Chapter 14: Family Assessment and Interventions - PrepU

A nurse is planning an educational program for families with a mentally ill relative. Which goal is consistent with the current objectives of family education? 1- Fewer hospital admissions 2- Improved medication compliance 3- Improved family quality of life 4- Increased independence with activities of daily living

3

Which of the following would be most appropriate for a nurse to do when attempting to view a whole family's composition as a unit? 1- Compile a list of family members. 2- Construct a family genogram. 3- Determine the internal power structure. 4- Identify communication patterns.

2

The Calgary family assessment model and the Calgary family intervention model are dimensional frameworks that conceptualize the family into categories of structural, developmental, and ... 1- interpersonal. 2- cultural. 3- functional. 4- educational.

3

A teenage son is missing the remainder of the school year because he is in a program receiving treatment for his abuse of marijuana. His parents tell his friends that he is attending an alternative school for the remainder of the semester. All family members agree to adhere to this false explanation. What is this agreement an example of? 1- A triad 2- Interdependency 3- A family boundary 4- Carrying out family roles

3

Acting in a family therapist role is relatively new for psychiatric-mental health nurses. Which of the following describes an appropriate intervention for a nurse who is functioning in this capacity? 1- Conduct family assessments and draw genograms. 2- Perform psychological tests and assessments. 3- Prescribe psychotropic medications and order drug screening. 4- Write process recordings and discharge orders.

1

Parents of a child with a psychiatric illness are devastated by the problems. The husband has a difficult time with the diagnosis and isolates himself from the situation by beginning an intimate affair with another woman. What type of a relational pattern is this family exhibiting? 1- Differentiation of self 2- Circular communication 3- Triangles 4- Intellectual differentiation

3

A nurse is caring for a client at the community health care facility. The client informs the nurse that the client and the client's partner will be adopting a child in 1 week. Which stage of family life is the client entering? 1- Transitional stage 2- Expanding family stage 3- Postparenting phase 4- Establishment phase

2

A psychiatric-mental health nurse is reviewing information obtained from a family assessment. Which situation would the nurse interpret as a triangle? 1- Husband and wife have a stable relationship but when wife becomes uncomfortable with a conflict with the spouse, she confides in a close friend instead of her spouse. 2- Husband stays emotionally distant from the spouse, acting in the same manner as the husband's father did with his spouse. 3- A child moves away from the parents because the child cannot differentiate from the family, but becomes helpless when the child is with the parents. 4- The middle child of a family with three children is less outgoing and less confident than the older child in the family.

1

A psychiatric-mental health nurse is reviewing the plan of care for a family. The nursing diagnosis of Interrupted Family Processes has been identified. The nurse interprets this as indicating which issue? 1- A family member who is usually supportive is experiencing an acute illness which is interfering with the family's ability to function. 2- The family is having problems dealing with an ill member because the illness is affecting the daily activities of the family. 3- A family member who is the primary support person is unable to provide enough support to the member who is ill. 4- Family members are finding it difficult to address the ill family member's needs resulting from the complications being experienced by the ill member.

1

To best avoid mislabeling a new immigrant family as dysfunctional, the psychiatric nurse should engage in what? 1- Assess the effects of existing cultural beliefs and practices on the family's dynamics 2- Recognize the stressors that the immigration has caused to the family members 3- Insist that a translator be present during the assessment to minimize any miscommunication 4- Pay close attention to the parent-child relationships

1

A client has completed treatment for an addiction to prescription pain medications. As part of the client's therapy, the family participates in a family therapy program. Which reason would bestexplain the need for a family system approach to therapy? 1- The family needs to focus on helping the client until equilibrium is regained. 2- The dynamics of the entire family have and will continue to shift to accommodate a change. 3- The family has unresolved issues toward the client. 4- The family needs to learn signs of relapse if the client begins taking pills again.

2

A nurse is preparing to assess a family. The nurse best adopts the view of the family unit as a system by using which approach? 1- Focusing on each individual member's health problems 2- Identifying strengths and problem areas within the family structure 3- Educating the sick client with methods to maintain independence 4- Fostering emotional support for each family member

2

A psychiatric-mental health nurse is reviewing information obtained from a family assessment. The assessment reveals that the family has been providing care to a member diagnosed with schizophrenia for several years. Over that time, the client has experienced numerous relapses which required hospitalizations as well as changes in medication. The family has continued to adjust to these changes and stresses positively. The nurse identifies this family as having which characteristic? 1- Boundaries 2- Resilience 3- Dyad 4- Engagement

2

A psychiatric-mental health nurse is working at a community mental health center providing care to families from several different cultures. When providing this care, which aspect would be mostimportant for the nurse to keep in mind? 1- The family life cycle of different cultures progresses through similar phases. 2- The concept of what constitutes a family is highly variable among cultures. 3- The nuclear family is considered the predominant view of family in most cultures. 4- Life cycle transitions are viewed with similar importance across different cultures.

