Family Focused Nursing Care 1st Edition by Sharon A. Denham-Test Bank

Family Focused Nursing Care 1st Edition By
Sharon A. Denham-Test Bank
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Family Focused Nursing Care 1st Edition By Sharon A.
Denham-Test Bank
SAMPLE TEST
Chapter 3- Moving to Family-Focused Care
MULTIPLE CHOICE
1. Which of the following does not contribute to the high costs of medical care in the last year of
life?
1. Caring for severe illness
2. Functional impairment
3. Nursing home expenditures
4. Over-prescribing practices
ANS: 4
Rationale:
According to Hogan (2001), caring for severe illness, functional impairment, and nursing home
expenditures contribute to the high cost of medical care in the last year of life.
PTS: 1
KEY: Content Area: Differentiate among terms like healthy, unhealthy, and societal health |
Integrated Process: Caring | Client Need: Physiological Integrity | Cognitive Level: Knowledge |
Question Type: Multiple Choice
2. What percent of U.S. adults are overweight or obese?

1. Less than 25%
2. 34%
3. 40%
4. More than 50%
ANS: 2
Rationale:
The obesity crisis is of great concern. According to the Centers for Disease Control and
Prevention (2011), about 33.8% of U.S. adults are overweight or obese.
PTS: 1
Integrated Process: Nursing Process | Client Need: Physiological Integrity | Cognitive Level:
Knowledge | Question Type: Multiple Choice
3. Consider the following statements:

Statement A. When physicians discuss end-of-life with cancer patients, their health-care costs are
much higher in the last week of life.
Statement B. Many dying persons never get referred to hospice care.
1. Both statements A and B are true.
2. Both statements A and B are false.
3. Statement A is true and statement B is false.
4. Statement A is false and statement B is true.
ANS: 4
Rationale:
According to Zhang et al. (2009), costs are much lower when physicians discuss end-of-life care
with their patients. Yet many dying persons are never referred to hospice. More than a third of
those referred only spend seven days enrolled, although many would benefit greatly from aspects
of care management lasting longer (Jennings, Ryndes, D’Onofrio, & Baily, 2010).
PTS: 1
Integrated Process: Nursing Process | Client Need: Safe and Effective Care Environment |
Cognitive Level: Knowledge | Question Type: Multiple Choice
4. An ____ point of view encourages one to see connections between society and individual or
societal health.
1. Educated
2. Ecumenical
3. Ecological
4. Environmental
ANS: 3
Rationale:
An ecological point of view encourages one to see connections between society and individual or
societal health.
PTS: 1
KEY: Content Area: Discuss ways thinking family improves individual, family, and societal health |
Integrated Process: Nursing Process | Client Need: Health Promotion and Maintenance | Cognitive
Level: Knowledge | Question Type: Multiple Choice
5. How much greater is U.S. health-care spending compared to other nations?

1. About 2.5 times as high
2. About 4 times as high
3. About 7.5 times as high
4. About 10 times as high
ANS: 1
Rationale:
The United States is one of the wealthiest nations in the world and spends more money on health
care than anywhere else; health-care spending is about 2.5 times as high as other nations.
PTS: 1
6. Which of the following is not a priority of the Affordable Care Act’s quality improvement
strategy?
1. New health-care delivery models.
2. Families engaged as partners in care.
3. Less emphasis on preventive care.
4. Use of best practices.
ANS: 3
Feedback
1 New health-care delivery models, families engaged as partners in care, and use of best practices are all priorities of t
Health Care Act’s quality improvement strategy.
3 Rather than less emphasis on preventive care, a priority is to promote the most effective prevention and treatment
leading causes of mortality.
PTS: 1
MULTIPLE RESPONSE
1. Which of the following may prevent illness?

1. Adequate sleep
2. Early diagnosis
3. Stress management
4. Adequate nutrition
ANS: 1, 3, 4
Rationale:
Adequate sleep, nutrition, and stress management help to prevent illness. Early diagnosis of
illness is important too, but it does not prevent illness.
PTS: 1
KEY: Content Area: Identify various perspectives linked with health and illness | Integrated
Process: Nursing Process | Client Need: Health Promotion and Maintenance | Cognitive Level:
Knowledge | Question Type: Multiple Response
2. Which of the following increase risk for illness?

