Chapter 42: Self-Concept PrepU
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." Explanation: If questions in childhood are discounted, met with great anxiety, or answered with misinformation, children may develop a negative self-concept or poor body image. The mother is perpetuating the belief that death is a punishment by saying, "Did you do something wrong to your grandmother?" When the mother says, "Your grandmother will come back in a week," she is misinforming the client. By saying, "You are not supposed to ask such questions," she is discounting the question because of the client's age. By answering, "Your grandmother died because she was sick and was not getting better," the mother shows that she is taking the client's question seriously and is fostering a sense of cause and effect. This will promote positive self-concept. By saying "Your grandmother is free from any pain now," the mother is giving the client encouraging information. This will positively influence his coping process and will strengthen his self-concept.
A client verbalizes experiencing a loss of control over life. Which follow-up question will the nurse ask this client?
"How do you view yourself in regard to your importance in your job and in your life?" Explanation: Self-perception is how a person explains behavior based on self-observation. Asking how the client views job and life represents a broad question that will provide a wide range of information regarding self-perception. Asking if the client feels appreciated is a closed-ended question and will not facilitate a discussion about self-perception. Asking about the client's failings is a closed-ended question and also will not lead to a discussion about self-perception. Asking if the client feels threatened at work or in life would be appropriate if the client communicated this fear.
The nurse takes the health history of a soldier who lost the right leg in a roadside bomb. Which question will the nurse ask the client while performing the health history?
"How has the loss of your leg affected your body image?" Explanation: The human body is the self's physical manifestation. How a person pictures and feels about the body describes body image. Any deviation from the ideal body, such as the loss of a limb, might affect a person's body image. Asking how the client feels about family and friends would be part of the social history assessment. Watching the client ambulate is not part of the health history and may be performed during the physical assessment. A support group would be helpful for a client who lost a limb but would not be included in the health history.
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." Explanation: With healthy self-esteem, a person is assertive in expressing needs and opinions; confident in the ability to make decisions; able to form secure and honest relationships—and less likely to stay in unhealthy ones; realistic in expectations and less likely to be overcritical of self and others; and more resilient and better able to weather stress and setbacks.
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." Explanation: A person with internal locus of control believes that personal behavior influences outcome and that he can achieve desired results. Therefore, the statement about eating healthy and taking medications indicates that the client believes that his actions influenced the outcome. A person with external locus of control perceives that outcomes happen because of luck, chance, or the influence of powerful others.
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." Explanation: The newborn has no self-concept at birth. In late infancy, an infant starts to differentiate between self and non-self. In childhood, differences between self and others are strong. During adolescence one's sense of self becomes very consolidated.
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?" Explanation: Asking "What new behaviors might be necessary to help modify your current roles?" allows the client to think through what she could do to regain a sense of balance in the performance of her role. The other options are judgmental or impose solutions versus allowing the client to think through the options related to the role struggle.
A client is requesting that the nurse speak with the health care provider regarding alternate treatment options. What comment by the nurse would be most appropriate to help the client identify and use personal strength?
"You can speak with the doctor about all treatment options. I will stay with you while you talk to the doctor, if you like." Explanation: Nurses frequently fall into the trap of "doing" for clients. Some clients have even learned to communicate a manipulative helplessness that encourages the nurse to take charge. Using a positive that could occur (the client can hear all the treatment options firsthand) allows the client to use personal strength, and offering to be present affirms that the nurse remains an advocate while "helping" the client speak for oneself.
A client had a traumatic amputation of the arm in a motor vehicle accident. Which intervention will the nurse use to assist a client in managing body image disturbance?
Assist the client in exploring thoughts and feelings related to body image changes. Explanation: Interventions for body image disturbances include assisting the client in exploring thoughts and feelings related to body image changes; encouraging the client to participate in self-care behaviors as able; understanding there is no correct way to progress through the various stages of loss and grief; and allowing the client to feel depressed, to cry, and to be angry. The nurse cannot provide limits or set boundaries as to when the client can express grief. Grief may need to be expressed at any time.
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 Explanation: As per Sullivan's interpersonal theory, the toddler begins to integrate the good me, bad me, and not me into self-concept. Freud's theory indicates the toddler is learning role performance in the family. Erikson's theory lists body image and self-esteem develop as the child experiences self-control through exploration in the world. Havighurst's theory indicates the toddler learns body image through walking, talking, and controlling waste.
