Pediatric Physical Examination & Health Assessment 1

st Edition

Sawyer TESTBANK

Chapter1 Family Dynamics

1. A nurse is selecting a family theory to assess a patients family dynamics. Which family theory

best describes a series of tasks for the family throughout its life span?

a. Interactional theory

b. Developmental systems theory

c. Structural-functional theory

d. Duvalls developmental theory

ANS: D

Duvalls developmental theory describes eight developmental tasks of the family throughout its

life span. Interactional theory and structural-functional theory are not family theories.

Developmental systems theory is an outgrowth of Duvalls theory. The family is described as a

small group, a semiclosed system of personalities that interact with the larger cultural system.

Changes do not occur in one part of the family without changes in others.

2. Which family theory explains how families react to stressful events and suggests factors that

promote adaptation to these events?

a. Interactional theory

b. Developmental systems theory

c. Family stress theory

d. Duvalls developmental theory

ANS: C

Family stress theory explains the reaction of families to stressful events. In addition, the theory

helps suggest factors that promote adaptation to the stress. Stressors, both positive and negative,

are cumulative and affect the family. Adaptation requires a change in family structure or

interaction. Interactional theory is not a family theory. Interactions are the basis of general

systems theory. Developmental systems theory is an outgrowth of Duvalls theory. The family is

described as a small group, a semiclosed system of personalities that interact with the larger

cultural system. Changes do not occur in one part of the family without changes in others.

Duvalls developmental theory describes eight developmental tasks of the family throughout its

life span.

3. Which is the term for a family in which the paternal grandmother, the parents, and two minor

children live together?

a. Blended

b. Nuclear

c. Binuclear

d. Extended

ANS: D

An extended family contains at least one parent, one or more children, and one or more members

(related or unrelated) other than a parent or sibling. A blended family contains at least one stepWWW.qwivy.COM

WWW.qwivy.COM

 1 / 4

parent, step-sibling, or half-sibling. The nuclear family consists of two parents and their children.

No other relatives or nonrelatives are present in the household. In binuclear families, parents

continue the parenting role while terminating the spousal unit. For example, when joint custody

is assigned by the court, each parent has equal rights and responsibilities for the minor child or

children.

4. A nurse is assessing a familys structure. Which describes a family in which a mother, her

children, and a stepfather live together?

a. Blended

b. Nuclear

c. Binuclear

d. Extended

ANS: A

A blended family contains at least one step-parent, step-sibling, or half-sibling. The nuclear

family consists of two parents and their children. No other relatives or nonrelatives are present in

the household. In binuclear families, parents continue the parenting role while terminating the

spousal unit. For example, when joint custody is assigned by the court, each parent has equal

rights and responsibilities for the minor child or children. An extended family contains at least

one parent, one or more children, and one or more members (related or unrelated) other than a

parent or sibling.

5. Which is considered characteristic of children who are the youngest in their family?

a. More dependent than firstborn children

b. More outgoing than firstborn children

c. Identify more with parents than with peers

d. Are subject to greater parental expectations

ANS: B

Later-born children are obliged to interact with older siblings from birth and seem to be more

outgoing and make friends more easily than firstborns. Being more dependent, identifying more

with parents than peers, and being subject to greater parental expectations are characteristics of

firstborn children and only children.

6. Parents of a firstborn child are asking whether it is normal for their child to be extremely

competitive. The nurse should respond to the parents that studies about the ordinal position of

children suggest that firstborn children tend to:

a. be praised less often.

b. be more achievement oriented.

c. be more popular with the peer group.

d. identify with peer group more than parents.

ANS: B

Firstborn children, like only children, tend to be more achievement-oriented.

Being praised less often, being more popular with the peer group, and identifying with peer

groups more than parents are characteristics of later-born children.

7. A 35-year-old client is currently on fertility treatments. When responding to a question from

the client about multiple births, which statement by the nurse is accurate?

a. Use of fertility treatments has been associated with an increase in multiple births.

b. Your chance of having multiple births is at the same rate as all women of childbearing age.

WWW.qwivy.COM

WWW.qwivy.COM

 2 / 4

c. There is not enough evidence about the use of fertility treatments increasing the rate of

multiple births.

d. Because of your age and the fertility treatments, you have almost a 100% chance of a multiple

birth.

ANS: A

Because women in their thirties are almost 2.5 times as likely as women in their twenties to have

higher-order plural births, increased childbearing among older women and the expanded use of

fertility drugs have been associated with an increase in the multiple-birth ratio. The rate of

having a multiple birth for this client is not the same for all women of childbearing age. There

are data indicating that fertility treatments increase the rate of multiple births, but fertility

treatments do not have a 100% rate of multiple births.

