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1
Treas: Basic Nursing, 3e
Chapter 10
Chapter 10. Family Health
Multiple Choice
Identify the choice that best completes the statement or answers the question.
____
1. The graduate nurse tells the preceptor that the newly admitted patient has a strange living
arrangement. The patient lives in a household that consists of two aunts, a grandparent, a niece, a
nephew, and their best friend. Which response by the preceptor is best?
1. “You are correct. That is a different type of household.”
2. “That is an example of a family defined by a different culture.”
3. “This is considered an extended family, which is not unusual.”
4. “This type of blended family is statistically shown to be increasing.”
____
2. An older adult patient is admitted to the hospital with heart failure. The patient’s best friend is
present during admission. The two have shared a home since they were widowed 3 years ago. Both
have grown children who live out of state. Which family nursing approach does the nurse use?
1. Involve the friend in the care, discharge planning, and home care.
2. Encourage the friend to wait until discharge to provide care for the patient at home.
3. Explain to the friend an inability to be involved in patient care for confidentiality reasons.
4. Encourage liberal visiting hours by the friend and the patient’s children.
____
3. The nurse is providing care for a patient diagnosed with lung cancer. The patient and the spouse
are 2 years from retirement. However, which typical stage of family development is this couple
likely experiencing?
1. Family launching young adults
2. Postparental family
3. Family with frail elderly
4. Family with teenagers and young adults
____
4. A nurse is providing care for a patient newly diagnosed with type 1 diabetes mellitus. The patient’s
spouse states, “We are a family of diabetics.” The nurse advises attendance to the free nutrition,
cooking, and exercise classes at the health center near their neighborhood. The nurse also provides
the name of the public health nurse for their area. Which perspective of family nursing is the nurse
practicing?
1. Family as a unit of care
2. Family as a system
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Chapter 10
3. Family as the context of care
4. Family as a resource and stressor
____
5. The parents of three children, aged 3, 6, and 8 years, comment that although the children are close
in age, they each seem to have different needs. The nurse teaches the parents what tasks the
children should accomplish based on the different age groups and provide strategies to help meet
the children’s needs. Which theory best explains the nurse’s teaching plan?
1. General systems theory
2. Family interactional theory
3. Family as a context theory
4. Developmental theory
____
6. The nurse is aware that which situation best depicts a midlife crisis?
1. A college graduate moves in with parents because of an inability to find employment.
2. Parents enroll their two toddlers in daycare because two incomes are needed to meet the
household’s financial demands.
3. After the couple’s daughter leaves for college, the husband quits his job and decides to “see
the world.”
4. An older adult widower rejects the children’s advice to move into an assisted-living
facility.
____
7. To prevent a reduction in herd immunity, which information does the nurse teach in a class of
pregnant women?
1. “You should increase your intake of milk to meet your growing calcium needs.”
2. “It is important to take prenatal vitamins daily to provide the essential vitamins and
minerals your body needs.”
3. “You should ensure your child gets immunizations at the recommended scheduled times.”
4. “You should limit the time your child is in crowded environments for the first 6 months of
life.”
____
8. For which patient in the emergency room is it most important that the nurse conduct a thorough
assessment for abuse and neglect?
1. A 6-year-old male with complaints of abdominal pain
2. A 2-year-old male with injuries from a fall
3. A 7-year-old female with a broken arm from a motor vehicle accident
4. A 4-year-old female who complains of an earache
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Chapter 10
____
9. The nurse on a medical-surgical unit is providing care for a patient with diabetes mellitus. During a
teaching session with the patient and the family, the nurse asks questions regarding care at home,
ability to perform blood glucose testing, and administration of insulin. Which perspective of family
nursing is the nurse providing?
1. Family as context for care
2. Family as a unit of care
3. Family as a system
4. A blend of all of the above
____
10. The nurse is participating in a family conference regarding one of the patients on the geriatric unit.
During the conference, each family member is asked about their role in the family, communication
style, coping strategies, and relationship with other family members. This type of family
conference best illustrates the use of which theory related to family care?
1. General systems theory
2. Structural–functional theory
3. Family interactional theory
4. Developmental theory
____
11. The grown child of an older adult patient tells the nurse, “I’m starting to worry about my father’s
eating habits. He lives alone and has been able to cook, but now he doesn’t want to cook and says
he is too tired to go to the store.” Which is the most appropriate response by the nurse?
1. “We may need to contact the physician for a nutritional assessment.”
2. “Your family members will need to get together and bring him meals.”
3. “It may be time for you to think about nursing home placement.”
4. “What are your feelings on using some community resources for meals?”
