Sample Chapter

INSTANT DOWNLOAD COMPLETE TEST BANK WITH ANSWERS
 
Family Focused Nursing Care Ist Edition By Sharon A. Denham – Test Bank
 
Sample  Questions         

 

Chapter 1- Health Care Needs for the 21st Century

 

MULTIPLE CHOICE

 

  1. The nurse is teaching a class on global trends linked with nursing practice. Which response from a student indicates a need for additional teaching?
1. Technology is a huge force in global change.
2. Humans have had increasing effect on the natural environment.
3. Technology has slowed the development of new infectious diseases.
4. Medical tourism is a legitimate, growing source of income for many nations.

 

 

ANS:  3

 

  Feedback
1 Science and technology are huge drivers of global change.
2 There is increasing awareness of humankind’s effect on the planet including environmental resources.
3 Although technology has flourished, more than 30 new infectious diseases have been identified since 1973, and the next pandemics are predicted to arise from organisms not yet identified.
4 Medical tourism is one of the fastest growing industries in the health-care sector and is a positive source of revenue for many nations.

 

 

PTS:   1

KEY:  Content Area: Global trends | Integrated Process: Nursing Process | Client Need: Health Promotion and Maintenance | Cognitive Level: Comprehension | Question Type: Multiple Choice

 

  1. Which of the following statements on global trends linked with nursing practice is inaccurate?
1. Globalization ensures the equal distribution of costs and benefits of health care.
2. Parts of the world may be considered more youthful than other parts of the world.
3. By 2025, the majority of the world’s population will live in urban areas.
4. As countries modernize, the risk for developing certain health problems changes.

 

 

ANS:  1

 

  Feedback
1 The costs and benefits of globalization are not always distributed equally—globalization does not ensure equal distribution of health-care costs and benefits.
2 Trends in birth, death, immigration, and migration patterns point toward population growth in Asia and Africa that will result in them becoming the youthful areas of the world.
3 In 2009, 50% of the world’s population lived in urban areas; by 2025, this is projected to increase to 57%.
4 A shift from traditional diseases, such as those resulting from infection, to modern diseases that result from lifestyle choices has been noted in developed countries.

 

 

PTS:   1

KEY:  Content Area: Global trends | Integrated Process: Nursing Process | Client Need: Health Promotion and Maintenance | Cognitive Level: Comprehension | Question Type: Multiple Choice

 

  1. The nurse is coordinating care with a family whose 10-year old daughter has diabetes. Which of the following principles of care coordination guides the nurse’s actions?
1. Provide the right care at the right time for the right person.
2. Identify health problems and intervene.
3. Allow families to initiate contact as they determine all their needs.
4. Ensure family privacy by limiting interdisciplinary information exchange.

 

 

ANS:  1

 

  Feedback
1 Providing the right care at the right time for the right person is a principle of health-care reform to obtain the best quality outcomes in the best possible way.
2 The nurse must form a partnership with the family and negotiate to create a plan that fits with the family priorities and concerns.
3 The nurse must work together with the family to determine needs and assist them in contacting resources if the family wishes the nurse to do so.
4 The nurse must consider privacy laws, institutional policies, and family preferences to create an effective care coordination communication plan.

 

 

PTS:   1

KEY:  Content Area: Care coordination | Integrated Process: Nursing Process | Client Need: Safe and Effective Care Environment | Cognitive Level: Comprehension | Question Type: Multiple Choice

 

  1. The nurse is teaching a class on coordinating care for families with a chronically ill member. Which response made by a student indicates a need for further teaching in the area of family assessment?
1. Identifying accessible community resources is an important aspect of family assessment.
2. Family engagement in shared health-care decision-making has little impact on health outcomes.
3. Lifestyle factors to assess include family access to food, housing, and transportation.
4. Money spent is not always linked to better health outcomes.

 

 

ANS:  2

 

  Feedback
1 The nurse will benefit families greatly by providing families with appropriate resource information in their home communities for health promotion and chronic disease management.
2 Shared decision-making occurs within therapeutic relationships that honor family preferences and unique circumstances.
3 Environmental factors include family access to food, housing, and transportation; lifestyle factors include tobacco use, lack of adequate nutrition, physical inactivity, and substance abuse.
4 The U.S. spends much more on health care than the other 12 industrial nations in the Organization for Economic Cooperation and Development, but the quality and availability of care varies.

 

 

PTS:   1

KEY:  Content Area: Global trends | Integrated Process: Nursing Process | Client Need: Safe and Effective Care Environment | Cognitive Level: Comprehension | Question Type: Multiple Choice

 

  1. Health disparities occur as a result of which of the following?
1. Groups being at different risk for disease.
2. Equal distribution of health-care dollars.
3. Gender equity.
4. Multicultural understandings.