8. Nicole and Kelly, age 5 years, are identical twins. Their parents tell the nurse that the girls

always want to be together. The nurses suggestions should be based on which statement?

a. Some twins thrive best when they are constantly together.

b. Individuation cannot occur if twins are together too much.

c. Separating twins at an early age helps them develop mentally.

d. When twins are constantly together, pathologic bonding occurs.

ANS: A

Twins work out a relationship that is reasonably satisfactory to both. They develop a remarkable

capacity for cooperative play and considerable loyalty and generosity toward each other. Parents

should foster individual differences and allow the children to follow their natural inclinations.

Individuation does occur. In twinship, one member of the pair is more dominant, outgoing, and

assertive than the other. Early separation may produce unnecessary stresses for the children.

There is no evidence that pathologic bonding occurs when twins are constantly together.

9. The nurse is teaching a group of new parents about the experience of role transition. Which

statement by a parent would indicate a correct understanding of the teaching?

a. My marital relationship can have a positive or negative effect on the role transition.

b. If an infant has special care needs, the parents sense of confidence in their new role is

strengthened.

c. Young parents can adjust to the new role easier than older parents.

d. A parents previous experience with children makes the role transition more difficult.

ANS: A

If parents are supportive of each other, they can serve as positive influences on establishing

satisfying parental roles. When marital tensions alter caregiving routines and interfere with the

enjoyment of the infant, then the marital relationship has a negative effect. Infants with special

care needs can be a significant source of added stress. Older parents are usually more able to

cope with the greater financial responsibilities, changes in sleeping habits, and reduced time for

each other and other children. Parents who have previous experience with parenting appear more

relaxed, have less conflict in disciplinary relationships, and are more aware of normal growth

and development.

10. When assessing a family, the nurse determines that the parents exert little or no control over

their children. This style of parenting is called:

a. permissive.

b. dictatorial.

c. democratic.

WWW.qwivy.COM

WWW.qwivy.COM

 3 / 4

d. authoritarian.

ANS: A

Permissive parents avoid imposing their own standards of conduct and allow their children to

regulate their own activity as much as possible. The parents exert little or no control over their

childrens actions. Dictatorial or authoritarian parents attempt to control their childrens behavior

and attitudes through unquestioned mandates. They establish rules and regulations or standards

of conduct that they expect to be followed rigidly and unquestioningly. Democratic parents

combine permissive and dictatorial styles. They direct their childrens behavior and attitudes by

emphasizing the reasons for rules and negatively reinforcing deviations. They respect the childs

individual nature.

11. When discussing discipline with the mother of a 4-year-old child, the nurse should include

which instruction?

a. Children as young as 4 years old rarely need to be punished.

b. Parental control should be consistent.

c. Withdrawal of love and approval is effective at this age.

d. One should expect rules to be followed rigidly and unquestioningly.

ANS: B

For effective discipline, parents must be consistent and must follow through with agreed-on

actions. Realistic goals should be set for this age group. Parents should structure the environment

to prevent unnecessary difficulties. Requests for behavior change should be phrased in a positive

manner to provide direction for the child. Withdrawal of love and approval is never appropriate

or effective. Discipline strategies should be appropriate to the childs age, temperament, and

severity of the misbehavior. Following rules rigidly and unquestioningly is beyond the

developmental capabilities of a 4-year-old.

12. Which is most characteristic of the physical punishment of children, such as spanking?

a. Psychological impact is usually minimal.

b. Children rarely become accustomed to spanking.

c. Childrens development of reasoning increases.

d. Misbehavior is likely to occur when parents are not present.

ANS: D

Through the use of physical punishment, children learn what they should not do. When parents

are not around, it is more likely that children will misbehave because they have not learned to

behave well for their own sake, but rather out of fear of punishment. Spanking can cause severe

physical and psychological injury and interfere with effective parent-child interaction. Children

do become accustomed to spanking, requiring more severe corporal punishment each time. The

use of corporal punishment may interfere with the childs development of moral reasoning.

13. A 3-year-old girl was adopted immediately after birth. The parents have just asked the nurse

how they should tell the child that she is adopted. Which guidelines concerning adoption should

the nurse use in planning a response?

a. Telling the child is an important aspect of their parental responsibilities.

b. The best time to tell the child is between ages 7 and 10 years.

c. It is not necessary to tell the child who was adopted so young.

d. It is best to wait until the child asks about it.

ANS: A

It is important for the parents not to withhold information about the adoption from the child. It is

WWW.qwivy.COM

WWW.qwivy.COM

Powered by qwivy(www.qwivy.org)

 4 / 4