____
12. The Americans With Disabilities Act (ADA) defines a disability as a physical or mental
impairment that substantially interferes with a person’s ability to engage in major life activities.
Among the various disabilities in the United States, which is the most prevalent?
1. Vision
2. Hearing
3. Ambulation
4. Learning
____
13. According to Maslow’s hierarchy of needs, which is the nurse’s primary focus in caring for a
homeless family?
1. Food and shelter
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Treas: Basic Nursing, 3e
Chapter 10
2. Access to healthcare
3. Strengthening family relationships
4. Decreasing social isolation
____
14. The nurse is developing a teaching plan about coping strategies for an extended family of a
severely disabled 11-year-old child. Which step does the nurse take first in developing this plan?
1. Assess the current coping patterns.
2. Establish each member’s role.
3. Assign specific tasks and deadlines for each member.
4. Identify the family member with the most ineffective coping patterns.
____
15. The nurse schedules a meeting with a family to assess and assist with improving the family’s
communication patterns. Which is of primary importance for the nurse to focus on during the
assessment?
1. Identifying how family decisions are made
2. Documenting the number of family members attending the meeting
3. Assessing for the most frequently used means of communication among family members
4. Making careful observations of body language and nonverbal expressions during the
meeting
____
16. The nurse is providing care for a seriously ill child in the pediatric unit. Many family members are
present, including parents, aunts, and uncles. The nurse tells the nurse manager, “Every time I go
into the room, everyone is shouting at each other, they shout at me, and they ask me the same
questions over and over.” Which is the most appropriate response by the nurse?
1. “This is unacceptable and disruptive behavior. Tell them if the behavior continues, we may
need to call security.”
2. “Families experience a range of emotions when caring for an ill member, and these can be
normal reactions. Don’t take it personally.”
3. “There may be too many people in the room. You might consider limiting the number of
visitors at a time.”
4. “I know about this family’s culture and expect this behavior. Don’t worry about it. It is just
the way they are.”
____
17. The nurse is working with a spouse who is caring for a chronically ill patient who requires aroundthe-clock care. The nurse notices the spouse often speaks to the patient sharply. The bed linens are
soiled with food and the patient has a strong body odor. Both the house and the spouse are
unkempt. When encouraged to talk, the spouse says, “I just drag around. I can’t make myself do
anything. I’m so tired of it all.” Which nursing diagnosis best fits these defining characteristics?
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Chapter 10
1.
2.
3.
4.
Dysfunctional family processes
Caregiver role strain
Defensive coping
Impaired verbal communication
Multiple Response
Identify one or more choices that best complete the statement or answer the question.
____
18. Which family functions are outlined in the structural–functional family theory? Select all that
apply.
1. Meeting the emotional needs of family members
2. Reinforcing ethical and moral values
3. Promoting joint decision making among parents and children
4. Being a productive member of society
5. Possessing certain features common to small groups
____
19. The nurse is conducting a family assessment. Which assessment findings suggest a family health
problem may exist? Select all that apply.
1. Family members respect each other’s need for privacy.
2. Family members enact decisions made by the most powerful member.
3. Family members consider a conflict resolved when everyone agrees.
4. Family members set boundaries between family members.
5. Family members seem unaffected by an unkept environment.
____
20. The nurse is aware a family assessment includes which areas? Select all that apply.
1. Coping patterns
2. Health beliefs
3. Medical history
4. Physical examination
5. Medication information
____
21. The nurse is aware that homelessness is a growing problem in the United States. The nurse is
aware of which primary causes of homelessness? Select all that apply.
1. Lack of job skills
2. Lack of social skills
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Chapter 10
3. Underlying mental illness
4. Substance abuse
5. Loss of a job
____
22. The nurse is aware that the study of genomics and the use of a genogram are playing a larger role
in personalizing a patient’s plan of care. In which manner are genomics and the use of a genogram
helpful to the nurse in personalizing a patient plan of care? Select all that apply.
1. Assists in development of better preventative care by identifying at-risk individuals
2. Helps to more accurately detect illness, even before symptoms appear
3. Provides insight to how people respond differently to specific drugs and treatments
4. Increases the trust a patient and family have in the healthcare professionals
5. Prevents a disease-related crisis from developing for patients and families
____
23. A young adult couple with two children tells the nurse in the pediatric department they have been
struggling with raising them. They state, “We just don’t know what we are doing sometimes and
feel we are not always making good decisions for our children. It is time we sit down and figure
this out.” The nurse arrives at a nursing diagnosis of family processes: readiness for enhanced
parenting. Which nursing interventions are most appropriate for this family? Select all that apply.
