A nurse is assessing a family's dynamics during a counseling session. The nurse should recognize which of the following findings as an indication of a boundary issues? A. An adolescent family member who questions parental authority B. A family with three generations in the same household C. Older children who are responsible for their younger siblings D. Two adults and their children from prior relationships in the same household Correct: C - This is an example of enmeshed boundaries in which there are no distinctions between the roles of family members. A - incorrect - An adolescent who questions parental authority is demonstrating appropriate behaviors for developmental age B - incorrect - This scenario occurs in many households, not indication of boundary issue D. This is an example of a blended family, not indication of boundary issue A nurse is performing an admission assessment on a client and notices that the client appears withdrawn and fearful. To establish a trusting nurse=client relationship, which of the following actions should the nurse take first? A. Inform the client that this admission is confidential B. Introduce the client to other clients in the day room C. Assist the client in facilitating behavioral change