Cherry: Contemporary Nursing, 5th Edition
Chapter 05: Theories of Nursing Practice
Test Bank
MULTIPLE CHOICE
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
ANS: D
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.
Martha Rogers’ theory is based on the nurse’s promoting synchronicity between human
beings and the universe/environment.
Dorothea Orem’s self-care deficit model facilitates client self-care by measuring the
client’s deficit relative to self-care needs.
Hildegard Peplau’s theory identifies feelings of the client as a predictor of positive
outcomes related to health and wellness.
DIF: Application
REF: Page 95
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(n):
a. hypothesis.
b. model.
c. construct.
d. variable.
ANS: B
A model is a group of concepts that are associated because of their relevance to a
common theme.
A hypothesis asks the question that is to be the main focus of a theory.
A construct is similar to a concept; it is an idea or an object that can be “built” together
with others into a theory.
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: Page 90
Mosby items and derived items © 2011, 2008 by Mosby Inc., an imprint of Elsevier Inc.
Test Bank
5-2
3. The statement, “Nursing is a caring profession that focuses on assisting people to be as
healthy as possible,” is an example of a:
a. concept.
b. construct.
c. philosophy.
d. model.
ANS: C
A philosophy is the values and beliefs of the discipline.
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.
A construct is a building part that combines with others to make up a theory.
A model is a group of concepts that are associated because of their relevance to a
common theme.
DIF: Comprehension
REF: Page 90
4. Einstein’s theory of relativity laid the groundwork for theories of mathematics, and Freud
and Jung provided the basis for the philosophy of man. Which nursing theory served as
the foundation for nursing science?
a. Rogers’s 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
ANS: B
Florence Nightingale investigated the effect of the environment on healing, and this
serves as the foundation for nursing science.
Rogers in 1970 proposed the science of unitary human beings.
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.
King’s theory of goal attainment, proposed in 1971, addresses client systems and includes
society, groups, and the individual.
DIF: Comprehension
REF: Page 92
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.
ANS: A
Mosby items and derived items © 2011, 2008 by Mosby Inc., an imprint of Elsevier Inc.
Test Bank
5-3
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.
The role of translator is not needed, and Leininger’s theory of cultural care diversity and
universality focuses on diversity, universality, worldview, and ethnohistory, none of
which is needed in this situation.
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. This theory is not as pertinent in this acute situation.
Rogers’s science of unitary human beings theory is one in which the nurse promotes
synchronicity between human beings and their environment; it is not appropriate to this
acute situation.
DIF: Application
REF: Page 95
6. What are general explanations that scholars use to explain, predict, control, and
understand commonly occurring events?
a. Theories
b. Constructs
c. Systems
d. Propositions
ANS: A
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.
Constructs are the events, ideas, or objects that make up a theory.
A system is an orderly collection of logically related principles, facts, or objects.
Propositions are statements that propose the relationships between and among concepts.
DIF: Comprehension
REF: Page 89
7. Which type of theory most often guides present nursing practice?
a. Grand theory
b. Middle range theory
c. Developmental theory
d. Values theory
ANS: B
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 of middle range
theory is the theory of unpleasant symptoms (Lenz and Pugh), which examines symptoms
that are influenced by physiologic, psychologic, and situational factors as they relate to
performance.
Grand theory is broad in scope and may describe and explain large segments of human
experience.
Developmental theory is not a standard term applied to nursing theory.
Values theory is not a standard term applied to nursing theory.
Mosby items and derived items © 2011, 2008 by Mosby Inc., an imprint of Elsevier Inc.
Test Bank
DIF: Knowledge
5-4
REF: Page 91
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
ANS: B
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.
Martha Rogers’ theory is based on humans as energy fields that interact constantly with
the environment.
Florence Nightingale’s theory of practice is based on environmental adaptation.
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: Page 96
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
ANS: D
Rogers’ science of unitary human beings: humans 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.
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.
Roy’s adaptation model identifies the client’s adaptation to conditions by using
environmental stimuli to adjust perception.
Mosby items and derived items © 2011, 2008 by Mosby Inc., an imprint of Elsevier Inc.
