Test bank for contemporary nursing issues trends and management 5th edition by cherry

Dorothea Orem’s self-care deficit model facilitates client self-care by measuring the client’s deficit relative to self-care needs.. Peplau’s interpersonal relations model explores the i

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Chapter 05: Theories of Nursing Practice

MULTIPLE CHOICE

1 Which nursing theory might a nurse use as a conceptual framework to determine how to meet the needs of immigrants while ensuring provision of high-quality and culturally sensitive care?

a Martha Rogers’ nursing theory

b Dorothea Orem’s nursing theory

c Hildegard Peplau’s nursing theory

d Madeleine Leininger’s nursing theory

Madeleine Leininger proposed the theory of cultural care diversity and universality This theory of transcultural nursing comprises concepts

involving caring and the components of a cultural care theory: diversity, universality, worldview, and ethnohistory

Martha Rogers’ theory is based on the nurse’s promoting synchronicity between human beings and the universe/environment

Dorothea Orem’s self-care deficit model facilitates client self-care by

measuring the client’s deficit relative to self-care needs

Hildegard Peplau’s theory identifies feelings of the client as a predictor of positive outcomes related to health and wellness

DIF: Application REF: Page 95

2 When reading Peplau’s theory, a nurse was unable to determine the

relationships among concepts The nurse listed each concept and drew lines denoting relationships to be able to understand the effect of each element The nurse created a(n):

a hypothesis

b model

c construct

d variable

A model is a group of concepts that are associated because of their relevance

to a common theme

A hypothesis asks the question that is to be the main focus of a theory

A construct is similar to a concept; it is an idea or an object that can be

“built” together with others into a theory

A variable is an object, event, or person that has an effect on a theory; a variable is usually manipulated or measured

DIF: Application REF: Page 90

3 The statement, “Nursing is a caring profession that focuses on assisting people to be as healthy as possible,” is an example of a:

a concept

b construct

c philosophy

d model

A philosophy is the values and beliefs of the discipline

A concept consists of labels given to ideas, objects, and events; it is a

summary of thoughts or a way to categorize thoughts or ideas

A construct is a building part that combines with others to make up a theory

A model is a group of concepts that are associated because of their relevance

to a common theme

DIF: Comprehension REF: Page 90

4 Einstein’s theory of relativity laid the groundwork for theories of

mathematics, and Freud and Jung provided the basis for the philosophy of man Which nursing theory served as the foundation for nursing science?

a Rogers’s science of unitary human beings

b Nightingale’s theory of practice

c Watson’s theory of human caring

d King’s theory of goal attainment

Florence Nightingale investigated the effect of the environment on healing, and this serves as the foundation for nursing science

Rogers in 1970 proposed the science of unitary human beings

Watson’s theory of human caring is a holistic outlook, proposed in 1978, that addresses the effect and importance of altruism, sensitivity, trust, and interpersonal skills

King’s theory of goal attainment, proposed in 1971, addresses client systems and includes society, groups, and the individual

DIF: Comprehension REF: Page 92

5 A community health nurse has been visiting a postpartum client who

suffered domestic violence throughout the pregnancy, and now the infant may be at risk The nurse assisted the client in finding shelter and legal

protection The nurse’s role and the conceptual framework involved are:

a change agent according to Roy’s adaptation model

b translator according to Leininger’s theory of cultural care diversity and universality

c case manager according to Peplau’s interpersonal relations model

d caregiver according to Rogers’ science of unitary human beings

In Roy’s adaptation model, when the client incurs an insult that renders him

or her in need of environmental modification, the nurse will be the change agent in assisting the individual with this adaptation

The role of translator is not needed, and Leininger’s theory of cultural care diversity and universality focuses on diversity, universality, worldview, and ethnohistory, none of which is needed in this situation

Peplau’s interpersonal relations model explores the interpersonal

relationship between the nurse and the client and identifies the client’s

feelings as a predictor of positive outcomes related to health and wellness This theory is not as pertinent in this acute situation

Rogers’s science of unitary human beings theory is one in which the nurse promotes synchronicity between human beings and their environment; it is not appropriate to this acute situation

DIF: Application REF: Page 95

6 What are general explanations that scholars use to explain, predict, control, and understand commonly occurring events?

a Theories

b Constructs

c Systems

d Propositions

Theories are a group of related concepts that explain existing phenomena and predict events Theories provide us with a frame of reference, the ability

to choose concepts to study, or ideas that are within one’s practice

Constructs are the events, ideas, or objects that make up a theory

A system is an orderly collection of logically related principles, facts, or objects