2

Parents of adults with mental illness often express which of the following concerns? 1- "Will we ever have an opportunity to live our lives without being caregivers?" 2- "What will happen when we're gone?" 3- "Will the costs of care prevent us from having a comfortable retirement?" 4- "Who will take care of us if we get sick?"

2

When discussing boundaries with a family, the nurse determines that the family has permeable boundaries. The nurse interprets this as serving which purpose? 1- Restrict self-differentiation 2- Encourage emotional development 3- Dissuade family cohesiveness 4- Inhibit emotional communication

2

Assessment of an adult client reveals that he lives with his wife and three children. The client's father-in-law lives in an in-law suite attached to the client's home. The client's parents live about a block away and visit the family often. The nurse interprets this as which type of family? 1- Nuclear 2- Blended 3- Extended 4- Single-parent

3

During the initial interview, a nurse-therapist has created a genogram on a whiteboard utilizing the input of the family members. What is an advantage of using genograms in family therapy? 1- Hierarchies of power can be represented graphically. 2- Family members can identify who is most important in the immediate and extended family. 3- A concise diagram of family relationships is produced, including significant information. 4- Potential goals for therapy can be identified.

3

A nurse is reviewing a genogram created for a family. When evaluating the information, which aspect would the nurse review first? 1- Recurring family medical problems 2- Family composition 3- Relationship problems 4- Mental health patterns

2

The nurse is obtaining a history from a client. What does the nurse understand about the importance of doing a genogram? 1- It helps to view the whole family as a unit. 2- It helps the patient see who their family members are. 3- It is designed to determine ancestry. 4- It is used to determine if the patient has an illness because of a family member.

1

The nurse-therapist's priority when implementing a genogram is to ... 1- Assess how a family has functioned both in the past and currently 2- Provide a couple with activities to strengthen problem-solving skills 3- Improve communication between parents and their children 4- Help a group refocus on their original goals

1

A psychiatric-mental health nurse is assisting a family and providing counseling. When intervening with this family, which concept would be most important for the nurse to keep in mind? 1- Past, present, and future issues should be addressed. 2- The focus should be on problem-solving. 3- Alliances with a subgroup are important. 4- Advice is permissible for specific issues.

2

Which client population is among the most stigmatized? 1- gay or lesbian 2- female mothers 3- single fathers 4- childless families

1

The nurse is planning care for a family with a child having peer difficulties due to the child's conduct. The nurse demonstrates understanding of the principles of family system theories by which action? 1- Addressing the child and family as a single inseparable unit. 2- Developing a therapeutic relationship with the child. 3- Working with the parents to meet the child's needs. 4- Developing interventions for the parents and siblings to adjust to the child's needs.

1

An important part of the nurse's role as a family consultant is to do what? 1- Acknowledge and show respect for what the family has experienced. 2- Identify enabling behaviors in family members. 3- Address the issue of communication deviance. 4- Subtly work through codependency issues.

1

Because of high divorce rates and separations in recent years, there has been a significant increase in the family structure termed ... 1- Single-parent 2- Communal 3- Extended 4- Foster child

1

Family members are often reluctant to discuss the mental disorders of other family members because of ... 1- stigma associated with mental illness. 2- relationship issues. 3- coping strategies. 4- lack of support available.

1

In viewing the stages of the family life cycle, those families in later life undergo which emotional transition? 1- Accepting the shifting of generational roles 2- Accepting of new members into the system 3- Accepting emotional and financial responsibility for oneself 4- Accepting multitudes of exits from and entries into the family system

1

A family's genogram reveals that two family members have struggled with issues involving alcohol use. When intervening with the family, which question would be most appropriate for the nurse to ask? 1- "How did the alcohol problems of these family members affect others in the family?" 2- "What, if any, treatment did each family member with the alcohol problem receive? " 3- "How long has each family member been struggling with alcohol?" 4- "Was the family member ever hospitalized for problems with alcohol?"

1

A nurse assesses a family of a 19-year-old client diagnosed with first-episode psychosis. The family is experiencing stressful events that challenge its previously effective functioning. The appropriate nursing diagnosis is ... 1- interrupted family processes. 2- ineffective therapeutic regimen management. 3- ineffective coping mechanisms. 4- challenging individual processes.

