Professional Nursing EAQ: Ch. 10- Family Nursing

The caregiver of a young child with unmet social needs tells the nurse, "The child lives with his parents and grandparents." Which characteristic of the family is involved in the social challenge? Diversity Durability Resiliency Configuration

1 The nurse tries to understand the family dynamics before initiating nursing care. Family diversity refers to the uniqueness of each family unit. Grandparents, parents, and young children living together is a unique feature of the family. If the child has unmet social needs, it indicates that there is a problem with the family diversity. Family durability is the ability to withstand pressures or changes in the family's structure. Therefore, durability is not involved in unmet social needs. Family resiliency is the ability of the family to cope with stressors. It has no role in unmet social needs. Configuration is the makeup of the family, which includes the number of people in the family.

The nurse is caring for a couple whose son relocated to a different country for better job prospects. What strategies should the nurse suggest to help the couple cope with their new family form? Select all that apply. Adjust to reduction in family size. Develop adult-to-adult relationship with children. Take on parental roles. Adjust the marital system to make space for children. Refocus on career issues.

1, 2 The nurse should help the couple to cope with the children's exits from the family as the grown children leave. The couple should try to adjust to the reduced family size. The couple should try to develop an adult-to-adult relationship with their adult children. Taking on parental roles and adjusting the marital system to make space for children is applicable for a family with young children. Refocusing on a career is a coping strategy for a family with adolescents. p. 121

The nurse is assessing a family in which a wife is providing care for her husband, who is bedridden due to a chronic ailment. What observations made by the nurse confirm that the wife is experiencing caregiver burden? Select all that apply. Changes in mood Tension in the relationship Changes in wife's level of health Changes in the patient's treatment Improvement in the patient's health

1, 2, 3 A caregiver experiencing role strain may have mood changes due to stress. The relationship between the patient and his wife may become tense due to the demands of caregiving. A change in the caregiver's health indicates that the caregiver is stressed due to the responsibilities. A change in the patient's treatment may be due to the improvement or aggravation in the health. The patient's improving health status would decrease the wife's burden of caring for the patient.

The nurse is teaching a group of teenagers about adolescent pregnancy. Which information should the nurse include? Select all that apply. Adolescent mothers may lack support. Adolescent mothers may be unable to complete their education. Adolescent mothers may find motherhood stressful. Adolescent mothers are prepared for a parenting role. Adolescent mothers are well informed about motherhood.

1, 2, 3 Adolescent mothers may not be very well accepted in their families and may lack support from the partner's side. Due to the responsibilities of motherhood, adolescent mothers may have to stop their education, which may lead to poor job prospects. Inadequate job skills, financial burdens, and inadequate health care resources can make motherhood stressful for adolescent mothers. Adolescent or teenage mothers are often psychologically and physically unprepared for a parenting role. They often lack adequate knowledge and understanding of the responsibilities involved in motherhood.

Which factors are included in a family function assessment? Select all that apply. Cultural practices Decision making Rituals and celebrations Neighborhood crime data Family status of influenza vaccinations

1, 2, 3 Cultural practices, decision making, rituals, and celebrations are included in a family function assessment. Cultural practices help identify culturally related health practices, diets, and religious practices. Decision making provides information as to how the family copes and meets challenges related to changes in family life or dynamics. Rituals and celebrations address how a family celebrates accomplishments and how they deal with challenges. Neighborhood crime data are relevant for community assessment, but they do not give sufficient information about family function. The status of influenza vaccinations is part of the health processes of the family assessment plan.

Which options contribute to family hardiness? Select all that apply. Family meetings Established family roles Willingness to change in times of stress Passive orientation to life Positive perceptions of self

1, 2, 3 Family hardiness is the internal strengths and durability of the family unit. It includes a sense of control over the outcome of life, a view of change as beneficial and essential for growth, and an active orientation (such as family meetings) rather than a passive orientation in adapting to stressful events. Family meetings, understanding of roles, and the adaptation to stressors along with a willingness to change affect family hardiness.

The nurse is teaching a family about the caregiver's responsibilities in a family. Which activities should the nurse include in the caregiver's responsibilities? Select all that apply. Provide personal care. Monitor for complications. Improve family coping. Provide emotional support. Prescribe medications.

