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A couple who have a 7-year-old son have been experiencing growing tension and anxiety in their relationship. However, the tension and anxiety between them lessened when the mother began focusing most of her attention on the son. When applying the family systems therapy model concept of triangulation, which of the following would the nurse expect to assess in the child?
- A. Enjoying his mother?s increasing attention and growing even closer to her
- B. Growing distant from his father and blaming him for all of the family?s problems
- C. Developing problematic symptoms in response to his mother?s increasing attention
- D. Resenting mother for her suffocating attention and his father?s growing distance
Correct Answer: C
Rationale: In triangulation, a family member (the child) is drawn into parental conflict, often leading to problematic symptoms (e.g., behavioral or emotional issues) due to the stress of being the focus of redirected tension. Options A, B, and D may occur but are not the primary expected outcome in triangulation.
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While caring for a family, the nurse determines that first-order changes have occurred with which of the following?
- A. The children are all in school, and the parent returns to work.
- B. The daughter leaves home to attend college.
- C. The son marries his long-time sweetheart and moves into his own home.
- D. The grandmother who has been living in the household dies.
Correct Answer: A
Rationale: First-order changes are superficial adjustments within a family system that do not alter its structure, such as a parent returning to work when children start school. Options B, C, and D involve structural changes (leaving home, marriage, or death), which are second-order changes.
A nurse is working with a family and using the Calgary Family Model. Problems have been identified, and the family being in which stage of the model?
- A. Engagement
- B. Assessment
- C. Intervention
- D. Termination
Correct Answer: C
Rationale: In the Calgary Family Model, identifying problems marks the transition from assessment to the intervention stage, where the nurse collaborates with the family to address issues. Engagement initiates contact, assessment gathers data, and termination concludes the process.
The nurse is assessing a family system applying the family system framework model. Which assessment would be important for the nurse?
- A. Acceptance of the family rules
- B. Adjustment to the family boundaries
- C. Degree of enmeshment in the system
- D. Interpersonal differentiation
Correct Answer: C
Rationale: The family systems framework, such as Bowen?s theory, emphasizes assessing the degree of enmeshment (overly close emotional boundaries) to understand family dynamics. Acceptance of rules, boundary adjustment, and differentiation are relevant but secondary to enmeshment, which directly impacts family functioning.
A female patient is an adolescent who recently tried to overdose because her boyfriend broke up with her. Her father is a single parent, and he has been drinking excessively to cope with his stress. The patient tells the nurse that whenever she needs to talk to her father, he is always drunk or away drinking with his drinking buddies. Based on this information, which nursing diagnosis would be most appropriate for this patient?s family?
- A. Ineffective Family Therapeutic Regimen Management
- B. Compromised Family Coping
- C. Ineffective Denial
- D. Caregiver Role Strain
Correct Answer: B
Rationale: The father?s excessive drinking and unavailability indicate compromised family coping, as the family struggles to manage stress and support the adolescent?s needs. Ineffective therapeutic regimen management, denial, and caregiver role strain are less specific to the family?s overall coping deficit.
A nurse is using a genogram as an intervention strategy based on the understanding of which of the following?
- A. It provides information about appropriate methods for problem solving.
- B. It allows the family to view its evolution over several generations.
- C. It permits a subjective yet factual perspective of family relationships.
- D. It provides a means for identifying the family?s beliefs about mental illness.
Correct Answer: B
Rationale: A genogram maps family relationships and patterns across generations, helping families visualize their evolution and dynamics. It does not directly provide problem-solving methods, subjective perspectives, or specific beliefs about mental illness, though it may indirectly inform these.