Question 1

A nurse is caring for a preschool-age client who was admitted for dehydration.The child lives with the parents and maternal grandparents.In which type of family does this child reside?&#10;A) Blended family&#10;B) Extended&#10;C) Two-career family&#10;D) Traditional family

Accepted Answer

A) In some cultures and as people live longer, more than two generations may live together in an extended setting. A two-career family is one where both partners are employed. A blended family occurs when existing family units join together to form new families. A traditional family is viewed as an autonomous unit in which both parents reside in the home.
B) In some cultures and as people live longer, more than two generations may live together in an extended setting. A two-career family is one where both partners are employed. A blended family occurs when existing family units join together to form new families. A traditional family is viewed as an autonomous unit in which both parents reside in the home.
C) In some cultures and as people live longer, more than two generations may live together in an extended setting. A two-career family is one where both partners are employed. A blended family occurs when existing family units join together to form new families. A traditional family is viewed as an autonomous unit in which both parents reside in the home.
D) In some cultures and as people live longer, more than two generations may live together in an extended setting. A two-career family is one where both partners are employed. A blended family occurs when existing family units join together to form new families. A traditional family is viewed as an autonomous unit in which both parents reside in the home.

Question 2

A client with a bipolar disorder arrives at the emergency department disheveled,arguing with family members.The nurse recognizes that the family is suffering from an objective family burden.To which is this burden related?

A) The client's symptomatic behaviors
B) Family conflict
C) Anger
D) Caregiving problems

Accepted Answer

A) The objective family burden is related to the actual, identifiable family problems associated with an individual's mental illness. One burden the family must manage relates to symptomatic behaviors. Deficit behaviors of their loved ones-such as lack of motivation, difficulty in completing tasks, isolation from others, inability to manage money, poor grooming and personal care, and poor eating and sleeping behavior-can be of great concern to families. Intrusive or acting-out behaviors-such as lack of consideration for others, excessive arguing, conflicts with neighbors and friends, damaging material possessions, inappropriate sexual behavior, suicide attempts, substance abuse, and violent outbursts-are very disturbing to family members. The family may be experiencing caregiving problems, fear, or family conflict, but these arise from the client's symptomatic behaviors.
B) The objective family burden is related to the actual, identifiable family problems associated with an individual's mental illness. One burden the family must manage relates to symptomatic behaviors. Deficit behaviors of their loved ones-such as lack of motivation, difficulty in completing tasks, isolation from others, inability to manage money, poor grooming and personal care, and poor eating and sleeping behavior-can be of great concern to families. Intrusive or acting-out behaviors-such as lack of consideration for others, excessive arguing, conflicts with neighbors and friends, damaging material possessions, inappropriate sexual behavior, suicide attempts, substance abuse, and violent outbursts-are very disturbing to family members. The family may be experiencing caregiving problems, fear, or family conflict, but these arise from the client's symptomatic behaviors.
C) The objective family burden is related to the actual, identifiable family problems associated with an individual's mental illness. One burden the family must manage relates to symptomatic behaviors. Deficit behaviors of their loved ones-such as lack of motivation, difficulty in completing tasks, isolation from others, inability to manage money, poor grooming and personal care, and poor eating and sleeping behavior-can be of great concern to families. Intrusive or acting-out behaviors-such as lack of consideration for others, excessive arguing, conflicts with neighbors and friends, damaging material possessions, inappropriate sexual behavior, suicide attempts, substance abuse, and violent outbursts-are very disturbing to family members. The family may be experiencing caregiving problems, fear, or family conflict, but these arise from the client's symptomatic behaviors.
D) The objective family burden is related to the actual, identifiable family problems associated with an individual's mental illness. One burden the family must manage relates to symptomatic behaviors. Deficit behaviors of their loved ones-such as lack of motivation, difficulty in completing tasks, isolation from others, inability to manage money, poor grooming and personal care, and poor eating and sleeping behavior-can be of great concern to families. Intrusive or acting-out behaviors-such as lack of consideration for others, excessive arguing, conflicts with neighbors and friends, damaging material possessions, inappropriate sexual behavior, suicide attempts, substance abuse, and violent outbursts-are very disturbing to family members. The family may be experiencing caregiving problems, fear, or family conflict, but these arise from the client's symptomatic behaviors.

