Chapter 07: The Nurse and the Family Nursing School Test Banks

Chapter 07: The Nurse and the Family
Linton: Introduction to Medical-Surgical Nursing, 6th Edition

MULTIPLE CHOICE

1. What is the primary reason that family is an important unit in society?
a. Offers unconditional love and acceptance
b. Provides emotional support and security
c. Is essential to life and society
d. Promotes cultural values and attitudes
ANS: B
A family is defined as being joined together by bonds of sharing and emotional closeness.

DIF: Cognitive Level: Comprehension REF: p. 83 OBJ: 1
TOP: The Family Unit KEY: Nursing Process Step: N/A
MSC: NCLEX: N/A

2. What should a nurse assess when a patient comes from an extended family?
a. Multiple wage earners
b. Three generations living together
c. Children from previous marriages
d. Parents of different ethnic origins
ANS: B
The extended family consists of relatives of either spouse who live with the nuclear family. Children, regardless of their parentage, are considered part of the nuclear family.

DIF: Cognitive Level: Comprehension REF: p. 83 OBJ: 2
TOP: Types of Families KEY: Nursing Process Step: Assessment
MSC: NCLEX: Psychosocial Integrity: Psychosocial Adaptation

3. What type of families is most prevalent in the United States according to the latest Census Bureau report?
a. Nontraditional
b. Blended
c. Multigenerational
d. Traditional
ANS: D
Nearly 50% of families live in a traditional family setting according to the2010 Census Bureau report.

DIF: Cognitive Level: Knowledge REF: p. 83 OBJ: 2
TOP: Family Settings KEY: Nursing Process Step: N/A
MSC: NCLEX: N/A

4. In what type of family are children of racial minorities most likely to belong?
a. Blended
b. Extended
c. Traditional
d. Nontraditional
ANS: B
Census Bureau findings from 2000 indicate that children of racial minorities are twice as likely as white children to live in extended families.

DIF: Cognitive Level: Knowledge REF: p. 83 OBJ: 2
TOP: Family Settings KEY: Nursing Process Step: N/A
MSC: NCLEX: N/A

5. A nurse is designing a home care plan for a child with a congenital disease and is assessing the family values regarding home care. What is the best resource for the nurse to use?
a. Current literature on congenital deformities
b. General knowledge of the culture
c. Patients family
d. Written survey
ANS: C
Determining the familys values, beliefs, customs, and behaviors that influence health needs and health care practice is important. The best source is the family itself.

DIF: Cognitive Level: Comprehension REF: p. 84 OBJ: 2
TOP: Cultural Aspects KEY: Nursing Process Step: Planning
MSC: NCLEX: Psychosocial Integrity: Coping and Adaptation

6. A nurse counsels a family regarding the stage of families with adolescents. Which developmental task is appropriate for the nurse to include?
a. Maintaining relationships with the extended family
b. Developing parental roles to meet the needs of children
c. Maintaining a satisfying marital relationship
d. Maintaining open communication between parent and children
ANS: D
The family developmental tasks at this stage include balancing freedom with responsibility and maintaining communication between parents and children.

DIF: Cognitive Level: Comprehension REF: p. 84 | p. 88 OBJ: 3
TOP: Family Life Cycles KEY: Nursing Process Step: Implementation
MSC: NCLEX: Health Promotion and Maintenance: Growth and Development

7. Which developmental task should families master in later life?
a. Becoming role models for their grandchildren
b. Making a significant contribution to society
c. Abandoning the parental role to grown children
d. Maintaining a satisfactory living arrangement
ANS: D
The last stage of the family life cycle includes families in later life who are adjusting to retirement, the aging process, decreased self-esteem, and changes in status and health issues. Maintaining a satisfactory living arrangement is the primary developmental task.

DIF: Cognitive Level: Comprehension REF: p. 85 OBJ: 3
TOP: Family Life Cycles KEY: Nursing Process Step: Planning
MSC: NCLEX: Health Promotion and Maintenance: Growth and Development

8. Culture and social class usually set a precedent for different roles and responsibilities of each family member. Which example best demonstrates the healthiest family?
a. The father assumes the role as breadwinner.
b. The mother assumes the role as homemaker.
c. The father or mother shares the roles of breadwinner and homemaker.
d. The roles of breadwinner or homemaker can be shifted as needed.
ANS: D
A healthy family is one in which the opportunity to shift roles occurs easily from time to time.

