Core Concepts of Patient Family Care

Core Concepts of Patient Family Care Related

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Mr. and Mrs. Smith and their three children (ages 5, 8, and 10) are in therapy with the nurse psychotherapist. Mrs. Smith tells the nurse that their marriage has been 'falling apart' since the birth of their youngest child, Tom. She explains that they 'did not want a third child, and I became pregnant even after my husband had undergone a vasectomy. We were very angry, the pregnancy was a problematic one, and the child has been difficult since birth. We had problems before he was born, but since Tom was born, things have gone from bad to worse. No one can control him, and he is wrecking our family!' The nurse assesses that which of the following may be occurring in this family?

  • A. Scapegoating
  • B. Triangling
  • C. Disengagement
  • D. Enmeshment
Correct Answer: A

Rationale: The correct answer is A: Scapegoating. Scapegoating occurs when one family member is blamed for the family's issues. In this case, Tom, the youngest child, is being blamed for the family's problems since his birth. Mrs. Smith explicitly states that they did not want a third child and that Tom has been difficult since birth. By blaming Tom for the family's issues, the family is using him as a scapegoat to avoid addressing their underlying problems. This behavior can negatively impact Tom's self-esteem and create further dysfunction within the family dynamics.

Incorrect Choices:
B: Triangling involves involving a third person in a conflict to avoid directly addressing the issue. While the family dynamics may involve triangulation, the primary issue here is scapegoating.
C: Disengagement refers to emotional withdrawal and lack of involvement in family dynamics. This does not align with the scenario provided.
D: Enmeshment is when boundaries between family members are blurred, leading to a

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The nurse is caring for the newborn of a mother who is HIV positive. What treatment should the nurse expect to be prescribed for the infant?

  • A. Bacitracin
  • B. Erythromycin
  • C. Protease inhibitor
  • D. Zidovudine (AZT)
Correct Answer: D

Rationale: The correct answer is D: Zidovudine (AZT). This antiretroviral medication is commonly used to prevent transmission of HIV from mother to child during pregnancy and delivery. AZT reduces the risk of vertical transmission by inhibiting viral replication in the newborn. Bacitracin (A) and Erythromycin (B) are antibiotics that do not treat HIV. Protease inhibitors (C) are not typically used in newborns due to safety concerns and efficacy in preventing transmission.

Nurse Jones decides to go against family wishes and tell the client of his terminal status because that is what she would want if she were the client. Which of the following ethical theories is considered in this decision?

  • A. Kantianism
  • B. Christian ethics
  • C. Natural law theories
  • D. Ethical egoism
Correct Answer: A

Rationale: Nurse Jones bases her decision on what she would want in the client's position, reflecting a duty-based approach focused on universal moral principles, which aligns with Kantianism, option a.

Shaken baby syndrome refers to:

  • A. The increasing rate of epilepsy and other seizure disorders in infants born to mothers with a history of psychiatric disorders.
  • B. A form of child abuse in which a baby is shaken hard enough to cause trauma and death.
  • C. The physical and developmental problems faced by infants of drug-addicted mothers.
  • D. The psychological trauma that children experience from perceived threats to their safety.
Correct Answer: B

Rationale: Shaken baby syndrome occurs when a caregiver shakes a child to control crying. It is a form of child abuse.

An older adult with Lewy body dementia lives with family. After observing multiple bruises, the home health nurse talked with the daughter, who became defensive and said, My mother often wanders at night. Last night she fell down the stairs. Which nursing diagnosis has priority?

  • A. Risk for injury related to poor judgment, cognitive impairments, and inadequate supervision
  • B. Wandering related to confusion and disorientation as evidenced by sleepwalking and falls
  • C. Chronic confusion related to degenerative changes in brain tissue as evidenced by nighttime wandering
  • D. Insomnia related to sleep disruptions associated with cognitive impairment as evidenced by wandering at night
Correct Answer: A

Rationale: The patient is at high risk for injury because of her confusion. The risk increases when caregivers are unable to give constant supervision. Insomnia, chronic confusion, and wandering apply to this patient; however, the risk for injury is a higher priority.

How should physicians initiate conversations with patients who use complementary or alternative therapies?

  • A. In a frank but open manner
  • B. In a nonjudgmental manner
  • C. In a suspicious manner
  • D. In a curious manner
Correct Answer: B

Rationale: Nonjudgmental dialogue encourages openness and integrates CAM into care plans.

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