Chapter 3: The Childbearing and Childrearing Family in the Community
1. A community health nurse is preparing to teach childbirth classes at
the local high school. This nurse is actively involved in which type of
community health care?: Primary prevention Explanation:
Primary prevention involves teaching and promotes health and prevention of injury.
Childbirth classes are primary prevention. Secondary prevention focuses on health-
screening activities that aid in early diagnosis and encourage prompt treatment
before long-term negative effects. Tertiary prevention includes health-promoting
activities that focus on rehabilitation and providing information to prevent further
injury or illness. Couplet care is allowing the newborn and mother to stay in the
same room after delivery.
2. After teaching a pregnant woman about using complementary and
alternative medicine (CAM) therapies, the nurse determines that the
teaching was successful based on which client statement?: "I need to talk
with my provider before I try using any therapy." Explanation:
If a client is considering the use of or is using CAM therapies, the nurse will suggest
the client check with the health care provider before taking any substance, even if
it is natural. The client needs to know that even if a remedy is listed as natural, it
does not mean that it is safe. The package label should list all ingredients, including
the amounts of each. Mixing of remedies is unsafe and may result in harm.
3. The nurse recognizes that which factors contribute to the increase in
single-parent families?: Rising divorce rates Explanation:
Rising divorce rates, along with wider acceptance of babies born out of wedlock
and changes in adoption laws, have caused an increase in single-parent-families.
Birth rates in the U.S. have actually declined over the last decade, and thus have
not increased the number of single-parent families. Additionally, the increase in
gay and lesbian couples has actually decreased the single-parent-family numbers.
The decrease in communal family units has not affected single-parent family
numbers.
4. A female client came to the clinic inquiring if there was a form of birth
control that did not have a hormonal component. The client states that their
mother had breast cancer and the client does not want to interfere with the
natural hormonal process, even if the birth control has a higher failure rate.
Which form of birth control would be the best option for this client?: cervical
cap Explanation:
The nurse will suggest a cervical cap as a nonhormonal form of birth control for
female clients. A cervical cap is placed over the cervix and used with a
spermicidal jelly. It is important to explain the process for insertion and failure rate
,Chapter 3: The Childbearing and Childrearing Family in the Community
so that the client understands the birth control method fully. The intrauterine
device (IUD) is only used in a small number of women in the United States,
possibly due to the need for the device to be fitted by a health care provider. Also,
IUDs typically contain a hormone, but one form, with copper, is nonhormonal. A
vaginal estrogen/progestin (contraceptive) ring continually releases estrogen and
progesterone. Intramuscular injections include progesterone, which inhibits
ovulation.
5. A 2-year-old child has been diagnosed recently with leukemia. She has
been admitted to the hospital for initiation of treatment. The family is trying
to cope with the new diagnosis, and family members describe themselves
as being "in a state of shock." In working with the family, which of the
following would be the priority nursing diagnosis?: Ineffective family coping
related to new illness of the child
Explanation:
We know that the family is not coping well with this new diagnosis and
hospitalization. All the other choices imply situations that are potential
consequences of this change in the family, but we do not have any specific
information telling us that these alterations have actually taken place.
6. Assessment of an adult client reveals that he lives with his wife and
three children. The client's father-in-law lives in an in-law suite attached to
the client's home. The client's parents live about a block away and visit the
family often. The nurse interprets this as which type of family?: extended
family Explanation:
The client is describing an extended family which consists of the immediate family
and grandparents, aunts, uncles and cousins who may or may not live under the
same roof. A nuclear family traditionally includes a married adult man and woman
and their children. A blended family includes children who live with one birth
parent and one parent, as well as any offspring of the non-birth parent. A single-
parent family is composed of one parent and one or more children.
7. Assessment of a client reveals that he is part of a nuclear family. The
nurse interprets this as which of the following?: The family includes a married
adult man, his wife, and their children.
Explanation:
A nuclear family includes a married adult man, his wife, and their children. A
communal family is one in which members share a common belief or bond. Family
members may not always live together in one household. However, they remain
connected through their relationships. Each family member exerts varying, not
similar, influence on the other persons.
