Craven Ch. 9: Patient Education and Health Promotion

A nurse refers a client with a new colostomy to a support group. This nurse is practicing which aim of nursing?

Facilitating coping

A nurse is engaged in primary prevention activities as part of an education plan about heart disease for a client. Which activity would be most appropriate?

explaining the need for regular exercise and stress management

The spouse of a client who has recently been diagnosed with early-stage Alzheimer's disease asks the nurse to recommend websites that may supplement the spouse's learning about this diagnosis. How should the nurse respond to the spouse's request?

Identify and recommend some credible websites appropriate to the spouse's learning needs.

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 mother understands what to do?" What is the appropriate nursing response?

"When 15 minutes have passed, I will ask your mother to show me how to instill the drops."

Which documentation example best reflects the complexity of client teaching by the nurse?

"Client and spouse taught how to use phone app to count carbohydrates; client return demonstrated carb counting for a hypothetical meal."

Which statements made by the nurse would facilitate a teaching session for adult clients? Select all that apply.

"Does anyone have any barriers that would make it difficult to see or hear the audiovisuals?" "This will be a short presentation followed by 15 minutes of questions and answers." "We will have our presentation in this room because it is quieter and has less distractions." "This session will only last for 30 minutes."

Which statement made by a client who was recently admitted to the medical unit with a diagnosis of pneumonia indicates a physical inability to learn?

"I am having difficulty breathing."

A nurse is caring for a client with diabetes and foot gangrene who is scheduled for surgery that involves amputation of the affected foot. What would be most effective in helping the client cope with the fear and pain of surgery?

Explain the surgery and its importance to the client.

The nurse has completed teaching. Which client behavior demonstrates understanding within the psychomotor domain?

Provides return demonstration of use of inhaler.

A 56-year-old client meets with the nurse for education about a recently diagnosed atrial fibrillation. The client verbalizes concerns about being away from work too long and doubts about the necessity of having blood tests every week, as the client has no symptoms. Which is the best motivational statement by the nurse for this client?

"The medicine and blood work can help prevent blood clots, which can lead to strokes. What do you know about warfarin therapy?"

A nurse is preparing a discharge education plan for a client who has had abdominal surgery. What would be most important for the nurse to include in this plan?

Activity limitations

The nurse is planning to provide teaching to a client who is recovering from abdominal surgery. When is the most appropriate time to teach the client?

As the client is sitting quietly, reading a book

The nurse is caring for a 70-year-old client with a fractured wrist. Which is the best method to determine whether the client has retained the information taught?

Ask the client to recall after approximately 15 minutes.

When preparing client teaching materials, how does the nurse best assess a client's preferred learning style?

Ask the client, "Do you learn best by observing, valuing, or doing?"

A client informs the nurse about being committed to quitting smoking to improve health. 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?

Assessing importance

The nurse is going to teach the parent of a toddler to do cardiopulmonary resuscitation (CPR). What information would be the most important to prepare this education?

Baseline knowledge

The nurse is caring for a client with a migraine, who is admitted to the health care facility for observation. How can the nurse ensure that the client's learning needs are fulfilled?

Begin teaching as soon as possible after admission.

The nurse is caring for a 60-year-old client with an improper bowel movement regimen. Which is the most appropriate method for the nurse to use in teaching this client?

Begin the session with a reference to the client's actual experience.

A nurse is educating a 4-year-old client about cast care following a tibia-fibula fracture. Which action is not developmentally appropriate to include in the nurse's teaching?

Blocking 30 minutes of time for skill teaching

Which statement about providing client education before discharge is most accurate?

Client education focuses on identified home needs.

A client who is a chronic smoker comes to the clinic for a routine follow-up evaluation. The client takes numerous medications and is prescribed a new one to treat hypertension. Which topic should the nurse include when teaching the client about this new health condition?

Correlation between hypertension and smoking

A nurse is designing an education program for individuals who have recently immigrated from Iraq. Which consideration is necessary for culturally competent client education?

