Chapter 21 Teacher and Counselor Funds prepU
The nurse is writing learner outcomes for a client admitted with heart failure. Which learner outcomes statement is correctly written? The client will describe symptoms of hypokalemia associated with diuretic use. The client will understand the relationship between sodium intake and fluid retention. The client will comprehend the signs and symptoms of heart failure. The client will know how to weigh himself daily at home.
The client will describe symptoms of hypokalemia associated with diuretic use. Explanation: An appropriately constructed learner outcome statement will include verbs from the cognitive, affective, or psychomotor domains. The verb "describe" is a cognitive domain verb and allows the nurse to measure a client's understanding of information. Verbs such as "understand," "know how to," and "comprehend" are not found in these domains, and measurability is difficult to determine.
The nurse is providing instrcutions to a client about performance of breast self-examination. What outcome does the nurse evaluate regarding this education? The client will use the self-examination for breast cancer detection and prevention. The client will demonstrate improved coping skills. The client will have restoration of breast function. The client will demonstrate self-efficacy and improved body image.
The client will use the self-examination for breast cancer detection and prevention. Explanation: Client education also focuses on the knowledge and skills for early detection or prevention of disease and disability. Studies have proven the importance of early detection in support of teaching breast self-examination.
The nurse has completed teaching. Which client behavior demonstrates understanding within the psychomotor domain? states, "I feel comfortable using my walker." provides a description of what appropriate wound healing should look like provides return demonstration of use of inhaler verbalizes key points of a brochure about diabetes that was read
provides return demonstration of use of inhaler Explanation: The psychomotor domain is a style of processing information that focuses on learning by doing. In this scenario, the client has shown learning in the psychomotor domain by providing a hands-on return demonstration. Other options demonstrate other learning domains.
Which nursing action is applicable to the psychomotor domain of learning when conducting a teaching session for breastfeeding mothers? telling the mothers to avoid taking over the counter drugs while breast feeding showing charts to the mothers that illustrate the types of breast milk observing a mother expressing the breast milk advising the mothers to drink plenty of water
observing a mother expressing the breast milk Explanation: Observing is one of the levels of psychomotor skills, which involves watching an experienced person perform a physical skill. Telling, showing, and advising are examples of cognitive domain, which help the mothers process information by listening or reading facts.
A nurse is developing a contractual agreement with a client. Which statement is true of a contractual agreement? The contract serves to meet the client's learning outcomes. The contract is legally binding. The contract is a formal agreement. The contract serves to meet nursing goals.
The contract serves to meet the client's learning outcomes. Explanation: A contractual agreement is a pact between two people setting out mutually agreed-upon goals. The contracts are usually informal and not legally binding. The contract can serve to motivate the client and nurse to do what is necessary to meet the learning needs of the client; the contract does not serve to meet nursing goals.
The nurse is teaching an 80-year-old client how to instill eye drops for glaucoma. The client's daughter asks, "How do you know that my parent understands what to do?" What is the appropriate nursing response? "I will have you bring your parent back next week to see how things are going." "We can never be completely sure that your parent understands instructions." "When 15 minutes have passed, I will ask your parent to show me how to instill the drops." "After I demonstrate it once, your parent will be able to do it."
"When 15 minutes have passed, I will ask your parent to show me how to instill the drops." Explanation: Older clients may interact in a socially appropriate manner and may indicate that they understand the material being taught. Asking a client to recall what has been discussed after approximately 15 minutes have passed may help determine what information has actually been retained. The other responses do not demonstrate proper understanding of the condition.
The nurse is visiting a client who was released from inpatient rehabilitation 6 weeks ago after a 5-month recovery from a motor vehicle accident that left him immobile. As the nurse enters the home, the client braces his hands on the arms of his chair to rise and uses crutches to walk across the room. What is the best response by the nurse? "Those physical therapists work wonders. "Let me document that you can walk." "Are you supposed to be out of the wheelchair?" "You have made an amazing recovery."
