Family Focused Nursing Care 1st Edition By Sharon A. Denham-Test Bank

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Family Focused Nursing Care 1st Edition By Sharon A. Denham-Test Bank

Chapter 2- Innovating Traditional Thinking about Nursing Practice

 

MULTIPLE CHOICE

 

  1. Which of the following is the best reason for a nurse to consider the family as a unit of care?
1. The family is recognized as a unified whole.
2. All family members are treated equally.
3. Family members will receive care from other family members.
4. The ill individual is given the best care possible.

 

 

ANS:  1

 

  Feedback
1 The family as a whole influences the individual family member.
2 Equality of treatment is not necessarily a goal of nursing care.
3 Care provided by family members is situational and not predictable.
4 No guarantee of the best care for the ill individual.

 

 

PTS:   1

KEY:  Content Area: Support systems/Family dynamics | Integrated Process: Communication and Documentation | Client Need: Psychosocial Integrity | Cognitive Level: Application | Question Type: Multiple Choice | Chapter Objective: 3

 

  1. Which of the following is not a domain of the Family Health Model?
1. Structure
2. Interaction
3. Function
4. Context

 

 

ANS:  2

Interaction will occur between family members but is not a domain of model.

 

PTS:   1

KEY:  Content Area: Support systems/Family dynamics | Integrated Process: Nursing Process | Client Need: Psychosocial Integrity | Client Need: Physiological Integrity | Cognitive Level: Knowledge | Question Type: Multiple Choice | Chapter Objective: 4

 

  1. Which of the following statements describe the new patient/health-care consumer role?
  2. Provide only the information asked for by the provider
  3. Obtain information from a variety of sources
  4. Engage in self-management of care
  5. Assume providers will understand their needs
1. b only
2. b and c
3. a, b and c
4. All of the above.

 

 

ANS:  2

 

  Feedback
1 Not the only descriptor of the new patient/consumer listed.
2 Both b and c describe the new patient/consumer.
3 Providing minimal information will not assist with problem solving.
4 Includes incorrect descriptors of patient/consumer.

 

 

PTS:   1

KEY:  Content Area: Health and Wellness | Integrated Process: Caring | Client Need: Health Promotion and Maintenance | Cognitive Level: Knowledge | Question Type: Multiple Choice | Chapter Objective: 2

 

  1. Which of the following statements is most accurate concerning thinking family? A nurse who is thinking family:
1. Recognizes only the family members who are present with the ill family member.
2. Realizes that all persons receiving nursing care are interdependent with family members.
3. Only considers the point of view of the ill family member.
4. Believes that including the family will improve patient care.

 

 

ANS:  2

 

  Feedback
1 Family is family no matter where members reside.
2 Interdependence is a characteristic of a functioning family.
3 Family members have opinions that will influence health and illness.
4 There is no guarantee that including family will improve care.

 

 

PTS:   1

KEY:  Content Area: Family Dynamics | Integrated Process: Nursing Process | Client Need: Safe and Effective Care | Cognitive Level: Comprehension | Question Type: Multiple Choice | Chapter Objective: 1

 

MULTIPLE RESPONSE

 

  1. The Institute for Patient- and Family-Centered Care proposes which of the following desired changes in the way health care is provided to individuals and their families? Select all that apply. Each health encounter should:
1. Include all family members.
2. Enhance individual and family strengths.
3. Build the confidence and competence of family members.
4. Discourage care giving by family members.

 

 

ANS:  2, 3

Rationale:

  1. Family members cannot always be present but can still be involved.
  2. This will assist family members with health maintenance and promotion.
  3. May lead to behaviors that promote and maintain health.
  4. Care giving by family members is often necessary and desired.

 

PTS:   1

KEY:  Content Area: Support systems/Family dynamics | Integrated Process: Communication and Documentation | Client Need: Psychosocial Integrity | Cognitive Level: Application | Question Type: Multiple Response | Chapter Objective: 6

 

  1. Select all that apply. A family is a group of people
1. Living together.
2. Related by blood.
3. Connected emotionally.
4. Committed to each other.
5. Who call themselves family.

 

 

ANS:  2, 3, 4, 5

Rationale:

A family does not need to physically live together and may not be connected by blood or emotion.

