Chapter 5: Health Education and Health Promotion, PATIENT EDUCATION AND HEALTH PROMOTION

The nurse is planning to teach a client who was recently diagnosed with migraine headaches. It is best to teach the client 1- During the headache recovery phase 2- In a quiet room 3- With her spouse and children present 4- Immediately following a headache experience

2

Which of the following teaching strategies may be used with a patient diagnosed with a developmental disability? Select all that apply. 1- Encourage active participation. 2- Use nonverbal cues as needed. 3- Use simple explanations. 4- Demonstrate information followed by return demonstration. 5- Base information on chronologic age.

1,2,3,4

4 central, preventable causes of death in united states

*smoking, *bad diet, * physical inactivity, *excessive alcohol use (heart disease, copd, cancer, and stroke/cereb vascular disease)

A current trend in health education that significantly influences nursing practice is: 1- Increased emphasis on patient involvement in their own care. 2- Improved distribution of health information materials. 3- Increased numbers of health care providers. 4- Increased emphasis on the diversity of patient needs.

1

A community health nurse is well aware that taking responsibility for oneself is the key to successful health promotion. Which of the following actions by the nurse's patients best demonstrates self-responsibility and health promotion? 1- A woman takes action to quit smoking cigarettes. 2- A man seeks care because of an apparent cognitive decline. 3- A man questions his pharmacist when having a prescription refilled. 4- A woman reluctantly agrees to have her infant immunized.

1

Describe encourage adherence?

encourage the patient to adhere to medical advice because they don't always do.

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? 1- "I know I have to quit, and I'm sure that I will at some point." 2- "From what I've seen, chewing is a lot better for you than smoking." 3- "You can say what you want, but I just can't see myself kicking the habit." 4- "I know it's bad for me, and I'm going to quit at the end of the month."

1

best way to show a patient has learned

evaluation

The school nurse informs the mother of a second-grade student that lice were found in the child's hair. The mother explains to the nurse that she has another child to pick up and cannot stay to receive education related to the treatment of lice at this time. The mother reassures the nurse that she will "look up treatment options on the Internet and take care of the child." What would be the best action of the school nurse in this situation? 1- Provide the mother with a list of credible websites related to the treatment of lice 2- Instruct the mother to treat the other child for lice in the same manner as the second-grade child 3- Perform hand hygiene and notify the second-grade teacher to wash down the classroom 4- Notify the social worker of suspected child neglect and make a referral to child protective services

1

The termination stage of the Transtheoretical Model of Change occurs when: 1- The person has the ability to resist relapse back to unhealthy behavior. 2- The person takes steps to operationalize the plan of action. 3- The person constructs a plan to change behavior. 4- The person is not thinking about making a change.

1

What percentage of people older than 65 years have one or more chronic disease(s)? 1- 80 2- 50 3- 60 4- 70

1

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. 1- Deficient knowledge 2- Ineffective therapeutic regimen management 3- Ineffective coping 4- Health-seeking behaviors Impaired adjustment

1,2

Which of the following are effective teaching strategies for elderly persons? Select all that apply. 1- Slow-paced presentation 2- Frequent repetition 3- Use of reinforcement techniques 4- Use of written materials 5- Workplace has become a center for health promotion

1,2,3,4

What are the five principles of teaching and learning?

1. Focus the learning 2. Consider learning styles 3. Motivate the patient to learn. 4. Encourage adherence 5. Space content

teaching sessions should last

20-30 minutes

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? 1- Speak in a loud voice. 2- Position the hearing-impaired client 8 feet away. 3- Turn to any client who asks questions. 4- Use a model of the hip.

4

The nurse is teaching a client with diabetes how to perform checks of blood glucose level. To optimize learning, it is best for the nurse to 1- Verbally tell the client. 2- Demonstrate to the client. 3- Provide written instructions. 4- Have the client return demonstrate.

4

four factors that need to be considered in the area of values and beliefs.

family, culture, economic factor, and society

which of the learning domains should be evaluated before you proceed with patient education?

Affective domain

Maslow's heirarchy of needs explains why a dyspneic patient will not be very receptive to learning a new skill. how can you assess readiness to learn?

Because they have breathing problems to deal with, you can assess readiness by the patients awareness.

the primary goal of health education is to__________ people's __________.

Change, behavior

what are the top five causes of death in the united states?

Heart disease, cancer, cerebrovascular disease, copd, accidents

why is educating the public about these illnesses so important?

It is the key to prevention

Describe Focus the learning?

Patient must be allowed to focus on the material or task.

what is the key to teaching psychomotor skills? how can you confirm that a patient or family member has learned a new skill?

Provide plenty of opportunity for patient to practice activity. repetition is important.

What is the teach back method?

Referring to asking the patient educational question about what was just taught to them.

Describe space content?

Staggering the amount of material given during one session should be considered to help patient understand.

Describe Motivate the patient to learn?