, Chapter 3: The Childbearing and Childrearing Family in the Community
8. A couple with infertility has decided to adopt an infant and receive a call
several months later that an infant is available. The social worker gives
them the history of the biological mom, a teenager who tried to conceal
her pregnancy by dieting and taking laxatives. However, at 26 weeks'
gestation, the teenager shared her pregnancy with the family and
received prenatal care. Given this history, the couple should be
counseled to observe the infant for
which possible abnormality?: abnormal neurologic development
Explanation:
If the birth mother of an adopted child ate inadequately or received little prenatal
care, for example, the adopted child is at a higher than normal risk for abnormal
neurologic development. The risk for development of kidney problems or eating
disorders would be the same as any other child. There is no proof that
immunizations cause autism. The risk for autism would be the same as any other
child.
9. While assessing a family, the nurse notes indications of altered family
functioning. Which of the following would the nurse most likely note?
Select all that apply.: expression of guilt noncompliance with treatment
regimen Significant difficulty with changes Explanation:
Altered family functioning may be noted by an inability to express or accept
emotions, a lack of respect or support for other family members, and an inability to
adapt to change. In addition, members may verbalize feelings of inadequacy, guilt,
anxiety, failure, helplessness, and powerlessness, Noncompliance with treatment
may be a manifestation of denial or refusal to acknowledge a problem's existence.
10. A nurse is conducting an assessment of a family. Which question would
be most appropriate for the nurse to use when obtaining information
about the family's structure and function?: "Who is the primary decision-
maker in the household?"
Explanation:
The question about the primary decision-maker reflects the family structure and
function. The questions about available support persons and going out with friends
and coworkers provides information about social interaction. The question about
income and lifestyle addresses occupational role factors.
11. During assessment for a child with cystic fibrosis who is new to the
practice, the nurse notes that the father keeps asking about costs and if
there is a "cheaper" way of providing the care that the child needs
without compromising health. For example, instead of buying
prepackaged normal saline for breathing treatments, he asks if they can
1. A community health nurse is preparing to teach childbirth classes at
the local high school. This nurse is actively involved in which type of
community health care?: Primary prevention Explanation:
Primary prevention involves teaching and promotes health and prevention of injury.
Childbirth classes are primary prevention. Secondary prevention focuses on health-
screening activities that aid in early diagnosis and encourage prompt treatment
before long-term negative effects. Tertiary prevention includes health-promoting
activities that focus on rehabilitation and providing information to prevent further
injury or illness. Couplet care is allowing the newborn and mother to stay in the
same room after delivery.
2. After teaching a pregnant woman about using complementary and
alternative medicine (CAM) therapies, the nurse determines that the
teaching was successful based on which client statement?: "I need to talk
with my provider before I try using any therapy." Explanation:
If a client is considering the use of or is using CAM therapies, the nurse will suggest
the client check with the health care provider before taking any substance, even if
it is natural. The client needs to know that even if a remedy is listed as natural, it
does not mean that it is safe. The package label should list all ingredients, including
the amounts of each. Mixing of remedies is unsafe and may result in harm.
3. The nurse recognizes that which factors contribute to the increase in
single-parent families?: Rising divorce rates Explanation:
Rising divorce rates, along with wider acceptance of babies born out of wedlock
and changes in adoption laws, have caused an increase in single-parent-families.
Birth rates in the U.S. have actually declined over the last decade, and thus have
not increased the number of single-parent families. Additionally, the increase in
gay and lesbian couples has actually decreased the single-parent-family numbers.
The decrease in communal family units has not affected single-parent family
numbers.
4. A female client came to the clinic inquiring if there was a form of birth
control that did not have a hormonal component. The client states that their
mother had breast cancer and the client does not want to interfere with the
natural hormonal process, even if the birth control has a higher failure rate.