1. Collaborate with the couple in problem-solving and decision making.
2. Assign specific roles to each member of the couple’s extended family.
3. Encourage the couple to verbalize concerns, fears, and perceptions.
4. Obtain a comprehensive family health assessment from each parent.
5. Promote adaptability, ability to deal with dress, and an openness to change.
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Chapter 10
Chapter 10. Family Health
Answer Section
MULTIPLE CHOICE
1. ANS: 3
Chapter: Chapter 10: Family Health
Objective: Distinguish among different family structures.
Page: 2
Heading: Extended Families
Integrated Processes: Culture and Spirituality
Client Need: Psychological Integrity
Cognitive Level: Comprehension [Understanding]
Concept: Family Dynamics
Difficulty: Moderate
Feedback
1
This is incorrect. This comment by the preceptor does not offer any information
to the nurse.
2
This is incorrect. Although extended family arrangements may occur in some
cultures, this is not the best response to the nurse’s interpretation of the family
living arrangement.
3
This is correct. The description fits the definition for an extended family, which
can consist of various biological relatives and also nonrelatives who live
together or in close proximity.
4
This is incorrect. A blended family consists of two single parents who marry and
raise their children together.
PTS:
1
CON: Family Dynamics
2. ANS: 1
Chapter: Chapter 10: Family Health
Objective: Describe approaches to working with various types of families to provide optimal care
to both well and ill clients.
Page: 4
Heading: Approaches to Family Nursing
Integrated Processes: Culture and Spirituality
Client Need: Psychosocial Integrity
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Treas: Basic Nursing, 3e
Chapter 10
Cognitive Level: Application [Applying]
Concept: Family Dynamics
Difficulty: Moderate
Feedback
1
This is correct. The nurse can best intervene by involving the friend in the
patient’s care, discharge planning, and home care.
2
This is incorrect. The friend may or may not be able to care for the patient at
home. But, if planning to provide home care, the patient’s friend should be
informed of the patient’s needs while in the hospital and have an opportunity to
participate prior to discharge.
3
This is incorrect. The nurse can involve the friend with the patient’s consent
without infringing on the patient’s privacy. The friend’s name needs to be listed
on the patient privacy (Health Insurance Portability and Accountability Act of
1996 [HIPAA]) form.
4
This is incorrect. The nurse can encourage liberal visiting hours by the friend
and the patient’s children if it is beneficial for the patient’s recovery.
PTS:
1
CON: Family Dynamics
3. ANS: 2
Chapter: Chapter 10: Family Health
Objective: Explain how family theories provide a framework to understand family functioning.
Page: 5
Heading: Developmental Theories
Integrated Processes: Culture and Spirituality
Client Need: Psychosocial Integrity
Cognitive Level: Application [Applying]
Concept: Family Dynamics
Difficulty: Moderate
Feedback
1
This is incorrect. In the stage of family launching young adults, the parents
maintain support of young adults as they leave the security of family and the
parents rediscover marriage.
2
This is correct. This couple is most likely experiencing the postparental stage of
family development. During this stage, the parents prepare for retirement and
adjust to their children moving into phases of adulthood.
3
This is incorrect. The family stage where frail elderly live with the family is
called the “sandwich family.” There is no information to support the existence
of this stage.
4
This is incorrect. During the stage of family with teenagers and young adults,
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Chapter 10
open communication is maintained among family members, ethical and moral
values are reinforced, and there is a balance established between rules and
independence among teens.
PTS:
1
CON: Family Dynamics
4. ANS: 2
Chapter: Chapter 10: Family Health
Objective: Explain how family theories provide a framework to understand family functioning.
Page: 5
Heading: General Systems Theory
Integrated Processes: Culture and Spirituality
Client Need: Psychosocial Integrity
Cognitive Level: Analysis [Analyzing]
Concept: Family Dynamics
Difficulty: Moderate
Feedback
1
This is incorrect. A slightly more complex approach views the family as the unit
of care. The nurse must assess and provide care to each member because
wellness is critical to promoting family health.
2
This is correct. The nurse is viewing the family as a system because the nurse is
providing information based on the spouse’s response that will benefit the entire
family. A system approach looks beyond the immediate family and views the
community and its resources as a part of the suprasystem.
3
This is incorrect. The nurse needs to be prepared to work, at a minimum, with
the family as the context for care of an individual person. The nurse’s focus in
this approach is on the ill individual.
4
This is incorrect. When the nurse views the family as either a resource or a
stressor to the patient, the nurse is looking at the family as the context for care of
an individual person.
