Stanhope Ch 11

A nurse in community health is planning to begin a class to help mothers returning to work better cope with the stresses of multiple roles. The nurse would most likely use: a) an andragogical approach b) a behavioral approach c) an operational approach d) pedagogical approach

A Andragogy is the art and science of teaching adults and individuals with some knowledge about a health-related topic. In the andragogical model, learners influence what they need and want to learn. Learning strategies for children and individuals with little knowledge about a health-related topic are characterized as pedagogy. Various approaches, methods, and tools can be used to evaluate health and behavioral changes. A behavioral or operational approach to educational classes would not be useful in this situation.

Which educational method has been shown to be most effective in fostering treatment adherence? a) Internet based education b) In-person counseling c) Telephone counseling d) Self-directed learning

A Educating people through the Internet has been shown to be more effective in fostering treatment adherence than in-person counseling, telephone counseling, or self-directed learning. It is important to be aware that people increasingly are using the Internet as a source of health information. Clients may ask nurses to provide them with information about ways to evaluate the quality and reliability of this information.

A nurse established an ongoing group meeting of teenagers with diabetes. In the early stages, the nurse was very directive in arranging location, providing low-carbohydrate drinks and snacks, steering the discussion, and trying to meet all the teenagers' needs. After the group had been meeting for about 3 months, the nurse noticed that the group members no longer simply accepted everything the nurse suggested. Instead, the teenagers began making decisions themselves, and eventually, the nurse no longer controlled the group. Which of the following most likely happened to cause this shift? a) The group became cohesive enough to share leadership tasks b) Teenagers don't like feeling dependent on adults with power c) Teenagers often rebel against adult authority d) The nurse was overwhelmed and lost control of task process

A In the beginning, the nurse used an authoritarian style because the nurse was responsible for the group direction. However, as the group matured, continuing an authoritarian style would have resulted in low morale and lack of cohesion. After a group is well established, nurses may best facilitate leadership by relinquishing central control and encouraging group members themselves to determine the norms for their group.

A nurse in community health integrates new slides into a presentation that will be given to a local elementary school group regarding the techniques of proper hand washing. The new slides will repeat essential points during the presentation. This demonstrates the nurse's understanding of what principle? a) Repetition b) Integration c) Participation d) Sequencing

A Incorporating repetitive health behaviors into games helps children retain knowledge and acquire skills. When learners are dependent and entering a totally new content area, they may require more pedagogical experiences. Consider both the age of the learner population and their learning needs as you choose either the pedagogical and andragogical principles for the program. In educational programs for children, provide information that matches the developmental abilities of the group.

8. Which of the following statements regarding the Health Belief Model is accurate? a) Cues to action are an important component of the model b) Multiple methods of education should be used when implementing this model c) The first stage experienced in this model is the pre-contemplation stage d) To successfully implement this model, ongoing maintenance of the behavior must be considered

A The Health Belief Model includes six components that attempt to answer the question of what motivates an individual to do something. These components are perceived susceptibility, perceived severity, perceived benefits, perceived barriers, cues to action, and self-efficacy. The pre-contemplation stage is part of the Transtheoretical Model. Maintenance is part of the Precaution Adoption Process Model.

A neighborhood association group has asked the local nurse in community health for a class on environmental hazards. The nurse in community health has seen good information in the community health text and thinks about getting permission to copy some of the information. The most important thing the nurse should do before using copies of this material is to: a) assess the literacy level of the group b) see how many plan to attend c) see whether the group is ready to learn d) secure a good space for a group meeting

A Two of the most important learner-related barriers are low literacy and lack of motivation to learn information and make needed behavioral changes. Nurses often deal with individuals and populations who are illiterate or who have low literacy levels.One out of every five Americans reads below the fifth-grade level, and one out of every three lacks the literacy needed to understand health care providers. Typically, individuals read three to five grade levels below the last year of school completed. It has been found that most health instructions continue to be written at the 10th grade reading level which is too difficult for almost half of the adult readers in the United States.

When evaluating an educational program, the nurse discovers that only 25% of community members met the learning objectives. Which of the following parts of the program should be improved? a) Educator b) Content c) Learners d) Objectives

A Ultimately, the educator is responsible for the success or failure of the educational process and the development of learner knowledge, skills, and abilities. The educator determines how content can be tailored to the learner. The educator determines the objectives. If evaluation reveals that the learning objectives are not being met, the nurse must determine why the instruction is not effective. The educator is responsible for presenting the material creatively and meaningfully in new ways to increase learner retention and ability to apply the new knowledge.

