C35 family interventions test bank PDF

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VARCAROLIS FOUNDATIONS OF PSYCHIATRIC MENTAL HEALTH NURSING 8TH EDITION HALTER TEST BANK

Chapter 35: Family Interventions Halter: Varcarolis’ Foundations of Psychiatric Mental Health Nursing: A Clinical Approach, 8th Edition MULTIPLE CHOICE 1. A married couple has two biologic children who live with them as well as a child from the

wife’s first marriage. What type of family is evident? a. Homogeneous b. Extended c. Blended d. Nuclear ANS: C

A blended family is made up of members from two or more unrelated families. It is not a nuclear family because a stepchild is present. It is not an extended family, because there are only two generations present. Homogeneous is not a family type. PTS: 1 DIF: Cognitive Level: Understand (Comprehension) REF: Page 35-5 TOP: Nursing Process: Assessment MSC: Client Needs: Health Promotion and Maintenance 2. A married couple has two children living in the home. Recently, the wife’s mother moved in.

This family should be assessed as a. nuclear. b. blended. NURSINGTB.COM c. extended. d. alternative. ANS: C

An extended family has members from three or more generations living together. Nuclear family refers to a couple and their children. A blended family is one made up of members from two or more unrelated families. An alternative family can consist of a same-sex couple or an unmarried couple and children. PTS: 1 DIF: Cognitive Level: Understand (Comprehension) REF: Page 35-5 TOP: Nursing Process: Assessment MSC: Client Needs: Health Promotion and Maintenance 3. When a nurse assesses a family, which family task has the highest priority for healthy family

functioning? a. Allocation of family resources b. Physical maintenance and safety c. Maintenance of order and authority d. Reproduction of new family members ANS: B

Physical and safety needs have greater importance in Maslow’s hierarchy than other needs. PTS: 1 REF: Page 35-3

DIF: Cognitive Level: Apply (Application) TOP: Nursing Process: Assessment

VARCAROLIS FOUNDATIONS OF PSYCHIATRIC MENTAL HEALTH NURSING 8TH EDITION HALTER TEST BANK

MSC: Client Needs: Health Promotion and Maintenance 4. Which documentation of family assessment indicates a healthy and functional family? a. Members provide mutual support. b. Power is distributed equally among all members. c. Members believe there are specific causes for events. d. Under stress, members turn inward and become enmeshed. ANS: A

Healthy families nurture and support their members, buffer against stress, and provide stability and cohesion. The distracters are unrelated or incorrect. PTS: 1 DIF: Cognitive Level: Understand (Comprehension) REF: Pages 35-3, 4, 9 TOP: Nursing Process: Assessment MSC: Client Needs: Health Promotion and Maintenance 5. A 15-year-old is hospitalized after a suicide attempt. This adolescent lives with the mother,

stepfather, and several siblings. When performing a family assessment, the nurse must first determine a. how the family expresses and manages emotion. b. names and relationships of the family’s members. c. the communication patterns between the patient and parents. d. the meaning that the patient’s suicide attempt has for family members. ANS: B

The identity of the members of the family is the most fundamental information and should be obtained first. Without this, the nurse cannot fully process the other responses. NURSINGTB.COM

PTS: 1 DIF: Cognitive Level: Apply (Application) REF: Page 35-17 TOP: Nursing Process: Assessment MSC: Client Needs: Health Promotion and Maintenance 6. Which information is the nurse most likely to find when assessing the family of a patient with

a serious mental illness? a. The family exhibits many characteristics of dysfunctional families. b. Several family members have serious problems with their physical health. c. Power in the family is maintained in the parental dyad and rarely delegated. d. Stress from living with a mentally ill member has challenged the family’s function. ANS: D

The information almost universally obtained is that the family is under stress associated with having a mentally ill member. This stress lowers the family’s level of functioning in at least one significant way. Stress does not necessarily mean the family has become dysfunctional. PTS: 1 DIF: Cognitive Level: Apply (Application) REF: Pages 35-3, 12, 13 (Vignette) TOP: Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity 7. The parent of an adolescent diagnosed with mental illness asks the nurse, “Why do you want

to do a family assessment? My teenager is the patient, not the rest of us.” Select the nurse’s best response. a. “Family dysfunction might have caused the mental illness.”

