Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: Partner with clients and their families in recognizing when family interventions, referral to NAMI, or family therapy are appropriate.

Question 16

Type: MCSA

A client diagnosed with bipolar disorder is starting the first family therapy session. The nurse knows the clients children, aged 2 and 4, will:

1. Not be included in the therapy session.

2. Help the client acclimate to the mental health clinic.

3. Benefit from the therapy session.

4. Help the client understand the importance of getting well.

Correct Answer: 1

Rationale 1: Children 4 years of age and younger are often not included in ongoing family therapy sessions. They may misinterpret or be frightened by the dialogue. In addition, small children tend to be disruptive. The children are not expected to help the client.

Rationale 2: Children 4 years of age and younger are often not included in ongoing family therapy sessions. They may misinterpret or be frightened by the dialogue. In addition, small children tend to be disruptive. The children are not expected to help the client.

Rationale 3: Children 4 years of age and younger are often not included in ongoing family therapy sessions. They may misinterpret or be frightened by the dialogue. In addition, small children tend to be disruptive. The children are not expected to help the client.

Rationale 4: Children 4 years of age and younger are often not included in ongoing family therapy sessions. They may misinterpret or be frightened by the dialogue. In addition, small children tend to be disruptive. The children are not expected to help the client.

Global Rationale:

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: Design family psychoeducation activities to improve client recovery and family well-being.

Question 17

Type: MCSA

In order to help improve the functioning of mental health clients and their families, nurses must:

1. Teach the client communication skills.

2. Help each member negotiate what they need within the family.

3. Decrease the clients stress by compromising the integrity of family interactions.

4. Normalize the familys experience.

Correct Answer: 2

Rationale 1: The negotiation phase of family therapy is begun by identifying what each member would like to change in the family. When each family member and the therapist have identified important goals, they begin negotiating a set of attainable goals that everyone is willing to work on. Some give-and-take among the family members is needed to achieve workable goals. At this time, the family therapist, along with the family, may also identify the meanstasks, strategies, and so onthat will be used to reach the negotiated goals. Teaching the client communication skills may be one of the tasks the family identifies. Normalizing the familys experience may result from improvement of family functioning. It is nontherapeutic for the nurse to actively compromise the integrity of family interactions.

Rationale 2: The negotiation phase of family therapy is begun by identifying what each member would like to change in the family. When each family member and the therapist have identified important goals, they begin negotiating a set of attainable goals that everyone is willing to work on. Some give-and-take among the family members is needed to achieve workable goals. At this time, the family therapist, along with the family, may also identify the meanstasks, strategies, and so onthat will be used to reach the negotiated goals. Teaching the client communication skills may be one of the tasks the family identifies. Normalizing the familys experience may result from improvement of family functioning. It is nontherapeutic for the nurse to actively compromise the integrity of family interactions.

Rationale 3: The negotiation phase of family therapy is begun by identifying what each member would like to change in the family. When each family member and the therapist have identified important goals, they begin negotiating a set of attainable goals that everyone is willing to work on. Some give-and-take among the family members is needed to achieve workable goals. At this time, the family therapist, along with the family, may also identify the meanstasks, strategies, and so onthat will be used to reach the negotiated goals. Teaching the client communication skills may be one of the tasks the family identifies. Normalizing the familys experience may result from improvement of family functioning. It is nontherapeutic for the nurse to actively compromise the integrity of family interactions.

Rationale 4: The negotiation phase of family therapy is begun by identifying what each member would like to change in the family. When each family member and the therapist have identified important goals, they begin negotiating a set of attainable goals that everyone is willing to work on. Some give-and-take among the family members is needed to achieve workable goals. At this time, the family therapist, along with the family, may also identify the meanstasks, strategies, and so onthat will be used to reach the negotiated goals. Teaching the client communication skills may be one of the tasks the family identifies. Normalizing the familys experience may result from improvement of family functioning. It is nontherapeutic for the nurse to actively compromise the integrity of family interactions.

Global Rationale:

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: Design family psychoeducation activities to improve client recovery and family well-being.

Question 18

Type: MCSA

When instructing nursing students on therapy termination strategies for families and clients with mental health disorders, the nursing instructor teaches that effective family nursing strategies include:

1. Helping families achieve realistic goals.

2. Giving criticism in a calm voice.

3. Knowing effective communication skills.

4. Monitoring nonverbal communication.

Correct Answer: 1

Rationale 1: Family therapists use various criteria to determine when termination is appropriate. Termination occurs in a flexible way, helping families achieve realistic goals, thus ending therapy with a feeling of accomplishment. Knowing effective communication skills, giving criticism in a calm voice, and monitoring nonverbal communication may be included in the goals.

