process of arriving at the best solution.

21

Which one of the following is a primary prevention activity for decreasing the incidence of communicable diseases?a.Identifying and treating clients in a clinic for sexually transmitted infections (STIs)b.Partnering with school teachers to teach handwashing to elementary school children and observe their techniquesc.Providing case management services that link clients with communicable diseases to health care and community support servicesd.Providing directly observed therapy (DOT) to clients with active tuberculosis (TB)

BAn example of primary prevention is to educate daycare centres, schools, and the general community about the importance of hand hygiene to prevent transmission of communicable diseases.

22

A PHN is participating in which activity when tracing the sexual contacts of clients with STIs for screening purposes?a.Primary preventionb.Secondary preventionc.Tertiary preventiond.Secondary and tertiary prevention

APrimary prevention activities include contacting and tracing individuals exposed to a client with an active case of TB or an STI. Once contact has been made, the actual screening is a secondary prevention activity.

23

Through which one of the following actions can the community health nurse (CHN) provide tertiary prevention?a.Disseminating information about mental health to community organizationsb.Partnering with PHNs for early identification of children with mental health challengesc.Providing case management services that link clients with serious mental illnesses to mental health and community support servicesd.Screening clients at high risk for mental disorders

CAn example of tertiary prevention is the provision of case management services that link clients identified with serious mental illnesses to mental health and community support services.

24

Which of the following represents the primary difference between parish nursing and all other fields of nursing?a.Affiliation with a church or congregationb.Incorporation of spiritual aspects into nursing carec.Provision of holistic nursing cared.Residence within the community of service

AParish nurses are found in faith congregations, including communities that serve diverse cultures. Parish nurses also serve faith communities in other countries.

25

To help congregation members better meet their nutritional needs, a parish nurse encourages them to participate in activities that focus on fellowship, as well as serving healthy meals to both attending and homebound church members. What do programs such as this exemplify?a.Entitlement programsb.Health ministriesc.Partnershipsd.Pastoral care practices

BHealth ministries comprise those activities and programs in faith communities that are organized around health and healing to promote whole health across the lifespan. Health ministries’ services may be specifically planned or informal and may include visiting the homebound, providing meals for families in crisis or for those returning home after hospitalization, organizing prayer circles, volunteering in community HIV/AIDS care groups, serving “heart healthy” church suppers, and holding regular grief support groups.

26

As part of primary prevention, a parish nurse wants to encourage some elementary school students to increase their vigorous exercise. Which action by the parish nurse will help these students attain an improved health status?a.Encouraging families to ensure that the students receive healthy diets and plenty of restb.Fostering relationships among families with children of similar ages so that they can work together toward goal attainmentc.Partnering with a youth pastor to establish sports activities that will include those individuals with special needsd.Working with faith-based school teachers to include in the curriculum teaching about healthy diet and food selection

CParish nursing’s goal is to develop and sustain health ministries within faith communities. Some of the usual functions of parish nurses include providing personal health counselling and health education, acting as a liaison between the faith community and the local community, facilitating activities, and providing pastoral care.

27

Which statement by a parish nurse exhibits a misunderstanding of the concept of pastoral care?a.“By working with my clients to help them identify their spiritual strengths, I am drawing on the pastoral care aspects of practice.”b.“I incorporate pastoral care in my practice when I involve the pastor in ministering to the members of the congregation.”c.“I am practising pastoral care when I emphasize the spiritual dimension of nursing while providing care.”d.“Lending support to clients during their times of joy as well as times of sorrow is part of providing pastoral care.”

BPastoral care by a parish nurse implies providing care by stressing the spiritual dimension of nursing, lending support during times of joy and sorrow, guiding the person through health and illness throughout life, and helping identify the spiritual strengths that assist in coping with particular events. The parish nurse is able to provide pastoral care; she or he does not have to involve the pastor.

28

Through which one of the following interventions can the parish nurse implement primary prevention of obesity in school-aged church members?a.Establishing a walking program that is sufficiently challenging, yet not too strenuous, for those who are obeseb.Partnering with youth camp cooks to ensure that a nutritious diet is providedc.Supervising height and weight measurements taken by clinic assistantsd.Working with parents of obese children to implement lifestyle changes in the family

BAn example of primary prevention is encouraging the provision of healthy snacks and meals to children and adults at all events inside and outside of school.

29

What is the basic difference between home health care and other types of health care?a.Home health care is individualized care for the client and family.b.Home health care is provided in the client’s environment.c.Reimbursement for home health care is different from that of care provided in institutions.d.Home health care focuses on community health.

BHome health care differs from other types of health care in that home health care providers practice in the client’s environment.

30

A CHN has just received word that the provincial health care plan will provide compensation for the care that she provided to a homeless man with schizophrenia, who was unwilling to come to the clinic to receive health care. How can this type of nursing service be best classified?a.Community-oriented nursingb.Home health nursingc.Hospice nursingd.Private duty nursing

BHome health nursing is provided in the client’s environment, wherever that may be. “Home” may be a house, apartment, trailer, boarding and care home, shelter, car, makeshift shelter under a bridge, or cardboard box.