ANGELES UNIVERSITY FOUNDATION

COLLEGE OF NURSING

THEORETICAL FOUNDATION IN NURSING

1ST SEMESTER, AY 2018-2019

MODULE 3
DIFFERENT VIEWS OF NON-NURSING THEORIES

A. SYSTEMS THEORY IN NURSING

Systems are difficult to define but at its most fundamental, a system is “an ordered,
interrelated set of items linked by flows of energy and matter as distinct from their
surrounding environment.” Thus, most systems are composed of sub-systems, which
operate and interact in a (more-or-less) coherent way and make the larger system
separate from the environment in which it operates.

An important distinction between types of systems is the open system versus the
closed system. Closed systems gain no energy or mass from beyond the system
boundaries. Open Systems may get energy and/or mass from the surrounding
environment. Note that some systems, like the earth, have elements of both open and
closed systems. The earth receives energy from beyond the earth system, the sun,
and it returns energy to space after it has driven processes on the earth. So the earth
is an open system with respect to transfers of energy. Sometimes this is called an
energy cascade. However, the earth does not gain mass from space, nor does it send
mass to space (not usually anyway). Thus, the earth acts as a closed system with
respect to transfers of mass.

One curious and interesting attribute of many systems is that they are self regulating.
This is also known as homeostasis. The interaction of the sub-systems within the
larger system is governed by feedback loops. As the system operates, it generates
outputs that influence its own operations. These outputs represent a kind of
“information” that is sent or returned to various points in the system via pathways
called feedback loops. Feedback information can control (or guide) subsequent
system operations through positive and negative feedbacks. If feedback information
encourages increased response in the system, it is called positive feedback. The rate
of change accelerates causing even more change. Further production in the system
stimulates growth of the system. Unchecked positive feedback in a system can create
a runaway (“Snowballing”) condition. In natural systems, such unchecked growth will
reach a critical limit, leading to instability and disintegration. However most systems
maintain their structure and character over time. If the flows of energy and material
through the system remain balanced over time, it is called a steady state system.
More often systems will show a trend in increasing outputs for a time and then
decreasing outputs for a time. However, the ups balance the downs and the system
continues to operate. This can only occur through negative feedback that dampens
out the change that has started. Some negative feedbacks operate immediately,
others take longer to have an effect. The speed with which negative feedbacks
operate, determines how much the system fluctuates around an average value. A
system exhibiting such dynamic equilibrium fluctuates more than a steady state
system. Most systems resist abrupt change. However the system may reach a
threshold at which it can no longer maintain its character, so it lurches to a new
operational level. This abrupt change places the system in a metastable equlibrium.

Types of Systems

A model is a simplifed, idealized representation of some part (or system) of the real
world. The model makes the system easier to understand. Adjusting one variable in
the model produces a system response and allows prediction of possible changes in
outputs. Models are designed with varying degrees of abstraction. Types of models
range from conceptual to physical, to computer (mathematical) models. To understand
system models, one must first understand various types of systems.

There are many different types of systems , and ther are many different ways to model
them. We are going to apply systems theory to river systems. Rivers are prominent
features on the landscape, and, therefore on maps. They are not only agents of
erosion, but also the means by which the product of erosion (sediment) is carried off
and deposited elsewhere. River systems are very dynamic. Sometimes they carry
tremendous amounts of water, other times they are almost dry. They are linked as
networks. Two or three rivers join to make a larger river and so on. A river system
may be thought of as several types of systems.

Morphological Systems. These are defined only by their structural relationships. A

map shows the structure of a place. A topographic map is a model of the landforms in
a give place. An organizational chart tells you make up and structure of an
organization. These can perhaps show how items are linked but have little idea as to
the flow or dynamics of the system. In the context of streams and rivers, defining its
morphological system wold involve analysis of stream orders and other measurable
characteristics of the drainage basin. These might be slope of the channel, number of
channels, perimeter, shape, etc.

