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Potter & Perry: Fundamentals of Nursing, 7th Edition

Test Bank
Chapter 10: Caring for Families
MULTIPLE CHOICE
1. Which of the following is a current trend in families or family living?
1. People marrying earlier
2. Reduction in the divorce rate
3. People having more children
4. More people choosing to live alone
ANS: 4
The number of people living alone is expanding rapidly and represents approximately
26% of all households. People are marrying later, not earlier. The rate of divorce appears
to have stabilized, with approximately 55% of marriages ending in divorce. Couples are
choosing to have fewer children or none at all.
DIF: A
REF: 122
OBJ: Comprehension
TOP: Nursing Process: Assessment
MSC: NCLEX test plan designation: Health Promotion and Maintenance/Family
Systems; Psychosocial Integrity/Family Dynamics
2. Of the following trends, which one represents the greatest current health care challenge to
nurses?
1. Homelessness
2. Single parent families
3. Alternative relationship patterns
4. Sandwiched or middle generation
ANS: 1
Homelessness is identified as one of the greatest health care challenges to nurses. The
trend of single parent families is not the greatest current health care challenge to nurses.
The trend of alternate relationship patterns is not the greatest current health care
challenge to nurses. The trend of a sandwiched or middle generation is not the greatest
current health care challenge to nurses.
DIF: A
REF: 124
OBJ: Knowledge
TOP: Nursing Process: Assessment
MSC: NCLEX test plan designation: Health Promotion and Maintenance/Family
Systems; Psychosocial Integrity/Family Dynamics
3. When working with families, the nurse may view the family as context or client. Which
one of the following examples demonstrates the view of the family as context?
1. The familys ability to support the clients dietary and recreational needs
2. The clients ability to understand and manage his own personal dietary needs
3. The familys demands on the client that are based on the clients role performance
Mosby items and derived items 2009, 2005 by Mosby, Inc., an affiliate of Elsevier Inc.

Test Bank

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4. The adjustment of both the client and the family to changes in diet and exercise
ANS: 2
When the nurse views the family as context, the primary focus is on the health and
development of an individual member existing within the clients family. The clients
ability to understand and manage his own dietary needs is an example of viewing the
family as context. The familys ability to support the clients dietary and recreational
needs is an example of viewing the family as client. The familys demands on the client
based on his role performance is an example of viewing the family as client. The
adjustment of the client and family to changes in diet and exercise is an example of
viewing the family as system.
DIF: A
REF: 128
OBJ: Comprehension
TOP: Nursing Process: Assessment
MSC: NCLEX test plan designation: Health Promotion and Maintenance/Family
Systems; Psychosocial Integrity/Family Dynamics
4. What would a nurse expect to find in an assessment of a healthy family?
1. Change is viewed as detrimental to the family.
2. There is a passive response to most stressors.
3. The structure is flexible enough to adapt to crises.
4. Minimum influence is being exerted on the environment.
ANS: 3
A healthy family has a flexible structure that allows adaptable performance of tasks and
acceptance of help from outside the family system. The structure is flexible enough to
allow adaptability but not so flexible that the family lacks cohesiveness and a sense of
stability. The healthy family is able to integrate the need for stability with the need for
growth and change. It does not view change as detrimental to family processes. The
healthy family demonstrates control over the environment and does not passively respond
to stressors. The healthy family exerts influence on the immediate environment of home,
neighborhood, and school.
DIF: A
REF: 127
OBJ: Comprehension
TOP: Nursing Process: Assessment
MSC: NCLEX test plan designation: Health Promotion and Maintenance/Family
Systems; Psychosocial Integrity/Family Dynamics
5. Initially, the nurse should begin by doing what in completing a clients family
assessment?
1. Collecting health data from all the family members
2. Testing the familys ability to cope with normal stressors
3. Evaluating the familys interpersonal communication patterns
4. Determining the clients definition of familiar structure and attitudes
ANS: 4

Mosby items and derived items 2009, 2005 by Mosby, Inc., an affiliate of Elsevier Inc.

