Family Focused Nursing Care 1st Edition By Sharon A. Denham - Test Bank

Family Focused Nursing Care 1st Edition By Sharon A. Denham – Test Bank

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Chapter 5- Family Assessment

MULTIPLE CHOICE

1.Which of the following assessment measures would be most beneficial to complete with a 30-year-old female whose family has a history of breast cancer?

1. Ecogram
2. Ecomap
3. Genogram
4. Geographic information system

ANS: 3

Feedback
1 An ecogram is a visual representation showing relationships, activities, and influences a person has in the family system; it does not focus on illness information.
2 An ecomap helps the nurse visualize the various activities and relationships of the family with the larger ecological environment; it does not focus on illness information.
3 Detailed illness information can be added to a genogram to create a family pedigree depicting transmission of such things as genetic conditions, familial conditions, and psychosocial patterns, such as chemical dependency and suicide. The genogram can be useful to aid early diagnosis, identification of risk factors for particular conditions, and to reveal potential prevention strategies.
4 Geographic information systems capture, store, analyze, and display referenced information about specific environmental concerns that are geographically and ecologically pertinent to families; they do not focus on illness information.

PTS:1

KEY: Content Area: Explain ways that genograms, ecograms, and ecomaps can be used to assess family from an ecological point of view | Integrated Process: Nursing Process | Client Need: Health Promotion and Maintenance | Cognitive Level: Comprehension | Question Type: Multiple Choice

2.When is nursing assessment most complete?

1. When insight is gained through an assessment of individual needs before the needs of the family
2. When insight is gained through an assessment of the family needs before the needs of the individual
3. When insight is gained through an assessment of the needs of the individual and family simultaneously
4. When insight is gained through an individual-nurse-family relationship with consideration of the surrounding community

ANS: 4

Rationale: 

Nursing assessment is most effective when nurses complete every assessment with ideas gained through an individual-nurse-family relationship enacted with consideration of the surrounding community.

PTS:1

KEY:Content Area: Discuss assessment that includes the predictive and protective factors that influence the health and illness of individuals, families, communities, and populations | Integrated Process: Nursing Process | Client Need: Health Promotion and Maintenance | Cognitive Level: Application | Question Type: Multiple Choice

3.The nurse is working with a client to identify the factors that cause risks or benefits to health. Which questions best reflect “thinking family” to help identify factors requiring further teaching?

1. “How many cigarettes a day do you smoke? Where do you usually smoke?”
2. “Do you enjoy taking long walks in the winter? How many times a week do you walk?”
3. “Do you prefer water aerobics over floor aerobics? How many times a week do you attend aerobics class?”
4. “How many family members do you have? What do you all do together?”

ANS: 1

Feedback
1 “How many cigarettes a day do you smoke? Where do you usually smoke?” are questions about behaviors that pose a risk to the health of individuals, families, and communities. These questions best identify further teaching needs.
2 “Do you enjoy taking long walks in the winter? How many times a week do you walk?” are questions about behaviors that pose a benefit to the health of individuals, families, and communities. There is no need for teaching.
3 “Do you prefer water aerobics over floor aerobics? How many times a week do you attend aerobics class?” are questions about behaviors that pose a benefit to the health of individuals, families, and communities. There is no need for teaching.
4 “How many family members do you have? What do you all do together?” are questions about facts that pose no risk or benefit to the health of individuals, families, and communities. There is no need for teaching. 

PTS:1

KEY:Content Area: Discuss assessment that includes the predictive and protective factors that influence the health and illness of individuals, families, communities, and populations | Integrated Process: Nursing Process | Client Need: Health Promotion and Maintenance | Cognitive Level: Application | Question Type: Multiple Choice

4.The nurse is working with the client to assess multiple family members’ involvement in his disease process. Which questions best fit this assessment?

1. “Are you married? How long have you been married?”
2. “Do you have children? How many children do you have?”
3. “What do you usually have for dinner? Do you sit down with your family for a meal?”
4. “What do you do for yourself? What do your family members do for you?”

ANS: 4

Feedback
1 “Are you married? How long have you been married?” are direct questions asking specific information to determine the presence or absence of a spouse; they do not address family member involvement. It should not be assumed that if the person is married, the family members are involved in his care.
2 “Do you have children? How many children do you have?” are direct questions asking specific information to determine the presence or absence of children; they do not address family member involvement. It should not be assumed that if the person has children, they are involved in his care. 
3 “What do you usually have for dinner? Do you sit down with your family for a meal?” are direct questions to obtain specific information related to the client and meals; they do not address family member involvement in the disease process. It should not be assumed that if a family shares meals together, the family members are involved in his care. 
4 “What do you do for yourself? What do your family members do for you?” are open ended questions to obtain information about family member involvement in the client’s disease process. It is important to identify the degree of involvement of multiple members who may contribute to the health or well-being of individuals within families.

PTS:1

KEY:Content Area: Discuss assessment that includes the predictive and protective factors that influence the health and illness of individuals, families, communities, and populations | Integrated Process: Nursing Process | Client Need: Health Promotion and Maintenance | Cognitive Level: Application | Question Type: Multiple Choice

5.What can nurses learn when using geographic information system (GIS) databases?

