Deck 35: Family Interventions

Question 1

The school nurse learns that since the death of their youngest son,Mr.and Mrs.Jones have been missing work enough to face disciplinary action.The surviving children,aged 8 and 10 years,are having to make their own dinners as best they can.The school nurse notices that the children are wearing dirty clothes and sometimes are inadequately clothed.Which nursing diagnosis would be a priority in this situation?

A) Caregiver role strain
B) Interrupted family processes
C) Compromised resilience
D) Dysfunctional family processes

Answer 1

Interrupted family processes

Question 2

Since the death of their youngest son,Mr.and Mrs.Jones have been missing work and leaving their surviving children,aged 8 and 10 years,to make their own dinners as best they can.The children are wearing dirty clothes and are sometimes inadequately clothed.Which outcome would be most appropriate to identify for this family?

A) Children will demonstrate improved self-sufficiency.
B) Family will demonstrate effective problem-solving skills.
C) Parents will demonstrate effective parental role function.
D) Family will display understanding of each others' emotional needs.

Answer 2

Parents will demonstrate effective parental role function.

Question 3

The nurse therapist assessing a family system perceives the family to be poorly differentiated and determines that family members have little sense of individuality.A desirable outcome is that members will:

A) distinguish who is at fault for the family's dysfunction.
B) develop their own values and beliefs instead of simply adopting those of others.
C) become comfortable adhering to family norms and rules.
D) integrate more effectively with other social systems.

Answer 3

develop their own values and beliefs instead of simply adopting those of others.

Question 4

The nurse is to meet a family for the first family therapy session.The husband/father is an accountant who admits to being skeptical of the idea that talking can help the family strengthen its ability to cope with life stressors.The wife/mother is a teacher who states she is not skillful in conflict resolution.The son,aged 15 years,defies parents and teachers and is in academic trouble.The daughter,aged 17 years,is trying to decide whether to attend a local college and live at home or attend an out-of-state university.The family member listed on the referral as the identified patient is most likely to be the:

A) husband/father.
B) wife/mother.
C) son.
D) daughter.

Question 5

A 16-year-old girl is old enough to drive,but her parents do not want her to,although they will not explain why.Her 14-year-old sister has been invited to several sleepovers,but her parents find reasons not to grant permission.Both children are also annoyed because the parents buy them clothes that are more suitable for younger children,resulting in teasing at school.The parents explain to the nurse that they just don't want their kids "growing up too fast." The nurse would recognize that family boundaries are:

A) enmeshed.
B) clear.
C) differentiated.
D) rigid.

Question 6

A woman tells the BSN-prepared community health nurse that she and her son fight all the time since the son started using drugs.The son tells his mother that his drug use is none of her business.Which initial response by the nurse would be most appropriate?

A) Have separate,informal,nonjudgmental conversations with the mother and the son about their respective concerns.
B) Initiate family therapy with the family unit,focusing on dysfunctional communication patterns.
C) Advise the mother to motivate her son by telling him that if he doesn't get drug abuse treatment,she'll report him to the police.
D) Discuss the dangers of substance abuse with the son,and then refer him to substance abuse treatment providers.

Question 7

Mary believes that her husband John is having an affair because he has become increasingly distant and disinterested in romantic activities over the past several months and stays late at work.John is in charge of an important project at work that is running behind and claiming more and more of his time.Mary asks her 12-year-old daughter if she has noticed anything different about her father.The daughter later mentions this to her father,who responds by telling the daughter to tell her mother that he cannot deal with her insecurities right now.The nurse family therapist should assess this phenomenon as:

A) triangulation.
B) multigenerational dysfunction.
C) blaming.
D) enmeshment.

Question 8

A 16-year-old girl obtains her driver's license and begins to socialize independently with her friends.Her older sister has just left for college.Her mother is moving from a part-time position to a full-time position,and her father is worried that he may be laid off because of the tight economy.These events illustrate:

A) unpredictable structural changes.
B) the family life cycle.
C) enmeshment.
D) multigenerational issues.