 

 

ANS:  1

 

  Feedback
1 Health disparities refer to differences in health outcomes that occur between groups, usually in minority or at-risk groups.
2 Health disparities occur as a result of unequal distribution of health-care dollars.
3 Health disparities occur as a result of being treated differently based on gender.
4 Health disparities occur with misunderstanding of cultures that leads to differences in treatment.

 

 

PTS:   1

KEY:  Content Area: Health disparities | Integrated Process: Nursing Process | Client Need: Health Promotion and Maintenance | Cognitive Level: Comprehension | Question Type: Multiple Choice

 

  1. Which statement best describes health inequity?
1. Differences in health outcomes between groups.
2. Disruptions in family health due to war.
3. Shifts in population health due to changing immigration patterns.
4. Differences in infectious disease risk between genders.

 

 

ANS:  1

 

  Feedback
1 Health inequity refers to differences or inequalities in health outcomes between groups.
2 War is best described as a social factor that can disrupt health.
3 Change in immigration patterns is best described as a social factor that can influence health.
4 Differences in infectious disease risk leading to health inequities are typically due to poverty, not gender.

 

 

PTS:   1

KEY:  Content Area: Health inequity | Integrated Process: Nursing Process | Client Need: Health Promotion and Maintenance | Cognitive Level: Evaluation | Question Type: Multiple Choice

 

  1. Which of the following best describes the health implications of industrialization in remote areas?
1. Economic opportunities outweigh the health risks.
2. Projects protect local health by developing indigenous crops.
3. Local people have more dollars for health care through new job opportunities.
4. Access to health-care facilities is improved.

 

 

ANS:  3

 

  Feedback
1 Industrial processes often lead to environmental conditions such as erosion, air pollution, or contaminated ground water that have unwelcome health effects. Economic gains go to project developers, not the indigenous people.
2 Projects typically develop land for high-value nonindigenous crops that require fertilizers and irrigation, which pose health risks rather than protect health.
3 Increased employment provides economic resources to enable local people to seek health care.
4 Industrialization is not a guarantee that health-care facilities will be built and access increased.

 

 

PTS:   1

KEY:  Content Area: Perspectives on health and illness | Integrated Process: Nursing Process | Client Need: Health Promotion and Maintenance | Cognitive Level: Evaluation | Question Type: Multiple Choice

 

  1. Which of the following is an example of the effects of globalization on health care?
1. Globalization makes the exchange of health-care information more difficult.
2. The health-care costs and benefits of globalization are distributed equitably.
3. Globalization eases the transition of foreign-educated nurses into U.S. employment.
4. Global demand for nurses continues to exceed supply.

 

 

ANS:  4

 

  Feedback
1 Globalization includes the international exchange of ideas, languages, peoples, and popular culture, and eases the exchange of health-care information.
2 Globalization does not ensure equal distribution of the benefits and costs of health care. Manufacturers take advantage of cheap labor, and workers are not always afforded the same protections from one nation to the next.
3 Globalization does not ease the transition of foreign educated nurses into U.S. employment. Pathways for becoming a nurse differ greatly across nations, as do regulations guiding nursing practice.
4 The global demand for nurses exceeds supply. An increase of 712,000 nurses is predicted to be needed by 2020 to meet health care demand in the U.S. alone.

 

 

PTS:   1

KEY:  Content Area: Globalization’s effects on health care | Integrated Process: Nursing Process | Client Need: Health Promotion and Maintenance | Cognitive Level: Comprehension | Question Type: Multiple Choice

 

  1. Which of the following statements about links between families and their community is inaccurate?
1. The negative influences of poverty and unrest continue for generations even after community conditions improve.
2. Understanding the culture of the community is essential for being able to address family health needs.
3. Families in low-resourced areas contend with malnutrition.
4. Political unrest has little effect on the health and well-being of families.

 

 

ANS:  4

 

  Feedback
1 Employment rates do not often capture the discouragement experienced by people who have long lost hope of ever finding a job.
2 Understanding the culture of communities is essential for addressing individual and family health and illness needs.
3 Food supply is often limited by uneven food distribution in low-resourced areas.
4 Political unrest can result in displaced populations that have increased health risks.

 

 

PTS:   1

KEY:  Content Area: Family and community health linkages | Integrated Process: Nursing Process | Client Need: Health Promotion and Maintenance | Cognitive Level: Comprehension | Question Type: Multiple Choice

 

  1. Which of the following statements on women and health is inaccurate?
1. Women worldwide are often able to overcome poverty and its ill effects on health.
2. Women represent two-thirds of the world’s poor people.
3. Women’s rights are a way to understanding personal health and well-being.
4. Women in developing countries often die as a result of pregnancy complications and childbirth.