1. Population trends and how to target population health interventions
2. Education trends and how to target community education
3. Transmission of inherited traits from one generation to another among similar or related organisms
4. Genes that regulate human susceptibility to viruses

ANS: 1

Feedback
1 GIS databases can be successfully used to facilitate learning about population trends and how to target population health interventions.
2 GIS databases are not typically used to track education trends; they are useful in tracking population trends and how to target population health interventions.
3 GIS databases are not used to track transmission of inherited traits across generations or organisms; they are useful in learning about population trends and how to target population health interventions.
4 GIS databases are not used to learn about genes that regulate human susceptibility to viruses; they are used to track population trends and to target population health interventions.

PTS:1

KEY: Content Area: Describe ways that computer-based geographic information systems can be used to understand family, community, and population health needs | Integrated Process: Nursing Process | Client Need: Health Promotion and Maintenance | Cognitive Level: Comprehension | Question Type: Multiple Choice

6.Identification of genetic patterns of inheritance is important not only for individuals and families, but also communities. Some autosomal recessive disorders are more commonly seen among which of the following groups?

1. Persons from different economic classes
2. Certain racial/ethnic groups
3. Certain age groups
4. Certain social networks

ANS: 2

Some autosomal recessive disorders are more commonly seen among certain racial/ethnic groups such as hemochromatosis in Caucasians, and sickle cell disease in black Americans.

PTS:1

KEY: Content Area: Recognize ways that genetics and genomics influence health, disease prevention, treatments, screening, and outcomes | Integrated Process: Nursing Process | Client Need: Health Promotion and Maintenance | Cognitive Level: Knowledge | Question Type: Multiple Choice

7.When completing a family unit assessment, what would the nurse assess?

1. Family household information
2. Complaints of physical problems
3. The implications of individual differences between the family members
4. The implications of family members’ knowledge of the disease process

ANS: 1

Feedback
1 The family household is the place where health and illness are produced and thus is an important focus for assessing the family as a unit. 
2 Considering complaints of physical problems is a focus of individual assessment.
3 Looking at implications of individual differences between family members focuses the assessment on individuals rather than the family as a unit.
4 Looking at implications of family members’ knowledge of the disease process focuses the assessment on individuals rather than the family as a unit.

PTS:1

KEY:Content Area: Differentiate between individual, family, and community assessment | Integrated Process: Nursing Process | Client Need: Health Promotion and Maintenance | Cognitive Level: Knowledge | Question Type: Multiple Choice

8.What is one way the nurse can maintain a broad-minded perspective when completing a family assessment?

1. By using the Family Functioning Framework.
2. By using the Family Health Model.
3. By using either the Family Functioning Framework or the Family Health Model.
4. Use of a model or framework is not necessary for a broad-minded and comprehensive approach to family assessment.

ANS: 2

Feedback
1 Family functioning is only one aspect of a comprehensive family assessment. To maintain a broad-minded stance, the nurse uses a family nursing model, framework, or theory in its entirety.
2 Clarity of assessment benefits when the nurse takes a broad-minded perspective and considers multiple health determinants in any health situation at the individual, family, or community level. One way to maintain a broad-minded stance is to guide the nursing assessment in an organized way by using a family nursing model or theory or a family science model or theory, such as the Family Health Model.
3 Family functioning is only one aspect of a comprehensive family assessment. To maintain a broad-minded stance the nurse uses a family nursing model, framework, or theory in its entirety, such as the Family Health Model. 
4 One way to maintain a broad-minded stance and to obtain a comprehensive assessment is to guide the nursing assessment in an organized way by using a family nursing model or theory or a family science model or theory, such as the Family Health Model.

PTS:1

KEY:Content Area: Differentiate between individual, family, and community assessment | Integrated Process: Nursing Process | Client Need: Health Promotion and Maintenance | Cognitive Level: Comprehension | Question Type: Multiple Choice

9.Coordinated family care relies on ____ that provides an accurate picture of the ____.

1. Collection of information; actual living conditions
2. Cooperation of family members; family dynamics
3. The skill of the nurse; nurse-individual-family relationship
4. Assessment of family functioning; ways family members process information

ANS: 1

Feedback
1 Coordinated family care relies upon collection of information about the family as a unit. Assessing the family household, including living conditions where health and illness occur, gives the nurse important information to plan care.
2 An assessment of family dynamics is obtained through a comprehensive assessment of the family as a unit; it is not obtained through the cooperation of family members in coordinating care.
3 The skill of the nurse is not applied to provide an accurate picture of the nurse-individual-family relationship, but to collect information about the family as a unit in order to plan care, and to develop the nurse-individual-family relationship. 
4 Coordinated family care relies upon a comprehensive family assessment, not simply on assessment of family functioning. Family processes need to be assessed in addition to family functioning.

PTS:1

KEY:Content Area: Differentiate between individual, family, and community assessment | Integrated Process: Nursing Process | Client Need: Health Promotion and Maintenance | Cognitive Level: Comprehension | Question Type: Multiple Choice

MULTIPLE RESPONSE

1.Which of the following scenarios could result in greater continuity of care because of documentation by electronic health record?

