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Family Final Flashcards

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1
Q

The nurse is transferring to a care area that focuses on family nursing practice. What should the nurse realize about this approach to care?

  1. Interventions in family care address the future plans for the family.
  2. Family members must be present before the implementation of family care.
  3. Resources are placed to support a family member experiencing illness with the greatest chance for recovery.
  4. The nurse and family together define the family and where therapeutic energy should be placed.
A
  1. The nurse and family together define the family and where therapeutic energy should be placed.
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2
Q

The nurse notes that a client has been previously married and participates in raising the current spouse’s children from a previous marriage. How should the nurse document this family type?

  1. Extended
  2. Cohabitation
  3. Nuclear dyad
  4. Blended
A
  1. Blended
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3
Q

The nurse prepares an in-service program on family nursing for new graduate employees. Which definition of family is the best one for the nurse to use?

  1. Members of a family are self-defined
  2. People who share strong emotional ties
  3. A family is defined by blood ties, adoption, and marriage
  4. A group of people who live together with or without legal or biological ties
A
  1. Members of a family are self-defined
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4
Q

The nurse prepares to assess a client whose family is being used as a resource. Which approach to family nursing care is the nurse implementing?

  1. Family as client
  2. Family as system
  3. Family as context
  4. Family as component of society
A
  1. Family as context
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5
Q

During a home visit the nurse teaches the client and family about actions to reduce the spread of infection between the family members. Which role is the nurse implementing?

  1. Counselor
  2. Care deliverer
  3. Health teacher
  4. Family advocate
A
  1. Health teacher
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6
Q

The nurse is preparing the client for their first chemotherapy treatment and a family member has accompanied the client to the clinic. The nurse explains to the client and family what to expect from the treatment, including how long it will take, how the treatment will be administered, and potential side effects. The nurse has provided time for the client and family to ask questions and express concerns. Which role is the nurse implementing with the client?

  1. Surrogate
  2. Researcher
  3. Role model
  4. Case manager
A
  1. Surrogate
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7
Q

The spouse of a client with complex care needs is unavailable to attend a care conference at 2 p.m. What should the nurse do to support family nursing care?

  1. Have the client attend in place of the spouse
  2. Schedule the conference when the spouse is available
  3. Ask the spouse to telephone in during the time of the conference
  4. Provide the spouse with outcomes determined during the meeting
A
  1. Schedule the conference when the spouse is available
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8
Q

The nurse observes parents discussing an adolescent’s plans for the weekend and setting boundaries to which the adolescent agrees. Which function did this family unit demonstrate?

  1. Affective
  2. Economic
  3. Health care
  4. Socialization
A
  1. Affective
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9
Q

The adult daughter of an older client is expected to be at the client’s bedside, yet personal family responsibilities are not being completed. Which family interactional process is the daughter experiencing?

  1. Role strain
  2. Role conflict
  3. Role ambiguity
  4. Role expectations
A
  1. Role conflict
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10
Q

The nurse reviews potential theories to use as a guide for providing care to a family in the community. What should the nurse keep in mind as a primary function of theory in family nursing?

  1. Identifies a specific hypothesis
  2. Answers “How?” or “Why?” questions
  3. Examines how the concepts create a meaningful pattern
  4. Improves nursing services provided to families
A
  1. Improves nursing services provided to families
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11
Q

The nurse reviews a theory for applicability to a family health situation. On which part of the theory should the nurse focus to understand the expected relationship between the theory’s concepts?

  1. System
  2. Hypothesis
  3. Propositions
  4. Conceptual model
A
  1. Hypothesis
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12
Q

The nurse prepares to assess a family according to a family development theory. Which action will the nurse complete first during this assessment?

  1. Health of individual members
  2. Employment status of the parents
  3. Family structure and life cycle stages
  4. Education status of the children
A
  1. Family structure and life cycle stages
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13
Q

The nurse is struggling with using a developmental model when assessing a family new to a community. Which data could explain the difficulty the nurse is having using this model?
1. The parental units are same-sexed.
2. The youngest son is beginning college.
3. The middle child is attending high school.
4. The oldest daughter has just gotten married.

A
  1. The parental units are same-sexed.
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14
Q

The nurse uses the bioecological system theory to assess a family. On which system should the nurse focus to determine the impact of the mother’s change in employment?

  1. Mesosystem
  2. Exosystem
  3. Microsystem
  4. Macrosystem
A
  1. Exosystem

The answer is “Exosystem” because, in Bronfenbrenner’s bioecological systems theory, the exosystem refers to settings that indirectly affect an individual. These are environments that the individual does not directly interact with but still impact their life through relationships with those who are part of that system.

In this case, a mother’s change in employment (work environment) would belong to the exosystem because:
• The child (or other family members) does not directly interact with the mother’s workplace.
• However, changes in her job (e.g., schedule, income, stress levels) indirectly impact the child and family dynamics.

This contrasts with other systems:
• Microsystem: Direct environments the individual interacts with (e.g., family, school).
• Mesosystem: Interconnections between microsystems (e.g., parent-teacher relationships).
• Macrosystem: Cultural or societal contexts that influence all other systems.

Thus, the exosystem is the correct choice because it captures how external, indirect systems influence the family unit.

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15
Q

The nurse reviews the bioecological system theory before discussing this approach with a group of new graduate nurses. What should the nurse explain as the blueprint for the ecology of human and family development?

  1. There is no one system that can serve as a blueprint.
  2. Macrosystems contain mesosystems and exosystems.
  3. The microsystem sets the stage for all future development.
  4. Sociohistorical conditions determine developmental progress
A
  1. Macrosystems contain mesosystems and exosystems.

The correct answer, “Macrosystems contain mesosystems and exosystems”, reflects the hierarchical structure of Bronfenbrenner’s bioecological systems theory.

