Foundations of Nursing Chapter 4 Theoretical Foundations of Nursing Practice

1 Orem's theory focuses on the patient's self-care needs. Evidence gained by the research based on insulin self-administration would help in facilitating self-care in patients with diabetes. Research based on effective strategies to improve nurse-patient communication would be based on Peplau's theory. Studies based on pathological processes in diabetes would help to improve the descriptive theories based on diabetes. Research focused on medications for diabetes is useful for improving prescriptive theories.

A group of researchers is conducting research on diabetic patients based on Orem's theory. What is the most probable topic of research? 1 Self-administration of insulin 2 Effective nurse-patient communication 3 Pathological process in diabetes 4 Medications for diabetes

2 The immediate priority is air, water, and nutrition. The patient needs to have sufficient air exchange, which might require oxygen administration. In addition, the patient needs to have appropriate fluid balance and some nutritional supplement.

A patient is admitted to an acute care area. The patient is a businessman who is worried about getting back to work. He has had severe diarrhea and vomiting for the last week. He is weak, and his breathing is labored. Using Maslow's hierarchy of needs, what is this patient's immediate priority? 1 Self-actualization 2 Air, water, and nutrition 3 Safety 4 Esteem and self-esteem needs

1, 2, 4

A patient is bedridden after an accident and she needs to adapt to her surroundings for physiological, sociological, and psychological needs. The nurse has decided to apply Roy's theory to the patient's condition. Which statements apply to Roy's theory when establishing patient adaptations? Select all that apply. 1 The nurse will determine which demands are causing problems for the patient. 2 The nurse assesses how well the patient is adapting to problems. 3 Adaptation to the basic physiological need should be the only goal of the nurse. 4 Nursing care should be directed toward helping the patient adapt to changes. 5 The need for nursing care arises only when the person cannot adapt to internal environmental demands.

1 This patient is newly diagnosed with diabetes and is under stress. The patient responds to stress by eating too many carbohydrates. This process is explained by Neuman's theory, which focuses on stress and the reaction of patients to that stress. Orem's theory focuses on the self-care needs of the patient. According to the theory, the patient should be able to manage health problems. Peplau's theory focuses on the nurse-patient interpersonal relationship. Leininger's theory focuses on providing culturally competent care. Unlike Neuman's systems model, Orem's theory, Peplau's theory, and Leininger's theory do not specifically explain the relationship between the stressor and the stress-related behavior.

A patient is newly diagnosed with diabetes. The diagnosis has made the patient feel stressed, and the patient eats more carbohydrates. Which theory explains this phenomenon? 1 Neuman's theory 2 Orem's theory 3 Peplau's theory 4 Leininger's theory

3 Peplau's theory focuses on developing interpersonal relationships among the nurse, the patient, and the patient's family. Following this theory, the nurse acts as a counselor, a resource person, and a surrogate. Thus, the nurse helps the patient reduce the anxiety related to health care problems. Leininger's theory focuses on cultural diversity and providing culturally specific health care. Roy's theory deals with helping the patient to adapt to changes, and Nightingale's theory focuses on environmental factors influencing the patient's health status.

A patient who is bedridden after an accident has become very quiet and is not interacting with her family or hospital staff. The nurse is focusing on efforts to develop effective nurse-patient communication. Which theory is useful for developing interpersonal relationships? 1 Leininger's theory 2 Roy's theory 3 Peplau's theory 4 Nightingale's theory

2 Mishel's theory on uncertainty focuses on dealing with uncertainty in disease processes such as cancers. Therefore, this theory can assist the nurse in developing strategies to help the patient deal with the uncertainty of the prognosis of leukemia. A grand theory does not guide the nursing interventions but provides a structural framework for broad, abstract ideas about nursing. They are extremely comprehensive. They do not specifically help in developing strategies to increase coping. Peplau's theory focuses on the nurse-patient interpersonal relationship; increasing coping skills is just one aspect of the theory. Descriptive theories explain phenomena that would be helpful to explain in nursing assessments. They are not useful for guiding nursing actions. However, they would be helpful in explaining the phenomena of stress and coping but may not be helpful to the nurse in developing strategies for coping.

