6TH_Ed Test Bank Contemporary Nursing_Issues_Trends & Management by Barbara Cherry-Susan R.Jacob
Chapter 05: Theories of Nursing Practice
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
Correct: 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.
a. Martha Rogers’ theory is based on the nurse’s promoting synchronicity between human beings and the universe/environment.
b. Dorothea Orem’s self-care deficit model facilitates client self-care by measuring the client’s deficit relative to self-care needs.
c. Hildegard Peplau’s theory identifies feelings of the client as a predictor of positive outcomes related to health and wellness.
DIF: Application REF: p. 82
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:
Correct: A model is a group of concepts that are associated because of their relevance to a common theme.
a. A hypothesis asks the question that is to be the main focus of a theory.
c. A construct is similar to a concept; it is an idea or an object that can be “built” together with others into a theory.
d. 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: p. 75 | p. 77
3.The statement, “Nursing is a caring profession that focuses on helping people be as healthy as possible,” is an example of a:
Correct: A philosophy is the values and beliefs of the discipline.
a. 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.
b. A construct is a building part that combines with others to make up a theory.
d. A model is a group of concepts that are associated because of their relevance to a common theme.
DIF:ComprehensionREF:p. 78; Table 5-1
4.Einstein’s theory of relativity laid the groundwork for theories of mathematics, and Freud and Jung provided the basis for a philosophy of man. Which nursing theory served as the foundation for nursing science?
a. Rogers’ 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
Correct: Florence Nightingale investigated the effect of the environment on healing, and this serves as the foundation for nursing science.
a. Rogers in 1970 proposed the science of unitary human beings.
c. 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.
d. King’s theory of goal attainment, proposed in 1971, addresses client systems and includes society, groups, and the individual.
DIF: Comprehension REF: pp. 78-80
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.
Correct: 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.
b. The role of translator is not needed. Leininger’s theory of cultural care diversity and universality focuses on the concepts of diversity, universality, worldview, and ethnohistory, none of which is relevant in this situation.
c. 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. In this acute situation, the case manager conceptual model in not as pertinent as the change agent model.
d. Rogers’ science of unitary human beings theory is one in which the nurse, as caregiver, promotes synchronicity between human beings and their environment; it is not relevant to this acute situation.
DIF: Application REF: p. 84
6.What are general explanations that scholars use to explain, predict, control, and understand commonly occurring events?
Correct: 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.
b. Constructs are the events, ideas, or objects that make up a theory.
c. A system is an orderly collection of logically related principles, facts, or objects.
d. Propositions are statements that propose the relationships between and among concepts.
DIF: Comprehension REF: p. 85
7.Which type of theory most often guides present nursing practice?
a. Grand theory
b. Middle range theory
c. Developmental theory
d. Values theory
Correct: 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 is the theory of unpleasant symptoms (Lenz and Pugh), which examines symptoms that are influenced by physiologic, psychological, and situational factors as they relate to performance.
a. Grand theory is broad in scope and may describe and explain large segments of human experience.
c. Developmental theory is not a standard term applied to nursing theory.
d. Values theory is not a standard term applied to nursing theory.
DIF: Knowledge REF: p. 78
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
Correct: 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.
a. Martha Rogers’ theory is based on humans as energy fields that interact constantly with the environment.
c. Florence Nightingale’s theory of practice is based on environmental adaptation.
d. 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: p. 81 | p. 82; Table 5-2
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
Correct: Rogers’ science of unitary human beings, in which humans are seen 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.
a. 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.
b. Roy’s adaptation model identifies the client’s adaptation to conditions by using environmental stimuli to adjust perception.
c. 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:ApplicationREF:p. 83 |p. 82; Table 5-2
10.A client involved in a motor vehicle accident is blinded. The nurse helps the client 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 in illness
c. Orem’s self-care deficit
d. Rogers’ science of unitary human beings
Correct: In Orem’s self-care deficit theory, the nurse implements measures to help clients meet self-care needs by matching them with an appropriate supportive intervention.
a. 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.
b. Mishel’s uncertainty in illness theory holds 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 help the client develop new skills of assimilation and accommodation.
d. Rogers’ science of unitary human beings is one in which the nurse promotes synchronicity between human beings and their universe/environment.
DIF: Application REF: p. 83 | p. 82; Table 5-2
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
Correct: 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.
b. The appraisal stage is when the client applies a negative value to environmental conditions.
c. In the initiation of coping mechanisms stage, the individual uses coping skills to deal with negative environmental stimuli.
d. Adaptation occurs as the nurse intervenes in the previous stage, and ideally, fear decreases.
DIF: Application REF: p. 85
12.A nurse researcher determines whether findings are substantial by calculating the level of significance. Which aspect of the scientific inquiry is being conducted?
c. Data collection
Correct: During evaluation, results are examined with the goal of determining the relevance of outcome data in answering the hypothesis; the significance of the data and the potential for future research are also explored.
a. The hypothesis asks the question that is to be the main focus.
b. The method decides what data will be collected to answer the question.
c. Data collection is a step-by-step procedure that is undertaken with the goal of answering the question.
DIF:ApplicationREF:p. 76; Box 5-1
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 unfamiliar with this disease 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
Correct: In Mishel’s uncertainty of illness theory, the core position is that uncertainty in illness must be addressed. When uncertainties are not addressed, clients’ negative perceptions will escalate and they will suffer. Nursing responsibility based on this theory consists of reframing the client’s perceived loss of control, or uncertainty, and helping the client develop new skills of assimilation and accommodation.
b. In Orem’s self-care deficit model, nursing facilitates client self-care by measuring the client’s deficit relative to self-care needs.
c. Nightingale’s canons of nursing is an environmental adaptation theory.
d. Levine’s conservation model identifies four conservation principles of client resources (energy, structural integrity, personal integrity, and social integrity).