Explanation of Systems:
1. Macrosystem:
• This is the overarching layer that includes cultural values, laws, customs, and societal norms that influence the other systems.
• The macrosystem acts as the “blueprint” because it shapes the mesosystem, exosystem, and microsystem, providing the context in which development occurs.
2. Mesosystem:
• Refers to the interactions between microsystems (e.g., parent-teacher communication, relationships between home and school).
• It connects individual systems to create a larger developmental context.
3. Exosystem:
• Includes external environments that indirectly affect the individual, such as a parent’s workplace or social policies.
4. Microsystem:
• The immediate environment where direct interactions occur (e.g., family, peers, school).

Why the Answer is Correct:

The macrosystem encompasses and influences the mesosystem and exosystem because it provides the broader societal context. For example:
• A society’s cultural emphasis on work-life balance (macrosystem) influences parental workplace policies (exosystem), which then impacts family dynamics (mesosystem).

Thus, the macrosystem serves as the “blueprint” for understanding the ecological relationships of human and family development.

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16
Q

The nurse notes that the community health clinic has added a section for “family” on the assessment form. Which definition is most likely being used for “family”?

  1. Biologically related members
  2. Anyone who lives in the same residence
  3. Anyone who the client says is the family
  4. Two or more people living together who are related by birth, marriage, or adoption
A
  1. Two or more people living together who are related by birth, marriage, or adoption
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17
Q

The nurse works in an environment in which a family therapy theory serves as the model for assessing and planning care. Which data should the nurse expect when assessing the family?

  1. Pathology
  2. Health problem
  3. Illness treatment
  4. Normal trajectory
A
  1. Pathology

The correct answer, “Pathology”, is based on the use of family therapy theory as the model for assessing and planning care.

Explanation:
• Family therapy theory focuses on understanding family functioning, relationships, and dysfunctions that may contribute to or exacerbate health issues.
• Pathology refers to identifying the root causes of dysfunctions or problems within the family system, such as communication breakdowns, unresolved conflict, or systemic stressors.

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18
Q

The nurse provides care in the women and children’s shelter twice a week. What characteristic of the child should the nurse consider when providing care?

  1. Educationally equal to children living in a permanent home
  2. Educationally inferior to children living in a permanent home
  3. Emotionally advanced over children living in a permanent home
  4. Emotionally inferior to children living in a permanent home
A
  1. Educationally inferior to children living in a permanent home

The correct answer, “Educationally inferior to children living in a permanent home”, is grounded in the understanding of how unstable living environments, such as shelters, impact a child’s development.

Reasons for Educational Inferiority:
1. Lack of Stability:
• Children in shelters often experience frequent moves and disruptions, leading to inconsistent school attendance and educational gaps.
2. Limited Resources:
• Shelters may lack access to books, technology, or quiet study spaces that children in permanent homes typically have.
3. Stress and Trauma:
• Homelessness or living in shelters can result in emotional stress, which may impair concentration, memory, and overall academic performance.
4. Missed Opportunities:
• Instability may limit access to enrichment programs, extracurricular activities, and adequate educational support.

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19
Q

The nurse prepares a presentation on health disparities for the city council. What should the nurse identify as the social determinant contributing to health disparities?

  1. Poverty
  2. Housing
  3. Education
  4. Food security
A
  1. Poverty

Why Not the Other Options?
• Housing: While critical, housing issues often stem from poverty.
• Education: Lower educational attainment is often a consequence of poverty.
• Food Security: Food insecurity is directly tied to financial instability caused by poverty.

In summary, poverty is the most fundamental social determinant contributing to health disparities, as it drives inequities in housing, education, and food security.

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20
Q

The nurse learns that a client with a chronic health problem has not been taking medication as prescribed. Which social issue should the nurse consider as a potential reason for this client’s nonadherence to treatment?

  1. Racism
  2. Isolation
  3. Health literacy
  4. Social exclusion
A
  1. Health literacy
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21
Q

The nurse understands that which of the following is not a level of racism according to Jones’s Three Levels of Racism Theory?

  1. Institutional racism
  2. Personally remediated racism
  3. Family racism
  4. Internalized racism
A
  1. Family racism

The correct answer, “Family racism,” is not one of the levels of racism identified in Camara Phyllis Jones’s Three Levels of Racism Theory.

The Three Levels of Racism:
1. Institutional Racism:
• Refers to discriminatory practices and policies within organizations and institutions (e.g., healthcare, education, criminal justice) that create systemic inequities.
2. Personally Mediated Racism:
• This involves interpersonal acts of discrimination or prejudice, such as stereotyping, disrespect, and unfair treatment based on race.
3. Internalized Racism:
• Occurs when individuals from marginalized racial groups internalize negative messages or stereotypes about their own abilities and worth.

Why “Family Racism” is Incorrect:
• Jones’s theory does not include “family racism” as a distinct level.
• While family environments can influence beliefs and behaviors about race, they fall under personally mediated or internalized racism, depending on the context.

In summary, the levels focus on systemic, interpersonal, and internalized experiences of racism, and “family racism” is not part of this framework.

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22
Q

A nursing student is asking why it is important to apply the use of theoretical models, such as Jones’s Three Levels of Racism Theory and Bronfenbrenner’s Ecological Systems Theory, to policies. Which response by the nursing instructor is not accurate when addressing the student’s question?

  1. “Theories such as these improve our understanding of health care.”
  2. “Theories such as these emphasize the importance of recognizing environmental impact on health.”
  3. “Theories such as these improve our treatment and promotion of health care.”
  4. “Theories such as these will eradicate all health disparities.”
A
  1. “Theories such as these will eradicate all health disparities.”
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23
Q

The nurse prepares to assess a family which includes several members with chronic health problems. Which definition of assessment will the nurse use when meeting with this family?

  1. The use of an instrument to quantify a particular family attribute
  2. The use of a tool to collect family information within 15 minutes
  3. The collection of subjective and objective data that begins upon first contact with the family
  4. The process of assigning numbers or symbols to variables to assist nurses in measuring family member characteristics
A
  1. The collection of subjective and objective data that begins upon first contact with the family
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24
Q

The nurse plans to use a family genogram during a family assessment. What assessment information does this tool provide?

