Chapter 14. The Family My Nursing Test Banks

Chapter 14. The Family

Multiple Choice

Identify the choice that best completes the statement or answers the question.

____ 1. A 12-year-old patients mother recently married a man who has a 13-year-old daughter. The nurse recognizes that the patient belongs to which type of family?

1)

Extended

2)

Traditional

3)

Blended

4)

Nuclear

ANS: 3

The patient belongs to a blended family; in which two single parents marry and raise their children together. An extended family may contain grandparents, aunts, uncles, cousins, and other biological relatives. A traditional, or nuclear, family contains a husband, wife, and their children.

PTS:1DIF:EasyREF:p. 301

KEY: Nursing process: N/A | Client need: PSPI | Cognitive level: Application

____ 2. A 65-year-old patient is admitted to the hospital with heart failure. The patients best friend accompanies her on admission. They have been sharing a home since they each were widowed 3 years ago. Both women have grown children who live out of state. Using the family nursing approach, how can the nurse best intervene?

1)

Involve the friend and children in the patients 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 that for confidentiality reasons she cannot be involved in the patients care.

4)

Encourage liberal visiting hours by the friend and the patients children.

ANS: 1

The nurse can best intervene by involving the friend and the patients children in the patients care, discharge planning, and home care. The friend may or may not be able to care for the patient at home. But if planning to provide home care, the patients friend should be informed of the patients needs while in the hospital and have an opportunity to participate prior to discharge. The nurse can involve the friend with the patients consent without infringing on the patients privacy. Her name needs to be listed on the patient privacy (HIPAA) form. The nurse should also encourage liberal visiting hours by the friend and the patients children if it is beneficial for the patients recovery; however, comprehensive involvement in care is more inclusive than simply liberalizing visiting hours and therefore is the best answer.

PTS:1DIF:ModerateREF:pp. 301-302

KEY: Nursing process: Interventions | Client need: SECE | Cognitive level: Application

____ 3. A patient and his wife are 2 years from retirement when he is diagnosed with lung cancer. Although with delayed childbearing, developmental stages can vary among families, 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

ANS: 2

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. 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. During the stage of family with teenagers and young adults, 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 DIF: Moderate REF: p. 303

KEY: Nursing process: Assessment | Client need: PSI | Cognitive level: Application

____ 4. A 13-year-old girl is admitted to the adolescent unit with acute leukemia. The patient has a support system that includes her brother, sister, mother, father, and grandmother as well as members of her local community. Which component of her support system is considered a suprasystem?

1)

The community

2)

The parents

3)

Her mother

4)

Her sister

ANS: 1

Her surrounding community is considered a suprasystem because it is larger than the family system. Subsystems within the family include the parents, mother, siblings, sister, brother, father, and grandmother; they are smaller components that fit within the family system.

PTS:1DIF:ModerateREF:p. 302

KEY: Nursing process: Assessment | Client need: PSI | Cognitive level: Analysis

____ 5. The nurse is developing a teaching plan for an older adult patient with Alzheimer disease and her family. Which point should the nurse include in the teaching plan before discharge?

1)

Importance of quitting smoking

2)

Availability of community resources

3)

Adherence to a low-fat diet

4)

Importance of physical exercise

ANS: 2

When teaching the family of an older adult, the nurse should include information about community resources that are available, especially when caring for chronically ill, disabled, or elderly family members. Middle-age adults typically begin experiencing signs and symptoms associated with long-standing, unhealthy behaviors. Therefore, consuming a low-fat diet and limiting the intake of alcohol and tobacco are likely appropriate topics to include in the teaching plan for a middle-aged adult. Physical exercise and activity promote the quality of life. Careful planning is necessary to ensure safety and well-being for the family member with memory loss, confusion, and disorientation.

PTS:1DIF:ModerateREF:p. 306

KEY: Nursing process: Interventions | Client need: SECE | Cognitive level: Application

____ 6. Which factor is related to the increased risk of acquiring polio in the United States after the disease was thought to be eradicated?

