Question 1

A nurse in the oncology clinic uses Aguilera's theory of coping to work with patients.After assessing the patient's usual coping strategies and the patient's perception of the event, what action should the nurse take next?

Accepted Answer

Aguilera identifies three balancing factors (the perception of the event, the availability of situational supports, and usual coping mechanisms)that prevent an adverse reaction to a stressful situation.The nurse should assess for all three.Developmental crises are more appropriate to theorists such as Erickson or Duvall.Change theory is the work of Lewin, among others.Perceived threat is part of Lazarus's theory of coping.

Question 2

A nurse working in a rehabilitation unit wishes to use nursing theory to guide a personal concept of practice but has become frustrated when the chosen theory does not seem to be helpful.The nurse consults an expert on theory.What statement by the theory expert would best help the nurse choose a theory from which to work?

Accepted Answer

Types of patients, setting, and practice should influence the theory chosen to guide practice.A specific setting is best served by a theory with specificity in its components.A global theory would be better suited for research and knowledge generation.Not all theories fit all circumstances, and in fact, many of the theories in this chapter are too broad to be used in their entirety.It is valid to suggest a theory that has clear explanations of all four key concepts; however, it does not go far enough in giving the nurse direction in choosing a theory.Nursing theory can guide practice in any setting; the key is finding a theory that fits.

Question 3

A word or phrase used to convey the main thoughts in ideas, observations, and experiences is called a:

Accepted Answer

According to Fawcett (2005), a concept is "a word or phrase that summarizes ideas, observations, and experiences" .The concept is the basic building block of a theory.A construct is a working hypothesis or idea that is part of a bigger whole.A proposition is another name for theoretical statements.A theory is a statement or group of statements that describe, explain, or predict relationships among concepts.

Question 4

A nursing educator summarizes the role of nursing theory across the domains of nursing practice, education, and research by pointing out that in all three areas, theory:

Accepted Answer

Across all three domains of nursing (education, practice, and research), theory remains a tool that serves to make meaningful connections among various bits of information collected.Theories and frameworks provide direction and guidance for structuring professional nursing practice, education, and research.This meaning then guides nursing action.Theory can guide data collection and implementation of nursing activities, but all situations need to be seen in their holistic and individualized entireties.Theory should drive nursing actions, just as nursing action should inform theory.Theories are not meant to be rigid and unyielding; in fact, theories help explain variations in patient situations, guide holistic nursing education, and can help formulate questions for research.

Question 5

A nurse subscribing to Neuman's system model would explain to a patient that illness is caused by:

Accepted Answer

In Neuman's model, the patient is seen as an open system exchanging energy with the environment; disharmony between the two leads to illness.The idea of disorganization and dysfunction leading to imbalances in the system is a key concept of Johnson's behavioral systems model.For King, health is the ability to function within social roles; conversely, illness is the lack of this ability.Structural disturbances interrupt a person's ability for self-care agency, or the ability to perform self-care in Orem's self-care deficit theory.

Question 6

A nursing unit subscribes to Orem's theory as an overarching conceptual framework for nursing care.A nurse on that unit would most likely include which intervention in a patient's plan of care?

Accepted Answer

In Orem's self-care deficit theory, nurses assist patients with self-care activities while helping them move toward self-care agency, which is the ability to meet one's own self-care needs.Addressing questions and concerns to the eldest male relative present might be a topic addressed in Leininger's cultural care theory.Nightingale was most concerned with manipulating certain environmental features, including nutritious food, to promote health via the restorative processes.For Rosemarie Parse, illness is a lived experience, and nursing action is directed toward mobilizing family interrelationships.

Question 7

Using Maslow's hierarchy of needs, which patient should the nurse assess first?

Accepted Answer

Maslow's hierarchy of needs prioritizes physiological and safety needs over emotional and self-fulfillment needs. Disorientation and agitation (C) could indicate a physiological imbalance or a safety concern, making it the highest priority to assess.

Question 8

The nurse using Watson's theory to guide practice would put highest priority on:

Accepted Answer

Jean Watson's theory of caring sees caring as a moral value instead of a task.The goal of nursing is to develop a caring relationship that the patient can use for growth, personal development, and healing.Self-actualization is part of Maslow's hierarchy of needs.Several theorists look at the role of stress, especially as a disrupting influence on harmony or system balance.This would be most consistent with Leininger's theory.

Question 9

The nursing instructor summarizes Imogene King's view of health as:

Accepted Answer

For King, health is the ability to function in social roles.Rogers' science of unitary beings is concerned with harmonious interactions between humans and their environment.Stability within the human system is a concept in Betty Neuman's systems model.None of the nursing theorists studied view health as the absence of illness or disability.

Question 10

A nurse whose practice is most strongly guided by Nightingale's theory would likely incorporate which intervention into the patient's plan of care?

Accepted Answer

For Nightingale, the goal of nursing was to manipulate the environment in order to promote the reparative process.The key environmental elements to be manipulated include fresh air, pure water, warmth, cleanliness, an appropriate diet, and quiet.A good nurse never allowed the patient to be awakened from sleep.Helping with ADLs would be more appropriate for Orem's self-care deficit theory.Encouraging independence would be appropriate for Virginia Henderson's complementary supplemental model, in which the goal of nursing is to assist the patient to become as independent as possible.Installation of faith-hope is a carative factor found in Jean Watson's theory of caring.

