Chapter 05: Theoretical Foundations of Nursing Practice

Test Bank
MULTIPLE CHOICE
1. Which of the following definitions best explains the idea of a theory?
a. Mental maps that make sense of information and decisional processes
b. Mental formulations of objects or events
c. Aspects of reality that can be consciously sensed
d. A purposeful set of assumptions that identify relationships between concepts
ANS: D
Feedback
A
B
C
D

The description Mental maps that make sense of information and decisional
processes explains the idea of conceptual frameworks, which link ideas together.
The description Mental formulations of objects or events explains the idea of
concepts.
The description Aspects of reality that can be consciously sensed explains the
idea of phenomena.
A theory is a purposeful set of assumptions that identify the relationships between
concepts. Theories are useful because they provide a systematic view of
explaining, predicting, and prescribing phenomena.

DIF: Cognitive Level: Knowledge

TOP: Nursing Process: Assessment

REF: page 54
OBJ: 1
MSC: CRNE: PP-11

2. Different types of theories may be used by nurses seeking to study the basis of nursing

practice. Which one of the following types of theories speculates on why phenomena occur?
Prescriptive
Descriptive
Grand
Middle-range

a.
b.
c.
d.

ANS: B
Feedback
A
B
C
D

Prescriptive theories address nursing interventions and predict the consequences

of a specific nursing intervention.
Descriptive theories describe phenomena, speculate on why phenomena occur,
and describe the consequences of phenomena.
Grand theories provide the structural framework for broad, abstract ideas about
nursing.
Middle-range theories address specific phenomena or concepts and reflect
practice.

DIF: Cognitive Level: Knowledge

REF: page 57, Table 5-2
OBJ: 2
TOP: Nursing Process: Assessment
MSC: CRNE: PP-11

3. Which of the following is referred to as a body of knowledge that encompasses definitions of

person, environment, health, and nursing?

Family nursing practice
Prescriptive nursing theory
Advanced nursing practice
Metaparadigm of nursing

a.
b.
c.
d.

ANS: D
Feedback
A
B
C
D

Family nursing practice, although perhaps focusing on all of these concepts, is not
a body of knowledge.
Prescriptive nursing theory addresses nursing interventions and helps predict
consequences of a specific intervention.
Advanced nursing practice may focus on these concepts but is not a body of
knowledge specific to these concepts.
The major components of nursing theory, sometimes called the metaparadigm
concepts, are person, environment, health, and nursing.

DIF: Cognitive Level: Comprehension

TOP: Nursing Process: Assessment

REF: page 56
OBJ: 1
MSC: CRNE: PP-11

4. The nurse is working within a health care system that uses Neumans theory. A patient is

having difficulty breathing and requires oxygen and medication. Which of the following
approaches is the nurses goal?
a. Strengthen the line of defences, and focus on prevention.
b. Promote attainment of biological self-care requisites.
c. Assist in physiological adaptation to internal changes.
d. Achieve the 14 basic needs.
ANS: A
Feedback
A
B
C
D

Neumans framework for practice includes nursing actions that focus on actual or
potential stressors, and thus on prevention.
Orems theory focuses on the attainment of self-care.
Roys theory focuses on adaptation.
Hendersons theory focuses on helping the client to achieve 14 basic needs.

DIF: Cognitive Level: Knowledge

TOP: Nursing Process: Assessment

REF: page 62
OBJ: 2
MSC: CRNE: PP-11

5. Although similarities exist in the different nursing theories, key elements distinguish one from

another. Which of the following is the emphasis of Jean Watsons conceptual model?
a. Self-care maintains wholeness.
b. Subsystems exist in dynamic stability.
c. Stimuli disrupt an adaptive system.
d. Caring is central to the essence of nursing.
ANS: D

Feedback
A
B
C
D

Self-care is central to Orems theory.

The key emphasis of Johnsons theory is that subsystems exist in dynamic
stability.
The key emphasis of Roys theory is that stimuli disrupt an adaptive system.
Watson believed that nurses must do far more than deal with physical illness; they
must attend to their primary function, which is caring. From Watsons
perspective, caring infuses all aspects of a nurses role and draws attention to
nursing acts as embodying an esthetic that facilitates both healing and growth.

DIF: Cognitive Level: Comprehension

TOP: Nursing Process: Implementation

REF: page 62
OBJ: 2
MSC: CRNE: PP-11

6. A community health nurse is working with a variety of clients and decides to use a systems

theory approach to help them to meet their health care needs. When using systems theory, on
which of the following should the nurse focus?
a. The clients interaction with his or her environment
b. The hierarchy of the clients human needs
c. The clients attitudes toward health behaviours
d. The response of the client to the process of growth and development
ANS: A
Feedback
A

B
C
D

According to systems theory, a system is made up of parts that depend on one

another, are interrelated, share a common purpose, and together form a whole. A
clients interaction with the environment is an example of an open system. The
nurse understands that factors that change the environment also can have an
impact on the system.
Maslows hierarchy of human needs is an interdisciplinary theory useful in
planning individualized care.
Determining a clients attitudes toward health behaviours follows a health and
wellness theoretical model.
Focusing on the response of a client to the process of growth and development is
consistent with developmental theories.

DIF: Cognitive Level: Knowledge

TOP: Nursing Process: Assessment

REF: page 61
OBJ: 2
MSC: CRNE: CH-1

7. While working on a postoperative unit, the nurse is applying elements of self-care theory, and

is assisting a patient to attain and manage self-care in wound management. Which one of the
following nursing pioneers developed this theory?
a. Florence Nightingale
b. Virginia Henderson
c. Dorothea Orem
d. Hildegard Peplau
ANS: C
Feedback
A

The goal of Nightingales theory is to shift the focus from the disease process

C
D

toward an environment conducive to healing.