 

 

ANS:  1

 

  Feedback
1 Women often work for meager pay, have little financial security, and are unable to make personal decisions affecting their well-being.
2 Women comprise two-thirds of the world’s poor population and often experience poverty.
3 In male dominated cultures, women are often treated as second-class citizens, are primary targets of physical and sexual violence, and have little voice in society or at home.
4 Lack of prenatal care in developing countries often results in fatalities for women.

 

 

PTS:   1

KEY:  Content Area: Gender perspective about health or illness | Integrated Process: Nursing Process | Client Need: Health Promotion and Maintenance | Cognitive Level: Comprehension | Question Type: Multiple Choice

 

  1. A nurse is developing an international health project on delivery of prenatal care to low-resourced communities. Which of the following principles guides the nurse’s planning?
1. Nurses are in the best position to decide what the community needs.
2. The project is dependent on political influences or partisanship.
3. Short- and long-term goals contribute to the sustainability of the project.
4. Local community leaders are best to oversee the project.

 

 

ANS:  3

 

  Feedback
1 International projects must be based on grass-roots requests from communities.
2 Successful international projects are independent of political influence or partisanship.
3 Projects must be built for long-term sustainability through engaging community participants in identifying short- and long-term goals.
4 Successful international projects are overseen by established, qualified advisory boards.

 

 

PTS:   1

KEY:  Content Area: International health project characteristics | Integrated Process: Teaching/Learning | Client Need: Health Promotion and Maintenance | Cognitive Level: Application | Question Type: Multiple Choice

 

MULTIPLE RESPONSE

 

  1. Which of the following are social determinants of health?
1. Family income.
2. Presence of food and water in the home.
3. Age of the family member with an illness.
4. Distance traveled to the workplace.

 

 

ANS:  1, 2, 4

Rationale:

Social determinants of health are factors that arise from the social or physical environment that can lead to health problems. Age is not a social or physical factor; however, income is a factor that arises from the social environment, while food and water and the distance one must travel to the workplace are components of the physical environment, all of which can influence health.

 

PTS:   1

KEY:  Content Area: Social determinants of health | Integrated Process: Nursing Process | Client Need: Health Promotion and Maintenance | Cognitive Level: Comprehension | Question Type: Multiple Response

 

  1. Which of the following nursing actions are considered primary care?
1. Making sure that all family members are immunized.
2. Monitoring chronic conditions of a family member over time.
3. Supporting families in critical care situations.
4. Educating elders in the family about screening for colon cancer.

 

 

ANS:  1, 2, 4

Rationale:

Supporting families in critical care situations is typically a role for hospital-based nurses rather than primary care nurses, who work in communities and in clinics where they ensure that all family members are immunized, monitor chronic conditions of a family member over time, or educate elders in the family about screening for colon cancer. These actions can reduce modifiable risk factors and thus decrease the potential of acquiring diseases and complications at earlier ages. Education can motivate people to seek care that can prevent and detect diseases early.

 

PTS:   1

KEY:  Content Area: Care coordination | Integrated Process: Nursing Process | Client Need: Safe and Effective Care Environment | Cognitive Level: Comprehension | Question Type: Multiple Response

 

  1. Which of the following groups would be considered a vulnerable population?
1. Intergenerational households.
2. Families experiencing social isolation.
3. Frail elderly.
4. Migrating families.

 

 

ANS:  2, 3, 4

Rationale:

Vulnerable populations include those who are at risk for health problems. Intergenerational households do not pose risk for health problems; in fact, this arrangement may benefit members by providing social interactions never previously considered. Social isolation is a risk factor for health problems, although it is less common in undeveloped countries where people are less likely to live alone. Aging increases the likelihood of acquiring multiple noncommunicable diseases, while migration can increase the risk of spreading infectious diseases among populations.

 

PTS:   1

KEY:  Content Area: Global trends | Integrated Process: Nursing Process | Client Need: Safe and Effective Care Environment | Cognitive Level: Comprehension | Question Type: Multiple Response

 

  1. Which of the following represent United Nations Millennium Development Goals and Targets?
1. Global education to at least the elementary level.
2. Protection and improvement of the environment.
3. Treatment of infectious diseases.
4. Improved health of fathers.

 

 

ANS:  1, 2, 3

Rationale:

Access to good education is a social indicator of health and disease risk, and improved education globally is a Millennium Goal. Erosion, contaminated groundwater, shrinking aquifers, air pollution, and urbanization are environmental factors that can result in unwelcome health effects, and thus protection of the environment is a Millennium Goal. Treating infectious diseases is a Millennium Goal, since the spread of infectious diseases can be influenced by changes in human behavior, often occurring at the family level. Improving the health of mothers, not fathers, is an international goal that improves overall population health.

 

PTS:   1

KEY:  Content Area: Global trends | Integrated Process: Nursing Process | Client Need: Safe and Effective Care Environment | Cognitive Level: Comprehension | Question Type: Multiple Response

 

COMPLETION

 

  1. The increase in health-care-related knowledge has shifted education of health-care providers from a focus on ____________________ to a focus on ____________________.