Propositions are statements that propose the relationships between and

among concepts

DIF: Comprehension REF: Page 89

7 Which type of theory most often guides present nursing practice?

a Grand theory

b Middle range theory

c Developmental theory

d Values theory

Middle range theory is a nursing theory that refers to a specific population or

to a specific situation, thereby making the theory easy to understand An example of middle range theory is the theory of unpleasant symptoms (Lenz and Pugh), which examines symptoms that are influenced by physiologic, psychologic, and situational factors as they relate to performance

Grand theory is broad in scope and may describe and explain large segments

of human experience

Developmental theory is not a standard term applied to nursing theory

Values theory is not a standard term applied to nursing theory

DIF: Knowledge REF: Page 91

8 A client is hypertensive, and the doctor prescribes weight reduction The client is excited about beginning the diet, but on arriving home the spouse states, “You have always been fat and I am not going to starve because you can’t control yourself.” The client becomes anxious and is unable to

participate in the diet plan, resulting in a weight gain of 5 pounds in 2 weeks

Which theorist could best be referred to for guidance regarding interventions

in this situation?

a Martha E Rogers

b Hildegard E Peplau

c Florence Nightingale

d Myra Estrin Levine

Hildegard Peplau’s theory describes interpersonal relations as a nursing process Nursing intervention in Peplau’s model focuses on reducing related incapacitating stressors through therapeutic interpersonal interaction

Martha Rogers’ theory is based on humans as energy fields that interact constantly with the environment

Florence Nightingale’s theory of practice is based on environmental

adaptation

Myra Levine proposed the conservation model, which comprises four

conservation principles of inpatient resources: energy, structural integrity, personal integrity, and social integrity

DIF: Application REF: Page 96

9 A nurse believes that humans use creativity and critical thinking to balance their connections with their surroundings The nurse decides to conduct a

study on the basis of this belief Which nursing theory would be best for this

study?

a Peplau’s interpersonal relations as a nursing process: man as an

organism that exists in an unstable equilibrium

b Roy’s adaptation model: assistance with the adaptation to stressors to facilitate the integration process of the client

c Orem’s self-care deficit model: self-care, self-care deficits, and nursing systems

d Rogers’ science of unitary human beings: humans as energy fields that interact constantly with the environment

Rogers’ science of unitary human beings: humans as energy fields that

interact constantly with the environment is a theory in which the nurse

promotes synchronicity between human beings and their

universe/environment

Peplau’s theory explores the interpersonal relationship between the nurse and the client and identifies the client’s feelings as a predictor of positive outcomes related to health and wellness

Roy’s adaptation model identifies the client’s adaptation to conditions by using environmental stimuli to adjust perception

In Orem’s self-care deficit model, the nurse facilitates client self-care by measuring the client’s deficit relative to self-care needs

DIF: Application REF: Page 97

10 A client involved in a motor vehicle accident is blinded The nurse assists the client to obtain a guide dog so the client may continue grocery shopping and visiting friends and family This enables the client to cope with the handicap and perform activities of daily living Which nursing theory can be applied to this scenario?

a Watson’s philosophy and science of caring and humanistic nursing

b Mishel’s uncertainty of illness

c Orem’s self-care deficit

d Rogers’ science of unitary human beings

In Orem’s self-care deficit the nurse implements measures to assist clients in meeting self-care needs by matching them with an appropriate supportive intervention

Watson’s model of human caring identifies 10 “carative” factors that are core to nursing This holistic outlook addresses the impact and importance of altruism, sensitivity, trust, and interpersonal skills

Mishel’s uncertainty of illness identifies that negative perceptions due to the perceived illness will escalate and clients will suffer The nurse’s

responsibility is to reframe the client’s perceived loss of control and assist the client in developing new skills of assimilation and accommodation Rogers’ science of unitary human beings is one in which the nurse promotes synchronicity between human beings and their universe/environment

DIF: Application REF: Page 97

11 A young child is having abdominal pain, and the doctor informs the parents that a computed tomography (CT or CAT) scan of the abdomen will be ordered The doctor tells the child, “This CAT scan won’t hurt you.” The child is visibly upset because of a fear of cats According to Mishel’s

uncertainty in illness theory, which stage of the framework is represented?

a Stimuli frame

b Appraisal stage

c Initiation of coping mechanisms

d Adaptation

In the stimuli frame the client reacts to some stimulus in a negative manner The nurse at this stage should listen carefully and then initiate, seek, and clarify concerns and questions

