Deck 40: Self-Concept

Question 1

A nurse is assessing an Indigenous client for self-esteem following a suicide attempt. The nurse notices that he does not maintain eye contact and is hesitant at answering questions. The nurse documents this as:

A) Ineffective Role Performance.
B) Chronic Low Self-esteem.
C) Normal Cultural Behaviour.
D) Disturbed Personal Identity.

Answer 1

Normal Cultural Behaviour.

Question 2

Which statement should the nurse make first when assessing the client's self-concept?

A) "Tell me about your family."
B) "Tell me about the work you do."
C) "Describe what you do when you have free time."
D) "Describe yourself as a person."

Answer 2

"Describe yourself as a person."

Question 3

Which statement, made by the client, would indicate a "me-centred" self-concept?

A) "The world has always been against people like me."
B) "My sister is so much smarter than I am."
C) "My future is based on the decisions I make today."
D) "I couldn't stand to disappoint my parents."

Answer 3

"My future is based on the decisions I make today."

Question 4

The nurse is assisting a client in setting goals as a strategy to reinforce strengths. What intervention should the nurse employ?

A) Help the client choose a significant goal, even if it is time-consuming.
B) Encourage the client to set attainable goals, even if small.
C) Advise the client to avoid goals that will require too much effort.
D) Devise a set of goals from which the client can pick.

Question 5

During assessment, the client frequently refers to her Indigenous Australian cultural background. The nurse assesses that the client's culture is a strong part of which of the following?

A) Client's role-performance.
B) Client's personal identity.
C) Client's body image.
D) Client's self-esteem.

Question 6

A rare malignancy will require the amputation of an adolescent client's leg. The client refuses the surgery, stating: "I would rather die than have my leg amputated". The nurse plans future interventions based upon which of the following?

A) The fact that the parents will have the ultimate decision about surgery.
B) The ability of the adolescent to understand medical terminology.
C) Concern about need for education regarding the danger of delaying surgery.
D) The knowledge that adolescents are very concerned about body image.

Question 7

During the assessment interview, the client is quiet and answers questions only minimally. What action should the nurse take in regard to this apparent unwillingness to share information?

A) Ask another nurse to sit in on the next interview attempt.
B) Consider any cultural implications of these actions.
C) Document that the client is not cooperative.
D) Assume that the client has something to hide.

Question 8

The adolescent male client who weighs 45 kilograms tells the nurse that he is considering taking "some herbal stuff" to increase his muscle mass and make him stronger. The nurse should interpret this statement as an indication that this client has which of the following?

A) The need for referral to a psychologist.
B) Serious problems with logical thinking.
C) Contrast between reality and ideal self.
D) A strong need for admiration.

Question 9

The clinical nurse consultant/unit coordinator has instituted a series of classes on self-concept development for staff nurses. Why is it important that the classes include information to improve the nurses' self-concept as well as information to use with clients?

A) Nurses with positive self-concept are better able to help clients.
B) Nurses with poor self-concept are more likely to make errors.
C) Poor self-concept is the number one reason for nursing burnout.
D) The nurse's self-concept is more important than the client's.

Question 10

Which of the following is not a component of self-concept?

A) Self-knowledge.
B) Self-appraisal.
C) Self-expectations.
D) Self-awareness.

Question 11

A client who has recently lost the 34 kilograms recommended by his doctor continues to dress in loose, baggy clothing and frequently refers to himself as "fat". The nurse interprets this finding as most likely indicating which of the following?

A) Fear of success.
B) Role confusion.
C) Lack of education.
D) Body image disturbance.

Question 12

The client's wife complains to the nurse that it seems as if her husband is not making much progress in developing a more positive self-esteem. What statement by the nurse would be appropriate?

A) "Do you think that your husband is really trying?"
B) "Self-esteem work takes time and is not easily evaluated."
C) "What have you done to help your husband with this work?"
D) "Most clients make quicker progress than your husband has made."

Question 13

Which nursing intervention would be helpful when caring for a client who has negative self-esteem?

A) Tell the client how much easier life would be with positive self-esteem.
B) Design a series of "small successes" for the client.
C) Find a way to praise the client during each encounter.
D) Correct the client when negativity arises.

Question 14

The newly graduated nurse is working with a mentor who has been a nurse for 25 years. The mentor tells the new graduate, "I learn something new about nursing every day". What does this indicate about the mentor's self-awareness?

A) This nurse is not very self-aware.
B) Since self-awareness is never complete, this nurse is demonstrating desirable behaviour.
C) Since this mentor has been a nurse for so long, self-awareness is no longer an important issue.
D) The mentor's self-awareness is behind normal development.

Question 15

Which common characteristic of persons with low self-esteem can make it difficult for the nurse to effectively intervene?

