Family Concepts

Every question here, with the answer

1. A patient tells the nurse that the people they rely on most are two close friends and a former teammate, and says, “They are my family.” The nurse’s own family structure is very different. Which response best supports patient-centered care?

   1. Avoid asking about the patient’s family structure because perceptions of family are too personal for nursing care.
   2. Ask the patient to identify only legally recognized family members before discussing the care plan.
   3. Include the identified support people in care discussions as appropriate and approach the patient’s definition of family with respect.
   4. Explain that family members must be related by birth, marriage, or adoption to be included in care planning.

   Answer: Include the identified support people in care discussions as appropriate and approach the patient’s definition of family with respect.

   The section emphasizes that people define family in different ways and that nurses should create inclusion and respect when family structures differ from their own. Limiting care discussions only to legally recognized relatives would miss the patient’s own perception of family and could make care less individualized.

2. A nurse is assessing the family of a patient with a chronic illness. Which possible effects on other family members should the nurse assess? Select all that apply.

   1. Altered nutrition choices
   2. Sleep disruptions
   3. Caregiver fatigue
   4. Increased anxiety or depression
   5. Guaranteed improvement in family coping

   Answer: Altered nutrition choices, Sleep disruptions, Caregiver fatigue, Increased anxiety or depression

   The section states that illness in one family member can negatively affect other family members through sleep disruption, nutrition changes, anxiety/depression, and caregiver fatigue. It does not state that chronic illness guarantees improved coping; coping may be affected positively or negatively depending on family interactions and other factors.

3. A 25-year-old patient reports that her mother was diagnosed with breast cancer and encouraged her to have BRCA testing. The patient says, “I’m young and healthy, so I don’t think I need that.” Which nursing response is best?

   1. “Your mother’s diagnosis does not affect your health unless you develop symptoms.”
   2. “A healthy lifestyle helps, but some cancers have a stronger genetic component; genetic counseling can help you understand your risk.”
   3. “If you have the gene mutation, it means you will definitely get breast cancer.”
   4. “Because you are young and have no breast concerns, genetic testing is not useful right now.”

   Answer: “A healthy lifestyle helps, but some cancers have a stronger genetic component; genetic counseling can help you understand your risk.”

   The patient conversation in the section models teaching that healthy lifestyle matters but does not remove genetic risk. The nurse should clarify that testing can help identify risk and offer referral to a genetic counselor, rather than reassuring falsely or implying cancer is certain.

4. A nurse is using the CFAM/CFIM 15-minute interview and wants to apply the “manners” key ingredient when meeting a patient and family. Which actions are appropriate? Select all that apply.

   1. Refer to the patient by name
   2. Make eye contact
   3. Avoid explaining procedures to save time
   4. Acknowledge family members or other support persons
   5. Introduce oneself

   Answer: Refer to the patient by name, Make eye contact, Acknowledge family members or other support persons, Introduce oneself

   The 15-minute interview identifies manners as culturally appropriate respectful behavior, including introducing oneself, eye contact, using the patient’s name, and acknowledging family or support persons. Avoiding explanations would not reflect the listed nursing actions for manners.

5. A nurse is admitting a patient to an in-patient hospice facility and needs to quickly understand how to support the patient and family through difficult physical and emotional changes. Which assessment approach is most appropriate according to the section?

   1. Delay family assessment until after discharge planning begins.
   2. Use only the U.S. Census Bureau definition of family.
   3. Use the CFAM/CFIM 15-minute interview.
   4. Focus on heredity and genetic disorders before discussing family needs.

   Answer: Use the CFAM/CFIM 15-minute interview.

   The section specifically identifies the CFAM/CFIM 15-minute interview as a good choice for a patient being admitted to an in-patient hospice facility. It is designed to gather useful family information within a timeframe appropriate for busy nursing practice.

6. A nurse is applying family systems theory while planning care for a patient whose illness is changing family roles and relationships. Which nursing considerations are consistent with this theory? Select all that apply.

   1. Integrate healthcare interventions for the individual with care of the family.
   2. Consider how illness contributes to family function or dysfunction.
   3. Assess boundaries between individuals, roles, and family subsystems.
   4. Assume the family is best understood as a fixed structure that does not change.
   5. Consider how family dysfunction affects illness.

   Answer: Integrate healthcare interventions for the individual with care of the family., Consider how illness contributes to family function or dysfunction., Assess boundaries between individuals, roles, and family subsystems., Consider how family dysfunction affects illness.

   Family systems theory views the family as complex, dynamic, and changing, and it directs nurses to consider both the individual and family system. The section also emphasizes the importance of boundaries and the reciprocal effects of illness and family dysfunction; it does not describe the family as fixed or unchanging.