 

ANS:

memorization, accessing and analyzing information.

Rationale:

Advances in communication and technologies allow nurses to draw on and select from global knowledge. The nurse must be able to search for evidence on the effectiveness of various forms of care or interventions and analyze it to identify what best alleviates a problem.

 

PTS:   1

KEY:  Content Area: Global trends | Integrated Process: Nursing Process | Client Need: Safe and Effective Care Environment | Cognitive Level: Comprehension | Question Type: Completion

Chapter 3- Moving to Family-Focused Care

 

MULTIPLE CHOICE

 

  1. Which of the following does not contribute to the high costs of medical care in the last year of life?
1. Caring for severe illness
2. Functional impairment
3. Nursing home expenditures
4. Over-prescribing practices

 

 

ANS:  4

Rationale:

According to Hogan (2001), caring for severe illness, functional impairment, and nursing home expenditures contribute to the high cost of medical care in the last year of life.

 

PTS:   1

KEY:  Content Area: Differentiate among terms like healthy, unhealthy, and societal health | Integrated Process: Caring | Client Need: Physiological Integrity | Cognitive Level: Knowledge | Question Type: Multiple Choice

 

  1. What percent of U.S. adults are overweight or obese?
1. Less than 25%
2. 34%
3. 40%
4. More than 50%

 

 

ANS:  2

Rationale:

The obesity crisis is of great concern. According to the Centers for Disease Control and Prevention (2011), about 33.8% of U.S. adults are overweight or obese.

 

PTS:   1

KEY:  Content Area: Differentiate among terms like healthy, unhealthy, and societal health | Integrated Process: Nursing Process | Client Need: Physiological Integrity | Cognitive Level: Knowledge | Question Type: Multiple Choice

 

  1. Consider the following statements:

Statement A. When physicians discuss end-of-life with cancer patients, their health-care costs are much higher in the last week of life.

Statement B. Many dying persons never get referred to hospice care.

1. Both statements A and B are true.
2. Both statements A and B are false.
3. Statement A is true and statement B is false.
4. Statement A is false and statement B is true.

 

 

ANS:  4

Rationale:

According to Zhang et al. (2009), costs are much lower when physicians discuss end-of-life care with their patients. Yet many dying persons are never referred to hospice. More than a third of those referred only spend seven days enrolled, although many would benefit greatly from aspects of care management lasting longer (Jennings, Ryndes, D’Onofrio, & Baily, 2010).

 

PTS:   1

KEY:  Content Area: Differentiate among terms like healthy, unhealthy, and societal health | Integrated Process: Nursing Process | Client Need: Safe and Effective Care Environment | Cognitive Level: Knowledge | Question Type: Multiple Choice

 

  1. An ____ point of view encourages one to see connections between society and individual or societal health.
1. Educated
2. Ecumenical
3. Ecological
4. Environmental

 

 

ANS:  3

Rationale:

An ecological point of view encourages one to see connections between society and individual or societal health.

 

PTS:   1

KEY:  Content Area: Discuss ways thinking family improves individual, family, and societal health | Integrated Process: Nursing Process | Client Need: Health Promotion and Maintenance | Cognitive Level: Knowledge | Question Type: Multiple Choice

 

  1. How much greater is U.S. health-care spending compared to other nations?
1. About 2.5 times as high
2. About 4 times as high
3. About 7.5 times as high
4. About 10 times as high

 

 

ANS:  1

Rationale:

The United States is one of the wealthiest nations in the world and spends more money on health care than anywhere else; health-care spending is about 2.5 times as high as other nations.

 

PTS:   1

KEY:  Content Area: Discuss ways thinking family improves individual, family, and societal health | Integrated Process: Nursing Process | Client Need: Safe and Effective Care Environment | Cognitive Level: Knowledge | Question Type: Multiple Choice

 

  1. Which of the following is not a priority of the Affordable Care Act’s quality improvement strategy?
1. New health-care delivery models.
2. Families engaged as partners in care.
3. Less emphasis on preventive care.
4. Use of best practices.

 

 

ANS:  3

 

  Feedback
1 New health-care delivery models, families engaged as partners in care, and use of best practices are all priorities of the Affordable Health Care Act’s quality improvement strategy.
2 New health-care delivery models, families engaged as partners in care, and use of best practices are all priorities of the Affordable Health Care Act’s quality improvement strategy.
3 Rather than less emphasis on preventive care, a priority is to promote the most effective prevention and treatment practices for leading causes of mortality.
4 New health-care delivery models, families engaged as partners in care, and use of best practices are all priorities of the Affordable Health Care Act’s quality improvement strategy.

