Chapter 10: Family Dynamics

During a visit to a family clinic, a nurse teaches a mother about immunizations, car-seat use, and home safety for an infant and toddler. Which type of nursing interventions are these? 1. Health promotion activities 2. Acute care activities 3. Restorative care activities 4. Growth and development care activities

Answer: 1

A family has decided to care for a grandparent with terminal cancer in the daughter's home. Family caregiving is new to the family. When helping this family as they begin to plan for their caregiving roles, what are the two top priority assessments to best learn about family functioning? (Select all that apply.) 1. Communication 2. Decision making 3. Development 4. Economic status 5. Family structure

Answer: 1, 2

A new immigrant family consisting of a grandparent, two adults, and three school-age children has decided to receive their health promotion care at the Community Wellness Center. This is their first visit, and a family assessment, a health history, and a physical of each family member are needed. Which of the follow- ing are included in a family function assessment? (Select all that apply.) 1. Cultural practices 2. Decision making 3. Neighborhood services 4. Rituals and celebrations 5. Neighborhood crime data 6. Availability of parks

Answer: 1, 2

A family is facing job loss of the father, who is the major wage earner, and relocation to a new city where there is a new job. The children will have to switch schools, and his wife will have to resign from the job she likes. Which of the following contribute to this family's hardiness? (Select all that apply.) 1. Family meetings 2. Established family roles 3. New neighborhood 4. Willingness to change in time of stress 5. Passive orientation to life

Answer: 1, 2, 4

A family consisting of a grandparent, two adults, and three school age children just immigrated to the United States. They come to a community wellness center to establish health care. Which of the following questions does the nurse ask to assess the family's function? (Select all that apply.) 1. "What does your family do to keep members healthy?" 2. "How does your family usually make decisions?" 3. "What health services are available in your neighborhood?" 4. "Which rituals or celebrations are important for your family?" 5. "Is there a lot of crime in your neighborhood?" 6. "How many parks are there in your community?"

Answer: 1, 2, 4. Cultural practices, decision making, and rituals and celebrations describe what is important to a family. This set of assessment data helps you gain insight into how the family functions and what they consider important to their health and family functioning.

A family is facing job loss of the father, who is the major wage earner, and relocation to a new city where there is a new job. The children will have to switch schools, and his wife will have to resign from the job she enjoys. Which of the following contribute to this family's hardiness? (Select all that apply.) 1. Family meetings 2. Established family roles 3. New neighborhood 4. Willingness to change in time of stress 5. Passive orientation to life

Answer: 1, 2, 4. Family hardiness refers to the internal strengths and durability of the family unit. A sense of control over the outcome of life, a view of change as beneficial and growth producing, communication with family members (as in family meetings), well-established family roles among family members, and an active rather than passive orientation in adapting to stressful events all contribute to family hardiness.

Which of the following are possible outcomes with clear family communication? (Select all that apply.) 1. Family goals 2. Increased socialization 3. Decision making 4. Methods of discipline 5. Improved education 6. Impaired coping

Answer: 1, 3, 4

A nurse is caring for a 66-year-old patient who lives alone and is receiving chemotherapy and radiation for a new cancer diagnosis. He is unable to care for himself because of severe pain and fatigue. He moves into his 68-year-old brother's home so his brother can help care for him. Which assessment findings indicate that this family caregiving situation will be successful? (Select all that apply.) 1. Both the patient and his brother attend church together regularly. 2. The brothers are living together and enjoy eating the same foods. 3. Other siblings live in the same city and are willing to help. 4. The patient and his brother have a close network of friends. 5. The patient has obsessive-compulsive disorder and has difficulty throwing away possessions.

Answer: 1, 3, 4. Many older adults use their faith and spirituality to cope with life changes. Having a close social network and other family members who are willing to assist with caregiving helps to alleviate the stress experienced by caregivers. Potential risk factors for caregiver distress and burden in this relationship include that the brothers are living together and that one of the brothers has a mental illness.

You are caring for a family that consists of a father and 3-year-old boy who has well-managed asthma but misses care infrequently. They live in state-supported housing. The father is in school studying to be an information technology professional. His income and time are limited, and he admits to going to fast-food restaurants frequently for dinner. However, he and his son spend a lot of time together. The family receives state-supported health care for his son, but he does not have health insurance or a personal physician. He has his son enrolled in a government-assisted day care program. Which of the following are risks to this family's level of health? (Select all that apply.) 1. Economic status 2. Chronic illness 3. Underinsured 4. Government-assisted day care 5. Frequency of fast-food dinners 6. State-supported housing

Answer: 1, 3, 5

A family is undergoing a major change. Just as twins graduate from college and leave home to begin their careers, the husband loses his executive well-paying job. Because the family had two children in college at the same time, they did not save for retirement. They planned to save aggressively after the children left college. In this situation, which of the following demonstrate family resiliency? (Select all that apply.) 1. Resuming full-time work when a spouse loses job 2. Increasing problems among siblings 3. Developing hobbies when children leave home 4. Placing blame on family members 5. Expecting children to help financially 6. Consulting a financial planner

Answer: 1, 3, 6

A patient who is newly diagnosed with breast cancer states, "Although I am really scared about what is going to happen to me, I know my family will learn from this experience, and we will be stronger in the end." What term does the nurse use in the patient's medical record to describe the characteristic displayed in this statement? 1. Resiliency 2. End-of-life care 3. Family functioning 4. Family's culture

Answer: 1. Family resiliency helps families maintain a healthy response even when they are experiencing stressful events.

