prepu test 1

self-recognition

18 months

self-definition

3 years

self-concept

6-7 years

(see full question) A nurse is assessing the nutritional needs of clients. Which criteria indicates that a client most likely needs total parenteral nutrition (TPN)?

Absence of bowel sounds Explanation: The absence of bowel sounds is the primary reason that a client would most likely need TPN. Residual of more than 100 mL could be normal for the individual, or could indicate the need to decrease the rate of the tube feeding, or a need to change the formula. The presence of dumping syndrome would not be a reason for a client to most likely need TPN. A serum albumin level of 2.5 g/dL is low, but this value indicates a prolonged malnutrition. This does not indicate that the client needs TPN, but rather is malnourished.

Which scenario does not illustrate a normal lifespan variant regarding urination?

An 8-year-old is continent during the day but is incontinent 2 times during the night. Explanation: By the age of 5, children should be continent both during the day and the night. Although most children in North America achieve daytime continence by 3 years of age, some can take a bit longer. Most children will achieve daytime urinary control by 3 to 4 years of age. The first voiding may be slightly pink-tinged. This is caused by uric acid crystals being excreted. School-age children should achieve urinary elimination habits that are similar to adults. This frequency and color are very normal.

A nurse educator is teaching a student nurse how to choose the correct needle for an injection. Which guidelines for needle selection might they discuss?

As the gauge number becomes larger, the size of the needle becomes smaller. Correct Explanation: The larger the gauge, the smaller the needle. The first number on a needle package is the gauge or diameter of the needle; the second number is the length in inches. When giving an injection, the viscosity of the medication directs the choice of gauge. The size of the syringe is directed by the amount of the medication to be given.

Which statement should the nurse convey to the mother of a 3-year-old son who has not achieved urinary continence?

Boys may take longer for daytime continence than girls. Explanation: Children in North American cultures usually achieve daytime urinary continence by 3 years of age; boys may take longer than girls. Nighttime continence may not occur until 4 or 5 years of age.

Which nursing action associated with successful tube feedings follows recommended guidelines?

Check the residual before each feeding or every 4 to 8 hours during a continuous feeding. Explanation: The nurse should check the residual before each feeding or every 4 to 8 hours during a continuous feeding. High gastric residual volumes (200 to 250 mL or greater) can be associated with high risk for aspiration and aspiration-related pneumonia. A closed system is the best way to prevent contamination during enteral feedings. The bowel sounds do not have to be assessed as often as 4 times per shift. Once a shift is sufficient. Food dye should not be added as a means to assess tube placement or potential aspiration of fluid.

(see full question) The nurse uses the acronym TEACH when planning care for patients on a busy hospital ward. Which intervention accurately represents an aspect of this acronym? (Select all that apply.)

Correct response: • A—The nurse acts on every teaching moment. • C—The nurse clarifies often. • H—The nurse honors the patient as a partner in the education process. Explanation: the acronym TEACH stands for the following: T: Tune into the patient. E: Edit patient information. A: Act on every teaching moment. C: Clarify often. H: Honor the patient as a partner in the education process. The "T" does not stand for the nurse turns to the doctor for support. The nurse does not education the client before teaching as the "E" in TEACH. The "H" does not stand for the nurse helps the client cope when education fails.

The nurse is working with Mrs. Xander, a 60-year-old woman recently diagnosed with Stage 2 ovarian cancer. The nurse would like to provide some health literature to help Mrs. Xander educate herself about this new diagnosis. Several of the nurse's clients have mentioned internet resources they found particularly helpful. When considering these resources for Mrs. Xander, the nurse knows that which statements are true? Select all that apply.

Correct response: • Many websites are above the recommended reading level for clients with low literacy. • Sites that target multiple audiences (health care providers and clients) provide less individualized information. • Lack of stability of web addresses provides confusion and frustration. Explanation: The internet can be a wonderful resource for clients to learn about a new diagnosis. However, there are reports of websites not maintaining up-to-date information. A reputable website should provide the date in which it was last updated and reviewed.

