Conceptual Foundations The Bridge Professional Nursing 6th Edition Friberg Creasia - Test Bank

Conceptual Foundations The Bridge Professional Nursing 6th Edition Friberg Creasia – Test Bank

 

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Sample Questions Are Posted Below

 

Chapter 05: Theories and Frameworks for Professional Nursing Practice

 

MULTIPLE CHOICE

 

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

a.	does not consider the patient’s environment.
b.	is concerned with the wholeness of human beings.
c.	primarily involves following doctors’ orders.
d.	revolves completely around systems theory.

 

 

ANS:  B

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.

 

DIF:    Cognitive Level: Understand            REF:   71

TOP:   Integrated Process: Teaching/Learning                              MSC:  NCLEX Client Needs: N/A

 

2. 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

a.	assists nurses to view patients and information in a uniform way.
b.	is useful for prediction but not for driving nursing activities.
c.	rigidly structures data collection and protocol implementation.
d.	serves to organize information in a meaningful, useful manner.

 

 

ANS:  D

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.

 

DIF:    Cognitive Level: Analyze                TOP:   Integrated Process: Teaching/Learning

MSC:  NCLEX Client Needs: N/A

 

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

a.	concept.
b.	construct.
c.	proposition.
d.	theory.

 

 

ANS:  A

According to Fawcett (2005), a concept is “a word or phrase that summarizes ideas, observations, and experiences” (p. 4). 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.

 

DIF:    Cognitive Level: Remember            REF:   71

TOP:   Integrated Process: Teaching/Learning                              MSC:  NCLEX Client Needs: N/A

 

4. 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

a.	corollary theory.
b.	grand theory or framework.
c.	midrange theory.
d.	practice-level theory.

 

 

ANS:  D

A situation-specific 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.

 

DIF:    Cognitive Level: Apply                   TOP:   Nursing Process: Implementation

MSC:  NCLEX Client Needs: N/A

 

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

a.	Allow the patient to have uninterrupted periods of rest.
b.	Assist the patient with activities of daily living (ADLs) and other self-care deficits.
c.	Encourage the patient to be as independent as possible.
d.	Use installation of faith and hope to encourage the patient.

 

 

ANS:  A

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.

 

DIF:    Cognitive Level: Apply                   TOP:   Nursing Process: Implementation

MSC:  NCLEX Client Needs: Physiological Integrity: Basic Care and Comfort

 

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

a.	assists in setting goals that they work together to meet.
b.	has mastered all tasks and knowledge needed for self-care.
c.	is able to adapt to limitations and alter ways of doing activities of daily living (ADLs).
d.	understands the effects of stress in exacerbating illness.

 

 

ANS:  A

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.

 

DIF:    Cognitive Level: Evaluate                TOP:   Nursing Process: Evaluation

MSC:  NCLEX Client Needs: Psychosocial Integrity

 

7. 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

a.	Dorothea Orem.
b.	Imogene King.
c.	Jean Watson.
d.	Virginia Henderson.

 

 

ANS:  D

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.

 

DIF:    Cognitive Level: Understand            REF:   74

TOP:   Integrated Process: Teaching/Learning

MSC:  NCLEX Client Needs: Physiological Integrity: Basic Care and Comfort

 

8. A student studying nursing theory recognizes that unique concepts in Martha Rogers’ science of unitary human beings include

a.	carative factors.
b.	cognator subsystems.
c.	homeodynamics.
d.	open systems.

 

 

ANS:  C

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.

 

DIF:    Cognitive Level: Remember            REF:   73

TOP:   Integrated Process: Teaching/Learning

MSC:  NCLEX Client Needs: Psychosocial Integrity

 

9. 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?

a.	Address all questions and concerns to the eldest male relative present.
b.	Assist the patient to order nutritious, heart-healthy foods from the menu.
c.	Dress the patient’s lower body and then have the patient dress his or her own upper body.
d.	Help the family understand the patient’s lived experience of the illness.

 

 

ANS:  C

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.

 

DIF:    Cognitive Level: Apply                   TOP:   Nursing Process: Implementation

MSC:  NCLEX Client Needs: Physiological Integrity: Basic Care and Comfort

 

10. The nursing instructor summarizes Imogene King’s view of health as

a.	a state of harmony with the environment.
b.	being able to function in social roles.
c.	stability within the human system.
d.	the absence of illness or disability.

 

 

ANS:  B

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.

 

DIF:    Cognitive Level: Understand            REF:   79

TOP:   Integrated Process: Teaching/Learning

MSC:  NCLEX Client Needs: Psychosocial Integrity

 

11. A nurse subscribing to Neuman’s system model would explain to a patient that illness is caused by

a.	disharmony between the patient and the patient’s environment.
b.	disorganization and dysfunction, leading to imbalances in the system.
c.	losing the ability to successfully negotiate differing social roles.
d.	structural disturbances that limit the patient’s self-care abilities.

