Chapter 10 - Family Dynamics (Exam #6)

1, 2, 4

8. 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?"

3

1. 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 that 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

c

1. You are caring for a patient. Visitors at the bedside include the patient's life partner, widowed father, brother, and niece. The nurse acknowledges that the current trends in American families include: a) couples without children b) more singles choosing to live alone c) a very different look from 15 years ago d) a mother, father, and more than one child

2

10. 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

3, 4

19. A married couple has three children. The youngest child has graduated from college and is moving to a different city to take a job. The other two children left the home several years ago. What developmental tasks does the nurse expect this family to experience at this point in time? (Select all that apply.) 1. Take on parenting roles 2. Making room for the wisdom of older adults 3. Refocusing on marital issues 4. Determining new focus on recreational activities 5. Developing intimate relations with others

2, 4, 5

2. 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.

a

2. A patient comes from a close-knit family. The patient's family functions as context. You will need to evaluate: a) attainment of patient needs b) family attainment of developmental tasks c) individual family members caring about one another d) family satisfaction with its new level of functioning

3 (Ongoing membership of the family and the pattern of relationships, which are often numerous and complex)

20. Family structure can best be described as: 1. A complex set of relationships 2. A basic pattern of predictable stages 3. The pattern of relationships and ongoing membership 4. Flexible patterns that contribute to adequate functioning

4 (Is critical in forming an understanding of family life, current changes in family life, overall goals and expectations, and planning family-centered care)

21. When planning care for a patient and using the concept of family as patient, the nurse: 1. Includes only the patient and his or her significant other 2. Considers the developmental stage of the patient and not the family 3. Understands that the patient's family will always be a help to the patient's health goals 4. Realizes that cultural background is an important variable when assessing the family

3 (Very rigid structures impair functioning)

22. Interventions used by the nurse when providing care to a rigidly structured family include: 1. Attempting to change the family structure 2. Providing solutions for problems as they arise 3. Exploring with the family the benefits of moving toward more flexible modes of action 4. Administering nursing care in a manner that provides minimal opportunity for change

1, 3, 4

3. 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.

c

3. When completing the nursing data on a client, to complete the admission and develop a plan of care, the nurse will need to: a) test the family unit's ability to co0pe b) evaluate communication patterns c) identify family unit form and attitudes d) father health data from all family members

4

7. 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've 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 worked out a schedule to check on her before and after school." 4. "We haven't been spending time with our parents because we're so busy taking care of our daughter."

1, 2, 4

4. 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

1

5. A patient who is newly divorced states, "Although I'm really scared about what happens next to my children and myself, I know that divorce is not uncommon today." What term does the nurse use in the patient's medical record to describe the characteristic displayed in this statement? 1. Durability 2. End-of-life care 3. Family functioning 4. Family's culture

2

6. 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

a (the client is experiencing role conflict because their career is extremely physical, and they can no longer perform the job duties. However, the client is the primary wage earner in the family.)

A nurse is caring for a client who has left-sided hemiplegia resulting from a CVA. The client works as a carpenter and is now experiencing a situational role change based on physical limitations. The client is the primary wage earner in the family. Which of the following describes the client's role problem? a) role conflict b) role overload c) role ambiguity d) role strain

3, 4, 5

9. 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 home several years ago. The parents of both spouses 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?"

c (providing privacy and time for the reading of religious materials supports the client's spiritual health)

A nurse enters the room of a client who is crying while reading from a religious book and asks to be left alone. Which of the following actions should the nurse take? a) contact the hospital's spiritual services b) ask what is making the client cry c) ensure no visitors or staff enter the room for a short time period d) turn on the television for a distraction

c (in the alarm stage of GAS, body functions such as blood pressure and heart rate, are heightened in order to respond to stressors)