"You have made an amazing recovery." Explanation: Reinforcement of learning shows that the nurse supports and wants to encourage the client. Giving credit where it is due communicates these values. Documenting is necessary, but stating this does not show interest in the client's progress. Crediting the therapists does not encourage the client. Asking about permission to ambulate negates the goal for improving wellness.
A nurse is counseling several clients for depression. Four of them do not seem to be improving, which leads the nurse to suggest a referral to a psychiatric nurse practitioner. Which of these clients would be most likely to attend the scheduled appointment? A 36-year-old male; uses public transportation, unable to read, wants to confer with pastor. A 28-year-old female; works nights, willing to try, asking about insurance coverage of appointment. A 45-year-old female; unsure of the benefit of psychiatric care, on a fixed income, good family support. A 51-year-old male; walks to most places because of no transportation, low income, works days.
A 28-year-old female; works nights, willing to try, asking about insurance coverage of appointment. Explanation: Cultural issues, poor family support, or lack of transportation may cause barriers to obtaining needed care. If a client must choose between work and keeping an appointment, scheduling is an important factor. The characteristics of a client who will keep appointments with specialists include those clients who have been well educated about the importance of the referral, understand the benefit to seeing a specialist, and those who will not have to struggle to keep the appointment. A client who agrees, who has input in scheduling, and shows curiosity or hope about the benefit of the referral is more likely to keep the appointment.
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? Observe the change in client's behavior for a month. Test the client on the health education and information imparted. Ask the client to administer the doses of drug himself. Ask the client to recall after approximately 15 minutes.
Ask the client to recall after approximately 15 minutes. Correct: Expl: 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.
The parents of an infant suffering from apnea need to be educated on the apnea monitor and cardiopulmonary resuscitation. What should the nurse assess first regarding the parents? Baseline knowledge of these concepts Infant bonding Educational levels Home environment
Baseline knowledge of these concepts Explanation: Before educating parents on the apnea monitor and cardiopulmonary resuscitation, the nurse should determine the parents' baseline knowledge so that the nurse knows where to begin. Educational level would be the next assessment in order to plan the appropriate teaching delivery method.
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? Interpersonal domain Psychomotor domain Cognitive domain Affective domain
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.
When the newly diagnosed client with insulin-dependent diabetes tells the nurse that he has never received instruction on the administration of injections, an appropriately stated nursing diagnosis for the client is: Deficient Knowledge of Injection Administration as verbalized by the client, related to the lack of instruction and experience Self-care Deficit related to lack of knowledge about injections Ineffective Health Care Maintenance related to diabetic instructions Knowledge Deficit related to lack of knowledge about injections
Deficient Knowledge of Injection Administration as verbalized by the client, related to the lack of instruction and experience Explanation: Many factors can contribute to deficient knowledge, such as a lack of exposure, lack of recall, information misinterpretation, cognitive limitations, lack of interest in learning, and unfamiliarity with information resources.
A nurse is discussing the benefits of smoking cessation with a client. The nurse informs the client that smoking cessation will reduce his risk for cancer, improve his respiratory status, and enhance the quality of his life. The nurse also shares her story of smoking cessation, provides information on other individuals who have successfully quit, and encourages the client to attend a support group for smoking cessation. The client discusses his feelings on smoking cessation and verbalizes a desire to quit smoking. What type of counseling did the nurse provide to this client? Motivational counseling Developmental counseling Long-term counseling Situational counseling
Motivational counseling Explanation: Motivational counseling involves discussing feelings and incentives with the client. Long-term counseling extends over a period of time. Developmental counseling occurs when a client is going through a developmental stage or passage. Situational counseling occurs when a client faces an event or situational crisis.
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? Orthopedic surgical history Formal religious beliefs Floor plan of the client's dwelling Personal perception of health and aging
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.
