Community - Week 6 (Ch 19 20) - Evolve Questions

Question 1

During a family nursing assessment, a parent questions whether God is punishing the family, because one of the children has just been diagnosed with leukemia. The most facilitative response by the nurse would be:

1. “God is loving and doesn’t punish people.”
2. “Tell me more about your family’s spiritual beliefs.”
3. “That is not part of my religious belief system, so I don’t know.”
4. “Why do you think your family needed to be punished?”

Answer 1

2. “Tell me more about your family’s spiritual beliefs.”

The focus of the Neuman Systems Model would be to assess the family’s ability to adapt to this stressful change. Assessment of spirituality is an important variable in assessing family strengths and weaknesses. The Neuman Systems Model is a wellness-oriented model in which the nurse uses the strengths and resources of the family to maintain system stability while adjusting to stress reactions that may lead to health change and affect wellness. In other words, this model focuses on family wellness in the face of change.
DIF: Cognitive Level: Application
REF: Page 327

Question 2

A nurse doing a family assessment asks the client, “Have any of your blood relatives had mental illness?” The nurse is asking this question to:

1. determine whether the family is stable.
2. assess for biological risk factors.
3. decide whether this family member needs medication.
4. demonstrate open-mindedness about mental illness.

Answer 2

2. assess for biological risk factors.

Healthy People 2020 (U.S. Department of Health and Human Services, 2010) identified the following major categories as being: inherited biological risk, including age-related risks, social and physical environmental risks and behavioral risks as well as health care risks. Although single risk factors can influence outcomes, the combined effect of several risks has greater influence.
DIF: Cognitive Level: Application
REF: Page 327

Question 3

One member of an older couple has just retired. This is considered a:

1. developmental stage that will help the family with stress reduction.
2. nonnormative event that will have psychological impact on the family.
3. normative event and can increase the family’s risk for illness.
4. normative event and will have little effect on the family’ well-being.

Answer 3

3. normative event and can increase the family’s risk for illness.

Life events can increase the risk for illness. Normative events are those that are generally expected to occur at a particular stage of development or the life span. If the event is normative, families may be able to identify needed resources, make plans to cope with the change, learn new skills, and prepare for the event and its consequences. This kind of anticipatory preparation can increase the family’s coping ability and decrease stress and negative outcomes. However, when the event is nonnormative, or unexpected, families have little or no time to prepare and the outcome can be increased stress, crisis, or even dysfunction.
DIF: Cognitive Level: Application
REF: Pages 329-330

Question 4

A parent with two school-age children has just finished a family health assessment questionnaire. The parent asks the nurse why one of the questions asks whether there is a neighborhood playground. The nurse’s best response would be:

1. “Don’t worry about it. We are going to talk about all this anyway.”
2. “It’s important to good health to have adequate recreation resources.”
3. “We want to be able to report any dangerous playground equipment to the city.”
4. “We want to know what kind of neighborhood you’re in so we can assess income.”

Answer 4

2. “It’s important to good health to have adequate recreation resources.”

The importance of social risks to family health is gaining increased recognition. A family’s health risk increases if they are living in high-crime neighborhoods, communities without adequate recreation or health resources, in communities with major noise pollution or chemical pollution, or in other high-stress environments.
DIF: Cognitive Level:Application
REF: Page 333

Question 5

A nurse in community health decides to form a contract with a family. The contract states that the family will designate one night as a family night. The nurse is most likely using the contract to:

1. make sure the family does what is expected.
2. encourage the family to put plans in writing.
3. let the family know that this is a legal agreement.
4. shift the responsibility so that it becomes a shared effort.

Answer 5

4. shift the responsibility so that it becomes a shared effort.

Contracting involves a shift in responsibility and control toward a shared effort by the client and 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, its ability to make healthful choices is increased. Contracting is a strategy aimed at formally involving the family in the nursing process and jointly defining the roles of both the family members and the health professional.
DIF: Cognitive Level: Application
REF: Pages 340-341

Question 6

A nurse in community health is conducting a parenting class for prospective parents that will focus on the development of new skills, identification of needed resources, planning, and other preparations for the arrival of a newborn. This intervention is addressing a potential risk associated with:

1. biology.
2. behavior.
3. environment.
4. transitions.

Answer 6

4. transitions.

Transitions, or the movement from one stage or condition to another, are times of potential risk for families. Age-related or life event risks often occur during transitions from one developmental stage to another. They require families to learn new skills; change behaviors, schedules, or patterns of communication; identify needed resources; and make plans.
DIF: Cognitive Level: Knowledge
REF: Pages 329-330

Question 7

A nurse in community health is conducting an assessment on a family of four. During the course of the assessment, the nurse collects information about previous generations of the family and siblings. The results are used to create a diagram for the family that displays the family unit across generations. Further discussions occur regarding the patterns of health and illness that relate to biological health risks. The diagram is called:

1. an ecomap.
2. a family plan.
3. a genogram.
4. a risk plot.