(see full question) Which statement best describes the client most motivated to learn?

Correct response: A 70-year-old female; learning care so spouse can come home Explanation: Adults learn best when the information given to them is something they need to use immediately, when they are strongly motivated to learn, and if there is an internal motivation to learn the topic. When the adult learner does not see importance in the topic, or has no emotional need to learn, motivation is low. Motivation to learn may also be lacking if the adult learner has just reached completion of a major task. The adult learner who is seeking knowledge to assist a loved one may be the most motivated.

(see full question) The nurse is working with a panel of clients who have diabetes. Part of the nurse's job description is to provide education to clients about the benefits of healthy food choices. The nurse's education has taught a few of her clients the benefit of healthy food choices. This is an example of what type of learning?

Correct response: Affective learning Explanation: The education that the nurse provided has influenced the value some of her clients place on their food choices. This is the definition of affective learning.

(see full question) The nurse is caring for a 70-year-old client with a fractured wrist. Which of the following is the best method to determine if the client has retained the information taught?

Correct response: Ask the client to recall after approximately 15 minutes. Explanation: Asking a client to recall what has been discussed after approximately 15 minutes helps determine what information the client has actually retained. Observing the change in the client's behavior for a month, testing the client on the health education and information imparted, and asking the client to administer the doses of drug himself are not appropriate methods to determine the information that has actually been retained.

(see full question) The nurse is working with a 26-year-old smoker who is a client in an outpatient center. The client states that she is very committed to quitting smoking to improve her health as well as to provide a good example for her young son. The nurse knows that participating in a smoking cessation support group is a key component to smoking cessation. During discussion, the nurse asks the client "on a scale of 0 to 10, how likely are you to attend a support group?" Which strategy of motivational interviewing is the nurse using with the client?

Correct response: Assessing importance Explanation: Using the 0 to 10 scale is a key aspect of assessing importance with motivational interviewing. It helps the nurse to understand the client's feelings toward the recommended activity and can help start a conversation about why the client chose that rating number—and what the nurse could do to increase the number.

A 20-year-old client reads the nutritional chart and follows it accurately. The nurse also notes that the client understands the need of a balanced diet and its relationship with a quick recovery. Which domain correctly identifies the client's learning style?

Correct response: Cognitive domain Explanation: As the client is able to understand the need for a balanced diet after the session and follows the nutritional chart accurately, the client's learning style falls in the cognitive domain. The cognitive domain is a style of processing information by listening to or reading facts and descriptions. The affective domain is a style of processing that appeals to a person's feelings, beliefs, or values. The psychomotor domain is a style of processing that focuses on learning by doing. The interpersonal domain is a style of processing that focuses on learning through social relationships.

The nurse is performing data collection on an elderly client brought to the clinic by his daughter. Which finding collected would indicate to the nurse that the client may have a urinary tract infection (UTI)?

Correct response: Confusion Explanation: The elderly client, with an UTI, may be asymptomatic except for mental confusion. In aging, the kidneys' ability to concentrate urine may result in nocturia. The urinary bladder may have reduced capacity due to decreased muscle tone that results in urinary frequency in the elderly. Women are more vulnerable to UTIs because the urethra is shorter and in closer proximity to the vagina and rectum.

(see full question) Which example of nursing documentation is the most appropriate concerning a teaching session?

Correct response: Family requested education on turning client. Explanation of use of draw sheet and body mechanics provided. Family coached through turning and repositioning client. Members state confidence and understanding. Explanation: Complete documentation must always include the topic taught and who was present during the teaching session.

Question 79: (see full question) A nurse is caring for a client 72 years of age with arthritis. Which action is the highest priority for the nurse when conducting the health education for the client?

