67 Questions
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 statements about self.
True
_______________________is the fulfillment of one's self-defined destiny.
self-actualization
_________________or self-awareness involves a basic understanding of oneself
self-knowledge
________________ is when People who are able to adapt to stress and resolve conflicts through coping tend to develop healthy self-concepts
stress tolerance
A nurse is developing a plan of care for an older adult to promote self-esteem. What intervention would be most appropriate to include?
Explain that his life experience will help to 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?
inadequate coping
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?
External locus of control
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?
Communicates a sense of helplessness to his spouse.
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 statements about self
True
A person with external locus of control perceives that outcomes happen because of luck, chance, or the influence of powerful others. A person with internal locus of control believes that personal behavior influences outcome and that he can achieve desired results.
True
Stages in the development of the self include self-awareness (infancy), self-recognition (18 months), self-definition (3 years), and self-concept (6–7 years).
True
Which question would provide the nurse with the information needed first when assessing self-concept?
How would you describe yourself to others?
Which client will the nurse monitor closely for signs of role strain?
client who is a new parent and who feels inadequate in this new identity
A person's self-knowledge includes basic facts (sex, age, race, occupation, cultural background, sexual orientation); the person's position within social groups; and the qualities or traits that describe typical behaviors, feelings, moods, and other characteristics (e.g., generous, hot-headed, ambitious, intelligent, sexy). A person's self-expectations are reflected by who or what the person wants to be. Self-esteem is reflected in how well the person likes himself or herself.
True
Fear is a cognitive response to a known threat, while anxiety is the emotional response to that threat. Fear does not necessarily resolve in the short term, and an action plan may or may not be formulated by the individual. The fact that fear involves the identification of a known threat does not necessarily mean that the object of fear is objectively real.
True
Progressive relaxation consists of systematically tensing and relaxing various muscle groups from head to toe. Progressive relaxation provides a method of identifying particular muscle groups and distinguishing between sensations of tension and tranquility.
True
Dysfunctional grief can be unresolved or inhibited. In unresolved grief, a person may have trouble expressing feelings of loss or may deny them. Unresolved grief also describes a state of bereavement that extends over a lengthy period. With inhibited grief, a person suppresses feelings of grief and may instead manifest somatic (body) symptoms. Coping strategies are necessary in the grieving process and for resolution of grief. Many times individuals experiencing dysfunctional grief have difficulty with self-care activities; however, the individual should be encouraged to perform these activities independently. Pain management is usually not necessary in the management of dysfunctional grief. The spiritual needs of the client are important as well and should be considered after coping strategies have been addressed.
True
The clinical definition of depression is anxiety and hostility turned inward. The statement asking the nurse to go away and a desire to be “left alone” indicates withdrawal, which is a characteristic of depression. “This does not seem real to me” indicates the client is in denial. Blaming oneself for the loss is an expression of guilt that may occur in the anger phase of grieving. Feeling uncertain about the future may occur as the grieving person accepts that the loved one is deceased and life will be different.
True
Signs of an impending death include noisy respirations, abdominal distention, constipation, and cyanosis of the extremities. The pulse may be slow and/or irregular. The systolic blood pressure would be decreasing, not increasing.
True
The client is exhibiting signs of developing awareness when demonstrating anger, feelings of emptiness, and crying "Why me?" Shock and disbelief are usually defined as refusal to accept the fact of loss, followed by a stunned and numb response. Restitution involves rituals surrounding loss. Idealization is the exaggeration of the good qualities that the person or object had, followed by acceptance of the loss and a lessened need to focus on it.
True
In unresolved grief, a person may have trouble expressing feelings of loss, may deny them, and the bereavement may extend over a lengthy period. Anticipatory loss or grief occurs when a person displays loss and grief behaviors for a loss that has yet to take place. Inhibited grief occurs when a person suppresses feelings of grief and may instead manifest somatic (body) symptoms, such as abdominal pain or heart palpitations. Normal expressions of grief may be physical (crying, headaches, difficulty sleeping, fatigue), emotional (feelings of sadness and yearning), social (feeling detached from others and isolating oneself from social contact), and spiritual (questioning the reason for the loss, the purpose of pain and suffering, the purpose of life, and the meaning of death).
True
What aspect of self does self-esteem reflect?
Self-knowledge
Which behavior is a sign of dysfunctional self-concept?
Avoiding eye contact
In the stages of self-development, which stage typically occurs around 18 months of age?
Self-recognition
What is the cognitive response to a known threat?
Fear
Which type of grief involves manifesting somatic symptoms instead of expressing grief feelings?