 

PTS:   1

KEY:  Content Area: Support systems/Family dynamics | Integrated Process: Communication and Documentation | Client Need: Psychosocial Integrity | Cognitive Level: Application | Question Type: Multiple Response | Chapter Objective: 2

 

  1. Select all that apply. According to the WHO, a family health nurse:
1. Possesses the usual knowledge expected of a competent nurse.
2. Is a generalist with specialty knowledge of culture and family.
3. Attempts to create a healthy family by addressing health problems.
4. Only works with families in the community setting.

 

 

ANS:  1, 2, 3

Rationale:

Number 4 is not correct because a family health nurse coordinates care among the diverse settings where care is provided.

 

PTS:   1

KEY:  Content Area: Case Management | Content Area: Collaboration | Integrated Process: Caring | Client Need: Management of Care | Cognitive Level: Knowledge | Question Type: Multiple Response | Chapter Objective: 2

 

  1. Which of the following assumptions about family will assist the nurse to plan and deliver meaningful care? Select any that apply.
1. The nurse has limited information about family function.
2. Individual family members seldom have only one problem at a time.
3. Disease management may be influenced by family responsibilities.
4. Family members are not able to prioritize activities related to health care.

 

 

ANS:  1, 2, 3

Rationale:

Conducting a family assessment that includes function, other problems, and family roles will provide necessary information for developing goals for family members. Family members are able to prioritize, and when they do, compliance with treatments may not be possible.

 

PTS:   1

KEY:  Content Area: Management of Care | Integrated Process: Caring | Client Need: Safe and Effective Care | Cognitive Level: Knowledge | Question Type: Multiple Response | Chapter Objective: 6

 

COMPLETION

 

  1. ____________________ is established as individual members find their places within the family household and then separate themselves from it.

 

ANS:  Family identity

 

PTS:   1

KEY:  Content Area: Family dynamics | Integrated Process: Nursing Process | Client Need: Psychosocial Integrity | Cognitive Level: Knowledge | Question Type: Completion | Chapter Objective: 3

 

  1. Families who had children with type 1 diabetes and had ____________________ family cohesion and ____________________ family conflict responded positively to a family-centered care approach, according to Hanson (1995).

 

ANS:  high, low

 

PTS:   1

KEY:  Content Area: Support systems/Family dynamics | Integrated Process: Caring | Client Need: Psychosocial Integrity | Cognitive Level: Knowledge | Question Type: Completion | Chapter Objective: 6

 

  1. Family health as a whole implies a ____________________ that optimizes the actions and abilities of each member, which influence the good of all, yet regards the ____________________ of each individual.

 

ANS:  Group functionality, needs

 

PTS:   1

KEY:  Content Area: Support systems/Family dynamics | Integrated Process: Caring | Client Need: Psychosocial Integrity | Cognitive Level: Knowledge | Question Type: Completion | Chapter Objective: 5

 

SHORT ANSWER

 

  1. List the pros and cons of the application of General Systems Theory to family nursing.

 

ANS:

Pros: Encourages consideration of the whole; connectedness and feedback; the whole and its parts are important. Cons: Ignores historical, cultural, and political factors; may overlook multiple forces and processes.

 

PTS:   1

KEY:  Content Area: Support systems | Integrated Process: Nursing Process | Client Need: Psychosocial Integrity | Cognitive Level: Comprehension | Question Type: Short Answer | Chapter Objective: 4

 

  1. Differentiate healthy families from unhealthy families, including three characteristics of each type.

 

Healthy families                                            Unhealthy families

_1__________________________________1_______________________________

_2_________________________________  2_______________________________

_3__________________________________3_______________________________

 

ANS:

Healthy: Nurturing, supportive, balancing. Unhealthy: inability to complete usual tasks, satisfy social obligations, or fulfill customary roles

 

PTS:   1

KEY:  Content Area: Support systems/Family dynamics | Integrated Process: Nursing Process | Integrated Process: Caring | Client Need: Psychosocial Integrity | Cognitive Level: Comprehension | Question Type: Short Answer | Chapter Objective: 5

 

  1. Define family health and list processes that influence it.

 

ANS:

According to Denham (2003), family health is defined as a phenomenon that includes the complex interactions and relationships members have with one another within the household, and the potential ways they collaborate to maximize individual abilities to develop and maintain what they view as meaningful and healthful ways. Examples of processes include interaction, coping, integrity, development.