Correct response: Find out what the client wants to know. Explanation: Finding out what the client wants to know helps the nurse in showing personal interest, which facilitates better learning to an adult client. Dividing information into manageable amounts, providing an environment that promotes learning, and identifying how long the education session will last can be done only when the assessment of the client is completed.

A nurse is preparing to teach a 6-year-old with a broken arm and her mother about caring for the child's cast. Which statement reflects the best education plan for these clients?

Correct response: Include the child in the education; ask questions of both mother and child. Explanation: School-age children are able to make decisions and provide care for themselves. Focusing on the mother or teaching them separately does not make good use of time or validate the child's abilities.

Question 64: (see full question) During the health education session at the health care facility, the nurse notes that a client is able to recognize what is being taught, and is able to describe the information to others. The client is also able to explain the information learned. What is the final learning stage of the client in this case?

Correct response: Independent use of new learning Explanation: The final learning stage for the client in this case is the independent use of the new learning. The client demonstrates the ability to recall the information being taught by describing it to others. Involvement of the client in the health education in an active way is required to maintain the attention and the concentration of the client. Repetition of information for memorization is a technique to teach illiterate clients.

A nurse is forming an education plan for a client who is being discharged from the nursing unit after cardiac catheterization. Which diagnosis and intervention are most appropriate for this client?

Correct response: Knowledge Deficient: Risk for altered perfusion secondary to re-occlusion Explanation: Urinary output should not be changed from a cardiac catheterization. The incision for this procedure may require 8 hours of lying flat, but mobility returns to baseline before discharge home. The risk for ineffective breathing pattern would not be due to incisional pain, which would be in the groin or elbow. Educating the client to be aware for the safety issue of chest pain resulting from the newly opened coronary arteries becoming re-occluded and blocking blood flow to the heart is the highest priority focus.

Question 2: (see full question) A female client has developed an abscess following abdominal surgery, and her food intake has been decreasing over the past 2 weeks. Which laboratory finding may suggest the need for nutritional support?

Correct response: Low serum albumin levels Explanation: Serum albumin levels are a good indicator of a client's nutritional status; decreased levels are suggestive of malnutrition. Protein in the client's urine, low blood sugars, and increased white blood cells are not necessarily indicative of malnutrition.

(see full question) An active, otherwise healthy, older adult client presents to the clinic with severe osteoarthritis in the bilateral knees. The nurse knows this client does not want to be a burden on his family, and he remains stoic even though he reports the pain as severe. He avoids the topic of surgery and attends church weekly. His family is supportive of any decisions he makes regarding his health. Which of the assessment data are most important to forming an individualized education plan for this client concerning treatment for his osteoarthritis?

Correct response: Personal perception of health and aging Explanation: Knowing about the client's orthopedic history, religious beliefs, and barriers to mobility in the home are all helpful for an overall plan of care, but do not address individualism. Gaining insight into the client's own perceptions of health and aging, however, will allow the nurse to tailor the plan of care to the client's personal needs.

(see full question) A school nurse is discussing bike and outdoor safety measures with a group of Boy Scouts. What type of health education and counseling is the nurse providing to this group of children?

Correct response: Preventing illness Explanation: Preventing illness includes first aid, safety, immunizations, screening, and identification and management of risk factors. Promoting health focuses on developmental and maturation issues, hygiene, nutrition, exercise, mental health, and spiritual health. Restoring health focuses on developing self-care practices that promote recovery. Facilitating coping assists the client in learning to cope with permanent health alterations.

see full question) A young woman has just started a nursing program. She is trying to balance going to school full-time, a part-time job, and spending time with her family. Recently she has been feeling a lot of stress and doesn't feel as if she is able to do any of the three very well. Which role problem is this young woman experiencing from this role transition?

Correct response: Role strain Explanation: Role strain occurs when the person perceives himself as inadequate or unsuited for a role and can occur when a person is forced to assume many roles. Role ambiguity occurs when a person lacks knowledge of role expectations. This lack of knowledge causes anxiety and confusion. Role conflict is related to expectations concerning the role.