1

A psychiatric-mental health nurse is assessing a family. Currently, the family consists of a mother, age 48, father, age 52, 3 children (ages 12, 15 and 17), and a set of grandparents, ages 76 and 74. The father is currently pursuing his MBA part-time to improve his employment status. The mother has just returned to work as financial loan officer. The grandparents have just moved into the family's home after living in Florida for the past 15 years after the grandfather experienced some health issues. The parents wanted to help the grandmother care for the grandfather. The nurse determines that this family is in which phase of the family life cycle? 1- Families with adolescents 2- Launching children 3- Families in late middle age 4- Families nearing end of life

1

A psychiatric-mental health nurse is working as part of community group to establish programs for families living in poverty. When developing these programs, which information would be mostimportant for the nurse to incorporate into the plan? 1- Meeting developmental needs may be difficult 2- Families living in poverty are dysfunctional 3- Poverty has a negligible effect on family functioning 4- The family life cycle is the same regardless of finances

1

A psychiatric-mental health nurse is assessing a family's development. Which finding would the nurse interpret as supporting optimal family development? 1- Individuals are highly dependent on one another. 2- Family members are involved in asking many questions. 3- Anxiety levels are high among several members. 4- Parents have good relationships with own families of origin.

4

Horizontal lines in a genogram represent ... 1- divorces. 2- geographic movements. 3- deaths. 4- marriages.

4

According to the Calgary family intervention model, in which stage does the core of the clinical work occur? 1- intervention 2- engagement 3- assessment 4- termination

1

Matthew and Janice have been married for 5 years and plan on having children. In what stage of the family life cycle are Matthew and Janice? 1- Expanding family 2- Transitional 3- Contracting family 4- Launching

1

A generalist psychiatric-mental health nurse is providing care to a family. Which intervention would be most appropriate for the nurse to do? Select all that apply. 1- Family therapy 2- Counseling 3- Self-care promotion 4- Health teaching 5- Genogram use

2,3,4

A psychiatric-mental health nurse is assessing a family. The family consists of a husband, age 68, a wife, age 61, a son, age 32, his wife, age 32, their two children, ages 4 and 1 with a third child on the way, and a daughter, age 24. The son, his wife and children live about 20 minutes away from the parents. The daughter lives about 30 minutes away but works near the parents' home. The husband has had multiple health issues over the past 5 years requiring numerous hospitalizations, emergency department visits, surgeries, and health care provider visits. The husband is semi-retired. The wife continues to work full time and is the primary breadwinner for the household. The nurse would identify this family is in which phase of the family life cycle? 1- Families with young children 2- Launching children 3- Families in late middle age 4- Families nearing the end of life

3

Assessment of a family reveals that the parents are addressing changes involving their careers and beginning to assume care of their parents. The nurse interprets this information as reflecting which phase of the family life cycle? 1- Couples formation 2- Families with young children 3- Families with adolescents 4- Launching children

3

A psychiatric-mental health nurse is assessing a family. During the interview, the nurse asks how each family member acts when the member gets angry with the family. One member responds by saying, "I might be angry, but I take the time to think about things and try to figure out what might be going on before I say or do anything." The nurse interprets this statement as indicating which concept? 1- Family projection process 2- Triangle 3- Nuclear family emotional process 4- Differentiation of self

4

The Lawson family has been caring for Randy, their 35-year-old son with schizophrenia, for about 15 years. They report that they often are fearful that Randy will become psychotic and hurt someone in public. They are sad because they remember that when Randy was in high school, he was a star student and athlete, and they enjoyed watching him play football. These feelings of the family can best be described as ... 1- inability to cope with the difficult work of caring for Randy. 2- exaggerated response to a normal, manageable situation. 3- objective family burden that includes many thoughts and feelings about caring for a loved one who is psychotic. 4- subjective family burden that occurs in many families who have a mentally ill loved one.

4

The nurse is analyzing a genogram of a large family. Included in most family genograms are the ... 1- occupations of the members. 2- relationships with the community. 3- educational levels. 4- ages of the members.

4

The nurse therapist is setting goals for a family in therapy. One goal is for the family to adopt a healthy family structure. Which would be an appropriate outcome criterion for this goal? 1- Family conflict is avoided 2- Family members are protected from external conflict 3- Family appears to function in harmony 4- Conflicts are resolved in a rational manner

4

A nurse is assessing a family and evaluating the family's problem-solving skills. During the interaction, which question would be most important for the nurse to assess? Select all that apply. 1- Who sits next to who? 2- Which topics are not addressed? 3- Which situations are identified as stressful? 4- Who makes the decisions for child care? 5- How does the family handle conflict?

4,5

A psychiatric-mental health nurse is conducting a family assessment. The nurse notes that one of the family members is moving to another state for a new job, another older family member is experiencing a significant decline in health, and another member is returning to the workforce after being a stay-at-home mother for the past 10 years. The nurse documents these findings using which term? 1- Transition times 2- Subsystems 3- Family development 4- Resilience

1