Chapter 24 My Nursing Test Banks

 

Kozier & Erbs Fundamentals of Nursing, 9/E
Chapter 24

Question 1

Type: MCSA

A client is asked during an admission interview to describe her family. She proceeds to list parents, siblings, grandparents, aunts, uncles, and cousins. This client is describing which type of family?

1. Nuclear

2. Extended

3. Traditional

4. Blended

Correct Answer: 2

Rationale 1: The nuclear family contains parents and offspring.

Rationale 2: The extended family includes parents and offspring (nuclear) along with relatives such as grandparents, aunts, and uncles.

Rationale 3: A traditional family is viewed as one in which both parents reside in the home with their childrenthe mother assuming the nurturing role and the father providing the necessary economic resources

Rationale 4: A blended family consists of existing family units joined together to form new families, also known as stepfamilies or reconstituted families.

Global Rationale: Page Reference: 435

Cognitive Level: Understanding

Client Need: Health Promotion and Maintenance

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 02 Describe different types of families.

Question 2

Type: MCSA

A nurse is working with a particular cultural group in which it is not uncommon for grandparents to live with their married children and to assist with child rearing and discipline issues. This is an example of which of the following?

1. Two-career family

2. Blended family

3. Intragenerational family

4. Traditional family

Correct Answer: 3

Rationale 1: A two-career family is one where both partners are employed.

Rationale 2: A blended family occurs when existing family units join together to form new families.

Rationale 3: In some cultures and as people live longer, more than two generations may live together in an intragenerational setting, as described.

Rationale 4: A traditional family is viewed as an autonomous unit in which both parents reside in the home.

Global Rationale: Page Reference: 436

Cognitive Level: Understanding

Client Need: Health Promotion and Maintenance

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 01 Describe the functions of the family.
02 Describe different types of families.

Question 3

Type: MCSA

Two nursing students, both single parents, have decided to move into a larger house. Part of their rationale includes providing support for studying and sharing responsibilities of parenting. This is an example of which of the following?

1. Cohabiting family

2. Blended family

3. Foster family

4. Intragenerational family

Correct Answer: 1

Rationale 1: Cohabiting (or communal) families consist of unrelated individuals or families that live under one roof. Reasons for cohabiting may be a need for companionship, a desire to achieve a sense of family, sharing expenses, and household management.

Rationale 2: A blended family occurs when existing family units join together to form new families, also known as stepfamilies or reconstituted families.

Rationale 3: Foster family situations occur when children can no longer live with their birth parents and require placement with a family that has agreed to include them temporarily.

Rationale 4: Intragenerational families occur when more than two generations live together.

Global Rationale: Page Reference: 436

Cognitive Level: Understanding

Client Need: Health Promotion and Maintenance

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 02 Describe different types of families.

Question 4

Type: MCMA

Which of the following is the purpose of a family assessment?

Standard Text: Select all that apply.

1. Determine the level of family functioning.

2. Identify family strengths and weaknesses.

3. Provide legal guidelines for consent to health care.

4. Clarify family interaction patterns.

Correct Answer: 1,2,4

Rationale 1: One other purpose is to describe the health status of the family and its individual members. Legal guidelines regarding health care issues such as insurance coverage and the right to consent for health care are important when working with same-sex couples.

Rationale 2: One other purpose is to describe the health status of the family and its individual members. Legal guidelines regarding health care issues such as insurance coverage and the right to consent for health care are important when working with same-sex couples.

Rationale 3: One other purpose is to describe the health status of the family and its individual members. Legal guidelines regarding health care issues such as insurance coverage and the right to consent for health care are important when working with same-sex couples.

Rationale 4: One other purpose is to describe the health status of the family and its individual members. Legal guidelines regarding health care issues such as insurance coverage and the right to consent for health care are important when working with same-sex couples.

Global Rationale: Page Reference: 437

Cognitive Level: Applying

Client Need: Health Promotion and Maintenance

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 04 Identify the components of a family health assessment.

Question 5

Type: MCSA

A nurse is conducting a family assessment as part of the process for services provided through the community. Of the following, which would provide the best information in identifying existing or potential health problems?

1. Ecomap

2. Genogram

3. Cultural assessment

4. Family communication patterns

Correct Answer: 2

Rationale 1: An ecomap provides a visualization of how the family unit interacts with the external communityfor example, schools, religious commitments, occupational duties, and recreational pursuits.

