Chapter 41: Self-Concept
11. An infant learns that the physical self is different from the environment. What term is used to describe this stage of self-concept? A) self-awareness B) self-recognition C) self-definition D) self-concept
A) self-awareness
8. Which of the following are components of Maslows self-esteem needs? Select all that apply. A) strength B) status C) independence D) mastery and competence E) importance F) appreciation
A) strength C) independence D) mastery and competence page: 1635 Self-Evaluation: "How Well Do I Like Myself?"
18. According to Aguilera, which of the following are factors that influence a persons response to crisis? Select all that apply. A) the persons perception of the event or situation B) the persons social standing C) the persons mental acuity D) the persons situational supports (external resources) E) the coping mechanisms the person possesses (internal resources.) F) the persons disposition
A) the persons perception of the event or situation D) the persons situational supports (external resources) E) the coping mechanisms the person possesses (internal resources.)
7. What is the name given to the evaluative and affective component of the self-concept? A) ideal self B) body image C) self-esteem D) self-knowledge
C) self-esteem
A nurse is performing a psychological assessment of a 19-year-old patient who has Down's syndrome. The patient is mildly developmentally disabled with an intelligence quotient of 82. He told his nurse, "I'm a good helper. You see I can carry these trays because I'm so strong. But I'm not very smart, so I have just learned to help with the things I know how to do." What findings for self-concept and self-esteem would the nurse document for this patient? Negative self-concept and low self-esteem Negative self-concept and high self-esteem Positive self-concept and fairly high self-esteem Positive self-concept and low self-esteem
Positive self-concept and fairly high self-esteem The data point to the patient having a positive self-concept ("I'm a good helper") and fairly high self-esteem (realizes his strengths and limitations). The statement "But I'm not very smart" is accurate and is not an indication of a negative self-concept.
What term best describes a person's sense of his own adequacy and worth? Esteem Self-esteem Love Self-actualization
Self-esteem Explanation: Self-esteem is a person's sense of his own adequacy and worth. Chapter 41: Self-Concept - Page 1635
The nurse takes the health history of a soldier who lost the right leg in a roadside bomb. Which question will the nurse ask the client while performing the health history? "How has the loss of your leg affected your body image?" "Has your family been a good support for you?" "Do you attend a support group of people who lost limbs?" "Will you show me how you ambulate?"
"How has the loss of your leg affected your body image?" Explanation: The human body is the self's physical manifestation. How a person pictures and feels about the body describes body image. Any deviation from the ideal body, such as the loss of a limb, might affect a person's body image. Asking how the client feels about family and friends would be part of the social history assessment. Watching the client ambulate is not part of the health history and may be performed during the physical assessment. A support group would be helpful for a client who lost a limb but would not be included in the health history. Chapter 41: Self-Concept - Page 1641
The nurse is working on the rehabilitation unit today caring for a client with a traumatic amputation of the left hand 6 days ago. The nurse is assessing the client for adaptive responses to physical deficits. Which statement by the client indicates an adaptive response? Select all that apply. "I am so angry that this has happened to me." "I don't believe this has happened to me." "I am okay with this now." "I am not going to any of the rehab classes." "I am not worth anything to anybody now."
"I am so angry that this has happened to me." "I don't believe this has happened to me." "I am okay with this now." The client exhibits signs of adaptive behavior by showing grief and mourning (shock, disbelief, denial, anger, guilt, acceptance). The client shows signs of maladaptive behavior by continuing to deny, and to avoid dealing with, the deformity or limitation, engaging in self-destructive behavior, and talking about feelings of worthlessness or insecurity. Chapter 41: Self-Concept - Page 1641-1642
A school nurse is teaching parents how to foster a healthy development of self in their children. Which statement made by one of the parents needs to be followed up with further teaching? "I love my child so much I 'hug him to death' every day." "I think children need challenges, don't you?" "My husband and I both grew up in very restrictive families. We want our children to be free to do whatever they want." "My husband and I have different ideas about discipline, but we're talking this out because we know it's important for Johnny that we be consistent."
"I love my child so much I 'hug him to death' every day." The patient's self-expectations are realistic, given his multiple commitments, and seem to be positively motivating his development.