 

 

PTS:   1

KEY:  Content Area: Discuss ways thinking family improves individual, family, and societal health | Integrated Process: Nursing Process | Client Need: Safe and Effective Care Environment | Cognitive Level: Knowledge | Question Type: Multiple Choice

 

MULTIPLE RESPONSE

 

  1. Which of the following may prevent illness?
1. Adequate sleep
2. Early diagnosis
3. Stress management
4. Adequate nutrition

 

 

ANS:  1, 3, 4

Rationale:

Adequate sleep, nutrition, and stress management help to prevent illness. Early diagnosis of illness is important too, but it does not prevent illness.

 

PTS:   1

KEY:  Content Area: Identify various perspectives linked with health and illness | Integrated Process: Nursing Process | Client Need: Health Promotion and Maintenance | Cognitive Level: Knowledge | Question Type: Multiple Response

 

  1. Which of the following increase risk for illness?
1. Physical activity
2. Tobacco use
3. Sedentary lifestyle
4. Poverty

 

 

ANS:  2, 3, 4

Rationale:

Tobacco use and a sedentary lifestyle are high-risk behaviors; socioeconomic status also correlates with increased risk for illness.

 

PTS:   1

KEY:  Content Area: Identify various perspectives linked with health and illness | Integrated Process: Nursing Process | Client Need: Health Promotion and Maintenance | Cognitive Level: Knowledge | Question Type: Multiple Response

 

  1. What do families desire from hospice care?
1. Continuity of care.
2. Comfort for the dying family member.
3. Autonomy for family members.
4. Case management.

 

 

ANS:  1, 2, 3, 4

Rationale:

Continuity of care, comfort for the dying family member, autonomy for family members, and case management are all aspects of hospice care.

 

PTS:   1

KEY:  Content Area: Differentiate among terms like healthy, unhealthy, and societal health | Integrated Process: Caring | Client Need: Safe and Effective Care Environment | Cognitive Level: Knowledge | Question Type: Multiple Response

 

  1. Which of the following factors influence societal health?
1. Access to care providers
2. Educational institutions
3. Wealth distribution
4. Respect of human rights

 

 

ANS:  1, 3, 4

Rationale:

Access to care providers, distribution of wealth, and respect of human rights all influence the health of society. Educational institutions are not essential for health and wellness.

 

PTS:   1

KEY:  Content Area: Discuss ways thinking family improves individual, family, and societal health | Integrated Process: Nursing Process | Client Need: Health Promotion and Maintenance | Cognitive Level: Comprehension | Question Type: Multiple Response

 

  1. Which of the following are reasons the United States has a growing health disadvantage when compared with peer countries?
1. Uninsured segments of the population
2. High poverty rates
3. An efficient health-care delivery system
4. Lack of care coordination

 

 

ANS:  1, 2, 4

Rationale:

Uninsured people, high poverty rates, and lack of care coordination contribute to the growing health disadvantage of the United States, despite it being one of the wealthiest countries and spending more on health care compared to other nations. The U.S. health-care system is not efficient. There is much duplication, yet there are many gaps in care.

 

PTS:   1

KEY:  Content Area: Discuss ways thinking family improves individual, family, and societal health | Integrated Process: Nursing Process | Client Need: Safe and Effective Care Environment | Cognitive Level: Comprehension | Question Type: Multiple Response

 

  1. Which of the following assumptions about the family perspective will guide nursing actions?
1. Family members need full disclosure and clear explanations.
2. Family members are usually afraid of being involved in care.
3. Family confidence influences care giving.
4. Family members have rights and can make choices.

 

 

ANS:  1, 3, 4

Rationale:

Assumptions that may help to guide nursing actions include that family members need full disclosure and clear explanations, that their confidence influences care giving, and that they have rights and can make choices. Families are usually comfortable with other family members and want to be involved, but will need information that will enable their involvement.

 

PTS:   1

KEY:  Content Area: Describe ways nurses think family to deliver family focused care | Integrated Process: Nursing Process | Client Need: Psychosocial Integrity | Cognitive Level: Application | Question Type: Multiple Response

 

  1. Which of the following actions by the nurse demonstrate the nurse is thinking family? Susan, a nurse who thinks family:
1. Introduces herself to each of her patients in the acute-care setting.
2. Ensures that family members are not in the room when procedures are done.
3. Practices active listening with all her patients’ visitors.
4. Commends family members for their positive interactions with her patients.

 

 

ANS:  3, 4

Rationale:

Thinking family is demonstrated by actively listening to patients’ visitors and commending family members for their positive interactions with patients. Introducing oneself to each patient and ensuring that family members are not in the room when procedures are done only shows concern for the individual, not for the family.

 

PTS:   1

KEY:  Content Area: Describe ways nurses think family to deliver family focused care | Integrated Process: Communication and Documentation | Client Need: Psychosocial Integrity | Cognitive Level: Application | Question Type: Multiple Response

 

COMPLETION

 

  1. As early as 1995, the American Nurses Association’s Social Policy Statement described ____________________ as a target for nursing care.

