Chapter 2 Community-Based Nursing Care of the Child and Family

Talk to a working, recently divorced single parent to assess problem areas. Answer the following questions. 1. What changes or feelings accompany single parenthood?

The parent may feel guilty about time spent away from children; overburdened by responsibility and demands on time; depressed and doubtful of ability to cope with the child's emotional needs; isolated and lonely; and over- worked and anxious about the financial difficulties often asso- ciated with being a single-parent family.

The best type of consequences of negative behavior in children is a. natural or logical. b. negative reinforcement. c. withdrawing privileges. d. grounding

a

The nursing student is caring for an adopted preteen. Which of the following interventions is the most important to provide for the parents of this child? a. Reassuring their child that they understand the need to search for their identity. b. Planning for their child to reconnect with his or her biologic parents. c. Reminding their child that they have his or her best interest in mind. d. Tempering the child's desire to discover more information about his or her biologic parents.

a

Which of the following is recognized to be a common cause for misbehavior in children? a. Desire for attention b. Feeling of acceptance c. Display of regression d. Display of adequacy

a

Which theory identifies the family as a small group (ie, a semiclosed system of personalities that interacts with the larger cultural social system)? a. Developmental theory b. Family systems theory c. Family stress theory d. Resilience theory

a

Describe four categories of external assets that youth receive from the community. a. Support b. Empowerment c. Boundaries and expectations d. Constructive use of tim

a. Young people need to feel support, care, and love from their families, neighbors, and others. They also need organizations and institutions that offer positive, supportive environments. b. Young people need to feel valued by their community and be able to contribute to others. They need to feel safe and secure. c. Young people need to know what is expected of them, what activities and behaviors are within the community boundaries, and what are out- side of them. d. Young people need oppor- tunities for growth through constructive, enriching oppor- tunities and through quality time at home

List four social supports and community resources needed by single-parent families.

a. Health care services that are open nights and weekends b. High-quality child care c. Respite child care d. Parent enhancement centers

Match each family structure with its description. a. ____________ Traditional nuclear family b. ____________ Blended family c. ____________ Single parent d. ____________ Binuclear family e. ____________ Polygamous family f. ____________ Communal family g. ____________ Gay, lesbian, bisexual, and transgender family 1. Family is one in which there is a legal or common-law tie between two persons of the same sex who have children 2. May have divergent beliefs, practices, and organization; the basic impetus for formation is often dissatisfaction with the nuclear family structure, social systems, and goals of the larger community 3. The conjugal unit is sometimes extended by the addition of spouses 4. Parents continuing the parenting role while terminating the spousal unit 5. Has emerged partially as a consequence of the women's rights movement and also as a result of more women (and men) establishing separate households because of divorce, death, or desertion 6. Also called a reconstituted family, includes at least one stepparent, stepsibling, or half-sibling 7. Composed of two parents and their children; the parent-child relationship may be biologic, step, adoptive, or foster

a.7 b.6 c.5 d.4 e.3 f.2 g.1

ndicate whether each of the following statements is true or false. a.TF Children from lower-income, single-mother, and mother-partner families are considerably more likely to be living in foster care. b.TF Children in foster care are less likely to have a higher than normal incidence of acute and chronic health problems than children who are not in foster care. c.TF Foster children are often at risk because of their previous caretaking environment.

a.T b.F c.T

Indicate whether each of the following statements is true or false. a.TF When reprimanding children, focus only on the misbehavior, not on the child. b.TF Logical consequences occur without any intervention, such as being late and missing dinner. c.TF Consistency is when disciplinary action is implemented exactly as agreed on for each infraction.

a.T b.T c.T

Interview an expectant couple and then parents with a school-age child to contrast their views of parenthood. Answer the following questions. Include the parents' responses to illustrate these concepts. 1. According to Duvall's developmental stages of the family theory, what are the tasks for each of the following families? Are the families you interviewed successful in accomplishing these tasks? a. Expectant couple b. Parents of a school-age child

a.Tasks include integrating infants into the family unit, accommodating to new par- enting roles, and maintaining the marital bond. b.Children develop new peer relations and new roles. They also spend more time away from parents. Parental role changes include adjusting to children's peer and school relationships while maintain- ing the marital bond.

The parenting style that includes control that is firm and consistent but tempered with encouragement, understanding, and security is referred to as __

authoritarian

A school-age boy is stomping around at the clinic, dropping markers on the floor, and saying in an angry tone, "I can't make the picture look right!" The nursing student noticed that his mother said, "You are in so much trouble for acting this way. Just wait until I tell your father how bad you were at the doctor's office!" The nursing student recognizes this type of discipline is ineffective because a. the child's feelings are being maximized. b. the mother is delaying punishment. c. the father is not present. d. the child's behavior is normal and does not need to be addressed.

b

Which of the following definitions views the family from an economic standpoint? a. Interpersonal aspects of the family and its responsibility for personality development b. A productive unit providing for material needs. c. A social unit interacting with the larger society, creating the context within which cultural values and identity are formed d. Fulfilling the biologic function of perpetuation of the species

b

Which of the following is primarily responsible for shaping children's roles? a. Teachers b. Parents c. Siblings d. Friends

b

Which of the following social supports and community resources help meet the needs of single-parent families? a. Traditional health care services with typical office hours b. Respite child care to relieve parental exhaustion c. Promotion and acceptance of children taking on adult responsibilities d. Activities designed to increase the child's exposure to two-parent families

b

Culture includes which of the following? Select all that apply. a. Cultural competence, which includes building skills in the health care provider, such as offering lists of common foods, health care beliefs, and important rituals b. Cultural humility, which requires that health care providers participate in a continual process of self-reflection and self-critique c. Recognizing the power of the health care provider role that views the patient and family as full members of the health care team d. A particular group with its values, beliefs, norms, patterns, and practices that are learned, shared, and transmitted from one generation to another e. A complex whole in which each part is interrelated, including beliefs, tradition, lifeways, and heritage

