Chapter 29 My Nursing Test Banks

 

Kneisl, Contemporary Psychiatric-Mental Health Nursing, 3/e Test Bank
Chapter 29

Question 1

Type: MCSA

A client with a diagnosis of bipolar disorder lives with his family and discontinues taking medication when he begins feeling his symptoms are under control. Family members express their concern to the clients therapist whenever they realize the client is off his meds. The therapist understands that within the clients family, each persons behavior is contingent on and:

1. Reflects the characteristics of the clients family.

2. Affects the behavior of others.

3. Is affected by the functionality of the group.

4. Is reflective of the clients mental illness.

Correct Answer: 2

Rationale 1: Whether they are functional or dysfunctional, families have certain characteristics and dynamics. In a family, each persons behavior is contingent on and affects the behavior of the others. Family members behavior is not necessarily reflective of the clients mental illness. Each family members behavior affects the behavior of others, which may, in turn, reflect the characteristics of the family as a whole. The functionality of the group does not address family relationships.

Rationale 2: Whether they are functional or dysfunctional, families have certain characteristics and dynamics. In a family, each persons behavior is contingent on and affects the behavior of the others. Family members behavior is not necessarily reflective of the clients mental illness. Each family members behavior affects the behavior of others, which may, in turn, reflect the characteristics of the family as a whole. The functionality of the group does not address family relationships.

Rationale 3: Whether they are functional or dysfunctional, families have certain characteristics and dynamics. In a family, each persons behavior is contingent on and affects the behavior of the others. Family members behavior is not necessarily reflective of the clients mental illness. Each family members behavior affects the behavior of others, which may, in turn, reflect the characteristics of the family as a whole. The functionality of the group does not address family relationships.

Rationale 4: Whether they are functional or dysfunctional, families have certain characteristics and dynamics. In a family, each persons behavior is contingent on and affects the behavior of the others. Family members behavior is not necessarily reflective of the clients mental illness. Each family members behavior affects the behavior of others, which may, in turn, reflect the characteristics of the family as a whole. The functionality of the group does not address family relationships.

Global Rationale:

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: Describe families and their dynamics in terms of relationships, associations, and connections.

Question 2

Type: MCSA

The nurse knows that when clients are unable or unwilling to perform assigned family roles, the family experiences:

1. Stress and disequilibrium.

2. Recognition and communication.

3. Personal and political advocacy.

4. Acceptance.

Correct Answer: 1

Rationale 1: When members are unable or unwilling to perform assigned roles, the family experiences stress. For the health of the family systemnot only family members but also their relationships, their communication with one another, and their interactions with the environmentroles often must be negotiated in other than stereotyped ways. When the roles are not negotiated satisfactorily, family disequilibrium results. Not following assigned family roles does not result in recognition, communication, advocacy, or acceptance.

Rationale 2: When members are unable or unwilling to perform assigned roles, the family experiences stress. For the health of the family systemnot only family members but also their relationships, their communication with one another, and their interactions with the environmentroles often must be negotiated in other than stereotyped ways. When the roles are not negotiated satisfactorily, family disequilibrium results. Not following assigned family roles does not result in recognition, communication, advocacy, or acceptance.

Rationale 3: When members are unable or unwilling to perform assigned roles, the family experiences stress. For the health of the family systemnot only family members but also their relationships, their communication with one another, and their interactions with the environmentroles often must be negotiated in other than stereotyped ways. When the roles are not negotiated satisfactorily, family disequilibrium results. Not following assigned family roles does not result in recognition, communication, advocacy, or acceptance.

Rationale 4: When members are unable or unwilling to perform assigned roles, the family experiences stress. For the health of the family systemnot only family members but also their relationships, their communication with one another, and their interactions with the environmentroles often must be negotiated in other than stereotyped ways. When the roles are not negotiated satisfactorily, family disequilibrium results. Not following assigned family roles does not result in recognition, communication, advocacy, or acceptance.

Global Rationale:

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: Describe families and their dynamics in terms of relationships, associations, and connections.

Question 3

Type: MCSA

For the last three generations, the men of the family have worked in logging. The younger son wants to go to college and become a marine biologist. His parents tell him that logging is what our family does and refuse to discuss the issue. The son chooses to pursue employment in logging rather than upset his parents desires for their son. This family is experiencing:

1. Enmeshment.

2. Pseudohostility.

3. Pseudomutuality.

4. Schism.

Correct Answer: 3

Rationale 1: A family in which pseudomutuality occurs experiences persistent sameness in the structuring of roles, insistence on the desirability and appropriateness of family role structures, and intense concern over deviations from the role structure or emerging autonomy, and requires its members to give up their sense of personal identity. The family is not exhibiting pseudohostility in which there is chronic conflict, remoteness, or denial to negate hostility. Enmeshed families have diffuse boundaries. In schismatic families, adult partners devalue and undercut each other.