Cascading Systems. In these systems, the subsystems are functionally linked so that
the output of one becomes the input for another. The flow or progression of mass and
energy through several subsystems is known as a cascade. Rivers are classic open,
cascading systems.

Process Response Systems. The focus here is on the total dynamics of the system
not simply the flow. Both mass (water and sediment) and energy (moving water) flow
downward through the system. However these flows vary tremendously and the
response will be different in different river systems or in streams of different age. How
large are the flows of mass and energy and when? What is the system response to
high flow or low flow? In the context of river systems, a mature river will be in a graded
condition. This means the river has attained an equilibrium with the amounts of water
and sediments typically supplied to it. A young river is attempting to attain grade
through the erosional process and will have a different response than a mature river.
The young river also has a steeper slope/profile and different morphological
measures.
Intelligent Systems. This is where the people who came up with systems theory really
blew it. Their idea was that any system that is (largely) under human-control would be
called an intelligent system because human intelligence directed the dynamics and
outcome. However, in the context of river system, some control is more intelligent
than others. Building dams for flood mitigation might be viewed as good and therefore
intelligent. However, stripping the land of vegetation, so that floods occur more often
and the soil is eroded away more quickly is not exactly an intelligent thing to do. Both
are a result of human intelligence (well, at least human activity), but that does not
mean the result is good. Nevertheless, many river systems, especially in modern,
developed countries can be viewed as an intelligently controlled cascading, process-
response systems.

Biological (eco)systems. Finally we need to mention biological systems. A river is not a

biological system in the sense that the Amazon rainforest is a biological system. Any
organism is, in fact, a system maintained with flows of mass and energy. That is true
of micro-organisms, and it is true of humans. When many groups of organisms form
functioning ecological system it is called an ecosystem. Finally, the earth can be
viewed as one, single living organism. This is the Gaia theory of James Lovelock. He
argues that life on the earth regulates many other systems on the plant by affecting (if
not controlling) the composition of gasses in the atmosphere, and through that
regulating the temperature of the planet. Life on the earth is not simply a passenger
on a pile of rocks but rather contributes to homeostasis of subsystems which comprise
all the earth system processes.

B. CHANGE THEORIES IN NURSING

Change theories are used in nursing to bring about planned change. Planned
change involves, recognizing a problem and creating a plan to address it. There are
various change theories that can be applied to change projects in nursing. Choosing
the right change theory is important as all change theories do not fit every change
project. Some change theories used in nursing are Lewin’s, Lippitt’s, and Havelock’s
theories of change.

The change theory by Kurt Lewin is widely used in nursing and involves three
stages. The first stage in Lewin's change theory is the unfreezing stage. In this stage,
the need for change is recognized, the process of creating awareness for change is
begun and acceptance of the proposed change is developed. The second stage is
moving, during which the need for change is accepted and implemented. The third
stage is refreezing and during this stage, the new change is made permanent. Lewin's
theory depends on the presence of a driving and resistant force. The driving force are
facilitators of change and the change agents who are pushing employees in the
direction of change. The resistant forces are the employees or nurses who do not
want the proposed change. For this theory to be successful, the driving force has to
dominate the resistant force.

Lippitt’s theory is based on bringing in an external change agent to put a plan in

place to effect change. There are seven stages in this theory and they are diagnose
the problem, assess motivation, assess change agent’s motivation and resources,
select progressive change objects, choose change agent role, maintain change,
terminate helping relationships. The first three stages correspond to Lewin's
unfreezing stage, the next two to his moving stage and the final two to his freezing
change. In this theory, there is a lot of focus on the change agent. The third stage
assesses the change agent’s stamina, commitment to change and power to make
change happen. The fifth stage describes what the change agent’s role will be so that
it is understood by all the parties involved and everyone will know what to expect from
him. At the last stage, the change agent separates himself from the change project. By
this time, the change has become permanent.

