Deck 13: Family Case Management

Question 1

After assessment and discussion with a family,a nurse had a list of 12 areas of need,none of which involved life-threatening issues.Which of the following needs should the nurse address first?

A)The area in which the nurse is most expert
B)The area the family wants to address first
C)The area in which the nurse is most able to obtain resources to assist
D)The area that matches the agency's current marketing plan

Answer 1

The area the family wants to address first

Question 2

The community/public health nurse asks a married couple to review important family events.What is the nurse accomplishing through this review?

A)Giving the family members an opportunity to emote about negative events
B)Recognizing how past events have changed their lives
C)Providing an opportunity to review how they interact with each other
D)Putting distance between past events and current reality

Answer 2

Providing an opportunity to review how they interact with each other

Question 3

The nurse used multiple assessment tools to gather data on the family,which resulted in the nurse's feeling overwhelmed.What action should the nurse take next?

A)Meet with the agency supervisor and review the data together.
B)Summarize all the data into five or six categories.
C)Talk to a colleague and share the information gathered.
D)Work with the family at the next visit to draw conclusions.

Answer 3

Summarize all the data into five or six categories.

Question 4

A community/public health nurse is conducting a family assessment.Which source of data would be most helpful?

A)Information from other cooperating health care agencies
B)Input from other professional health care providers
C)Observation and interaction with the family members
D)Review of family members' charts and medical record data

Question 5

A mother was very upset and said to a nurse,"My mother would never have allowed such behavior.I punish the baby for doing it,and she just does it again." What conclusion can the nurse make from this interaction?

A)The family should be referred to community resources such as a daycare center.
B)The infant may be developmentally delayed.
C)The family needs assistance with growth and development education.
D)The mother's actions need to be reported to children's protective services.

Question 6

What is the primary goal of case management of families?

A)To ensure the care is given in the most cost-effective manner possible
B)To coordinate all of the community agencies involved in care of the family
C)To focus on communication,counseling,and teaching
D)To work to maximize the family's self-care capabilities

Question 7

A home health nurse was making an initial visit to an elderly man.As the nurse began the assessment,the man's wife gave all of the information requested.Which of the following actions should the nurse take next?

A)Agreeing on appropriate interventions with the family
B)Determining appropriate nursing diagnoses
C)Assessing the environment of the wider community
D)Confirming the information with the client

Question 8

A community/public health nurse is working with a family whose members are experiencing an incredible amount of stress.Which source of social support should the nurse encourage the family to use?

A)Family service workers from the agency
B)Close friends and neighbors
C)Family self-help groups
D)Mental health counseling centers

Question 9

A nurse met with a client before hospital discharge to make arrangements to visit the client at home.Why would the nurse visit the client's home when the assessment could be completed while the client is still in the hospital?

A)The client may not realize all of the assistance that is needed until he or she returns home.
B)The client needed time to consider the community resources that would be used in the future.
C)The nurse wanted to include family and environmental conditions in the assessment.
D)The nurse wanted to ask the client questions in a private setting.

Question 10

A community/public health nurse is visiting a family for the first time.Which of the following should be the priority action for the nurse?

A)Assessing how the family is adjusting to the illness of the sick family member
B)Clarifying what insurance or third-party payer is reimbursing this care
C)Determining the problem or reason for the referral
D)Establishing a relationship with the family

Question 11

The teenage mother admitted to the nurse that sometimes she was sorry she had the baby,and all she wanted was to be able to sleep all night.Which of the following is the most appropriate action for the nurse to take?

A)Ask the grandmother if she could take the baby for a few nights so the teenager could catch up on her sleep.
B)Assure the mother that her feelings were normal and that no one likes being exhausted.
C)Call Children's Protective Services as this mother is at high risk for child abuse.
D)Explain normal growth and development for toddlers.

Question 12

A community/public health nurse is teaching a family about how to care for an ill member of the family.Upon which family member should the nurse focus on teaching?

A)Teach the family member with the most resilience and competence to do what must be done to ensure that it gets done.
B)Teach the ill member what must be done because he or she is responsible for his or her own care.
C)Teach the weakest family member what must be done because that will strengthen his or her position in the family.
D)Teach the wife or mother what must be done because caring for others is a female role and expectation.

Question 13

Why do community/public health nurses focus on families?