Rationale 2: A family in which pseudomutuality occurs experiences persistent sameness in the structuring of roles, insistence on the desirability and appropriateness of family role structures, and intense concern over deviations from the role structure or emerging autonomy, and requires its members to give up their sense of personal identity. The family is not exhibiting pseudohostility in which there is chronic conflict, remoteness, or denial to negate hostility. Enmeshed families have diffuse boundaries. In schismatic families, adult partners devalue and undercut each other.

Rationale 3: A family in which pseudomutuality occurs experiences persistent sameness in the structuring of roles, insistence on the desirability and appropriateness of family role structures, and intense concern over deviations from the role structure or emerging autonomy, and requires its members to give up their sense of personal identity. The family is not exhibiting pseudohostility in which there is chronic conflict, remoteness, or denial to negate hostility. Enmeshed families have diffuse boundaries. In schismatic families, adult partners devalue and undercut each other.

Rationale 4: A family in which pseudomutuality occurs experiences persistent sameness in the structuring of roles, insistence on the desirability and appropriateness of family role structures, and intense concern over deviations from the role structure or emerging autonomy, and requires its members to give up their sense of personal identity. The family is not exhibiting pseudohostility in which there is chronic conflict, remoteness, or denial to negate hostility. Enmeshed families have diffuse boundaries. In schismatic families, adult partners devalue and undercut each other.

Global Rationale:

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: Describe families and their dynamics in terms of relationships, associations, and connections.

Question 4

Type: MCSA

The nursing student taking care of a client in the mental health clinic learns through assessment that the clients wife insisted he admit himself into the clinic even though his wife is the one with a documented history of mental illness. The client states, I just want her to be happy. The nursing student suspects that the clients relationship with his wife may be:

1. Enmeshed.

2. Disengaged.

3. Hostile.

4. Skewed.

Correct Answer: 4

Rationale 1: Families in which one mate is severely dysfunctional are called skewed families. The other mate, who is usually aware of the dysfunction of the partner, assumes a passive, peace-making, submissive stance to preserve the relationship. The couples relationship does not appear enmeshed, disengaged, or hostile.

Rationale 2: Families in which one mate is severely dysfunctional are called skewed families. The other mate, who is usually aware of the dysfunction of the partner, assumes a passive, peace-making, submissive stance to preserve the relationship. The couples relationship does not appear enmeshed, disengaged, or hostile.

Rationale 3: Families in which one mate is severely dysfunctional are called skewed families. The other mate, who is usually aware of the dysfunction of the partner, assumes a passive, peace-making, submissive stance to preserve the relationship. The couples relationship does not appear enmeshed, disengaged, or hostile.

Rationale 4: Families in which one mate is severely dysfunctional are called skewed families. The other mate, who is usually aware of the dysfunction of the partner, assumes a passive, peace-making, submissive stance to preserve the relationship. The couples relationship does not appear enmeshed, disengaged, or hostile.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: Differentiate among schism, skew, enmeshment, and disengagement as problems of intimacy and control in families.

Question 5

Type: MCSA

The nurse is working with a family in the process of a divorce. The parents are pressuring the children to decide which parent to live with after the divorce. The children are conflicted because they love both parents equally and want the family to stay together. This is an example of a:

1. Schismatic family.

2. Skewed family.

3. Hostile family.

4. Disengaged family.

Correct Answer: 1

Rationale 1: Families in which the children are forced to join one or the other camp of two warring spouses or adult caretakers are called schismatic families. The constant fighting in these families is most likely a defense against intimacy or closeness. The family does not appear skewed, disengaged, or hostile.

Rationale 2: Families in which the children are forced to join one or the other camp of two warring spouses or adult caretakers are called schismatic families. The constant fighting in these families is most likely a defense against intimacy or closeness. The family does not appear skewed, disengaged, or hostile.

Rationale 3: Families in which the children are forced to join one or the other camp of two warring spouses or adult caretakers are called schismatic families. The constant fighting in these families is most likely a defense against intimacy or closeness. The family does not appear skewed, disengaged, or hostile.

Rationale 4: Families in which the children are forced to join one or the other camp of two warring spouses or adult caretakers are called schismatic families. The constant fighting in these families is most likely a defense against intimacy or closeness. The family does not appear skewed, disengaged, or hostile.

Global Rationale:

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: Differentiate among schism, skew, enmeshment, and disengagement as problems of intimacy and control in families.

