Honan - CH. 2 Health education and health promotion

Choose the nursing statement that would best reflect the final component of the "Ask-Tell-Ask-Close" technique of communication and demonstration

"Can you repeat for me the information I just reviewed about weighing food portions?" The last component to the "Ask-Tell-Ask-Close" communication technique is "Close the Loop." This component recommends asking the patient to restate the information as the patient understands it.

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 Teaching techniques and aids enhance learning if they are appropriate to the needs of the client. A client who cannot read will not be able to use a written report about a medication. Insufficient data are in the stem for the student to select the client's physical readiness, social and cultural patterns, and past experiences.

An example of a nursing action that modifies a teaching program because a learner is not experientially ready is:

Changing the wording in a teaching pamphlet so that a patient with a fourth-grade reading level can read and understand the sentences. Experiential readiness to learn refers to past experiences that may influence a person's ability to learn. Previous educational experiences and life experiences in general are significant determinants of a person's approach to learning. People with little or no formal education may not be able to understand the instructional materials presented. People who have had difficulty learning in the past may be hesitant to try again.

In many situations, measurement of which of the following is the most accurate measurement technique to identify changes in patient behavior?

Direct observation of behavior In many situations, measurement of actual behavior is the most accurate and appropriate technique. A variety of measurement techniques can be used to identify changes in patient behavior as evidence that learning has taken place. These techniques include directly observing the behavior; using rating scales, checklist, or anecdotal notes to document the behavior; and indirectly measuring results using oral questioning and written tests.

Select the nursing action that is least likely to motivate a person to learn.

Emphasis on negative outcomes as a method to prevent learning incorrect practices Successful learning is associated with positive encouragement and feedback, a comfortable learning environment, and realistic learning outcomes that an individual can understand and embrace.

Which step of the nursing process determines whether the client understands the health teaching that is provided?

Evaluation Evaluation includes observing the client, asking questions, and then comparing the client's behavioral responses with the expected outcomes. Assessment includes determining the client's readiness regarding learning. Planning includes identification of teaching strategies and writing the teaching plan. Implementation is the step during which the teaching plan is put into action.

A nurse is aware of the fact that nonadherence to prescribed therapy is both common and harmful. How can a nurse best promote adherence to therapeutic regimens among patients?

Help individuals be aware of the benefits of adhering to their prescribed therapy There are numerous strategies and variables involved in promoting adherence. However, helping individuals be cognizant of the specific benefits of adherence is likely to achieve this goal. Negative examples and punitive measures are less effective, and ethically questionable. It is neither practical nor possible to make adherence a precondition for care.

Nonadherence to therapeutic regimens is a significant problem, especially in the elderly population. Nonadherence can lead to which outcome?

Increased cost of treatment Nonadherence to therapeutic regimens is a significant problem for elderly people, leading to increased morbidity, mortality, and cost of treatment. There is an increasing rate of nonadherence among persons with chronic illness. Elderly people may also have problems that affect adherence to therapeutic regimens, such as the side effects of medications and financial constraints

A current trend in health education that significantly influences nursing practice is:

Increased emphasis on patient involvement in their own care. Much of the core of health education today is focused on increasing patient involvement and accountability for their care and treatment plans. Health education programs are often designed as patient safety initiatives and are geared toward encouraging increased communication between patients and care providers.

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?

Maintenance A person is in the 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 nurse is planning to teach a 75-year-old patient about administering his medication. How can the nurse best enhance the patient's ability to learn?

Making the information relevant to the patient's condition Studies have shown that older adults can learn and remember if the information is paced appropriately, relevant, and followed by appropriate feedback.

A nurse is providing feedback to a client who demonstrates how to use an incentive spirometer. What primary role does feedback have in the adult learning process?

Motivates learning Feedback about progress motivates learning. This feedback should be presented as positive reinforcement when the learner is successful, and in the form of constructive suggestions when learning is not successful. Self-esteem may improve as the client increases knowledge; however, this is not the primary role that feedback has on the adult learning process. Decreased client questioning does not necessarily equate to enhanced learning. While effective feedback may enhance the nurse-client relationship, this is not the primary role feedback has in the adult learning process.

Which of the following is accurate regarding wellness? Select all that apply.

