test 2 Flashcards
One challenge in working with families for healthy outcomes when the following capacity-building practice model occurs when the nurse steps aside in:
a. defining the problem.
b. designing family interventions.
c. evaluating the plan.
d. pre-encountering data collection.
B. designing family interventions
When the community health nurse displays pertinent family information in a family tree format, the family can see the family structure, its members and their relationships over at least three generations and provides a visual source for planning family interventions. This approach also assists the nurse in making clinical judgments relevant to family structure and history. This type of family assessment instrument is referred to as:
a. ecomap.
b. genogram.
c. family developmental task.
d. family diagnosis.
B. genogram
One of the most significant household changes in the second half of the twentieth century in North America was the increase in men and women living together without marrying. Effects of this trend on the children of cohabitating couples include:
a. increased chance of exposure to second-hand smoke.
b. decreased chance of parental separation.
c. more behavioral and cognitive problems.
d. more stable living conditions.
A. increased chance of exposure to second-hand smoke
C. more behavioral problems and cognitive problems
A community health nurse is working with a single parent with a special needs child and a child with asthma. The maternal grandmother lives with the family and was recently diagnosed with diabetes. The nurse understands the importance of including the grandmother in her assessment and interventions because families are:
a. resistant to outside intervention or involvement.
b. involved in the health care of their members.
c. unable to manage the stress of complex health needs.
d. restricted in their ability to identify interventions.
b. involved in the health care of their members.
The nurse working with the family of a child recently diagnosed with juvenile diabetes asks the parents about any changes in their relationship since the child’s diagnosis. This family nursing approach can best be described as treating the family as a:
a. client.
b. component of society.
c. context.
d. system.
d. system.
One major challenge in the development of social policies that affect families is related to:
a. absence of any federal family policies.
b. indirect negative effects on families.
c. attempts at welfare reform.
d. ongoing debate as to what constitutes a family.
d. ongoing debate as to what constitutes a family.
Two of the most significant barriers to practicing family nursing are the narrow definition of family used by health care professionals and social policy makers and:
a. lack of consensus on what constitutes a healthy family.
b. medical and nursing diagnosis systems.
c. nursing’s historical ties with the medical model.
d. lack of exposure of practicing nurses to family concepts.
a. lack of consensus on what constitutes a healthy family.
A nurse is evaluating the outcome of a family with children’s action plan to address the incorporation of caregiving needs of the paternal grandfather. Although evaluation includes many tasks, the critical thinking process includes: (Select all that apply.)
a. conducting a summative evaluation meeting.
b. determining the timeliness of the plan outcome.
c. identifying changes in the family story.
d. identifying nurse-related barriers.
e. making the transition of nurse to family dependence.
b. determining the timeliness of the plan outcome.
c. identifying changes in the family story.
d. identifying nurse-related barriers.
Family health can be defined as a dynamic relative state of well-being that involves the biological, psychological, sociological, cultural, and spiritual aspects of the family system. This approach to family health is consistent with which of the following principles? (Select all that apply.)
a. Assessment of the individual’s health does not reveal the overall family system’s health
b. Family functioning affects the health of individuals
c. Family system assessment specifically addresses the individual’s health
d. The individual’s health affects the family’s functioning
e. Individual family members and the family system as a whole are assessed simultaneously
b. Family functioning affects the health of individuals
d. The individual’s health affects the family’s functioning
e. Individual family members and the family system as a whole are assessed simultaneously
what are the benefits of bedside report?
acknowledge patients as partners; builds trust; encourages pt/family engagement
what is teach back?
pt/family repeats back in their own words what they need to know or do to be sure you explained things well
after d/c when would do a follow-up for complications? (hours)
48-72 hours
A nurse contacts a family to arrange an initial home visit. The nurse explains the source of the referral and the purpose of the visit. The husband expresses his concerns about the need for a home visit but agrees to a date and time for the home visit. The nurse reviews the agency’s family record and the referral. The nurse has completed which phase(s) of the home visit?