A pediatric nurse provides education to numerous clients in their care. Which group of children benefits most from being involved in the teaching-learning process? School-age children Infants Preschoolers Toddlers
School-age children Correct: Explanation: School-age children are capable of logical reasoning and should be included in the teaching and learning process whenever possible.Education related to infants, toddlers, and preschool children should be directed at the parents as they are primarily teaching their children and the information can be reinforced by the parents. pg. 484
When establishing a teaching-learning relationship with a client, it is most important for the nurse to remember that effective learning can best be achieved through which concept? The client and the nurse are equal participants. The nurse must be able to handle criticism during the process. The nurse is the expert in the teaching-learning environment. Assimilation and application of psychomotor concepts is essential.
The client and the nurse are equal participants. Explanation: Effective learning occurs when clients and health care professionals are equal participants in the teaching-learning process.
A nurse is providing teaching to clients in a short-term rehabilitation facility. Which examples are common teaching mistakes made by health care professionals? Select all that apply. The nurse negotiates goals with the client. The nurse ignores the restrictions of the client's environment. The nurse reviews educational media when planning learner objectives. The nurse evaluates what the client has learned. The nurse uses medical jargon frequently when discussing the teaching plan. The nurse fails to accept that clients have the right to change their minds.
The nurse fails to accept that clients have the right to change their minds. The nurse uses medical jargon frequently when discussing the teaching plan. The nurse ignores the restrictions of the client's environment. Explanation: Common teaching mistakes made by health care professionals would include the following: the nurse failing to accept that clients have the right to change their minds; the nurse using medical jargon frequently when discussing the teaching plan; and the nurse ignoring the restrictions of the client's environment. The nurse does negotiate goals with the client. The nurse would evaluate what the client had learned. The nurse would review educational media when planning learner objectives.
A nurse is writing learner objectives for a client who was recently diagnosed with type 2 diabetes. Which statement best describes the proper method for writing objectives? The nurse plans learner objectives with another nurse before obtaining input from the client and family. The nurse writes general statements for learner objectives that could be accomplished in any amount of time. The nurse writes one long-term objective for each diagnosis, followed by several specific objectives. The nurse writes one or two broad objectives rather than several specific objectives.
The nurse writes one long-term objective for each diagnosis, followed by several specific objectives. Explanation: The statement that best describes the proper method for writing objectives would be that the nurse writes one long-term objective for each diagnosis, followed by several specific objectives. The nurse would not use general statements that could be accomplished in any amount of time because this action is not addressing the specific needs of the client, and the setting in which the client is in. The nurse would not plan learner objectives with another nurse and would not always obtain input from the family of the client. The objectives need to be specific so the outcomes can be measured in the evaluation phase.
Which principle of teaching-learning is an accurate guideline for the nurse/teacher? The teaching-learning process can be facilitated by a helping relationship. Planning learner objectives should be done by the teacher alone. Past life experience should not be a factor when helping clients assimilate new knowledge. Client education should occur independently of the nursing process.
The teaching-learning process can be facilitated by a helping relationship. Explanation: The teaching-learning process can be facilitated by a helping relationship. This is an important principle for the nurse/teacher to remember. Teaching is part of the nursing process. Past life experiences should be a factor when helping clients assimilate new knowledge because this is the application to Knowles's adult learning principles. Planning learner objectives should not be done by the teacher alone; the entire process should involve the client to be sure that the plan is focused on the individual client's needs.
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? Previous experiences have little impact on learning. The material presented should focus on future application. Peer group acceptance is a critical issue for this age group. Their readiness to learn is often related to a developmental task or social role.
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 and not adults.
A client is admitted to the health center with chronic diarrhea. When should the nurse begin imparting health teaching about the benefits of proper diet to the client so that the risk of diarrhea is minimized? When discharging the client When providing treatment When admitting the client When performing follow up care
When admitting the client Explanation: Potential teaching needs should be identified from the time when the client is admitted. The client would therefore need to be taught the benefits of a proper diet during admission so as to minimize the risk of diarrhea. There is a greater probability of the client retaining the teaching if the teaching starts during admission. The teaching may be amended during the caring, treatment, and discharge phases, as well as during any follow up treatment.
