# Situation: The public health nurse follows up a family in an urban barangay. The son, 9, has cerebral palsy and uses a wheelchair; the house has two steps at the entrance and raised door thresholds. The mother, 36, is his only caregiver and also looks after a 2-year-old daughter. The father, 40, will leave next month to work abroad for 2 years. The nurse scores the father's departure to work abroad next month. She rates it as partially modifiable with moderate preventive potential; the family recognizes it as a problem but says it does not need immediate attention. What is the total score? Compute each criterion as (score ÷ highest possible score) × weight, and round off the total to two decimal places.

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=627144  
> language: ko  
> subject: Nursing Practice I — Community Health Nursing

## 문제

Situation: The public health nurse follows up a family in an urban barangay. The son, 9, has cerebral palsy and uses a wheelchair; the house has two steps at the entrance and raised door thresholds. The mother, 36, is his only caregiver and also looks after a 2-year-old daughter. The father, 40, will leave next month to work abroad for 2 years.

The nurse scores the father's departure to work abroad next month. She rates it as partially modifiable with moderate preventive potential; the family recognizes it as a problem but says it does not need immediate attention. What is the total score? Compute each criterion as (score ÷ highest possible score) × weight, and round off the total to two decimal places.

## 보기

1. 2.00
2. 2.50 **✔ 정답**
3. 2.83
4. 3.00

**정답: 2**

## 해설

An anticipated period of unusual demand, such as a parent leaving to work abroad, is a foreseeable crisis (stress point): nature 1/3 × 1 = 0.33. Modifiability is 1/2 × 2 = 1.00, preventive potential 2/3 × 1 = 0.67, and salience 1/2 × 1 = 0.50. Total: 0.33 + 1.00 + 0.67 + 0.50 = 2.50.

## 심화 해설

Scoring the Health Problem: Step-by-Step Computation

The scenario presents a foreseeable crisis — the father's departure abroad for two years — which the nurse must score using the family health problem prioritization tool. The scoring formula for each criterion is (score ÷ highest possible score) × weight, and the four criteria are nature, modifiability, preventive potential, and salience.

Criterion 1: Nature of the Problem

The father's departure is classified as a health threat or foreseeable crisis, not an actual deficit or current illness. In the standard scoring rubric, a foreseeable crisis receives a nature score of 1 out of a possible 3. The weight assigned to nature is 1. Therefore: (1 ÷ 3) × 1 = 0.33.

Criterion 2: Modifiability of the Problem

The problem is described as partially modifiable. In the scoring rubric, partial modifiability corresponds to a score of 1 out of a possible 2. The weight for modifiability is 2. Therefore: (1 ÷ 2) × 2 = 1.00.

Criterion 3: Preventive Potential

The nurse rates the preventive potential as moderate. A moderate preventive potential receives a score of 2 out of a possible 3. The weight for preventive potential is 1. Therefore: (2 ÷ 3) × 1 = 0.67.

Criterion 4: Salience

The family recognizes the father's departure as a problem but states it does not need immediate attention. This reflects a salience score of 1 out of a possible 2 — the family perceives the problem but does not see it as urgent. The weight for salience is 1. Therefore: (1 ÷ 2) × 1 = 0.50.

Total Score

Adding the weighted scores: 0.33 + 1.00 + 0.67 + 0.50 = 2.50. The total is already at two decimal places, so no further rounding is needed.

| Criterion | Score | Highest Possible | Weight | Computation | Weighted Score |
| --- | --- | --- | --- | --- | --- |
| Nature | 1 | 3 | 1 | (1 ÷ 3) × 1 | 0.33 |
| Modifiability | 1 | 2 | 2 | (1 ÷ 2) × 2 | 1.00 |
| Preventive potential | 2 | 3 | 1 | (2 ÷ 3) × 1 | 0.67 |
| Salience | 1 | 2 | 1 | (1 ÷ 2) × 1 | 0.50 |
| Total |  |  |  |  | 2.50 |

Key point! The weight for each criterion is not arbitrary — it reflects the relative importance of that criterion in determining the priority of a family health problem. Modifiability carries the heaviest weight (2) because a problem that the nurse and family can change is more actionable than one that is fixed. This is why a partially modifiable problem still contributes a full 1.00 to the total, even though its raw score is only 1 out of 2.

Watch out! Do not confuse salience with urgency. A family can recognize a problem (high salience) but still not feel it needs immediate action. In this case, the family acknowledges the father's departure but does not perceive it as requiring prompt intervention, which lowers the salience score to 1 out of 2.

The concept of family resilience is relevant here. Systematic reviews of family resilience assessment questionnaires emphasize that family functioning and coping capacity are measured within specific adversity domains, such as caregiving burden or major life transitions . The father's departure represents a transitional stressor that will alter the family's caregiving structure — the mother will become the sole caregiver for a child with cerebral palsy and a toddler. Instruments designed to assess family caregiver needs consistently identify anticipatory concerns about role strain and resource adequacy as central dimensions . The scoring of this problem as a foreseeable crisis with moderate preventive potential aligns with the understanding that family-level interventions can be planned before the departure, even though the event itself is not fully preventable.

The moderate preventive potential score (2 out of 3) reflects that while the father's departure cannot be stopped, the family can prepare for it — arranging additional caregiver support, modifying the home environment for wheelchair access, or connecting with community resources. This is distinct from a problem with high preventive potential, where early intervention could prevent the problem entirely, and from low preventive potential, where little can be done to alter the outcome.

## 임상 시나리오

Scoring a Foreseeable Family CrisisFather's departure abroad as a health threat
Classify the father's departure as a foreseeable crisis, not an actual deficit. Nature score is 1/3 × weight 1 = 0.33.

For partial modifiability, use 1/2 × weight 2 = 1.00. For moderate preventive potential, use 2/3 × weight 1 = 0.67.

When the family recognizes the problem but says it does not need immediate attention, salience is 1/2 × weight 1 = 0.50. Total = 0.33 + 1.00 + 0.67 + 0.50 = 2.50.

CautionDo not over-score salience as 2/2 or preventive potential as 3/3; the family's non-urgent perception and the moderate rating keep the total at 2.50, not higher.

## 핵심 개념

- **Foreseeable crisis** — An anticipated stressful event or period of unusual demand, such as a parent leaving to work abroad, scored as nature 1/3.
- **Modifiability** — The degree to which the family and nurse can change or control the problem; partial modifiability scores 1/2 with weight 2.
- **Preventive potential** — The likelihood that intervention can prevent or minimize future problems; moderate potential scores 2/3 with weight 1.
- **Salience** — The family's perception of the problem's importance and urgency; recognizing a problem but not needing immediate attention scores 1/2 with weight 1.
- **Weighted scoring** — Each criterion is computed as (score ÷ highest possible score) × weight, then summed for the total problem score.

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