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. Explanation: Wellness, as a reflection of health, involves a conscious and deliberate attempt to maximize one's health. Wellness requires planning and conscious commitment and is the result of adopting lifestyle behaviors for the purpose of attaining one's highest potential for well-being. Wellness is not the same for every person.

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:

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.

Which phase of the nursing process encompasses the establishment of expected outcomes?

Planning Planning encompasses specifying expected outcomes. Assessment is directed toward the systematic collection of data about the client's learning needs and readiness to learn. In the implementation phase, the client, the family, and the members of the nursing and health care teams carry out activities outlined in the teaching plan.

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. Older adults frequently have one or more chronic illnesses that are managed with numerous medications and complicated by periodic acute episodes. Older adults may also have other problems that affect adherence to therapeutic regimens, such as increased sensitivity to medications and their side effects, difficulty in adjusting to change and stress, financial constraints, forgetfulness, inadequate support systems, lifetime habits of self-treatment with over-the-counter medications, visual and hearing impairments, and mobility limitations. To promote adherence among older adults, all variables that may affect health behavior should be assessed

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

Requires another opportunity for practice The nurse needs to provide the client with ample opportunity for practice. Only one option represents this answer. The client did not demonstrate adequate knowledge in counting the radial pulse. She would have taken digoxin based on the pulse rate she counted. Insufficient data support that the client cannot learn the skill. Having a family member perform the skill does not ensure it will be done correctly.

The nurse is revising a client's plan of care. What is an example of an expected client outcome?

The client will have the ability to climb a flight of stairs without experiencing difficulty in breathing. The expected outcome needs to be precise and measurable, not general; otherwise, measurement could be generalized. The ability to climb a flight of stairs without experiencing difficulty in breathing is measurable. An expectation of stable blood pressure is not measurable. Purchasing a pair of glasses or attending weekday church is not specific.

Despite chronic illnesses and disabilities, the elderly benefit most from what kind of activities?

Those that help them maintain independence. Although their chronic illnesses and disabilities cannot be eliminated, these adults (the elderly) can benefit most from activities that help them maintain independence and achieve an optimal level of health.

The nurse is providing preoperative information about hip replacement to a group of clients scheduled for this surgery. One of the clients is slightly hearing impaired. What is the best action of the nurse?

Use a model of the hip. For those people who have a hearing impairment, teaching strategies include using visual aids, such as models. The nurse should not speak louder, but should use normal or lower pitch to the voice and position himself or herself so that the clients can see mouth movement.

Which action would be incorporated in a teaching strategy for a hearing-impaired client?

Use of slow, directed, and deliberate speech When teaching clients with a hearing impairment, the nurse should use slow, directed, and deliberate speech. Use of large-print materials and arrangement of materials in a clockwise position would be used for clients with a visual impairment. Demonstrating information and having the person perform a return demonstration would be appropriate for a person with a developmental disability.

Health education of a client by the nurse

is an independent function of nursing practice. Health education is an independent function of nursing practice and is included in all state nurse practice acts. Teaching, as a function of nursing, is included in all state nurse practice acts. Health education is a primary responsibility of the nursing profession. Health education by the nurse focuses on: promoting, maintaining, and restoring health; preventing illness; and assisting people to adapt to the residual effects of illness.

A nurse is exploring various barriers to adult learning in order to promote and enhance learning readiness and comprehension. Which situation does the nurse recognize as being a potential experiential barrier to learning?

An adult with no formal education Experiential readiness refers to past experiences that influence an individual's ability to learn. The adult with no formal education has an experiential barrier to learning. The adult experiencing acute pain has a physical barrier to learning. A client from another culture has a cultural barrier to learning. A client who lacks motivation has a learning readiness barrier to learning.

The nursing instructor has given an assignment to a group of nurse practitioner students. They are to break into groups of four and complete a health-promotion teaching project and present a report back to their fellow students. What project is the best example of health-promotion teaching?

Discussing the importance of preventing sexually transmitted infections (STIs) to a group of 12th-grade students Health promotion encourages people to live a healthy lifestyle and to achieve a high level of wellness. Discussing the importance of STI prevention to a group of 12th-grade students is the best example of a health-promotion teaching project.

There are many goals for health teaching. Which of the following is the primary goal of family and patient education?

Improve patient outcomes The primary goal of patient and family education is to achieve, improve, or alter behaviors that directly or indirectly change and improve patient outcomes.

