NSG 526 Exam 3 Actual Exam V3 | NSG 526 Family Nursing (NSG526
Exam 3) | Herzing University PDF
1. A nurse is assessing a family where the primary caregiver of a patient with Alzheimer’s
disease reports feeling ‘constant exhaustion and resentment.’ Which assessment tool is most
appropriate for the nurse to utilize first?
A. The Family APGAR
B. The Zarit Burden Interview
C. The Geriatric Depression Scale
D. The McMaster Model of Family Functioning
Answer: B
Rationale: The Zarit Burden Interview is specifically designed to measure the level of
subjective burden experienced by caregivers of persons with dementia. By using this tool,
the nurse can quantify the caregiver’s stress and identify specific areas where support is
needed. This targeted assessment is the first step in developing a collaborative plan to
prevent caregiver burnout and ensure the safety of both the caregiver and the patient.
2. When applying the Double ABCX Model to a family dealing with a child’s chronic illness,
what does the ‘aA’ factor represent?
A. The pile-up of stressors over time
B. The family’s adaptive resources
C. The initial stressor event only
D. The family’s perception of the crisis
Answer: A
Rationale: In the Double ABCX Model, the ‘aA’ factor refers to the pile-up of demands,
which includes the initial stressor, normative transitions, and prior strains. This model
helps nurses understand that families rarely deal with a single stressor in isolation but
rather a cumulative effect of multiple challenges. Identifying this pile-up allows the nurse
to prioritize interventions that address the most pressing stressors while acknowledging
the family’s history of adaptation.
3. A family system is observed to have very rigid boundaries, where members are expected to
follow strict rules and rarely interact with the outside community. This is best described as:
A. Enmeshment
B. Disengagement
,C. Open system flexibility
D. Closed system functioning
Answer: D
Rationale: A closed system is characterized by rigid boundaries that limit the exchange of
information and energy with the external environment. This often leads to isolation and a
lack of external support during times of crisis, which can impede family resilience. The
nurse must work carefully to build trust with such families to encourage the gradual
opening of boundaries for health-promoting resources.
4. During a family interview, the nurse notices that whenever the mother and father begin to
argue about finances, they immediately redirect their focus to their son’s poor grades. This
behavior is known as:
A. Differentiation of self
B. Triangulation
C. Circular questioning
D. Reframing
Answer: B
Rationale: Triangulation occurs when a two-person relationship under stress involves a
third person to reduce tension and stabilize the relationship. In this scenario, the son
becomes the focus to avoid the primary conflict between the parents, which is a common
but dysfunctional coping mechanism. Recognizing this allows the nurse to help the parents
address their issues directly rather than projecting them onto the child.
5. Which intervention should the nurse prioritize for a family experiencing ‘chronic sorrow’
related to a child’s permanent disability?
A. Validating their feelings as a normal response to ongoing loss
B. Encouraging the family to seek a cure to eliminate grief
C. Referring the parents to individual long-term psychotherapy
D. Advising the family to avoid discussing the disability
Answer: A
Rationale: Chronic sorrow is a normal, non-pathological recurring grief experienced by
parents of children with chronic conditions. Validation helps the family understand that
their feelings of sadness are expected as they reach different developmental milestones
that highlight the child’s limitations. This supportive approach builds a therapeutic alliance
and promotes long-term family adaptation and resilience.
, 6. A family is struggling to care for an elderly member with multiple comorbidities. The nurse
suggests a ‘family meeting’ primarily to:
A. Determine which family member is to blame for the decline
B. Inform the family of the nurse’s pre-set care plan
C. Assess the financial status of each individual member
D. Facilitate collective problem-solving and role distribution
Answer: D
Rationale: Family meetings serve as a collaborative platform to ensure all members are
informed and involved in the care process. This intervention encourages shared decision-
making and helps clarify roles, which can reduce conflict and prevent any one member
from becoming overwhelmed. By fostering open communication, the nurse empowers the
family to utilize their collective strengths to manage complex health needs.
7. According to the Family Systems Stressor-Strength Model, which of the following is
considered a ‘general resistance resource’?
A. The illness itself
B. The death of a secondary family member
C. Financial debt incurred from treatment
D. A strong social support network
Answer: D
Rationale: General resistance resources are factors that help a family manage stress and
maintain stability, such as social support, financial security, and intelligence. These
resources act as buffers against the negative impacts of stressors, promoting health and
recovery. Nurses assess these resources to identify family strengths that can be leveraged
during the care planning process.
8. A nurse is working with a family where the father has recently lost his job, and the mother
has been diagnosed with breast cancer. Using the ABCX model, the father’s job loss is best
categorized as:
A. The ‘A’ factor (Stressor)
B. The ‘B’ factor (Resources)
C. The ‘X’ factor (Crisis)
D. The ‘C’ factor (Perception)
Answer: A
Exam 3) | Herzing University PDF
1. A nurse is assessing a family where the primary caregiver of a patient with Alzheimer’s
disease reports feeling ‘constant exhaustion and resentment.’ Which assessment tool is most
appropriate for the nurse to utilize first?
