Nursing Fundamental Chapter 42 self concept PREP U 8
An 8-year-old child whose grandparent died 1 week ago asks the parents about the grandparent's absence. Which statement(s) by the parents could lead to a negative self-concept in the child? Select all that apply. "Did you do something wrong to your grandparent?" "Your grandparent died because they were sick and were not getting better." "Your grandparent will come back in a week." "You are not supposed to ask such questions." "Your grandparent is free from any pain now."
"Did you do something wrong to your grandparent?" "Your grandparent will come back in a week." "You are not supposed to ask such questions."
The nurse takes the health history of a client who lost the right leg in a roadside bomb. Which question will the nurse ask the client while assessing self-concept? "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?"
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 nurse is working on an oncology unit and is visiting with colleagues about how to prevent burnout as a professional nurse. The nurse works on a checklist that will provide information about how well the nurse is meeting the need for positive self-concept. The checklist contains statements that are answered with a positive or negative. Which statements would be good to have on the list? Choose all that apply. "I cope effectively with change and loss." "I set very high goals and expectations for myself." "I always keep in mind how I need to improve." "I have good relationships with others." "I accept and feel good about myself."
"I cope effectively with change and loss." "I have good relationships with others." "I accept and feel good about myself."
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?"
"I feel like I'm so ugly." "What good am I?" "I'm such a horrible person." "Who would want to marry me now the way I look?"
A nurse is conducting the initial assessment of a client admitted to the hospital for surgery. The nurse determines that the client has a healthy self-esteem based on which statement? Select all that apply. "I find it very easy to offer my opinions and tell people what I need." "When it comes to making decisions, I'm not always so sure I make the right one." "I have several very close friends that I depend on." "I don't know why people can't always do their best all the time." "I've been through a lot and came back even stronger."
"I find it very easy to offer my opinions and tell people what I need." "I have several very close friends that I depend on." "I've been through a lot and came back even stronger."
A client had an above-the-knee amputation due to necrotizing fasciitis. Which statement by the client indicates an adaptive response? "I can see I am going to need lots of help." "I am worthless without both of my lower limbs." "I am not a whole person anymore." "I want my crutches close to my bed."
"I want my crutches close to my bed."
The nurse is caring for a 26-year-old client who has just delivered a healthy female infant. The client says they want to be a good parent and help their child develop in the best way possible. They ask the nurse, "What kind of self-concept is an infant born with?" The nurse's best answer is: "The differences between self and others are strong at birth." "No self-concept is present at birth." "The sense of self is very consolidated at birth." "The newborn has a beginning differentiation of self."
"No self-concept is present at birth."
A client with breast cancer needs a bilateral mastectomy. Having already established a strong therapeutic partnership with the client, how can the nurse best assess the client's self-concept in light of this bodily change? "Now that it's scheduled, how are you feeling about the surgery that you will have?" "Has anyone talked to you yet about your options for breast reconstruction?" "How do you think that you'll accommodate this change in your daily routines?" "Do you have any friends or family members who have had breast cancer?"
"Now that it's scheduled, how are you feeling about the surgery that you will have?"
A pediatric nurse is caring for a 9-year-old child admitted with a respiratory infection. The child's parent says they want their child to develop in the best way possible. The parent asks the nurse, "What kind of self-concept should my child have at their age?" How will the nurse respond? "The differences between self and others are strong at this age." "Your child has developed no self-concept at this age." "Your child's sense of self is very consolidated at this age." "Your child is beginning the differentiation of self and non-self."
"The differences between self and others are strong at this age."
An older adult client with a diagnosis of early-stage Alzheimer's disease has recently moved to a long-term care facility, largely as a result of the spouses caregiver burnout. What question can the nurse ask to foster the client's sense of self? "What line of work were you in?" "How are you feeling about being apart from your wife?" "Do you feel like you're adjusting to the routines around here?" "How did you feel when you first got your diagnosis?"
"What line of work were you in?"
A pediatric nurse is caring for a 13-month-old child admitted with a respiratory infection. The child's parent says they want their child to develop in the best way possible. The parent asks the nurse, "What kind of self-concept should my child have at their age?" How should the nurse respond? "The differences between self and others are strong at this age." "Your child has developed no self-concept at this age." "Your child's sense of self is very consolidated at this age." "Your child is beginning the differentiation of self and non-self."
"Your child is beginning the differentiation of self and non-self."
