Fundamentals of Nursing P&P Chapter 25

The nurse is assessing a patient and trying to identify the patient's learning needs and abilities. Which factors is the nurse likely to find affecting the ability of a patient to learn optimally?

- Physical strength - Hearing deficit - Shortness of breath

While providing medical care, the nurse intends to provide the patient with clear information about his or her rights. Which statement by the nurse would make the patient pay more attention to the care being provided?

"You should make sure that you are getting the right treatment from the right health care professional."

A 69-year-old patient is diagnosed with myocardial infarction. The patient is scheduled for coronary artery bypass grafting surgery. The nurse teaches the patient about coughing and deep breathing exercises. Before starting to teach, which questions should the nurse ask to assess the patient's attentiveness?

- "Are you comfortable here?" - "Do you have any pain right now?"

The nurse is designing a teaching plan for a patient to prevent urinary tract infections. When planning the teaching, what factors should the nurse keep in mind?

- Provide only necessary information. - Teaching should be problem based. - It should cater to the needs of the patient. - It should prompt the learner to engage in activities that lead to a desired change.

When teaching a group of patients with heart disease how to plan a meal, which teaching principles used by the nurse would be most appropriate?

- Simulating - Maintaining learning attention and participation

The nurse is teaching a patient with newly diagnosed congestive heart failure about behavioral and lifestyle modifications. Which domains of learning should the nurse focus on while teaching this patient?

- cognitive - affective

A patient with chronic diabetes is started on insulin therapy. The nurse has to teach the patient how to self-administer insulin and to adjust the insulin dosage according to blood sugar levels. What domain is required for this learning?

- cognitive - psychomotor

The nurse is teaching a patient about diabetes. Which statement made by the patient indicates the affective domain of learning?

"I would like to participate in the discussion about the treatment plan."

The nurse is caring for a patient with cancer who was previously in a state of denial but has now accepted the illness. The patient asks the nurse questions about the illness and expresses emotions openly. What interventions should the nurse perform at this stage?

- Involve the family in teaching information for discharge. - Encourage the expression of feelings. - Set aside formal times for discussion.

Health literacy is defined as the cognitive and social skills that determine the motivation and ability of individuals to use information to promote and maintain good health. What individuals are most at risk of having low health literacy?

- older adults - minority adults - people living below the poverty line

The nurse is teaching a patient about hygiene practices. During the interaction, the patient expresses feelings and opinions about the teaching provided and hygiene practices. The nurse understands that these expressions are a part of the affective domain of learning. Which behaviors are included in affective learning?

- organizing - responding - characterizing

The nurse is teaching dietary modifications to a group of people with heart disease. Which actions by the nurse would maintain the attention and participation of the class?

- maintaining eye contact - using gestures - asking questions

A nurse describes arterial blood pressure as "like water flowing through a hose." Which teaching technique does this exemplify?

Analogy

The registered nurse (RN) is teaching a patient about The Joint Commission (TJC) Speak Up Initiatives. Which action taken by the patient indicates that the patient needs further teaching about these initiatives?

Asking the primary health care provider to act as his or her advocate

A nursing student is giving preparatory instructions to a patient undergoing an unfamiliar test. Which preparatory approach by the nursing student indicates the need for further learning?

Preparing patients for aspects of the experience that are rarely experienced

Cognitive learning includes

Remembering, understanding, analyzing, applying, evaluating, creating

The nurse allows a patient to actively apply knowledge in controlled situations. Which teaching technique is the nurse is applying in this scenario?

Role play

Which aspect of psychomotor learning involves an awareness of qualities through the use of sensory stimulation?

Perception

Psychomotor learning includes

Perception, set, guiding, mechanism, complex overt response, adaptation, and origination

The nurse is planning a teaching session a group of children who are in first grade about healthy nutrition. The nurse determines that after the teaching session the children will be able to name three examples of foods that are fruits. Of what is this is an example?

a learning objective

A 62-year-old patient is diagnosed with colorectal cancer and is scheduled for surgery. Following the surgery, the healthcare provider informs the patient the surgery was successful. However, the patient is told that she needs chemotherapy, because the cancer had spread to other organs. The patient asks the nurse whether the spread of cancer will stop if she stops smoking and consuming alcohol. Which stage of grieving is the patient experiencing?

The stage of bargaining

Cognitive learning

requires thinking and encompasses the acquisition of knowledge and intellectual skills

The registered nurse (RN) is teaching a nursing student about effective teaching. Which statements made by the nursing student about teaching indicates effective learning?

- "Teaching is most effective when it responds to the learner's needs." - "Teaching is the concept of imparting knowledge through a series of directed activities." - "Teaching consists of a conscious, deliberate set of actions that help individuals gain new knowledge, change attitudes, adopt new behaviors, or perform new skills."

An older adult is being started on a new antihypertensive medication. In teaching the patient about the medication, what should the nurse do?

- Allow the patient time to express himself or herself and ask questions.

Which principles should be followed when using analogies?