1, 2, 3, 4 A caregiver's responsibilities include providing personal care such as bathing and feeding. The caregiver also monitors for complications and side effects of treatment, and informs the health care provider. By providing care, the caregiver improves the family's ability to cope with the illness. The caregiver is responsible for providing emotional support to the patient and the entire family. A caregiver does not prescribe medications but ensures that the medications are administered correctly.

The nurse is teaching a family about the caregiver's role. What changes in a caregiver should the family learn to identify as signs of caregiver role strain? Select all that apply. The caregiver has a change in appetite. The caregiver is socially withdrawn. The caregiver is fearful of learning new therapies. The caregiver experiences anger and irritability. The caregiver takes an interest in his or her personal appearance.

1, 2, 3, 4 When a caregiver experiences role strain, there will be a change in the caregiver's appetite or weight. The caregiver is socially withdrawn due to limited opportunities for socialization. The caregiver will be fearful of learning new therapies or administering new medication to the patient due to stress. Role strain also brings behavioral changes such as anger and irritability. A caregiver who experiences role strain is too stressed to care about his or her personal appearance.

The nurse is caring for a 70-year-old patient who lives with her children and grandchildren in an extended family. The patient is suffering from chronic bronchitis and does not want to be admitted to the hospital. The family has decided to take care of the patient at home. The patient's 35-year-old daughter takes care of the patient. What interventions should the nurse suggest to manage the caregiver's role strain? Select all that apply. Set alternating schedules to give the caregiver some rest. Arrange a support system to provide groceries, meals, and housekeeping for the caregiver. Identify community resources such as support groups. Suggest that the patient be hospitalized. Educate and provide training to the caregiver for effective caregiving.

1, 2, 3, 5 Setting an alternating schedule helps ensure that the caregiver gets rest from the caregiving role. The caregiver's stress may be reduced if the groceries, meals, and housekeeping activities are taken care of. The family can also look to community support groups for help. If the patient does not want to be hospitalized, she should not be forced. Educating the caregiver on ways to provide effective care helps to reduce the stress of caregiving.

The community health nurse performs an assessment of families and categorizes them under different family forms. Which groups would the nurse identify as alternative family forms? Select all that apply. Multi-adult household Communal groups with children Husband and wife caring for children Grandparents caring for grandchildren Single parent caring for an adopted child

1, 2, 4 Alternative family types include family situations that are different from traditional family types, but share personal ties similar to a traditional family. Communal groups with children are an alternative family type but have a set of relationships between the groups. Grandparents caring for grandchildren is a type of alternative family, even though there is a relationship. A husband and wife caring for children is a nuclear family. A single parent caring for an adopted child is a single-parent family.

The nurse is caring for a 5-year-old girl who is living with her family. The family includes her parents and a grandmother who is 65 years old. The girl is suffering from tuberculosis. The nurse visits the girl daily to administer medication. What should the nurse advise the family to do? Select all that apply. Maintain hygiene and cleanliness at home. Strengthen the economic resources. Admit the patient to the hospital. Take measures to prevent the spread of infection. Gather all the neighbors for tuberculosis screening.

1, 2, 4 Chronic illnesses pose unique challenges for the family. The nurse should teach a family to maintain cleanliness at home to prevent diseases. If possible, the family should strengthen their economic resources to face the costs of the chronic illness. The family should be taught measures to prevent the spread of infection from the patient to healthy family members. Immediate hospitalization of the patient is not required, because tuberculosis can be managed at home. Screening tests for tuberculosis are required only for the family members.

The nurse is caring for a 5-year-old girl who is living with her family. The family includes her mother and a grandmother who is 65 years old. Her father is in the military. The girl's parents divorced a year before. Her mother works in a store, and the grandmother takes care of the girl. What societal factors have led to this new parenting responsibility for grandparents? Select all that apply. Single parenthood Both parents working Rich grandparents Increased rates of divorce Blended family

1, 2, 4 Many grandparents are raising their grandchildren due to high divorce rates and because the current state of the economy has resulted in both parents having to work. Thus single parenthood, both parents working, and increased rates of divorce are societal factors leading to new parenting responsibilities for grandparents. The grandparents' wealth does not influence whether or not they care for their grandchildren. A blended family is formed when parents bring unrelated children from prior adoptive or foster parenting relationships into a new, joint living situation.

