Exam 8 Self-Concept

Question 0

Self actualization

Answer 0

The need to reach one’s potential through full development of one’s unique capability

Question 1

Self concept

Answer 1

The mental image or picture of self

Question 2

Self esteem

Answer 2

The need to feel good about oneself and to believe that others hold one in high regard.

Question 3

Global self

Answer 3

The composite of all the basic facts, qualities, traits, images and feeling one holds about oneself.

Question 4

Identity diffusion

Answer 4

is the failure to integrate various childhood identifications into a harmonious adult psychosocial identity, which can lead to disruptions in relationships

Question 5

Depersonalization

Answer 5

is the subjective experience of the partial or total disruption of one’s ego and the disintegration and disorganization of one’s self- concept.

Question 6

Components of self concepts

Answer 6

1 Personal Identity
2 Body Image
3 Self-Esteem
4 Role Performance

Question 7

Body image

Answer 7

subjective view a person has about his or her physical appearance.

Question 8

Role Performance

Answer 8

ability to successfully execute societal as well as our own expectations, is easily compromised by illness and injury.

Question 9

What are the three dimensions of self concepts?

Answer 9

Self knowledge. Who am I? Global self
Self expectation. Who or what do I want to be? Flows from various sources are they a positive or negative role model
Self evaluation How well do I like myself? Looking at self esteem.

Question 10

Which one of the following terms best describes a person’s need to reach his or her potential by pursuing a career in medicine?

A. Self esteem
B. self concept
C. Self actualization
D. Self knowledge

Answer 10

C. Self actualization
Rationale
Self actualization is the need to reach one’s potential through full development of one’s unique capability.
Self esteem is the need to feel good about oneself and believe others hold one in high regard.
Self concept is the mental image or picture of self.
Self knowledge is the composite of the facts, qualities, images, and feelings one holds about oneself.

Question 11

Maslow’s subset of esteem needs

Answer 11

Self esteem - approval of myself

Respect needs - approval of others

Question 12

Robert, aged 19 years, has Down syndrome and is mildly developmentally disabled with an intelligence quotient of 82. He told his nurse, “I’m a good helper. You see I can carry these trays because I’m so strong. But I’m not very smart, so I have just learned to help with the things I know how to do.” Robert most likely has which of the following?

a. Negative self-concept and low self-esteem
b. Negative self-concept and high self-esteem
c. Positive self-concept and fairly high self-esteem
d. Positive self-concept and low self-esteem

Answer 12

c. The data point to Robert having a positive self-concept (“I’m a good helper”) and fairly high self-esteem (realizes his strengths and limitations). The statement “But I’m not very smart” is accurate and is not an indication of a negative self-concept.

Question 13

Joe was asked to make a list of 20 words that describe him. After 15 minutes, Joe listed the following: 25 years old, male, named Joe; then declared he couldn’t think of anything else. Joe has demonstrated which of the following?

a. Lack of self-esteem
b. Deficient self-knowledge
c. Unrealistic self-expectation
d. Inability to evaluate himself

Answer 13

b. Joe’s inability to list more than three items about himself indicates deficient self-knowledge. There are not enough data provided to determine whether he lacks self-esteem, has unrealistic self-expectations, or is unable to evaluate himself.

Question 14

Joe was able to list only three facts, traits, or qualities to describe himself. The nurse then asked him to list facts, traits, or qualities that he would like to be descriptive of himself or that he thinks he should have. Joe quickly listed 25, all of which were characteristic of a successful man. When asked if he knew anyone like this, he replied, “My father.” This discrepancy between Joe’s description of himself as he is and as he would like to be indicates which of the following?

a. Negative self-concept
b. Joe’s modesty (lack of conceit)
c. Body image disturbance
d. Low self-esteem

Answer 14

d. Low self-esteem is characterized by great discrepancy between the ideal and real selves. There are no data in this item to suggest that Joe has either a negative self- concept or a body image disturbance. The data do indi- cate something more serious than modesty.

