Test bank for Introduction to Medical Surgical Nursing 4th Edition by Adrianne Dill Linton Chapter 7: The Nurse and the Family MULTIPLE CHOICE 1. The family is an important unit in society primarily because it: 1. offers unconditional love and acceptance. 2. provides emotional support and security. 3. is essential to life and society. 4. promotes cultural values and attitudes. The family is defined as being joined together by bonds of sharing and emotional closeness. PTS: 1 DIF: Cognitive Level: ComprehensionREF: 72 OBJ: 1 TOP: The Family Unit 2. The nurse assesses that the client comes from an extended family because it has: 1. multiple wage earners. 2. three generations living together. 3. children from previous marriages. 4. parents of different ethnic origins. ANS: 3 The extended family consists of relatives of either spouse who live with the nuclear family. PTS: 1 DIF: Cognitive Level: Application REF: 72 OBJ: 2 TOP: Types of Families KEY: Nursing Process Step: Assessment MSC: NCLEX: N/A 3. According to the latest Census Bureau report, most families in the United States are: 1. nontraditional. 2. blended. 3. multigenerational. 4. traditional. Fifty-two percent of families live in a traditional family setting (current Census Bureau report).
PTS: 1 DIF: Cognitive Level: Knowledge REF: 72 OBJ: 2 TOP: Family Settings 4. Children of racial minorities are more likely to live in a family that is: 1. blended. 2. extended. 3. traditional. 4. nontraditional. Current Census Bureau findings indicate that children of racial minorities are twice as likely as white children to live in extended families. PTS: 1 DIF: Cognitive Level: Knowledge REF: 72 OBJ: 2 TOP: Family Settings 5. The nurse is designing a home care plan for a child with a congenital disease and is assessing the family values regarding home care. The nurse will use as her best source: 1. current literature on congenital deformity. 2. general knowledge of the culture. 3. the family itself. 4. written survey. ANS: 3 It is important to determine the family s values, beliefs, customs, and behaviors that influence health needs and health care practice. The best source is the family itself. PTS: 1 DIF: Cognitive Level: ComprehensionREF: 73 OBJ: 2 TOP: Cultural Aspects 6. The nurse counsels a family that during the families with adolescents stage, one of the developmental tasks is to: 1. maintain relationships with the extended family. 2. develop parental roles to meet the needs of children. 3. maintain a satisfying marital relationship. 4. communicate openly between parent and children. The family developmental tasks at this stage include balancing freedom with responsibility, and maintaining communication between parents and children. PTS: 1 DIF: Cognitive Level: ComprehensionREF: 73 OBJ: 3 TOP: Family Life Cycles
7. Because the patients are attending role modification classes, the nurse assesses this family as being at the developmental stage of: 1. beginning families. 2. families with young children. 3. families with adolescents. 4. families in later life. The last stage of the family life cycle includes families in later life who are adjusting to retirement, the aging process, decreased self-esteem, status, and health issues. PTS: 1 DIF: Cognitive Level: ComprehensionREF: 74 OBJ: 3 TOP: Family Life Cycles KEY: Nursing Process Step: Assessment 8. Culture and social class usually set precedent for different roles and responsibilities of each family member. The healthiest family is one in which the: 1. father assumes the role as breadwinner. 2. mother assumes the role as homemaker. 3. father or mother shares the roles of breadwinner and homemaker. 4. roles of breadwinner or homemaker can be shifted as needed. A healthy family is one in which there is opportunity to shift roles easily from time to time. PTS: 1 DIF: Cognitive Level: Analysis REF: 74 TOP: Family Role Structure 9. During a family counseling session, the patient, mother of a 5-year-old son states that I don t understand why my husband continually tries to get our son involved in T-ball. My son said the coach and his dad yelled at him and told him the game was lost because he couldn t catch the ball. As a nurse, you know that to maintain a healthy family unit, one of the most important family interactions is to: 1. maintain open communication among all family members. 2. encourage self-acceptance and self-esteem for all family members. 3. encourage all family members to participate in community events. 4. realize that not all family members may be able to fulfill assigned roles. The most important influence on family interaction is the self-esteem of each member. PTS: 1 DIF: Cognitive Level: Analysis REF: 75 TOP: Family Interaction
10. For the past three evenings, shortly after their arrival in the hospital unit, the parents of a 14-year-old patient begin to argue about the cost of the hospitalization and the time required to come to the hospital. Your patient begins to cry and complain about her abdominal pain. The nurse assesses that the patient is assuming the role of: 1. caretaker. 2. martyr. 3. blocker. 4. scapegoat. A scapegoat usually assumes the role to maintain homeostasis, serving to divert attention from marital conflict between spouses. PTS: 1 DIF: Cognitive Level: Analysis REF: 74-75 TOP: Family Role Structure 11. The patient, a 36-year-old mother of four, is crying. She relates to you that her best friend just told her, You are a good mother and you do everything perfectly, but I don t think you enjoy it. The nurse assesses that the patient has taken the role of: 1. caretaker. 2. martyr. 3. contributor. 4. harmonizer. A martyr sacrifices everything for the sake of the family. PTS: 1 DIF: Cognitive Level: Analysis REF: 74 TOP: Family Role Structure KEY: Nursing Process Step: Assessment 12. The nurse explains that children learn roles during family interaction by the process of: 1. interaction. 2. role playing. 3. observation. 4. rewards. Parents reward children for fulfilling certain roles. PTS: 1 DIF: Cognitive Level: ComprehensionREF: 75 TOP: Family Role Structure 13. The patient confides that her husband shares only the incidental happenings of his day at work as he reads the paper, but he never tells her that he loves her any more. She is beginning to wonder if their marriage is getting stale. The nurse recognizes this communication pattern as: 1. affective.