The nurse is caring for a teenaged patient who is a pregnant. The nurse understands that teenage pregnancies carry a risk for complications. How should the nurse determine if this patient and her partner need supportive measures? Select all that apply. Identify pregnancy-associated stressors. Identify stressors in the father. Evaluate the patient's beliefs about pregnancy. Assess the patient's level of achievement of developmental tasks. Evaluate the contraceptive methods the patient used.

1, 2, 4 The nurse should evaluate the stressors in the pregnant patient and the stressors in the father. Teenage pregnancy may cause a lot of stress for the girl and her partner. These stressors usually interfere with the normal tasks of development, so the nurse should assess these tasks of development. Because the patient has already conceived, assessment of beliefs about pregnancy and contraceptive methods is currently irrelevant.

The nurse is teaching a group of caregivers about how to apply family nursing. What instructions would the nurse include in the teaching? Select all that apply. Focus interventions on the family's strengths. Teach older children to be part of the support system. Assign all care tasks to the primary caregiver, regardless of experience. Focus only on weaknesses and challenges in order to improve them. Encourage the caregiver to set a routine time for respite.

1, 2, 5 Family health nursing should focus interventions on the family's strengths. If one family member is better at doing something, that family member should be involved in the same care. Older children can be a valuable resource and should be made a part of the support system. They should be taught the ways to participate in the care of a family member. The caregiver should be encouraged to set a routine time for respite because taking occasional breaks from caregiving is necessary for the health of the caregiver. Consider the primary caregiver's experience when designing the intervention. Build on the strengths of the patient and the caregivers, including their sense of hope, rather than focusing solely on any weaknesses and challenges.

A patient with prostate cancer is in the terminal stage of the disease and wishes to have home care. How can the nurse help the family achieve optimal end-of-life care? Select all that apply. Advise the family members to apply for hospice care. Provide grief support measures. Motivate family members to consider euthanasia. Leave the patient alone at the time of death. Educate the family about the dying process.

1, 2, 5 The nurse should help the family members obtain hospice care for the last days of the patient's life. Providing grief support to the family helps them to cope better with the anticipated loss. Educating the family members about the dying process helps them become mentally prepared for the loss. Euthanasia is not an ethically acceptable part of end-of-life care and is not legal in many countries. The nurse should arrange to provide privacy for the patient at the time of death but should not leave the patient alone.

David is a single parent of a 3-year-old boy, Kevin. Kevin has well-managed asthma and misses day care infrequently. David 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. David 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 factors are risks to this family's level of health? Select all that apply. Economic status Chronic illness Being underinsured Government-assisted day care Caregiver role strain

1, 3 David's economic status is stretched. He has multiple resources for his son, but he is not insured. Thus, there is a potential that David will not follow through with personal health promotion activities. Although asthma is a chronic illness, this is well managed, and there is adequate health care for his son.

Which actions demonstrate family resiliency? Select all that apply. One parent resuming full-time work when the spouse loses a job Arguing about ways to deal with problems among siblings The parents developing hobbies when the children leave home Placing blame on family members Avoiding risks to deal with current family problems

1, 3 Family resiliency is the ability to cope with expected and unexpected stressors. Resiliency helps to evaluate healthy responses when individuals and families are experiencing stressful events. So, one parent resuming full-time work when a spouse loses a job and the parents developing hobbies when children leave home both demonstrate the internal strength and resiliency of the family unit.

The nurse is taking care of a terminally ill patient in a cancer unit. The patient has a wife and two children. Which healthy family attributes would be especially helpful to the family because they take care of the patient at the terminal stage? Select all that apply. Hardiness Friendship Resiliency Compatibility Privacy

1, 3 Hardiness and resiliency are the two factors that contribute to long-term health. Family hardiness contributes to a family's resiliency in the face of illness. Hardiness and resiliency foster a sense of control that allow an active rather than passive orientation in adapting to stressful events. Friendship, compatibility, and privacy are not the primary factors of a healthy family.

The nurse is caring for a 70-year-old patient who lives with her children and grandchildren in an extended family. The patient is suffering from chronic bronchitis and does not want to be admitted to the hospital. The family has decided to take care of the patient at home. The patient's 35-year-old daughter takes care of the patient. Which symptoms in the caregiver indicate the caregiver's strain? Select all that apply. A change in appetite A cheerful attitude Irritability Anger Socializing

1, 3, 4 The primary caregiver may feel overburdened by caregiving activities. This strain can result in a change in appetite, irritability, and anger. A cheerful attitude and socializing do not indicate caregiver's strain.

