Homework Lance
1. Which of the following is a current trend in families or family living?
1.
People marrying earlier
2.
Reduction in the divorce rate
3.
People having more children
4.
More people choosing to live alone
ANS: 4
The number of people living alone is expanding rapidly and represents approximately 26% of all households. People are marrying later, not earlier. The rate of divorce appears to have stabilized, with approximately 55% of marriages ending in divorce. Couples are choosing to have fewer children or none at all.
DIF: A REF: 122 OBJ: Comprehension
TOP: Nursing Process: Assessment
MSC: NCLEX® test plan designation: Health Promotion and Maintenance/Family Systems; Psychosocial Integrity/Family Dynamics
2. Of the following trends, which one represents the greatest current health care challenge to nurses?
1.
Homelessness
2.
Single parent families
3.
Alternative relationship patterns
4.
“Sandwiched” or middle generation
ANS: 1
Homelessness is identified as one of the greatest health care challenges to nurses. The trend of single parent families is not the greatest current health care challenge to nurses. The trend of alternate relationship patterns is not the greatest current health care challenge to nurses. The trend of a “sandwiched” or middle generation is not the greatest current health care challenge to nurses.
DIF: A REF: 124 OBJ: Knowledge
TOP: Nursing Process: Assessment
MSC: NCLEX® test plan designation: Health Promotion and Maintenance/Family Systems; Psychosocial Integrity/Family Dynamics
3. When working with families, the nurse may view the family as context or client. Which one of the following examples demonstrates the view of the family as context?
1.
The family’s ability to support the client’s dietary and recreational needs
2.
The client’s ability to understand and manage his own personal dietary needs
3.
The family’s demands on the client that are based on the client’s role performance
4.
The adjustment of both the client and the family to changes in diet and exercise
ANS: 2
When the nurse views the family as context, the primary focus is on the health and development of an individual member existing within the client’s family. The client’s ability to understand and manage his own dietary needs is an example of viewing the family as context. The family’s ability to support the client’s dietary and recreational needs is an example of viewing the family as client. The family’s demands on the client based on his role performance is an example of viewing the family as client. The adjustment of the client and family to changes in diet and exercise is an example of viewing the family as system.
DIF: A REF: 128 OBJ: Comprehension
TOP: Nursing Process: Assessment
MSC: NCLEX® test plan designation: Health Promotion and Maintenance/Family Systems; Psychosocial Integrity/Family Dynamics
4. What would a nurse expect to find in an assessment of a healthy family?
1.
Change is viewed as detrimental to the family.
2.
There is a passive response to most stressors.
3.
The structure is flexible enough to adapt to crises.
4.
Minimum influence is being exerted on the environment.
ANS: 3
A healthy family has a flexible structure that allows adaptable performance of tasks and acceptance of help from outside the family system. The structure is flexible enough to allow adaptability but not so flexible that the family lacks cohesiveness and a sense of stability. The healthy family is able to integrate the need for stability with the need for growth and change. It does not view change as detrimental to family processes. The healthy family demonstrates control over the environment and does not passively respond to stressors. The healthy family exerts influence on the immediate environment of home, neighborhood, and school.
DIF: A REF: 127 OBJ: Comprehension
TOP: Nursing Process: Assessment
MSC: NCLEX® test plan designation: Health Promotion and Maintenance/Family Systems; Psychosocial Integrity/Family Dynamics
5. Initially, the nurse should begin by doing what in completing a client’s family assessment?
1.
Collecting health data from all the family members
2.
Testing the family’s ability to cope with normal stressors
3.
Evaluating the family’s interpersonal communication patterns
4.
Determining the client’s definition of familiar structure and attitudes
ANS: 4
The nurse begins the family assessment by determining the client’s definition of and attitude toward family and the extent to which the family may be incorporated into nursing care. The nurse also assesses family form and membership. Gathering health data from the family members is not the starting point for a family assessment. Testing a family’s ability to cope is not where the nurse should begin a family assessment. Evaluating communication barriers would not be an initial action of the nurse when completing a client’s family assessment.