1. Physical activity
2. Tobacco use
3. Sedentary lifestyle
4. Poverty
ANS: 2, 3, 4
Rationale:
Tobacco use and a sedentary lifestyle are high-risk behaviors; socioeconomic status also
correlates with increased risk for illness.
PTS: 1
3. What do families desire from hospice care?

1. Continuity of care.
2. Comfort for the dying family member.
3. Autonomy for family members.
4. Case management.
ANS: 1, 2, 3, 4
Rationale:
Continuity of care, comfort for the dying family member, autonomy for family members, and case
management are all aspects of hospice care.
PTS: 1
Integrated Process: Caring | Client Need: Safe and Effective Care Environment | Cognitive Level:
4. Which of the following factors influence societal health?

1. Access to care providers
2. Educational institutions
3. Wealth distribution
4. Respect of human rights
ANS: 1, 3, 4
Rationale:
Access to care providers, distribution of wealth, and respect of human rights all influence the
health of society. Educational institutions are not essential for health and wellness.
PTS: 1
Level: Comprehension | Question Type: Multiple Response
5. Which of the following are reasons the United States has a growing health disadvantage when
compared with peer countries?
1. Uninsured segments of the population
2. High poverty rates
3. An efficient health-care delivery system
4. Lack of care coordination
ANS: 1, 2, 4
Rationale:
Uninsured people, high poverty rates, and lack of care coordination contribute to the growing
health disadvantage of the United States, despite it being one of the wealthiest countries and
spending more on health care compared to other nations. The U.S. health-care system is not
efficient. There is much duplication, yet there are many gaps in care.
PTS: 1
Cognitive Level: Comprehension | Question Type: Multiple Response
6. Which of the following assumptions about the family perspective will guide nursing actions?
1. Family members need full disclosure and clear explanations.
2. Family members are usually afraid of being involved in care.
3. Family confidence influences care giving.
4. Family members have rights and can make choices.
ANS: 1, 3, 4
Rationale:
Assumptions that may help to guide nursing actions include that family members need full
disclosure and clear explanations, that their confidence influences care giving, and that they have
rights and can make choices. Families are usually comfortable with other family members and
want to be involved, but will need information that will enable their involvement.
PTS: 1
KEY: Content Area: Describe ways nurses think family to deliver family focused care | Integrated
Process: Nursing Process | Client Need: Psychosocial Integrity | Cognitive Level: Application |
Question Type: Multiple Response
7. Which of the following actions by the nurse demonstrate the nurse is thinking family? Susan, a
nurse who thinks family:
1. Introduces herself to each of her patients in the acute-care setting.
2. Ensures that family members are not in the room when procedures are done.
3. Practices active listening with all her patients’ visitors.
4. Commends family members for their positive interactions with her patients.
ANS: 3, 4
Rationale:
Thinking family is demonstrated by actively listening to patients’ visitors and commending family
members for their positive interactions with patients. Introducing oneself to each patient and
ensuring that family members are not in the room when procedures are done only shows concern
for the individual, not for the family.
PTS: 1
KEY: Content Area: Describe ways nurses think family to deliver family focused care | Integrated
Process: Communication and Documentation | Client Need: Psychosocial Integrity | Cognitive
Level: Application | Question Type: Multiple Response
COMPLETION
1. As early as 1995, the American Nurses Association’s Social Policy Statement described
____________________ as a target for nursing care.
ANS: family
PTS: 1
Integrated Process: Nursing Process | Client Need: Psychosocial Integrity | Cognitive Level:
Knowledge | Question Type: Completion
SHORT ANSWER
1. List several influencers of norms or standards regarding health.
ANS:
Age, genetics, geographical region, culture/ethnicity, etc.
PTS: 1
Comprehension | Question Type: Short Answer
2. Compare and contrast obesity and malnutrition as public health issues, and describe how
families can influence them.
ANS:
Nurses and the general public are often unaware of public health measures that might be used to
reverse the obesity epidemic. Some solutions rest outside the health-care industry, but clinicians
might make important differences. For example, lifestyle choices, the built environment, leadership
capacities, prevention, public policy, and government interventions offer alternative approaches to
the obesity problem. Coordinated actions are needed to solve a problem of this magnitude. Nurses
that think family can help by looking beyond primary care settings and find ways to address this
concern—one of which is to educate families. Malnutrition and starvation are also growing
problems, not only for the homeless or the unemployed, but one that is faced daily by families with
inadequate incomes. Families often choose between food and other basic needs (e.g., rent,
utilities, and medical care). Nurses that think family consider the health and illness of the family
units and the larger society, not merely individuals.
PTS: 1
Comprehension | Question Type: Short Answer
