chap9

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A client is asking for the nurse to explain acupuncture. What would the nurse tell the client?

Acupuncture is used to correct disharmony. Acupuncture can be used to correct disharmony or prevent disharmony from developing.

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

The nurse and the client The nurse and the client should be the individuals who decide who should be included in the learning sessions. The nurse cannot assume that family members are wanted by the client to be included. The client must always be included in the learning session

During a client interview, the client tells the nurse about using ginkgo biloba to improve memory. When reviewing the client's medication history, which medication if used by the client would be a cause for concern?

Warfarin Ginkgo biloba, the most widely sold herb in Europe and used by many to improve memory, affects platelet function and thus should not be used concurrently with warfarin or aspirin. It appears that acetaminophen, guaifenesin, and azithromycin would not be a concern.

While assessing a client, the client tells the nurse that he is a follower of traditional Chinese medicine and the concept of qi. Based on the nurse's understanding of this concept, which treatment modality would the nurse expect the client to mention?

Acupuncture Acupuncture is based on energy regulation of qi through meridians. It is a core principle in traditional Chinese medicine. Therapeutic Touch (TT) is not a form of traditional Chinese medicine and is based on the consciously directed process of energy exchange. Physiotherapy and allopathy are not based on the concept of qi.

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, and affective learning changes beliefs, attitudes, or values. Cognitive learning involves the client's critical thinking and reason. Psychomotor learning involves physically performing a task--learning by doing. Behavioral learning involves learning new, helpful behaviors and unlearning old, unhelpful ones.

The nurse is teaching a client with diabetes how to inject daily insulin. Which method is most effective in evaluating the teaching?

Ask the client to demonstrate how to self-inject the morning insulin. By using the teach-back method, the nurse teaches and demonstrates a skill, then the client returns the skill as if teaching the nurse how it is done. This is an effective way to determine the client's ability to independently perform a skill. Asking the client to repeat the steps is good, but self-administering the injection is a better indicator. A brochure could be used as a teaching aid, but it is not the most effective means of determining if the client can perform the skill. Providing a teaching session that includes questions and answers should be done; however, the client should demonstrate the skill.

A nurse is working with a 15-year-old client with sickle cell anemia. The client was started on a new pain management plan today, and the nurse is evaluating the effectiveness of the plan. Which is not appropriate to include in the nursing care?

Asking only the client's parents to be present at the education session Peers are often more influential than parents, nurses, or teachers at this age. It is often appropriate to include a close friend in on the education session. The other answers are developmentally appropriate for a 15-year-old.

A nurse is teaching a client experiencing stress about how relaxation helps to reduce the effects of stress on the body. Which underlying concept would the nurse integrate into the explanation about how relaxation works?

Helps to increase the effects of parasympathetic nervous system on the mind and body Relaxation techniques promote parasympathetic nervous system activity, helping to reduce sympathetic activity and restore the balance of the two systems. The ultimate goal is to increase the parasympathetic system influence in the mind-body and thus reduce the effect of stress and stress-related illness on the body. Natural products can boost the body's immunity. Energy healing activates natural pleasure centers. Hands-on techniques such as massage promote circulation throughout the body.

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. The statement that best describes the proper method for writing objectives would be that the nurse writes one long-term objective for each diagnosis, followed by several specific objectives. The nurse would not use general statements that could be accomplished in any amount of time because this action is not addressing the specific needs of the client, and the setting in which the client is in. The nurse would not plan learner objectives with another nurse and would not always obtain input from the family of the client. The objectives need to be specific so the outcomes can be measured in the evaluation phase.

According to survey results, who are the most prevalent users of complementary or alternative therapies?

Women, ages 35-50, with college degree, former smokers The most prevalent users of CAT are women, ages 35-50, with higher levels of education, who are former smokers.

The mind and body are connected in the provision of care. This statement describes:

holistic care. Holistic interventions focus on the interrelated needs of body, mind, emotions, and spirit.