The nurse is providing care to a client who is recovering from mild myocardial infarction. The nurse determines that the client has an internal locus of control based on which client statement? "I've been eating healthy and taking my medication. Otherwise, it could have been a lot worse." "I'm just glad that the paramedics came so quickly when I called 9-1-1." "It was by chance that my sister, who is a nurse, was visiting me at the time." "Boy, I was really lucky that this was only a mild heart attack."
"I've been eating healthy and taking my medication. Otherwise, it could have been a lot worse." Explanation: A person with internal locus of control believes that personal behavior influences outcome and that he can achieve desired results. Therefore, the statement about eating healthy and taking medications indicates that the client believes that his actions influenced the outcome. A person with external locus of control perceives that outcomes happen because of luck, chance, or the influence of powerful others. Chapter 41: Self-Concept - Page 1637
A new mother of twins is struggling with role performance issues related to balancing the demands of motherhood with working outside the home. What question would be most appropriate to help the client move forward with a positive self-concept? "Why do you think it is so hard to raise two babies?" "Would it be an option for you to quit your job and stay home?" "What new behaviors might be necessary to help modify your current roles?" "What do you think makes this struggle that you feel?"
"What new behaviors might be necessary to help modify your current roles?" Explanation: Asking "What new behaviors might be necessary to help modify your current roles?" allows the client to think through what she could do to regain a sense of balance in the performance of her role. The other options are judgmental or impose solutions versus allowing the client to think through the options related to the role struggle. Chapter 41: Self-Concept - Page 1643
A client is requesting that the nurse speak with the health care provider regarding alternate treatment options. What comment by the nurse would be most appropriate to help the client identify and use personal strength? "I will discuss treatment options with your doctor and let you know what is decided." "You can speak with the doctor about all treatment options. I will stay with you while you talk to the doctor, if you like." "You are not helpless. When the doctor comes in you need to talk for yourself. I will stay with you while you talk." "I wonder if your spouse would be willing to talk with the doctor for you? I will ask your spouse for you."
"You can speak with the doctor about all treatment options. I will stay with you while you talk to the doctor, if you like." Explanation: Nurses frequently fall into the trap of "doing" for clients. Some clients have even learned to communicate a manipulative helplessness that encourages the nurse to take charge. Using a positive that could occur (the client can hear all the treatment options firsthand) allows the client to use personal strength, and offering to be present affirms that the nurse remains an advocate while "helping" the client speak for oneself. Chapter 41: Self-Concept - Page 1645
A nurse practicing in a health care provider's office assesses self-concept in patients during the patient interview. Which patient is least likely to develop problems related to self-concept? A 55-year-old television news reporter undergoing a hysterectomy (removal of uterus) A young clergyperson whose vocal cords are paralyzed after a motorbike accident A 32-year-old accountant who survives a massive heart attack A 23-year-old model who just learned that she has breast cancer
A 55-year-old television news reporter undergoing a hysterectomy (removal of uterus) Based simply on the facts given, the 55-year-old news reporter would be least likely to experience body image or role performance disturbance because she is beyond her childbearing years, and the hysterectomy should not impair her ability to report the news. The young clergyperson's inability to preach, the 32 year old's massive myocardial infarction, and the model's breast resection have much greater potential to result in self-concept problems.
24. A nurse always addresses patients by the preferred name when entering a patients home or room. What is the nurse facilitating by this action? A) a sense of self and worth B) reorientation to who they are C) personal strengths D) negative self-concept
A) a sense of self and worth
3. Which of the following are specific components of self-concept? Select all that apply. A) personal identity B) personal wealth C) body image D) self-esteem E) role performance F) personal space
A) personal identity C) body image D) self-esteem E) role performance
9. A nurse working with patients in a healthcare facility influences them to make healthy lifestyle choices. According to Coopersmith, which of the following bases of self-esteem for the nurse does this example represent? A) power B) significance C) competence D) virtue
A) power
A sophomore in high school has missed a lot of school this year because of leukemia. He said he feels like he is falling behind in everything, and misses "hanging out at the mall" with his friends most of all. For what disturbance in self-concept is this patient at risk? Personal Identity Disturbance Body Image Disturbance Self-Esteem Disturbance Altered Role Performance
Altered Role Performance Important roles for this patient are being a student and a friend. His illness is preventing him from doing either of these well. This self-concept disturbance is basically one that concerns role performance.