The nurse explains to the family of a patient how to provide home care and identify caregiver role strain. About what indicators of caregiver role strain should the nurse teach the family? Select all that apply. The caregiver loses interest in his or her appearance. The caregiver completely focuses on the patient. The caregiver is fearful of learning new therapies. The caregiver is keen to learn new therapies or techniques. The caregiver loses interest in his or her social life and becomes irritable.

1, 3, 5 Caregiving can take a toll on the caregiver's physical, emotional, and social well-being. This can be manifested by the caregiver losing interest in his or her appearance. Role strain is also indicated by the caregiver's fear of learning new therapies or techniques. If the caregiver loses interest in his or her social life and becomes irritable or withdrawn, it indicates that he or she is facing role strain. Completely focusing on the patient and showing interest in learning new techniques indicate that the caregiver is interested in the caregiver role.

The nurse is teaching a family about ways to prevent caregiver role strain. What suggestions should the nurse provide? Select all that apply. Identify and seek help from support groups. Avoid help from community resources. Develop a schedule to provide groceries and meals. Allow the primary caregiver to function without a break. Set alternate schedules to help the primary caregiver.

1, 3, 5 Identify support groups to obtain additional help in providing care will reduce caregiver role strain. A schedule to provide groceries and meals to the caregiver and the patient can reduce the caregiver's burden. Setting alternate schedules to help the primary caregiver can give the caregiver some time to rest. Community resources can be of help in providing transportation or respite care and should be identified. The primary caregiver should not function continuously and family members should alternate schedules to help the primary caregiver.

The nurse is speaking to a couple concerned about their 21-year-old unmarried child. How can the nurse help this family achieve an optimal family environment? Select all that apply. Encourage the child to establish a sense of self in his or her work. Focus on the materialistic desires of the adult child. Encourage the adult child to develop intimate peer relationships. Teach the couple about good parenting techniques. Encourage the parents and child to develop independent identities.

1, 3, 5 The nurse can help this family have an optimal family environment. Establishing a sense of self in work promotes self- respect and a sense of achievement in the child. The young adult should be encouraged to develop good peer relationships and become involved with people other than his or her family. Focusing on material issues is not helpful in this situation. Talking about parental roles is helpful for families who have young children but may not be necessary for families with adult children. p. 121

The nurse is teaching a family whose caretakers are in the "sandwich generation" of taking care of older parents while raising adolescents and adopting some young children. Which instruction does the nurse recommend for the further development of family status? Select all that apply. "Take up the parental roles." "Develop intimate peer relationships." "Adjust the marital system to make space for children." "Begin a shift toward concern for the older generation." "Realign relationships as parenting and grandparenting roles."

1, 3, 5 The nurse teaches the family about the changes that are required to promote its future development. The nurse will insist that the parents accept their parenting roles to find a more comfortable and balanced way of living. The nurse requests changes in the marital system that will promote space for the children. The nurse also will teach about the realignment of relationships that include parenting and grandparenting. This promotes growth and a deeper sense of connectedness with all members of the family. The nurse should instruct an unattached young adult to develop intimate peer relationships to promote high energy in day-to-day activities. In a family with adolescents, the nurse teaches about a shift toward concerns for older adults. This is because the "sandwich generation" is more prone to stressors due to taking a dual-caretaker role in taking care of both children and aging parents.

A family has children who are on the verge of entering adolescence. How can the nurse help the family have good relationships with the adolescent children? Select all that apply. Help the parents redefine their relationships with their adolescent children. Help the adolescent children refocus on midlife material and career issues. Help the family adjust to a reduction in family size. Help the adolescent children initiate concern for the older generation. Help the adolescent children differentiate their own personalities.

1, 4 The nurse plays a vital role in helping the family cope with transitions of children into adolescence. The nurse should help the parents redefine their relationships with their adolescent children. The nurse can also assist the adolescent children initiate awareness of, and concern for, the older generation. The parents need to refocus on midlife material and career issues. Adjusting to a reduction in family size is helpful for families that are launching their children into adulthood, not those with children facing adolescence. Families with young, unattached adult children may be concerned about the children differentiating their own personalities, but families with adolescents normally are not.