Test Bank

10-3

The nurse begins the family assessment by determining the clients definition of and
attitude toward family and the extent to which the family may be incorporated into
nursing care. The nurse also assesses family form and membership. Gathering health data
from the family members is not the starting point for a family assessment. Testing a
familys ability to cope is not where the nurse should begin a family assessment.
Evaluating communication barriers would not be an initial action of the nurse when
completing a clients family assessment.
DIF: C
REF: 126
OBJ: Analysis
TOP: Nursing Process: Assessment
MSC: NCLEX test plan designation: Health Promotion and Maintenance/Family
Systems; Psychosocial Integrity/Family Dynamics
6. Post discharge, the client is returning to their home environment. In assisting the client
with that, specifically in implementing family-centered care, the nurse:
1. Provides personal beliefs regarding problem-solving
2. Assists the family members to assume dependent roles
3. Works with the client to accept responsibility for role in discourse
4. Offers both client and family information about necessary self-care abilities
ANS: 4
When implementing family-centered care, the nurse adopts the role of educator and offers
information about necessary self-care abilities. In family-centered care, the nurse guides
the family in problem solving without providing his/her own beliefs. In family-centered
care, the nurse assists clients to assume independent roles by increasing family members
abilities in certain areas. In family-centered care, the nurse guides the family in problem
solving, not in helping them accept blame.
DIF: A
REF: 129
OBJ: Comprehension
TOP: Nursing Process: Planning
MSC: NCLEX test plan designation: Health Promotion and Maintenance/Family
Systems; Psychosocial Integrity/Family Dynamics
7. A client is unable to independently perform colostomy care due to arthritis. The nurse
should first:
1. Offer to assist the client to learn to manage the care
2. Arrange for home care services to care for the colostomy
3. Inquire as to family members who may be able to assist with the care
4. Suggest that the client attend a colostomy self-help support group
ANS: 3

Mosby items and derived items 2009, 2005 by Mosby, Inc., an affiliate of Elsevier Inc.

Test Bank

10-4

The nurse should first find out if there is anyone else in the family or neighborhood who
would or could assist with the colostomy care. Informing the client that management of
the colostomy must be learned will not change the fact that the client has arthritis and
needs assistance. The nurse should first determine whether there is someone else who
could perform the task. If not, the nurse arranges for a home care service referral. A
colostomy self-help support group may provide emotional support, but it will not meet
the clients need for assistance with colostomy care.
DIF: C
REF: 131
OBJ: Analysis
TOP: Nursing Process: Planning
MSC: NCLEX test plan designation: Health Promotion and Maintenance/Family
Systems; Psychosocial Integrity/Family Dynamics
8. The optimum goal of effective communication within the family, according to the nurse
observing the family members and their interaction, is:
1. Problem solving and psychological support
2. Role development of individual members
3. Socialization among individual members
4. Better financial conditions for the family
ANS: 1
The optimum goal of effective communication within the family is to be able to problem
solve and provide psychological support for its members. Role development is not the
optimum goal of effective communication within the family. Socialization among
individual family members is not the optimum goal of effective communication within
the family. Improving financial conditions for the family is not the optimum goal of
effective communication within the family.
DIF: A
REF: 129
OBJ: Comprehension
TOP: Nursing Process: Assessment
MSC: NCLEX test plan designation: Health Promotion and Maintenance/Family
Systems; Psychosocial Integrity/Family Dynamics
9. Which of the following is a gerontological principle related to families?
1. Later-life families need not work on developmental tasks.
2. The caregivers are often not members of the clients family.
3. Role reversal is usually expected and well accepted by the older client.
4. Support systems are likely to be different than those of younger age-groups.
ANS: 4
It is true that social support systems for older adults are likely to be different from those
for clients in younger age-groups. Members of later-life families need to be working on
developmental tasks. Caregivers for older adults are usually either spouses or middle-age
children. Accepting shifting of generational roles is often difficult for the older client.
DIF: A
REF: 125
TOP: Nursing Process: Assessment

OBJ: Comprehension

Mosby items and derived items 2009, 2005 by Mosby, Inc., an affiliate of Elsevier Inc.