Question 6

Type: MCSA

A child with ADHD is referred to the nurse practitioner for family therapy. The father and mother are out of the country and have been out of touch for three months. The childs older sister has assumed the role of parenting her younger sibling. This is an example of a:

1. Disengaged family.

2. Enmeshed family.

3. Skewed family.

4. Schismatic family.

Correct Answer: 1

Rationale 1: In disengaged families, family members seem oblivious to the effects of their actions on one another. They are unresponsive and unconnected to each other. Structure, order, or authority in the family may be weak or nonexistent. In these families, a child often assumes the parental role. The family does not appear skewed, enmeshed or schismatic.

Rationale 2: In disengaged families, family members seem oblivious to the effects of their actions on one another. They are unresponsive and unconnected to each other. Structure, order, or authority in the family may be weak or nonexistent. In these families, a child often assumes the parental role. The family does not appear skewed, enmeshed or schismatic.

Rationale 3: In disengaged families, family members seem oblivious to the effects of their actions on one another. They are unresponsive and unconnected to each other. Structure, order, or authority in the family may be weak or nonexistent. In these families, a child often assumes the parental role. The family does not appear skewed, enmeshed or schismatic.

Rationale 4: In disengaged families, family members seem oblivious to the effects of their actions on one another. They are unresponsive and unconnected to each other. Structure, order, or authority in the family may be weak or nonexistent. In these families, a child often assumes the parental role. The family does not appear skewed, enmeshed or schismatic.

Global Rationale:

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: Differentiate among schism, skew, enmeshment, and disengagement as problems of intimacy and control in families.

Question 7

Type: MCSA

The nursing student knows that involving families with the clients treatment is an important aspect of family nursing. Certain biases, such as believing families are responsible for the clients mental illness, prevents:

1. Social interaction and violates family rights.

2. Hope, support, and happiness.

3. Future episodes of negative client behavior.

4. Family identity and reduces negative perceptions.

Correct Answer: 1

Rationale 1: Assessing and intervening with the families of clients is an essential nursing role. Unfortunately, some mental health care professionals still have a bias against family involvement. This bias is a remnant of now-discredited theories that poor parenting and dysfunctional family interaction patterns give rise to mental illness. A related bias is the belief that if families cause schizophrenia, then the familys contact with the client should be limited for the clients sake. Besides violating family rights, this bias prevents social interaction with family members that might serve as a normalizing force by confronting clients with reality. These biases do not reduce negative perceptions, negative client behavior, or hope, support, and happiness.

Rationale 2: Assessing and intervening with the families of clients is an essential nursing role. Unfortunately, some mental health care professionals still have a bias against family involvement. This bias is a remnant of now-discredited theories that poor parenting and dysfunctional family interaction patterns give rise to mental illness. A related bias is the belief that if families cause schizophrenia, then the familys contact with the client should be limited for the clients sake. Besides violating family rights, this bias prevents social interaction with family members that might serve as a normalizing force by confronting clients with reality. These biases do not reduce negative perceptions, negative client behavior, or hope, support, and happiness.

Rationale 3: Assessing and intervening with the families of clients is an essential nursing role. Unfortunately, some mental health care professionals still have a bias against family involvement. This bias is a remnant of now-discredited theories that poor parenting and dysfunctional family interaction patterns give rise to mental illness. A related bias is the belief that if families cause schizophrenia, then the familys contact with the client should be limited for the clients sake. Besides violating family rights, this bias prevents social interaction with family members that might serve as a normalizing force by confronting clients with reality. These biases do not reduce negative perceptions, negative client behavior, or hope, support, and happiness.

Rationale 4: Assessing and intervening with the families of clients is an essential nursing role. Unfortunately, some mental health care professionals still have a bias against family involvement. This bias is a remnant of now-discredited theories that poor parenting and dysfunctional family interaction patterns give rise to mental illness. A related bias is the belief that if families cause schizophrenia, then the familys contact with the client should be limited for the clients sake. Besides violating family rights, this bias prevents social interaction with family members that might serve as a normalizing force by confronting clients with reality. These biases do not reduce negative perceptions, negative client behavior, or hope, support, and happiness.

Global Rationale:

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: Carry out a family assessment.

Question 8

Type: MCSA

In order to obtain detailed information that gives insight into how a clients family may function, the nurse knows to ask:

1. What are your goals after discharge?

2. How often do you attend church?

3. What are your favorite foods?

4. Do you take your medicine at the same time every day?

Correct Answer: 2

Rationale 1: How actively the family pursues religious/spiritual activities is the sort of detailed information that will give insight into family functioning. Goals after discharge, favorite foods, and medication information are not related to family functioning.