A mother of a 10-year-old daughter tells the nurse: "I feel incompetent as a parent and don't know how to discipline my daughter." What should be the nurse's first intervention when counseling this patient? Recommend that she discipline her daughter more strictly and consistently. Make a list of things her husband can do to give her more time and help her improve her parenting skills. Assist the mother to identify both what she believes is preventing her success and what she can do to improve. Explore with the mother what the daughter can do to improve her behavior and make the mother's role as a parent easier.
Assist the mother to identify both what she believes is preventing her success and what she can do to improve. Each option with the exception of c correctly addresses some aspect of fostering healthy development in children. Because children need effective structure and development, giving them total freedom to do as they please may actually hinder their development.
21. A young woman has been in an automobile crash and sustained a laceration across the left side of her face, resulting in a large scar. What nursing diagnosis would be appropriate for this disfigurement? A) Anxiety B) Disturbed Body Image C) Deficient Knowledge D) Impaired Memory
B) Disturbed Body Image
23. Which of the following strategies can be used to help patients overcome powerlessness? A) Encourage patients to identify their weaknesses. B) Encourage patients to identify their strengths. C) Provide advice on how to handle problems. D) Set goals and make decisions for the patient.
B) Encourage patients to identify their strengths.
4. The wife of an elderly man has recently died. The couple was married for 32 years. What part of the mans self-concept may be influenced by this loss? A) ideal self B) global self C) body image D) false self
B) global self
2. A young woman patient admits to a nurse that she cannot control her jealousy when she and her partner are out together and states, It's like were back in high school again. This is an example of which of the following identity disorders? A) self-actualization B) identity diffusion C) depersonalization D) lack of self-esteem
B) identity diffusion
12. Who or what plays the most influential role in the internalization of self-concept in children? A) peers B) parents C) school D) church
B) parents
16. Which of the following statements is an example of the effect of aging, illness, or trauma on self- concept? A) society values the wisdom of aging B) society devalues aging and chronic illness C) few people take a healthy body for granted D) most people accept the inevitability of illness
B) society devalues aging and chronic illness
20. During a self-esteem assessment of a young woman undergoing a complicated divorce, a nurse states: Tell me something about the moralethical principles that govern your life. What aspect of self-esteem is the nurse assessing? A) significance B) virtue C) power D) competence
B) virtue
A college freshman away from home for the first time says to a counselor, "Why did I have to be born into a family of big bottoms and short fat legs! No one will ever ask me out for a date. Oh, why can't I have long thin legs like everyone else in my class? What a frump I am." What type of disturbance in self-concept is this patient experiencing? Personal Identity Disturbance Body Image Disturbance Self-Esteem Disturbance Altered Role Performance
Body Image Disturbance This patient's concern is with body image. The information provided does not suggest a nursing diagnosis of Personal Identity Disturbance, Self-Esteem Disturbance, or Altered Role Performance.
25. A nurse caring for critically ill patients uses interventions to help patients maintain a sense of self. Which of the following are recommended interventions? A) Disregard the patients status. B) Do not use touch out of respect for the patients privacy. C) Converse with the patient about his or her life experience. D) Do not acknowledge or allow expression of negative feelings.
C) Converse with the patient about his or her life experience.
17. During an assessment of a patients self-esteem, a 45-year-old man tells the nurse that he lost his job due to downsizing and has been unemployed for 6 months. What would be the appropriate response from the nurse? A) You shouldnt feel bad about losing a job, it happens to everyone. B) Do you need your job to support a family? C) How has losing your job affected your life and the lives of your significant others? D) There are more important things in life to worry about other than losing a job.
C) How has losing your job affected your life and the lives of your significant others?
10. A child learns to feel secure within the bonds of his immediate family by interacting with his caretakers. What is the term for this process? A) self-reflection B) adaptation C) attachment D) globalization
C) attachment
15. The children of immigrants may have different values and practices than do their parents, causing them to abandon their parents cultural beliefs. What is this called? A) cultural expectations B) cultural competence C) cultural dissonance D) cultural modernization
C) cultural dissonance
5. A teenager describes herself as tall, attractive, female, student, intelligent. What part of her self-concept is she describing? A) self-expectations B) self-esteem C) self-knowledge D) self-evaluation
C) self-knowledge
A client who has multiple sclerosis (MS) has been diagnosed with ineffective coping related to a diagnosis of chronic health alteration. What outcome is least appropriate to include in a plan of care? Integrates positive self-knowledge into self-concept. Reports feeling better about himself. Communicates his feelings in a way that is comfortable. Communicates a sense of helplessness to his spouse.