A nurse is caring for a client awaiting transport to the surgical suite for a coronary artery by pass graft. Just as the transport team arrives, the nurse takes a client's vital signs and notes an elevation in blood pressure and heart rate. The nurse should recognize this response as which part of the general adaptation syndrome? a) exhaustion stage b) resistance stage c) alarm stage d) recovery stage

b, c, e

A nurse is caring for a client who has a new diagnosis of type 2 diabetes mellitus. Which of the following nursing interventions for stress, coping, and adherence to the treatment plan should the nurse initiate at this time? (select all that apply) a) suggest coping skills for the client to use in this situation b) allow the client to provide input in the treatment plan c) assist the client with time management, and address the client's priorities d) provide extensive instructions on the client's treatment regimen e) encourage the client in the expression of feelings and concerns

d (involving the client's religious and spiritual leaders is a culturally responsive action at this point. Alternative forms of blood products can be discussed and a plan reasonable to all can be reached)

A nurse is caring for a client who tells the nurse that based on religious values and mandates, a blood transfusion is not an acceptable treatment option. Which of the following responses should the nurse make? a) "I believe in this case you should really make an exception and accept the blood transfusion" b) "I know your family would approve of the decision to have a blood transfusion" c) "Why does your religion mandate that you cannot receive any blood transfusions?" d) "Let's discuss the necessity for a blood transfusion with your religious and spiritual leaders and come to a reasonable solution."

b (By stating there is a lack of understanding, the nurse is using the therapeutic communication technique of validation, whereby a person shows sensitivity to the meaning behind a behavior. The nurse is creating a supporting and nonjudgemental environment, and inviting the client to express frustration.)

A nurse is caring for a client whose partner passed away four months ago. The client has a recent diagnosis of diabetes mellitus. The client is tearful and states, "How could you possibly understand what I am going through?" Which of the following responses should the nurse make? a) "It takes time to get over the loss of a loved one." b) "You are right. I cannot really understand. Perhaps you'd like to tell me more about what you're feeling." c) "Why don't you try something to take your mind off your troubles, like watching a funny movie." d) "I might not share your exact situation, but I do know what people go through when they deal with a loss."

d (an open structure is loose, and convening a family meeting would give all family members input and an opportunity to express their feelings)

A nurse is caring for a family who is experiencing a crisis. Which of the following approaches should the nurse use when working with a family using an open structure for coping with crisis? a) prescribing tasks unilaterally b) delegating care to one member c) speaking to the primary client privately d) conveying a family meeting

c (members of any particular religion should be assessed for individual feelings and ideas)

A nurse is caring for two clients who report following the same religion. Which of the following information should the nurse consider when planning care for these clients? a) members if the same religion share similar feelings about their religion b) a shared religious background generates mutual regard for one another c) the same religious beliefs can influence individuals differently d) the nurse and client should discuss differences and commonalities in their beliefs

b (Islamic practices include praying 5 times per day, work with the client to establish a schedule for the day, noting which times the client prefers to pray, and scheduling treatments around those times when possible)

A nurse is discussing the plan of care for a client who reports following Islamic practices. Which of the following statements by the nurse indicates culturally responsive care to the client? a) "I will make sure the menu includes kosher options." b) "I will ask the client if they want to schedule some times to pray during the day." c) "I will avoid discussing care when the client's family is around." d) "I will make sure daily communication is available for this client."

b, d, e

A nurse is using an interpreter to communicate with a client. Which of the following actions should the nurse use when communicating with a client and family members? (Select all that apply) a) talk to the interpreter about the family while the family is in the room b) determine the client understanding several times during the conversation c) look at the interpreter when asking the family questions d) use lay terms if possible e) do not interrupt the interpreter and the family as they talk

B (Since Ms. Jones and Mr. Sanders live together as cohabitating partners, they are considered an alternative family)

