Fundamentals Nursing Prep U Chapter 40 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 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."

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."

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

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

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 spouse's 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 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

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 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 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.

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 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 client who is 5 ft 2 in (1.57 m) tall and weighs 120 lb (54.4 kg) states, "I wish for once I had a normal weight and I weren't so fat." What is the priority nursing diagnosis?

Disturbed body image

The 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

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?

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

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?

Limits visitation of friends

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

Offering a simple explanation before initiating any procedure

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 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.

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 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.

Which of the following nursing diagnoses lacks a self-concept disturbance etiology?

Self-Care Deficit related to dysfunctional grieving

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

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

Self-esteem

A student nurse who has not maintained healthy relationships with his or her peers would be at risk for what self-concept disturbance?

Self-esteem disturbance

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 client states, "I'm concerned about my ability to take care of my mother because I've got a tendency to become impatient when I don't see quick results." This statement addresses which characteristic of the client?

Self-knowledge

Which describes an ascribed role?

Son

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

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.

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

The client will be able to stop smoking

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 developmental stage does Erikson term autonomy vs. shame?

Toddler

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.

Which of the following is an appropriate intervention for body image disturbance?

assisting the client in exploring thoughts and feelings related to body image changes

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.

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 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

A mental health nurse has been asked to be a guest speaker at a seminar on self-concept. When describing the normal patterns of self-concept, which component would the nurse most likely address? Select all that apply.

• Body image • Self-esteem • Personal identity • Role performance

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 would be appropriate nursing intervention for this client?

• Exercising to maintain muscle mass • Proper nutrition • Measures for basic skin care • Yoga to maintain joint flexibility

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.

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

A nurse is providing anticipatory guidance to the parents of an adolescent regarding issues related to developmental changes that affect self-concept. What should the nurse discuss with the parents regarding these changes? Select all that apply.

• Peers become more important than parental influences. • The adolescent's sense of self is consolidated. • The adolescent is developing a sexual identity. • The adolescent is developing secondary sex characteristics and experiencing rapid body changes.

A nurse is providing anticipatory guidance to the parents of a toddler regarding ways to promote self-concept and personal identity. Which actions would the nurse recommend? Select all that apply.

• allowing exploration of the surroundings • assisting in maintaining self-control

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