Rationale 2: How actively the family pursues religious/spiritual activities is the sort of detailed information that will give insight into family functioning. Goals after discharge, favorite foods, and medication information are not related to family functioning.

Rationale 3: How actively the family pursues religious/spiritual activities is the sort of detailed information that will give insight into family functioning. Goals after discharge, favorite foods, and medication information are not related to family functioning.

Rationale 4: How actively the family pursues religious/spiritual activities is the sort of detailed information that will give insight into family functioning. Goals after discharge, favorite foods, and medication information are not related to family functioning.

Global Rationale:

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: Carry out a family assessment.

Question 9

Type: MCSA

When collecting family interactional data, the nurse knows to ask:

1. How do the actions of your family worsen your symptoms of schizophrenia?

2. Since you have been in the hospital, who is taking care of your children?

3. How often do you shop for nutritional items for your family?

4. What do you buy when you shop at the local market?

Correct Answer: 2

Rationale 1: Family interactional data is probably the most complex data to obtain. It is important to determine family alliances and family supports. Information about shopping habits is not part of the interactional data. Implying that the family causes or affects the clients mental illness reflects the nurses bias.

Rationale 2: Family interactional data is probably the most complex data to obtain. It is important to determine family alliances and family supports. Information about shopping habits is not part of the interactional data. Implying that the family causes or affects the clients mental illness reflects the nurses bias.

Rationale 3: Family interactional data is probably the most complex data to obtain. It is important to determine family alliances and family supports. Information about shopping habits is not part of the interactional data. Implying that the family causes or affects the clients mental illness reflects the nurses bias.

Rationale 4: Family interactional data is probably the most complex data to obtain. It is important to determine family alliances and family supports. Information about shopping habits is not part of the interactional data. Implying that the family causes or affects the clients mental illness reflects the nurses bias.

Global Rationale:

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: Carry out a family assessment.

Question 10

Type: MCSA

The nurse knows that because people with mental illness continue to be ostracized by mainstream society, families must cope with the burden of:

1. Dementia.

2. Shame.

3. Isolation.

4. Stigma.

Correct Answer: 4

Rationale 1: Family burden refers to the difficulties and responsibilities of family members who assume a caretaking function for relatives with psychiatric disability. Stigma is one example of family burden. Other family burdens reported most often are financial strain, violence in the household, reductions in the physical and mental health of family caregivers, disruption of family routines, worry about the future, the mental health system itself as a stressor, and feeling overwhelmed or unable to cope. Isolation is more of an issue for the person with mental illness than for the family. Dementia and shame are not considered family burdens.

Rationale 2: Family burden refers to the difficulties and responsibilities of family members who assume a caretaking function for relatives with psychiatric disability. Stigma is one example of family burden. Other family burdens reported most often are financial strain, violence in the household, reductions in the physical and mental health of family caregivers, disruption of family routines, worry about the future, the mental health system itself as a stressor, and feeling overwhelmed or unable to cope. Isolation is more of an issue for the person with mental illness than for the family. Dementia and shame are not considered family burdens.

Rationale 3: Family burden refers to the difficulties and responsibilities of family members who assume a caretaking function for relatives with psychiatric disability. Stigma is one example of family burden. Other family burdens reported most often are financial strain, violence in the household, reductions in the physical and mental health of family caregivers, disruption of family routines, worry about the future, the mental health system itself as a stressor, and feeling overwhelmed or unable to cope. Isolation is more of an issue for the person with mental illness than for the family. Dementia and shame are not considered family burdens.

Rationale 4: Family burden refers to the difficulties and responsibilities of family members who assume a caretaking function for relatives with psychiatric disability. Stigma is one example of family burden. Other family burdens reported most often are financial strain, violence in the household, reductions in the physical and mental health of family caregivers, disruption of family routines, worry about the future, the mental health system itself as a stressor, and feeling overwhelmed or unable to cope. Isolation is more of an issue for the person with mental illness than for the family. Dementia and shame are not considered family burdens.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: Carry out a family assessment.

Question 11

Type: MCSA

The family nurse therapist, in an effort to learn more details about family patterns and interactions over time, may use:

1. The psychiatrists progress notes.

2. Anecdotes from family and friends.

3. Police reports.

4. A genogram.

Correct Answer: 4

Rationale 1: From the study of families in detail, it becomes apparent that patterns are spread over generations. The timeline, or genogram, is highly effective as a visual representation of family patterns from one generation to the next. The other choices have not been proven effective in soliciting information about multigenerational patterns.

Rationale 2: From the study of families in detail, it becomes apparent that patterns are spread over generations. The timeline, or genogram, is highly effective as a visual representation of family patterns from one generation to the next. The other choices have not been proven effective in soliciting information about multigenerational patterns.