Rationale 2: The health history is one of the most effective ways of identifying existing or potential health problems. A genogram will help the nurse to visualize how all family members are genetically related to each other and how patterns of chronic conditions are present within the family unit.

Rationale 3: A cultural assessment will provide information about health beliefs and health practices of a particular family.

Rationale 4: Family communication patterns determine the familys ability to function as a cooperative, growth-producing unit.

Global Rationale: Page Reference: 438

Cognitive Level: Applying

Client Need: Health Promotion and Maintenance

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 04 Identify the components of a family health assessment.

Question 6

Type: MCSA

A family struggles with clear communication, and members of the family often seek the help of other systems for personal validation and gratification. What would be an appropriate nursing diagnosis for this family?

1. Altered Family Processes related to communication patterns

2. Impaired Verbal Communication related to inability to communicate

3. Ineffective Family Coping evidenced by assistance from outside sources

4. Knowledge Deficiency (communication patterns) related to dysfunctional patterns of communication

Correct Answer: 1

Rationale 1: This describes a state in which a family with previous normal functioning experiences a dysfunction. The communication patterns have affected how the family works as a unit.

Rationale 2: Impaired Verbal Communication means that the members are not able to communicate because of complications with speaking or saying the words, which is not the case in this situation.

Rationale 3: Ineffective Family Coping must be related to an etiology, so this option is not worded correctly.

Rationale 4: Knowledge Deficiency is not correct as the family does recognize the problem since members of the family seek assistance from outside sources, as given in the scenario.

Global Rationale: Page Reference: 438-439

Cognitive Level: Applying

Client Need: Health Promotion and Maintenance

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Diagnosis

Learning Outcome: 06 Develop nursing diagnoses, outcomes, and interventions pertaining to family functioning.

Question 7

Type: MCSA

A nurse is conducting a family assessment and is focusing, for the moment, on the family members communication patterns. Which of the following indicate that there are existing or potential problems with family communication?

1. All members are participating in the discussion equally, some quite vocally.

2. The verbal communication is congruent with the nonverbal messages.

3. A few of the members just sit and listen.

4. Disagreements are not addressed among members, rather ignored by the person who does the most talking.

Correct Answer: 4

Rationale 1: Even though some members are more vocal, at least all are participating in the discussion..

Rationale 2: Nonverbal communication is important because it gives valuable clues about what people are feeling. Even though some members are more vocal, at least all are participating in the discussion. Verbal communication should be congruent with nonverbal cues.

Rationale 3: Listening is an art, and not all members of a family need to speak in the same setting.

Rationale 4: This option describes an authoritarian setting where other members may be cautious in expressing their feelings because of power struggles, hostility, or anger. Nurses should pay special attention to who does the talking for the family, which members are silent, how disagreements are handled, and how well the members listen to one another and encourage the participation of others.

Global Rationale: Page Reference: 438-439

Cognitive Level: Applying

Client Need: Health Promotion and Maintenance

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 04 Identify the components of a family health assessment.

Question 8

Type: MCSA

A nurse has been working with a family at the community health office and is alert to signs of family violence. Which of the following would the nurse most concerning?

1. The baby always seems to have a cold.

2. One of the children never speaks and seems on guard when in the presence of a parent.

3. The familys clothes are relatively clean, but the children usually have some kind of dirt stain on their shirt or pants.

4. The family does not have a regular physician.

Correct Answer: 2

Rationale 1: The baby may have an untreated condition, but chronic cold symptoms are not evidence of abuse.

Rationale 2: A child who doesnt speak and is watchful when parents are near would be a significant indicator of a possible abuse situation.

Rationale 3: Dirty clothes or clothes not meeting the nurses standards are not signs of abusemaybe for this family, appearance is not a high priority.

Rationale 4: Not having a regular physician would be a concern for health promotion and maintenance, but not for abuse.

Global Rationale: Page Reference: 439

Cognitive Level: Applying

Client Need: Health Promotion and Maintenance

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 05 Identify common risk factors for family health problems.

Question 9

Type: MCSA

The nurse is performing a family risk assessment. Which of the following factors would indicate that this family is at risk of developing health problems?

1. The family is an elderly couple who are active in their retirement community.

2. The family is a teenage mother and child. The mother is enrolled in parenting classes at the high school.

3. The family belongs to the local synagogue and has family members still living in Germany.

4. The family depends on two incomes with a limit on their health insurance spending.

Correct Answer: 3

Rationale 1: The elderly couple is active and so is not at as high of risk simply because of age.

