Question 1

In preparing to review different theories,the nurse reviews basic information to assist in understanding the material.Theories are defined as:

Accepted Answer

A theory is a set of concepts,definitions,relationships,and assumptions that project a systematic view of phenomena.
Mental formulations of objects or events are called concepts.
Aspects of reality that can be consciously sensed are called phenomena.
Statements that describe concepts or connect concepts are called assumptions.

Question 2

While the nurse realizes that the definition of health is unique to the client,the most universal factor is that health is:

Accepted Answer

Health has different meanings for each client,the clinical setting,and the health care profession (see Chapter 6).Health is dynamic and continuously changing.Your challenge is to provide the best possible care based on the client's level of health and health care needs at the time of care delivery.
While the other options may be true,they are not universally true to all individuals because not everyone is involved in a nurse-client relationship,wellness can be affected by internal factors,external factors,or a combination of both,and not everyone is capable of perceiving and defining their own wellness.

Question 3

The nurse is working within a health care system that employs Neuman's theory.A client is having difficulty breathing and requires oxygen and medication.Within Neuman's theory,the nurse approaches the client to:

Accepted Answer

Neuman's framework for practice included nursing actions as primary,secondary,or tertiary levels of prevention in caring for clients holistically.Secondary prevention strengthens internal defenses and resources by establishing priorities and treatment plans for identified symptoms.
In Henderson's theory,nurses help the client to perform 14 basic needs.
The goal of Orem's theory is to promote attainment of self-care.
Roy's theory focuses on adaptation.

Question 4

A community health nurse is working with a variety of clients and decides to use a systems theory approach to assist them to meet their health care needs.In using this approach,the nurse focuses on the:

Accepted Answer

According to systems theory,a system is made up of parts that rely on one another,are interrelated,share a common purpose,and together form a whole.A client's interaction with the environment is an example of an open system.The nurse understands factors that change the environment can also have an impact on the system.
Maslow's hierarchy of human needs is an interdisciplinary theory useful in planning individualized care.
Determining a client's attitudes toward health behaviors follows a health-and-wellness theoretical model.
Focusing on the response of a client to the process of growth and development is consistent with developmental theories.

Question 5

Swanson's theory of caring is best demonstrated when the nurse:

Accepted Answer

Swanson's theory of caring defines five components of caring: knowing,being with,doing for,enabling,and maintaining belief (see Chapter 8).These components provide a foundation of knowledge for the direction and delivery of caring nursing practice.This theory provides a basis for identifying and testing nurse caring behaviors to determine if caring improves client health outcomes.Offering to stay with the client is an intervention directly reflected of 'being with' the client.Efficiency is a component of caring but it is not the best option available because it is not exclusively directed toward Swanson's theory.Administering pain medication promptly reflects effective nursing care as well as a client's right.It is a component of caring but it is not the best option available because it is not exclusively directed towards Swanson's theory.Effective nursing care and caring for the family is important,but it is not the best option available because it is not directed towards the client.

Question 6

Which one of the four linkages of interest in the nursing paradigm refers to factors in the home or school?

Accepted Answer

Environment/situation includes all possible conditions affecting the client and the setting in which health care needs occur,such as the home,school,workplace,or community.
Person refers to the recipient of nursing care,including individual clients,families,and the community.
Health is the goal of nursing care.
Nursing care refers to the "diagnosis and treatment of human responses to actual or potential health problems" (ANA,1995).

Question 7

The nurse plans to apply a theory that focused on stress reduction.A theory proposed by which one of the following individuals should be selected?

Accepted Answer

Stress reduction is the goal of the systems model of nursing practice according to Neuman's theory.
Parse's theory focuses on indivisible beings and the environment co-creating health.
Peplau's theory focuses on the interpersonal process as the maturing force for personality.
Orlando's theory focuses on the interpersonal process to alleviate distress.