Havelock's change theory has six stages and is a modification of the Lewin's
theory of change. The six stages are building a relationship, diagnosing the problem,
gathering resources, choosing the solution, gaining acceptance and self renewal. In
this theory, there is a lot of information gathering in the initial stages of change during
which staff nurses may realize the need for change and be willing to accept any
changes that are implemented. The first three stages are described by Lewin's
unfreezing stage the next two by his moving stage and the last by the freezing stage.

C. DEVELOPMENT THEORY IN NURSING

Developmental Task – is a skill or a growth responsibility arising at a particular time in

an individual’s life, the successful achievement of which will provide a foundation for
the accomplishment of futured tasks.

1. FREUD’S PSYCHOANALYTIC THEORY

Sigmund Frued (1856 – 1939), an Austrian neurologist and founder of

psychoanalytic offered the first real theory of personality development.

He described child development as being a series of psychosexual stages in which

the child’s interests become focused on a particular body site.

Age Name Pleasure Source Conflict

0-2 years old Oral Mouth: sucking, biting, Weaning away from
swallowing mother’s breast
2-4 years old Anal Anus: defecating or Toilet training
retaining feces
4-5 years old Phallic Genitals Oedipus (boys),
Electra (girls)
6 puberty Latency Sexual urges
sublimated into sports
and hobbies. Same-sex
friends also help avoid
sexual feelings
puberty Genital Physical sexual Social Rules
onwards changes reawaken
repressed needs.
Direct sexual feelings
towards others lead to
sexual gratification.

2. ERICKSON’S THEORY OF PSYCHOSOCIAL DEVELOPMENT

Erickson (1902) was trained in psychoanalytic theory but later developed his
own theory of psychosocial development that considers the importance of culture
and society in development of the personality.
 One of the main concept of his theory, that a person’s social view of himself of
herself is more important than instinctual drives in determining behavior, allows for
a more optimistic view of the possibilities for human growth.

According to Erikson, the successful resolution of each conflict, or

accomplishment of the development task of that stage, allows the individual to go
on the next phase of development.

Stages Developmental Task or Conflict to be Resolved

Oral-Sensory (birth to 1
year)
Musculo-anal (1-3 years)
Locomotor-Genital (3-5
years)
Latency ( 6-11 years)
Adolescence (12-18 years)
Young Adulthood (19-35
years)
Adulthood (35-50 years)
Maturity (50+ years)
Trust vs. mistrust. Babies learn either to trust or
to mistrust that other will care for their basic
needs including nourishment, sucking, warmth,
cleanliness and physical contact.
Autonomy vs. shame and doubt. Children learn
either to be self sufficient in many activities,
including toileting, feeding, walking and talking or
to doubt their own abilities.
.Initiative vs. guilt. Children want to undertake
many adultlike activities, sometimes
overstepping the limits set by parents and feeling
guilty.
Industry vs. inferiority. Children busily learn to be
competent and productive or feel inferior and
unable to do anything well.
Identity vs. role confusion. Adolescents try to
figure out “Who Am I?”. They establish sexual,
ethnic, and career identities, or are confused
about what future roles to play.
Intimacy vs. isolation. Young adults seek
companionship and love with another person or
become isolated from others.
Generativity vs. stagnation. Middle aged adults
are productive, performing meaningful work, and
raising a family, or become stagnant and
inactive.
Integrity vs. despair. Older adults try to make
sense out of their lives, either seeing life as a
meaningful whole or despairing at goals never
reached and questions never answered.

3. PIAGET’S THEORY OF COGNITIVE DEVELOPMENT

Piaget (1896-1980), a Swiss psychologist, introduced concept of cognitive

development. Within each stage are finer units or scheme.

To progress from one period to the text, the child reorganize his or her thinking
processes to bring them closer to reality.

