NSG222 Family Nursing – Comprehensive Final Exam
(Latest 2024/2025 Update) | 100 Questions | Verified Answers
SECTION 1: FAMILY THEORY & ASSESSMENT
(Bowen, Minuchin, Calgary FAM, Genograms) — 20 Questions
Comprehensive Scenario: The Henderson Family
Sarah Henderson, 42, presents to the family nurse practitioner with her husband
Mark (45), their daughter Emma (16), and Sarah's mother Dorothy (68). Sarah reports
frequent headaches and insomnia. Mark states he feels "caught in the middle"
between Sarah and Dorothy regarding parenting decisions. Emma has been
withdrawn since her parents considered separating six months ago. Dorothy moved
in two years ago after her husband's death. The family lives in a three-bedroom
home. Sarah works full-time as a teacher; Mark is an electrician. Financial strain has
increased since Dorothy moved in. The nurse completes a genogram and ecomap.
Q1: Based on Bowen's family systems theory, Mark's statement that he feels "caught
in the middle" between Sarah and Dorothy best demonstrates which concept?
A. Multigenerational transmission
B. Differentiation of self
C. Triangulation [CORRECT]
D. Family projection process
Correct Answer: C
Rationale: Correct because triangulation occurs when tension between two people
causes a third person to be drawn into the conflict to stabilize the system, which
matches Mark's position between his wife and mother-in-law.
Q2: According to structural family theory (Minuchin), the nurse assesses that
Dorothy frequently overrides Sarah's parenting decisions regarding Emma. This
pattern indicates a problem with which structural component?
A. Family hierarchy [CORRECT]
,B. Family boundaries
C. Family coalition
D. Subsystem alignment
Correct Answer: A
Rationale: Correct because family hierarchy refers to the appropriate authority
structure within a family; when a grandparent overrides parental authority, the
generational hierarchy is disrupted.
Q3: The nurse uses the Calgary Family Assessment Model (CFAM) to evaluate this
family. Which domain assesses the family's instrumental functioning including meal
preparation, transportation, and sleep routines?
A. Structural assessment
B. Developmental assessment
C. Functional assessment [CORRECT]
D. Interactional assessment
Correct Answer: C
Rationale: Correct because the functional assessment domain of CFAM examines
how family members perform both instrumental (daily tasks) and expressive
(emotional) functions.
Q4: When constructing a genogram for this family, which symbol represents a
female family member?
A. Square
B. Circle [CORRECT]
C. Triangle
D. Diamond
Correct Answer: B
Rationale: Correct because standard genogram conventions use circles to denote
females and squares to denote males in family diagrams.
Q5: The nurse notes on the genogram that Sarah's father died of myocardial
infarction at age 58 and Dorothy has type 2 diabetes. This information is most
relevant to which aspect of family nursing care?
A. Family developmental stage
B. Family health risk assessment [CORRECT]
C. Family communication patterns
D. Family cultural identity
Correct Answer: B
,Rationale: Correct because documenting medical history across generations through
a genogram directly supports identification of genetic and lifestyle-related health
risks for family members.
Q6: (Comprehensive Scenario continues) Using Duvall's family life cycle stages, the
Henderson family with a 16-year-old daughter and a grandparent in the home
represents which developmental stage?
A. Families with adolescents [CORRECT]
B. Launching center families
C. Families in later life
D. Families with young children
Correct Answer: A
Rationale: Correct because Duvall's stage of families with adolescents encompasses
households with children aged 13-20 years who are developing identity and
autonomy.
Q7: According to Carter and McGoldrick's expanded family life cycle, which
additional factor must the nurse consider when assessing the Henderson family's
current developmental task?
A. Racial identity formation
B. Horizontal stressors including economic downturns and vertical stressors
including multigenerational patterns [CORRECT]
C. Sibling position only
D. Family income as the sole determinant
Correct Answer: B
Rationale: Correct because Carter and McGoldrick emphasize that families face both
horizontal stressors (current life events) and vertical stressors (historical,
multigenerational patterns) that intersect with developmental stages.
