nur 335 self concept
Which statement made by a patient with cancer reflects positive thoughts about personal health?
"I have the ability to get well quickly." A person's belief about personal health helps the nurse to understand the patient's self-concept. The patient who feels he or she has the ability to get well reflects positive thoughts about personal health. A verbalization such as, "I will not get better soon," indicates that the patient is suffering from chronic illnesses. If the patient states that he or she is a burden to his or her family, it indicates negative perceptions about personal health. The patient who states, "I can't stand to look at myself anymore" is indicating that he or she does not have positive thoughts about personal health.
Following a bilateral mastectomy, a 50-year-old patient refuses to eat, discourages visitors, and pays little attention to her appearance. One morning the nurse enters the room to see the patient with her hair combed and makeup applied. Which statement is the best response from the nurse?
"I see that you've combed your hair and put on makeup." When the nurse uses a matter-of-fact approach and acknowledges a change in the patient's behavior or appearance, it allows the patient to establish its meaning.
The nurse is caring for an 87-year-old patient. What factor most directly influences this patient's current self-concept?
Adjustment to role change, loss of loved ones, and physical energy Older adults experience significant challenges to self-concept, including mental and physical changes associated with aging and changes in identity and roles following retirement and/or loss of significant others. The adjustment to stressors is most important. The other influences are important but to a lesser degree.
The nurse is teaching a 10-year-old patient about personal hygiene. What observation would indicate that the child has not reached an age-appropriate developmental stage?
An inability to understand and master brushing technique As per Erikson's developmental stages, a 10-year-old child should be able to understand and reinforce information provided and master new skills, such as the basic hygiene tasks the nurse discusses. A person starts to accept age-related body changes and begins to establish goals in adolescence, but may not do so as young as 10 years of age. The assessment of life goals is not expected until adulthood. Setting goals for the future, such as deciding which school to attend or what career to pursue, is a developmental behavior for children 12 to 20 years old.
A patient underwent six cycles of chemotherapy for her cancer. She lost all of her hair due to drug effects. She is very worried and says, "My children may find me ugly. I will not be able to tolerate that." What stressor is most affecting her self-concept?
Body Image The patient is very concerned about her physical appearance and is worried that her children will be shocked on seeing her with no hair. She has low self-concept related to body image. Chemotherapy does not affect the patient's self-concept as much as body image. The patient does not doubt herself in the role of a mother and is not facing any identity issues.
A 50-year-old female patient with breast cancer is admitted to the hospital for surgical management. On the second postoperative day, the nurse finds the patient crying. She tells the nurse that she had agreed to take care of her 8-month-old granddaughter but knows she will be unable to do so. The patient also expresses concern about her looks and that she feels worthless. Which aspects of the patient's self-concept are affected? Select all that apply.
Body image Self-esteem Role performance Body image is the way a person perceives her body including physical appearance, structure, and function. The patient is unhappy with the way she looks. Self-esteem is the feeling of self-worth. The patient indicates a negative self-esteem. Role performance is the way in which a person perceives the ability to carry out a significant role. The patient doubts she can handle the responsibility of looking after her granddaughter. This shows negative role performance. Concentration, memory, and recall are intellectual aspects and are unaffected in this patient.
After assessing a 2-year-old child, the nurse observes that the child is in the psychosocial development stage of autonomy versus shame and doubt, according to Erikson's theory of self-concept. Which developmental tasks does the nurse observe in the child? Select all that apply.
Communication of likes and dislikes Appreciation of body appearance and function Increased independence in thoughts and actions Children between the ages of 1 and 3 years of age are in the psychosocial development stage of autonomy versus shame and doubt. During this stage, children begin to communicate likes and dislikes that promote the development of self-concept. The positive appreciation of body appearance and function increases the self-esteem and self-concept. Children from 1 to 3 years of age gain independence in actions and thoughts due to self-exploration. This also promotes development of self-concept due to increased autonomy. Children between 1 and 3 years of age cannot understand feedback given by peers and teachers. Children from 3 to 6 years of age have increased language skills, including the identification of feelings.
A patient diagnosed with major depressive disorder has long-term low self-esteem related to negative view of the self. Which action would be the most appropriate cognitive intervention by the nurse?
Focus on identifying strengths and accomplishments. Focusing on strengths and accomplishments to minimize the emphasis on failures assists the patient in altering distorted and negative thinking. The other interventions are important, but they are not designed to impact thoughts.
A 55-year-old male patient underwent a colostomy. Earlier he underwent coronary artery bypass graft (CABG) surgery. The nurse finds the patient depressed and weeping. The patient expresses that he is fed up with his poor health. He feels that he has become a burden on his family because he can't work now. The nurse finds that the patient's body language is suggestive of altered self-concept. Which behaviors suggest low self-esteem? Select all that apply.
Frequent crying Hesitant speech Avoidance of eye contact Behaviors that are suggestive of altered self-esteem include frequent crying, hesitant speech, avoiding eye contact, slumped posture, and an unkempt appearance. Normal speech and maintaining good eye contact are suggestive of a normal and positive self-esteem.
What is the most common reason for elective cosmetic surgery?
