Chapter 34: Self-Concept
Chapter 34: Self-Concept
Potter et al.: Fundamentals of Nursing, 9th Edition
MULTIPLE CHOICE
1. The nurse is caring for an older-adult patient. Which technique will the nurse
use to enhance an older-adult patient’s self-concept?
a. Discussing current weather
b. Encouraging patients to sing
c. Reviewing old photos with patients
d. Allowing patients extra computer time
ANS: C
Nurses can improve self-concept by reviewing old photographs when working
with older-adult 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 does not improve self-concept. Giving
patients extra computer time is not applicable to improving self-concept but may
help with learning.
DIF:Apply (application)REF:706
OBJ:Apply the nursing process to promote a patient’s self-concept.
TOP: Implementation MSC: Psychosocial Integrity
2. While gathering an adolescent’s health history, the nurse recognizes that the
patient began to act out behaviorally and engaged in risky behavior when the
patient’s parents divorced. Which information will the nurse gather to determine
situational low self-esteem?
a. How long the parents were married
b. How the patient views behaviors
c. Why the parents are divorcing
d. Why the patient is acting out of control
ANS: B
A nurse can identify situational life stressors that can impact a person’s self-
concept. By asking about a patient’s thoughts and feelings, the nurse will be
able to use communication skills in a therapeutic manner. This will facilitate the
patient’s 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 patient’s behaviors. Why the patient is
acting out of control is not as important as how the patient views actions when
out of control.
DIF:Analyze (analysis)REF:709
OBJ:Apply the nursing process to promote a patient’s self-concept.
TOP: Assessment MSC: Psychosocial Integrity
3. A nurse is assessing a group of adolescents. Which person is most 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
When cultural identity is central to self-concept and is positive, cultural pride
and self-esteem tend to be strong. Environmental stressors such as low-income,
body image stressors such as acne, and role performance failure often influence
self-esteem negatively.
DIF:Understand (comprehension)REF:701 | 703
OBJ: Examine cultural considerations that affect self-concept. TOP: Assessment
MSC: Psychosocial Integrity
4. A nurse is caring for a patient who is dealing with the developmental task
known as initiative versus guilt. The nurse is providing care to which patient?
a. A 3-week-old neonate
b. A 5-year-old kindergarten student
c. An 11-year-old student
d. A 15-year-old high school student
ANS: B
The initiative versus guilt developmental stage occurs between the ages of 3
and 6 years. The patient is a 5-year-old kindergarten student. 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 (industry), and a 15-year-old is struggling with identity versus role
confusion.
DIF:Understand (comprehension)REF:702
OBJ:Describe the components of self-concept as related to psychosocial and
cognitive developmental stages.TOP:Implementation
MSC:Health Promotion and Maintenance
5. A verbally abusive partner has told a significant other many negative
comments over the years. In the crisis center, the nurse would anticipate that
the patient may have which self-concept deficits?
a. Body image
b. Role confusion
c. Rigidity
d. Yearning
ANS: A
Over the years of marriage, the significant other incorporates this devaluation
into his or her own self-concept, negatively affecting body image. The way
others view a person’s body and the feedback offered are also influential on body
image and self-concept. Role confusion is part of a developmental task (identity
versus role confusion) for adolescents. Rigidity and yearning are not components
of self-concept.
DIF:Understand (comprehension)REF:702-703
OBJ:Discuss factors that influence the components of self-concept.
TOP: Assessment MSC: Psychosocial Integrity
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. Which developmental stage
is the second man exhibiting?
a. Mistrust
b. Inferiority
c. Generativity
d. Self-absorption
ANS: D
In the generativity versus self-absorption developmental task, a self-absorbed
person is concerned about own personal wants and desires in a self-centered
manner. Generativity is the first man’s developmental stage. Trust versus
mistrust 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:Apply (application)REF:702-703
OBJ:Describe the components of self-concept as related to psychosocial and
cognitive developmental stages.TOP:Assessment
MSC:Health Promotion and Maintenance
7. An adult son is adjusting to the idea of his chronically ill parents moving into
his family home. The community health nurse is assessing the adult son for
potential stressors secondary to the new family living arrangement. Which
stressor will the nurse assess for in this adult son?
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 is the way in
which individuals perceive their ability to carry out significant roles; it is not a
stressor unless it is judged ineffective. There is no data in the question to
indicate this.
DIF:Apply (application)REF:706
OBJ:Identify stressors that affect self-concept and self-esteem.
TOP: Assessment MSC: Psychosocial Integrity
8. A nurse grimaces while changing a patient’s colostomy bag. Which effect will
the nurse’s behavior most likely have 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 bag.
ANS: C
Negative nonverbal reactions by a nurse to a patient’s scar or surgical
alterations contribute to the patient’s developing a negative body image. Nurses
who have shocked or disgusted facial expressions contribute to 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 bag by adopting a positive nickname.
