chp 3 med surg
A current trend in health education that significantly influences nursing practice is: Improved distribution of health information materials. Increased emphasis on the diversity of patient needs. Increased numbers of health care providers. Increased emphasis on patient involvement in their own care.
Increased emphasis on patient involvement in their own care.
The nurse is planning to teach a client who was recently diagnosed with migraine headaches. It is best to teach the client In a quiet room With her spouse and children present During the headache recovery phase Immediately following a headache experience
In a quiet room
Based on the nurse's knowledge of nonadherence to therapeutic regimens, which nurse needs to place extra emphasis on adherence to the treatment plan? The nurse planning to teach teenagers about mononucleosis The nurse planning to teach adults aged 65 about congestive heart failure management The nurse planning to teach a group of children about healthy eating The nurse planning to teach middle-aged adults about stress management
The nurse planning to teach adults aged 65 about congestive heart failure management
Which phase of the nursing process encompasses the establishment of expected outcomes? Assessment Evaluation Implementation Planning
Planning
Which step of the nursing process determines whether the client understands the health teaching that is provided? Assessment Evaluation Implementation Planning
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.
Which of the following is a diagnosis related to health education? Self-esteem disturbance Ineffective airway clearance Ineffective health maintenance Altered nutrition, less than body requirements
Ineffective health maintenance
Which of the following is an example of adherence to treatment? Select all that apply. Self-monitoring for signs and symptoms of illness Maintaining a healthy diet Taking prescribed medications Increasing daily activities Inability to comply with follow-up appointments
Maintaining a healthy diet Self-monitoring for signs and symptoms of illness Taking prescribed medications Increasing daily activities
When a client who has successfully completed a smoking cessation program removes ashtrays from their home and takes a short walk after work instead of joining the usual group of coworkers at the local hangout, which stage of the Transtheoretical Model of Change is the patient portraying? Termination Contemplative Maintenance Action
Maintenance
The practice of nursing care is multifaceted in its scope and delivery. Which of the following activities describe the role of nursing? Select all that apply. Preventing illness Promoting health Health education and maintenance Changing prescribed treatment protocols Altering a medical plan of care
Preventing illness Health education and maintenance Promoting health
The nurse is preparing to teach a client about a newly prescribed medication. The client lacks insurance. The medication costs approximately $100 per month. The client states, "I can't afford it." The nurse assesses a variable to successful education and health promotion for this client based on the Health Belief Model is Perceptual factors Demographic and disease factors Barriers Resources
Resources The Health Belief Model is based on the premise that four variables influence health promotion behaviors. Resources address financial and social behaviors. Demographics and disease factors include client age, gender, education, employment, severity of illness or disability, and length of illness. Barriers are factors that lead to unavailability or difficulty in gaining access to a health promotion alternative. Perceptual factors are how a client views his health status, self-efficacy, and the perceived demands of the illness.
A 27-year-old client is a regular smoker, has diabetes, and has been diagnosed with hypertension. The client says it is cumbersome and time consuming to visit the doctor regularly just for a blood pressure check. Which aspect of teaching would the nurse use with this client? Suggest the client purchase a self-monitoring cuff Apply glycemic control Advise smoking cessation Discuss methods for stress reduction
Suggest the client purchase a self-monitoring cuff
A nurse developed a program of increased ambulation for a patient with an orthopedic disorder. This goal setting is a component of the nursing process known as: Evaluation Assessment Planning Implementation
Planning
In many situations, measurement of which of the following is the most accurate measurement technique to identify changes in patient behavior? Use of checklists Use of rating scales Anecdotal notes Direct observation of behavior
Direct observation of behavior
Which health promotion model does the nurse identify is the reason some people choose actions to foster health and others refuse to participate? Social Learning Theory Model Resource Model of Preventive Health Health Belief Model Achieving Health for All Model
Health Belief Model The Health Belief Model was designed to foster understanding of why some healthy people choose actions to prevent illness while others do not. Another model, the Resource Model of Preventive Health Behavior, addresses the ways in which people use resources to promote health (Pender et al., 2011). It is based on social learning theory and emphasizes the importance of motivational factors in acquiring and sustaining health promotion behaviors. The Canadian health promotion initiative, Achieving Health for All, builds on the work of Lalonde (1977), in which four determinants of health—human biology, environment, lifestyle, and the health care delivery system—were identified. Determinants of health were defined as factors and conditions that have an influence on the health of individuals and communities.
