Chapter 32: Family Interventions My Nursing Test Banks

Chapter 32: Family Interventions

Test Bank

MULTIPLE CHOICE

1. Which term refers to the mutual support, time, energy, resources, and advancement of awareness about psychiatric illness needed to advocate for improved family services?

a.

Family advocacy

b.

Family community aid

c.

Suicide prevention advocacy

d.

Community advancement agency

ANS: A

Family advocacy refers to the mutual support, time, energy, and resources needed to advocate for improved services and opportunities for family members with psychiatric illness. It is effective in raising awareness among service providers, legislators, and the public.

DIF: Cognitive Level: Knowledge REF: Text Page: 628

TOP: Nursing Process: Implementation MSC: NCLEX: Psychosocial Integrity

2. A nurse is managing the care of a family who has had no previous experience with community mental health care. The intervention addressed at the initial meeting should focus on:

a.

determining similarities between the family and the other families presently receiving care at the clinic.

b.

arranging for a social worker to be present to help the family acquire supportive community services.

c.

helping the family meet other families in the community who have members with mental illnesses.

d.

examining whether the nurses cultural background reflects those of the family members.

ANS: A

The nurse needs to recognize similarities and differences with those of patients and other families being served. The other choices can be assets, but self-reflection is the priority for the nurse.

DIF: Cognitive Level: Application REF: Text Page: 629

TOP: Nursing Process: Planning MSC: NCLEX: Psychosocial Integrity

3. When assessing a family for functional versus dysfunctional characteristics, which is a dysfunctional target symptom the nurse should identify?

a.

An adolescent who is failing math

b.

A teenage daughter who is 6 months pregnant

c.

A spouse who maintains family peace at any price

d.

A young adult who is working full-time as a laundry worker

ANS: C

The spouse who maintains peace at any price is said to be in a dysfunctional family system.

DIF: Cognitive Level: Analysis REF: Text Page: 631

TOP: Nursing Process: Diagnosis|Nursing Process: Analysis

MSC: NCLEX: Psychosocial Integrity

4. The diagnosis of a parent-child relational problem is indicated on which DSM-IV-TR axis?

a.

Axis I

b.

Axis II

c.

Axis III

d.

Axis IV

ANS: A

A psychiatric diagnosis related to family-related problems is an Axis I diagnosis.

DIF: Cognitive Level: Comprehension REF: Text Pages: 631-632

TOP: Nursing Process: Assessment MSC: NCLEX: Psychosocial Integrity

5. A nurse suspects that an adolescent patient is at risk for psychiatric problems according to the risk and protective factors model. Which information gathered during the intake assessment supports this suspicion?

a.

The patient lives with a parent and a half-sibling whom the patient hates.

b.

The patient readily admits to regularly having a few beers to loosen up.

c.

The patient repeatedly says, I want to play drums for a rock band for a living.

d.

The patients parents are divorced and both of them date a lot of different people.

ANS: B

According to the risk and protective factors model, this adolescent has at least one of the risk factors, indicated by the attitude toward alcohol consumption.

DIF: Cognitive Level: Analysis REF: Text Pages: 630-631

TOP: Nursing Process: Assessment MSC: NCLEX: Psychosocial Integrity

6. An adolescent with a history of multiple minor physical injuries is sent to the school nurse because of a large bruise on the lower left leg. The adolescent says, I think I got the bruise when I fell. The school nurse should interview the adolescent with a primary focus on:

a.

having the adolescent describe the circumstances of the fall that resulted in the bruise.

b.

determining whether this adolescent will identify other risk factors for physical abuse.

c.

gathering data to include in a report to the department of social services for adolescent abuse.

d.

establishing the likelihood that the adolescent has a physical condition that accounts for the frequent injuries.

ANS: B

The correct option indicates the primary focus of the interview is the use of the risk and protective factors model to assess the child with a suspicious bruise. Because of the history of minor physical injuries the nurse is obligated to assess the child for the possibility of abuse. The remaining options, while addressing reasonable questions, fail to determine the childs safety.

DIF: Cognitive Level: Analysis REF: Text Page: 630

TOP: Nursing Process: Assessment MSC: NCLEX: Psychosocial Integrity

7. An adolescent has been hospitalized after telling the mother, I cant stand all the arguing between Dad and me; I just want to die and be away from all the yelling. The unit nurse manager expects the patients psychiatric health provider will recommend _____ therapy.

a.

group

b.

family

c.

social skills

d.

short-term individual

ANS: B

Family therapy is designed to address the dysfunctional interactions among family members.

DIF: Cognitive Level: Application REF: Text Page: 630

TOP: Nursing Process: Planning MSC: NCLEX: Psychosocial Integrity

8. An essential outcome of family therapy is:

a.

change.

b.

acceptance.

c.

accountability.

d.

participation.

ANS: A

An essential outcome of family therapy and all models of therapy is positive change in all affected family members.

DIF: Cognitive Level: Comprehension REF: Text Page: 632

TOP: Nursing Process: Evaluation MSC: NCLEX: Psychosocial Integrity

9. It is useful initially for a therapist who is completing a family assessment to:

a.

have members also attend individual therapy.

b.

interview members individually.

c.

consider cultural influences.

d.

visit the family home.

ANS: C

Considering cultural influences on the functioning of a family is essential and should be addressed early in the assessment process.