VARCAROLIS FOUNDATIONS OF PSYCHIATRIC MENTAL HEALTH NURSING 8TH EDITION HALTER TEST BANK

b. “Family members provide more accurate information than the patient.” c. “Family assessment is part of the protocol for care of all patients with mental

illness.” d. “Every family member’s perception of events is different and adds to the total

picture.” ANS: D

The identified patient usually bears most of the family system’s anxiety and may have come to the attention of parents, teachers, or law enforcement because of poor coping skills. The correct response helps the family understand that the opinions of each will be valued. It allows the nurse to assess individual coping and prepares the family for the experience of working together to set goals and solve problems. The other responses are either incorrect or evasive. PTS: 1 DIF: Cognitive Level: Apply (Application) REF: Pages 35-14 to 16 TOP: Nursing Process: Implementation MSC: Client Needs: Psychosocial Integrity 8. An adult diagnosed with schizophrenia lives with elderly parents. The patient was recently

hospitalized with acute psychosis. One parent is very anxious, and the other is ill because of the stress. Which nursing diagnosis is most applicable to this scenario? a. Ineffective family coping related to parental role conflict b. Caregiver role strain related to the stress of chronic illness c. Impaired parenting related to patient’s repeated hospitalizations d. Interrupted family processes related to relapse of acute psychosis ANS: B

Caregiver role strain refers to a caregiver’s felt or exhibited difficulty in performing a family NURSINGTB.COM caregiver role. In this case, one parent exhibits stress-related illness and the other exhibits increased anxiety. The other nursing diagnoses are not substantiated by the information given and are incorrectly formatted (one nursing diagnosis should not be the etiology for another). PTS: 1 DIF: Cognitive Level: Apply (Application) REF: Pages 35-21, 35 (Box 35-3) TOP: Nursing Process: Diagnosis/Analysis MSC: Client Needs: Psychosocial Integrity 9. An adult, recently diagnosed with AIDS, is hospitalized with pneumonia. The patient and

family are very anxious. Select the best outcome to add to the plan of care for this family. a. Describe the stages of the anticipatory grieving process. b. Identify and describe effective methods for coping with anxiety. c. Recognize ways dysfunctional communication is expressed in the family. d. Examine previously unexpressed feelings related to the patient’s sexuality. ANS: B

Desired outcomes might be set for the family as a whole or for individuals within the family. The outcome most closely associated with the anxiety that each member is experiencing is to focus on identifying and describing ways of coping with the anxiety. The other options are not appropriate at this time. PTS: 1 DIF: Cognitive Level: Apply (Application) REF: Pages 35-21, 22 TOP: Nursing Process: Outcomes Identification MSC: Client Needs: Psychosocial Integrity

VARCAROLIS FOUNDATIONS OF PSYCHIATRIC MENTAL HEALTH NURSING 8TH EDITION HALTER TEST BANK

10. A parent is admitted to a unit for treatment of addictions. The patient’s spouse and adolescent

children participate in a family session. What is the most important aspect of this family’s assessment? a. Spouse’s codependent behaviors b. Interactions among family members c. Patient’s reaction to the family’s anger d. Children’s responses to the family sessions ANS: B

Interactions among all family members are the raw material for family problem solving. By observing interactions, the nurse can help the family make its own assessments of strengths and deficits. The other options are narrower in scope when compared with the correct option. PTS: 1 DIF: Cognitive Level: Analyze (Analysis) REF: Pages 35-3, 4, 9, 10 TOP: Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity 11. A parent is admitted to a unit for treatment of addictions. The patient’s spouse and adolescent

children attend a family session. Which initial assessment question should the nurse ask of family members? a. “What changes are most important to you?” b. “How are feelings expressed in your family?” c. “What types of family education would benefit your family?” d. “Can you identify a long-term goal for improved functioning?” ANS: B

It is important to understand family characteristics, particularly in a family under stress. NURSINGTB.COM Expression of feelings is an important aspect of assessment of the family’s function (or dysfunction). The distracters relate more to outcome identification and planning interventions, both of which should be delayed until the assessment is complete. PTS: 1 DIF: Cognitive Level: Apply (Application) REF: Pages 35-8, 9 TOP: Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity 12. A nurse interviews a homeless parent with two teenage children. To best assess the family’s

use of resources, the nurse should ask a. “Can you describe a problem your family has successfully resolved?” b. “What community agencies have you found helpful in the past?” c. “What aspect of being homeless is most frightening for you?” d. “Do you feel you have adequate resources to survive?” ANS: B