Rationale 2: Just because the family is led by a teenage mother, even though maturity is one of the factors the nurse will assess in this situation does not necessarily indicate that a health risk exists.

Rationale 3: Tay-Sachs is a neurodegenerative disease that occurs primarily in descendants of Eastern European Jews. Simply because of this familys race, they are at risk for developing this health problem.

Rationale 4: Although poverty is a major problem that affects the family, the fact that there is health insurance is a positive sociologic factor.

Global Rationale: Page Reference: 440

Cognitive Level: Applying

Client Need: Health Promotion and Maintenance

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 04 Identify the components of a family health assessment.
05 Identify common risk factors for family health problems.

Question 10

Type: MCSA

During a previous family assessment, the nurse realized that the mother did most of the talking and was quick to make decisions, which appeared to be acceptable to the father. When one of their children is hospitalized, the nurse will:

1. Make sure that both parents are involved in all decision making.

2. Allow the mother to make the decisions.

3. Include both parents in the decision making, but be accepting if the mother retains control.

4. Make sure that the physician understands the family dynamics so parental consent comes from the mother.

Correct Answer: 3

Rationale 1: The nurse uses information gained from the assessment to help diagnose, plan, and implement care. Understanding that the mother assumes the authority role in this particular family, the nurse may find it easier to address things with both present but not be surprised if this pattern continues during the childs hospitalization.

Rationale 2: The nurse should not assume that in a crisis situation or during stress that family processes will be the same and will want to make sure that the father is present during the process.

Rationale 3: The nurse uses information gained from the assessment to help diagnose, plan, and implement care. Understanding that the mother assumes the authority role in this particular family, the nurse may find it easier to address things with both present but not be surprised if this pattern continues during the childs hospitalization. However, the nurse should not assume that in a crisis situation or during stress that family processes will be the same and will want to make sure that the father is present during the process.

Rationale 4: This option reflects an inappropriate assumption that only the mother can provide consent to treat.

Global Rationale: Page Reference: 442

Cognitive Level: Applying

Client Need: Health Promotion and Maintenance

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 04 Identify the components of a family health assessment.

Question 11

Type: MCSA

A family member is hospitalized with an illness. Which of the following factors will the nurse assess to determine the impact this illness will have on the family?

1. Nature of the illness

2. Duration of the illness

3. Cause of the illness

4. Financial impact of the illness

5. Effect of the illness on future family functioning

Correct Answer: 1,2,4,5

Rationale 1: Other factors include residual effects of the illness, meaning of the illness to the family, and its significance to family systems. The cause of the illness is not a factor that determines the impact on the family.

Rationale 2: Other factors include residual effects of the illness, meaning of the illness to the family, and its significance to family systems. The cause of the illness is not a factor that determines the impact on the family.

Rationale 3: Other factors include residual effects of the illness, meaning of the illness to the family, and its significance to family systems. The cause of the illness is not a factor that determines the impact on the family.

Rationale 4: Other factors include residual effects of the illness, meaning of the illness to the family, and its significance to family systems. The cause of the illness is not a factor that determines the impact on the family.

Rationale 5: Other factors include residual effects of the illness, meaning of the illness to the family, and its significance to family systems. The cause of the illness is not a factor that determines the impact on the family.

Global Rationale: Page Reference: 442- 443

Cognitive Level: Applying

Client Need: Health Promotion and Maintenance

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 05 Identify common risk factors for family health problems.

Question 12

Type: MCSA

A father of a family was killed in a motor vehicle crash. Which of the following would the nurse consider a normal reaction to this event?

1. Family disorganization may occur.

2. Family members become detached from extended family.

3. The family feels that their place in the community has been eliminated.

4. The family withdraws into seclusion during the grief process.

Correct Answer: 1

Rationale 1: The death of a family member often has a profound effect on the whole familyespecially if the deceased, as in this situation, was the head of the family. Family disorganization would be common, but as the family begins to recover, a new sense of normalcy develops and the family reintegrates its roles and functions.

Rationale 2: Families need support from extended family members, their community, and spiritual advisers.

Rationale 3: This option isnot considered a normalpatterns of family grieving, and the nurse should be alert for problems that may develop if these are present.

Rationale 4: This option (Isolating) is not considered a normal pattern of family grieving, and the nurse should be alert for problems that may develop if these are present.

