NURS 1200-Family Dynamics
Which description of family-centered care is correct? 1 The nursing care is focused on the client as an individual. 2 A collaborative plan of care is developed to achieve optimal health. 3 The health care provider is the expert in developing a plan of care. 4 The nursing care is based solely on standards of practice.
A collaborative plan of care is developed to achieve optimal health. Family-centered care is commonly used to describe optimal health care as experienced by families. The term is frequently accompanied by terms such as "partnership," "collaboration," and families as "experts" to describe the process of care delivery. Family care addresses the family versus one individual. The health care provider collaborates with the family to develop a plan of care. Evidence-based standards of practice are incorporated into a collaborative family-centered care plan. Standards are not the only guidelines considered in a family-centered plan of care.
What are the Snellen and Rosenbaum charts used to assess? A. Optic nerve B. Trigeminal nerve C. Abducens nerve D. Facial nerve
A. Optic nerve Rationale: The Snellen and Rosenbaum charts are used to assess the optic nerve. The Snellen chart tests distance vision, and the Rosenbaum chart tests near vision.
Which are exemplars of negative/dysfunctional family dynamics? (Select all that apply.) Codependency Divorce/remarriage Marital infidelity Sibling rivalry Traumatic injury of a family member
Codependency Marital infidelity Sibling rivalry Codependency, marital infidelity, and sibling rivalry are exemplars of negative/dysfunctional family dynamics. Divorce/remarriage and traumatic injury of a family member are exemplars of changes to family dynamics.
The nursing student is learning about the realms of family life. Which component would be included while learning about integrity processes? 1 Family rituals 2 Family relationships 3 Family life stressors and daily hassles 4 Family care takings and responsibilities
Family Rituals The family health system includes five realms, or processes, of family life. These realms are interactive, developmental, coping, integrity, and health. This approach is a method for family assessment used to determine areas of concern and strengths and to help develop an effective care plan. The component of integrity includes family rituals. Family relationships are a part of interactive processes. Family life stressors and daily hassles are considered components of coping processes. Health processes include family care takings and responsibilities.Test-Taking Tip: Identify option components as correct or incorrect. This may help you identify a wrong answer.
A new mother says to the nurse, "I would like to care for my baby independently rather than depending on the baby's grandparents." From this information, which culture would the nurse infer that the new mother belongs to? 1 Asian culture 2 African culture 3 North American culture 4 Latin American culture
North American culture People who belong to North American and Western European cultures generally possess individualistic characteristics. People who belong to Asian, African, and Latin American cultures generally do not possess individualistic characteristics; instead, they have a collectivistic approach. The new mother who belongs to any of these cultures, other than the North American culture, may depend on elder family members for child-rearing.
Which statement or question by the nurse illustrates the role of nursing assistive personnel (NAP) in providing perioperative instruction to the family of a patient scheduled for surgery? A. "Do the family members have any language barriers?" B. "Let me know when the patient's family is visiting with the patient." C. "Which family member seems to be the patient's primary caregiver?" D. "Please give the family a copy of the preoperative literature for cataract surgery."
B. "Let me know when the patient's family is visiting with the patient." Rationale: The nurse may ask the NAP to notify him or her of the family's arrival for a visit. The responsibility for patient and family education may not be delegated to NAP.
How can the nurse evaluate a family's anxiety concerning its role in providing the patient's postsurgical care? A. Observe the rapport among various family members and the patient. B. Interview family members individually about their role in the patient's recovery. C. Ask the family to identify specific areas of concern. D. Determine how much help the family will need.
C. Ask the family to identify specific areas of concern. Rationale: Exploring the family's specific concerns will quickly show the nurse what is causing the anxiety. Although observing the family's interaction is appropriate, doing so will not allow adequate evaluation of the reason for the family members' anxiety. Although appropriate to talk to family members individually, doing so will not allow adequate evaluation of the reason for the family members' anxiety. Although it is appropriate to estimate the family's need for help, doing so will not allow adequate evaluation of the reason for the family members' anxiety.
Which would the nurse consider when caring for a family with three school-aged children as the unit of service? 1 Certain members of the family may be capable of giving more support than the nurse. 2 Assessing each family member is not necessary to plan care for the family as a whole. 3 Family values are not as important as other factors regarding how assistance is perceived. 4 Helping the family requires separating health problems from other aspects of the family's life.
Certain members of the family may be capable of giving more support than the nurse. Family strengths must be identified and used by the nurse. It is necessary to assess each family member to plan care for the whole family. Family values, beliefs, and attitudes greatly influence perceptions. The family members and their problems must be viewed as an integrated whole.