The correct option asks about use of resources in an open, direct fashion. It will give information about choices the family has made regarding use of resources in the community. The other questions do not address prior use of resources or focus on other aspects of coping. PTS: 1 DIF: Cognitive Level: Apply (Application) REF: Pages 35-3, 22, 23 TOP: Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity

VARCAROLIS FOUNDATIONS OF PSYCHIATRIC MENTAL HEALTH NURSING 8TH EDITION HALTER TEST BANK

13. Two divorced people plan to marry. The man has a teenager, and the woman has a toddler.

This family will benefit most from a. role-playing opportunities for conflict resolution regarding discipline. b. guidance about parenting children at two developmental levels. c. formal teaching about problem-solving skills. d. referral to a family therapist. ANS: B

The newly formed family will be coping with tasks associated with the stage of rearing preschool children and teenagers. These stages require different knowledge and skills. There is no evidence of a problem, so the distracters are not indicated. PTS: 1 DIF: Cognitive Level: Apply (Application) REF: Pages 35-4, 6, 10 TOP: Nursing Process: Planning MSC: Client Needs: Health Promotion and Maintenance 14. Parents of a teenager recently diagnosed with serious mental illness express dismay. One

parent says, “Our hopes for our child’s future are ruined. We probably won’t ever have grandchildren.” The nurse will use interventions to assist with a. denial. b. acceptance. c. acting out. d. manipulation. ANS: B

The parents comment suggests they are experiencing grief, a common reaction to having a family member diagnosed with mental illness. The grief stems from actual or potential losses, NURSINGTB.COM such as the family’s ability to function, financial well-being, and altered future. Supporting the parents’ acceptance of the patient’s illness will enhance coping. Data do not support choosing any of the other options. PTS: 1 DIF: Cognitive Level: Analyze (Analysis) REF: Pages 35-21, 22 TOP: Nursing Process: Planning MSC: Client Needs: Psychosocial Integrity 15. Parents of a teenager recently diagnosed with serious mental illness express dismay. One

parent says, “Our child acts so strangely that we don’t invite friends to our home. We quit taking vacations. Sometimes we don’t get any sleep.” Which nursing diagnosis best applies? a. Impaired parenting b. Parental role conflict c. Impaired social interaction d. Interrupted family processes ANS: D

Interrupted family processes are evident in the face of disruptions in family functioning as a result of having a mentally ill member. Assessment data best support this diagnosis. Data are insufficient to support the other diagnoses. PTS: 1 DIF: Cognitive Level: Apply (Application) REF: Pages 35-21, 22, 35 (Box 35-3) TOP: Nursing Process: Diagnosis/Analysis MSC: Client Needs: Psychosocial Integrity

VARCAROLIS FOUNDATIONS OF PSYCHIATRIC MENTAL HEALTH NURSING 8TH EDITION HALTER TEST BANK

16. A family expresses helplessness related to dealing with a mentally ill member’s odd

behaviors, mood swings, and argumentativeness. An effective nursing intervention for this family would be to a. express sympathy for their situation. b. involve local social service agencies. c. explain symptoms of relapse. d. role-play difficult situations. ANS: D

Helping a family learn to set limits and deal with difficult behaviors can often be accomplished by using role-playing situations, which give family members the opportunity to try new, more effective approaches. The other options would not provide learning opportunities. PTS: 1 DIF: Cognitive Level: Apply (Application) REF: Page 35-19 TOP: Nursing Process: Implementation MSC: Client Needs: Psychosocial Integrity 17. Parents of a mentally ill teenager say, “We have never known anyone who was mentally ill.

We have no one to talk to because none of our friends understand the problems we are facing.” Select the nurse’s most helpful intervention. a. Refer the parents to a support group. b. Build the parents’ self-concept as coping parents. c. Teach the parents techniques of therapeutic communication. d. Facilitate achievement of normal developmental tasks of the family. ANS: A NURSINGTB.COM The need for support is evident. Referrals are made when working with families whose needs are unmet. A support group will provide the parents with support of others with similar experiences and with whom they can share feelings and experiences. The distracters are less relevant to providing a network of support.