Question 3

A client being treated for newly diagnosed schizophrenia will be discharged to the family home.The family is developing an image of the disease process and expectations of mental health professionals and has reached Stage 2 of family recovery.Which concepts are included in this stage of recovery? Select all that apply.

A) Coping
B) Problem solving
C) Acceptance
D) Recognition
E) Personal and political advocacy

Problem solving
Acceptance
Recognition

Accepted Answer

A) Stage 2 of family recovery is one of recognition and acceptance. As it becomes more evident that there is a significant problem, the family begins to search for reasons and solutions by gathering available information. Families begin to develop their own image of the disease process and expectations of mental health professionals. Many families also hope for what was in the past and for what might be in the future. Personal and political advocacy occurs in the final stage of recovery. Coping and competence occur in Stage 3.
B) Stage 2 of family recovery is one of recognition and acceptance. As it becomes more evident that there is a significant problem, the family begins to search for reasons and solutions by gathering available information. Families begin to develop their own image of the disease process and expectations of mental health professionals. Many families also hope for what was in the past and for what might be in the future. Personal and political advocacy occurs in the final stage of recovery. Coping and competence occur in Stage 3.
C) Stage 2 of family recovery is one of recognition and acceptance. As it becomes more evident that there is a significant problem, the family begins to search for reasons and solutions by gathering available information. Families begin to develop their own image of the disease process and expectations of mental health professionals. Many families also hope for what was in the past and for what might be in the future. Personal and political advocacy occurs in the final stage of recovery. Coping and competence occur in Stage 3.
D) Stage 2 of family recovery is one of recognition and acceptance. As it becomes more evident that there is a significant problem, the family begins to search for reasons and solutions by gathering available information. Families begin to develop their own image of the disease process and expectations of mental health professionals. Many families also hope for what was in the past and for what might be in the future. Personal and political advocacy occurs in the final stage of recovery. Coping and competence occur in Stage 3.
E) Stage 2 of family recovery is one of recognition and acceptance. As it becomes more evident that there is a significant problem, the family begins to search for reasons and solutions by gathering available information. Families begin to develop their own image of the disease process and expectations of mental health professionals. Many families also hope for what was in the past and for what might be in the future. Personal and political advocacy occurs in the final stage of recovery. Coping and competence occur in Stage 3.

Question 4

The nurse is caring for a client who was involved in a car accident.The client's spouse was killed in the accident.The couple has two teenage children.Which statement explains how this tragedy will be approached by the family?

A) The family feels that their place in the community has been eliminated.
B) Family members may become detached from extended family.
C) Family disorganization may occur.
D) The family may withdraw into seclusion during the grief process.

Accepted Answer

A) The death of a family member often has a profound effect on the whole family-especially if the deceased, as in this situation, was the head of the family. Family disorganization would be common, but as the family begins to recover, a new sense of normalcy develops and the family reintegrates its roles and functions. Families need support from extended family members, their community, and spiritual advisers. The other options are not considered normal patterns of family grieving, and the nurse should be alert for problems that may develop if these are present.
B) The death of a family member often has a profound effect on the whole family-especially if the deceased, as in this situation, was the head of the family. Family disorganization would be common, but as the family begins to recover, a new sense of normalcy develops and the family reintegrates its roles and functions. Families need support from extended family members, their community, and spiritual advisers. The other options are not considered normal patterns of family grieving, and the nurse should be alert for problems that may develop if these are present.
C) The death of a family member often has a profound effect on the whole family-especially if the deceased, as in this situation, was the head of the family. Family disorganization would be common, but as the family begins to recover, a new sense of normalcy develops and the family reintegrates its roles and functions. Families need support from extended family members, their community, and spiritual advisers. The other options are not considered normal patterns of family grieving, and the nurse should be alert for problems that may develop if these are present.
D) The death of a family member often has a profound effect on the whole family-especially if the deceased, as in this situation, was the head of the family. Family disorganization would be common, but as the family begins to recover, a new sense of normalcy develops and the family reintegrates its roles and functions. Families need support from extended family members, their community, and spiritual advisers. The other options are not considered normal patterns of family grieving, and the nurse should be alert for problems that may develop if these are present.

