Chapter 38- Families and Their Relationships Nursing School Test Banks

 

1.

The nurse is assessing a family for potential sources of conflict. Which of the following assessment findings would not be a potential source of conflict?

A)

The mother and father both work outside the home

B)

The fathers parents live next door.

C)

Lower socioeconomic status

D)

Recent relocation for new jobs for both parents

Ans:

D

Feedback:

Potential sources of conflict include both parents working outside the home and sharing child rearing roles, inlaws, lower socioeconomic status, and relocation for the benefit of only one family member.

2.

The nursing instructor has just finished a lecture on family function. Which statement by a student indicates a need for further education?

A)

Previous life experiences can affect the way a family functions.

B)

Chronic illness does not affect the way a family functions, only acute illnesses do.

C)

A familys culture may affect the way a family functions.

D)

A change in a persons lifestyle may affect the way their family functions.

Ans:

B

Feedback:

Factors that affect family function include culture, values and beliefs, economics, lifestyle, previous life experience, stress, and illness.

3.

The nurse is providing assistance to a family experiencing altered family function. Which of the following interventions should the nurse utilize? Select all that apply.

A)

Assist the family to clarify the conflict

B)

Correct misconceptions

C)

Focus on facts, not feelings

D)

Stress effective communication practices

E)

Provide concrete feedback

Ans:

A, B, D, E

Feedback:

Aim interventions at resolving family conflicts by first identifying the participants willingness to acknowledge a problem and to work on their ability to communicate. Stress effective communication practices. Allow each member to speak, listen, and express feelings as well as facts. Clarify the conflict with participants, help participants identify contributing factors, correct misconceptions, provide concrete feedback based on nursing observations, assist participants to develop solutions, and support decision making among participants.

4.

A patient states, I cant go to therapy everyday. I cant miss that much work. They will fire me and then how will I provide for my family? Which is the most appropriate nursing diagnosis?

A)

Ineffective Role Performance

B)

Caregiver Role Strain

C)

Denial

D)

Interrupted Family Process

Ans:

A

Feedback:

The patient is concerned about his ability to provide for his family. Ineffective Role Performance would be the most appropriate diagnosis. Caregiver Role Strain focuses on the caregiver. Denial is not a NANDA-I approved nursing diagnosis. Interrupted Family Process would be applicable if the patient did lose his job and was not able to provide for his family.

5.

The hospice nurse has completed a family function assessment on a patient who is dying. Which of the following behavioral signs would suggest family dysfunction?

A)

The patient states, I cant live like this anymore.

B)

The patients mother is laughing one minute and crying the next.

C)

The patients daughter states, I havent slept in 3 days.

D)

The patient makes good eye contact during the assessment.

Ans:

B

Feedback:

Objective data for assessing family function includes observation of family interactions and the behavior of members, as well as physical examination. Behavioral signs of family dysfunction include labile emotions, withdrawal, irritability, poor sleeping and eating, inability to concentrate, and dependency. Direct quotes are subjective data.

6.

The nurse has completed an altered family function risk assessment and has identified several potential risk factors for the family. Which of the following would not be considered a risk factor for altered family function?

A)

Father has a history of drug abuse

B)

Grandparents live next door

C)

Child has a diagnosis of ADHD

D)

Mother lost her job 2 weeks ago

Ans:

B

Feedback:

Characteristic risk factors for potential alterations in family processes include unrealistic expectations of self or others; lack of appropriate role models; history of abuse; inability to bond with others; inadequate support systems; presence of stress; skill or knowledge deficit; acute or chronic illness; and unmet psychosocial needs of children or adults

7.

The nurse is preparing to do an altered family function risk assessment on a patient. Which question should the nurse ask first?

A)

What are the potential sources of stress in your family?

B)

Are you able to cope with family health problems?

C)

Tell me about your familys eating habits?

D)

What is the general sleep pattern in your family?

E)

How would each member describe this family?

Ans:

A

Feedback:

History taking to identify areas of risk or potential problems requires both open-ended and focused questioning. Questions related to potential sources of stress in the areas of roles, finances, lifestyle, previous experience, and general health are crucial. Follow a general question, such as What are the potential sources of stress in your family? with more specific questions.

8.

The nurse is caring for a patient who is an alcoholic. The patients daughter states, I dont understand why my mother keeps buying beer for my dad. She wont admit that hes an alcoholic. Which of the following is the best response by the nurse?

A)

Your father would still be an alcoholic even if your mother didnt buy his beer.

B)

Your mother is trying to keep your family functioning.

C)

Your father is an enabler.

D)

If your mother stopped buying beer for your father he would most likely stop drinking.