DIF: Cognitive Level: Comprehension REF: p. 85 OBJ: 2
TOP: Family Role Structure KEY: Nursing Process Step: N/A
MSC: NCLEX: N/A

9. During a family counseling session, a patient, a mother of a 5-year-old son, states, I dont understand why my husband continually tries to get our son involved in T-ball. My son said the coach and his dad yelled at him and told him the game was lost because he couldnt catch the ball. What is the most important family interaction to maintain a healthy family unit?
a. Maintain open communication among all family members.
b. Encourage self-acceptance and self-esteem for all family members.
c. Encourage all family members to participate in community events.
d. Realize that not all family members may be able to fulfill assigned roles.
ANS: B
The most important influence on family interaction is the self-esteem of each member.

DIF: Cognitive Level: Comprehension REF: p. 86 OBJ: 4
TOP: Family Interaction KEY: Nursing Process Step: Implementation
MSC: NCLEX: Health Promotion and Maintenance: Growth and Development

10. For the past three evenings, shortly after their arrival in the hospital unit, the parents of a 14-year-old daughter begin to argue about the cost of the hospitalization and the time required to come to the hospital. The patient begins to cry and complains about her abdominal pain. What role is the patient assuming?
a. Caretaker
b. Martyr
c. Blocker
d. Scapegoat
ANS: D
A scapegoat usually assumes the role to maintain homeostasis, serving to divert attention from marital conflict between spouses.

DIF: Cognitive Level: Analysis REF: p. 86 OBJ: 4
TOP: Family Role Structure KEY: Nursing Process Step: Assessment
MSC: NCLEX: Psychosocial Integrity: Coping and Adaptation

11. A patient, a 36-year-old mother of four children, is crying. She relates to you that her best friend just told her, You are a good mother and you do everything perfectly, but I dont think you enjoy it. What role is the patient assuming?
a. Caretaker
b. Martyr
c. Contributor
d. Harmonizer
ANS: B
A martyr sacrifices everything for the sake of the family.

DIF: Cognitive Level: Analysis REF: p. 86 OBJ: 4
TOP: Family Role Structure KEY: Nursing Process Step: Assessment
MSC: NCLEX: Psychosocial Integrity: Coping and Adaptation

12. What is the basis for the roles children assume in families?
a. Obligation
b. Instinct
c. Observation
d. Rewards
ANS: D
Parents reward children for fulfilling certain roles, which children adopt and maintain as they mature.

DIF: Cognitive Level: Comprehension REF: p. 86 OBJ: 4
TOP: Family Role Structure KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity: Psychosocial Adaptation

13. A patient confides that her husband shares only the incidental happenings of his day at work as he reads the paper, and he never tells her that he loves her anymore. She is beginning to wonder if their marriage is getting stale. What communication pattern should the nurse recognize?
a. Affective
b. Affectional
c. Functional
d. Dysfunctional
ANS: D
One type of dysfunctional communication involves using chitchat about unimportant daily occurrences to avoid discussing meaningful issues or expressing feelings.

DIF: Cognitive Level: Analysis REF: p. 87 OBJ: 4
TOP: Functional Communication KEY: Nursing Process Step: Assessment
MSC: NCLEX: Psychosocial Integrity: Coping and Adaptation

14. What should a nurse consider when discussing the communication patterns of families with the patient?
a. Cultural aspects of the family
b. Age of the family members
c. Role adopted by each family member
d. Number of members in the family
ANS: A
Although each option has significance, cultural aspects must be considered in determining the functioning level of the family as it affects the roles taken.

