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A group of nursing students is reviewing information about the changing family structure and its effect on mental health and illness. The students demonstrate understanding of the information when they identify which of the following?
- A. Middle-aged childless adults are more vulnerable to loneliness and depression.
- B. In stepfamilies, caring for the children often is a primary stressor to the marital partners.
- C. Separation because of relocation provides additional support from extended family.
- D. Same-sex families typically demonstrate lower rates for depression and stress.
Correct Answer: B
Rationale: In stepfamilies, caring for children often introduces stress to marital relationships due to complex dynamics, a well-documented effect. Childless adults may face loneliness but not universally, relocation often reduces extended family support, and same-sex families do not consistently show lower depression rates.
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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.
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 male patient has recently been diagnosed with type II diabetes. His family is having trouble incorporating the dietary and exercise regimen prescribed by his physician into their daily routines. They tell the nurse that they are all tired when they return home from school and work and that the last thing any of them want to do is go on a walk. In addition, the patient?s wife discloses that she is unable to prepare any sugar-free or low-sugar foods that her husband enjoys eating. Based on this information, which nursing diagnosis would be most appropriate for this family?
- A. Interrupted Family Processes
- B. Ineffective Denial
- C. Caregiver Role Strain
- D. Ineffective Family Therapeutic Regimen Management
Correct Answer: D
Rationale: The family?s difficulty incorporating the prescribed dietary and exercise regimen indicates ineffective family therapeutic regimen management, as they struggle to adhere to the medical plan. Interrupted processes, denial, and caregiver strain do not directly address the regimen adherence issue.
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.
A group of nursing students is reviewing system models used in caring for families. The students demonstrate understanding of the information when they identify which of the following as characteristic of the Calgary Family Model?
- A. Differentiation of self
- B. Sibling position
- C. Family development
- D. Subsystems
Correct Answer: C
Rationale: The Calgary Family Model emphasizes family development, focusing on stages and transitions in family life. Differentiation of self and sibling position are from Bowen?s theory, and subsystems are part of Minuchin?s structural model, not the Calgary model.