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 Young adults in their reproductive years want information about parenting issues. Values training is geared more for adolescents. Information about bone-density screening and mammography are for older women.

A nurse is discussing the need for a client to increase activity level and eat a heart-healthy diet. The client tells the nurse, "I eat just fine and I'm not that fond of exercising." The nurse would identify this client at which stage of change?

Precontemplation The client is in the precontemplation stage. In this stage, the client would disagree with suggestions that a change in behavior is needed, as evidenced by the client's terse statement in the scenario. In the contemplation stage, the client would seriously consider the suggestion. In the preparation stage, the client would begin the initial steps toward changing the behavior, with the intent to make the change in the next 30 days. In the action stage, the client engages in the activities that would lead to the behavior change.

A health care provider asked a nurse to teach a patient how to self-administer subcutaneous insulin. After collecting her assessment data and drafting her plan, the nurse selected the teaching strategy that research has indicated has the highest chance of reinforcing knowledge. Which of the following strategies did the nurse select?

Assisting the patient to perform the skill in a simulated setting The highest percentage of information that is retained (90%) occurs when an individual performs a task in comparison to 10% (reading) and 65% (seeing and hearing).

A nurse is preparing an in-service education program for a group of nurses involved in health education. When describing the connection between health teaching and health promotion, which information would the nurse most likely include?

Both are linked by the common goal of achieving high-level wellness. Health teaching and health promotion are linked by a common goal—to encourage people to achieve the highest level of wellness possible so that they can live healthy lives and avoid preventable illnesses. Health teaching goals are not necessarily achieved before those of health promotion. Clients are the primary managers of their health conditions. Nurses are in an ideal position to provide the kind of support that clients need to manage their conditions. Health promotion has become a cornerstone in health policy because of the need to control costs and reduce unnecessary sickness and death.

Place the following nursing actions in sequence in the nursing process. Determining what the patient wants to learn Identifying learning needs and etiology Identifying alterations that need to be made to the teaching plan Putting the teaching plan into action Establishing expected outcomes

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 The steps of the teaching/nursing process are assessment, diagnosis, planning, implementation, and evaluation. Assessment in the teaching-learning process is directed toward the systematic collection of data about the person and family's learning needs and readiness to learn. A nursing diagnosis that relates specifically to a patient's and family's learning needs serves as a guide in the development of the teaching plan. The expected outcomes, which identify the desired behavioral responses of the learner, are completed during the planning phase of the nursing process. The implementation phase of the teaching-learning process, the patient, the family, and other members of the nursing and health care team carry out the activities outlined in the teaching plan. The evaluation phase of the teaching-learning process is used to determine what was effective and what needs to be changed.

Which step of the nursing process determines whether the client understands the health teaching that is provided?

Evaluation Evaluation includes observing the client, asking questions, and then comparing the client's behavioral responses with the expected outcomes. Assessment includes determining the client's readiness regarding learning. Planning includes identification of teaching strategies and writing the teaching plan. Implementation is the step during which the teaching plan is put into action.

Specifying the immediate, intermediate, and long-term goals of learning is an integral component of the teaching-learning process. Which of the following individuals should be included in this goal-setting process? Select all that apply. The patient's primary care provider The nurse who will conduct the teaching The patient himself or herself The patient's family members

The nurse who will conduct the teaching The patient himself or herself The patient's family members Developing the plan and goals of teaching should be a joint effort by the nurse and the patient and family members. This does not imply that involvement by the patient's primary care provider or an advanced practice nurse is detrimental, but it is not normally necessary to include these professionals in the planning stage of health teaching.

Which patient is most in need of health education by the nurse?

A 62-year-old male with chronic kidney injury People with chronic illnesses and disabilities are among those most in need of health education. As the lifespan of the population increases, the number of people with such illnesses also increases. Health information targeted at identifying and managing the exacerbations or issues commonly associated with having a chronic illness or disability is a major focus of health education. People with chronic illness need health care information to participate actively in and assume responsibility for self-care. Health education can help those with chronic illness adapt to their illness, prevent complications, carry out prescribed therapy, and solve problems when confronted with new situations. It can also help to prevent crisis situations and reduce the potential for rehospitalization resulting from inadequate information about self-care.