A. The Family APGAR
B. The Zarit Burden Interview
C. The Geriatric Depression Scale
D. The McMaster Model of Family Functioning
Answer: B
Rationale: The Zarit Burden Interview is specifically designed to measure the level of
subjective burden experienced by caregivers of persons with dementia. By using this tool,
the nurse can quantify the caregiver’s stress and identify specific areas where support is
needed. This targeted assessment is the first step in developing a collaborative plan to
prevent caregiver burnout and ensure the safety of both the caregiver and the patient.
2. When applying the Double ABCX Model to a family dealing with a child’s chronic illness,
what does the ‘aA’ factor represent?
A. The pile-up of stressors over time
B. The family’s adaptive resources
C. The initial stressor event only
D. The family’s perception of the crisis
Answer: A
Rationale: In the Double ABCX Model, the ‘aA’ factor refers to the pile-up of demands,
which includes the initial stressor, normative transitions, and prior strains. This model
helps nurses understand that families rarely deal with a single stressor in isolation but
rather a cumulative effect of multiple challenges. Identifying this pile-up allows the nurse
to prioritize interventions that address the most pressing stressors while acknowledging
the family’s history of adaptation.
3. A family system is observed to have very rigid boundaries, where members are expected to
follow strict rules and rarely interact with the outside community. This is best described as:
A. Enmeshment
B. Disengagement
,C. Open system flexibility
D. Closed system functioning
Answer: D
Rationale: A closed system is characterized by rigid boundaries that limit the exchange of
information and energy with the external environment. This often leads to isolation and a
lack of external support during times of crisis, which can impede family resilience. The
nurse must work carefully to build trust with such families to encourage the gradual
opening of boundaries for health-promoting resources.
4. During a family interview, the nurse notices that whenever the mother and father begin to
argue about finances, they immediately redirect their focus to their son’s poor grades. This
behavior is known as:
A. Differentiation of self
B. Triangulation
C. Circular questioning
D. Reframing
Answer: B
Rationale: Triangulation occurs when a two-person relationship under stress involves a
third person to reduce tension and stabilize the relationship. In this scenario, the son
becomes the focus to avoid the primary conflict between the parents, which is a common
but dysfunctional coping mechanism. Recognizing this allows the nurse to help the parents
address their issues directly rather than projecting them onto the child.
5. Which intervention should the nurse prioritize for a family experiencing ‘chronic sorrow’
related to a child’s permanent disability?
A. Validating their feelings as a normal response to ongoing loss
B. Encouraging the family to seek a cure to eliminate grief
C. Referring the parents to individual long-term psychotherapy
D. Advising the family to avoid discussing the disability
Answer: A
Rationale: Chronic sorrow is a normal, non-pathological recurring grief experienced by
parents of children with chronic conditions. Validation helps the family understand that
their feelings of sadness are expected as they reach different developmental milestones
that highlight the child’s limitations. This supportive approach builds a therapeutic alliance
and promotes long-term family adaptation and resilience.
, 6. A family is struggling to care for an elderly member with multiple comorbidities. The nurse
suggests a ‘family meeting’ primarily to:
A. Determine which family member is to blame for the decline
B. Inform the family of the nurse’s pre-set care plan
C. Assess the financial status of each individual member
D. Facilitate collective problem-solving and role distribution
Answer: D
Rationale: Family meetings serve as a collaborative platform to ensure all members are
informed and involved in the care process. This intervention encourages shared decision-
making and helps clarify roles, which can reduce conflict and prevent any one member
from becoming overwhelmed. By fostering open communication, the nurse empowers the
family to utilize their collective strengths to manage complex health needs.
7. According to the Family Systems Stressor-Strength Model, which of the following is
considered a ‘general resistance resource’?
A. The illness itself
B. The death of a secondary family member
C. Financial debt incurred from treatment
D. A strong social support network
Answer: D
Rationale: General resistance resources are factors that help a family manage stress and
maintain stability, such as social support, financial security, and intelligence. These
resources act as buffers against the negative impacts of stressors, promoting health and
recovery. Nurses assess these resources to identify family strengths that can be leveraged
during the care planning process.
8. A nurse is working with a family where the father has recently lost his job, and the mother
has been diagnosed with breast cancer. Using the ABCX model, the father’s job loss is best
categorized as:
A. The ‘A’ factor (Stressor)
B. The ‘B’ factor (Resources)
C. The ‘X’ factor (Crisis)
D. The ‘C’ factor (Perception)
Answer: A
