Chapter 13: Family Case Management
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- 1.
1. Why do community/public health nurses focus on families?
- A.
A. Families will understand the higher cost of care if they are active participants.
- B.
B. Improving the health of a family improves the health of a community.
- C.
C. Nurses find such a focus much easier than trying to focus on the community.
- D.
D. Nurses allow family members to receive respite by providing this type of care.
Correct Answer
B. B. Improving the health of a family improves the health of a community.Explanation
Focusing on families is important for community/public health nurses because improving the health of a family directly contributes to the overall health of the community. Families are the basic unit of society, and their well-being has a significant impact on the well-being of the larger community. By addressing the health needs of families, nurses can prevent the spread of diseases, promote healthy behaviors, and create a healthier environment for everyone. This approach recognizes the interconnectedness of individuals within a family and the ripple effect their health can have on the community as a whole.Rate this question:
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- 2.
2. 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.
A. Assessing how the family is adjusting to the illness of the sick family member
- B.
B. Clarifying what insurance or third-party payer is reimbursing this care
- C.
C. Determining the problem or reason for the referral
- D.
D. Establishing a relationship with the family
Correct Answer
D. D. Establishing a relationship with the familyExplanation
Establishing a relationship with the family should be the priority action for the nurse because it is important to establish trust and rapport with the family in order to provide effective care. By building a relationship, the nurse can gather important information about the family's needs, concerns, and resources, which will guide the nursing interventions. This will also help the nurse to understand the family's dynamics and cultural background, which are crucial for providing culturally sensitive care. Additionally, establishing a relationship will help the nurse to effectively communicate and collaborate with the family in developing a plan of care that meets their specific needs.Rate this question:
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- 3.
3. What is the primary goal of case management of families?
- A.
A. To ensure the care is given in the most cost-effective manner possible
- B.
B. To coordinate all of the community agencies involved in care of the family
- C.
C. To focus on communication, counseling, and teaching
- D.
D. To work to maximize the familys self-care capabilities
Correct Answer
D. D. To work to maximize the familys self-care capabilitiesExplanation
The primary goal of case management of families is to work towards maximizing the family's self-care capabilities. This means that the case manager aims to empower the family to take care of themselves and their needs as much as possible, promoting independence and self-sufficiency. This may involve providing resources, support, and education to help the family develop the skills and knowledge necessary to manage their own care effectively. By doing so, the case manager can help the family become more self-reliant and less dependent on external assistance.Rate this question:
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- 4.
4. A community/public health nurse is conducting a family assessment. Which source of data would be most helpful?
- A.
A. Information from other cooperating health care agencies
- B.
B. Input from other professional health care providers
- C.
C. Observation and interaction with the family members
- D.
D. Review of family members charts and medical record data
Correct Answer
C. C. Observation and interaction with the family membersExplanation
Observation and interaction with the family members would be the most helpful source of data for a community/public health nurse conducting a family assessment. This is because direct observation and interaction allows the nurse to gather firsthand information about the family's dynamics, relationships, and health behaviors. It also provides an opportunity for the nurse to establish rapport and trust with the family, which can enhance the accuracy and completeness of the data collected. Information from other cooperating health care agencies, input from other professional health care providers, and review of family members' charts and medical record data may provide additional information, but they are not as comprehensive or personal as direct observation and interaction with the family members.Rate this question:
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- 5.
5. A nurse met with a client before hospital discharge to make arrangements to visit the client at home. Why would the nurse visit the clients home when the assessment could be completed while the client is still in the hospital?
- A.
A. The client may not realize all of the assistance that is needed until he or she returns home.
- B.
B. The client needed time to consider the community resources that would be used in the future.
- C.
C. The nurse wanted to include family and environmental conditions in the assessment.
- D.
D. The nurse wanted to ask the client questions in a private setting.
Correct Answer
C. C. The nurse wanted to include family and environmental conditions in the assessment.Explanation
The nurse would visit the client's home to include family and environmental conditions in the assessment. This is important because the client's living situation and support system can greatly impact their health and well-being. By assessing the family dynamics and environmental factors, the nurse can better understand the client's overall situation and develop a more comprehensive care plan. Additionally, visiting the home allows the nurse to observe the client's living conditions and identify any potential barriers or challenges that may affect their recovery or ability to follow medical advice.Rate this question:
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- 6.
6. A home health nurse was making an initial visit to an elderly man. As the nurse began the assessment, the mans wife gave all of the information requested. Which of the following actions should the nurse take next?
- A.
A. Agreeing on appropriate interventions with the family
- B.
B. Determining appropriate nursing diagnoses
- C.
C. Assessing the environment of the wider community
- D.