Question 15

David and his wife decided that she will get a job so that David can go to pharmacy school, as he has wanted to do for some time. Their three teenagers, who were involved in the decision, are also getting jobs
to buy their own clothes. David plans to work 12 to16 hours weekly. He states, “I was always an A student, but I may have to settle for Bs now because I don’t want to neglect my family, and I need to work a few hours so that my wife won’t have to work overtime.” David’s self-expectations are:
a. Realistic and positively motivating his development
b. Unrealistic and negatively motivating his development
c. Unrealistic but positively motivating his development
d. Realistic but negatively motivating his development

Answer 15

a. David’s self-expectations are realistic, given his multiple commitments, and seem to be positively motivating his development.

Question 16

Which of the following statements made by the parent of a child you are seeing in clinic needs to be followed up with teaching about how to foster healthy development of the self in children?

a. “I love my child so much I ‘hug him to death’ every day.”
b. “I think children need challenges, don’t you?”
c. “My husband and I both grew up in very restrictive families. We want our children to be free to do whatever they want.” d. “My husband and I have different ideas about discipline, but we’re talking this out because we know it’s important for Johnny that we be consistent.”

Answer 16

c. Each option with the exception of c correctly addresses some aspect of fostering healthy development in children. Because children need effective structure and development, giving them total freedom to do as they please may actually hinder their development.

Question 17

Which intervention would you take first to assist a woman who states that she feels incompetent as the mother of a teenage daughter?

a. Recommend that she discipline her daughter more strictly and consistently
b. Make a list of things her husband can do to help her improve
c. Assist the mother to identify both what she believes is preventing her success and what she can do to improve
d. Explore with the mother what the daughter can do to improve her behavior

Answer 17

c. The first intervention priority with a mother who feels incompetent to parent a teenage daughter is to assist the mother to identify what is preventing her from being an effective parent and then to explore solutions aimed at improving her parenting skills. The other interventions may prove helpful, but they do not directly address the mother’s problem with her feelings of incompetence.

Question 18

Which of the following patients is least likely to develop problems related to self-concept?

a. A 55-year-old woman television news reporter undergoing a hysterectomy (removal of uterus)
b. A young clergy person whose vocal cords are paralyzed after a motorbike accident
c. A 32-year-old accountant who survives a massive heart attack
d. A 23-year-old model who just learned that she has breast cancer

Answer 18

a. Based simply on the facts given, the 55-year-old news reporter would be least likely to experience body image or role performance disturbance because she is beyond her childbearing years, and the hysterectomy should not impair her ability to report the news. The young clergyperson’s inability to preach (b), the 32-year-old’s massive myocardial infarction (c), and the model’s breast resection (d) have much greater potential to result in self-concept problems.

Question 19

Juanita Sanchez has been in the United States only 3 months and has recently suffered the loss of her husband and job. She states that nothing feels familiar . . . “I don’t know who I am supposed to be here” and she misses home (Nicaragua) terribly.
For questions 8 to 11, read the patient data below and use the following letters to indicate the diagnosis that data suggest (each response may be used only once):
a. Personal Identity Disturbance
b. Body Image Disturbance
c. Self-Esteem Disturbance
d. Altered Role Performance

Answer 19

a. An unfamiliar culture, coupled with traumatic life events and loss of husband and job, had resulted in this patient’s total loss of her sense of self: “I don’t know who I am supposed to be here.” Her very sense of identity is at stake, not merely her body image, self-esteem, or role performance.

Question 20

Jim Boa, a sophomore in high school, has missed a lot of school this year because of leukemia. He said he feels like he is falling behind in everything and misses “hanging out at the mall” with his friends most of all.

a. Personal Identity Disturbance
b. Body Image Disturbance
c. Self-Esteem Disturbance
d. Altered Role Performance

Answer 20

d. Important roles for Jim are being a student and a friend. His illness is preventing him from doing either of these well. This self-concept disturbance is basically one that concerns role performance.

Question 21

Kelly Smith, a college freshman away from home for the first time, says, “Why did I have to be born into a family of big bottoms and short fat legs! No one will ever ask me out for a date. Oh, why can’t I have long thin legs like everyone else in my class? What a frump I am.”

a. Personal Identity Disturbance
b. Body Image Disturbance
c. Self-Esteem Disturbance
d. Altered Role Performance

Answer 21

b. Clearly, this patient’s concern is with his or her body image.