PTS:
1
CON: Family Dynamics
5. ANS: 4
Chapter: Chapter 10: Family Health
Objective: Explain how family theories provide a framework to understand family functioning.
Page: 5
Heading: What Theories Are Useful for Family Care?
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Chapter 10
Integrated Processes: Culture and Spirituality
Client Need: Psychological Integrity
Cognitive Level: Analysis [Analyzing]
Concept: Family Dynamics
Difficulty: Moderate
Feedback
1
This is incorrect. General systems theory focuses on interactions between
systems and the changes that result from these interactions. Developmental
theory is part of the general systems theory.
2
This is incorrect. Family interactional theory views the family as a unit of
interacting personalities. Nurses working from an interactional perspective focus
family healthcare on the interaction and communication between family
members, their roles and power, family coping, and relationships with other
people outside the direct family unit.
3
This is incorrect. There is no part of the general systems theory specifically
identified as “family as a context theory.”
4
This is correct. Developmental theories focus on the stage of development of
each family member, usually based on age or growth stage. These theories have
developmental tasks that should be accomplished at each stage of development
to successfully progress and master the next stage. These stages begin at birth
and continue through old age. Thus, each child will have different
developmental tasks based on their age and stage of development; because tasks
are different, so are each child’s needs.
PTS:
1
CON: Family Dynamics
6. ANS: 3
Chapter: Chapter 10: Family Health
Objective: Identify family risk factors across five different stages.
Page: 8
Heading: Families With Middle-Aged Adults
Integrated Processes: Culture and Spirituality
Client Need: Psychosocial Integrity
Cognitive Level: Analysis [Analyzing]
Concept: Family Dynamics
Difficulty: Difficult
Feedback
1
This is incorrect. Although a college graduate moving in with parents may
involve middle-aged adults, it does not necessarily precipitate a midlife crisis for
the parents.
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Chapter 10
2
3
4
This is incorrect. It is not unusual, or a crisis, for parents to enroll young
children in daycare in order for both parents to work. It often takes two
paychecks to meet the household financial needs.
This is correct. The middle-aged years occur after the demands of raising
children are over. This can be a time of personal fulfillment, career success, and
social expansion. It can also be a time of intense questioning about the meaning
of life, longing for one’s youth, and seeking direction in life (midlife crisis). It is
not uncommon for couples who have been married for many years to get a
divorce or for one spouse to engage in atypical behaviors.
This is incorrect. It is not considered a midlife crisis when an older adult rejects
children’s advice to move into an assisted-living facility.
PTS:
1
CON: Family Dynamics
7. ANS: 3
Chapter: Chapter 10: Family Health
Objective: Identify family risk factors across five different stages.
Page: 7
Heading: Families With Young Children
Integrated Processes: Culture and Spirituality
Client Need: Psychosocial Integrity
Cognitive Level: Comprehension [Understanding]
Concept: Family Dynamics
Difficulty: Moderate
Feedback
1
This is incorrect. Instructing a pregnant woman on the need to increase her milk
intake is not addressing the reduction in herd immunity.
2
This is incorrect. Instructing a pregnant woman on the necessity of taking
prenatal vitamins does not address the reduction in herd immunity.
3
This is correct. A reduction in herd immunity occurs when families do not
follow the immunization schedule. Old diseases, once thought eradicated, begin
to reappear and cause illness and even death in persons who are not adequately
protected through immunizations. Such diseases include pertussis (whooping
cough), measles, polio, mumps, and smallpox.
4
This is incorrect. Limiting crowd exposure of an infant for the first 6 months of
life may or may not be necessary, depending on the health of the infant, the
season of the year, and/or the incidences of communicable disease/illness.
PTS:
1
CON: Family Dynamics
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Chapter 10
8. ANS: 2
Chapter: Chapter 10: Family Health
Objective: Demonstrate an understanding of family violence.
Page: 11
Heading: Violence and Neglect Within Families
Integrated Processes: Culture and Spirituality
Client Need: Psychosocial Integrity
Cognitive Level: Analysis [Analyzing]
Concept: Family Dynamics
Difficulty: Difficult
Feedback
1
This is incorrect. Abdominal pain can result from a variety of
conditions/illnesses. Unless the nurse finds other supporting signs of abuse or
neglect, the nurse is not likely to suspect this child as being in danger.
2
This is correct. The younger the child, the more vulnerable they are to abuse
owing to their dependency, small size, and inability to defend themselves. The
2-year-old child is the youngest and the injuries are from a fall. The nurse
should assess all children and adults for signs of violence and neglect; however,
the 2-year-old has priority.
