Question 1

The nurse overhears a school-age client tearfully telling his mother about an incident on the playground in which another child pushed him down and threw dirt at him.The boy's mother takes him on her lap,hugs him,and explains that if it happens again he should firmly but politely ask the child to stop.If that does not work,he should walk away from the child.If the child continues to pursue him,he should find an adult to intervene.Which of the following family roles is the boy's mother assuming in this interaction?

Accepted Answer

The mother is assuming the family role of caring, nurturing, and educating her child by providing emotional support and teaching him how to handle conflict in a positive manner.

Question 2

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.

Accepted Answer

The nurse should consider obtaining information about community healthcare providers to refer families for ongoing care, individuals who provide mental health services to address mental health concerns, and nutritionists to educate families on healthy eating habits. Emergency first responders and law enforcement officials may not be necessary for a wellness seminar unless the seminar specifically focuses on emergency preparedness or community safety.

Question 3

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

Accepted Answer

A)When working with families, nurses will often need to collaborate with other healthcare professionals. For families in need of counseling, financial assistance may be available. When making these recommendations, nurses should be aware of some stigmas surrounding therapy and counseling, and work to assure families of the potential benefits of these modes of care. Families facing economic challenges should be made aware of community resources, including wellness clinics and food banks. The hours for the library and the park would not help the family with the issues that the nurse observed.
B)When working with families, nurses will often need to collaborate with other healthcare professionals. For families in need of counseling, financial assistance may be available. When making these recommendations, nurses should be aware of some stigmas surrounding therapy and counseling, and work to assure families of the potential benefits of these modes of care. Families facing economic challenges should be made aware of community resources, including wellness clinics and food banks. The hours for the library and the park would not help the family with the issues that the nurse observed.
C)When working with families, nurses will often need to collaborate with other healthcare professionals. For families in need of counseling, financial assistance may be available. When making these recommendations, nurses should be aware of some stigmas surrounding therapy and counseling, and work to assure families of the potential benefits of these modes of care. Families facing economic challenges should be made aware of community resources, including wellness clinics and food banks. The hours for the library and the park would not help the family with the issues that the nurse observed.
D)When working with families, nurses will often need to collaborate with other healthcare professionals. For families in need of counseling, financial assistance may be available. When making these recommendations, nurses should be aware of some stigmas surrounding therapy and counseling, and work to assure families of the potential benefits of these modes of care. Families facing economic challenges should be made aware of community resources, including wellness clinics and food banks. The hours for the library and the park would not help the family with the issues that the nurse observed.
E)When working with families, nurses will often need to collaborate with other healthcare professionals. For families in need of counseling, financial assistance may be available. When making these recommendations, nurses should be aware of some stigmas surrounding therapy and counseling, and work to assure families of the potential benefits of these modes of care. Families facing economic challenges should be made aware of community resources, including wellness clinics and food banks. The hours for the library and the park would not help the family with the issues that the nurse observed.

Question 4

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 of the following types of family does this child reside?

Accepted Answer

The child lives with both parents and maternal grandparents, indicating that this is an extended family structure. A blended family would involve step-parents and step-siblings from previous marriages, a two-career family would involve both parents working outside of the home, and a nuclear family would involve only the parents and their children living together.

Question 5

A pediatric home healthcare nurse is making an initial visit to assess the parenting style of a family preparing to treat a child with medications to reduce hyperactivity.Which approach should the nurse use for this assessment?

Accepted Answer

Asking the parents how they handle situations that require limit setting will provide insight into their parenting style and discipline strategies, which are important factors to consider when treating a child with hyperactivity. Asking the child about their obedience may not accurately reflect the parenting style, and observing parent-child interaction for only 5 minutes may not provide enough information. Asking about the house rules may not necessarily reveal the parenting style or discipline strategies used by the parents.

Question 6

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.