The nurse is teaching a group of nursing students about the importance of a family. Which family functions are important? Select all that apply. Providing care and protection Creating an insecure environment Developing conflict and using power Cooperatively meeting financial needs Socializing and nurturing relationships

1, 4, 5 A family aims to provide care and protection to all the family members. Members of a family work cooperatively to meet financial needs for the benefit of the family. Socializing and nurturing relationships are important, because they help to maintain the bonds between family members. The family aims to create a secure environment for all family members, tries to resolve conflicts, and improve family relations with respect and mutual understanding.

The nurse is caring for a 70-year-old patient who lives with her children and grandchildren in an extended family. The patient is suffering from chronic bronchitis and does not want to be admitted to the hospital. The family has decided to take care of her at home. The patient's 35-year-old daughter takes care of the patient. What questions should the nurse ask to assess the coping process of the family? Select all that apply. "How did your family solve their previous problems?" "How does your family celebrate different festivals?" "Does your family give equal importance to all members?" "How does your family solve financial problems?" "Do your family members suffer from any addictions?"

1, 4, 5 Questions about the problem-solving skills of the family help the nurse to determine the best coping strategies. The nurse needs to ask about any past financial problems and how the family dealt with them. This information helps the nurse to assess the family's coping abilities. Similarly, asking about the family's addiction history may help the nurse learn how the family handles crises. Asking about festival celebrations and the relative importance of family members speaks to the family's cultural background and beliefs, but does not help the nurse determine the family's ability to cope with crises.

The nurse learns that an adolescent patient, who has been in and out of the hospital, has many young siblings and an extended family. What measures should this nurse institute to help the family? Select all that apply. Talk about parental roles. Help find work for the family members. Help the family to focus on materialistic and career issues as a break from health concerns. Make adjustments in the patient's room to provide space for the siblings. Guide the extended family in caring for the patient and siblings.

1, 4, 5 The nurse can play an important role in establishing a good family environment for a family with young children. Talking about parental roles may help the family provide better care for the children. Providing space for the siblings may help the children feel that they are a welcome part of the family. The extended family should be encouraged to help take care of the child and siblings so that the parents can take a break. Helping family members find work is only appropriate for families who have unattached young adults. Advising the family to focus on materialistic and career issues is not helpful in this situation, even if it does provide a break from health concerns.

When assessing a family, which process should the nurse include in the family assessment plan? Leisure process Integrity process Financial process Ritualistic process

2

The nurse is caring for a 5-year-old girl who is living with her family. The family includes her mother and a grandmother who is 65 years old. Which category does this family belong to? A nuclear family An extended family An alternative family A blended family

2 An extended family includes parents and grandparents. A nuclear family does not include other members such as grandparents; it includes only the parents and the child or children. Examples of alternative families include households headed by homosexual couples and households in which grandparents alone care for their grandchildren. A blended family is one that includes children from the parents' previous relationships.

A family includes a mother, stepfather, two teenage biological daughters of the mother, and a biological daughter of the father. Of what type of family is this an example? A nuclear family A blended family An extended family An alternative family

2 Blended families result when two people who have children from a previous marriage or relationship marry.

A patient is in the terminal stages of cancer. The nurse learns that the patient's caregiver is extremely stressed and has not been able to take time for a personal life. How can the nurse provide relief to the caregiver? Ask the caregiver to withhold caregiving activities. Help the caregiver set a regular time for respite. Explain the need to focus more on the patient now and less on the caregiver's personal life. Encourage the caregiver by praising his or her actions.

2 The nurse may provide relief to the caregiver without compromising the patient's care by helping him or her set a regular time for rest and personal time. Withholding care would hamper the patient's situation. Even though the patient needs the caregiver's help, the caregiver's personal life is also important. Expressing appreciation about the caregiver's work is nice, but it is not necessarily helpful in providing relief to the caregiver.

The community health nurse is caring for a terminally ill patient at home. The nurse provides symptomatic management and assists the family with coping skills. Which approach does the nurse include in the family nursing plan? Family as system Family as patient Family as context Family as structure

2 The nurse provides compassionate family nursing care to help the family and its individual members reach the best health beyond the illness experience. The nurse primarily focuses the care on the patient and the caregivers in the given scenario. Therefore, the nurse includes a family-as-patient approach in the family nursing plan. In the family-as-system approach, the nurse includes all available environmental, social, psychological, and community resources in the care of the ill patient. Therefore, the nurse does not include the family-as-system approach. The family-as-context approach is incorrect, because it includes only the health and development of an individual member (the terminally ill patient). The family-as-structure approach helps the caregiver to maintain a sense of hope and includes individual members.