 

PTS:   1

KEY:  Content Area: Support systems/Family dynamics|Content Area: Management of care | Integrated Process: Communication | Client Need: Psychosocial Integrity | Client Need: Physiological Integrity | Cognitive Level: Knowledge | Question Type: Short Answer | Chapter Objective: 5

 

  1. Explain what is meant by this statement: “Changes in the household experience can negatively or positively influence the health of family members.”

 

ANS:

Resources (presence or absence), and location of household (isolated or urban) are important influencing factors of health.

 

PTS:   1

KEY:  Content Area: Health promotion and maintenance | Integrated Process: Nursing Process | Client Need: Psychosocial Integrity | Client Need: Physiological Integrity | Cognitive Level: Application | Question Type: Short Answer | Chapter Objective: 5

Chapter 8- Developing Ideas for Family-focused Practice

 

MULTIPLE CHOICE

 

  1. Which of the following areas is not a realm of family life in the Family Health System (FHS) Model?
1. Developmental
2. Interactional
3. Functional
4. Health

 

 

ANS:  3

Rationale:

The five realms of family life in the Family Health System Model are interactional, developmental, coping, integrity, and health.

 

PTS:   1

KEY:  Content Area: Describe the characteristics of a family practice model | Integrated Process: Nursing Process | Client Need: Psychosocial Integrity | Client Need: Physiological Integrity | Cognitive Level: Knowledge | Question Type: Multiple Choice

 

  1. Which of the following principles of the concept thinking family is inaccurate?
1. The nurse is the expert about the family health experience.
2. The nurse identifies needs of multiple persons.
3. The nurse understands family dynamics.
4. The nurse appreciates family stories.

 

 

ANS:  1

 

  Feedback
1 The family unit is the expert about its experience of health and illness.
2 The nurse identifies the needs of all persons within the family.
3 The nurse understands family dynamics and how members have a bidirectional influence on one another in a family.
4 The nurse appreciates family stories because they can reveal important facts from the person’s or family’s point of view.

 

 

PTS:   1

KEY:  Content Area: Discuss family nursing skills used to provide family nursing care | Integrated Process: Caring | Client Need: Psychosocial Integrity | Cognitive Level: Knowledge | Question Type: Multiple Choice

 

  1. Which of the following nurse actions demonstrates a nonjudgmental view of a family that has a member with a chronic illness?
1. The nurse tells each family member how to interact with the chronically ill family member.
2. The nurse recognizes each family member will react differently to health problems.
3. The nurse expects all family members to share responsibility for care giving equally.
4. The nurse sets goals for the family’s adaptation that he deems appropriate.

 

 

ANS:  2

 

  Feedback
1 A nurse with a nonjudgmental view will work in a partnership with this family, not telling them what to do nor having the same expectations of all members.
2 A nurse with a nonjudgmental view recognizes that family members will react differently to health problems.
3 A nurse with a nonjudgmental view will work in a partnership with this family, neither telling them what to do nor having the same expectations of all members.
4 A nurse with a nonjudgmental view will work in a partnership with this family to set goals; setting goals without the family’s input and agreement will not lead to positive outcomes.

 

 

PTS:   1

KEY:  Content Area: Discuss family nursing skills used to provide family nursing care | Integrated Process: Caring | Client Need: Safe and Effective Care | Cognitive Level: Knowledge | Question Type: Multiple Choice

 

  1. Which one of the following aspects of hypothesizing by a family nurse is inaccurate?
1. Guides the family assessment
2. Predicts family outcomes
3. Explores potential strategies
4. Helps to attribute meaning to behaviors

 

 

ANS:  2

 

  Feedback
1 The nurse uses hypothesizing, or hunches, to help determine the meanings of behaviors, which is helpful in guiding the family assessment.
2 Family outcomes cannot be predicted by hunches and the use of propositions.
3 The nurse uses hypothesizing, or hunches, to guide questioning or explore problem-solving strategies.
4 The nurse uses hypothesizing, or hunches, to help determine the meaning of behaviors, which is helpful in assessment and problem solving.

