# Situation: The public health nurse makes a home visit to a family. The father, 58, a driver, has hypertension and smokes daily. The mother, 34, is 7 months pregnant with their third child. Their eldest child, who will start school next month, missed a scheduled vaccine dose and is underweight on growth monitoring. The household stores its water in uncovered drums near the kitchen. After the family lets the nurse into the home, which should the nurse do FIRST?

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=627033  
> language: ko  
> subject: Nursing Practice I — Community Health Nursing

## 문제

Situation: The public health nurse makes a home visit to a family. The father, 58, a driver, has hypertension and smokes daily. The mother, 34, is 7 months pregnant with their third child. Their eldest child, who will start school next month, missed a scheduled vaccine dose and is underweight on growth monitoring. The household stores its water in uncovered drums near the kitchen.

After the family lets the nurse into the home, which should the nurse do FIRST?

## 보기

1. Set up the public health bag on a lined table away from the children
2. Take the father's blood pressure while he is seated and rested
3. Check the water drums near the kitchen for mosquito larvae
4. Introduce herself and explain the purpose of the visit **✔ 정답**

**정답: 4**

## 해설

A home visit begins with the initiation phase: the nurse greets the family, introduces herself, states the purpose of the visit, builds rapport, and obtains consent. The nurse is a guest in the home, so assessment and care come only after this.

## 심화 해설

Home Visit Initiation Phase

A home visit is not a clinic encounter where the nurse controls the environment. In the community setting, the nurse is a guest in the family's private space, and the visit follows a structured sequence. The first step is the initiation phase, which includes greeting the family, introducing oneself, stating the purpose of the visit, building rapport, and obtaining consent before any assessment or intervention begins [1].

The nurse must establish a trusting relationship and obtain the family's permission before touching equipment, taking vital signs, or inspecting the household environment. This principle is foundational to community health nursing practice. The Ghanaian study on home visit challenges highlights that successful visits depend on the nurse's ability to engage the family respectfully from the moment of entry, as perceived intrusiveness or rushing into tasks can undermine cooperation [1].

| Option | Action | Why It Is Not First |
| --- | --- | --- |
| 1 | Set up the public health bag on a lined table away from children | This is part of the working phase. Preparing equipment before introducing oneself and explaining the visit would be presumptuous and may create anxiety or resistance. |
| 2 | Take the father's blood pressure while seated and rested | Assessment begins only after the initiation phase. The father's hypertension is a priority concern, but consent and rapport must come first. |
| 3 | Check the water drums near the kitchen for mosquito larvae | Environmental inspection is a core public health nursing task, but entering the kitchen area and examining household items without permission violates the family's autonomy and privacy. |
| 4 | Introduce herself and explain the purpose of the visit | Key point! This is the correct first action. It establishes the nurse's identity, clarifies the visit's intent, and sets the foundation for informed consent and cooperation. |

The initiation phase is not a formality. It is the mechanism by which the nurse transitions from being an outsider to a welcomed professional guest. The Korean home-visiting program experiences reinforce that standardized visits still require individualized, respectful entry into each home, as the family's acceptance of the nurse determines whether subsequent assessments and interventions can occur at all . The randomized controlled trial protocol for early childhood home visiting similarly assumes that the nurse's first task is to establish a working alliance with the family before delivering any health content .

In community health nursing, the sequence of the home visit is initiation, assessment, planning, intervention, and evaluation. Skipping the initiation phase compromises every subsequent step. The father's blood pressure, the uncovered water drums, and the underweight child are all important findings that the nurse will address, but only after the family has been properly greeted, informed, and given the opportunity to consent. The public health bag setup is a practical task that follows the same principle: the nurse must first be invited into the relational space of the home before occupying its physical space with equipment.

Watch out! In a clinical setting, assessment often precedes introductions because the patient has already consented to care by presenting to the facility. In the home, consent is not implied; it must be actively sought at the door. The nurse's role as a guest means that the family retains control over the visit's pace and scope until they choose to share that control.References (research sources)

- [1]Challenges of home visit practice and perceived solutions for improvement in Ghanaian context: perspectives of healthcare professional and community informants.Research articleOhene LA, Adjorlolo S, Chandi MG, Aryeetey C, Ansah-Ofei AM, Aikins M, Aziato L. (2026) · DOI: 10.1186/s12961-026-01461-w

## 임상 시나리오

Home Visit Initiation PhaseEnter as a guest, not as a clinician in control
The first step in any home visit is the initiation phase: greet the family, introduce yourself, state the purpose of the visit, build rapport, and obtain consent.

Only after consent is obtained should the nurse proceed to the working phase, which includes setting up equipment, taking vital signs, and inspecting the environment.

CautionRushing into tasks such as taking blood pressure or checking water drums before introductions can be perceived as intrusive and may undermine family cooperation.

## 핵심 개념

- **Initiation Phase** — The first phase of a home visit in which the nurse greets the family, introduces herself, states the purpose, builds rapport, and obtains consent.
- **Working Phase** — The phase of a home visit during which assessments, interventions, and environmental inspections are carried out after consent is obtained.
- **Rapport** — A trusting and respectful relationship established between the nurse and the family, essential for cooperation in community settings.
- **Consent** — Permission obtained from the family before any assessment, care, or inspection begins in the home environment.

## 같은 주제 문제

- [Situation: The public health nurse makes a home visit to a family. The father, 58, a drive…](https://mymerci.kr/pages/nclex_q.php?qn_id=627032)
- [Situation: The public health nurse at a Barangay Health Station (BHS) is assessing a newly…](https://mymerci.kr/pages/nclex_q.php?qn_id=627037)
- [Situation: The public health nurse at a Barangay Health Station (BHS) is assessing a newly…](https://mymerci.kr/pages/nclex_q.php?qn_id=627038)
- [Situation: The public health nurse at a Barangay Health Station (BHS) is assessing a newly…](https://mymerci.kr/pages/nclex_q.php?qn_id=627039)
- [Situation: The public health nurse at a Barangay Health Station (BHS) is assessing a newly…](https://mymerci.kr/pages/nclex_q.php?qn_id=627040)
- [Situation: The public health nurse of a Rural Health Unit (RHU) plans her week of contacts…](https://mymerci.kr/pages/nclex_q.php?qn_id=627041)
- [Situation: The public health nurse of a Rural Health Unit (RHU) plans her week of contacts…](https://mymerci.kr/pages/nclex_q.php?qn_id=627042)
- [Situation: The public health nurse of a Rural Health Unit (RHU) plans her week of contacts…](https://mymerci.kr/pages/nclex_q.php?qn_id=627043)

---

More free questions: [기출문제](https://mymerci.kr/)

_학습 참고용입니다. 실제 임상은 최신 지침과 소속 기관 프로토콜을 따르세요._