Post RN BSN Advanced Concepts in Nursing I – Unit III Functional Health Patterns (Gordon) Solved Answers
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| Gordon's 11 Functional Health Patterns Solved Answers | Post RN BSN ACN-I Use as a revision guide and verify with your course notes. |
Unit III: Functional Health Patterns (Gordon)
Course syllabus · Model exam answers
B.Sc NURSING (POST-RN), FIRST YEAR, SEMESTER-I
ADVANCED CONCEPTS IN NURSING I (ACN-I) – COURSE NO. 701
UNIT III: FUNCTIONAL HEALTH PATTERNS (GORDON)
Syllabus topics: Concepts of functional health patterns; enumerate the 11 functional health patterns according to Gordon.
Q-1. What are functional health patterns (FHPs)? Explain the concept and who developed it.
Functional health patterns are a framework for nursing assessment developed by Marjory Gordon (nurse theorist, Boston College). A pattern is a sequence of behaviours across time that expresses the way a person lives and functions. Gordon described eleven areas that together give a holistic picture of the client’s health, and used them to organize data collection and to link findings to nursing diagnoses (she was also a founding member of NANDA).
- They are not a nursing theory but an assessment framework.
- Each pattern is influenced by biological, developmental, social, cultural and spiritual factors.
- Findings are judged as functional (effective) or dysfunctional (ineffective), compared with the client’s own norm, age group and culture.
- Data are collected by interview, observation and examination.
Q-2. List the 11 functional health patterns according to Gordon.
- Health perception–health management
- Nutritional–metabolic
- Elimination
- Activity–exercise
- Sleep–rest
- Cognitive–perceptual
- Self-perception–self-concept
- Role–relationship
- Sexuality–reproductive
- Coping–stress tolerance
- Value–belief
Memory aid: Health, Nutrition, Elimination, Activity, Sleep, Cognition, Self, Roles, Sex, Coping, Values (H-N-E-A-S-C-S-R-S-C-V).
Q-3. Why are functional health patterns used in nursing? Write their advantages and limitations.
| Advantages | Limitations |
|---|---|
| Holistic: covers physical, psychological, social and spiritual health | Long; takes time for a full assessment |
| Not tied to a medical model; useful in any setting and age group | Needs good communication skills and privacy |
| Organizes data for nursing diagnosis (NANDA-I, linked to patterns) | Some questions are sensitive (sexuality, values) |
| Standardized: easier documentation and handover | Interpretation depends on norms and culture |
| Used in teaching, research and community assessment | Not all data fit neatly in one pattern (overlap) |
Q-4. Describe how the FHP assessment is carried out. State the steps and give a sample assessment.
- Prepare: private, quiet place; explain the purpose; obtain consent.
- Interview using the pattern headings, starting with the client’s own words.
- Observe and examine (appearance, vital signs, skin, nutrition, mobility, mood).
- Review records and speak to family when needed.
- Cluster data by pattern and compare with norms.
- Identify functional and dysfunctional patterns, then write nursing diagnoses and a care plan.
- Re-assess at intervals.
Sample (made-up) data cluster: a 62-year-old man admitted with a leg ulcer: “I stop my sugar tablets when I feel well” (health management), eats rice and sweets daily (nutrition), wound not healing (nutrition/skin), cannot walk far (activity), sleeps 4 hours (sleep). Possible diagnoses: ineffective health management, imbalanced nutrition, impaired skin integrity, impaired physical mobility, disturbed sleep pattern.
Q-5. Health perception–health management: explain this pattern.
1. Health perception–health management pattern
How the client perceives and manages health and well-being; health practices; adherence; preventive habits.
| Assess (examples) | Possible dysfunctional pattern / nursing diagnoses | Nursing focus |
|---|---|---|
| Health in own words; illness history; immunization and screening; smoking, alcohol, tobacco; medicines and adherence; safety habits; knowledge of illness. | Ineffective health management; Deficient knowledge; Noncompliance (adherence); Risk-prone health behaviour; Readiness for enhanced health management. | Health teaching, motivation, support systems, follow-up (see Part 4). |
Q-6. Nutritional–metabolic: explain this pattern.
2. Nutritional–metabolic pattern
Food and fluid intake relative to metabolic need; condition of skin, hair, nails, mucosa and teeth; healing; temperature.
| Assess (examples) | Possible dysfunctional pattern / nursing diagnoses | Nursing focus |
|---|---|---|
| 24-hour diet recall; appetite; weight change; allergies; swallowing; special diets; skin, teeth; height, weight, BMI. | Imbalanced nutrition; Overweight; Deficient fluid volume; Impaired swallowing; Impaired skin integrity; Hyperthermia / hypothermia. | Dietary counselling, weight monitoring, hydration, skin care (see Part 5). |
Q-7. Elimination: explain this pattern.