A group of teenagers with diabetes become upset and angry because they cannot agree on whether or not to have meetings during summer vacation. Which of the following should the nurse do to be effective in helping the teenagers resolve the conflict? a) Admit that it is difficult for everyone to agree on everything; then ask whether the group can try to decide how to agree on the issue. b) Assume adult authority and announce that meetings will be suspended until fall. c) Recognize that most of the teenagers want to have the meetings, but two are being stubborn; ask the two deviant members to leave the group. d) Suggest that the group avoid discussing it further but rather think about it over the next week and try to discuss the situation more rationally next week.

A When you respond to conflict by avoiding (suggesting that they avoid further discussion), forcing with power (assuming adult authority), capitulating, or excluding some members (asking the deviant members to leave), the behavior fails to satisfy the concerns of those involved. Open communication and recognition that conflict is inevitable may allow the group to focus on a procedure for fairly resolving the conflict.

A patient tells a nurse, "I know all about this already. I read about it on the Internet." The patient then summarizes what he has learned. Because some of this information seems incorrect, what questions would be effective for the nurse to ask? (Select all that apply.) a) Were you able find what you wanted easily on the website? b) Did the website say when the information was updated? c) Did the website state who was responsible for the information? d) Did you enjoy reading the material on the website?

A, B, C To assess the quality of information, the nurse should attempt to find information about the authors, the purpose of the site (to share information or sell a product?), any available editorial reviews, the date of the material, the design of the site (easy to navigate? well organized?), etc.

A nurse is conducting an in-service education session on the Centers for Disease Control and Prevention's (CDC's) updates for preventive services for a group of nurses in community health. The nurse would demonstrate the best understanding of the educational process by integrating which planning strategies? (Select all that apply.) a) Use of films b) Small group interaction c) Use of games d) Session timing e) Session space

A, B, C, D, E Many factors influence a person's learning needs and the ability to learn, including the learners' demographic, physical, geographical, economic, psychological, social, and spiritual characteristics. Also consider the learner's knowledge, skills, and motivation to learn, as well as what resources are available to support and possibly prevent learning. Resources include printed, audio or visual materials, equipment, agencies, and other individuals. Barriers for the presenter include lack of time, skill and/or confidence, money, space, energy, and organizational support.

A nurse has been making ongoing visits to a preschool to help the staff teach the children important skills, such as brushing their teeth after meals. Now the nurse is scheduled to teach carbohydrate counting to adults newly diagnosed with diabetes. Which of the following actions will the nurse need to take when teaching this population? (Select all that apply.) a) Appeal to the need for autonomy and choice b) Emphasize that anyone with diabetes must know this information c) Explain how to cope with being a guest at a dinner d) Recognize that this audience will depend on the instructor to set goals for learning

A, C For this audience, the best approach will be to use adult experiences and practical problems as learning motivators—for instance, appealing to adults' sense of autonomy and choice, basing examples on practical adult situations such as cooking meals or eating in restaurants, and discussing how clients can cope with possibly awkward situations such as being a guest at dinner but having diet restrictions.

Which of the following characteristics must a learner possess to successfully master psychomotor learning? (Select all that apply.) a) The necessary ability to perform the skill b) An open mind to learning the new skill c) A sensory image of how to perform the skill d) Opportunities to practice the skill

A, C, D Psychomotor learning is dependent on the learners meeting the following three conditions: having the necessary ability including both cognitive and psychomotor ability, having a sensory image of how to carry out the skill, having opportunities to practice the new skill.

Which of the following barriers are specific to the educator? (Select all that apply.) a) Fear of public speaking b) Low literacy c) Limited experience with the topic d) Lack of motivation e) Lack of experience with gaining participation

A, C, E Barriers to learning fall into two broad categories: one concerning the educator and the other concerning the learner. Common educator-related barriers include a fear of public speaking, limited experience with the topic, and lack of experience with gaining participation in the group. Two of the most important learner-related barriers are low literacy and lack of motivation to learn information and make needed behavioral changes.

The nurse gives a very informative and engaging presentation and then gives everyone in the audience a handout that outlines the presentation. Later, the nurse discovers that many of the handouts were thrown away before the audience left the building. Which of the following educational principles has the nurse forgotten? a) Audiences expect PowerPoint or video presentations, not lectures. b) Many Americans do not have a high reading level. c) People want photographs and images, not wordy outlines. d) The nurse gave them too much information too fast for them to want to cope with it all.

B Although visual images are certainly helpful, this does not explain why the handouts were discarded. Most health information is printed at a tenth-grade reading level—yet the average U.S. adult reads at the eighth-grade level and 40% of adults over age 65 read below the fifth-grade level. If people cannot read or understand the material, they discard it.