Q8: Emma's withdrawal since her parents' separation threat most closely aligns with
which family systems concept?
A. Emotional cutoff
B. Undifferentiated family ego mass
C. Symptom bearer [CORRECT]
D. Sibling position
Correct Answer: C
Rationale: Correct because the symptom bearer concept describes a family member
who expresses the family's distress through physical or emotional symptoms, which
aligns with Emma's withdrawal reflecting family tension.
, Q9: The nurse observes that Sarah and Mark have not discussed their separation
threat directly but communicate through Emma. This pattern is best described as:
A. Disengagement
B. Enmeshment
C. Detouring [CORRECT]
D. Coalition
Correct Answer: C
Rationale: Correct because detouring occurs when parents redirect conflict or focus
onto a child rather than addressing marital issues directly, which places the child in a
stressful mediating role.
Q10: From a developmental perspective, the nurse recognizes that Emma's primary
task at age 16 includes:
A. Establishing financial independence
B. Achieving identity formation and peer relationships [CORRECT]
C. Developing object permanence
D. Resolving integrity versus despair
Correct Answer: B
Rationale: Correct because Erikson's stage of identity versus role confusion during
adolescence emphasizes the development of personal identity and meaningful peer
connections.
Q11: (Scenario continues) Sarah reports that since Dorothy moved in, the family has
stopped their weekly game nights and no longer eats dinner together. Using the
CFAM functional assessment, this data reflects a change in:
A. Family rituals and routines [CORRECT]
B. Family power structure
C. Family genogram structure
D. Family ethnic background
Correct Answer: A
Rationale: Correct because family rituals and routines are patterns of behavior that
provide stability and meaning; their disruption indicates altered family functioning.
Q12: The nurse learns that Dorothy believes Emma should focus only on schoolwork
while Sarah wants Emma to have part-time employment. This intergenerational
difference represents:
A. A structural boundary violation
B. A developmental transition conflict [CORRECT]
C. An example of emotional cutoff
D. A sign of family disengagement
(Latest 2024/2025 Update) | 100 Questions | Verified Answers
SECTION 1: FAMILY THEORY & ASSESSMENT
(Bowen, Minuchin, Calgary FAM, Genograms) — 20 Questions
Comprehensive Scenario: The Henderson Family
Sarah Henderson, 42, presents to the family nurse practitioner with her husband
Mark (45), their daughter Emma (16), and Sarah's mother Dorothy (68). Sarah reports
frequent headaches and insomnia. Mark states he feels "caught in the middle"
between Sarah and Dorothy regarding parenting decisions. Emma has been
withdrawn since her parents considered separating six months ago. Dorothy moved
in two years ago after her husband's death. The family lives in a three-bedroom
home. Sarah works full-time as a teacher; Mark is an electrician. Financial strain has
increased since Dorothy moved in. The nurse completes a genogram and ecomap.
Q1: Based on Bowen's family systems theory, Mark's statement that he feels "caught
in the middle" between Sarah and Dorothy best demonstrates which concept?
A. Multigenerational transmission
B. Differentiation of self
C. Triangulation [CORRECT]
D. Family projection process
Correct Answer: C
Rationale: Correct because triangulation occurs when tension between two people
causes a third person to be drawn into the conflict to stabilize the system, which
matches Mark's position between his wife and mother-in-law.
Q2: According to structural family theory (Minuchin), the nurse assesses that
Dorothy frequently overrides Sarah's parenting decisions regarding Emma. This
pattern indicates a problem with which structural component?
A. Family hierarchy [CORRECT]
,B. Family boundaries
C. Family coalition
D. Subsystem alignment
Correct Answer: A
Rationale: Correct because family hierarchy refers to the appropriate authority
structure within a family; when a grandparent overrides parental authority, the
generational hierarchy is disrupted.
Q3: The nurse uses the Calgary Family Assessment Model (CFAM) to evaluate this
family. Which domain assesses the family's instrumental functioning including meal
preparation, transportation, and sleep routines?