Accepted Answer

Activities that promote health and health maintenance include providing education on healthy behaviors, such as feeding schedules and dental hygiene, and providing preventative measures, such as administering vaccines. Teaching parents how to perform pulmonary drainage and cupping is a treatment for an already ill child and not necessarily promoting health and health maintenance. Treating a child diagnosed with pneumonia is also not a preventative measure, but rather a treatment for an illness.

Question 7

The nurse is evaluating the success of wellness care provided to a new family in the community.Which observations by the nurse indicate that care has been successful? Select all that apply.

Accepted Answer

Option B shows that the family is up-to-date with their immunizations, which is an essential part of wellness care. Option C indicates that the family is participating in physical activities every Saturday, which promotes physical wellness. Options A, D, and E indicate areas where the family could improve their wellness practices.

Question 8

A cohesive nuclear family has one kindergarten-aged child.The mother works from home and is the primary caregiver for the child.The father is required to travel a lot for work.Currently,the father is on an out-of-town project that will last for 6 months.He is home on the weekends,but gone the rest of the week.The nurse understands that family cohesion in this family is likely to become:

Accepted Answer

With the father being gone for most of the week, it is likely that the mother and child will develop a strong bond and cohesive relationship without the father's presence. This would result in a cohesive dyadic relationship between the mother and child. It is less likely that the father would maintain a strong bond with either the mother or child due to his frequent absence. As such, choices A and B are less likely. Choice D is a possibility, but less likely given the absence of the father during the majority of the week.

Question 9

The nurse is caring for a client who is hospitalized with pneumonia.Which of the following will the nurse assess when determining the impact of the illness on the family? Select all that apply.

Accepted Answer

A)The impact on the family is assessed by the duration of the illness as well as its effect on the family finances and functioning. Other factors include residual effects of the illness, meaning of the illness to the family, and its significance to family systems. The cause of the illness is not a factor that determines the impact on the family.
B)The impact on the family is assessed by the duration of the illness as well as its effect on the family finances and functioning. Other factors include residual effects of the illness, meaning of the illness to the family, and its significance to family systems. The cause of the illness is not a factor that determines the impact on the family.
C)The impact on the family is assessed by the duration of the illness as well as its effect on the family finances and functioning. Other factors include residual effects of the illness, meaning of the illness to the family, and its significance to family systems. The cause of the illness is not a factor that determines the impact on the family.
D)The impact on the family is assessed by the duration of the illness as well as its effect on the family finances and functioning. Other factors include residual effects of the illness, meaning of the illness to the family, and its significance to family systems. The cause of the illness is not a factor that determines the impact on the family.
E)The impact on the family is assessed by the duration of the illness as well as its effect on the family finances and functioning. Other factors include residual effects of the illness, meaning of the illness to the family, and its significance to family systems. The cause of the illness is not a factor that determines the impact on the family.

Question 10

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?

Accepted Answer

The family is experiencing multiple stressors including the father's job loss, the child's injury and resulting medical expenses, and the disruption to the family routine. This can lead to compromised family coping and a need for nursing interventions to support coping strategies. The other options may also be appropriate but do not address the multiple stressors that the family is facing.

Question 11

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.

Accepted Answer

When creating a plan of care for a family with a client who has a terminal illness, it is important to guide the family in determining realistic goals for care, and to identify strategies that can enhance family functioning during this difficult time. Emphasizing medication administration may be important, but it is not the most important aspect of the family's care plan. Similarly, it is important to address the client's health needs, but this should not come at the expense of addressing the needs of the family as a whole. Finally, suggesting that cultural practices be minimized at this time would not be appropriate, as cultural practices can be an important source of support and comfort for the family.

Question 12

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.