PTS: 1 DIF: Cognitive Level: Analyze (Analysis) REF: Page 35-23 TOP: Nursing Process: Implementation MSC: Client Needs: Psychosocial Integrity 18. Select the best question for the nurse to ask to assess a family’s ability to cope. a. “What strengths does your family have?” b. “Do you think your family copes effectively?” c. “Describe how you successfully handled one family problem.” d. “How do you think the current family problem should be resolved?” ANS: C

The correct option is the only statement addressing coping strategies used by the family. The distracters seek opinions or use closed-ended communication techniques. PTS: 1 DIF: Cognitive Level: Apply (Application) REF: Pages 35-16, 17 TOP: Nursing Process: Assessment MSC: Client Needs: Health Promotion and Maintenance 19. Which scenario best illustrates scapegoating within a family? a. The identified patient sends messages of aggression to selected family members.

VARCAROLIS FOUNDATIONS OF PSYCHIATRIC MENTAL HEALTH NURSING 8TH EDITION HALTER TEST BANK

b. Family members project problems of the family onto one particular family

member. c. The identified patient threatens separation from the family to induce feelings of

isolation and despair. d. Family members give the identified patient nonverbal messages that conflict with

verbal messages. ANS: B

Scapegoating projects blame for family problems onto a member who is less powerful. The purpose of this projection is to distract from issues or dysfunctional behaviors in the members of the family. PTS: 1 DIF: Cognitive Level: Understand (Comprehension) REF: Page 35-32 (Box 35-1) | Page 35-33 (Box 35-2) TOP: Nursing Process: Assessment MSC: Client Needs: Health Promotion and Maintenance 20. A parent became unemployed 6 months ago. The parent has subsequently been verbally

abusive toward the spouse and oldest child. The child ran away twice, and the spouse has become depressed. What is the most appropriate nursing diagnosis for this family? a. Impaired parenting related to verbal abuse of oldest child b. Impaired social interaction related to disruption of family bonds c. Ineffective community coping related to fears about economic stability d. Disabled family coping related to insecurity secondary to loss of family income ANS: D

Disabled family coping refers to the behavior of a significant family member that disables his or her own capacity as well as another’s capacity to perform tasks essential to adaptation. The distracters are inaccurate because NURSINGTB.COM the stressors influence more than one individual. PTS: 1 DIF: Cognitive Level: Apply (Application) REF: Pages 35-21, 35 (Box 35-3) TOP: Nursing Process: Diagnosis/Analysis MSC: Client Needs: Health Promotion and Maintenance 21. A parent says, “My son and I argue constantly since he started using drugs. When I talk to

him about not using drugs, he tells me to stay out of his business.” What is the nurse’s first most appropriate action? a. Educate the parent about stages of family development. b. Report the son to law enforcement authorities. c. Refer the son for substance abuse treatment. d. Make a referral for family therapy. ANS: D

Family therapy is indicated, and the nurse should provide a referral. Reporting the child to law enforcement would undermine trust and violate confidentiality. The other distracters may occur later. PTS: 1 DIF: Cognitive Level: Apply (Application) REF: Pages 35-10, 11, 25 TOP: Nursing Process: Implementation MSC: Client Needs: Psychosocial Integrity 22. Which scenario best demonstrates a healthy family? a. One parent takes care of children. The other parent earns income and maintains the

VARCAROLIS FOUNDATIONS OF PSYCHIATRIC MENTAL HEALTH NURSING 8TH EDITION HALTER TEST BANK

home. b. A family has strict boundaries that require members to address problems within the

family. c. A couple requires their adolescent children to attend church services three times a

week. d. A couple renews their marital relationship after their children become adults. ANS: D

Revamping the marital relationship after children move out of the family of origin indicates the family is moving through its stages of development. Strict family boundaries or roles interfere with flexibility and use of outside resources. Adolescents should have some input into deciding their activities. PTS: 1 DIF: Cognitive Level: Apply (Application) REF: Pages 35-3, 5, 6, 8 to 10 TOP: Nursing Process: Assessment MSC: Client Needs: Health Promotion and Maintenance 23. Which comment by a mother during a family therapy session shows evidence of

scapegoating? a. “Our youngest child always starts arguments and upsets everyone else.” b. “We all express our feelings openly except when we think it might upset my husband.” c. “Our oldest child knows that my husband and I are doing all we can for the others.” d. “After my husband has been drinking, I have to get everyone up and ready for school.” ANS: A

NURSINGTB.COM

Scapegoating is blaming family problems on a member of the family who is not very powerful. The purpose of the blaming is to keep the focus off painful issues and off the blamers themselves. A dou...