Rationale 3: From the study of families in detail, it becomes apparent that patterns are spread over generations. The timeline, or genogram, is highly effective as a visual representation of family patterns from one generation to the next. The other choices have not been proven effective in soliciting information about multigenerational patterns.

Rationale 4: From the study of families in detail, it becomes apparent that patterns are spread over generations. The timeline, or genogram, is highly effective as a visual representation of family patterns from one generation to the next. The other choices have not been proven effective in soliciting information about multigenerational patterns.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: Incorporate the data obtained in a family assessment into the care plan for the client.

Question 12

Type: MCSA

When developing a care plan for a client in family therapy, which of the following questions will provide the best information for planning appropriate interventions?

1. What kinds of activities does your family enjoy together?

2. Who is the primary caregiver in your family?

3. What is the most important problem that you want help with?

4. How often do you attend church together as a family?

Correct Answer: 3

Rationale 1: The best way to find out what families need from mental health professionals is to ask them directly. The other questions provide information during a family assessment, but do not solicit the familys opinion of what they think they need help with.

Rationale 2: The best way to find out what families need from mental health professionals is to ask them directly. The other questions provide information during a family assessment, but do not solicit the familys opinion of what they think they need help with.

Rationale 3: The best way to find out what families need from mental health professionals is to ask them directly. The other questions provide information during a family assessment, but do not solicit the familys opinion of what they think they need help with.

Rationale 4: The best way to find out what families need from mental health professionals is to ask them directly. The other questions provide information during a family assessment, but do not solicit the familys opinion of what they think they need help with.

Global Rationale:

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: Incorporate the data obtained in a family assessment into the care plan for the client.

Question 13

Type: MCSA

Which of the following interventions is not an appropriate strategy for the family therapist?

1. Openly disagree with one another when appropriate

2. Showing that anger and pain are not safe emotions to examine

3. Delineating family roles and functions

4. Openly discuss problems with one another

Correct Answer: 2

Rationale 1: The family therapist should encourage examination of all emotions in a safe environment. There are no forbidden areas that cannot be examined during family therapy. The other interventions are all appropriate strategies for the family therapist to engage in during therapy.

Rationale 2: The family therapist should encourage examination of all emotions in a safe environment. There are no forbidden areas that cannot be examined during family therapy. The other interventions are all appropriate strategies for the family therapist to engage in during therapy.

Rationale 3: The family therapist should encourage examination of all emotions in a safe environment. There are no forbidden areas that cannot be examined during family therapy. The other interventions are all appropriate strategies for the family therapist to engage in during therapy.

Rationale 4: The family therapist should encourage examination of all emotions in a safe environment. There are no forbidden areas that cannot be examined during family therapy. The other interventions are all appropriate strategies for the family therapist to engage in during therapy.

Global Rationale:

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: Incorporate the data obtained in a family assessment into the care plan for the client.

Question 14

Type: MCSA

Parents of adult clients with mental health disorders struggle to find a balance between emotional support and fostering independence. The nurse helps by:

1. Teaching the client and family about past mistakes.

2. Providing psychoeducation group therapy.

3. Providing interaction with family members.

4. Teaching the client to embrace the future.

Correct Answer: 2

Rationale 1: Family members can benefit from psychoeducation groups designed to help them cope with their loved ones illness. Family psychoeducation programs have emerged as a strongly supported evidence-based practice in the treatment of schizophrenia, bipolar disorder, depression, obsessive-compulsive disorder, and borderline personality disorder. Family psychoeducation has also been found to reduce psychotic relapse and rehospitalization and to improve client recovery and family well-being. The other answers may be results of psychoeducation group therapy.

Rationale 2: Family members can benefit from psychoeducation groups designed to help them cope with their loved ones illness. Family psychoeducation programs have emerged as a strongly supported evidence-based practice in the treatment of schizophrenia, bipolar disorder, depression, obsessive-compulsive disorder, and borderline personality disorder. Family psychoeducation has also been found to reduce psychotic relapse and rehospitalization and to improve client recovery and family well-being. The other answers may be results of psychoeducation group therapy.

Rationale 3: Family members can benefit from psychoeducation groups designed to help them cope with their loved ones illness. Family psychoeducation programs have emerged as a strongly supported evidence-based practice in the treatment of schizophrenia, bipolar disorder, depression, obsessive-compulsive disorder, and borderline personality disorder. Family psychoeducation has also been found to reduce psychotic relapse and rehospitalization and to improve client recovery and family well-being. The other answers may be results of psychoeducation group therapy.

