Fundamentals Ch. 24

Two nursing students, both single parents, have decided to move into a larger house. Part of their rationale includes providing support for studying and sharing the responsibilities of parenting. Which type of living arrangement are these students implementing? 1. Cohabiting family 2. Blended family 3. Foster family 4. Intragenerational family

Correct Answer: 1 Rationale 1: Cohabiting (or communal) families consist of unrelated individuals or families that live under one roof. Reasons for cohabiting may be a need for companionship, a desire to achieve a sense of family, sharing expenses, and household management. Rationale 2: A blended family occurs when existing family units join together to form new families, also known as stepfamilies or reconstituted families. Rationale 3: Foster family situations occur when children can no longer live with their birth parents and require placement with a family that has agreed to include them temporarily. Rationale 4: Intragenerational families occur when more than two generations live together.

During a family assessment, the nurse asks How, as a family, do you deal with disappointments or stressful changes that occur and affect the members of your family? What is the nurse attempting to identify? 1. Family coping mechanisms 2. Whether the family experiences stress 3. Which family members are most stressed 4. Family dynamics

Correct Answer: 1 Rationale 1: Family coping mechanisms are behaviors that families use to deal with stress or changes imposed from either within or without. The coping mechanisms families and individuals develop reflect their individual resourcefulness. The assessment of coping mechanisms is a way to determine how families relate to stress. Rationale 2: The scenario correctly assumes that families will periodically experience stress. Rationale 3: The question is not focused on who is stressed but rather how stress is handled by the family. Rationale 4: The question is not focused on the general function of the family but rather how stress is handled by the family.

A father of a family was killed in a motor vehicle crash. What should the nurse consider a normal reaction to this event? 1. Family disorganization may occur. 2. Family members become detached from extended family. 3. The family feels that their place in the community has been eliminated. 4. The family withdraws into seclusion during the grief process.

Correct Answer: 1 Rationale 1: The death of a family member often has a profound effect on the whole familyespecially if the deceased, as in this situation, was the head of the family. Family disorganization would be common, but as the family begins to recover, a new sense of normalcy develops and the family reintegrates its roles and functions. Rationale 2: Families need support from extended family members, their community, and spiritual advisers. Rationale 3: This option is not considered a normal pattern of family grieving, and the nurse should be alert for problems that may develop if these feelings are present. Rationale 4: Seclusion is not considered a normal pattern of family grieving, and the nurse should be alert for problems that may develop if this response is present.

A family struggles with clear communication, and members of the family often seek the help of other systems for personal validation and gratification. What should the nurse identify as an appropriate nursing diagnosis for this family? 1. Altered Family Processes related to communication patterns 2. Impaired Verbal Communication related to inability to communicate 3. Ineffective Family Coping evidenced by assistance from outside sources 4. Knowledge Deficiency (communication patterns) related to dysfunctional patterns of communication

Correct Answer: 1 Rationale 1: This describes a state in which a family with previous normal functioning experiences a dysfunction. The communication patterns have affected how the family works as a unit. Rationale 2: Impaired Verbal Communication means that the members are not able to communicate because of complications with speaking or saying the words, which is not the case in this situation. Rationale 3: Ineffective Family Coping must be related to an etiology, so this option is not worded correctly. Rationale 4: Knowledge Deficiency is not correct, as the family does recognize the problem because members of the family seek assistance from outside sources, as stated in the scenario.

The nurse has identified a coping problem in a family that recently lost their house and all of their belongings in a fire. What should the nurse identify as this familys external support systems? Standard Text: Select all that apply. 1. Grandparents 2. The parents siblings 3. Local social services agencies 4. The familys religious leader 5. The familys communication skills

Correct Answer: 1, 2, 3, 4 Rationale 1: External support includes extended family members. Rationale 2: External support includes extended family members. Rationale 3: External support includes social services. Rationale 4: External support includes religious organizations. Rationale 5: Individual family members, along with knowledge, skills, and effective communication patterns, provide internal support.

During a family assessment, the nurse determines that a family functions according to the systems theory. What did the nurse assess to make this clinical decision? Standard Text: Select all that apply. 1. Family members work together towards goals. 2. Family members seek out and use community resources. 3. Family members interact with other community systems. 4. Healthy boundaries are used to regulate influence by other systems. 5. Family members are encouraged to hold fast to beliefs and practices.

Correct Answer: 1, 2, 3, 4 Rationale 1: In systems theory, family members work together to achieve specific purposes and goals. Rationale 2: In systems theory, family members seek out health care information and use community resources. Rationale 3: In systems theory, family members interact with and are influenced by other systems in the community. Rationale 4: In systems theory, boundaries regulate the input from other systems that interact with the family system. Rationale 5: In systems theory, family members are encouraged to adapt beliefs and practices to meet the changing demands of society.