Sensorimotor (0-2 years) Development proceeds from reflex activity to

representation and sensorimotor solutions to

Pre-operational (2-7
years)
Concrete Operation (7-11
years)
Formal Operation (11
years-adulthood)
problems
Problems solved through representation;
language development; (2-4 years); thoughts and
language both egocentric; cannot solve
conservation problems.
Reversibility attained; can solve conservation
problems; Logical operation developed and
applied to concrete problems; cannot solve
complex verbal problems.
Logically solves all types of problems; thinks
scientifically; solves complex problems; cognitive
structures mature.

4. KOHLBERG’S STAGES OF MORAL DEVELOPMENT

According to Kohlberg (1984), recognizing these moral stages is important

when caring for children to help identity how a child may feel about an illness,
whether the child can be depended on to carry out self-care activities, or whether
the child has internalized standards of conduct so he or she does not “cheat” when
away from external control.

Moral stages closely approximate cognitive stages of development, because a

child must be able to think abstractly before being able to understand how rules the
child cannot see apply to him or her, even when no one is there to enforce them.

Level of Moral Stage of Reasoning Approximate

development Age
Preconventional Stage 1: (Punishment and Obedience <11
“do’s and don’ts” Orientation). Right is obedience to
power and avoidance of punishment. (“I
must follow the rules otherwise I will be
punished”).
Stage 2: Instrumental Relativist
Orientation. Right is taking responsibility
and leaving others to be responsible for
themselves. (“I must follow the rules for
the reward and favor it gives”).
Conventional Stage 3: Good-Boy-Nice Girl adolescence
Orientation. Right is being considerate: and
“uphold the values of other adolescents adulthood
and adults” rules of society”. (“I must
follow the rules so I will be accepted”)
Stage 4: Society-Maintaining
Orientation. Right is being good, with
the values and norms of family and
society at large.(“I must follow rules so
there is order in the society”).
Postconventional Stage 5: Social Contract after 20
Reorientation. Right is finding inner
“universal rights” balance between self-
rights and societal rules – a social
 contract.(“I must follow rules as there are
reasonable laws for it”).
Stage 6: Universal Ethical Principle
orientation. Right is based on a higher
order of applying principles to all human-
kind; being non-judgmental and
respecting all human life. (“I must follow
rules because my conscience tells me”).

Health, defined.

The WHO defines health as “a state of complete physical, mental and social well-being
and not merely the absence of disease or infirmity.”

Factors affecting Health

Political Factors

This factor refers to one’s leadership, how he rules, manages and how other people
concerned are followed to actively participate in the decision making process.

1. Political will – the determination to pursue something that is in the interest of the
majority.
2. Empowerment – the ability of the person to do something; it involves creating
the circumstances where people can use their faculties and abilities at maximum
level in the pursuit of common goals.

Economic Factors

This refers to the production, distribution and consumption of goods and services and
how these affect health and development. A study of this factor leads one to look into
economic factor influence how, and at what point, the client enters the health care
system.

Socio – cultural Factors

Social and cultural variables influence a client’s health practices, the dynamics of health
care, and the client – care provider relationship.

Environment Factors

This refers to the sum total of all the conditions and elements that makes up the
surroundings and influence the health and health practices of clients. The environment
with which the client lives and works either promote and maintain health or increase the
likelihood of illness or even death.

DOH THINK HEALTH LINK

1. Healthy Workplaces

A healthy workplace is clean, orderly, well ventilated, adequately lighted, smoke free
and adequately secured. It promotes and protects the health and safety of workers and
their families.

2. Healthy Barrios
A healthy barrios is where people work together towards attaining sustainable
improvement in their lives and aspirations.

3. Healthy Prison

A healthy prison is a clean and safe detention place with adequate facilities and
services address the physical, mental, spiritual, social and economic needs of inmates.
It is temporary home that promotes justice, peace, rehabilitation and healthy lifestyle.

4. Healthy Homes

A healthy homes is where responsible parents provide household members with the
basic physical, social, economic, emotional, mental, moral, spiritual care in a safe
peaceful sanitary environmental where God reigns supreme.