Accepted Answer

A) For the family with alcohol or substance abuse, the nurse should evaluate family members' potential for being a danger to self or others and recommend community resources to family members to help with substance abuse behaviors. Grief counseling would be appropriate for the family who has suffered a loss of a family member. Educational activities and being alert to sibling jealousy would be appropriate for the antepartum or postpartum family.
B) For the family with alcohol or substance abuse, the nurse should evaluate family members' potential for being a danger to self or others and recommend community resources to family members to help with substance abuse behaviors. Grief counseling would be appropriate for the family who has suffered a loss of a family member. Educational activities and being alert to sibling jealousy would be appropriate for the antepartum or postpartum family.
C) For the family with alcohol or substance abuse, the nurse should evaluate family members' potential for being a danger to self or others and recommend community resources to family members to help with substance abuse behaviors. Grief counseling would be appropriate for the family who has suffered a loss of a family member. Educational activities and being alert to sibling jealousy would be appropriate for the antepartum or postpartum family.
D) For the family with alcohol or substance abuse, the nurse should evaluate family members' potential for being a danger to self or others and recommend community resources to family members to help with substance abuse behaviors. Grief counseling would be appropriate for the family who has suffered a loss of a family member. Educational activities and being alert to sibling jealousy would be appropriate for the antepartum or postpartum family.
E) For the family with alcohol or substance abuse, the nurse should evaluate family members' potential for being a danger to self or others and recommend community resources to family members to help with substance abuse behaviors. Grief counseling would be appropriate for the family who has suffered a loss of a family member. Educational activities and being alert to sibling jealousy would be appropriate for the antepartum or postpartum family.

Question 13

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 of the following is this burden related?

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 14

A nurse in an 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?

Accepted Answer

The appropriate action by the nurse is to call the parents and encourage them to bring the child for recommended care. This approach is non-judgmental and focuses on promoting health rather than chastising the parents for missing an appointment. The nurse should use this opportunity to communicate the importance of keeping up-to-date with vaccinations and other recommended care.

Question 15

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?

Accepted Answer

Family disorganization may occur after a tragedy such as a car accident resulting in the death of a family member. This can involve difficulty with roles, communication, and daily routines. The children may struggle with the loss of a parent and adapting to potentially new family dynamics. The family may benefit from counseling or support groups to help with the process of adjusting to their new reality.

Question 16

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?

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 17

The nurse is meeting with the family of a 16-year-old patient who was recently diagnosed with depression.His younger sister states that she finds the patient's behavior distressing,as well as the way in which her parents respond to the behavior.She also states that she is tired from doing many of her brother's chores for him because he can't or won't do them himself.What type of family burden is the patient's sister experiencing?

Accepted Answer

The patient's sister is experiencing a high level of subjective burden, which refers to the emotional distress experienced by the family member due to the patient's condition and associated behavioral disturbances. Additionally, she is feeling burdened by having to take on extra responsibilities and chores, which further adds to her distress.

Question 18

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?

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 19

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 observations by the nurse indicate that internal resources are being accessed? Select all that apply.

Accepted Answer

Effective communication and skill in providing care are examples of internal resources. A next-door neighbor and church members are examples of external resources, and the Center for Aging is an outside service.

Question 20

A nuclear family has three children-an infant who is 18 months old,a preschooler who is 4 years old,and a first grader who is 7 years old.According to Duvall's eight-stage family life cycle,what is this family's current stage?

Accepted Answer

A)The oldest child serves as a marker for the family's developmental stage. In this case, the family is in stage IV, which is characterized by having school-aged children. Stage I is a couple that does not yet have children, stage II is a family whose oldest child is up to 30 months of age, and stage III is a family whose oldest child is in preschool.
B)The oldest child serves as a marker for the family's developmental stage. In this case, the family is in stage IV, which is characterized by having school-aged children. Stage I is a couple that does not yet have children, stage II is a family whose oldest child is up to 30 months of age, and stage III is a family whose oldest child is in preschool.
C)The oldest child serves as a marker for the family's developmental stage. In this case, the family is in stage IV, which is characterized by having school-aged children. Stage I is a couple that does not yet have children, stage II is a family whose oldest child is up to 30 months of age, and stage III is a family whose oldest child is in preschool.
D)The oldest child serves as a marker for the family's developmental stage. In this case, the family is in stage IV, which is characterized by having school-aged children. Stage I is a couple that does not yet have children, stage II is a family whose oldest child is up to 30 months of age, and stage III is a family whose oldest child is in preschool.

Quiz 26: Family