N104 TEST 3 ATI STUDY GUIDE
1. Client-Centered Care
What it means
Client-centered care means the nurse puts the client’s values, needs, preferences, culture, and
choices at the center of care.
ATI way to think about it
Ask yourself:
What does the client want?
What matters most to this client?
Is the client safe?
Is the client being respected?
Is the client included in decisions?
Nursing actions
Listen actively
Respect choices and beliefs
Include the client in planning care
Protect dignity, privacy, and autonomy
Teach in a way the client understands
Adapt care to culture, age, language, and values
Example
A client refuses pork for religious reasons.
Client-centered care = the nurse does not say “just eat it.”
The nurse requests another meal that respects the client’s beliefs.
2. Self-Concept
What is self-concept?
Self-concept is how a person sees and feels about themselves.
It has 4 parts:
,A. Body Image
How a person sees their physical appearance.
Example:
A client after mastectomy says, “I do not feel like myself anymore.”
This is body image.
B. Self-Esteem
How much value or worth a person feels they have.
Example:
A client says, “I am useless now that I cannot work.”
This is low self-esteem.
C. Role Performance
How a person functions in their expected role in life.
Examples of roles:
mother
father
student
nurse
provider
Example:
A father in the hospital says, “I cannot take care of my children the way I used to.”
This is role performance.
D. Identity
A person’s sense of who they are as a unique individual.
Example:
An adolescent says, “I do not know who I am or where I fit in.”
This is identity.
How to assess self-concept
You assess self-concept by looking at how the client talks, acts, and feels about self.
,Ask questions like:
“How do you feel about yourself?”
“How has this illness changed the way you see yourself?”
“How do you feel about your body now?”
“What concerns do you have about your role in your family/work?”
“How would you describe yourself?”
Things the nurse observes
posture
eye contact
grooming
willingness to talk
negative self-talk
social withdrawal
crying
hopelessness
Example
A client avoids looking in the mirror after an amputation.
This suggests a disturbed body image.
How to determine a patient’s identity
Ask questions that help the client describe who they are.
Ask:
“How would you describe yourself?”
“Who are you to yourself?”
“What is important to you?”
“What gives your life meaning?”
“How do you see yourself now?”
ATI may give a question where the nurse is assessing identity, and the best answer will usually
ask about how the client views self as a person.
Congruent vs Incongruent
, Congruent
The words and actions match.
Example:
A client says, “I am okay,” and is calm, relaxed, and smiling.
This is congruent.
Incongruent
The words and actions do not match.
Example:
A client says, “I’m fine,” but is crying, shaking, and avoiding eye contact.
This is incongruent.
ATI tip
When communication is incongruent, pay attention more to the nonverbal behavior.
3. Adolescence and Erikson Theory
Adolescence
Adolescence is a time of:
identity formation
peer influence
body changes
independence
emotional ups and downs
Erikson stage for adolescence
Identity vs Role Confusion
Task of this stage
The adolescent is trying to answer:
“Who am I?”
1. Client-Centered Care
What it means
Client-centered care means the nurse puts the client’s values, needs, preferences, culture, and
choices at the center of care.
ATI way to think about it
Ask yourself:
What does the client want?
What matters most to this client?
Is the client safe?
Is the client being respected?
Is the client included in decisions?
Nursing actions
Listen actively
Respect choices and beliefs
Include the client in planning care
Protect dignity, privacy, and autonomy
Teach in a way the client understands
Adapt care to culture, age, language, and values
Example
A client refuses pork for religious reasons.
Client-centered care = the nurse does not say “just eat it.”
The nurse requests another meal that respects the client’s beliefs.
2. Self-Concept
What is self-concept?
Self-concept is how a person sees and feels about themselves.
It has 4 parts:
,A. Body Image
How a person sees their physical appearance.
Example:
A client after mastectomy says, “I do not feel like myself anymore.”
This is body image.
B. Self-Esteem
How much value or worth a person feels they have.
Example:
A client says, “I am useless now that I cannot work.”
This is low self-esteem.
C. Role Performance
How a person functions in their expected role in life.
Examples of roles:
mother
father
student
nurse
provider
Example:
A father in the hospital says, “I cannot take care of my children the way I used to.”
This is role performance.
D. Identity
A person’s sense of who they are as a unique individual.
Example:
An adolescent says, “I do not know who I am or where I fit in.”
This is identity.
How to assess self-concept
You assess self-concept by looking at how the client talks, acts, and feels about self.
,Ask questions like:
“How do you feel about yourself?”
“How has this illness changed the way you see yourself?”
“How do you feel about your body now?”
“What concerns do you have about your role in your family/work?”
“How would you describe yourself?”
Things the nurse observes
posture
eye contact
grooming
willingness to talk
negative self-talk
social withdrawal
crying
hopelessness
Example
A client avoids looking in the mirror after an amputation.
This suggests a disturbed body image.
How to determine a patient’s identity
Ask questions that help the client describe who they are.
Ask:
“How would you describe yourself?”
“Who are you to yourself?”
“What is important to you?”
“What gives your life meaning?”
“How do you see yourself now?”
ATI may give a question where the nurse is assessing identity, and the best answer will usually
ask about how the client views self as a person.
Congruent vs Incongruent
, Congruent
The words and actions match.
Example:
A client says, “I am okay,” and is calm, relaxed, and smiling.
This is congruent.
Incongruent
The words and actions do not match.
Example:
A client says, “I’m fine,” but is crying, shaking, and avoiding eye contact.
This is incongruent.
ATI tip
When communication is incongruent, pay attention more to the nonverbal behavior.
3. Adolescence and Erikson Theory
Adolescence
Adolescence is a time of:
identity formation
peer influence
body changes
independence
emotional ups and downs
Erikson stage for adolescence
Identity vs Role Confusion
Task of this stage
The adolescent is trying to answer:
“Who am I?”