A)Families will understand the higher cost of care if they are active participants.
B)Improving the health of a family improves the health of a community.
C)Nurses find such a focus much easier than trying to focus on the community.
D)Nurses allow family members to receive respite by providing this type of care.

Question 14

A family had just moved to the city when the illness struck the father.The wife had always been a stay-at-home mother with the three young children.The nurse developed a list of short-term resources for the family.Which of the following actions should the nurse take next?

A)Give the family the complete list,including the free transportation assistance program.
B)Involve the family with a local church where people could educate the family about the community and be supportive.
C)Share with the family two resources that are the most immediate needs: namely,housing and food.
D)Tell the family about all the resources and let the family decide what to do with the list.

Question 15

A nurse asked quite a few questions about what each family member did during the day,including school,work,and recreation outside the home.What was the nurse accomplishing by asking these questions?

A)Assessing the community environment for possible community-wide problems
B)Creating a picture of the family's relationships with outside agencies and resources
C)Looking for topics the nurse might have in common with a family member
D)Seeking an appropriate topic around which to establish rapport

Question 16

When a client's wife asked whether the nurse would like a tour of the yard and her gardens,the nurse agreed immediately.Considering the limited time the nurse had to spend with the family,why did the nurse agree to tour the gardens?

A)Accepting the invitation encourages the wife to speak privately to the nurse.
B)Completing the environmental assessment will assist with drawing a genogram.
C)Examining of the environment helps identify potential health or safety problems.
D)Touring the grounds allows the nurse to learn more about the family.

Question 17

A nurse is assigned to care for a client who has just been discharged from the hospital.What should be the nurse's priority assessment after discovering that other family members desperately need health care as well?

A)Focusing on identified problems and the person with the most problems
B)Reviewing the home and the immediate environment for external problems
C)Interviewing the family members to get an overall picture of family functioning
D)Providing care for the client who has been discharged from the hospital

Question 18

A community/public health nurse is providing care in the home of a family with children.The father returned from the physician during the nurse's visit and reported that the physician wanted several diagnostic tests performed.The father believed that the physician had looked quite serious.Which of the following actions would be most appropriate for the nurse?

A)Assisting both parents with recognizing and meeting their children's needs
B)Discussing illness management skills with the father and mother
C)Sharing literature about hospice and family needs at the end of life
D)Helping the family deal with anxiety and uncertainty

Question 19

The father of a family was told he had metastatic pancreatic cancer too advanced for any treatment.Which of the following is the most appropriate intervention for the nurse?

A)Assisting the family in finding a physician who can offer hope and possible treatment
B)Helping the family deal with anxiety and uncertainty
C)Sharing information about hospice and family needs at the end of life
D)Trying to help the family find meaning in their situation

Question 20

After a family and a nurse discussed the family needs,they began to discuss what each member of the family might be willing to contribute.Which of the following would be the most important variable in determining the probable success of the plan?

A)What is involved in the plan
B)When the plan is scheduled to be implemented
C)Where the plan will be implemented
D)Who agreed to implementing the plan

Question 21

Why is it necessary for a nurse to assess strengths when the primary reason for being in the home is to assist with areas of need? (Select all that apply.)

A)Such assessment helps the family recognize their own assets.
B)It creates a forum for change as family perspective changes.
C)It allows the family to avoid becoming depressed about the situation.
D)It helps the family see problem behaviors as assets to be used.
E)It allows the nurse to identify resources that can be used to address areas of need.
F)It promotes use of strengths in a different context.

Question 22

Which of the following interventions would a nurse use to keep a family interaction focused on the problems that need to be resolved or improved?

A)Clarifying the consequences if the problems are not resolved
B)Emphasizing how many sessions the family may receive
C)Stressing the seriousness of the problems that are confronting the family
D)Demonstrating that there is no one else to help the family unless they act now

Question 23

What factors are involved in a nurse's decision as to which responsibilities can be accepted when a family's needs and desires are overwhelming? (Select all that apply.)

A)External variables such as neighborhood environment
B)Family's demands
C)Nurse's competencies and preferences
D)Only needs related to health
E)Reimbursement rules
F)Resources such as time and energy

Question 24

A community/public health nurse is drawing a genogram about a client's extended family.Which of the following purposes would this serve? (Select all that apply.)

