Chapter 35 - Family Interventions

Question 1

A married couple has two biologic children who live with them as well as a child from the wife’s first marriage. What type of family is evident?

a. Homogeneous
b. Extended
c. Blended
d. Nuclear

Answer 1

c. Blended

Question 2

A married couple has two children living in the home. Recently, the wife’s mother moved in. This family should be identified using what term?

a. nuclear.
b. blended.
c. extended.
d. alternative.

Answer 2

c. extended.

Question 3

When a nurse assesses a family, which family task has the highest priority for 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

Answer 3

b. Physical maintenance and safety

Question 4

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 there are specific causes for events.
d. Under stress, members turn inward and become enmeshed.

Answer 4

a. Members provide mutual support.

Question 5

A 15-year-old is hospitalized after a suicide attempt. This adolescent lives with the mother, stepfather, and several siblings. When performing a family assessment, the nurse must first determine information?

a. how the family expresses and manages emotion.
b. names and relationships of the family’s members.
c. the communication patterns between the client and parents.
d. the meaning that the client’s suicide attempt has for family members

Answer 5

b. names and relationships of the family’s members.

Question 6

Which information is the nurse most likely to find when assessing the family of a client with a serious 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. Stress from living with a mentally ill member has challenged the family’s function

Answer 6

d. Stress from living with a mentally ill member has challenged the family’s function

Question 7

The parent of an adolescent diagnosed with mental illness asks the nurse, “Why do you want to do a family assessment? My teenager is the client, not the rest of us.” What is the nurse’s best response?

a. “Family dysfunction might have caused the mental illness.”
b. “Family members provide more accurate information than the client.”
c. “Family assessment is part of the protocol for care of all clients with mental illness.”
d. “Every family member’s perception of events is different and adds to the total picture.”

Answer 7

d. “Every family member’s perception of events is different and adds to the total picture.”

Question 8

An adult diagnosed with schizophrenia lives with elderly parents. The client was recently hospitalized with acute psychosis. One parent is very anxious, and the other is ill because of the stress. Which nursing diagnosis is most applicable to this scenario?

a. Ineffective family coping related to parental role conflict
b. Caregiver role strain related to the stress of chronic illness
c. Impaired parenting related to client’s repeated hospitalizations
d. Interrupted family processes related to relapse of acute psychosis

Answer 8

b. Caregiver role strain related to the stress of chronic illness

Question 9

An adult with a history of mental illness is hospitalized with pneumonia. The client and family are very anxious. What is the best outcome to add to the plan of care for this family?

a. Describe the stages of the anticipatory grieving process.
b. Identify and describe effective methods for coping with anxiety.
c. Recognize ways dysfunctional communication is expressed in the family.
d. Examine previously unexpressed feelings related to the client’s sexuality.

Answer 9

b. Identify and describe effective methods for coping with anxiety.

Question 10

A parent is admitted to a unit for treatment of addictions. The client’s spouse and adolescent children participate in a family session. What is the most important aspect of this family’s assessment?

a. Spouse’s codependent behaviors
b. Interactions among family members
c. Client’s reaction to the family’s anger
d. Children’s responses to the family sessions

Answer 10

b. Interactions among family members

Question 11

A parent is admitted to a unit for treatment of addictions. The client’s spouse and adolescent children attend a family session. Which initial assessment question should the nurse ask of family members?

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?”

Answer 11

b. “How are feelings expressed in your family?”

Question 12

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

a. “Can you describe a problem your family has successfully resolved?”
b. “What community agencies have you found helpful in the past?”
c. “What aspect of being homeless is most frightening for you?”
d. “Do you feel you have adequate resources to survive?”

Answer 12

b. “What community agencies have you found helpful in the past?”

Question 13

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

a. role-playing opportunities for conflict resolution regarding discipline.
b. guidance about parenting children at two developmental levels.
c. formal teaching about problem-solving skills.
d. referral to a family therapist.

Answer 13

b. guidance about parenting children at two developmental levels.

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 will use interventions to assist with which likely reaction?

a. denial.
b. acceptance.
c. acting out.
d. manipulation.

Answer 14

b. acceptance.

Question 15

Parents of a teenager recently diagnosed with serious mental illness express dismay. One parent says, “Our child acts so strangely that we don’t invite friends to our home. We quit taking vacations. Sometimes we don’t get any sleep.” Which nursing diagnosis best applies?

a. Impaired parenting
b. Parental role conflict
c. Impaired social interaction
d. Interrupted family processes

Answer 15

d. Interrupted family processes

Question 16

A family expresses helplessness related to dealing with a mentally ill member’s odd behaviors, mood swings, and
argumentativeness. Which nursing intervention will be of greatest benefit for this family?

a. Expression of sympathy for their situation.
b. Involve with local social service agencies.
c. An explanation of relapse symptoms.
d. Instruction regarding the benefit of role-playing difficult situations.

Answer 16

d. Instruction regarding the benefit of role-playing difficult situations.