DIF: C REF: 126 OBJ: Analysis
TOP: Nursing Process: Assessment
MSC: NCLEX® test plan designation: Health Promotion and Maintenance/Family Systems; Psychosocial Integrity/Family Dynamics
6. Post discharge, the client is returning to their home environment. In assisting the client with that, specifically in implementing family-centered care, the nurse:
1.
Provides personal beliefs regarding problem-solving
2.
Assists the family members to assume dependent roles
3.
Works with the client to accept responsibility for role in discourse
4.
Offers both client and family information about necessary self-care abilities
ANS: 4
When implementing family-centered care, the nurse adopts the role of educator and offers information about necessary self-care abilities. In family-centered care, the nurse guides the family in problem solving without providing his/her own beliefs. In family-centered care, the nurse assists clients to assume independent roles by increasing family members’ abilities in certain areas. In family-centered care, the nurse guides the family in problem solving, not in helping them accept blame.
DIF: A REF: 129 OBJ: Comprehension
TOP: Nursing Process: Planning
MSC: NCLEX® test plan designation: Health Promotion and Maintenance/Family Systems; Psychosocial Integrity/Family Dynamics
7. A client is unable to independently perform colostomy care due to arthritis. The nurse should first:
1.
Offer to assist the client to learn to manage the care
2.
Arrange for home care services to care for the colostomy
3.
Inquire as to family members who may be able to assist with the care
4.
Suggest that the client attend a colostomy self-help support group
ANS: 3
The nurse should first find out if there is anyone else in the family or neighborhood who would or could assist with the colostomy care. Informing the client that management of the colostomy must be learned will not change the fact that the client has arthritis and needs assistance. The nurse should first determine whether there is someone else who could perform the task. If not, the nurse arranges for a home care service referral. A colostomy self-help support group may provide emotional support, but it will not meet the client’s need for assistance with colostomy care.
DIF: C REF: 131 OBJ: Analysis
TOP: Nursing Process: Planning
MSC: NCLEX® test plan designation: Health Promotion and Maintenance/Family Systems; Psychosocial Integrity/Family Dynamics
8. The optimum goal of effective communication within the family, according to the nurse observing the family members and their interaction, is:
1.
Problem solving and psychological support
2.
Role development of individual members
3.
Socialization among individual members
4.
Better financial conditions for the family
ANS: 1
The optimum goal of effective communication within the family is to be able to problem solve and provide psychological support for its members. Role development is not the optimum goal of effective communication within the family. Socialization among individual family members is not the optimum goal of effective communication within the family. Improving financial conditions for the family is not the optimum goal of effective communication within the family.
DIF: A REF: 129 OBJ: Comprehension
TOP: Nursing Process: Assessment
MSC: NCLEX® test plan designation: Health Promotion and Maintenance/Family Systems; Psychosocial Integrity/Family Dynamics
9. Which of the following is a gerontological principle related to families?
1.
Later-life families need not work on developmental tasks.
2.
The caregivers are often not members of the client’s family.
3.
Role reversal is usually expected and well accepted by the older client.
4.
Support systems are likely to be different than those of younger age-groups.
ANS: 4
It is true that social support systems for older adults are likely to be different from those for clients in younger age-groups. Members of later-life families need to be working on developmental tasks. Caregivers for older adults are usually either spouses or middle-age children. Accepting shifting of generational roles is often difficult for the older client.
DIF: A REF: 125 OBJ: Comprehension
TOP: Nursing Process: Assessment
MSC: NCLEX® test plan designation: Health Promotion and Maintenance/Family Systems; Psychosocial Integrity/Family Dynamics
10. In assessing the roles and power structure of a client’s nuclear family, the nurse should specifically ask the client:
1.
“Who decides where to go on vacation?”