The nurse must instruct a 35-year-old client with Down syndrome about use of an albuterol rescue inhaler. Which of the following demonstrates individualization of the education plan for this client? lesson focused for client of school-age developmental level, authoritarian style, client taught at meal time client understanding of illness, motor skills and developmental stage assessed, clarification provided developmental stage is adult at age 35, information given in short sentences, motor skills not assessed client's understanding of health assessed, questions answered on age-appropriate level, television on in room
client understanding of illness, motor skills and developmental stage assessed, clarification provided Explanation: Distractions to learning, such as the television or meal time, will diminish any education plan. An authoritarian style of teaching does not honor the client as a partner in the learning process. Age does not necessarily determine developmental stage. Assessing developmental stages, understanding of the problems, clarification of difficult areas, and ensuring that the client is physically able to perform the task are all aspects of a well-planned education session for all clients.
The client reports to the clinic as ordered by her primary care provider for counseling on weight loss to improve overall health. The client received printed information in the mail to review before the session, and states having read through it before the appointment. Which client statement alerts the nurse to a need for clarification and further education? "I will be doing well if I lose between 5 and 10 lb (2.3 and 4.5 kg) per week." "I can lower my blood pressure by losing weight." "I can monitor my caloric intake by measuring portions." "Osteoarthritis in my knees may be because of my weight."
"I can monitor my caloric intake by measuring portions." Incorrect Correct: "I will be doing well if I lose between 5 and 10 lb (2.3 and 4.5 kg) per week." Explanation: Blood pressure can be reduced with weight loss. Osteoarthritis may be caused by destruction of cartilage from the pressure on the knee joints caused by excessive weight. Measuring portions is essential to understanding caloric intake. Healthy weight loss is generally accepted as 1 to 2 lb (0.45 to 0.90 kg) per week, or a reduction of 500-1000 calories per day, which includes decreased intake of foods and burning calories with exercise.
A 56-year-old executive meets with the nurse for education about recently diagnosed atrial fibrillation. He verbalizes concerns about the time he will spend away from his work, and that he is not sure it is necessary to have blood tests every week. He feels it is a waste of time when he does not have any symptoms. Which is the best motivational statement by the nurse for this client? "Atrial fibrillation is when your upper heart beats ineffectively and blood clots can go to your brain. Would you like some printed information about this?" "You have to take your warfarin and go to the clinic every week for a blood draw. It's not the most convenient way to live, but you have to do it." "Your doctor wants you to take your warfarin every day, go to the clinic every week to have blood drawn, and then wait for any dosage change. Do you understand?" "The medicine and blood work for atrial fibrillation can help prevent blood clots that have the potential to cause debilitating strokes. What have you heard about warfarin therapy?"
"The medicine and blood work for atrial fibrillation can help prevent blood clots that have the potential to cause debilitating strokes. What have you heard about warfarin therapy?" Explanation: Adults learn best when the information given to them will be used immediately, is presented as important to the client, and when the client's autonomy is preserved. As with all learners, the teaching approach must reflect respect for what the client already knows. By presenting the facts in a way that gives the client control over a health alteration, and by assessing current knowledge, these qualities that are important to forming a learning plan for an adult are met. When education plans take control out of the client's hands, (such as stating the doctor wants compliance) or when the lifestyle change is presented as a burden, motivation may be low. If the nurse shows interest in working with and discussing issues with the client, a partnership is formed that can boost motivation.
The nurse is preparing to teach four clients. Which client will the nurse plan to teach using principles associated with gerogogy? 56-year old who likes to take notes on paper 79-year old who has slight cognitive changes 31-year old who continuously used the internet 4-year old who likes to play with blocks
79-year old who has slight cognitive changes Explanation: Gerogogy is the unique techniques that enhance learning among older adults. Therefore, the nurse will use gerogogy with the 79-year-old client. Pedagogy is the science of teaching children or those with cognitive ability comparable to children, and would be appropriate for the 4-year-old client. Andragogy is the principles of teaching adult learners, and would be appropriate for the 31-year-old client and the 56-year-old client.