Question 17

Parents of a mentally ill teenager say, “We have never known anyone who was mentally ill. We have no one to talk to because none of our friends understand the problems we are facing.” What is the nurse’s most helpful intervention?

a. Referring the parents to a support group.
b. Building the parents’ self-concept as coping parents.
c. Teaching the parents techniques of therapeutic communication.
d. Facilitating achievement of normal developmental tasks of the family.

Answer 17

a. Referring the parents to a support group.

Question 18

What is the best question for the nurse to 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. “Can you describe how you successfully handled one family problem.”
d. “How do you think the current family problem should be resolved?”

Answer 18

c. “Can you describe how you successfully handled one family problem.”

Question 19

Which scenario best illustrates scapegoating within a family?

a. The identified client sends messages of aggression to selected family members.
b. Family members project problems of the family onto one particular family member.
c. The identified client threatens separation from the family to induce feelings of isolation and despair.
d. Family members give the identified client nonverbal messages that conflict with verbal messages.

Answer 19

b. Family members project problems of the family onto one particular family member.

Question 20

A parent became unemployed 6 months ago. The parent has subsequently been verbally abusive toward the spouse and oldest child. 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 community coping related to fears about economic stability
d. Disabled family coping related to insecurity secondary to loss of family income

Answer 20

d. Disabled family coping related to insecurity secondary to loss of family income

Question 21

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 is the nurse’s first most appropriate action?

a. Educate the parent about 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.

Answer 21

d. Make a referral for family therapy.

Question 22

Which scenario best demonstrates a healthy family?

a. One parent takes care of children. The other parent earns income and maintains the home.
b. A family has strict boundaries that require members to address problems within 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.

Answer 22

d. A couple renews their marital relationship after their children become adults.

Question 23

Which comment by a mother during a family therapy session shows evidence of scapegoating?

a. “Our youngest child always starts arguments and upsets everyone else.”
b. “We all express our feelings openly except when we think it might upset my husband.”
c. “Our oldest child knows that my husband and I are doing all we can for the others.”
d. “After my husband has been drinking, I have to get everyone up and ready for school.”

Answer 23

a. “Our youngest child always starts arguments and upsets everyone else.”

Question 24

Which example of behavior in a family system demonstrates double bind communication?

a. A mother tells her daughter, “You make me so mad that sometimes I wish I had never had you.”
b. A teenager tells her father, “You are treating me like a baby when you tell me I must be home by 10 PM on a school night.”
c. A son tells his mother, “You worry too much about what might happen. Nothing has happened yet, so why worry?”
d. A wife tells her husband, “You go ahead with your bowling trip. Try not to worry about me falling on my crutches while I’m alone at home.”

Answer 24

d. A wife tells her husband, “You go ahead with your bowling trip. Try not to worry about me falling on my crutches while I’m alone at home.”

Question 25

A wife believes her husband is having an affair. Lately, he has been disinterested in romance and working late. The husband has an important, demanding project at work. The mother asks her teen, “What have you noticed about your father?” The teen later mentions this to the father, who says, “Tell your mother that I can’t deal with her insecurities right now.” Which family dynamic is evident?

a. Multigenerational dysfunction
b. Triangulation
c. Enmeshment
d. Blaming

Answer 25

b. Triangulation

Question 26

A 16-year-old wants to drive, but the parents will not allow it. A 14-year-old sibling was invited to several sleepovers, but the parents found reasons to deny permission. Both teens are annoyed because the parents buy clothes for them that are more suitable for younger children. The parents say, “We don’t want our kids to grow up too fast.” Which term best describes this family’s boundaries?

a. Rigid
b. Clear
c. Enmeshed
d. Differentiated

Answer 26

a. Rigid

Question 27

A wife believes her husband is having an affair. Lately, he has been disinterested in romance and working late. The husband has an important, demanding project at work. The mother asks her teen, “What have you noticed about your father?” The teen later mentions this to the father, who says, “Tell your mother that I can’t deal with her insecurities right now.” Family therapy should focus on (Select all that apply.)

a. identifying and reducing the cognitive distortion in each parent’s perceptions.
b. confronting the family with the need for honest, direct, assertive communication.
c. helping the parents find ways to cope more effectively with their stress and fears.
d. supporting the teen to redirect the parents when they try to communicate through her.
e. convincing the mother that her fear of an affair is due to her own insecurities and unfounded.
f. helping the husband understand how others might misinterpret the changes in his behavior.

Answer 27

a. identifying and reducing the cognitive distortion in each parent’s perceptions.
c. helping the parents find ways to cope more effectively with their stress and fears.
d. supporting the teen to redirect the parents when they try to communicate through her.
f. helping the husband understand how others might misinterpret the changes in his behavior.

Question 28

A parent was recently hospitalized with severe depression. Family members say, “We’re falling apart. Nobody knows what to expect, who should make decisions, or how to keep the family together.” Which interventions should the nurse use when working with 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 planning on the family rather than on the client.

Answer 28

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.

Question 29

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, aged 9, 7, and 2 years, get a divorce.
e. A parent retires after working at the same job for 28 years

Answer 29

a. A parent needs long-term care after sustaining a severe brain injury.
c. A spouse is diagnosed with liver failure and needs a transplant.
d. Parents of three children, aged 9, 7, and 2 years, get a divorce.