Deck 14: Multiproblem Families

Question 1

A community/public health nurse is visiting a new teenaged mother in her home.As the teenage mother walked into the room,the baby's grandmother stated,"This whole thing is your fault.Why are you still in this house?" The teenager walked out the front door with her baby.Which of the following reasons explains why the grandmother would say such a thing to her teenage daughter?

A)The teenager created the problem;therefore,she should be the one to cope with it.
B)The grandmother is jealous that the teenager is young and lacks responsibility.
C)The use of scapegoating is an attempt to decrease overwhelming anxiety.
D)The fight had begun earlier,and the nurse just witnessed a part of the conversation.

Answer 1

The use of scapegoating is an attempt to decrease overwhelming anxiety.

Question 2

Having completed an initial assessment,a nurse was overwhelmed with the current problems the family was facing.Which of the following actions should the nurse take first?

A)Arranging for tangible sources of external support
B)Helping the family explore current and alternative coping mechanisms
C)Providing information on crisis management and the health issues that the family is facing
D)Recognizing sources of family resiliency and strength

Answer 2

Recognizing sources of family resiliency and strength

Question 3

Which of the following statements is a reality regarding disturbances in family dynamics and high-risk problems in families?

A)"Chronic ongoing problems have no relationship to disturbed family dynamics."
B)"Chronic family problems lead to difficulties in family dynamics."
C)"Disturbances in these areas lead to the majority of problems in families."
D)"It is impossible to state which issue leads to the other."

Answer 3

"It is impossible to state which issue leads to the other."

Question 4

What typically happens to the adults who grew up in maladaptive families?

A)They create very different lifestyles,as they promised themselves when very young.
B)They look back and laugh at how naive they were.
C)They repeat the multigenerational life patterns of their parent or parents.
D)They attempt to change,but some behaviors consistent with their parents' behaviors remain.

Question 5

When working with a multiproblem family,which of the following goals should the nurse approach first?

A)The goal that best matches the agency's policies and procedures
B)The goal that can be achieved "behind the scenes" without any effort from the family
C)The goal easiest for the nurse to complete because of her or his expertise
D)The goal that the family believes is the most important

Question 6

A nurse is planning care for multiproblem families.Which of the following is the most important action for the nurse to take?

A)Bring another nurse along to assist.
B)Keep goals concrete,realistic,and mutually desired.
C)List all needs to be addressed in a systematic,organized manner.
D)Plan for longer-than-normal visits.

Question 7

A nurse believed that it would be unprofessional to continue in a role that had become intolerable and left the community/public health area to work in acute care.Which of the following actions should the nurse continue to perform?

A)Advocate for health legislation and funding supportive of families and professional nursing.
B)Encourage new graduates to enter the community/public health nursing area of practice.
C)Send cards and small gifts to the staff at the nurse's former agency.
D)Write letters to the newspaper editorial page describing the heroism of the agency's nurses in their ongoing endeavors against great odds.

Question 8

A home health nurse did not know what to do when a family was home but did not invite the nurse in.Which of the following actions should the nurse take?

A)Leave a note saying the nurse would come back,and return as stated in the note.
B)Give care to someone who wants nursing care services.
C)Report the incident to the agency supervisor and ask to be reassigned elsewhere.
D)Stay for awhile;the family might change their mind and let the nurse in.

Question 9

After obtaining several resources for a family with multiple problems,a nurse was unprepared when,during the next visit,although two children peeked out the window,no one answered the door.Which of the following best explains why the family did not answer the door?

A)They did not want those particular resources.
B)They had really expected more from the nurse than they had received.
C)They had not had time to clean their house.
D)They were testing the nurse to see whether she was really reliable and consistent.

Question 10

Which of the following is the most crucial factor in how a family responds to a natural disaster that almost destroyed their house?

A)How many of the family's relatives will allow them to move in temporarily
B)How much of house is repairable
C)How much governmental aid will be given to them to rebuild their house
D)How the family perceives the disaster and their ability to cope

Question 11

A community/public health nurse has been having difficulty interacting with a family with multiple problems and has asked the agency supervisor for advice.Which of the following actions will most likely be suggested?

A)Exchange caseloads with another nurse at periodic intervals to obtain fresh insight.
B)Reassure the family that things will eventually be alright.
C)Help the family recognize how they are responsible for their own problems.
D)Recognize that the family has potential for improvement.

Question 12

Statistically,what are poverty-stricken families more likely to have demographically?