3. Elimination pattern
Bowel, bladder and skin excretion: regularity and control.
| Assess (examples) | Possible dysfunctional pattern / nursing diagnoses | Nursing focus |
|---|---|---|
| Bowel frequency, consistency, aids; urine pattern; incontinence; sweating; odours; drainage tubes or stomas. | Constipation; Diarrhea; Bowel incontinence; Urinary retention; Urge or stress incontinence; Impaired urinary elimination. | Fluids, fibre, routine, toileting programme, skin and catheter care (see Part 6). |
Q-8. Activity–exercise: explain this pattern.
4. Activity–exercise pattern
Exercise, activity, leisure and recreation; energy needed for daily living; also cardiovascular and respiratory function.
| Assess (examples) | Possible dysfunctional pattern / nursing diagnoses | Nursing focus |
|---|---|---|
| Daily activities; exercise; ADLs (bathing, dressing, feeding, toileting); mobility aids; breathlessness; chest pain; leisure; muscle strength. | Activity intolerance; Impaired physical mobility; Self-care deficit; Sedentary lifestyle; Ineffective breathing pattern; Decreased cardiac output; Deficient diversional activity. | Graded exercise, ADL assistance, positioning, ambulation, energy conservation. |
Q-9. Sleep–rest: explain this pattern.
5. Sleep–rest pattern
Pattern of sleep, rest and relaxation across 24 hours and the client’s feeling of restedness.
| Assess (examples) | Possible dysfunctional pattern / nursing diagnoses | Nursing focus |
|---|---|---|
| Usual sleep hours; difficulty falling or staying asleep; naps; night-time habits; day-time tiredness; medicines; relaxation methods. | Disturbed sleep pattern; Insomnia; Sleep deprivation; Fatigue; Readiness for enhanced sleep. | Sleep hygiene, comfortable environment, treat pain and anxiety, relaxation. |
Q-10. Cognitive–perceptual: explain this pattern.
6. Cognitive–perceptual pattern
Senses, perception, language, memory, orientation, learning, decision making and pain perception.
| Assess (examples) | Possible dysfunctional pattern / nursing diagnoses | Nursing focus |
|---|---|---|
| Vision, hearing, taste, smell, touch; pain; orientation; memory; language; education level; learning preferences; decision making. | Acute or chronic pain; Disturbed sensory perception; Impaired memory; Acute confusion; Deficient knowledge; Impaired verbal communication; Unilateral neglect. | Safe environment, pain relief, orientation, teaching adapted to the client. |
Q-11. Self-perception–self-concept: explain this pattern.
7. Self-perception–self-concept pattern
How the client sees and feels about self: body image, self-esteem, identity, abilities and mood.
| Assess (examples) | Possible dysfunctional pattern / nursing diagnoses | Nursing focus |
|---|---|---|
| “How would you describe yourself?”; feelings about appearance and body changes; confidence; mood; eye contact, posture, voice. | Disturbed body image; Low self-esteem (chronic or situational); Disturbed personal identity; Hopelessness; Powerlessness; Anxiety; Fear. | Active listening, strengths, goal setting, support groups, counselling. |
Q-12. Role–relationship: explain this pattern.
8. Role–relationship pattern
Roles in family, work and society and the quality of relationships.
| Assess (examples) | Possible dysfunctional pattern / nursing diagnoses | Nursing focus |
|---|---|---|
| Family structure and living arrangements; job and income; important relationships; responsibilities; social contact; abuse or violence screening. | Ineffective role performance; Parental role conflict; Impaired parenting; Caregiver role strain; Social isolation; Interrupted family processes; Grieving; Risk for violence. | Family conferences, social support, community resources, referral (social worker). |
Q-13. Sexuality–reproductive: explain this pattern.
9. Sexuality–reproductive pattern
The client’s satisfaction or dissatisfaction with sexuality and reproductive patterns, including menstrual and fertility history.
| Assess (examples) | Possible dysfunctional pattern / nursing diagnoses | Nursing focus |
|---|---|---|
| Menstrual history, pregnancies, contraception, menopause; sexual function and satisfaction; concerns; STI and cancer screening. | Sexual dysfunction; Ineffective sexuality pattern; Ineffective childbearing process; Risk for infection (STI). | Ask respectfully and privately; reassure; teach; maintain confidentiality; refer. |
Q-14. Coping–stress tolerance: explain this pattern.
10. Coping–stress tolerance pattern
The client’s general coping pattern and effectiveness in handling stress, including support systems.
| Assess (examples) | Possible dysfunctional pattern / nursing diagnoses | Nursing focus |
|---|---|---|
| Recent big changes or losses; main stressors; usual coping (talking, prayer, withdrawing, anger, substances); who helps; how well coping works. | Ineffective coping; Defensive coping; Compromised family coping; Anxiety; Post-trauma syndrome; Stress overload; Risk for self-directed violence. | Problem solving, relaxation, counselling, family support; assess suicide risk if hopeless (see Part 2). |
Q-15. Value–belief: explain this pattern.
