Deck 6: Family Influences

Question 1

An adult child is finalizing arrangements to provide in-home care for a dependent parent.In order to best foster the long-term wellness for both the patient and the caregiver,the nurse:

A)explains the patient's plan of care in detail with both the patient and the caregiver.
B)discusses the importance and availability of respite care.
C)encourages the patient and caregiver to seek assistance with problems as they arise.
D)provides written information regarding available in-home services.

Answer 1

discusses the importance and availability of respite care.

Question 2

The nurse is helping an adult child transition into the role of full-time caregiver for an older parent with dementia.What action by the nurse is best?

A)Ensure the child has information on long-term care.
B)Help the child negotiate care issues with siblings.
C)Teach the child about the parent's illness.
D)Offer the child information on support groups.

Answer 2

Help the child negotiate care issues with siblings.

Question 3

An adult child of a parent with mild dementia is worried about the parent driving.Where does the nurse refer the adult child to find out about safe driving courses?

A)Senior Driving from AAA
B)AARP Driver Safety
C)Older Drivers Education
D)State Department of Transportation

Answer 3

AARP Driver Safety

Question 4

The nurse working in a diverse community would most expect the eldest son from which community to care for aging parents?

A)African Americans
B)East Asian
C)Native American
D)Hispanic

Question 5

An older patient who lives with family has a history of chronic alcohol abuse and poor compliance with the medical plan.The patient has begun to experience a marked decline.His family tells the nurse that these problems are a result of their inability to care for the patient properly.The nurse best responds by:

A)evaluating the care the family has been providing.
B)suggesting that care should be assumed by a professional caregiver.
C)helping the family recognize that the decline is a result of the patient's condition and personal choices.
D)assuring them they are providing the patient with care motivated by love.

Question 6

The nurse works with older adults to help plan for possible in-home care needs knowing that what percentage of older adults will need this type of care during their lifetimes?

A)50%
B)60%
C)75%
D)85%

Question 7

An 80-year-old patient with diminishing cognitive function is being discharged into the care of his 72-year-old spouse.The nurse recognizes that besides the spouse's physical ability to provide appropriate care,there is a need to evaluate the:

A)couple's financial resources.
B)couple's social support system.
C)spouse's cognitive level of function.
D)patient's long-term health prognosis.

Question 8

The adult child of a patient diagnosed with Alzheimer disease has shared that he feels "so sad" that he is not able to carry on a social conversation with the patient anymore because of her loss of memory.The nurse suggests:

A)keeping conversations short while focusing on things that happened in the past.
B)concentrating on doing things his mother enjoys rather than focusing on talking.
C)participating in support groups that offer suggestions for communication.
D)allowing his mother to pick the topic and then simply being with her "in her world."

Question 9

A nurse has worked with an older adult who has mild dementia and the patient's family to ensure the financial status of the older person is sound and well managed on a day-to-day basis.The nurse knows planning was successful by assessing that:

A)the parent and children are happy with the arrangements.
B)the children have the older person's checkbook themselves.
C)one adult child pays all the bills and sends reports each month.
D)the children were granted conservatorship and manage the money.

Question 10

An older patient with cognitive impairment is being cared for by family members.They have expressed concerns about providing appropriate care as his functional level declines.The nurse responds:

A)"I'm glad that you are interested enough in his care that you've expressed this concern."
B)"His abilities will certainly decline.This is the time to discuss other care options."
C)"You are right to be concerned.Let's talk about issues that may come up in the future."
D)"The condition will get worse,so think about what will happen if you can't meet his needs."

Question 11

The physical changes that occur naturally as a result of the aging process often create an autonomy versus safety issue and is most problematic when:

A)protracted reaction time increases the risk for driving accidents.
B)arthritic knee and hip joints make falls more prevalent.
C)eyesight diminishes,making following written instruction more difficult.
D)responding to warning alarms is affected because of impaired hearing acuity.

Question 12

The nurse working with older patients understands what fact about a health care proxy?

A)It states that no resuscitation should occur if breathing or heartbeat cease.
B)It can specify what treatment measures are or are not acceptable to the patient.
C)It explains patient's wishes regarding treatment if the patient cannot communicate.
D)It designates a surrogate health care decision maker if the patient is incapacitated.