Mr. Tom Sanders is a 48-year-old male who suffered a myocardial infarction (MI) forwhich he is being hospitalized. He is transferred from the emergency department to thecardiac unit for 48-hour observation and medication therapy. He has a strong familyhistory for MI and heart disease, which contributed to his heart attack.He lives with his girlfriend of 5 years, Ms. Cheryl Jones. Ms. Jones found Mr. Sanders slumped against the kitchen cabinets clutching his chest; she called 9-1-1 for emergency assistance. Rochelle is the nursing student assigned to Mr. Sanders. Rochelle speaks with both Ms. Jones and Mr. Saunders to gain an understanding of their needs and desires to help her further develop Mr. Saunders' care plan. 1. Ms. Jones and Mr. Sanders explain their relationship and living arrangement to Rochelle. Ms. Jones and Mr. Sanders are an example of which type of family form? A. Split B. Alternative C. Nuclear D. Blended E. Extended

context, patient, system

Rochelle adds the social and family information to Mr. Sanders' existing care plan. She knows that family nursing practice involves three levels of approach. These levels of approach are the family as _____, _____, and _____.

A, C (Family hardiness contributes to a family's resiliency in the face of illness.Hardiness and resiliency foster a sense of control that allows an active rather than passive orientation in adapting to stressful events.)

Rochelle assesses Mr. Sanders' support system to ensure that he is receiving the attention he requires. The strength of Ms. Jones and Mr. Sanders' relationship and their ability to adapt to challenges and stressors shows that their relationship is built on which of the following factors? (Select all that apply.) a) hardiness b) friendship c) resiliency d) compatibility e) trust

C (An extended family includes other relatives besides the nuclear family. By having the grandchildren as part of the family, this is an extended family)

Sarah Buchanan is a nursing student who is doing a home health care nursing clinical. She is assigned to visit Ted Wall, a 50-year-old black man who is in the late stage of AIDS. His wife Sheri is also 50 years old and is raising their daughter's two children who are 3 and 5 years of age. Sheri does not work outside the home. Ted is receiving Social Security benefits. The mother of the children is in jail for dealing drugs.The children's father has not been involved with them at all. 1. Sarah determines that this is an example of what type of family? A. Nuclear family B. Blended family C. Extended family D. Alternative family

A, B, C, D

Sarah Buchanan is a nursing student who is doing a home health care nursing clinical. She is assigned to visit Ted Wall, a 50-year-old black man who is in the late stage of AIDS. His wife Sheri is also 50 years old and is raising their daughter's two children who are 3 and 5 years of age. Sheri does not work outside the home. Ted is receiving Social Security benefits. The mother of the children is in jail for dealing drugs.The children's father has not been involved with them at all. 2. Which of the following factors should Sarah assess in determining the health of the Wall family? (select all that apply) A. Economic stability B. Ethnic background C. Social class D. Structure of the family

Sandwich generation

Sheri's mother is a widow and is becoming unable to care for herself. Sheri is now also spending more of her time taking care of her mother. What is the term for this phenomenon?

family

a set of relationships that a patient identifies as ______ or as a network of individuals who influence one another's lives, whether there are actual or biological ties

family caregiving

crucial part of the healthcare team because they provide most of the physical and emotional care to patients who wish to remain in their homes

family forms

patterns of people considered by family members to be included in a family

Family durability

system of support and structure within the family that extends beyond the walls of the household

family resiliency

the ability of a family to cope with expected and unexpected stressors, familial ability to adapt to role and structural changes, family developmental milestones and crises show this

family as patient

the family's needs, processes, and relationships are the primary focus of nursing care, you are focusing on family patterns vs characteristics of individual members

family dynamics

the interactions between and among family members that are affected by a family's makeup, structure, function, problem solving, and coping capacity

family hardiness

the internal strengths and durability of the family unit

family as context

the primary focus is on the health and development of an individual member existing within a specific family unit

family diversity

uniqueness of each family unit

family function

what a family does, such as how a family interacts to socialize younger family members, cooperates to meet economic standards, and relates to the larger society

family as a system

you care for each family member (family as context) and the family unit (family as patient) using all available environmental, social, psychological, and community resources