Henderson defined nursing practice as assisting the individual, sick or well, in the
performance of those activities that will contribute to health, recovery, or a
peaceful death.
The goal of Orems theory is to help the patient perform self-care.
Peplaus theory defined the core of nursing as the interpersonal relationship
between the nurse and the patient.

DIF: Cognitive Level: Comprehension

TOP: Nursing Process: Implementation

REF: pages 6063 OBJ: 2

MSC: CRNE: PP-11

8. Which of the following elements is key to the framework for practice in Martha Rogerss

theory?
Human becoming
Manipulation of the patients environment
Seven categories of behaviour and behavioural balance
Focus upon the life process of a human being along a timespace continuum

a.
b.
c.
d.

ANS: D
Feedback
A

C
D

Rosemarie Parses theory of human becoming (1997) viewed the individual as a

unitary being who is indivisible, unpredictable, and ever-changing and a freely
choosing being who can be recognized through paradoxical patterns co-created
all-at-once in mutual process with the universe.
Nightingales theory includes manipulation of the patients environment (i.e.,
appropriate noise, nutrition, hygiene, light, comfort, socialization, and hope) in
the framework for practice.
Johnsons theory includes seven categories of behaviour and behavioural balance
in the framework for practice.
The framework for practice, according to Martha Rogerss theory, consisted of
presenting the client of nursing not simply as a person but as an energy field in
constant interaction with the environment, which itself was also an irreducible
energy field, co-extensive with the universe. Nursings role was to focus upon the
life process of a human being along a timespace continuum.

DIF: Cognitive Level: Knowledge

TOP: Nursing Process: Planning

REF: page 62
OBJ: 2
MSC: CRNE: PP-11

9. Which one of the following individuals theories should be selected if the nurse wants to focus

on stress reduction for a client?

Peplau
Henderson
Neuman
Parse

a.
b.
c.
d.

ANS: C
Feedback
A

Peplaus theory focuses on interpersonal relationships between nurses and clients

B
C
D

and the interactive, therapeutic nature of the nursing process.

Hendersons theory focuses on the 14 basic human needs.
Neumans theory focuses on stress reduction as the goal of the systems model of
nursing practice.
Parses theory focuses on the notion of nurses engagement with, and care of,
people in a continuous process of making choices and changing health priorities.

DIF: Cognitive Level: Application

TOP: Nursing Process: Planning

REF: page 6162 OBJ: 2

MSC: CRNE: PP-11

10. Which of the following correctly defines the theorizing term proposition?
a. A purposeful set of assumptions
b. A declarative assertion
c. The process of formulating concepts
d. The structure that links concepts together
ANS: B
Feedback
A
B
C
D

A purposeful set of assumptions is a theory.

A proposition is a declarative assertion.
The process of formulating concepts is conceptualization.
The structure that links concepts together is a conceptual framework.

DIF: Cognitive Level: Knowledge

REF: page 56, Table 5-1
OBJ: 1
TOP: Nursing Process: Planning
MSC: CRNE: PP-11
11. Which of the following is a characteristic of complexity science?
a. Patterns of knowledge application
b. A rigid approach for describing experiences
c. Reducing phenomena to smallest properties
d. Orientation to studying the nature of peoples needs
ANS: C
Feedback
A
B
C

Patterns of knowledge application are not characteristic of complexity science.

Complexity science is not a rigid approach for describing experiences.
Complexity science consists of dynamic and interactive phenomena reduced to the
smallest properties that can be observed within their natural context so that their
interactions can be interpreted with as little interference as possible from prior
assumptions.
Complexity science is not characterized by an orientation to studying the nature of
peoples needs.

DIF: Cognitive Level: Comprehension

TOP: Nursing Process: Planning

REF: page 58
OBJ: 5
MSC: CRNE: PP-11

12. Which of the following statements reflects a current concern with the use of the nursing

diagnoses approved by the North American Nursing Diagnoses Association (NANDA)?

a. NANDAs list of nursing diagnoses stifles critical thinking.

b. NANDAs list of nursing diagnoses should replace conceptual nursing models.

c. NANDAs list of nursing diagnoses is an inherent barrier to individualized care.
d. NANDAs list of nursing diagnoses does not reflect practical diagnoses.
ANS: C
Feedback
A
B

NANDAs list of nursing diagnoses may stifle critical thinking, but this has not
been recognized as a concern.
NANDAs list of nursing diagnoses is often considered to be less thorough than
conceptual models of nursing, as it involves only one aspect of caring for
patients.
NANDAs list of nursing diagnoses is recognized by many nurses as a system that
relies entirely upon an agreement about what constitutes average wellness and
illness experiences. It can therefore create worrisome barriers to the
individualized care of patients.
NANDAs list of nursing diagnoses does reflect practical diagnoses.

DIF: Cognitive Level: Knowledge

TOP: Nursing Process: Diagnosis

REF: page 59
OBJ: 8
MSC: CRNE: PP-15

13. The shift in scholarly work regarding nursing theories in the late 1980s challenged nurses to

include which of the following types of knowledge when theorizing?

Clinical
Intuitive
Theoretical
Substantive

a.
b.
c.
d.

ANS: D
Feedback
A
B
C
D

Clinical knowledge was not related to this challenge.

Intuitive knowledge was not related to this challenge.
Theoretical knowledge had been the focus of theorizing for many years before the
late 1980s.
Meleis (1987) challenged nurses to direct their theorizing away from the
processes by which nurses use knowledge and toward the equally challenging
issues associated with the substance of that knowledgethat is, to include
substantive knowledge.

DIF: Cognitive Level: Comprehension

TOP: Nursing Process: Planning

REF: page 63
OBJ: 8
MSC: CRNE: PP-11