 

 

PTS:   1

KEY:  Content Area: Discuss family nursing skills used to provide family nursing care | Integrated Process: Nursing Process | Client Need: Psychosocial Integrity | Cognitive Level: Application | Question Type: Multiple Choice

 

  1. Which of the following questions is an example of an interventive question by the nurse?
1. “Why did you say that to your father?”
2. “Are you ready to take on the responsibility of care giving?”
3. “What is it like for you to communicate with your father now?”
4. “When will your father return home from the hospital?”

 

 

ANS:  3

 

  Feedback
1 A “why” question is likely to cause a defensive reaction rather than further communication.
2 A question that allows for a yes or no answer closes down on communication.
3 Asking “what is it like” is an interventive question because it facilitates further communication.
4 A question that seeks specific information will not necessarily encourage further communication.

 

 

PTS:   1

KEY:  Content Area: Discuss family nursing skills used to provide family nursing care | Integrated Process: Communication | Client Need: Psychosocial Integrity | Cognitive Level: Application | Question Type: Multiple Choice

 

  1. Which of the following outcomes of conducting a 15-minute family interview is unlikely?
1. Eliciting the family’s perceptions of the health/illness experience
2. Demonstrating interest in the family as a unit of care
3. Identifying several problems that require solution
4. Providing a caring initial impression

 

 

ANS:  3

 

  Feedback
1 The questions asked in a 15-minute family interview aim to elicit the family’s perceptions of the health/illness experience.
2 The questions asked in a 15-minute family interview reflect the nurse’s interest in the family as a unit of care.
3 The questions asked in a 15-minute family interview do not focus on multiple problems and this outcome is unlikely.
4 The questions asked in a 15-minute family interview allow the nurse to convey caring upon initially meeting the family.

 

 

PTS:   1

KEY:  Content Area: Discuss family nursing approaches/models used in family nursing care practice | Integrated Process: Communication | Client Need: Psychosocial Integrity | Cognitive Level: Knowledge | Question Type: Multiple Choice

 

  1. Which of the following is an inaccurate example of a therapeutic question included in the 15-minute family interview?
1. “What has been most helpful to you and your family during your hospitalization?”
2. “What is the one question you would like answered now?”
3. “Why don’t you think you can be a caregiver?”
4. “Which of your family members can we share information with?”

 

 

ANS:  3

 

  Feedback
1 Asking what has been helpful is therapeutic because it allows the family to reflect on their experiences.
2 Asking the family what question they would like answered is therapeutic because it helps the nurse focus his assessment and identify family needs.
3 Asking “why” is not therapeutic because it is likely to cause defensiveness and block communication.
4 Asking with whom the family would like information shared is therapeutic because it helps with assessment of family resources and demonstrates respect for family wishes.

 

 

PTS:   1

KEY:  Content Area: Discuss family nursing approaches/models used in family nursing care practice | Integrated Process: Communication | Client Need: Psychosocial Integrity | Cognitive Level: Application | Question Type: Multiple Choice

 

MULTIPLE RESPONSE

 

  1. Which of the following assumptions would be made by nurses who think family and intend to practice family-focused nursing care?
1. Families always think as a whole.
2. Nurses need to solve family problems.
3. Nurses need to know the limits of their scope of practice.
4. The individual and the family are not separate.

 

 

ANS:  3, 4

Rationale:

The individual and family are not separate and families do not always think as a whole. Families may be fragmented by histories of tragedies, misunderstandings, and conflict. Thinking family does not imply that nurses need to solve family problems, especially if they do not relate to health issues. Knowing one’s scope of practice facilitates appropriate family-focused nursing care.

 

PTS:   1

KEY:  Content Area: Describe the nature of individual-nurse-family relationship and its importance in family nursing practice | Integrated Process: Nursing Process | Client Need: Psychosocial Integrity | Cognitive Level: Comprehension | Question Type: Multiple Response

 

  1. Which nursing actions would be recommended for a family nurse beginning a relationship with a family?
1. Welcoming care recipients and families.
2. Identifying medical problems.
3. Listening to family stories.
4. Being present with care recipients.

 

 

ANS:  1, 3, 4

Rationale:

Welcoming care recipients and their families, listening to family stories, and being present are practices nurses use to develop caring relationships with families. Medical and nursing problems are identified after assessment, not as the relationship is developing.