- Being familiar with the concept - Keeping the analogy simple and clear - Knowing the patient's background, experience, and culture

The nurse has to teach a patient how to change dressings at home. What qualities will enable the patient to perform such tasks at home?

- Coordination - Sensory acuity - Adequate strength

A patient is preoccupied with the feeling that she suffers from breast cancer. She asks the nurse to insist that the healthcare provider perform a mastectomy. Following several tests, the nurse finds that the patient has no symptoms of or risk factors for breast cancer. Which are ethical nursing interventions for this patient?

- Educate the patient about the risk factors of breast cancer. - Educate the patient on self-examination and mammography - Educate the patient about her health status and promote acceptance.

The nurse is teaching hand washing to a group of preschoolers. Which teaching interventions would facilitate learning in this group?

- Encourage learning together through pictures and short stories about how to perform hygiene. - Use role-playing, imitation, and play to make learning fun.

An older adult is being started on a new anti-asthmatic medication. Which interventions should the nurse follow while teaching the patient about medication?

- Establish personalized, realistic short-term learning goals. - Present only the most significant information.

Role of the Nurse in Teaching and Learning

- Speak up if you have questions or concerns. If you still do not understand, ask again. It is your body, and you have a right to know. - Pay attention to the care you get. Always make sure that you are getting the right treatments and medicines by the right health care professionals. Do not assume anything. - Educate yourself about your illness. Learn about the medical tests that are prescribed and your treatment plan. - Ask a trusted family member or friend to be your advocate (advisor or supporter). - Know which medicines you take and why you take them. Medication errors are the most common health care mistakes. - Use a hospital, clinic, surgery center, or other type of health care organization that has been checked out carefully. For example, TJC visits hospitals to see if they are meeting TJC quality standards. - Participate in all decisions about your treatment. You are the center of the health care team.

The nurse needs to teach a group of college students the importance of donating blood. What nursing action would encourage active participation of the students?

- Teach while touring the blood bank. - Ask the students questions during the session. - Demonstrate the procedure of blood donation in the actual setting.

A patient diagnosed with coronary heart disease(CAD) has deficient knowledge related to the illness and its implications. Which teaching is a priority for the patient?

- Teaching what to do if chest pain occurs - Teaching how to take medication

The nurse is planning to include information about coronary artery disease in the discharge notes of a patient. Which learning objectives should be evaluated in the discharge notes?

- The patient is able to perform exercises in the correct way that is necessary to improve cardiac function and prevent trauma as well. - The patient is able to state the signs of heart attack.

The nurse is planning a teaching session on hygiene practices for preschoolers. What teaching methods should the nurse use?

- Use role-playing and imitation. - Encourage questions and offer explanations. - Encourage the children to learn together through short stories and pictures.

The nurse is trying to assess the health literacy status of a patient in a clinic. What screening tools can be used to test literacy?

- Wide Range Achievement Test (WRAT) 3 - Cloze test - Rapid Estimate of Adult Literacy in Medicine (REALM)

Which teaching tool is beneficial for patients with reading comprehension problems and visual deficits?

Audiovisual materials

A patient is learning about his disease and trying to understand how it relates to his present condition. Which learning domain is the patient using?

Cognitive

Domains of Learning

Cognitive, Affective, Psychomotor

The nurse is teaching a group of young college-age women the importance of using sunscreen when going out in the sun. What type of content is the nurse providing?

Health promotion and illness prevention

Affective learning includes

Receiving, responding, characterizing, organizing, valuing

A patient who was hospitalized due to a smoking-related illness tells the nurse, "I am ready to accept responsibility for learning and I need your help." Which stage of psychosocial grief is reflected in this statement?

Resolution

A patient with newly diagnosed Alzheimer's disease expresses concern to the nurse that the disease has affected her daily life. The patient feels sad about it. What stage of grieving is this patient in?

Resolution

The nurse teaches a patient with diabetes how to use a glucometer, and then asks the patient to use the glucometer to measure his blood sugar. Which teaching method is the nurse following?

Return demonstration

A pregnant patient reports abdominal pain. The nurse takes the patient for an emergency fetal fibronectin diagnostic test. Which teaching approach does the nurse use in this situation?

Telling

The nurse is caring for a patient who is undergoing a colonoscopy. Which method of teaching is most suitable to the patient?

Telling

A patient recently diagnosed with Acquired Immunodeficiency Syndrome (AIDS) states, "I am perfectly fine, and I don't want to discuss my treatment and condition." After considering the patient's current stage of grief, which action by the nurse would be appropriate?

The nurse should explain the situation to the patient's family.

A patient needs to learn how to administer a subcutaneous injection. Which action reflects that the patient is ready to learn?

The patient expresses the importance of performing the skill correctly.

Affective learning

deals with expression of feelings and development of values, attitudes, and beliefs

Psychomotor learning

involves acquiring motor skills that require coordination and the integration of mental and physical movements such as the ability to walk or use an eating utensil