NUR315: Chapter 42: Self Concept

A child age 5 years wakes up at night and finds he has wet the bed. He feels embarrassed 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 pajamas because he still feels shame for this accident. This child is experiencing which feeling of self-evaluation? A) Shame B) C) D)

shame

anxiety and depression

psychological manifestations of self-concept dysfunction.

Globalization

the process by which clients develop international influence or start operating on an international scale

A client had an above-the-knee amputation due to necrotizing fasciitis. Which statement by the client indicates an adaptive response? A) "I am not a whole person anymore." B) "I can see I am going to need lots of help." C) "I want my crutches close to my bed." D) "I am worthless without both of my lower limbs."

"I want my crutches close to my bed"

The nurse is caring for a 26-year-old client who has just delivered a healthy female infant. The client says they want to be a good parent and help their child develop in the best way possible. They ask the nurse, "What kind of self-concept is an infant born with?" The nurse's best answer is: A) "The sense of self is very consolidated at birth." B) "No self-concept is present at birth." C) "The newborn has a beginning differentiation of self." D) "The differences between self and others are strong at birth."

"No self-concept is present at birth."

A client with breast cancer needs a bilateral mastectomy. Having already established a strong therapeutic partnership with the client, how can the nurse best assess the client's self-concept in light of this bodily change? A) "Has anyone talked to you yet about your options for breast reconstruction?" B) "How do you think that you'll accommodate this change in your daily routines?" C) "Now that it's scheduled, how are you feeling about the surgery that you will have?" D) "Do you have any friends or family members who have had breast cancer?"

"Now that it's scheduled, how are you feeling about the surgery that you will have?"

A nurse is working with the parents of a child about ways to communicate effectively to build the child's self-esteem when dealing with inappropriate behavior. Which statement by the nurse is appropriate? A) "Start by describing the behavior and then why it needs to change." B) "When addressing the behavior, be sure to overgeneralize your comments." C) "It is important to be stern and attack the child's behavior immediately." D) "Use the silent treatment anytime there is inappropriate behavior."

"Start by describing the behavior and then why it needs to change."

A pediatric nurse is caring for a 9-year-old child admitted with a respiratory infection. The child's parent says they want their child to develop in the best way possible. The parent asks the nurse, "What kind of self-concept should my child have at their age?" How will the nurse respond? A) "Your child has developed no self-concept at this age." B) "Your child is beginning the differentiation of self and non-self." C) "Your child's sense of self is very consolidated at this age." D) "The differences between self and others are strong at this age."

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

Which question would the nurse ask to assess a client's self-identity during a focused self-concept assessment? A) Who would you like to be? B) What do you like most about your body? C) What are your personal strengths? D) Do you like being a teacher?

"What are your personal strengths?"

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 spouses caregiver burnout. What question can the nurse ask to foster the client's sense of self? A) "How are you feeling abut being apart from your wife?" B) What line of work were you in?" C) D)

"What line of work were you in?"

A new parent of twins is struggling with role performance issues related to balancing the demands of parenthood with working outside the home. What question would be most appropriate to help the parent move forward with a positive self-concept? A) "Why do you think it is so hard to raise two babies?" B) "What new behaviors might be necessary to help modify your current roles?" C) "What do you think makes this struggle that you feel?" D) "Would it be an option for you to quit your job and stay home?"

"What new behaviors might be necessary to help modify your current roles?"

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? A) "You can speak with the doctor about all treatment options. I will stay with you while you talk to the doctor, if you like." B) "I wonder if your spouse would be willing to talk with the doctor for you? I will ask your spouse for you." C) "You are not helpless. When the doctor comes in you need to talk for yourself. I will stay with you while you talk." D) "I will discuss treatment options with your doctor and let you know what is decided."

"You can speak with the doctor about all treatment options. I will stay with you while you talk to the doctor, if you'd like."

when does self recognition happen?

18 months

A nurse is educating the parents of an infant about the development of self-concept. Applying Freud's psychodynamic theory, the nurse would explain that the infant begins to be able to distinguish his body from objects in the environment at approximately what age? A) 9 months B) 3 months C) D)

3 months

when does self definition happen?

3 years

when does self-concept happen?

6-7 years

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? Select all that apply. A) "I feel like I'm so ugly." B) "Who would want to marry me now the way I look?" C) "I'm such a horrible person." D) "I like myself and my life." E) "What good am I?"