 

PTS:   1

KEY:  Content Area: Describe the nature of individual-nurse-family relationship and its importance in family nursing practice | Integrated Process: Caring | Client Need: Psychosocial Integrity | Cognitive Level: Application | Question Type: Multiple Response

 

  1. Which of the following statements describing the Family Health System Model (FHS) are accurate?
1. Nurses using the FHS work with families across the continuum of care.
2. The FHS examines family life dynamics.
3. The FHS attends to family members one at a time
4. The goal of the FHS is improved family health and functioning.

 

 

ANS:  2, 4

Rationale: The FHS model considers the family as a unit during assessment. Nurses work with families across the lifespan, examining family life dynamics and working with both individuals and the family as a whole to reach a goal of improved health and functioning of the family as a unit.

 

PTS:   1

KEY:  Content Area: Describe the characteristics of a family practice model | Integrated Process: Caring | Client Need: Management of Care | Cognitive Level: Knowledge | Question Type: Multiple Response

 

COMPLETION

 

  1. As the family’s story emerges, meaningful ____________________ occur, ____________________is built and the groundwork for a/an ____________________ is established.

 

ANS:  interactions or conversations, trust, relationship or individual-nurse-family relationship

 

PTS:   1

KEY:  Content Area: Describe the nature of individual-nurse-family relationship and its importance in family nursing practice | Integrated Process: Caring | Client Need: Psychosocial Integrity | Cognitive Level: Knowledge | Question Type: Completion

 

SHORT ANSWER

 

  1. List the characteristics of a reflective individual-nurse-family relationship.

 

ANS:

Thoughtful appraisal from the perspective of others, vulnerability, checking personal reactions, and authentic care that is sensitive to other’s needs are four possibilities.

 

PTS:   1

KEY:  Content Area: Describe the nature of individual-nurse-family relationship and its importance in family nursing practice | Integrated Process: Caring | Client Need: Psychosocial Integrity | Cognitive Level: Application | Question Type: Short Answer

 

  1. Provide an example to demonstrate understanding of the meaning of this statement: “Whatever happens to one person influences the family, and whatever influences the family also influences persons that comprise the family.”

 

ANS:

If one member of the family is diagnosed with an illness, all family members will react in some way to this new experience. Also, if the main financial supporter of the family loses his or her job, all family members are likely to feel the effect of this lack of resources.

 

PTS:   1

KEY:  Content Area: Describe the characteristics of a family practice model | Integrated Process: Nursing Process | Client Need: Psychosocial Integrity | Client Need: Physiological Integrity | Cognitive Level: Application | Question Type: Short Answer

 

  1. Define neutrality and describe its importance in family-focused nursing practice.

 

ANS:

Taking a neutral view or not taking sides or making judgments helps nurses to be respectful of families’ abilities and gain humility. The nurse will entertain alternative points of view to more clearly understand a situation. Nurses do not need to decide how things will get done. Neutrality fosters openness and curiosity.

 

PTS:   1

KEY:  Content Area: Discuss family nursing skills used to provide family nursing care | Integrated Process: Communication | Client Need: Psychosocial Integrity | Client Need: Physiological Integrity | Cognitive Level: Application | Question Type: Short Answer

 

  1. Provide an example to demonstrate understanding of the meaning of this statement: “Circular communication by a family nurse goes two ways.”

 

ANS:

The example needs to show that the nurse first listens and reflects in a clear, open, and neutral way what was heard. Then, in a caring manner, the nurse assists the family members to respond to what has been said. The nurse then goes on to clarify meanings and gain insight into what is happening with the family.

 

PTS:   1

KEY:  Content Area: Discuss family nursing skills used to provide family nursing care | Integrated Process: Communication | Client Need: Psychosocial Integrity | Cognitive Level: Application | Question Type: Short Answer

Chapter 14- Family-Focused Nursing Actions

 

MULTIPLE CHOICE

 

  1. A nurse is making a visit to the home following a family member’s discharge from the hospitalization. Which of the following data would be most helpful?
1. Identify potential areas of strengths in the family.
2. Plan for family care based on assessment of core processes.
3. View the priority of the home visit as the individual who was hospitalized.
4. Conduct a family assessment that remains focused on management of the symptoms.