Question 5

The nurse is determining psychosocial risk factors for a family prior to planning care.Which assessment tool should the nurse use when initially screening families for these health risks?&#10;A) The Friedman Family Assessment Tool&#10;B) The Family Ecomap&#10;C) The Home Observation for Measurement of the Environment (HOME)&#10;D) The Family APGAR

Accepted Answer

A) The Family APGAR is a quick five-item questionnaire that may be used as an initial screening tool for family assessment. All other choices are family assessment tools but are not appropriate for initial family assessments.
B) The Family APGAR is a quick five-item questionnaire that may be used as an initial screening tool for family assessment. All other choices are family assessment tools but are not appropriate for initial family assessments.
C) The Family APGAR is a quick five-item questionnaire that may be used as an initial screening tool for family assessment. All other choices are family assessment tools but are not appropriate for initial family assessments.
D) The Family APGAR is a quick five-item questionnaire that may be used as an initial screening tool for family assessment. All other choices are family assessment tools but are not appropriate for initial family assessments.

Question 6

A pediatric home health care nurse is making an initial visit to assess the parenting style for a family in preparation for treating a child with drugs to reduce hyperactivity.Which approach should the nurse use for this assessment?

A) Ask the parents, "How do you handle situations that require limit setting?"
B) Ask the child, "What rule is hardest for you to obey?"
C) Observe the parent interacting with the child for 5 minutes.
D) Ask the parents, "What are the house rules?"

Accepted Answer

A) Parental styles are best assessed while the family explains how it handles situations that require limit setting. A less complete picture of parenting style is obtained during a brief artificial observation. Asking the child which rule is hardest for him or her to follow will not give the nurse insight into parenting styles. Learning about rules is less helpful than is an explanation of enforcement efforts and success.
B) Parental styles are best assessed while the family explains how it handles situations that require limit setting. A less complete picture of parenting style is obtained during a brief artificial observation. Asking the child which rule is hardest for him or her to follow will not give the nurse insight into parenting styles. Learning about rules is less helpful than is an explanation of enforcement efforts and success.
C) Parental styles are best assessed while the family explains how it handles situations that require limit setting. A less complete picture of parenting style is obtained during a brief artificial observation. Asking the child which rule is hardest for him or her to follow will not give the nurse insight into parenting styles. Learning about rules is less helpful than is an explanation of enforcement efforts and success.
D) Parental styles are best assessed while the family explains how it handles situations that require limit setting. A less complete picture of parenting style is obtained during a brief artificial observation. Asking the child which rule is hardest for him or her to follow will not give the nurse insight into parenting styles. Learning about rules is less helpful than is an explanation of enforcement efforts and success.

Question 7

A nurse is caring for family members who have recently lost their home and belongings in a fire.The family is staying with extended family in the area.Which is the most appropriate nursing diagnosis for this family?

A) Readiness for Enhanced Family Processes
B) Dysfunctional Family Processes
C) Compromised Family Coping
D) Ineffective Individual Coping

Accepted Answer

A) The family has experienced a devastating loss. The family's ability to cope has been compromised and the nurse will also assess their external support systems. The family is not in a state of readiness yet. There is no evidence that the family is dysfunctional or that any family member is experiencing ineffective coping.
B) The family has experienced a devastating loss. The family's ability to cope has been compromised and the nurse will also assess their external support systems. The family is not in a state of readiness yet. There is no evidence that the family is dysfunctional or that any family member is experiencing ineffective coping.
C) The family has experienced a devastating loss. The family's ability to cope has been compromised and the nurse will also assess their external support systems. The family is not in a state of readiness yet. There is no evidence that the family is dysfunctional or that any family member is experiencing ineffective coping.
D) The family has experienced a devastating loss. The family's ability to cope has been compromised and the nurse will also assess their external support systems. The family is not in a state of readiness yet. There is no evidence that the family is dysfunctional or that any family member is experiencing ineffective coping.