Question 22

Marissa Yule, a 33-year-old businessperson, is now in counseling attempting to deal with a long-repressed history of sexual abuse by her father. “I guess I should feel satisfied with what I’ve achieved in life, but I’m never content, and nothing I achieve makes me feel good about myself . . . I hate my father for making me feel like I’m no good. This is an awful way to live.”

a. Personal Identity Disturbance
b. Body Image Disturbance
c. Self-Esteem Disturbance
d. Altered Role Performance

Answer 22

c. Marissa’s self-concept disturbance is mainly one of devaluing herself and thinking that she is no good. This is a self-esteem disturbance.

Question 23

Nancy, 36 years old, who was divorced 5 years earlier, entered the emergency department with severe burns and cuts on her face after an auto accident in a car driven by her fiancé of 3 months. Three weeks later, her fiancé has not yet contacted her. Nancy states that he is so busy and she is too tired to have visitors anyway. Nancy frequently lies with her eyes closed and head turned away. These data suggest that:

a. There is no disturbance in self-concept.
b. This patient has ego strength and high self-esteem but may have a disturbance of body image.
c. The area of self-esteem has very low priority at this time and should be ignored until much later.
d. It is probable that there are disturbances in self-esteem and body image.

Answer 23

d. The traumatic nature of Nancy’s injuries, her fiancé’s failure to contact her, and Nancy’s response, that is, her withdrawal, all point to potential problems with both body image and self-esteem. It is not true that self- esteem needs are of low priority.

Question 24

Which of the nursing interventions below is least likely to assist a severely ill patient with cancer to maintain a positive sense of self?

a. Making it a point to address the patient by name each time you enter the room
b. Fatiguing the patient as little as possible by performing all procedures in silence
c. Continuing to respect the patient’s privacy and sensibilities
d. Offering the patient a simple explanation before moving her in any way

Answer 24

b. Each option with the exception of b should assist the patient to maintain a positive sense of self. Working in silence with the patient may be preferable to idle chatter, but the idea is to address the patient by name, give simple explanations of procedures, and communicate by simple words of caring that he or she is a person of worth.

Question 25

Doris, 16 years old, has a nursing diagnosis of Body Image Disturbance related to severe acne. In planning nursing care, an appropriate goal for this nursing diagnosis is “The patient will

a. make above-B grades in all tests at school.”
b. demonstrate by diet control and skin care increased interest in control of acne.”
c. report that she feels more self-confidence in her music and art, which she enjoys.”
d. express that she is very smart in school.”

Answer 25

b. All of these patient goals may be appropriate for Doris, but the only goal that directly addressed her body image disturbance is b.

Question 26

A 4 1/2-year-old boy required stitches for a laceration on the eyebrow. After the doctor held him, visited with him, and explained what was going to be done and that his eye would get better and look just like it did before, the boy placed his hands under his hips as instructed and quietly permitted the procedure. He then expressed pride in himself. Evaluation of the effect of this health- care experience is best expressed in which of the following?

a. The doctor did an excellent job.
b. The child’s self-esteem was enhanced and fear of bodily mutilation decreased, and the parents were given an excellent role model.
c. The child was made the center of attention and the situation exaggerated, thus encouraging the child to become self centered
d. These interventions consumed too much physician time to be evaluated positively.

Answer 26

b. The physician enhanced the child’s self-esteem by teaching him how to participate effectively, decreased his fear of bodily mutilation by telling him that his eyebrow would heal and look normal, and gave the parents an excellent role model.

Question 27

The nurse assessing self concept focuses on the patient’s

Answer 27

1 personal identity
2 body image
3 self-esteem
4 role performance

Question 28

Personal identity

Answer 28

Individual’s conscious sense of who he or she is.

Question 29

Coopersmith 1967

The four bases of self esteem

Answer 29

1 significance the way a person feels he or she is loved and approved of by other people important to that person
2 competence the way tasks that are considered important are performed.
3 virtue the attainment of moral - ethical standards
4 power the extent to which a person influences his or her own and other lives.

Question 30

3 major self-evaluation feelings or affects found in individuals

Answer 30

1. Pride- based on a positive self-evaluation
2. Guilt- based on behaviors incongruent with ideal self.
3. Shame- associated with low global self-worth.

