Deck 11: Working With the Family

Question 1

A parent is admitted to a chemical dependency treatment unit, where the patient's spouse and adolescent children participate in a family session. What is the most important aspect of family function to be initially assessed?

A) Spouse's co-dependent behaviors
B) Interactions among family members
C) Patient's reaction to the family's anger
D) Children's responses to the family sessions

Answer 1

Interactions among family members

Question 2

Parents of a teenager recently diagnosed with serious mental illness express dismay. One parent says, "Our child sometimes acts so strangely that we don't invite friends to the house. Sometimes we don't get any sleep. We quit taking vacations." Which nursing diagnosis applies?

A) Impaired parenting
B) Dysfunctional grieving
C) Impaired social interaction
D) Interrupted family processes

Answer 2

Interrupted family processes

Question 3

A family expresses helplessness related to dealing with a mentally ill member's odd behaviors, mood swings, and argumentativeness. Which nursing intervention for the family should be included into the careplan to help reduce interpersonal stress by learning new coping skills?

A) Express sympathy regularly.
B) Involve local social services.
C) Explain symptoms of relapse.
D) Role-play problem situations.

Answer 3

Role-play problem situations.

Question 4

A parent is admitted to a chemical dependency treatment unit. The patient's spouse and adolescent children attend a family session. What is the priority assessment question to ask family members to best assess family unit characteristics?

A) "What changes are most important to you?"
B) "How are feelings expressed in your family?"
C) "What types of family education would benefit your family?"
D) "Can you identify a long-term goal for improved functioning?"

Question 5

The patient's parent asks the nurse, "Why do you want to do a family assessment? My child is the patient, not the rest of us." What response best addresses the parent's concern?

A) "Family dysfunction might have caused the mental illness."
B) "Family members provide more accurate information than the patient."
C) "Family assessment is part of the protocol for care of all patients with mental illness."
D) "Every family member's perception of events is different and adds to the total picture."

Question 6

A parent says, "My son and I argue constantly since he started using drugs. When I talk to him about not using drugs, he tells me to stay out of his business." What nursing action most appropriately addresses the parent's concern?

A) Educate the parent about the stages of family development.
B) Report the son to law enforcement authorities.
C) Refer the son for substance abuse treatment.
D) Make a referral for family therapy.

Question 7

Parents of a mentally ill teenager say, "We've never known anyone who was mentally ill. We have no one to talk to because none of our friends understand the problems." What intervention by the nurse would be most helpful in meeting the parent's expressed need?

A) Referring the parents to a family support group
B) Building their self-esteem as coping parents
C) Teaching techniques of therapeutic communication
D) Facilitating achievement of normal developmental tasks

Question 8

A nurse interviews a homeless parent with two teenage children. To best assess the family's use of resources, what question should the nurse ask?

A) "Can you describe a problem your family has successfully resolved?"
B) "What community agencies have you found helpful in the past?"
C) "Do you feel you have adequate resources to survive?"
D) "What is one thing you dislike about this family?"

Question 9

What assessment question should the nurse ask to assess a family's ability to cope?

A) "What strengths does your family have?"
B) "Do you think your family copes effectively?"
C) "Describe how you successfully handled one family problem."
D) "How do you think the current family problem should be resolved?"

Question 10

A 15-year-old patient is hospitalized after a suicide attempt. The adolescent lives with his mother, stepfather, and several siblings. When performing a family assessment, the nurse must first focus on securing what information?

A) How the family expresses and manages emotion.
B) The names and relationships of the patient's family members.
C) The communication patterns between the patient and parents.
D) The meaning the patient's suicide attempt has for family members.

Question 11

Which scenario best illustrates scapegoating within a family?

A) Messages of aggression are sent by the identified patient to selected family members.
B) Family members project problems of the family onto one particular family member.
C) The identified patient threatens separation to induce feelings of isolation and despair.
D) Family members give the identified patient nonverbal messages that conflict with verbal messages.

Question 12

After a parent is hospitalized with severe depression, family members say, "We're falling apart. Nobody knows what to expect, who should make decisions, or what to do to keep the family together." Which interventions should the nurse include in the plan of care for this family? (Select all that apply.)

A) Help the family set realistic expectations.
B) Provide empathy, acceptance, and support.
C) Empower the family by teaching problem-solving.
D) Negotiate role flexibility among family members.
E) Focus on the family rather than on the patient in planning.

Question 13

Parents of a teenager recently diagnosed with serious mental illness express dismay. One parent says, "Our hopes for our child's future are ruined. We probably won't ever have grandchildren." The nurse should use interventions to assist with the parent's demonstration of what process?

A) Denial
B) Mourning
C) Acting out
D) Manipulation

Question 14

When a nurse assesses a family, which family task has the highest priority to facilitate healthy family functioning?

A) Allocation of family resources
B) Physical maintenance and safety
C) Maintenance of order and authority
D) Reproduction of new family members

Question 15

Which information is the nurse most likely to find when assessing the family of a patient with a serious and persistent mental illness?

A) The family exhibits many characteristics of dysfunctional families.
B) Several family members have serious problems with their physical health.
C) Power in the family is maintained in the parental dyad and rarely delegated.
D) The stress of living with a mentally ill individual has negatively affected family function.

Question 16

Which documentation of family assessment indicates a healthy and functional family?

A) Members provide mutual support.
B) Power is distributed equally among all members.
C) Members believe that there are specific causes for events.
D) Under stress, members turn inward and become enmeshed.

Question 17

Which option describes an action that is common among healthy families?

A) One parent takes care of the children. The other parent earns income and maintains the home.
B) A family has strict boundaries that require members to address problems inside the family.
C) A couple requires their adolescent children to attend church services three times a week.
D) A couple renews their marital relationship after their children become adults.

Question 18

An adult recently diagnosed with a mental illness is hospitalized with pneumonia. The patient and family are very anxious. What outcome should the nurse add to the plan of care for this family to meet their immediate needs?

A) Identify and describe effective coping methods.
B) Describe the stages of the anticipatory grieving process.
C) Recognize the ways dysfunctional communication is expressed in the family.
D) Examine previously unexpressed feelings related to the patient's sexuality.

Question 19

Two divorced people plan to marry. The man has a teenager, and the woman has a toddler. This family will benefit most from what form of counseling?

A) Guidance about parenting at two developmental levels.
B) Role-playing opportunities for conflict resolution.
C) Formal teaching about problem-solving skills.
D) Referral to a family therapist with divorce counseling experience.

Question 20

A patient has become verbally abusive toward their spouse and oldest child since losing a job 6 months ago. The child ran away twice, and the spouse has become depressed. What is the most appropriate nursing diagnosis for this family?

A) Impaired parenting, related to verbal abuse of oldest child
B) Impaired social interaction, related to disruption of family bonds
C) Ineffective individual coping, related to fears about economic stability
D) Disabled family coping, related to insecurity secondary to loss of family income

Question 21

Which situations are most likely to place severe, disabling stress on a family? (Select all that apply.)

A) A parent needs long-term care after sustaining a severe brain injury.
B) The youngest child in a family leaves for college in another state.
C) A spouse is diagnosed with liver failure and needs a transplant.
D) Parents of three children, age 9, 7, and 2 years, get a divorce.
E) A parent retires after working at the same job for 28 years.