2.
“What type of health care insurance do you have?”
3.
“How many family members currently live in your home?”
4.
“What types of social activities do you and your family enjoy?”
ANS: 1
Asking, “Who decides where to go on vacation?” enables the nurse to determine the power structure and patterning of roles and tasks of the family. Asking about health insurance does not assess the roles and power structure of the family. Inquiring about family members living at home may be used to help determine family form, not the power structure and roles of the family. Asking about social activities may provide information on the interactive processes of the family and how time is spent, but it does not assess the roles and power structure of the family.
DIF: C REF: 126 OBJ: Analysis
TOP: Nursing Process: Assessment
MSC: NCLEX® test plan designation: Health Promotion and Maintenance/Family Systems; Psychosocial Integrity/Family Dynamics
11. Needing assistance with daily living activities, an older adult with two grown children is being discharged home. Although both children live nearby, the daughter is expressing concern about handling her parent’s physical needs. The nurse’s initial response is to:
1.
Work with the family on delegating responsibility
2.
Suggest short-term nursing home placement to the client
3.
Arrange for the client to remain hospitalized in the medical center
4.
Make decisions for the family on how to manage the care at home
ANS: 1
The nurse must consider caregiver strain and work with the family on delegating responsibility. Nursing home placement should not be the nurse’s initial response to caregiver strain. Arranging for the client to remain in the medical center is not always feasible and does not address the problem of caregiver strain. It should not be the nurse’s initial response in this situation. The nurse should not make decisions for the family, but rather work with the family to problem solve.
DIF: C REF: 126 OBJ: Analysis
TOP: Nursing Process: Planning
MSC: NCLEX® test plan designation: Health Promotion and Maintenance/Family Systems; Psychosocial Integrity/Family Dynamics
12. The nurse suspects that there is physical abuse present after visiting the client in the home. In recognition of the pattern of family violence, the nurse knows that:
1.
Child abuse is declining in frequency
2.
Spouses are the most frequent abusers
3.
Mental illness is a major cause of abuse
4.
Abuse is primarily seen in lower income families
ANS: 2
In recognition of the pattern of family violence, the nurse knows that spouses are the most frequent abusers. Child abuse is increasing, not decreasing. Mental illness may increase the incidence of abuse within a family, but is not a major cause of abuse. Emotional, physical, and sexual abuse occurs across all social classes.
DIF: A REF: 124 OBJ: Comprehension
TOP: Nursing Process: Assessment
MSC: NCLEX® test plan designation: Health Promotion and Maintenance/Family Systems; Psychosocial Integrity/Family Dynamics
13. The primary goal of family-centered nursing is to:
1.
Promote the wellness of the family and its members
2.
Implement appropriate care for the family and its members
3.
Provide support and care for the family and its individual members
4.
Identify physical and emotional problems affecting the family as a unit
ANS: 3
The goal of family-centered nursing care is to promote, support, and provide for the well-being and health of the family and individual family members. While the other options are appropriate goals, they are not the primary goal because promoting, supporting, and providing for the well-being and health of the family and individual family members will result in this option
DIF: C REF: 122 OBJ: Analysis
TOP: Nursing Process: Assessment
MSC: NCLEX® test plan designation: Health Promotion and Maintenance/Family Systems; Psychosocial Integrity/Family Dynamics
14. A nurse who is sensitive to the care of families recognizes that the term ‘family’ is primarily defined:
1.
As individuals legally bound to the client
2.
As people with biological connections to the client
3.
In terms generally accepted by the majority of clients
4.
By the client as individuals important to the client
ANS: 4
A nurse can think of the family as a set of relationships that the client identifies as family or as a network of individuals who influence each other’s lives. People related legally and biologically may be criterion used to determine family. General terms may not be correct in today’s diversified world.