Question 31

Formation off self-concept

Answer 31

Infant learns physical self is different from environment
If basic needs are met, child has positive feelings of self
Child internalizes other people’s attitudes toward self
Child or adult internalizes standards of society.

Question 32

Ideal self

Answer 32

The self one wants to be.

Question 33

False self

Answer 33

Individuals who have the emotional need to respond to the needs and ambitions significant people such as parents, have for them.

Question 34

Stages of development of self

Answer 34

1. Self-awareness ( infancy) - dependent of needs being met.
2. Self-recognition (18 months) know who they are
3. Self-definition (3years) recognize others think differently from them
4. Self-concept (6-7 years) how do I compare to others

Question 35

People are born with self-concept?

True or false.

Answer 35

False

People are not born with a self-concept, it is formed over the course of time.

Question 36

Factors affecting self-concept

As one matures the factors change.

Answer 36

Developmental considerations
Culture
Internal and external resources 
History of success and failure
Crisis or life stressors
Aging, illness, or trauma

Question 37

Assessing self-concept

Answer 37

Personal identity
Body image
Self-esteem
Role performance

Question 38

Assessing self-esteem

Answer 38

Socialization and communication
Adaptive response (describe yourself to others)
Maladaptive response (superficial self confidence
Significance
Competence
Virtue
Power

Question 39

Stressors affecting self-concept

Answer 39

Identify stressors
Body image stressor
Self-esteem stressor
Role stressor

Question 40

3 factors that determine a Person’s response to crisis/stressor.

Answer 40

1. The person’s perception of the event or situation
2. The person’s situational support (external resources)
3. The coping mechanisms the person possesses (internal resources)

Question 41

A nurse ask a patient: " How important is it to you to believe that your work has value to others?"  Which of the following aspects of self-esteem might this nurse be assessing?
A.  Socialization and communication
B.  competence
C.  Virtue 
D.  Power

Answer 41

B. competence
Competence refers to a person’s ability to perform a job or role in life.
Socialization and communication refer to the quantity and quality of a person’s interpersonal relationships.
Virtue refers to the moral-ethical principles guiding a person’s life.
Power refers to the control people have over their lives.

Question 42

Diagnosing disturbances in self-concept.

Answer 42

As a problem
A cause of problem
A sign that a problem exists

Question 43

NANDA Nursing Diagnoses

Examples

Answer 43

1. Disturbed body image. Irreversible body changes
2. Low self-esteem. Feeling unloved or unapproved by significant others.
3. Ineffective Role Performance rejection of role
4. Disturbed personal identity. Unresolved crisis, declining physical, mental, or sensory abilities.

Question 44

Look at me. Nothing can ever be the same again. I feel less whole. When I look in the mirror all I see is this stump. I know that when others look at me they are repulsed or at least pity me.

Answer 44

Disturbed body image

Question 45

An eighty year old man who lost his wife 6 months ago. His wife took care of all of his needs. Now, he sits around in the house all day. We always did everything together. I wish I had died first. What shall I do?

Answer 45

Ineffective role performance

Question 46

I try and make my dad like me, but he acts like I don’t exist. I wouldn’t even cared if he yelled at me so long as he noticed me. I wonder why he doesn’t like me?

Answer 46

Low self-esteem

Question 47

Nursing strategies to identify

Personal strengths

Answer 47

Encourage patients to identify their strengths.
Replace self-negation with positive thinking
Notice and reinforce patient strengths.
Encourage patients to will for themselves.
Help patients cope with necessary dependency related to age or illness.

Question 48

Helping patients maintain sense of self

Answer 48

Communicate worth with looks, speech, and judicious touch.
Acknowledge patient status, role and individuality.
Speak to patient respectfully.
Offer simply explanations for procedures.
Move patients body respectfully .
Respect patients privacy and sensibilities.
Acknowledge and allow expression of negative feelings.
Help patients recognize strengths and explore alternatives.

Question 49

Self actualization needs

Answer 49

Highest level on hierarchy of needs
Need or effort to reach ones full potential
Lower level need must be met before actualization needs can be satisfied
Continue throughout life.

Question 50

Nursing interventions aimed at meeting self actualization needs

Answer 50

Providing a sense of direction and hope

Providing teaching aimed at maximizing potential.