11. Value–belief pattern
Values, beliefs (including spiritual and religious) and goals that guide choices and decisions about health.
| Assess (examples) | Possible dysfunctional pattern / nursing diagnoses | Nursing focus |
|---|---|---|
| “What is important in life?”; religious or spiritual beliefs; practices affecting care (prayer, diet, dress, fasting); conflicts with treatment; hopes. | Spiritual distress; Moral distress; Decisional conflict; Readiness for enhanced spiritual well-being. | Respect beliefs, allow rituals, refer to religious leader, explain care options. |
Q-16. Write the interview questions a nurse might use for a quick FHP screening.
| Pattern | Sample question |
|---|---|
| Health perception | “How has your health been? What do you do to stay healthy?” |
| Nutrition | “What did you eat yesterday? Any change in weight?” |
| Elimination | “Any problem passing urine or stool?” |
| Activity | “Can you do your daily activities by yourself?” |
| Sleep | “Do you feel rested after sleep?” |
| Cognition | “Any problem with seeing, hearing, memory or pain?” |
| Self-concept | “How do you feel about yourself?” |
| Role | “Who lives with you? Who supports you?” |
| Sexuality | “Do you have any concerns related to reproductive or sexual health?” (ask privately) |
| Coping | “What has been stressful lately? How do you cope?” |
| Values | “Is there anything in your faith or beliefs that you want us to respect during care?” |
Q-17. Compare Gordon’s functional health patterns with the nursing process and with Maslow’s hierarchy.
| Point | FHP | Nursing process | Maslow |
|---|---|---|---|
| Nature | Assessment framework | Problem-solving method (ADPIE) | Theory of human needs |
| Use | Organizes assessment data | Whole care cycle | Ranks needs by priority |
| Link | Data lead to diagnoses (step 2) | FHP supports step 1 (assessment) | Physiological and safety needs first; FHP has no ranking |
FHP are used at the assessment step of the nursing process (Unit I); Maslow’s hierarchy helps to prioritize the problems found.
Q-18. Solve the following made-up case using FHP.
Case. Mrs R, 68, widow, admitted with fractured hip after a fall at home. She lives alone, sleeps poorly, eats little, says “I am a burden; it is God’s will,” and has not moved her bowels for 4 days.
| Pattern | Data | Possible nursing diagnosis |
|---|---|---|
| Health management | Fall at home | Risk for falls (home safety teaching) |
| Nutrition | Eats little | Imbalanced nutrition: less than body requirements |
| Elimination | No bowels for 4 days | Constipation |
| Activity | Fractured hip | Impaired physical mobility; Acute pain |
| Sleep | Poor sleep | Disturbed sleep pattern |
| Self-concept | “I am a burden” | Low self-esteem; Hopelessness (assess mood and suicide risk) |
| Role / relationship | Widow, lives alone | Social isolation; Loneliness |
| Value-belief | “God’s will” | Possible spiritual strength: support practices; Readiness for enhanced spiritual well-being |
Priority: pain and safety, then elimination and nutrition, then psychosocial support and discharge planning.
Q-19. Write the importance of this unit for a Post RN BSN nurse.
- A single, holistic framework for assessment in hospital and community.
- Makes documentation and handover uniform and complete.
- Connects assessment findings to nursing diagnoses and care plans.
- Useful for the family and community health assessments in later courses.
Conclusion: Gordon’s eleven patterns turn a scattered history into a structured, holistic assessment that leads directly to nursing diagnoses.
Suggested references (see the syllabus page for its own reading list): Gordon, M. Manual of Nursing Diagnosis (Functional Health Patterns; latest edition). Jones & Bartlett / Elsevier.
Herdman, T. H., Kamitsuru, S., & Lopes, C. T. (Eds.). NANDA International Nursing Diagnoses: Definitions and Classification (current edition). Thieme.
Potter, P. A., & Perry, A. G. Fundamentals of Nursing (latest edition). Elsevier.
Smeltzer, S. C., & Bare, B. G. Brunner & Suddarth’s Textbook of Medical-Surgical Nursing (latest edition). Lippincott.
Kozier, B., Erb, G., et al. Fundamentals of Nursing (latest edition). Pearson.
Source syllabus: Post RN BSN Nursing ACN-I Course (course syllabus) (original post dated April 12, 2019).
Series (Advanced Concepts in Nursing I, Course No. 701): Part 1: Unit I – Nursing Process and Diagnoses. Part 2: Unit II – Theoretical Frameworks. Part 3: Unit III – Functional Health Patterns. Part 4: Unit IV – Health Perception and Health Management. Part 5: Unit V – Nutritional-Metabolic Pattern. Part 6: Unit VI – Elimination Pattern. Part 7: Units VII–VIII – Activity-Exercise and Coping-Stress. Part 8: Units IX–X – Sleep-Rest and Sexuality-Reproduction. Part 9: Units XI–XII – Role Relationships and Pain. Part 10: Units XIII–XIV – Self-Perception and Values-Beliefs. Part 11: Clinical Objectives. Part 12: Learning Advanced Nursing Concepts – facts, skills, uses, benefits and hurdles.
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