Test Bank
5-5
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: Application
REF: Page 97
10. A client involved in a motor vehicle accident is blinded. The nurse assists the client to
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 of illness
c. Orem’s self-care deficit
d. Rogers’ science of unitary human beings
ANS: C
In Orem’s self-care deficit the nurse implements measures to assist clients in meeting
self-care needs by matching them with an appropriate supportive intervention.
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.
Mishel’s uncertainty of illness identifies 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 assist the client in developing new skills of
assimilation and accommodation.
Rogers’ science of unitary human beings is one in which the nurse promotes
synchronicity between human beings and their universe/environment.
DIF: Application
REF: Page 97
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
d. Adaptation
ANS: A
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.
The appraisal stage is when the client applies a negative value to environmental
conditions.
In the initiation of coping mechanisms stage, the individual uses coping skills to deal
with negative environmental stimuli.
Mosby items and derived items © 2011, 2008 by Mosby Inc., an imprint of Elsevier Inc.
Test Bank
5-6
Adaptation occurs as the nurse intervenes in the previous stage, and ideally, fear
decreases.
DIF: Application
REF: Page 99
12. A nurse researcher determines that findings are substantial by calculating the level of
significance. Which aspect of the scientific inquiry is being conducted?
a. Hypothesis
b. Method
c. Data collection
d. Evaluation
ANS: D
During evaluation, results are examined with the goal of determining the relevance of
outcome data in answering the hypothesis; also the significance of the data and the
potential for future research are explored.
The hypothesis asks the question that is to be the main focus.
The method decides what data will be collected to answer the question.
Data collection is a step-by-step procedure that is undertaken with the goal of answering
the question.
DIF: Application
REF: Page 88
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 unsure 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
ANS: A
In Mishel’s uncertainty of illness theory, the core position is that uncertainty in illness
must be addressed. If left unheeded, negative perceptions will escalate and clients will
suffer. Nursing responsibility based on this theory consists of reframing the client’s
perceived loss of control, or uncertainty, and assisting the client in developing new skills
of assimilation and accommodation.
In Orem’s self-care deficit model, nursing facilitates client self-care by measuring the
client’s deficit relative to self-care needs.
Nightingale’s canons of nursing is an environmental adaptation theory.
Levine’s conservation model identifies four conservation principles of client resources
(energy, structural integrity, personal integrity, and social integrity).
DIF: Analysis
REF: Page 99
Mosby items and derived items © 2011, 2008 by Mosby Inc., an imprint of Elsevier Inc.
Test Bank
5-7
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 secondly 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. request 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.
ANS: D
Nightingale believed that light was second only to the need for fresh air.
Although she believed noise should be controlled it was not the second most important.
Nightingale did believe food should do the work of the patient’s ailing digestive system
but it was not second.
Nightingale did believe in variety, which included pets and beautiful objects.
DIF: Application
REF: Pages 93-94
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 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?
a. Inclusiveness
b. Consistency
c. Accuracy
d. Simplicity
ANS: C
Accuracy of theory acceptance examines the theory’s ability to explain past occurrences
while being applicable for use in determining future outcomes.
Inclusiveness is evaluation that all concepts related to this field are included.
Consistency is the criteria that evaluate the theory’s ability to deal with new entities
without altering its original assumptions.
The process is not being examined.
DIF: Application
REF: Page 89
MULTIPLE RESPONSE
1. Which concepts relate to nursing theory? (Select all that apply.)
a. Environment
b. Health
c. Nursing
d. Relevance
e. Comfort
Mosby items and derived items © 2011, 2008 by Mosby Inc., an imprint of Elsevier Inc.
Test Bank
5-8
ANS: A, B, C, E
“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.
“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.
“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.
“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
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: Pages 89-90
COMPLETION
1. The basic ingredients of theory are ____________________.
ANS:
concepts
A theory is defined as a group of related concepts that explain existing phenomena and
predict future events.
DIF: Knowledge
REF: Page 89
Mosby items and derived items © 2011, 2008 by Mosby Inc., an imprint of Elsevier Inc.