Inhibited grief
What characterizes a person with an external locus of control?
Feels that outcomes happen due to luck or chance
What type of stress occurs when a person progresses through stages of growth and development?
Developmental stress
Which situation best exemplifies situational stress?
Experiencing paralysis overnight
Which activity is recommended as part of stress management techniques?
Deep breathing exercises
What is suggested to be the duration of daily exercise for stress reduction?
30-45 minutes per day, 4 days a week
Which technique involves using mental imagery to relax, such as envisioning a peaceful beach?
Guided imagery
What is the recommended daily duration for rest and sleep as part of healthy living?
8 hours per day
Which of the following is NOT an example of a physiologic stressor mentioned in the text?
Emotional distress from a loved one's death
At what age does self-concept typically develop?
6-7 years
Which of the following is the best example of a coping strategy mentioned in the text?
Encouraging patients to will for themselves
What is the clinical definition of depression according to the text?
Anxiety and hostility turned inward
What does the text say is the purpose of progressive relaxation?
Both A and B
Based on the information in the text, what is the difference between fear and anxiety?
Fear is a cognitive response, anxiety is an emotional response
Which of the following best describes anticipatory loss?
A person displaying grief behaviors for a loss that has not yet occurred
According to Engel's Six Stages of Grief, which stage involves finding peace with the loss?
Restitution
What is the medical criterion used to certify a death, according to the Uniform Definition of Death Act?
Both (b) and (c)
Which of the following is NOT a stage in Engel's Six Stages of Grief?
Bargaining
If a person says, 'It was just bad luck that I got in a motor vehicle accident and broke my arm,' what are they demonstrating?
An external locus of control
Which of the following is NOT a characteristic of dysfunctional grief?
Anticipatory grief
When assessing a patient's ability to cope with stress and anxiety, which of the following outcomes would be most appropriate?
The patient verbalizes the causes and effects of stress and anxiety.
Which type of loss is characterized by an intangible experience that is not readily apparent to others?
Perceived loss
During a crisis intervention, which of the following actions should the nurse avoid?
Providing false promises
Which of the following represents a maturational loss?
A child experiencing a loss of status when a sibling is born
In the context of self-concept, what does it mean when a person exhibits an external locus of control?
The person perceives their outcomes are influenced by external factors.
Which of the following statements best describes the idealization stage of grief?
The person exaggerates the good qualities of the lost object or person.
Which of the following is a characteristic of unresolved grief?
Bereavement extending over a lengthy period
What is the primary difference between fear and anxiety as described in the text?
Fear involves a known threat, while anxiety involves an unknown threat
Which of the following is NOT a characteristic of dysfunctional grief?
Expressing feelings of loss openly
What is the purpose of progressive muscle relaxation as described in the text?
To identify particular muscle groups and distinguish between sensations of tension and tranquility
What does it mean when a person exhibits an external locus of control?
The person perceives that outcomes happen because of luck, chance, or the influence of powerful others
Which of the following best represents a physiologic stressor mentioned in the text?
Eye twitching
Which of the following is an example of a situational stressor?
Getting divorced
In the context of self-concept, what does it mean when a person says, 'It was just bad luck that I got in a motor vehicle accident and broke my arm'?
The person is exhibiting an external locus of control
Which stage of self-development typically occurs around 18 months of age?
Self-recognition
Which of the following is NOT mentioned in the text as a recommended relaxation activity?