 

 

ANS:  A

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.

 

DIF:    Cognitive Level: Understand            REF:   76

TOP:   Integrated Process: Teaching/Learning

MSC:  NCLEX Client Needs: Psychosocial Integrity

 

12. 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?

a.	Ask the family to describe the importance of their beliefs.
b.	Call an interpreter to make sure they really understand.
c.	Determine whether instructions are available in their language.
d.	Give the family both written and verbal instructions.

 

 

ANS:  A

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.

 

DIF:    Cognitive Level: Apply                   TOP:   Nursing Process: Assessment

MSC:  NCLEX Client Needs: Psychosocial Integrity

 

13. The nurse using Watson’s theory to guide practice would put highest priority on

a.	assisting patients to achieve the state of self-actualization.
b.	creating a caring relationship with the patient.
c.	helping the patient understand the role of stress on illness.
d.	negotiating health care in a culturally congruent manner.

 

 

ANS:  B

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.

 

DIF:    Cognitive Level: Apply                   TOP:   Nursing Process: Implementation

MSC:  NCLEX Client Needs: Psychosocial Integrity

 

14. 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?

a.	“Any theory should work fine for you as long as you understand the concepts.”
b.	“Choose a theory that has clear explanations of all four key concepts.”
c.	“Rehabilitation nursing is probably too broad to find an appropriate theory.”
d.	“Since you work in a specialized area, use a theory that is very specific.”

 

 

ANS:  D

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.

 

DIF:    Cognitive Level: Apply                   TOP:   Integrated Process: Teaching/Learning

MSC:  NCLEX Client Needs: N/A

 

15. 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?

a.	Conceptual frameworks are the basic building blocks of theory and practice.
b.	Education is the foundation for all nursing understanding, including theory.
c.	Nursing knowledge can only be derived from well-tested theoretical models.
d.	Theory informs practice, research, and education, which in turn inform theory.

 

 

ANS:  D

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.

 

DIF:    Cognitive Level: Analyze                TOP:   Integrated Process: Teaching/Learning

MSC:  NCLEX Client Needs: N/A

 

16. 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?

a.	Educate the shelter clients on the benefits of vaccines.
b.	Give vaccinations after meals in a corner of the cafeteria.
c.	Make vaccinations mandatory for staying at the shelter.
d.	Offer vaccinations as clients check in to spend the night.

 

 

ANS:  B

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.

 

DIF:    Cognitive Level: Apply                   TOP:   Nursing Process: Implementation

MSC:  NCLEX Client Needs: Physiological Integrity: Basic Care and Comfort

 

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

a.	Describe, explain, or predict relationships among concepts.
b.	Explain nursing in the broadest terms possible.
c.	Generate knowledge to be tested in practice situations.
d.	Predict what people will do in certain situations.

 

 

ANS:  A

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.

 

DIF:    Cognitive Level: Understand            REF:   71

TOP:   Integrated Process: Teaching/Learning                              MSC:  NCLEX Client Needs: N/A

 

18. 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?

a.	Creating a healing environment
b.	Developing helping, trusting, and caring relationships
c.	Practicing loving kindness
d.	Promoting and accepting positive and negative feelings

 

 

ANS:  D

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.

 

DIF:    Cognitive Level: Apply                   TOP:   Integrated Process: Caring

MSC:  NCLEX Client Needs: Psychosocial Integrity

 

19. 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?

a.	Assess for available situational coping supports.
b.	Determine if there are concurrent developmental crises.
c.	Question the patient’s readiness to make needed changes.
d.	Work to reduce the perceived threat to the patient.

 

 

ANS:  A

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.

 

DIF:    Cognitive Level: Apply                   TOP:   Nursing Process: Assessment

MSC:  NCLEX Client Needs: Psychosocial Integrity

 

20. Using Maslow’s hierarchy of needs, which patient should the nurse assess first?

a.	Complains of pain of 6 on a scale of 1 to 10
b.	Crying after receiving a terminal diagnosis
c.	Disoriented and agitated
d.	Waiting for discharge teaching

 

 

ANS:  C

According to Maslow, basic needs such as food, water, shelter, and safety are the priority before other needs can be met. The nurse should see the disoriented agitated patient first, because this patient has immediate safety concerns. The patient in pain should be seen next because this is a physiological need. The patient crying and the patient waiting for discharge instructions certainly need the nurse’s attention, but safety comes first.