A, B, C, E

self-concept in adolescents

ones sense of self becomes very consolidated

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? A) Focus on assisting the client through the sequential stages of grief. B) Assist the client in exploring thoughts and feelings related to body image changes. C) Provide limits and set boundaries so the client can express grief. D) Assume self-care behaviors for the client.

Assist the client in thoughts and feelings related to body image changes.

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. A) taking on of additional responsibility B) difficulty making decisions C) social withdrawal D) intensive eye contact E) inability to discuss a change in body function

B, C, E

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? A) Communicates his feelings in a way that is comfortable. B) Reports feeling better about himself. C) Communicates a sense of helplessness to his spouse. D) Integrates positive self-knowledge into self-concept.

Communicate a sense of helplessness to his spouse

A nurse who is caring for a client in critical condition uses interventions to help the client maintain a sense of self. Which is the most appropriate nursing intervention? A) Encourage the client to wash and dress. B) Converse with the client about the individual's life experience. C) Do not use touch the client out of respect for individual privacy. D) Allow the expression of negative feelings to dominate conversation.

Converse with the client about individuals life experience

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. A) depends on others for care B) declines responsibility for his care C) refuses necessary help D) uses available resources E) makes decisions related to his care

D, E

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? A) making decisions for children B) disciplining the child C) encourage participation in family health behaviors D) Modeling bad behavior to influence good behavior

Encourage participation in family health behaviors

A nurse is developing a plan of care for an older adult to promote self-esteem. What intervention would be most appropriate to include? A) Encourage the client to do activities that younger people do. B) Explain that getting older is part of life and the client needs to start thinking about what will happen when he dies. C) Explain that the younger generation is fast-moving and it's best to be around just those of the same generational age. D) Explain that his life experience will help to develop a plan of care.

Explain that his life experience will help develop a plan of care.

The emergency department nurse is triaging a 15-year-old adolescent who is brought in by a family member after finding the adolescent with a bottle filled with a variety of pills. The family member shares that the adolescent's parents recently divorced and one parent moved out-of-state, leaving the adolescent and two younger siblings with the other parent who travels frequently for work. During these trips, the adolescent is alone to take care of the younger siblings. Which nursing concern should the nurse prioritize for care planning? A) inadequate coping B) low confidence C) low self esteem D)

Inadequate coping

Who or what plays the most influential role in the internalization of self-concept in children? A) Parents B) Peers C) Church D) School

Parents

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? A) Role conflict B) Role ambiguity C) Role strain D) Role agreement

Role strain

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? A) Self-expectation B) Self-knowledge C) Social self D) Self-evaluation

Self-evaluation

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? A) Meeting friends B) Allowing life to unfold C) Taking a self-improvement class D) Setting goals

Setting goals

Which statement is an example of the effect of aging, illness, or trauma on self-concept? A) Society values the wisdom of aging. B) Few people take a healthy body for granted. C) Society devalues aging and chronic illness. D) Most people accept the inevitability of illness.

Society devalues aging and chronic illness

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? A) The client will voice reasons for not being able to quit. B) The client will refrain from participating in trying to quit. C) The client will focus on another activity. D) The client will be able to stop smoking.

The client will be able to stop smoking

self-knowledge

a basic understanding of oneself

adaptation

a change or the process of change by which a client becomes better suited to its environment.

Role ambiguity occurs when

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

attachment

a process by which the child maintains security via an interpersonal bond with close caregivers, most notably parents.

self-destructive behaviors

addictive, giving immediate gratification only. The client is bound to gambling because of the temporary gratification it provides. The client is unable to see the cause-and-effect relationship between the addiction and the current situation due to their self-concept dysfunction.

self-concept in late infancy

an infant starts to differentiate between self and non-self

A child learns to feel secure within the bonds of the immediate family by interacting with his caretakers. What is the term for this process? A) adaptation B) self-reflection C) globalization D) attachment

attachment

internal locus of control

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

During a health history, a client states, "Whatever happens, happens because of luck." The nurse interprets this statement as indicating: A) internal locus of control B) self-efficacy C) external locus of control D) expectancy for success

external locus of control

cultural dissonance

children of immigrants may have different values and practices than their parents, causing them to abandon their parents cultural beliefs. This disconnect can lead to cultural confusion and conflict between the parents and children

The children of immigrants may have different values and practices than do their parents, causing them to abandon their parents' cultural beliefs. What is this called? A) Cultural dissonance B) Cultural expectations C) Cultural modernization D) Cultural competence

cultural dissonance

self-concept in childhood

differences between self and others are strong

A nurse who works on the pediatric unit wants to help a child cope with the loss of a leg. What would the nurse implement to help the child express feelings? A) Television cartoons B) Dolls or animals C) Support from other family members D) Story books

dolls or animals

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? A) evaluate his or her own self-concept B) C) D)

evaluate his or her own self concept

Role conflict is related to

expectations concerning the role.

