Community-based nursing: Katie and Monica case guide
Three case-study questions on a family receiving community care: identify the social determinants of health affecting Katie, a severely disabled 17-year-old, and her mother Monica; identify the resources the family needs; and explain how you would help them envision a new family structure as the two older siblings move out.
Editorial process
Last reviewed · August 12, 2026
Why does the case give you a family instead of a patient?
The case gives you a family, not a patient, and the questions are constructed to make sure you notice. You are managing care for Katie, and the brief tells you in the same sentence that you are also providing care to Monica — so the unit of care is the household, and an answer organised around Katie's cerebral palsy will miss most of what the case contains. Read the detail as a family system: Monica has cardiac disease and all three of her siblings died in their late fifties; she cannot work and is on public insurance; Katie is on a separate state programme; Josh and Marilyn both have cardiac disease, live at home, are in college and manage it with diet and exercise. Every one of those facts belongs to somebody's health and to the family's capacity at the same time, which is what makes it a community nursing case rather than a paediatric one.
Question one names social determinants of health and points you at a definition, which means the answer should use the framework's categories rather than listing the family's troubles. Economic stability is obvious here. Health care access and quality is a live issue because two different insurance programmes cover two members of the same household. Education access appears twice over, in Katie's entitlement to special education until twenty-one and in the two siblings currently in college. Social and community context is visible in the great-grandparents' limited capacity. Neighbourhood and built environment barely appears in the case at all, and saying so is a legitimate answer — a determinant the record is silent about is a gap in the assessment, and naming it is better than inventing detail to fill the category. It also tells the marker you applied the framework rather than reverse-engineered it from the story.
The third question is the one that separates competent answers from good ones, because it is not a resource question. Josh and Marilyn moving out is a developmental transition for the family, and it removes two people who are currently, whether or not anyone has said so, part of Monica's care capacity. Envisioning the new structure means working through what happens to the tasks they absorb, what Monica's own cardiac risk means for a household about to lose two adults, and how Katie's approaching transition out of school-based services at twenty-one intersects with the same period. Answer it as anticipatory planning done with the family rather than as advice delivered to them, and name the conversation you would actually have and who would be in the room for it. Monica is encouraging the move, which tells you the plan has her support and not yet her preparation.
Likely learning objectives
Inferred from the brief — check these against your own rubric.
- 01Assess a household rather than an individual when care is delivered in the community.
- 02Apply the social determinants framework's categories rather than listing problems.
- 03Identify a determinant the case record is silent about, and treat the silence as a finding.
- 04Recognise a family transition as a change in care capacity.
- 05Plan anticipatorily with a family rather than advising them.
Read the full question
Review every instruction before using the planning guidance that follows.
Turn the brief into deliverables
- 01An identification of social determinants of health for this family, using the CDC definitions the brief supplies.
- 02The resources you would need to identify for the family.
- 03An explanation of how you would help the family envision its new structure as Josh and Marilyn move out.
Determinants, resources, and the transition nobody has planned for
Frame the unit of care
State in one or two sentences that the household is the unit, and why the case makes that necessary.
Economic stability and health care access
Monica's inability to work, public insurance, Katie's separate state programme, and what the split means in practice.
Education and social context
Katie's entitlement to special education until twenty-one, and the siblings in college, as determinants working in both directions.
What the case does not say
Name the determinant categories the record leaves blank, and say what you would need to ask.
Resources, matched
Identify the resources the family needs, each attached to a determinant named above.
The transition
Work through what the siblings' departure changes for care capacity, for Monica's own health risk, and for Katie's approaching change in services.
Where the determinants framework and the entitlements are defined
Recommended databases
- CDC social determinants definitions
- Healthy People 2030
- IDEA, US Department of Education
- NCBI Bookshelf
Search sequence
- 1.Read the determinant definitions first and use their category names as your headings.
- 2.Check what happens to educational entitlement at twenty-one, since the case flags the age explicitly.
- 3.Look up what transition planning is required for young people leaving school-based services.
- 4.Find one source on family caregiving capacity to support the third answer.
Reference shortlist
These are authoritative starting points, not a ready-made bibliography. A qualified reviewer must confirm that each source fits the assignment and supports the claim beside which it is cited.
Nothing here is cleared for citation until you have read it.
- 01
Social Determinants of Health
Healthy People 2030, odphp.health.gov · 2024
The five-domain framework whose category names should structure the first answer, and the closest current equivalent of the CDC definitions the brief links to.
- 02
Eligibility Criteria (IDEA Part C)
Individuals with Disabilities Education Act, US Department of Education · 2024
The entitlement structure behind Katie's special education services, and the reason age twenty-one is a cliff rather than a milestone.
- 03
Communities in Action: Pathways to Health Equity
National Academies, NCBI Bookshelf · 2017
The mechanisms linking economic and social conditions to health outcomes, which is what turns a list of the family's difficulties into an assessment.
- 04
Advanced Practice Registered Nurse Roles
StatPearls, NCBI Bookshelf · 2023
Scope and referral boundaries for community nursing, useful for saying which resources you would identify yourself and which need another discipline.
Review before submission
Common mistakes
- Organising the answer around Katie's diagnosis when the brief names Monica as a recipient of care too.
- Listing the family's difficulties instead of mapping them onto determinant categories.
- Inventing neighbourhood detail the case does not contain, rather than noting the gap.
- Answering question three as a second resource list.
- Overlooking Katie's education entitlement ending at twenty-one, which is the other transition running in parallel.
- Treating Monica's cardiac history as background rather than as a determinant of the family's capacity.
- Giving the family advice rather than describing a planning conversation with them.
Submission checklist
- Both Katie and Monica are treated as recipients of care.
- Determinants are named using the framework's categories, with the case detail attached to each.
- At least one category the case is silent about is identified as a gap.
- Resources are matched to determinants already identified.
- The insurance split between Katie and Monica is addressed.
- Question three addresses care capacity, not just emotional adjustment.
- Katie's transition out of school-based services is connected to the siblings' departure.
- The answer describes a conversation with the family rather than instructions to them.
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Written by
Aaron Bishop
MA, Education
assignment interpretation and research-methods coaching across disciplines
Aaron leads the EssayCrackers editorial desk. He works on how assignment briefs are read — what a rubric is actually asking for, and where students most often answer a different question than the one set.
Reviewed by
Dr. Nathan Cole
PhD, Rhetoric & Composition
Argumentation and thesis development
Nathan teaches first-year composition and directs a university writing center. He reviews EssayCrackers guides for argumentative soundness and citation accuracy.