TEST BANK
Wright & Leahey's Nurses And Families A Guide To
Family Assessment And Intervention
,Table of Contents
Chapter 1 — Family Assessment and Intervention: An Overview
Chapter 2 — Theoretical Foundations of the Calgary Family Assessment and Intervention Models
Chapter 3 — The Calgary Family Assessment Model
Chapter 4 — The Calgary Family Intervention Model
Chapter 5 — Family Nursing Interviews: Stages and Skills
Chapter 6 — How To Prepare for Family Interviews
Chapter 7 — How To Conduct Family Interviews
Chapter 8 — How To Use Questions in Family Interviewing
Chapter 9 — How To Do a 15-Minute (or Shorter) Family Interview
Chapter 10 — How To Move Beyond Basic Family Nursing Skills
Chapter 11 — How To Avoid the Three Most Common Errors in Family Nursing
Chapter 12 — How To Terminate With Families
Chapter 13 — Pulling It All Together
,CHAPTER 1: Family Assessment and Intervention: An Overview
MULTIPLE CHOICE QUESTIONS
Question 1
Which of the following BEST defines a family in the context of family nursing practice?
A) Only individuals who are biologically related and share the same household
B) Who the family says they are — a group of individuals who are bound by strong emotional
ties, a sense of belonging, and a commitment to one another
C) A legally married couple with dependent children
D) Any group of people who live together in the same residence
Answer: B
Rationale: Wright and Leahey's foundational definition of family is broad and inclusive — the
family is who they say they are. This definition moves beyond biological or legal boundaries to
encompass the emotional bonds and commitment that define family relationships, reflecting
the diverse family structures encountered in nursing practice.
Question 2
The Calgary Family Assessment Model (CFAM) is BEST described as:
A) A model used exclusively for psychiatric nursing assessments
B) An integrated, multidimensional framework for assessing family structure, development, and
functioning
C) A model that focuses solely on the biological health of individual family members
D) A tool used only in pediatric nursing settings
Answer: B
Rationale: The CFAM is a comprehensive framework that organizes family assessment into three
main categories: structural, developmental, and functional. It provides nurses with a systematic
approach to understanding families in the context of health and illness across all nursing
practice settings.
,Question 3
Which of the following BEST describes the generalist level of nursing practice with families?
A) Conducting advanced family therapy sessions
B) Providing family-focused care that incorporates the family into the patient's care without
specialized family therapy training
C) Performing psychiatric assessments of all family members
D) Developing family research protocols for academic institutions
Answer: B
Rationale: Generalist nurses integrate family into care by acknowledging the family's role,
providing information, and offering support without conducting specialized family therapy. This
level of practice is appropriate for all professional nurses and forms the foundation of family
nursing practice.
Question 4
The Calgary Family Intervention Model (CFIM) is MOST accurately described as:
A) A model for diagnosing psychiatric disorders in families
B) An organizing framework that identifies specific nursing interventions designed to promote,
improve, or sustain family functioning in the cognitive, affective, and behavioral domains
C) A model exclusively used for family conflict resolution
D) A legal framework for family guardianship decisions
Answer: B
Rationale: The CFIM complements the CFAM by providing a framework for designing
interventions that target the cognitive (beliefs and perceptions), affective (emotions), and
behavioral (actions) domains of family functioning. It guides nurses in selecting purposeful
interventions to support families experiencing health challenges.
,Question 5
Family nursing interventions are MOST appropriately described as:
A) Actions taken by nurses to replace family members in caregiving roles
B) Purposeful nursing actions directed at the whole family or specific family members to
promote, improve, or sustain family functioning
C) Interventions designed to separate family members from patient care
D) Administrative actions taken to manage family complaints
Answer: B
Rationale: Family nursing interventions are goal-directed actions that target family functioning
as a whole. They are designed to support families through health challenges by strengthening
their resources, improving communication, and addressing emotional and cognitive responses
to illness.
MEDIUM QUESTIONS (6–11)
Question 6
Which of the following is a recognized contraindication for conducting a full family assessment?
A) The patient has a chronic illness
B) The family is in acute crisis requiring immediate stabilization before assessment can proceed
meaningfully
C) The family consists of more than five members
D) The patient is over 65 years of age
Answer: B
Rationale: While family assessment is broadly indicated, a full CFAM-based assessment may be
contraindicated or need to be modified when the family is in acute crisis. Immediate safety and
stabilization take priority before comprehensive assessment activities can be undertaken
effectively.
