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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.
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A nursing instructor is developing a teaching plan for a class about families. Which of the following would the instructor be most likely to include?
- A. Families are primarily determined by blood.
- B. New members are added by birth, marriage, or adoption.
- C. In the United States, family size has been on the increase.
- D. Families are less mobile today than in the past.
Correct Answer: B
Rationale: Families expand through birth, marriage, or adoption, reflecting a fundamental aspect of family structure. Families are not solely blood-based (A), family size has generally decreased in the U.S., and mobility has increased, not decreased, making B the most accurate.
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.
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 nurse is engaged in developing a relationship with a family during a family assessment. Which of the following would be important? Select all that apply.
- A. Demonstrating culturally competent nursing skills
- B. Completing the assessment efficiently in the first meeting
- C. Identifying the family?s immediate needs
- D. Exhibiting a professional image
- E. Investigating the adherence to the medication regimen
Correct Answer: A,C,D
Rationale: Building a relationship involves culturally competent skills (A), identifying immediate needs (C), and maintaining professionalism (D) to establish trust. Completing the assessment in one meeting (B) is unrealistic, and medication adherence (E) is a specific intervention, not relationship-building.
A nurse is constructing a genogram of a family. Which of the following would the nurse do?
- A. Use circles to represent the male members.
- B. Use horizontal lines to connect the parents with children.
- C. Use horizontal lines to show marriages.
- D. Use asterisks to denote ages listed at the bottom.
Correct Answer: C
Rationale: In a genogram, horizontal lines represent marriages, connecting spouses. Males are represented by squares (not circles), vertical lines connect parents to children, and ages are typically noted near the individual, not with asterisks.