3. Explain what is meant by this statement of the Royal College of Physicians and Surgeons:
“Societal needs for medical health care have both quantitative and qualitative perspectives.”
ANS:
Quantitative means that the appropriate number, type, and mix of physicians, nurses, or other
health-care professionals are available. Qualitative needs have to do with the adequacy of the
professionals’ knowledge, skills, attitudes, and willingness to assume the roles needed by diverse
societies. Professional competencies needed by population groups are often culturally specific
responses to societal needs, social determinants of health, and the burden of illness.
PTS: 1
Level: Application | Question Type: Short Answer
Chapter 5- Family Assessment
MULTIPLE CHOICE
1. Which of the following assessment measures would be most beneficial to complete with a 30-
year-old female whose family has a history of breast cancer?
1. Ecogram
2. Ecomap
3. Genogram
4. Geographic information system
ANS: 3
Feedback
1 An ecogram is a visual representation showing relationships, activities, and influences a person has in the family syste
focus on illness information.
2 An ecomap helps the nurse visualize the various activities and relationships of the family with the larger ecological en
does not focus on illness information.
3 Detailed illness information can be added to a genogram to create a family pedigree depicting transmission of such th
conditions, familial conditions, and psychosocial patterns, such as chemical dependency and suicide. The genogram c
aid early diagnosis, identification of risk factors for particular conditions, and to reveal potential prevention str
4 Geographic information systems capture, store, analyze, and display referenced information about specific environm
that are geographically and ecologically pertinent to families; they do not focus on illness information.
PTS: 1
KEY: Content Area: Explain ways that genograms, ecograms, and ecomaps can be used to
assess family from an ecological point of view | Integrated Process: Nursing Process | Client
Need: Health Promotion and Maintenance | Cognitive Level: Comprehension | Question Type:
Multiple Choice
2. When is nursing assessment most complete?
1. When insight is gained through an assessment of individual needs before the needs of the family
2. When insight is gained through an assessment of the family needs before the needs of the individual
3. When insight is gained through an assessment of the needs of the individual and family simultaneously
4. When insight is gained through an individual-nurse-family relationship with consideration of the surrounding com
ANS: 4
Rationale:
Nursing assessment is most effective when nurses complete every assessment with ideas gained
through an individual-nurse-family relationship enacted with consideration of the surrounding
community.
PTS: 1
KEY: Content Area: Discuss assessment that includes the predictive and protective factors that
influence the health and illness of individuals, families, communities, and populations | Integrated
Application | Question Type: Multiple Choice
3. The nurse is working with a client to identify the factors that cause risks or benefits to health.
Which questions best reflect “thinking family” to help identify factors requiring further teaching?
1. “How many cigarettes a day do you smoke? Where do you usually smoke?”
2. “Do you enjoy taking long walks in the winter? How many times a week do you walk?”
3. “Do you prefer water aerobics over floor aerobics? How many times a week do you attend aerobics class?
4. “How many family members do you have? What do you all do together?”
ANS: 1
Feedback
1 “How many cigarettes a day do you smoke? Where do you usually smoke?” are questions about behaviors that pose
health of individuals, families, and communities. These questions best identify further teaching needs.
2 “Do you enjoy taking long walks in the winter? How many times a week do you walk?” are questions about behavior
benefit to the health of individuals, families, and communities. There is no need for teaching.
3 “Do you prefer water aerobics over floor aerobics? How many times a week do you attend aerobics class?” are que
behaviors that pose a benefit to the health of individuals, families, and communities. There is no need for tea
4 “How many family members do you have? What do you all do together?” are questions about facts that pose no risk o
health of individuals, families, and communities. There is no need for teaching.
PTS: 1
4. The nurse is working with the client to assess multiple family members’ involvement in his
disease process. Which questions best fit this assessment?
1. “Are you married? How long have you been married?”
2. “Do you have children? How many children do you have?”
3. “What do you usually have for dinner? Do you sit down with your family for a meal?”
4. “What do you do for yourself? What do your family members do for you?”
ANS: 4
Feedback
1 “Are you married? How long have you been married?” are direct questions asking specific information to determine t
absence of a spouse; they do not address family member involvement. It should not be assumed that if the person is
family members are involved in his care.
2 “Do you have children? How many children do you have?” are direct questions asking specific information to determin
or absence of children; they do not address family member involvement. It should not be assumed that if the person h