a. Initiation phase
b. Initiation and postvisit phase
c. Initiation and previsit phase
d. Previsit phase
c. Initiation and previsit phase
The nurse continues the assessment of a family’s ability to provide home care for their 6 year old, who is a quadriplegic as a result of an automobile accident, noting that the parents are in good physical health with no genetic or lifestyle risks, live in a safe neighborhood with caring neighbors, are dealing with grief and stress as they adjust to their child’s injury, and are concerned that their insurance benefits may not adequately cover their child’s expenses. The family’s current health risk appraisal identifies the following risks:
a. Biological and life-event risks
b. Economic and life-event risks
c. Life-event and social risks
d. Social risks and biological risks
b. Economic and life-event risks
During a home visit, a nurse teaches a husband who is recovering from a stroke and his wife how to modify their home environment to prevent falls. This education represents:
a. primary prevention.
b. secondary prevention.
c. secondary and tertiary prevention.
d. tertiary prevention.
d. tertiary prevention.
During an assessment of a family of four, the nurse completes a genogram. This assessment tool is effective in identifying:
a. behavioral health risk.
b. biological health risk.
c. nonnormative life events.
d. normative age-related risk.
b. biological health risk.
When conducting an environmental risk assessment, the nurse explores the economic risk and social risk of the family. To capture social risk assessment data, the nurse can best use which of the following?
a. Community assessment and ecomap
b. Genogram and ecomap
c. Genogram and history
d. Double ABC-X model
a. Community assessment and ecomap
Government programs that support family health through the promotion of healthy lifestyles affect the health of individuals, family health, and overall community health. The best example of a government-sponsored program that can promote health and prevent illness for middle-income, subsistence-level families is:
a. Medicaid.
b. Medicare.
c. nongovernmental organization.
d. Women, Infants, and Children (WIC).
d. Women, Infants, and Children (WIC).
How can CHNs use knowledge of developmental tasks to provide primary prevention?
anticipatory guidance
What does the conceptual framework of family systems refer to?
Encourages nurses to view “all” as participating members of a family
What does the conceptual framework of family structural/functional refer to?
Families examined in terms of their relationship with other major social structures/institutions…think comparing
What does the conceptual framework of family interaction refer to?
Views families as units of interacting personalities and examines the symbolic communications by which family members relate to each other
What does the conceptual framework of family developmental refer to?
Looks at the family system over time through different phases that can be predicted with known family transitions based on norms
What factors should be considered when holistically assessing family health risk?
- Biologic
- Social
- Economic
- Lifestyle
- Situational life events*
What is a genogram?
Displays family information graphically in a way that provides a quick view of complex family patterns
What is an ecomap?
Diagram of the connections between a family and other systems in its ecological environment
What is a sociogram?
Graphic representation of social links that a person has
What is family policy?
Government actions that have a direct or indirect effect on families (Ex. recognition of same sex marriage)
What are the advantages of contracting within a family?
Willingness for mutual responsibility (buy in)
What does FAMILY contracting consist of?
- Mutual sets of activities
- Family has an active role*
What is the focus of community-oriented practice?
The population
What does community-oriented nursing involve?
- Requires a greater cognizance of the connections of various factors with health
- Involves ensuring ease of access to competent nursing services
- Involves community diagnosis*
What is an endemic?
High presence of a disease within a geographic area or population
What is an epidemic?
Greater occurrence of a disease in a community than expected
What is a pandemic?
Worldwide epidemic affecting large populations
What does the epidemiologic triangle include?
Host-Agent-Environment
What is a host?
Susceptible human or animal (so a vulnerable population) who harbors and nourishes a disease or illness-causing agent
Communicable period
Interval when infectious agent can be spread directly or indirectly from one to another
Incubation period
Time between invasion of the infectious agent and the first appearance of signs and symptoms of disease
- The most effective primary prevention intervention to reduce the incidence of child abuse is:
a. adolescent role playing of the realities of parenting.
b. education of grandparents on the risk factors and indicators of child abuse.
c. provision of parenting classes for college students.
d. provision of parenting and conflict-management classes for survivors of child abuse.
d. provision of parenting and conflict-management classes for survivors of child abuse.