A patient with leukemia is admitted to a hospital. The nurse is developing strategies to help the patient cope with the prognosis. Which theory could help the nurse in developing the strategies? 1 Grand theory 2 Mishel's theory 3 Peplau's theory 4 Descriptive theory

1, 2, 3 As a science, the field of nursing relies on knowledge gained through nursing research, other disciplines, and scientifically tested theories applied in the practice setting.

As an art, nursing relies on knowledge gained from practice and reflection on past experiences. As a science, what does nursing rely on? Select all that apply. 1 Experimental research 2 Nonexperimental research 3 Research from other disciplines 4 Professional opinions

14 Henderson's theory is based on the individual needs of a person. According to this theory, each person has 14 basic needs that are divided into five domains: physiological, psychological, sociocultural, spiritual, and developmental. This theory defines nursing as assisting an individual—well or sick—in performing activities that would contribute to health, recovery, or a peaceful death.

Henderson's theory focuses on the basic needs of the patient, which are divided into five domains: physiological, psychological, sociocultural, spiritual, and developmental. According to this theory, how many basic needs does a person have? Record your answer using a whole number. ___

4 Theoretical models that explain or predict patient responses related to any physiological, psychological, sociocultural, developmental, and spiritual domain come under psychological theories. Culturally competent care is based on behavioral responses of people across varied cultures. Thus, it can be explained under psychosocial theories. Systems theory explains the components of a theory that are interrelated to form a whole. An interdisciplinary theory explains the systematic view of a phenomenon. Developmental theories explain the processes that start with conception and continue until death.

In order to care for a wide variety of patients from various cultural backgrounds, the nurse should have a thorough knowledge of culturally competent care. On which theory is this statement based? 1 Systems theory 2 Interdisciplinary theory 3 Developmental theory 4 Psychological theory

1 Input is the data that is obtained after examining the patient. The statement that the patient has difficulty urinating is input data. Output is the result, and hence, an increase in urinary output can be considered as an output. The outcome for a patient who has difficulty urinating is an ability to urinate without difficulty. Thus, urination without difficulty is output data. The patient thanking the nurse because of improvement in the condition is the feedback, and the information that a diuretic should be given is content.

The nurse is caring for a patient with a urinary tract infection. According to systems theory, which statement should be considered as an input from the patient? 1 The patient reports difficulty with urination. 2 The patient voided normally without any difficulty. 3 The patient is feeling better and thanks the nurse for the intervention. 4 The patient should be given a diuretic to assist with urination.

4 The nurse should be able to prioritize the needs of a patient. This patient seems to have no immediate physical needs but is feeling lonely and may have psychological needs that should be the priority of nursing care. Although spiritual and self-esteem needs are important, they are above physiological and psychological needs in the hierarchy of care and should not be the first priority in nursing care.

The nurse is consulting with a patient who lives alone after the death of a spouse 3 years ago. The patient, who has no children and few close friends, reports good physical health but has been feeling listless. What should be the priority in nursing care for this patient, according to Maslow's hierarchy of needs? 1 Physiological needs 2 Spiritual needs 3 Self-esteem needs 4 Psychological needs

3, 4, 5

The nurse is discussing Orem's nursing theory with a colleague. Which statements about this theory are true? Select all that apply. 1 The goal of nursing care is to provide culturally competent care. 2 Orem's theory focuses on interpersonal relations between the nurse, the patient, and the patient's family. 3 Orem's theory focuses on the patient's self-care needs. 4 The goal is to help the patient perform self-care and manage his or her health problems. 5 Nursing care aims to increase the patient's ability to independently meet his or her own needs.

1, 2, 4 Nursing theories focus on the phenomena of nursing and nursing care. A phenomenon is the term, description, or label given to describe an idea or responses to or about an event, a situation, a process, a group of events, or a group of situations. Examples of nursing phenomena include caring, self-care, and the patient responding to stress. Pathophysiological processes and sociocultural factors affecting health are not phenomena but concepts that help describe a phenomenon.

