Ch 41 Prep U Self Concept

An adolescent states, "I want to go to college and learn to be a chef." This is an example of:

self-expectation.

During a health history, a client states, "Whatever happens, happens because of luck." The nurse interprets this statement as indicating:

external locus of control.

A group of nursing students is attending a seminar on self-concept. Which statement by a student concerning self-esteem indicates a need for further education?

"Children who agree with their parents' opinions have higher self-esteem."

An 8-year-old client whose grandmother died a week ago asks the parents about the grandmother's absence. Which statement by the parents could lead to a negative self-concept in the client? Select all that apply.

"Did you do something wrong to your grandmother?" "Your grandmother will come back in a week." "You are not supposed to ask such questions."

The nurse is caring for 14-year-old who is admitted with a respiratory infection. The parent states, " I want my child to develop in the best way possible. What kind of self-concept should my child have at this age?". What is the best response by the nurse?

"Her sense of self is very consolidated at this age."

A nurse wants to know about the client's self-perception. Which question will assess for the client's self-perception?

"How do you view yourself in regards to your importance both in your job and in your life?"

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 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." "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." "I have several very close friends that I depend on." "I've been through a lot and came back even stronger."

A client is requesting that the nurse speak with the physician regarding alternate treatment options. What comment by the nurse would be most appropriate to help the client identify and use her personal strength?

"I wonder why you want me to talk with the doctor? If you talk with them, you could hear all the treatment options firsthand. I will gladly stay with you while you talk to the doctor."

A young adult has come to the clinic for a routine visit, and the nurse is assessing her self-concept. Which statement by the client would the nurse interpret as reflecting the client's self-knowledge? Select all that apply.

"I'm a 23-year-old who just graduated from college." "I'm the child of parents who immigrated here from Russia." "I think I'm an intelligent, generous person."

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."

The nurse is caring for Mrs. Grace, a 26-year-old woman who has just delivered a healthy baby girl. Mrs. Grace says she wants to be a good mother and help her child develop in the best way possible. She asks the nurse, "What kind of self-concept is a baby born with?" The nurse's best answer is:

"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 completed, how are you feeling about the surgery that you had?"

A pediatric nurse is caring for Beth, a 13-month-old who is admitted with a respiratory infection. Her mother says she wants her child to develop in the best way possible. She asks the nurse, "What kind of self-concept should Beth have at her age?" What is the nurse's best response?

"She has a beginning differentiation of self and non-self."

A pediatric nurse is caring for Shawna, a 9-year-old who is admitted with a respiratory infection. Her mother says she wants her child to develop in the best way possible. She asks the nurse, "What kind of self-concept should Shawna have at her age?" The nurse's best answer is which of the following?

"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?"

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?

"What new behaviors might be necessary to help modify your current roles?"

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. -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.

The nurse is caring for a group of clients. Which assessment indicates a high risk for altered self-concept related to personal identity?

A 12-year-old who is developing pubic hair and breasts

A client has recently immigrated without his family. The client reports that he cannot find a job and has no friends here. The client reports that without his family he doesn't know who he really is and everything around him is different. Which nursing diagnosis is most appropriate?

Altered personal identity related to the new environment and separation from family

Which newborn, cared by the nurse is at greatest risk for the developement of distrubances in self-concept?

An infant with cleft lip whose parents have difficulty accepting the appearance.

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 teen 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?

Behavioral change

The nurse is working on the rehabilitation unit caring for Don Wilson, a 16-year-old who has suffered a traumatic amputation of his left leg. During his physical assessment, he comments to the nurse, "I hate the way I look now with my leg gone." Which nursing diagnosis is most important for this client?

Body Image Disturbance

A nurse is providing care to a client who has undergone skin grafting to her face due to a burn injury. The client states, "I know it could have been worse, but my face will never be the same as it was. I haven't been able to look at myself in the mirror because of what I might see." The nurse interprets this statement as most likely reflecting which pattern?

Body image

A nurse assessing children in a pediatrician's office would expect a child to achieve self-recognition at what age?

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?

Communicates a sense of helplessness to his spouse.

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?

Discuss the noted discrepancy between action and words with the client.

A female client, prominent in the local media, has had surgery for a colostomy. The client avoids looking at the colostomy and refuses visitors. Identify the most appropriate nursing diagnosis.

Disturbed Body Image related to colostomy as evidenced by avoidance of colostomy

A 73-year-old man has been the primary caregiver for his wife, who has multiple sclerosis (MS). After 30 years with the disease she died and he has become increasingly withdrawn and refuses to leave the house. Which nursing diagnosis is most appropriate?

Disturbed personal identity related to the unresolved crisis of his wife's death

he nurse is assisting an adolescent female with the identification and recognition of personal strengths. Which of the following is a technique the nurse will employ?

Encourage the client to identify strengths and ways to gain strengths she desires.

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 his life experience will help to develop a plan of care.

A client has suffered an amputation of the right leg due to a motor vehicle accident. What would be an example of a maladaptive response?

Expressing they will never be a whole person again

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?

External locus of control

A client with cancer has a family who is emotionally supportive of the client. Having a supportive family is which type of resource?

External resource

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.

Which question would the nurse include on a self-concept assessment related to body image?

How do you feel about any physical changes you noticed recently?

Which question would provide the nurse with the information needed first when assessing self-concept?

How would you describe yourself to others?

The pediatric nurse is caring for a boy 5 years of age, who is being seen in the clinic today. He is very worried that the doctor may harm his body. His mother asks the nurse if this is normal for this age. The nurse shares with the mother that the very young child worries about which of the following related to his body?

Intactness and mutilation

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 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?