A nurse is providing education to a client newly diagnosed with metastatic cancer. The client states, "It does not matter what treatment I receive; my future health is up to God." The nurse understands that this client has which? A) self-esteem deficit B) underdeveloped self-concept C) negative prognosis D) external locus of control

external locus of control

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? A) Expectancy B) Control reasoning C) Internal locus of control D) External locus of control

external locus of control

The nurse is assessing for information about a client's self-concept. The information needed first is about which of the following? A) Gender identity B) Personal identity C) Body image D) Sexual orientation

personal identity

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? A) personal identity B) self esteem C) role performance D) Body image

personal identity

Culture

provides a pattern of perceptions, values and behaviors that have influenced a persons perspective on life and the environment in which he or she lives.

self-expectation

goals that someone sets

social self

how a person sees himself in relation to social situations

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 verbalizations about self.

when does self awareness happen?

infancy

The pediatric nurse is caring for a 5-year-old child, who is being seen in the clinic today. The child is very worried that the health care provider may harm their body. The child's parent asks the nurse if this is normal for this age. The nurse shares with the parent that children this age worry about which issue related to their body? A) intactness and mutilation B) C) D)

intactness and mutilation

How can nurses who provide care in long-term care settings best enhance the self-esteem of older adults who reside in these facilities? A) Provide opportunities for the residents to engage with children and adolescents. B) Maximize the autonomy of residents in organizing their routines. C) Encourage residents to talk openly about their opinions. D) Ensure that residents are not presented with tasks that carry a risk of failure.

maximize the autonomy of residents in organizing their routines

self-care deficit

may manifest as disregard for special diet restriction, refusal to take medication, or missing follow-up appointments.

self concept in newborns

newborns have no self-concept at birth

An infant learns that the physical self is different from the environment. What term is used to describe this stage of self-concept? A) Self-awareness B) Self-concept C) Self-recognition D) Self-definition

self-awareness

A nurse visits a 60-year-old client with diabetes at their home after the client's above-the-knee amputation of the left leg. The client appears disheveled and with poor hygiene and also avoids making eye contact with the nurse. The nurse will assess for what consequence of the client's reduced self-esteem? A) self-care deficit B) lack of interest C) withdrawal D) lethargy

self-care deficit

While interviewing 45-year-old client who gambles impulsively, the nurse observes that the client blames the loss of job, estrangement from spouse, and lack of friends on destiny. The nurse interprets this information as indicative of which aspect of altered self-concept? A) self-destructive behavior B) behavioral changes C) anxiety and depression D) self-care deficit

self-destructive behavior

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"? A) Self-expectation B) C) D)

self-expectation

Which nursing intervention is inappropriate when developing a plan of care to modify a negative self-concept? A) Teaching the client how to repeat "I can do this" when she has negative feelings B) Asking the client to describe what makes her feel successful C) Teaching the client how to "red flag" negative self-talk D) Teaching the client that everything will work out better than she expects

teaching the client that everything will work out better than she expects

Cultural competence

the ability of health care providers and organizations to effectively deliver health care services that meet the social, cultural, and linguistic needs of the clients.

self-reflection

the capacity of humans to exercise introspection and the willingness to learn more about their functional nature, purpose, and essence.

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? A) the specific location of the ostomy B) the prognosis of the client's cancer after the surgery C) the coping mechanisms that the client possesses D) the client's knowledge of a peer who also has an ostomy

the coping mechanisms that the client possesses

Self-efficacy

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

cultural modernization

the modernization of the cultural field

Expectancy for success

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

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

Which of the following is objective data related to self-concept? A) The person admits that she always wears baggy clothes in order to hide her body. B) The person states, "I am worthless." C) The person's mom tells a nurse that her child is never happy. D) The person refuses to make eye contact.

the person refuses to make eye contact