Question 1

A parent is admitted to a chemical dependency treatment unit, where the patient's spouse and adolescent children participate in a family session. What is the most important aspect of family function to be initially assessed?

Accepted Answer

Interactions among family members are the most important aspect to be initially assessed. It is important to understand how the family communicates, behaves, and interacts with each other in order to identify any dysfunctional patterns and work towards improving family dynamics. While co-dependency, patient's reactions, and children's responses are also important factors to consider, they are secondary to the overall interactions and communication patterns within the family.

Question 2

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

The parents' statements suggest that the family's normal processes have been disrupted, such as the ability to socialize and engage in leisure activities, due to the teenager's illness. Interrupted family processes is a nursing diagnosis that addresses disruptions in family functioning caused by illness or other stressors, and it would be appropriate in this case. Impaired parenting, dysfunctional grieving, and impaired social interaction may also be relevant, but Interrupted family processes is the most comprehensive and inclusive option based on the information provided.

Question 3

A family expresses helplessness related to dealing with a mentally ill member's odd behaviors, mood swings, and argumentativeness. Which nursing intervention for the family should be included into the careplan to help reduce interpersonal stress by learning new coping skills?

Accepted Answer

Role-playing problem situations can help the family members learn and practice new coping skills to manage the mentally ill member's odd behaviors, mood swings, and argumentativeness. This will help to reduce interpersonal stress in the family. Expressing sympathy regularly can be helpful, but it is not a specific coping skill. Involving social services and explaining symptoms of relapse may be important interventions, but they do not specifically address reducing interpersonal stress through learning new coping skills.

Question 4

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 to best assess family unit characteristics?

Accepted Answer

Asking how feelings are expressed in the family allows the healthcare provider to assess communication patterns and emotional expression within the family unit. This information can provide insight into potential areas of dysfunction and guide therapy goals. The other options may also be important to address, but do not prioritize assessment of family unit characteristics.

Question 5

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." What response best addresses the parent's concern?

Accepted Answer

Family assessment provides a more holistic picture of the patient's life and experiences. Each family member has their own perception of the events and dynamics within the family, which can aid in the diagnosis and treatment of the patient. It also helps to identify any possible sources of stress or conflict that may be contributing to the patient's mental illness.

Question 6

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 nursing action most appropriately addresses the parent's concern?

Accepted Answer

Making a referral for family therapy would be the most appropriate nursing action in this scenario, as it would provide an opportunity for the parent and son to work through their conflicts and improve their communication. It may also help address any underlying issues that may have contributed to the son's drug use. Reporting the son to law enforcement authorities may be necessary in certain situations, but it would not address the parent's concern or assist with improving their relationship. Referring the son for substance abuse treatment is important, but it does not directly address the parent's concern of constant arguing. Education about family development may be useful, but it would not directly address the parent's current situation.

Question 7

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." What intervention by the nurse would be most helpful in meeting the parent's expressed need?

Accepted Answer

Referring the parents to a family support group would be the most beneficial intervention as it provides a space for the parents to talk to others who have experienced similar situations and can offer support and understanding.

Question 8

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

Accepted Answer

Asking what community agencies the family has found helpful in the past will provide insight into their utilization of resources and what resources may be most beneficial for them in the future. Option A evaluates problem-solving skills, option C asks for a vague assessment of resources without specifying which ones, and option D is an inappropriate and unhelpful question to ask.

Question 9

What assessment question should the nurse ask to assess a family's ability to cope?

Accepted Answer

The answer of What assessment question should the nurse ask...

Question 10

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 focus on securing what information?

Accepted Answer

The nurse must first focus on securing information about the names and relationships of the patient's family members, as this information is essential for the nurse to identify potential sources of support or stress for the patient. Once this information is obtained, the nurse can then explore other aspects of family dynamics, such as communication patterns and how the family expresses and manages emotion, as well as the meaning the patient's suicide attempt has for family members.

Question 11

Which scenario best illustrates scapegoating within a family?

Accepted Answer

Scapegoating in a family occurs when family members blame one individual for the problems and dysfunction within the family. This individual is often the target of criticism, hostility, and rejection by other family members. This scenario is best illustrated by choice B, where family members project their problems onto one particular family member, who becomes the scapegoat for the family's issues.