  1. Tension between family members
  2. Multigenerational patterns and health conditions
  3. Communication patterns among family members
  4. Relationships between family members and the community
A
  1. Multigenerational patterns and health conditions

Why Not the Other Options?
1. Tension between family members:
• While genograms can reflect strained relationships, identifying tension specifically requires other tools like communication assessments.
2. Communication patterns:
• A genogram does not focus on the flow of communication but rather on structure and history.
3. Relationships with the community:
• Genograms focus on internal family systems, not external community ties.

Summary:

The family genogram primarily reveals multigenerational patterns and health conditions, making it a powerful tool for identifying hereditary risks and understanding family health trends.

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25
The nurse meets with a family to complete a genogram. How many generations should the nurse ask the family members about? 1. One 2. Two 3. Three 4. Four
3. Three
26
The nurse begins to assess a family. What best describes the family story? 1. The analysis of outcomes 2. The gathering of data from a variety of sources to see the whole picture of the family experience 3. The process of establishing intervention plans 4. The clustering of data into meaningful groups, identifying pertinent relationships between variables
2. The gathering of data from a variety of sources to see the whole picture of the family experience Why Not the Other Options? 1. The analysis of outcomes: This focuses on evaluating results, which comes after gathering the data. 2. The process of establishing intervention plans: While important, this step occurs after understanding the family story. 3. Clustering of data into meaningful groups: This refers more to analytical processes like identifying patterns or trends rather than understanding the holistic family.
27
The nurse refers to the Family Reasoning Web when caring for a family. What is the purpose of this tool? 1. Diagrams family members across three generations 2. Diagrams relationships within and external to the immediate family 3. Provides comprehensive data about family structure, development, and function 4. Organizes data into family categories
4. Organizes data into family categories
28
The nurse prepares to use the Family Assessment and Intervention Model when assessing a family. What is this model based on? 1. Orem’s Self-Care Theory 2. Neuman Systems Model of Health Care 3. Rogers’ Theory of Unitary Human Beings 4. Bronfenbrenner’s Bioecological Systems Theory
2. Neuman Systems Model of Health Care
29
The nurse reviews the Calgary Family Assessment Model (CFAM). What does this model blend? 1. Nursing and family therapy 2. Medicine and nursing 3. Nursing and social work 4. Nursing and ecology
1. Nursing and family therapy
30
The nurse is working with a new graduate nurse about the importance of health literacy when working with families. Which statement by the new graduate nurse requires further education by the nurse? 1. “I understand that the concept of health literacy includes comprehension of medical words.” 2. “I understand that the concept of health literacy includes the ability to follow medical instructions.” 3. “I understand that the concept of health literacy includes the understanding of the consequences when instructions are not followed.” 4. “I understand that the concept of health literacy has no direct impact on health outcomes.”
4. “I understand that the concept of health literacy has no direct impact on health outcomes.”
31
The nurse understands that which of the following is not considered an important aspect of setting up and organizing family appointments? 1. Apologizing for the meeting 2. Stating the purpose of the meeting 3. Providing factual details 4. Confirming the date, time, place, and directions of the meeting
1. Apologizing for the meeting
32
Family health promotion is not merely techniques and behavioral objectives. Which description of family health promotion is the best fit for the nurse’s role? 1. It is an approach to supporting the family to plan for a healthy retirement and a dignified death. 2. It is a way of thinking and acting to strengthen the quality of family life and the health of the family members. 3. It is an approach to family teaching that helps them identify a location to live where health resources are readily available. 4. It is a way of thinking that integrates spiritual well-being into the overall health of the family.
2. It is a way of thinking and acting to strengthen the quality of family life and the health of the family members. The correct answer is “2. It is a way of thinking and acting to strengthen the quality of family life and the health of the family members” because it provides the broadest and most comprehensive description of family health promotion. It reflects the nurse’s role in promoting holistic well-being for the entire family unit. Why Not Option 4? While “4. Integrates spiritual well-being into the overall health of the family” is important, it focuses solely on spiritual health. Spiritual well-being is only one dimension of health promotion, alongside physical, emotional, social, and mental health. Family health promotion requires an inclusive and multifaceted approach to improve overall family quality of life. Key Differences: • Option 2 encompasses all aspects of health promotion: • Physical, emotional, mental, and social well-being. • Enhances family functioning and quality of life through active interventions and strategies. • Option 4 is narrower in focus: • While spiritual well-being is significant, it does not fully address the other components of family health that nurses promote. Summary: Option 2 is the best fit for the nurse’s role in family health promotion because it emphasizes a holistic, inclusive approach to strengthening family health and life quality, aligning more closely with the goals of comprehensive nursing care. Option 4 is important but lacks the scope to address all health promotion dimensions.
32
A holistic definition of family health encompasses all aspects of family life. Choose the best description for what the definition includes. 1. Knowledge of social determinants of health 2. Immediate family and extended family 3. Family interactions and health care functions 4. Access to primary care and hospital coverage
3. Family interactions and health care functions
33
Empowering nursing practice is concerned with uplifting humanity, without bias, judgment, or blame. Which statement made by a nurse would not fit this definition? 1. “Let’s work together to find a solution to this problem.” 2. “Let’s talk about setting a goal for the health of your family that you feel is a priority.” 3. “I have noticed some things about how you communicate in your family. I appreciate how kind and accepting you are with each other.” 4. “It seems obvious that your children use tobacco products because they see you using them.”
4. “It seems obvious that your children use tobacco products because they see you using them.”
34
Home visiting done by nurses in the community has been associated with positive outcomes when working with families to promote their health. Which of the following is not a routine home visit intervention for working with families on maternal-child health? 1. Promoting baby and toddler development 2. Annual gynecological screening 3. Self-care and stress management for mothers 4. Family planning and parenting support 5. Reduction of child exposure to toxic stress and trauma