5. Healthy Cities

One where the physical environment especially the workplace, street, and other public
places promote safety, order and cleanliness through structural and manpower support.

6. Healthy Resort

A healthy resort is a place providing rest, recreation, relaxation and wholesome

entertainment that is clean, safe, accessible and affordable to most Filipino families. It
promotes, provides and maintains condition addressing social, environmental and
health concerns.

7. Healthy Hospitals

Is one that provides comprehensive care. It is not only a center for care but also of
preventive care, hence, the concept of hospitals as center of wellness. Clean and
adequate resources, competent hospitals personnel, affordable and accessible services
are some of its key features. It is patient – centered and has provisions for health
education for patients, watchers and the visiting public.

8. Healthy Vehicles

Is clean, safe, comfortable, well ventilated and in good running condition; manned by
reliable and dependable licensed operators who are physically and mentally fit; has one
or two – health information giving posters, stickers or other educational materials and
are smoke free.

9. Healthy Streets

Is that fare that has the following features:

1. well maintained roads and public waiting areas

2. well – marked traffic signs and pedestrian crossing lanes
3. clean and obstruction – free side walks
4. free or has minimal traffic problems
5. fight air pollution by being a part of the clean and green initiative
6. proper and visible street names
7. with adequate and strict law enforcement
 10. Healthy Hotels

Is clean and pleasant place that provides comfort, security, conforms to a set a
guidelines and standards and promotes a healthy lifestyle.

11. Healthy Schools

Is one that provides health instruction through classroom learning / non- curricular
activities and maintains adequate basic health services to both pupils and teachers and
other personnel. It promotes healthy school living through the creation and
maintenance of supportive structures for positive health behavior change.

12. Healthy Eating Places

Places which serve / cater food and drinks that are safe, nutritious, properly prepared,
stored and transported and complies with sanitary standard.

13. Healthy Movie Houses

Is a place providing rest, creation and wholesome entertainment. It safe, and has
competent and friendly employees who are available to assist moviegoers with their
needs. It promotes and maintains conditions addressing social, developmental and
healthy concerns. It has sanitary toilets and adequate communication facilities.

14. Healthy Ports

Is clean, spacious and secure with facilities for public waiting areas, passenger
terminals, safe drinking water, sanitary food shops and public toilets; control disease
causing vectors, minimized unnecessary hazards and with medical facilities
conveniently and economically accessible to public transport and communication.

15. Healthy Markets

Is a place that is characterized by the following features:

1. There is enough water supply, proper drainage and well – maintained

toilet facilities.
2. Quality food are sold within the reach of the common people.
3. Market vendors, buyers, supervisory team and sanitary inspectors are
working together for well – organized and honest market system.

Interlinking Relationships of Factors Affecting Health

A. Political

Involves one’s leadership, how he/she rules, manages and involves other people in
decisions making.

Safety

- the condition of being free from harm, injury loss

 - protection from exploitative working conditions

- expanding access to social security

Oppression

- unjust or cruel exercise of authority or power

Political Will

- determination to pursue something which is in the interest of the

majority

Empowerment

- the ability of a person to do something

- creating the circumstances where people can use their faculties

and abilities at the maximum level in the pursuit of common goals.

B. Cultural

Relating to the representation of nonphysical traits, such as values beliefs, attitudes and
customs shared by a group of people and passed from one generation to the next.

Practices

- a customary action usually done to maintain or promote health

likes use of “anting-anting” or lucky charms.

Beliefs

- a state or habit of mind wherein a group of people place a trust into

something or a person.

C. Heredity

The genetic transmission of traits from parents to offspring, genetically determined.

D. Environment

The sum total of all conditions and elements that make up the surroundings and
influence the development of an individual.
E. Socio-Economic

Refers to the production activities, distribution, and consumption of goods of an

individual.

