Family Focused Nursing Care 1st

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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

2. 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

3. 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

4. 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

5. 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

6. 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

7. 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

2. 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

3. 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

2. 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

3. 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
4. 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