2. Annual gynecological screening
35
When working with Indigenous families and understanding the impact of structural and social factors, what health equity perspective should the nurse keep in mind? 1. The nurse should prioritize setting goals for the family for health promotion and disease prevention. 2. The family will demonstrate actions that prioritize their spiritual health over physical health. 3. The nurse should prioritize learning from them directly to understand their health needs and experiences. 4. The nurse should ask the family to discuss their experiences with trauma and adversity.
3. The nurse should prioritize learning from them directly to understand their health needs and experiences.
36
The nurse seeks to develop their advocacy skills for promoting the health of children and youth who self-identify as LGBTQ+. Which topic is the highest priority for increasing the nurse’s knowledge? 1. Understanding the effects of intersecting stigma and discrimination on the family 2. Understanding the experience of bullying and victimization that may be occurring at school 3. Understanding the risks for youth who are rejected by their families (e.g., homelessness) 4. Understanding the risks for youth related to social isolation and mental health challenges 5. All are critical to understand for nurses advocating on behalf of this vulnerable group
5. All are critical to understand for nurses advocating on behalf of this vulnerable group
37
The nurse desires to improve competency when caring for families within the LGBTQ+ community. Which first step should the nurse take to improve this competency? 1. Learn the relevant language. 2. Evaluate personal background, beliefs, and biases. 3. Build cultural and personal knowledge. 4. Understand the unique disparities of the population.
2. Evaluate personal background, beliefs, and biases.
38
During a family assessment, the nurse learns that one parent is heterosexual, and the other family member is bisexual of the opposite sex. How should the nurse document this family structure? 1. Blended family 2. Family of choice 3. Mixed-orientation 4. Live Apart Together
3. Mixed-orientation
39
A school nurse working at a middle school recognizes that several students identify as LGBTQ+. Which of the following should the school nurse keep in mind when assessing these students? 1. Later onset of puberty 2. Greater popularity among student peers 3. Earlier sexual activity 4. Greater risk of teen pregnancy
4. Greater risk of teen pregnancy The correct answer, “Greater risk of teen pregnancy,” highlights a specific health concern that is relevant when assessing LGBTQ+ students, particularly in a school setting. Why is this the case? • Lack of Comprehensive Education: Many LGBTQ+ youth may not receive inclusive or accurate sexual health education. Heteronormative curricula often leave out LGBTQ+ perspectives, which can result in misconceptions or risky sexual behaviors. • Exploratory Behaviors and Risks: LGBTQ+ youth may engage in sexual exploration without proper guidance or access to resources, increasing the risk of unintended pregnancy. • Peer Pressure and Stigma: Social pressures, rejection, or stigma can influence risky sexual behavior as a means of seeking acceptance, validation, or coping. • Bisexual and Pansexual Youth: Youth who identify as bisexual, pansexual, or questioning may have relationships with partners of different genders, which increases the potential for teen pregnancy. Why Not the Other Options? 1. Later onset of puberty: Sexual orientation or gender identity does not significantly influence the timing of puberty. 2. Greater popularity among peers: LGBTQ+ youth often face bullying, stigma, or exclusion rather than increased popularity. 3. Earlier sexual activity: While LGBTQ+ youth may engage in sexual activity, evidence does not strongly indicate earlier onset compared to heterosexual peers. Summary: LGBTQ+ students may be at a greater risk of teen pregnancy due to inadequate sexual education, stigma, or exploratory behaviors. School nurses play a critical role in providing inclusive education, resources, and support to mitigate this risk.
40
The nurse notes that a transgender man has elevated liver enzymes and poor bone density. What should the nurse consider as a reason for these findings? 1. Poor calcium intake 2. High intake of alcohol 3. Masculinizing hormone therapy 4. Chronic use of tobacco and substances
3. Masculinizing hormone therapy
41
During a health assessment a middle-aged gay man asks the nurse not to document his sexual preference because his primary health care provider is not aware. What should this request indicate to the nurse? 1. Fear of not receiving required care 2. Fear of having to pay more for care 4. Fear of not having anyone to help as aging occurs 3. Fear that family members will be discriminated against
1. Fear of not receiving required care
42
. A nurse is presenting information to their unit regarding the use of pronouns. Which statement by the nurse would require further education? 1. “People use the pronouns that fit their identify.” 2. “The correct pronoun is always discernible from how the person chooses to express their gender.” 3. “Misgendering is considered a microaggression that can stigmatize and erode trust.” 4. “It is critical to simply ask people what pronouns they want used if you are unclear.”
2. “The correct pronoun is always discernible from how the person chooses to express their gender.”
43
The nurse is providing care for a family who has an intersex child. Which action by the nurse would require an intervention? 1. Respecting the privacy of the patient and their family by avoiding disclosure of intersex status to members outside of the care team. 2. Suggesting that the parents delay filing the birth certificate or selecting a name until they feel ready. 3. Maintaining empathy and engaging in active listening. 4. Providing information to the family prior to their readiness.
4. Providing information to the family prior to their readiness.
44
The nurse is working with an adolescent individual who is undergoing the process of coming out as transgender. The nurse understands that which of the following would be the final stage in this process? 1. Surgical affirmation 2. Social affirmation 3. Medical affirmation 4. Legal affirmation
1. Surgical affirmation
45
During a family conference, the nurse practitioner is leading a discussion with a family, which includes a 15-year-old adolescent who often “forgets” to check his morning blood glucose levels. Which questions would be the most appropriate for the nurse to ask? 1. Why would a person neglect his body? 2. Can I tell you about the dangers of high blood glucose levels? 3. Do you think forgetting to check the blood glucose is a way of acting out? 4. I understand that you are all concerned with checking blood sugars. Is that right?
4. I understand that you are all concerned with checking blood sugars. Is that right?
46
When planning interventions for a family with rheumatoid arthritis, it is essential that the nurse include which family member in the discussions regarding treatment options? 1. The child with the illness 2. The father as the breadwinner 3. The mother as the primary caregiver 4. All family members who are available
4. All family members who are available
47