(see full question) Mrs. Bryant is 40 years old. Her family nurse practitioner has prescribed a mammogram as part of Mrs. Bryant's annual examination. Mammograms are an example of which type of preventative healthcare?

Correct response: Secondary prevention Explanation: Secondary prevention seeks to identify specific illnesses or conditions at an early stage with prompt intervention to prevent or limit disability.

Mrs. Bryant is 40 years old. Her family nurse practitioner has prescribed a mammogram as part of Mrs. Bryant's annual examination. Mammograms are an example of which type of preventative healthcare?

Correct response: Secondary prevention Explanation: Secondary prevention seeks to identify specific illnesses or conditions at an early stage with prompt intervention to prevent or limit disability.

(see full question) A client is reluctant to learn to do finger sticks for her home INR monitoring. What is the best statement by the nurse?

Correct response: Tell me what you know about these tests. Explanation: Saying something to encourage the client to openly discuss personal issues is the best option. Assessing worry about pain narrows the client's answer to only addressing pain. Asking "why" questions may be considered probing or accusatory and tends to block communication. Grouping the client into generalizations is belittling. Assessing the client's perceptions about checking the INR opens up the discussion about the client's barrier to learning to perform this test.

When teaching an adult client how to control stress through relaxation techniques, the nurse should consider what assumption concerning adult learners?

Correct response: The nurse should be able to draw from the previous experience of the client to emphasize the importance of stress reduction. Explanation: Knowles (1990) listed the following four assumptions about adult learners: (1) As people mature, their self-concept is likely to move from dependence to independence. (2) The previous experience of the adult is a rich resource for learning. (3) An adult's readiness to learn is often related to a developmental task or a social role. (4) Most adults' orientation to learning is that material should be useful immediately, rather than at some time in the future. With this in mind, adult learners would appreciate the nurse being able to draw from previous experiences of the client to emphasize the importance of stress reduction. The other options do not apply to Knowles's assumptions about adult learners.

(see full question) A parish nurse is preparing to provide a health promotion class to a group of adults in the parish. In preparing to meet the learning needs of this group, the nurse recognizes which of the following as a characteristic of an adult learner?

Correct response: Their readiness to learn is often related to a developmental task or social role. Explanation: An adult's readiness to learn is often related to a developmental task or social role. The previous experience of the adult is a rich resource for learning. Most adults' orientation to learning is that material should be useful immediately. Peer group acceptance is a critical issue for the adolescent group.

Which diagnosis would best describe a situation in which a woman has a knowledge deficit concerning child safety for her toddler who is currently being treated for burns and was previously treated for a fracture from a fall?

Correct response: Toddler at High Risk for Injury, related to mother's lack of knowledge about child safety Explanation: The best answer would be "Toddler at High Risk for Injury, related to mother's lack of knowledge about child safety". The question states the woman has a knowledge deficit, and this is what the focus of the plan of care would be. The mother's lack of knowledge puts the toddler at high risk for injury.

Which of the nurse's following actions is most likely to promote a patient's compliance with her antiretroviral drug regimen for the treatment of human immunodeficiency virus (HIV)?

Correct response: Use interactive and learner-appropriate teaching techniques. Explanation: Noncompliance has serious consequences for the health of patients. It can often be prevented by ensuring that patient teaching is interactive and appropriate to the needs and development of each individual learner. Patient education should indeed be evidence-based, but this does not necessarily enhance compliance. Overemphasizing the negative and grounding the education in virology or other forms of science will also not guarantee compliance.

(see full question) When the nurse performs a Hemoccult test on a stool specimen, blood in the stool will change the color on the test paper to:

Correct response: blue. Explanation: Blue is a positive diagnostic finding, indicating the presence of blood in the stool sample.

(see full question) Before starting the education process, the nurse should determine the preferred learning style, age and developmental level, capacity to learn, motivation level, readiness to learn, and learning needs of the client. How does this help the nurse in the client's health education?