What questions can you ask a patient to assess his or her state of consciousness? A. Ask the patient about his or her thoughts, feelings, and emotions. B. Ask for the date, his or her name, and the location. C. Ask the patient to repeat a series of five numbers. D. Ask the patient to write his or her name and address.
B. Ask for the date, his or her name, and the location. Rationale: Begin with asking the patient today's date, then ask the patient to state his or her name. A patient should be oriented to time, place, and person and be able to respond appropriately to questions about the environment. Thoughts, feelings, and emotions are not part of an assessment for state of consciousness. Repeating a series of numbers is not part of an assessment for state of consciousness. Having the ability to write his or her name and address is not part of an assessment for state of consciousness.
Which of the following cranial nerves is assessed by holding a scented object under the patient's nose? A. Facial nerve B. Oculomotor nerve C. Olfactory nerve D. Acoustic nerve
C. Olfactory nerve Rationale: The olfactory nerve is assessed by having a patient close his or her eyes, inhale deeply, and identifying the smell. The facial nerve is assessed by observing the patient making specific facial movements. The oculomotor nerve is assessed by inspecting the eyelids and by checking the pupils. The acoustic nerve is assessed by performing the whispered voice test.
The nurse is assessing a middle-aged client whose children have left home in search of work. The client is trying to adjust to these family changes. Which family life-cycle stage is the client going through? 1 Family in later life 2 Family with adolescents 3 Unattached young adult 4 Launching children and moving on
Launching children and moving on The client is adjusting to a reduction in family size after the adult children have left home in search of work. The client is going through the launching children and moving on stage of the family life-cycle stage. An individual going through the family in later life stage deals with retirement and the loss of a spouse, siblings, or other peers. The family in the adolescence stage of the family life cycle involves establishing flexible boundaries to accommodate the growing child's independence. Individuals experiencing the unattached young adult stage begin to differentiate themselves from their families of origin. The young adult establishes himself or herself at work while the young adult's parents experience the launching children and moving on stage.
The practice of separating parents from their newborn immediately after birth and limiting their time with the infant during the first few days after delivery contradicts studies related to which? 1 Early rooming-in 2 Taking-in behaviors 3 Taking-hold behaviors 4 Parent-child attachment
Parent-child attachment There is a sensitive period in the first minutes or hours after birth during which it is important for later interpersonal development that the parents have close contact with their newborn. Rooming-in may not be instituted immediately after birth. Taking-in is a maternal psychological behavior described by Reva Rubin that occurs during the first 2 postpartum days. Taking-hold is a maternal psychological behavior described by Rubin that occurs after the third postpartum day.
The nurse working with a family to prepare them for discharge of the father after a stroke would help them to address the things they can control. Which factor should the nurse include in the education? Economic state of society Genetic inheritance Maturity of individuals Psychological defenses
Psychological defenses Nursing intervention can help the family with psychological defense strategies, which are the ways a family reacts to the stress of a member whose health status has changed. This nurse would use knowledge of family stress theory in differentiating things the family can control and things the family cannot control. The family has no control over the economic state of society. The family would have no control over genetic inheritance in this situation. The family would have no control over the maturity of the individuals involved. Psychological defense strategies could promote adaptation of the family unit
Which behavior would be exhibited in a 2-year-old child after the death of a family member? 1 The child shows resiliency over the loss. 2 The child understands the cause of the loss. 3 The child exhibits changes in eating and sleeping patterns. 4 The child is unable to develop an autonomous sense of self.
The child exhibits changes in eating and sleeping patterns. The parent will notice that after the death of a family member, his or her child exhibits changes in eating and sleeping patterns. Older adults, not toddlers, show resiliency over the loss of a family member. Toddlers do not understand the cause of the loss. The loss of a family member may disrupt the development of autonomy in young adults.
What question should the nurse ask to assess the function of a family? Who lives with you? Who does the grocery shopping? Who are the members of your family? How old are the members of your family?
Who does the grocery shopping? The question "Who does the grocery shopping?" would provide information about family functioning and how individuals actually behave in relation to one another. The question "Who lives with you?" would provide information about the structure of the family. The question "Who are the members of your family?" provides information about the structure of the family. The question "How old are the members of your family?" would provide information about family development.
Which of the following actions are part of the assessment of the glossopharyngeal and vagus nerves? A. Testing the gag reflex B. Having the patient swallow C. Touching the patient's face with dull and sharp objects D. Both A and B
D. Both A and B Rationale: Both testing the gag reflex and having the patient swallow are part of a thorough assessment of the glossopharyngeal and vagus nerves. Testing the gag reflex is part of a thorough assessment of the glossopharyngeal and vagus nerves. When the posterior wall of the pharynx is touched, the patient should gag and the uvula should stay midline. Having the patient swallow is part of a thorough assessment of the glossopharyngeal and vagus nerves. Have the patient drink some water while you observe her ability to swallow. Touching the patient's face with dull and sharp instruments is not part of assessment of the glossopharyngeal and vagus nerves.
