Question 1

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.)

Accepted Answer

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. A, B, C, D

Question 2

Which scenario best illustrates scapegoating within a family?

Accepted Answer

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. B

Question 3

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?

Accepted Answer

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. B

Question 4

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

Accepted Answer

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 5

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

Accepted Answer

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

Question 6

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?

Accepted Answer

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 7

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?

Accepted Answer

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 8

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

Accepted Answer

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 9

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?

Accepted Answer

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 10

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

Accepted Answer

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.

Question 11

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?

Accepted Answer

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 12

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?

Accepted Answer

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

Question 13

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?

Accepted Answer

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

Question 14

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?

Accepted Answer

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

Question 15

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?

Accepted Answer

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 16

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?

Accepted Answer

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 17

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?

Accepted Answer

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

Question 18

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?

Accepted Answer

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 19

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

Accepted Answer

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 20

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?

Accepted Answer

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?"

Exam 11: Working With the Family