Care Enhancement Qualities including Core Values

 The phrase "core competencies in nursing" refers to a standard set of
performance "domains" in which it is necessary to demonstrate proficiency to
enter into professional practice. In the U.S., the National Organization of
Nurse Practitioner Faculties (NONPF) identifies these competencies for more
than 90% of the national nursing practitioner education programs, as well as
several in the UK and Canada. The latest guide to domains and
competencies was released in 2006.

Management of Patient Health/Illness Status

o This domain consists of demonstrating competence in applying critical

thinking skills to assess and prioritize patients in a clinical setting, provide
diagnosis through screening, examination and differentiation, as well as offer
guidance and counseling to patients. In addition, the nurse practitioner (NP)
is expected to identify community resources related to rehabilitative services
and follow-up care.

Nurse Practitioner-Patient Relationship

o The NP should be able to communicate effectively with patients to

facilitate an environment of trust and confidentiality while maintaining a
professional demeanor at all times. The NP must also be able to act
collaboratively with patients and other caregivers to achieve a managed-care
plan that respects individual preferences and retains the patient's right to
make decisions about his or her health care.
o

Teaching-Coaching Function

o This domain relates to the ability to evaluate and further the educational
needs of individual patients by providing individual coaching and
personalized learning plans in a supportive environment.

Professional Role

o As a contributing member of various health care teams, the NP must

exhibit leadership qualities to advance safe care practices, promote patient
advocacy and endorse collaborative efforts between the NP and other care
providers in a manner that demonstrates adherence to professional and
ethical standards.

Managing and Negotiating Health Care Delivery Systems

o The NP must participate in managing and enhancing various health care

delivery systems that impact patient care in terms of quality, scope and cost-
effectiveness. In addition, the NP must demonstrate a willingness to explore
new technologies and procedures that affect care delivery, as well as
measures to modify or improve existing systems.
Monitoring and Ensuring the Quality of Health Care Practice

o The competencies considered in this domain include active participation

in monitoring and improving the quality of care.

Culturally-Sensitive Care

o The NP must demonstrate the ability to acknowledge cultural diversity

and actively incorporate the core values and beliefs of various cultures into
the patient's managed-care plan without forming or enforcing a personal
bias. In addition, the NP must consider the spiritual needs of individual
patients and their families.

Core Competencies Under the Eleven Key of Responsibility of Nursing list core
competencies for the nursing profession.

The nursing industry has established eleven key areas of responsibility that
provide a framework for unifying nursing education, practice and regulation. This
comprehensive list of key areas and core competencies within each key area
furnishes the industry with a standardized measure that is used in all aspects of the
nursing profession.

Safety and Quality

o The first key area of nursing responsibility focuses on providing nursing

care that is safe and of high quality. Under this key area, core competencies
include demonstrating knowledge about the health status and illness of a
patient; making appropriate decisions when caring for patients and their
families; and ensuring patient safety, privacy and comfort. Competencies also
include setting appropriate priorities in patient care, working with the medical
team to ensure stability of care, effectively administering medications and
other treatment modalities and performing assessments and nursing services
against a background of established nursing guidelines. The nurse also works
with the medical team and patient's family to develop a plan of care.
Identifying the goals of care and evaluating progress toward those goals are
also core competencies within this key area.

Resources and Environment

o The next key area is the management of resources and environment.

Core competencies in this area include identifying tasks that need to be
completed, developing financially effective programs, ensuring that
equipment performs adequately and maintaining safety in the environment.
o

Health Education

o Educational core competencies include assessing the educational needs

of the patient and family, developing and implementing health education plans
and learning materials and evaluating the outcome of education administered.

Legal Responsibilities

o Core competencies in the legal key area include following legally

mandated state and federal processes and procedures, such as obtaining
 informed consent from patients and adequately documenting all procedures
performed for patients.

Ethical Responsibilities

o In this key area that concerns morals and ethics, core competencies
include respecting the rights of all individuals and groups, accepting
responsibility for individual decisions and adhering to the nurses' national and
international code of ethics.