The nurse is learning about nursing theories and their focus on the phenomena of nursing and nursing care. What would the nurse describe as a phenomenon of nursing? Select all that apply. 1 Self-care 2 Nursing care 3 Pathophysiological processes 4 Client response to stress 5 Sociocultural factors affecting health

4 Prescriptive theories are action oriented and validate a nursing intervention. Thus, the nurse should refer to descriptive theories to find the efficacy of an intervention. Grand theories do not provide guidance for specific nursing interventions. Middle-range theory tends to focus on a specific field of nursing, rather than reflect on a wide variety of nursing care situations. Descriptive theories explain why a phenomenon occurs. These theories do not guide nursing interventions.

The nurse is studying the effectiveness of breathing exercises for asthmatic patients. Which theories should the nurse consider to find the effectiveness of a particular intervention? 1 Grand theories 2 Middle-range theories 3 Descriptive theories 4 Prescriptive theories

1, 2, 4 Nursing theories focus on the phenomena of nursing and nursing care. A phenomenon is the term, description, or label given to describe an idea or response to or about an event, situation, process, group of events, or group of situations. Examples of nursing phenomena include caring, self-care, and patient responses to stress. Pathophysiological processes and sociocultural factors affecting health are not phenomena but concepts that help describe a phenomenon.

The nurse is studying the theories of nursing. Which would the nurse categorize as phenomena of nursing? Select all that apply. 1 Self-care 2 Nursing care 3 Pathophysiological processes 4 Client response to stress 5 Sociocultural factors affecting health

4 There are multiple theories for the practice of nursing; these theories are tested to develop the evidence to describe or predict patient outcomes

Theory-based nursing practice uses a theoretical approach for nursing care. This approach moves nursing forward as a science. What does this suggest? 1 One theory will guide nursing practice. 2 Scientists will decide nursing decisions. 3 Nursing will only base patient care on the practice of other sciences. 4 Theories will be tested to describe or predict patient outcomes.

4 The nursing paradigm focuses on the person, health, the environment/situation, and nursing. All the elements interact with one another with the patient being central.

What are components of the nursing paradigm? 1 The person, health, the environment, and theory 2 Health, theory, concepts, and the environment 3 Nurses, physicians, health, and patient needs 4 The person, health, the environment/situation, and nursing

4 A system functions on its content, input, output, and feedback. The components are interrelated and share a common purpose to form a whole; there is a continuous process of input, output, and feedback data. The content is the product and information obtained from the system.

What is content? 1 Content is data entering the system. 2 Content is the end product. 3 Content is data related to system functioning. 4 Content is product and information obtained from the system.

3 A system functions on its content, input, output, and feedback. The components are interrelated and share a common purpose to form a whole; there is a continuous process of input, output, and feedback data. Feedback serves to inform a system about how it functions.

What is feedback? 1 Data entering the system 2 The end product 3 Data related to system functioning 4 Product and information obtained from the system

2 A system functions on its content, input, output, and feedback. The components are interrelated and share a common purpose to form a whole; there is a continuous process of input, output, and feedback data. Output is the end product of a system. In the case of the nursing process, it is whether the patient's health status improves, declines, or remains stable as a result of nursing care.

What is output? 1 It is data entering the system. 2 It is the end product. 3 It is data related to system functioning. 4 It is product and information obtained from the system.

2 Jean Watson's theory is related to the humanistic aspects of life. The main goal of Watson's theory is to promote health, restore the patient's health, and prevent illness. Developing a nurse-patient relationship is the main goal of Peplau's theory. Focusing on caring and personal concern is the goal of Benner and Wrubel's theory. Facilitating the reparative processes of the body by manipulating the patient's environment is a goal of Nightingale's theory.