Question 9

A daughter describes her family as follows: "I play sweet so Dad won't come down on me,and mom takes the blame when I mess up.My brother usually ends up getting blamed for nobody getting along because he doesn't stand up for himself." Assuming the daughter's descriptions are accurate,which three forms of dysfunction should the nurse document as present?

A) Manipulating,placating,and scapegoating
B) Placating,scapegoating,and generalizing
C) Manipulating,distracting,and generalizing
D) Manipulating,placating,and differentiating

Question 10

The nurse performing a family assessment determines that the parents jointly make decisions regarding family rules and apportion the family resources in ways that serve the interests of all members.Plans for the future exist but are flexible and allow for changing circumstances.The three teenage children participate in discussions but do not have responsibility for decisions.The assessment the nurse should document is:

A) family management function is appropriate and adequate.
B) boundary function makes a distinction between individuals.
C) communication function of the family is healthy.
D) emotional-supportive function is dominated by conflict.

Question 11

Which comment during a family therapy session would best be assessed as scapegoating?

A) "Billy is always the one that starts these arguments and upsets everyone else."
B) "You have to express your feelings more,but not if it might upset your father."
C) "Our son Tom will tell you,my husband and I are doing all we can for the others."
D) "After mom has been drinking,I have to get the others up and ready for school."

Question 12

A woman and her son fight constantly since the son started using drugs.The son tells his mother that his drug use is none of her business.Which of the following responses by the community health nurse would be most appropriate?

A) Talk to the mother and son about their dysfunctional relationship,guiding them to understand that both of them are at fault.
B) Talk to the mother and son to help them recognize their present dysfunctional relationship,and find problem-solving interventions that benefit both.
C) Educate the mother about more effective ways to motivate her son to reconsider his desire to abuse drugs.
D) Refer the mother and son to family therapy because of the degree of dysfunction evident in their relationship.

Question 13

Which example of behavior within a family system should be assessed as 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 PM 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 and go bowling and try not to worry about me falling on my crutches while I'm alone at home."

Question 14

Mary believes that her husband John is having an affair because he has become increasingly distant,disinterested in romance,and works late.John is in charge of an important project at work that is running behind and causing stress.Mary asks her daughter if she has noticed anything different about her father,and when the daughter mentions it to her father,the father tells her to tell her mother that he cannot deal with her insecurities right now.After establishing a therapeutic relationship,which initial intervention by the nurse therapist would be most therapeutic?

A) Ask the parents what they would most like to change in each other.
B) Advise the parents to stop communicating through their daughter.
C) Point out that the parents have something in common: both are hurting.
D) Ask the daughter to explain to her parents how she is feeling about them.

Question 15

The nurse is to meet a family for the first family therapy session.The husband/father is an accountant who admits to being skeptical of the idea that talking can help the family strengthen its ability to cope with life stressors.The wife/mother is a teacher who states she is not skillful in conflict resolution.The son,aged 15 years,defies parents and teachers and is in academic trouble.The daughter,aged 17 years,is trying to decide whether to attend a local college and live at home or attend an out-of-state university.During the first meeting,the nurse should plan to:

A) elicit the perspective and feelings of each family member.
B) maintain the focus of all members on the here and now.
C) provide psychoeducation regarding oppositional defiant disorder.
D) state the expectation that members will support family coping.

Question 16

Mary believes that her husband John is having an affair because he has become increasingly distant,disinterested in romance,and works late.John is in charge of an important project at work that is running behind and causing stress.Mary asks her daughter if she has noticed anything different about her father,and when the daughter mentions it to her father,the father tells her to tell her mother that he cannot deal with her insecurities right now.Which nursing diagnosis should the nurse therapist make her initial priority?

A) Defensive coping
B) Impaired parenting
C) Interrupted family processes
D) Dysfunctional family processes