MEDSURG CHAPTER 2

A nurse is aware of both the importance of health education and the fact that it is an independent function of nursing practice. Under which of the following circumstances should a nurse consider providing health education?

During each contact that the nurse has with a health care consumer

When a client who has successfully completed a smoking cessation program removes ashtrays from their home and takes a short walk after work instead of joining the usual group of coworkers at the local hangout, which stage of the Transtheoretical Model of Change is the patient portraying?

Maintenance

A 36-year-old man who has chewed tobacco since he was a teenager is having a discussion about this habit with his nurse practitioner. What statement would suggest that the man is in the contemplation stage of change?

"I know I have to quit, and I'm sure that I will at some point."

Which statement made by the client indicates understanding of the Centers for Disease Control and Prevention and U.S. Preventive Services Task Force recommendation for prostate screening frequency?

"I will see you next year for my prostate exam. EXPLANATION: Prostate examinations should be done yearly. PSA levels are assessed every 2 years after age 50. Colonoscopy examinations are every 5 years.

A nurse on a postsurgical unit has performed health education on the correct technique for emptying a drain for a woman who will be discharged home with a drain in situ. The nurse has asked the patient to demonstrate the correct technique and will now provide feedback. Which of the following statements provides the most effective feedback for the patient?

"You kept the drain clean when you emptied it, and you restored the negative pressure effectively."

What percentage of people older than 65 years have one or more chronic disease(s)?

80

Which patient is most in need of health education by the nurse?

A 62-year-old male with chronic kidney injury

Health education is an integral component of all nurse-person interactions. However, certain individuals have a greater need for health education than others. Which one of the following individuals likely has the greatest need for health education?

An elderly woman who has just been diagnosed with congestive heart failure (|CHF)

Which is an example of a direct measurement technique used to evaluate the teaching-learning process?

Behavioral observation

An example of a nursing action that modifies a teaching program because a learner is not experientially ready is:

Changing the wording in a teaching pamphlet so that a patient with a fourth-grade reading level can read and understand the sentences.

The nurse is educating the client about management of diabetes. Which statement by the student would indicate to the nurse that further teaching is necessary?

Checks of blood glucose level are to be done ac and hs." EXPLANATION: When providing education, the nurse is to give clear information and avoid the use of medical terminology or "jargon" as in ac and hs.

Which phase of the process of patient teaching ends when the strategies have been completed and when the client's responses to the actions have been recorded?

Implementation

A patient with a visual impairment would benefit from which of the following teaching strategies?

Magnifying lenses

The nurse is performing discharge teaching for an elderly client with mild visual impairment. The nurse provides written instructions with large print and highlighted parts. The nurse also sits near the client, faces the client, and speaks in a lower-pitched voice. When the client arrives home, the client has difficulty following instructions. What error in teaching did the nurse commit?

Providing written instructions that are highlighted

A nurse is preparing teaching for a client with an auditory perceptual disorder. Which educational strategy will be most effective?

Repeat and reinforce words frequently

Which of the following are effective teaching strategies for elderly persons? Select all that apply.

Slow-paced presentation Frequent repetition Use of reinforcement techniques Use of written materials

A nurse is evaluating a client's motivation to make decisions that promote healthy behavior change, using the transtheoretical model of change. Which description best describes the decision making stage of this model?

The client constructs a plan to change behavior.

Based on the nurse's knowledge of nonadherence to therapeutic regimens, which nurse needs to place extra emphasis on adherence to the treatment plan?

The nurse planning to teach adults aged 65 about congestive heart failure management EXPLANATION: Eighty percent of people older than 65 years of age have one or more chronic illness, and many have limited activity. These chronic illnesses may be managed with numerous medications and complicated by periodic acute episodes, making adherence to a regimen difficult. Problems of teenagers generally are time-limited and specific and require promoting adherence to treatment in order to return to health. In general, the compliance of children to a regimen depends on the compliance of their parents. Middle-aged adults, in general, have fewer health problems, thus promoting adherence to a regimen.

A nurse is planning a smoking-cessation program for a client and incorporates stages from the Transtheoretical Model of Change in the program. For the client to be successful, the client follows the stages in this order from steps 1 to 5:

Thinks about smoking cessation Makes a plan to cease smoking Takes steps to stop smoking Works to prevent relapse of smoking Resists relapsing into smoking

The nurse is providing preoperative information about hip replacement to a group of clients scheduled for this surgery. One of the clients is slightly hearing impaired. What is the best action of the nurse?

Use a model of the hip.

A staff nurse teaches a client on the proper technique of self-injection for a client with multiple sclerosis. When does the nurse anticipate the end of the implementation phase of teaching-learning process?

When the client's responses to the actions have been recorded

The home care nurse is evaluating a client's technique for self administration of medication. The nurse identifies a client's inability to pour a liquid medication into a measuring spoon. What is this teaching part of the nursing process called?

assessment

Which stage of the transtheoretical model occurs when the patient has serious consideration of change, but it is sometime in the future?

Contemplation

Ms. Jimenez is a 27-year-old first-time mother who developed mastitis in the weeks following the birth of her infant. She was prescribed antibiotics and has informed the nurse that her symptoms of breast pain, redness, and swelling ceased 2 days after she began antibiotic therapy. As a result, Ms. Jimenez stopped taking her antibiotics and did not complete the ordered course. What nursing diagnoses should the nurse identify when planning health education for Ms. Jimenez? Select all that apply.

Deficient knowledge Ineffective therapeutic regimen management

The home health nurse is planning teaching for a client with COPD and a history of noncompliance to the medication regimen. Which factor does the nurse recognize as having the most influence to enabling complete adherence of a health regimen?

Motivation

When providing discharge instructions, the nurse recognizes that which client is most likely to comply with the therapeutic treatment regimen?

The client with pneumonia who requires 1 week of oral antibiotics

A nurse is teaching an older adult about a medication that the client will take at home. The nurse assesses which of the following factors as promoting adherence to the medication regimen?

The client's daughter is present and provides care to the client at home.

A 35-year-old client with a developmental age of 10 years is being taught to take medication every morning. The nurse assesses that the client brushes his teeth every morning. For learning to occur, which of the following techniques should the nurse employ? Select all answers that apply.

Use simple explanations. Repeat information frequently. Encourage the client to take the medication after brushing his teeth. Look directly at the client when speaking.

What is the priority responsibility for the nurse providing patient teaching? (Select all that apply.)

Determining individual needs for teaching Motivating each person to learn Presenting information at the level of the learner