,Question 7
The evolution of family nursing has moved from viewing the family as:
A) The primary focus of care from the beginning of modern nursing
B) Context for the patient, to a sum of its parts, to a unit of care in which the whole family is the
patient
C) An obstacle to individual patient care
D) A resource to be utilized only in pediatric nursing
Answer: B
Rationale: The evolution of family nursing reflects a progressive shift in perspective: initially
families were background context for individual patient care; then the focus expanded to view
each family member as a patient; and finally the family as a whole unit became the focus of
nursing care — the approach that defines contemporary family nursing practice.
Question 8
A specialist level of family nursing practice differs from the generalist level PRIMARILY in that the
specialist:
A) Works exclusively in hospital settings
B) Has advanced education and training in family systems theory and family therapy, enabling
complex therapeutic work with families experiencing significant dysfunction
C) Provides care to larger families only
D) Has more years of clinical experience regardless of additional education
Answer: B
Rationale: The specialist level of family nursing practice requires advanced graduate education
in family systems theory, family therapy models, and supervised clinical practice. Specialists are
equipped to address complex family dysfunction, whereas generalists integrate family into care
within the scope of standard professional nursing practice.
,Question 9
When determining whether a family intervention is indicated, which factor is MOST important
to assess?
A) The family's financial resources
B) The fit between the family's identified concerns and problems and the nurse's ability to
address those concerns within the current clinical context
C) The number of family members present at the clinical encounter
D) The nurse's personal comfort with family interactions
Answer: B
Rationale: Determining the appropriateness of family intervention requires assessing whether
the nurse's skills, the clinical context, and available resources match the family's identified
needs. This ensures that interventions are purposeful, feasible, and likely to be effective rather
than burdensome to the family or the system.
Question 10
Which of the following BEST illustrates the concept of the family as the unit of care?
A) A nurse focuses exclusively on the patient's physical recovery without engaging family
members
B) A nurse involves the entire family in care planning, assesses family dynamics, provides
education to family members, and evaluates the impact of illness on family functioning as a
whole
C) A nurse manages family members' expectations by limiting their involvement in clinical
decisions
D) A nurse assigns one family member as the spokesperson and interacts only with that
individual
, Answer: B
Rationale: When the family is the unit of care, nursing assessment and intervention address the
family system as a whole. This includes engaging all relevant family members, assessing how
illness affects family roles and relationships, and designing interventions that support the entire
family's response to health challenges.
Question 11
A nurse working on a medical unit recognizes that a patient's recovery is significantly affected by
family stress and poor communication. At the generalist level, which action is MOST
appropriate?
A) Referring the family immediately to a family therapist without any initial nursing engagement
B) Conducting a brief family assessment using the CFAM, acknowledging the family's concerns,
providing information about community resources, and facilitating improved communication
between the patient and family members
C) Advising the family to resolve their conflicts outside of the healthcare setting
D) Documenting family stress as irrelevant to the patient's physical recovery
Answer: B
Rationale: Generalist nurses have both the obligation and the skills to engage families
experiencing stress that affects patient outcomes. Brief family assessment and targeted
interventions such as information provision, acknowledgment, and facilitated communication
are within the generalist scope and can significantly improve both family and patient outcomes.
HARD QUESTIONS (12–15)
Question 12
A nurse working with a family whose cultural background differs significantly from the nurse's
own is planning a family assessment. Applying the principles of family nursing from Chapter 1,
which approach MOST appropriately reflects culturally responsive family-centered care?
,A) Applying the standard CFAM framework rigidly without modification to maintain assessment
consistency
B) Recognizing the influence of cultural beliefs on family structure, roles, and functioning;
approaching the family with curiosity and humility; allowing the family to define themselves and
their needs; and adapting assessment questions and intervention strategies to align with the
family's cultural context
C) Referring all culturally diverse families to a specialist without attempting generalist-level
assessment
D) Focusing assessment exclusively on observable behaviors to avoid culturally biased
interpretation
Answer: B
Rationale: Cultural responsiveness requires nurses to approach families with humility and
curiosity rather than applying frameworks rigidly. Allowing families to define themselves,
exploring culturally shaped beliefs about health and family roles, and adapting assessment and
intervention strategies reflect the foundational principles of family nursing that respect the
diversity of family forms and experiences.