Guided imagery
Match the following defense mechanisms with their descriptions:
Denial = Refusing to acknowledge a disturbing condition Displacement = Putting stress on somebody else Adaptation = Responding to a stressor by adapting to it Regression = Reverting to a previous childhood state in response to stress
Match the following stress-related effects with their descriptions:
Stress in health and illness = Causes symptoms like nausea, vomiting, diarrhea, and headache Autoimmune diseases like lupus = Can be triggered by a large stressful event Long term stress on the brain = Can alter brain function and structure Family stress = Leads to feelings of anger, helplessness, and guilt
Match the following stages of self-development with their typical ages:
Self-awareness = Infancy Self-recognition = Around 18 months Self-definition = Around 3 years Self-concept = 6-7 years
Match the following grief types with their characteristics:
Unresolved grief = Trouble expressing feelings of loss or denial over a lengthy period Anticipatory loss or grief = Behaving as if the loss has already occurred before it actually has Inhibited grief = Suppressing feelings of grief and manifesting somatic symptoms Dysfunctional grief coping strategies = Necessary for resolution, but not necessarily involving pain management
Match the following stress-related terms with their definitions:
Situational stress = Stress arising from a particular situation or event Locus of control = Internal perception that personal behavior influences outcomes vs. external perception influenced by luck or others Progressive relaxation = Systematically tensing and relaxing muscle groups for tranquility identification Self-esteem reflection = Reflects how well a person likes themselves
Match the following stages of grief with their characteristics:
Engel's Six Stages of Grief: finding peace =
Study Notes
Factors Affecting Self-Concept
- Children with special needs may have a difficult time developing self-concept
- Culture affects self-concept, and cultural dissonance occurs when a child has different beliefs than their parents
- Internal and external resources, such as history of success and failure, crisis or life stressors, affect self-concept
- Aging, illness, disability, or trauma also impact self-concept
Assessing Self-Concept
- Nurses assess self-concept by respecting personal identity, personal strengths, and body image
- Denial, displacement, adaptation, and regression are coping mechanisms that can affect self-concept
Stress and Adaptation
- Stress is a response to change in a normal balanced state
- Physiologic stressors include chemical agents, physical agents, infectious agents, nutritional imbalances, hypoxia, genetic or immune disorders, and age
- Examples of stress include developmental stress, situational stress, and anticipatory loss
Grief and Loss
- Anticipatory loss occurs when a person displays loss and grief behaviors for a loss that has yet to take place
- Engel's Six Stages of Grief: shock and disbelief, developing awareness, restitution, resolving the loss, idealization, and outcome
- Loss occurs when a valued person, object, or situation is changed or becomes inaccessible
Palliative Care and Hospice
- Terminal illness is an illness in which death is expected within a limited period of time
- The Dying Person's Bill of Rights includes the right to autonomy, dignity, and comfort
- Palliative care and hospice care focus on comfort and support for the dying patient and their family
Nurse-Patient Relationship
-
Developing a trusting nurse-patient relationship involves explaining the patient's condition and treatment, teaching self-care, and meeting the patient's needs
-
Nurses can use relaxation activities, such as deep breathing and progressive muscle relaxation, to help patients cope with stress and anxiety### Crisis Intervention
-
In a crisis, avoid giving false promises and information to patients, as they may not remember it due to stress.
-
Patients should verbalize the causes and effects of stress and anxiety, identify sources of support, and use problem-solving to find solutions to stressors.
-
Patients should practice healthy lifestyle habits and anxiety-reducing techniques, ultimately leading to a decrease in anxiety and increase in comfort.
Types of Loss
- Actual loss: a recognizable loss, such as the loss of a limb.
- Perceived loss: felt by the person but intangible to others, such as the loss of peace of mind.
- Physical loss versus psychological loss.
- Maturational loss: experienced as a result of natural developmental processes, such as a first child feeling a loss of status with the arrival of a sibling.
- Situational loss: experienced as a result of an unpredictable event, including traumatic injury, disease, death, or national disaster.
Stages in Development of Self
- Self-awareness (infancy): the child becomes self-aware and realizes they are a separate entity from their parents.
- Self-recognition (18 months): the child starts developing their own personality and becomes aware of their likes and dislikes.
- Self-definition (3 years): the child can walk, talk, and tell about themselves, including their name.
- Self-concept (6-7 years): the child understands the changes they're going through and understands their gender and differences from others.
Factors Affecting Self-Concept Development
- Developmental considerations: children with special needs might have difficulty going through the stages of development.
- Culture: affects self-concept, and cultural dissonance can occur when children have different beliefs than their parents.
- Internal and external resources.
- History of success and failure.
- Crisis or life stressors: can interfere with self-concept.
Assessing Self-Concept
- Personal identity: respect the patient's personal identity and call them as they wish to be called.
- Personal strengths: identify the patient's strengths and focus on them.
- Body image: assess the patient's body image, especially after trauma.
- Significance: ask the patient about the significance of their experiences.
- Competence: assess the patient's competence and ability to make changes.
- Virtue: ask the patient about their beliefs, ethics, and morals.
Nursing Strategies to Identify Personal Strengths
- Encourage patients to identify their strengths.
- Replace self-negation with positive thinking.
- Notice and reinforce patient strengths.
- Encourage patients to take will for themselves.
Stress and Adaptation
- Stress is a response to change in a normal balanced state.
- Physiologic stressors include chemical agents, physical agents, infectious agents, nutritional imbalances, hypoxia, genetic or immune disorders, and age.
- Examples of stress include denial, displacement, regression, and adaptation.
- Stress can affect basic human needs, health, and illness, and can even change the structure of the brain.
Explore behavioral changes that may signify self-concept dysfunction, such as lack of interest in activities, withdrawal from social settings, and negative self-statements.
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