Deck 34: Family Interventions

Question 1

An adult recently diagnosed with AIDS is hospitalized with pneumonia. The patient and family are very anxious. Select the best outcome to add to the plan of care for this family.

A) Describe the stages of the anticipatory grieving process.
B) Identify and describe effective methods for coping with anxiety.
C) Recognize ways dysfunctional communication is expressed in the family.
D) Examine previously unexpressed feelings related to the patient's sexuality.

Answer 1

Identify and describe effective methods for coping with anxiety.

Question 2

Select the best question for the nurse to ask to assess a family's ability to cope.

A) "What strengths does your family have?"
B) "Do you think your family copes effectively?"
C) "Describe how you successfully handled one family problem."
D) "How do you think the current family problem should be resolved?"

Answer 2

"Describe how you successfully handled one family problem."

Question 3

Parents of a teenager recently diagnosed with a serious mental illness express dismay. One parent says, "Our hopes for our child's future are ruined. We probably won't ever have grandchildren." The nurse will use interventions to assist with which of the following?

A) Denial
B) Grieving
C) Acting out
D) Manipulation

Answer 3

Grieving

Question 4

Parents of a teenager recently diagnosed with a serious mental illness express dismay. One parent says, "Our child acts so strangely that we don't invite friends to our home. We quit taking vacations. Sometimes we don't get any sleep." Which nursing diagnosis best applies?

A) Impaired parenting
B) Dysfunctional grieving
C) Impaired social interaction
D) Interrupted family processes

Question 5

A family expresses helplessness related to dealing with a mentally ill member's odd behaviours, mood swings, and argumentativeness. Which of the following would be an effective nursing intervention for this family?

A) To express sympathy for their situation
B) To involve local social service agencies
C) To explain symptoms of relapse
D) To role-play difficult situations

Question 6

A parent became unemployed 6 months ago. The parent has subsequently been verbally abusive toward the spouse and oldest child. The child ran away twice, and the spouse has become depressed. What is the most appropriate nursing diagnosis for this family?

A) Impaired parenting related to verbal abuse of oldest child
B) Impaired social interaction related to disruption of family bonds
C) Ineffective community coping related to fears about economic stability
D) Interrupted family processes related to insecurity secondary to loss of family income

Question 7

A married couple has two biological children who live with them, as well as a child from the wife's first marriage. What type of family is evident?

A) Homogeneous
B) Extended
C) Blended
D) Nuclear

Question 8

A 15-year-old is hospitalized after a suicide attempt. This adolescent lives with her mother, stepfather, and several siblings. When performing a family assessment, which of the following must the nurse first determine?

A) How the family expresses and manages emotion
B) Names and relationships of the family's members
C) The communication patterns between the patient and parents
D) The meaning that the patient's suicide attempt has for family members

Question 9

A married couple has two children living in the home. Recently, the wife's mother moved in. They should be assessed as which type of family?

A) Nuclear
B) Blended
C) Extended
D) Alternative

Question 10

When a nurse assesses a family, which family function is the highest priority?

A) Allocation of family resources
B) Physical maintenance and safety
C) Maintenance of order and authority
D) Reproduction of new family members

Question 11

A parent is admitted to a chemical dependency treatment unit. The patient's spouse and adolescent children participate in a family session. What is the most important aspect of this family's assessment?

A) Spouse's codependent behaviours
B) Interactions among family members
C) Patient's reaction to the family's anger
D) Children's responses to the family sessions

Question 12

Parents of a mentally ill teenager say, "We have never known anyone who was mentally ill. We have no one to talk to because none of our friends understand the problems we are facing." Select the nurse's most helpful intervention.

A) Refer the parents to a support group.
B) Build the parents' self-concept as coping parents.
C) Teach the parents techniques of therapeutic communication.
D) Facilitate achievement of normal developmental tasks of the family.

Question 13

Which information is the nurse most likely to find when assessing the family of a patient with a serious mental illness?

A) The family exhibits many characteristics of dysfunctional families.
B) Several family members have serious problems with their physical and emotional health.
C) Power in the family is maintained in the parental dyad and rarely delegated.
D) Stress from growing up with a mentally ill parent has contributed to a young adult's emotional health problems.

Question 14

A parent is admitted to a chemical dependency treatment unit. The patient's spouse and adolescent children attend a family session. Which initial assessment question should the nurse ask of family members?

A) "What changes are most important to you?"
B) "How are feelings expressed in your family?"
C) "What types of family education would benefit your family?"
D) "Can you identify a long-term goal for improved functioning?"

Question 15

A nurse interviews a homeless parent with two teenage children. To best assess the family's use of resources, which of the following should the nurse ask?

A) "Can you describe a problem your family has successfully resolved?"
B) "What community agencies have you found helpful in the past?"
C) "What aspect of being homeless is most frightening for you?"
D) "Do you feel you have adequate resources to survive?"

