Chapter 12: WORKING WITH FAMILY Flashcards
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 demographics b. Family dynamics c. Family function d. Family system
A
Family 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.
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?”
D
The 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.
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.
A
The 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.
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 client b. Family as a component of society c. Family as context d. Family as a system
C
Family 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.
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 theory b. Interactional theory c. Structure–function theory d. Systems theory
B
An interactional framework emphasizes interaction between and among family members and family communication patterns about health and illness behaviours appropriate for different roles.
Which one of the following nursing functions that identify family problems and strengths is the foundation for family nursing interventions? a. Assessment b. Plan c. Implementation d. Evaluation
A
Family 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.
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.
C
Certain 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.
When drawing a genogram, which one of the following will the CHN use to demonstrate a marital relationship between two individuals? a. A broken line b. A dashed line c. A solid line d. Two parallel lines
C
In a genogram, marriage is indicated by a solid line between two individuals.
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.
C
During 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.
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. Contracting b. Crisis intervention c. Empowerment d. Strategic planning
A
Contracting, 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.
Which one of the following is the most important predictor of health? a. Biological risk b. Economic risk c. Life-event risk d. Health values
B
Economic 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.
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 behalf
b.
Arranging for community members to assist with child care
c.
Recommending that the mother join a cancer support group
d.
Teaching the family how to navigate the health care system
D
Definitions 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.
The CHN conducting a health risk appraisal assesses which one of the following? a. Health promotion activities b. Illness prevention activities c. Risk reduction activities d. Unhealthy events
D
Health 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.
During which of the following phases should documentation of home visits take place? a. Engagement phase b. In-home phase c. Termination phase d. Postvisit phase
D
Even 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.
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 nutrients
b.
Initiating early intervention in the school system through education programs designed to focus on healthy food choices
c.
Conducting laboratory testing and physical assessments to identify nutritional deficits resulting from pica and the lack of regular food intake
d.
Surveying families to determine the presence and extent of pica
A
Tertiary 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.
