Core Assessment of the Father’s Statement
The father’s words reveal two distinct cognitive steps. First, he says, “I know high blood pressure can lead to a stroke.” This shows that
problem recognition is intact — he correctly identifies hypertension as a health threat and understands a serious potential consequence. Second, he explains why he stopped the medication: “my neighbor told me these tablets will destroy my kidneys.” This is the pivotal clue. He is not ignoring the problem; he is acting on
misinformation about the treatment itself.
In family nursing, the relevant typology asks whether the family can
decide on a health action that is appropriate to the recognized problem. The father made a decision — to stop the antihypertensive — but that decision was based on a false belief about medication harm. Therefore, the deficit is not in recognizing the condition, but in
choosing a correct health action when faced with conflicting lay advice. This directly supports the family nursing problem of
inability to make decisions about appropriate health action.
Watch out! Do not select “inability to recognize the presence of the health problem.” The father explicitly names hypertension and its stroke risk, so recognition is present. The failure occurs one step later, at the decision-making stage.
Key point! A family can recognize a problem yet still choose an inappropriate action because of cultural beliefs, fear of side effects, or advice from non-professionals. The nurse must first correct the misconception before any other intervention can succeed.
Why the Other Options Do Not Fit
| Option | Why It Is Incorrect Here |
|---|
| 1. Inability to provide nursing care to the sick member | This refers to a family’s inability to carry out prescribed care tasks, such as wound care or feeding. The father is not failing to perform a care procedure; he is refusing a medication based on a false belief. |
| 2. Inability to use community resources for health care | This would apply if the family did not know how to access a health center, schedule a visit, or obtain medications. The father already has a prescription and previously took the medicine, so resource access is not the barrier. |
| 4. Inability to recognize the presence of the health problem | The father states he knows hypertension can lead to stroke. Recognition is clearly present, making this option incompatible with the scenario. |
Decision-Making as a Distinct Family Nursing Competency
The distinction between
recognition and
decision-making matters because each requires a different nursing response. If the family cannot recognize the problem, the nurse focuses on health teaching about signs, symptoms, and risks. If the family recognizes the problem but cannot decide on an appropriate action, the nurse must address
beliefs, fears, and sources of misinformation that block sound judgment.
In this case, the father’s decision is shaped by a
lay referral system — the neighbor’s warning about kidney damage. The Health Belief Model helps explain this: the father perceives a
barrier to taking the medication (fear of kidney harm) that outweighs his
perceived benefit of stroke prevention. Even though he knows hypertension is dangerous, the perceived cost of treatment feels more immediate and concrete. This is a classic barrier-benefit imbalance that impairs appropriate health action.
The priority nursing intervention is to correct the misconception about antihypertensive medications and kidney function, using clear, evidence-based information. Only after the father can weigh the true risks and benefits can he make an informed decision to resume treatment. The nurse may also explore what specifically the neighbor said, validate the father’s concern, and provide accurate teaching about how antihypertensives are monitored for kidney safety — which can reduce the perceived barrier without dismissing his fear.
Clinical Application for the Home Visit
During the visit, the nurse should first acknowledge the father’s awareness of his condition and his stroke risk. Then the nurse can gently ask about the neighbor’s advice and explore the father’s understanding of how blood pressure medications work. The teaching should emphasize that
uncontrolled hypertension is a far greater threat to kidney function than properly monitored antihypertensive therapy. This reframes the risk perception and supports a return to appropriate health action. The nurse can also involve the mother, who is pregnant and may share similar concerns, to strengthen family-level decision-making.