Chapter 10: Using Nursing Theory to Guide Professional Practice My Nursing Test Banks

Chapter 10: Using Nursing Theory to Guide Professional Practice

Test Bank

MULTIPLE CHOICE

1. Which of the following are the concepts common among most nursing philosophies, models, and theories?

a.

Person, nurse, health, and environment

b.

Person, physician, health, and environment

c.

Person, nurse, health, and culture

d.

Person, nurse, environment, and culture

ANS: A

Person, nurse, health, and environment are the four universal concepts central to nursing practice. The physician and culture are not considered to be among the four universal concepts. These themes are described, defined, ordered, and interrelated in distinctive, meaningful, and powerful ways as nursing theorists endeavor to continue the development of nursings unique body of knowledge.

DIF: Cognitive Level: Analysis REF: Pages 153-154

OBJ: Apply the four universal concepts central to nursing practice.

TOP: Nursing Theory

MSC: NCLEX: Safe, Effective Care Environment: Management of Care

2. What skills would a nurse demonstrate if the nurse reached the competent stage of Patricia Benners theory of skill acquisition?

a.

Relies on more experienced nurses for guidance

b.

Can multitask, set goals, and think analytically

c.

Can see the whole picture and recognizes subtle changes in condition

d.

Recognizes patterns and responds automatically

ANS: B

The competent nurse is able to multitask, set goals, and think analytically. The advanced beginner is the new graduate nurse with marginally acceptable performance who relies on other experienced nurses. The proficient nurse sees the whole and focuses on long-term goals, and the level of expert nurse is reached after considerable experience (recognizes patterns and has responses that are automatic and integrated).

DIF: Cognitive Level: Application REF: Page 150

OBJ: Compare and contrast the nursing philosophies, theories, models, and frameworks discussed in this chapter. TOP: Nursing Theory

MSC: NCLEX: Safe, Effective Care Environment: Management of Care

3. A group of nursing students was discussing the functions of nursing theories. Which statement below would give the impression a student requires more review of the material?

a.

Nursing theories help guide professional practice by interpreting evidence.

b.

Nursing theories have little effect on decision-making in practice.

c.

Nursing theories are influenced by personal values and beliefs.

d.

Nursing theories influence professional behaviors.

ANS: B

The statements that nursing theories serve as guidelines for professional practice, nursing theories are influenced by values and beliefs, and nursing theories influence professional behaviors are true about nursing theories. The statement that nursing theories have little effect on decision-making is incorrect because nursing theories do have a significant effect on decision-making.

DIF: Cognitive Level: Application REF: Page 145

OBJ: Discuss the role of nursing theory in the practice of nursing.

TOP: Nursing Theory

MSC: NCLEX: Safe, Effective Care Environment: Management of Care

4. What criterion would the nurse use to support Hildegard Peplaus Theory of Interpersonal Relations?

a.

The relationship between nurse and doctor

b.

The mutual caring relationship

c.

Meeting the needs of nurse and patient

d.

The relationship between nurse and patient

ANS: D

The nurse-patient relationship is the focus of Hildegard Peplaus theory. The doctor-nurse relationship, the mutual caring relationship, and meeting the needs of the nurse and patient are not the focus of Hildegard Peplaus theory.

DIF: Cognitive Level: Evaluation REF: Page 150

OBJ: Compare and contrast the nursing philosophies, theories, models, and frameworks discussed in this chapter. TOP: Nursing Theory

MSC: NCLEX: Safe, Effective Care Environment: Management of Care

5. The nurse providing teaching on a weight loss program to the obese patient is applying which nursing model developed by Nola Pender?

a.

Interpersonal relations

b.

Health promotion

c.

Conservation

d.

Adaptation

ANS: B

Penders Health Promotion Model emphasizes the importance of the patient to manage his or her own health actively and focuses on wellness. Interpersonal relations is the theory developed by Hildegard Peplau. The Conservation Model was developed by Myra Levine, and the Adaptation Model was developed by Sister Callista Roy.