The nurse is caring for a group of clients. Which assessment indicates a high risk for altered self-concept associated with personal identity? adult who reports feeling powerless in an executive occupational role 12-year-old child who is developing pubic hair and breasts 12-year-old child who has not started to menstruate 40-year-old adult who is struggling to balance the role of parenthood with a career
12-year-old child who is developing pubic hair and breasts
A nurse is educating the parents of an infant about the development of self-concept. Applying Freud's psychodynamic theory, the nurse would explain that the infant begins to be able to distinguish his body from objects in the environment at approximately what age? 1 month 3 months 6 months 9 months
3 months
Which scenario illustrates interrole conflict? A nurse is asked to provide birth control education even though the nurse does not believe in using birth control. A client decides they want to quit their job to try something new and their spouse values financial security. A parent is expected to play the role of father, wage earner, and cook for the family and is unsure of how to fulfill all of them. A health care provider is asked to decide whether a client who has recovered from alcohol use disorder is a liver transplant candidate.
A parent is expected to play the role of father, wage earner, and cook for the family and is unsure of how to fulfill all of them.
The nurse is assessing a young child in the clinic by asking simple questions. Which concept will the nurse predict this toddler to verify as per Sullivan's theory? Begins integrating good me and bad me into self-concept Is learning role performance in family Is developing self-esteem through experiences Is learning body image through walking
Begins integrating good me and bad me into self-concept
A nurse is working on a pediatric psychiatry floor. One of the nurse's clients is a 17-year-old girl who was admitted to the hospital for anorexia nervosa. The nurse decides, based on his assessment of this client, that he is going to help the adolescent accept responsibility for herself, help her define realistic goals, help her utilize resources to enact change, and will reward positive outcomes. Which nursing intervention is the nurse using with this client? Therapeutic relationship Self-evaluation Behavioral change Developmental
Behavioral change
A nurse assessing children in a pediatrician's office would expect a child to achieve self-recognition at what age? At birth By 18 months By 3 years By 6 years
By 18 months
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. TAKE ANOTHER QUIZ
The nurse is working on the rehabilitation unit caring for a 16-year-old client who has suffered a traumatic amputation of the left leg. During the physical assessment, the client comments to the nurse, "I hate the way I look now with my leg gone." Which action will the nurse take to support the client? Discuss the benefit of talking with others who have lost a limb. Encourage the client to resume work to divert attention from the loss. Demonstrate fashions that conceal the loss of the leg. Provide constant privacy to prevent embarrassment.
Discuss the benefit of talking with others who have lost a limb.
The nurse performs an assessment observing for clues about the client's self-concept and coping ability. The client is scheduled for surgery today and while twisting and shredding a tissue states, "I have no concerns about this procedure...a piece of cake!" Which is the best nursing action? Notify the client's health care provider to determine if the surgery should be cancelled. Ask to speak to the client's spouse privately about the client's anxiety. Discuss the noted discrepancy between action and words with the client. Get the client another tissue and ask what the problem is.
Discuss the noted discrepancy between action and words with the client.
A nurse is nervous about interacting with a new client due to the memories of a similar past situation the nurse has experienced. Which action should this nurse prioritize when caring for this client? Evaluate his or her own self-concept Discuss the situation with a colleague Share personal situation with client Ask another nurse to take over
Evaluate his or her own self-concept
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.
An 18-year-old says that it was just bad luck that he got in a motor vehicle accident and broke his arm. What is the client demonstrating by saying this? Internal locus of control Control reasoning External locus of control Expectancy
External locus of control
A client with an altered self-concept would most likely exhibit which emotional responses? Select all that apply. Feelings of worthlessness Feelings of superiority Helplessness Fear of acceptance Guilt
Feelings of worthlessness Helplessness Guilt
A nurse is working to change the behavior of a client experiencing personal identity problems. Which action would be most appropriate for the nurse to suggest when helping the client accept responsibility for herself? Have the client make "I" statements. Encourage realistic goal setting. Offer positive feedback. Role model confident actions
Have the client make "I" statements.
Which question would provide the nurse with the information needed first when assessing self-concept? How would you describe yourself to others? Do you like yourself? What do you see yourself doing 5 years from now? What are some of your personal strengths?
How would you describe yourself to others?
The nurse is assessing an older client who lives alone and states, "My husband died 6 months ago. My friends have died. I have no one to talk to. I feel lost." What interventions would the nurse use to promote the client's self-esteem? Select all that apply. Include a depression scale in the assessment of the client. Encourage the client to reminisce about the spouse. Address the client by her preferred name. Facilitate community services to engage the client in available activities. Inform the client that the time for grieving is usually less than 6 months.
Include a depression scale in the assessment of the client. Encourage the client to reminisce about the spouse. Address the client by her preferred name. Facilitate community services to engage the client in available activities.