Question 13
Critically evaluating the evolution of family nursing, which statement MOST accurately reflects
the theoretical significance of moving from "family as context" to "family as unit of care"?
A) This shift is primarily administrative, affecting documentation requirements rather than
clinical practice
B) This evolution represents a fundamental paradigm shift in nursing epistemology — from a
reductionist focus on the individual patient to a systemic understanding that health and illness
are experienced and managed within relational contexts, requiring nurses to develop new
assessment skills, theoretical frameworks, and intervention approaches
C) The shift is relevant only in community health nursing and has no implications for acute care
settings
, D) This evolution reduced the complexity of nursing practice by simplifying patient assessment
Answer: B
Rationale: The shift from family as context to family as unit of care reflects a profound
epistemological transformation in nursing. It requires nurses to adopt systems-based thinking,
develop relational assessment skills, and design interventions that address the family as a
dynamic, interdependent system — not merely a backdrop for individual patient care. This shift
has implications across all nursing specialties and settings.
Question 14
A family with a member recently diagnosed with a terminal illness presents with conflicting
information needs — the patient wants full disclosure of prognosis, while other family members
request that the prognosis be withheld. Applying Chapter 1's overview of family assessment and
intervention principles, which approach MOST appropriately addresses this ethical and clinical
complexity?
A) Following the family members' request to withhold information to maintain family harmony
B) Prioritizing the patient's autonomous right to information while acknowledging the family's
protective motivations, facilitating an open family discussion about information preferences and
fears, exploring the family's beliefs about illness disclosure, and involving the interprofessional
team and ethics consultation if needed
C) Providing full prognosis information to the patient without acknowledging the family's
concerns
D) Deferring entirely to the physician's decision about information disclosure without nursing
input
Answer: B
Rationale: Family nursing in complex situations requires balancing individual patient rights with
family relational dynamics. The patient's autonomy is primary, but family concerns reflect
protective motivations that deserve acknowledgment. Facilitated family dialogue, exploration of
underlying beliefs and fears, and collaborative decision-making with the interprofessional team
reflect the sophisticated, family-centered approach that Shajani and Snell's framework
advocates.
Wright & Leahey's Nurses And Families A Guide To
Family Assessment And Intervention
,Table of Contents
Chapter 1 — Family Assessment and Intervention: An Overview
Chapter 2 — Theoretical Foundations of the Calgary Family Assessment and Intervention Models
Chapter 3 — The Calgary Family Assessment Model
Chapter 4 — The Calgary Family Intervention Model
Chapter 5 — Family Nursing Interviews: Stages and Skills
Chapter 6 — How To Prepare for Family Interviews
Chapter 7 — How To Conduct Family Interviews
Chapter 8 — How To Use Questions in Family Interviewing
Chapter 9 — How To Do a 15-Minute (or Shorter) Family Interview
Chapter 10 — How To Move Beyond Basic Family Nursing Skills
Chapter 11 — How To Avoid the Three Most Common Errors in Family Nursing
Chapter 12 — How To Terminate With Families
Chapter 13 — Pulling It All Together
,CHAPTER 1: Family Assessment and Intervention: An Overview
MULTIPLE CHOICE QUESTIONS
Question 1
Which of the following BEST defines a family in the context of family nursing practice?
A) Only individuals who are biologically related and share the same household
B) Who the family says they are — a group of individuals who are bound by strong emotional
ties, a sense of belonging, and a commitment to one another
C) A legally married couple with dependent children
D) Any group of people who live together in the same residence
Answer: B
Rationale: Wright and Leahey's foundational definition of family is broad and inclusive — the
family is who they say they are. This definition moves beyond biological or legal boundaries to
encompass the emotional bonds and commitment that define family relationships, reflecting
the diverse family structures encountered in nursing practice.
Question 2
The Calgary Family Assessment Model (CFAM) is BEST described as:
A) A model used exclusively for psychiatric nursing assessments
B) An integrated, multidimensional framework for assessing family structure, development, and
functioning
C) A model that focuses solely on the biological health of individual family members
D) A tool used only in pediatric nursing settings
Answer: B
Rationale: The CFAM is a comprehensive framework that organizes family assessment into three
main categories: structural, developmental, and functional. It provides nurses with a systematic
approach to understanding families in the context of health and illness across all nursing
practice settings.