Communicates a sense of helplessness to his spouse. Explanation: All are appropriate outcomes except communicating a sense of helplessness. Some clients who are struggling with self-concept issues will communicate manipulative helplessness that encourages another (the spouse or nurse) to take charge. This does not promote coping or acceptance of self. Chapter 41: Self-Concept - Page 1644
19. What might a nurse ask during a health history to assess personal identity? A) Tell me how your illness has affected you in your job. B) Tell me what you do for fun and what you do for work. C) How do you believe others see you? Why do you believe that? D) How would you describe yourself to others?
D) How would you describe yourself to others?
22. Which of the following nursing diagnoses reflects disturbance in self-concept as the etiology? A) Disturbed Personal Identity B) Ineffective Role Performance C) Chronic Low Self-Esteem D) Impaired Adjustment
D) Impaired Adjustment
26. A nurse who works on the pediatric unit wants to help a child cope with the loss of a leg in a hunting accident. What would the nurse implement to help the child express feelings? A) support from other family members B) television cartoons C) story books D) dolls or animals
D) dolls or animals page 1647 Developing a Positive Body Image. dolls or animals help a child use their imagination better in an interactive way, where as TV or a story book would require sitting still with little movement.
27. A school nurse is teaching parents how to build self-esteem in their children. Which of the following is a recommended strategy? A) use praise and compliments judiciously B) wait for your child to initiate conversation C) focus on remedying the childs negative qualities D) give your child many opportunities to display abilities
D) give your child many opportunities to display abilities
14. In which of the following age groups do interpersonal losses play a role in disturbances in self-concept? A) child B) teenager C) adult D) older adult
D) older adult
6. As a child grows, he unconsciously develops a component of self-concept based on the image of role models. What part of the self-concept does this describe? A) false self B) evolving self C) self-knowledge D) self-expectations
D) self-expectations
Which of the following terms best describes an individuals self-concept? A) self-esteem B) self-actualization C) self-realization D) self-image
D) self-image
13. An adolescent rapidly develops secondary sex characteristics and body changes. What should the nurse assess to determine how these changes might affect the adolescents self-concept? A) expectations of the parents B) developmental environment C) meaningful use of time D) understanding of changes
D) understanding of changes
A nurse asks a 25-year-old patient to describe himself with a list of 20 words. After 15 minutes, the patient listed "25 years old, male, named Joe," then declared he couldn't think of anything else. What should the nurse document regarding this patient? Lack of self-esteem Deficient self-knowledge Unrealistic self-expectation Inability to evaluate himself
Deficient self-knowledge The patient's inability to list more than three items about himself indicates deficient self-knowledge. There are not enough data provided to determine whether he lacks self-esteem, has unrealistic self-expectations, or is unable to evaluate himself.
A client is telling the nurse about the client's two children, a toddler and a preschool-aged child. The client talks about providing them with colorful toys and puzzles and how much the client enjoys playing with them and reading to them. Which other strategies can be shared with the client to promote healthy development in the children? Demonstrate bad behavior to educate about good behavior. Make decisions for the children to model right from wrong. Discipline the children to establish boundaries. Encourage participation in family health behaviors.
Encourage participation in family health behaviors. Explanation: Allowing the children to participate in family health behaviors will focus on good behavior and encourage participation and future development of positive habits. Making decisions for children, rather than helping them to come to a decision, will not model good habits. Disciplining a child only establishes boundaries when a problem arises. Modeling bad behavior as a method of influencing good behavior is not an effective methodology. Chapter 41: Self-Concept - Page 1636-1637
A nurse is developing a plan of care for an older adult to promote self-esteem. What intervention would be most appropriate to include? Explain that getting older is part of life and the client needs to start thinking about what will happen when he dies. Explain that the younger generation is fast-moving and it's best to be around just those of the same generational age. Explain that his life experience will help to develop a plan of care. Encourage the client to do activities that younger people do.
Explain that his life experience will help to develop a plan of care. Explanation: Using older people's life experiences to shape the plan of care shows value for who they are (unconditional affirmation). While getting older is part of life it does not mean they need to dwell on death or surround themselves with older people. While it is appropriate to encourage older clients to try new things, it is not appropriate to encourage them to be like younger people but rather find hobbies that help define who they are at this stage of life. Chapter 41: Self-Concept - Page 1649
Which question would the nurse include on a self-concept assessment related to body image? Do you like who you are? Who influenced you the most growing up? How do you feel about any physical changes you noticed recently? Who would you most like to be?