Intervening when a client's spouse makes the client cry

A student nurse is preparing a care plan for a hospitalized school-age client focusing on ways to promote self-concept. Which intervention would not be appropriate?

Limit visitation of friends

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.

Which nursing action helps to maintain a sense of self for clients?

Offering a simple explanation before initiating any procedure

The nurse is assessing for information about a client's self-concept. The information needed first is about which of the following?

Personal identity

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?

Personal identity

Which of the following are specific components of self-concept? Select all that apply.

Personal identity Body image Self-esteem Role performance

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.

The nurse is caring for 13-year-old Carol, who is being seen in the clinic today. She is very worried that the doctor may need to look at her body. Her mother asks the nurese if this behavior is normal for this age. The nurse shares with the mother that the adolescent worries about which of the following related to her body?

Rapid changes

The nurse is caring for 13-year-old Carol, who is being seen in the clinic today. She is very worried that the doctor may need to look at her body. Her mother asks the nurse if this behavior is normal for this age. The nurse shares with the mother that the adolescent worries about which of the following related to her body?

Rapid changes

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

The nurse works in the emergency department and feels like they are becoming somewhat jaded about her nursing practice. The nurse talks to the supervisor about this and suggests making some goals for enhancing their self-concept as a professional nurse. Which of the following would be an important goal to establish that would build up the nursing self-concept?

Schedule time every day to meet personal needs.

Which nursing diagnosis lacks a self-concept disturbance etiology?

Self-Care Deficit related to dysfunctional grieving

A nurse encourages a young female whose leg was amputated to continue to pursue her dream to become a dancer. How does the nurse identify this need to reach one's potential through full development of one's unique capability?

Self-actualization

The nurse is assessing for information about a client's self-concept. The information needed first is about which of the following?

person identity

A 24-year-old man is suffering from depression. He has come to the clinic today for a follow-up visit with his provider and the nurse has been asked to provide some client education on the antidepressants he has been prescribed. When the nurse asks him how he is feeling today, he responds that he is feeling down because he feels as if he is a failure. This scenario best describes which dimension of self-perception?

Self-evaluation

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-expectation

A child lists his favorite sports figures and tells the nurse he is going to be just like them. How does the nurse identify this human need?

Self-expectations

A nurse 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?

Stress tolerance

Which nursing intervention is inappropriate when developing a plan of care to modify a negative self-concept?

Teaching the client that everything will work out better than she expects

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:

external locus of control.

The nurse is performing a psychosocial assessment for a client. What data obtained by the nurse indicates the client has a healthy self-esteem?

The client is assertive in expressing needs and opinions related to health care The client reports feeling confident in their ability to make decisions The client reports leaving an unhealthy relationship

A nurse is caring for a middle-age client who has recently been diagnosed with breast cancer. The nurse determines that the client is experiencing a self-concept dysfunction when the client engages in which behavior?

The client refuses to meet visitors by saying she is tired.

The nurse is preparing a care plan for client with the nursing diagnosis of Ineffective Coping. The client has had a mastectomy and refuses to participate in the care of the surgical site. What would be an appropriate initial goal for the client?

The client will look at the surgical site in a mirror within 2 days.

Which of the following is objective data related to self-concept?

The person refuses to make eye contact.

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 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?

What are your personal strengths?

A construction worker age 33 years experienced a fall on a job site that resulted in a spinal cord injury. In recent days, the client has alluded to the fact that he feels "useless" because he now sees himself as "a burden instead of a provider." The nurse would be justified in choosing interventions to:

address the client's negative self-concept.

A female client experienced facial burns in a motor vehicle accident. Recently, the client told her nurse, "I can't stop worrying that my fiance isn't going to want me anymore." Which of the following nursing diagnoses is most clearly suggested by the client's statement?

anxiety

The nurse is preparing to assess a client newly admitted to the behavioral health unit. Assessing the client's self-concept will focus on questions related to:

body image

A nurse is assessing a client who has experienced significant trauma affecting her body appearance. The nurse identifies a nursing diagnosis of Disturbed Body Image. When developing the plan of care, which information would be most important for the nurse to consider? Select all that apply.

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 mother age 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 of the following?

competence

A nurse is assessing a client and suspects that the client is experiencing a dysfunction in self-concept based on which behavioral findings? Select all that apply.

difficulty making decisions inability to discuss a change in body function social withdrawal

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

A client with uncontrolled hypertension experienced a stroke a week ago, leading to significant motor losses. A successful and normal adaptive response to these new limitations is evident if the client:

exhibits signs of grief.

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.

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.

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.

A newly married client is attempting to fulfill the role of wife, professional, and lover. She tells the nurse that she does not feel that she is fulfilling any of the roles well. The nurse will document this as:

role strain

What term best describes a person's sense of his own adequacy and worth?

self esteem,

During an interview, the client tells the nurse, "I know who I am and I know my strengths and weaknesses." How will the nurse interpret this statement?

self-concept

Asking a client to describe himself is one way to assess his:

self-concept.

Preschoolers exhibit sexual curiosity. This builds the preschooler's:

self-concept.

A client with paraplegia from a boating accident demonstrates the ability to cope with personal handicaps and to maximize strengths. What does the nurse determine that the client has developed?

self-esteem

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

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

The nurse is caring for a middle-age client who is admitted after taking an overdose of benzodiazepines. The client states, "I lost my job and I am just a failure at everything." The nurse is aware that potential causes of poor self-concept at this age can be related to which factors? Choose all that apply.

unsatisfying career choice failure to accept role responsibility failure to develop meaningful goals

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.

uses available resources makes decisions related to his care