# Situation: The public health nurse visits a family in which the grandfather, 76, has type 2 diabetes with blood sugar that stays high and was recently found to have early dementia. His wife, 70, cares for him and is scheduled for cataract surgery next month. Their son, 45, who lives with them, collects the grandfather's monthly pension. The house has loose rugs and a dimly lit stairway, and the grandfather fell once last month. In the first-level assessment, which condition in this family is a FORESEEABLE CRISIS?

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=627242  
> language: ko  
> subject: Nursing Practice I — Community Health Nursing

## 문제

Situation: The public health nurse visits a family in which the grandfather, 76, has type 2 diabetes with blood sugar that stays high and was recently found to have early dementia. His wife, 70, cares for him and is scheduled for cataract surgery next month. Their son, 45, who lives with them, collects the grandfather's monthly pension. The house has loose rugs and a dimly lit stairway, and the grandfather fell once last month.

In the first-level assessment, which condition in this family is a FORESEEABLE CRISIS?

## 보기

1. The loose rugs and the dimly lit stairway
2. The wife's cataract surgery next month **✔ 정답**
3. The grandfather's persistently high blood sugar
4. The grandfather's recently found early dementia

**정답: 2**

## 해설

A foreseeable crisis (stress point) is an anticipated period of unusual demand on the family, such as a hospitalization. The wife's surgery will take the main caregiver away for a time. Home hazards are health threats, while uncontrolled diabetes and dementia are health deficits already present.

## 심화 해설

Three types of family health problems
In the first-level assessment of the family nursing care plan, problems are classified by nature into health threats, health deficits, and foreseeable crises (stress points). A health threat is a condition that favors disease, injury, or failure to reach health potential, such as hazards in the home. A health deficit is an instance of failure in health maintenance already present, such as illness or disability. A foreseeable crisis is an anticipated period of unusual demand on the family, for which it must adjust its resources. The wife's cataract surgery next month will take the main caregiver away for a time, so it is a foreseeable crisis.

Why the surgery fits
The wife is the grandfather's caregiver. While she is in surgery and recovering, she will be unable to supervise his diabetes management, watch over him for falls, or manage his medicines. The family must plan in advance: who will care for the grandfather, how his meals and medicines will be handled, and how she herself will be supported after surgery. Other typical foreseeable crises include pregnancy, a birth, school entry, marriage, retirement, a planned move, and death of a member.

| Condition in this family | Type of problem |
| --- | --- |
| Loose rugs and dim stairway | Health threat (accident hazard) |
| Persistently high blood sugar | Health deficit (illness present) |
| Early dementia | Health deficit (illness present) |
| Wife's cataract surgery next month | Foreseeable crisis (stress point) |

Why the other options are not foreseeable crises
Loose rugs and a dimly lit stairway are health threats: they favor accidents, and the grandfather has already fallen once. The persistently high blood sugar and the recently diagnosed dementia are health deficits, conditions already present. Watch out! The word "recently" in the dementia option may suggest an emerging crisis, but a diagnosed illness is a deficit. A foreseeable crisis is an event yet to come that will strain the family.

Exam takeaway
Ask whether the condition favors future harm (threat), is already present (deficit), or is an anticipated event that will strain the family (foreseeable crisis). For this family, the nurse plans with them before the surgery: identifying another caregiver such as the son, arranging diabetes monitoring and fall prevention, and preparing the wife for her own recovery. Anticipatory planning lessens the crisis when it comes.

## 임상 시나리오

First-Level AssessmentRecognizing a foreseeable crisis
Health threat: a condition that favors disease or injury, such as loose rugs and a dim stairway.

Health deficit: a problem already present, such as uncontrolled diabetes or diagnosed dementia.

Foreseeable crisis: an anticipated period of unusual demand, such as the caregiver's cataract surgery next month.

CautionDo not label a recently diagnosed illness a crisis; it is a health deficit already present.

## 핵심 개념

- **First-level assessment** — The step of family nursing assessment that identifies health threats, deficits, and foreseeable crises.
- **Foreseeable crisis** — An anticipated period of unusual demand on a family, also called a stress point.
- **Health threat** — A condition that favors disease, injury, or failure to reach full health potential.
- **Health deficit** — An instance of failure in health maintenance already present, such as illness or disability.

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