Question 1

The nurse is practicing self-reflection when caring for a patient with a severe mental illness. How will the nurse measure the effect of self-reflection?

Accepted Answer

4. The nurse may measure the effect of self-reflection by changes in the nurse's own thoughts and behaviors. Self-disclosure is a strategy to decrease the hidden area of self, but is not self-reflection. Self-reflection is the nurse's opportunity to examine his or her own actions and motivations and feelings. Evaluation of the nurse's self-reflection is not dependent on the patient's ability to use self-disclosure or changes in the patient's thoughts and behaviors.

Question 2

The novice nurse is learning how to use self as a therapeutic tool in nursing. When caring for a patient with mental illness, what is the best way the nurse can examine how the use of self assists in providing therapeutic care to individuals with mental illness?

Accepted Answer

3. By learning about human behavior, the nursing student will examine how the use of self assists nurses in providing therapeutic care to individuals with mental illness. Learning the neurobiology of mental illness and providing empathy are also important in the provision of nursing care; however, these tools do not directly influence the use self as a therapeutic tool. Providing sympathy is not as therapeutic as providing empathy to the patient. This is also not a way the nursing student can use self as a therapeutic tool.

Question 3

The novice nurse is learning about Maslow's hierarchy of needs and its relationship to the theories of human development and the concept of self. What concepts are true regarding self-actualization? Select all that apply.

Accepted Answer

1. Abraham Maslow developed the idea that the individual would not seek need fulfillment at the highest level-self-actualization-if basic human needs such as food, water, and shelter were not met. According to Maslow, this multi-dimensional level involves a comfort with one's own self and with one's life meaning.
3. Abraham Maslow developed the idea that the individual would not seek need fulfillment at the highest level-self-actualization-if basic human needs such as food, water, and shelter were not met. According to Maslow, this multi-dimensional level involves a comfort with one's own self and with one's life meaning.
4. Abraham Maslow developed the idea that the individual would not seek need fulfillment at the highest level-self-actualization-if basic human needs such as food, water, and shelter were not met. According to Maslow, this multi-dimensional level involves a comfort with one's own self and with one's life meaning.
5. Abraham Maslow developed the idea that the individual would not seek need fulfillment at the highest level-self-actualization-if basic human needs such as food, water, and shelter were not met. According to Maslow, this multi-dimensional level involves a comfort with one's own self and with one's life meaning.

Question 4

The novice nurse is learning how different nursing theorists developed philosophies on the concept of self. Which theorist will the nurse be emulating when the nurse reflects on the revolving self and evaluating the suffering of a patient with mental illness?

Accepted Answer

2. Martha Rogers stated that the student of psychiatric nursing will reflect on an endlessly evolving self. This evolution will occur while the nurse is participating in a therapeutic interpersonal relationship with the patient who lives with a psychiatric illness. The student will evaluate the patient's suffering, as it is both witnessed and reflected upon. Hildegard Peplau introduced the idea of the concept of self as a "tool" as important to the nurse as a stethoscope. Ida Jean Orlando stated that the nurse uses self as a reaction of perceptions, thoughts, and feelings in response to the patient's behavior. Patricia Benner also discussed nurse's using self as a tool to care for patients with mental illness.

Question 5

The novice nurse working in psychiatric-mental health unit wishes to build on the skills of utilizing the authentic self while caring for patients with mental illness. Which is the most likely initial emotion from the nurse that may be associated with the nurse's use of authenticity?

Accepted Answer

2. As each self is personal and unique, being authentic is necessarily unconventional and anxiety inducing. This use of authenticity does not usually initially cause sadness, confusion, or confidence.

Question 6

The psychiatric-mental health nurse is caring for a patient with mental illness. What action by the nurse best exemplifies authenticity?

Accepted Answer

2. The nurse's authenticity is reflected in how the nurse directs energy toward getting to know the patient as the patient is, in the patient's world. Thus, the best example of authenticity is showing empathy towards the patient. Empathy is the ability to feel for others, whereas sympathy is feeling pity toward others. Sitting quietly with the patient is displaying the therapeutic communication technique of silence. Sharing personal information with the patient is not therapeutic and does not exemplify authenticity.

Question 7

The nurse is applying nursing theory to enhance therapeutic relationships with patients with mental illness through the use of self as a tool. Which theorist does the nurse recognize as having introduced this concept?

Accepted Answer

3. Hildegard Peplau introduced the idea of the concept of self as a "tool" as important to the nurse as a stethoscope. Peplau described the concept of self as standardized and able to be continually evaluated and refined to ensure that is the optimal design for its purpose. Patricia Benner also described the concept of self as a tool; however, Peplau, not Benner, introduced the concept. Ida Jean Orlando stated that the nurse use self as a reaction of perceptions, thoughts, and feelings in response to the patient's behavior. Florence Nightingale described the concept of self as necessary for all nurses, and emphasized the concept of "whole self."