Rationale 2: Family therapists use various criteria to determine when termination is appropriate. Termination occurs in a flexible way, helping families achieve realistic goals, thus ending therapy with a feeling of accomplishment. Knowing effective communication skills, giving criticism in a calm voice, and monitoring nonverbal communication may be included in the goals.

Rationale 3: Family therapists use various criteria to determine when termination is appropriate. Termination occurs in a flexible way, helping families achieve realistic goals, thus ending therapy with a feeling of accomplishment. Knowing effective communication skills, giving criticism in a calm voice, and monitoring nonverbal communication may be included in the goals.

Rationale 4: Family therapists use various criteria to determine when termination is appropriate. Termination occurs in a flexible way, helping families achieve realistic goals, thus ending therapy with a feeling of accomplishment. Knowing effective communication skills, giving criticism in a calm voice, and monitoring nonverbal communication may be included in the goals.

Global Rationale:

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: Design family psychoeducation activities to improve client recovery and family well-being.

Question 19

Type: MCSA

Which of the following information should be included in psychoeducation with a family of a client recently diagnosed with a mental illness?

1. Most mental illnesses are inherited so the entire family should be tested for the same disorder.

2. Mental illness is extremely complex and it may take several years for the right treatment to be effective.

3. Most mental illnesses are caused by an imbalance of chemicals in the brain and can be treated with medications and therapy.

4. Earlier screening and diagnosis could have prevented the severity of symptoms and behavior problems.

Correct Answer: 3

Rationale 1: Families misunderstand mental illness to be a personal failing and are comforted by the fact that it has a biologic basis and can be treated with medications and therapy. There is no truth to the other statements.

Rationale 2: Families misunderstand mental illness to be a personal failing and are comforted by the fact that it has a biologic basis and can be treated with medications and therapy. There is no truth to the other statements.

Rationale 3: Families misunderstand mental illness to be a personal failing and are comforted by the fact that it has a biologic basis and can be treated with medications and therapy. There is no truth to the other statements.

Rationale 4: Families misunderstand mental illness to be a personal failing and are comforted by the fact that it has a biologic basis and can be treated with medications and therapy. There is no truth to the other statements.

Global Rationale:

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: Provide information about family therapy and support to clients and their families while they are engaged in family therapy.

Question 20

Type: MCSA

Which of the following behaviors indicate that family therapy has been effective and can be terminated?

1. Family members are able to give feedback to others, telling them how they appear

2. Family members are able to identify faults and failures of others, telling them how to act better

3. Family members are able to give praise and criticism in equal measure

4. Family members are able to identify problems with communication

Correct Answer: 1

Rationale 1: Termination in family therapy occurs in a flexible way, helping families achieve realistic goals, thus ending therapy with a feeling of accomplishment. The ability to give feedback to each other in a constructive manner is the sign of a healthy family. The ability to identify problems with communication is an early goal of therapy. Identifying faults and failures of others is not the focus of family therapy. Giving praise and criticism in equal measure is not a goal of family therapy and does not indicate the need for termination.

Rationale 2: Termination in family therapy occurs in a flexible way, helping families achieve realistic goals, thus ending therapy with a feeling of accomplishment. The ability to give feedback to each other in a constructive manner is the sign of a healthy family. The ability to identify problems with communication is an early goal of therapy. Identifying faults and failures of others is not the focus of family therapy. Giving praise and criticism in equal measure is not a goal of family therapy and does not indicate the need for termination.

Rationale 3: Termination in family therapy occurs in a flexible way, helping families achieve realistic goals, thus ending therapy with a feeling of accomplishment. The ability to give feedback to each other in a constructive manner is the sign of a healthy family. The ability to identify problems with communication is an early goal of therapy. Identifying faults and failures of others is not the focus of family therapy. Giving praise and criticism in equal measure is not a goal of family therapy and does not indicate the need for termination.

Rationale 4: Termination in family therapy occurs in a flexible way, helping families achieve realistic goals, thus ending therapy with a feeling of accomplishment. The ability to give feedback to each other in a constructive manner is the sign of a healthy family. The ability to identify problems with communication is an early goal of therapy. Identifying faults and failures of others is not the focus of family therapy. Giving praise and criticism in equal measure is not a goal of family therapy and does not indicate the need for termination.

Global Rationale:

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: Provide information about family therapy and support to clients and their families while they are engaged in family therapy.

Question 21

Type: MCSA

The mother of a young child diagnosed with conduct disorder asks the nurse to recommend a qualified nurse to provide family therapy. The nurse knows that:

1. Nurse family therapists should be clinical specialists or advanced practitioners in mental health nursing.

2. Nurses with a bachelors degree are qualified to provide family therapy if they are nationally certified in mental health nursing.