A hospice nurse is caring for a family that is providing end-of-life care for their grandmother, who has terminal breast cancer. When the nurse visits, the focus is on symptom management for the grandmother and helping the family with coping skills. This approach is an example of which of the following? 1. Family as context 2. Family as patient 3. Family as system 4. Family as structure

Answer: 2

What is the most common reason for calling on grandparents to raise their grandchildren? 1. Single parenthood 2. Legal interventions 3. Dual-income families 4. Increased divorce rate

Answer: 2

A family has decided to care for their father who is in the last stages of a debilitating neurological illness. Although he is alert, he cannot speak clearly or carry out self-care activities; he indicates that he wants to remain involved in family life as long as possible and loves spending time with his wife and two teenage children. Which best defines family caregiving? (Select all that apply.) 1. Designing a nurturing family to raise children 2. Providing physical and emotional care for a family member 3. Establishing a safe physical environment for a family 4. Monitoring for side effects of illness and treatments 5. Reducing the use of community resources

Answer: 2, 3, 4

A mother and her two children are homeless and enter a free health care clinic. Which statements most likely describe the effects of homelessness on this family? (Select all that apply.) 1. The children have stability in their education. 2. The family members may have symptoms of malnutrition, such as anemia. 3. The family is at a low risk for experiencing violence. 4. The children are at higher risk for developing ear infections. 5. All family members may have mental health issues.

Answer: 2, 4, 5. Families who are homeless often experience difficulty in accessing food and have a poor nutritional status. Children are at a higher risk for developing ear infections. Homelessness puts all family members at risk for developing mental health issues. Children have difficulty proving residency for school enrollment, so they are more likely not to be in school or to drop out. Families that are homeless are also at a higher risk for experiencing physical and emotional violence.

During a visit to a family clinic, a nurse teaches a mother about immunizations, the use of car seats, and home safety for an infant and toddler. Which type of nursing interventions are these? 1. Restorative 2. Health promotion 3. Acute care 4. Growth and development

Answer: 2. Health promotion activities focus on interventions designed to maintain the physical, social, emotional, and spiritual health of the family unit, including information about specific health behaviors and family coping techniques.

A hospice nurse is caring for a family that is providing end-of-life care for their grandmother, who has terminal breast cancer. The nurse focuses on symptom management for the grandmother and on helping the family with developing coping skills. This approach is an example of which of the following? 1. Family as context 2. Family as patient 3. Family as a system 4. Family as structure

Answer: 2. When the family as patient is the approach, the family's needs, processes, and relationships (e.g., parenting or family caregiving) are the primary focuses of nursing care.

Which of the following family assessments are most important for successful family caregiving? (Select all that apply.) 1. Educational level of family members 2. Cultural food preferences 3. Collaboration between family members 4. Social support 5. Conflict resolution practices

Answer: 3, 4, 5

A married couple has three children. The youngest child just graduated from college and is moving to a different city to take a job. The other two children left the home several years ago. Both of their parents are older and are beginning to need help to maintain their home. What assessment questions will help the nurse determine the family's functioning? (Select all that apply). 1. Which transitions or changes in your family are you currently experiencing? 2. Are your children having any problems that are affecting your family right now? 3. Describe a recent family conflict and how your family resolved it. 4. What coping strategies do you typically use as a family? 5. Who is involved in helping care for your parents?

Answer: 3, 4, 5. This family is recently without children and has older parents to assist. Assessment questions about family functioning address how individuals behave in relation to one another, which is reflected in questions that determine how the family completes routine activities (e.g., making meals, doing laundry), communicates, and solves problems.

A family includes a mother, a stepfather, two teenage biological daughters of the mother, and a biological daughter of the father. The father's daughter just moved home following the loss of her job in another city. The family is converting a study into a bedroom and is in the process of distributing household chores. Nursing assessment reveals all members of the family think that their family can adjust to lifestyle changes. This is an example of family: 1. Diversity. 2. Durability. 3. Resiliency. 4. Configuration.

Answer: 3. Resiliency is the ability of the family to cope with the unexpected. This family used resources to provide some short-term solutions for the return home of an adult child.

In viewing the family as context, what is the primary focus? 1. Family members within a system 2. Family process and relationships 3. Family relational and transactional concepts 4. Health needs of an individual member

Answer: 4

Two single mothers are active professionals and have teenage daughters. They also have busy social lives and date occasionally. Three years ago they decided to share a house and housing costs, living expenses, and child care responsibilities. The children con- sider one another as their family. What type of family form does this represent? 1. Diverse family relationship 2. Blended family relationships 3. Extended family relationship 4. Alternative family relationship

Answer: 4

Which of the following most greatly affects a family's access to adequate health care, opportunity for education, and sound nutrition? 1. Development 2. Family function 3. Family structure 4. Economic stability

Answer: 4

A 7-year-old child was recently diagnosed with asthma. A nurse is providing education to the child and her parents about the treatment and management of asthma and changes they need to make in their home environment to promote her health. Which statement made by the parents requires follow-up by the nurse? 1. "We have made an appointment to talk with the school nurse about the change in our child's health." 2. "We forgot to give our daughter her medications before bedtime, so we made a list of her medications to help us remember." 3. "We have worked out a schedule to check on her before and after school." 4. "We have not been spending time with our parents because we are so busy taking care of our daughter."

Answer: 4. Changes in family relationships indicate possible family caregiver stress.