The nurse is caring for a 7-year-old client with burn scars on the face from a previous accident that is struggling with developing and maintaining a positive self-concept. The client is admitted for the third plastic surgery to remedy the scar tissue. The nurse identifies which key factors that affect self-concept? Select all that apply. Internal and external resources Height and weight Appropriate role models Stressors Illness or trauma
Internal and external resources Stressors Illness or trauma
A client who recently had a bilateral mastectomy is working on developing a positive body image. Which intervention by the nurse is most appropriate? Teaching the client how she will feel regarding the removal of the breasts Intervening when a client's spouse makes the client cry Encouraging the client to move forward and understanding that grief is not necessary Providing all the wound care if the client does not want look at the surgical area
Intervening when a client's spouse makes the client cry
How can nurses who provide care in long-term care settings best enhance the self-esteem of older adults who reside in these facilities? Maximize the autonomy of residents in organizing their routines. Encourage residents to talk openly about their opinions. Ensure that residents are not presented with tasks that carry a risk of failure. Provide opportunities for the residents to engage with children and adolescents.
Maximize the autonomy of residents in organizing their routines.
The school nurse is teaching parents how to build self-esteem in children. Which strategies would the nurse include? Select all that apply. Notice examples of your child's ability in many different circumstances and point this out to the child. Listen to what your child says about his or her behavior and try to provide a possible "fix" for the problem. Address your child's negative qualities, including those that are a matter of taste, preference, or personal style. Find occasions to frequently and honestly praise your child. Ask yourself what need is being expressed by your child's negative behavior and address that behavior. Let your child know what to expect; let your child practice the necessary skills; be patient; and make it safe to fail.
Notice examples of your child's ability in many different circumstances and point this out to the child. Find occasions to frequently and honestly praise your child. Ask yourself what need is being expressed by your child's negative behavior and address that behavior. Let your child know what to expect; let your child practice the necessary skills; be patient; and make it safe to fail.
Which nursing action helps to maintain a sense of self for clients? Offering a simple explanation before initiating any procedure Assessing weight and overall nutritional status Asking the client to refrain from negative expressions Maintaining the privacy of the client's room number
Offering a simple explanation before initiating any procedure
Which of the following are specific components of self-concept? Select all that apply. Personal identity Personal wealth Body image Self-esteem Role performance
Personal identity Body image Self-esteem Role performance
The nurse cares for a hospitalized school-age client. The nurse is planning care focusing on ways to promote self-concept. Which intervention should the nurse include? Limit privacy in order to promote interaction. Limit visitation of friends so family can visit more often. Provide age-appropriate activities to promote engagement. Teach the client's parents about the child's need for socialization.
Provide age-appropriate activities to promote engagement.
A 2-year-old boy has had a bowel repair for gastroparesis. He is doing well but has a colostomy to aid in healing of the surgical bowel. What would be an appropriate nursing intervention for the client to enhance self-concept? Provide the client with room to move around in, and lots of toys to interact with, while securing his colostomy so it does not get in his way. Assist the client's parents in accepting their role as caregivers to a child with a colostomy. Educate the client's parents on how to provide a safe environment for him. Support and educate the client about health maintenance behaviors such as personal hygiene.
Provide the client with room to move around in, and lots of toys to interact with, while securing his colostomy so it does not get in his way.
A client started a nursing program and is trying to balance going to school full-time, a part-time job, and spending time with family. The client states, "I am trying to do everything and doing nothing well." Which role problem is this client experiencing from this role transition? Role strain Role ambiguity Role conflict Role agreement
Role strain
A nurse is developing a plan of care for a client with a negative self-concept. The nurse implements the interventions based on the understanding that a positive self-concept is most important for the client to meet which need? Select all that apply. Safety Love and belonging Physiologic Self-actualization Self-Esteem
Self-actualization Self-Esteem
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
When asked to describe oneself, the client states, "I am a 47-year-old Hispanic male, married with two children, and I work as a finance manager." What is this client demonstrating? Self-knowledge Self-expectations Self-evaluation Self-concept
Self-knowledge
x An adolescent client tells the nurse about asking oneself, "Do I like who I see in the mirror?" Which additional strategy can the nurse encourage the client to use to promote self-evaluation? Allowing life to unfold Taking a self-improvement class Meeting friends Setting goals
Setting goals
A nurse is working with a 16 year-year-old client who is concerned that her parents will shun and reject her upon finding out that she is pregnant. Based upon Coopersmith's four bases of self-esteem, this adolescent is concerned about which base of self-esteem? Significance Competence Virtue Power
Significance
The pediatric nurse is caring for a 3-year-old child who is admitted for pneumonia. The nurse notes the child is becoming more depressed, see note above. When similar actions occur the following day, which action should the nurse prioritize? Speak with the father concerning the child's needs. Wake the child the next time the father visits. Ask the family to bring a photo of the father. Arrange for the child to talk with the father via video call.