3
This is incorrect. When a child experiences a broken bone resulting from a
definitive cause, there is no reason for the nurse to suspect abuse or neglect.
4
This is incorrect. Many children suffer from otitis media (ear infection), which
manifests as earache; this child is not a priority concern for abuse or neglect.
PTS:
1
CON: Family Dynamics
9. ANS: 1
Chapter: Chapter 10: Family Health
Objective: Describe approaches to working with various types of families to provide optimal care
to both well and ill clients.
Page: 4
Heading: Approaches to Family Nursing
Integrated Processes: Culture and Spirituality
Client Need: Psychosocial Integrity
Cognitive Level: Comprehension [Understanding]
Concept: Family Dynamics
Difficulty: Moderate
Feedback
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Chapter 10
1
2
3
4
PTS:
This is correct. The nurse is using family as the context for care. In this
approach, the focus is on the ill individual, and family is viewed as either a
resource or a stressor to the patient.
This is incorrect. Unit of care is more complex, as the wellness of each member
is critical to promoting family health. The family is viewed as the sum of all
individual members, and assessment and care are provided for all family
members.
This is incorrect. Family as a system focuses on the family as a whole and as an
interactional system. This approach sees the family as embedded in and
interacting with a larger community.
This is incorrect. The nurse’s teaching approach is not a blend of the provided
options.
1
CON: Family Dynamics
10. ANS: 3
Chapter: Chapter 10: Family Health
Objective: Explain how family theories provide a framework to understand family functioning.
Page: 5-6
Heading: What Theories Are Useful for Family Care?
Integrated Processes: Culture and Spirituality
Client Need: Psychosocial Integrity
Cognitive Level: Application [Applying]
Concept: Family Dynamics
Difficulty: Moderate
Feedback
1
This is incorrect. Several theories have been proposed to help us understand
family functioning. Four such theories are general systems theory, structural–
functional theories, family interactional theory, and developmental theory.
2
This is incorrect. Structural–functional theories include the concepts of family
roles and interaction; however, the focus is on outcome rather than on process.
This theory is best used to assess family function, both internally among family
members and externally with outside systems.
3
This is correct. Family interactional theory views the family as a unit of
interacting personalities. The major emphasis is on family roles. This approach
to understanding families de-emphasizes the influence of the external world on
what occurs within the family. The focus is on interaction, communication roles
and power, family coping, and relationships.
4
This is incorrect. Developmental theories focus on the stage of family
development, typically the eight stages in the family life cycle.
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Chapter 10
PTS:
1
CON: Family Dynamics
11. ANS: 4
Chapter: Chapter 10: Family Health
Objective: Describe approaches to working with various types of families to provide optimal care
to both well and ill clients.
Page: 9
Heading: Families With Older Adults
Integrated Processes: Culture and Spirituality
Client Need: Psychosocial Integrity
Cognitive Level: Application [Applying]
Concept: Family Dynamics
Difficulty: Moderate
Feedback
1
This is incorrect. A nutritional assessment may be needed at some point if poor
eating or weight loss continues.
2
This is incorrect. Instructing family members to bring meals over is
inappropriate, as the nurse has not assessed family circumstances and
availability.
3
This is incorrect. In this item, we have no indication that the patient has any
deficits, so the best and initial response by the nurse is to offer/educate the
family on outside community resources for meals. There is no specific need to
discuss nursing home placement.
4
This is correct. Maintaining good nutrition and hydration becomes more difficult
as a person ages. Nutrition in older adults may be compromised for a multitude
of reasons, such as forgetting to eat, inadequate transportation to shop, lack of
money, loss of appetite, and physical changes. It is easy to understand how one
of the above problems can affect another.
PTS:
1
CON: Family Dynamics
12. ANS: 3
Chapter: Chapter 10: Family Health
Objective: Discuss the effects of chronic and life-threatening illness on families.
Page: 10
Heading: Chronic Illness and Disability
Integrated Processes: Culture and Spirituality
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Chapter 10
Client Need: Physiological Integrity: Physiological Adaptation
Cognitive Level: Knowledge [Remembering]
Concept: Family Dynamics
Difficulty: Moderate
Feedback
1
This is incorrect. The ADA defines one component of disability as a physical or
mental impairment that substantially interferes with a person’s ability to engage
in major life activities; 3.5 million have a vision disability.
2
This is incorrect. In the United States (U.S. Census Bureau, 2017), 8 million
people 18 and older in 2015 had significant hearing difficulty or reported
deafness; 6.9 million of those were aged 65 years or older.
