Ch. 7 – Health Promotion and the Family

Useful health-promotion family assessments involve listening to families, engaging in participatory dialogue, recognizing patterns, and assessing family potential for active, positive change.
A nurse is determining which family assessment tool would be best to implement with a family when planning home visits for health promotion. Which of the following criteria should the nurse use to evaluate these tools?
a. The number of questions asked on the assessment tool
b. The linkages of the assessment to Healthy People 2020
c. The amount of involvement that the family has in completing the tool
d. The capability of the tool to assess goals and outcomes
The nurse’s role in health promotion and disease prevention is best described as acting as a role model for the family. Implementing the nursing process, identifying areas for family improvement, and educating about home safety measures are all part of the nurse’s role but do not describe the comprehensive role of the nurse.
Which of the following best describes the nurse’s role in health promotion and disease prevention?
a. Educating about home safety measures
b. Identifying areas for family improvement
c. Implementing the nursing process using a systems perspective
d. Acting as a role model for the family
Systems theory is an attempt to explain patterns of living among the individuals who make up the family system.
Which of the following theories is an attempt to explain families as a set of interacting individuals with patterns of living that influence health decisions?
a. Feminist theory
b. Systems theory
c. Developmental theory
d. Resiliency theory
Duvall and Miller identified stages of the family life cycle and critical family developmental tasks, through a developmental perspective. This conceptual model helps to anticipate family events and discusses how families complete basic family tasks as they transition through these events.
A nurse is assessing how a family will transition and adapt after their youngest child leaves for college. By using this framework, which of the following perspectives is the nurse implementing?
a. Risk-factor
b. Structural-functional
c. Open systems
d. Developmental
Structural components of the family refer to family roles and relationships.
Which of the following would be described as a family structural component?
a. Income earner of the house
b. Socialization for the family
c. Immunization of infants
d. Launching of children
The cognitive-perceptual pattern identified characteristics of language, cognitive skills, and perception that influence desired or required family activities. The availability of books in the home for preschool age children impacts this functional health pattern.
A nurse is collecting data for a family assessment using Gordon’s functional health patterns. The nurse learns that the family has no books in the home to read to the preschool-age children. To which of the following functional health patterns does this information pertain?
a. Roles-relationship
b. Cognitive-perceptual
c. Health-perception-health-management
d. Self-perception-self-concept
How problems in the family are resolved relates to assessment of the roles-relationships pattern. The family’s philosophy of health relates to the health perception-health management pattern. What the family does to have fun relates to the activity-exercise pattern. The decision concerning when and how children go to sleep relates to the sleep-rest pattern.
A nurse who is using Gordon’s functional health patterns is planning to assess its roles-relationships pattern. Which of the following questions would be most appropriate for the nurse to ask?
a. What is the family’s philosophy of health?
b. What does the family do to have fun?
c. How are problems in the family resolved?
d. Who decides when and how children go to sleep?
A genogram shows a variety of family structures and highlights family health patterns, which can be used for anticipatory health guidance. Significant diseases and disorders of the family members are highlighted on the genogram. Data on at least three generations are reported on a genogram. The genogram uses a variety of symbols to demonstrate connections but does not begin with a circle in the center of the page.
A nurse is using a genogram to represent a family. Which of the following statements is accurate?
a. A genogram identifies the genetic disorders of the family.
b. A genogram includes information about the past two generations.
c. A genogram can be used to make connections about family health patterns.
d. A genogram begins with a circle in the center of the page.
Slashed lines on an ecomap signify stressful relationships.
The ecomap of a client’s family has slashed lines drawn from the son to the family church. Based on this information, what conclusion can the nurse make?
a. The son is deceased.
b. The son is actively involved with the family church.
c. The son has a stressful relationship with the church.
d. The son has no relationship with the church.
The family’s ability to cope with demands of everyday living determines its level of success. The nurse needs to assess how the family usually copes with stressful situations to find ways that might be available to the family now to cope with the current situation.
A client reports that her family will be moving because her husband is taking a new job in another state. She is very unhappy about the decision and doesn’t want to move. What action should the nurse take next?
a. Assess the client’s and family’s coping mechanisms in handling stress.
b. Encourage the client to act excited about the move.
c. Talk to the husband to get his perspective on the move.
d. Tell her that all families must cope with new situations from time to time.
When strategies are used that are congruent with each individual’s values, the couple adjusts.
In a family in which the mother and the father differ on how to spend and save money, the parents are constantly arguing with each other. Which of the following interventions should the nurse include in the plan of care for this couple?
a. Assist them to develop strategies that are congruent with their values.
b. Allow each of them to defend his or her own values.
c. Focus on outcomes that each wants to accomplish.
d. Divert their attention to areas in which they are successful.
Risks associated with role relationships in blended families include multiple closely spaced children, which limits the parents’ time for interaction to meet individual children’s needs.
A blended family has six children, ages 2, 4, 4, 5, 7, and 10. During a visit to the home, the nurse notices that the 7-year-old seems quiet and withdrawn, whereas the other children are playing loudly in the garage. Which of the following conclusions can the nurse make from this observation?
a. This child has most likely been abused.
b. This child is one of multiple children closely spaced in age.
c. This family suffers from low self-esteem.
d. This family provides harsh punishment for their children.
Two-year-olds are prone to wandering to where water is and could fall into a swimming pool without being noticed.
The nurse is caring for a family who has 2-year-old twins. Which of the following health promotion advice would be included in the nurse’s plan of care for this couple?
a. Wear bicycle helmets for safety.
b. Use caution around the family swimming pool.
c. Cross the street at using the crosswalks.
d. Advocate for the day care to provide adequate socialization.