How do you feel about any physical changes you noticed recently? Body image is the person's subjective view of one's physical appearance. Therefore, asking a client how he or she feels about physical changes addresses body image. "Do you like who you are?" assesses a person's self-esteem. Asking "Who influenced you the most growing up?" and "Who would you most like to be?" assesses a person's self-expectation. Chapter 41: Self-Concept - Page 1641
The emergency department nurse is triaging a 15-year-old adolescent who is brought in by a family member after finding the client with a bottle filled with a variety of pills. The family member shares that the client's parents recently divorced and the client's mother moved out-of-state, leaving the client and two younger siblings with the father. The father travels frequently for work, leaving the client alone to take care of the younger siblings. Which factor should the nurse prioritize? Inadequate coping Low self-esteem Stress tolerance Lack of confidence
Inadequate coping Explanation: Stressful events can lead to inadequate coping. The stress of the divorce, mother leaving without the client and siblings, going to school, and taking care of the siblings without assistance can be extremely stressful and result in low self-esteem and depression and progress to suicidal ideation, which in this case should be assessed due to the bottle of pills. This could be a sign the individual is planning suicide. The other choices can all contribute to inadequate coping. Chapter 41: Self-Concept - Page 1639
A 36-year-old woman enters the emergency department with severe burns and cuts on her face after an auto accident in a car driven by her fiancé of 3 months. Three weeks later, her fiancé has not yet contacted her. The patient states that she is very busy and she is too tired to have visitors anyway. The patient frequently lies with her eyes closed and head turned away. What do these data suggest? There is no disturbance in self-concept. This patient has ego strength and high self-esteem but may have a disturbance of body image. The area of self-esteem has very low priority at this time and should be ignored until much later. It is probable that there are disturbances in self-esteem and body image.
It is probable that there are disturbances in self-esteem and body image. The traumatic nature of this patient's injuries, her fiancé's failure to contact her, and her withdrawal response all point to potential problems with both body image and self-esteem. It is not true that self-esteem needs are of low priority.
A nurse asks a patient who has few descriptors of his self to list facts, traits, or qualities that he would like to be descriptive of himself. The patient quickly lists 25 traits, all of which are characteristic of a successful man. When asked if he knows anyone like this, he replies, "My father; I wish I was like him." What does the discrepancy between the patient's description of himself as he is and as he would like to be indicate? Negative self-concept Modesty (lack of conceit) Body image disturbance Low self-esteem
Modesty (lack of conceit) The nurse can obtain a quick indication of a patient's self-esteem by using a graphic description of self-esteem as the discrepancy between the "real self" (what we think we really are) and the "ideal self" (what we think we would like to be). The nurse would have the patient plot two points on a line—real self and ideal self (Fig. 41-5). The greater the discrepancy, the lower the self-esteem; the smaller the discrepancy, the higher the self-esteem.
A patient who has been in the United States only 3 months has recently suffered the loss of her husband and job. She states that nothing feels familiar—"I don't know who I am supposed to be here"—and says that she "misses home terribly." For what alteration in self-concept is this patient most at risk? Personal Identity Disturbance Body Image Disturbance Self-Esteem Disturbance Altered Role Performance
Personal Identity Disturbance An unfamiliar culture, coupled with traumatic life events and loss of husband and job, result in this patient's total loss of her sense of self: "I don't know who I am supposed to be here." Her very sense of identity is at stake, not merely her body image, self-esteem, or role performance.