Question 8

While working on a postoperative unit,the nurse is applying the elements of the self-care theory.The nurse who assists the client to manage or attain self-care in wound management is using the theory developed by:

Accepted Answer

The goal of Orem's theory is to help the client perform self-care.
The goal of King's theory is to use communication to help the client reestablish positive adaptation to the environment.
The goal of Henderson's theory is to work independently with other health care workers assisting the client to gain independence as quickly as possible.
The goal of Nightingale's theory is to facilitate "the body's reparative processes" by manipulating the client's environment.

Question 9

Which of the following responses observed in a client recently diagnosed with lung cancer is most directly addressed by the Neuman System Model?

Accepted Answer

Examples of phenomena of nursing include caring,self-care,and client responses to stress.In the Neuman Systems Model (1995),phenomena include all client responses,environmental factors,and nursing actions.Crying is reflective of a client's response to stress to a second level need (Maslow's)and so is directly related to Neuman's model.
While consulting with clergy is reflective of a client need,it is higher on Maslow's hierarchy and so not the best option available.
While requesting family photos is reflective of a client need,it is higher on Maslow's hierarchy and so not the best option available.
The client stating that he/she will trust the health team is reflective of a client response,it is less reflective of a need and so not the best option available.

Question 10

Which of the following statements by the nurse best defines 'nursing diagnoses' for a client?

Accepted Answer

In medicine,physicians diagnose and treat disease.In contrast,nursing is the "… diagnosis and treatment of human responses to actual or potential health problems …" (ANA,2003).The scope of nursing is broad.For example,a nurse does not medically diagnose the client's heart condition but instead assesses the client's response to the disease and may develop nursing diagnoses of fatigue,change in body image,and altered coping.From these nursing diagnoses,the nurse creates an individualized plan of care for each of the client's health problems.
Although the other statements are correct,they are not the best options available because they do not fully explain the function of a nursing diagnosis.

Question 11

The best example of an appropriate nursing assumption is:

Accepted Answer

Assumptions are the "taken for granted" statements that explain the nature of the concepts,definitions,purpose,relationships,and structure of a theory (Meleis,2006;Chinn and Kramer,2004).It is a reasonable assumption that a client who recently underwent surgery would require and expect prompt administration of medications to manage that pain.
Not all clients will openly communicate their needs/wants to the staff so this option is not the best example offered.
While most clients will rest effectively in a quiet,darken environment,it is not required by all clients so this option is not the best example offered.
While many clients will want family present in this situation,not all will.Therefore this option is not the best example offered because an incorrect assumption would result in a violation of a client's right to privacy.

Question 12

The nurse is caring for a client newly diagnosed with type 2 diabetes mellitus.Which of the following nursing interventions best reflects Orem's nursing theory?

Accepted Answer

If a nurse uses Orem's theory in practice,the nurse assesses and interprets the data to determine the client's self-care needs,self-care deficits,and self-care abilities in the management of a disease.The theory then guides the design of individualized nursing interventions.
While the other interventions are appropriate and will ultimately affect effective client self-care/management of the diabetes,they are not the correct option because they are not directly involved in determining client self-care needs.

Question 13

Although there are similarities in the different nursing theories,there are key elements that distinguish one from another.The emphasis of Jean Watson's conceptual model is that:

Accepted Answer

Like Benner and Wrubel's theory,Watson emphasized caring in her theory.Watson's model is designed around the caring process,assisting clients in attaining or maintaining health or in dying peacefully.The key emphasis of her theory is that caring is the moral ideal: mind-body-soul engagement with another.
Self-care is central to Orem's theory.
The key emphasis of Roy's theory is that stimuli disrupt an adaptive system.
The key emphasis of Johnson's theory is that subsystems exist in dynamic stability.

Question 14

The nurse is working with a client diagnosed with multiple sclerosis.The goal is that the client will be capable of living independently.The nursing theory that best supports this client's situation is:

Accepted Answer

According to Orem,the goal of nursing is to increase the client's ability to independently meet biological,psychological,developmental,or social needs.
Neuman's theory is concerned with the whole person.According to Neuman,the focus of nursing is on the variables affecting the client's response to a stressor.
Abdellah's theory emphasizes the delivery of nursing care for the whole person.
According to Henderson,nurses help clients to perform 14 basic needs.