Speak with the father concerning the child's needs.
The nurse is preparing a care plan for client who is coping ineffectively with a recent a mastectomy. The client refuses to participate in the care of the surgical site. What goal is appropriate for the client's care plan? The client will look at the surgical site in a mirror within 2 days. The client will assist with the dressing change. The nurse will change the dressing while the client is hospitalized. The nurse will take a picture of the site to allow the client to view it when desired.
The client will look at the surgical site in a mirror within 2 days.
A nurse is providing care to a newborn. When implementing care to foster the infant's self-concept, which information would the nurse need to keep in mind? Select all that apply. Newborns have a clear sense of self. The nurse can transmit self-concept to the newborn. The parents can convey their sense of competence to the newborn Anxiety felt by those caring for the newborn can be sensed by the newborn. The basis for the newborn's self-concept does not occur until older childhood.
The nurse can transmit self-concept to the newborn. The parents can convey their sense of competence to the newborn Anxiety felt by those caring for the newborn can be sensed by the newborn.
Which of the following is objective data related to self-concept? The person states, "I am worthless." The person refuses to make eye contact. The person's mom tells a nurse that her child is never happy. The person admits that she always wears baggy clothes in order to hide her body.
The person refuses to make eye contact.
The nurse is assessing a 16-year-old adolescent who has undergone an emergent appendectomy. The nurse notes the client has become more depressed as the shift progresses. Which activity by the client should the nurse question? Time spent on Facebook Googling information about appendectomy Visits from classmates Phone calls from family
Time spent on Facebook
Which developmental stage does Erikson term autonomy vs. shame? Toddler Adolescent Preschooler School-age child
Toddler
The parent of a toddler brings the child to the clinic for a well-child visit. The nurse is teaching the parent about ways to promote a positive self-concept. Which concept would the nurse need to integrate into the education plan? Toddlers have a clearly distinct understanding of their body image. Toddlers lack an understanding of where their bodies end. Toddlers are aware of specific influences. Toddlers are unable to understand others' responses to behavior.
Toddlers lack an understanding of where their bodies end.
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?
A client has had abdominal surgery and the creation of a colostomy. The client avoids looking at the colostomy and refuses visitors. Which nursing concern is appropriate for this client? altered self-esteem related to colostomy and poor self-image altered body image related to colostomy as evidenced by avoidance of colostomy fear of rejection by others related to colostomy and altered self-image altered role performance related to inability to cope with visitors
altered body image related to colostomy as evidenced by avoidance of colostomy
A 73-year-old client has been the primary caregiver for their spouse, who had multiple sclerosis (MS). After 30 years with the disease, the spouse has died and the client has become increasingly withdrawn and refuses to leave the house. Which nursing concern is most appropriate for the nurse to identify for care planning? low self-esteem related to feeling unloved now that their spouse has passed away altered body image related to death of spouse and loss of the role of caregiver altered personal identity related to the unresolved crisis of their spouse's death altered self-esteem risk related to the recent death of their spouse
altered personal identity related to the unresolved crisis of their spouse's death
A client experienced facial burns in a motor vehicle collision. Recently, the client told the nurse, "I cannot stop worrying that my fiancé is not going to want me anymore." Which nursing concern is most clearly suggested by the client's statement? anxiety altered adjustment unproductive coping hopelessness
anxiety
A nurse is assessing a client who has experienced significant trauma affecting their body appearance. The nurse identifies a nursing concern of altered body image. When developing the plan of care, which information is most important for the nurse to consider? Select all that apply. the medical treatment plan client's perception of the alteration client's view of the importance of the alteration on the body part or function feelings associated with the change in body image the conflict arising from a change in roles
client's perception of the alteration client's view of the importance of the alteration on the body part or function feelings associated with the change in body image
A single parent, aged 51 years, has been recently diagnosed with multiple sclerosis. As a component of assessment, the nurse has asked the client, "How important is it for you to keep up the day-to-day maintenance of your household?" This question addresses the client's perception of which aspect of self-esteem? competence power virtue significance
competence
A pediatric nurse understands the concepts surrounding the formation of self-concept and incorporates these concepts into the delivery of nursing care to the pediatric population. Based upon these concepts, when does an individual learn that the physical self is different from the environment? during infancy during the preschool years during the school-age years during adolescence
during infancy
The nurse is caring for an older adult client who is admitted for a hip replacement related to osteoarthritis. The client expresses distress about the aging process and how it affects appearance. Which nursing intervention(s) is appropriate to address this client's stated concern? Select all that apply. exercising to maintain muscle mass proper nutrition identification of depression measures for basic skin care yoga to maintain joint flexibility
exercising to maintain muscle mass proper nutrition measures for basic skin care yoga to maintain joint flexibility
An infant who was born with Down syndrome, gastrointestinal anomalies, and cardiac defects has required nearly continuous hospitalization in the neonatal intensive care and pediatric care units of the hospital during her first year of life. To counteract the negative effects of prolonged hospitalization, the nurse should: facilitate as many opportunities as possible for infant-parent attachment. give the parents details about their infant's daily routines. remind the parents that their infant's circumstances are just as nurturing as a home environment. educate the parents about the fact that the infant is less emotionally vulnerable than an infant with no cognitive deficits.