Which statement best describes the client most motivated to learn? A 29-year-old male; significant other insisting on education A 25-year-old female; just completed a course of physical therapy A 52-year-old male; hired to drive client home from clinic A 70-year-old female; learning care so spouse can come home
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.
Which guideline is most important for the nurse to keep in mind when planning to teach an exercise class to a group of older adults? Allow ample time for psychomotor skills. Provide information in a structured format. Keep the session at 2 to 3 hours. Allow for long-term memory loss.
Allow ample time for psychomotor skills. Explanation: Older adults need more time to learn psychomotor skills. Sessions of 2 to 3 hours are too long; short-term rather than long-term memory loss affects older adults; and information can be structured or non-structured, depending on the content.
Which documentation example best reflects the complexity of client teaching by the nurse? "Client return demonstrated how to use glucometer." "Taught client about peak flows; client verbalized understanding." "Told client to take antibiotic as ordered." "Client and spouse taught how to use phone app to count carbohydrates; client return demonstrated carb counting for a hypothetical meal."
Client and spouse taught how to use phone app to count carbohydrates; client return demonstrated carb counting for a hypothetical meal." Explanation: The nurse should document who the teaching was provided to, what was taught, the teaching method, and the evidence of learning. The other answer choices are not as comprehensive and, therefore, are not the best examples of teaching.
When caring for a client, the nurse observes that the client enjoys reading books and magazines. In which of the following learning domains does the client's learning style fall? Interpersonal domain Psychomotor domain Affective domain Cognitive domain
Cognitive domain Correct Explanation: As the client enjoys reading books and magazines, the client's learning style would fall in the cognitive domain, where information is processed by listening 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. pg. 487
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. 1 Revise the learning plan if needed. 2 Draft learning outcomes. 3 Implement various educational techniques. 4 Select educational strategies. 5 Determine their emotional readiness to learn.
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.
The nurse needs to understand the teaching-learning process when administering Psychosocial interventions Technical interventions Educational interventions Physician-initiated interventions
Educational interventions correct Explanation: Educational interventions require the application of the teaching-learning process.
As the nurse enters the room to teach the client about self-care at home, the client states, "I am glad you are here. I need some pain medicine. I can't stand it anymore." What is the best action of the nurse? Redirect client to learning about self-care and begin education. Have client rate pain level and reschedule the teaching session. Assess client understanding of self-care and administer medication. Give written materials to client and retrieve pain medication.
Have client rate pain level and reschedule the teaching session. Explanation: The client is not ready or able to learn and is reporting a need that first must be met. Assessing the client's knowledge of self-care or redirecting the subject only delays the care that must be done before the client is able to learn. Although providing written materials is an excellent supplement to an teaching session, it does not replace teaching the client. It is best to address the physical needs before attempting to educate the client.
When providing client education it is essential for the nurse to incorporate what action so that learning can be optimized? Administer tests to evaluate learning. Include educational strategies that encourage clients to be active participants. Be sure that clients are formally engaged. Have the clients read material after client education.
Include educational strategies that encourage clients to be active participants. Explanation: The teaching-learning relationship is a dynamic, interactive process that involves active participation from the nurse and client.
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? Role play Lecture/discussion Demonstration Test taking
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.
While applying dressings to a client's wound, the nurse teaches the client about his wound care. To promote the most effective teaching-learning relationship with this client, what would be most important for the nurse to keep in mind? The nurse and client relationship is based on mutual sharing and negotiation. Nurses barter knowledge of medication with the client for compliance. Nurses have control over the client because of their knowledge and expertise. Nurses are experts who generously bestow knowledge upon clients.