3
This is correct. The ADA defines one component of disability as a physical or
mental impairment that substantially interferes with a person’s ability to engage
in major life activities. Among the various types of disabilities, 10.2 million are
people with ambulatory disabilities.
4
This is incorrect. In the United States (U.S. Census Bureau, 2017), 12.9 million
people 18 and older in 2015 had a physical, mental, or emotional condition that
resulted in serious difficulty concentrating, remembering, or making decisions;
4.2 million of those were aged 65 years or older.
PTS:
1
CON: Family Dynamics
13. ANS: 1
Chapter: Chapter 10: Family Health
Objective: Identify populations most at risk for homelessness.
Page: 10
Heading: Homelessness
Integrated Processes: Caring
Client Need: Safe and Effective Care Environment: Management of Care
Cognitive Level: Analysis [Analyzing]
Concept: Safety
Difficulty: Moderate
Feedback
1
This is correct. Homelessness is a growing problem in many U.S. cities, not
only for individuals but also for families. The primary focus is on meeting basic
needs of food and shelter, which, according to Maslow, must be met before the
family can grow and address other areas.
2
This is incorrect. Physical health is considered a risk for the homeless; however,
the basic needs of food and shelter must be met first according to Maslow.
3
This is incorrect. Homelessness threatens family relationships, but this is not the
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4
PTS:
primary need according to Maslow.
This is incorrect. Because of social isolation, the homeless are at emotional risk
related to lack of a sense of belonging. However, Maslow states the need for
food and shelter needs to be met first.
1
CON: Safety
14. ANS: 1
Chapter: Chapter 10: Family Health
Objective: Review how risk factors such as illness and death, substance abuse, violence, mental
health disorders, financial hardship, unemployment, and other issues can change a family’s
structure, communication, and coping strategies.
Page: 10
Heading: Chronic Illness and Disability
Integrated Processes: Culture and Spirituality
Client Need: Psychosocial Integrity
Cognitive Level: Analysis [Analyzing]
Concept: Family Dynamics
Difficulty: Difficult
Feedback
1
This is correct. Assessing family coping is the first step to helping the family
develop more effective coping patterns.
2
This is incorrect. After identifying family coping ability, the nurse can assess for
and address family member roles.
3
This is incorrect. After assessing family coping, the nurse can define the
interactions between family members and role expectations.
4
This is incorrect. Family members who are not coping effectively may cause the
patient to become stressed, anxious, or have problems sleeping.
PTS:
1
CON: Family Dynamics
15. ANS: 4
Chapter: Chapter 10: Family Health
Objective: Review how risk factors such as illness and death, substance abuse, violence, mental
health disorders, financial hardship, unemployment, and other issues can change a family’s
structure, communication, and coping strategies.
Page: 11
Heading: Assessment
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Chapter 10
Integrated Processes: Culture and Spirituality
Client Need: Psychosocial Integrity
Cognitive Level: Analysis [Analyzing]
Concept: Family Dynamics
Difficulty: Difficult
Feedback
1
This is incorrect. It is important to uncover information such as how decisions
are made within the family, but the primary focus is on careful observation of
nonverbal cues.
2
This is incorrect. How much participation by the family is a relevant observation
for the nurse to make during the meeting; however, the primary focus is careful
observation of nonverbal cues.
3
This is incorrect. What means of communication are used (telephone calls,
texting, visiting) by the family is important information, but it is not the primary
focus for the nurse.
4
This is correct. Do not rely solely on the information provided by the family
members during the interview process. Families usually want to “put on the best
face” for healthcare providers, so they may be careful to give socially desirable
responses. Carefully observe the words people use and other cues involved in
communication, such as body language, direct eye contact, and other nonverbal
expressions, particularly among family members.
PTS:
1
CON: Family Dynamics
16. ANS: 2
Chapter: Chapter 10: Family Health
Objective: Identify common health beliefs and communication patterns in families.
Page: 11
Heading: Assessment
Integrated Processes: Culture and Spirituality
Client Need: Psychosocial Integrity
Cognitive Level: Analysis [Analyzing]
Concept: Family Dynamics
Difficulty: Moderate
Feedback
1
This is incorrect. There are times to call security if the behavior escalates and
begins to affect other patients and families.
2
This is correct. When a family member is ill or hospitalized, the other family
members experience a range of emotions—especially when the illness is severe
or of sudden onset. Family members may display signs of stress in a variety of
Copyright © 2022 F. A. Davis Company
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Treas: Basic Nursing, 3e
Chapter 10
3
4
PTS:
ways—for example, by arguing with each other or with healthcare providers, by
insisting on immediate care for their loved one, by being critical of the care
provided, or by frequently asking that information be repeated. These are normal
reactions; do not take them personally.