are involved in his care.
3 “What do you usually have for dinner? Do you sit down with your family for a meal?” are direct questions to obta
information related to the client and meals; they do not address family member involvement in the disease process. I
assumed that if a family shares meals together, the family members are involved in his care.
4 “What do you do for yourself? What do your family members do for you?” are open ended questions to obtain infor
family member involvement in the client’s disease process. It is important to identify the degree of involvement of mu
who may contribute to the health or well-being of individuals within families.
PTS: 1
5. What can nurses learn when using geographic information system (GIS) databases?
1. Population trends and how to target population health interventions
2. Education trends and how to target community education
3. Transmission of inherited traits from one generation to another among similar or related organisms
4. Genes that regulate human susceptibility to viruses
ANS: 1
Feedback
1 GIS databases can be successfully used to facilitate learning about population trends and how to target populati
interventions.
2 GIS databases are not typically used to track education trends; they are useful in tracking population trends and ho
population health interventions.
3 GIS databases are not used to track transmission of inherited traits across generations or organisms; they are useful in
population trends and how to target population health interventions.
4 GIS databases are not used to learn about genes that regulate human susceptibility to viruses; they are used to track po
and to target population health interventions.
PTS: 1
KEY: Content Area: Describe ways that computer-based geographic information systems can be
used to understand family, community, and population health needs | Integrated Process: Nursing
Process | Client Need: Health Promotion and Maintenance | Cognitive Level: Comprehension |
Question Type: Multiple Choice
6. Identification of genetic patterns of inheritance is important not only for individuals and
families, but also communities. Some autosomal recessive disorders are more commonly seen
among which of the following groups?
1. Persons from different economic classes
2. Certain racial/ethnic groups
3. Certain age groups
4. Certain social networks
ANS: 2
Some autosomal recessive disorders are more commonly seen among certain racial/ethnic groups
such as hemochromatosis in Caucasians, and sickle cell disease in black Americans.
PTS: 1
KEY: Content Area: Recognize ways that genetics and genomics influence health, disease
prevention, treatments, screening, and outcomes | Integrated Process: Nursing Process | Client
Need: Health Promotion and Maintenance | Cognitive Level: Knowledge | Question Type: Multiple
Choice
7. When completing a family unit assessment, what would the nurse assess?
1. Family household information
2. Complaints of physical problems
3. The implications of individual differences between the family members
4. The implications of family members’ knowledge of the disease process
ANS: 1
Feedback
1 The family household is the place where health and illness are produced and thus is an important focus for assessing
unit.
2 Considering complaints of physical problems is a focus of individual assessment.
3 Looking at implications of individual differences between family members focuses the assessment on individuals rathe
as a unit.
4 Looking at implications of family members’ knowledge of the disease process focuses the assessment on individuals r
family as a unit.
PTS: 1
KEY: Content Area: Differentiate between individual, family, and community assessment |
Level: Knowledge | Question Type: Multiple Choice
8. What is one way the nurse can maintain a broad-minded perspective when completing a family
assessment?
1. By using the Family Functioning Framework.
2. By using the Family Health Model.
3. By using either the Family Functioning Framework or the Family Health Model.
4. Use of a model or framework is not necessary for a broad-minded and comprehensive approach to family asses
ANS: 2
Feedback
1 Family functioning is only one aspect of a comprehensive family assessment. To maintain a broad-minded stance, th
family nursing model, framework, or theory in its entirety.
2 Clarity of assessment benefits when the nurse takes a broad-minded perspective and considers multiple health deter
health situation at the individual, family, or community level. One way to maintain a broad-minded stance is to guid
assessment in an organized way by using a family nursing model or theory or a family science model or theory, such
Health Model.
3 Family functioning is only one aspect of a comprehensive family assessment. To maintain a broad-minded stance the
family nursing model, framework, or theory in its entirety, such as the Family Health Model.
4 One way to maintain a broad-minded stance and to obtain a comprehensive assessment is to guide the nursing asse
organized way by using a family nursing model or theory or a family science model or theory, such as the Family He
PTS: 1
Level: Comprehension | Question Type: Multiple Choice
9. Coordinated family care relies on ____ that provides an accurate picture of the ____.
1. Collection of information; actual living conditions
2. Cooperation of family members; family dynamics