DIF: Cognitive Level: Application REF: Page 151

OBJ: Compare and contrast the nursing philosophies, theories, models, and frameworks discussed in this chapter. TOP: Nursing Theory

MSC: NCLEX: Safe, Effective Care Environment: Management of Care

6. What changes in nursing practice did Florence Nightingale make to improve the personal care of patients?

a.

Behaviors

b.

Environment

c.

Culture

d.

Communication

ANS: B

Florence Nightingales theory of nursing primarily focused on the environment. It described in detail the concepts of light, cleanliness, ventilation, warmth, diet, and noise. Behaviors, culture, and communication were not her primary focus.

DIF: Cognitive Level: Synthesis REF: Page 148

OBJ: Compare and contrast the nursing philosophies, theories, models, and frameworks discussed in this chapter. TOP: Nursing Theory

MSC: NCLEX: Safe, Effective Care Environment: Management of Care

7. Betty Neumans Systems Model for nursing emphasizes the holistic aspects of nursing from a systems-based perspective. Which of the following is not an example of the clinical application of this theory?

a.

Caring for the patient at the primary, secondary, and tertiary levels of care

b.

Evaluating patient stability

c.

Focusing on the nurse-patient relationship

d.

Evaluating the effect of stressors on the patient

ANS: C

Focusing on the nurse-patient relationship is the focus of Hildegard Peplaus Theory of Interpersonal Relations. Caring for the patient at the primary, secondary, and tertiary levels of care; evaluating patient stability; and evaluating the effect of stressors on the patient are examples of the clinical application of Neumans theory. The Neuman Systems Model focuses on responses of patient systems to actual or potential stressors and uses primary, secondary, and tertiary nursing interventions for optimal wellness.

DIF: Cognitive Level: Application REF: Pages 154-155

OBJ: Compare and contrast the nursing philosophies, theories, models, and frameworks discussed in this chapter. TOP: Nursing Theory

MSC: NCLEX: Safe, Effective Care Environment: Management of Care

8. Which statement by a nurse reflects an accurate understanding of systems theory?

a.

My patient has anemia reflected by low RBC, Hgb, and Hct values, so I have to monitor for fatigue, dyspnea, and tachycardia.

b.

It is my responsibility to provide my patients with basic human needs including food, water, and sleep.

c.

Would you like me to call the chaplain for you to discuss your feelings about your upcoming surgery?

d.

My patients daughter makes all decisions and living arrangements for my patient such as reserving a home health aide and Meals on Wheels during the week.

ANS: A

A change in one part of the whole will have an effect on another is an accurate understanding of systems theory. Humans have certain basic needs explains Maslows Theory of the Hierarchy of Needs. One must consider how humans cope or do not cope with stress is an example of Betty Neumans Healthcare Systems Model. Roles change over a lifetime illustrates role theory.

DIF: Cognitive Level: Evaluation REF: Page 147

OBJ: Compare and contrast the nursing philosophies, theories, models, and frameworks discussed in this chapter. TOP: Nursing Theory

MSC: NCLEX: Safe, Effective Care Environment: Management of Care

9. Which statement about nursing conceptual models is true?

a.

Nursing conceptual models provide a broad explanation of the world.

b.

Nursing conceptual models are composed of a defined and interrelated set of concepts.

c.

Nursing conceptual models are abstract concepts that propose outcomes.

d.

Nursing conceptual models are related constructs that broadly explain a phenomenon of interest.

ANS: D

Nursing conceptual models are related constructs that broadly explain a phenomenon of interest is true of nursing conceptual models. Nursing conceptual models provide a broad explanation of the world is true of nursing philosophies, and Nursing conceptual models are composed of a defined and interrelated set of concepts and Nursing conceptual models are abstract concepts that propose outcomes are true of nursing theories.

