Nursing NUR408 Exam 2 – Practice Questions and Answers Study
Guide
A fatherless, 11-year-old African American girl lives with her grandmother after the death of her
mother. Her older stepbrother is very involved in her life. How should the community health
nurse view this family constellation, and why?
A. Abnormal; the grandmother should be concerned with issues other than childrearing.
B. Abnormal; a two-parent household is the most advantageous arrangement for parenting.
C. Normal; cultural variations exist in the family life cycle.
D. Normal; because of their wisdom, older adults make better parenting figures. - correct
answer ✔✔ANS: C
The nurse should be aware that cultural differences and specific events may lead to variety in
family constellations. This is normal.
KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Assessment | Client
Need: Psychosocial Integrity
In defiance of parental wishes, a Japanese teenager succumbs to peer pressure and gets a
tattoo. According to Bowen's family systems theory, how should the community health nurse
interpret the teenager's action?
A. The teenager is attempting to differentiate self.
B. The teenager is triangulating self.
C. The teenager is cutting self off emotionally.
D. The teenager is exhibiting antisocial traits. - correct answer ✔✔ANS: A
The teenager is taking on some of the cultural values of peers and is beginning to develop a
unique identity. This process is called differentiation and is a normal task of adolescence.
KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Analysis | Client Need:
Psychosocial Integrity
,A home health nurse is visiting an Asian family. A married couple, their three children, and the
maternal grandparents all live in the home. How should the nurse interpret the presence of the
grandparents in the home?
A. The parents have diffuse boundaries and have allowed the grandparental subsystem to be
present.
B. The grandparental subsystem is not successfully managing separation from the parental
subsystem.
C. Extended family living arrangements are common in some cultures.
D. The nuclear family living arrangement is the preferred environment for childrearing. - correct
answer ✔✔ANS: C
The Asian culture highly respects the elderly. Having the grandparents living in the home is not
uncommon in this culture.
KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Analysis | Client Need:
Psychosocial Integrity
A depressed 21-year-old client has lived with his mother ever since the death of his father 3
years ago. After the client received a college acceptance, the mother repeatedly states, "That's
wonderful. I'll be fine all alone." How would the nurse interpret the mother's statements?
A. The mother is withholding supportive messages.
B. The mother is expressing denigrating remarks.
C. The mother is communicating indirectly.
D. The mother is using double-bind communication. - correct answer ✔✔ANS: D
The client's mother says she is fine with him going away to college but then tries to make him
feel guilty about her being left alone. The client is in a no-win situation because his mother has
given a mixed message—a double-bind communication.
KEY: Cognitive Level: Application | Integrated Process: Nursing Process: Analysis | Client Need:
Psychosocial Integrity
,In a family that is in the life cycle stage called "The Family with Adolescents," which changes
must occur for the family to proceed developmentally?
A. Making adjustments within the marital system to meet the responsibilities of parenthood
B. Establishing a new identity as a couple by realigning relationships with extended family
C. Redefining the level of dependence so that adolescents are provided with greater autonomy
D. Reestablishing the bond of the dyadic marital relationship - correct answer ✔✔ANS: C
Stage IV of the family life cycle is described as "The Family with Adolescents." The task of this
stage is to redefine the level of dependence so that adolescents are provided with greater
autonomy while parents remain responsive to teenagers' dependency needs.
KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Assessment | Client
Need: Psychosocial Integrity
A clinic nurse is caring for a 40-year-old client who lives with his parents. The client's mother
continues to do the client's laundry and provides spending money. Based on this situation,
which family dynamic does the nurse recognize?
A. Taking over
B. Communicating indirectly
C. Belittling feelings
D. Making assumptions - correct answer ✔✔ANS: A
Taking over occurs when a family member fails to allow another member to develop a sense of
responsibility and self-worth. By doing the client's laundry and managing finances, the mother is
fostering the client's dependence.
KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Assessment | Client
Need: Psychosocial Integrity
, A 30-year-old client seeking therapy states, "My mom cries when she is not included in all my
social activities and thinks of my friends as her own." How would the nurse describe the
boundaries between this family's parent and child subsystems?
A. The boundaries are rigid.
B. The boundaries are restructured.
C. The boundaries are enmeshed.
D. The boundaries are disengaged. - correct answer ✔✔ANS: C
With enmeshed boundaries, family members lack individuation and experience exaggerated
connectedness. The client's mother is trying to prevent independence by generating feelings of
guilt.
KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Assessment |Client
Need: Psychosocial Integrity
A nurse enters an inpatient room and finds the family disagreeing about the client's living
arrangements after discharge. Which information should the nurse provide when teaching
techniques to resolve family conflicts?
A. All family members should use past incidents to make their point.
B. One family member should act as a gatekeeper in order to avoid family confrontation.
C. One family member should act as a compromiser to preserve harmony in the family system.
D. All family members should respect differing opinions and use compromise and negotiation. -
correct answer ✔✔ANS: D
Functional families allow and respect differences among members. They learn to handle
differences and conflict through negotiation and compromise.
KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Implementation |
Client Need: Health Promotion and Maintenance
Guide
A fatherless, 11-year-old African American girl lives with her grandmother after the death of her
mother. Her older stepbrother is very involved in her life. How should the community health
nurse view this family constellation, and why?
A. Abnormal; the grandmother should be concerned with issues other than childrearing.
B. Abnormal; a two-parent household is the most advantageous arrangement for parenting.
C. Normal; cultural variations exist in the family life cycle.
D. Normal; because of their wisdom, older adults make better parenting figures. - correct
answer ✔✔ANS: C
The nurse should be aware that cultural differences and specific events may lead to variety in
family constellations. This is normal.
KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Assessment | Client
Need: Psychosocial Integrity
In defiance of parental wishes, a Japanese teenager succumbs to peer pressure and gets a
tattoo. According to Bowen's family systems theory, how should the community health nurse
interpret the teenager's action?
A. The teenager is attempting to differentiate self.
B. The teenager is triangulating self.
C. The teenager is cutting self off emotionally.
D. The teenager is exhibiting antisocial traits. - correct answer ✔✔ANS: A
The teenager is taking on some of the cultural values of peers and is beginning to develop a
unique identity. This process is called differentiation and is a normal task of adolescence.
KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Analysis | Client Need:
Psychosocial Integrity
,A home health nurse is visiting an Asian family. A married couple, their three children, and the
maternal grandparents all live in the home. How should the nurse interpret the presence of the
grandparents in the home?
A. The parents have diffuse boundaries and have allowed the grandparental subsystem to be
present.
B. The grandparental subsystem is not successfully managing separation from the parental
subsystem.
C. Extended family living arrangements are common in some cultures.
D. The nuclear family living arrangement is the preferred environment for childrearing. - correct
answer ✔✔ANS: C
The Asian culture highly respects the elderly. Having the grandparents living in the home is not
uncommon in this culture.
KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Analysis | Client Need:
Psychosocial Integrity
A depressed 21-year-old client has lived with his mother ever since the death of his father 3
years ago. After the client received a college acceptance, the mother repeatedly states, "That's
wonderful. I'll be fine all alone." How would the nurse interpret the mother's statements?
A. The mother is withholding supportive messages.
B. The mother is expressing denigrating remarks.
C. The mother is communicating indirectly.
D. The mother is using double-bind communication. - correct answer ✔✔ANS: D
The client's mother says she is fine with him going away to college but then tries to make him
feel guilty about her being left alone. The client is in a no-win situation because his mother has
given a mixed message—a double-bind communication.
KEY: Cognitive Level: Application | Integrated Process: Nursing Process: Analysis | Client Need:
Psychosocial Integrity
,In a family that is in the life cycle stage called "The Family with Adolescents," which changes
must occur for the family to proceed developmentally?
A. Making adjustments within the marital system to meet the responsibilities of parenthood
B. Establishing a new identity as a couple by realigning relationships with extended family
C. Redefining the level of dependence so that adolescents are provided with greater autonomy
D. Reestablishing the bond of the dyadic marital relationship - correct answer ✔✔ANS: C
Stage IV of the family life cycle is described as "The Family with Adolescents." The task of this
stage is to redefine the level of dependence so that adolescents are provided with greater
autonomy while parents remain responsive to teenagers' dependency needs.
KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Assessment | Client
Need: Psychosocial Integrity
A clinic nurse is caring for a 40-year-old client who lives with his parents. The client's mother
continues to do the client's laundry and provides spending money. Based on this situation,
which family dynamic does the nurse recognize?
A. Taking over
B. Communicating indirectly
C. Belittling feelings
D. Making assumptions - correct answer ✔✔ANS: A
Taking over occurs when a family member fails to allow another member to develop a sense of
responsibility and self-worth. By doing the client's laundry and managing finances, the mother is
fostering the client's dependence.
KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Assessment | Client
Need: Psychosocial Integrity
, A 30-year-old client seeking therapy states, "My mom cries when she is not included in all my
social activities and thinks of my friends as her own." How would the nurse describe the
boundaries between this family's parent and child subsystems?
A. The boundaries are rigid.
B. The boundaries are restructured.
C. The boundaries are enmeshed.
D. The boundaries are disengaged. - correct answer ✔✔ANS: C
With enmeshed boundaries, family members lack individuation and experience exaggerated
connectedness. The client's mother is trying to prevent independence by generating feelings of
guilt.
KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Assessment |Client
Need: Psychosocial Integrity
A nurse enters an inpatient room and finds the family disagreeing about the client's living
arrangements after discharge. Which information should the nurse provide when teaching
techniques to resolve family conflicts?
A. All family members should use past incidents to make their point.
B. One family member should act as a gatekeeper in order to avoid family confrontation.
C. One family member should act as a compromiser to preserve harmony in the family system.
D. All family members should respect differing opinions and use compromise and negotiation. -
correct answer ✔✔ANS: D
Functional families allow and respect differences among members. They learn to handle
differences and conflict through negotiation and compromise.
KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Implementation |
Client Need: Health Promotion and Maintenance