According to Knafl and colleagues’ theory of normalization, families including a child with a chronic illness must perform which action to adopt a “normalcy lens”? 1. Actively deny aspects of the illness that are unpleasant or burdensome. 2. Focus attention equally on “normal” siblings and the child with the chronic illness. 3. Recognize the ongoing processes of actively adapting to the child’s evolving physical, emotional, and social needs and establishing new family routines. 4. Advocate for the child to ensure that he or she is mainstreamed, because doing so provides the best hope for the child’s development.
3. Recognize the ongoing processes of actively adapting to the child’s evolving physical, emotional, and social needs and establishing new family routines.
48
The nurse notes that a family with a child newly diagnosed with a chronic illness has no experience with the disease. Therefore, required routines and family life are disorganized. Which need is this family experiencing? 1. Re-education 2. Redefinition 3. Remediation 4. Realignment
1. Re-education
49
The parents of a child with muscular dystrophy have a negative view of the child’s future and feel hopeless about future care needs. Which view of the child is the family demonstrating? 1. Thriving 2. Enduring 3. Floundering 4. Accommodating
3. Floundering The correct answer, “Floundering,” describes a family’s negative and overwhelmed perspective regarding their child’s condition and future care needs. Why Floundering? • Families who are floundering are often unable to adapt or cope effectively with the child’s condition. • They feel hopeless, overwhelmed, or pessimistic, and this results in emotional distress, indecision, or difficulty managing care. • In this scenario, the parents’ negative outlook and feelings of hopelessness about the child’s future align with this concept. Why Not the Other Options? 1. Thriving: • Families who are thriving demonstrate resilience, hope, and positive adaptation to the child’s condition. • This is the opposite of floundering. 2. Enduring: • Enduring families may feel strained or challenged but are managing to maintain stability without completely falling apart. • They endure hardship without succumbing to overwhelming negativity. 3. Accommodating: • Families in this stage have adjusted to the child’s condition and have integrated the care needs into their daily life. Summary: The term floundering best captures the family’s negative outlook and sense of hopelessness about their child’s future care needs. It reflects a family struggling to cope emotionally and practically with their situation.
50
A mother of a child with asthma is confident about her ability to manage the child’s care. The father is not as confident about his abilities to manage the child’s asthma. Which view of the child is the mother demonstrating? 1. Accommodating 2. Floundering 3. Struggling 4. Thriving
1. Accommodating
51
The nurse understands that which of the following would not be part of the contextual aspect when addressing the social construction of family health? 1. Family members 2. Community content 3. Member traits 4. Routine meetings
4. Routine meetings
52
The nurse is conducting an information session regarding factors that affect self-management of care. Which statement by the nurse would have to be addressed as not being factual? 1. “Personal/lifestyle characteristics have an impact on self-management of care.” 2. “Resources have an impact on self-management of care.” 3. “Gender has an impact on self-management of care.” 4. “Environmental characteristics have an impact on self-management of care.”
3. “Gender has an impact on self-management of care.”
53
The family of a client with a terminal illness hesitates to agree to palliative care because of not wanting to give up on a possible cure. How should the nurse respond while also including a principle of palliative care? 1. “Most people don’t realize that palliative care means there is no cure.” 2. “There will not be another opportunity if palliative care is refused now.” 3. “The client can continue to receive treatment intended to cure the disease.” 4. “Palliative care and curative treatments cannot be provided at the same time.”
3. “The client can continue to receive treatment intended to cure the disease.”
54
The family of a client receiving palliative care for a terminal illness hesitate to call for the nurse because all staff seem to be too busy to address the client’s needs. Which action should the nurse take to improve the connection with the family? 1. Vary the number and type of caregivers who respond to the client’s needs. 2. Enter the room and stand or sit at the bedside to talk with the client and family. 3. Provide the family with reading material that explains the role of palliative care. 4. Attend to infusions and environmental issues while talking with the client and family.
2. Enter the room and stand or sit at the bedside to talk with the client and family.
54
The spouse of a client nearing death is concerned because the client’s breathing is “so noisy.” How should the nurse refer to the client’s respiratory status when talking with the spouse? 1. Pneumonia 2. Congestion 3. Death rattle 4. Fluid in the lungs
2. Congestion
55
The family of a client nearing end of life asks if they can leave to get dinner. Which client observation causes the nurse to suggest that the family wait a while longer before leaving the client? 1. Cheyne-Stokes respiration pattern 2. Apneic periods of 15 to 30 seconds 3. Shallow respirations at 30 per minute 4. Use of neck and shoulder muscles to breathe
2. Apneic periods of 15 to 30 seconds
56
A client assigned to a student nurse for care dies shortly after the student completes morning care. What should the nurse do to support the student at this time? 1. Suggest that the student leave the clinical area. 2. Encourage the student to participate in post-mortem care. 3. Talk with the student about the experience and answer any questions. 4. Assign the student to another client for the remainder of the clinical day.
3. Talk with the student about the experience and answer any questions.
57
The nurse understands that which of the following provides Canadian residents with public, accessible, universal, comprehensive, and portable health care? 1. Canada Health Act 2. Affordable Care Act 3. Canada Institute for Health Information 4. Organization for Economic Co-operation and Development
1. Canada Health Act
58
A Canadian nurse is preparing a presentation to colleagues regarding racism’s effect on health. Which of the following statements by the nurse requires more education regarding the impact of discrimination based on race? 1. “Racism and discrimination have been linked to hypertension and other chronic diseases.” 2. “Racism and discrimination have not had an impact on health outcomes in Canada.” 3. “Racism and discrimination have been linked to mental health problems.” 4. “Racism and discrimination have been linked to complications among childbearing people.”
2. “Racism and discrimination have not had an impact on health outcomes in Canada.”
59
A nurse is working with a family and wants to acknowledge the family’s religious beliefs to maximize responsive nursing care. Which of the following would not be appropriate at this time? 1. The nurse should learn the family’s expectations regarding incorporating their religious beliefs into the care they will receive. 2. The nurse should share their own religious beliefs with the family in order to find common ground. 3. The nurse should follow the lead of the family regarding their religious beliefs, as the nurse cannot be knowledgeable about all religions. 4. The nurse should ask the family about their religious affiliations and how their beliefs affect their values and beliefs about healing