Test Bank

10-5

MSC: NCLEX test plan designation: Health Promotion and Maintenance/Family


Systems; Psychosocial Integrity/Family Dynamics
10. In assessing the roles and power structure of a clients nuclear family, the nurse should
specifically ask the client:
1. Who decides where to go on vacation?
2. What type of health care insurance do you have?
3. How many family members currently live in your home?
4. What types of social activities do you and your family enjoy?
ANS: 1
Asking, Who decides where to go on vacation? enables the nurse to determine the
power structure and patterning of roles and tasks of the family. Asking about health
insurance does not assess the roles and power structure of the family. Inquiring about
family members living at home may be used to help determine family form, not the
power structure and roles of the family. Asking about social activities may provide
information on the interactive processes of the family and how time is spent, but it does
not assess the roles and power structure of the family.
DIF: C
REF: 126
OBJ: Analysis
TOP: Nursing Process: Assessment
MSC: NCLEX test plan designation: Health Promotion and Maintenance/Family
Systems; Psychosocial Integrity/Family Dynamics
11. Needing assistance with daily living activities, an older adult with two grown children is
being discharged home. Although both children live nearby, the daughter is expressing
concern about handling her parents physical needs. The nurses initial response is to:
1. Work with the family on delegating responsibility
2. Suggest short-term nursing home placement to the client
3. Arrange for the client to remain hospitalized in the medical center
4. Make decisions for the family on how to manage the care at home
ANS: 1
The nurse must consider caregiver strain and work with the family on delegating
responsibility. Nursing home placement should not be the nurses initial response to
caregiver strain. Arranging for the client to remain in the medical center is not always
feasible and does not address the problem of caregiver strain. It should not be the nurses
initial response in this situation. The nurse should not make decisions for the family, but
rather work with the family to problem solve.
DIF: C
REF: 126
OBJ: Analysis
TOP: Nursing Process: Planning
MSC: NCLEX test plan designation: Health Promotion and Maintenance/Family
Systems; Psychosocial Integrity/Family Dynamics
12. The nurse suspects that there is physical abuse present after visiting the client in the
home. In recognition of the pattern of family violence, the nurse knows that:

Mosby items and derived items 2009, 2005 by Mosby, Inc., an affiliate of Elsevier Inc.

Test Bank
1.
2.
3.
4.

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Child abuse is declining in frequency


Spouses are the most frequent abusers
Mental illness is a major cause of abuse
Abuse is primarily seen in lower income families

ANS: 2
In recognition of the pattern of family violence, the nurse knows that spouses are the
most frequent abusers. Child abuse is increasing, not decreasing. Mental illness may
increase the incidence of abuse within a family, but is not a major cause of abuse.
Emotional, physical, and sexual abuse occurs across all social classes.
DIF: A
REF: 124
OBJ: Comprehension
TOP: Nursing Process: Assessment
MSC: NCLEX test plan designation: Health Promotion and Maintenance/Family
Systems; Psychosocial Integrity/Family Dynamics
13. The primary goal of family-centered nursing is to:
1. Promote the wellness of the family and its members
2. Implement appropriate care for the family and its members
3. Provide support and care for the family and its individual members
4. Identify physical and emotional problems affecting the family as a unit
ANS: 3
The goal of family-centered nursing care is to promote, support, and provide for the wellbeing and health of the family and individual family members. While the other options
are appropriate goals, they are not the primary goal because promoting, supporting, and
providing for the well-being and health of the family and individual family members will
result in this option
DIF: C
REF: 122
OBJ: Analysis
TOP: Nursing Process: Assessment
MSC: NCLEX test plan designation: Health Promotion and Maintenance/Family
Systems; Psychosocial Integrity/Family Dynamics
14. A nurse who is sensitive to the care of families recognizes that the term family is
primarily defined:
1. As individuals legally bound to the client
2. As people with biological connections to the client
3. In terms generally accepted by the majority of clients
4. By the client as individuals important to the client
ANS: 4
A nurse can think of the family as a set of relationships that the client identifies as family
or as a network of individuals who influence each others lives. People related legally and
biologically may be criterion used to determine family. General terms may not be correct
in todays diversified world.
DIF:

REF: 122

OBJ: Analysis

Mosby items and derived items 2009, 2005 by Mosby, Inc., an affiliate of Elsevier Inc.