Develop written materials in the client's native language.

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?

Knowledge Deficient: Risk for altered perfusion secondary to re-occlusion

A new client comes into the urgent care center with the spouse with a report of severe itchy rash with small blisters on the arms and hands. The nurse is documenting assessment data for the client. What is the nurse's best assessment action?

Make an open-ended statement to the client to elicit the history of the rash.

A client who recently underwent a coronary artery bypass graft is taking furosemide and metoprolol following the procedure. While developing a plan for a heart-healthy diet with the nurse, the client states that diet did not contribute to the heart disease and that the client should be fine just continuing to take the medications. According to the Transtheoretical Model of Change, which stage of change is the client in related to diet?

Precontemplation

A 46-year-old obese client has been diagnosed with hypertension and type 2 diabetes. The client acknowledges the need to lose weight. The client recently visited a local fitness club, obtained a membership, and has signed up for their next water aerobics class. According to the Transtheoretical Model of Change, what stage of change is this client in related to her weight loss?

Preparation

Which observation during the nursing assessment of a client supports the documentation of low health literacy?

The client avoids health care screenings and seeks care in the local emergency department.

A Chinese client who was previously treated at the health care facility for an open wound has been admitted again because the wound has become gangrenous. It has been identified that the client failed to understand proper wound care. What is the probable reason for the client failing to understand the instruction?

The client belongs to a different culture.

A nurse is preparing an education plan for an older adult. What would be least appropriate for the nurse to include in this plan?

scheduling education sessions to last 45 minutes

The World Health Organization (WHO) has committed to the health of all people. It directs nurses to improve partnership with:

the community.

A client is newly diagnosed with hypertension. While providing education on hypertension which behavior should the nurse employ to reinforce the desired outcomes?

having the client teach back what has been learned

The nurse is conducting a teaching session regarding HIV/AIDS for adult clients in the community. What consideration(s) will the nurse make when teaching this type of session? Select all that apply.

identifying the length of the session beginning with basic concepts about HIV/AIDS providing adequate lighting and comfortable temperature identifying the time, place, and content for the next teaching session

A diabetes nurse educator is teaching a client, newly diagnosed with diabetes, about his disease process, diet, exercise, and medications. What is the goal of this education?

to help the client develop self-care abilities

A client diagnosed with type 2 diabetes has been prescribed insulin therapy in conjunction with an oral agent because the client has been experiencing difficulty controlling blood sugar levels with an oral agent alone. The nurse is preparing a teaching plan for this client. Which intervention would the nurse include in the teaching plan to address the psychomotor domain?

Demonstrating the technique for insulin self-injection

Which strategy might a nurse use to increase compliance with education?

Include the client and family as partners.

The nurse is working with an older adult client recently diagnosed with Stage 2 ovarian cancer. The nurse is providing some health literature to help the client understand the new diagnosis. When considering internet resources for the client, what should the nurse take into consideration? Select all that apply.

Many internet websites may be 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.

A client informs the nurse about being committed to quitting smoking to improve health. 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?

Motivational counseling

At completion of a teaching session with a client, the nurse documents the details of this education encounter in the client's health record. What should another nurse be able to determine from reading this documentation?

The client's response to the health education that was provided

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.

What is the most critical element to document regarding client education?

Evidence that learning has occurred

A nurse is preparing an education plan for a client who has been newly diagnosed with diabetes. Which method would be appropriate for the nurse to use to foster effective learning? Select all that apply.

Role playing Simulation Demonstration Discussion

A client with a body mass index (BMI) of 40.3 kg/m2 states, "I know I need to get rid of this fat. I just don't know how." Which is the best assessment for the nurse to make at this time?

Past interventions for weight loss

A client age 61 years has been admitted to a medical unit with a diagnosis of pancreatitis secondary to alcohol use. Which statement by the client suggests that the nurse's teaching has resulted in affective learning?

"I'm starting to see how my lifestyle has caused me to end up here."