Correct response: by implementing effective teaching Explanation: To implement effective teaching, the nurse should determine the preferred learning style, age and developmental level, capacity to learn, motivation level, readiness to learn, and learning needs of the client, before starting the teaching process. Fulfilling the client's requirements and assisting the client's learning can happen only when effective teaching is implemented. The chances of miscommunication can be reduced once an effective education plan is made.

In regards to development of self-concept, an infant:

Correct response: has no separate existence. Explanation: Newborns have undifferentiated selves; they do not experience separate existence from others.

Question 81: (see full question) A nurse and client are working together to help the client with lifestyle changes to promote improved health. Which is the best statement about contractual agreements? Select all that apply.

Correct response: • "Our goals are defined, as are ways to meet them." • "With this contract, we show that we are both dedicated to helping you." Explanation: A contractual agreement is not a formal document, nor is it binding. It lists common goals to client and nurse, but does not require completion of those goals. It is a document of partnership between the client and nurse to reach the goals they are both trying to meet.

The nurse is preparing to teach a client about enoxaparin sodium for the first time. This client has never given a self-injection before. Which actions are the most appropriate for the nurse to do first? Select all that apply.

Correct response: • Gather supplies for injection teaching. • Review medication data sheets. Explanation: Enoxaparin sodium is not given IM, nor does it require injection diagrams. Needle size is not determined by client size. Before doing anything else, the nurse must first assess her personal knowledge of enoxaparin sodium injections to ensure the client is taught accurately. Reviewing medication data sheets and gathering teaching equipment are appropriate actions.

A nurse is working with a 54-year-old obese man who is interested in losing weight. He asks the nurse why trans fats are so bad for you. The nurse's response includes which answers? Select all that apply.

Correct response: • Trans fats lower HDL levels. • Trans fats raise LDL levels. • Trans fats raise cholesterol levels. Explanation: The level of HDL cholesterol, or "good" cholesterol, in the blood is lowered by trans fats.

(see full question) A couple has just learned that their newborn infant has a congenital cardiac anomaly that will require many lifestyle modifications, surgical corrections, and hospital stays. Place the following aspects of the couple's client education in the correct order that nurses should conduct them.

Determine their emotional readiness to learn. Draft learning outcomes. Select educational strategies. Implement various educational techniques. Revise the learning plan if needed. Explanation: The education process parallels the learning process. It begins with assessment of variables such as readiness to learn, and learning needs that lead to a determination of learning outcomes. Teaching strategies are selected, implemented, evaluated, and then revised if necessary. (

(see full question) The nurse is preparing to auscultate the bowel sounds of a client with a nasogastric tube in place set to low intermittent suction. How shall the nurse approach the assessment of bowel sounds and manage the nasogastric tube?

Disconnect the nasogastric tube from suction during the assessment of bowel sounds. Explanation: If the client has a nasogastric tube in place, disconnect it from the suction during this assessment to allow for accurate interpretation of sounds.

The nurse is coaching a client who stated a desire to stop smoking without medication. At several sessions to assess the client's success with agreed-upon interventions, the client reports roadblocks to each action and continues to smoke. What is the best action of the nurse?

Discuss the client's case with a colleague. Explanation: The focus is not to have the client please the nurse, but to improve client health behaviors. Telling a client that his efforts are disappointing is not an effective communication technique and can result in disruption of the therapeutic trust relationship between the nurse and client. The client does not necessarily need therapy just because initial attempts have been unsuccessful. The client desires not to have medication, so arranging for medications goes against the client's wishes in the plan of care. A colleague may shed light on additional actions based on experience with similar issues in the past.

Which factor does not increase the basal metabolic rate?

Exercise Explanation: Exercise increases metabolic demands beyond the basal metabolic rate.

What is the most appropriate teaching strategy for the nurse to use for a 1-hour presentation on the prevention of osteoporosis to a group of 30 college-age women?