Question 8

The nurse is caring for a 32-year-old woman who is a professional dancer. The patient recently lost a limb in a motor vehicle accident. When planning care for this patient, which factor will the nurse focus on?

Accepted Answer

2. Because the patient is a professional dancer, the loss of a limb also means the loss of her profession. Losing both her leg and her profession will likely alter the patient's self-concept. While they can inform the nurse's work with patients, the nurse's self-concept and self-perception are not the focus of care for this patient. Information about the patient's support system may prove helpful in planning care, but it is not the focus of care for this patient.

Question 9

The nurse is caring for patient who has major depressive disorder who has recently been terminated from his job. The patient tells the nurse, "I just don't know what to do. I identified myself through my work. I don't know who I am anymore." Which psychological theorist best describes the patient's current identification of self?

Accepted Answer

2. William James established the framework for modern psychology and psychiatry that attends to the person as both one who experiences and is aware of the process of experiencing. It is this concept that explains how a loss of a job may lead to a sense of loss of self. The other theorists listed did not develop the concept linking loss of self to certain meaningful losses such as the loss of a job or moving from a well-loved community.

Question 10

The nurse is performing an admission assessment on a patient presenting with mental health issues. Which question would the nurse ask to best assess the patient's perception of self?

Accepted Answer

3. To assess a patient's perception of self, the nurse will ask the patient how he or she describes him or herself. Asking this question allows patients to elaborate on their identification of self. Asking patients how they think they look, what activities make them happy, and how others would describe them will not elicit information about patients' perceptions of themselves.

Question 11

The psychiatric-mental health nurse is using self-reflection in the therapeutic nurse-patient relationship. Which best describes the rationale? Select all that apply.

Accepted Answer

1. The practice of self-reflection provides an opportunity for nurses to examine their own actions and motivations and feelings. It helps nurses make sense of their actions within the context of their relationships with patients and develop creativity in nursing practice. Self-reflection does not provide an opportunity for the nurse to assess the patient; rather, the nurse is assessing his or her own thoughts, feelings, and perceptions during the process of self-reflection. Autonomy is the right to self-determination, not self-reflection.
3. The practice of self-reflection provides an opportunity for nurses to examine their own actions and motivations and feelings. It helps nurses make sense of their actions within the context of their relationships with patients and develop creativity in nursing practice. Self-reflection does not provide an opportunity for the nurse to assess the patient; rather, the nurse is assessing his or her own thoughts, feelings, and perceptions during the process of self-reflection. Autonomy is the right to self-determination, not self-reflection.
4. The practice of self-reflection provides an opportunity for nurses to examine their own actions and motivations and feelings. It helps nurses make sense of their actions within the context of their relationships with patients and develop creativity in nursing practice. Self-reflection does not provide an opportunity for the nurse to assess the patient; rather, the nurse is assessing his or her own thoughts, feelings, and perceptions during the process of self-reflection. Autonomy is the right to self-determination, not self-reflection.

Question 12

The novice nurse is learning about the various theories of psychological development and the relationship to Maslow's hierarchy of needs. The nurse realizes that which situation may create a barrier to the use of developmental theories when working with a patient?

Accepted Answer

2. The patient who has been kicked out of his apartment for failing to pay rent is unable to meet basic needs, the lowest level of Maslow's hierarchy. The various theories of psychological development are dependent on the individual achieving basic needs. Patients whose basic needs for shelter and food are not met will likely be unable to work toward mastery in other areas, such as establishing new friendships. The patient who is getting married is achieving needs on the level of love and belonging, and may be able to work with the nurse in other areas. Unconsciously incorporating the ideas of others is not necessarily a barrier to working with the nurse.

Question 13

The novice nurse is learning about the various theories of psychological development and the understanding of self. Which are purposes of Harry Stack Sullivan's self-system that the nurse will learn? Select all that apply.

Accepted Answer

1. Twentieth-century psychiatrist Harry Stack Sullivan built on the work of James and Freud with his emphasis on the impact of the interpersonal experience on the intrapsychic development. He described a "self-system" consisting of the self-images reflected from interactions with one's environment, the "good me," the "bad me," and the "not me." Sullivan stated that this self-system served three purposes: connection, self-definition, and protection. Communication and self-esteem are not purposes of Sullivan's self-system.
2. Twentieth-century psychiatrist Harry Stack Sullivan built on the work of James and Freud with his emphasis on the impact of the interpersonal experience on the intrapsychic development. He described a "self-system" consisting of the self-images reflected from interactions with one's environment, the "good me," the "bad me," and the "not me." Sullivan stated that this self-system served three purposes: connection, self-definition, and protection. Communication and self-esteem are not purposes of Sullivan's self-system.
4. Twentieth-century psychiatrist Harry Stack Sullivan built on the work of James and Freud with his emphasis on the impact of the interpersonal experience on the intrapsychic development. He described a "self-system" consisting of the self-images reflected from interactions with one's environment, the "good me," the "bad me," and the "not me." Sullivan stated that this self-system served three purposes: connection, self-definition, and protection. Communication and self-esteem are not purposes of Sullivan's self-system.

