Question 1

A family expresses helplessness related to dealing with a mentally ill member's odd behaviors, mood swings, and argumentativeness. An effective nursing intervention for this family would be to

Accepted Answer

Helping a family learn to set limits and deal with difficult behaviors can often be accomplished by using role-playing situations, which give family members the opportunity to try new, more effective approaches. The other options would not provide learning opportunities.

Question 2

A married couple has two children living in the home. Recently, the wife's mother moved in. This family should be assessed as

Accepted Answer

An extended family has members from three or more generations living together. Nuclear family refers to a couple and their children. A blended family is one made up of members from two or more unrelated families. An alternative family can consist of a same-sex couple or an unmarried couple and children.

Question 3

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

Accepted Answer

A blended family is made up of members from two or more unrelated families. It is not a nuclear family because a stepchild is present. It is not an extended family, because there are only two generations present. Homogeneous is not a family type.

Question 4

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

Accepted Answer

The correct option asks about use of resources in an open, direct fashion. It will give information about choices the family has made regarding use of resources in the community. The other questions do not address prior use of resources or focus on other aspects of coping.

Question 5

Parents of a teenager recently diagnosed with 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?

Accepted Answer

Interrupted family processes are evident in the face of disruptions in family functioning as a result of having a mentally ill member. Assessment data best support this diagnosis. Data are insufficient to support the other diagnoses.

Question 6

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?

Accepted Answer

Caregiver role strain refers to a caregiver's felt or exhibited difficulty in performing a family caregiver role. In this case, one parent exhibits stress-related illness and the other exhibits increased anxiety. The other nursing diagnoses are not substantiated by the information given and are incorrectly formatted (one nursing diagnosis should not be the etiology for another).

Question 7

When a nurse assesses a family, which family task has the highest priority for healthy family functioning?

Accepted Answer

Physical and safety needs have greater importance in Maslow's hierarchy than other needs.

Question 8

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

Accepted Answer

Healthy families nurture and support their members, buffer against stress, and provide stability and cohesion. The distracters are unrelated or incorrect.

Question 9

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

Accepted Answer

It is important to understand family characteristics, particularly in a family under stress. Expression of feelings is an important aspect of assessment of the family's function (or dysfunction). The distracters relate more to outcome identification and planning interventions, both of which should be delayed until the assessment is complete.

Question 10

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.

Accepted Answer

The need for support is evident. Referrals are made when working with families whose needs are unmet. A support group will provide the parents with support of others with similar experiences and with whom they can share feelings and experiences. The distracters are less relevant to providing a network of support.

Question 11

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

Accepted Answer

The correct option is the only statement addressing coping strategies used by the family. The distracters seek opinions or use closed-ended communication techniques.

Question 12

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

Accepted Answer

Interactions among all family members are the raw material for family problem solving. By observing interactions, the nurse can help the family make its own assessments of strengths and deficits. The other options are narrower in scope when compared with the correct option.

Question 13

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

Accepted Answer

The identity of the members of the family is the most fundamental information and should be obtained first. Without this, the nurse cannot fully process the other responses.

Question 14

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?

Accepted Answer

Disabled family coping refers to the behavior of a significant family member that disables his or her own capacity as well as another's capacity to perform tasks essential to adaptation. The distracters are inaccurate because the stressors influence more than one individual.

Question 15

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

Accepted Answer

The newly formed family will be coping with tasks associated with the stage of rearing preschool children and teenagers. These stages require different knowledge and skills. There is no evidence of a problem, so the distracters are not indicated.

Question 16

Parents of a teenager recently diagnosed with 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

Accepted Answer

The parents comment suggests they are experiencing grief, a common reaction to having a family member diagnosed with mental illness. The grief stems from actual or potential losses, such as the family's ability to function, financial well-being, and altered future. Supporting the parents' acceptance of the patient's illness will enhance coping. Data do not support choosing any of the other options.

Question 17

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.

Accepted Answer

Desired outcomes might be set for the family as a whole or for individuals within the family. The outcome most closely associated with the anxiety that each member is experiencing is to focus on identifying and describing ways of coping with the anxiety. The other options are not appropriate at this time.

Question 18

Which scenario best illustrates scapegoating within a family?

Accepted Answer

Scapegoating projects blame for family problems onto a member who is less powerful. The purpose of this projection is to distract from issues or dysfunctional behaviors in the members of the family.

Question 19

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

Accepted Answer

The information almost universally obtained is that the family is under stress associated with having a mentally ill member. This stress lowers the family's level of functioning in at least one significant way. Stress does not necessarily mean the family has become dysfunctional.

Question 20

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.

Accepted Answer

The identified patient usually bears most of the family system's anxiety and may have come to the attention of parents, teachers, or law enforcement because of poor coping skills. The correct response helps the family understand that the opinions of each will be valued. It allows the nurse to assess individual coping and prepares the family for the experience of working together to set goals and solve problems. The other responses are either incorrect or evasive.

Quiz 35: Family Interventions