facilitate as many opportunities as possible for infant-parent attachment.
The emergency department nurse is triaging a 15-year-old adolescent who is brought in by a family member after finding the adolescent with a bottle filled with a variety of pills. The family member shares that the adolescent's parents recently divorced and one parent moved out-of-state, leaving the adolescent and two younger siblings with the other parent who travels frequently for work. During these trips, the adolescent is alone to take care of the younger siblings. Which nursing concern should the nurse prioritize for care planning? inadequate coping low self-esteem stress tolerance lack of confidence
inadequate coping
The pediatric nurse is caring for a 5-year-old child, who is being seen in the clinic today. The child is very worried that the health care provider may harm their body. The child's parent asks the nurse if this is normal for this age. The nurse shares with the parent that children this age worry about which issue related to their body? intactness and mutilation rapid changes fitness and energy sexuality and style
intactness and mutilation
Which data obtained by the nurse from the client may indicate that a client has altered self-concept? Select all that apply. lack of eye contact, contrary to cultural norms states, "I am worthless." wants to perform hygiene independently states, "I do not want anyone to see me like this." client always conceals below-the-knee amputation
lack of eye contact, contrary to cultural norms states, "I am worthless." states, "I do not want anyone to see me like this." client always conceals below-the-knee amputation
A client tells the nurse, "I am not the person I was yesterday, but I can draw on things from the past so that I can achieve in the future." The nurse interprets this statement as reflecting: personal identity. role performance. self-esteem. body image.
personal identity.
A client comes to the clinic for an annual physical exam. During the history, the client tells the nurse about starting a new job but being unsure about success in this new role because since the expectations are unknown. What does the nurse determine this indicates for the client? role ambiguity. role strain. intrapersonal role conflict. role transition.
role ambiguity.
A nurse is reviewing a journal article about the development of the self. Place the stages listed below in their correct sequence from first to last that reflect the nurse's understanding of this development. Use all options. Click an option, hold and drag it to the desired position, or click an option to highlight it and move it up or down in the order using the arrows to the left. 1self-awareness 2self-recognition 3self-definition 4self-concept
self-awareness self-recognition self-definition self-concept
Which problem-based nursing concern lacks a self-concept disturbance etiology? self-care deficiency due to dysfunctional grieving noncompliance due to low self-esteem posttrauma syndrome due to an alteration in personal identity unproductive health maintenance due to an alteration in role performance
self-care deficiency due to dysfunctional grieving
A client with paraplegia from a boating accident demonstrates the ability to cope with personal limitations and to maximize strengths. What does the nurse determine that the client has developed? self-identity self-evaluation self-esteem self-image
self-esteem
The nurse is assessing a client's sense of adequacy and worth. What domain is the nurse assessing? esteem self-esteem identity self-actualization
self-esteem
x The nurse is interviewing a client and the client describes how they feel others perceive them and how they respond during interactions with others. The nurse will document the client's description in relation to what psychosocial concept? self-awareness social self self-concept self-perception
social self
A nursing student states, "I feel good that I put an indwelling catheter in my client without any problem even though it was an emergency." This demonstrates which factor affecting self-concept? self-knowledge self-actualization stress tolerance values
stress tolerance
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
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
A rehabilitation nurse is caring for Steve Branson, a 23-year-old man, who has suffered a spinal cord injury and has tetraplegia. One of the rehabilitative goals for Steve is to attain adaptive patterns of behavior related to his injury. Which of the following would indicate that he is achieving this goal? Choose all that apply. refuses necessary help uses available resources makes decisions related to his care declines responsibility for his care depends on others for care
uses available resources makes decisions related to his care