DIF: Analysis REF: pp. 79-80; Box 5-3 | p. 85
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, second, 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. ask 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.
Correct: Nightingale believed the need for light was second only to the need for fresh air.
a. Although she believed noise should be controlled, it was not the second most important consideration.
b. Nightingale did believe food should do the work of healing the patient’s ailing digestive system, but this was not second most important consideration.
c. Nightingale did believe in variety, which included pets and beautiful objects, but the needs for light and air were more important to her.
DIF: Application REF: p. 81
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 them from 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?
Correct: The accuracy of a theory is its ability to explain past occurrences while being useful in determining future outcomes.
a. A theory can be validated as inclusive when it is found that it includes all concepts related to its field.
b. The consistency of a theory is its ability to deal with new entities and situations without altering its original assumptions.
d. The simplicity of the nurse’s theory is not being examined in this example.
DIF: Application REF: p. 76
A nurse practicing on a unit where domestic violence is common wants to learn how to apply nursing theory to practice on this unit. She considers the interrelatedness of the constructs of Watson’s Theory of Caring and designs the above:
a. conceptual model of caring.
b. hypothesis of the impact of caring on domestic violence.
c. proposition of how caring is conceptualized.
d. theory of scientific inquiry.
Correct: The above conceptual models demonstrates how the concepts of compassion, commitment, conscience, confidence, and competence form a theme of caring (Watson).
b. A hypothesis is the first step of scientific inquiry.
c. A proposition is a statement rather than a model of how constructs are related.
d. Theory of scientific inquiry uses set steps in figuring out how a phenomenon happens.
DIF: Application REF: p. 77
17.A nurse in a rehabilitation unit plans activities of daily living to prevent excessive fatigue, helps the patient dress before the family visits, assists with range of motion, and allows the patient to decide which clothes to wear during the visit. This nurse is best applying which theory to practice?
a. Watson’s Theory of Caring
b. Rogers’ Theory of Unitary Humans
c. Levine’s Theory of Conservation
d. Leininger’s Theory of Transcultural Nursing
Correct: Certain parts of all the theories can be applied; however all the constructs of Levine’s Model of Conservation are applied, including energy conservation, structural integrity, personal integrity, and social integrity. In this situation, the nurse conserved energy by planning ADLs, conserved structural integrity through ROMs, conserved social integrity by helping patient with appearance during family visits thus improving the milieu for social visits.
a. Watson’s Theory of Caring meets some of the criteria, but all concepts are not applied.
b. The constructs—energy fields, openness, pattern, and organization—in Rogers’ Theory of Unitary Humans are not all employed in this example.
d. Leininger’s Theory is not applied because no indication of cultural diversity is noted.
DIF:ApplicationREF:p. 82; Table 5-2
18.A nurse is evaluating Levin’s Theory of Conservation to determine if it can be applied to patients in the initial phases of chemotherapy treatment. During this phase of theory acceptance, the nurse wants to determine if all the concepts of energy, structural integrity, personal integrity, and social integrity are included in the care of cancer treatment. The nurse is applying which criteria of theory acceptance?
Correct: Inclusiveness asks the question, “Does the theory include all concepts related to the area of interest?”
b. Consistency asks the question, “Can the theory address new entities without having its founding assumptions changed?”
c. Accuracy asks the question, “Does the theory explain retrospective occurrences?”
d. Fruitfulness asks the question, “Does the theory generate new directions for future research?”
DIF:ApplicationREF:p. 76; Box 5-2
19.A nurse is heard making this comment, “I believe human dignity is based on perceived self-worth while caring is based on perceived role in society that forms the basis of nursing practice.” This nurse is:
a. demonstrating a model of human dignity.
b. evaluating the relevance of Leininger’s Theory.
c. applying Mishel’s Theory of Disease Uncertainty.
d. making a proposition concerning the constructs of nursing practice.
Correct: A proposition is a statement that proposes the relationship between and among concepts.
a. A model is a visual representation rather than a statement.
b. Leininger’s Theory is founded on transcultural nursing.
c. Nothing related to the theory of disease uncertainty occurs in this scenario.
DIF: Application REF: p. 77
20.A group of nurses are interested in the how to improve teaching effectiveness for patients who have a hearing impairment and lack family involvement while hospitalized. They believe “hearing loss decreases the teaching effectiveness while hospitalized.” The group plans to evaluate teaching effectiveness using a 10-point Likert Scale pre-post teaching, perform a hearing test to determine degree of hearing loss on admission, and have social work evaluate the impact of hearing impairment on patient’s ability to safely live alone prior to discharge. The group is working in which step of the scientific process?
Correct: During the method step, the group decides what data will be collected to answer the question and identifies step-by-step procedures that will be used to collect these data.
a. Hypothesis is the formation of the question, and the group has already completed this step.
c. Results (outcomes) are identified or predicted based on data’s significance.
d. In the evaluation step, results are assessed to determine if they support the original hypothesis.
DIF:ApplicationREF:p. 76; Box 5-1
1.Which of the following are concepts related to nursing theory? (Select all that apply.)
ANS: A, B, C, E
a. 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.
b. 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.
c. 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.
e. 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
d. 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: p. 77
1.The basic ingredients of theory are ____________.
A theory is defined as a group of related concepts that explain existing phenomena and predict future events.
DIF: Knowledge REF: p. 77
6TH_Ed Test Bank Contemporary Nursing_Issues_Trends & Management by Barbara Cherry-Susan R.Jacob