A 15-year-old is hospitalized after a suicide attempt. This adolescent lives with the mother, stepfather, and several siblings. When performing a family assessment, the nurse must first determine:

Correct Answer: B

Rationale: In the context of patient-family-centered care in nursing, the correct answer is B) names and relationships of the family members. This is because before delving into more complex aspects of family dynamics such as emotions, communication patterns, or the impact of the suicide attempt, it is crucial to establish a foundational understanding of who comprises the patient's immediate support system. Knowing the names and relationships of family members allows the nurse to create a comprehensive family genogram, which is essential for identifying key influencers, support systems, and potential sources of conflict or stress within the family unit. Option A) is incorrect because while understanding how the family expresses and manages emotions is important, it is a more advanced aspect of family assessment that should come after establishing basic information about family members. Option C) is incorrect as well because while communication patterns are important, they also come after identifying the family members and their relationships with the patient. Option D) is incorrect because although understanding the meaning of the suicide attempt for family members is crucial, it is a deeper level of assessment that should follow the establishment of basic family composition. Educationally, understanding the rationale behind prioritizing the identification of family members in a family assessment helps nurses to approach patient care in a systematic and holistic manner. By first establishing the basic family structure, nurses can then proceed to explore more nuanced aspects of family dynamics effectively, leading to better-informed and more personalized patient care plans.

Correct Answer: C

Rationale: The correct answer is C) Individual, subsystem, and family. The therapeutic alliance in patient family-centered care exists on these three levels to ensure comprehensive and effective care. Explanation: 1. Individual level: This refers to the relationship between the healthcare provider and the individual patient. It focuses on building trust, communication, and collaboration to meet the patient's needs. 2. Subsystem level: This involves considering the patient within the context of their immediate family or support system. It recognizes the impact of family dynamics, roles, and relationships on the patient's well-being and care. 3. Family level: This extends the therapeutic alliance to include the entire family unit. It acknowledges the importance of involving and supporting the family in the patient's care, as they play a vital role in the patient's health outcomes. Why others are wrong: A) Short term, medium term, and long term: This does not align with the concept of the therapeutic alliance in patient family-centered care, which focuses on interpersonal relationships and support systems rather than time frames. B) Individual, family, and community: While family and community are important aspects of care, the concept of subsystem, which focuses on immediate support systems, is more specific and relevant in the context of patient family-centered care. Educational context: Understanding the levels of the therapeutic alliance in patient family-centered care is crucial for nurses to provide holistic and patient-centered care. By recognizing and addressing the needs and dynamics at each level, nurses can foster effective communication, collaboration, and support to optimize patient outcomes and experiences.

Correct Answer: A

Rationale: In the context of patient-family centered care nursing, it is crucial to consider the factors at the Ontological Level during a home visit with a Level 1 family. Option A, focusing on basic needs, safety, and existential stressors, is the correct choice. This is because at the Ontological Level, individuals and families are dealing with fundamental aspects of their existence, such as meeting their basic needs for survival, ensuring safety in their environment, and coping with existential stressors that impact their overall well-being. Option B, which includes financial planning and career goals, is not directly related to the Ontological Level. While these factors are important in a person's life, they are more aligned with the Pragmatic Level, where individuals engage in planning and goal-setting for their future financial stability and career advancement. Option C, addressing intimacy issues and self-esteem, pertains more to the Interpersonal Level of family dynamics and individual relationships. These factors are critical but do not directly address the foundational aspects of existence that the Ontological Level encompasses. Option D, involving moral values and philosophical beliefs, is more reflective of the Ideological Level where individuals' values, beliefs, and ethical considerations shape their worldview. While these aspects are significant in understanding a person's holistic health perspective, they do not specifically address the basic needs and existential stressors at the Ontological Level. Educationally, understanding the different levels of family assessment is essential for nurses to provide comprehensive and individualized care. By recognizing and addressing factors at the Ontological Level, nurses can better support families in meeting their fundamental needs and navigating existential challenges, ultimately promoting holistic well-being.

Correct Answer: B

Rationale: In patient family-centered care nursing, it is essential to involve all adult family members and children in the care process to ensure holistic and comprehensive care. However, in the context of the initial interview, it may not always be necessary or appropriate to involve all family members and children. The correct answer, B) FALSE, is accurate because during the initial interview, the primary focus should be on building a therapeutic relationship with the patient, gathering pertinent medical information, and understanding the patient's needs and concerns. Including all family members and children in the initial interview may hinder the establishment of trust and confidentiality between the nurse and the patient. While family involvement is crucial in the care process, particularly in decision-making and support, it should be done strategically and based on the patient's preferences and needs. In some cases, involving all family members and children in the initial interview may be overwhelming for the patient or may not contribute significantly to the assessment and care planning process. Educationally, it is important for nurses to understand the principles of patient family-centered care and how to appropriately involve family members in the care process. By recognizing the right timing and approach to family involvement, nurses can promote effective communication, collaboration, and patient-centered care. This ensures that the patient's autonomy, dignity, and preferences are respected while also considering the valuable role of family support in the patient's well-being.

Correct Answer: D

Rationale: In patient family-centered care nursing, using a strengths-perspective model is crucial for empowering families and enhancing their overall well-being. The correct answer, option D, encompasses all the key components of a strengths-based approach. A) Option A is incorrect because a strengths-perspective model focuses not only on what a family wants to change but also on their existing strengths and capabilities. It is about building on these strengths to promote positive outcomes. B) Option B is incorrect as well because while it is important to encourage clients to set their own agenda and engage with their environment, a strengths-perspective model goes beyond that by actively identifying and leveraging the strengths of the family unit. C) Option C is also incorrect because while recognizing clients as unique and complex individuals is essential in nursing care, a strengths-perspective model goes further by specifically highlighting and utilizing the strengths of the family to promote resilience and positive outcomes. Educationally, understanding the importance of a strengths-perspective model in patient family-centered care nursing is crucial for nurses to provide holistic and effective care. By focusing on strengths, nurses can empower families, promote collaboration, and foster a more positive and effective healthcare experience for all involved parties.