Nokea
A nurse is conducting a parent workshop on how to build self-esteem in children. Which teaching points would the nurse include to help parents achieve this goal? Select all that apply.
- A. Reinforce their child's positive qualities.
- B. Overlook occasional negative behavior.
- C. Ignore neutral behavior that is a matter of personal preference.
- D. Listen and "fix things" for their children.
- E. Describe the child's behavior and judge it.
- F. Let their children practice skills and make it safe to fail.
Correct Answer: A,C,F
Rationale: The nurse should include the following teaching points for parents: (1) reinforce their child's positive qualities; (2) address negative qualities constructively; (3) ignore neutral behavior that is a matter of taste, preference, or personal style. Parents should allow children to be challenged or fail, rather than "fix things" for their children; avoid judgmental observations and let their child know what to expect, practice the necessary skills, be patient, and make it safe to fail.
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An older adult patient has a health problem of Disturbed Body Image documented on their care plan. The nurse discovers that patient feels they look old and feeble when ambulating with an assistive device often walking without it. The patient has fallen several times. What is an appropriate goal for this patient?
- A. The patient will state the need to use the assistive device both inside and outside the house.
- B. The patient will demonstrate proper use of the assistive device as observed by the nurse and physical therapist.
- C. The patient will discuss their feelings about the device and compare that with the need for safety.
- D. The patient will be given a wheelchair for mobility, as it is safer.
Correct Answer: C
Rationale: The patient is demonstrating a maladaptive response. Patients who deny and avoid dealing with limitations or deformity, engage in self-destructive behavior, or fail to estimate relationship of body to environment are experiencing a disturbed self-concept. The patient will need to discuss their feelings to reframe the situation and prioritize safety.
A nurse is counseling a couple who have decided that the wife will provide financial support for the family while the husband attends pharmacy school. The husband plans to work 16 hours weekly, while attending school and states, "I was always an A student, but I might have to settle for Bs now because I don't want to neglect my family." How would the nurse document the husband's self-expectations?
- A. Realistic and positively motivating their development
- B. Unrealistic and negatively motivating their development
- C. Unrealistic but positively motivating their development
- D. Realistic but negatively motivating their development
Correct Answer: A
Rationale: The patient's self-expectations are realistic, given their multiple commitments, and seem to be positively motivating their self-development.
A school nurse is teaching parents how to foster a healthy development of self in their children. Which statement made by one of the parents requires further teaching?
- 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 partner and I grew up in restrictive families; we want our children to be free to do whatever they want."
- D. "We have different ideas about discipline, but we've continued our discussions so we can be consistent."
Correct Answer: C
Rationale: Each option with the exception of 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.
A nurse is performing a psychological assessment of an adolescent patient who has Down syndrome with mild intellectual disability. The patient tells the nurse, "I'm a good helper. I can carry things because I'm strong, but I'm not real smart, so I help with things I know how to do." What findings for self-concept and self-esteem would the nurse document for this patient?
- 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
Correct Answer: C
Rationale: The data point to the patient's positive self-concept ("I'm a good helper") and fairly high self-esteem (realizes their strengths and limitations). Stating, "But I'm not really smart" is likely accurate compared to non-disable peers and is not an indication of a negative self-concept.
A nurse practicing in a health clinic assesses patient's self-concept during the patient intake. Which of these patients would the nurse identify has risk for problems related to self-concept?
- A. Older adult scheduled for a hysterectomy next week
- B. Young adult pastor whose vocal cords were paralyzed after a surgical procedure
- C. Young accountant who survives a heart attack and near-death experience
- D. Model who just learned that they have breast cancer
- E. Adolescent recovering from a spinal cord injury who will be wheelchair "mobile"
Correct Answer: B,C,D,E
Rationale: Based on the data, those who are at risk for negative self-concept include the pastor who will face challenges without his voice, the survivor of the near-death experience, and the model, whose work and livelihood depends on their physical appearance. The older adult would be least likely to experience body image or role performance disturbance because they are beyond childbearing years, and the surgery should not impair their functional ability.