Rationale 4: Family members can benefit from psychoeducation groups designed to help them cope with their loved ones illness. Family psychoeducation programs have emerged as a strongly supported evidence-based practice in the treatment of schizophrenia, bipolar disorder, depression, obsessive-compulsive disorder, and borderline personality disorder. Family psychoeducation has also been found to reduce psychotic relapse and rehospitalization and to improve client recovery and family well-being. The other answers may be results of psychoeducation group therapy.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: Partner with clients and their families in recognizing when family interventions, referral to NAMI, or family therapy are appropriate.

Question 15

Type: MCSA

Which of the following is a grassroots, self-help support organization of families, friends, and clients with severe mental illness?

1. National Institute of Mental Health (NIMH)

2. American Mental Health Association (AMHA)

3. A mental health clinic

4. National Alliance on Mental Illness (NAMI)

Correct Answer: 4

Rationale 1: The National Alliance on Mental Illness (NAMI) is a grassroots, self-help, advocacy and support organization of families, consumers (a term used by NAMI to describe people diagnosed with and receiving treatment for severe mental illness), and friends of people with severe mental disorders. NAMI provides several services to families and consumers, including general information on mental disorders, psychiatric medications, and mental health policy positions; referral to state and local affiliates and support groups throughout the country; and support from trained volunteersconsumers and family memberswho know what its like to have a mental disorder or to have a family member with a mental disorder. The other agencies are not grassroots self-help organizations.

Rationale 2: The National Alliance on Mental Illness (NAMI) is a grassroots, self-help, advocacy and support organization of families, consumers (a term used by NAMI to describe people diagnosed with and receiving treatment for severe mental illness), and friends of people with severe mental disorders. NAMI provides several services to families and consumers, including general information on mental disorders, psychiatric medications, and mental health policy positions; referral to state and local affiliates and support groups throughout the country; and support from trained volunteersconsumers and family memberswho know what its like to have a mental disorder or to have a family member with a mental disorder. The other agencies are not grassroots self-help organizations.

Rationale 3: The National Alliance on Mental Illness (NAMI) is a grassroots, self-help, advocacy and support organization of families, consumers (a term used by NAMI to describe people diagnosed with and receiving treatment for severe mental illness), and friends of people with severe mental disorders. NAMI provides several services to families and consumers, including general information on mental disorders, psychiatric medications, and mental health policy positions; referral to state and local affiliates and support groups throughout the country; and support from trained volunteersconsumers and family memberswho know what its like to have a mental disorder or to have a family member with a mental disorder. The other agencies are not grassroots self-help organizations.

Rationale 4: The National Alliance on Mental Illness (NAMI) is a grassroots, self-help, advocacy and support organization of families, consumers (a term used by NAMI to describe people diagnosed with and receiving treatment for severe mental illness), and friends of people with severe mental disorders. NAMI provides several services to families and consumers, including general information on mental disorders, psychiatric medications, and mental health policy positions; referral to state and local affiliates and support groups throughout the country; and support from trained volunteersconsumers and family memberswho know what its like to have a mental disorder or to have a family member with a mental disorder. The other agencies are not grassroots self-help organizations.

Global Rationale:

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: Partner with clients and their families in recognizing when family interventions, referral to NAMI, or family therapy are appropriate.

Question 16

Type: MCSA

A client diagnosed with bipolar disorder is starting the first family therapy session. The nurse knows the clients children, aged 2 and 4, will:

1. Not be included in the therapy session.

2. Help the client acclimate to the mental health clinic.

3. Benefit from the therapy session.

4. Help the client understand the importance of getting well.

Correct Answer: 1

Rationale 1: Children 4 years of age and younger are often not included in ongoing family therapy sessions. They may misinterpret or be frightened by the dialogue. In addition, small children tend to be disruptive. The children are not expected to help the client.

Rationale 2: Children 4 years of age and younger are often not included in ongoing family therapy sessions. They may misinterpret or be frightened by the dialogue. In addition, small children tend to be disruptive. The children are not expected to help the client.

Rationale 3: Children 4 years of age and younger are often not included in ongoing family therapy sessions. They may misinterpret or be frightened by the dialogue. In addition, small children tend to be disruptive. The children are not expected to help the client.

Rationale 4: Children 4 years of age and younger are often not included in ongoing family therapy sessions. They may misinterpret or be frightened by the dialogue. In addition, small children tend to be disruptive. The children are not expected to help the client.

Global Rationale:

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: Design family psychoeducation activities to improve client recovery and family well-being.