3. The skill of the nurse; nurse-individual-family relationship
4. Assessment of family functioning; ways family members process information
ANS: 1
Feedback
1 Coordinated family care relies upon collection of information about the family as a unit. Assessing the family househ
living conditions where health and illness occur, gives the nurse important information to plan care.
2 An assessment of family dynamics is obtained through a comprehensive assessment of the family as a unit; it is not ob
the cooperation of family members in coordinating care.
3 The skill of the nurse is not applied to provide an accurate picture of the nurse-individual-family relationship, but to col
about the family as a unit in order to plan care, and to develop the nurse-individual-family relationship
4 Coordinated family care relies upon a comprehensive family assessment, not simply on assessment of family functio
processes need to be assessed in addition to family functioning.
PTS: 1
Level: Comprehension | Question Type: Multiple Choice
MULTIPLE RESPONSE
1. Which of the following scenarios could result in greater continuity of care because of
documentation by electronic health record?
1. A public health screening for hypertension
2. A 12-year-old female with an asthma flare-up during recess at school being seen by the school’s nurse
3. Walgreen’s nationwide flu shot clinics
4. An 89-year-old male dismissing home from a hospital with home-health care for assistance with dressing cha
ANS: 1, 2, 3, 4
Rationale:
All scenarios contain either intergenerational issues or connections between the individual and the
family within the community that could be documented and referred to by a wide variety of
providers for more effective long term treatment.
PTS: 1
Process: Communication and Documentation | Client Need: Health Promotion and Maintenance |
Cognitive Level: Application | Question Type: Multiple Response
2. What information does the geographic expansion of family-focused assessment to the

