chapter 9

While the nurse is caring for a hearing impaired client, and a family member of the client 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."

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." Asking a client to recall what has been discussed after approximately 15 minutes have passed may help determine what information has actually been retained

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 This client is clearly expressing a negative feeling about the upcoming treatment: fear. Therefore, the nurse needs to provide teaching that addresses the client's emotional learning needs, or affective learning. Affective refers to emotions or feelings

The nurse is providing education to parents at a preschool regarding child safety and primary prevention. Which topic(s) would the nurse choose to discuss with the parents to represent primary prevention? Select all that apply.

Car seat restraints Bicycle helmets Immunizations

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

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. School-age children are able to make decisions and provide care for themselves.

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 Observing is one of the levels of psychomotor skills, which involves watching an experienced person perform a physical skill.

To maximize the effectiveness of patient teaching, remember the acronym

T.E.A.C.H

What does T.E.A.C.H stand for?

T: Tune into the patient E: Edit patient information A: Act on every teaching moment C: Clarify often H: Honor the patient as a partner in the education process

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. Saying something to encourage the client to openly discuss personal issues is the best option.

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 client's ability to describe the signs and symptoms of hypoglycemia demonstrates cognitive learning (the storing and recalling of new knowledge in the brain). Demonstrating a skill, such as insulin injection, is an example of psychomotor learning. Affective learning includes changes in attitudes, values, and feelings (e.g., desire to lose weight).

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 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.

basic purpose of teaching and counseling

To help patients and families develop self-care abilities they need to maximize their functioning and quality of life

A nurse is preparing to teach a patient with asthma how to use his inhaler. Which teaching method would be the BEST choice to teach the patient this skill? a.Demonstration b.Lecture c.Discovery d.Panel session

a

A registered nurse assumes the role of nurse coach to provide teaching to patients who are recovering from a stroke. Which nursing intervention directly relates to this role? a.The nurse uses discovery to identify the patients' personal goals and create an agenda that will result in change. b.The nurse is the expert in providing teaching and education strategies to provide dietary and activity modifications. c.The nurse becomes a mentor to the patients and encourages them to create their own fitness programs. d.The nurse assumes an authoritative role to design the structure of the coaching session and support the achievement of patient goals.

a, A nurse coach establishes a partnership with a patient and, using discovery, facilitates the identification of the patient's personal goals and agenda to lead to change rather than using teaching and education strategies with the nurse as the expert.

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? a. The client and the nurse are equal participants. b. Assimilation and application of psychomotor concepts is essential.

a. Effective learning occurs when clients and health care professionals are equal participants in the teaching-learning process, not when the nurse is viewed as the expert

psychomotor learning:

acquisition of physical skills

negative reinforcement

an ineffective teaching strategy that uses criticism or punishment

A nurse is teaching first aid to counselors of a summer camp for children with asthma. This is an example of what aim of health teaching? a.Promoting health b.Preventing illness c.Restoring health d.Facilitating coping

b

A nurse is caring for a patient who is admitted to the hospital with injuries sustained in a motor vehicle accident. While he is in the hospital, his wife tells him that the bottom level of their house flooded, damaging their belongings. When the nurse enters his room, she notes that the patient is visibly upset. The nurse is aware that the patient will most likely be in need of which type of counseling? a. Long-term developmental b. Short-term situational c. Short-term motivational d. Long-term motivational

b,

A nurse forms a contractual agreement with a morbidly obese patient to achieve optimal weight goals. Which statement best describes the nature of this agreement? a. "This agreement forms a legal bond between the two of us to achieve your weight goals." b. "This agreement will motivate the two of us to do what is necessary to meet your weight goals." c. "This agreement will help us determine what learning outcomes are necessary to achieve your weight goals." d. "This agreement will limit the scope of the teaching session and make stated weight goals more attainable."

b, A contractual agreement is a pact two people make, setting out mutually agreed-on goals

A nurse has taught a patient with diabetes how to administer his daily insulin. How should the nurse evaluate the teaching-learning process? a.By determining the patient's motivation to learn b.By deciding if the learning outcomes have been achieved c.By allowing the patient to practice the skill he has just learned d.By documenting the teaching session in the patient's medical record

b, The nurse cannot assume that the patient has actually learned the content unless there is some type of proof of learning.