DIF:Understand (comprehension)REF:706-707
OBJ: Explore ways in which a nurse’s self-concept and nursing actions affect a
patient’s self-concept and self-esteem. TOP: Evaluation MSC: Psychosocial
Integrity
9. A male patient states, “I’m such a loser. I only had that job for a month.”
Which outcome criteria will the nurse add to the patient’s care plan?
a. The patient will verbalize two life areas in which he functions well.
b. The patient will find new employment before the next clinic visit.
c. The patient will confront a former boss about previous work problems.
d. The patient will identify two reasons why he 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 patient is voicing
that he 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. Focusing on the negative of why the
patient is considered a bad employee is not as beneficial as focusing on
strengths.
DIF:Analyze (analysis)REF:710 | 711-712 | 713
OBJ:Apply the nursing process to promote a patient’s self-concept.
TOP: Planning MSC: Psychosocial Integrity
10. A nurse is teaching a patient about self-concept. Which information from the
patient indicates the nurse needs to follow up about components of self-
concept?
a. One component is identity.
b. One component is coping.
c. One component is body image.
d. One component is role performance.
ANS: B
The nurse will need to follow up for the information that a component of self-
concept is coping; this is a misconception and must be corrected. The
components of self-concept are identity, body image, and role performance.
While self-concept may affect coping, coping is not a component of self-concept.
DIF:Understand (comprehension)REF:701 | 703-704
OBJ:Describe the components of self-concept as related to psychosocial and
cognitive developmental stages.TOP:Teaching/Learning
MSC:Management of Care
11. Which individual is most likely to need the nurse’s assistance in coping
with identity confusion?
a. A 49-year-old male with stable employment
b. A 35-year-old recently divorced mother of twins
c. A 22 year old in the third year of college
d. A 50-year-old self-employed woman
ANS: B
Identity confusion results 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:Apply (application)REF:705
OBJ: Discuss evidence-based practice applicable for identity confusion,
disturbed body image, low self-esteem, and role conflict. TOP: Planning MSC:
Psychosocial Integrity
12. A nurse is assessing a patient for possible altered self-concept. Which
assessment finding is consistent with altered self-concept?
a. Appropriately dressed with clean clothes
b. Hesitant to express opinions
c. Independent attitude
d. Holds eye contact
ANS: B
Hesitant to express views or opinions is a behavior suggestive of altered self-
concept. Holds eye contact, independent attitude, and appropriate appearance
are all signs of normal self-concept.
DIF:Apply (application)REF:708
OBJ:Apply the nursing process to promote a patient’s self-concept.
TOP: Assessment MSC: Psychosocial Integrity
13. A nurse is caring for a postoperative mastectomy patient. Which action is
a priority for increasing self-awareness?
a. Solving problems for the patient before developing insight
b. Using communication skills to clarify family and patient expectations
c. Telling the patient that it will be fine because many others have survived
d. Rotating nursing personnel in the patient’s care, so the patient can talk to many people
ANS: B
Increase the patient’s self-awareness by allowing him or her to openly explore
thoughts and feelings. A priority nursing intervention is the expert use of
therapeutic communication skills to clarify the expectations of a patient and
family. Interventions designed to help a patient reach the goal of adapting to
changes in self-concept or attaining a positive self-concept are based on the
premise that the patient first develops insight and self-awareness concerning
problems and stressors and then acts to solve the problems and cope with the
stressors. 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 (comprehension)REF:712
OBJ:Apply the nursing process to promote a patient’s self-concept.
TOP: Implementation MSC: Psychosocial Integrity
14. The nurse in an addictions clinic is working with a patient on priority setting
before the patient’s discharge from residential treatment. Which goal is
a priority at this time?
a. Identifying local self-help groups before being discharged from the program
b. Stating a plan to never be tempted by illicit substances after discharge
c. Staying away from all triggers that cause substance abuse
d. Recognizing personal areas of weakness to grow stronger
ANS: A
Look for strengths in both the individual and the family, and provide resources
and education to turn limitations into strengths, such as local self-help groups. 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 post-discharge setting. Having a person talk
about weaknesses without recognizing a person’s strengths could be a trigger to
return to an addictive lifestyle, so this would not be the most appropriate
priority.
DIF:Analyze (analysis)REF:712
OBJ:Apply the nursing process to promote a patient’s self-concept.
TOP: Planning MSC: Psychosocial Integrity
15. A nurse is teaching a patient about self-concept. Which information from the
patient indicates a correct understanding of the teaching?
a. Self-concept is how a person feels about others.
b. Self-concept is how a person thinks about others.
c. Self-concept is how a person feels about oneself.
d. Self-concept is how a person thinks about oneself.
ANS: D
Self-concept, or how a person thinks about oneself, directly affects self-esteem,
or how one feelsabout oneself. While others may influence self-concept, self-
concept is not how one feels or thinks about others.
DIF:Apply (application)REF:701
OBJ:Discuss factors that influence the components of self-concept.
TOP: Teaching/Learning MSC: Psychosocial Integrity
16. A nurse is evaluating a patient’s self-concept. Which key indicator will the
nurse use?
a. Drug abuse history
b. Nonverbal behavior
c. Personal journal entries
d. Posts on social media
ANS: B
Key indicators of a patient’s self-concept are nonverbal behaviors. 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 patient’s personal journal or
social media posts.