Improve self-image Improvement of body image is the most common reason for undergoing cosmetic surgery, because appearance is an important part of confidence and self-assurance. Acne scars, pigmentation problems, and wrinkling can also be treated with cosmetic surgery, but the surgery does not prevent the skin changes associated with aging.
Based on knowledge of the developmental tasks of Erikson's industry-versus-inferiority stage, the nurse emphasizes proper technique for use of an inhaler with a 10-year-old boy. Why does the nurse do this?
It increases the patient's self-esteem with the mastery of a new skill. The developmental stage of industry versus inferiority (ages 8 to 12) is focused on incorporating feedback from peers and teachers, increasing self-esteem with the mastery of new skills, and promoting awareness of strengths and limitations.
A 55-year-old male patient underwent a colostomy. Earlier he underwent coronary artery bypass graft (CABG) surgery. The nurse finds the patient depressed and weeping. The patient expresses that he is fed up with his poor health. He feels that he has become a burden on his family because he can't work now. The nurse concludes that the patient is experiencing role performance issues. Which statement is true about role performance?
It is the way an individual perceives his or her ability to responsibly carry out significant roles. Role performance is the way in which an individual perceives his or her ability to carry out significant roles responsibly. Self-esteem is an individual's holistic feeling of self-worth or emotional appraisal. Body image involves ideas and views of an individual related to the body including physical appearance, structure, or function. Role conflict is a conflict a person experiences when he or she has to perform two or more mutually exclusive responsibilities.
A 50-year-old female patient is admitted to the hospital for surgical management of breast cancer. On the second postoperative day, the nurse finds the patient crying. She tells the nurse that she had agreed to take care of her 8-month-old granddaughter, but knows she will be unable to do so. The patient also expresses concern about her looks and that she feels worthless. Identify the stressor that influenced the patient's self-esteem.
Mastectomy Mastectomy is a surgical procedure for removal of affected breast tissues. Mastectomy has a negative effect on the physical appearance of a female and may be unacceptable to many women. This can be a major factor in lowering their self-esteem. Chronic illness and the idea of depending on others also lower self-esteem. In this case, there is no mention of pain, job loss, or repeated failure, which may also reduce self-esteem. What is the most common reason for elective cosmetic surgery?
In planning nursing care for an 85-year-old male, what is the most important, basic need that must be met?
Preservation of self-esteem Self-esteem is essential for physical and psychological health across the life span.
A 20-year-old woman who lives with her parents gives birth to a baby. Around the same time, her parents adopt a 5-year-old child. The young woman is overwhelmed and has difficulty balancing her role as a mother with her role as a sister. What kind of role performance stressor does the woman experience?
Role conflict Role conflict happens when a person has to assume two or more inconsistent roles. This new mother is trying to cope with the physical and psychological burdens of raising a child and is stressed by the addition of a new relationship with a young sibling, creating role conflicts. Role ambiguity occurs when a person is confused and not sure of his or her role. Role strain results from role conflict and role ambiguity. When a person has more responsibilities within a role than she can manage, she experiences role overload.
A person tries to meet the strenuous demands of employment while taking care of a family of six and manages to fulfill the responsibilities with great difficulty. What kind of role performance stressor is affecting this person?
Role overload When the expectations and responsibilities of a role are unmanageable, it is referred to as role overload. A person may experience role overload when trying to meet employment demands and caring for a family. Role conflict happens when a person has to assume two or more inconsistent and mutually exclusive roles. Role ambiguity occurs when a person is confused and not sure of his or her role. Role strain results from role conflict and role ambiguity combined.
What term describes how one thinks of oneself?
Self-concept Self-concept is how one thinks of oneself. It is subjective and is a mixture of conscious and unconscious thoughts, attitudes, and perceptions. Self-awareness is having knowledge about one's feelings, thoughts, and attitudes. Self-esteem is how one feels about oneself. Self-expression is expressing one's own character, feelings, thoughts, and mind-sets.
The nurse asks the patient, "How do you feel about yourself?" What is the nurse assessing?
Self-esteem Self-esteem is how a person feels about himself or herself. Asking open-ended questions about self-esteem is important during the nursing assessment.
When developing an appropriate outcome for a 15-year-old girl, what primary developmental task of adolescence should the nurse consider?
The ability to form a sense of identity Understanding developmental tasks across the life span is essential in designing nursing care. Adolescents are focused on establishing their identities outside of their families and should be supported in meeting this developmental task.
A 55-year-old male patient recently underwent a colostomy. Prior to the colostomy, the patient underwent coronary artery bypass graft (CABG) surgery. The nurse finds the patient depressed and weeping. The patient expresses that he is fed up with his poor health. He feels that he has become a burden on his family because he can't work now. Which factors are responsible for lowering the patient's self-esteem? Select all that apply.
The colostomy Dependency on others A physical deficit preventing role assumption Procedures such as colostomies alter the physical appearance of people, thereby lowering their self-esteem. This patient is dependent on his family due to his physical deficits. This can be a major stressor and further reduce his self-esteem. His self-esteem is also lowered by the fact that he is unable to handle his responsibilities. Abuse or neglect and change in marital status do affect a person's self-esteem, but in this case, these factors are not evident.