Ans:

B

Feedback:

A spouse or child usually becomes the alcoholics enabler, the person who keeps the family functioning even at an altered level. The enabler assumes tasks that the alcoholic cannot accomplish and cares and makes excuses for the alcoholic. These behaviors enable the alcoholic to continue drinking, which contributes to the deterioration of the family unit.

9.

The nurse is concerned that a child may have been neglected or abused at home. Which of the following assessment findings would not support this concern?

A)

Diagnosis of failure to thrive

B)

A strong attachment to the parental figure

C)

Multiple bruises to the childs back

D)

Underweight for age and height

Ans:

B

Feedback:

A lack of attachment (bonding) may be evidenced by an adults failure to care for the childs physical or emotional needs or by verbalized resentment or indifference toward the parenting role. Evidence of neglect or physical abuse may be noted, as well as failure to thrive.

10.

A nursing instructor has been discussing abuse with a group of students. Which statement by a student indicates a need for further education?

A)

Factors that contribute to abuse in families include unemployment, substance abuse, and chronic illness.

B)

Many abused children grow up and abuse their own children.

C)

Changing abusive patterns is easy once they are detected.

D)

Abuse can happen in any socioeconomic status.

Ans:

C

Feedback:

Factors that contribute to abuse in families include unemployment, substance abuse, chronic illness, inadequate housing, and lack of education and other resources (Chartier, Hesselbrock, & Hesselbrock, 2009; Moracco, Runyan, Bowling & Earp, 2007). Abuse is not limited to any one socioeconomic level and frequently is passed down through the generations. Many abused children grow up to abuse family members. Changing abusive patterns of behavior is difficult.

11.

A student nurse is preparing a presentation on the functions of a family. What information should the student include? Select all that apply.

A)

Family functions do not change over time

B)

Economic provisions of care

C)

Socialization

D)

Provide nurturing

E)

Provide support and security for family members

Ans:

B, C, D, E

Feedback:

The usual functions of families involve physical and economic provisions of care, sexual intimacy, reproduction, education, socialization (including communication), and nurturing and support for problem solving and goal setting. Besides the physical bonds of family relationships, members experience emotional bonds that provide support and security for members, thereby fostering growth and development. Like family structures, family functions evolve over time within individual families.

12.

A patient states that she has just moved in with her boyfriend. They are going to try living together prior to getting married. The nurse would document this as what type of family?

A)

Blended

B)

Cohabitated

C)

Extended

D)

Nuclear

Ans:

B

Feedback:

Cohabitated family structure means people living together without the formal or legal bond of marriage. Blended families or stepfamilies include children who live with one birth parent and one non-birth parent, as well as any offspring of the non-birth parent. Extended families include grandparents, aunt/uncles, and/or cousins.

13.

A child states that she lives with her parents, sister, and grandmother. The nurse would document this as what type of family?

A)

Extended

B)

Cohabitated

C)

Nuclear

D)

Blended

Ans:

A

Feedback:

The extended family structure expands the previously listed family types by adding grandparents, aunts, uncles, and cousins. Cohabitated family structure means people living together without the formal or legal bond of marriage. Members of a blended family (stepfamily) include children who live with one birth parent and one non-birth parent, as well as any offspring of the non-birth parent. The nuclear family traditionally includes a married adult man and woman and their children.

14.

During a home visit in the postpartum period, the nurse notes the patient is having difficulty with breastfeeding. The nurse should refer the patient to

A)

A nurse practitioner

B)

LaLeche League International

C)

Parent effectiveness training

D)

Nurses for Newborns

Ans:

B

Feedback:

Professional referrals and peer support groups may be sources of help to those experiencing difficulty with parenting roles. LaLeche League International focuses on issues with breastfeeding.

15.

The spouse of a terminally ill woman states, I cannot do this anymore. It is so hard to go to work every day and leave her. I know she is dying and we have such limited time, but my company will not give me any more time off. The most appropriate nursing diagnosis is

A)

Caregiver role strain related to difficulty with specific caregiving activities as evidenced by situational factors with other responsibilities

B)

Ineffective family coping related to terminal illness and impending death

C)

Ineffective family coping related to cancer as evidenced by statements of anxiety

D)

Altered family processes related to age of caregiver and employment responsibilities

Ans:

A

Feedback:

The most appropriate nursing diagnosis is caregiver role strain since the caregivercare receiver relationship is changed.

16.

The daughter of an ill patient states, I feel so guilty that I have to go to work and cannot be with my mother. The nurse realizes this statement reflects

A)

Caregiver role conflict

B)

Separation anxiety

C)

Coping with change

D)

Fear of the unknown

Ans:

A

Feedback:

As an ill family member experiences change, the caregivers role changes as well. This may be evidenced by verbalization of feelings of inadequacy, guilt, anxiety, failure, helplessness, and powerlessness.