DIF: Cognitive Level: Knowledge REF: Page 146

OBJ: Compare and contrast the nursing philosophies, theories, models, and frameworks discussed in this chapter. TOP: Nursing Theory

MSC: NCLEX: Safe, Effective Care Environment: Management of Care

10. Which of the following is an example of the application of Levines Conservation Model to the clinical setting?

a.

Teaching the patient to self-administer insulin

b.

Encouraging the patient to ambulate

c.

Obtaining a wheelchair for the patient

d.

Arranging for the patients family to visit

ANS: C

Obtaining a wheelchair for the patient is a correct example of the application of Levines Conservation Model. Teaching the patient to self-administer insulin and encouraging the patient to ambulate will not facilitate rest, and arranging for the patients family to visit may or may not further stress the patient.

DIF: Cognitive Level: Application REF: Page 154

OBJ: Compare and contrast the nursing philosophies, theories, models, and frameworks discussed in this chapter. TOP: Nursing Theory

MSC: NCLEX: Safe, Effective Care Environment: Management of Care

11. Select the scientific theory used in several nursing theories to explain the following scenario: One nurse, whose adult son died in the ER 11 years ago, contends that she can never walk into a hospital again and quits her job. A second nurse, whose husband died in the hospital, continues to work her shifts responsibly and compassionately without incident.

a.

Role theory

b.

Adaptation theory

c.

Developmental theories

d.

Systems theory

ANS: B

Adaptation theory explains the ability of living things to adjust, or adapt, in response to continuous internal or external stimuli. This theory illustrates how humans cope or dont cope with physical, developmental, emotional, intellectual, social, and spiritual stressors. Role theory describes how roles of individuals in their family may change over a lifetime. Developmental theories explain the interdependence of the systems in the body helping to reveal the presence of health and illness. Systems theory describes the relationship of the environment, both internal and external, with the individual and how changing one part affects all other parts.

DIF: Cognitive Level: Synthesis REF: Page 147

OBJ: Compare and contrast the nursing philosophies, theories, models, and frameworks discussed in this chapter. TOP: Nursing Theory

MSC: NCLEX: Safe, Effective Care Environment: Management of Care

12. Identify the catalyst of Jean Watsons Theory of Care.

a.

Personal values and beliefs

b.

Belief that nursing practice should be autonomous

c.

Changes in health care delivery and patient satisfaction survey responses

d.

Theories promoting the capacity of self-care

ANS: A

Jean Watsons Theory of Care (1979) emerged from her own values and beliefs guided by her commitment to the caring-healing role or nursing and its mission to help sustain humanity and wholeness as the foundation of health and nursings purpose for existing. The belief that nursing practice should be autonomous, changes in health care delivery and patient satisfaction survey responses, and the three theories promoting the capacity of self-care have nothing in common with Jean Watsons Theory of Care.

DIF: Cognitive Level: Application REF: Page 149

OBJ: Compare and contrast the nursing philosophies, theories, models, and frameworks discussed in this chapter. TOP: Nursing Theory

MSC: NCLEX: Safe, Effective Care Environment: Management of Care

13. Which of the following is an example of the application of Madeleine Leiningers Cultural Care Theory of Diversity and Universality?

a.

Preparing a patient for a medical procedure by using medical terminology

b.

Learning about diverse ethnic patient populations

c.

Planning nursing care in a standardized manner ensuring that everyone is treated the same way

d.

Asking a nonEnglish-speaking patient to provide an English-speaking person to translate details of care

ANS: B

Demonstrating cultural competency includes learning about the cultural community as individuals, families, and communities and their expressive abilities of caring, values, beliefs, actions, and practices that are based on their cultural lifestyles. This will ensure that nurses deliver the appropriate level of care respectfully based on these aspects with a noted increase in nursing satisfaction performance, healing, and well-being. Speaking in medical jargon is discouraged and does not help to explain or alleviate anxiety. Planning individualized nursing care is the goal, rather than treating everyone in the same manner. Asking a nonEnglish-speaking patient to provide a translator does not demonstrate respect for a diverse population.