Question 14

The novice nurse is learning about the contributions of philosophy to understanding the concept of self. When learning about Patricia Benner's theory of the concept of self, what will the nurse recognize as the definition of a novice nurse?

Accepted Answer

1. According to Patricia's Benner's theory of the concept of self, any nurse who is unfamiliar with both the patients and the tools required to provide patient care will be considered a novice and will remain so until those conditions change. Benner refers to the concept of self as a tool that the nurse must learn to use in order to gain more experience. While the other answer choices may indicate a nurse who lacks experience, these are not the definition of novice nurse according to Benner.

Question 15

Which therapeutic approach by the nurse involves the use of personal awareness in order to carry out the steps of the nursing process?

Accepted Answer

1. The nurse's use of self occurs when the nurse uses his or her personality in full awareness when providing patient care. It is this use of self as a therapeutic tool that allows the nurse to constantly be aware of his or her personal influences and to objectively assess and provide care for the patient. While therapeutic communication, empathy, and open-ended questions are appropriate interventions, these do not describe the nurse's ability to use his or her personality in full awareness in order to plan and implement appropriate nursing interventions.

Question 16

Which characteristics or experiences indicate the nurse is in the third stage of the process of reflection?

Accepted Answer

4. The process of self-reflection occurs in three stages. The third stage is characterized by the development of a new perspective, with a commitment to change if necessary. In the first stage, the nurse struggles between comfort and discomfort while focusing on thoughts, behaviors, and feelings. The second stage, critical analysis of the situation, involves exploring new alternatives and determining strengths and areas for improvement.

Question 17

The nurse is planning care for a patient admitted for depression. The patient has severe cerebral palsy, communicates only with a computer, and is quadriplegic. Which statement best demonstrates that the nurse has engaged in self-reflection prior to caring for this patient?

Accepted Answer

3. The nurse must be aware of his or her feelings when caring for this patient. The nurse recognizes that before meeting any patient, it is important to recognize one's feelings and clarify beliefs and attitudes, especially when receiving medical information that might be unusual or even frightening. Assessing the patient's needs and abilities and interviewing the family may be helpful in caring for this patient, but these actions will not necessarily enhance the nurse's self-awareness. Reading the record and talking with the health care provider suggests that the nurse has difficulty confronting feelings and will rely on others for guidance.

Question 18

Which statement best demonstrates that the novice nurse has engaged in the process of self-reflection while preparing to fulfill the professional role of a nurse working on an inpatient psychiatric unit?

Accepted Answer

1. Asking for support indicates that the nurse recognizes the challenges of working on an inpatient psychiatric unit, has engaged in self-reflection, and realizes the value of sharing perceptions, feelings, and concerns with professional colleagues in order to fulfill professional responsibilities. Believing that there is a fine line between the patients and staff reveals the nurse has difficulty separating his or her own identity from the patient's. Engaging in a course in self-defense or therapeutic interventions does not support the idea of self-reflection.

Question 19

The nurse receives the shift report on a newly admitted patient with a history of behavior that the nurse feels is inappropriate. Which action best demonstrates the nurse's ability to enhance self-knowledge regarding this patient?

Accepted Answer

4. Examining one's own feelings regarding a patient who engages in behaviors that are outside the nurse's behavior norms promotes self-awareness and allows the nurse to respond with compassion and maintain empathy when meeting the patient for the first time. Self-reflection allows the nurse to form a therapeutic nurse-patient relationship, even when the nurse does not agree with the patient's past behavior. Asking for guidance or reviewing the literature before examining one's feelings indicates that the nurse is unaware or uncomfortable with feelings and relies on others for guidance. Ignoring how one's own views might be challenged by a patient situation indicates the nurse is not able to confront how the diversity of patient behaviors or experiences. This will impact the quality and nature of the nurse's relationships with others.

Question 20

The nurse who uses his or her whole self to achieve the moral ideal when caring for the patient with mental illness is providing care most closely associated with which nursing theorist?

Accepted Answer

4. Florence Nightingale believed that the nurse achieves "the moral ideal" when using
"the whole self " to establish a caring relationship with the patient. While the other answer choices were nurse theorists, these individuals did not emphasize "the moral ideal" as Nightingale did.

Quiz 7: Self-Reflection and Self-Awareness