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." Using flash cards and writing pads to communicate is a good substitute for verbal instructions for persons with hearing impairment. Speaking words that begin with "f," "s," "k," and "sh" typically requires forming high-pitched sounds, which are difficult for clients with hearing impairment to discriminate. Do not limit communication, because it will alienate the client from family and friends. Lowering (rather than increasing) the vocal pitch is better, as hearing loss is generally in the higher pitch ranges.

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 An adult's readiness to learn is often related to a developmental task or social role. The previous experience of the adult is a rich resource for learning. Most adults' orientation to learning is that material should be useful immediately. Peer group acceptance is a critical issue for the adolescent group and not adults.

A client is in the last stage of labor. During each contraction, she is focusing on her husband's voice and a picture brought from home. She is demonstrating which type of meditation?

Concentrative Concentrative meditation is probably the most familiar. The person focuses on an internal or external object. Receptive meditation refers to being mindful and aware of the present moment. Reflective meditation involves gaining insight into one's own thoughts and experiences. Expressive meditation involves actual movement, such as dance.

A client with stage IV colon cancer reports back pain and appears to be anxious. What response should the nurse provide when asked if therapeutic touch may be beneficial?

"Therapeutic touch is a holistic practice that works to redirect energy in the body and may help with pain and anxiety." Therapeutic touch involves "unruffling," or clearing, congested areas of energy in the body and redirecting this energy. After assessing a client's "energy field," the nurse uses therapeutic touch to promote comfort, relaxation, healing, and a sense of well-being. The nurse should not dismiss or belittle the use of alternative therapies. Questioning the client's choice may appear dismissive or challenging which can cause the client to shut-down and not trust the nurse.

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." Older clients may interact in a socially appropriate manner and may indicate that they understand the material being taught. Asking a client to recall what has been discussed after approximately 15 minutes have passed may help determine what information has actually been retained. Saying that the client will understand what to do after observing the nurse demonstrate the skill is not necessarily true and does not address the daughter's concern. Waiting a week to determine whether the client understands the teaching is too late, as the client must begin using this skill before then.

The client has Alzheimer disease and is a new admission to the nursing home. The client was transferred from the hospital. When first meeting the client, what technique(s) will the nurse use to facilitate communication with this client? Select all that apply.

Approach the client from the front of the client. Call the client by the client's preferred name. Use simple words and short sentences when talking with the client. When communicating with a client who has Alzheimer disease, the nurse must use techniques that will facilitate communication. The nurse will approach from the front of the client to obtain the attention of the client. Coming from the side or the back of the client may startle or agitate the client. Using the client's preferred name will also gain the client's attention. The nurse will use simple words and short sentences to allow the client to understand the nurse. The nurse must show patience and allow the client time to respond. The client may have difficulty finding the correct words or expressing thoughts. Correcting the client or providing information may confuse or agitate the client even more.

The nurse is caring for a 48-year-old Native American/First Nations client hospitalized following a myocardial infarction. The client tells the nurse about not understanding the plan of care and asks to see the healer from home. The nurse arranges for the healer to come see the client. What primary benefit will the healer provide for the client?

Integrative health care that is part of the client's particular belief system can be developed by the healer that incorporates both traditional and complementary medicine. Complementary and alternative medicine (CAM) practices are very important to incorporate into the biomedical care of clients who routinely practice naturopathic healing. Many Native Americans/First Nations people routinely see a healer. Arranging a visit with the client's healer is important to the client's care because this is in line with the client's established beliefs. The purpose is not to provide a placebo effect or offer false reassurance, demonstrate that traditional medicine is not effective, or provide replacement therapy. Allopathic medicine is modern Western medicine which the healer will not dismiss.

The nursing instructor is discussing complementary and alternative medicine with a group of students. One of the students questions "What therapies are considered complementary and alternative medicine?" The instructor bases her response on her knowledge that which of the following are considered complementary and alternative therapies? Select all that apply.

Prayer Relaxation Qi gong Acupuncture Tylenol is a medication and would be considered medical care not complementary or alternative therapy. The other choices are all considered complementary or alternative therapies.


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