b, c, d, e

At what age is reasoning appropriate to use when addressing negative behavior in children? a. Infancy b. Preschool c. School age d. Toddlers

c

The nurse is explaining the strategy of consequences to a parent he is working with. Which response by the parent indicates more teaching is needed when he describes the types of consequences? a. Natural: Those that occur without any intervention b. Logical: Those that are directly related to the rule c. Transforming: Allowing the child to come to the conclusion on his or her own d. Unrelated: Those that are imposed deliberately

c

The nursing student observes a parent instructing her child to sit still by controlling the child's behavior through unquestioned mandates. She keeps telling her child to sit still "because I said so!" The nursing student recognizes this style of parenting to be a. permissive. b. authoritative. c. authoritarian. d. none of the above

c

The nursing student recognizes that ____________ is an important institution in which children systematically learn about the negative consequences of behavior that departs from social expectations. a. church b. athletics c. school d. family

c

What does family systems theory include? a. Direct causality, meaning each change affects the whole family b. Family systems react to changes as they take place, not initiate it c. A balance between morphogenesis and morphostasis is necessary 36 d. Theory is used primarily for family dysfunction and pathology

c

What is the most effective way for nurses to identify family strengths and weaknesses? a. Asking open-ended questions b. Observing for family patterns c. Performing a detailed nursing assessment d. Making assumptions based on past experience with families

c

Which of the following discipline strategies by parents may interfere with the child's development and moral reasoning? a. Use of time-out b. Withdrawing privileges c. Corporal punishment d. Negative reinforcement

c

Which of the following theories is derived from general systems theory, a science of "wholeness" characterized by interaction among the components of the system and between the system and the environment? a. Family stress theory b. Developmental theory c. Family systems theory d. Resilience theory

c

What is a way to integrate spiritual practices into nursing care? a. Explaining the religious practices you personally take part in b. Realizing that young children have little understanding regarding their spirituality c. Agreeing with children and their families when they explain their religious beliefs so that they are not offended d. Becoming knowledgeable about the religious worldviews of cultural groups found in the patients you care for

d

What is one of the primary emphases of Bowen's family theory? a. Family members do not distinguish between one another emotionally or intellectually. b. The family unit has a high level of enmeshment and rigid control. c. When problems arise within the family, change occurs by maintaining the interaction or feedback messages that perpetuate disruptive behavior. d. Positive feedback initiates change, negative feedback resists change.

d

Which of the following are common feelings 2- to 3-year-old children have when their parents are going through a divorce? a. Fear of abandonment b. Blaming themselves for the divorce; decreased self-esteem c. Bewilderment regarding all human relationships d. Fear and confusion

d

What does Duvall's Developmental Stages of the Family include? Select all that apply. a. Stages an individual progresses through in their moral and spiritual development b. Stages families progress through in adulthood c. Stages that designate how parenting progresses as a child develops d. Stages that designate appropriate discipline related to developmental stages e. Stages that describe the journey a couple will take as their children mature

b, c, e

Which of the following are common feelings 9- to 12-year-old adolescents have when their parents are going through a divorce? a. Expression of anger, sadness, shame, and/or embarrassment b. Withdrawal from family and friends c. Disturbed concept of sexuality d. Decline in school performance

d

Which of the following predictable stressors are identified by the family stress theory? a. Divorce b. Illness c. Unemployment d. Parenthood

d

After talking with a variety of families with children of various developmental ages, answer the following questions that deal with the effects of different family structures on child development. Include specific examples to illustrate these concepts. 1. What life events might alter family structure? 2. What implication does an alteration in composition have for the family and child? 3. List the qualities of strong families, regardless of their configuration.

1. Events such as marriage, divorce, birth, sickness, stressors (new sibling, career change, mov- ing residences), financial stress, marital stress, lack of social sup- port, death, abandonment, and incarceration 2. Roles must be redefined or redistributed. 3. a. Commitment b. Appreciation c. Time d. Purpose e. Congruence f. Communication g. Family rules, values, beliefs h. Coping strategies i.Problem solving j.Positive attitude k. Flexibility and adaptability l. Balance

Which theorist states that a person's behavior results from the interaction of his or her traits and abilities with the environment? a. Piaget b. Maslow c. Bronfenbrenner d. Vygotsky

Bronfenbrenner

Interview a couple who consist of dual-career parents and a couple who consist of a stay-at-home parent and a career parent. Assess both problem and strength areas in these families. Identify two strengths and two weaknesses associ- ated with the dual-career parents and with the stay-at-home parent and career parent.

Examples of weaknesses of dual- career parents include less quality time spent with the children, more reported guilt, overload, stress, and undefined roles. Strengths of dual- career parents may include higher education levels of parents, better child care options, less isolation and loneliness, and fewer financial stressors. Examples of weaknesses of a family with a career parent and a stay-at-home parent include specific and somewhat fixed gender roles, less quality time to care for self, risk of isolation and loneliness, and more pressure and stress on the career parent. Strengths of families with a career parent and a stay-at-home par- ent include more defined roles, more social support from one another and often more support for the children, less hectic schedules throughout the work week, and more quality time for the children at home with a parent.

Define joint legal custody.

Joint legal custody occurs when children reside with one par- ent but both parents are legal guardians and both participate in childrearing.

2. What factors affect the transition to parenthood?

Parental age, father's involve- ment, parenting education, stressors in the family, having a child with a difficult tempera- ment, stressed marital relation- ships, support systems