2. The nurse should share their own religious beliefs with the family in order to find common ground.
60
The nurse provides care to a client who is experiencing an acute illness. What information about family-centered care should the nurse keep in mind when planning this client’s care? 1. Visiting hours should be strictly enforced. 2. Care conferences serve little purpose. 3. Families influence client recovery. 4. Discharge planning begins when the client stabilizes.
3. Families influence client recovery.
60
What should the nurse consider when determining the degree of family involvement in discharge planning? 1. Current advance directive for the client 2. Family’s education and information needs 3. A family letter stating expectations for discharge 4. Legal advice provided by an attorney during the discharge meeting
2. Family’s education and information needs
61
How should the nurse categorize a family who is willing to discuss withdrawal of treatment, has good communication with other family members, uses facts and family wishes to make decisions, and is able to identify a time and date to withdraw treatment? 1. Struggling 2. Progressing 3. Maintaining 4. Accommodating
2. Progressing
62
For which reason might a nurse experience role ambiguity when caring for a critically ill client and the family? 1. Deciding whether to eliminate the family’s worries or provide emotional support 2. Weighing the biomedical technical model of care against the holistic nursing model of care 3. Asking to withhold information from the health care provider until test results are confirmed 4. Balancing the professional relationship and the more personal relationship the family seeks with the nurse
1. Deciding whether to eliminate the family’s worries or provide emotional support Why Not the Other Options? 2. Weighing the biomedical model vs. holistic care: This represents a philosophical challenge but not necessarily role ambiguity. 3. Withholding information: While this raises ethical concerns, it does not align with role ambiguity—it is more about decision-making and patient rights. 4. Balancing relationships: This is a boundary issue, which is related but does not fully capture the ambiguity between eliminating worries and providing emotional support.
62
What type of communication from nurses do families find the most helpful? 1. Brief 2. Honest 3. Vague 4. Limited
2. Honest
63
What research information should the nurse manager use as evidence to increase the amount of family involvement in the care of a hospitalized client? 1. Increases the cost of care 2. Causes poor outcomes 3. Increases family stress 4. Improves outcomes
4. Improves outcomes
64
The nurse notes that a client has an advance directive stating that no cardiopulmonary resuscitation (CPR) should be performed if the heart stops. Which type of prescription should the nurse expect to be placed on this client’s medical record? 1. All but CPR 2. Do not resuscitate (DNR) 3. Comfort measures only 4. No extraordinary measures
2. Do not resuscitate (DNR)
65
What age group should the nurse identify as the fastest growing group of older adults in the United States? 1. 55 to 65 years 2. 65 to 75 years 3. 75 to 85 years 4. Older than 85 years
4. Older than 85 years
66
The nurse notes that a large number of older clients are living longer. What could be the reason for this? 1. Decreased birth rates 2. Increased family care of older adults by family members 3. Improved social and community support systems 4. Overhospitalization and prescription drug use
4. Overhospitalization and prescription drug use
67
Changes result in stress. Which type of change is found to be the most stressful for an older adult? 1. Normative 2. Nonnormative 3. Normative and nonnormative 4. Neither normative nor nonnormative
2. Nonnormative
68
The nurse suspects that a family is experiencing ambivalence. To what does this term refer in the family? 1. The ability to avoid stress over time 2. Conflicting emotions regarding relationships with older adults 3. The level of harmony with extended family members over time 4. Maintaining a stable level of balance in the midst of changes
2. Conflicting emotions regarding relationships with older adults
69
The nurse learns that a grandparent will be the guardian of a grandchild. Which relationship is the strongest predictor of the grandparent–grandchild relationship? 1. Father and child 2. Mother and father 3. Father and grandparent 4. Mother and grandparent
4. Mother and grandparent
70
A frail older client does not have children. What should the nurse consider when planning this client’s care? 1. Depend on formal services for assistance 2. Rely on friends and extended family for care 3. Consider admission to a long-term care facility 4. Identify an agency that provides care 24/7 in the home
1. Depend on formal services for assistance
71
The nurse completes an instrumental activity of daily living (IADL) with an older client. Which activity will this assessment include? 1. Bathing 2. Hygiene 3. Shopping 4. Toileting
3. Shopping
72
Which approach describes a growing trend in the care of individuals with a mental health condition? 1. Use of family members as caregivers 2. Implementation of wraparound services in all communities 3. Practice of multigenerational assessments in all settings 4. Decreased use of psychotropic medications in the treatment
1. Use of family members as caregivers
73
The nurse learns that a client with a mental health condition has an 8-year-old child. What action should the nurse take? 1. Arrange for another family member to care for the child. 2. Complete a family-centered assessment of the child’s needs. 3. Discuss placing the client in a treatment center to protect the child. 4. Identify medication that might enable the child to be more helpful to the client.
2. Complete a family-centered assessment of the child’s needs.
74
The nurse is leading a presentation on the topic of guiding principles of the Recovery Model to assist families when a mental health condition is diagnosed within the family unit. Which statement by the nurse is not appropriate when addressing the guiding principles? 1. “Discussing hope is important as a guiding principle.” 2. “Providing a holistic approach is important as a guiding principle.” 3. “Addressing trauma experienced within the family is important as a guiding principle.” 4. “Informing the family that there is only one pathway is important as a guiding principle.”
4. “Informing the family that there is only one pathway is important as a guiding principle.”
75
A new graduate nurse is working with a nurse who is using the Tidal Model when meeting with a family. Which of the following approaches would the new graduate nurse understand is not accurate regarding the Tidal Model? 1. The nurse values the voice of the family members. 2. The nurse provides their time when working with the family members. 3. The nurse reveals personal wisdom when working with the family members. 4. The nurse understands the importance of keeping some information from the family members.
4. The nurse understands the importance of keeping some information from the family members.
76
It is important for nurses to understand the impact that social determinants of health have on the families they work with. This is a foundation of population health. Which list includes the best examples of social determinants of health (SDOHs)? 1. Age, marital status, and job 2. Income, history of incarceration, and vaccination status 3. Issues of violence, homelessness, and unemployment 4. Number of siblings, sexual orientation, and family history