A nurse planned a presentation about the latest trends in disaster planning for the senior nursing students at the local college. However, when the nurse began to share the information, the students were talking to one another and essentially ignoring the nurse. Which of the following actions should be taken by the nurse? a) Ask the students why they are being so rude b) Explain why the information is crucial to their current clinical practice c) Nothing; let the instructor of the course handle the problem. d) Tell a joke to get the students' attention

B Before learning can take place, you need to gain the learner's attention. One way to do this is by convincing the learner that the information about to be presented is important and beneficial to them personally.

A community-oriented nurse convenes a support group for teenage mothers. The nurse understands that this strategy fosters cohesiveness among members and allows the members to learn from one another. What other benefit specific to group teaching will be achieved? a) Cultural sensitivity b) Efficiency in client service c) Learning of new skills d) Distraction-free surroundings

B In the education process, one of the important skills for educators to develop in selecting appropriate educational methods is realizing the benefits of group teaching, such as cohesiveness among members, increased number of clients seen, clients learning from one another, and cost effectiveness. Cohesive groups tend to be more productive and able to accomplish their goals; cohesion can be increased as members better understand the experiences of others and identify common ideas and reactions to various issues. Nurses facilitate this process by pointing out similarities, contrasting supportive differences, or helping members redefine differences in ways that make those dissimilarities compatible.

A nurse is using the technique of motivational interviewing when working with a client. Which of the following statements by the client indicates the client is ready to make the change? a) "I should change." b) "I am willing to change." c) "It's important to change." d) "I want to change."

B Motivational interviewing uses the term "change talk" to refer to statements by the client that he or she is motivated and willing to make change. An easy to use mnemonic is "DARN-CAT" which refers to desire, ability, reason, need, activation, commitment, and taking steps. "I am willing to change" demonstrates activation, a client who is ready, prepared, and willing to make the change. The other statements refer to the client who is preparing to make the change, but not yet ready to implement the change.

A nursing student prepares a treatment plan for a client that draws upon the student's understanding of pathophysiology and nursing practice theory learned in the student's coursework. This application of new information used in a different way demonstrates the educational principle of: a) affective domain b) cognitive domain c) events of instruction d) principles of effective education

B The cognitive domain of learning includes memory, recognition, understanding, reasoning, application, and problem solving and is divided into hierarchical classifications of behaviors (i.e., knowledge, comprehension, application, analysis, synthesis, and evaluation). Learners master each level of recognition in order of difficulty. The level of application involves the use of new information in a different way. The affective domain includes changes in attitudes and the development of values. This situation does not demonstrate events of instruction or educational principles.

Which of the following strategies should be used when providing educational programs for children? (Select all that apply.) a) Emphasize how to build learning from previous experiences b) Use simple words to enhance understanding c) Use objects to help increase their attention d) Emphasize the importance of the long-term consequences

B, C When providing educational programs for children, the nurse should use more concrete examples and word choices; use objects or devices to increase attention; incorporate repetitive behaviors into games to help with knowledge retention and acquiring new skills.

A nurse uses lecturing as the primary method of educating clients. Which part of the education process is missing? a) Evaluation b) Experience c) Participation d) Understanding

C Educators should include participation. (This is one of the six principles of education.) Merely sitting and listening to someone lecture are not as effective as discussion, even when the presentation is stimulating, interesting, and dynamic.

The nurse has just taught a client newly diagnosed with diabetes how to administer sliding-scale insulin. The most effective way to evaluate learning is to: a) provide an online test module b) ask whether there are any questions c) ask for a return demonstration d) give a short paper-and-pencil quiz

C Evaluation is important in the educational process and the nursing process. You will need to evaluate the educator, the process, and the product. Feedback to the educator provides the educator an opportunity to modify the teaching process and to better meet the learner's needs. The educator may ask for verbal feedback, as well as get nonverbal feedback by using return demonstrations to see what learners have mastered and by observing facial expressions when feedback is being given.

A man says, "I just can't get myself to leave the house and go for a 30-minute walk each day. I wish I could think of some way to motivate myself." Which of the following would be the best action for the nurse to take? a) Establish a written contract between him and his employer that states walking is required each day b) Recognize the reasons why 30 minutes of walking each day is one of the best health promotion activities he can choose c) Join a group that walks early each morning d) Set up rewards for himself, such as a nice snack after he gets back from walking

C Health behavior is influenced by the groups to which people belong. Having someone else to walk with is an effective way to maintain the behavior.

