Motivation
While communicating with a patient, the nurse determines that the patient has realized the harmful effects of alcohol consumption and plans to stop drinking within 6 months. To what stage of Transtheoretical Model of Change does the nurse correlate the patient's behavior?
Contemplation
Which are extrinsic factors that determine motivation? Select all that apply.
Human resources Community systems Accessibility of facilities
The nurse is interviewing a female adolescent with anorexia nervosa who is malnourished and severely underweight. The nurse concludes that the client is experiencing secondary gains from her behavior when she says:
My mother keeps trying to get me to eat
During follow-up visits, the patient's child reports to the nurse, "I tell my parent every day about what may happen if medications aren't taken as prescribed. Despite that, my parent does not take the medication regularly and is depressed." What can be inferred about the patient's motivational level?
Not motivated
After a mild brain attack (cerebrovascular accident, CVA) a client has difficulty grasping objects with the dominant hand. To increase hand mobility and strength, the nurse should teach the client range-of-motion exercises, specifically:
Opposition
A stationary (nonrolling) walker has been prescribed for a client to aid in ambulation. The nurse should teach the client to:
Place the walker flat on the floor with the front legs about 12 inches in front of the feet, shift the body weight to the walker, and step forward to take initial steps
The parent of a 7-year-old child wants to improve the child's performance on schoolwork. What advice should the school nurse provide?
Praise your child's accomplishments
What is the most basic method the nurse can use when encouraging hospitalized clients to void?
Providing privacy
Which action made by the patient indicates that they are in the precontemplation stage of Transtheoretical Model of Change?
Refuses to think about changing
After three months of rehabilitation following a craniotomy, a client still is having some motor speech difficulty. What should the nurse do to promote the client's use of speech?
Respond to the client's crude efforts of speaking
What is the priority nursing intervention in the planning of nursing care for an adolescent client with anorexia nervosa
Rewarding weight gain by increasing privileges
A client with a diagnosis of cancer of the stomach expresses a lack of interest in food and eats only small amounts. What should the nurse provide?
Small portions more frequently
A client with emphysema has a history of smoking two packs of cigarettes a day. What is the best approach for the nurse to help the client stop smoking?
Suggest that the client limit smoking to one pack of cigarettes a day
The nurse teaches isometric exercises to a client with a long leg cast. Which client statement about when the exercises should be performed best indicates a positive response to the nurse's teaching?
Ten times each waking hour
A 22-year-old client with an antisocial personality disorder is being discharged and is to continue psychotherapy on an outpatient basis. When evaluating the client's chance of improvement, what should the nurse anticipate?
That the client's ability to change will be limited unless there is a readiness to accept the uncertainty associated with change
Why does the nurse establish "moderately hard" patient-centered goals? Select all that apply.
To prevent the patient from quitting before the goal is achieved To prevent the patient from losing motivation toward achieving the goal
A woman questions the nurse about the effectiveness of oral contraceptives. What most important factor about the effectiveness of oral contraceptives should be included in the reply to this question?
User motivation
A girl comes to the physician's office for her 14-year-old check-up. What is the most important anticipatory guidance that can be offered to the client?
Ways to prevent accidents
A nurse is planning to provide self-care health information to several clients. Which client should the nurse anticipate will be most motivated to learn?
A 56-year-old male who had a heart attack last week and is requesting information about exercise
A nurse is caring for a client with severe rheumatoid arthritis. What is most important in the nurse's approach to help this client achieve self-reliance and independence?
A positive attitude toward the eventual outcome
A nurse identifies that a client who had a myocardial infarction is struggling with an alteration in self-concept. The nurse intervenes to promote client autonomy. The behavior that demonstrates an increase in client autonomy is when the client:
Actively participates in providing self-care
A client hospitalized with thrombophlebitis asks how to prevent it from occurring again. What should the nurse teach the client?
Apply elastic stockings before arising.
What should the nurse assess to determine whether a 75-year-old individual is meeting the developmental task associated with aging?