Question 17

Type: MCSA

In order to help improve the functioning of mental health clients and their families, nurses must:

1. Teach the client communication skills.

2. Help each member negotiate what they need within the family.

3. Decrease the clients stress by compromising the integrity of family interactions.

4. Normalize the familys experience.

Correct Answer: 2

Rationale 1: The negotiation phase of family therapy is begun by identifying what each member would like to change in the family. When each family member and the therapist have identified important goals, they begin negotiating a set of attainable goals that everyone is willing to work on. Some give-and-take among the family members is needed to achieve workable goals. At this time, the family therapist, along with the family, may also identify the meanstasks, strategies, and so onthat will be used to reach the negotiated goals. Teaching the client communication skills may be one of the tasks the family identifies. Normalizing the familys experience may result from improvement of family functioning. It is nontherapeutic for the nurse to actively compromise the integrity of family interactions.

Rationale 2: The negotiation phase of family therapy is begun by identifying what each member would like to change in the family. When each family member and the therapist have identified important goals, they begin negotiating a set of attainable goals that everyone is willing to work on. Some give-and-take among the family members is needed to achieve workable goals. At this time, the family therapist, along with the family, may also identify the meanstasks, strategies, and so onthat will be used to reach the negotiated goals. Teaching the client communication skills may be one of the tasks the family identifies. Normalizing the familys experience may result from improvement of family functioning. It is nontherapeutic for the nurse to actively compromise the integrity of family interactions.

Rationale 3: The negotiation phase of family therapy is begun by identifying what each member would like to change in the family. When each family member and the therapist have identified important goals, they begin negotiating a set of attainable goals that everyone is willing to work on. Some give-and-take among the family members is needed to achieve workable goals. At this time, the family therapist, along with the family, may also identify the meanstasks, strategies, and so onthat will be used to reach the negotiated goals. Teaching the client communication skills may be one of the tasks the family identifies. Normalizing the familys experience may result from improvement of family functioning. It is nontherapeutic for the nurse to actively compromise the integrity of family interactions.

Rationale 4: The negotiation phase of family therapy is begun by identifying what each member would like to change in the family. When each family member and the therapist have identified important goals, they begin negotiating a set of attainable goals that everyone is willing to work on. Some give-and-take among the family members is needed to achieve workable goals. At this time, the family therapist, along with the family, may also identify the meanstasks, strategies, and so onthat will be used to reach the negotiated goals. Teaching the client communication skills may be one of the tasks the family identifies. Normalizing the familys experience may result from improvement of family functioning. It is nontherapeutic for the nurse to actively compromise the integrity of family interactions.

Global Rationale:

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: Design family psychoeducation activities to improve client recovery and family well-being.

Question 18

Type: MCSA

When instructing nursing students on therapy termination strategies for families and clients with mental health disorders, the nursing instructor teaches that effective family nursing strategies include:

1. Helping families achieve realistic goals.

2. Giving criticism in a calm voice.

3. Knowing effective communication skills.

4. Monitoring nonverbal communication.

Correct Answer: 1

Rationale 1: Family therapists use various criteria to determine when termination is appropriate. Termination occurs in a flexible way, helping families achieve realistic goals, thus ending therapy with a feeling of accomplishment. Knowing effective communication skills, giving criticism in a calm voice, and monitoring nonverbal communication may be included in the goals.

Rationale 2: Family therapists use various criteria to determine when termination is appropriate. Termination occurs in a flexible way, helping families achieve realistic goals, thus ending therapy with a feeling of accomplishment. Knowing effective communication skills, giving criticism in a calm voice, and monitoring nonverbal communication may be included in the goals.

Rationale 3: Family therapists use various criteria to determine when termination is appropriate. Termination occurs in a flexible way, helping families achieve realistic goals, thus ending therapy with a feeling of accomplishment. Knowing effective communication skills, giving criticism in a calm voice, and monitoring nonverbal communication may be included in the goals.

Rationale 4: Family therapists use various criteria to determine when termination is appropriate. Termination occurs in a flexible way, helping families achieve realistic goals, thus ending therapy with a feeling of accomplishment. Knowing effective communication skills, giving criticism in a calm voice, and monitoring nonverbal communication may be included in the goals.

Global Rationale:

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: Design family psychoeducation activities to improve client recovery and family well-being.

Question 19

Type: MCSA

Which of the following information should be included in psychoeducation with a family of a client recently diagnosed with a mental illness?

1. Most mental illnesses are inherited so the entire family should be tested for the same disorder.

2. Mental illness is extremely complex and it may take several years for the right treatment to be effective.

3. Most mental illnesses are caused by an imbalance of chemicals in the brain and can be treated with medications and therapy.

4. Earlier screening and diagnosis could have prevented the severity of symptoms and behavior problems.

Correct Answer: 3

Rationale 1: Families misunderstand mental illness to be a personal failing and are comforted by the fact that it has a biologic basis and can be treated with medications and therapy. There is no truth to the other statements.

