Ch 41 Self-Concept

You are the pediatric nurse 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 you, "What kind of self-concept should Shawna have at her age?" Your best answer is which of the following?

"The differences between self and others are strong at this age."

A client is requesting that the nurse speak with the physician regarding alternate treatment options. What comment by the nurse would be the 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 other treatment options firsthand. I will gladly stay with you while you talk to the doctor."

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 new mother of twins is struggling with role performance issues related to balancing the demands of motherhood w/ working outside of 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?"

3 majors self-evaluation feelings or affects found in individuals are:

1) pride, based on a positive self-evaluation 2) guilt, based on behaviors incongruent with the ideal self 3) shame, associated with low global self-worth. -these affects are learned in early childhood within relationships w/ significant others and maintained through practice.

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?

- "I'm such a horrible person" - "I feel so ugly" - "What good am I?" - "Who would want to marry me now the way I look?"

A nurse is providing care to a newborn. When implementing care to foster the infant's self concept, which info would the nurse need to keep in mind?

-Anxiety felt by those caring for the newborn can be sensed by the newborn -the parents can convey their sense of competence to the newborn -the nurse can transmit her self concept to the newborn

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

How to assess a patient's body image?

Asking the patient what he or she likes most about their body

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.

A person with external locus of control...

perceives that outcomes happen because of luck, chance, or the influence of powerful others.

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

The nurse is working on an oncology unit and is visiting with colleagues about how to prevent burnout as a professional nurse. Everyone suggests things and the group comes up with a very good list of self-care behaviors and ways that will help prevent burnout. Which of the following would be good things to have on the list? Select all that apply.

Emphasize your strengths and the things you do well. Know that no one person can be all things to all people. Live life one day at a time and do your best.

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

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

External resource

Which of the following questions 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?

Self-identity

Identifying one's own personal strengths

The nurse is caring for 7-year-old Marcie today. Marcie is struggling with developing and maintaining a positive self-concept due to burn scars on her face from an accident 4 years ago. She does not remember the incident, but she is very aware of how she appears to others. She is admitted for her third plastic surgery to remedy the scar tissue. The nurse is aware of which key factors that affect self-concept? Select all that apply.

Internal and external resources Stressors Illness or trauma

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 patient to describe her personal characteristics and traits, the nurse is most likely assessing the patient for what self-concept factors?

Personal identity

A young woman has just started a nursing program. She is trying to balance going to school full-time, a part-time job, and spending time with her family. Recently she has been feeling a lot of stress and doesn't feel as if she is able to do any of the three very well. Which role problem is this young woman experiencing from this role transition?

Role strain

The nurse works in the emergency department and feels like she is becoming somewhat jaded about her nursing practice. The nurse talks to her supervisor about this and he suggests making some goals for enhancing her 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.

A nurse visits a diabetic client age 60 years in his home after the client's above-the-knee amputation of his left leg. The client appears disheveled and with poor hygiene. He also avoids making eye contact with the nurse. What is likely to occur as a result of the client's reduced self-esteem?

Self-care deficit

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

Self-concept

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 child age 5 yrs wakes up at night and finds he has wet the bed. He feels embarrasses that he had this accident and sleeps in the wet bed all night, afraid to tell his parents. In the morning, he wakes up early, gets dressed, and hides his pjs because he still feels shame for this accident. This child is experiencing which feeling of self-evaluation?

Shame

A nurse 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

Which client outcome indicates effectiveness in a plan of care to promote self-concept?

The client describes herself as a mother of two who is content with life and loves her husband.

A nurse is educating a client about smoking cessation. The nurse determines that the client has a high self-efficacy. Which outcome would the nurse expect to occur?

The client will be able to stop smoking

A client has a nursing diagnosis of body image disturbance related to a recent bilateral mastectomy. Which goal is most appropriate to include in the nursing plan of care?

The client will participate as she is able in the daily care of the incisions.

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

The person refuses to make eye contact.

Which of these is a situational transition?

The transition from being married to being divorced

Which of the following questions would the nurse ask to assess a patient's self-identity during a focused self-concept assessment?

What are your personal strengths?

The nurse promotes the self-concept of the parents of an infant age 6 months admitted to the hospital with a fever and dehydration by:

allowing the parents to participate in the infant's care.

The nurse is working with a client to assist him in "reframing" his thoughts regarding a new diagnosis of diabetes. Which of the following best defines reframing?

altering a perception of a situation from a negative view to a positive view

Self-expectations

are goals that someone sets

A person with internal locus of control...

believes that personal behavior influences outcome and that he can achieve desired results

A soldier has lost his right leg in a roadside bomb. This accident will affect his:

body image

How do you assess a person's role performance?

by asking the patient about their satisfaction in their job.

How to assess Self-esteem?

by asking the patient who he or she would like to be

toddler stage

characterized by beginning differentiation.

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

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

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 nurse introduces herself to a visually impaired client, addresses the client by name, speaks to the client respectfully, and explains all the nursing activities. The nurse is implementing health promotion with this client by which mechanism?

fostering a sense of self

Self-perception

how a person explains behavior based on self-observation

Social Self

how a person sees himself in relation to social situations, including behavior and interaction with others.

Social self

how a person sees himself in relation to social situations.

adolescence stage

identity, body image, and role continue to develop or be redefined as individuation progresses.

maladaptive responses

in which a client assigns responsibility for his care to others, becomes increasingly dependent, or stubbornly refuses necessary help.

adaptive responses

in which a client assumes responsibility for care (makes decisions), develops new self-care behaviors, uses available resources, and interacts in a mutually supportive way with family

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.

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

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.

Self-knowledge

is a basic understanding of oneself

Self-efficacy

is the degree of confidence a person has about the ability to perform specific activities.

Self-concept

is the mental image a person has of himself. It is the person's meaning when stated as "I" or "me."

Expectancy of success

means the person has a belief that personal behavior will lead to something desired.

Role ambiguity

occurs when a person lacks knowledge of role expectations. This lack of knowledge causes anxiety and confusion.

Role Strain

occurs when the person perceives himself as inadequate or unsuited for a role and can occur when a person is forced to assume many roles

Maladaptive response

one in which the self concept is disturbed and coping is not evident

According to Sullivan's Interpersonal Theory, a person undergoes the process of individuation during which stage?

school age child (According to Sullivan's Interpersonal Theory, the process of individuation occurs during the school-age child stage as peer relationships develop. )

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

self-concept

A person's sense of his own adequacy and worth

self-esteem

Self-evaluation

the conscious assessment of the self

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

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

goals that will enhance a nurse's professional self concept:

• Identify basic unmet human needs, exploring positive means to meet these needs. • Schedule time every day to meet personal needs. • Assess the effect of feedback from significant others on self-esteem. • Describe personal strengths accurately. • Develop a realistic plan to achieve goals for personal growth and development. • Don't dwell on errors; remember them so you don't repeat them, but don't make remembering them a goal. • Pursuing a higher degree may be a worthy goal, but it will not enhance self-concept right now. • Avoiding weaknesses will not make them become strengths.