 

ANS:  family

 

PTS:   1

KEY:  Content Area: Discuss ways thinking family improves individual, family, and societal health | Integrated Process: Nursing Process | Client Need: Psychosocial Integrity | Cognitive Level: Knowledge | Question Type: Completion

 

SHORT ANSWER

 

  1. List several influencers of norms or standards regarding health.

 

ANS:

Age, genetics, geographical region, culture/ethnicity, etc.

 

PTS:   1

KEY:  Content Area: Identify various perspectives linked with health and illness | Integrated Process: Nursing Process | Client Need: Health Promotion and Maintenance | Cognitive Level: Comprehension | Question Type: Short Answer

 

  1. Compare and contrast obesity and malnutrition as public health issues, and describe how families can influence them.

 

ANS:

Nurses and the general public are often unaware of public health measures that might be used to reverse the obesity epidemic. Some solutions rest outside the health-care industry, but clinicians might make important differences. For example, lifestyle choices, the built environment, leadership capacities, prevention, public policy, and government interventions offer alternative approaches to the obesity problem. Coordinated actions are needed to solve a problem of this magnitude. Nurses that think family can help by looking beyond primary care settings and find ways to address this concern—one of which is to educate families. Malnutrition and starvation are also growing problems, not only for the homeless or the unemployed, but one that is faced daily by families with inadequate incomes. Families often choose between food and other basic needs (e.g., rent, utilities, and medical care). Nurses that think family consider the health and illness of the family units and the larger society, not merely individuals.

 

PTS:   1

KEY:  Content Area: Identify various perspectives linked with health and illness | Integrated Process: Nursing Process | Client Need: Health Promotion and Maintenance | Cognitive Level: Comprehension | Question Type: Short Answer

 

  1. Explain what is meant by this statement of the Royal College of Physicians and Surgeons:

“Societal needs for medical health care have both quantitative and qualitative perspectives.”

 

ANS:

Quantitative means that the appropriate number, type, and mix of physicians, nurses, or other health-care professionals are available. Qualitative needs have to do with the adequacy of the professionals’ knowledge, skills, attitudes, and willingness to assume the roles needed by diverse societies. Professional competencies needed by population groups are often culturally specific responses to societal needs, social determinants of health, and the burden of illness.

 

PTS:   1

KEY:  Content Area: Discuss ways thinking family improves individual, family, and societal health | Integrated Process: Nursing Process | Client Need: Health Promotion and Maintenance | Cognitive Level: Application | Question Type: Short Answer

Chapter 11- Family-Focused Care with Chronic Illness

 

MULTIPLE CHOICE

 

  1. Which of the following statements about family-focused chronic illness case management is accurate?
1. Family-focused chronic illness case management focuses on the individual family member with the chronic illness.
2. Family-focused chronic illness case management begins with a nurse sharing advice with family members.
3. Family-focused chronic illness case management may lead to delayed or prevented complications.
4. Family-focused chronic illness case management determines certain family members with whom to communicate.

 

 

ANS:  3

 

  Feedback
1 The family is the unit of care in family-focused chronic illness case management, not the individual.
2 Giving advice is not therapeutic and should be avoided.
3 Vigilant family members can observe signs and symptoms of complications to either prevent or delay their onset.
4 The family is the unit of care in family-focused chronic illness case management, not certain members.

 

 

PTS:   1

KEY:  Content Area: Examine special family concerns associated with chronic disease management | Integrated Process: Caring | Client Need: Safe and Effective Care | Cognitive Level: Comprehension | Question Type: Multiple Choice

 

  1. Which of the following is a unique family intervention that will facilitate family-focused care?
1. Communicating with every family member
2. Commending strengths of the family unit
3. Contacting only the significant others for information
4. Interviewing all family members

 

 

ANS:  2

 

  Feedback
1 Although communicating with every family member is important, it is not a unique intervention.
2 Commending the family members on their strengths as a family may encourage their involvement in care.
3 All family members may be involved in providing significant information.
4 Although interviewing all family members is important, it is not a unique intervention.

 

 

PTS:   1

KEY:  Content Area: Describe ways nurses prepare families to satisfy various member needs associated with chronic illness | Integrated Process: Nursing Process | Client Need: Psychosocial Integrity | Cognitive Level: Application | Question Type: Multiple Choice

 

  1. Monica is a 55-year-old woman who has suffered from diabetes mellitus for 30 years. The nurse enters the room to check routine vital signs and sees that both Monica and her husband appear upset; they tell the nurse to leave. Which of the following responses by the nurse reflect an accurate understanding of family-focused chronic illness care?
1. “I need to take Monica’s vital signs. You (husband) can return when I am done.”
2. “I’m so pleased you understand your disease, Monica.”
3. “Has your doctor talked with you about your future?”
4. “I will give you some more time to be alone. Let me know if you have questions.”