When a nurse asks a client to describe her personal characteristics and traits, the nurse is most likely assessing the client for what self-concept factors? Body image Role performance Self-esteem Personal identity
Personal identity Explanation: Personal identity describes a person's conscious sense of who he or she is. Asking the client to describe her personal characteristics and traits assesses a person's personal identity. Body image is the person's subjective view of one's physical appearance. Role performance is one's ability to successfully live up to societal as well one's own expectations regarding role-specific behaviors. Self-esteem can be described as the need to feel good about oneself and to believe that others hold one in high regard. Chapter 41: Self-Concept - Page 1641
The nurse is assessing for information about a client's self-concept. The information needed first is about which of the following? Personal identity Body image Gender identity Sexual orientation
Personal identity Explanation: When assessing self-concept, the information needed first is the client's description of self. Personal identity describes an individual's conscious sense of who he is. Sexual orientation may not be how someone identifies themselves, or may only be a small part of their personal identity. Body image and gender identity may also be only part of their self-identity. Chapter 41: Self-Concept - Page 1633-1640
A nurse is counseling a husband and wife who have decided that the wife will get a job so that the husband can go to pharmacy school. Their three teenagers, who were involved in the decision, are also getting jobs to buy their own clothes. The husband, who plans to work 12 to 16 hours weekly, while attending school, states, "I was always an A student, but I may have to settle for Bs now because I don't want to neglect my family." How would the nurse document the husband's self-expectations? Realistic and positively motivating his development Unrealistic and negatively motivating his development Unrealistic but positively motivating his development Realistic but negatively motivating his development
Realistic but negatively motivating his development The patient's self-expectations are realistic, given his multiple commitments, and seem to be positively motivating his development.
A 33-year-old businessperson is in counseling, attempting to deal with a long-repressed history of sexual abuse by her father. "I guess I should feel satisfied with what I've achieved in life, but I'm never content, and nothing I achieve makes me feel good about myself.... I hate my father for making me feel like I'm no good. This is an awful way to live." What self-concept disturbance is this person experiencing? Personal Identity Disturbance Body Image Disturbance Self-Esteem Disturbance Altered Role Performance
Self-Esteem Disturbance This patient's self-concept disturbance is mainly one of devaluing herself and thinking that she is no good. This is a Self-Esteem Disturbance.
A nurse is assessing a client's self-perception. Which dimension is reflected by the client's statement, "I want to use my skills to become the best artist I can be"? Self-knowledge Self-expectation Social self Self-evaluation
Self-expectation Explanation: Self-expectation involves the "ideal" self — the self a person wants to be. It is the setting of present and future goals. Self-knowledge or self-awareness involves a basic understanding of oneself, a cognitive perception. It is consciousness of one's abilities: cognitive, affective, and physical. Self-knowledge involves basic facts (age, weight, sex) and qualities (sincere, athletic, intelligent) related to oneself. Social self is how a person sees himself in relation to social situations, including behavior and interaction with others. Self-evaluation is the conscious assessment of the self, leading to self-respect or self-worth. "Have I met my expectations? Do I like who I see in the mirror? Do I like how I behave?" Chapter 41: Self-Concept - Page 1635
A nurse is counseling parents attending a parent workshop on how to build self-esteem in their children. Which teaching points would the nurse include to help parents achieve this goal? Select all that apply. Teach the parents to reinforce their child's positive qualities. Teach the parents to overlook occasional negative behavior. Teach parents to ignore neutral behavior that is a matter of personal preference. Teach parents to listen and "fix things" for their children. Teach parents to describe the child's behavior and judge it. Teach parents to let their children practice skills and make it safe to fail.
Teach the parents to reinforce their child's positive qualities. Teach parents to ignore neutral behavior that is a matter of personal preference. Teach parents to let their children practice skills and make it safe to fail. The nurse should include the following teaching points for parents: (1) reinforce their child's positive qualities; (2) address negative qualities constructively; (3) ignore neutral behavior that is a matter of taste, preference, or personal style; (4) don't feel they have to "fix things" for their children; (5) describe the child's behavior in a nonjudgmental manner; and (6) let their child know what to expect, practice the necessary skills, be patient, and make it safe to fail.
A nurse is performing patient care for a severely ill patient who has cancer. Which nursing interventions are likely to assist this patient to maintain a positive sense of self? Select all that apply. The nurse makes a point to address the patient by name upon entering the room. The nurse avoids fatiguing the patient by performing all procedures in silence. The nurse performs care in a manner that respects the patient's privacy and sensibilities. The nurse offers the patient a simple explanation before moving her in any way. The nurse ignores negative feelings from the patient since they are part of the grieving process. The nurse avoids conversing with the patient about her life, family, and occupation.
The nurse makes a point to address the patient by name upon entering the room. The nurse performs care in a manner that respects the patient's privacy and sensibilities. The nurse offers the patient a simple explanation before moving her in any way. When assisting the patient to maintain a positive sense of self, the nurse should address the patient by name when entering the room; perform care in a manner that respects the patient's privacy; offer a simple explanation before moving the patient's body in any way; acknowledge the patient's status, role, and individuality; and converse with the patient about the patient's life experiences.