Lecture/discussion Explanation: Lecture/discussion is appropriate for this topic, audience, and group size. A lecture is a formal presentation of information by a teacher to a group of learners. This format is most effective when communicating facts.

(see full question) The average dietary nutrient intake level that meets the nutritional requirement of almost all healthy people in a selected age and gender group is the:

RDA level Explanation: The RDA level is the average dietary intake level that meets the nutritional requirement of almost all healthy people in a selected age and gender group

The nurse is preparing to catheterize a client who is incontinent of urine following bladder surgery. What fact should the nurse keep in mind when performing catheterization?

The bladder normally is a sterile cavity. Explanation: The bladder is normally a sterile cavity. It is not possible to sterilize a part of the human body, only disinfect it. Pathogens introduced into the bladder have the ability to enter other parts of the body, including the blood stream. An injured bladder is much more susceptible to infection than a normal bladder.

The nurse is working on an oncology unit and is visiting with colleagues about how to prevent burnout as a professional nurse. Everyone suggests things and the group comes up with a very good list of self-care behaviors and ways that will help prevent burnout. Which of the following would be good things to have on the list?

You selected: • Emphasize your strengths and the things you do well. • Know that no one person can be all things to all people. • Live life one day at a time and do your best. Correct Explanation: Self-Care Behaviors: 1. Accept normal variations in physical appearance and capabilities. 2. Use problem-solving and decision-making strategies to define expectations and set goals. 3. Set priorities and accept that no one person can be all things to all people. 4. Forget past mistakes; carrying around "excess baggage" is unhealthy. 5. Emphasize strengths and abilities in self. 6. Take an active part in group activities in school, work, church, or the community. 7. Volunteer time, talents, or services. 8. Avoid excessive alcohol and drugs. 9. Live life one day at a time. 10. Get help for self-concept disturbances that interfere with healthy social and professional activities.

A nurse assessing children in a pediatrician's office would expect a child to achieve self-recognition at what age?

You selected: By 18 months Correct Explanation: Stages in the development of the self include self-awareness (infancy), self-recognition (18 months), self-definition (3 years), and self-concept (6-7 years).

Nursing documentation is inclusive. Which is the best example of documentation of a teaching plan?

You selected: Cord care shown to mother, questions answered. Return demonstration observed. Correct Explanation: Documentation of teaching must include who was taught, the topic taught, and some indication of the success of the learning plan. Only the answer with a mother being taught cord care and a return demonstration is complete.

An 18-year-old says that it was just bad luck that he got in a motor vehicle accident and broke his arm. What is the client demonstrating by saying this?

You selected: External locus of control Correct Explanation: A person with external locus of control perceives that outcomes happen because of luck, chance, or the influence of powerful others.

Which question would provide the nurse with the information needed first when assessing self-concept?

You selected: How would you describe yourself to others? Correct Explanation: Global self is the term used to describe the composite of all the basic facts, qualities, traits, images, and feelings one holds about oneself. Global self provides the basis for assessing a person's self-concept. How well one likes themselves refers to self-esteem. The ideal self is assessed by asking clients what they see themselves doing in 5 years. Identifying personal strengths refers to personal identity.

What self-concept is demonstrated when a child says that he wants to be "just like my dad"?

You selected: Ideal self Correct Explanation: The ideal self constitutes the self one wants to be. These expectations develop early in childhood and are based on the images of role models such as parents

Which nursing action helps to maintain a sense of self for clients?

You selected: Offering a simple explanation before initiating any procedure Correct Explanation: The way nurses care for clients has a direct impact on the client's sense of self. By offering a simple explanation prior to any procedure, the nurse is respecting the client and shows that the client is a person first and foremost. Negative expressions should be encouraged and allowed. Privacy related to condition and keeping the body covered is important. The client's weight assessment does not help or hinder the client's sense of self.

The nurse is assessing for information about a client's self-concept. The information needed first is about which of the following?