Question 8

While attending a community health fair,the nurse observes the children of one family walking quietly behind the father with their mother and periodically shyly asking the father questions.The father responds gruffly and continues walking while the children and mother scurry behind to keep up.What does this observation indicate to the nurse? Select all that apply.

A) The father is in a hurry.
B) The father is the leader in the family.
C) The children are not to bother the father.
D) The children need discipline.
E) The mother's role is to care for the children.

Accepted Answer

A) This observation indicates a paternal family structure where the father makes the decisions for the family. The children appear fearful to ask the father a question, which is supported by the father's gruff response and the father's brisk walking. The mother is behind the father with the children, which could indicate that her role is child care. There is no evidence that these children need discipline or that the father is in a hurry.
B) This observation indicates a paternal family structure where the father makes the decisions for the family. The children appear fearful to ask the father a question, which is supported by the father's gruff response and the father's brisk walking. The mother is behind the father with the children, which could indicate that her role is child care. There is no evidence that these children need discipline or that the father is in a hurry.
C) This observation indicates a paternal family structure where the father makes the decisions for the family. The children appear fearful to ask the father a question, which is supported by the father's gruff response and the father's brisk walking. The mother is behind the father with the children, which could indicate that her role is child care. There is no evidence that these children need discipline or that the father is in a hurry.
D) This observation indicates a paternal family structure where the father makes the decisions for the family. The children appear fearful to ask the father a question, which is supported by the father's gruff response and the father's brisk walking. The mother is behind the father with the children, which could indicate that her role is child care. There is no evidence that these children need discipline or that the father is in a hurry.
E) This observation indicates a paternal family structure where the father makes the decisions for the family. The children appear fearful to ask the father a question, which is supported by the father's gruff response and the father's brisk walking. The mother is behind the father with the children, which could indicate that her role is child care. There is no evidence that these children need discipline or that the father is in a hurry.

Question 9

The nurse is assigned to care for a child in a spica cast for a fractured femur suffered in an automobile accident.The child's father was driving the car,which was badly damaged.In assessing the family,the nurse learns that the father just recently lost his job and the mother has been working through a "temp" agency.Which nursing diagnosis is most appropriate for this family?

A) Disabled Family Coping related to the effects of multiple simultaneous stressors
B) Interrupted Family Processes related to child with a significant disability requiring alteration in family functioning
C) Caregiver Role Strain related to a child with a disability and the associated financial burden
D) Impaired Social Interaction (parent and child) related to the lack of family or respite support

Accepted Answer

A) Disabled Family Coping related to the effects of multiple simultaneous stressors best fits the multiple crises to which this family is responding. Lack of family or respite support was not mentioned in the scenario. The spica cast might result in an alteration in family functioning; however, fractures generally are not considered a significant long-term disability. The need for a spica cast is not considered a newly acquired disability.
B) Disabled Family Coping related to the effects of multiple simultaneous stressors best fits the multiple crises to which this family is responding. Lack of family or respite support was not mentioned in the scenario. The spica cast might result in an alteration in family functioning; however, fractures generally are not considered a significant long-term disability. The need for a spica cast is not considered a newly acquired disability.
C) Disabled Family Coping related to the effects of multiple simultaneous stressors best fits the multiple crises to which this family is responding. Lack of family or respite support was not mentioned in the scenario. The spica cast might result in an alteration in family functioning; however, fractures generally are not considered a significant long-term disability. The need for a spica cast is not considered a newly acquired disability.
D) Disabled Family Coping related to the effects of multiple simultaneous stressors best fits the multiple crises to which this family is responding. Lack of family or respite support was not mentioned in the scenario. The spica cast might result in an alteration in family functioning; however, fractures generally are not considered a significant long-term disability. The need for a spica cast is not considered a newly acquired disability.

Question 10

The nurse is observing a family counseling session that is focusing on the family members' communication patterns.Which observation indicates that there are existing or potential problems with family communication?