Test Bank

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TOP: Nursing Process: Assessment


MSC: NCLEX test plan designation: Health Promotion and Maintenance/Family
Systems; Psychosocial Integrity/Family Dynamics
15. The nurse is preparing a new mother for discharge when the woman shares that she is
worried about going back to work and its effects on my infant. The most therapeutic
response by the nurse is:
1. Do you want to go back to work?
2. Just be sure you have an excellent baby sitter.
3. There is no proof that working will harm your baby.
4. Can your husband share in the child care responsibilities?
ANS: 3
Balancing employment and family life creates a variety of challenges in terms of child
care and household work for both parents. There is no proof maternal employment is
damaging for children (Shpancer and others, 2006; Hill, 2005). Although the other
options may be true or attempt to offer a solution, they do not address her concerns
regarding the effects on her child.
DIF: C
REF: 123
OBJ: Analysis
TOP: Nursing Process: Implementation
MSC: NCLEX test plan designation: Health Promotion and Maintenance/Family
Systems; Psychosocial Integrity/Family Dynamics
16. The greatest risk to a child of adolescent parents comes from the:
1. Increased family stressors resulting in domestic violence
2. Lack of appropriate parenting resources and role models
3. Statically high potential for physical and emotional abuse
4. Parents inability to provide health care and economic support
ANS: 2
The greatest risk to a child of adolescent parents is derived from the parents strong
potential to lack good parenting skills. This inability can result in both physical and
emotional harm. Increased family stressors resulting in domestic violence and statically
high potential for physical and emotional abuse often result from poor parenting and
coping skills. The parents inability to provide health care and economic support is more
likely in an adolescent-headed family resulting from limited marketable skills.
DIF: C
REF: 123
OBJ: Analysis
TOP: Nursing Process: Assessment
MSC: NCLEX test plan designation: Health Promotion and Maintenance/Family
Systems; Psychosocial Integrity/Family Dynamics
17. Which of the following nursing statements has the greatest therapeutic value when
counseling a sandwich generation client caring for a chronically ill parent?
1. I can help you in finding assistance with the in-home care.
2. What is the most stressful aspect of caring for your parent?

Mosby items and derived items 2009, 2005 by Mosby, Inc., an affiliate of Elsevier Inc.

Test Bank

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3. Im sure your children love having grandmother in the house.


4. What do you do for relaxation now that your mom lives with you?
ANS: 4
Assess for caregiver stress, such as tension in relationships with family and care
recipient, changes in level of health, changes in mood, and anxiety and depression.
Asking the caregiver about hobbies or other means of relaxation is a nonthreatening way
to assess tension levels. Offering to help find assistance infers a need for help that may
insult the caregiver. Assuming the caregiver is stressed or assuming the living situation is
good may cause the caregiver to be reluctant to discuss existing problems.
DIF: C
REF: 133
OBJ: Analysis
TOP: Nursing Process: Assessment
MSC: NCLEX test plan designation: Health Promotion and Maintenance/Family
Systems; Psychosocial Integrity/Family Dynamics
18. The mother of a child receiving immunizations at a health clinic shares with the nurse
that she and the child have not eaten today. Which of the following nursing interventions
is best directed at impacting the immediate problem while being sensitive to the mothers
sense of self-worth?
1. Notifying family services of the problem
2. Taking both mother and child to the cafeteria
3. Informing the mother that she is eligible for food stamps
4. Providing her with contacts at the neighborhood food bank
ANS: 4
When caring for these families, the nurse needs to be sensitive to the familys desire for
independence, but also help them with obtaining appropriate food, financial, and health
care resources. Notifying family services may become necessary, but attempts to provide
the mother with available means of assistance has priority. Taking them to the cafeteria
would provide immediate food but does not address future needs or show sensitivity to
the mother. Informing the mother about local and state aid may become necessary, but it
does not address the immediate need, nor does it show sensitivity to the mother.
DIF: C
REF: 124
OBJ: Analysis
TOP: Nursing Process: Planning/Implementation
MSC: NCLEX test plan designation: Health Promotion and Maintenance/Family
Systems; Psychosocial Integrity/Family Dynamics
19. The nurse recognizes that the presence of an alcohol-abusing parent places a child at
greatest risk for:
1. Homelessness
2. School truancy
3. Family violence
4. Accident-related injuries
ANS: 3

Mosby items and derived items 2009, 2005 by Mosby, Inc., an affiliate of Elsevier Inc.

