Chapter 4: Health Education & Health Promotion
Which phase of the nursing process encompasses the establishment of expected outcomes?
Planning -Planning encompasses specifying expected outcomes.
Choose the nursing statement that would best reflect the final component of the "Ask-Tell-Ask-Close" technique of communication and demonstration. - "Is this a good time for me to show you how to irrigate your colostomy?" -"Can you repeat for me the information I just reviewed about weighing food portions?" -"Here are the written directions for changing your dressings." -"Do you understand how to take your blood pressure?"
"Can you repeat for me the information I just reviewed about weighing food portions?"
A nurse is teaching a client on the proper technique of using a metered dose inhaler. In the middle of the teaching the client states, "This is so hard! I'm nervous I'm going to do this wrong!" To facilitate learning for the client, what statement will the nurse use in response to the client's concern? - "Let me break it down in smaller steps." -"What is it that you don't understand?" -"Let me re-read the teaching material to you." -"Why do you feel it is too hard?"
"Let me break it down in smaller steps."
The nurse is administering a new medication to an elderly male client and begins instruction about the medication. The client states, "Tell my wife. She takes care of all this kind of stuff." The nurse replies - "It is necessary that you learn about this medication." -"When your wife comes in to visit, I will return and provide the information to both of you." -"I will print the information about this medication and leave it with you to give to her." -"I will have to return when she arrives."
"When your wife comes in to visit, I will return and provide the information to both of you."
Which of the following is accurate regarding wellness? Select all that apply. - It requires a conscious commitment. -It is the result of adopting lifestyle behaviors for the attainment of one's highest potential. -One tries to maximize one's own health. -It is a specific health status with the absence of disease. -Is the same for every person
- One tries to maximize one's own health. -It requires a conscious commitment. -It is the result of adopting lifestyle behaviors for the attainment of one's highest potential.
Which of the following is an example of adherence to treatment? Select all that apply - Inability to comply with follow-up appointments -Self-monitoring for signs and symptoms of illness -Increasing daily activities -Maintaining a healthy diet -Taking prescribed medications
-Maintaining a healthy diet -Self-monitoring for signs and symptoms of illness -Taking prescribed medications -Increasing daily activities
What percentage of people older than 65 years of age has one or more chronic disease?
80
A recommended approach to planning health teaching is applying the trans-theoretical model, which considers the stages of behavioral change. The stage in which the patient engages in calorie counting to reduce weight is called: -Maintenance -Preparation -Action -Contemplation
Action
What nursing action involves modifying a teaching program if a learner is not experientially ready? -Postponing a teaching session with a patient until pain has subsided -Changing the wording in a teaching pamphlet so that a patient with a fourth-grade reading level can understand it -Notifying the physician that the patient will not yet be eligible for discharge -Contacting family members to assist in goal development to help stimulate motivation
Changing the wording in a teaching pamphlet so that a patient with a fourth-grade reading level can understand it
Which action by the nurse can negatively affect the patient's ability to learn?
Criticism when the patient is unsuccessful so that inappropriate behavior patterns will not be learned
A community health nurse is preparing learning materials for an upcoming public seminar for adults. What factors will the nurse consider, based on applying concepts of adult learning readiness? Select all that apply. -Physical status -Culture -Teaching style -Personal values -Emotional status
Culture Personal values Physical status Emotional status
In many situations, measurement of which of the following is the most accurate measurement technique to identify changes in patient behavior? -Anecdotal notes -Use of rating scales -Direct observation of behavior -Use of checklists
Direct observation of behavior
Select the nursing action that is least likely to motivate a person to learn. - The creation of an atmosphere in which the patient is encouraged to express anxiety -The establishment of learning goals based on individual needs -Emphasis on negative outcomes as a method to prevent learning incorrect practices -Constructive encouragement when a person has been unsuccessful in the learning proces
Emphasis on negative outcomes as a method to prevent learning incorrect practices
There are many goals for health teaching. Which of the following is the primary goal of family and patient education? -Establish trust -Motivate people to learn -Improve patient outcomes -Increase knowledge
Improve patient outcomes
The nurse is planning to teach a client who was recently diagnosed with migraine headaches. It is best to teach the client -In a quiet room -Immediately following a headache experience -With her spouse and children present -During the headache recovery phase
In a quiet room
Which of the following is a nursing diagnosis related to health education? -Ineffective health maintenance -Self-esteem disturbance -Ineffective airway clearance -Altered nutrition, less than body requirements
Ineffective health maintenance -Diagnoses related to health education may include ineffective health maintenance, health-seeking behaviors, deficient knowledge, and readiness for enhanced knowledge. The other nursing diagnoses do not related to health education.
