A married couple brings their two children to counseling for behavioral problems. The 13-year-old son is smoking and skipping school, and the 16-year-old daughter is staying out past her curfew and sneaking out at night. According to family systems theory, who is the identified patient?
The son
The daughter
Both children
The entire family
The Correct Answer is D
Choice A reason: While the son exhibits problematic behavior, family systems theory emphasizes that symptoms in one member often reflect dysfunction in the entire system. Focusing solely on him overlooks systemic dynamics.
Choice B reason: The daughter also displays concerning behavior, but isolating her as the identified patient ignores the broader family context.
Choice C reason: Labeling both children as identified patients is closer to systemic thinking but still implies that the problem lies only with them, rather than with the family unit.
Choice D reason: Family systems theory posits that the identified patient is the person whose symptoms reflect the dysfunction of the entire family system. In this case, both children’s behaviors suggest systemic issues, making the whole family the identified patient.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: While rhabdomyolysis is a known rare adverse effect of atorvastatin, the risk increases significantly when atorvastatin interacts with other drugs that inhibit its metabolism. This answer is partially correct but does not explain the mechanism.
Choice B reason: Fluoxetine is not commonly associated with rhabdomyolysis as a direct side effect. Its role in this case is more likely due to drug-drug interaction rather than intrinsic toxicity.
Choice C reason: Fluoxetine is not a CYP450 3A4 inducer. This choice is incorrect because it misrepresents fluoxetine’s pharmacologic profile.
Choice D reason: Fluoxetine is a known inhibitor of CYP450 3A4. Atorvastatin is metabolized by this enzyme. Inhibition of CYP3A4 by fluoxetine can lead to increased plasma levels of atorvastatin, raising the risk of statin-induced rhabdomyolysis due to impaired clearance.
Correct Answer is B
Explanation
Choice A reason: This response shifts the focus to the clinician’s personal life and may come across as dismissive or lacking empathy. It does not validate the client’s concerns or maintain therapeutic boundaries.
Choice B reason: This response is professional, empathetic, and maintains boundaries. It explains the rationale for scheduling without being defensive or judgmental. It also communicates fairness and respect for all clients, which helps preserve the therapeutic alliance.
Choice C reason: This response is overly interpretive and risks pathologizing the client’s behavior without adequate context. It may feel intrusive and could damage rapport.
Choice D reason: This response is punitive and lacks empathy. It may reinforce the client’s mistrust and escalate the situation rather than de-escalate it.
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