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?

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 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:

Accepted Answer

The need for support can be clearly identified. Referrals are made when working with families whose needs are unmet. A support group such as the National Alliance for the Mentally Ill (NAMI) will provide these parents with the support of others who have had similar experiences and with whom they can share feelings and experiences. The distracters are less relevant.

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?

Accepted Answer

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

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?

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 more than one individual is affected by the stressors.

Question 5

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

Accepted Answer

Physical and safety needs are given greater importance in Maslow's hierarchy of needs than other needs.

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?

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 too narrow in scope when compared with the correct option.

Question 7

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 family members.

Question 8

Select the best question 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 other options seek opinions or are closed-ended.

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:

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 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:

Accepted Answer

Grief is a common reaction to having a family member diagnosed with mental illness. The grief stems from actual or potential losses such as ability to function, altered family functioning, income, and altered future prospects. Data do not support choosing any of the other options.

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:

Accepted Answer

The correct option asks about resource use in an open, direct fashion. It will give information about choices that the family has made to use other family members or resources in the community. The other questions do not address prior use of resources.

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:

Accepted Answer

The names and relationships of the patient's family members constitute the most fundamental information and should be obtained first. Without this, the nurse cannot fully process the other responses.

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.

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 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 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.

Accepted Answer

This 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.

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 stages of rearing preschool children and dealing with teenagers. These stages require different knowledge and skills. There is no evidence of a problem, so the distracters are not indicated.

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?

Accepted Answer

It is important to understand family characteristics in both the family of origin and the present family. The other questions are related more to outcome identification and planning intervention, neither of which should be attempted until assessment is complete.

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.

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 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?

Accepted Answer

Family therapy is indicated, and the nurse should provide a referral. Reporting the child to law enforcement would undermine trust and violate confidentiality. The other distracters may occur later.

Question 19

Which option describes a healthy family?

Accepted Answer

Revamping the marital relationship after children move out of the family of origin indicates that the family is moving through its stages of development. Strict family boundaries or roles interfere with flexibility and the use of outside resources. Adolescents should have some input into deciding their activities.

Question 20

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.

Quiz 11: Working with the Family