Concept 3 - Family Dynamics

The nurse planning to assess the structure of a family would which question? a. "Who lives with you?" b. "Who does the grocery shopping?" c. "Who provides support in your family?" d. "How old are the members of your family?"

ANS: A The structure of the family includes who is in the family and what their relationship is. "Who does the shopping?" would provide information about family functioning. "Who provides support?" would provide information about family functioning. "How old are the members?" would provide information about family development.

When reviewing the purposes of a family assessment, the nurse educator would identify a need for further teaching if the student responded that family assessment is used to gain an understanding of the family a. development. b. function. c. political views. d. structure.

ANS: C An understanding of the political views of family members is not a primary purpose of a family assessment. A family assessment provides the nurse with information and an understanding of family dynamics. This is important to nurses for the provision of quality health care. A family assessment provides an understanding of family development, function, and structure.

The nurse caring for a patient would identify a need for additional interventions related to family dynamics when a. extended family offers to help. b. family members express concern. c. the ill member demands attention. d. memories are shared.

ANS: C It is not uncommon for the ill family member to become demanding and indicate that they deserve special treatment and care, and the supportive family may need assistance in understanding the dynamics of the illness in order to continue to be supportive. Offers from extended family to help can be indicative of positive dynamics. Concern expressed by family members can be indicative of positive dynamics. Sharing of family memories can be indicative of positive dynamics.

Jane and Janet have an established long-term relationship and are attending parenting classes in anticipation of finalizing adoption of baby Joan. Jane and Janet would be considered which type of family? a. Cohabiting b. Nuclear c. Same-sex d. Single parent

ANS: C Jane and Janet would be considered a same-sex family. Cohabiting refers to a couple who live together with no legal bond. Nuclear refers to the traditional male and female core family with one or more children. Single parent refers to a family with one adult and one or more children.

Factors which would alert the nurse to negative/dysfunctional family dynamics include a. aging of family members. b. chronic illness of a family member. c. disability of a family member. d. intimate partner violence.

ANS: D Intimate partner violence is an exemplar of negative/dysfunctional family dynamics. Aging of family members is an exemplar of changes to family dynamics. Chronic illness of a family member is an exemplar of changes to family dynamics. Disability of a family member is an exemplar of changes to family dynamics.

The most appropriate initial nursing intervention when the nurse notes dysfunctional interactions and lack of family support for a patient would be to a. enforce hospital visiting policies. b. monitor the dysfunctional interactions. c. notify the primary care provider. d. role model appropriate support.

ANS: D Nurses can, at times, role model more appropriate interactions or provide suggestions for improving communication and interactions among family members. If the nurse determines that the number of visitors has a negative impact on the patient, hospital policy may be to limit visitors, but that would not be the initial action. Monitoring the dysfunctional interactions would not be an adequate response. The primary care provider should certainly be notified, but that would not be the initial response.

Critical Thinking: The nurse identifies the family with a child graduating from college as being in the family life cycle of a. single young adult leaving home. b. new couple joins their families through marriage or living together. c. families with young children. d. launching children and moving on.

ANS: D The launching children and moving cycle occurs when the children become independent and establish their own home, as when they graduate and begin to establish their own lives, separate from the family of origin. The single young adult leaving home cycle occurs when the "child" establishes their own home away from the family they grew up with. The new couple joins their families through marriage or living together cycle begins when a couple establishes a household separate from the family of origin. The families with young children cycle begins with the addition of a child to the family.