The nurse is providing education to a group of clients with diabetes about the benefits of healthy food choices. What type of learning is the nurse using with this client group?

Affective

A nurse is working with a 15-year-old client with sickle cell anemia. The client was started on a new pain management plan today, and the nurse is evaluating the effectiveness of the plan. Which is not appropriate to include in the nursing care?

Asking only the client's parents to be present at the education session

The nurse must instruct a 35-year-old client with Down syndrome about the use of an albuterol rescue inhaler. Which documentation demonstrates appropriate individualization of the education plan for this client?

Assessed the client's understanding of illness; assessed motor skills and developmental stage; provided clarification

When caring for a client, the nurse gives day-to-day examples to explain certain points of the health education. The nurse also notes the client's concentration level and educates when the client is active. Which aspect related to learning is the nurse targeting in this approach to teaching the client?

Attention and concentration

A nurse is working with an older adult client, educating the client on how to ambulate with the aid of a walker. The nurse notes that the client appears to lack the motivation to learn how to use the device. The client states, "I'm just too old to learn." What would be most appropriate for the nurse to do to motivate this client?

Describe how the walker can improve the client's quality of life.

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

Include the child in the education; ask questions of both the mother and the child.

The nurse is preparing discharge teaching for a client with diabetes. Which information should the nurse include? Select all that apply.

Meal planning Community resources Appropriate use of a glucometer Instructions to follow up with the health care provider

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?

Preventing illness

The nurse has been working with a client for several days during the client's recovery from a femoral head fracture. How should a nurse best evaluate whether client education regarding the prevention of falls in the home has been effective?

"What changes will you make around your house to reduce the chance of future falls?"

A client is meeting with the nurse to discuss options for smoking cessation. Which statement by the nurse is most appropriate for this client?

"What do you see as your biggest hurdle to stopping?"

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 28-year-old female who works nights, is willing to try, and asks about insurance coverage of the appointment

Which statement describes the person who is likely the most motivated to learn?

A 70-year-old female who is the client's spouse and is learning the care so the client can come home

When caring for a client at the health care facility, the nurse observes that the client is having difficulty understanding the health education. Which action is most appropriate?

Assess for cultural differences.

Which is an essential component of the definition of learning?

Can be measured

A client reads the nutritional chart and follows it accurately. The nurse also notes that the client understands the need for a balanced diet and its relationship with a quick recovery. In which domain is the client demonstrating successful learning?

Cognitive

A nurse instructs a client to tell the nurse about the side effects of a medication. What learning domain is the nurse evaluating?

Cognitive

When caring for a client, the nurse observes that the client enjoys reading books and magazines. In which learning domain does the client's learning style fall?

Cognitive

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 barriers to each action and continues to smoke. What is the best action of the nurse?

Discuss the client's case with a colleague.

The nurse is caring for a client who has been admitted for a new diagnosis of hypertension. When should the nurse begin client teaching?

During the admission process

The client is newly diagnosed with type 2 diabetes. After teaching the client about diabetes and how to self-administer insulin, the nurse identifies which client response as a need for additional education?

During the return demonstration, the client draws up insulin, leaving tiny bubbles in the syringe.

A nurse notices that a toddler is constantly snatching toys from the hands of other preschool children at the health care facility, placing the toddler and other children at risk for injury. What would be a most effective method for teaching the toddler not to snatch toys?

Enlist the aid of the toddler's parents in education.

During the health education session at the health care facility, the nurse notes that a client is able to recognize, describe to others, and explain the information learned. What is the final learning stage of the client in this case?

Independent use of new learning

An older adult client who is recovering from a stroke is scheduled to be transferred to the rehabilitation unit in the morning. The client is tearful and reports feeling lonely and abandoned in the hospital unit. The family visits daily, and flowers and cards are 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?

Ineffective Coping; verbalizes support systems.

Which nursing action is applicable to the psychomotor domain of learning when conducting a teaching session for breastfeeding mothers?

Observing a mother expressing the breast milk

The nurse completed education with a client. Which documentation entry represents the mostcomplete teaching plan?