What is the most common reason grandparents are called on to raise their grandchildren? Single parenthood Legal interventions Dual-income families Increased divorce rate

2 This new parenting responsibility is caused by a number of societal factors: the increase in the divorce rate, dual-income families, and single parenthood. But, most often, it is a consequence of legal intervention when parents are unfit or renounce their parental obligations.

Diane is a hospice nurse who is caring for the Robinson family. This family is providing end-of-life care for their grandmother, who has terminal breast cancer. When Diane visits the home 3 times a week, she focuses on symptom management for the grandmother and assists the family with coping skills. Of what is Diane's approach an example? Family as context Family as patient Family as system Family as structure

2 When the family as patient is the approach, family processes and relationships (e.g., parenting or family caregiving) are the primary focuses of nursing care. The family as a context approach focuses primarily on an individual member, whereas the family as a system is caring for the family as context plus the family as patient. Family structure is an attribute of families and is based on complex relationships of the family members. p. 123

A large, blended family is in the process of converting a study into a bedroom for an adult child who is moving home following a job loss. The family is in the process of distributing household chores.When you talk to members of the family, they all think that their family can adjust to lifestyle changes. Of what is this an example? Diversity Durability Resiliency Configuration

3

The nurse has been asked to assess the developmental process of a family. How should the nurse evaluate the developmental process of a family? Select all that apply. Assess the family's beliefs. Learn how the family dealt with recent family transitions, such as a birth or a death. Assess for health-related issues. Identify the support systems used by the family. Assess the family roles.

2, 3 Evaluating the developmental process of a family includes determining how the family deals with transitions such as deaths, divorce, and births. Assessment of the developmental process of the family also includes assessing health-related issues such as acute illness, chronic illness, and delayed physical development. Assessment of family beliefs is helpful in evaluating the family's integrity process. Identification of support systems helps the nurse evaluate the coping process of the family. Identifying the family roles is a part of the evaluation of the interactive process of the family.

Which best defines family caregiving? Select all that apply. Designing a nurturing family to raise children Providing physical and emotional care for a family member Establishing a safe physical environment for a family Monitoring for side effects of illness and treatments Providing an environment conducive to spirituality

2, 3, 4 Family caregiving by spouses, siblings, or parents involves routinely providing services and personal care activities for a family member. Caregiving activities include finding resources, personal care (bathing, feeding, or grooming), monitoring for complications or side effects of illness and treatments, providing instrumental activities of daily living (shopping or housekeeping), and the ongoing emotional support and decision making that are necessary. Developing a nurturing family to raise children and providing a spiritual environment are important but are not part of the caregiver's role.

The nurse is teaching a family about achieving family goals. Which processes should the nurse teach the families to adopt? Select all that apply. Neglecting problems Setting goals for the family Communicating with family members Resolving conflicts among family members Avoiding discussions with family members

2, 3, 4 Goal setting is one of the processes used by a family to achieve its goals. Having clear and direct communication with family members makes achievement of family goals more successful. Resolving conflicts among family members helps members respect each other and work cooperatively towards family goals. Neglecting the problems leaves those problems unidentified and will not help the family achieve their goals. Avoiding discussions may leave the problem unidentified, while clear communication helps resolve problems.

The nurse is assessing the interactive process of a family. How does the nurse analyze the family's interactive processes? Select all that apply. Assess family transitions. Assess family relationships. Assess the social support of the family. Evaluate the strategies used by the family to cope with stress. Assess family roles.

2, 3, 5 Assessment of the interactive process of the family involves determining the family relationships and determining whether the family is an extended or a nuclear family. The nurse should assess the social support of the family. The nurse should also assess the family roles such as wage earner, disciplinarian, and problem solver. Family transitions such as death and divorce are indicative of the developmental process in the family. Evaluating coping strategies helps the nurse learn about the family's coping process.