D. Confirming the information with the client
Correct Answer
D. D. Confirming the information with the clientExplanation
The nurse should take the next action of confirming the information with the client because it is important to gather accurate and reliable information directly from the client themselves. Even though the wife provided the information, it is necessary to verify it with the client to ensure accuracy and to allow the client to have a voice in their own care. This step also helps to establish a trusting and therapeutic relationship between the nurse and the client.Rate this question:
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- 7.
7. A nurse is assigned to care for a client who has just been discharged from the hospital. What should be the nurses priority assessment after discovering that other family members desperately need health care as well?
- A.
A. Focusing on identified problems and the person with the most problems
- B.
B. Reviewing the home and the immediate environment for external problems
- C.
C. Interviewing the family members to get an overall picture of family functioning
- D.
D. Providing care for the client who has been discharged from the hospital
Correct Answer
D. D. Providing care for the client who has been discharged from the hospitalExplanation
After discovering that other family members desperately need health care as well, the nurse's priority assessment should be providing care for the client who has been discharged from the hospital. This is because the nurse's primary responsibility is to ensure the well-being and recovery of the client under their care. While it is important to address the needs of other family members, the immediate focus should be on the client who has just been discharged and requires immediate attention and care.Rate this question:
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- 8.
8. The community/public health nurse asks a married couple to review important family events. What is the nurse accomplishing through this review?
- A.
A. Giving the family members an opportunity to emote about negative events
- B.
B. Recognizing how past events have changed their lives
- C.
C. Providing an opportunity to review how they interact with each other
- D.
D. Putting distance between past events and current reality
Correct Answer
C. C. Providing an opportunity to review how they interact with each otherExplanation
The nurse is accomplishing the goal of providing the married couple an opportunity to review how they interact with each other. By reviewing important family events, the nurse can assess the dynamics of their relationship, identify any issues or areas of improvement, and provide guidance or support as needed. This process allows the couple to reflect on their interactions and potentially make positive changes in their relationship.Rate this question:
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- 9.
9. When a clients 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.
A. Accepting the invitation encourages the wife to speak privately to the nurse.
- B.
B. Completing the environmental assessment will assist with drawing a genogram.
- C.
C. Examining of the environment helps identify potential health or safety problems.
- D.
D. Touring the grounds allows the nurse to learn more about the family.
Correct Answer
C. C. Examining of the environment helps identify potential health or safety problems.Explanation
The nurse agreed to tour the gardens because examining the environment helps identify potential health or safety problems. By taking a tour of the yard and gardens, the nurse can assess the surroundings and identify any potential hazards or risks that may affect the client's health or safety. This allows the nurse to provide appropriate recommendations or interventions to ensure a safe and healthy environment for the client.Rate this question:
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- 10.
10. 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.
A. Assessing the community environment for possible community-wide problems
- B.
B. Creating a picture of the familys relationships with outside agencies and resources
- C.
C. Looking for topics the nurse might have in common with a family member
- D.
D. Seeking an appropriate topic around which to establish rapport
Correct Answer
B. B. Creating a picture of the familys relationships with outside agencies and resourcesExplanation
By asking questions about what each family member did during the day, including school, work, and recreation outside the home, the nurse is creating a picture of the family's relationships with outside agencies and resources. This information can help the nurse understand the family's support system, access to resources, and potential challenges they may be facing. It can also provide insight into the family's social connections and overall well-being.Rate this question:
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- 11.
11. The nurse used multiple assessment tools to gather data on the family, which resulted in the nurses feeling overwhelmed. What action should the nurse take next?
- A.
A. Meet with the agency supervisor and review the data together.
- B.
B. Summarize all the data into five or six categories.
- C.
C. Talk to a colleague and share the information gathered.
- D.
D. Work with the family at the next visit to draw conclusions.
Correct Answer
B. B. Summarize all the data into five or six categories.Explanation
The nurse should summarize all the data into five or six categories. This will help the nurse organize and make sense of the overwhelming amount of information gathered. By categorizing the data, the nurse can identify patterns, prioritize the most important information, and create a more manageable plan of action. Meeting with the agency supervisor and reviewing the data together may be helpful, but it does not directly address the issue of feeling overwhelmed. Talking to a colleague and sharing the information may provide some support, but it does not address the need to organize the data. Working with the family at the next visit to draw conclusions is premature without first summarizing and analyzing the data.Rate this question:
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- 12.
12. 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.
A. The family should be referred to community resources such as a daycare center.
- B.
B. The infant may be developmentally delayed.
- C.
C. The family needs assistance with growth and development education.
- D.