Nurses are experts who generously bestow knowledge upon clients. Incorrect Correct: The nurse and client relationship is based on mutual sharing and negotiation. Explanation:When providing nursing care, the teaching-learning relationship between the nurse and client is special, characterized by mutual sharing, advocacy, and negotiation. Effective learning occurs when clients and health care professionals are equal participants in the teaching-learning process. Unlike some traditional views, nurses are not experts who generously bestow knowledge upon clients, nor do they barter knowledge for compliance. Both images represent the relationship as a power imbalance in which nurses, because of their knowledge and expertise, control the situation.
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? Orthopedic surgical history Formal religious beliefs Personal perception of health and aging Floor plan of the client's dwelling
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.
A nurse assisting a new mother in the act of breastfeeding is represented by which form of learning? Cognitive Simplistic Affective Psychomotor
Psychomotor Explanation: Psychomotor refers to the muscular movements learned to perform new skills and procedures.
When caring for a diabetic client, the nurse notes that the client learns better when he practices the self-administration of the insulin injection by himself. In which learning domain does this client's learning style fall? Cognitive domain Affective domain Psychomotor domain Interpersonal domain
Psychomotor domain Correct: Explanation: Because the client learns better by practicing the self-administration of the insulin injection himself, his learning style falls in the psychomotor domain. The psychomotor domain is a style of processing that focuses on learning by doing. The client's learning style does not fall in the cognitive, affective, or interpersonal 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 interpersonal domain is a style of processing that focuses on learning through social relationships. pg. 487
Which strategy should the nurse use when providing education to the older adult client? Teach from books only and remain calm. Teach in a monotone voice in a quiet environment. Remain calm and conduct the teaching session in a quiet environment. Avoid the use of colorful materials and keep the session short.
Remain calm and conduct the teaching session in a quiet environment. Expl: Remaining calm and conducting the teaching session in a quiet environment would decrease anxiety or distractions that interfere with learning for the older adult. Keeping the session short will increase concentration, but is not unique to older adults. The nurse is to use colorful materials in a variety of ways and the nurse's tone and pitch should vary.
A nurse evaluates whether a middle-age client with chronic back pain has been performing the different exercises and physiotherapy procedures recommended by the physician. What would the nurse most likely use to evaluate the client? Simulation Written test Oral test Return demonstration
Return demonstration Explanation: The nurse is evaluating psychomotor skills; thus, a return demonstration is a method of testing skill performance. Written tests are time-consuming, intimidating, and not always specific to the client. Oral tests can be useful in testing cognitive learning. Simulation evaluates whether the client can apply learning in different situations, but not his ability to perform the exercises.
A nurse evaluates whether a middle-age client with chronic back pain has been performing the different exercises and physiotherapy procedures recommended by the physician. What would the nurse most likely use to evaluate the client? Return demonstration Written test Oral test Simulation
Return demonstration correct: Expl: The nurse is evaluating psychomotor skills; thus, a return demonstration is a method of testing skill performance. Written tests are time-consuming, intimidating, and not always specific to the client. Oral tests can be useful in testing cognitive learning. Simulation evaluates whether the client can apply learning in different situations, but not his ability to perform the exercises.
A nurse may attempt to help a client solve a situational crisis during what type of counseling session? Long-term counseling Professional counseling Motivational counseling Short-term counseling
Short-term counseling Explanation: Short-term counseling would help a client solve a situational crisis. A client experiencing a developmental crisis, for example, might need long-term counseling. Motivational counseling is an evidence-based counseling approach that involves discussing feelings and incentives with the client. Professional counseling is a general term.
When a nurse is planning for learning, who must decide who should be included in the learning sessions? The client and the client's family The nurse and the client The doctor and nurse The health care team
The client and the client's family Incorrect Correct: The nurse and the client Explanation: The nurse and the client should be the individuals who decide who should be included in the learning sessions. The nurse cannot assume that family members are wanted by the client to be included. The client must always be included in the learning session.