A client is dying. Hesitatingly, his wife says to the nurse, "I'd like to tell him how much I love him, but I don't want to upset him." Which is the correct response by the nurse? 1 "You must keep up a strong appearance for him." 2 "I think he'd have difficulty dealing with that now." 3 "Don't you think he knows that without you telling him?" 4 "You should share your feelings with him while you can."
"You should share your feelings with him while you can." It is difficult to work through a loss; however, encouraging the sharing of feelings helps both parties feel better about having to let go. The response, "You must keep up a strong appearance for him" impedes the work of acceptance of one's finality and the use of the remaining time to the best advantage. There is no evidence to suggest that the client cannot cope with these emotions; the response, "I think he'd have difficulty dealing with that now" denies that this is a time for closeness and honesty. The response, "Don't you think he knows that without you telling him?" is demeaning, closes off communication, and does not foster the expression of feelings.
Which statement by a new mother observing her preterm infant in the neonatal intensive care nursery indicates that she has not yet begun the bonding process? 1 "It's such a tiny baby." 2 "Do you think he'll make it?" 3 "Why does he need to be in an incubator?" 4 "My baby looks so much like my husband."
"It's such a tiny baby." By failing to acknowledge the infant as a person, the client indicates that she has not released her fantasy baby and accepted the real baby. Acknowledging the infant by using the word "he" denotes a relationship. Saying that the baby looks like her husband indicates that the mother has incorporated the infant into the family.
Which of the following are included in the assessment of mental status? A. Speech and language B. Emotional stability C. Physical appearance and behavior D. All of the above
D. All of the above Rationale: Speech and language, emotional stability, and physical appearance and behavior are all part of a thorough assessment of mental status.
A 50-year-old client has difficulty communicating because of expressive aphasia after a cerebrovascular accident (CVA, also known as a "brain attack"). When the nurse inquired about the client's feelings, the spouse responded. Which communication strategy would the nurse use to address this behavior? 1 Ask the spouse how to know the client's feelings. 2 Instruct the spouse to let the client answer. 3 When the spouse leaves, return to speak with the client. 4 Acknowledge the spouse, but look at the client for a response.
Acknowledge the spouse, but look at the client for a response. The client must have the opportunity to practice language skills; family participation must be accepted and recognized. The spouse should be included and involved in the client's care. Asking the wife how she knows the client's feelings, instructing the wife to let the client answer for himself, and returning to speak with the client when the wife leaves, demeans the spouse and cuts off communication.
What is the primary purpose of promoting preoperative family participation? A. To prepare family members for the role of patient advocate B. To reduce the level of presurgical anxiety for family and patient C. To identify important cultural factors influencing the patient's perception of health and healing D. To evaluate the family's interest in and ability to provide postsurgical care and support to the patient
B. To reduce the level of presurgical anxiety for family and patient Rationale: Presurgical contact with the family supports both the family and the patient as they prepare for surgery. The nurse, not the patient's family, acts as the patient's advocate. Although appropriate to consider cultural factors and to evaluate the family's eagerness to care for the patient and their ability to do so, doing so is not the primary purpose of preoperative family participation
How will the nurse ensure privacy when discussing a patient's surgical needs with the family? A. Include the family in discussions only if the patient makes the request. B. Discuss the patient's right to privacy with all family members who wish to participate. C. Secure the patient's permission to include family members in the presurgical counseling sessions. D. Reassure the patient that he or she will be consulted concerning any surgery-related decision.
C. Secure the patient's permission to include family members in the presurgical counseling sessions. Rationale: Asking the patient's permission to include the family ensures that the patient is fully willing to allow the family to participate in his or her care. Including the family in discussions only if the patient makes the request is not appropriate. The nurse may approach the patient to ask his or her permission to include the family. Although appropriate to discuss the patient's right to privacy with all family members, doing so alone is not sufficient. Although appropriate to reassure the patient that he or she will be consulted concerning any surgery-related decision, this action alone is not sufficient.
Two female adults have an established long-term relationship and are attending parenting classes in anticipation of finalizing the adoption of their first baby. This couple demonstrates understanding of potential effects on family dynamics when making which statement? "Our relationship with one another will not be affected." "Any stress will finally be over once the baby arrives." "Communication may be a challenge since we'll be busier." "Codependency is important to support each other."