DIF: C REF: 122 OBJ: Analysis
TOP: Nursing Process: Assessment
MSC: NCLEX® test plan designation: Health Promotion and Maintenance/Family Systems; Psychosocial Integrity/Family Dynamics
15. The nurse is preparing a new mother for discharge when the woman shares that she is “worried about going back to work and its effects on my infant.” The most therapeutic response by the nurse is:
1.
“Do you want to go back to work?”
2.
“Just be sure you have an excellent baby sitter.”
3.
“There is no proof that working will harm your baby.”
4.
“Can your husband share in the child care responsibilities?”
ANS: 3
Balancing employment and family life creates a variety of challenges in terms of child care and household work for both parents. There is no proof maternal employment is damaging for children (Shpancer and others, 2006; Hill, 2005). Although the other options may be true or attempt to offer a solution, they do not address her concerns regarding the effects on her child.
DIF: C REF: 123 OBJ: Analysis
TOP: Nursing Process: Implementation
MSC: NCLEX® test plan designation: Health Promotion and Maintenance/Family Systems; Psychosocial Integrity/Family Dynamics
16. The greatest risk to a child of adolescent parents comes from the:
1.
Increased family stressors resulting in domestic violence
2.
Lack of appropriate parenting resources and role models
3.
Statically high potential for physical and emotional abuse
4.
Parents inability to provide health care and economic support
ANS: 2
The greatest risk to a child of adolescent parents is derived from the parents’ strong potential to lack good parenting skills. This inability can result in both physical and emotional harm. Increased family stressors resulting in domestic violence and statically high potential for physical and emotional abuse often result from poor parenting and coping skills. The parents’ inability to provide health care and economic support is more likely in an adolescent-headed family resulting from limited marketable skills.
DIF: C REF: 123 OBJ: Analysis
TOP: Nursing Process: Assessment
MSC: NCLEX® test plan designation: Health Promotion and Maintenance/Family Systems; Psychosocial Integrity/Family Dynamics
17. Which of the following nursing statements has the greatest therapeutic value when counseling a ‘sandwich generation’ client caring for a chronically ill parent?
1.
“I can help you in finding assistance with the in-home care.”
2.
“What is the most stressful aspect of caring for your parent?”
3.
“I’m sure your children love having grandmother in the house.”
4.
“What do you do for relaxation now that your mom lives with you?”
ANS: 4
Assess for caregiver stress, such as tension in relationships with family and care recipient, changes in level of health, changes in mood, and anxiety and depression. Asking the caregiver about hobbies or other means of relaxation is a nonthreatening way to assess tension levels. Offering to help find assistance infers a need for help that may insult the caregiver. Assuming the caregiver is stressed or assuming the living situation is good may cause the caregiver to be reluctant to discuss existing problems.
DIF: C REF: 133 OBJ: Analysis
TOP: Nursing Process: Assessment
MSC: NCLEX® test plan designation: Health Promotion and Maintenance/Family Systems; Psychosocial Integrity/Family Dynamics
18. The mother of a child receiving immunizations at a health clinic shares with the nurse that she and the child have not eaten today. Which of the following nursing interventions is best directed at impacting the immediate problem while being sensitive to the mother’s sense of self-worth?
1.
Notifying family services of the problem
2.
Taking both mother and child to the cafeteria
3.
Informing the mother that she is eligible for food stamps
4.
Providing her with contacts at the neighborhood food bank
ANS: 4
When caring for these families, the nurse needs to be sensitive to the family’s desire for independence, but also help them with obtaining appropriate food, financial, and health care resources. Notifying family services may become necessary, but attempts to provide the mother with available means of assistance has priority. Taking them to the cafeteria would provide immediate food but does not address future needs or show sensitivity to the mother. Informing the mother about local and state aid may become necessary, but it does not address the immediate need, nor does it show sensitivity to the mother.