DIF: Cognitive Level: Application REF: Page 152

OBJ: Compare and contrast the nursing philosophies, theories, models, and frameworks discussed in this chapter. TOP: Nursing Theory

MSC: NCLEX: Safe, Effective Care Environment: Management of Care

14. Which is an example of Dorothea Orems Theory of Self-Care Deficit?

a.

A nurse asks a patient how much she can do for herself following a stroke.

b.

A nurse performs total care on a stroke patient to conserve the patients energy.

c.

A nurse leaves a stroke patient to walk to the bathroom and shower by herself.

d.

A nurse enables a stroke patient to wash up in bed by providing bath wipes.

ANS: D

Dorothea Orems Theory of Self-Care Deficit is explained in the fifth edition of her book, Nursing: Concepts of Practice. In this model of practice, the outcomes of all nursing actions should be to promote the capacity for self-care in all individuals; activities of self-care are defined as purposeful, ordered, and learned; and the degree to which a person is able to participate in this is called self-care agency.

DIF: Cognitive Level: Application REF: Page 155

OBJ: Compare and contrast the nursing philosophies, theories, models, and frameworks discussed in this chapter. TOP: Nursing Theory

MSC: NCLEX: Safe, Effective Care Environment: Management of Care

15. The goal of Ida Jean Orlandos theory of effective nursing practice is to:

a.

focus on relationships among the environment, nurse, and patient.

b.

reduce the duration of hospital stays.

c.

meet the immediate needs of the patient and relieve distress or discomfort.

d.

integrate holism into nursing.

ANS: C

Orlando believed that the goal of the nurse is to meet the immediate needs of the patient and relieve distress and discomfort. A major assumption by Orlando was that nursing practice should be autonomous. She believed that using the nursing process in the provision of nursing care provides an overall framework for nursing and is effective in achieving a good outcome. Florence Nightingales theory focused on three major relationships: environment to patient, nurse to environment, and nurse to patient. Virginia Henderson is well known for defining nursing. She was also credited with integrating the view of holism into nursing. She believed that humans have needs that are not only biological but also psychological. Reduction of hospital stays is not discussed.

DIF: Cognitive Level: Application REF: Page 151

OBJ: Compare and contrast the nursing philosophies, theories, models, and frameworks discussed in this chapter. TOP: Nursing Theory

MSC: NCLEX: Safe, Effective Care Environment: Management of Care

16. Which theory focuses on patterns, life processes, and wholeness and describes seeing the life process as a progression believing that health and the evolving pattern of consciousness are the same?

a.

Theory of Goal Attainment

b.

Theory of Health as Expanding Consciousness: Margaret Newman

c.

Theory of Interpersonal Relations

d.

Roy Adaptation Model

ANS: B

Margaret Newmans Theory of Health as Expanding Consciousness focuses on patterns, life processes, and wholeness. She saw the life process as a progression toward higher levels of consciousness health and believed that health and the evolving pattern of consciousness are the same. Imogene King developed the Theory of Goal Attainment. Her theory is based on her belief that humans are composed of three interacting systems (personal, interpersonal, and social), and that they can lead to goal attainment, representing outcomes. Hildegard Peplau developed the Theory of Interpersonal Relations. This theory describes the connection of nurse, patient, health, and environment and should be viewed within the context of environment. Sister Callista Roy developed the Roy Adaptation Model. Roy believed that the goal of nursing is to promote adaptive responses through a six-step nursing process.

DIF: Cognitive Level: Application REF: Page 152

OBJ: Compare and contrast the nursing philosophies, theories, models, and frameworks discussed in this chapter. TOP: Nursing Theory

MSC: NCLEX: Safe, Effective Care Environment: Management of Care

17. What example illustrates the conclusion that can be drawn from deductive reasoning?

a.