The nurse is planning to use the structural-functional theory when assessing a family new to a community. What should the nurse include when conducting this assessment? Standard Text: Select all that apply. 1. Individuals in the family 2. The familys sense of purpose 3. Relationships among family members 4. Strategies to restrict outside influences on the family 5. The approach the family uses to socialize new family members

Correct Answer: 1, 2, 3, 5 Rationale 1: The structuralfunctional theory focuses on family structure and function. The structural component of the theory addresses the membership of the family. Rationale 2: The functional aspect of the theory examines the effects of intrafamily relationships on the family system. Some of the main functions of the family include developing a sense of family purpose. Rationale 3: The structuralfunctional theory focuses on family structure and function. The structural component of the theory addresses the relationships among family members. Rationale 4: Outside influences on the family would be a part of systems theory. Rationale 5: The functional aspect of the theory examines the effects of intrafamily relationships on the family system. Some of the main functions of the family include socializing new members

The nurse is preparing to assess a family regarding the impact of one of its members being diagnosed with diabetes. What should the nurse include in this assessment? Standard Text: Select all that apply. 1. The seriousness of the disorder 2. Whether the family has ever dealt with a chronic illness before 3. The age of the affected member 4. The financial impact the illness will have on the family 5. The number of members of the family

Correct Answer: 1, 2, 4 Rationale 1: It is appropriate to consider the seriousness of the disorder, as the impact on the family will be in proportion to the degree of seriousness. Rationale 2: It is appropriate to consider the effect of the illness on future family functioning. Rationale 3: The age of the affected member will generally not have a large impact, as such an illness at any age will affect family functioning. Rationale 4: It is appropriate to consider the financial impact of the illness, which is influenced by factors such as insurance and the ability of the ill member to return to work. Rationale 5: The number of members in the family has little impact on the overall change an illness will cause.

A family member is hospitalized with an illness. What should the nurse assess to determine the impact this illness will have on the family? 1. Nature of the illness 2. Duration of the illness 3. Cause of the illness 4. Financial impact of the illness 5. Effect of the illness on future family functioning

Correct Answer: 1, 2, 4, Rationale 1: Factors that determine the impact of illness on the family include the nature of the illness. Rationale 2: Factors that determine the impact of illness on the family include the duration of the illness. Rationale 3: The cause of the illness is not a factor that determines the impact on the family. Rationale 4: Factors that determine the impact of illness on the family include the financial impact of the illness. Rationale 5: Factors that determine the impact of illness on the family include the effect of the illness on future family functioning.

The nurse is planning to complete a family assessment. For which reasons is the nurse completing this assessment? Standard Text: Select all that apply. 1. Determine the level of family functioning. 2. Identify family strengths and weaknesses. 3. Provide legal guidelines for consent to health care. 4. Clarify family interaction patterns. 5. Describe the health status of individual members.

Correct Answer: 1, 2, 4, 5 Rationale 1: The purpose of family assessment is to determine the level of family functioning. Rationale 2: The purpose of family assessment is to identify family strengths and weaknesses. Rationale 3: Legal guidelines regarding health care issues such as insurance coverage and the right to consent for health care are important when working with same-sex couples. Rationale 4: The purpose of family assessment is to clarify family interaction patterns. Rationale 5: The purpose of family assessment is to describe the health status of the family and its individual members.

The nurse is confident that a family is functioning appropriately. What findings did the nurse use to make this determination? Standard Text: Select all that apply. 1. The teenage son keeps the money he earns from cutting grass for his car fund. 2. All the children are expected to excel in the sport of their choice. 3. A parent reads the preschool child a bedtime story each night. 4. All the children have household chores once they reach school age. 5. A young adult child moves back home after losing his job

Correct Answer: 1, 3, 4, 5 Rationale 1: An appropriately functioning family has the economic resources needed by the family secured by adult members. Rationale 2: An appropriately functioning family provides support, understanding, and encouragement to all members without rigid expectations that unnecessarily force decisions. Rationale 3: An appropriately functioning family creates an atmosphere that influences the cognitive and psychosocial growth of its members. Rationale 4: In an appropriately functioning family, the members support each other and the family unit. Rationale 5: An appropriately functioning family provides support, understanding, and encouragement to all members as they progress through predictable developmental stages, as they move in or out of the family unit, and as they establish new family units.

A nurse is conducting a family assessment as part of the process for services provided through the community. Which part of the assessment should provide the nurse with the best information in identifying existing or potential health problems? 1. Ecomap 2. Genogram 3. Cultural assessment 4. Family communication patterns

Correct Answer: 2 Rationale 1: An ecomap provides a visualization of how the family unit interacts with the external communityfor example, schools, religious commitments, occupational duties, and recreational pursuits. Rationale 2: The health history is one of the most effective ways of identifying existing or potential health problems. A genogram will help the nurse to visualize how all family members are genetically related to each other and how patterns of chronic conditions are present within the family unit. Rationale 3: A cultural assessment will provide information about the health beliefs and health practices of a particular family. Rationale 4: Family communication patterns determine the familys ability to function as a cooperative, growth-producing unit.

The nurse has been working with a family at the community health office and is concerned about signs of family violence. Which finding should the nurse identify as most concerning? 1. The baby always seems to have a cold. 2. One of the children never speaks and seems on guard when in the presence of a parent. 3. The familys clothes are relatively clean, but the children usually have some kind of dirt stain on their shirts or pants. 4. The family does not have a regular physician.