The nurse is reviewing the immunization record of a 62-year-old client who has no chronic health problems. To determine if this client is due for any vaccinations, which vaccine(s) will the nurse ask if the patient has already received? Select all that apply. Zoster Pneumococcal conjugate Human papillomavirus Pneumococcal polysaccharide Influenza
Zoster Influenza
Choose the nursing statement that would best reflect the final component of the "Ask-Tell-Ask-Close" technique of communication and demonstration. "Is this a good time for me to show you how to irrigate your colostomy?" "Here are the written directions for changing your dressings." "Can you repeat for me the information I just reviewed about weighing food portions?" "Do you understand how to take your blood pressure?"
"Can you repeat for me the information I just reviewed about weighing food portions?"
The nurse determines that a client would benefit from changing a lifestyle factor that adversely affects health. Which statement indicates to the nurse that the client takes responsibility for the health problem created by the lifestyle factor? "My health was predetermined by my parents through genetics." "No one in my family developed lung cancer from smoking, so why should I?" "I get enough exercise by taking care of the house and cooking my family dinner." "Having a cocktail every night after work has contributed to my liver disease."
"Having a cocktail every night after work has contributed to my liver disease."
The nurse is caring for a client who is newly diagnosed with diabetes. Which statement indicates to the nurse that the client is ready to learn about the disease process and treatment? "This is not a bad disease like cancer, so I will eventually get over it." "There must be some mistake because I cannot believe I have this disease." "I watched my parent check blood sugar levels several times." "I see the television commercials for diabetes medication, so I know I will be all right."
"I watched my parent check blood sugar levels several times."
The nurse is administering a new medication to an elderly male client and begins instruction about the medication. The client states, "Tell my wife. She takes care of all this kind of stuff." The nurse replies "It is necessary that you learn about this medication." "When your wife comes in to visit, I will return and provide the information to both of you." "I will print the information about this medication and leave it with you to give to her." "I will have to return when she arrives."
"When your wife comes in to visit, I will return and provide the information to both of you."
A nurse is preparing teaching for a client with an auditory perceptual disorder. Which educational strategy will be most effective? Explain noises associated with procedures. Repeat and reinforce words frequently. Avoid medical terminology. Explain important information verbally.
Repeat and reinforce words frequently.
A recommended approach to planning health teaching is applying the trans-theoretical model, which considers the stages of behavioral change. The stage in which the patient engages in calorie counting to reduce weight is called: Contemplation Maintenance Preparation Action
Action
A nurse is caring for a client who wants to quit smoking. The client tells the nurse he has thrown out all of his cigarettes. Which stage is the client in, according to the transtheoretical model of change? Precontemplative Contemplative Action Decision-making
Action The client is in the action stage of the transtheoretical model of change because this is the stage where the client takes decision action—in this case, the client throws away cigarettes in order to stop smoking. The precontemplative stage is when the client does not express a desire to change. The contemplative stage is when the client only begins to think about change.
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 The establishment of learning goals based on individual needs The creation of an atmosphere in which the patient is encouraged to express anxiety Constructive encouragement when a person has been unsuccessful in the learning process
Emphasis on negative outcomes as a method to prevent learning incorrect practices
A nurse is evaluating education provided to various clients being discharged to home. The nurse assesses that client most likely to be nonadherent with treatment is the one who Has a duodenal ulcer and is prescribed a histamine-2 receptor blocker Had abdominal surgery and will be changing the dressing daily Has tuberculosis and is taking multiple antitubercular medications Has pneumonia and is prescribed an oral antibiotic
Has tuberculosis and is taking multiple antitubercular medications
Which phase of the process of patient teaching ends when the strategies have been completed and when the client's responses to the actions have been recorded? Planning Evaluation Assessment Implementation
Implementation
There are many goals for health teaching. Which of the following is the primary goal of family and patient education? Establish trust Increase knowledge Improve patient outcomes Motivate people to learn
Improve patient outcomes
Nonadherence to therapeutic regimens is a significant problem, especially in the elderly population. Nonadherence can lead to which outcome? Decreased morbidity Increased cost of treatment Decreased chronic illness Increased compliance with medical regimen
Increased cost of treatment
The nurse is in the process of initiating and delivering a teaching-learning program. What is the strongest predictor of a client's health status? Cultural skills High socio- economic level Life style Health literacy skills
Life style
The nurse is caring for a 33-year-old male client. Which clinical screening should the client have, based on his age? Colonoscopy Lipid panel Hemoccult screening Electrocardiogram
Lipid panel
The nurse is caring for a 33-year-old male client. Which clinical screening should the client have, based on his age? Lipid panel Colonoscopy Electrocardiogram Hemoccult screening
Lipid panel A lipid panel should be performed at age 20, then mutually determined by both the client and clinician. A baseline hemoccult screening and colonoscopy should occur at age 50. An electrocardiogram should be performed at age 40.