All men are mortal and the Dalai Lama is a man; therefore, the Dalai Lama is mortal.

b.

The planet Earth orbits the Sun; therefore, all planets orbit the Sun.

c.

Five marbles taken from the bag are blue; therefore, all marbles from the bag are blue.

d.

The first five people you met at a work interview were nice; therefore, everyone at this office is nice.

ANS: A

All men are mortal and the Dalai Lama is a man; therefore, the Dalai Lama is mortal is correct. Deductive reasoning goes from the general to the specific. Here the reasoning progresses such that you would use a true broad premise or principle to progress logically to a more detailed conclusion. The other answer choices are all examples of inductive reasoning. Reasoning proceeds from the specific to the general.

DIF: Cognitive Level: Analysis REF: Page 146

OBJ: Compare and contrast the nursing philosophies, theories, models, and frameworks discussed in this chapter. TOP: Reasoning

MSC: NCLEX: Safe, Effective Care Environment: Management of Care

18. What example illustrates the conclusion that can be drawn from inductive reasoning?

a.

Bachelors are unmarried men and Danny is unmarried; therefore, Danny is a bachelor.

b.

Every eagle seen this week has dark feathers; therefore, all eagles have dark feathers.

c.

Most Ford vehicles are reliable, so the Ford you just bought will be reliable, too.

d.

All dogs have fleas; therefore, my dog has fleas.

ANS: B

Every eagle seen this week has dark feathers; therefore, all eagles have dark feathers is correct. Inductive reasoning proceeds from the specific to the general. That is, an observation is made, and patterns are recognized; this leads to a tentative hypothesis and then finally a general conclusion about a broad generalization. The other answer choices are all examples of deductive reasoning. Deductive reasoning goes from the general to the specific.

DIF: Cognitive Level: Analysis REF: Page 146

OBJ: Compare and contrast the nursing philosophies, theories, models, and frameworks discussed in this chapter. TOP: Reasoning

MSC: NCLEX: Safe, Effective Care Environment: Management of Care

MULTIPLE RESPONSE

1. What parts make up and work together in Imogene Kings Theory of Goal Attainment? (Select all that apply.)

a.

Creating a method to evaluate outcomes

b.

Defining quality nursing care

c.

Setting goals

d.

Focusing on self-care

e.

Maintaining a clean environment

ANS: A, B, C

Imogene King believed that humans are composed of three interacting and changing systems consisting of social, interpersonal, and personal systems. Creating a method to evaluate outcomes, defining quality nursing care, and setting goals are reflective of Kings theory that emphasizes goal setting and evaluating outcomes. Focusing on self-care and maintaining a clean environment are not included in Kings theory.

DIF: Cognitive Level: Analysis REF: Page 146

OBJ: Compare and contrast the nursing philosophies, theories, models, and frameworks discussed in this chapter. TOP: Nursing Theory

MSC: NCLEX: Safe, Effective Care Environment: Management of Care

2. How would you justify that a nursing theory is, in fact, a middle-range nursing theory? (Select all that apply.)

a.

It is simple, clear, generalizable, and accessible.

b.

It focuses on answering specific nursing practice questions.

c.

It predicts the effects of one phenomenon on another.

d.

It explains relationships.

e.

It is built on several important adapted scientific theories.

ANS: B, C, D

Middle-range nursing theories focus on answering specific nursing practice questions. They can describe phenomena, explain relationships, and predict the effects of one phenomenon on another. All theories should be clear, simple, generalizable, important, and accessible, not just middle-range nursing theories. Nursing theories, in general, are built on adapted scientific theories, not just middle-range nursing theories.

DIF: Cognitive Level: Evaluation REF: Page 146

OBJ: Compare and contrast the nursing philosophies, theories, models, and frameworks discussed in this chapter. TOP: Middle-Range Nursing Theory

MSC: NCLEX: Safe, Effective Care Environment: Management of Care

Leave a Reply