 

 

ANS:  2

 

  Feedback
1 Identifying the strengths will only provide a limited picture of the family.
2 Assessment of the core process will provide direction for family nursing.
3 The individual and family health are related. The priority may be the family.
4 Focusing on the symptoms may limit the effectiveness of the visit by not addressing concerns of individual or family.

 

 

PTS:   1

KEY:  Content Area: Management of Care | Integrated Process: Caring | Client Need: Safe and Effective Care | Cognitive Level: Comprehension | Question Type: Multiple Choice

 

  1. Which of the following statements reflect an accurate understanding family core processes?
1. Core family processes focus on family structure
2. Core processes influence the health of family, rather than the individual
3. Core family processes can guide family nursing practices.
4. Nursing actions focused on family core processes focus on individual with an illness.

 

 

ANS:  3

 

  Feedback
1 Core processes focus on family processes
2 Core processes influence the health of both individual and the family
3 Core processes provide a framework for family nursing practice.
4 Core processes focus on both individual and family.

 

 

PTS:   1

KEY:  Content Area: Management of Care | Integrated Process: Caring | Client Need: Safe and Effective Care | Cognitive Level: Comprehension | Question Type: Multiple Choice

 

  1. Which of the following statements indicate a nurse needs further education about family nursing using core family processes?
1. Core processes can provide a framework when family is the unit of care, rather than the individual with an illness.
2. Exploring core processes can help nurses find ways to empower and support families.
3. Core processes offers directions for family-focused nursing actions that intentionally include the family.
4. Core processes provide ways to approach family care that include both assessment and nursing actions.

 

 

ANS:  1

 

  Feedback
1 Core processes provide a framework for caring for individual and family.
2 Core processes provides direction for empowering and supporting families.
3 Core processes deliberatively direct nursing attention to family.
4 Core processes provide a framework for assessment and nursing action.

 

 

PTS:   1

KEY:  Content Area: Management of Care | Integrated Process: Caring | Client Need: Safe and Effective Care | Cognitive Level: Comprehension | Question Type: Multiple Choice

 

  1. A nurse is caring for a patient with a terminal diagnosis of a brain tumor. The family and patient wish for him to be in their home during the end of his life. The family has decided hospice will become involved. Which of the following nursing actions address priority core processes at this time?
1. Determine the number of family members available to participate in care.
2. Helping the family determine the ways they will celebrate holidays after the death.
3. Discuss the communication patterns and emotional bonds of the family at this time and prior to the illness.
4. Identify the health routines of the family that need to be modified so family health can be regained.

 

 

ANS:  3

 

  Feedback
1 The number of family members is not a priority.
2 Celebrations are most likely not the focus of the family at this time.
3 Prior communication and cathexis processes will be important to family during this time of care at end of life.
4 Modifying the family health routines would not be a priority at this time

 

 

PTS:   1

KEY:  Content Area: Management of Care | Integrated Process: Caring | Client Need: Safe and Effective Care | Cognitive Level: Comprehension | Question Type: Multiple Choice

 

  1. Family-focused nursing actions view a family within the larger social system. Which of the following statements reflect accurate understandings of this view of family nursing practice?
1. Effective nursing address the complexity of an individual’s illness, as well as their family and social networks.
2. Nurses who practice in the hospital seldom need to address the patient’s community networks.
3. Effective family nursing practice maintains a focus on the current situation.
4. Family nursing practice is based on one model of nursing care that places the family as the unit care.

 

 

ANS:  1

 

  Feedback
1 Family nursing thinking and care provides the optimal outcomes when care addresses the individual, family, and social systems.
2 Transition from hospital to home often requires nurses to plan for discharge by engaging community networks.
3 Family thinking considers the past, present, and future. Maintaining a focus on the current situation limits effectiveness.
4 Multiple models of nursing care may be used to guide family nursing practice.

 

 

PTS:   1

KEY:  Content Area: Management of Care | Integrated Process: Caring | Client Need: Safe and Effective Care | Cognitive Level: Comprehension | Question Type: Multiple Choice

 

  1. After years of caregiving in the home, a family has recently moved their family member to a nursing home. Which of the following would be appropriate nursing actions at this time?
1. An assessment of the core process of celebration
2. Emphasize the family’s opportunities, since the nursing home will replace the family member’s caregiving responsibilities.
3. An assessment for ambiguous loss in the core process of cathexis
4. Use motivational interviewing techniques to guide family behavioral changes.