What is the goal of Watson's theory? 1 To develop interaction between the nurse and patient 2 To promote health, restore the patient's health, and prevent illness 3 To focus on caring as a means of coping with illness 4 To facilitate the reparative processes of the body by manipulating the patient's environment

1 Leininger's theory of transcultural nursing focuses on the patient's culture and the impact of cultural heritage on health care needs and interventions.

Which option is closely aligned with Leininger's theory? 1 Caring for patients from unique cultures 2 Understanding the humanistic aspects of life 3 Variables affecting a patient's response to a stressor 4 Caring for patients who cannot adapt to internal and external environmental demands

3 Theory-based nursing practice does reflect nursing outcomes. For example, prescriptive theories address specific nursing interventions and predict the patient response.

Which statement about theory-based nursing practice is incorrect? 1 It contributes to evidence-based practice. 2 It provides a systematic process for designing nursing interventions. 3 It is not linked to nursing outcomes. 4 It guides the nurse's assessment.

1 A paradigm is the term used to describe the pattern of thoughts that explain the domain of a particular discipline such as nursing. A phenomenon is the term, description, or label used to describe an idea or responses about an event, a situation, a process, a group of events, or a group of situations. A nursing theory is a conceptualization of some aspect of nursing that describes, explains, predicts, or prescribes nursing care. Peplau's theory is one of the nursing theories.

Which term is referred to as the pattern of thoughts that describe the domain of a discipline? 1 Paradigm 2 Phenomena 3 Nursing theory 4 Peplau's theory

1 Roy's theory explains the adaptation model and considers the patient to be an adaptive system. According to Roy's theory, the patient adapts to changes in physiological needs, self-concept, and interdependent relations during health and illness. This theory mainly identifies a patient's demands, assesses adaptation to demands, and helps the patient to adapt. Orem's theory mainly focuses on self-care. The goal of Orem's theory is to help the patient perform self-care and manage his or her own health problems. Peplau's theory focuses on the interpersonal relations between the nurse, the patient, and the patient's family members. It helps in developing the nurse-patient relationship. Henderson's theory states that nursing aids in assisting sick or well individuals in the performance of activities that will contribute to health, recovery, or a peaceful death.

Which theory states that the patient adapts to changes in physiological needs, self-concept, and interdependent relations during health and illness? 1 Roy's theory 2 Orem's theory 3 Peplau's theory 4 Henderson's theory

1, 2, 3 There is continuous interaction by both the patient and the nurse throughout all phases of the nurse-patient relationship. One choice is incorrect because the focus is only on the nurse.

While working in a community health clinic, it is important to obtain nursing histories and get to know the patients. Part of history taking is to develop the nurse-patient relationship. Which statements apply to Peplau's theory when establishing the nurse-patient relationship? Select all that apply. 1 An interaction between the nurse and patient must develop. 2 The patient's needs must be clarified and described. 3 The nurse-patient relationship is influenced by the patient's and the nurse's preconceptions. 4 The nurse-patient relationship is influenced only by the nurse's preconceptions. 5 The nurse-patient relationship should not establish trust.

1 Leininger used her background in anthropology to form her theory of cultural care diversity and universality. Roy identified types of demands placed on the patient, assessed adaptation to demands, and helped the patient with adaptation. King used communication to help the patient reestablish positive adaptation to environment, and Orem promoted patient care and helped the patient fully attain self-care.

Who used anthropology to form a theory of cultural care diversity and universality? 1 Leininger 2 Roy 3 King 4 Orem

1, 4, 5 Research that tests nursing theories determines how accurately a theory describes a nursing phenomenon. Testing helps to develop evidence for describing or predicting patient outcomes. The researcher has a theoretical idea of how patients describe or respond to a phenomenon and subsequently generates research questions or hypotheses to test the assumptions of the theory. Research is useful to test a theory before it is implemented. No single study tests all components of a theory.

Why is nursing research important in the profession of nursing? Select all that apply. 1 Research can lead to new theories. 2 Research helps to test all components of a theory. 3 Research is not done in nursing. 4 Research determines the accuracy of a theory. 5 Research helps in testing a theory before it is implemented.