Deck 3: The Calgary Family Assessment Model

Question 1

The nurse is talking with the client and her partner during the initial assessment. She asks the client if there have been any losses of family members. The client tearfully replies that their 15-year-old dog died 3 weeks ago. The nurse will record this information in which subsection of the structural section of the Calgary Family Assessment Model?

A) Gender
B) Subsystems
C) Rank order
D) Family composition

Answer 1

Family composition

Question 2

The nurse is reflecting on her conversation with a client, a 17-year-old high school senior. The client revealed that when she is anxious about her decision to attend a college several hours away from home, she often talks to her grandmother. She is worried about how her younger brothers and sister will cope with her absence, but her grandmother encourages her to "spread her wings" and enjoy her time at college. In which of the following subsections does this conversation belong?

A) Family composition
B) Boundaries
C) Rank order
D) External structure

Answer 2

Boundaries

Question 3

The nurse is investigating how racial identity may influence the health beliefs and behaviors of a new client who recently immigrated from Africa. Which of the following questions is most appropriate to ask?

A) "Thinking about your overall health, what do I need to understand in order to be most helpful to you?"
B) "What health strengths and challenges do you face due to race?"
C) "Tell me about your family's traditional practices when it comes to illness."
D) "Is there a difference between how your family defines your illness and how the health-care system defines your illness?"

Answer 3

"Thinking about your overall health, what do I need to understand in order to be most helpful to you?"

Question 4

The nurse is caring for the family of a deceased car accident victim as they gather in the waiting room of the emergency room. Which of the following questions is most important to ask?

A) "What spiritual or cultural needs do you have at this time?"
B) "How did your loved one's job as an executive impact the family?"
C) "With the loss of the breadwinner, what challenges will you face with affording your medications?"
D) "How do you define health?"

Question 5

The nurse is giving an end-of-shift report. She explains how the family interacts with the community, focusing on the family's contact with those outside the family. Which of the following is an appropriate diagram for this information?

A) Social assessment
B) Genogram
C) Ecomap
D) Cultural assessment

Question 6

The nurse is caring for a client who has been diagnosed with hypertension. The client reveals that his son just started taking medication to lower his cholesterol, his mother had a stroke at 72, his father died of a heart attack at 57, and his grandfather died of a heart attack at 52. He has a very close relationship with his mom, who lives with him so that he can take care of her. The nurse plans to create a diagram of the family dynamics. Which of the following is most appropriate?

A) Genogram
B) Ecomap
C) Structural assessment
D) Developmental assessment

Question 7

The nurse is caring for a married couple who are rebuilding their home after it was destroyed by a hurricane. The nurse assesses how the couple's unique family experiences have shaped their family. Which of the following best describes what the nurse is assessing?

A) Family life cycle
B) Family development
C) Multicontextual life cycle
D) The stages and tasks the family must face

Question 8

The nurse is finishing discharge instructions for a client and her newborn. The client and her husband have three children at home, ages 3 to 12. During the conversation, the nurse asks, "How do you balance caring for the children and time with your spouse, and how do you think this will change with the new baby?" This question is most likely an example of assessing which of the following?

A) Attachment in a middle-class North American family in stage three of the family life cycle
B) Attachment in a middle-class North American family in stage one of the family life cycle
C) Attachment in an adoptive family life cycle
D) Attachment in an LGBQITT relationship

Question 9

The nurse is caring for a 93-year-old resident at the extended-care facility. The client enjoys talking about his family. He had eight siblings and was married to his wife for 62 years until she died of cancer. Of their four living children, only his oldest daughter comes to visit once a month. The other children do not live close by and rarely visit or call. The client admits that he wishes his children would visit more often because he has so much he wants to tell them. The nurse knows the client is facing which task in the "families near the end of life" stage of the middle-class North American family life cycle?

A) Maintaining functioning despite physical decline
B) Dealing with the disabilities and death of elderly parents
C) Beginning shift toward joint caring for older generation
D) Dealing with loss of spouse, siblings, and other peers and preparation for death

Question 10

The nurse is interviewing a client whose blood glucose has been high for the past several weeks. The client and her husband divorced 6 months ago, and they were awarded shared custody of their three children, aged 14, 9, and 4. Which of the following questions is appropriate for the nurse to ask to assess how the family is coping with the new situation?

A) "When you look back over your life, what aspects have you enjoyed the most?"
B) "As your attachment to your ex-husband changed, what changes did you notice in your children?"
C) "What has given you the most happiness in life?"
D) "What advice do you have for new stepfamilies?"

Question 11

The nurse is interviewing a young gay couple, in their 20s, who have recently "come out" to both sets of parents. Whereas one man's parents were accepting, the other man's parents are struggling with acceptance. As they work to deal with the core issues of coupling, what other concerns should the nurse address?

A) Illness of aging parents
B) Issues related to adoption
C) Issues of oppression and privilege
D) Issues of ethnicity and religion

Question 12

The nurse is caring for an 8-year-old client who has been diagnosed with diabetes mellitus type 1. The nurse assesses how the client and his parents are doing with his new insulin regimen that includes self-administering of insulin injections. Which of the following best describes what the nurse is assessing?

A) Instrumental functioning
B) Expressive functioning
C) Structural assessment
D) Developmental assessment

Question 13

The nurse is assessing the expressive functioning of a family whose 12-year-old daughter, Jan, was recently involved in a motor vehicle accident that has left her wheelchair bound. Which of the following questions is most appropriate to assess the circular communication in the family?

A) "When Jan gets dressed in the morning, whose role is it to help?"
B) "How can you tell when Mom is stressed over caring for Jan?"
C) "Who has Jan's illness caused the most distress for in the family?"
D) "When Jan is frustrated with her inability to go upstairs and yells at you, how does it make you feel?"

Question 14

After 5 years of marriage, a client couple has experienced two miscarriages. The nurse is speaking to the wife after a recent positive pregnancy test. The wife is worried that the added financial and emotional stress may increase her husband's drinking but is reluctant to discuss the issue with him. She feels that ignoring the issue will keep peace in the family. She says that she often avoids conversations that may lead to conflict. What category does her behavior fall under?

A) Roles
B) Nonverbal communication
C) Problem solving
D) Alliances and coalitions

Question 15

The nurse is constructing a genogram for a family. Which of the following should the nurse consider to construct a complete genogram that will most effectively help assess the family?

A) Limit participation to two or three family members.
B) Determine the priorities for the genogram.
C) Genogram questions should be introduced only after the nurse has established a very close working relationship with the family.
D) Children should be excluded from genogram questions.