Question 15

A client diagnosed with type 2 diabetes mellitus reports poor glucose control since starting her new stressful job.The nurse uses Neuman's theory to focus on the:

Accepted Answer

The Neuman Systems Model uses a systems' approach to describe how clients deal with stressors in their internal or external environments.Nurses using Neuman's theory in practice focus their care on client responses to the stressors (Meleis,2006).For example,when a client takes on a new role within their employment,they may react to the stress by eating an improper diet.In this situation the nurse focuses on the client response to the stressors and designs interventions related to improving nutritional intake,both actions directed towards improving glucose control.
While acquiring good interpersonal communication skills may help minimize the stress the client is currently experiencing,it does not address identifying the source of the stress or the management of the type 2 diabetes.
While acquiring effective coping and relaxation skills may help manage the stress the client is currently experiencing,it does not address identifying the source of the stress or the management of the type 2 diabetes.
While implementing effective exercise routines may help in the management of the type 2 diabetes,it does not address identifying the source of the stress or the thorough management of the type 2 diabetes.

Question 16

Martha Rogers' theory has a framework for practice that includes the:

Accepted Answer

The framework for practice according to Martha Rogers' theory is the unitary human continuously changing and coexisting with the environment.
Nightingale's theory includes manipulation of the client's environment (i.e. ,appropriate noise,nutrition,hygiene,light,comfort,socialization,and hope)in the framework for practice.
Abdellah's nursing theory includes 21 nursing problems within 4 major client needs in the framework for practice.
Johnson's theory includes seven categories of behavior and behavioral balance in the framework for practice.

Question 17

A similarity between the theories of Leininger and of Benner and Wrubel is:

Accepted Answer

Leininger states that care is the essence of nursing and the dominant,distinctive,and unifying feature of nursing.Caring is also central to the theory of Benner and Wrubel,depicting personal concern as an inherent feature of nursing practice.
The theories of Roy and Johnson focused on the client's adaptation to demands.
Neuman's theory places emphasis on achieving a maximum level of wellness.Abdellah's theory also addressed the person as a whole.
King's theory and Peplau's theory share a similarity with a focus on interpersonal communication.

Question 18

The nurse realizes that which of the following stated client needs has the highest priority?

Accepted Answer

The second level of Maslow's hierarchy includes safety and security needs,which involve physical and psychological security.The client's concern about securing the medication needed to minimize the potential for breathing problems has the highest priority of the options available.
The fourth level encompasses esteem and self-esteem needs,which involve self-confidence,usefulness,achievement,and self-worth.Although important,a client's concern regarding her appearance would not have priority over the other options available.
The third level contains love and belonging needs,including friendship,social relationships,and sexual love.Although important,a client's reaction to the loss of a loved one does not have priority over the other options available.
The second level of Maslow's hierarchy includes safety and security needs,which involve physical and psychological security.While the client's concern for the safety of his belongs is on the same level,it does not take priority over the client whose concern relates to potential breathing problems.

Question 19

An example of a nursing activity directed towards providing input to the nursing process is:

Accepted Answer

Input for the nursing process is the data or information that comes from a client's assessment (i.e. ,how the client interacts with the environment and the client's physiological function).
This is an example of the nursing process content: the information about the nursing care for clients with specific health care problems.
Feedback serves to inform a system about how it functions: how the client responds to the intervention.
Output is the end product of a system and in the case of the nursing process it is whether the client's health status improves or remains stable as a result of nursing care.

Question 20

There are different types of theories that may be used by nurses seeking to study the basis of nursing practice.When the goal of a theory is to speculate on why phenomena occur,it is termed a:

Accepted Answer

Descriptive theories describe phenomena,speculate on why phenomena occur,and describe the consequences of phenomena.
Grand theories provide the structural framework for broad,abstract ideas about nursing.
Prescriptive theories address nursing interventions and predict the consequence of a specific nursing intervention.
Middle range theories address specific phenomena or concepts and reflect practice.

Quiz 4: Theoretical Foundations of Nursing Practice