 

DIF:    Cognitive Level: Analyze                TOP:   Nursing Process: Assessment

MSC:  NCLEX Client Needs: Physiological Integrity: Reduction of Risk Potential

 

MULTIPLE RESPONSE

 

1. Theories attempt to explain the relationships among the central phenomena of nursing, which include (Select all that apply.)

a.	caring.
b.	environment.
c.	health/illness.
d.	nursing.
e.	person.

 

 

ANS:  B, C, D, E

The phenomena addressed by nursing theories include person, environment, health/illness, and nursing.

The phenomena addressed by nursing theories include person, environment, health/illness, and nursing.

The phenomena addressed by nursing theories include person, environment, health/illness, and nursing.

The phenomena addressed by nursing theories include person, environment, health/illness, and nursing.

Caring, although vital to the art and science of nursing, is subsumed into “nursing” and is not, by itself, one of the four phenomena addressed in nursing theories.

 

DIF:    Cognitive Level: Remember            REF:   71

TOP:   Integrated Process: Teaching/Learning                              MSC:  NCLEX Client Needs: N/A

 

2. The nursing student learning about theory understands that which terms are sometimes used instead of “grand theory”? (Select all that apply.)

a.	Conceptual model
b.	Framework
c.	Interrelated model
d.	Paradigm
e.	System

 

 

ANS:  A, B

Grand theories are also known as conceptual models or frameworks. They are not known as interrelated models, paradigms, or systems.

 

DIF:    Cognitive Level: Remember            REF:   71

TOP:   Integrated Process: Teaching/Learning                              MSC:  NCLEX Client Needs: N/A

 

3. The nurse using Nightingale’s theory to guide nursing practice will manipulate which features in the environment to enhance patient healing? (Select all that apply.)

a.	Airflow
b.	Light
c.	Noise
d.	Roommates
e.	Temperature

 

 

ANS:  A, B, C, E

Nightingale believed that nurses should manipulate environmental conditions to enhance healing, including ventilation (air flow), light, noise, and temperature. The nurse may not have any control over roommates.

 

DIF:    Cognitive Level: Remember            REF:   72

TOP:   Nursing Process: Implementation

MSC:  NCLEX Client Needs: Physiological Integrity: Basic Care and Comfort

 

4. A nurse uses Roy’s model to guide nursing care. When using this model, what stimuli would be important for the nurse to assess? (Select all that apply.)

a.	Adaptive stimuli: Stimuli the patient knows is beneficial
b.	Contextual stimuli: all stimuli in the patient’s environment
c.	Focal stimuli: what is confronting the patient immediately
d.	Residual stimuli: stimuli that is left over from prior experience
e.	Transient stimuli: stimuli that is not expected to have a permanent effect

 

 

ANS:  B, C

According to Roy, there are three types of stimuli: focal (what is confronting the patient in the immediate time), contextual (all other stimuli in the environment), and residual (beliefs, attitudes, or traits that have an indeterminate effect on the present situation). Adaptive and transient stimuli are not part of Roy’s theory.

 

DIF:    Cognitive Level: Apply                   TOP:   Nursing Process: Assessment

MSC:  NCLEX Client Needs: N/A

 

5. A nurse manager is planning a major change on an inpatient unit. Using Lewin’s theory, what areas does the manager assess? (Select all that apply.)

a.	Coping factors
b.	Driving forces
c.	Motivators
d.	Restraining forces
e.	States of change

 

 

ANS:  B, C, D, E

Lewin’s change theory examines driving and restraining forces, motivators, and states of change. Coping factors are not part of this theory.

 

DIF:    Cognitive Level: Apply                   TOP:   Nursing Process: Assessment

MSC:  NCLEX Client Needs: Psychosocial Integrity

 

6. A nurse works in an emergency department and frequently uses Lazarus’s theory of coping. When a family is distraught by a family member’s apparent heart attack, what action by the nurse is best from this theory’s standpoint? (Select all that apply.)

a.	Assess the family for coping strategies used during previous crises.
b.	Begin assessing the family for discharge teaching and support needs.
c.	Help the family understand treatments available to manage the condition.
d.	Inform the family of the location of the cafeteria and waiting rooms.
e.	Provide the family with food and beverages as a universal sign of caring.

 

 

ANS:  A, C

The nurse’s role when using this theory is to use nursing interventions designed to alter the perception of the threat level and promote and support the coping process. By teaching the family how the patient’s condition will be managed, the nurse is helping to reduce the perception of the threat. Assessing previous coping methods helps support the coping process. The other actions are not related to this theory.

 

DIF:    Cognitive Level: Apply                   TOP:   Nursing Process: Implementation

MSC:  NCLEX Client Needs: Psychosocial Integrity