 

 

ANS:  4

 

  Feedback
1 Routine vital signs can be postponed for a while if the family is upset.
2 By focusing on Monica, the nurse fails to acknowledge the husband.
3 Family-focused chronic illness care recognizes that their current emotions take priority over the future.
4 By giving the family time to be alone, the nurse shows willingness to answer questions and allow privacy.

 

 

PTS:   1

KEY:  Content Area: Describe ways nurses prepare families to satisfy various member needs associated with chronic illness | Integrated Process: Caring | Client Need: Psychosocial Integrity | Cognitive Level: Comprehension | Question Type: Multiple Choice

 

  1. Which of the following discourages family-focused chronic illness care?
1. “Thinking family”
2. Adequate nurse staffing
3. Time constraints
4. Human connections

 

 

ANS:  3

 

  Feedback
1 “Thinking family” reminds the nurse that all family members are influenced by a chronic illness.
2 Adequate staffing allows time for effective family-focused care.
3 Adequate time is required for the nurse to share the chronic health experience with the family.
4 Human connections lead to attentive and effective communication.

 

 

PTS:   1

KEY:  Content Area: Use family-focused care to support and overcome barriers when child and adult members have a chronic illness | Integrated Process: Caring | Client Need: Safe and Effective Care | Cognitive Level: Comprehension | Question Type: Multiple Choice

 

  1. Which of the following descriptions of the chronic illness experience is inaccurate?
1. Chronic illness may lead to a decreased life span.
2. Chronic illness modifies functional status.
3. Chronic illness often improves a family’s quality of life.
4. Chronic illness makes use of family strengths.

 

 

ANS:  3

 

  Feedback
1 Chronic illness often decreases life span.
2 Chronic illness has a great capacity to change a family’s functional status.
3 Chronic illness is unlikely to improve a family’s quality of life, since the entire family will be affected by the illness in some manner.
4 Chronic illness often requires family strengths to maintain resiliency.

 

 

PTS:   1

KEY:  Content Area: Explain chronic illness experiences from individual and family perspectives | Integrated Process: Nursing Process | Client Need: Psychosocial Integrity | Client Need: Physiological Integrity | Cognitive Level: Knowledge | Question Type: Multiple Choice

 

MULTIPLE RESPONSE

 

  1. Family-focused care can assist a nurse to help a family achieve which of the following desired outcomes?
1. Decreased hospitalizations of the chronically ill member
2. Support of family resilience
3. Ambiguous loss
4. Realization of “courtesy stigma”

 

 

ANS:  1, 2

Rationale:

Decreased hospitalizations may occur as the result of family vigilance in detecting symptoms early. Family-focused nurses will commend the family for its resilience. Ambiguous loss would not be desired, since there is often no closure as the person gets stuck or is unable to move on. Courtesy stigma, or avoidance of ridicule that extends to others associated with a person viewed differently, would not be desired.

 

PTS:   1

KEY:  Content Area: Use family-focused care to support and overcome barriers when child and adult members have a chronic illness | Integrated Process: Caring | Client Need: Management of Care | Cognitive Level: Application | Question Type: Multiple Response

 

  1. The nurse is beginning the care of a 38-year-old adult mother of two who has just come to the ER with an acute asthma attack. The nurse is told that the patient’s family is anxiously waiting to see him. Which of the following responses by the nurse reflect his understanding of the family’s needs?
1. “I will go and answer the family’s questions as soon as possible.”
2. “If your mom is hospitalized, what does this mean for your family?”
3. “Don’t worry; your mom will be better soon.”
4. “I can see you are worried about your mother.”

 

 

ANS:  1, 2, 4

Rationale:

The nurse understands that families need information, and is readily able to provide it and respond to questions. The nurse understands that families have routines that may be disrupted when hospitalization occurs, and strives to understand what a hospitalization would mean for a particular family. The nurse understands that telling the family not to worry does not meet the family’s need for respect and understanding of feelings. Acknowledging worry demonstrates active listening and is therapeutic for the family.

 

PTS:   1

KEY:  Content Area: Examine special family concerns associated with chronic disease management | Integrated Process: Caring | Client Need: Psychosocial Integrity | Cognitive Level: Application | Question Type: Multiple Response

 

  1. Which of the following are family needs during chronic disease care coordination?
1. Vigilance
2. Knowledge
3. Self-care
4. Counseling

 

 

ANS:  1, 2, 3, 4

Rationale:

Vigilance, knowledge, self-care, and counseling are all family needs when a family member has a chronic disease.

