Deck 11: Working with the Family

Question 1

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

A) The family exhibits many characteristics of dysfunctional families.
B) Several family members have serious problems with their physical health.
C) Power in the family is maintained in the parental dyad and rarely delegated.
D) The stress of living with a mentally ill individual has negatively affected family function.

Answer 1

The stress of living with a mentally ill individual has negatively affected family function.

Question 2

Parents of a mentally ill teenager say, "We've never known anyone who was mentally ill. We have no one to talk to because none of our friends understand the problems." The nurse's most helpful intervention would be to:

A) refer the parents to a support group.
B) build their self-esteem as coping parents.
C) teach techniques of therapeutic communication.
D) facilitate achievement of normal developmental tasks.

Answer 2

refer the parents to a support group.

Question 3

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

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

Answer 3

Interrupted family processes

Question 4

A parent has become verbally abusive toward the spouse and oldest child since losing a job 6 months ago. 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 individual coping, related to fears about economic stability
D) Disabled family coping, related to insecurity secondary to loss of family income

Question 5

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

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

Question 6

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 family assessment?

A) Spouse's co-dependent behaviors
B) Interactions among family members
C) Patient's reaction to the family's anger
D) Children's responses to the family sessions

Question 7

Which scenario best illustrates scapegoating within a family?

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

Question 8

Select the best question 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?"

Question 9

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

A) express sympathy.
B) involve local social services.
C) explain symptoms of relapse.
D) role-play problem situations.

Question 10

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 should use interventions to assist with the parent's:

A) denial.
B) grieving.
C) acting out.
D) manipulation.

Question 11

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

A) "Can you describe a problem your family has successfully resolved?"
B) "What community agencies have you found helpful in the past?"
C) "Do you feel you have adequate resources to survive?"
D) "What is one thing you dislike about this family?"

Question 12

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

A) how the family expresses and manages emotion.
B) the names and relationships of the patient's family members.
C) the communication patterns between the patient and parents.
D) the meaning the patient's suicide attempt has for family members.

Question 13

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

Question 14

The patient's parent asks the nurse, "Why do you want to do a family assessment? My child 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 15

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

A) guidance about parenting at two developmental levels.
B) role-playing opportunities for conflict resolution.
C) formal teaching about problem-solving skills.
D) referral to a family therapist.

Question 16

A parent is admitted to a chemical dependency treatment unit. The patient's spouse and adolescent children attend a family session. What is the priority assessment question to ask 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 17

An adult diagnosed with paranoid schizophrenia lives with older adult parents. The patient was recently hospitalized with acute psychosis. One parent is very anxious, and the other is ill from all the stress. Select the most applicable nursing diagnosis.

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

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 action?

A) Educate the parent about the 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 19

Which option describes 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 inside 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 20

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

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

Question 21

Which situations are most likely to place severe, disabling stress on a family? Select all that apply.

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, age 9, 7, and 2 years, get a divorce.
E) A parent retires after working at the same job for 28 years.

Question 22

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 what to do to keep the family together." Which interventions should the nurse use when working with this family? Select all that apply.

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 among family members.
E) Focus on the family rather than on the patient in planning.