Global Rationale: Page Reference: 443

Cognitive Level: Applying

Client Need: Health Promotion and Maintenance

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 05 Identify common risk factors for family health problems.

Question 13

Type: MCSA

A nurse is conducting a family assessment, and asks the following question: How, as a family, do you deal with disappointments or stressful changes that occur and affect the members of your family? The nurse is trying to identify:

1. Family coping mechanisms.

2. Whether the family experiences stress.

3. Which family members are most stressed.

4. Family dynamics.

Correct Answer: 1

Rationale 1: Family coping mechanisms are behaviors that families use to deal with stress or changes imposed from either within or without. The coping mechanisms families and individuals develop reflect their individual resourcefulness. The assessment of coping mechanisms is a way to determine how families relate to stress.

Rationale 2: The scenario correctly assumes that families will periodically experience stress.

Rationale 3: The question is not focused on whom but rather how stress in handled by the family.

Rationale 4: The question is not focused on the general function of the family but rather how stress in handled by the family.

Global Rationale: Page Reference: 439

Cognitive Level: Applying

Client Need: Health Promotion and Maintenance

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 04 Identify the components of a family health assessment.

Question 14

Type: MCMA

A nurse has identified a coping problem in a family that recently lost their house and all of their belongings in a fire. The nurse next will assess the familys external support systems. These would include which of the following?

Standard Text: Select all that apply.

1. Grandparents.

2. The parents siblings.

3. Local social services agencies.

4. The familys religious leader.

5. The familys communication skills.

Correct Answer: 1,2,3,4

Rationale 1: External support includes extended family members.

Rationale 2: External support includes extended family members.

Rationale 3: External support includes social services.

Rationale 4: External support includes religious organizations.

Rationale 5: Individual family members, along with knowledge, skills, and effective communication patterns, provide internal support.

Global Rationale: Page Reference: 439

Cognitive Level: Understanding

Client Need: Health Promotion and Maintenance

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 01 Describe the functions of the family.

Question 15

Type: MCMA

A nurse is confident a family is functioning appropriately when:

Standard Text: Select all that apply.

1. The teenaged son keeps the money he earns cutting grass for his car fund.

2. All the children are expected to excel in the sport of their choice.

3. A parent reads the preschool child a bedtime story each night.

4. All the children have household chores once they reach school age.

5. A young adult child moves back home when losing his job.

Correct Answer: 1,3,4,5

Rationale 1: An appropriately functioning family has the economic resources needed by the family secured by adult members.

Rationale 2: An appropriately functioning family provides support, understanding, and encouragement to all without rigid expectations that unnecessarily force decisions.

Rationale 3: An appropriately functioning family creates an atmosphere that influences the cognitive and the psychosocial growth of its members.

Rationale 4: An appropriately functioning family supports each other and the family unit.

Rationale 5: An appropriately functioning family provides support, understanding, and encouragement to all as they progress through predictable developmental stages, as they move in or out of the family unit, and as they establish new family units.

Global Rationale: Page Reference: 439

Cognitive Level: Applying

Client Need: Health Promotion and Maintenance

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 01 Describe the functions of the family.

Question 16

Type: MCMA

The nurse appropriately prepares to assess a family regarding the impact of one of its members being diagnosed with diabetes when considering:

Standard Text: Select all that apply.

1. The seriousness of the disorder.

2. Whether the family has ever dealt with a chronic illness before.

3. The age of the affected member.

4. The financial impact the illness will have on the family.

5. The number of members of the family.

Correct Answer: 1,2,4

Rationale 1: It is appropriate to consider the seriousness of the disorder, since the impact on the family will be in proportion to the degree of seriousness.

Rationale 2: It is appropriate to consider the effect of the illness on future family functioning. (For instance, previous patterns might be restored, or new patterns might be established.)

Rationale 3: The age of the affected member is generally not impactful, since such an illness at any age will affect the family function.

Rationale 4: It is appropriate to consider the financial impact of the illness, which is influenced by factors such as insurance and the ability of the ill member to return to work.

Rationale 5: The number of members in the family has little impact on the overall change an illness will cause.

Global Rationale: Page Reference: 442-443

Cognitive Level: Applying

Client Need: Health Promotion and Maintenance

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 04 Identify the components of a family health assessment.

Kozier & Erbs Fundamentals of Nursing, 9/E Test Bank

Copyright 2012 by Pearson Education, Inc.

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