Nurses must be aware of the incidence of incest, its signs and symptoms, and the psychological and physical trauma it causes. One fact relevant to comprehensive nursing assessment is that incest:
a. occurs in all races, religious groups, and socioeconomic classes.
b. often occurs in father-son relationships.
c. occurs only in father-daughter relationships.
d. never occurs in stepparent-child relationships.
a. occurs in all races, religious groups, and socioeconomic classes.
In conducting a nursing assessment of new parents the nurse should be aware of the warning signs of actual or potential abuse, including:
a. history of adolescent depression and suicidal thoughts.
b. intermittent religious affiliations.
c. lack of legal marital status.
d. verbal aggressiveness or detachment.
d. verbal aggressiveness or detachment.
In caring for a rape victim/survivor, the nurse should be aware that the client will initially exhibit:
a. anger and fear with repeated recounting of the sequence of events during the assault.
b. crying, shouting, and hysteria followed by helplessness and self-blame.
c. different responses that vary from client to client and may include emotional withdrawal, silence, and/or repeated verbal description of the event.
d. symptoms of early onset posttraumatic stress disorder.
c. different responses that vary from client to client and may include emotional withdrawal, silence, and/or repeated verbal description of the event.
Professional nursing organizations recommend that all women be routinely screened for domestic violence when they:
a. come to the emergency department with physical trauma.
b. come to any health care setting.
c. repeatedly visit their primary care provider with symptoms of depression or anxiety.
d. report increased financial stress in the home.
b. come to any health care setting.
In following the principles of nursing interventions with violent families, nurses should:
a. avoid provoking the perpetrator by initially suggesting that the victim leave the relationship.
b. indicate zero tolerance for any further violence, degradation, or exploitation of family members.
c. provide assurances that the family’s confidentiality will not be violated.
d. threaten to report child abuse to the authorities.
b. indicate zero tolerance for any further violence, degradation, or exploitation of family members.
Community-level factors that influence violence and human abuse are:
a. bullying, gangs, and corporal punishment.
b. job boredom and unemployment rate.
c. population density, sense of cohesiveness, and diversity.
d. poverty, recreational facilities, and access to health care.
c. population density, sense of cohesiveness, and diversity.
Violent crimes in the United States include rape, robbery, homicide, and assault. Although rates are decreasing, the long-term consequences of victimization reveal troubling trends that best support the realization that violence must be addressed as which of the following?
a. Community and public health problem
b. Legal and political concern
c. Medical and health care concern
d. Nursing concern
a. Community and public health problem
When working with battered women, the nurse needs to know that research suggests that the response to abuse is a process that moves from:
a. commitment to the relationship to leaving to start a new life.
b. emotional degradation to financial dependence to dominance.
c. heated argument to hitting to battering.
d. self-blame to fear to terror.
a. commitment to the relationship to leaving to start a new life.
When conducting a nursing assessment of a child, the nurse should be aware that indicators of potential or actual child abuse may include which of the following? (Select all that apply.)
a. Cognitive impairment
b. Unusual fear of the nurse and others
c. Injuries not mentioned in history
d. Seems to need to take care of the parent
e. Evidence of general poor care
b, c, d, e
A home health nurse is charged with identifying opportunities for health promotion and illness primary prevention. The activity that bests demonstrate this focus is:
a. collaborating with the chaplain to address the spiritual needs of a hospice patient.
b. educating a school nurse on the care regime of a returning student newly diagnosed with asthma.
c. referring a newly diagnosed diabetic patient to the nutritionist for dietary teaching.
d. tracking the immunization status of patients.
d. tracking the immunization status of patients.