2. affectional. 3. functional. 4. dysfunctional. One type of dysfunctional communication involves using chitchat about unimportant daily occurrences to avoid discussing meaningful issues or expressing feelings. PTS: 1 DIF: Cognitive Level: Analysis REF: 75 TOP: Functional Communication 14. When discussing the communication patterns of families with the patient, it is important for the nurse to consider the: 1. cultural aspects of the family. 2. age of the family members. 3. role adopted by each family member. 4. number of members in the family. ANS: 1 Although each option has significance, cultural aspects must be considered in determining the functioning level of the family in regard to roles taken. PTS: 1 DIF: Cognitive Level: Analysis REF: 75 TOP: Functional Communication 15. The patient states that her 5-year-old is always running up to relatives and friends and wants to give them a big hug and kiss. The patient asks if her daughter is appropriate in her actions. Based on the concepts of functional communication, the most appropriate reply would be: 1. Your daughter s actions are definitely dysfunctional. 2. Your daughter is just being a little girl and will outgrow being so affectionate. 3. Your daughter is going through a normal developmental phase. 4. Does your mother-in-law show signs of affection toward your daughter? ANS: 3 Physical expression of emotion usually dominates in early childhood and is normal in the developmental pattern. PTS: 1 DIF: Cognitive Level: Application REF: 75 TOP: Functional Communication 16. The nurse reminds the client that functional patterns of communication within the family setting provide a means of: 1. nurturing. 2. information. 3. closeness. 4. openness.
ANS: 1 Functional patterns of communication include emotional and affective communication dealing with the expression of feelings and nurturing. A healthy family is able to demonstrate a wide range of emotions and feelings. PTS: 1 DIF: Cognitive Level: Analysis REF: 75 TOP: Functional Communication 17. The nurse counsels a client that the manner in which a family unit adapts to stress can affect the family s: 1. communication and function. 2. health and function. 3. affective communication. 4. adaptation and function. The manner in which a family handles stress can affect the health of the family. PTS: 1 DIF: Cognitive Level: ComprehensionREF: 76 OBJ: 5 TOP: Stress and Adaptation 18. The patient who was recently diagnosed with cancer tells the nurse that she is so grateful for her children and family, because she does not know what she would do without them. Your patient is exhibiting which of the following coping responses? 1. Internal family 2. External family 3. Family communication 4. Social support ANS: 1 Coping responses of internal family are those that the family relationships use as support. PTS: 1 DIF: Cognitive Level: Application REF: 76 OBJ: 5 TOP: Coping Strategies KEY: Nursing Process Step: Assessment 19. The nurse clarifies that the main role of the nurse when assessing families and their coping strategies is: 1. emotional support and reassurance. 2. information and reassurance. 3. emotional support and referral. 4. elimination of the stressor. Families need information and reassurance.