Printed and verbal information provided on gluten-free diet. Questions answered. Verbalizes understanding. Follow-up scheduled.

A client 36 years of age is able to understand the health education when given the opportunity to put the education into practice. The nurse helps the client to self-administer the medication dosage before the client is discharged from the health care facility. Which domain correctly identifies the client's learning style?

Psychomotor

When caring for a diabetic client, the nurse notes that the client learns better when practicing the self-administration of the insulin injection alone. In which learning domain does this client's learning style fall?

Psychomotor

A new nurse is developing a teaching plan for an assigned client who has just started receiving chemotherapy. The nurse plans to teach the client about symptoms to report after chemotherapy. What is the priority action by the nurse?

Research information available in journal articles and other authoritative sources.

The nurse has provided teaching for a client with a sinus infection who has been prescribed antibiotics and a decongestant. The client states, "I'm not sure how many days I'm supposed to take this antibiotic." What is the nurse's appropriate response?

Reteach the length of time to take the prescription.

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

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?

Revise the education plan that has guided education.

The nurse is conducting a community health promotion class and has developed scenarios that will involve active participation by the class attendees. What type of education strategy is the nurse incorporating into this class?

Role-playing

A pediatric nurse provides education to numerous clients. Which group of children benefits most from being involved in the teaching-learning process?

School-age children

A nurse is educating a client with a new diagnosis of diabetes. Which example demonstrates cognitive learning by the client?

The client describes signs and symptoms of hypoglycemia.

The nurse is educating a client regarding a new skill. When evaluating the client's knowledge about the topic covered, which best represents that the client has learned a new skill?

The client organizes materials needed and gives return demonstration.

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.

While applying dressings to a client's wound, the nurse teaches the client about wound care. To promote the most effective teaching-learning relationship with this client, what would be mostimportant for the nurse to keep in mind?

The nurse and client relationship is based on mutual sharing and negotiation.

When a nurse is planning for learning, who must decide who should be included in the learning sessions?

The nurse and the client

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 writes one long-term objective for each diagnosis, followed by several specific objectives.

An experienced nurse is educating a client about the client's disease and how best to promote optimal health. The nurse is focusing the education on the cognitive domain of learning. Given this focus, the nurse would incorporate the client's:

critical thinking.

The nurse is providing education for a client who will be providing self-care at home. The client states, "I just do not think I can do all of this. It is too much to learn." What is the bestresponse by the nurse?

"I understand that you feel overwhelmed with all of the information. Tell me what I can do to help."

Which response from the client enables the nurse to determine the effectiveness of a recent medication teaching session for an older adult client who is diagnosed with tuberculosis (TB)?

"I will be taking the TB medication for at least 6 months, because it takes a long time to kill the TB germs."

A nurse is trying to encourage a client with paraplegia who is depressed and not adhering to the treatment program to join a support group. Which statement by the nurse is most appropriate?

"What do you know about support groups?"

A nurse is working with the Red Cross to assist a family whose home was destroyed by fire. Which statement is most appropriate to assist with this situational crisis?

"You have had a tremendous loss. What are your plans for shelter tonight?"

During a health teaching session, the nurse notes that the client is not attentive and loses concentration easily. Which of the following techniques is most appropriate to grab the attention of the client during the education?

Involve the client in an active way.

Which client characteristic is important to assess when using the health belief model as the framework for education?

Motivation to learn

When a client says, "I don't care if I get better; I have nothing to live for, anyway," which type of counseling would be appropriate?

Motivational counseling

The nurse is teaching a client newly diagnosed with diabetes about the disease, testing, diet, and how to self-administer insulin. The client does not speak the dominant language. What is the appropriate nursing action?

Obtain a medical interpreter.

An active, otherwise healthy, older adult client presents to the clinic with severe osteoarthritis in both knees. The nurse knows this client does not want to be a burden on the family, and the client remains stoic despite reporting the pain as severe. The client avoids the topic of surgery and attends church weekly. The client's family is supportive of any decisions the client makes regarding health. Which of the assessment data is most important to forming an individualized education plan for this client concerning treatment for osteoarthritis?