Which form of birth control would be the best option for this client?: cervical
cap Explanation:
The nurse will suggest a cervical cap as a nonhormonal form of birth control for
female clients. A cervical cap is placed over the cervix and used with a
spermicidal jelly. It is important to explain the process for insertion and failure rate
,Chapter 3: The Childbearing and Childrearing Family in the Community
so that the client understands the birth control method fully. The intrauterine
device (IUD) is only used in a small number of women in the United States,
possibly due to the need for the device to be fitted by a health care provider. Also,
IUDs typically contain a hormone, but one form, with copper, is nonhormonal. A
vaginal estrogen/progestin (contraceptive) ring continually releases estrogen and
progesterone. Intramuscular injections include progesterone, which inhibits
ovulation.
5. A 2-year-old child has been diagnosed recently with leukemia. She has
been admitted to the hospital for initiation of treatment. The family is trying
to cope with the new diagnosis, and family members describe themselves
as being "in a state of shock." In working with the family, which of the
following would be the priority nursing diagnosis?: Ineffective family coping
related to new illness of the child
Explanation:
We know that the family is not coping well with this new diagnosis and
hospitalization. All the other choices imply situations that are potential
consequences of this change in the family, but we do not have any specific
information telling us that these alterations have actually taken place.
6. Assessment of an adult client reveals that he lives with his wife and
three children. The client's father-in-law lives in an in-law suite attached to
the client's home. The client's parents live about a block away and visit the
family often. The nurse interprets this as which type of family?: extended
family Explanation:
The client is describing an extended family which consists of the immediate family
and grandparents, aunts, uncles and cousins who may or may not live under the
same roof. A nuclear family traditionally includes a married adult man and woman
and their children. A blended family includes children who live with one birth
parent and one parent, as well as any offspring of the non-birth parent. A single-
parent family is composed of one parent and one or more children.
7. Assessment of a client reveals that he is part of a nuclear family. The
nurse interprets this as which of the following?: The family includes a married
adult man, his wife, and their children.
Explanation:
A nuclear family includes a married adult man, his wife, and their children. A
communal family is one in which members share a common belief or bond. Family
members may not always live together in one household. However, they remain
connected through their relationships. Each family member exerts varying, not
similar, influence on the other persons.
, Chapter 3: The Childbearing and Childrearing Family in the Community
8. A couple with infertility has decided to adopt an infant and receive a call
several months later that an infant is available. The social worker gives
them the history of the biological mom, a teenager who tried to conceal
her pregnancy by dieting and taking laxatives. However, at 26 weeks'
gestation, the teenager shared her pregnancy with the family and
received prenatal care. Given this history, the couple should be
counseled to observe the infant for
which possible abnormality?: abnormal neurologic development
Explanation:
If the birth mother of an adopted child ate inadequately or received little prenatal
care, for example, the adopted child is at a higher than normal risk for abnormal
neurologic development. The risk for development of kidney problems or eating
disorders would be the same as any other child. There is no proof that
immunizations cause autism. The risk for autism would be the same as any other
child.
9. While assessing a family, the nurse notes indications of altered family
functioning. Which of the following would the nurse most likely note?
Select all that apply.: expression of guilt noncompliance with treatment
regimen Significant difficulty with changes Explanation:
Altered family functioning may be noted by an inability to express or accept
emotions, a lack of respect or support for other family members, and an inability to
adapt to change. In addition, members may verbalize feelings of inadequacy, guilt,
anxiety, failure, helplessness, and powerlessness, Noncompliance with treatment
may be a manifestation of denial or refusal to acknowledge a problem's existence.
10. A nurse is conducting an assessment of a family. Which question would
be most appropriate for the nurse to use when obtaining information
about the family's structure and function?: "Who is the primary decision-
maker in the household?"
Explanation:
The question about the primary decision-maker reflects the family structure and
function. The questions about available support persons and going out with friends
and coworkers provides information about social interaction. The question about
income and lifestyle addresses occupational role factors.
11. During assessment for a child with cystic fibrosis who is new to the
practice, the nurse notes that the father keeps asking about costs and if
there is a "cheaper" way of providing the care that the child needs
without compromising health. For example, instead of buying
prepackaged normal saline for breathing treatments, he asks if they can