The nurse is explaining family structure to a group of nursing students. Which type of family structures need to be modified? Select all that apply. Open structure Very rigid structure Blended family Extremely open structure Adaptable family structure

2, 4 A very rigid structure dictates the ability of one family member to do a task. The family faces difficulty when the member is unable to do the specified task. Extremely open structure may lead to inconsistent behavior patterns, which can confuse the family members. An open structure can promote healthy family relationships, because the family can adjust to sudden changes. The adaptable family structure makes it easy for family members to adapt during a crisis or sudden changes and still maintain healthy relationships. A blended family is not a type of family structure.

The nurse is assessing the family of a patient. Which questions should the nurse include to assess the interactive processes of the family? Select all that apply. "How and when did your physical complaints start?" "How do you and your family spend your leisure time together?" "On a scale of 0 to10, what is the rating of your pain in terms of severity?" "Is your family a nuclear family, blended family, or a single-parent family?" "Who establishes your house rules and how are they communicated?"

2, 4, 5 While assessing a family, the nurse should focus on the family and the relationships between the family members. In the interactive process assessment, the nurse tries to understand the interactive relationship between the patient and his or her family. For this assessment, the nurse may ask how the family spends their leisure time. The nurse also may ask the patient if the family is nuclear, blended, or single parent. The nurse can also ask who sets the house rules. This gives a proper assessment of the family structure. Asking about how and when the health-related issues began helps to assess the physical complaint, not the family. Similarly, rating the severity of pain helps to assess the physical complaint.

What assessments are required to evaluate the integrity processes of the family? Select all that apply. Identify family illness stressors. Assess whether family rituals are conducted. Identify the family stressors and daily hassles. Identity the level of social support in the family. Assess what a family means to each member of the family.

2, 5 The nurse assesses the integrity of a family by looking for family rituals such as birthdays, weddings, wakes, and funerals. The nurse should also determine what a family means to each member of the family. Family illness stressors are indicative of the health process of the family. How the family deals with stressors and hassles reveals the coping process of the family. Identifying social support reveals the interactive process of the family.

A nursing student is learning about the different types of families. What could be an example of a blended family? A woman raising her son alone after her husband's death A homosexual couple raising a daughter on their own A woman bringing her adopted son into a new family when she remarries A grandfather taking care of his granddaughter after his daughter's demise

3 A blended family is formed when parents bring children who may or may not be biologically related to them into a new, joint-living situation. Hence, a woman bringing her adopted son into a new family when she remarries is an example of blended family. A woman raising her son alone after her husband's death is an example of single-parent family. A homosexual couple raising a daughter on their own is an example of an alternative family. A grandfather taking care of his granddaughter after his daughter's demise is also an example of an alternative family.

During an assessment, a patient tells the nurse, "I live with my grandparents because my parents work abroad." To which type of family does the patient belong? A blended family An extended family An alternative family A single-parent family

3 Alternative families include multiadult households, skipped-generation families, and homosexual couples. Therefore, the nurse identifies that the patient belongs to an alternative family. Blended families include unrelated children from adoptive parenting relationships. Extended families include the relatives of one or both spouses. In a single-parent family, one parent leaves the family due to death, divorce, or desertion. In this case, the patient's parents are not divorced or dead. p. 118

The nurse is assessing a family. Which question should the nurse include to assess the coping process of the family? "When somebody is ill in the house, who is the caregiver?" "What do you do as a family for relaxation and leisure?" "How does your family solve the problems you face?" "Who forms the house rules and how are they communicated?"

3 Asking how the family solves their problems helps to understand the coping process of the family. Asking whom the caregiver is helps to assess the health process. Asking what the family does for relaxation helps to assess the interactive process. Asking who forms the house rules helps to assess the interactive process of the family.

The nurse is assessing the family status of a patient. Which question should the nurse include to assess the health process of the family? "How does your family resolve conflicts?" "Does your family hug, cry, or laugh together?" "What type of health care provider does your family have?" "What are your family's beliefs about health and illness or end-of-life care?"

3 Asking the patient about the type of health care provider his family has helps in assessing the family's health process. Asking how the family resolves conflicts and whether they cry, laugh, or hug together helps to assess the interactive process of the family. Asking the family about their beliefs on health and illness helps to assess the integrity process of the family.

The nurse is explaining family assessment to a group of nursing students. The nurse discusses the ability of a family to cope with expected and unexpected stressors. What is this ability? Love Integrity Resiliency Hardiness

3 Resiliency is the ability of a family to cope with expected and unexpected stressors. It is an important factor to consider when assessing a family. Love is the feeling of attachment towards family and other people. Family integrity is the feeling of oneness among family members. Family hardiness is the internal strengths and durability of the family.