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. Explanation: All are appropriate outcomes except communicating a sense of helplessness. Some clients who are struggling with self-concept issues will communicate manipulative helplessness that encourages another (the spouse or nurse) to take charge. This does not promote coping or acceptance of self.
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. Explanation: The client should be referred to a support group to learn more about how others cope with such a loss. By beginning that discussion the nurse will support the client to begin healing. An extreme need for privacy may be reflective of impaired self-concept and does not prevent embarrassment. A lack of self-esteem may indicate an impairment in self-worth. Demonstrating fashions to conceal the leg can be beneficial in the long run but cannot take the place of confronting one's feelings. Returning to work can help to maintain role performance but should not be allowed to be a way to deny feelings.
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 Explanation: A person with external locus of control perceives that outcomes happen because of luck, chance, or the influence of powerful others.
A client is telling the nurse about the client's two children, a toddler and a preschool-aged child. The client talks about providing them with colorful toys and puzzles and how much the client enjoys playing with them and reading to them. Which other strategies can be shared with the client to promote healthy development in the children?
Encourage participation in family health behaviors. Explanation: Allowing the children to participate in family health behaviors will focus on good behavior and encourage participation and future development of positive habits. Making decisions for children, rather than helping them to come to a decision, will not model good habits. Disciplining a child only establishes boundaries when a problem arises. Modeling bad behavior as a method of influencing good behavior is not an effective methodology.
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 Explanation: Each nurse should conduct a self-assessment of one's own self-concept to be better prepared to assist each client. If the nurse is dysfunctional in this area, he or she will not be able to properly meet the needs of the client. The nurse should be careful about sharing one's own experience with the client. Asking another nurse to take over will not assist this nurse in dealing with this situation properly and will add to a continued lack of self-concept. Discussing the situation with another colleague may help in the process but the priority is for the nurse to evaluate his or her personal self-concept.
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 Explanation: A person's situational support is considered an external resource, whereas a person's coping mechanisms are internal resources. A health care professional is a professional resource. Financial resources are provided by income, benefits, and contributions.
Which question would provide the nurse with the information needed first when assessing self-concept?
How would you describe yourself to others? Explanation: Global self is the term used to describe the composite of all the basic facts, qualities, traits, images, and feelings one holds about oneself. Global self provides the basis for assessing a person's self-concept. How well one likes themselves refers to self-esteem. The ideal self is assessed by asking clients what they see themselves doing in 5 years. Identifying personal strengths refers to personal identity.
The emergency department nurse is triaging a 15-year-old adolescent who is brought in by a family member after finding the client with a bottle filled with a variety of pills. The family member shares that the client's parents recently divorced and the client's mother moved out-of-state, leaving the client and two younger siblings with the father. The father travels frequently for work, leaving the client alone to take care of the younger siblings. Which factor should the nurse prioritize?
Inadequate coping Explanation: Stressful events can lead to inadequate coping. The stress of the divorce, mother leaving without the client and siblings, going to school, and taking care of the siblings without assistance can be extremely stressful and result in low self-esteem and depression and progress to suicidal ideation, which in this case should be assessed due to the bottle of pills. This could be a sign the individual is planning suicide. The other choices can all contribute to inadequate coping.
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 Explanation: Almost any life experience can influence a person's self-concept. Key factors include developmental considerations, culture, internal and external resources, history of success and failure, stressors, and illness or trauma. Height and weight and appropriate role models may affect self-concept in negative or positive ways, but they fall under the key factor categories. They are not, in and of themselves, key factors.
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. Explanation: Interventions that focus on supporting self-concept in school-age children include allowing for privacy. Educate parents about the need for socialization and belonging. Allow liberal visitation and age-appropriate activities if hospitalized.
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. Explanation: Maximizing autonomy and control is likely to enhance the self-esteem of older adults who may be very aware of their increasing dependence and loss of control. Encouraging frank discussion and interaction with other generations are also positive interventions, but these are less direct methods of fostering self-esteem. It is inappropriate to completely remove all risk of failure from older adults' activities as this encourages growth even in the older adult years.
Which nursing action helps to maintain a sense of self for clients?
Offering a simple explanation before initiating any procedure Explanation: The way nurses care for clients has a direct impact on the client's sense of self. By offering a simple explanation prior to any procedure, the nurse is respecting the client and shows that the client is a person first and foremost. Negative expressions should be encouraged and allowed. Privacy related to condition and keeping the body covered is important. The client's weight assessment does not help or hinder the client's sense of self.
