Nokea
A home-health nurse is working with a poverty-stricken family that has two small children, ages 2 and 3 years. The family lives in an isolated rural area. The family?s home has a dirt floor, and there are chickens living in the house with the family. Because of a recent wind storm, there is a sizeable hole in the roof that lets rain and snow into the house. Which nursing intervention would be the highest priority in this situation?
- A. Make immunization appointments for the children in a nearby town?s public health clinic.
- B. Help the family find funding and manpower to patch and repair the roof of their home.
- C. Determine the educational readiness of the two children.
- D. Report the family for child abuse because of neglect.
Correct Answer: B
Rationale: Repairing the roof is the highest priority to ensure a safe, habitable environment, protecting the children from health risks due to exposure. Immunizations are important but less urgent, educational readiness is secondary, and reporting neglect is premature without assessing intent or resources.
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While caring for a family who lost a 10-year-old son in a car accident, the nurse should instruct the parents to tell the 4-year-old sister which of the following about her brother?
- A. He died and is not coming back.
- B. He passed on to the other side.
- C. He departed on a long journey.
- D. He has gone to see the Lord above.
Correct Answer: A
Rationale: For a 4-year-old, clear, simple language like 'He died and is not coming back' is appropriate to help them understand death without confusion. Euphemisms like 'passed on,' 'long journey,' or 'seeing the Lord' may confuse young children who think concretely and may expect the person to return.
A nurse is developing a plan of care for a family who is experiencing problems related to their child?s chronic illness. The nurse plans to have the family read a group of short stories written by parents of children with chronic illnesses. The nurse will be using which technique?
- A. Psychoeducation
- B. Social skills training
- C. Bibliotherapy
- D. Assertiveness training
Correct Answer: C
Rationale: Using stories written by parents of chronically ill children is bibliotherapy, which promotes insight and coping through reading relevant materials. Psychoeducation involves direct teaching, social skills training targets interpersonal behaviors, and assertiveness training focuses on communication skills.
After teaching a class about childhood and adolescent mental health, the instructor determines that additional teaching is needed when the class identifies which of the following as promoting mental health in children?
- A. Difficult temperament
- B. Age-appropriate physical development
- C. Secure attachment
- D. Normal psychosocial development
Correct Answer: A
Rationale: Difficult temperament is a risk factor for mental health issues, not a promoter, indicating a need for further teaching. Age-appropriate physical development, secure attachment, and normal psychosocial development are protective factors that support mental health.
A nurse is working with a family in which the parents have just gotten divorced. After teaching the parents about measures to reduce the risk of emotional problems for the children, which statement by the parents indicates a need for additional teaching?
- A. We will try to alter their routines so they don?t think about the past.
- B. We will make sure that they understand that they did not cause the divorce.
- C. We will develop a regular and consistent schedule for visitation.
- D. We will make sure that we are consistent in the limit that we set.
Correct Answer: A
Rationale: Altering routines to avoid the past may disrupt stability and hinder processing the divorce, indicating a need for further teaching. Ensuring children don?t feel responsible, consistent visitation, and consistent limits are appropriate strategies to reduce emotional problems.
A nurse is providing teaching to a group of parents with children and adolescents who have experienced losses. The nurse determines that the teaching was successful when the group states which of the following?
- A. Children grieve in similar ways regardless of their age.
- B. Children often use fantasy to fill in their gaps in understanding.
- C. Families tend to grieve at similar times after the loss.
- D. Children and adults grieve much in the same manner.
Correct Answer: B
Rationale: Children often use fantasy to process grief, filling gaps in their understanding due to developmental limitations, indicating successful teaching. Grief varies by age, families may grieve at different times, and children?s grief differs from adults? due to cognitive differences.