 

 

ANS:  3

 

  Feedback
1 Celebrations are less likely to be a family priority during this initial transition phase.
2 Emphasizing the family’s opportunities minimizes the family’s prior roles in caregiving.
3 Ambiguous loss in family process of cathexis often occurs in dementia, when the person’s body is present but the prior way of being is no longer.
4 Motivational interviewing focused on family behavior changes may not be appropriate during this initial transition phase.

 

 

PTS:   1

KEY:  Content Area: Management of Care | Integrated Process: Caring | Client Need: Safe and Effective Care | Cognitive Level: Comprehension | Question Type: Multiple Choice

 

  1. Family interventions in the core process of connections focus on which of the following?
1. Discussing a family genogram and ecomap
2. Completing a chronic sorrow assessment
3. Engaging a family in motivational interviewing
4. Facilitating family decision-making

 

 

ANS:  1

 

  Feedback
1 A family genogram and ecomap are priority methods of assessing connections that provide a foundation for family intervention of discussions and identifying priority concerns and strengths.
2 Chronic sorrow assessment is directed toward family process of cathexis.
3 Motivational interview focuses on family process of change.
4 Family decision-making primarily focuses on family process other than connections.

 

 

PTS:   1

KEY:  Content Area: Management of Care | Integrated Process: Caring | Client Need: Safe and Effective Care | Cognitive Level: Comprehension | Question Type: Multiple Choice

 

  1. Mary is the mother of a six-year-old son, James, with cerebral palsy. James uses wheelchair to attend school. However, lately he has had a tutor in the home because of declining health. James is being seen in the clinic for possible pneumonia. Effective family focused nursing actions should focus on which of the following core processes?
1. Cathexis
2. Coordination
3. Caregiving
4. All of the above

 

 

ANS:  4

All family processes of emotional bonds, coordination, and caregiving would be important in caregiving of a child with a chronic disability.

 

PTS:   1

KEY:  Content Area: Management of Care | Integrated Process: Caring | Client Need: Safe and Effective Care | Cognitive Level: Comprehension | Question Type: Multiple Choice

 

  1. Which of the following statements reflect an understanding of family-focused nursing actions? A nurse who is implementing family-focused nursing actions:
1. Partners with a family
2. Assesses family core processes
3. Identifies both the strengths and the concerns of a family
4. All of the above

 

 

ANS:  4

Rationale:

Partnerships, assessment, and family strengths and concerns are important to family-focused nursing actions.

 

PTS:   1

KEY:  Content Area: Management of Care | Integrated Process: Caring | Client Need: Safe and Effective Care | Cognitive Level: Comprehension | Question Type: Multiple Choice

 

  1. A nurse is caring for a 62-year-old woman with respiratory failure who has an advance directive that indicates her wishes related to resuscitation. The woman has two adult children and a husband who express differing views about the directive. The nurse decides to lead a family meeting. Which of the following would be the best purposes of this particular family meeting?
1. Provide information that convinces the family to follow the health-care team’s directions.
2. Assist individual family members to share individual beliefs and understandings.
3. Increase efficiency of the nurse by decreasing the number of questions.
4. Create an environment where prior stresses and conflicts can be resolved.

 

 

ANS:  2

 

  Feedback
1 The focus of a family meeting is listening to the family, rather than convincing them to follow the health-care team directions. Sharing an exchange of information will be a way build consensus.
2 Sharing family beliefs and understandings is a purpose of a family meeting.
3 The nurse’s efficiency may be an outcome of the family meeting, but it is not a purpose.
4 Resolving prior conflicts may not be the best use of a family meeting at this time when there are current concerns.

 

 

PTS:   1

KEY:  Content Area: Management of Care | Integrated Process: Caring | Client Need: Safe and Effective Care | Cognitive Level: Comprehension | Question Type: Multiple Choice

 

  1. Which of the following statements by a nurse who is planning to being leading family meetings reflect a need for additional education before she conducts the meetings?
1. “I must be sure to provide plenty of time so I can listen to each of the family members.”
2. “I plan to direct my attention to the family’s identified strengths and concerns.”
3. “ It is important for me to help clarify each of the family member’s beliefs.”
4. “It is best if I wait to hold a meeting until the family asks for this action.”