Rationale 2: Families misunderstand mental illness to be a personal failing and are comforted by the fact that it has a biologic basis and can be treated with medications and therapy. There is no truth to the other statements.

Rationale 3: Families misunderstand mental illness to be a personal failing and are comforted by the fact that it has a biologic basis and can be treated with medications and therapy. There is no truth to the other statements.

Rationale 4: Families misunderstand mental illness to be a personal failing and are comforted by the fact that it has a biologic basis and can be treated with medications and therapy. There is no truth to the other statements.

Global Rationale:

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: Provide information about family therapy and support to clients and their families while they are engaged in family therapy.

Question 20

Type: MCSA

Which of the following behaviors indicate that family therapy has been effective and can be terminated?

1. Family members are able to give feedback to others, telling them how they appear

2. Family members are able to identify faults and failures of others, telling them how to act better

3. Family members are able to give praise and criticism in equal measure

4. Family members are able to identify problems with communication

Correct Answer: 1

Rationale 1: Termination in family therapy occurs in a flexible way, helping families achieve realistic goals, thus ending therapy with a feeling of accomplishment. The ability to give feedback to each other in a constructive manner is the sign of a healthy family. The ability to identify problems with communication is an early goal of therapy. Identifying faults and failures of others is not the focus of family therapy. Giving praise and criticism in equal measure is not a goal of family therapy and does not indicate the need for termination.

Rationale 2: Termination in family therapy occurs in a flexible way, helping families achieve realistic goals, thus ending therapy with a feeling of accomplishment. The ability to give feedback to each other in a constructive manner is the sign of a healthy family. The ability to identify problems with communication is an early goal of therapy. Identifying faults and failures of others is not the focus of family therapy. Giving praise and criticism in equal measure is not a goal of family therapy and does not indicate the need for termination.

Rationale 3: Termination in family therapy occurs in a flexible way, helping families achieve realistic goals, thus ending therapy with a feeling of accomplishment. The ability to give feedback to each other in a constructive manner is the sign of a healthy family. The ability to identify problems with communication is an early goal of therapy. Identifying faults and failures of others is not the focus of family therapy. Giving praise and criticism in equal measure is not a goal of family therapy and does not indicate the need for termination.

Rationale 4: Termination in family therapy occurs in a flexible way, helping families achieve realistic goals, thus ending therapy with a feeling of accomplishment. The ability to give feedback to each other in a constructive manner is the sign of a healthy family. The ability to identify problems with communication is an early goal of therapy. Identifying faults and failures of others is not the focus of family therapy. Giving praise and criticism in equal measure is not a goal of family therapy and does not indicate the need for termination.

Global Rationale:

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: Provide information about family therapy and support to clients and their families while they are engaged in family therapy.

Question 21

Type: MCSA

The mother of a young child diagnosed with conduct disorder asks the nurse to recommend a qualified nurse to provide family therapy. The nurse knows that:

1. Nurse family therapists should be clinical specialists or advanced practitioners in mental health nursing.

2. Nurses with a bachelors degree are qualified to provide family therapy if they are nationally certified in mental health nursing.

3. Nurses are not reimbursed by third party insurers to provide family therapy.

4. Nurses specializing in family therapy are expensive and it is difficult to get a timely appointment.

Correct Answer: 1

Rationale 1: Family therapists should be specially educated in the practice of family therapy and strongly committed to a belief in the importance of the family. Nurse family therapists should be clinical specialists or advanced practitioners prepared in graduate programs that provide both theory and supervised clinical practice in this specialized area. All other statements are false.

Rationale 2: Family therapists should be specially educated in the practice of family therapy and strongly committed to a belief in the importance of the family. Nurse family therapists should be clinical specialists or advanced practitioners prepared in graduate programs that provide both theory and supervised clinical practice in this specialized area. All other statements are false.

Rationale 3: Family therapists should be specially educated in the practice of family therapy and strongly committed to a belief in the importance of the family. Nurse family therapists should be clinical specialists or advanced practitioners prepared in graduate programs that provide both theory and supervised clinical practice in this specialized area. All other statements are false.

Rationale 4: Family therapists should be specially educated in the practice of family therapy and strongly committed to a belief in the importance of the family. Nurse family therapists should be clinical specialists or advanced practitioners prepared in graduate programs that provide both theory and supervised clinical practice in this specialized area. All other statements are false.

Global Rationale:

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: Provide information about family therapy and support to clients and their families while they are engaged in family therapy.

Kneisl, Contemporary Psychiatric-Mental Health Nursing, 3/e Test Bank

Copyright 2012 by Pearson Education, Inc.

Leave a Reply