Answer 7

3. a genogram.

A genogram is a drawing that shows the family unit of immediate interest and includes several generations, using a series of circles, squares, and connecting lines. Basic information about the family, relationships in the family, and patterns of health and illness can be obtained by completing the genogram with the family.
DIF: Cognitive Level: Application
REF: Page 330

Question 8

Many families have financial resources that allow them to maintain themselves but limit the quality of their purchasing power. Food high in fat and calories may be affordable, whereas fresh fruits and vegetables may not be affordable. A federal program that attempts to promote healthier diets for vulnerable populations is:

1. Medicaid
2. Medicare
3. Supplemental Security Income (SSI)
4. Women, Infants, and Children (WIC)

Answer 8

4. Women, Infants, and Children (WIC)

Nutritious diets are important in preventing illness and promoting health. A U.S. Department of Agriculture (USDA) study examined the effects of its Women, Infants, and Children (WIC) nutrition program. The study found that children who participated in WIC were more linked to the health care system than children who were not. Children in WIC were more likely to receive both preventive and curative care more often than children not participating in WIC.
DIF: Cognitive Level: Application
REF: Pages 333-334

Question 9

Nursing interventions and approaches for helping individuals and families to assume an active role in their care should focus on empowerment rather than on enabling. The underlying principle to empowerment is:

1. client dominance.
2. decreased competence.
3. professional dominance.
4. professional-client partnership.

Answer 9

4. professional-client partnership.

Empowerment’s underlying assumption is one of partnership between the professional and the client, as opposed to one in which the professional is dominant. Families are assumed to be either competent or capable of becoming competent. For families to become active participants, they need to feel a sense of personal competence and a desire for and willingness to take action.
DIF: Cognitive Level: Application
REF: Pages 341-342

Question 10

The problem of the working poor and uninsured places a major burden on the current health care system that affects those families and the community in general. Nurses in community health see this as a major: (select all that apply)

1. behavioral issue.
2. policy issue.
3. health risk issue.
4. social issue.
5. nursing issue.

Answer 10

2. policy issue.
3. health risk issue.
4. social issue.

Economic risk is one of the foremost predictors of health. It is useful to know whether families’ resources are adequate to meet their needs. The standard of living they are comfortable with is not the measure of risk. If the main wage earner is employed but receives no medical benefits, and the salary is not sufficient for health promotion or illness-related care, the family may qualify for available government-sponsored programs. This is a major policy issue of concern to nurses.
DIF: Cognitive Level: Comprehension
REF: Page 334

Question 11

A school nurse is working with the Parent Teacher Organization (PTO) to improve the health status of preschool students in a lower socioeconomic urban community. Given the demographics of the community, the nurse is aware that this population is at greatest risk for:

1. asthma.
2. attention deficit disorder (ADD).
3. childhood obesity.
4. poisoning.

Answer 11

3. childhood obesity.

Obesity among the youth of the nation has reached epidemic proportions. Many factors contribute to the likelihood that a child will become overweight or obese. Factors include genetics, family eating, and physical activity patterns and time spent inactive while viewing television, playing computer games, or using other electronic devices. The environment in which children live influences obesity.
DIF: Cognitive Level: Application
REF: Page 348

Question 12

The school nurse is interested in providing an antismoking program in a local middle school and is aware that programs are more effective for this age group when they focus on short-term versus long-term effects of smoking. Besides including health risks and cosmetic effects, the nurse should also consider:

1. behavior modification techniques.
2. effects on the environment.
3. laws regarding tobacco sales to minors.
4. social skills instruction to resist pressure to smoke.

Answer 12

4. social skills instruction to resist pressure to smoke.

Antismoking programs directed toward children and teenagers are more successful if the focus is on short-term effects rather than long-term effects. Developmentally, children and teenagers cannot visualize the future to imagine the consequences of smoking. Teaching should include how advertising puts pressure on people to smoke.
DIF: Cognitive Level: Application
REF: Page 355

Question 13

The most important causes of preventable disease, disability, and death among children are:

1. injuries and accidents.
2. maintaining a healthful diet.
3. physical activity.
4. cardiovascular health.

Answer 13

1. injuries and accidents.

Injuries and accidents are the most important causes of preventable disease, disability, and death among children. Unintentional injuries are any injuries sustained by accident such as falls, fires, drowning, suffocation, poisoning, sports, recreation, or motor vehicle accidents. Because of their size, growth and development, inexperience, and natural curiosity, children and teens are especially at risk for injury.
DIF: Cognitive Level: Knowledge
REF: Page 350

Question 14

The Patient Self-Determination Act of 1991 requires that providers receiving Medicare and Medicaid funds give clients written information regarding:

1. legal options for treatment choices in the event the person becomes incapacitated.
2. patient rights.
3. the cost of services.
4. patient privacy.