PTS: 1 DIF: Cognitive Level: Analysis REF: 77 OBJ: 6 TOP: Role of the Nurse 20. The patient who is recovering from a mastectomy relates that she doesn t feel like a woman any more. The best response by the nurse would be: 1. I am sure you will feel differently once you have your prosthetic bra. 2. Have you told your husband how you feel? 3. I will bring you a catalogue that carries built-in prosthetic bras. 4. Would you like me to arrange a visit from Reach for Recovery? Information through organizations can help a patient learn about what to expect, the disease process, and recovery. PTS: 1 DIF: Cognitive Level: Analysis REF: 77 OBJ: 7 TOP: Community Resources MSC: NCLEX: N/A 21. The client states that her mother has just been diagnosed with Alzheimer s disease and that she is devastated and does not know what to do. The nurse suggests that she attend a support group meeting where she can discuss her concerns with others. The patient says that she will call and attend a meeting. The nurse assesses the coping strategy the client is using as: 1. internal family coping by sharing feelings. 2. external family coping by seeking information. 3. external family coping by seeking social support. 4. internal family coping to maintain a cohesive family unit. Coping responses include internal and external family coping. External coping strategies refer to the use of social support systems to solve problems. PTS: 1 DIF: Cognitive Level: Application REF: 76 OBJ: 6 TOP: Coping Strategies 22. When assessing the coping measures of families under stress, the first priority of the nurse should be to: 1. determine the type of coping mechanisms used by the family in the past. 2. consider the relationship of the family members. 3. relieve the anxiety and fear of the family members. 4. determine what stressors the family is currently experiencing. Family coping strategies are actions that families use to respond to stressors. PTS: 1 DIF: Cognitive Level: Application REF: 76 OBJ: 5 TOP: Coping Mechanisms
KEY: Nursing Process Step: Assessment 23. As the nurse is preparing the patient for a colonoscopy, the patient states that she is nervous about the procedure, but that she knows it will help her physician to diagnose her problem. The nurse assesses that this patient is using the coping strategy of: 1. internal family coping by interpreting events in a positive manner. 2. internal family coping by relieving anxiety and tension with humor. 3. external family coping by seeking social support. 4. external family coping by using information as an adjunct to serve. ANS: 1 Coping strategies include interpreting the events in a positive way. PTS: 1 DIF: Cognitive Level: Analysis REF: 76 OBJ: 5 TOP: Coping Strategies KEY: Nursing Process Step: Assessment 24. The current view of the family as a unit would generally best be described as: 1. functioning together to provide security and support to its members. 2. functioning to meet the needs of society and support its members. 3. a unit of two or more that shares common goals and mutual support. 4. a unit of two or more joined together by mutual bonds and identity. Friedman (1997) defined the family as two or more persons joined together by bonds of sharing and emotional closeness and who identify themselves as being part of the family. PTS: 1 DIF: Cognitive Level: ComprehensionREF: 74 OBJ: 1 TOP: Family Role Structure 25. The nurse reminds the client that communication in the family unit involves continual exchange of information and includes: 1. determining the intent of the communication being sent. 2. determining if the communication is functional or dysfunctional. 3. acceptance of individual differences. 4. exclusion of emotional responses. ANS: 3 Clear communication is a way of fostering a nurturing environment. Communication patterns in a functional family demonstrate acceptance of individual differences, openness, honesty, and recognition of needs. PTS: 1 DIF: Cognitive Level: ComprehensionREF: 75 TOP: Family Communication MULTIPLE RESPONSE
1. When the nurse is assessing for functional communication styles in a family, the nurse will be looking for evidence of (select all that apply): 1. openness. 2. subtlety. 3. chit-chat. 4. spontaneity. 5. self disclosure. ANS: 1, 4, 5 Functional communication is open and honest and has no subtlety or superficial chit-chat. PTS: 1 DIF: Cognitive Level: Analysis REF: 75 TOP: Functional Communication KEY: Nursing Process Step: Assessment 2. The nurse makes a client referral to community resource, knowing that such a resource can (select all that apply): 1. provide helpful literature. 2. offer ongoing and consistent assistance. 3. reassure the family that they are not alone. 4. offer a variety of free services. 5. organize a support group. ANS: 1, 2, 3, 5 Community resources can provide assistance, literature, and support in an ongoing and consistent manner, but the services are not always free. PTS: 1 DIF: Cognitive Level: Application REF: 77 OBJ: 7 TOP: Community resources MSC: NCLEX: Safe, Effective Care Environment COMPLETION 1. The nurse congratulates the client for successfully coping with a family crisis. The state of having used coping strategies effectively is classified as. ANS: Mastery PTS: 1 DIF: Cognitive Level: Application REF: 76 OBJ: 5 TOP: Mastery KEY: Nursing Process Step: Evaluation 2. The nurse includes the family in client care to maintain the family s. ANS: Self-esteem PTS: 1 DIF: Cognitive Level: Application REF: 75 OBJ: 5 TOP: Maintenance of Self-Esteem
KEY: Nursing Process Step: Planning