This is incorrect. Limiting visiting hours is not always beneficial, especially
when dealing with children.
This is incorrect. In this instance, citing a cultural connection is inappropriate, as
it reflects stereotyping and is judgmental.
1
CON: Family Dynamics
17. ANS: 2
Chapter: Chapter 10: Family Health
Objective: Discuss the effects of chronic and life-threatening illness on families.
Page: 11
Heading: Assessing for Example Problem: Caregiver Role Strain
Integrated Processes: Culture and Spirituality
Client Need: Psychosocial Integrity
Cognitive Level: Analysis [Analyzing]
Concept: Family Dynamics
Difficulty: Difficult
Feedback
1
This is incorrect. Dysfunctional family processes usually include denial of
problems, resistance to change, and a series of crises; depression is not a
symptom.
2
This is correct. The defining characteristics best fit a nursing diagnosis of
caregiver role strain. The caregiver exhibits dysfunctional communication
(speaking sharply), is not performing well in the caregiver role (soiled bed
linens, patient’s body odor), and is experiencing and expressing depressive
symptoms.
3
This is incorrect. Defensive coping is more about a falsely positive selfevaluation; the spouse does not seem defensive but admits to having difficulty.
Although the spouse’s communication may sound angry, verbal communication
is not really impaired.
4
This is incorrect. Impaired verbal communication is characterized by difficulty
receiving, processing, and/or using words to communicate. Furthermore, a
diagnosis of impaired verbal communication would not address the spouse’s
depression and inability to provide satisfactory care.
PTS:
1
CON: Family Dynamics
Copyright © 2022 F. A. Davis Company
19
Treas: Basic Nursing, 3e
Chapter 10
MULTIPLE RESPONSE
18. ANS: 1, 4, 5
Chapter: Chapter 10: Family Health
Objective: Explain how family theories provide a framework to understand family functioning.
Page: 5
Heading: Structural–Functional Theories
Integrated Processes: Culture and Spirituality
Client Need: Psychosocial Integrity
Cognitive Level: Analysis [Analyzing]
Concept: Family Dynamics
Difficulty: Difficult
Feedback
1. This is correct. Family functions outlined in the structural–functional family theory
include meeting physical and emotional needs of family members. This model is
more focused on the outcomes of family function than the process by which action
occurs.
2. This is incorrect. Reinforcing ethical and moral values is a task outlined in family
development theories.
3. This is incorrect. Promoting joint decision making among parents and children is an
example of family development theories.
4. This is correct. Family functions outlined in the structural–functional family theory
include being productive members of society.
5. This is correct. According to the structural–functional theories, a family is a small
group possessing certain features common to small groups.
PTS:
1
CON: Family Dynamics
19. ANS: 2, 3, 5
Chapter: Chapter 10: Family Health
Objective: Conduct a family assessment.
Page: 11-12
Heading: Assessment
Integrated Processes: Culture and Spirituality
Client Need: Psychosocial Integrity
Copyright © 2022 F. A. Davis Company
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Treas: Basic Nursing, 3e
Chapter 10
Cognitive Level: Analysis [Analyzing]
Concept: Family Dynamics
Difficulty: Difficult
Feedback
1. This is incorrect. Respect for privacy and clear boundaries between family members
are characteristics of a healthy family; lack of respect is a sign of a family health
problem.
2. This is correct. In healthy families, there is typically an egalitarian distribution of
power. When family members enact decisions made by the most powerful member,
the nurse can suspect a family health problem.
3. This is correct. In healthy families, it is not always necessary for all members to
agree; instead, they have the ability to compromise, and members feel free to
disagree. If family members consider a conflict resolved when everyone agrees, the
behavior is likely indicative of a family health problem.
4. This is incorrect. In a healthy family, boundaries define the responsibilities of adults
that are clear and separate from responsibilities of growing children.
5. This is correct. In a healthy family, the environment is most likely to be well kept. If
the family seems unconcerned about the orderliness of the surroundings, the nurse
recognizes the probability of a family health problem.
PTS:
1
CON: Family Dynamics
20. ANS: 1, 2
Chapter: Chapter 10: Family Health
Objective: Conduct a family assessment.
Page: 11-12
Heading: Assessment
Integrated Processes: Culture and Spirituality
Client Need: Psychosocial Integrity
Cognitive Level: Analysis [Analyzing]
Concept: Family Dynamics
Difficulty: Difficult
Feedback
1. This is correct. Conducting a family assessment includes identifying family stressors
and coping patterns.