A) All members are participating in the discussion equally.
B) A few of the members just sit and listen.
C) Disagreements are ignored by the family leader.
D) The verbal communication is congruent with the nonverbal messages.

Accepted Answer

A) An authoritarian setting is one in which one or more members set firm, nonnegotiable limits and other members may be cautious in expressing their feelings because of power struggles, hostility, or anger. Nurses should pay special attention to who does the talking for the family, which members are silent, how disagreements are handled, and how well the members listen to one another and encourage the participation of others. Nonverbal communication is important because it gives valuable clues about what people are feeling. Even though some members are more vocal, at least all are participating in the discussion. Verbal communication should be congruent with nonverbal cues. Listening is an art, and not all members of a family need to speak in the same setting.
B) An authoritarian setting is one in which one or more members set firm, nonnegotiable limits and other members may be cautious in expressing their feelings because of power struggles, hostility, or anger. Nurses should pay special attention to who does the talking for the family, which members are silent, how disagreements are handled, and how well the members listen to one another and encourage the participation of others. Nonverbal communication is important because it gives valuable clues about what people are feeling. Even though some members are more vocal, at least all are participating in the discussion. Verbal communication should be congruent with nonverbal cues. Listening is an art, and not all members of a family need to speak in the same setting.
C) An authoritarian setting is one in which one or more members set firm, nonnegotiable limits and other members may be cautious in expressing their feelings because of power struggles, hostility, or anger. Nurses should pay special attention to who does the talking for the family, which members are silent, how disagreements are handled, and how well the members listen to one another and encourage the participation of others. Nonverbal communication is important because it gives valuable clues about what people are feeling. Even though some members are more vocal, at least all are participating in the discussion. Verbal communication should be congruent with nonverbal cues. Listening is an art, and not all members of a family need to speak in the same setting.
D) An authoritarian setting is one in which one or more members set firm, nonnegotiable limits and other members may be cautious in expressing their feelings because of power struggles, hostility, or anger. Nurses should pay special attention to who does the talking for the family, which members are silent, how disagreements are handled, and how well the members listen to one another and encourage the participation of others. Nonverbal communication is important because it gives valuable clues about what people are feeling. Even though some members are more vocal, at least all are participating in the discussion. Verbal communication should be congruent with nonverbal cues. Listening is an art, and not all members of a family need to speak in the same setting.

Question 11

The nurse has completed a family assessment and is planning care for a newly blended family.The children are having trouble adapting to the new situation.Which is the primary goal for this family?&#10;A) Improve family situations.&#10;B) Work with other families.&#10;C) Practice life skills.&#10;D) Self-evaluate.

Accepted Answer

The answer of The nurse has completed a family assessment...

Question 12

The nurse educator is teaching a group of students about health promotion and disease prevention.Which nursing activities promote health and health maintenance? Select all that apply.&#10;A) Helping a mother determine a daily feeding schedule for her infant&#10;B) Teaching a school-age child how to use dental floss&#10;C) Teaching parents how to perform pulmonary drainage and cupping on their ill child.&#10;D) Treating a child diagnosed with pneumonia&#10;E) Administering the flu vaccine for an infant who is 9 months of age

Accepted Answer

The answer of The nurse educator is teaching a group...

Question 13

The nurse is evaluating the success of wellness care provided to a new family in the community.Which observations indicate that care has been successful? Select all that apply.&#10;A) The children are observed eating donuts for breakfast.&#10;B) All family members have up-to-date immunizations.&#10;C) The family spends every Saturday afternoon participating in physical activities.&#10;D) The youngest child squints when reading school work.&#10;E) The oldest child does not wash his hands before eating.

Accepted Answer

The answer of The nurse is evaluating the success of...

Question 14

During a home visit,the nurse determines that care interventions are needed to address alcohol and substance abuse by family members.Which interventions should the nurse consider when planning care for this family? Select all that apply.

A) Suggest grief counseling.
B) Evaluate family members' potential for being a danger to self or others.
C) Suggest engaging in educational activities.
D) Be alert to behaviors that indicate sibling jealousy.
E) Recommend community resources to assist with substance abuse behavior.

Accepted Answer

The answer of During a home visit,the nurse determines that...

