Fundamentals Nursing Prep U Chapter 21 Teacher and Counselor

The nurse is using Teach-Back to evaluate the client's understanding of new information given during discharge. Which statement indicates the use of this technique?

"Please repeat to me the different signs and symptoms of stroke."

Which topics would the nurse be most likely to explore with a patient with the aim of restoring health? (Select all that apply.)

*Education of a client about living with a suprapubic catheter *Postoperative teaching for the client after prostate surgery *Orientation to treatment center and staff *The medical and nursing regimens and how the patient can participate in care

The nurse is planning client education based on the developmental stage of the client. Which nursing actions best reflect this consideration? Select all that apply.

*The nurse directs the health education for a 3-year-old to the parents. *The nurse includes a school-age child in the teaching and learning process. *The nurse determines the learning needs of the client. *The nurse provides material that is useful immediately to adult clients.

Which statement best describes the client most motivated to learn?

A 70-year-old female; learning care so spouse can come home

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.

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

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 education?

Blocking 30 minutes of time for skill teaching.

A nurse has permission from the homebound client to educate any of the family members about providing care for the client. Which family member is the most appropriate choice?

Brother who visits daily, does laundry, and cooks all meals for the client.

The nurse is completing documentation after an education session with a client. What statement best demonstrates detailed documentation of an effective teaching plan?

Demonstrated cord care to mother and states understanding. Return demonstration performed using correct technique

The nurse needs to understand the teaching-learning process when administering

Educational interventions

A female client has recently been diagnosed with early-stage Alzheimer's disease and her husband has asked the nurse to recommend Web sites that may supplement his learning about her diagnosis. How should the nurse respond to the husband's request?

Identify and recommend some credible Web sites appropriate to his learning needs.

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

Independent use of new learning

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

A client with a body mass index 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 nurse assisting a new mother in the act of breastfeeding is represented by which form of learning?

Psychomotor

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 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

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.

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?

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

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

by implementing effective teaching

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 her class?

role playing

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

during the admission process

The nurse is caring for a hearing impaired client and a family member states, "What do you think is the best way to communicate?" What is the best response by the nurse?

"Use flash cards and writing pads."

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?"

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?

"You have made an amazing recovery."

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: 7-year-old male, diabetes mellitus type 1 with a hemoglobin A1C of 8.3%, BMI of 31.7, 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.

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

Intellectual development

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?

Personal perception of health and aging

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?

Psychomotor domain

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.

A nurse may attempt to help a patient solve a situational crisis during what type of counseling session?

Short-term counseling

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.

Outcome identification directs client education by focusing interventions in a timely and accurate manner. The outcome statement is "Mr Jones and his wife will demonstrate the correct steps of taking blood pressure unassisted before day of discharge to properly monitor blood pressure at home." Place the client outcomes in the correct order.

• Who • Does • What • How • When • Goal

The nurse is caring for a 5-year old child on the pediatric unit. Which activities would promote the psychomotor skills of this child? (Select all that apply.)

• assembling blocks • building a house with popsicle sticks • removing the toys from the toy box

The nurse is preparing to teach four clients. Which client will the nurse plan to teach using principles associated with geragogy?

79-year old who has slight cognitive changes

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; works nights, willing to try, asking about insurance coverage of appointment.

A nurse is trying to encourage a client with paraplegia, who is depressed and not adhering to his treatment program, to join a support group. What would be most appropriate for the nurse to do when attempting to modify the client's attitude?

Acknowledge the client's ability to accept or reject suggestions.

The nurse is caring for a 60-year-old client with an improper bowel movement regimen. Which of the following is the most appropriate method the nurse should use to conduct new learning?

Beginning the session with a reference to the client's actual experience will help provide a link to which the new learning can connect.

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.

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

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

The nurse is teaching a client who does not speak the primary language of the hospital where the client was admitted. What is the appropriate nursing action?

Obtain an interpreter

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.

A nurse is working with a 15-year-old client with sickle cell anemia. He 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

A client shares with the nurse how much she appreciates understanding the physiology of her breastfeeding. She states, "I felt very comfortable with what you explained to me and I feel I will be successful at breastfeeding." In affective learning, this represents:

creating an atmosphere for discussion of feelings.

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

critical thinking

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 is preparing to teach a client about postsurgical care after a laparoscopic cholecystectomy. What determining factors demonstrates that the client is ready and able to learn?

physical condition

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

provides return demonstration of use of inhaler

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

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 client is reluctant to learn to do finger sticks for home INR monitoring. What is the best statement by the nurse?