The nurse is providing information to a client about the safe use of a newly prescribed medication. The first question the nurse should ask is -What teaching aids do I need? -What is the expected outcome? -How do I evaluate client learning? -Is the client ready to learn?
Is the client ready to learn?
Which factor is a leading health indicator used to measure the health of the nation? -Religion -Overweight and obesity -Intelligence -Cultural awareness
Overweight and obesity
The nurse is developing a health-promotion program at a company in which many employees are women in their 20s and 30s. For this population, the nurse plans to include information about - Parenting issues -Mammography -Bone-density screening -Values training
Parenting issues
A nursing student observes the home care nurse provide education to a client with congestive heart failure (CHF). The nurse teaches the client how to read food labels and calculate sodium content. The nursing student recognizes that the home care nurse is aware of which basic principle of patient education? - Patient instruction related to self-care activities promotes patient independence -The home care nurse has a physician order to teach a 2-g sodium diet -The home care nurse is providing hospital discharge instructions -Patients are required to learn about their therapeutic nutritional regimen
Patient instruction related to self-care activities promotes patient independence
A nurse developed a program of increased ambulation for a patient with an orthopedic disorder. This goal setting is a component of the nursing process known as: - Evaluation -Implementation -Planning -Assessment
Planning -Once assessment data are collected, the next step is to plan the teaching intervention, which begins with specifying immediate, intermediate, and long-term goals.
The home health nurse reviews a medication administration calendar with an elderly patient. In order to consider sensory changes that occur with aging, how should the nurse proceed? -Print directions in large, bold type, preferably using black ink. -Type out the information on the computer. -Highlight or shade important dates and times with contrasting colors. -Use several different colors to emphasize special dates.
Print directions in large, bold type, preferably using black ink.
A nurse is teaching a client taking digoxin about checking the pulse rate daily. The client counts her radial pulse as 64 beats/min. The nurse counts at the same time and assesses the rate as 58 beats/min. When evaluating response to treatment, the nurse would chart that the client - Cannot satisfactorily learn the skill -Needs a family member to perform this skill -Demonstrates adequate knowledge of the skill -Requires another opportunity for practice
Requires another opportunity for practice
A 27-year-old client is a regular smoker, has diabetes, and has been diagnosed with hypertension. The client says it is cumbersome and time consuming to visit the doctor regularly just for a blood pressure check. Which aspect of teaching would the nurse use with this client? - Advise smoking cessation -Discuss methods for stress reduction -Apply glycemic control -Suggest the client purchase a self-monitoring cuff
Suggest the client purchase a self-monitoring cuff
A nurse is planning discharge instructions for a client from another culture. What does the nurse understand about the relationship of values and beliefs and the client's readiness to learn? - The client will likely accept health education, but will take longer to learn. -The client will be less likely to accept health education unless the nurse and client share values and beliefs. -The client will be less likely to accept health education unless values and beliefs are respected. -The client will likely accept health education regardless of values and beliefs.
The client will be less likely to accept health education unless values and beliefs are respected
The nurse is revising a client's plan of care. What is an example of an expected client outcome? - The client will accept the option of attending church on weekdays. =The client's blood pressure will be stable. -The client will buy a pair of reading glasses to help with reading. -The client will have the ability to climb a flight of stairs without experiencing difficulty in breathing.
The client will have the ability to climb a flight of stairs without experiencing difficulty in breathing.
