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A nurse is determining which family assessment tool would be best to implement with a family when planning home visits for health promotion. Which of the following criteria should the nurse use to evaluate these tools?
- A. The number of questions asked on the assessment tool
- B. The linkages of the assessment to Healthy People 2020
- C. The amount of involvement that the family has in completing the tool
- D. The capability of the tool to assess goals and outcomes
Correct Answer: C
Rationale: The family’s involvement in completing the tool is essential for understanding their needs and fostering active participation in health promotion.
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A nurse is caring for a woman who is in labor. The nurse anticipates that the labor will progress through which of the following sequences?
- A. Dilation stage, pressure stage, placental stage, recovery stage
- B. Dilation stage, pushing stage, pain stage, recovery stage
- C. Dilation stage, pushing stage, placental stage, recovery stage
- D. Dilation stage, pushing stage, placental stage, refractory stage
Correct Answer: C
Rationale: The correct sequence of the four stages of labor is dilation, pushing, placental, and recovery stages.
A 63-year-old woman complains of insomnia. Which response is appropriate?
- A. "Do you want a sleeping pill?"
- B. "Make sure that you do not nap during the day even if you are tired."
- C. "Do you feel excessively tired during the day?"
- D. "The nurse practitioner may want to run some simple tests to find out why you are having trouble sleeping."
Correct Answer: C
Rationale: The nurse should assess the quality of sleep and how it affects daily activities before suggesting interventions.
A nurse is using a health education component when teaching about smoking cessation. Which of the following actions is the nurse implementing?
- A. Setting a quit date for people in a smoking cessation class
- B. Providing education regarding the benefits of smoking cessation
- C. Allowing smokers to participate in a smoking cessation program only if they use the patch nicotine replacement system
- D. Encouraging attendees of a smoking cessation program to participate in a research study
Correct Answer: B
Rationale: The nurse is educating individuals about the benefits of smoking cessation, allowing them to make informed decisions.
A client reports that her family will be moving because her husband is taking a new job in another state. She is very unhappy about the decision and doesn’t want to move. What action should the nurse take next?
- A. Assess the client’s and family’s coping mechanisms in handling stress.
- B. Encourage the client to act excited about the move.
- C. Talk to the husband to get his perspective on the move.
- D. Tell her that all families must cope with new situations from time to time.
Correct Answer: A
Rationale: The nurse should assess how the family usually copes with stressful situations to help them manage the current stressor effectively.
The nurse has determined that a person has a dysfunction in the nutritional-metabolic pattern. Which action would be the next step for the nurse to take?
- A. Weigh the person.
- B. Set a goal weight with the person.
- C. Ask the person what her favorite foods are.
- D. Develop a plan for weight loss.
Correct Answer: B
Rationale: Setting a goal weight is essential before developing an intervention plan for weight loss.