CH 9 - Teaching & Counseling

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)? "It is okay to skip some doses if I don't feel well or sick to my stomach." "I can't remember when I have to take my medications, so I have my son come and give me my pills." "If I stop coughing after 3 months, I can stop taking my TB medication because that means I no longer have the germ in my system." "I will be taking the TB medication for at least 6 months, because it takes a long time to kill the TB germs."

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

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? "I would like you to demonstrate how to change the dressing on your leg." "I notice that you do not have the dressing secured. Place a piece of tape on the wrap." "Let's see how you irrigate the wound with saline." "Tell me about what signs of infection you will report to the health care provider."

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

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? "I will have you bring your mother back next week to see how things are going." "We can never be completely sure that your mother understands instructions." "After I demonstrate it once, your mother will be able to do it." "When 15 minutes have passed, I will ask your mother to show me how to instill the drops."

"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? "Are you supposed to be out of the wheelchair?" "Those physical therapists work wonders." "Let me document that you can walk." "You have made an amazing recovery."

"You have made an amazing recovery."

It is important for nurses to remember that patients learn in three domains: ______, cognitive, and psychomotor.

Affective

Pedagogy, the science of teaching, generally refers to the teaching of children and adolescents, whereas ______ refers to the study of teaching adults.

Andragogy

The nurse has educated the client on the pathophysiology of osteoarthritis and degenerative joint disease. This type of teaching best illustrates which learning theory? Behavioral learning theory Cognitive learning theory Developmental learning theory Adaptive learning theory

Cognitive learning theory

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? A. Ensuring the client's parents are present B. Giving stickers as a reward for task completion C. Using dolls to demonstrate psychomotor skills D. Blocking 30 minutes of time for skill teaching

D. Blocking 30 minutes of time for skill teaching Preschool age children (2 to 5 years) have short attention spans. Five- to ten-minute blocks of time are age appropriate. A 30-minute block is more appropriate for an older client. The other answers are developmentally appropriate for a 4-year-old.

What would be the best teaching strategy to teach a patient how to care for an indwelling catheter? A. Lecture B. Role modeling C. Discovery D. Demonstration

D. Demonstration

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? Explaining what to do if hypoglycemia occurs Demonstrating the technique for insulin self-injection Reviewing with the client appropriate foods to eat Describing the signs and symptoms of low blood sugar

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? Explain how the walker supports the client's lower extremities. Tell the client how to move the walker as the client ambulates. Fully discuss the rationale for using the walker. Describe how the walker can improve the client's quality of life.

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

Patient ______ is the process of influencing the patient's behavior to effect changes in knowledge, attitudes, and skills needed to maintain and improve health.

Education

Patient teaching plans, different than nursing care plans, do not need to follow the steps of the nursing process. T/F?

FALSE

According to the National Center for Education Statistics, the majority of Americans (65%) are proficient in health literacy. T/F?

FALSE According to the National Center for Education Statistics, in 2008, more than a third of US adults (77 million people) have below basic or basic health literacy and would have difficulty with common health tasks.

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? Test taking Demonstration Role play Lecture/discussion

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? Reinforcement Positive feedback Health promotion Motivation

Positive feedback

A nurse is conducting a teaching session with a client about heart-healthy nutrition. Which teaching strategy would be appropriate to foster learning in the affective domain? Select all that apply. Printed materials Discussion Demonstration Role playing Discovery

Printed materials (psychomotor domain?) Discussion Role playing

Which strategy should the nurse use when providing education to the older adult client? Avoid the use of colorful materials and keep the session short. Remain calm and conduct the teaching session in a quiet environment. Teach in a monotone voice in a quiet environment. Teach from books only and remain calm.

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 Written test Oral test Simulation

Return demonstration

A nurse may attempt to help a client solve a situational crisis during what type of counseling session? Professional counseling Short-term counseling Motivational counseling Long-term counseling

Short-term counseling

The cognitive processes of adolescents are similar to those of adults, thus the content and strategies of patient teaching should resemble those used for teaching adults. T/F?

TRUE

When a nurse is planning for learning, who must decide who should be included in the learning sessions? The nurse and the client The client and the client's family The doctor and nurse The health care team

The nurse and the client

Three critical developmental areas to consider when developing a teaching plan are: the patient's physical maturation and abilities, psychosocial development, and ______ capacity.

cognitive

The nurse needs to understand the teaching-learning process when administering technical interventions. psychosocial interventions. educational interventions. physician-initiated interventions.

educational interventions.

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." "I can monitor my caloric intake by measuring portions." "Osteoarthritis in my knees may be because of my weight." "I can lower my blood pressure by losing weight."

"I will be doing well if I lose between 5 and 10 lb (2.3 and 4.5 kg) per week." Healthy weight loss is generally accepted as 1 to 2 lb (0.45 to 0.90 kg) per week, or a reduction of 500 to 1,000 calories per day, which includes decreased intake of foods and burning calories with exercise.

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 36-year-old male who uses public transportation, is unable to read, and wants to confer with a pastor A 45-year-old female who is unsure of the benefit of psychiatric care, on a fixed income, and has good family support A 28-year-old female who works nights, is willing to try, and asks about insurance coverage of the appointment A 51-year-old male who walks to most places because of a lack of transportation, has a low income, and works days

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

The process of ______ occurs when a person acquires or increases knowledge, or changes behavior in a measurable way, as the result of a teaching experience.

Learning

Health care information and directions are generally more easily understood when written at a fifth-grade reading level. T/F?

TRUE

Learning readiness, the patients' willingness to engage in the teaching--learning process, is distinguished from the patient's actual ability to learn. T/F?

TRUE

Long-term counseling is often appropriate for a person experiencing a developmental crisis. T/F?

TRUE

Most adults' orientation to learning is that material should be useful immediately, rather than at some time in the future. T/F?

TRUE

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. Provide less health teaching because of the language barrier. Request family members to serve as translators. Elongate the teaching session to be sure the client understands.

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