The nurse is caring for a patient with breast cancer. The nurse finds that the patient's partner is of great help to the patient while she exercises. What should the nurse do to enhance this helpful attitude? Set a routine time for the patient's partner to have a break. Talk to the patient's children about the family background of the patient. Involve the patient's partner in physical rehabilitation activities. Involve the patient's partner in psychological rehabilitation activities.

3 The patient's partner should be encouraged to help with physical rehabilitation activities if the partner shows an interest and natural aptitude. It would promote family involvement in caregiving activities. Setting time for a break is helpful for the caregiver's schedule, but it is unrelated to the patient's exercise. Discussing the family background is not directly related to the patient's exercise. The patient's partner would be more useful in physical rehabilitation than in psychological rehabilitation. pp. 126-128

Many grandparents have taken on the responsibility of raising grandchildren, which creates a new parenting responsibility within the home. Which factors does the nurse suspect to be the result of this? Select all that apply. Homelessness Family violence Single parenthood Dual-family incomes An increase in the divorce rate

3, 4, 5 A number of factors affect the new parenting responsibility when grandparents raise grandchildren. The factors include single parenthood due to death, divorce, or desertion; dual-family incomes, with both spouses maintaining different careers; or an increase in the divorce rate. Homelessness is a major public health issue that causes changes in the structure and roles of family members. This is not a sole or direct factor affecting the new parenting responsibility. Family violence is described as emotional, physical, social, or sexual abuse. This is not a factor responsible for the new parenting culture.

A group of nurses at an institution is being taught about common forms of the family in the society. Which of the relationships may represent an alternative family? Select all that apply. Single person adopting a child Foster children Adults living alone Grandparents caring for grandchildren Homosexual couples

3, 4, 5 In an alternative family form, the relationships include adults living alone, grandparents caring for grandchildren, and homosexual couples. When a single person decides to have or adopt a child, it is a single-parent family form. A blended family is formed when parents bring unrelated children from prior marriages, adoptive, or foster relationships into a new, joint living situation.

A family consists of a mother and her 3-year-old daughter. This is an example of which kind of family? A nuclear family A blended family An extended family A single-parent family

4 A single-parent family is one in which one parent takes care of the child or children. A nuclear family consists of the husband, wife, and their children. A blended family is formed when parents bring children from previous relationships into a new, joint living setting. An extended family includes a nuclear family and relatives. p. 118

The nurse is caring for a family with a series of health-related issues. How does the nurse evaluate the health process of the family? Assess the family's values. Look for family transitions. Identify family resistance resources. Identify possible family illness stressors

4 Identification of family illness stressors is helpful in evaluating the health processes of the family. Assessment of family values helps identify the family's integrity processes. Studying family transitions helps assess the family's developmental process. Identifying family resistance resources is helpful in assessing the coping process of the family.

By what is a family's access to adequate health care, opportunity for education, sound nutrition, and decreased stress affected? Development Family function Family structure Economic stability

4 The ability of families to meet health care, educational, and basic needs is often affected by the economic resources of the family.

When nurses view the family as context, what is their primary focus? Family members within a system Family process and relationships Family relational and transactional concepts Health needs of an individual member

4 When you view the family as context, the primary focus is on the health and development of an individual member existing within a specific environment (i.e., the patient's family). Although the focus is on the individual's health status, assessment is on how much the family provides the individual's basic needs

The nurse is assessing a family that is grieving the loss of a family member. How does the nurse evaluate the coping process of the family? Select all that apply. By assessing the family's culture and practices By assessing the social support of the family By evaluating the family's health issues and the impact of these issues By evaluating the coping strategies of the family and the effectiveness of those strategies By evaluating the family's problem-solving strategies

4, 5 In order to evaluate the coping processes of the family, the nurse should study the behaviors adopted by the family to deal with stress, such as exercise, overeating, and arguing. The nurse should also evaluate the family's approach to solving problems. Assessing family culture and practices is helpful in evaluating the integrity process of the family. Assessment of social support is helpful in assessing the interactive process of the family. Evaluating health issues and how they affect the family helps the nurse assess the family's developmental process.