Attainment of a sense of worth as a person
An older adult comes for an annual physical and tells the nurse, "I had three respiratory infections last year. How can I prevent this from happening again?" What is the nurse's best response?
Avoid putting your hands near your nose and mouth.
A client, with a history of occasional pain in the left foot when walking, now has pain at rest. The left foot is cyanotic, numb, and painful. The suspected cause is arteriosclerosis. The nurse teaches the client that the pain in the foot is more likely to decrease if the client:
Complies with the prescribed exercise program
A client has a diagnosis of multiple sclerosis and currently is in remission. The client is a parent of two active preschoolers. The nurse should encourage the client to:
Develop a flexible schedule for completion of routine daily activities
After a laryngectomy a client is concerned about improving the ability to communicate. What topic should the nurse include in a teaching plan for the client?
Esophageal speech
A client has just been admitted with the diagnosis of borderline personality disorder. There is a history of suicidal behavior and self-mutilation. The nurse remembers that the main reason that clients use self-mutilation is to:
Express anger or frustration.
What is an appropriate behavior modification goal for a client with anorexia nervosa?
Gaining 1 lb of weight a week
A client is diagnosed as having malabsorption syndrome secondary to celiac sprue. The client asks the nurse if there is anything that can help improve symptoms of the syndrome. The nurse encourages the client to incorporate which addition for symptom improvement?
Gluten-free diet
A nurse is assessing a client with bulimia nervosa. What should the nurse ask to obtain information about the client's intake habits and patterns?
How frequently are you eating in response to your feelings rather than because you're hungry?
A nurse is instructing a client to cough and deep-breathe after an emergency cesarean birth. The client says, "Get out of here. Can't you see that I'm in pain?" Which response will be the most effective?
If you can't cough, try taking six very deep breaths."
An unmarried pregnant client who has been attending a crisis intervention clinic has decided to keep the baby and is looking forward to motherhood. The nurse identifies that the decision to attend prenatal childcare classes as an example of:
Intrinsic motivation
The nurse teaches a premenopausal obese client about strategies to prevent osteoporosis. Which strategy identified by the client indicates that the teaching is effective?
Joins a tennis league and practices every day
A client who had a right total hip replacement is progressing from the use of a walker to the use of a cane. In which hand should the nurse teach the client to hold the cane?
Left hand
The nurse develops a goal that makes a patient feel as if the patient is engaging in a competition. Which type of motivation is the nurse using in this situation?
Power Motivation
A 5-foot 5-inch 15-year-old girl who weighs 80 lb is admitted to a mental health facility with a diagnosis of anorexia nervosa. The nurse recognizes that her problem most likely is caused by:
A desire to control her life
A patient reports that the patient's family members are pressuring the patient to attend physical therapy sessions. What does the nurse infer from this report?
The patient is extrinsically motivated without self-determination. If the patient participates in an activity as a result of family pressure and does not understand the importance of the activity, the patient is said to be extrinsically motivated without self-determination.
What should the nurse instruct family members to do to help an aphasic client regain as much speech function as possible?
Encourage the client to speak while being patient with the attempts.
A nurse is providing postoperative teaching to a client who is scheduled to have an above-the-knee amputation. The client will use crutches during the postoperative period. Which activity will prepare the client for crutch walking?
Lifting weights
Which action correlates with the relevance strategy of the motivational learning model proposed by John Keller?
Linking the person's needs, interests, and motives for learning
A 42-year-old adult with a long history of alcohol abuse seeks help in one of the local hospitals. The nurse considers that the major underlying factor for success in an alcohol treatment program is the client's:
Motivation
What client factor does the nurse consider to have the greatest impact on the effectiveness of bariatric surgery?
Motivation to cooperate with required lifestyle changes
The nurse is caring for a patient who was just diagnosed with diabetes mellitus. The patient appears willing to learn how to manage the disease by stating, "I will take insulin (Humulin R) regularly to maintain my blood sugar levels." What should the nurse infer from this information?
The patient is extrinsically motivated with self-determination. the patient shows interest in learning new tasks that would benefit their health