2. This is correct. Conducting a family assessment includes identifying health beliefs.
3. This is incorrect. Obtaining a medical history of individuals is only relevant to the
family assessment if the information affects an individual family member or
members.
4. This is incorrect. A physical examination of individuals is relevant to the family
Copyright © 2022 F. A. Davis Company
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Chapter 10
5.
PTS:
assessment only if it affects an individual family member or members.
This is incorrect. During a family assessment, it is unlikely for the nurse to assess
medication information unless it affects an individual family member or members.
1
CON: Family Dynamics
21. ANS: 1, 2, 3, 4, 5
Chapter: Chapter 10: Family Health
Objective: Identify populations most at risk for homelessness.
Page: 10
Heading: Homelessness
Integrated Processes: Safe and Effective Care Environment: Safety and Infection Control
Client Need: Psychosocial Integrity
Cognitive Level: Analysis [Analyzing]
Concept: Safety
Difficulty: Difficult
Feedback
1. This is correct. A cause of homelessness is directly impacted by a lack of job skills, a
situation that causes a person to be unemployable.
2. This is correct. Lacking social skills is a key factor in being able to obtain a job.
Persons who cannot interact appropriately with others are likely to be unemployable.
3. This is correct. Many homeless persons are affected by underlying mental illness,
which makes the person difficult to place in programs aimed at resolving the
homeless situation.
4. This is correct. Because persons who engage in substance abuse use whatever money
they obtain for drugs, they are often homeless due to financial distress.
5. This is correct. Persons who are employed but lose their jobs are often at high risk
for becoming homeless. This is most frequent among persons with low job skills and
being on menial pay scales.
PTS:
1
CON: Safety
22. ANS: 1, 2, 3
Chapter: Chapter 10: Family Health
Objective: Identify appropriate nursing interventions when a family member is ill.
Page: 12-13
Heading: Assessing the Family’s Genetic History
Integrated Processes: Nursing Process
Copyright © 2022 F. A. Davis Company
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Treas: Basic Nursing, 3e
Chapter 10
Client Need: Physiological Integrity: Physiological Adaptation
Cognitive Level: Analysis [Analyzing]
Concept: Health Promotion
Difficulty: Difficult
Feedback
1. This is correct. Genomics can be used to personalize a patient’s plan of care by
identifying at-risk individuals for certain conditions so more effective preventive
care can be provided.
2. This is correct. Genomics allows for more accurate detection of illness, even before
symptoms appear, and promotes tailoring healthcare to the individual while reducing
a trial-and-error approach.
3. This is correct. The use of genomics assists in evaluating a person’s response to care
and helping to understand how people respond differently to particular drugs and
medical treatments.
4. This is incorrect. There is no evidence to support that the use of genomics and
genograms has any effect on trust. Many individuals and families have an intense
skepticism or mistrust of medical care and hospitals based on their own health belief
systems or on past experiences with medical care and hospitals.
5. This is incorrect. Genomics does not prevent a disease-related crisis from developing
for patients and families. However, attempts at prevention, detection, and treatment
can be enhanced.
PTS:
1
CON: Health Promotion
23. ANS: 1, 3, 5
Chapter: Chapter 10: Family Health
Objective: Describe approaches to working with various types of families to provide optimal care
to both well and ill clients.
Page: 16
Heading: Box 10-2: Characteristics of a Healthy Family
Integrated Processes: Culture and Spirituality
Client Need: Psychosocial Integrity
Cognitive Level: Analysis [Analyzing]
Concept: Family Dynamics
Difficulty: Difficult
Feedback
1. This is correct. The most appropriate interventions for this family are to collaborate
with them in problem-solving and decision making.
2. This is incorrect. Roles for each member should not be “assigned” by the nurse, as
this should be a collaborative process between the nurse and family.
Copyright © 2022 F. A. Davis Company
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Treas: Basic Nursing, 3e
Chapter 10
3.
4.
5.
PTS:
This is correct. Because communication is vital to a healthy family, the nurse
encourages each member to verbalize concerns, fears, and perceptions. Honesty and
freedom of expression include different opinions or viewpoints.
This is incorrect. Obtaining a comprehensive health history is not indicated at this
time, as there are no health issues identified and a health history is usually only
relevant for a family assessment if it affects an individual family member.
This is correct. The nurse will promote adaptability, an ability to deal with stress,
and an openness to change, which are characteristics of a healthy family.
1
CON: Family Dynamics
Copyright © 2022 F. A. Davis Company