Which level of prevention is being implemented when a forensic nurse implements a program aimed at preventing domestic abuse?
a. Primary prevention
b. Secondary prevention
c. Tertiary prevention
d. Assessment
A. Primary prevention
A nurse collects evidence from a victim following a sexual assault. Which level of prevention is being used?
a. Primary prevention
b. Secondary prevention
c. Tertiary prevention
d. Assessment
B. Secondary prevention
A nurse working in a correctional setting is implementing care using which level of prevention?
a. Primary prevention
b. Secondary prevention
c. Tertiary prevention
d. Assessment
C. Tertiary prevention
Sexual Assault Nurse Examiner (SANE)
a registered nurse specially trained to provide care to sexual assault patients. The SANE conducts medical forensic examinations and can serve as an expert witness
Forensic nurses work collaboratively with professionals both within and outside of nursing. When working as content experts or clinician advisors to develop injury prevention programs, the forensic nurse is:
Addressing injury as a public health concern.
Forensic nurses practice in a variety of arenas including (select all that apply): Courtrooms. Correctional facilities. Hospital risk-management departments. Medical examiner offices. Police departments.
Courtrooms. Correctional facilities. Hospital risk-management departments. Medical examiner offices. Police departments.
A forensic nurse maintains an awareness of human behavior and environment which is then interpreted by knowledge and lived experience in making expert decisions. This concept of forensic nursing theory is known as:
Perceptivity.
When forensic nurses provide direct care to all victims injured following an alcohol-related auto accident, the forensic nurse is engaged in:
Secondary prevention.
index case
the first case identified in a population
primary case
the person that brings the infection into a population
secondary case
someone who is infected by a primary case
tertiary case
someone who is infected by a secondary case
droplet transmission
-droplets travel
airborne transmission
- small particles remain suspended in air; sometimes for a long time and inhaled into alveoli
- i.e. measles, chicken pox, TB, small pox
vector borne transmission
- transmission through a living object carrier (not human)
- i.e. west nile, malaria, lyme disease, rocky mountain spotted fever
virulence
the ability of an infectious agent to cause severe disease, measured as the proportion of persons with the disease who become severely ill or die
quarantine
separation and restriction of movement of currently healthy person who has been exposed to a disease and may become infectious
natural immunity
species-specific resistance to disease of other species
passive immunity
we are given antibodies; does not last long, weeks to months
vertical passive immunity
mom to baby
passive immunization
IVIG to protect after exposure to a specific communicable disease
acquired immunity
exposure to disease
active immunization
we make antibodies after being exposed; long-lasting
Sporadic disease
disease that occurs occasionally in a population
reservoirs of infection… Human
AIDS, gonorrhea - carriers may have subclinical infections or latent diseases.
Reservoirs of infection…. Animal
Rabies, lyme disease - some zoonotic/vector borne diseases may be transmitted to humans.
Reservoirs of infection…. nonliving
Tetanus, Legionnaires disease. Soil or water.
Lyme disease
Vectorborne -Usually occurs in the summer in rural and suburban areas of the northeast, mid-Atlantic, and north-central states, particularly Wisconsin and Minnesota. Most common vector borne disease in the US.
Rocky Mountain spotted Fever
Vector borne - Most commonly occurs in the southeast: Oklahoma, Kansas, and Missouri
Tick-borne diseases
Vector borne -Prevention and control.
Primary Prevention for disease
immunization, safe sex practice, education, sanitation, restaurant inspections, block transmission.
Secondary Prevention for disease
notification, diagnosis, investigation, quarantine.
Tertiary prevention for disease
treatment and maintenance
Herd immunity
85%-95% of population needs to be immune to prevent the majority of diseases from spreading.
Secondary prevention for violence
screening for violence -ask questions, crisis lines, and use of SANE nurses in ERs.
Tertiary prevention for violence
counseling - provide a safe place to talk, mandatory reporting, family support and resilience training/coping skills.
primary violence prevention
addressing social determinants (i.e. poverty, neighborhood, education, stressors); teaching parents positive child-rearing and management skills and strategies that are safe and nurturing; educate on healthy relationships
A population-level tertiary prevention intervention typically carried out by nurses caring for those with communicable disease in the community is:
Instruction in standard precautions.
