chapter 34- self concept
A patient suffers from situational low self-esteem following the death of her pet dog. What are the appropriate questions for the nurse to ask during assessment of her self-esteem?
"How do you feel about yourself?"
What statements made by the patient indicate that the patient's self-concept is improving following treatment? Select all that apply.
"I am pretty comfortable with my crutches." "It is easier to administer insulin than I had imagined." "Physical therapy is going well. I'm going to be on my feet soon."
Which statement made by a patient with cancer reflects positive thoughts about personal health?
"I have the ability to get well quickly."
A single mother expresses that she feels inefficient because she is unable to balance her work and family roles. She takes care of her 5-year-old son without any support. She works as a store manager in a retail outlet. What are the role stressors that are responsible for her current state of mind? Select all that apply.
Role conflict 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
Due to a shortage of staff, the nurse has been on duty for both morning and night shifts for the last 2 days. Which role performance is the nurse experiencing?
Role overload
What term describes how one thinks of oneself?
Self-concept
The nurse asks the patient, "How do you feel about yourself?" What is the nurse assessing?
Self-esteem
The nurse is teaching a group of young adults about the normal changes in role performance associated with maturation. What are the common stressors related to role performance in this stage of life? Select all that apply.
Transition from school to work setting Physical, emotional, or cognitive deficits preventing role assumption Death of a loved one
Which question should the nurse ask a patient with low self-esteem in order to assess the nature of the problem?
"What do you like about your appearance?"
A patient has a large facial scar after the removal of a tumor of the buccal mucosa. The patient is extremely depressed due to this facial disfiguration. Which nursing actions would be helpful in motivating the patient? Select all that apply.
Examine the scar and assuring the patient that it is healing well. Tell the patient about a good plastic surgeon who can improve the appearance of the scar. State that the scar does not look as bad as anticipated
The nurse is caring for an 80-year-old patient. What factors influence this particular patient's current self-concept? Select all that apply.
Adjustment to a role change Adjustment to the loss of a spouse
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
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
Which body image stressors would likely damage the self-concept of an individual? Select all that apply.
Alopecia due to chemotherapy Amputation of the foot
Self-esteem stressors vary with developmental stages. In children, what are the stressors that affect self-esteem and self-worth? Select all that apply.
An inability to meet parents' expectations Sibling rivalry
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
The nurse is planning care and treatment of a patient with a below-the-knee amputation who currently has very low self-esteem. What interventions should the nurse include to improve the self-concept of the patient when outlining the care plan? Select all that apply.
Enroll the patient in a class that will teach ambulation with assistive devices. Involve the patient in planning the schedule and extent of physical therapy. Schedule a prosthetic expert to talk to the patient.
The nurse is teaching the proper technique for using an inhaler to a 12-year-old patient who suffers from asthma; the nurse is also teaching exercises to improve the breathing process. What should the nurse focus on to avoid development of an altered self-concept? Select all that apply.
Awareness of limitations Awareness of strengths Acceptance of changes in physical endurance Providing reinforcement for mastery of a new skill
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
A 30-year-old patient suffering from osteoarthritis is unable to move without using a splint and lives with her mother. The patient no longer has a job. The patient refuses to meet anyone and feels worthless. What factors are responsible for this change in self-concept? Select all that apply.
Chronic illness Dependency on others Physical impairment Loss of job identity
The nurse is interviewing a 15-year-old female patient and finds that the patient has an altered body image. Which factors can affect body image in this patient? Select all that apply.
Cognitive and physical growth Cultural and societal attitudes
The nurse plans her nursing care with the knowledge that old age is primarily focused on which of Erikson's stages of growth and development?
Ego integrity versus despair
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.
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
Which events in life can alter the self-concept of a person significantly? Select all that apply.
Having a child Losing a child Being promoted at work Being diagnosed with a chronic illness
How can the nurse increase a patient's self-awareness? Select all that apply.
Help the patient define his or her problems clearly. Allow the patient to openly explore thoughts and feelings. Reframe the patient's thoughts and feelings in a more positive way.
The nurse determines that a patient is experiencing repeated failures, having conflicts, with others, and is more dependent on his or her parents. Which component of self-concept is affected in the patient?
Identity
A 50-year-old female patient is admitted to the hospital for surgical management of breast cancer. The patient is now at home after a successful operation. During a home visit, the patient breaks down and expresses that she is overburdened with responsibilities. She takes care of her 8-month-old granddaughter as well as her 80-year-old mother who has Alzheimer's disease. What stressors is the patient facing? Select all that apply.
Role conflict Role overload
In assessing a patient for self-concept and self-esteem, on what components should the nurse focus? Select all that apply.
Identity Body image Role performance
What are the chief factors that determine the self-concept of an individual? Select all that apply.
Identity Body image Role performance
What is the most common reason for elective cosmetic surgery?