DIF: Cognitive Level: Comprehension REF: p. 87 OBJ: 4
TOP: Functional Communication KEY: Nursing Process Step: Planning
MSC: NCLEX: Psychosocial Integrity: Coping and Adaptation

15. A patient states that her 5-year-old daughter is always running up to relatives and friends and wants to give them a big hug and kiss. The patient asks if her daughter is appropriate in her actions. What is the most appropriate reply based on the concepts of functional communication?
a. Your daughters actions are definitely dysfunctional.
b. Your daughter is just being a little girl and will outgrow being so affectionate.
c. Your daughter is going through a normal developmental phase.
d. Does your mother-in-law show signs of affection toward your daughter?
ANS: C
Physical expression of emotion usually dominates in early childhood and is normal in the developmental pattern.

DIF: Cognitive Level: Application REF: p. 86-87 OBJ: 4
TOP: Functional Communication KEY: Nursing Process Step: Implementation
MSC: NCLEX: Health Promotion and Maintenance: Growth and Development

16. For what should functional patterns of communication in the family setting provide a means?
a. Nurturing
b. Information
c. Closeness
d. Openness
ANS: A
Functional patterns of communication include emotional and affective communication that deals with the expression of feelings and nurturing. A healthy family is able to demonstrate a wide range of emotions and feelings.

DIF: Cognitive Level: Comprehension REF: p. 86-87 OBJ: 4
TOP: Functional Communication KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity: Coping and Adaptation

17. What does the manner in which a family unit adapts to stress affect?
a. Ability to communicate and function
b. Health and function
c. Level of affective communication
d. Ability to adapt and function
ANS: B
The manner in which a family handles stress can affect the health of the family.

DIF: Cognitive Level: Comprehension REF: p. 87 OBJ: 5
TOP: Stress and Adaptation KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity: Coping and Adaptation

18. A patient who was recently diagnosed with cancer tells the nurse that she is so grateful for her children and family because she does not know what she would do without them. Which coping response is being exhibited?
a. Internal family
b. External family
c. Family communication
d. Social support
ANS: A
The internal family coping responses are those that the family relationships use as support.

DIF: Cognitive Level: Comprehension REF: p. 88 OBJ: 5
TOP: Coping Strategies KEY: Nursing Process Step: Assessment
MSC: NCLEX: Psychosocial Integrity: Coping and Adaptation

19. What is the main role of the nurse when assessing families and their coping strategies?
a. Emotional support and reassurance
b. Information and reassurance
c. Emotional support and referral
d. Elimination of the stressor
ANS: B
Families need information and reassurance.

DIF: Cognitive Level: Comprehension REF: p. 88 OBJ: 6
TOP: Role of the Nurse KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity: Coping and Adaptation

20. A patient who is recovering from a mastectomy relates that she no longer feels like a woman. What is the best response by the nurse?
a. I am sure you will feel differently when you have your prosthetic bra.
b. Have you told your husband how you feel?
c. I will bring you a catalog that carries built-in prosthetic bras.
d. Would you like me to arrange a visit from Reach for Recovery?
ANS: D
Information through organizations can help a patient learn about what to expect, the disease process, and the recovery.

DIF: Cognitive Level: Application REF: p. 88-89 OBJ: 6 | 7
TOP: Community Resources KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity: Coping and Adaptation

21. A patient states that her mother has just been diagnosed with Alzheimer disease and that she is devastated and does not know what to do. The nurse suggests that she attend a support group meeting where she can discuss her concerns with others. The patient says that she will call and attend a meeting. Which coping strategy is the patient using?
a. Internal family coping by sharing feelings
b. External family coping by seeking information
c. External family coping by seeking social support
d. Internal family coping to maintain a cohesive family unit
ANS: C
Coping responses include internal and external family coping responses. External coping strategies refer to the use of social support systems to solve problems.

DIF: Cognitive Level: Comprehension REF: p. 88-89 OBJ: 5
TOP: Coping Strategies KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity: Coping and Adaptation

22. What is a nursing priority when assessing the coping measures of families under stress?
a. Determine the type of coping mechanisms used by the family in the past.
b. Consider the relationship of the family members.
c. Relieve the anxiety and fear of the family members.
d. Determine what stressors the family is currently experiencing.
ANS: D
Family coping strategies are actions that families use to respond to stressors.