 

 

ANS:  4

 

  Feedback
1 Time for listening to all family members is important in family meetings.
2 Attention to the family’s identified strengths and concerns is a purpose of family meetings.
3 Clarifying family member’s beliefs is a purpose of family meetings.
4 Families will often not request a family meeting because they are not accustomed to this family-focused nursing action. The nurse should lead this action.

 

 

PTS:   1

KEY:  Content Area: Management of Care | Integrated Process: Caring | Client Need: Safe and Effective Care | Cognitive Level: Comprehension | Question Type: Multiple Choice

 

  1. A nurse is being attentive to the distress a family is experiencing with the admission of a family member to the intensive care unit. The nurse makes the statement, “I know this is a stressful time for you and your family. Would you like to come to your family member’s room with me and I will explain equipment to you?” Which of the following is an accurate statement about the elements of this nursing action?
1. The critically ill patient is the recipient of this nursing action.
2. Characteristics of this settings is unrelated to this nursing action.
3. The anxiety and distress of the family is the focus of this nursing action.
4. All core processes need to be assessed at this time to gain a complete family assessment.

 

 

ANS:  3

 

  Feedback
1 The family of the critically ill patient is the focus of this nursing action.
2 The foreign, stressful, complex environment of the intensive care unit setting influences the focus and location of this nursing action.
3 The variable of concern for this family is the anxiety and distress.
4 Assessing all core processes at this time may not be effective use of time and draw attention to the priority concerns of the family at this time of admission to intensive care unit.

 

 

PTS:   1

KEY:  Content Area: Management of Care | Integrated Process: Caring | Client Need: Safe and Effective Care | Cognitive Level: Comprehension | Question Type: Multiple Choice

 

SHORT ANSWER

 

  1. Identify nursing actions that relates to three of the core family processes of connectedness, change, and coordination.

 

ANS:

Change: Motivational interviewing to identify areas of possible change in family routines.

Connectedness: Explore family bonds in the ecomap.

Coordination: Identify resources in the family social systems networks.

Rationale:

Family-focused nursing actions of motivational interviewing addresses family change.

Exploring family bonds addressed the core process of family connections.

Identifying resources in the community and social network will allow the nurse to help the family coordinate the available resources.

 

PTS:   1

KEY:  Content Area: Management of Care | Integrated Process: Caring | Client Need: Safe and Effective Care | Cognitive Level: Comprehension | Question Type: Short Answer

 

  1. Identify nursing actions that relate to three of the core family processes of communication, caregiving and cathexis.

 

ANS:

Examples of answers:

Communication: Family meeting to resolve family conflict.

Caregiving: Complete family caregiving strain index to assess caregiving.

Cathexis: Assess chronic sorrow.

Rationale:

Family meetings can help resolve family conflict through focusing on family core processes of communication.

Completing family caregiving strain index assesses the family core process of caregiving.

Assessing chronic sorrow addresses the family core processes of cathexis.

 

PTS:   1

KEY:  Content Area: Management of Care | Integrated Process: Caring | Client Need: Safe and Effective Care | Cognitive Level: Comprehension | Question Type: Short Answer

 

  1. Identify three core family processes and areas of concern that require the attention of the nurse in illness experiences.

 

ANS:

Example of answers:

Communication: Family silence about a family illness or diagnosis.

Caregiving: Fatigue and stress with long-term care of a family member with a chronic illness.

Cathexis: Chronic sorrow, loss, and ambiguous loss.

Celebration: Loss with changes in celebration rituals.

Change: Family needing to make lifestyle change in diet or exercise.

Connectedness: Family lacks relationships with connections of extended family, friends, support groups, schools, religious affiliations, employers, and professionals.

Coordination: Family may have difficulties in making decisions about care of a family member.

 

Rationale:

A number of core family process and concerns emerge during a family illness experience. The nurse can have an impact and influence a variety of core processes by identifying concerns and directing nursing actions.

 

PTS:   1

KEY:  Content Area: Management of Care | Integrated Process: Caring | Client Need: Safe and Effective Care | Cognitive Level: Comprehension | Question Type: Short Answer

 

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