Question 12

After a parent is 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 include in the plan of care for this family? (Select all that apply.)

Accepted Answer

All of these interventions are appropriate and necessary for helping this family cope with the hospitalization of a parent with severe depression. Setting realistic expectations will help alleviate some of the uncertainty and anxiety the family is feeling. Providing empathy, acceptance, and support will help the family feel emotionally supported during this difficult time. Teaching problem-solving skills will empower the family to work together to make decisions and take action as necessary. Negotiating role flexibility will help ensure that the family can adapt to changing circumstances and share responsibilities effectively. It is important to focus on both the patient and the family in planning, as they are interconnected and both need support.

Question 13

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 demonstration of what process?

Accepted Answer

The parent's statement of "Our hopes for our child's future are ruined" indicates a sense of loss and sadness, which is characteristic of the mourning process. The parent's mention of not having grandchildren may also signify grieving over potential life events that may no longer come to fruition. The nurse should provide support and resources for the family to cope with this difficult diagnosis and the changes it may bring to their future plans.

Question 14

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

Accepted Answer

Physical maintenance and safety is the highest priority task for a family, as it lays the foundation for the family's overall health and well-being. This includes ensuring access to basic needs such as shelter, food, and healthcare, as well as ensuring that the household is safe and free from hazards. Without physical safety and stability, it is difficult for a family to perform other tasks such as allocating resources or maintaining order and authority.

Question 15

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 stress of living with a mentally ill individual can have a negative impact on family function. It is common for families of individuals with serious and persistent mental illness to experience high levels of stress, stigma, and social isolation, which can lead to dysfunction in family relationships. While dysfunctional family characteristics may be present, this is not necessarily the most likely finding or universal to all families of individuals with mental illness. Additionally, while physical health problems among family members may be present, it is not necessarily the most likely finding or universal to all families of individuals with mental illness. Power dynamics within the family may vary and are not necessarily maintained solely in the parental dyad.

Question 16

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

Accepted Answer

A healthy and functional family is one where members provide mutual support, help each other in times of need, and work together towards common goals. This indicates that the family has strong relationships and effective communication, which are key components of a healthy family dynamic. Options B, C, and D may not necessarily indicate a healthy family as power imbalances, a belief in external causes for events, and enmeshment can be signs of dysfunction within a family.

Question 17

Which option describes an action that is common among healthy families?

Accepted Answer

Renewing the marital relationship after children become adults is a common action among healthy families as it helps to maintain a strong and positive emotional connection between the couple. However, options A, B, and C can be restrictive and may not necessarily promote a healthy family dynamic.

Question 18

An adult recently diagnosed with a mental illness is hospitalized with pneumonia. The patient and family are very anxious. What outcome should the nurse add to the plan of care for this family to meet their immediate needs?

Accepted Answer

The immediate needs of the family in this situation would be to manage anxiety and stress related to the dual diagnosis of mental illness and pneumonia. Identifying effective coping methods can help alleviate this stress and provide some sense of control over the situation. Choices B, C, and D may be important components of the overall plan of care, but they do not meet the immediate needs of the family in this situation.

Question 19

Two divorced people plan to marry. The man has a teenager, and the woman has a toddler. This family will benefit most from what form of counseling?

Accepted Answer

This family will benefit most from guidance about parenting at two developmental levels, because two children in different age groups require different parenting techniques. The teenagers need more independence and freedom, whereas the toddler needs more supervision and attention. The couple will benefit from guidance on how to manage these two different developmental stages and provide the best possible care for the children. Role-playing for conflict resolution, formal teaching on problem-solving skills, and referral to a family therapist with divorce counseling experience may be helpful, but they do not specifically address the challenges of parenting at two developmental levels.

Question 20

A patient has become verbally abusive toward their 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

The family is experiencing difficulties coping with the loss of income and the resulting change in family dynamics. This is evidenced by the spouse's depression and the child's running away. Impaired parenting and impaired social interaction are secondary to the family's ineffective coping.

Quiz 11: Working With the Family