Professional Development

o The professional development key area includes core competencies of

identifying personal needs for education and pursuing those goals,
participating in professional organizations and community activities,
presenting a professional image and positive attitude as well as performing
work duties in a professional manner.

Quality Improvement

o In the quality improvement key area, core competencies include

identifying areas for improvement, participating in nursing rounds and audits,
staying aware of variances in treatment and recommending solutions to
improve quality.

Research

o Core competencies in the research key area include gathering and

analyzing research data, sharing results and applying findings to work
functions.

Records Management

o The records management key area includes core competencies of

maintaining appropriate documentation using the appropriate system and
staying within legal boundaries in the area of patient privacy.

Communication

o In this key area, core competencies include establishing communication

with the patient and treatment team, learning to read verbal and nonverbal
cues, using visual aids and other resources when necessary, responding to
patient and group needs and effectively using technology to facilitate
communication.

Teamwork

o The teamwork and collaboration key area includes core competencies of

establishing beneficial working relationships with peers and colleagues and
communicating care plans with health team members.
 EVALUATION
POST-TEST

I. Multiple Choices: Choose the correct answer and encircle the best
answer that suits the comprehensive question.

1. When as a graduate student she was challenge by a nurse theorist who

developed the behavioral systems model?

A. Sr. Callista Roy and Dorothea Orem

B. Sr. Calista Ror and Imogene King
C. Sr. Callista Rey and Florence Nightgale
D. Sr. Callista Roy and Dorothy Johnson
E. Sr. Calloi Poy and Dorothea Johnson

2. She was born in Los Angeles, California and her birthday is :

A. October 14, 1893

B. October 14.1988
C. October 14, 1984
D. October 14, 1983
E. October 14, 1939

3. Dr. Roy is best known for developing and continually updating her theory entitled:

A. Roy Adaptation
B. Roy Adaptive Model
C. Adaptation Model for Roy
D. Roy Adaptation Model
E. Roy Adaptation Model and 4 Modes of Adaptation

4. Roy believes that the Person as part of the Metaparadigm is defined as:

A. A behavioral system with adaptive mechanism

B. An Adaptive system
C. An individual with the ability to provide self care
D. An Adaptive system guided with the 4 subsystems
E. An adaptation of the environment

5. Roy believes that the Environment as part of the Metaparadigm is defined as:

A. An internal environment that interacts with the external environment

B. An internal and external stimuli who uses coping skills to cope with stressors
C. An individual who interacts in the external environment only
D. An external stimuli composed of internal stimuli
E. An internal and external stimuli that adapts to the demand of illness only

6. According to Roy each person is made up with two internal processes known as:
 A. Cognition and Regulatory
B. Cognitorum and Regulatorum
C. Condition and Relation
D. Cognator and Regulator
E. Cognition and Regularization
7. It is a coping mechanism that reacts automatically through neuro-chemical-
endocrine process:

A. Cognator
B. Regulator
C. Regulation
D. Cognition
E. Cognator and Regulator

8. A coping mechanism that functions using perception and information processing,

learning and judgement and emotion:

A. Cognition
B. Cognator
C. Condition of Cognition
D. Regulator and Cognition
E. Cognation

9. These are responses that do not contribute to integrity in terms of the goals of
the transformation:

A. Inadequate Responses
B. Ineffective Responses
C. Inefficient Responses
D. Unadaptive Responses
E. Ineffective Responsibility

10. These are responses that promotes integrity in terms of the goals of the human
system:

A. Adaptation
B. Adaptive Mechanism
C. Adaptive Responses
D. Adaptation Model
E. Adaptive individual

11. Dr. Roy developed the Four Modes of Adaption. The Four Modes of Adaptation
are the following:

A. Physiologic, Self-concept, Role function, Independent mode

B. Physiologic, Physical Self, Personal Self, Interdependent mode
C. Physiologic, Self-conscious, Personal, Independent mode
D. Physiologic, Self concept, Role function, Interdependent mode
E. Physiologic, Self, Role and Dependent mode