DIF: Cognitive Level: Comprehension REF: Text Page: 629

TOP: Nursing Process: Assessment MSC: NCLEX: Psychosocial Integrity

10. A family participating in family therapy has identified the middle child as being the source of the familys conflict. What will the family therapist most likely suggest?

a.

The parents should provide extra time and support to the middle child in order to facilitate necessary changes in behavior.

b.

All members should participate in therapy sessions by identifying the daily difficulties that the individual member is experiencing.

c.

The middle child should attend an educational group especially designed to address the special needs of this birth order position.

d.

All members should be active participants in suggested activities between therapy sessions that focus on improving their coping skills.

ANS: D

Family interventions are aimed at engaging families and encouraging them to be active participants in treatment and rehabilitation, thereby increasing their knowledge and improving coping skills in both patients and their families.

DIF: Cognitive Level: Analysis REF: Text Page: 632

TOP: Nursing Process: Planning MSC: NCLEX: Psychosocial Integrity

11. A nurse is planning a mental healthoriented training session for high school guidance counselors. Considering the counselors target population, which type of program should the nurse focus on in the training in-service?

a.

Comprehension skills

b.

Parenting skills

c.

Coping skills

d.

Social skills

ANS: C

Coping skills necessary for the teenage population would be the most appropriate topic for such an in-service. Comprehension skills are academic in their focus, whereas parenting skills do not relate to the target population. Social skills are important only if there is a general need for such instruction.

DIF: Cognitive Level: Application REF: Text Pages: 631-632

TOP: Nursing Process: Planning MSC: NCLEX: Psychosocial Integrity

12. Which method should be used to assess changes in parent-child interactions as part of a family intervention?

a.

Self-written reflections

b.

Direct observation

c.

Detailed questions

d.

Anecdotal accounts

ANS: B

Direct observation should be used to assess changes in parent-child interactions since the family psychotherapist is provided with the opportunity to evaluate the interactions without the bias of the parties involved. The remaining options reflect the opinions, feelings, and biases of the individual creating them.

DIF: Cognitive Level: Comprehension REF: Text Page: 631

TOP: Nursing Process: Implementation MSC: NCLEX: Psychosocial Integrity

13. To conduct research based on family intervention, the researcher would focus on the family as a unit or system to better understand family:

a.

roles.

b.

economics.

c.

ethnicity.

d.

functioning.

ANS: D

Research on families can include basic family research, family intervention research, and family-related research. In each of these areas of research, the conceptualization, measurement, and analysis aspects view the family as a unit or system and thus contribute to the knowledge of family functioning.

DIF: Cognitive Level: Comprehension REF: Text Pages: 632-633

TOP: Nursing Process: Assessment MSC: NCLEX: Psychosocial Integrity

14. One of the primary goals identified in marital therapy is:

a.

support from families of origin.

b.

consensus in all decisions related to the marriage.

c.

the preservation of good interpersonal communication skills.

d.

the maintenance of a support system comprised of mutual friends.

ANS: C

Marital therapy is the treatment of the distress in a committed relationship or the education of a couple in regard to what makes healthy relationships, such as good communication skills.

DIF: Cognitive Level: Comprehension REF: Text Page: 635

TOP: Nursing Process: Planning MSC: NCLEX: Psychosocial Integrity

15. The discharge plan for a patient newly diagnosed with bipolar disorder includes a variety of treatment modalities. The most likely rationale for including both psychoeducational and family therapy to the plan of care is that they are:

a.

viewed as effective by most private insurance providers as well as Medicaid.

b.

likely to affect the patients compliance with the prescribed treatment plan.

c.

likely to address the issues the disorder can cause for the patient and family.

d.

focused on communication and problem solving.

ANS: D

There is much overlap between psychoeducational and family and marital therapy for families with members who have schizophrenia and mood disorders. Psychoeducation is often combined with marital and family therapy. Both psychoeducation and psychotherapy focus on problem solving and communication therapy.

DIF: Cognitive Level: Analysis REF: Text Page: 635

TOP: Nursing Process: Planning MSC: NCLEX: Psychosocial Integrity

16. Skill building may include relapse-prevention drills and disorder-related conflict skills for adult patients diagnosed with schizophrenia or a mood disorder. Along with skill building, the patient typically receives individualized:

a.

pharmacotherapy.

b.

subsidized housing.

c.

occupational therapy.

d.

health care treatment.

ANS: A

Pharmacotherapy is typically combined with psychoeducation for families that include persons with severe disorders, such as schizophrenia, major depression, and bipolar disorder.

DIF: Cognitive Level: Comprehension REF: Text Page: 634

TOP: Nursing Process: Planning MSC: NCLEX: Psychosocial Integrity

MULTIPLE RESPONSE

1. A fundamental component of family therapy is: (Select all that apply.)

a.

attendance at all sessions by all family members.

b.

agreement on when the therapeutic sessions will terminate.

c.

consensus among all parties regarding the amount of needed therapy.

d.

understanding related to the target behaviors identified for therapeutic change.

e.

willingness on the part of all family members to actively participate in sessions.

ANS: A, D, E

It is most important to the success of family therapy, as in all treatments, that there is a clear understanding of the targets for therapeutic change and that all members agree to attend and actively participate in the work of the group.

DIF: Cognitive Level: Application REF: Text Page: 630

TOP: Nursing Process: Planning MSC: NCLEX: Psychosocial Integrity

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