Chapter 26: Self-Concept Nursing School Test Banks

Potter & Perry: Fundamentals of Nursing, 6th Edition

MULTIPLE CHOICE

1. The client has just learned that his motorcycle accident has resulted in his left leg being amputated. When helping this client form goals and strategies for realistic goals, the nurse needs to assess the clients:

a.

Interests and past accomplishments

b.

Intellectual and spiritual strengths

c.

Involvement with significant others

d.

Ideal and perceived self-concept

ANS: d

d. What individuals think and how they feel about themselves affects the way in which they care for themselves. A physical change in the body, such as an amputation, can lead to an altered body image affecting identity and self-esteem. The nurse should assess the clients ideal and perceived self-concept in order to help the client establish realistic goals and implementation strategies.

a. Assessing a clients interests and past accomplishments may provide information regarding a clients identity. Identity is only one component of self-concept. The nurse must determine the clients ideal and perceived self-concept to get the big picture, as this will greatly affect his response to the amputation.

b. Intellectual and spiritual strengths may be important when determining a clients ability to cope. However, when developing goals and implementation strategies, the process will begin with the clients perception of self-concept, as this will greatly affect his response to the amputation.

c. When assessing coping behaviors of an individual, involvement with significant others may be an indication of available resources, as well as a source of strength for a client.

REF: Text Reference: p. 502, Text Reference: p. 505

2. The nurse is working with a client who is manifesting behaviors that are consistent with a negative self-concept. The nurse has observed that the client maintains:

a.

Frequent eye contact

b.

A passive attitude

c.

Independence in self-care

d.

An interest in the surroundings

ANS: b

b. A passive attitude is a behavioral characteristic suggestive of a negative self-concept.

a. Avoidance of eye contact would be a behavior suggestive of a negative self-concept.

c. Being excessively dependent is characteristic of a negative self-concept.

d. A lack of interest in what is happening in ones surroundings is characteristic of a negative self-concept.

REF: Text Reference: p. 510

3. A 76-year-old client who recently lost his wife is admitted for surgery. The nurse is using Erikson as a psychosocial framework for client assessment. Which of the following behaviors would alert the nurse that the client has an alteration in the integrity stage of his psychosocial development?

a.

Accepting his own limitations

b.

Verbalizing fear about the surgery

c.

Expressing his thoughts about his care

d.

Demanding excessive assistance from his daughter

ANS: d

d. Being angry, excessively dependent, and having a passive attitude are all behaviors suggestive of an altered self-concept. The older client, who has lost a spouse and is now demanding excessive assistance from a child, is demonstrating an alteration in the integrity stage of his psychosocial development.

a. Accepting ones limitations is not consistent with a disturbance in the integrity stage of psychosocial development.

b. Verbalizing fear about the surgery is not consistent with a disturbance in the integrity stage of psychosocial development.

c. Expressing thoughts about ones care is not consistent with a disturbance in the integrity stage of psychosocial development.

REF: Text Reference: p. 510

4. A client has been hospitalized for an extended time while receiving therapies for lung cancer. The client has become very depressed, refuses to participate in personal grooming, and does not want visitors. To assist in achieving resolution of the clients problem, the nurse should have the client:

a.

Get washed and dressed independently

b.

Think positively instead of negatively

c.

Contact a support group and explore a psychological consultation

d.

Become more independent and return to prior activities

ANS: c

c. Consultation with significant others, mental health clinicians, and community resources can result in a more comprehensive and workable plan. Clients who are experiencing threats to or alterations in self-concept often benefit from collaboration with mental health and community resources to promote increased awareness.

a. The clients problem of a negative self-concept must be addressed first. As a result, the client may begin to bathe and dress independently.

b. The client needs to express his negative feelings. This would be one step in addressing his self-concept problem Stating that the client should think positively instead of negatively, at this point, is unrealistic.

d. A long-term goal may be that the client will become more independent and return to prior activities. It is not realistic at this time.

REF: Text Reference: p. 513

5. The client is on the orthopedic unit after back surgery. He states, I feel like I cant do anything anymoreand I wont be able to continue my landscaping business. This is predominantly an example of a problem in which of the following components of self-concept?

a.

Body image

b.

Self-esteem

c.

Identity

d.

Role

ANS: d

d. A physical health deficit that prevents role assumption can create a problem in the role-performance component of self-concept.

a. A client who is verbalizing concern about continuing a previous occupation is demonstrating a problem not in body image, but rather in the role-performance component of self-concept.

b. Self-esteem is closely related to self-concept, but is not a component of self-concept.

c. Identity involves the internal sense of individuality, wholeness, and consistency of a person over time and in various circumstances. The client is verbalizing concern about role performance, not necessarily identity.

REF: Text Reference: p. 506

6. A recently divorced client comes to the clinic. She has custody of her two teenagers and is an established lawyer. She states, I cant keep working so hard and raise my children the way I would like. This is an example of:

a.

Role ambiguity

b.

Role strain

c.

Role conflict

d.

Gender role stereotype

ANS: c

c. Role conflict results when a person is required to assume simultaneously two or more roles that are inconsistent, contradictory, or mutually exclusive. The single mother who is having difficulty managing working long hours and trying to raise her children, as she perceives she would like to, is experiencing role conflict.

a. Role ambiguity involves unclear role expectations. The client is not expressing doubt as to what her roles are.

b. Role strain is a feeling of frustration when a person feels inadequate or feels unsuited to a role, such as with gender role stereotypes.

d. A gender-role stereotype describes an expectation that something is a mans role or a womans role because the position has been typically held by a man or woman. The client is not expressing concern about a gender-role stereotype, but rather in managing two contradictory roles.

REF: Text Reference: p. 507

7. A prostitute, with the human immunodeficiency virus (HIV) and severe complications, is being cared for on a medical unit. The nurse is seeking to develop a therapeutic relationship with the client. Which of the following statements best reflects the nurses attempt to support the clients self-exploration?

a.

What type of support do you feel you need?

b.

Dont be embarrassed by your former occupation.

c.

On what type of schedule do you think you could realistically eat your meals without being nauseated?

d.

The people who work here are professionals, and well try not to judge your past actions.

ANS: a

a. Encouraging the clients self-exploration is achieved by accepting the clients thoughts and feelings, by helping the client to clarify interactions with others, and by being empathetic.

b. Telling the client not to be embarrassed does not encourage self-exploration. It also assumes that the client is embarrassed, which may not be the case.

c. This response involves the client in a decision-making process related to the clients care but does not support the clients self exploration. Self-exploration expands self-awareness.

d. This response is not therapeutic. Telling the client that staff will not try to judge the clients past implies that judgment is due and does not encourage open communication and self-exploration.

REF: Text Reference: p. 517

8. A school-aged client has just been diagnosed with juvenile diabetes. The client is very angry about the new disease. Which of the following statements is most appropriate for the nurse counselor working with this client?

a.

Try not to be angry because you are receiving the best care possible.

b.

It is all right to be angry with your friends, but try not be angry with your parents.

c.

You appear upset about the diagnosis. Lets talk about your feelings.

d.

You learn quickly and will probably handle the difficult treatments very well.

ANS: c

c. This response clarifies the meaning of verbal and nonverbal communication. This response also demonstrates acceptance of the clients thoughts and feelings and encourages open communication.

a. This response is not therapeutic. It does not address the clients feelings of anger and conveys a message that feeling angry is not acceptable.

b. This response is not therapeutic. It does not address the cause of the anger but puts limits on how the anger may be expressed.

d. This response is not therapeutic. It does not encourage the client to communicate his or her feelings.

REF: Text Reference: p. 517

9. A client is most concerned about the interactions that she has with her family, and she is in the process of establishing a positive view of herself. This client is meeting the developmental needs of the:

a.

12 to 20-year-old age group

b.

Early 20s to mid-40s age group

c.

Mid-40s to mid-60s age group

d.

Late-60s and older age group

ANS: b

b. The developmental needs of the early-20s to mid-40s age group includes the establishment of intimate relationships with family and significant others, having stable, positive feelings about self, and experiencing successful role transitions and increased responsibilities.

a. The self-concept developmental needs of the 12 to 20-year-old age group include accepting body changes, examining attitudes and beliefs, establishing goals for the future, and interacting with those whom he or she finds sexually attractive or intellectually stimulating.

c. The self-concept developmental tasks of the mid-40s to mid-60s age group include accepting changes in appearance and endurance, reassessing life goals, and showing contentment with aging.

d. The self-concept developmental needs of the late 60s and older age group include feeling positive about ones life and its meaning, and being interested in providing a legacy for the next generation.

REF: Text Reference: p. 503

10. In developing role behavior, the child learns which of the following through substitution?

a.

Engaging in an acceptable behavior instead of another unacceptable one

b.

Avoiding unacceptable behavior because it is punished

c.

Internalizing beliefs and values of role models

d.

Refraining from behavior even though tempted

ANS: a

a. In the process of substitution, an individual replaces one behavior with another that provides the same personal gratification. The child has learned to substitute one behavior for another for a positive outcome.

b. Avoiding unacceptable behavior because it is punished is seen in the process of reinforcement-extinction.

c. In the process of identification, an individual internalizes the beliefs, behavior, and values of role models into a personal, unique expression of self.

d. In the process of inhibition, an individual learns to refrain from behaviors, even when tempted to engage in them.

REF: Text Reference: p. 505

11. The nurse recognizes that self-concept develops throughout an individuals lifetime. Which developmental task associated with self-concept is expected in an assessment of an individual from the 12 to 20-year-old age group?

a.

Identifying with a gender

b.

Exploring goals for the future

c.

Distinguishing oneself from the environment

d.

Feeling positive about ones life achievements

ANS: b

b. The developmental tasks associated with self-concept in the 12 to 20-year-old age group include accepting body changes; examining attitudes, values, and beliefs; and establishing goals for the future.

a. Identifying with a gender is an expected developmental task associated with self-concept in the 3 to 6-year-old age group.

c. Distinguishing oneself from the environment is an expected developmental task associated with self-concept in the 0 to 1-year-old age group.

d. Feeling positive about ones life achievements is an expected developmental task associated with self-concept for the late 60s and older age group.

REF: Text Reference: p. 503

12. The nurse is working with a client and wants to learn about the individuals perception of identity. What question should the nurse use to assess this?

a.

What changes would you make in your appearance?

b.

What activities do you enjoy doing?

c.

How would you describe yourself?

d.

What is your usual day like?

ANS: c

c. Asking, How would you describe yourself? is an example of a question a nurse could use to assess a clients perception of identity.

a. Asking, What changes would you make in your appearance? is an example of a question a nurse could use to assess a clients perception of body image.

b. Asking, What activities do you enjoy doing? is an example of a question a nurse could use to assess a clients perception of self-esteem.

d. Asking, What is your usual day like? is an example of a question a nurse could use to assess a clients role performance.

REF: Text Reference: p. 512

13. The client has just been laid off from his job and is very upset about the loss of his position. In establishing a plan of care for the client, the nurse determines that an appropriate outcome for this client with situational low self-esteem is:

a.

Client will recognize his inability to make decisions.

b.

Client will respond to anxiety with decreased amounts of stress.

c.

Client will use therapeutic communication skills to discuss his needs.

d.

Client will discuss a minimum of two areas in which he is functioning well.

ANS: d

d. An appropriate outcome for the client with situational low self-esteem would be for the client to discuss a minimum of two areas in which he is functioning well.

a. This would not be an appropriate outcome for the client with low self-esteem. The focus should be on his abilities, not inability.

b. This outcome does not address the issue of low self-esteem.

c. Being able to use therapeutic communication is always an asset, but the focus should be on improving his self-esteem by determining his strengths, recognizing his worth as a person, realizing what he is able to control, and providing support from others who are having, or had, the same experience.

REF: Text Reference: p. 514

Copyright 2005 by Mosby, Inc. All rights reserved.

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