Ch. 9
Which response from the nurse allows the nurse to determine the effectiveness of a recent medication teaching session for an older adult client who is diagnosed with tuberculosis?
"Can you tell me how you are going to take this medication?"
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."
A nurse is assessing a client who has come to the clinic for a follow-up appointment. The client was diagnosed with asthma several months ago and has missed several appointments since that time. The client also has not been following the medication plan and has not kept the appointment for allergy testing. The nurse suspects that the client may be experiencing problems with health literacy. The nurse teaches the client about the condition and prescribed treatment. Which question from the nurse would help to assess the client's health literacy about the condition?
"How are you supposed to take your medication?"
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 nurse is discussing the use of the patient-controlled analgesia pump with the postoperative patient. Which statement by the patient indicates a need for additional education?
"I should not press the button more often than every 3 to 4 hours."
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 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."
A nurse and client are working together to help the client make lifestyle changes to promote improved health. The nurse is having the client sign a contractual agreement for the work they will do together. Which statements by the nurse reflect the proper purposes of such agreements? Select all that apply.
"Our goals are defined, as are ways to meet them." "With this contract, we show that we are both dedicated to improving your health."
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."
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?"
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."
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."
Which topics would the nurse be most likely to explore with a client 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 client can participate in care
A nurse is teaching a 5-year-old boy who was recently diagnosed with type 1 diabetes. The client's mother, who is the primary caregiver, informs the nurse of having a fear of needles. What acttions are appropriate for the nurse to take to ensure a successful education session? Select all that apply.
-Ensuring 20 minutes of uninterrupted teaching time -Using a doll to demonstrate giving an insulin injection -Providing the client's mother with an informational pamphlet about insulin injection
A nurse is preparing a teaching session about heart failure for a group of older adults. When planning this session, which action would be important for the nurse to integrate into the session? Select all that apply.
-Keep outside distractions to a minimum. -Allow for extra time to answer questions. -Plan sessions that are short in duration. -Tie in new information with things the group is familiar with.
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.
A nurse is providing teaching to clients in a short-term rehabilitation facility. Which examples are common teaching mistakes made by health care professionals? Select all that apply.
-The nurse fails to accept that clients have the right to change their minds. -The nurse uses medical jargon frequently when discussing the teaching plan. -The nurse ignores the restrictions of the client's environment.
The nurse has completed teaching. Which client behaviors demonstrate understanding within the cognitive domain? Select all that apply.
-Verbalizes key points of a brochure about diabetes that was read -Provides a description of what appropriate wound healing should look like
Which client would be the best candidate for the nurse to engage in motivational interviewing?
A 28-year-old client with elevated blood glucose for 8 months
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
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?
A brother who visits daily, does laundry, and cooks all meals for the client
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. 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.
A client states to the nurse, "I understand that I need a mastectomy for the treatment of my breast cancer, but I am fearful of learning about the drains I will need to empty." When responding to the client, the nurse will need to address which type of learning?
Affective
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.
An adolescent client is being taught about changing an abdominal dressing as part of the education for care at home. On removing the dressing and seeing the surgical incision, the client becomes tearful. What knowledge deficit is best to address for this client at this moment?
Altered body image related to surgical incision
The nurse is assisting a client 55 years of age to understand the anatomy and physiology of the heart following a heart attack. What type of learning is taking place?
Andragogy
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?"
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.
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
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
A nurse is preparing to educate about the importance of contraception and safe-sex practices to a group of college students. Which factors can affect the nurse's teaching strategies? Select all that apply.
Availability of resources Learning style preferences of students Literacy level of target audience
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
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
An occupational health nurse is planning inservice training sessions for the employees. Which teaching topic would be most appropriate to cover with these clients?
Cardiopulmonary resuscitation
A nurse is documenting assessment data for a new client. What is the best source of assessment information for the nurse?
Client
Which statement about providing client education before discharge is most accurate?
Client education focuses on identified home needs.
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
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 has educated the client on the pathophysiology of osteoarthritis and degenerative joint disease. This type of teaching best illustrates which learning theory?
Cognitive learning theory
A client states, "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 as having been successfully addressed by education?
Cognitive, affective, and psychomotor
When deciding what information the client needs to meet the learner objectives successfully, the nurse is formulating which part of the teaching plan?
Content
The nurse is preparing to teach a client from Generation X about hypertension. Which teaching approach should the nurse plan to implement?
Demonstrate the MyFoodPyramid phone app, to show the best food choices on a lunch tray.
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
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 caring for an older adult client with arthritis. Which action is the priority for the nurse when conducting the health education for the client?
Find out what the client wants to know.
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.
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.
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.
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 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
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
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 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
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 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 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
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
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
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
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 completed education with a client. Which documentation entry represents the most complete teaching plan?
Printed and verbal information provided on gluten-free diet. Questions answered. Verbalizes understanding. Follow-up scheduled.
A nurse assisting a new mother in the act of breastfeeding represents which form of learning?
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
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.
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
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
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 may attempt to help a client solve a situational crisis during what type of counseling session?
Short-term counseling
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.
A client is reluctant to learn to do finger sticks for home international normalized ratio (INR) monitoring. What is the best statement by the nurse?
Tell me what you know about these tests.
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 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 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.
Place the stages of learning in their order of progression.
The client reports the first symptom that appears. A family member reminds the older adult to take pain relief medication on alternate days. The client is now eating three servings of vegetables per day. An adolescent organizes a "safe sex" seminar.
The nurse is providing instructions to a client about performance of breast self-examination. What learning outcome would be most appropriate regarding this education?
The client will be able to perform proper breast self-examination for breast cancer detection and prevention.
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.
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 most important 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
When teaching an adult client how to control stress through relaxation techniques, the nurse should proceed on the basis of which 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.
Which principle of teaching-learning is an accurate guideline for the nurse/teacher?
The teaching-learning process can be facilitated by a helping relationship.
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.
The nurse has completed teaching. Which client behaviors demonstrate understanding within the cognitive domain? Select all that apply.
Verbalizes key points of a brochure about diabetes that was read Provides a description of what appropriate wound healing should look like
A client is admitted to the health center with chronic diarrhea. When should the nurse begin imparting health teaching about the benefits of proper diet to the client so that the risk of diarrhea is minimized?
When admitting the client
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 needs to understand the teaching-learning process when administering
educational interventions.
A home health nurse is visiting a 40-year-old client who has had abdominal surgery. The client is unable to change a dressing because of obesity. The nurse is to instruct the client's spouse on the sterile dressing technique. During the visit, the nurse notes that the spouse has limited abilities due to mental disabilities. One assessment to determine the spouse's literacy would be:
to assess her reading with WRAT.