Answer 14

1. legal options for treatment choices in the event the person becomes incapacitated.

The Patient Self-Determination Act of 1991 (PL 103-43) requires that providers receiving Medicare and Medicaid funds give clients written information regarding their legal options for treatment choices if they become incapacitated. A routine discussion of advance medical directives can help ease the difficult discussions faced by health care professionals, family, and clients. The nurse can assist an individual to complete a values history instrument. These instruments ask questions about specific wishes regarding different medical situations.
DIF: Cognitive Level: Comprehension
REF: Page 357

Question 15

Elderly clients should be assessed for signs of abuse. The illegal use of a person for another person’s profit is known as:

1. neglect.
2. incompetence.
3. exploitation.
4. self-determination.

Answer 15

3. exploitation.

Neglect refers to a lack of services that are necessary for the physical and mental health of an individual by the individual or a caregiver. Older persons can make independent choices with which others may disagree. Their right to self-determination can be taken from them if they are declared incompetent. Exploitation is the illegal or improper use of a person or their resources for another’s profit or advantage. During the assessment process, nurses need to be aware of conflicts between injuries and explanation of cause, dependency issues between client and caregiver, and substance abuse by the caregiver.
DIF: Cognitive Level: Application
REF: Page 358

Question 16

An underlying current throughout the special population groups with health disparities is:

1. poverty.
2. aging.
3. minority groups.
4. children.

Answer 16

1. poverty.

Health disparities present political implications and influence government actions. Certain groups have been recognized as experiencing health disparities and have become a priority for policy efforts. Poverty is a strong and underlying current throughout all of the special groups.
DIF: Cognitive Level: Knowledge
REF: Page 365

Question 17

The later years of life for many older adults mark a period of abruptly changing social dynamics over which the older adult has very little control. The nurse should understand that this phenomenon of later life challenges:

1. adapting and coping responses.
2. intellectual capacity.
3. socioeconomic status.
4. spiritual awareness.

Answer 17

1. adapting and coping responses.

Eighty-five percent of all elderly people live in homes alone, with spouses or other family or friends. For many families the caregiving experience is a positive, rewarding, and fulfilling one. Nursing intervention can facilitate good health for older persons and their caregivers and contribute to meaningful family relationships during this period.
DIF: Cognitive Level: Application
REF: Page 367

Question 18

A particular chronic health problem that adversely affects the aging experience for which it is difficult to estimate the number of individuals affected or the associated cost to manage is:

1. iatrogenic drug reactions.
2. immobility.
3. incontinence.
4. intellectual impairment.

Answer 18

3. incontinence.

Urinary incontinence often contributes to institutional care and social isolation. For that reason it is difficult to estimate the number of individuals affected by and the cost associated with incontinence. It is important to address continence routinely in the assessment process, identify the type of incontinence, and intervene appropriately.
DIF: Cognitive Level: Knowledge
REF: Page 358

Question 19

The community health nurse is aware that African-American adults are more likely to be admitted to the hospital for which of the following conditions?

1. Newly diagnosed HIV infection
2. Diabetic patient with lower extremity wound
3. Testicular cancer
4. Psychiatric disorders

Answer 19

2. Diabetic patient with lower extremity wound

Hospital admissions for lower extremity amputations in clients with diabetes and lack of prenatal care for pregnant women in the first trimester are the largest disparities for African Americans. For African Americans, large disparities remain in new AIDS cases despite significant decreases in other groups. The proportion of new AIDS cases was 9.4 times as high for African Americans as for whites. Although addressing these disparities is complex, the goal is to close the gap with regard to the health disparities in adults of color while at the same time preserving and respecting the richness and unique influences of various cultures.
DIF: Cognitive Level: Knowledge
REF: Page 365

Question 20

Which of the following statements are true regarding the health-related vulnerabilities of men? (Select all that apply.)

1. More males die at birth.
2. Fewer health services are offered to men.
3. Men often put work ahead of their health needs.
4. More males die from suicide.
5. Men often incur more work related injuries than women.

Answer 20

2. Fewer health services are offered to men.
3. Men often put work ahead of their health needs.
4. Men often incur more work related injuries than women.

Although health policies, campaigns, and community health organizations offer services for men, women’s health is more often emphasized. Treadwell and Marguerite (2008) noted that virtually no health services were offered to men, especially to men at the lowest socioeconomic levels or to those unable to work. Men often put work ahead of their own health needs. Large numbers of men do not receive the health screenings intended to prevent and identify disease. Men are more often employed in dangerous jobs and incur more work-related injuries than women.
DIF: Cognitive Level:Knowledge
REF: Page 363