Place the following nursing actions in sequence in the nursing process. 3 Identifying learning needs and etiology 4 Determining what the patient wants to learn 5 Establishing expected outcomes 2 Identifying alterations that need to be made to the teaching plan 1 Putting the teaching plan into action
-Determining what the patient wants to learn -Identifying learning needs and etiology -Establishing expected outcomes -Putting the teaching plan into action -Identifying alterations that need to be made to the teaching plan 4,3,5,2.1
The nurse is in the process of initiating and delivering a teaching-learning program. What is the strongest predictor of a client's health status? - High socio- economic level -Cultural skills -Health literacy skills -Life style
Life style -Lifestyle is the strongest predictor of a client's health status
The practice of nursing care is multifaceted in its scope and delivery. Which of the following activities describe the role of nursing? Select all that apply. - Health education and maintenance Promoting health -Altering a medical plan of care -Preventing illness -Changing prescribed treatment protocols
Promoting health Preventing illness Health education and maintenance
The nurse is providing discharge instructions to an elderly client. The nurse hands the client a paper about a new medication. The client cannot read. Learning does not occur. In this situation the nurse has failed to assess the -Appropriateness of teaching techniques -Client's social and cultural patterns -Physical readiness of the client -Past experiences of the client
Appropriateness of teaching techniques
Which step of the nursing process determines whether the client understands the health teaching that is provided? -Assessment -Planning -Implementation -Evaluation
Evaluation -Evaluation includes observing the client, asking questions, and then comparing the client's behavioral responses with the expected outcomes
The nurse is caring for a 33-year-old male client. Which clinical screening should the client have, based on his age? -Electrocardiogram -Colonoscopy -Hemoccult screening -Lipid panel
Lipid panel
Health education is important for all patients and families. Of the four groups listed below, which group is most in need of health teaching? -Patients with a terminal illness, because the process of dying can be managed with dignity -Patients under 21 years of age, because new behaviors can be practiced for many years -Patients with chronic illnesses, because life-long interventions and adjustments can improve the quality of life -Patients who are diagnosed with acute infections, because treatment and future prevention can be immediately addressed
Patients with chronic illnesses, because life-long interventions and adjustments can improve the quality of life
A hospitalized client reports right lower quadrant abdominal pain at a level of 8 on a 0 to 10 scale. The client is scheduled for an appendectomy. The nurse is teaching the client about use of the incentive spirometer postoperatively verbally and by demonstration. The client is on his side, clutching his abdomen. Learning is not occurring. The nurse has primarily failed to consider the client's -Experiential readiness -Physical readiness -Emotional readiness -Learning environment
Physical readiness
The nurse is preparing to teach a client about a newly prescribed medication. The client lacks insurance. The medication costs approximately $100 per month. The client states, "I can't afford it." The nurse assesses a variable to successful education and health promotion for this client based on the Health Belief Model is -Demographic and disease factors -Perceptual factors -Barriers -Resources
Resources -The Health Belief Model is based on the premise that four variables influence health promotion behaviors Resources address finanical and social behaviors
The nurse is teaching an elderly client about heart failure. What action will the nurse do to enhance learning? -provide the necessary information in one teaching session -sit in a chair a few feet away from the client -frequently repeat the provided information -look at notes to ensure all information is covered
frequently repeat the provided information
When a person works to prevent relapse and to sustain the gains made from actions taken, he or she is in which stage of the Transtheoretical Model of Change? -Termination -Contemplative -Action -Maintenance
Maintenance -maintenance stage of the Transtheoretical Model of Change when there is work to prevent relapse and to sustain the gains made from the actions taken.
The school nurse informs the mother of a second-grade student that lice were found in the child's hair. The mother explains to the nurse that she has another child to pick up and cannot stay to receive education related to the treatment of lice at this time. The mother reassures the nurse that she will "look up treatment options on the Internet and take care of the child." What would be the best action of the school nurse in this situation? - Perform hand hygiene and notify the second-grade teacher to wash down the classroom -Provide the mother with a list of credible websites related to the treatment of lice -Notify the social worker of suspected child neglect and make a referral to child protective services -Instruct the mother to treat the other child for lice in the same manner as the second-grade child
Provide the mother with a list of credible websites related to the treatment of lice
A current trend in health education that significantly influences nursing practice is: - Increased emphasis on the diversity of patient needs. -Improved distribution of health information materials. -Increased emphasis on patient involvement in their own care. -Increased numbers of health care providers.
Increased emphasis on patient involvement in their own care.
A nurse knows that the use of a learning contract increases motivation and increases the likelihood of patient compliance with the treatment regimen. Which client goal best exemplifies a well-designed learning contract? - The client who wishes to stop smoking agrees to cut back on one cigarette a day for the first week of treatment and then decrease smoking by two cigarettes the following week of treatment. -The client who wishes to lose weight immediately reduces caloric intake to 1000 calories a day and agrees to keep to this diet plan until a 9-kg weight loss has been achieved. -The client seeking alcohol treatment agrees to stop drinking all forms of alcohol immediately and plans to chew a stick of gum when they experience the urge to have a drink. -The client who wants to begin an exercise program agrees to participate in a 10-km run 6 months after starting the new exercise regimen.
The client who wishes to stop smoking agrees to cut back on one cigarette a day for the first week of treatment and then decrease smoking by two cigarettes the following week of treatment.