You selected: Personal identity Correct Explanation: When assessing self-concept, the information needed first is the client's description of self. Personal identity describes an individual's conscious sense of who he is. Sexual orientation may not be how someone identifies themselves, or may only be a small part of their personal identity. Body image and gender identity may also be only part of their self-identity.

(see full question) The nurse completed education with a client. Which documentation entry is the most complete teaching plan?

You selected: Printed and verbal information provided on gluten-free diet. Questions answered. Verbalizes understanding. Follow-up scheduled. Correct Explanation: Just like a plan of care, a teaching plan must show that evaluation of the intervention was performed, which demonstrates that learning occurred. Complete documentation records the topic taught, methods used to teach, clarification of concepts and the method used to evaluate how well the client understands the material.

(see full question) The nurse works in the emergency department and feels like she is becoming somewhat jaded about her nursing practice. The nurse talks to her supervisor about this and he suggests making some goals for enhancing her self-concept as a professional nurse. Which of the following would be an important goal to establish that would build up the nursing self-concept?

You selected: Schedule time every day to meet personal needs. Correct Explanation: These are goals that will enhance a nurse's professional self concept: • Identify basic unmet human needs, exploring positive means to meet these needs. • Schedule time every day to meet personal needs. • Assess the effect of feedback from significant others on self-esteem. • Describe personal strengths accurately. • Develop a realistic plan to achieve goals for personal growth and development. • Don't dwell on errors; remember them so you don't repeat them, but don't make remembering them a goal. • Pursuing a higher degree may be a worthy goal, but it will not enhance self-concept right now. • Avoiding weaknesses will not make them become strengths.

Which of the following is objective data related to self-concept?

You selected: The person refuses to make eye contact. Correct Explanation: Objective data constitutes what the nurse can observe with her own eyes. Other objective data that may be collected include a missing body part, a concealment of a body part, or weeping.

A client with uncontrolled hypertension experienced a stroke a week ago, leading to significant motor losses. A successful and normal adaptive response to these new limitations is evident if the client:

exhibits signs of grief. Explanation: Grief is a normal response to a recent deformity or limitation. Changing the subject and refusing treatment would be considered maladaptive responses. Stating that "it is what it is" may possibly signal resignation and defeat, neither of which is associated with an adaptive response.

self-awareness

infancy

A nurse needs to explain the importance of contraception and safe-sex practices to a group of college students. Which factors can affect the nurse's teaching strategies? Select all that apply.

• Availability of resources • Learning style preference • Literacy level of target audience Explanation: Availability of resources, learning style preference, and literacy level affect the planning of effective teaching strategies. Education sessions can be individual, small group, or large group sessions. The family background or the economic status of the target audience should not affect a nurse's teaching strategy because the nurse will be teaching the same thing to the entire group.

The nurse is assessing adequate nutrition for residents of a long-term care facility. Which strategies are recommended to address age-related changes affecting nutrition? Select all that apply.

• Avoid cold liquids with decreased peristalsis in the esophagus. • Avoid eating right before bedtime for gastroesophageal reflux. • Eat a high-fiber diet for slowed intestinal peristalsis. Explanation: To address age-related changes affecting nutrition, the nurse would avoid cold liquids with decreased peristalsis in the esophagus. The nurse would have the client avoid eating right before bedtime for gastroesophageal reflux. The nurse would have the client eat a high-fiber diet for slowed intestinal peristalsis. Small meals, not large meals, should be offered at frequent intervals.

(see full question) The school nurse is teaching parents how to build self-esteem in children. Which strategies would the nurse include? (Select all that apply.)