Correct Answer: 2 Rationale 1: The baby may have an untreated condition, but chronic cold symptoms are not evidence of abuse. Rationale 2: A child who doesnt speak and is watchful when parents are near would be a significant indicator of a possible abuse situation. Rationale 3: Dirty clothes or clothes not meeting the nurses standards are not signs of abusemaybe for this family, appearance is not a high priority. Rationale 4: Not having a regular physician would be a concern for health promotion and maintenance, but not for abuse.

A client is asked during an admission interview to describe her family. She proceeds to list parents, siblings, grandparents, aunts, uncles, and cousins. Which type of family should the nurse document for this client? 1. Nuclear 2. Extended 3. Traditional 4. Blended

Correct Answer: 2 Rationale 1: The nuclear family contains parents and offspring. Rationale 2: The extended family includes parents and offspring (nuclear) along with relatives such as grandparents, aunts, and uncles. Rationale 3: A traditional family is viewed as one in which both parents reside in the home with their childrenthe mother assuming the nurturing role and the father providing the necessary economic resources Rationale 4: A blended family consists of existing family units joined together to form new families, also known as stepfamilies or reconstituted families.

A nurse is working with a particular cultural group in which it is not uncommon for grandparents to live with their married children and to assist with childrearing and discipline issues. For which type of family should the nurse plan care for these clients? 1. Two-career family 2. Blended family 3. Intragenerational family 4. Traditional family

Correct Answer: 3 Rationale 1: A two-career family is one where both partners are employed. Rationale 2: A blended family occurs when existing family units join together to form new families. Rationale 3: In some cultures and as people live longer, more than two generations may live together in an intragenerational setting, as described. Rationale 4: A traditional family is viewed as an autonomous unit in which both parents reside in the home.

The nurse is performing a family risk assessment. Which factor should the nurse identify that indicates this family is at risk of developing health problems? 1. The family is an elderly couple who are active in their retirement community. 2. The family is a teenage mother and child. The mother is enrolled in parenting classes at the high school. 3. The family belongs to the local synagogue and has family members still living in Germany. 4. The family depends on two incomes with a limit on their health insurance spending.

Correct Answer: 3 Rationale 1: The elderly couple is active and so is not at as high of risk simply because of age. Rationale 2: Just because the family is led by a teenage mother, even though maturity is one of the factors the nurse will assess in this situation, does not necessarily indicate that a health risk exists. Rationale 3: Tay-Sachs is a neurodegenerative disease that occurs primarily in descendants of Eastern European Jews. Simply because of this familys ethnicity, they are at risk for developing this health problem. Rationale 4: Although poverty is a major problem that affects the family, the fact that there is health insurance is a positive sociologic factor.

During a previous family assessment, the nurse realized that the mother did most of the talking and was quick to make decisions, which appeared to be acceptable to the father. When one of their children is hospitalized, the nurse should 1. make sure that both parents are involved in all decision making. 2. allow the mother to make the decisions. 3. include both parents in the decision making, but be accepting if the mother retains control. 4. make sure that the physician understands the family dynamics so parental consent comes from the mother.

Correct Answer: 3 Rationale 1: The nurse uses information gained from the assessment to help diagnose, plan, and implement care. Understanding that the mother assumes the authority role in this particular family, the nurse may find it easier to address things with both present but should not be surprised if this pattern continues during the childs hospitalization. Rationale 2: The nurse should not assume that family processes will be the same in a crisis situation or during stress and will want to make sure that the father is present during the process. Rationale 3: The nurse uses information gained from the assessment to help diagnose, plan, and implement care. Understanding that the mother assumes the authority role in this particular family, the nurse may find it easier to address things with both present but should not be surprised if this pattern continues during the childs hospitalization. However, the nurse should not assume that family processes will be the same in a crisis situation or during stress and will want to make sure that the father is present during the process. Rationale 4: This option reflects an inappropriate assumption that only the mother can provide consent to treat.

A nurse is conducting a family assessment and is focusing, for the moment, on the family members communication patterns. Which observation indicates that there are existing or potential problems with family communication? 1. All members are participating in the discussion equally, some quite vocally. 2. The verbal communication is congruent with the nonverbal messages. 3. A few of the members just sit and listen. 4. Disagreements are not addressed among members; rather, they are ignored by the person who does the most talking.

Correct Answer: 4 Rationale 1: Even though some members are more vocal, at least all are participating in the discussion. Rationale 2: Nonverbal communication is important because it gives valuable clues about what people are feeling. Even though some members are more vocal, at least all are participating in the discussion. Verbal communication should be congruent with nonverbal cues. Rationale 3: Listening is an art, and not all members of a family need to speak in the same setting. Rationale 4: This option describes an authoritarian setting where other members may be cautious in expressing their feelings because of power struggles, hostility, or anger. Nurses should pay special attention to who does the talking for the family, which members are silent, how disagreements are handled, and how well the members listen to one another and encourage the participation of others.