Question 16

Two divorced people plan to marry. The man has a teenager, and the woman has a toddler. This family will benefit most from which of the following?

A) Role-playing opportunities for conflict resolution regarding discipline
B) Guidance about parenting children at two developmental levels
C) Formal teaching about problem-solving skills
D) Referral to a family therapist

Question 17

An adult diagnosed with schizophrenia lives with elderly parents. The patient was recently hospitalized with acute psychosis. One parent is very anxious, and the other is ill because of the stress. Which nursing diagnosis is most applicable to this scenario?

A) Ineffective family coping related to parental role conflict
B) Caregiver role strain related to the stress of chronic illness
C) Impaired parenting related to patient's repeated hospitalizations
D) Interrupted family processes related to relapse of acute psychosis

Question 18

Which finding of family assessment indicates a healthy and functional family?

A) Members provide nurturance
B) Power is distributed equally among all members
C) Members believe there are specific causes for events
D) Under stress, members turn inward and become enmeshed

Question 19

The parent of an adolescent diagnosed with mental illness asks the nurse, "Why do you want to do a family assessment? My teenager is the patient, not the rest of us." Select the nurse's best response.

A) "Family dysfunction might have caused the mental illness."
B) "Family members provide more accurate information than the patient."
C) "Family assessment is part of the protocol for care of all patients with mental illness."
D) "Every family member's perception of events is different and adds to the total picture."

Question 20

Which scenario best illustrates scapegoating within a family?

A) The identified patient sends messages of aggression to selected family members.
B) Family members project problems of the family onto one particular family member.
C) The identified patient threatens separation from the family to induce feelings of isolation and despair.
D) Family members give the identified patient nonverbal messages that conflict with verbal messages.

Question 21

Which example of behaviour in a family system demonstrates double-bind communication?

A) A mother tells her daughter, "You make me so mad that sometimes I wish I had never had you."
B) A teenager tells her father, "You are treating me like a baby when you tell me I must be home by 10 p.m. on a school night."
C) A son tells his mother, "You worry too much about what might happen. Nothing has happened yet, so why worry?"
D) A wife tells her husband, "You go ahead with your bowling trip. Try not to worry about me falling on my crutches while I'm alone at home."

Question 22

Which scenario best demonstrates a healthy family?

A) One parent takes care of the children. The other parent earns income and maintains the home.
B) A family has strict boundaries that require members to address problems within the family.
C) A couple requires their adolescent children to attend church services three times a week.
D) A couple renews their marital relationship after their children become adults.

Question 23

A parent was recently hospitalized with severe depression. Family members say, "We're falling apart. Nobody knows what to expect, who should make decisions, or how to keep the family together." Which interventions should the nurse use when working with this family?

A) Help the family set realistic expectations.
B) Provide empathy, acceptance, and support.
C) Empower the family by teaching problem solving.
D) Negotiate role flexibility amongst family members.
E) Focus planning on the family rather than on the patient.

Question 24

Which situations are most likely to place severe, disabling stress on a family?

A) A parent needs long-term care after sustaining a severe brain injury.
B) The youngest child in a family leaves for college in another state.
C) A spouse is diagnosed with liver failure and needs a transplant.
D) Parents of three children, aged 9, 7, and 2 years, get a divorce.
E) A parent retires after working at the same job for 28 years.

Question 25

A wife believes her husband is having an affair. Lately, he has been disinterested in romance and has been working late. The husband has an important, demanding project at work. The mother asks her teen, "What have you noticed about your father?" The teen later mentions this to the father, who says, "Tell your mother that I can't deal with her insecurities right now." Which family dynamic is evident?

A) Multigenerational dysfunction
B) Triangulation
C) Enmeshment
D) Blaming

Question 26

A parent says, "My son and I argue constantly since he started using drugs. When I talk to him about not using drugs, he tells me to stay out of his business." What is the nurse's most appropriate first action?

A) Educate the parent about stages of family development.
B) Report the son to law enforcement authorities.
C) Refer the son for substance abuse treatment.
D) Make a referral for family therapy.

Question 27

Which comment by a mother during a family therapy session shows evidence of scapegoating?

A) "Our youngest child always starts arguments and upsets everyone else."
B) "We all express our feelings openly, except when we think it might upset my husband."
C) "Our oldest child knows that my husband and I are doing all we can for the others."
D) "After my husband has been drinking, I have to get everyone up and ready for school."

Question 28

A 16-year-old wants to drive, but the parents will not allow it. The 14-year-old sibling was invited to several sleepovers, but the parents found reasons to deny permission. Both teens are annoyed because the parents buy clothes for them that are more suitable for younger children. The parents say, "We don't want our kids to grow up too fast." Which term best describes this family's boundaries?

A) Rigid
B) Clear
C) Enmeshed
D) Differentiated