The nurse provides care to residents of an assisted living facility. For which reason will the nurse discuss health promotion programs for the residents with the facility manager? Maximize resident independence. Provide methods of recreation. Reduce the cost for care. Enhance bonding with other residents.
Maximize resident independence.
Which of the following is accurate regarding wellness? Select all that apply. One tries to maximize one's own health. It is a specific health status with the absence of disease. It is the result of adopting lifestyle behaviors for the attainment of one's highest potential. Is the same for every person. It requires a conscious commitment.
One tries to maximize one's own health. It requires a conscious commitment. It is the result of adopting lifestyle behaviors for the attainment of one's highest potential.
Which factor is a leading health indicator used to measure the health of the nation? Cultural awareness Intelligence Overweight and obesity Religion
Overweight and obesity
The nurse is developing a health-promotion program at a company in which many employees are women in their 20s and 30s. For this population, the nurse plans to include information about Mammography Bone-density screening Values training Parenting issues
Parenting issues
A nursing student observes the home care nurse provide education to a client with congestive heart failure (CHF). The nurse teaches the client how to read food labels and calculate sodium content. The nursing student recognizes that the home care nurse is aware of which basic principle of patient education? The home care nurse is providing hospital discharge instructions Patient instruction related to self-care activities promotes patient independence The home care nurse has a physician order to teach a 2-g sodium diet Patients are required to learn about their therapeutic nutritional regimen
Patient instruction related to self-care activities promotes patient independence
The home health nurse reviews a medication administration calendar with an elderly patient. In order to consider sensory changes that occur with aging, how should the nurse proceed? Print directions in large, bold type, preferably using black ink. Type out the information on the computer. Use several different colors to emphasize special dates. Highlight or shade important dates and times with contrasting colors.
Print directions in large, bold type, preferably using black ink.
The school nurse informs the mother of a second-grade student that lice were found in the child's hair. The mother explains to the nurse that she has another child to pick up and cannot stay to receive education related to the treatment of lice at this time. The mother reassures the nurse that she will "look up treatment options on the Internet and take care of the child." What would be the best action of the school nurse in this situation? Perform hand hygiene and notify the second-grade teacher to wash down the classroom Provide the mother with a list of credible websites related to the treatment of lice Instruct the mother to treat the other child for lice in the same manner as the second-grade child Notify the social worker of suspected child neglect and make a referral to child protective services
Provide the mother with a list of credible websites related to the treatment of lice
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 Demonstrates adequate knowledge of the skill Needs a family member to perform this skill Cannot satisfactorily learn the skill Requires another opportunity for practice
Requires another opportunity for practice
A nurse knows that the use of a learning contract increases motivation and increases the likelihood of patient compliance with the treatment regimen. Which client goal best exemplifies a well-designed learning contract? The client who wants to begin an exercise program agrees to participate in a 10-km run 6 months after starting the new exercise regimen. The client who wishes to stop smoking agrees to cut back on one cigarette a day for the first week of treatment and then decrease smoking by two cigarettes the following week of treatment. The client seeking alcohol treatment agrees to stop drinking all forms of alcohol immediately and plans to chew a stick of gum when they experience the urge to have a drink. The client who wishes to lose weight immediately reduces caloric intake to 1000 calories a day and agrees to keep to this diet plan until a 9-kg weight loss has been achieved.
The client who wishes to stop smoking agrees to cut back on one cigarette a day for the first week of treatment and then decrease smoking by two cigarettes the following week of treatment.
The nurse is revising a client's plan of care. What is an example of an expected client outcome? The client's blood pressure will be stable. The client will accept the option of attending church on weekdays. The client will buy a pair of reading glasses to help with reading. The client will have the ability to climb a flight of stairs without experiencing difficulty in breathing.
The client will have the ability to climb a flight of stairs without experiencing difficulty in breathing.