A)Beginning with such a neutral task can help establish rapport.
B)Connections between events and relationships may be more clearly perceived.
C)A genogram establishes medical history and possible genetic vulnerabilities.
D)A genogram helps decrease negative feelings about a relationship.
E)A genogram helps share the family's perception of their own structure.
F)A genogram allows the family to reveal information about family secrets.

Question 25

A community/public health nurse is creating a family map.Which of the following information would be included? (Select all that apply.)

A)The address of the family and observations about the home and neighborhood
B)All the family systems,including microsystems,macrosystems,and suprasystems
C)Interaction patterns such as family coalitions or conflict between members
D)Roles such as the family leader or the family communicator
E)Hierarchies and power structures in the family
F)The extended family for three generations,including marriages and births

Question 26

The nurse has suggested that a family make several changes to make the care for their technology-dependent child easier,more effective,and even faster.However,the family took no action.Which of the following would explain the lack of response by the family?

A)The family did not like the nurse's suggestions but were too polite to tell the nurse.
B)The family did not really understand the nurse's suggestions.
C)The family lacked the resources necessary to implement the nurse's suggestions.
D)All families have a tendency to resist change,even if it is helpful.

Question 27

Before terminating care with a family,which of the following actions should a nurse accomplish? (Select all that apply.)

A)Allow the family members to express their feelings and reactions to having to terminate care.
B)Develop established criteria so the family knows when to seek care in the future.
C)Encourage crying or other actions to demonstrate their grief and loss.
D)Express the nurse's feelings about having to end the relationship.
E)Remind the family of the date or goal accomplishment that represents the time for termination.
F)Say goodbye for now,but plan to keep in touch with the family.

Question 28

A nurse left a home visit with a lengthy list of needs for which the family could use assistance.Which of these needs should be the priority for the nurse? (Select all that apply.)

A)The area around the house was covered with trash hidden in the weeds.
B)The teenage daughter did not have daycare for her 8-month-old son.
C)The wife would not speak to her teenage daughter,who had recently had a child.
D)The wife was having difficulty caring for her ill husband.
E)The teenage daughter was not at all sure what to expect from her 8-month-old son.
F)The husband had a stroke 2 years ago.

Question 29

What would be the most appropriate action for a nurse to take when helping a family who is in crisis when the husband/father of the family died suddenly? (Select all that apply.)

A)Assisting the family in reaching out to friends and neighbors for help
B)Being an emotional support for the family
C)Helping the family identify,recognize,and use their coping skills
D)Suggesting to the extended family that prepared food would be helpful
E)Recommending funeral homes in the community to the family
F)Volunteering to watch the children while the adults attend the funeral

Question 30

Which of the following actions should a nurse take to minimize the effort required in evaluating the success of interventions with a family? (Select all that apply.)

A)Choose criteria for evaluation that will demonstrate the value of the nursing interventions.
B)Evaluate care on the basis of the goals that the family and nurse together agreed upon.
C)Gather all possible data throughout the intervention so the data will be available for evaluation purposes.
D)Plan for evaluation while beginning assessment of the family.
E)Inform the family that they must contribute data for evaluation when it is requested.
F)Use only short-term criteria so the data can be gathered before care is terminated.

Question 31

Which of the following actions best demonstrates the use of summative evaluation?

A)Explaining the goals of blood glucose control and the diabetic diet plan
B)Asking a diabetic client what he ate for the last three meals to see whether it fits the diet plan
C)Reviewing the daily blood glucose levels each week with a diabetic client
D)Quizzing a diabetic client about his current diabetic medications before discharge

Question 32

Two nurses were discussing a family that was undergoing two major crises simultaneously.The nurse assigned to the family decided to work on helping the family learn better coping mechanisms.The colleague asked why the nurse would try to create change when the family was under so much stress at the moment.Which of the following responses would be the most appropriate?

A)"At the moment,I don't think the family will even notice I'm helping them change."
B)"I'm only focusing on one person because if I can get one member to change,the others will change as well."
C)"Now is when the family may recognize the need for change."
D)"The family is under so much stress that one more stressor won't matter."

Question 33

A nurse was assessing the family style.Which of the following should be a priority for the nurse to assess? (Select all that apply.)

A)Approach to accomplishing daily household tasks
B)Characteristic processes used to process information and solve problems
C)Consistent patterns of behavior over time
D)Demonstrations of affection between family members
E)Extent to which family is amenable or resistant to environmental factors
F)Style of responding to emergency situations