,Question 3
Which of the following BEST describes the generalist level of nursing practice with families?
A) Conducting advanced family therapy sessions
B) Providing family-focused care that incorporates the family into the patient's care without
specialized family therapy training
C) Performing psychiatric assessments of all family members
D) Developing family research protocols for academic institutions
Answer: B
Rationale: Generalist nurses integrate family into care by acknowledging the family's role,
providing information, and offering support without conducting specialized family therapy. This
level of practice is appropriate for all professional nurses and forms the foundation of family
nursing practice.
Question 4
The Calgary Family Intervention Model (CFIM) is MOST accurately described as:
A) A model for diagnosing psychiatric disorders in families
B) An organizing framework that identifies specific nursing interventions designed to promote,
improve, or sustain family functioning in the cognitive, affective, and behavioral domains
C) A model exclusively used for family conflict resolution
D) A legal framework for family guardianship decisions
Answer: B
Rationale: The CFIM complements the CFAM by providing a framework for designing
interventions that target the cognitive (beliefs and perceptions), affective (emotions), and
behavioral (actions) domains of family functioning. It guides nurses in selecting purposeful
interventions to support families experiencing health challenges.
,Question 5
Family nursing interventions are MOST appropriately described as:
A) Actions taken by nurses to replace family members in caregiving roles
B) Purposeful nursing actions directed at the whole family or specific family members to
promote, improve, or sustain family functioning
C) Interventions designed to separate family members from patient care
D) Administrative actions taken to manage family complaints
Answer: B
Rationale: Family nursing interventions are goal-directed actions that target family functioning
as a whole. They are designed to support families through health challenges by strengthening
their resources, improving communication, and addressing emotional and cognitive responses
to illness.
MEDIUM QUESTIONS (6–11)
Question 6
Which of the following is a recognized contraindication for conducting a full family assessment?
A) The patient has a chronic illness
B) The family is in acute crisis requiring immediate stabilization before assessment can proceed
meaningfully
C) The family consists of more than five members
D) The patient is over 65 years of age
Answer: B
Rationale: While family assessment is broadly indicated, a full CFAM-based assessment may be
contraindicated or need to be modified when the family is in acute crisis. Immediate safety and
stabilization take priority before comprehensive assessment activities can be undertaken
effectively.
,Question 7
The evolution of family nursing has moved from viewing the family as:
A) The primary focus of care from the beginning of modern nursing
B) Context for the patient, to a sum of its parts, to a unit of care in which the whole family is the
patient
C) An obstacle to individual patient care
D) A resource to be utilized only in pediatric nursing
Answer: B
Rationale: The evolution of family nursing reflects a progressive shift in perspective: initially
families were background context for individual patient care; then the focus expanded to view
each family member as a patient; and finally the family as a whole unit became the focus of
nursing care — the approach that defines contemporary family nursing practice.
Question 8
A specialist level of family nursing practice differs from the generalist level PRIMARILY in that the
specialist:
A) Works exclusively in hospital settings
B) Has advanced education and training in family systems theory and family therapy, enabling
complex therapeutic work with families experiencing significant dysfunction
C) Provides care to larger families only
D) Has more years of clinical experience regardless of additional education
Answer: B
Rationale: The specialist level of family nursing practice requires advanced graduate education
in family systems theory, family therapy models, and supervised clinical practice. Specialists are
equipped to address complex family dysfunction, whereas generalists integrate family into care
within the scope of standard professional nursing practice.
,Question 9
When determining whether a family intervention is indicated, which factor is MOST important
to assess?
A) The family's financial resources
B) The fit between the family's identified concerns and problems and the nurse's ability to
address those concerns within the current clinical context
C) The number of family members present at the clinical encounter
D) The nurse's personal comfort with family interactions
Answer: B
Rationale: Determining the appropriateness of family intervention requires assessing whether
the nurse's skills, the clinical context, and available resources match the family's identified
needs. This ensures that interventions are purposeful, feasible, and likely to be effective rather
than burdensome to the family or the system.
Question 10
Which of the following BEST illustrates the concept of the family as the unit of care?