A nurse is providing an educational program about testicular self-examination (TSE). Which of the following would be the best learning objective for this program? a) Each participant will state why TSE is important and explain how to do it b) Each participant will describe how to do TSE and discuss the dangers of testicular cancer c) 90% of the men will correctly demonstrate testicular self-examination d) 100% of the men will do a testicular examination correctly on a model

C If the goal is to learn TSE, the best goal is for the person to be able to do TSE correctly. Being able to state why it is important is a helpful first step, as is practice on a model, but to be sure the person can really do the procedure, you need to allow practice time and feedback until the person can demonstrate the procedure properly.

The leader of an Alzheimer's support group surveys the members of the group to determine the best time for the group to meet. Which of the following norms is being supported through this action? a) Group norms b) Task norms c) Maintenance norms d) Reality norms

C Maintenance norms create group pressure to affirm members and maintain their comfort. Maintenance behaviors include identifying the social and psychological tensions of members and taking steps to support those members at high-stress times. Maintenance norms often refer to things such as scheduling meetings at convenient times and in an accessible and comfortable space.

A member of a community weight-loss group has maintained a healthy weight for 2 years through healthy eating and daily exercise. Which of the following steps of the affective domain is this participant demonstrating? a) Analysis b) Application c) Evaluation d) Knowledge

C Steps in the affective domain have the learner doing the following in this sequence: (1) knowledge: receives the information; (2) comprehension: responds to what is being taught; (3) application: values the information; (4) analysis: makes sense of the information; (5) synthesis: organizes the information; (6) evaluation: adopts behaviors consistent with the new values. In this example, the individual has adopted the behavior and this has resulted in the ability to maintain the value of a healthy weight.

A nurse just finished teaching breast self-examination to a large group of women at a professional conference. During the session, she distributed literature and used culturally appropriate visual aids. However, the session was not as effective as it could have been. Which of the following was the most important thing omitted by the nurse? a) Time for audience members to ask questions and clarify the information b) Explanation of why culturally appropriate images are more acceptable c) Opportunity for the women to practice what they learned d) Use of simple language instead of printed material

C The learner must have opportunities to practice the new skills being learned. Provide practice sessions during the program because many people may not have the time, facilities, motivation, and/or support to practice at home what they have learned.

A nurse is meeting to discuss problems and solutions with a group of teenagers who have been newly diagnosed with diabetes. One teenager states, "My mom found this particular brand of popcorn that has only 15 carbohydrates in the whole giant bag." Which of the following best describes the group purpose that is being served by the teenager's statement? a) Maintenance function of encouraging everyone to continue the discussion b) Maintenance function of helping everyone feel comfortable talking about food c) Task function of resolving problems about what to nibble during movies d) Task function of sharing information and resources

D A task function is anything a member does that deliberately contributes to the group's purpose. Members with task-directed abilities are attractive to the group. These traits include strong problem-solving skills, access to material resources, and skills in directing. The teenager's statement shared information about a good resource for the group.

A nurse invited all the teenagers who were newly diagnosed with diabetes to a group meeting to discuss issues they all had in common. One teenager replied, "I don't know if I want to share all the problems I'm having with strangers." Which of the following is the best nurse response? a) "Don't share anything with anyone until you're comfortable doing so." b) "I can understand what you are saying." c) "No one will require you to do anything you don't want to do." d) "The purpose of the group is to have a safe place to share problems with others who may be having similar problems."

D All the responses are empathetic and supportive. However, during the first phase, potential participants do not know whether they can trust one another. The primary task of the leader at this point is to clarify the purpose. Even though a statement such as "Don't share anything until you're comfortable" is supportive, the response explaining that "the purpose is to have a safe place" both recognizes what was said and clarifies the purpose of the group.

A nurse is planning an educational program about cardiovascular disease. Which of the following would be the optimal time for the nurse to elicit feedback from program participants? a) At the beginning of the program b) At the program midpoint c) Immediately following program completion d) Throughout the program

D Not only should learners receive feedback, but the educator should also elicit feedback from learners throughout the educational process. On the basis of the feedback that the educator receives from learners, the implementation and presentation of the educational program can be modified.

A home health nurse receives a referral to educate an older adult client with diabetes in proper foot care. The nurse's assessment of the client determines that the client has poor eyesight that may affect the client's ability to learn and perform certain skills. Which educational principle is being examined? a) Cognitive domain b) Events of instruction c) Principles of effective instruction d) Psychomotor domain

D The psychomotor domain includes the performance of skills that require some degree of neuromuscular coordination and emphasizes motor skills. The cognitive domain includes memory, recognition, understanding, reasoning, application, and problem solving and is divided into a hierarchical classification of behaviors. Education is the establishment and arrangement of events to facilitate learning. Principles that guide the effective educator include message, format, environment, experience, participation, and evaluation.