Foundations of Psychiatric Mental Health Nursing A Clinical Approach, 5th Edition by Elizabeth M. Varcarolis
Foundations of Psychiatric Mental Health Nursing A Clinical Approach, 5th Edition by Elizabeth M. Varcarolis
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Chapter 36: Family Therapy
Complete Chapter Questions With Answers
Sample Questions Are Posted Below
MULTIPLE CHOICE
1) The nurse can identify scapegoating as occurring within a family when
| A. | the family members project the inadequacies of the family onto one particular family member. |
| B. | messages of hostility are sent by the identified patient to family members. |
| C. | the identified patient threatens separation to induce feelings of isolation and despair. |
| D. | family members use nonverbal techniques to disguise or qualify the meaning of verbal messages. |
ANS: A
Scapegoating is defined as blaming family problems on a member of the family who is not very powerful. The purpose of the blaming is to keep the focus off the painful issues and problems of the blamers. The behaviors described in options B and C are dysfunctional behaviors that have no specific name. Option D refers to a double bind.
DIF: Cognitive Level: Application REF: Text Page: 739
TOP: Nursing Process: Assessment MSC: NCLEX: Psychosocial Integrity
2) The nurse therapist assessing a family system perceives the family to be enmeshed and determines that family members have little sense of individuality. A desirable outcome is that members will
| A. | form groups of three to reduce anxiety. |
| B. | become more differentiated regarding values and beliefs. |
| C. | become comfortable adhering to family norms and rules. |
| D. | form two subgroups: the most capable and least capable members. |
ANS: B
Enmeshment results from high anxiety that keeps members emotionally bound to each other and unable to define individual values and beliefs. To define individual values and beliefs would mark progress in differentiation. Triangulation (option A) and subgrouping (option D) are not desirable. Option C: The members already adhere to the family norms and rules.
DIF: Cognitive Level: Analysis REF: Text Page: 746
TOP: Nursing Process: Planning (Outcome Identification)
MSC: NCLEX: Psychosocial Integrity
3) Bowen’s approach to family therapy focuses on differentiation of members. A therapist using this approach would negotiate with the family to arrive at the outcome criteria. The family will
| A. | restructure dysfunctional triangles. |
| B. | use straight messages without manipulation. |
| C. | achieve greater individuation of members. |
| D. | assess itself in terms of life cycle stage and multicultural issues. |
ANS: C
The identification of poor differentiation of family members calls for a goal of greater differentiation, that is, members developing a greater sense of individual selves. Differentiation does not relate directly to triangulating, improving the clarity of communication, or looking at family life cycles.
DIF: Cognitive Level: Application REF: Text Page: 735, Text Page: 736
TOP: Nursing Process: Planning (Outcome Identification)
MSC: NCLEX: Psychosocial Integrity
4) A client remarks to the nurse “The family therapist mentioned that our family is enmeshed. Can you tell me what that means?” The best reply from the nurse would be
| A. | “It means that your family members do not have a strong sense of their own individual selves.” |
| B. | “It means that your communication patterns often give double messages. Your body language does not match the meaning of what you say.” |
| C. | “Enmeshment refers to the tendency of your family to try to maintain balance. When the balance tips, you take measures to restore the balance.” |
| D. | “Enmeshment refers to blaming the weakest family member for all the troubles of the family.” |
ANS: A
Enmeshed families have unclear distinctions among family members. Option B refers to double-bind communication. Option C, the seeking of balance, refers to family homeostasis. Option D refers to scapegoating.
DIF: Cognitive Level: Application REF: Text Page: 731, Text Page: 732
TOP: Nursing Process: Implementation
MSC: NCLEX: Health Promotion and Maintenance
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