1. A public health screening for hypertension
2. A 12-year-old female with an asthma flare-up during recess at school being seen by the school’s nurse
3. Walgreen’s nationwide flu shot clinics
4. An 89-year-old male dismissing home from a hospital with home-health care for assistance with dressing changes

ANS: 1, 2, 3, 4

Rationale: 

All scenarios contain either intergenerational issues or connections between the individual and the family within the community that could be documented and referred to by a wide variety of providers for more effective long term treatment.

PTS:1

KEY:Content Area: Discuss assessment that includes the predictive and protective factors that influence the health and illness of individuals, families, communities, and populations | Integrated Process: Communication and Documentation | Client Need: Health Promotion and Maintenance | Cognitive Level: Application | Question Type: Multiple Response

2.What information does the geographic expansion of family-focused assessment to the community level provide the nurse?

1. Factors supporting health
2. Existing health disparities
3. Family health history
4. Risks to health
5. Historic migration patterns

ANS: 1, 2, 4

Rationale:

A broad snapshot of a community’s health strengths (factors supporting health) and weaknesses (health disparities) can be obtained from a “windshield survey” or a geographic information system (GIS). Risks to health can also be obtained from the geographic expansion of a family-focused assessment to the community level. A family history is obtained from assessment of the family, not the community. Historic migration patterns are obtained through genetic assessment, not community assessment.

PTS:1

KEY: Content Area: Differentiate between individual, family, and community assessment | Integrated Process: Nursing Process | Client Need: Health Promotion and Maintenance | Cognitive Level: Comprehension | Question Type: Multiple Response

3.Geographic information system (GIS) databases can be used to highlight geo-spatial patterns of concern and resources to nurses providing care to which of the following clients?

1. Acutely ill patients
2. Chronically ill persons being hospitalized due to environmental-related symptoms
3. Families seeking out grocery stores with affordable fresh fruits and vegetables
4. Skilled-care patients in a residential facility
5. Community members involved in community planning of transportation routes

ANS: 2, 3, 5

Rationale:

The GIS can highlight geo-spatial patterns of concern that occur in residential living environments that might contribute to exacerbations of chronic illness. Nurses can search the map based on different attributes to look for family or community resources available that may help with health promotion, disease prevention, or management of illness. Thus, it can be used to identify grocery stores with affordable fruits and vegetables, or be helpful in planning transportation routes. It would not be useful for nurses providing care for acutely ill inpatients or skilled-care patients in hospitals or residential facilities.

PTS:1

KEY: Content Area: Describe ways that computer-based geographic information systems can be used to understand family, community, and population health needs | Integrated Process: Nursing Process | Client Need: Health Promotion and Maintenance | Cognitive Level: Application | Question Type: Multiple Response

4.Which of the following roles for nurses exist in the genomic era?

1. Individual and family counseling
2. Clinical care and education
3. Advocacy
4. Spiritual care
5. Research
6. Ethics

ANS: 1, 2, 3, 5, 6

Rationale: 

Individual and family counseling are roles for nurses in the genomic era. Clinical care and education are roles for nurses in the genomic era. Advocate is a role for nurses in the genomic era. Research roles exist for nurses involved in the genomic era. The area of ethics has roles for nurses involved in care based in genomics. Spiritual care is an important role for the nurse but it does not directly relate to genomics.

PTS:1

KEY: Content Area: Recognize ways that genetics and genomics influence health, disease prevention, treatments, screening, and outcomes | Integrated Process: Nursing Process | Client Need: Health Promotion and Maintenance | Cognitive Level: Knowledge | Question Type: Multiple Response

5.Which of the following would be an intended outcome of the use and maintenance of electronic personal and family health records?

1. Continuity in care
2. Improved family care planning
3. Enhanced public health
4. Identification of health risks based on geographic location

ANS: 1, 2, 3

Rationale: 

Electronic records are one option to provide some form of an ongoing plan for some chronic conditions that identifies goals, strategies, supports, and outcomes linked with family unit needs and individual conditions, and that could be instrumental in family care planning to improve health outcomes and enhance public health. Identification of health risks based on geographic location is best obtained through geographic information system databases.

PTS:1

KEY:Content Area: Discuss assessment that includes the predictive and protective factors that influence the health and illness of individuals, families, communities, and populations | Integrated Process: Communication and Documentation | Client Need: Health Promotion and Maintenance | Cognitive Level: Comprehension | Question Type: Multiple Response

6.Which of the following are major ways that the family carries out its health-care functions?

1. Family provides preventative health care to its members at home
2. Family provides the major share of sick care to its members
3. Family pays for most health services received
4. Family has primary responsibility for initiating and coordinating health services

ANS: 1, 2, 3, 4

Rationale: 

All scenarios reflect ways that the family carries out its health-care functions.

PTS:1

KEY:Content Area: Discuss assessment that includes the predictive and protective factors that influence the health and illness of individuals, families, communities, and populations | Integrated Process: Nursing Process | Client Need: Health Promotion and Maintenance | Cognitive Level: Application | Question Type: Multiple Response

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