A typical 9-month-old is beginning to crawl. Houses built before 1974 may contain lead-based paint, to which a crawling baby might have access. Lead causes neurological damage and anemia.
A nurse is conducting a health promotion assessment for a family with a 9-month-old. Which of the following should be of most concern to the nurse?
a. The age of the house in which the family lives
b. Genetic diseases in the family
c. Driving practices in the family
d. Toilet training for the child
Open communication with parents is often difficult during the adolescent stage, partly because of the differing developmental tasks of adolescents and adults. Concerns about exposure to environmental hazards and parents finding fulfillment with raising the child typically are concerns with families with younger children. Concerns about career decisions are typically problematic for families with older children/young adults.
A nurse is caring for a family with an adolescent child. Which of the following problems would the nurse anticipate that the family would report?
a. Concerns about career decisions
b. Concerns about exposure to environmental hazards
c. Difficulty with parents finding fulfillment with raising the child
d. Difficulty with open communication with the child
Families with young adults act as launching centers for children ready to leave home.
The nurse is working with a middle-age married couple whose son has just graduated from college. Which developmental tasks would the nurse expect to find in this family?
a. Attending activities for their son
b. Strengthening their marital relationship for future family stages
c. Acting as a launching center for their son
d. Responding to the prospect of changing careers
Writing a family nursing diagnosis helps families promote health throughout the life cycle and prevents disease through decreasing risk-taking behaviors. Nurses derive diagnoses from assessed validated data. The nursing diagnosis describes and validates potential or actual health problems with families. The diagnosis provides direction for outcomes and interventions first identifying what the problem is.
A nurse has developed a family nursing diagnosis. Which of the following best describes the purpose of this action?
a. Describes the strengths of the family
b. Allows for creation of goals for the family
c. Promotes behavioral change among family members
d. Validates health problems with the family
Four types of nursing interventions appear in health-promotion and disease-prevention planning: increasing knowledge and skills, increasing strengths, decreasing exposure and decreasing susceptibility. Decreasing susceptibility means educating families about prevention principles. Examples include education about hand hygiene and how diseases are spread from person to person and by other factors in the environment.
A home care nurse is planning an intervention with a family focusing on decreasing susceptibility. Which of the following nursing interventions would be most appropriate to implement?
a. Education about building on current strengths of the family
b. Education about hand hygiene
c. Education about health care resources in the community
d. Education about child safety seats
The purpose of evaluation is to determine how the family has responded to the planned interventions and whether these interventions were successful. The family’s baseline data are used as comparative criteria in evaluation thus, it would be worthwhile to collect data similar to that collected at the initial visit to see if any changes have occurred. The nurse reassesses the situation and compares the new information with that on the original assessment to determine whether change has occurred.
A nurse is making a final home visit with a family to evaluate the nursing care plan. Which of the following actions would the nurse most likely complete during this visit?
a. Obtain vital signs from all members of the family.
b. Ask the family members to state the goals that were previously developed.
c. Collect data similar to that which was collected at the initial visit for comparison.
d. Educate about the importance of using role relationships to create a healthy family.
Part of planning the home visit is studying information regarding the family from agency records, referral forms, and other sources. Making a contract, identifying how the visit will be financed, and understanding the situation from the family’s perspective are all part of the process of making the visit.
A nurse is planning a home visit for a family. Which of the following actions would be most appropriate for the nurse to take?
a. Study information regarding the family from agency records and other sources.
b. Make a contract with the family that states specific goals and objectives.
c. Identify how the home visit will be financed.
d. Understand the situation from the family’s perspective.
Families in the beginning childbearing stage need education about the risk of SIDS for their infant. After the birth of the child, it is most likely that they do not need education about fetal alcohol syndrome, unless there were issues with alcohol use during the prenatal period. Discussion about communicable diseases and potentially Type 1 diabetes would be more common with families with school-aged children.
A nurse is providing follow-up care for a family who has recently had a baby. Which of the following topics should the nurse anticipate discussing with the family?
a. Type 1 diabetes
b. Fetal alcohol syndrome
c. Communicable diseases
A, B
Families provide the structure for many health promotion practices therefore, family assessment informs health promotion and disease prevention appraisal. Additionally, health providers are encouraged to include families in decision-making and encouraging their presence and participation in all aspects of care from acute care to health promotion. Thus, it is important to have assessed the family so that the family can be included in the care process.
A home health nurse is admitting a 54-year-old man for services following a coronary artery bypass graft (CABG). As part of the initial visit the nurse completes a family assessment. What is the purpose of this nursing action? (select all that apply)
a. Allows for health promotion and disease prevention appraisal
b. Allows for inclusion of family members in decision-making
c. Allows for data collection necessary for comparison to Healthy People 2020
d. Allows for development of patient-centered care
B, C, D
Coping mechanisms of each family member, potential risk factors within the family, and maintenance of trust within the family are all necessary characteristics for the nurse to assess when determining the health of a family. When assessing a family, the nurse will consider the developmental stage of the family before considering the developmental stage of each of the individual family members.
A nurse is providing care for a family in the community. Which of the following characteristics would the nurse assess to determine the health of the family? (select all that apply)
a. Developmental stage of each family member
b. Coping mechanisms of each family member
c. Potential risk factors within the family
d. Maintenance of trust within the family
A, B, C, D
The family environment is made up of the home, neighborhood, and community. Thus, aspects of the community as well as aspects of the home environment need to be analyzed during this assessment.
A nurse is conducting an environmental assessment as part of a family assessment. Which of the following would the nurse assess? (select all that apply)
a. Garbage collection in the neighborhood
b. Convenience stores in the neighborhood
c. Safety of the home
d. Climate of the home