A) A nurse focuses exclusively on the patient's physical recovery without engaging family
members
B) A nurse involves the entire family in care planning, assesses family dynamics, provides
education to family members, and evaluates the impact of illness on family functioning as a
whole
C) A nurse manages family members' expectations by limiting their involvement in clinical
decisions
D) A nurse assigns one family member as the spokesperson and interacts only with that
individual
, Answer: B
Rationale: When the family is the unit of care, nursing assessment and intervention address the
family system as a whole. This includes engaging all relevant family members, assessing how
illness affects family roles and relationships, and designing interventions that support the entire
family's response to health challenges.
Question 11
A nurse working on a medical unit recognizes that a patient's recovery is significantly affected by
family stress and poor communication. At the generalist level, which action is MOST
appropriate?
A) Referring the family immediately to a family therapist without any initial nursing engagement
B) Conducting a brief family assessment using the CFAM, acknowledging the family's concerns,
providing information about community resources, and facilitating improved communication
between the patient and family members
C) Advising the family to resolve their conflicts outside of the healthcare setting
D) Documenting family stress as irrelevant to the patient's physical recovery
Answer: B
Rationale: Generalist nurses have both the obligation and the skills to engage families
experiencing stress that affects patient outcomes. Brief family assessment and targeted
interventions such as information provision, acknowledgment, and facilitated communication
are within the generalist scope and can significantly improve both family and patient outcomes.
HARD QUESTIONS (12–15)
Question 12
A nurse working with a family whose cultural background differs significantly from the nurse's
own is planning a family assessment. Applying the principles of family nursing from Chapter 1,
which approach MOST appropriately reflects culturally responsive family-centered care?
,A) Applying the standard CFAM framework rigidly without modification to maintain assessment
consistency
B) Recognizing the influence of cultural beliefs on family structure, roles, and functioning;
approaching the family with curiosity and humility; allowing the family to define themselves and
their needs; and adapting assessment questions and intervention strategies to align with the
family's cultural context
C) Referring all culturally diverse families to a specialist without attempting generalist-level
assessment
D) Focusing assessment exclusively on observable behaviors to avoid culturally biased
interpretation
Answer: B
Rationale: Cultural responsiveness requires nurses to approach families with humility and
curiosity rather than applying frameworks rigidly. Allowing families to define themselves,
exploring culturally shaped beliefs about health and family roles, and adapting assessment and
intervention strategies reflect the foundational principles of family nursing that respect the
diversity of family forms and experiences.
Question 13
Critically evaluating the evolution of family nursing, which statement MOST accurately reflects
the theoretical significance of moving from "family as context" to "family as unit of care"?
A) This shift is primarily administrative, affecting documentation requirements rather than
clinical practice
B) This evolution represents a fundamental paradigm shift in nursing epistemology — from a
reductionist focus on the individual patient to a systemic understanding that health and illness
are experienced and managed within relational contexts, requiring nurses to develop new
assessment skills, theoretical frameworks, and intervention approaches
C) The shift is relevant only in community health nursing and has no implications for acute care
settings
, D) This evolution reduced the complexity of nursing practice by simplifying patient assessment
Answer: B
Rationale: The shift from family as context to family as unit of care reflects a profound
epistemological transformation in nursing. It requires nurses to adopt systems-based thinking,
develop relational assessment skills, and design interventions that address the family as a
dynamic, interdependent system — not merely a backdrop for individual patient care. This shift
has implications across all nursing specialties and settings.
Question 14
A family with a member recently diagnosed with a terminal illness presents with conflicting
information needs — the patient wants full disclosure of prognosis, while other family members
request that the prognosis be withheld. Applying Chapter 1's overview of family assessment and
intervention principles, which approach MOST appropriately addresses this ethical and clinical
complexity?
A) Following the family members' request to withhold information to maintain family harmony
B) Prioritizing the patient's autonomous right to information while acknowledging the family's
protective motivations, facilitating an open family discussion about information preferences and
fears, exploring the family's beliefs about illness disclosure, and involving the interprofessional
team and ethics consultation if needed
C) Providing full prognosis information to the patient without acknowledging the family's
concerns
D) Deferring entirely to the physician's decision about information disclosure without nursing
input
Answer: B
Rationale: Family nursing in complex situations requires balancing individual patient rights with
family relational dynamics. The patient's autonomy is primary, but family concerns reflect
protective motivations that deserve acknowledgment. Facilitated family dialogue, exploration of
underlying beliefs and fears, and collaborative decision-making with the interprofessional team
reflect the sophisticated, family-centered approach that Shajani and Snell's framework
advocates.