• Notice examples of your child's ability in many different circumstances and point this out to the child. • Find occasions to frequently and honestly praise your child. • Ask yourself what need is being expressed by your child's negative behavior and address that behavior. • Let your child know what to expect; let your child practice the necessary skills; be patient; and make it safe to fail. Explanation: To address the negative qualities of the child constructively the parent should ask: (1) What need is being expressed by this behavior? (2) Can I see a positive quality being expressed by this behavior? (3) How can I help my child express this quality and meet her needs in a more positive way? These strategies should be used rather than trying to "fix" a possible problem. Additionally, the parent should address the negative qualities of the child and ignore those that are merely a matter of taste, preference, or personal style, and not really negative in a harmful manner. Pointing out abilities of the child, and frequently praising the child for genuine reasons help to build self-esteem in children. Also, letting the child know what to expect; letting the child practice the necessary skills; being patient; and making it safe to fail are strategies to enhance a child's self-esteem.

A nurse is counseling adolescents in a group home setting. What aspect of self-esteem is developed in this age group? (Select all that apply.)

• Sense of self is consolidated. • Emphasis is on sexual identity. • Parental influences on self-concept are often rejected. Explanation: Developmental changes affecting the self-concept of the adolescent includes development of secondary sex characteristics; rapid body changes; sense of self is consolidated; emphasis on sexual identity; parental influences on self-concept are often rejected; peers become more important; and movement is toward development of own identity. Importance on meeting role expectations well is developed in adulthood. A sense of being trusted and loved, and differentiation of self and non-self develops during childhood.

(see full question) Which commonly used enema solutions would the nurse administer to distend the intestine and increase peristalsis? Select all that apply.

• Tap water • Normal saline Explanation: The nurse would give tap water and normal saline to distend the intestine and increase peristalsis.

A nurse is using the teaching-learning process to teach new parents how to care for their infants. Which nursing actions reflect recommended steps of this process? Select all that apply

• The nurse uses critical thinking skills to assess the learning needs and learning readiness of the parents. • The nurse formulates a verbal or written contract with the client. • The nurse relates new learning material to the client's past life experiences to help him to assimilate new knowledge. Explanation: The nurse would use critical thinking skills to assess the learning needs and learning readiness of the parents. The nurse would formulate a verbal or written contract with the client. The nurse would relate new learning material to the client's past life experiences to help him assimilate new knowledge. This is an example of applying adult learning principles. Goals should be specific, not general in focus. The nurse would not have to include group teaching and formal teaching in every education plan. The nurse must allow time constraints, schedules, and the physical environment to influence the choice of teaching strategies.

Question 88: (see full question) A nurse is using the teaching-learning process to teach new parents how to care for their infants. Which nursing actions reflect recommended steps of this process? Select all that apply.

• The nurse uses critical thinking skills to assess the learning needs and learning readiness of the parents. • The nurse formulates a verbal or written contract with the client. • The nurse relates new learning material to the client's past life experiences to help him to assimilate new knowledge. Explanation: The nurse would use critical thinking skills to assess the learning needs and learning readiness of the parents. The nurse would formulate a verbal or written contract with the client. The nurse would relate new learning material to the client's past life experiences to help him assimilate new knowledge. This is an example of applying adult learning principles. Goals should be specific, not general in focus. The nurse would not have to include group teaching and formal teaching in every education plan. The nurse must allow time constraints, schedules, and the physical environment to influence the choice of teaching strategies.

(see full question) A nurse caring for clients in a skilled nursing facility assesses client motivation to participate in care. Based on the health belief model, which clients would be most motivated? Select all that apply.

• a client who views a disease as a serious threat • A client who believes there are actions that will reduce the probability of contracting the disease • A client who believes that the threat of taking actions against a disease is not as great as the disease itself Explanation: The individuals that would be most motivated to participate in care based on the health belief model would be a client who views a disease as a serious threat, a client who believes that there are actions that will reduce the probability of contracting the disease, and a client who believes that the threat of taking action against a disease is not as great as the disease itself. Clients who would not be most motivated to participate in care include the client who does not view himself as susceptible to the disease; the client who believes that noncompliance is not an option; and the client who believes that doing nothing is preferable to painful treatments.