A)A female head of the family,with few social and financial resources
B)Employment outside the immediate neighborhood
C)More children than the male head of household can support
D)Ongoing predictable life events

Question 13

Which of the following internal coping strategies is often used by resilient and adaptive families?

A)Expressing their hopelessness with other family members
B)Supporting other family members while communicating information
C)Refusing to change lifestyles or functions until the crisis is over
D)Seeking financial assistance and information from community resources

Question 14

Although there were many problems,a family was struggling to survive and reached out to others with similar problems.What was this family doing that made the difference between them and families who were not able to cope?

A)Expressing their hopelessness and frustration through acting out
B)Rearranging roles and tasks of family members while communicating information
C)Refusing to change lifestyles or functions until the crisis is over
D)Retaining a sense of hope and mutual support

Question 15

In addition to having low income and few resources,how are poverty-stricken families often notably different from mainstream families?

A)Children have been removed from the household by Children's Protective Services.
B)Many predictable life events occur for which they do not prepare.
C)The time for each developmental period is shorter,with ambiguous transitions.
D)They have relationships with controlling family members.

Question 16

A home health nurse felt overwhelmed and asked to be assigned to a better neighborhood.Why would the agency supervisor decline to change the nurse's assignment?

A)Although the nurse is just beginning to assess the families,the nurse's continued efforts to visit and support the families will be therapeutic.
B)Lots of nurses are willing to work in nice neighborhoods;most agencies need nurses who are willing to work in poor,needy neighborhoods.
C)The nurse had signed a contract and must work where assigned,regardless of personal feelings.
D)The nurse is capable of learning about how to improve interactions with these families and will do better with experience.

Question 17

A community/public health nurse is caring for a family in poverty,who has stated that the nurse's visits cause them increased stress.Which of the following assumptions has the family made about health care providers?

A)That health care providers blame the family for their problems
B)That health care providers expect the family to know about available resources
C)That health care providers plan for the short term and do not recognize long-term needs
D)That health care providers wait for the family to decide what should be done

Question 18

Which of the following is the most probable reason that some families have multiple problems?

A)Presence of multiple,ongoing,intense stressors beyond their resources
B)Lack of cultural integration into mainstream society
C)Being supported by government resources for several generations
D)Being unwilling to change or consider new approaches to problems

Question 19

Which of the following would make a family with a newborn who is severely handicapped be considered a vulnerable family?

A)When all of the choices related to the situation have negative consequences
B)When there are no backup caregivers to care for the severely handicapped infant
C)When the family welcomes someone else taking responsibility for them
D)When the family has to choose a lifestyle that is dependent on others

Question 20

A home health nurse was visiting an assigned multiproblem family.The grandmother welcomed her in.Two toddlers were playing on the floor,but none of the other adults was present.Which of the following actions should the nurse take?

A)Complete a developmental assessment on the two toddlers playing on the floor.
B)Focus on interacting with the grandmother,who is caring for the toddlers.
C)Refuse to stay because none of the other adults were present.
D)Spend the majority of time discussing the need for interaction with the toddlers.

Question 21

What is the most important requirement in order for a community/public health nurse to continue to be effective when serving multiproblem families?

A)Ongoing graduate study
B)Supervision when requested
C)Support from other agency staff
D)Time for continuing education travel opportunities

Question 22

A community/public health nurse is assessing a family who is experiencing multiple problems.Which of the following observations is the nurse most likely to make if the family is experiencing a disturbance in internal dynamics? (Select all that apply.)

A)The family adapts to changing situations and problems.
B)Communication is indirect and sometimes inconsistent.
C)Family myths and secrets are shared among family members.
D)Achievement of tasks for the developmental stage is difficult.
E)Parental roles and functions are shared among the various family members.
F)Values are established and modifiable.

Question 23

Which of the following strategies should a nurse use when working with multiproblem families? (Select all that apply.)

A)Encouraging rapid progress toward change in behaviors
B)Focusing on empowering the family and developing its self-esteem
C)Helping the family identify its strengths
D)Organizing possible sources of tangible support
E)Pointing out opportunities for doing things differently
F)Trying to resolve one major problem before beginning work on another

Question 24

Which of the following nursing interventions would be appropriate when a nurse is working with a multiproblem family? (Select all that apply.)

A)Assuring the family that the nurse will be there to help them with their problems
B)Describing how one person's thoughts and behaviors affect another family member
C)Expressing the nurse's own feelings about the family and its situation
D)Giving feedback on emotions and behavior and distinguishing between them
E)Role-modeling circular communication with adequate ambiguity and vagueness
F)Working toward small but achievable success in small areas