Chapter 15: Family Assessment and Interventions

Format: Multiple Choice

Client Needs: Health Promotion and Maintenance

Cognitive Level: Apply

Integrated Process: Nursing Process

Objective: 1

Page and Header: 231, Family Life Cycles

1. While caring for a family, the nurse determines that first-order changes have occurred when what observation is made?

A) The children are all in school, and the parent returns to work.

B) The daughter leaves home to attend college.

C) The son marries his long-time sweetheart and moves into his own home.

D) The grandmother who has been living in the household dies.

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2. The nurse is conducting an assessment by applying the family system framework model. Which assessment would be important for the nurse?

A) Acceptance of the family rules

B) Adjustment to the family boundaries

C) Degree of enmeshment in the system

D) Interpersonal differentiation

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3. A nurse is assessing a family’s structure using Minuchin’s model. The nurse would most likely focus on which data to determine family function?

A) Boundaries

B) Emotional cutoff

C) Sibling position

D) Family projection process

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4. An adolescent client recently tried to overdose because of a relationship breakup. The client’s single parent has been drinking excessively to cope with the stress. The client tells the nurse, “Whenever I need to talk, my parent is always drunk or away drinking with friends.” Based on this information, which nursing diagnosis would be most appropriate for this client’s family?

A) Ineffective family therapeutic regimen management

B) Compromised family coping

C) Ineffective denial

D) Caregiver role strain

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5. A family has recently lost all their belongings in a house fire and has been living in temporary housing. Although the parents were previously very supportive and able to help their young children with their homework in the evenings, they have been unable to do so under their present circumstances. Based on this information, which nursing diagnosis would be most appropriate for this family?

A) Interrupted family processes

B) Compromised family coping

C) Ineffective family therapeutic regimen management

D) Caregiver role strain

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6. A client has recently been diagnosed with type II diabetes and the family is having trouble incorporating the dietary and exercise regimen prescribed by the primary health-care provider into their daily routines. They tell the nurse that they are all tired when they return home from school and work; the last thing any of them want to do is go on a walk. In addition, the client’s spouse discloses it’s very difficult to prepare any sugar-free or low-sugar foods that the client enjoys eating. Based on this information, which nursing diagnosis would be most appropriate for this family?

A) Interrupted family processes

B) Ineffective denial

C) Caregiver role strain

D) Ineffective family therapeutic regimen management

Page and Header: 236, Family Systems Therapy Model

7. A couple with a 7-year-old child has been experiencing growing tension and anxiety in the relationship. However, the tension and anxiety between the couple lessened when the mother began focusing most of her attention on the child. When applying the family systems therapy model concept of triangulation, what would the nurse expect to assess in the child?

A) Enjoying the mother’s increasing attention and growing even closer to her

B) Growing distant from the father and blaming him for all of the family’s problems

C) Developing problematic symptoms in response to the mother’s increasing attention

D) Resenting the mother for her suffocating attention and the father’s growing distance

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8. A nursing instructor is developing an education plan for a class about families. Which would the instructor be most likely to include in the lesson?

A) Families are primarily determined by blood.

B) New members are added by birth, marriage, or adoption.

C) In the United States, family size has been on the increase.

D) Families are less mobile today than in the past.

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9. A psychiatric–mental health nurse is reviewing information about the changing family structure and its effect on mental health and illness. The nurse demonstrates understanding of this information by identifying which aspect as an effect?

A) Middle-age childless adults are more vulnerable to loneliness and depression.

B) In stepfamilies, caring for the children often is a primary stressor to the marital partners.

C) Separation because of relocation provides additional support from extended family.

D) Same-sex families typically demonstrate lower rates for depression and stress.

Page and Header: 228, Effects of Mental Illness on Family Functioning

10. A nurse is planning a support group for the families of clients diagnosed with psychiatric disorders. The nurse integrates knowledge of which area as the primary underlying issue related to stress that the families experience?

A) Severity of the client’s symptoms

B) Barriers faced by the client

C) Stigma associated with the diagnosis

D) Risk for relapse

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11. A nurse is constructing a genogram of a family. Which would the nurse do?

A) Use circles to represent the male members.

B) Use horizontal lines to connect the parents with children.

C) Use horizontal lines to show marriages.

D) Use asterisks to denote ages listed at the bottom.

Page and Header: 231, Family Life Cycles; 232, Table 15.1. Phases of the Family Life Cycle

12. Assessment of a family reveals that the youngest child has moved out of the family home to live alone. One of the other two children is married, and the other child has just gotten engaged. The nurse interprets this family to be in which stage of the family life cycle?

A) Families with adolescents

B) Launching children and moving on

C) Families in later life

D) Leaving home: single young adults

Page and Header: 236, Calgary Family Model

13. A group of nursing students is reviewing system models used in caring for families. The students demonstrate understanding of the information when they identify which as characteristic of the Calgary family model?

A) Differentiation of self

B) Sibling position

C) Family development

D) Subsystems

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14. A nurse is using a genogram as an intervention strategy based on what understanding?

A) It provides information about appropriate methods for problem solving.

B) It allows the family to view its evolution over several generations.

C) It permits a subjective yet factual perspective of family relationships.

D) It provides a means for identifying the family’s beliefs about mental illness.

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15. A nurse is working with a family and using the Calgary family model to help address problems that have been identified. The family is in which stage of the model?

A) Engagement

B) Assessment

C) Intervention

D) Termination

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16. A psychiatric–mental health nurse is integrating the Calgary Family Assessment Model when caring for a family. The nurse has set up sessions that are amenable for the family as the family works to make changes. The nurse and family are at which stage?

A) Engagement

B) Assessment

C) Intervention

D) Termination

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17. When assessing the family’s communication patterns, the nurse would start with which area?

A) Observing which member initiates the conversation

B) Noting which member answers the most questions

C) Identifying which family members confide in one another

D) Assessing which family member volunteers information

Page and Header: 228, Effects of Mental Illness on Family Functioning

18. A nurse is assessing a family of a client diagnosed with a persistent mental disorder. In comparing this family to one without a member who has a mental disorder, which function would the nurse expect this family to serve? Select all that apply.

A) Providing support

B) Providing socialization

C) Advocating for services

D) Providing information

E) Monitoring services

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19. A nurse is engaged in developing a relationship with a family during a family assessment. Which would be important? Select all that apply.

A) Demonstrating culturally competent nursing skills

B) Completing the assessment efficiently in the first meeting

C) Identifying the family’s immediate needs

D) Exhibiting a professional image

E) Investigating the adherence to the medication regimen

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20. A nurse is assessing the communication patterns in the family. When observing the interaction, which area would be important for the nurse to keep in mind? Select all that apply.

A) Who sits next to who?

B) Which topics are not addressed?

C) Which situations are identified as stressful?

D) Who makes the decisions for child care?

E) How does the family handle conflict?