3. Nurses are not reimbursed by third party insurers to provide family therapy.

4. Nurses specializing in family therapy are expensive and it is difficult to get a timely appointment.

Correct Answer: 1

Rationale 1: Family therapists should be specially educated in the practice of family therapy and strongly committed to a belief in the importance of the family. Nurse family therapists should be clinical specialists or advanced practitioners prepared in graduate programs that provide both theory and supervised clinical practice in this specialized area. All other statements are false.

Rationale 2: Family therapists should be specially educated in the practice of family therapy and strongly committed to a belief in the importance of the family. Nurse family therapists should be clinical specialists or advanced practitioners prepared in graduate programs that provide both theory and supervised clinical practice in this specialized area. All other statements are false.

Rationale 3: Family therapists should be specially educated in the practice of family therapy and strongly committed to a belief in the importance of the family. Nurse family therapists should be clinical specialists or advanced practitioners prepared in graduate programs that provide both theory and supervised clinical practice in this specialized area. All other statements are false.

Rationale 4: Family therapists should be specially educated in the practice of family therapy and strongly committed to a belief in the importance of the family. Nurse family therapists should be clinical specialists or advanced practitioners prepared in graduate programs that provide both theory and supervised clinical practice in this specialized area. All other statements are false.

Question 1

Type: MCSA

The nurse finds that the client with a somatoform disorder has physical symptoms, but there is no evidence of physiologic disease. The client may have decreased amounts of serotonin and endorphins, causing the client to experience an increased sensitivity to pain. This explanation of the clients symptoms is based in:

1. Communication theory.

2. Humanistic theory.

3. Biologic theory.

4. Genetic theory.

Correct Answer: 3

Rationale 1: Research has shown that brain abnormalities such as decreased serotonin and endorphins may lead to altered pain perception. Genetic theorists believe that both genetic and environmental factors contribute to somatization disorders. Communication theorists believe somatization is nonverbal body language intended to communicate a message to significant others. Humanistic theorists believe one must look at clients with somatoform disorders in the context of what is happening in the clients lives.

Rationale 2: Research has shown that brain abnormalities such as decreased serotonin and endorphins may lead to altered pain perception. Genetic theorists believe that both genetic and environmental factors contribute to somatization disorders. Communication theorists believe somatization is nonverbal body language intended to communicate a message to significant others. Humanistic theorists believe one must look at clients with somatoform disorders in the context of what is happening in the clients lives.

Rationale 3: Research has shown that brain abnormalities such as decreased serotonin and endorphins may lead to altered pain perception. Genetic theorists believe that both genetic and environmental factors contribute to somatization disorders. Communication theorists believe somatization is nonverbal body language intended to communicate a message to significant others. Humanistic theorists believe one must look at clients with somatoform disorders in the context of what is happening in the clients lives.

Rationale 4: Research has shown that brain abnormalities such as decreased serotonin and endorphins may lead to altered pain perception. Genetic theorists believe that both genetic and environmental factors contribute to somatization disorders. Communication theorists believe somatization is nonverbal body language intended to communicate a message to significant others. Humanistic theorists believe one must look at clients with somatoform disorders in the context of what is happening in the clients lives.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub: Basic Care and Comfort

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: Describe theories that aid in the understanding of dissociative, somatoform, and factitious disorders.

Question 2

Type: MCSA

The client states, I was reared in a chaotic, alcoholic family situation. The nurse knows that the most useful theory for explaining the clients somatoform disorder would come from:

1. Humanistic theory.

2. Psychosocial theory.

3. Biologic theory.

4. Genetic theory.

Correct Answer: 2

Rationale 1: Psychosocial theorists believe that the client did not receive adequate nurturing. Biologic theorists believe that decreased serotonin and endorphins may lead to altered pain perception. Genetic theorists believe that both genetic and environmental factors contribute to somatization disorders. Humanistic theorists believe that one must look at clients with somatoform disorders in the context of what is happening in the clients lives.

Rationale 2: Psychosocial theorists believe that the client did not receive adequate nurturing. Biologic theorists believe that decreased serotonin and endorphins may lead to altered pain perception. Genetic theorists believe that both genetic and environmental factors contribute to somatization disorders. Humanistic theorists believe that one must look at clients with somatoform disorders in the context of what is happening in the clients lives.

Rationale 3: Psychosocial theorists believe that the client did not receive adequate nurturing. Biologic theorists believe that decreased serotonin and endorphins may lead to altered pain perception. Genetic theorists believe that both genetic and environmental factors contribute to somatization disorders. Humanistic theorists believe that one must look at clients with somatoform disorders in the context of what is happening in the clients lives.

Rationale 4: Psychosocial theorists believe that the client did not receive adequate nurturing. Biologic theorists believe that decreased serotonin and endorphins may lead to altered pain perception. Genetic theorists believe that both genetic and environmental factors contribute to somatization disorders. Humanistic theorists believe that one must look at clients with somatoform disorders in the context of what is happening in the clients lives.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub: