Chapter 33: Self-Concept Nursing School Test Banks

Test Bank

MULTIPLE CHOICE

1. The nursing student can help geriatric patients self-concept by using which technique?

a.

Discussing current weather

b.

Reviewing old photos with patients

c.

Encouraging patients to sing

d.

Allowing patients extra computer time

ANS: B

Nurses can improve self-image by reviewing old photographs when working with elderly patients. This form of life review is helpful to older adults in remembering positive life events and people. Discussing weather does not involve personal reflection. Singing improves global cognition, not self-concept. Giving patients extra computer time is not applicable to improving self-concept.

DIF: Apply REF: 663

OBJ: Apply the nursing process to promote a patients self-concept.

TOP: Implementation MSC: Self-Concept

2. While gathering an adolescents health history, the nurse recognizes that the patient began to act out behaviorally and engage in risky behavior when her parents divorced. In considering an altered self-concept nursing diagnosis, the nurse would gather what information?

a.

How long the parents were married

b.

How the patient views her behaviors

c.

Why the parents are divorcing

d.

Why she is acting out of control

ANS: B

A nurse can identify situational life stressors that can impact a persons self-concept. By openly exploring a patients thoughts and feelings, the nurse will be able to use communication skills in a therapeutic manner. This will facilitate the patients insight into behaviors and will enable the nurse to make referrals or provide needed health teaching. The length of time married and the reason for the parents divorce do not explain the patients behaviors. Why the patient is out of control is not as important as how the patient views her actions when out of control.

DIF: Evaluate REF: 666-667

OBJ: Apply the nursing process to promote a patients self-concept.

TOP: Implementation MSC: Self-Concept

3. Based on the following data, which person is likely to have the highest self-esteem?

a.

Latino adolescent female who has strong ethnic pride

b.

Caucasian boy who lives below federal poverty level

c.

African American adolescent male who has severe acne

d.

Adolescent who was suspended twice from high school

ANS: A

Ethnic and cultural differences in self-concept and self-esteem have been noted across the life span. Ethnic pride and self-esteem often are positively correlated. Environmental stressors such as low-income, body image stressors such as acne, and role performance failure often influence self-esteem negatively.

DIF: Remember REF: 658-661

OBJ: Examine cultural considerations that affect self-concept. TOP: Assessment

MSC: Self-Concept

4. The developmental self-concept task known as initiative versus guilt would occur in which person?

a.

3-week-old neonate

b.

5-year-old kindergarten student

c.

11-year-old student

d.

15-year-old high school student

ANS: B

The initiative versus guilt developmental stage occurs between the ages of 3 and 6 years. If a child shows initiative, the outcome of this developmental task is to develop purpose. A neonate developmental task is to develop trust. An 11-year-old is into new skill mastery, and a 15-year-old is struggling with identity versus role confusion.

DIF: Remember REF: 659

OBJ: Describe the components of self-concept as related to psychosocial and cognitive developmental stages. TOP: Assessment MSC: Self-Concept

5. A verbally abusive partner has told his significant other many negative comments over the years. In the crisis center, the nurse would anticipate that the patient may have which of the following self-concept deficits?

a.

Body image

b.

Role confusion

c.

Rigidity

d.

Yearning

ANS: A

Consistent negative comments can cause devaluation of an individuals self-concept. The impact of negative self-esteem can invade all areas of a persons life, including body image. Role confusion is part of a developmental task (identity versus role confusion). Rigidity and yearning are not components of self-concept.

DIF: Remember REF: 661

OBJ: Discuss factors that influence the components of self-concept.

TOP: Assessment MSC: Self-Concept

6. Two 50-year-old men are discussing their Saturday activities. The first man describes how he tutors children as a volunteer at a community center. The other man says that he would never work with children, and that he prefers to work out at the gym to meet young women to date. The second mans statement reflects which developmental stage?

a.

Inferiority

b.

Role confusion

c.

Self-absorption

d.

Mistrust

ANS: C

In the generativity versus self-absorption developmental task, a self-absorbed person is concerned about his or her own personal wants and desires in a self-centered manner. Mistrust versus trust occurs in the first year of life. Industry versus inferiority commonly occurs in school children. Identity versus role confusion commonly occurs at the start of adolescence into young adulthood.

DIF: Understand REF: 659

OBJ: Describe the components of self-concept as related to psychosocial and cognitive developmental stages. TOP: Assessment MSC: Self-Concept

7. An adult is adjusting to the idea of his chronically ill parent moving into the family home. The community health nurse would assess the adult son for which potential stressor secondary to the new family living arrangement?

a.

Role confusion

b.

Role ambiguity

c.

Role performance

d.

Role overload

ANS: D

Role overload involves having more roles or responsibilities within a role than are manageable. Role overload is common in individuals who unsuccessfully attempt to meet the demands of work and family while trying to find some personal time. Role confusion is an aspect of the developmental task of adolescence and young adulthood (identity versus role confusion). Role ambiguity involves unclear role expectations. Role performance itself is not a stressor unless it is judged ineffective.

DIF: Understand REF: 663

OBJ: Identify stressors that affect self-concept and self-esteem.

TOP: Assessment MSC: Self-Concept

8. A nurse who grimaces when seeing a patients colostomy opening while changing the colostomy bag is most likely to have what effect on the patient?

a.

Assist recovery by using honest communication.

b.

Motivate the patient to increase physical activity.

c.

Promote development of a negative body image.

d.

Develop a kind nickname for the colostomy opening.

ANS: C

Negative nonverbal reactions by a nurse to a patients scar or surgical alterations contribute to the patients developing a negative body image. Expressions of distaste by the nurse will not facilitate recovery or ongoing communication; encourage physical activity; or promote acceptance of the colostomy opening by adopting a positive nickname.

DIF: Understand REF: 664

OBJ: Explore ways in which a nurses self-concept and nursing actions affect a patients self-concept and self-esteem. TOP: Implementation

MSC: Self-Concept

9. Im such a loser. I only had that job for a month. Identify appropriate nursing outcome criteria for this individual.

a.

The patient will verbalize two life areas in which he or she functions well.

b.

The patient will find new employment before the next clinic visit.

c.

The patient will confront his or her former boss about work problems.

d.

The patient will identify why he or she is considered a bad employee.

ANS: A

Verbalizing two life areas in which a person functions well is an individualized measurable outcome that is realistic. Confronting a former boss could have physical and emotional repercussions for the patient. If the person is voicing that he or she has problems obtaining employment, then putting extra pressure to obtain employment would be detrimental to the patient and does not reflect a supportive and caring nursing outcome.

DIF: Analyze REF: 667

OBJ: Apply the nursing process to promote a patients self-concept.

TOP: Planning MSC: Self-Concept

10. Children learn to live an authentic lifestyle through culturally accepted behaviors, values, and role modeling. A child who does this is attempting to create his or her own

a.

Body image.

b.

Self-esteem.

c.

Identity.

d.

Role performance.

ANS: C

Identify versus role confusion occurs between the ages of 12 and 20 years. Body image and self-esteem are attitudes related to personal reflection and attitudes. Role performance is the result of creating an identity.

DIF: Understand REF: 660-661

OBJ: Describe the components of self-concept as related to psychosocial and cognitive developmental stages. TOP: Planning MSC: Self-Concept

11. Which of the following individuals is most likely to need the nurses assistance because of the presence of identity confusion?

a.

49-year-old male with stable employment

b.

35-year-old recently divorced mother of twins

c.

22-year-old in third year of college

d.

50-year-old self-employed woman

ANS: B

Identity confusion can occur when people do not maintain a clear, consistent, and continuous consciousness of personal identity. A newly divorced woman would be trying to adapt to a new lifestyle of being single while handling parenting of twins as a single parent. This situation could lead to identity confusion. A college sophomore would have had at least 2 years to adjust to the new life setting, and a self-employed woman would likely be content with creating her own employment opportunity. There is no indication that the middle-aged man with stable employment should have identity confusion.

DIF: Analyze REF: 662

OBJ: Discuss evidence-based practice applicable for identity confusion, disturbed body image, low self-esteem, and role conflict. TOP: Planning MSC: Self-Concept

12. Identify the assessments suggestive of an altered self-concept.

a.

Limping gait and large smile

b.

Slumped posture and poor personal hygiene

c.

Verbally responds when asked a question

d.

Appropriately dressed with clean clothes

ANS: B

A self-concept is created by an individuals identity, body image, and role performance. Poor personal hygiene and slumping posture best describe a person with an impaired self-concept. Smiling, appropriate responses, and appropriate appearance are all signs of normal self-concept.

DIF: Understand REF: 665

OBJ: Apply the nursing process to promote a patients self-concept.

TOP: Planning MSC: Self-Concept

13. A priority nursing intervention for a postoperative mastectomy patient is which of the following?

a.

Using therapeutic silence to encourage the patient to talk

b.

Using communication skills to clarify family and patient expectations

c.

Telling her that you know she will do fine because many other women have

d.

Rotating nursing personnel in the patients care, so the patient can talk to many people

ANS: B

The nurse recognizes the need to use therapeutic communication skills, allowing the opportunity to talk openly about issues that are important to a person who has undergone body-altering surgery. When a nurse does not allow for the development of a patient-nurse therapeutic relationship, open and honest conversation is impossible. Silence can be useful, but building rapport and opening the conversation are necessary first. Reassurance that a person will do fine dismisses any potential concerns the patient may have. Rotating nursing personnel does not allow time for the patient to build rapport with any one nurse.

DIF: Understand REF: 668| 670

OBJ: Apply the nursing process to promote a patients self-concept.

TOP: Planning MSC: Self-Concept

14. The nurse in an addictions clinic is working with a patient on priority setting before the patients discharge from residential treatment. An appropriate priority for a patient at this clinic would be

a.

Identifying local self-help groups before being discharged from the program.

b.

Staying away from all triggers that cause substance abuse.

c.

Stating a plan to never be tempted by illicit substances after discharge.

d.

Identifying personal areas of weakness to grow stronger.

ANS: A

Providing the patient with resources such as local self-help groups can help to turn limitations into strengths. It is not realistic to avoid ALL triggers that can result in addictive behaviors. It is unrealistic to believe that the patient will never be tempted because temptation can arise from multiple sources. On the other hand, an appropriate priority would be to recognize that triggers will arise, and that the patient should learn how to handle being confronted in the postdischarge setting. Having a person talk about his or her weaknesses without recognizing a persons strengths could be a trigger to return to an addictive lifestyle, so this would not be the most appropriate priority.

DIF: Apply REF: 667

OBJ: Apply the nursing process to promote a patients self-concept.

TOP: Planning MSC: Self-Concept

15. Based on current evidence, the nurse who plans smoking cessation interventions for adolescent girls should focus on interventions directed toward

a.

Obeying parents and reducing television viewing.

b.

Fostering generativity over self-absorption.

c.

Role overload, addiction counseling, and depression.

d.

Weight management, self-esteem, and stress management.

ANS: D

Current research indicates that smoking cessation efforts should include stress management and improvement of self-esteem and body image. Weight concerns, especially in females, promote continued smoking. Obeying parents and reducing television viewing are not effective smoking cessation strategies. The developmental task of generativity versus self-absorption occurs in adulthood. Role overload is not a usual contributor to smoking in adolescents, although it could be; addiction counseling is not a smoking cessation intervention; depression is associated with decreased self-esteem but is not a primary smoking cessation target for adolescent girls in general.

DIF: Apply REF: 664

OBJ: Discuss evidence-based practice applicable for identity confusion, disturbed body image, low self-esteem, and role conflict. TOP: Planning MSC: Self-Concept

16. The nurse can best assess the patients self-concept by evaluating the patients

a.

Drug abuse history.

b.

Nonverbal behavior.

c.

Personal journal.

d.

Social networking site.

ANS: B

Nonverbal behaviors are key indicators of a patients self-concept. A history of drug abuse does not necessarily indicate current self-concept, and people who do not have a drug abuse history may have a low self-concept. It would be an invasion of privacy and trust for a nurse to read a patients personal journal or social networking site.

DIF: Apply REF: 671

OBJ: Apply the nursing process to promote a patients self-concept.

TOP: Assessment MSC: Self-Concept

17. A newly hired nurse is struggling with night shift work and caring for multiple family members at home. The nurse manager calls the new nurse in to talk about how the nurse is negatively affecting patient self-concept by ignoring patients concerns. The nurse manager should focus on the new nurses

a.

Role overload.

b.

Self-esteem.

c.

Ego integrity.

d.

Ethics and morals.

ANS: A

Role overload involves having more roles or responsibilities than are manageable. Self-esteem is the overall feeling of self-worth. The nurse is not involved in an ethical or moral dilemma. Ego integrity is part of a developmental task associated with older adults.

DIF: Apply REF: 663

OBJ: Explore ways in which a nurses self-concept and nursing actions affect a patients self-concept and self-esteem. TOP: Implementation

MSC: Self-Concept

18. A 9-year-old is proudly telling everyone about mastering the yellow belt in her martial arts class. Identify the appropriate developmental task.

a.

Initiative versus guilt

b.

Industry versus inferiority

c.

Identity versus role confusion

d.

Autonomy versus shame and doubt

ANS: B

Industry versus inferiority occurs between the ages of 6 and 12 years. It is during this developmental task that a person gains self-esteem through new skill mastery. The other self-concept development tasks occur at other stages of life and would not apply to this situation.

DIF: Apply REF: 659

OBJ: Describe the components of self-concept as related to psychosocial and cognitive developmental stages. TOP: Planning MSC: Self-Concept

19. Potential predictors for suicidal thoughts and behaviors in adolescents are

a.

Stressful life events and a scholarship.

b.

Very high self-esteem and work failure.

c.

Health problems and developmental milestones.

d.

Negative body image and low self-esteem.

ANS: D

Low self-esteem and negative body image can be predictors for suicidal thoughts and behaviors. High self-esteem would help a person cope with work failure. Stressful life events when balanced with positive issues, such as receipt of a scholarship, are less likely to induce depression. Suicidal tendencies are based more on the individuals frame of mind than on individual events such as health problems and developmental milestones.

DIF: Apply REF: 661

OBJ: Identify stressors that affect self-concept and self-esteem.

TOP: Planning MSC: Self-Concept

20. The nurse can assist the patient in becoming more self-aware by using which technique?

a.

Setting up an appointment to allow the patient to vent

b.

Allowing the patient to openly explore thoughts and feelings

c.

Assisting the patient to physically punch a pillow when upset

d.

Providing materials for the patient to write complaint letters

ANS: B

By allowing open communication about thoughts and feelings, the nurse creates an environment for therapeutic communications. Punching pillows does not create self-awareness. Writing complaint letters and venting can create more internal turmoil in a person and do not promote self-awareness.

DIF: Apply REF: 670

OBJ: Apply the nursing process to promote a patients self-concept.

TOP: Planning MSC: Self-Concept

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