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 Explanation: Personal identity describes a person's conscious sense of who he or she is. Asking the client to describe her personal characteristics and traits assesses a person's personal identity. Body image is the person's subjective view of one's physical appearance. Role performance is one's ability to successfully live up to societal as well one's own expectations regarding role-specific behaviors. Self-esteem can be described as the need to feel good about oneself and to believe that others hold one in high regard.
The nurse is assessing for information about a client's self-concept. The information needed first is about which of the following?
Personal identity Explanation: When assessing self-concept, the information needed first is the client's description of self. Personal identity describes an individual's conscious sense of who he is. Sexual orientation may not be how someone identifies themselves, or may only be a small part of their personal identity. Body image and gender identity may also be only part of their self-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. Explanation: A toddler needs an environment that allows them to practice newly developing skills, especially those related to movement. Providing this encourages the development of a positive body image and self-esteem. Assisting the client's parents to accept their new role is most appropriate for the family of a newborn. Safety should be addressed with the parents of an infant. Preschoolers are more concerned with damage to their bodies so teaching them about good hygiene is important.
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 Explanation: 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. Role ambiguity occurs when a person lacks knowledge of role expectations. This lack of knowledge causes anxiety and confusion. Role conflict is related to expectations concerning the role.
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. Explanation: These are 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.
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 Explanation: Self-actualization refers to the need to reach one's potential through full development of one's unique capabilities. Self-concept includes personal identity, body image, self-esteem, and role performance. Self-esteem is the need to feel good about oneself and to believe that others hold one in high regard. Ideal self constitutes the self one wants to be.
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.
Self-awareness Self-recognition Self-definition Self-concept Explanation: Stages in the development of the self include self-awareness (infancy), self-recognition (18 months), self-definition (3 years), and self-concept (6-7 years).
What term best describes a person's sense of his own adequacy and worth?
Self-esteem Explanation: Self-esteem is a person's sense of his own adequacy and worth.
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 Explanation: The client is talking about self-evaluation, which is the conscious assessment of the self. Self-expectations are goals that someone sets. Self-knowledge is a basic understanding of oneself. Social self is how a person sees himself in relation to social situations.
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 Explanation: Expectations for the self arise from various sources. The ideal self refers to who a person wants to be. These self-expectations develop unconsciously early in childhood and are based on images of role models such as parents, other caregiving figures, and public figures (such as a child wanting to be like a favorite sports figure). A person's self-knowledge includes basic facts (such as sex, age, race, occupation, cultural background, sexual orientation); a person's position within social groups; and qualities or traits that describe typical behaviors, feelings, moods, and other characteristics (e.g., generous, hot-headed, ambitious, intelligent, sexy). Self-evaluation refers to how well a person likes themselves. Self-actualization refers to the need to reach one's potential through full development of one's unique capabilities.
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?
Setting goals Explanation: A client who asks oneself, "Do I like who I see in the mirror?" is engaging in self-evaluation. Self-evaluation is the conscious assessment of the self, leading to self-respect or self-worth. Setting goals will provide a client with a structured set of actions to attain. Allowing life to unfold does not provide structure for the client. Improving one's knowledge can be useful but does not factor into one's self-evaluation. Being more social may be a goal but is not a strategy for self-evaluation.
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 Explanation: Significance is the way a person feels he or she is loved and approved of by the people important to that person. Competence is the way tasks that are considered important are performed. Virtue is the attainment of moral-ethical standards. Power is the extent to which a person influences his or her own life and others' lives.
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 Explanation: Self-esteem for a 3-year-old child is greatly influenced by parenteral acceptance. The child may begin to feel he or she has made a mistake or has done something wrong so the father does not love him or her anymore. The nurse should speak with the father about this concern, so the father understands how his actions are affecting his child. The other choices are possible options; however, the priority is for the parents to realize how much their actions are affecting their child.
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 Explanation: Coping and stress tolerance influence self-concept. People who are able to adapt to stress and resolve conflicts through coping tend to develop healthy self-concepts.
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 Explanation: Replacing negative feelings with positive self-talk is appropriate. Asking clients to explore positive dimensions about themselves will help them to incorporate positive knowledge of themselves into their self-concept. Teaching clients to "red-flag" negative self-talk as soon as they are aware of it is important in the modification process. Teaching clients that everything will work out better than they expect is not true and situational success does not determine self-concept.
Which of the following is objective data related to self-concept?
The person refuses to make eye contact. Explanation: Objective data constitutes what the nurse can observe with her own eyes. Other objective data that may be collected include a missing body part, a concealment of a body part, or weeping.