1)

Lack of health insurance

2)

Bioterrorism

3)

Reduced compliance with vaccinations

4)

Drug resistance

ANS: 3

Reduced compliance with community immunization in the United States increases the risk for diseases, such as polio, that were thought to be eradicated. For vaccines to be effective, the population needs to receive them. Bioterrorism involves the introduction of a highly infectious microbe for which there is no protection to the population. Polio is not such a threat because immunization is available. Vaccinations are available through governmental programs for those who do not have health insurance. Drug resistance has led to the reemergence of tuberculosis, which was previously cured with antibiotics.

PTS:1DIF:EasyREF:p. 306

KEY: Nursing process: Assessment | Client need: SECE | Cognitive level: Comprehension

____ 7. Which question helps the nurse to assess family structure?

1)

Where does your family live?

2)

How are family decisions made?

3)

With which religious affiliation is your family associated?

4)

What is your ethnic background?

ANS: 2

Asking how family decisions are made helps the nurse to assess family structure. Asking about religious affiliation, ethnic background, and where the family lives provides identifying data but does not reveal lines of authority and relationships among family members.

PTS:1DIF:ModerateREF:p. 308

KEY: Nursing process: Assessment | Client need: PSI | Cognitive level: Application

____ 8. Which family member is most likely to be disabled?

1)

60-year-old African American male

2)

65-year-old Asian male

3)

70-year-old Caucasian female

4)

75-year-old Native American female

ANS: 4

Slightly more females (15.6%) than males (14.4%) reported a disability. In 2006, the prevalence of disability was lowest for persons ages 16 to 20 (6.9%) and highest for those 75 years and older (52.6%). Disability differs by ethnic group. Asians reported 6.3%, Caucasians 12.7%, African Americans 17.5%, Native Americans 21.7%, and persons of other ethnic backgrounds reported 11.9% disability. Therefore, the prevalence of disability would be highest in a female Native American who is 75 years or older.

PTS:1DIFifficultREF:p. 307

KEY: Nursing process: Assessment | Client need: PSI | Cognitive level: Application

Multiple Response

Identify one or more choices that best complete the statement or answer the question.

____ 1. Which family function(s) is/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 productive members of society

ANS: 1, 4

Family functions outlined in the structural-functional family theory include being productive members of society, caring for elderly members, meeting physical and emotional needs of family members, and socialization of children. This model is more focused on the outcomes of family function than the process by which action occurs. Maintaining support for young adults as they leave the security of the family, reinforcing ethical and moral values, and promoting joint decision making among parents and children are examples of tasks outlined in family development theories.

PTS:1DIF:ModerateREF:p. 302

KEY: Nursing process: N/A | Client need: PSI | Cognitive level: Recall

____ 2. Which of the following suggest that a family health problem may exist? Select all that apply. Family members

1)

Respect each others need for privacy

2)

Enact decisions made by the most powerful member

3)

Do not consider a conflict resolved until everyone agrees

4)

Set boundaries between family members

ANS: 2, 3

Respect for privacy and clear boundaries between family members are characteristics of a healthy family. Boundaries define the responsibilities of adults that are clear and separate from responsibilities of growing children. In healthy families, there is typically egalitarian distribution of power. 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.

PTS: 1 DIF: Moderate REF: p. 310

KEY: Nursing process: Analysis/nursing diagnosis | Client need: PSI | Cognitive level: Analysis

____ 3. A family assessment should include the following areas. Choose all that apply.

1)

Coping patterns

2)

Health beliefs

3)

Medical history

4)

Physical exam

ANS: 1, 2

Conducting a family assessment includes identifying the following: data; family composition; family history and developmental stage; environmental data; family structure; family function; health beliefs, values, and behaviors; family stressors and coping; and abuse and violence within the family. The medical history and physical exam of individuals are only relevant to the family assessment if it affects other family members.

PTS: 1 DIF: Moderate REF: pp. 308-311

KEY: Nursing process: Assessment | Client need: PSI | Cognitive level: Comprehension

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