Tell me what you know about these tests.

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 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."

The nurse is discussing the use of the patient-controlled analgesia pump with the postoperative patient. Which of the following statements by the patient indicate a need for additional education?

"I should not press the button more often than every 3-4 hours."

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."

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.

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?

"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 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?

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

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?"

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

A female adolescent is being taught about changing her abdominal dressing as part of the education for her care at home. When she removes the dressing, she becomes tearful when she sees her surgical incision. What knowledge deficit is best to address for this client at this moment?

Altered body image related to surgical incision

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

Ask the client, "Do you learn better by seeing how to use an inhaler, believing how the inhaler works, or showing me how to use the inhaler after I show you?".

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?

Cognitive domain

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?

Cognitive domain

The nurse has educated the client on the pathophysiology of osteoarthritis and degenerative joint disease. This is an example of what learning theory?

Cognitive learning theory

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

The nurse is documenting a teaching session with a client. Which nursing documentation is the most appropriate and detailed?

Family requested education on turning client. Explanation of use of draw sheet and body mechanics provided. Family coached through turning and repositioning client. Members state confidence and understanding.

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 client rate pain level and reschedule the teaching session.

When providing client education, it is essential for the nurse to incorporate what action so that learning can be optimized?

Include educational strategies that encourage clients to be active participants.

When teaching a client, the nurse notices the client tends to lose focus easily. The nurse would adapt client teaching in which way?

Talk with animation and vocal inflection, to stimulate the client aurally.

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?

Ineffective Coping; verbalizes support systems.

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

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

Lecture/discussion

A home health nurse states to her client, "I am very proud of you. You gave your first insulin injection without a problem. You have done wonderfully and are learning fast." What technique is the nurse using to compliment the client's progress?

Positive feedback

The nurse is working with Mr. Milner, a 55-year-old man who recently underwent a coronary artery bypass graft (CABG). He is taking furosemide and metoprolol following his procedure. Together the nurse and Mr. Milner are developing a plan for a heart-healthy diet. During their planning, Mr. Milner states that he really thinks that his diet did not contribute to his heart disease. If he continues to take his medications, he should be fine. According to the Transtheoretical Model of Change, what stage of change is Mr. Milner in related to his diet?

Precontemplation

Mrs. Shields is a 46-year-old obese woman diagnosed with hypertension and type 2 diabetes. She tells the nurse that she knows she needs to lose weight. She recently visited her 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 Mrs. Shields in related to her weight loss?

Preparation

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

Re-teach the length of time to take the prescription.

The nurse is preparing to teach a client from Generation X about hypertension. Which teaching approach will the nurse plan to implement?

Refer to the American Heart Association or Heart and Stroke Foundation of Canada website, Demonstrate MyFoodPyramid phone app, to show the best food choices on a lunch tray.

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

Risk for Injury, related to mother's lack of knowledge about child safety

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.

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 organizes materials needed and gives return demonstration.

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 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 nurse is providing instructions 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.

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

The nurse and the client

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

The nurse should be able to draw from the previous experience of the client to emphasize the importance of stress reduction.

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.

A home health nurse is visiting a 40-year-old man who has had abdominal surgery. He is unable to change his dressing because of obesity. The nurse is to instruct his wife on the sterile dressing technique. During the visit, the nurse notes that the wife has limited abilities due to mental disabilities. One assessment to determine the wife's literacy would be:

To assess her reading with WRAT.

A home health nurse states to her client, "I am very proud of you. You gave your first insulin injection without a problem. You have done wonderfully and are learning fast." What technique is the nurse using to compliment the client's progress?

positive feedback

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

states, "I feel comfortable using my walker."

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?

client understanding of illness, motor skills and developmental stage assessed, clarification provided

Which learning domain is the focus for instruction when the nurse educates a new mother about the breast and its role in milk production for feeding the newborn?

cognitive

A client stated, "I understand when the nurse explains the possible complications of my illness. I am appreciative of what insulin does to my body and I can now give myself insulin." Which domains of learning does the nurse identify for this client?

cognitive, affective, and psychomotor skills

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

• A—The nurse acts on every teaching moment. • C—The nurse clarifies often. • H—The nurse honors the patient as a partner in the education process.

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

• Determine their emotional readiness to learn. • Draft learning outcomes. • Select educational strategies. • Implement various educational techniques. • Revise the learning plan if needed.

A nurse is providing teaching to patients in a short-term rehabilitation facility. Which examples are common teaching mistakes made by health care professionals? (Select all that apply.)

• The nurse fails to accept that patients 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 patient's environment.