TOWNSEND MENTAL HEALTH NURSING
CH 11 QUESTIONS AND ANSWERS 2022
1. A fatherless, 11-year-old African American girl lives with her grandmother after the
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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. -
ANS: C
The nurse should be aware that cultural differences and specific events may lead to
variety in family constellations. This is normal.
PTS: 1 REF: 204
KEY: Cognitive Level: Application | Integrated Process: Assessment
2. 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. - 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.
PTS: 1 REF: 210
KEY: Cognitive Level: Application | Integrated Process: Evaluation
3. 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. - ANS: C
The Asian culture highly respects the elderly. Having the grandparents living in the
home is not uncommon in this culture.
PTS: 1 REF: 205
KEY: Cognitive Level: Application | Integrated Process: Evaluation
4. 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. - 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.
PTS: 1 REF: 206
KEY: Cognitive Level: Application | Integrated Process: Evaluation
5. Which task should the nurse recognize as appropriate to stage IV of the family life
cycle?
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 - ANS: C
Stage IV of the family life cycle is described as the "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.
PTS: 1 REF: 203
KEY: Cognitive Level: Application | Integrated Process: Assessment
6. 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 - 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.
PTS: 1 REF: 207
KEY: Cognitive Level: Application | Integrated Process: Assessment
7. 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. - 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.
PTS: 1 REF: 213
KEY: Cognitive Level: Application | Integrated Process: Assessment
8. 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? CONTINUES... [Show Less]