 

PTS:   1

KEY:  Content Area: Examine special family concerns associated with chronic disease management | Integrated Process: Nursing Process | Client Need: Safe and Effective Care | Cognitive Level: Knowledge | Question Type: Multiple Response

 

  1. Which of the following are needs of family members who have a chronically ill family member?
1. Care coordination
2. Constant supervision
3. Resilience
4. Some normalcy

 

 

ANS:  1, 3, 4

Rationale:

The family members of someone who is chronically ill commonly have need for care coordination, resilience, and some normalcy. They do not need constant supervision; family members are capable of being good caregivers who will ask for assistance when necessary.

 

PTS:   1

KEY:  Content Area: Discuss management of family stressors in living with uncertainty | Integrated Process: Caring | Client Need: Safe and Effective Care | Cognitive Level: Application | Question Type: Multiple Response

 

  1. Which of the following demonstrate family-focused chronic care management?
1. Evidence-based
2. Episodic care
3. Needs of family unit met
4. Preventive

 

 

ANS:  1, 2, 4

Rationale:

Family-focused chronic care management is characterized by being evidence-based, meeting family needs, and preventive. Episodic care is not a distinguishing feature of chronic care management.

 

PTS:   1

KEY:  Content Area: Use family-focused care to support and overcome barriers when child and adult members have a chronic illness | Integrated Process: Nursing Process | Client Need: Psychological Integrity | Client Need: Physiological Integrity | Cognitive Level: Application | Question Type: Multiple Response

 

COMPLETION

 

  1. Chronic diseases are health problems that require ____________________ over a period of ____________________, according to the World Health Organization.

 

ANS:

ongoing management; years or decades

ongoing management; years

ongoing management; decades

Rationale:

The World Health Organization defines chronic diseases as health problems that require ongoing management over a period of years or decades.

 

PTS:   1

KEY:  Content Area: Explain chronic illness experiences from individual and family perspectives | Integrated Process: Nursing Process | Client Need: Psychosocial Integrity | Client Need: Physiological Integrity | Cognitive Level: Knowledge | Question Type: Completion

 

  1. When individuals have more than one chronic condition, it is called ____________________.

 

ANS:

multimorbidity

Rationale:

The definition of multimorbidity is individuals having more than one chronic condition.

 

PTS:   1

KEY:  Content Area: Explain chronic illness experiences from individual and family perspectives | Integrated Process: Nursing Process | Client Need: Physiological Integrity | Cognitive Level: Knowledge | Question Type: Completion

 

SHORT ANSWER

 

  1. List three examples of how family-focused care differs between chronic illness and acute illness.

 

Chronic illness care                         Acute illness care

___________________________________________________

___________________________________________________

___________________________________________________

 

ANS:

Examples:

  1. Long-term family involvement necessary vs. short-term involvement
  2. Necessary to budget for non-insurance covered expenses vs. likely insurance coverage of hospitalization
  3. Family routines probably need to change vs. routines being disrupted temporarily

 

Rationale:

Multiple examples of differences are possible.

 

PTS:   1

KEY:  Content Area: Explain chronic illness experiences from individual and family perspectives | Integrated Process: Nursing Process | Integrated Process: Caring | Client Need: Psychosocial Integrity | Client Need: Physiological Integrity | Cognitive Level: Application | Question Type: Short Answer

 

  1. Explain what is meant by this statement: “Children with severe chronic conditions have complex care needs with great family demands.”

 

ANS:

Variety of answers possible to demonstrate children’s needs and family demands

 

PTS:   1

KEY:  Content Area: Describe ways nurses prepare families to satisfy various member needs associated with chronic illness | Integrated Process: Nursing Process | Client Need: Psychological Integrity | Client Need: Physiological Integrity | Cognitive Level: Synthesis | Question Type: Short Answer

 

  1. Explain what is meant by this statement: “Family nurses can teach ways to plan for on-time and off-time transitions and milestones.”

 

ANS:

Transitions that do not occur at an expected time are considered off-time and might require special focus. Chronic conditions can delay or alter development milestones for the entire family. The nurse’s assessment of the entire family as a unit will gather information for anticipatory guidance for on-time or off-time events.

 

PTS:   1

KEY:  Content Area: Discuss management of family stressors in living with uncertainty | Integrated Process: Caring | Client Need: Psychological Integrity | Cognitive Level: Application | Question Type: Short Answer

 

  1. List three assumptions of Hill’s original stress model that relate to family-focused care.

 

ANS:

Examples of assumptions:

  1. Unplanned and unexpected events can be more stressful than those anticipated.
  2. Severity of stress makes a difference.
  3. Stressors that are ambiguous are more challenging than ones less ambiguous.
  4. Stressors that occur within the family are more stressful than those outside the family.

 

PTS:   1

KEY:  Content Area: Discuss management of family stressors in living with uncertainty | Integrated Process: Nursing Process | Client Need: Psychosocial Integrity | Cognitive Level: Knowledge | Question Type: Short Answer