Question 15

During a home visit,the nurse observes children acting out,shouting,and hitting each other when taking a small amount of food out of the refrigerator.The mother sits nearby yelling for the children to shut up while reaching for a cigarette.Which should the nurse consider as being helpful for this family situation? Select all that apply.

A) Suggesting ways to improve the family's financial resources
B) Suggesting ways to improve the parent's behavior
C) Contacting the authorities because of child abuse
D) Making a list of community resources to help this family cope
E) Creating a genogram

Accepted Answer

The answer of During a home visit,the nurse observes children...

Question 16

A nurse in a busy outpatient pediatric clinic notes that a preschool-aged child who was due to be seen is a no-show.The child is not up to date on vaccinations.Which action by the nurse is appropriate?

A) Call the parents and encourage them to bring the child for recommended care.
B) Speak firmly with the parents about the importance of being compliant.
C) Notify the healthcare provider that the child's immunizations are no longer up to date.
D) Plan to discuss the principles of health supervision at the next scheduled visit.

Accepted Answer

The answer of A nurse in a busy outpatient pediatric...

Question 17

During a follow-up home visit,the nurse is evaluating the success of a family's ability to use internal resources to cope with the illness of a family member.Which does the nurse observe that indicates that internal resources are being accessed? Select all that apply.

A) Next-door neighbor helping with family chores
B) Effective communication pattern
C) Skill in providing care to the ill family member
D) Church members stopping by with groceries
E) Center for Aging picking up the family member to take to a physician's appointment

Accepted Answer

The answer of During a follow-up home visit,the nurse is...

Question 18

The community nurse identifies that a family new to the community needs assistance with family dynamics and material resources.What should the nurse consider offering to the parents of this family to support their needs? Select all that apply.

A) A list of free counseling services to assist with parental stress
B) Hours of the local health clinic
C) Location of the community library
D) Location of the community co-op food bank
E) Hours when the park is open

Accepted Answer

The answer of The community nurse identifies that a family...

Question 19

The nurse is caring for a client who is hospitalized with pneumonia.Which will the nurse assess when determining the impact of the illness on the family? Select all that apply.&#10;A) The duration of the illness&#10;B) The effect of the illness on future family functioning&#10;C) The cause of the illness&#10;D) The meaning of the illness to the family&#10;E) The financial impact of the illness

Accepted Answer

The answer of The nurse is caring for a client...

Question 20

The community nurse is planning a wellness seminar for families in an urban community.Which resources should the nurse consider obtaining to support these families' needs? Select all that apply.&#10;A) Emergency first responder personnel&#10;B) Information about community healthcare providers&#10;C) Individuals who provide mental health services&#10;D) Law enforcement officials&#10;E) Nutritionists

Accepted Answer

The answer of The community nurse is planning a wellness...

Question 21

The nurse is discussing hospice care with the family of a client dying of cancer.The spouse asks the nurse if Medicare will continue to pay if the client lives longer than 6 months.Which response by the nurse is appropriate?

A) "I will call someone in the finance office to come speak with you about your question."
B) "Are you concerned about paying for your spouse's health care?"
C) "It is unlikely your husband will live past 6 months."
D) "Please ask the doctor to explain the role of hospice before discharge."

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Accepted Answer

The answer of The nurse is discussing hospice care with...

Question 22

The nurse is determining the type of support the family of a client with newly diagnosed mood disorder is going to need.Which types of support should the nurse consider to help this family? Select all that apply.

A) Financial
B) Professional
C) Friend
D) Family
E) Spiritual

Accepted Answer

The answer of The nurse is determining the type of...

Question 23

The nurse is creating a plan of care for the family of a client with a terminal illness.Which aspects of this family's care should the nurse emphasize when creating this plan? Select all that apply.&#10;A) Instructing on medication administration&#10;B) Guiding to determine realistic goals&#10;C) Identifying strategies to enhance family functioning&#10;D) Suggesting that cultural practices be minimized at this time&#10;E) Focusing on the client's health needs as a priority

Accepted Answer

The answer of The nurse is creating a plan of...

Deck 26: Family