Personal perception of health and aging

The nurse is preparing to teach a client about postsurgical care after a laparoscopic cholecystectomy. Which factor should the nurse most consider when determining whether the client is ready and able to learn?

Physical condition

Which strategy should the nurse use when providing education to the older adult client?

Remain calm and conduct the teaching session in a quiet environment.

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 as a characteristic of an adult learner?

Their readiness to learn is often related to a developmental task or social role.

When caring for a client at a health care facility, the nurse discovers that the client is unable to read or write. Which of the following teaching approaches is most useful for the client?

Use verbal and visual modes of communication.

The nurse is caring for a client who demonstrates a health literacy concern. The nurse adjusts client teaching in which way?

uses videos, diagrams, and pictures rather than focusing on verbal teaching

The nurse conducts a teaching session for a group of middle-aged women. Which exercise information will the nurse share with this group? Select all that apply.

The importance of regular exercise to maintain health The use of exercise to improve quality of life The use of ambulation devices to improve exercise How to perform deep breathing exercises

A nurse is reviewing the teaching plan about heart failure with a client. The nurse determines that learning in the affective domain has been achieved based on which client statement?

"I realize now just how important it is to watch how much salt I use."

The client reports to the clinic as ordered by the 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 reports 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."

A nurse is caring for a slightly overweight client whose lipid panel revealed elevated cholesterol levels. The client was prescribed a statin by the health care provider. Which statement by the client would indicate a health literacy level that would enable the client to make appropriate health decisions to lower cholesterol levels?

"In addition to this cholesterol medication, I plan to reduce my consumption of red meat and other saturated fats and start walking again."

A nurse is showing an older adult client with severe diabetes the correct method of self-administering an insulin injection. What should be the nurse's comment if the client continues making mistakes when learning how to self-administer an insulin injection? Select all that apply.

"Lots of people have the same concern." "You've just about figured out how to give yourself an injection." "Try to angle the syringe a little more this way."

The nurse has provided education to a client about home care for an open surgical wound on the lower left extremity. When evaluating learning through the cognitive domain, what statement by the nurse would be appropriate?

"Tell me about what signs of infection you will report to the health care provider."

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 the client immobile. As the nurse enters the home, the client braces hands on the arms of a chair to rise and uses crutches to walk across the room. What is the best response by the nurse?

"You have made an amazing recovery."

A nurse is caring for a 45-year-old male client who lost function in both of his legs due to an automobile accident. Which of the following should the nurse do first to personalize the learning?

Gather pertinent information from the client.

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?

Have the client rate pain level, and reschedule the teaching session.

Which developmental consideration is a nurse assessing when determining that an 8-year-old child is not equipped to understand the scientific explanation of the child's disease?

Intellectual development

A nurse is discussing the benefits of smoking cessation with a client. The nurse informs the client that smoking cessation will reduce the client's risk for cancer, improve respiratory status, and enhance the quality of life. The nurse also shares a personal 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 feelings on smoking cessation and verbalizes a desire to quit smoking. What type of counseling did the nurse provide to this client?

Motivational

The nurse observes that a client responds better to health education when the nurse motivates him and assures him about the benefits of the teaching. In which of the following learning domains does the client's learning style fall?

affective domain

The nurse is providing education to a client recently diagnosed with diabetes. Which action should the nurse take first to address the client's educational needs?

creating a plan with the client based upon needs

The parents of a school-age child are meeting with the nurse for health promotional education for their child. The child has the following assessment data: a 7-year-old male with diabetes mellitus type 1 with a hemoglobin A1C level of 8.3%, a body mass index (BMI) of 31.7, and a BMI percentile of 99. What are the most appropriate learning diagnoses for this first session?

Deficient Knowledge: Imbalanced nutrition: more than body requirements, and ineffective health maintenance.