A nurse is planning a health education program for a group of high school students regarding the dangers of texting and driving. Which action by the nurse illustrates the understanding of health education as a primary nursing responsibility? After consulting the literature and preparing the educational program, the nurse contacts the school's medical director for approval of the planned educational program. The nurse obtains the name of the school's medical director and obtains a health care provider's order to conduct the education program. The nurse gathers evidenced-based information related to texting and driving and coordinates the education with the school. The nurse prepares a permission slip for all students to have signed by their parents, allowing the student to participate in the educational program.
The nurse gathers evidenced-based information related to texting and driving and coordinates the education with the school.
The nurse develops outcome criteria for a patient with chronic obstructive pulmonary disease. Which outcome criteria are appropriate for this patient? The nurse will obtain a pulse oximetry reading twice a day. The patient will have the ability to climb a flight of stairs without experiencing difficulty in breathing. The patient will not experience an alteration in skin integrity. The patient will perform passive range-of-motion exercises once daily.
The patient will have the ability to climb a flight of stairs without experiencing difficulty in breathing.
The nurse is instructing a client on the preparation and self-administration of insulin. Which technique will the nurse use to facilitate the client's emotional readiness to learn the skill? follow-up teach-back lecture online instruction
teach-back
The nurse is instructing a client on the preparation and self-administration of insulin. Which technique will the nurse use to facilitate the client's emotional readiness to learn the skill? teach-back lecture follow-up online instruction
teach-back
A client and his spouse are in the client's hospital room. The spouse says to the nurse, "I looked up one of the new drugs on the Internet, gabapentin. It said it is for seizures. My husband has never had a seizure." Which would be a therapeutic response by the nurse? "I will get you a current drug handbook; you can look it up." "Why are you asking? Your husband's physician has probably told him the reason." "I cannot discuss the drugs the physician has ordered. You need to call her to ask that question." "Gabapentin can also be used for leg pain associated with diabetes."
"Gabapentin can also be used for leg pain associated with diabetes."
A current trend in health education that significantly influences nursing practice is: Improved distribution of health information materials. Increased emphasis on patient involvement in their own care. Increased emphasis on the diversity of patient needs. Increased numbers of health care providers.
Increased emphasis on patient involvement in their own care.
A hospitalized client reports right lower quadrant abdominal pain at a level of 8 on a 0 to 10 scale. The client is scheduled for an appendectomy. The nurse is teaching the client about use of the incentive spirometer postoperatively verbally and by demonstration. The client is on his side, clutching his abdomen. Learning is not occurring. The nurse has primarily failed to consider the client's Learning environment Physical readiness Experiential readiness Emotional readiness
Physical readiness
A client with severe anemia is prescribed 2 units of packed red blood cells. The client refuses to sign the consent form for blood administration because to do so conflicts with the client's Jehovah's Witness faith. What did the nurse fail to assess prior to witnessing consent? learning readiness cultural beliefs emotional readiness learning environment
cultural beliefs
The nurse is performing discharge teaching for an elderly client with mild visual impairment. The nurse provides written instructions with large print and highlighted parts. The nurse also sits near the client, faces the client, and speaks in a lower-pitched voice. When the client arrives home, the client has difficulty following instructions. What error in teaching did the nurse commit? Sitting near and facing the client Providing written instructions that are highlighted Speaking in a lower-pitched voice Using instructions with large print
Providing written instructions that are highlighted
The termination stage of the Transtheoretical Model of Change occurs when: The person takes steps to operationalize the plan of action. The person is not thinking about making a change. The person has the ability to resist relapse back to unhealthy behavior. The person constructs a plan to change behavior.
The person has the ability to resist relapse back to unhealthy behavior.
The termination stage of the Transtheoretical Model of Change begins when which action occurs? The person has the ability to resist relapsing back to unhealthy behavior The person constructs a plan to change behavior The person is not thinking about making a change The person takes steps to operationalize the plan of action
The person has the ability to resist relapsing back to unhealthy behavior
The nurse cares for middle-aged clients in a community health clinic. Information on which topic(s) will be made available in the waiting room? Select all that apply. general wellness exercise prenatal health weight control smoking cessation
general wellness smoking cessation exercise weight control
Health education of a client by the nurse is an independent function of nursing practice. must be approved by the physician. must focus on wellness issues. requires a physician's order.
is an independent function of nursing practice.
The nurse is developing a teaching plan. What variables significantly influence non-adherence to a prescribed regimen? Select all that apply. self-concept emotional make-up racial considerations personal attitudes ethnic background social support
self-concept social support emotional make-up personal attitudes