17.

Using an interactional approach, the nurse focuses the assessment of a family on the familys

A)

Cultural practices

B)

Developmental stages

C)

Communication patterns

D)

Potential sources of stress

Ans:

C

Feedback:

Communication patterns are considered key to an interactional approach.

18.

When a member of the family is diagnosed with malignant cancer, the family functioning may be affected primarily by the

A)

Economic impact of the illness

B)

Absence of role models

C)

Family strengths

D)

Maintenance of roles

Ans:

A

Feedback:

Common stressors in chronic illness include exhaustion, anxiety, needing help from relatives and friends, alterations in social contacts or travel abilities, concern about sibling needs, and financial concerns. Family roles, responsibilities, and social relationships change to meet the needs of the family system as well as the ill child or adult.

19.

Research has shown that children of employed mothers are able to develop well and have their needs met as long as

A)

The parent has sufficient support

B)

Adequate childcare is provided

C)

The parent is well educated

D)

No crisis occurs in the family

Ans:

B

Feedback:

Research has shown that children of employed mothers are able to develop well and have their needs met as long as adequate childcare is available.

20.

A couple with two children are also caring for an aging parent who has become physically disabled. The couple may experience

A)

Frustration

B)

Substance abuse

C)

Illness

D)

Economic stability

Ans:

A

Feedback:

Relationships with aging parents may result in conflict, frustration, and/or anger as older adults become more dependent.

21.

A teenage girl does not physically develop as quickly as her peers. This can impair her

A)

Future development

B)

Physically

C)

Hygiene

D)

Psychosocially

Ans:

D

Feedback:

Psychosocial development is closely related to changes in physical development.

22.

You are working on the oncology division at a local hospital. An elderly patient has just passed away. He was very close to his grandchildren. To address care of the family, the nurse should

A)

Assist with funeral arrangements at the mortuary

B)

Assure preschoolers it is not their fault

C)

Tell toddlers grandpa died and is not coming back

D)

Only allow immediate family with the deceased

Ans:

B

Feedback:

Family members should assure preschool children that changes such as death are not their fault.

23.

The nurse instructs the parents of two preschool-aged children that children learn about relationships early in life primarily from

A)

Parents

B)

Peers

C)

Teachers

D)

Siblings

Ans:

A

Feedback:

Preschoolers identify with the role of man or woman as they interact differently with parents or primary caregivers. The caregiver of the opposite sex becomes the focus of the childs love, whereas the child may direct aggression toward adults of the same sex.

24.

A nurse working in a daycare setting understands that a common issue with toddlers is

A)

Neglect

B)

Separation anxiety

C)

Depression

D)

Sibling rivalry

Ans:

B

Feedback:

Despite power struggles, toddlers remain attached to their caregivers, and severe separation anxiety may be noted when primary caregivers leave these children from 18 to 24 months of age.

25.

Which of the following terms describes a support function of the family structure?

A)

Formal education

B)

Economic stability

C)

Problem solving

D)

Reproduction and unity

Ans:

C

Feedback:

The usual functions of families involve physical and economic provisions of care, sexual intimacy, reproduction, education, socialization, and nurturing and support for problem solving and goal setting.

26.

When a patient tells the nurse that she is divorced and remarried with one son from her first marriage, the nurse documents the patients family structure as

A)

Extended

B)

Blended

C)

Cohabitated

D)

Divided

Ans:

B

Feedback:

Members of a blended family include children who live with one birth parent and one non-birth parent, as well as any offspring of the non-birth parent.

27.

Because of high divorce rates and separations in recent years, there has been a significant increase in the family structure termed

A)

Single-parent

B)

Communal

C)

Extended

D)

Foster child

Ans:

A

Feedback:

Single-parent families, composed of one parent and one or more children, more than doubled from 11% in 1970 to 24% in 2000, because of increasing rates of separation and divorce.

28.

Which of the following statements is accurate related to the nuclear family structure in the United States?

A)

The number of traditional families is stable.

B)

It includes single-parent families.

C)

There are 17.3 million nuclear families in the United States.

D)

It included blended families.

Ans:

A

Feedback:

The number of traditional families remained stable over the last 30 years, ranging from 23.5 million to 26 million.

29.

When providing care to an elderly patient living with her son and daughter-in-law, the nurse assesses the patient and family. This is an aspect of

A)

Patient-centered nursing interventions

B)

Outcome criteria for care

C)

Family-centered care

D)

Age-related nursing care

Ans:

C

Feedback:

Nurses who practice family-centered care, which means caring for the patient and family as a unit, recognize the positive aspects of diversity and facilitate patient/caregiver/professional collaboration.

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