Question 13

While children voice concern about their father living alone after having a mild stroke that resulted in only minimal disability,the patient angrily disagrees,stating that he's always managed on his own and can do so now.The nurse can be most helpful to this family by:

A)assuring them that their father's physical limitations should not cause a safety issue.
B)assisting them in identifying how they can help their father to live independently.
C)offering to arrange a social service consult to arbitrate the conflict.
D)suggesting that the patient accept the services of a home care aide on a short-term trial basis.

Question 14

The family member caring for a dependent older patient tells the nurse that she feels his care is "so out of my control." To best assist the caregiver in achieving a sense of confidence,the nurse:

A)encourages the caregiver to regularly attend the meeting of a local support group.
B)identifies the skills and resources that the caregiver needs to provide for the patient.
C)arranges for in-home support services to assist with care as needed.
D)explores reasons why the caregiver feels such a lack of control.

Question 15

When discussing stressors with the primary caregiver of an 83-year-old patient,the nurse explores the issue of dissolving familiar social boundaries when asking:

A)"Has it been a problem taking over the role of head of the family?"
B)"What do you do to help relax and revitalize yourself?"
C)"Do you find it difficult to ask for help when you need it?"
D)"Are there any physical care tasks that you find difficult to complete?"

Question 16

A nurse is working with a family that is conflicted about care arrangements for an older parent who continues to live at home in less than safe conditions.What action by the nurse is best?

A)Identify and enlist the help of the prime mover
B)Tell the family you are calling social services
C)Give the family a deadline for making decisions
D)Offer to give the family tours of different facilities

Question 17

The family of an 80-year-old patient shares with the nurse that they are concerned that the patient is too frail to be living alone.The nurse's initial intervention is to:

A)help the patient express the importance of living independently to the family members.
B)assess the patient's functional abilities related to being able to safely live independently.
C)have the family provide specific examples of behaviors that cause them concern.
D)identify ways the family can help assure the patient's safety while living independently.

Question 18

The nurse working with older adults wonders why fewer of the aging patients seen in the clinic live with their adult children than in the past.What trend most likely explains this?

A)declining birth rate
B)mobility of families
C)rise of assisted living
D)healthier older adults

Question 19

A nurse is mediating a family meeting with an older adult and four grown children.One daughter,who has three small children of her own,keeps volunteering to do tasks until she has agreed to do about 90% of what is needed for the older adult.What action by the nurse is best?

A)Praise the daughter for being so willing to do so much for her father.
B)Ask the other children why they are so unwilling to help out.
C)Ask the daughter if she can realistically accomplish all these items.
D)Tell the daughter that she is unable to do all these things and to delegate.

Question 20

Adult children of a patient beginning to show early signs of cognitive decline share with the nurse that they are reluctant to discuss financial issues because the patient "was always private about money matters." The nurse responds most therapeutically when suggesting:

A)"Maybe it would less threatening to your father if a lawyer spoke to him about the matter."
B)"Assure your dad you are only interested in making the financial arrangements he wants."
C)"A social worker can discuss the financial aspects of long-term care with your dad."
D)"This is a conversation that has to occur in order for your father to receive appropriate care."

Question 21

The nurse working with older patients knows that which of the following items are important to most older adults as they approach the end of life? (Select all that apply. )

A)Pain and symptom control
B)Having funeral arrangements
C)Leaving money to children
D)Personal cleanliness
E)Being at peace with God

Question 22

The nurse is about to discuss the possible ways to meet the physical needs of an older adult patient with the patient's adult children.The nurse guides the discussion based on which of the following American societal realities? (Select all that apply. )

A)Most dependent older adults prefer to live with family members whenever possible.
B)Family members are generally the care providers for dependent older adult family members.
C)Nursing facilities are generally a family's last resort for the care of an older dependent adult.
D)A family is generally willing to pay for services for the care of their older family member.
E)Older dependent adults expect their adult family members to provide for care.

Question 23

The nurse is assessing a family caregiver for signs of role stress.Which assessment findings are consistent with this condition? (Select all that apply. )

A)Denial
B)Anger
C)Social withdrawal
D)Irritability
E)Restfulness