3. Issues of violence, homelessness, and unemployment
77
The nurse prepares material to share during a community health fair. Which definition of community should the nurse keep in mind while preparing this material? 1. A group of vulnerable people 2. A group of people with the same illness 3. A group of people with similar characteristics 4. A group of people living in the same environment
3. A group of people with similar characteristics
78
The nurse prepares health promotion activities for a family. Which statement best describes the nurse’s purpose for planning activities for this family? 1. To teach the family to resolve conflicts 2. To improve or maintain the well-being of family members 3. To help the family identify strengths and trust personal decisions 4. To protect family members from diseases and the outcomes of these illnesses
2. To improve or maintain the well-being of family members
79
The nurse compares the Ottawa Charter for Health Promotion with the Population Health Promotion Model. Which is a major difference between these two approaches to population care? 1. The Ottawa Charter focuses on social issues. 2. The Ottawa Charter uses determinants of health as a key assumption. 3. The Population Health Promotion Model focuses on issues that place a population at risk. 4. The Population Health Promotion Model uses strategies for families to improve their health.
3. The Population Health Promotion Model focuses on issues that place a population at risk. The correct answer, “The Population Health Promotion Model focuses on issues that place a population at risk,” highlights a key distinction between the Ottawa Charter for Health Promotion and the Population Health Promotion Model (PHPM). Ottawa Charter for Health Promotion: • Developed in 1986, it focuses on empowering individuals and communities to improve their health by addressing social determinants and creating supportive environments. • Key principles include: • Building healthy public policy • Creating supportive environments • Strengthening community action • Developing personal skills • Reorienting health services • It views health determinants holistically, considering factors like social, economic, and physical environments. Population Health Promotion Model (PHPM): • The PHPM focuses on specific populations and identifies issues that place them at risk for poor health outcomes. • It integrates: 1. Determinants of health: Key factors such as income, education, and environment that influence health. 2. Levels of intervention: Actions at individual, family, community, and system levels. 3. Health promotion strategies: A focus on prevention and health equity to reduce disparities within populations. • The PHPM emphasizes risk-focused interventions that target vulnerable populations. Key Differences: 1. Ottawa Charter: • Broader focus on social determinants of health and community empowerment. • Strategies target overall health improvement and health promotion. 2. PHPM: • Specifically identifies and addresses populations at risk. • Emphasizes targeted risk reduction and equity-focused interventions. Summary: The Ottawa Charter takes a holistic approach to promoting health and addressing social determinants, while the PHPM focuses on identifying populations at risk and implementing targeted strategies to mitigate risks and health inequities. Both models work together to guide health promotion but differ in their focus and approach.
80
The nurse provides care to people within an urban community. What should be established for interventions to be successful? 1. The nurse–client relationship 2. Payment for services provided 3. Times when the nurse is available 4. Frequency of visits to the families
1. The nurse–client relationship
81
1. What is the primary goal of family assessment therapy? a. To assign blame for family issues b. To understand family dynamics and needs c. To promote individual therapy within the family d. To validate the therapist’s assumptions
b. To understand family dynamics and needs
82
3. What does a genogram typically include? a. Detailed financial information b. Names and ages of family members c. Favourite foods of family members d. Political affiliations of family members
b. Names and ages of family members
83
1. What is family resilience? a. The ability of a family to withstand natural disasters b. The ability of a family to thrive despite challenges c. The ability of a family to avoid conflict altogether d. The ability of a family to isolate themselves from society
b. The ability of a family to thrive despite challenges
84
Which of the following is an example of a family intervention strategy? a. Ignoring family conflicts and hoping they resolve on their own b. Encouraging open communication and active listening c. Criticizing family members for their behaviour d. Setting rigid rules without discussion
b. Encouraging open communication and active listening
85
1. Why is it important to consider cultural factors in family assessment and intervention? a. To impose the therapist’s cultural beliefs on the family b. To ignore the unique needs and values of the family c. To provide culturally sensitive and effective interventions d. To exclude certain family members from therapy
c. To provide culturally sensitive and effective interventions
86
2. What is a common challenge therapists may face in family assessment and intervention? a. Lack of communication within the family b. Strong family cohesion c. Limited cultural diversity d. Clear boundaries between family members
a. Lack of communication within the family
87
2. How can therapists evaluate the effectiveness of family interventions? a. By assuming the interventions worked without evaluation b. By using standardized assessment tools and ongoing monitoring c. By focusing only on individual outcomes, not family outcomes d. By discontinuing therapy after a few sessions
b. By using standardized assessment tools and ongoing monitoring
88
2. Which ethical consideration is important in family assessment and intervention? a. Respecting autonomy and diversity b. Ignoring informed consent c. Encouraging dual relationships d. Disregarding cultural competence
a. Respecting autonomy and diversity
89
3. What can therapists do to promote long-term positive outcomes in families? a. Focus solely on individual family members b. Ignore family strengths and focus on weakness c. Encourage sustainable coping strategies and resilience-building d. Avoid discussing sensitive topics
c. Encourage sustainable coping strategies and resilience-building
90
1. What is the primary focus of the Calgary Family Assessment Model (CFAM)? a. Individual pathology within the family b. The family as a whole and its interactions c. Medical diagnoses of family members d. External factors affecting the family
b. The family as a whole and its interactions
91
2. Which theoretical framework heavily influenced the development of the CFAM? a. Behaviourism b. Attachment theory c. Psychoanalytic theory d. Systems theory
d. Systems theory
92
3. What does the CFAM emphasize in understanding family functioning? a. Individual traits of family members b. Family strengths and resources c. External influences only d. Past experiences of family members
b. Family strengths and resources
93