A. Structural assessment
B. Developmental assessment
C. Functional assessment [CORRECT]
D. Interactional assessment
Correct Answer: C
Rationale: Correct because the functional assessment domain of CFAM examines
how family members perform both instrumental (daily tasks) and expressive
(emotional) functions.
Q4: When constructing a genogram for this family, which symbol represents a
female family member?
A. Square
B. Circle [CORRECT]
C. Triangle
D. Diamond
Correct Answer: B
Rationale: Correct because standard genogram conventions use circles to denote
females and squares to denote males in family diagrams.
Q5: The nurse notes on the genogram that Sarah's father died of myocardial
infarction at age 58 and Dorothy has type 2 diabetes. This information is most
relevant to which aspect of family nursing care?
A. Family developmental stage
B. Family health risk assessment [CORRECT]
C. Family communication patterns
D. Family cultural identity
Correct Answer: B
,Rationale: Correct because documenting medical history across generations through
a genogram directly supports identification of genetic and lifestyle-related health
risks for family members.
Q6: (Comprehensive Scenario continues) Using Duvall's family life cycle stages, the
Henderson family with a 16-year-old daughter and a grandparent in the home
represents which developmental stage?
A. Families with adolescents [CORRECT]
B. Launching center families
C. Families in later life
D. Families with young children
Correct Answer: A
Rationale: Correct because Duvall's stage of families with adolescents encompasses
households with children aged 13-20 years who are developing identity and
autonomy.
Q7: According to Carter and McGoldrick's expanded family life cycle, which
additional factor must the nurse consider when assessing the Henderson family's
current developmental task?
A. Racial identity formation
B. Horizontal stressors including economic downturns and vertical stressors
including multigenerational patterns [CORRECT]
C. Sibling position only
D. Family income as the sole determinant
Correct Answer: B
Rationale: Correct because Carter and McGoldrick emphasize that families face both
horizontal stressors (current life events) and vertical stressors (historical,
multigenerational patterns) that intersect with developmental stages.
Q8: Emma's withdrawal since her parents' separation threat most closely aligns with
which family systems concept?
A. Emotional cutoff
B. Undifferentiated family ego mass
C. Symptom bearer [CORRECT]
D. Sibling position
Correct Answer: C
Rationale: Correct because the symptom bearer concept describes a family member
who expresses the family's distress through physical or emotional symptoms, which
aligns with Emma's withdrawal reflecting family tension.
, Q9: The nurse observes that Sarah and Mark have not discussed their separation
threat directly but communicate through Emma. This pattern is best described as:
A. Disengagement
B. Enmeshment
C. Detouring [CORRECT]
D. Coalition
Correct Answer: C
Rationale: Correct because detouring occurs when parents redirect conflict or focus
onto a child rather than addressing marital issues directly, which places the child in a
stressful mediating role.
Q10: From a developmental perspective, the nurse recognizes that Emma's primary
task at age 16 includes:
A. Establishing financial independence
B. Achieving identity formation and peer relationships [CORRECT]
C. Developing object permanence
D. Resolving integrity versus despair
Correct Answer: B
Rationale: Correct because Erikson's stage of identity versus role confusion during
adolescence emphasizes the development of personal identity and meaningful peer
connections.
Q11: (Scenario continues) Sarah reports that since Dorothy moved in, the family has
stopped their weekly game nights and no longer eats dinner together. Using the
CFAM functional assessment, this data reflects a change in:
A. Family rituals and routines [CORRECT]
B. Family power structure
C. Family genogram structure
D. Family ethnic background
Correct Answer: A
Rationale: Correct because family rituals and routines are patterns of behavior that
provide stability and meaning; their disruption indicates altered family functioning.
Q12: The nurse learns that Dorothy believes Emma should focus only on schoolwork
while Sarah wants Emma to have part-time employment. This intergenerational
difference represents:
A. A structural boundary violation
B. A developmental transition conflict [CORRECT]
C. An example of emotional cutoff
D. A sign of family disengagement