Which question would the nurse ask to assess a client's self-identity during a focused self-concept assessment?
What are your personal strengths? Explanation: Identifying one's own personal strengths describes a person's self-identity. Self-esteem is assessed by asking the client who he or she would like to be. Asking the client what he or she likes most about his or her body assesses body image. Role performance is assessed by asking the client about their satisfaction in his or her job.
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. Explanation: The client's statements reveal a strongly negative self-concept, a fact that the care team should address in an appropriate way. The client's statements relate more to his role and ability than his body image. Enhancing his mobility may be beneficial, but this will not necessarily change the fundamental way in which the client sees himself. Performing his ADLs may exacerbate, rather than alleviate, his negative self-concept.
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?
altered personal identity related to the unresolved crisis of their spouse's death Explanation: The client is experiencing an alteration in personal identity because they are is no longer a spouse or a caregiver. This concern was brought on by the recent death of the client's chronically ill spouse. Without the spouse to care for the client is unable to define who they are or what their role is without the spouse. The spouse does not have low self-esteem or an altered body image.
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.
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 Explanation: The ability to retain an intact self-concept in the face of illness, trauma, and surgery varies among people. Although the medical treatment plan and any role conflicts that arise due to the trauma may play a role, the person's perception of the alteration and the importance that the person places on the body part or function affected (as well as the feelings associated with altered body image) will influence body image dysfunction.
A client who is diagnosed with acute kidney injury has been informed about the need to start dialysis. Which assessment information supports the client is struggling with a change in life role?
client's worry about the inability to continue work Explanation: Life roles, such as one's occupation or profession, can constitute a major portion of a person's identity. The ability to successfully execute societal roles, as well as one's own expectations regarding role-specific behaviors (or role performance), is easily compromised by illness or injury. The inability to work temporarily is an example of this. A lack of interest in sex would be a normal response to illness. The client showing no changes and continuing on with life as usual would not signify struggle. Posttraumatic syndrome is a mental health condition that is triggered by a terrifying event—either experiencing it or witnessing it.
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 Explanation: Behavioral changes indicating self-concept dysfunction include lack of interest in activities, inability to make decisions, withdrawal from social situations, isolation, refusal to look in the mirror, refusal to look at an affected body part or discuss a limitation, avoidance of responsibility, show of hostility toward others, refusal to make eye contact, and negative statements about self.
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. Explanation: A person with external locus of control perceives that outcomes happen because of luck, chance, or the influence of powerful others. A person with internal locus of control believes that personal behavior influences outcome, and that he can achieve desired results.
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. Explanation: Prolonged hospitalization has a strong potential to interfere with the formation of the interpersonal bond between the child and parents. A daily update of the infant's care routines does not allow for the interpersonal bond and the nurse should incorporate the parents in the infant's care routine. A hospital environment is profoundly different from a home environment. The nurse should educate the parents that the infant is very emotionally vulnerable due to the prolonged hospitalization and bonding is essential.
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. Explanation: The client is exhibiting role ambiguity, which occurs when the person lacks knowledge of role expectations, which fosters anxiety and confusion. Role strain occurs when the person perceives himself as inadequate or unsuited for a role. Intrapersonal role conflict exists when role expectations conflict with the person's values, such as a nurse being asked to assist with an abortion when she believes it is immoral. Role transitions occur due to aging and growth or with a change in relationships.
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. Explanation: Role strain occurs when the person perceives himself as inadequate or unsuited for a role. This can occur in any role or because of numerous roles. People make multiple role transitions in a lifetime. Role ambiguity occurs when the person lacks knowledge of role expectations, which fosters anxiety and confusion. Role conflict is related to expectations concerning the role. Role conflict can be described as intrapersonal, interpersonal, or interrole.
Preschoolers exhibit sexual curiosity. This builds the preschooler's:
self-concept. Explanation: Self-concept continues to develop actively during preschool years. Preschoolers' sense of self becomes more defined as they realize that they are separate and unique. During this stage of development, children exhibit great sexual curiosity.
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 Explanation: While having a peer with a similar challenge is likely to facilitate adjustment to a change such as this, the most significant consideration is likely the client's own coping mechanisms. This factor supersedes the client's prognosis or the location of the ostomy.
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 Explanation: Dependency near the end of life can present a significant challenge to an individual's self-concept. Helping his grandchildren with the costs of education and facing financial challenges may be difficult, but these are likely less of a threat to self-concept than the realization of decreasing independence. The aging of the man's children is less likely to affect his own self-concept.