Communication may be a challenge since we'll be busier." Addition of children, whether by birth, adoption, or blending families, increases the complexity of interactions in a family, introduces stress, and provides the potential for growth and maturation. Communication and interactions between family members are affected with the addition of new family members. Addition of any new family may place added stress on the relationship of the couple. Codependency refers to the dependence on another individual, usually family member, who actually contributes to negative behaviors, such as substance abuse.
The family of a surgical patient is concerned about being able to provide the care the patient will need after surgery. What is the nurse's best response? A. "I'll have social services look into the possibility of short-term rehabilitative care." B. "Don't worry—your father's recovery should be relatively quick and his need for care minimal." C. "What do you see as being the problem your family has with providing the care he needs?" D. "Are you open to having a home health agency work with you to help provide care?"
D. "Are you open to having a home health agency work with you to help provide care?" Rationale: Offering home health as a possible partner in care takes into account the family's opinion and offers a reasonable solution. Having social services investigate additional care does not allow for the family to be involved in the decision. Minimizing the responsibility of providing care is not respectful of the family's concern. Although asking for specifics encourages open discussion with the family, this reply is likely to make the family feel defensive
Several hours after delivery, a new mother expresses ambivalence regarding her infant. How will the nurse promote bonding between this mother and her newborn? 1 Having the mother feed the infant 2 Removing the infant from the mother's arms if it cries 3 Positioning the infant so its head rests on the mother's shoulder 4 Encouraging the mother to sleep for 4 to 6 hours before interacting with the infant
Having the mother feed the infant Feeding the infant promotes bonding through physical interaction, and positioning the infant in a face-to-face position facilitates eye contact. Removing the infant decreases the pair's time together. Positioning the infant on the mother's shoulder prevents the face-to-face contact that promotes bonding. It is important to have the parent and infant interact as soon as possible after birth to promote bonding.
The nurse is assessing a family composed of a married couple with three children, one from the wife's previous marriage and two from the union of this couple. This couple would be considered what type of family? Married-blended family Nuclear family Same-sex family Single-parent family
Married-blended family This family is a married-blended family with one child from the wife's previous marriage and two children from the union of this couple. A nuclear family refers to the traditional male and female core family with one or more children. A same-sex family is one where two individuals of the same sex have an established relationship and commitment; this may be referred to as a homosexual couple or family, but the preferred term is same-sex family. A single-parent family refers to a family with one adult and one or more children.
The home health care nurse visits a client who lives with her two grandchildren. Which term would the nurse use to define this family form? 1 Nuclear family 2 Extended family 3 Single-parent family 4 Skip-generation family
Skip-generation family A skip-generation family is a kind of alternative family form where the grandparents care for the grandchildren. Divorce, working parents, and single parenthood are some of the reasons that lead to such family forms. A nuclear family consists of a husband and wife and one or more children. An extended family consists of the nuclear family and relatives such as aunts, uncles, cousins, or grandparents. A single-parent family is formed when one parent leaves the household due to death, divorce, or desertion. It may also occur when a single person decides to have or adopt a child.
Which rationale supports the use of family therapy when a child has a terminal illness? 1 It is more efficient to interact with the whole family during a scheduled session. 2 The entire family is involved because what happens to one member affects them all. 3 The parents are less likely to deceive each other about the nature of their child's condition. 4 This mode of intervention allows the nurse to preemptively control manipulation and alliances
The entire family is involved because what happens to one member affects them all. Family therapy views the whole (gestalt) within the context in which the emotional problems are occurring. Efficiency is not an adequate rationale for choosing this therapeutic approach. Promotion of truthfulness is a secondary gain achieved with this mode of therapy. An astute nurse can control manipulation and alliance within any group, but this is not the primary reason for selecting family therapy.
Which statement defines the term "family resiliency"? 1 Each family is unique. 2 The family has an ability to cope with stressors. 3 An interfamilial structure and support system exist. 4 The family has the ability to transcend lifestyle changes.
The family has an ability to cope with stressors. Family resiliency is the ability of the family to cope with expected and unexpected stressors. Family diversity is the uniqueness of each family. Family durability is the interfamilial support system that extends beyond the walls of the household. The parents of this family may remarry or children may leave the home as adults; however, the family is capable of transcending inevitable lifestyle changes.
Which is the primary focus of nursing care in the "family as context" approach? 1 The relationship among family members 2 The health and development of an individual 3 The ability of the family to meet its basic needs 4 The family's process of caregiving for a sick member
The health and development of an individual In the "family as context" approach, the primary focus is the health and development of an individual in a specific environment. The relationship and family processes are the primary focus when the family is viewed as the client. When the family is viewed as the context, the focus is on the ability of the family to meet the basic needs of the individual, not its own needs. The process followed by the family when caring for the sick family member is assessed when the family is viewed as the client.