12. A type of stimulus that immediately affects the person:

A. Focus
B. Focal
C. Context
 D. Contextual
E. Direct Focal

13. All other stimuli present, that are affecting the situation:

A. Focus
B. Focal
C. Context
D. Contextual
E. Direct Focal

14. Those stimuli whose effect on the situation are unclear:

A. Focal
B. Contextual
C. Residual
D. Focal and Residual
E. Residual and Contextual

15. She developed the 21 nursing problems?

A. Dorothy Johnson
B. Dorothea Orem
C. Imogene King
D. Faye Abdellah
E. Madeleine Leininger

16. She advocated that nursing is a humanistic and scientific mode of helping a client
through specific caring process. Who is she?

A. Imogene King
B. Orem
C. Madeleine Leininger
D. Madeleine Albright
E. Callista Roy

17. In order for us nurses to help people of different cultures, she developed three
intervention modes: one of which is:

A. Culture care preservation

B. Culture care
C. Culture care accommodation and relevance
D. Culture care negotiation only
E. Culture care preservation and maintenance

18. In order for us nurses to help people of different cultures, she developed three
intervention modes: one of which is:

A. Cultural Interaction
B. Cultural care repatterning
C. Culture care accommodation, negotiation or both
D. Culture care universality and diversity
E. Culture care preservation and presentation
 19. In order for us nurses to help people of different cultures, she developed three
intervention modes: one of which is:

A. Culture care preservation’

B. Culture care maintenance
C. Culture care accommodation
D. Culture care negotiation
E. Culture care restructuring and repatterning

20. These are caring and curing skilled actions and decision that conserve the
human’s well being:

A. Culture care preservation

B. Culture care
C. Culture care accommodation and relevance
D. Culture care negotiation only
E. Culture care preservation and maintenance

II. Matching type: Match Column A with Column B. Write letters only.

1. It refers to the period when toddlers’ A. Anal Stage

Interests widen and finds pleasure in
Both the retention and defecation of feces. B. Latent stage
2. It refers to the period when infants
Are so interested in oral stimulation. C. Genital Stage

3. It refers to the preschool period when D. Phallic Stage

A child learns sexual identity thru
Awareness of genitalia. E. Oral Stage

4. It refers to the school age period when F. Autonomy vs. Shame

His personality development appears to
Be non-active or dormant. G. Industry vs. Inferiority

5. It refers to the adolescent period when H. Sense of Identity vs Role

They establish satisfactory relationships Confusion
With the opposite sex.
I. Initiative vs. Guilt
6. The developmental task is preschooler.
J. Trust vs. Mistrust
7. The developmental task is school-age

8. The developmental task is infancy.

9. The developmental task is toddler.

10. The developmental task is adolescent.

 FEEDBACK ON PRETEST
III. MULTIPLE CHOICE

1. D.
2. E
3. D
4. D
5. B
6. D
7. B
8. B
9. A
10. B
11. A
12. B
13. D
14. C
15. D
16. C
17. E
18. C
19. E
20. E

I. MATCHING TYPE

1. A – Anal stage
2. E – Oral stage
3. D – Phallic stage
4. B – Latent stage
5. C – Genital stage
6. I – initiative vs. Guilt
7. G – Industry vs. Inferiority
8. J – Trust vs. Mistrust
9. F – Autonomy vs. Shame
10. H – Sense of Identity vs. Role Confusion

EVALUATION
A total score of 21 points (82%) is satisfactory. It indicates adequate
knowledge in the subject.

PREPARED BY:

(SGD)ROLANDO L. LOPEZ JR, RN.MN

TFN INSTRUCTOR

NOTED BY:
(SGD) MA. CORAZON M. TANHUECO, RN, MAN
LEVEL I COORDINATOR