D. The mothers actions need to be reported to childrens protective services.
Correct Answer
C. C. The family needs assistance with growth and development education.Explanation
The nurse can conclude that the mother is struggling with understanding and managing the baby's behavior, indicating a need for education on growth and development. This suggests that the family would benefit from assistance in learning how to support the baby's development and address any behavioral issues effectively. Referring the family to community resources such as a daycare center or reporting the mother's actions to child protective services may not be necessary or appropriate based on the information provided.Rate this question:
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- 13.
13. 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.
A. What is involved in the plan
- B.
B. When the plan is scheduled to be implemented
- C.
C. Where the plan will be implemented
- D.
D. Who agreed to implementing the plan
Correct Answer
D. D. Who agreed to implementing the planExplanation
The most important variable in determining the probable success of the plan is who agreed to implementing the plan. The success of any plan heavily relies on the commitment and willingness of the individuals involved in executing it. If all members of the family are on board and actively participate in implementing the plan, it increases the chances of success. Their agreement indicates their dedication and cooperation, which are crucial factors in achieving the desired outcome. The involvement and commitment of the individuals involved play a significant role in the success of any plan.Rate this question:
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- 14.
14. 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.
A. Teach the family member with the most resilience and competence to do what must be done to ensure that it gets done.
- B.
B. Teach the ill member what must be done because he or she is responsible for his or her own care.
- C.
C. Teach the weakest family member what must be done because that will strengthen his or her position in the family.
- D.
D. Teach the wife or mother what must be done because caring for others is a female role and expectation.
Correct Answer
A. A. Teach the family member with the most resilience and competence to do what must be done to ensure that it gets done.Explanation
The correct answer is a. Teach the family member with the most resilience and competence to do what must be done to ensure that it gets done. This answer focuses on identifying the family member who is best equipped to take on the responsibility of caring for the ill member. By teaching this family member, the nurse ensures that the necessary care will be provided effectively and efficiently. This approach recognizes the importance of selecting a capable caregiver rather than assigning the responsibility based on gender or perceived weakness.Rate this question:
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- 15.
15. 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.
A. The area in which the nurse is most expert
- B.
B. The area the family wants to address first
- C.
C. The area in which the nurse is most able to obtain resources to assist
- D.
D. The area that matches the agencys current marketing plan
Correct Answer
B. B. The area the family wants to address firstExplanation
The nurse should address the area the family wants to address first because it is important to prioritize the needs and preferences of the family when providing care. This approach ensures that the family feels heard and involved in the decision-making process, which can lead to better outcomes and satisfaction with the care provided. Additionally, addressing the family's immediate concerns can help establish trust and rapport between the nurse and the family, which is essential for effective communication and collaboration throughout the care process.Rate this question:
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- 16.
16. A community/public health nurse is providing care in the home of a family with children. The father returned from the physician during the nurses 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.
A. Assisting both parents with recognizing and meeting their childrens needs
- B.
B. Discussing illness management skills with the father and mother
- C.
C. Sharing literature about hospice and family needs at the end of life
- D.
D. Helping the family deal with anxiety and uncertainty
Correct Answer
D. D. Helping the family deal with anxiety and uncertaintyExplanation
The most appropriate action for the nurse in this situation would be to help the family deal with anxiety and uncertainty. The father's belief that the physician looked serious indicates that there may be a potential serious health issue for one of the family members. The nurse should provide emotional support, reassurance, and information to help the family cope with their anxiety and uncertainty during this difficult time. Assisting with recognizing and meeting the children's needs, discussing illness management skills, and sharing literature about hospice would not be the most appropriate actions in this situation.Rate this question:
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- 17.
17. 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.
A. Assisting the family in finding a physician who can offer hope and possible treatment
- B.
B. Helping the family deal with anxiety and uncertainty
- C.
C. Sharing information about hospice and family needs at the end of life
- D.
D. Trying to help the family find meaning in their situation
Correct Answer
D. D. Trying to help the family find meaning in their situationExplanation
The most appropriate intervention for the nurse in this situation is to try to help the family find meaning in their situation. Since the father has been told that his cancer is too advanced for treatment, it is important for the nurse to provide support and assistance to the family in coping with the emotional and existential challenges they may face. Helping the family find meaning in their situation can provide them with a sense of purpose and understanding, which can be valuable in navigating the difficult journey ahead.Rate this question:
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- 18.
18. 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.
A. Ask the grandmother if she could take the baby for a few nights so the teenager could catch up on her sleep.
- B.
B. Assure the mother that her feelings were normal and that no one likes being exhausted.
- C.
C. Call Childrens Protective Services as this mother is at high risk for child abuse.
- D.