The appraisal stage is when the client applies a negative value to

environmental conditions

In the initiation of coping mechanisms stage, the individual uses coping skills to deal with negative environmental stimuli

Adaptation occurs as the nurse intervenes in the previous stage, and ideally, fear decreases

DIF: Application REF: Page 99

12 A nurse researcher determines that findings are substantial by calculating the level of significance Which aspect of the scientific inquiry is being

conducted?

a Hypothesis

b Method

c Data collection

d Evaluation

ANS: D

During evaluation, results are examined with the goal of determining the relevance of outcome data in answering the hypothesis; also the significance

of the data and the potential for future research are explored

The hypothesis asks the question that is to be the main focus

The method decides what data will be collected to answer the question Data collection is a step-by-step procedure that is undertaken with the goal

of answering the question

DIF: Application REF: Page 88

13 A nurse who has practiced on an orthopedic unit for 10 years unexpectedly becomes pregnant At delivery the physician informs the mother, “Your baby has Alport syndrome, but then I don’t have to explain what that means with your medical background.” The mother is unsure and withdraws as a coping mechanism Which nursing theory would provide a framework to guide nursing care for this mother?

a Mishel’s uncertainty of illness

b Orem’s self-care deficit model

c Nightingale’s canons of nursing

d Levine’s conservation model

In Mishel’s uncertainty of illness theory, the core position is that uncertainty

in illness must be addressed If left unheeded, negative perceptions will escalate and clients will suffer Nursing responsibility based on this theory consists of reframing the client’s perceived loss of control, or uncertainty, and assisting the client in developing new skills of assimilation and

accommodation

In Orem’s self-care deficit model, nursing facilitates client self-care by

measuring the client’s deficit relative to self-care needs

Nightingale’s canons of nursing is an environmental adaptation theory Levine’s conservation model identifies four conservation principles of client resources (energy, structural integrity, personal integrity, and social

integrity)

DIF: Analysis REF: Page 99

14 If a nurse applies Nightingale’s theory to current practice, the nurse’s first

step will be to evaluate the hospital room’s air quality and secondly to:

a make certain that the volume of the television is not too loud

b consult the dietitian to check that essential nutrients are added to meet requirements noted on MyPyramid

c request the client’s family to bring family photographs and

bright-colored throws for the bed

d arrange for the client to go outside weather permitting while keeping the room’s window blinds open

Nightingale believed that light was second only to the need for fresh air Although she believed noise should be controlled it was not the second most important

Nightingale did believe food should do the work of the patient’s ailing

digestive system but it was not second

Nightingale did believe in variety, which included pets and beautiful objects DIF: Application REF: Pages 93-94

15 A nurse develops a new nursing theory related to stress and viability The nurse determines the theory accounts for historical events in which soldiers suffering from the stress of inadequate clothing to protect the cold and lack

of correspondence from home had an increased mortality related to gunshot wounds The theory will predict gunshot victims’ need for proper clothing and letters from significant others as they serve in Iraq Which criterion for theory acceptance is being validated?

a Inclusiveness

b Consistency

c Accuracy

d Simplicity

Accuracy of theory acceptance examines the theory’s ability to explain past occurrences while being applicable for use in determining future outcomes Inclusiveness is evaluation that all concepts related to this field are included

Consistency is the criteria that evaluate the theory’s ability to deal with new entities without altering its original assumptions

The process is not being examined

DIF: Application REF: Page 89

MULTIPLE RESPONSE

1 Which concepts relate to nursing theory? (Select all that apply.)

a Environment

b Health

c Nursing

d Relevance

e Comfort

ANS: A, B, C, E

“Environment” is a concept, which is a label given to ideas, objects, or

events; concepts become the “pieces” that make up a conceptual model or theory

“Health” is a concept, which is a label given to ideas, objects, or events; concepts become the “pieces” that make up a conceptual model or theory

“Nursing” is a concept, which is a label given to ideas, objects, or events; concepts become the “pieces” that make up a conceptual model or theory

“Comfort” is a concept, which is a label given to ideas, objects, or events; concepts become the “pieces” that make up a conceptual model or theory Relevance refers to one criterion for theory acceptance and how well the theory relates to the scientific foundation from which it was derived

DIF: Comprehension REF: Pages 89-90

COMPLETION

1 The basic ingredients of theory are

ANS:

concepts

A theory is defined as a group of related concepts that explain existing

phenomena and predict future events