Question 11

A nurse explains to a patient's family that the role of nursing is to help the patient with self-care when the patient is unable to do so.The nurse is using the theory of:

Accepted Answer

Orem's theory states that the individual practices self-care, a set of learned behaviors, to sustain life, maintain or restore functioning, and bring about a condition of well-being.The nurse assists the client with self-care when he or she experiences a deficit in the ability to perform.Peplau's theory revolves around interpersonal processes.Imogene King's theory states that the goal of nursing is to aid the patient in returning to health, so he or she can resume previous roles.Jean Watson's theory is concerned with caring and specific behaviors that exemplify caring.

Question 12

A nursing manager is explaining to the staff how nursing theory is related to all components of nursing practice.What statement by the manager best outlines this concept?

Accepted Answer

According to Figure 5-1, theory, research, education, and knowledge exist in a circular relationship, with each component influencing and informing the others.Concepts are the basic building blocks of theory.Education exists in a relationship with theory, practice, research, and knowledge but is not at the core of this relationship.Nursing knowledge is also derived from practice and experience.

Question 13

A student studying nursing theory recognizes that unique concepts in Martha Rogers' science of unitary human beings include:

Accepted Answer

For Rogers, homeodynamics are principles speculating about the nature and direction of unitary human development.Carative factors are part of Jean Watson's theory of caring.The cognator subsystem is a component of Roy's adaptation model.Open systems are part of several nursing theories.

Question 14

The nursing instructor explains that a theory, at its simplest, aims to do what?

Accepted Answer

Nursing theories aim to describe, explain, or predict relationships among the four main concepts of nursing: person, environment, health/illness, and nursing.They are not all broad theories; some are quite specific and limited to particular situations.Not all theories aim to generate knowledge.Theories cannot predict what all people will do in a certain situation.

Question 15

A nurse works in the intensive care unit (ICU)and is looking for an explanation of how patients and families experience weaning from ventilators.This nurse would find the most useful information by searching for an appropriate:

Accepted Answer

A situation-specific or practice-level theory seeks to explain and predict relationships among the core concepts for a specific patient population or nursing practice.In this case, ICU nursing and ventilated patients present situations best addressed by situation-specific theory.These are sometimes called practice-level theories.A grand theory or framework is an overarching theory that explains the goals, purpose, and broad nature of nursing.A midrange theory considers specific phenomena across nursing practice settings and nursing specialties."Corollary theory" is not a type of theory.

Question 16

A nurse whose practice is guided by Peplau's theory would judge that care objectives had been met when the patient:

Accepted Answer

Peplau's theory views nursing as an interactive process in which two or more individuals have common goals toward which they work.Mastering self-care tasks would be more demonstrative of Orem's self-care deficit theory.The ability to find alternate ways of doing ADLs might be applicable for Roy's adaptation model.Understanding that stress is related to illness is not specific to any theory.

Question 17

A patient is angry and frustrated and is complaining bitterly to the nurse about these feelings.The nurse sits quietly and listens attentively, nodding occasionally.What Watson caritas process is the nurse using?

Accepted Answer

Promoting and accepting positive and negative feelings as you listen to another's story is being demonstrated by this nurse.The other options are other caritas processes, but allowing the patient to reveal his or her narrative while not shutting down the negative feelings is the prime activity.

Question 18

A nurse volunteers time in a homeless shelter and wants to set up a free vaccination clinic in the shelter.Although the shelter's managers think that vaccinations are a good idea, they are skeptical that clients will take the time to visit the nurse.What modification to the proposal would generate better success according to Maslow?

Accepted Answer

According to Maslow's hierarchy of needs, there are five broad layers of need, starting with basic human physiological needs such as food and water.According to this theory, these basic needs must be met first.After clients' needs for food and water have been satisfied, they might be open to vaccinations.Education is always a good idea, but according to Maslow, basic human needs come first.Making vaccinations mandatory might drive some of the homeless clients away.Basic physiological needs should be met first; offering vaccinations before meeting the need for sleep and rest might not result in a high level of acceptance.

Question 19

A nurse is working with a family from a different culture with which he or she is not familiar.The family insists on continuing health practices that the nurse is trying to get them to abandon.This results in the nurse viewing the family as noncompliant, because they seem to understand the instructions.Which action by the nurse would be most helpful?

Accepted Answer

According to Leininger, if the nurse understands the cultural values and beliefs that underpin these behaviors, he or she might be able to engage in culture care preservation, which includes professional decisions and actions that help people retain their indigenous care values.Calling an interpreter would be important, especially if the patient's family's English proficiency is in question, but this would not be as effective as designing interventions and teaching around the family's beliefs.Giving the family both written and verbal instructions is also a helpful intervention, especially if instructions are available in their native language, but this would not be as effective as designing interventions and teaching around the family's beliefs.Giving both written and verbal directions is important when teaching, but it does not address cultural diversity.

Question 20

A nursing student is explaining to his or her family that nursing differs from medicine primarily in that nursing:

Accepted Answer

Whereas medicine focuses on the identification and treatment of disease, nursing focuses on the wholeness of human beings.All nursing theories conceptualize environment as a core concept, whether stated or implied.Although following physician-prescribed treatments is a component of nursing, nurses can also create their own care plans using both independent and dependent nursing activities.Systems theory is a part of many nursing theories but not all.

Quiz 5: Theories and Frameworks for Professional Nursing Practice