A nurse is planning teaching strategies based on the affective domain of learning for patients addicted to alcohol. What are examples of teaching methods and learning activities promoting behaviors in this domain? Select all that apply. a.The nurse prepares a lecture on the harmful long-term effects of alcohol on the body. b.The nurse explores the reasons alcoholics drink and promotes other methods of coping with problems. c.The nurse asks patients for a return demonstration for using relaxation exercises to relieve stress. d.The nurse helps patients to reaffirm their feelings of self-worth and relate this to their addiction problem. e.The nurse uses a pamphlet to discuss the tenants of the Alcoholics Anonymous program to patients. f.The nurse reinforces the mental benefits of gaining self-control over an addiction.

b, d, f Affective learning includes changes in attitudes, values, and feelings (e.g., the patient expresses renewed self-confidence to be able to give up drinking).

The nurse is preparing to teach a client from Generation X about hypertension. Which teaching approach should the nurse plan to implement? a. Have the client repetitively choose appropriate foods from various menus. b. Demonstrate the MyFoodPyramid phone app, to show the best food choices on a lunch tray.

b. Generations X, Y, and Z may share many learning characteristics. They are or will be technologically literate

A nurse is teaching a 50-year-old male patient how to care for his new ostomy appliance. Which teaching aid would be most appropriate to confirm that the patient has learned the information? a.Ask Me 3 b.Newest Vital Sign (NVS) c.Teach-back method d.TEACH acronym

c

A nurse is teaching patients of all ages in a hospital setting. Which examples demonstrate teaching that is appropriate based on the patient's developmental level? Select all that apply. a.The nurse plans long teaching sessions to discuss diet modifications for an older adult diagnosed with type 2 diabetes. b.The nurse recognizes that a female adolescent diagnosed with anorexia is still dependent on her parents and includes them in all teaching sessions. c.The nurse designs an exercise program for a sedentary older adult male patient based on the activities he prefers. d.The nurse includes an 8-year-old patient in the teaching plan for managing cystic fibrosis. e.The nurse demonstrates how to use an inhaler to an 11-year-old male patient and includes his mother in the session to reinforce the teaching. f.The nurse continues a teaching session on STIs for a sexually active male adolescent despite his protest that "I've heard enough already!"

c, d, e, Successful teaching plans for older adults incorporate extra time, short teaching sessions, accommodation for sensory deficits, and reduction of environmental distractions. Older adults also benefit from instruction that relates new information to familiar activities or information. School-aged children are capable of logical reasoning and should be included in the teaching-learning process whenever possible; they are also open to new learning experiences but need learning to be reinforced by either a parent or health care provider as they become more involved with their friends and school activities. Teaching strategies designed for an adolescent patient should recognize the adolescent's need for independence, as well as the need to establish a trusting relationship that demonstrates respect for the adolescent's opinions.

affective learning

changes in attitudes, values, and feelings

A nurse is counseling a 19-year-old athlete who had his right leg amputated below the knee following a motorcycle accident. During the rehabilitation process, the patient refuses to eat or get up to ambulate on his own. He says to the nurse, "What's the point. My life is over now and I'll never be the football player I dreamed of becoming." What is the nurse counselor's best response to this patient? a. "You're young and have your whole life ahead of you. You should focus on your rehabilitation and make something of your life." b. "I understand how you must feel. I wanted to be a famous singer, but I wasn't born with the talent to be successful at it." c. "You should concentrate on other sports that you could play even with a prosthesis." d. "I understand this is difficult for you. Would you like to talk about it now or would you prefer me to make a referral to someone else?"

d

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

educational interventions.

motivational interviewing

evidence-based counseling approach that involves discussing feelings and incentives with the patient.

Long-term counseling

extends over a prolonged period; a patient experiencing a developmental crisis, for example, might need long-term counseling

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

nurse and patient

When the patient is an infant teaching is directed towards the?

parents

learning readiness

patient's willingness to engage in the teaching-learning process (emotional readiness) and experiential readiness to begin the challenge of learning

formal teaching

planned teaching based on learner objectives

pedagogy

teaching of children and adolescents

andragogy

the study of teaching adults

informal teaching

unplanned teaching sessions dealing with the patient's immediate learning needs and concerns