D. Explain normal growth and development for toddlers.
Correct Answer
B. B. Assure the mother that her feelings were normal and that no one likes being exhausted.Explanation
The most appropriate action for the nurse to take is to assure the mother that her feelings are normal and that no one likes being exhausted. This response validates the mother's feelings and provides support and understanding. It acknowledges that being a new parent can be overwhelming and tiring, and reassures the mother that she is not alone in feeling this way. This approach promotes a trusting and empathetic relationship between the nurse and the mother, which can encourage the mother to seek help and support when needed.Rate this question:
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- 19.
19. 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.
A. Give the family the complete list, including the free transportation assistance program.
- B.
B. Involve the family with a local church where people could educate the family about the community and be supportive.
- C.
C. Share with the family two resources that are the most immediate needs: namely, housing and food.
- D.
D. Tell the family about all the resources and let the family decide what to do with the list.
Correct Answer
C. C. Share with the family two resources that are the most immediate needs: namely, housing and food.Explanation
The nurse should share with the family the two resources that are the most immediate needs: housing and food. This is the next step because the family is facing a crisis with the father's illness and they need immediate assistance. By providing them with information and resources for housing and food, the nurse can help address their most pressing needs and ensure their basic necessities are met. This will provide stability and support for the family during this difficult time.Rate this question:
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- 20.
20. 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.
A. Family service workers from the agency
- B.
B. Close friends and neighbors
- C.
C. Family self-help groups
- D.
D. Mental health counseling centers
Correct Answer
B. B. Close friends and neighborsExplanation
The nurse should encourage the family to use close friends and neighbors as a source of social support because they are likely to be familiar with the family's situation and can provide emotional support and practical help. They are also readily available and can offer a sense of belonging and connection, which can help alleviate stress. Family service workers from the agency may be helpful, but they may not have the same level of personal connection and understanding as close friends and neighbors. Family self-help groups and mental health counseling centers can also be beneficial, but they may require more time and effort to access compared to close friends and neighbors.Rate this question:
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- 21.
21. 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.
A. The family did not like the nurses suggestions but were too polite to tell the nurse.
- B.
B. The family did not really understand the nurses suggestions.
- C.
C. The family lacked the resources necessary to implement the nurses suggestions.
- D.
D. All families have a tendency to resist change, even if it is helpful.
Correct Answer
D. D. All families have a tendency to resist change, even if it is helpful.Explanation
The correct answer suggests that the lack of response by the family could be attributed to the common tendency of all families to resist change, even if it is beneficial. This implies that the family may have been reluctant to make the suggested changes due to their natural resistance to change, regardless of the potential benefits it may have brought.Rate this question:
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- 22.
22. 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.
A. At the moment, I dont think the family will even notice Im helping them change.
- B.
B. Im only focusing on one person because if I can get one member to change, the others will change as well.
- C.
C. Now is when the family may recognize the need for change.
- D.
D. The family is under so much stress that one more stressor wont matter.
Correct Answer
C. C. Now is when the family may recognize the need for change.Explanation
The most appropriate response is c. Now is when the family may recognize the need for change. This response suggests that during times of crisis, individuals and families may be more open to recognizing and addressing the need for change. It implies that the nurse believes that the family's current state of stress may create an opportunity for them to be receptive to learning better coping mechanisms. This response demonstrates a thoughtful and empathetic approach to supporting the family during their difficult time.Rate this question:
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- 23.
23. 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.
A. Clarifying the consequences if the problems are not resolved
- B.
B. Emphasizing how many sessions the family may receive
- C.
C. Stressing the seriousness of the problems that are confronting the family
- D.
D. Demonstrating that there is no one else to help the family unless they act now
Correct Answer
B. B. EmpHasizing how many sessions the family may receiveExplanation
By emphasizing how many sessions the family may receive, the nurse is redirecting the focus of the family interaction towards the problems that need to be resolved or improved. This intervention helps to keep the family on track and motivated to address the issues at hand.Rate this question:
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- 24.
24. Which of the following actions best demonstrates the use of summative evaluation?
- A.
A. Explaining the goals of blood glucose control and the diabetic diet plan
- B.
B. Asking a diabetic client what he ate for the last three meals to see whether it fits the diet plan
- C.
C. Reviewing the daily blood glucose levels each week with a diabetic client
- D.
D. Quizzing a diabetic client about his current diabetic medications before discharge
Correct Answer
D. D. Quizzing a diabetic client about his current diabetic medications before dischargeExplanation
The correct answer is d because quizzing a diabetic client about his current diabetic medications before discharge is an example of summative evaluation. Summative evaluation involves assessing the client's knowledge and understanding of a specific topic or skill at the end of a learning period. In this case, the nurse is evaluating the client's knowledge of his current diabetic medications before he is discharged, which demonstrates the use of summative evaluation.Rate this question:
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