community level provide the nurse?
1. Factors supporting health
2. Existing health disparities
3. Family health history
4. Risks to health
5. Historic migration patterns
ANS: 1, 2, 4
Rationale:
A broad snapshot of a community’s health strengths (factors supporting health) and weaknesses
(health disparities) can be obtained from a “windshield survey” or a geographic information system
(GIS). Risks to health can also be obtained from the geographic expansion of a family-focused
assessment to the community level. A family history is obtained from assessment of the family, not
the community. Historic migration patterns are obtained through genetic assessment, not
community assessment.
PTS: 1
Level: Comprehension | Question Type: Multiple Response
3. Geographic information system (GIS) databases can be used to highlight geo-spatial patterns
of concern and resources to nurses providing care to which of the following clients?
1. Acutely ill patients
2. Chronically ill persons being hospitalized due to environmental-related symptoms
3. Families seeking out grocery stores with affordable fresh fruits and vegetables
4. Skilled-care patients in a residential facility

5. Community members involved in community planning of transportation routes
ANS: 2, 3, 5
Rationale:
The GIS can highlight geo-spatial patterns of concern that occur in residential living environments
that might contribute to exacerbations of chronic illness. Nurses can search the map based on
different attributes to look for family or community resources available that may help with health
promotion, disease prevention, or management of illness. Thus, it can be used to identify grocery
stores with affordable fruits and vegetables, or be helpful in planning transportation routes. It
would not be useful for nurses providing care for acutely ill inpatients or skilled-care patients in
hospitals or residential facilities.
PTS: 1
KEY: Content Area: Describe ways that computer-based geographic information systems can be
used to understand family, community, and population health needs | Integrated Process: Nursing
Process | Client Need: Health Promotion and Maintenance | Cognitive Level: Application |
Question Type: Multiple Response
4. Which of the following roles for nurses exist in the genomic era?
1. Individual and family counseling
2. Clinical care and education
3. Advocacy
4. Spiritual care
5. Research
6. Ethics
ANS: 1, 2, 3, 5, 6
Rationale:
Individual and family counseling are roles for nurses in the genomic era. Clinical care and
education are roles for nurses in the genomic era. Advocate is a role for nurses in the genomic
era. Research roles exist for nurses involved in the genomic era. The area of ethics has roles for
nurses involved in care based in genomics. Spiritual care is an important role for the nurse but it
does not directly relate to genomics.
PTS: 1
KEY: Content Area: Recognize ways that genetics and genomics influence health, disease
prevention, treatments, screening, and outcomes | Integrated Process: Nursing Process | Client
Need: Health Promotion and Maintenance | Cognitive Level: Knowledge | Question Type: Multiple
Response
5. Which of the following would be an intended outcome of the use and maintenance of
electronic personal and family health records?
1. Continuity in care
2. Improved family care planning
3. Enhanced public health
4. Identification of health risks based on geographic location
ANS: 1, 2, 3
Rationale:
Electronic records are one option to provide some form of an ongoing plan for some chronic
conditions that identifies goals, strategies, supports, and outcomes linked with family unit needs
and individual conditions, and that could be instrumental in family care planning to improve health
outcomes and enhance public health. Identification of health risks based on geographic location is
best obtained through geographic information system databases.
PTS: 1
Process: Communication and Documentation | Client Need: Health Promotion and Maintenance |
Cognitive Level: Comprehension | Question Type: Multiple Response
6. Which of the following are major ways that the family carries out its health-care functions?
1. Family provides preventative health care to its members at home
2. Family provides the major share of sick care to its members
3. Family pays for most health services received
4. Family has primary responsibility for initiating and coordinating health services
ANS: 1, 2, 3, 4
Rationale:
All scenarios reflect ways that the family carries out its health-care functions.
PTS: 1
Application | Question Type: Multiple Response

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3. Nursing home expenditures

2. What percent of U.S. adults are overweight or obese?

4. More than 50%

3. Consider the following statements:

2. Both statements A and B are false.

3. Statement A is true and statement B is false.

4. Statement A is false and statement B is true.

5. How much greater is U.S. health-care spending compared to other nations?

2. About 4 times as high

3. About 7.5 times as high

4. About 10 times as high

2. Families engaged as partners in care.

3. Less emphasis on preventive care.

4. Use of best practices.

1. Which of the following may prevent illness?

2. Which of the following increase risk for illness?

3. What do families desire from hospice care?

2. Comfort for the dying family member.

3. Autonomy for family members.

4. Which of the following factors influence societal health?

4. Respect of human rights

2. High poverty rates

3. An efficient health-care delivery system

4. Lack of care coordination

2. Family members are usually afraid of being involved in care.

3. Family confidence influences care giving.

4. Family members have rights and can make choices.

3. Practices active listening with all her patients’ visitors.

1. List several influencers of norms or standards regarding health.

Chapter 5- Family Assessment

4. Geographic information system

2. “Do you have children? How many children do you have?”

2. Education trends and how to target community education

4. Genes that regulate human susceptibility to viruses

3. Certain age groups

4. Certain social networks

2. Complaints of physical problems

3. The implications of individual differences between the family members

4. The implications of family members’ knowledge of the disease process

2 Considering complaints of physical problems is a focus of individual assessment.

2. By using the Family Health Model.

2. Cooperation of family members; family dynamics

4. Assessment of family functioning; ways family members process information

3. Walgreen’s nationwide flu shot clinics

2. What information does the geographic expansion of family-focused assessment to the

2. Existing health disparities

3. Family health history

5. Historic migration patterns

2. Chronically ill persons being hospitalized due to environmental-related symptoms

4. Skilled-care patients in a residential facility

2. Clinical care and education

2. Improved family care planning

3. Enhanced public health

4. Identification of health risks based on geographic location

2. Family provides the major share of sick care to its members

3. Family pays for most health services received

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