A nurse is educating a client with a new diagnosis of diabetes. Which example demonstrates cognitive learning by the client? The client expresses a desire to improve his nutritional intake and lose weight. The client demonstrates proper technique for injecting insulin. The client describes signs and symptoms of hypoglycemia. The client prepares the skin for the administration of an insulin injection.
The client demonstrates proper technique for injecting insulin. Incorrect. Correct answer: The client describes signs and symptoms of hypoglycemia. Explanation: The client's ability to describe the signs and symptoms of hypoglycemia demonstrates cognitive learning (the storing and recalling of new knowledge in the brain). Demonstrating a skill, such as insulin injection, is an example of psychomotor learning. Affective learning includes changes in attitudes, values, and feelings (e.g., desire to lose weight). pg. 487
The nurse identifies which client response as a need for additional education? The client states, "I only have to worry about lowering the top number of my blood pressure." The client gives a return demonstration of cleaning the side of finger with alcohol before using lancet. The client reports taking levothyroxine every morning with only water for 30 minutes. Follow-up visit demonstrates a weight loss of 5 lb (2.3 kg) in 1 month.
The client states, "I only have to worry about lowering the top number of my blood pressure." Explanation: Cleaning the side of the finger to check blood glucose, losing weight at a rate of 0.5 to 1 lb (0.23 to 0.45 kg) per week, and taking levothyroxine on an empty stomach with nothing but water for 30 minutes are all appropriate actions. The statement about worrying only about the systolic blood pressure indicates the client does not understand the diagnosis of hypertension.
The nurse is educating a client regarding a new skill. When evaluating the client's knowledge about the topic covered, what best represents that the client has learned a new skill? The client verbalizes items needed and how to perform skill. The client organizes materials needed and gives return demonstration. The client nods when asked about process and assists with clean up. The client states understanding and passes a written test.
The client verbalizes items needed and how to perform skill. Incorrect Correct: The client organizes materials needed and gives return demonstration. Explanation: Skills require more than verbalization or passing a written test. Nodding and assisting with clean up does not indicate that learning has occurred, but may indicate a lack of readiness to learn. Being able to gather all equipment needed for a skill, and then performing it, demonstrates proficiency.
The nurse has educated the client on the pathophysiology of osteoarthritis and degenerative joint disease. This is an example of what learning theory? Developmental learning theory Adaptive learning theory Behavioral learning theory Cognitive learning theory
Cognitive learning theory Explanation: Cognitive learning theory is the result of people wanting to make sense of the world around them by assimilating and processing information to gain new understandings and insights.
An older adult female client who is recovering from a stroke is scheduled to be transferred to the rehabilitation unit in the morning. She is tearful and verbalizes that she feels lonely and abandoned in the hospital unit. The nurse noticed that family visits daily and that there are flowers and cards in the room. Documentation in the chart indicates that the client's pastor has been by twice in the past week to visit. Which nursing diagnosis and outcome criteria need to be addressed immediately for this client? Impaired Walking; unilateral neglect. Ineffective Coping; verbalizes support systems. Dysfunctional Family Processes; family contact daily. Altered Mobility; able to tie shoes.
Ineffective Coping; verbalizes support systems. Explanation: When considering appropriate evaluation criteria, be certain it relates directly to the diagnosis, and the diagnosis relates to the assessment data. There are not data to support unilateral neglect. Tying shoes evaluates client abilities, not mobility. The nurse assessed that the family visits daily, so the family process is functional. Ineffective coping is appropriately evaluated by identification of coping mechanisms, such as support systems.
A client is experiencing difficulty in adjusting to a new prosthesis despite conscientious client education by numerous members of the health care team. How should the team respond to the client's lack of learning to this point? Explore alternatives to prosthesis. Scale back the scope and detail of client education. Revise the education plan that has guided education. Refer the client to outside sources of information.
Revise the education plan that has guided education. Explanation: If evaluation of client education indicates that client learning has not met outcomes, it is appropriate to revise the education plan. This does not necessarily entail reducing the detail or referring the client to outside information sources. Exploring alternatives to prosthesis does not address the client's learning needs.