Improve self-image
Which factor will the nurse observe in the 22-year-old patient with low self-esteem who is in the intimacy-versus-isolation stage of psychosocial development, according to Erikson's theory of self-concept?
Increased responsibilities
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 self-concept of an individual is influenced by various environmental, social, and psychological factors. How is a self-concept stressor defined?
It is a real or perceived change that threatens a person's identity and body image.
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
The nurse is outlining a plan of care for a 9-year-old patient. What primary developmental task for this patient should the nurse consider?
Mastery of new skill
A 43-year-old female patient has come into the clinic for her annual physical examination. The patient has chronic arthritis, states that she feels incompetent doing simple tasks, and that she is a burden to others. Which techniques would the nurse perform to assess for low self-esteem? Select all that apply.
Observe patient's behavior. Ask patient to explain thoughts and feelings about self. Note clues about both stressful and supportive relationships.
A 20-year-old patient is diagnosed with an eating disorder. Which nursing intervention would be best to address self-esteem?
Offer independent decision-making opportunities.
What are the familial factors that contribute to the development of high self-esteem? Select all that apply.
Parental support Social support Positive communication
An adult woman is recovering from a mastectomy for breast cancer and is frequently tearful when left alone. On what should the nurse's approach be based?
Patients need support in dealing with the loss of a body part.
How does the nurse ensure that he or she meets the goals related to self-concept alterations in an acute care setting? Select all that apply.
Plan for the patient's discharge to home. Make referrals to other health care professionals. Schedule routine follow-up appointments.
What factors should the nurse look for when assessing the emotional development of a 15-year-old patient? Select all that apply.
Positive feelings of self Maturation Goals for the future Acceptance of bodily changes
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
A depressed patient is crying and verbalizes feelings of low self-esteem and self-worth such as, "I'm such a failure—I can't do anything right." What would be the best nursing intervention?
Remain with the patient until he or she stops crying.
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
What elements influence the achievement of identity in a person? Select all that apply.
Sexuality Gender Ethnicity
Which interventions should the nurse implement while caring for a patient with a disturbed body image who has undergone a modified radical mastectomy? Select all that apply.
Show acceptance of breast surgery when providing care. Ask the patient to identify personal strengths and talents. Assist the patient in developing a realistic perception of or her body. Tell the patient that her feelings are similar to feelings of other people in the same situation.
A patient is scheduled for colon resection with colostomy in 2 days. The nurse finds the patient appearing anxious and asking, "How am I going to live with a bag on my belly for the rest of my life?" Which nursing actions address the patient's self-concept and altered body image? Select all that apply.
Showing the patient a video about a healthy functioning body after a colostomy Discussing the availability of support groups for patients with colostomies
What stressors is a patient likely to experience in an acute care setting? Select all that apply.
Stress related to diagnostic tests and results Stress related to an altered body image Stress related to lifestyle modifications
The nurse cares for a family of four, offering routine medical care throughout the year. Which member of the family does the nurse expect to exhibit the highest levels of self-esteem?
The 8-year-old boy
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
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
Several staff members complain about a patient's constant questions such as "Should I have a cup of coffee or a cup of tea" and "Should I take a shower now or wait until later?" Which interpretation of the patient's behavior helps the nurses provide optimal care?
The inability to make decisions reflects a self-concept issue.
The nurse is assessing a patient who lost his fingers in an accident with a meat mincer. What patient behavior is suggestive of an altered self-concept? Select all that apply.
The patient does not make eye contact while talking. The patient still cannot believe he was so careless. The patient states that he wants to be left alone.
For what should the nurse look when assessing an altered self-concept in a patient? Select all that apply.
The patient has a slumped posture. The patient is overly apologetic. The patient uses hesitant speech. The patient avoids eye contact.
The nurse is trying to assess if a patient is free from identity stressors. What would suggest that the patient has a strong identity?
The patient has been happily married for 10 years.
The nurse is assigned to care for a patient who has low self-esteem after undergoing a right leg amputation. The goal for the patient is that the patient's self-esteem will improve in 2 weeks. What are the expected outcomes to achieve the goal? Select all that apply.
The patient will verbalize acceptance of the prosthetic leg. The patient will interact in a social setting. The patient will talk about his or her feelings.
A patient survived a motor vehicle accident; the driver of the other car did not. The patient feels extremely guilty and says, "I am never going to touch the wheel again in my life." If the nurse intervened to improve the patient's self-esteem, what would be the most likely immediate outcome?
The patient would at least sit in the driver's seat in 3 days.
The nurse is examining a patient who just had a spontaneous abortion. What observations suggest to the nurse that the patient has good self-esteem post incident and is coping well? Select all that apply.
The patient's husband stays by her side and holds her hand. The patient seems depressed but is asking the health care provider about conceiving again.