DIF: C REF: 124 OBJ: Analysis
TOP: Nursing Process: Planning/Implementation
MSC: NCLEX® test plan designation: Health Promotion and Maintenance/Family Systems; Psychosocial Integrity/Family Dynamics
19. The nurse recognizes that the presence of an alcohol-abusing parent places a child at greatest risk for:
1.
Homelessness
2.
School truancy
3.
Family violence
4.
Accident-related injuries
ANS: 3
Factors such as alcohol and drug abuse increase the incidence of abuse within a family (Family Violence Prevention Fund, 2006b). While the other options are possible, they are not the greatest negative outcome.
DIF: C REF: 124 OBJ: Analysis
TOP: Nursing Process: Assessment
MSC: NCLEX® test plan designation: Health Promotion and Maintenance/Family Systems; Psychosocial Integrity/Family Dynamics
20. The most important impact that truthful, timely communication between the nurse and the family of a critically ill client has is on the family’s ability to:
1.
Trust the nurse
2.
Adjust to “bad news”
3.
Be confident of the care the client is receiving
4.
Make appropriate choices regarding client treatment
ANS: 1
Provide realistic assurance; giving false hope breaks the nurse-client trust. Being trustful of the information provided by the nurse will aid in the adjustment to “bad news.” Trust is the basis for confidence in the care being provided and for appropriate decision-making.
DIF: C REF: 125 OBJ: Analysis
TOP: Nursing Process: Implementation
MSC: NCLEX® test plan designation: Health Promotion and Maintenance/Family Systems; Psychosocial Integrity/Family Dynamics
21. When caring for a terminally ill client, the nurse must also assess the family, because the primary benefit will be:
1.
Effective use of time and resources in the end-of-life care of the client
2.
Appropriate attention to the cultural beliefs and expectations of the family
3.
Added information regarding the care needs and preferences of the client
4.
The ability to respond effectively to the family unit during the dying process
ANS: 4
The more you know about your client’s family, how they interact with one another, their strengths, and their weaknesses, the better. Each family approaches and copes with end-of-life decisions differently. While the other responses may be true, they are not the primary benefit.
DIF: C REF: 125 OBJ: Analysis
TOP: Nursing Process: Assessment
MSC: NCLEX® test plan designation: Health Promotion and Maintenance/Family Systems; Psychosocial Integrity/Family Dynamics
22. When attempting to meet the needs of the family, the nurse recognizes the central concept of the theory of family developmental stages is that:
1.
Over time all families progress through developmental stages
2.
Needs differ as the family progresses through the various stages
3.
While each family is unique, they all tend to progress through similar stages
4.
The family will progress only when all the challenges of a particular stage are met
ANS: 3
Although families are far from identical to one another, they tend to go through certain stages. Nursing care can be delivered based on the assumption that all families progress through similar stages that present comparable challenges.
DIF: C REF: 125 OBJ: Analysis
TOP: Nursing Process: Assessment/Planning
MSC: NCLEX® test plan designation: Health Promotion and Maintenance/Family Systems; Psychosocial Integrity/Family Dynamics
23. The nurse can primarily affect the effectiveness of a family’s ability to cope with stress by encouraging:
1.
Flexible roles
2.
Distinct task assignment
3.
Individual independence
4.
Variable parenting models
ANS: 1
A rigid structure specifically dictates who is able to accomplish a task, and may limit the number of persons inside as well as outside the immediate family who can assume these tasks. Sharing tasks allows for reassignment of tasks when the need arises.
A rigid structure specifically dictates who is able to accomplish a task, and may limit the number of persons inside as well as outside the immediate family who can assume these tasks. Inability to reassign the tasks will impact the family’s ability to adjust to stressors.
DIF: C REF: 127 OBJ: Analysis
TOP: Nursing Process: Assessment/Planning
MSC: NCLEX® test plan designation: Health Promotion and Maintenance/Family Systems; Psychosocial Integrity/Family Dynamics
Mosby items and derived items © 2009, 2005 by Mosby, Inc., an affiliate of Elsevier Inc.
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