A 16-year-old patient has been diagnosed with Body Image Disturbance related to severe acne. In planning nursing care, what is an appropriate goal for this patient? The patient will make above-B grades in all tests at school. The patient will demonstrate, by diet control and skin care, increased interest in control of acne. The patient reports that she feels more self-confident in her music and art, which she enjoys. The patient expresses that she is very smart in school.
The patient will demonstrate, by diet control and skin care, increased interest in control of acne. All of these patient goals may be appropriate for the patient, but the only goal that directly addresses her body image disturbance is "the patient will demonstrate by diet control and skin care, increased interest in control of acne."
Which question would the nurse ask to assess a client's self-identity during a focused self-concept assessment? Who would you like to be? What do you like most about your body? What are your personal strengths? Do you like being a teacher?
What are your personal strengths? Explanation: Identifying one's own personal strengths describes a person's self-identity. Self-esteem is assessed by asking the client who he or she would like to be. Asking the client what he or she likes most about his or her body assesses body image. Role performance is assessed by asking the client about their satisfaction in his or her job. Chapter 41: Self-Concept - Page 1641
A nurse is reviewing the health history of a client. Which statement documented in the history would lead the nurse to suspect that the client has a negative self-concept? Select all that apply. "I feel like I'm so ugly." "I like myself and my life." "What good am I?" "I'm such a horrible person." "Who would want to marry me now the way I look?
What good am I?" "I'm such a horrible person." "Who would want to marry me now the way I look?" "I feel like I'm so ugly." People who do not possess a healthy self-concept are less able to cope with life, often expressing feelings of inferiority, self-doubt, and self-dislike. Statements that relate negative feelings (such as being ugly, questioning one's ability, being a horrible person, questioning attractiveness) suggest a dysfunction. Liking one's self and one's life expresses positive feelings that would be associated with a positive self-concept. Chapter 41: Self-Concept - Page 1647
A nurse is attempting to provide education to a newly diagnosed diabetic. The client states, "It doesn't matter what I eat, my future health is up to God." The nurse understands that this client has: internal locus of control. external locus of control. self-esteem deficit self-concept deficit
external locus of control. Explanation: A person with external locus of control perceives that outcomes happen because of luck, chance, or the influence of powerful others. A person with internal locus of control believes that personal behavior influences outcome, and that he can achieve desired results. Chapter 41: Self-Concept - Page 1639
Asking a client to describe himself is one way to assess his: self-concept. self-knowledge. self-expectation. social self.
self-concept. Explanation: Self-concept is the mental image a person has of himself. It is the person's meaning when stated as "I" or "me." Self-perception is how a person explains behavior based on self-observation. Self-knowledge or self-awareness involves a basic understanding of himself, a cognitive perception. It is consciousness of one's abilities: cognitive, affective, and physical. Social self is how a person sees himself in relation to social situations, including behavior and interaction with others. Chapter 41: Self-Concept - Page 1633
A client with a diagnosis of colon cancer has required the creation of an ostomy following bowel surgery. Which factor is most likely to influence the client's adjustment to this change? the coping mechanisms that the client possesses the prognosis of the client's cancer after the surgery the specific location of the ostomy the client's knowledge of a peer who also has an ostomy
the coping mechanisms that the client possesses Explanation: While having a peer with a similar challenge is likely to facilitate adjustment to a change such as this, the most significant consideration is likely the client's own coping mechanisms. This factor supersedes the client's prognosis or the location of the ostomy. Chapter 41: Self-Concept - Page 1639
Which of the following factors is most likely to present a challenge to the self-concept of a man 79 years of age? the man's increasing level of dependence on his children assisting his grandchildren with their college tuition costs financial pressures associated with the depletion of his savings the realization that his children are themselves undergoing age-related changes
the man's increasing level of dependence on his children Explanation: Dependency near the end of life can present a significant challenge to an individual's self-concept. Helping his grandchildren with the costs of education and facing financial challenges may be difficult, but these are likely less of a threat to self-concept than the realization of decreasing independence. The aging of the man's children is less likely to affect his own self-concept. Chapter 41: Self-Concept - Page 1638