DIF: Cognitive Level: Application REF: p. 87-88 OBJ: 5
TOP: Coping Mechanisms KEY: Nursing Process Step: Assessment
MSC: NCLEX: Psychosocial Integrity: Coping and Adaptation

23. As a nurse is preparing a patient for a colonoscopy, the patient states that she is nervous about the procedure but knows it will help her physician diagnose her problem. Which coping strategy should the nurse recognize the patient is using?
a. Internal family coping by interpreting events in a positive manner
b. Internal family coping by relieving anxiety and tension with humor
c. External family coping by seeking social support
d. External family coping by depersonalizing the procedure
ANS: A
Coping strategies include interpreting the events in a positive way.

DIF: Cognitive Level: Analysis REF: p. 87-88 OBJ: 5
TOP: Coping Strategies KEY: Nursing Process Step: Assessment
MSC: NCLEX: Psychosocial Integrity: Coping and Adaptation

24. What is the best description of the current view of the family as a unit?
a. Functioning together to provide security and support to its members
b. Functioning to meet the needs of society and support its members
c. A unit of two or more that shares common goals and mutual support
d. A unit of two or more joined together by mutual bonds and identity
ANS: D
Friedman (1997) defined the family as . . . two or more persons joined together by bonds of sharing and emotional closeness and who identify themselves as being part of the family.

DIF: Cognitive Level: Comprehension REF: p. 83 OBJ: 1
TOP: Family Role Structure KEY: Nursing Process Step: N/A
MSC: NCLEX: N/A

25. A nurse reminds a patient that communication in the family unit involves continual exchange of information. Which is the best example of this concept?
a. Determining the intent of the communication being sent
b. Determining whether the communication is functional or dysfunctional
c. Accepting individual differences
d. Excluding emotional responses
ANS: C
Clear communication is a way of fostering a nurturing environment. Communication patterns in a functional family demonstrate an acceptance of individual differences, openness, honesty, and recognition of needs.

DIF: Cognitive Level: Comprehension REF: p. 86 OBJ: 4
TOP: Family Communication KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity: Coping and Adaptation

MULTIPLE RESPONSE

26. What is included in the functional communication styles in a family? (Select all that apply.)
a. Openness
b. Subtlety
c. Chitchat
d. Spontaneity
e. Self-disclosure
ANS: A, D, E
Functional communication is open and honest and has no subtlety or superficial chitchat.

DIF: Cognitive Level: Comprehension REF: p. 87 OBJ: 4
TOP: Functional Communication KEY: Nursing Process Step: Assessment
MSC: NCLEX: Psychosocial Integrity: Coping and Adaptation

27. A nurse makes a patient referral to a community resource. What benefit(s) will this referral provide? (Select all that apply.)
a. Provision of helpful literature
b. Ongoing and consistent assistance
c. Reassurance to the family members that they are not alone
d. A variety of free services
e. Organization of a support group
ANS: A, B, C, E
Community resources can provide assistance, literature, and support in an ongoing and consistent manner, but the services are not always free.

DIF: Cognitive Level: Comprehension REF: p. 88 OBJ: 7
TOP: Community Resources KEY: Nursing Process Step: Implementation
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care

COMPLETION

28. A nurse congratulates a patient for successfully coping with a family crisis. The state of having used coping strategies effectively is classified as _____.

ANS:
mastery
Mastery is attained when coping skills are successful in coping with a crisis.

DIF: Cognitive Level: Comprehension REF: p. 87 OBJ: 5
TOP: Mastery KEY: Nursing Process Step: Evaluation
MSC: NCLEX: Psychosocial Integrity: Coping and Adaptation

29. The nurse includes the family in patient care to maintain the familys _____.

ANS:
self-esteem
Self-esteem is supported and maintained when family is given opportunity to contribute to the planning of patient care.

DIF: Cognitive Level: Comprehension REF: p. 86 OBJ: 5
TOP: Maintenance of Self-Esteem KEY: Nursing Process Step: Planning
MSC: NCLEX: Psychosocial Integrity: Coping and Adaptation

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