Test Bank

10-9

Factors such as alcohol and drug abuse increase the incidence of abuse within a family
(Family Violence Prevention Fund, 2006b). While the other options are possible, they are
not the greatest negative outcome.
DIF: C
REF: 124
OBJ: Analysis
TOP: Nursing Process: Assessment
MSC: NCLEX test plan designation: Health Promotion and Maintenance/Family
Systems; Psychosocial Integrity/Family Dynamics
20. The most important impact that truthful, timely communication between the nurse and
the family of a critically ill client has is on the familys ability to:
1. Trust the nurse
2. Adjust to bad news
3. Be confident of the care the client is receiving
4. Make appropriate choices regarding client treatment
ANS: 1
Provide realistic assurance; giving false hope breaks the nurse-client trust. Being trustful
of the information provided by the nurse will aid in the adjustment to bad news. Trust
is the basis for confidence in the care being provided and for appropriate decisionmaking.
DIF: C
REF: 125
OBJ: Analysis
TOP: Nursing Process: Implementation
MSC: NCLEX test plan designation: Health Promotion and Maintenance/Family
Systems; Psychosocial Integrity/Family Dynamics
21. When caring for a terminally ill client, the nurse must also assess the family, because the
primary benefit will be:
1. Effective use of time and resources in the end-of-life care of the client
2. Appropriate attention to the cultural beliefs and expectations of the family
3. Added information regarding the care needs and preferences of the client
4. The ability to respond effectively to the family unit during the dying process
ANS: 4
The more you know about your clients family, how they interact with one another, their
strengths, and their weaknesses, the better. Each family approaches and copes with endof-life decisions differently. While the other responses may be true, they are not the
primary benefit.
DIF: C
REF: 125
OBJ: Analysis
TOP: Nursing Process: Assessment
MSC: NCLEX test plan designation: Health Promotion and Maintenance/Family
Systems; Psychosocial Integrity/Family Dynamics
22. When attempting to meet the needs of the family, the nurse recognizes the central concept
of the theory of family developmental stages is that:

Mosby items and derived items 2009, 2005 by Mosby, Inc., an affiliate of Elsevier Inc.

Test Bank
1.
2.
3.
4.

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Over time all families progress through developmental stages


Needs differ as the family progresses through the various stages
While each family is unique, they all tend to progress through similar stages
The family will progress only when all the challenges of a particular stage are met

ANS: 3
Although families are far from identical to one another, they tend to go through certain
stages. Nursing care can be delivered based on the assumption that all families progress
through similar stages that present comparable challenges.
DIF: C
REF: 125
OBJ: Analysis
TOP: Nursing Process: Assessment/Planning
MSC: NCLEX test plan designation: Health Promotion and Maintenance/Family
Systems; Psychosocial Integrity/Family Dynamics
23. The nurse can primarily affect the effectiveness of a familys ability to cope with stress
by encouraging:
1. Flexible roles
2. Distinct task assignment
3. Individual independence
4. Variable parenting models
ANS: 1
A rigid structure specifically dictates who is able to accomplish a task, and may limit the
number of persons inside as well as outside the immediate family who can assume these
tasks. Sharing tasks allows for reassignment of tasks when the need arises.
A rigid structure specifically dictates who is able to accomplish a task, and may limit the
number of persons inside as well as outside the immediate family who can assume these
tasks. Inability to reassign the tasks will impact the familys ability to adjust to stressors.
DIF: C
REF: 127
OBJ: Analysis
TOP: Nursing Process: Assessment/Planning
MSC: NCLEX test plan designation: Health Promotion and Maintenance/Family
Systems; Psychosocial Integrity/Family Dynamics

Mosby items and derived items 2009, 2005 by Mosby, Inc., an affiliate of Elsevier Inc.