1. According to CFAM, what is crucial in assessing family dynamics? a. Family members physical health b. Communication patterns and interactional processes c. Family members personal goals d. Financial stability of the family
b. Communication patterns and interactional processes
94
2. Which component is part of the Calgary Family Intervention Model (CFIM)? a. Assigning blame for family issues b. Ignoring family strengths c. Enhancing family communication and problem-solving d. Focusing solely on individual family members
c. Enhancing family communication and problem-solving
95
1. How does CFAM approach understanding conflict? a. By encouraging blame and criticism b. By avoiding conflict resolution c. By promoting open communication and collaborative problem-solving d. By isolating family members
c. By promoting open communication and collaborative problem-solving
96
2. Which of the following is a key assumption of the CFAM? a. Families are static and unchanging b. Family members are always in competition with each other c. Families have unique strengths and resources d. Family problems are solely due to individual family members
c. Families have unique strengths and resources
97
3. What is the primary goal of the CFIM? a. To assign blame for family issues b. To promote individual therapy within the family c. To enhance family functioning and relationships d. To avoid discussing sensitive topics
c. To enhance family functioning and relationships
98
1. Which theoretical perspective does CFAM draw from to understand family dynamics? a. Individual psychology b. Behavioural theory c. Social constructionism and narrative theory d. Psychoanalytic theory
c. Social constructionism and narrative theory
99
1. What role does CFAM assign to the therapist? a. To blame family members for their issues b. To dictate solutions without family input c. To collaborate with the family and facilitate change d. To ignore family dynamics
c. To collaborate with the family and facilitate change
100
1. What does CFAM consider as important in understanding family members experiences? a. Objective facts only b. Eternal opinions about the family c. Each family member’s subjective perspective d. Historical events unrelated to the family
c. Each family member’s subjective perspective
101
1. Which aspect is central to CFAM’s approach to understanding family functioning? a. Individual symptoms of family members b. Family’s cultural background c. Patterns of interaction and communication d. Economic status of the family
c. Patterns of interaction and communication
102
1. What is a core principle of CFIM? a. Ignoring family strengths and resources b. Promoting individual therapy over family therapy c. Collaborative problem-solving and change facilitation d. Avoiding discussions about family dynamics
c. Collaborative problem-solving and change facilitation
103
1. Which concept is central to CFIM’s approach to change? a. Blame and punishment b. Resistance to change c. Collaboration and empowerment d. Isolation of family members
c. Collaboration and empowerment
104
1. According to CFAM, what contributes to family resilience? a. Blaming external factors for family changes b. Avoiding discussions about family problems c. Family’s ability to adapt and utilize strengths d. Ignoring family dynamics
c. Family’s ability to adapt and utilize strengths
105
1. What does CFAM emphasize in terms of family assessment? a. Assigning labels to family members b. Focusing solely on family weaknesses c. Exploring family strengths, resources, and interactions d. Ignoring the family’s cultural background
c. Exploring family strengths, resources, and interactions
106
1. What is the primary goal of the Calgary Family Intervention Model (CFIM)? a. To assign blame for family issues b. To promote individual therapy within the family c. To enhance family functioning and relationships d. To avoid discussing sensitive topics
c. To enhance family functioning and relationships
107
1. Which theoretical framework heavily influenced the development of the CFIM? a. Behaviourism b. Attachment theory c. Systems theory d. Psychoanalytical theory
c. Systems theory
108
1. What is a core principle of the CFIM? a. Ignoring family strengths and resources b. Promoting individual therapy over family therapy c. Collaborative problem-solving and change facilitation d. Avoiding discussions about family dynamics
c. Collaborative problem-solving and change facilitation
109
1. How does CFIM approach conflict resolution within families? a. By avoiding discussions about conflicts b. By encouraging open communication and problem-solving c. By assigning blame to specific family members d. By isolating family members
b. By encouraging open communication and problem-solving
110
1. What role does CFIM assign to the therapist? a. To blame family members for their issues b. To dictate solutions without family input c. To collaborate with the family and facilitate change d. To ignore family dynamics
c. To collaborate with the family and facilitate change
111
1. Which aspect is central to CFIM’s approach to understanding family functioning? a. Individual symptoms of family members b. Family’s cultural background c. Patterns of interaction and communication d. Economic status of the family
c. Patterns of interaction and communication
112
1. What is the emphasis of CFIM interventions? a. Focusing solely on family weaknesses b. Ignoring family strengths and resources c. Utilizing family strengths and enhancing communication d. Promoting individual therapy for family members
c. Utilizing family strengths and enhancing communication
113
1. According to CFIM, what contributes to family resilience? a. Blaming external factors in family challenges b. Avoiding discussions about family problems c. Family’s ability to adapt and utilize strengths d. Ignoring family dynamics
c. Family’s ability to adapt and utilize strengths
114
1. What is the collaborative approach in CFIM? a. Imposing solutions on the family b. Involving family members in decision-making and goal-setting c. Ignoring family input in interventions d. Focusing solely on individual family members
b. Involving family members in decision-making and goal-setting
115
1. Which concept is central to CFIM’s approach to change? a. Blame and punishment b. Resistance to change c. Collaboration and empowerment d. Isolation of family members
c. Collaboration and empowerment
116
1. How does CFIM view family conflicts? a. As unavoidable and unresolvable b. As opportunities for growth and change c. As solely the responsibility of one family member d. As a reason to avoid family interactions
b. As opportunities for growth and change
117
1. What role do family strengths play in CFIM interventions? a. They are ignored in interventions b. They are utilized to promote positive change c. They are blamed for family issues d. They are viewed as irrelevant
b. They are utilized to promote positive change
118
1. Which of the following is a key principle in CFIM? a. Ignoring family needs and goals b. Promoting individual therapy over family interventions c. Collaboration, respect, and empowerment d. Avoiding discussions about family dynamics
c. Collaboration, respect, and empowerment
119
1. What does CFIM emphasize regarding family decision-making? a. Dictating decisions to the family b. Ignoring family input in decision-making c. Involving the family in decision-making process d. Avoiding family decision-making altogether
c. Involving the family in decision-making process

Family Final (1 decks)

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