DIF:Apply (application)REF:713
OBJ:Apply the nursing process to promote a patient’s self-concept.
TOP: Evaluation MSC: Psychosocial Integrity
17. A nurse is assessing a patient’s self-concept. Which area should the nurse
assess first?
a. Role performance
b. Vital signs
c. Anxiety
d. Morals
ANS: A
In assessing self-concept and self-esteem, first focus on each component of self-
concept (identity, body image, and role performance). Self-concept is a
psychological/emotional issue, not a physical issue for vital signs. Anxiety may
be a stressors or a sign of low self-concept. Self-concept is not a moral issue.
DIF:Apply (application)REF:708
OBJ:Apply the nursing process to promote a patient’s self-concept.
TOP: Assessment MSC: Psychosocial Integrity
18. A 9-year-old is proudly telling the nurse about mastering the yellow belt in a
martial arts class. Which developmental stage is the child exhibiting?
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. Initiative versus guilt is for 3 to 6 years, focusing on increasing
language skills with identification of feelings. Identity versus role confusion is 12
to 20 years, focusing on finding a sense of self. Autonomy versus shame and
doubt is 1 to 3 years, focusing on becoming more independent.
DIF:Apply (application)REF:702
OBJ:Describe the components of self-concept as related to psychosocial and
cognitive developmental stages.TOP:Assessment
MSC:Health Promotion and Maintenance
19. A nurse is developing a drinking prevention presentation for adolescents.
Which areas should the nurse include in the teaching session?
a. Stressful life events and scholarships
b. Very high self-esteem and work failure
c. Health problems and avoidance of conflict
d. Stress management and improving self-esteem
ANS: D
Drinking prevention efforts should include stress management and improving
self-esteem. High self-esteem decreases risk of drinking. Stressful life events
when balanced with positive issues, such as receipt of a scholarship, are less
likely to induce drinking. Conflict resolution can strengthen adolescent coping
strategies to decrease drinking.
DIF:Apply (application)REF:707
OBJ:Discuss evidence-based practice applicable for identity confusion, disturbed
body image, low self-esteem, and role conflict.TOP:Teaching/Learning
MSC:Health Promotion and Maintenance
20. A nurse is completing a history on a patient with role conflict. Which finding
is consistent with role conflict?
a. A patient is unsure about job expectations in a fast-paced company.
b. A patient has to travel for work and misses children’s birthdays.
c. A patient feels less of a man after a leg amputation.
d. A patient loses a job from the company’s downsizing.
ANS: B
Role conflict results when a person has to simultaneously assume two or more
roles that are inconsistent, contradictory, or mutually exclusive—for example,
when a patient has to travel for work and misses children’s birthdays. Role
ambiguity is also common in employment situations. In complex, rapidly
changing, or highly specialized organizations, employees often become unsure
about job expectations. Feeling less of a man after a leg amputation is a body
image and self-concept/self-esteem problem. Losing a job can lead to low self-
esteem or loss of job identity.
DIF:Analyze (analysis)REF:705
OBJ: Discuss evidence-based practice applicable for identity confusion,
disturbed body image, low self-esteem, and role conflict. TOP: Assessment MSC:
Psychosocial Integrity
MULTIPLE RESPONSE
1. A nurse is assessing a patient’s self-concept. Which areas will the nurse
include? (Select all that apply.)
a. Identity
b. Body image
c. Coping behaviors
d. Significant others’ support
e. Availability of insurance
ANS: A, B, C, D
Assessment of self-concept includes identity, body image, coping behaviors, and
significant others’ support. Availability of insurance is not a component of self-
concept.
DIF:Understand (comprehension)REF:703-704
OBJ:Apply the nursing process to promote a patient’s self-concept.
TOP: Assessment MSC: Psychosocial Integrity
MATCHING
A nurse is assessing a group of patients. Match the assessment finding to the
area the nurse is assessing.
a. I am ugly with all these burn scars.
b. I am one with the universe.
c. I am good for nothing.
d. I am a good mother.
1. Identity confusion
2. Disturbed body image
3. Role performance
4. Low self-esteem
1.ANS:BDIF:Apply (application)REF:703-704
OBJ: Discuss evidence-based practice applicable for identity confusion,
disturbed body image, low self-esteem, and role conflict. TOP: Assessment MSC:
Psychosocial Integrity
2.ANS:ADIF:Apply (application)REF:703-704
OBJ: Discuss evidence-based practice applicable for identity confusion,
disturbed body image, low self-esteem, and role conflict. TOP: Assessment MSC:
Psychosocial Integrity
3.ANS:DDIF:Apply (application)REF:703-704
OBJ: Discuss evidence-based practice applicable for identity confusion,
disturbed body image, low self-esteem, and role conflict. TOP: Assessment MSC:
Psychosocial Integrity
4.ANS:CDIF:Apply (application)REF:703-704
OBJ: Discuss evidence-based practice applicable for identity confusion,
disturbed body image, low self-esteem, and role conflict. TOP: Assessment MSC:
Psychosocial Integrity