A) They express disinterest in working on improvement.
B) They are seldom satisfied with their personal situation.
C) They focus on their problems.
D) They have low motivation to improve.

Question 16

The nurse's global self-esteem is very low after a week of taking care of several clients who have unexpectedly died. What fact about self-esteem should this nurse remember?

A) Functional self-esteem develops early in life and shouldn't change related to situational problems.
B) It is important to focus on errors that contributed to client death.
C) Even during bad times, self-esteem will not regress to a level lower than basic self-esteem.
D) It is normal for self-esteem to fluctuate related to daily events and problems.

Question 17

The nurse is conducting a thorough psychosocial assessment of a client who presents with complaints of fatigue, tearfulness and relationship difficulties. What action by the nurse would support accurate assessment?

A) Start the interview by asking a series of yes/no questions.
B) Investigate the client's culture prior to the interview.
C) Take detailed notes to record client responses.
D) Ask as many questions as possible to explore all areas of concern.

Question 18

The nurse is teaching a new parents class about self-esteem development in infants. Which information should be included?

A) Use firm, loving discipline with the baby from the beginning.
B) Keep the baby on a three-hour feeding schedule, even if it means awakening him.
C) If the baby awakens at night, let him cry for a few minutes before responding.
D) Respond to the baby's needs promptly and consistently.

Question 19

Which statement, made by a new mother, would indicate to the nurse that there is potential for lowered self-esteem due to role ambiguity?

A) "I haven't even finished the baby's room."
B) "I'm so disappointed that this baby is not a girl."
C) "My husband will be a stay-at-home dad while I work."
D) "I don't know if I know how to be a mother."

Question 20

The nurse and client had set the following expected outcome: "At the next clinic visit, the client will report participation in three activities to increase self-esteem". At today's visit, the client is unable to meet the stated outcome. What should be the nurse's next action?

A) Explore the possible reasons for not meeting the outcome.
B) Identify new interventions to help the client achieve the outcome.
C) Re-evaluate the accuracy of the outcome statement.
D) Collaborate with the client to write a new expected outcome.

Question 21

The parents of an adolescent report that their child has recently gotten into trouble at school for cheating on an examination and has been barred from participating in a school trip as a consequence of that action. They ask for the nurse's professional opinion about the suitability of the punishment. Which answer best supports self-esteem development in this adolescent?

A) "I think the punishment may be excessive. Have you talked with the school officials about the incident?"
B) "Living with the consequences of your actions is a way to help the adolescent develop good self-esteem."
C) "Since my expertise is in health, I really can't respond to your question."
D) "Honesty and respect for authorities is important. I am surprised that the punishment is not more extensive."

Question 22

A nursing student is at the midpoint of a clinical rotation in which the student has had problems getting along with the clinical facilitator. The student has just received an evaluation that indicates difficulties with time management and prioritisation in the care of clients. How should the student react to this input?

A) Consider the feedback carefully but not change practice patterns.
B) Take the feedback seriously and use it to guide personal growth.
C) Blame the student-clinical facilitator relationship as the basis of the evaluation.
D) Dismiss the evaluation as invalid.

Question 23

The local playgroup encourages children to dress up in outlandish outfits. This activity is designed to:

A) confirm they are part of a group.
B) develop their own identity.
C) develop their skills.
D) keep them occupied.

Question 24

Nurses need to develop a therapeutic relationship to assist people with an altered self-concept. One of the techniques to enhance this relationship is:

A) reinforce their emotions with empathy.
B) criticise their inappropriate standards.
C) encourage self-exploration of issue.
D) support negative self-talk.

Question 25

The nurse working in a long-term care facility notices that one of the residents has had a recent decline in self-esteem. What intervention would be appropriate for this resident?

A) Ask the resident for advice in setting up an activity in the dayroom.
B) Meet with the social worker to plan all of the client's care.
C) Don't allow the resident to talk about minor concerns.
D) Keep the resident too busy to dwell in the past.

Question 26

A nurse is wanting to improve in "emotional intelligence" to improve the care provided. The nurse needs to focus on all of the following except:

A) motivation.
B) empathy.
C) knowledge.
D) social skills.

Question 27

Parents confide to the nurse that they are concerned about their preschooler because she demands to pick out her own clothes in the morning. The parents are concerned that their childcare workers may think they are negligent parents because their daughter often wears unmatched clothing. What should be the nurse's response to this concern?

A) "I am glad you brought that to our attention. I will make a note for her paediatrician."
B) "You should have better control of your daughter now if you have any hope of controlling her at 16."
C) "Your daughter is normal, and is just practicing skills she will need later in life."
D) "Don't worry, childcare workers are accustomed to that sort of thing."

Question 28

The nurse is developing a tool to document self-concept development among chronically ill children. Included in this tool should be areas to document development in personal identity, body image, role performance/relationships, and ________.