# 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. The father stopped his maintenance medicine last month. He says, "I know high blood pressure can lead to a stroke, but my neighbor told me these tablets will destroy my kidneys, so I stopped them." Which family nursing problem does this statement BEST support?

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=627035  
> 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.

The father stopped his maintenance medicine last month. He says, "I know high blood pressure can lead to a stroke, but my neighbor told me these tablets will destroy my kidneys, so I stopped them." Which family nursing problem does this statement BEST support?

## 보기

1. Inability to provide nursing care to the sick member
2. Inability to use community resources for health care
3. Inability to make decisions about appropriate health action **✔ 정답**
4. Inability to recognize the presence of the health problem

**정답: 3**

## 해설

The father recognizes his hypertension and its danger, so recognition is intact. He stopped treatment because of wrong information about the medicine, which is a failure to decide on appropriate health action. Correcting the misconception is the priority before care or use of resources can follow.

## 심화 해설

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.

## 임상 시나리오

Decision-Making in Family NursingWhen recognition is intact but action is wrong
The father recognizes hypertension and its risk of stroke, so problem recognition is present. His deficit is at the next step: choosing an appropriate health action. He stopped the medicine based on a neighbor's false claim about kidney damage.

The correct family nursing problem is inability to make decisions about appropriate health action. The priority intervention is to correct the misconception about antihypertensive medication before addressing care provision or resource use.

CautionDo not choose inability to recognize the health problem. The father explicitly names hypertension and its danger, so recognition is intact. The failure occurs one step later, at decision-making.

## 핵심 개념

- **Family nursing problem** — A deficit in the family's ability to perform health tasks, such as recognizing problems, deciding on actions, providing care, or using resources.
- **Inability to make decisions about appropriate health action** — Failure to choose a correct health action for a recognized problem, often due to misinformation, cultural beliefs, or fear of side effects.
- **Health belief** — A personal or cultural conviction about health, illness, or treatment that influences health behaviors and decisions.
- **Medication adherence** — The extent to which a patient follows prescribed medication regimens, often affected by beliefs about side effects and efficacy.

## 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=627034)
- [Situation: The public health nurse visits a family of six in a farming barangay. The grand…](https://mymerci.kr/pages/nclex_q.php?qn_id=627045)
- [Situation: The public health nurse visits a family of six in a farming barangay. The grand…](https://mymerci.kr/pages/nclex_q.php?qn_id=627046)
- [Situation: The public health nurse visits a family of six in a farming barangay. The grand…](https://mymerci.kr/pages/nclex_q.php?qn_id=627047)
- [Situation: The public health nurse visits a family of six in a farming barangay. The grand…](https://mymerci.kr/pages/nclex_q.php?qn_id=627048)
- [Situation: The public health nurse visits a family of six in a farming barangay. The grand…](https://mymerci.kr/pages/nclex_q.php?qn_id=627049)
- [Situation: During a follow-up home visit, the nurse learns that the father, 38, lost his j…](https://mymerci.kr/pages/nclex_q.php?qn_id=627050)
- [Situation: During a follow-up home visit, the nurse learns that the father, 38, lost his j…](https://mymerci.kr/pages/nclex_q.php?qn_id=627051)

---

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

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