The nurse must ensure the patient's basic needs are met then explain why are certain procedure is being done this help motivate the patient to learn

Describe Consider learning styles?

The nurse must fit the teaching techniques to the patient's style of learning.

psychomotor domain objective ex

have pt show you themselves how they will do the action

affective domain

area of emotion, mood, or feeling

psychomotor domain

area of observable performance of skills that require some degree of neuromuscular coordination

cognitive domain

area of the mental processes of comprehension, judgement, memory and reasoning

state objectives in measurable terms

begin with a .. phrase " at the end of the lesson you will be able to.." Write an action verb- list, describe, demonstrate. Add a condition with or without the use of notes. Write a standard eg-- how fast, accurate.

affective domain objective example

demonstrate genuine concern for yourself by using 02 correctly

cognitive domain objective example

list indications for oxygen therapy

where would you find resource materials to help in teaching children with asthma?

many local, state, and national lung associations offer such learning aids as age appropriate books, coloring books, and puppets to make learning fun.

what suggestions are given for rewarding performance?

stickers or treats

why develop written objectives for patient teaching?

to clarify the plan and have a checklist that shows your goals

A nurse is discussing the need for a client to increase activity level and eat a heart-healthy diet. The client tells the nurse, "I eat just fine and I'm not that fond of exercising." The nurse would identify this client at which stage of change? 1- Precontemplation 2- Contemplation 3- Preparation 4- Action

1

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? 1- The client constructs a plan to change behavior. 2- The client is thinking about change in the near future. 3- The client takes steps to put the plan into action. 4- The client works to sustain gains made from actions taken.

1

Which statement by the client indicates the client's experiential readiness to learn? 1- "Do you have a video about my disease? I don't like to read." 2- "Can we take a minute to pray before learning about my treatment plan?" 3- "Now that I am more comfortable, I am ready to learn about pain management techniques." 4- "I understand that I have diabetes and will need to learn how to administer my daily insulin injections."

1

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? 1- "I will see you next year for my prostate exam." 2- "I will make plans to see you every 6 months to keep an eye on my PSA levels." 3- "When I turn 50 I will need to have my PSA level checked every 5 years." 4- "I will schedule my prostate exam every 5 years after I am 50."

1

When constructing a teaching plan, the steps of the nursing process are utilized. In which step are teaching strategies identified? 1- Assessment 2- Planning 3- Implementation 4- Evaluation

2

A nurse is planning discharge instructions for a client from another culture. What does the nurse understand about the relationship of values and beliefs and the client's readiness to learn? 1- The client will likely accept health education regardless of values and beliefs. 2- The client will be less likely to accept health education unless the nurse and client share values and beliefs. 3- The client will be less likely to accept health education unless values and beliefs are respected. 4- The client will likely accept health education, but will take longer to learn.

3

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? 1- An IV drug user who is receiving antibiotics for the treatment of endocarditis 2- A young adult who has suffered traumatic injuries in a motorcycle accident 3- The parents of an infant who has been admitted for treatment of respiratory syncytial virus (RSV) 4- An elderly woman who has just been diagnosed with congestive heart failure (|CHF)

4

Part of health promotion in the adolescent population is health screening. What is the goal of health screening in this population? 1- To teach teenagers about health risks 2- To teach coping strategies 3- To discuss chronic health problems 4- To detect health problems at an early age, so that they can be treated at this time

4

health promotion

combo of educational, organizational, economic, environmental support necessary for behavior conductive to health disease prevention and wellness activity.

goals and examples of each of the levels of prevention

primary - prevent disease w/ immunization secondary - early detection w/ paps/mamograms Tertiary- prevent acceleration of disease w/ pulmonary rehab

Rt's could participate in org. health promotion activites within 3 goals

primary- smoking cessation program secondary- rehab programs tertiary- education on hazards of smoking

health education

process of planned learning opportunities designed to enable individuals to make informed decisions about and act to promote his or her health

Which stage of the transtheoretical model occurs when the patient has serious consideration of change, but it is sometime in the future? 1- Contemplation 2- Precontemplation 3- Action 4- Maintenance

1

Which step of the nursing process determines whether the client understands the health teaching that is provided? 1- Evaluation 2- Assessment 3- Planning 4- Implementation

1

A nurse is providing discharge teaching for an elderly patient who is fully dressed, watching television, and waiting for family. The nurse sits in a chair facing the patient and shows the patient a handout. The patient squints while reading and periodically looks at the television. The nurse is about to review the information and determine the patient's understanding of the material when the family enters the room. The nurse determines the need for further education due to learning barriers. Which barriers affected the patient's ability to comprehend the information? Select all that apply. 1- Patient is watching television. 2- The patient is elderly. 3- The patient squints while reading. 4- The family entered the room while teaching. 5- The patient is fully dressed.

1,2,3

A nurse is evaluating education provided to various clients being discharged to home. The nurse assesses that client most likely to be nonadherent with treatment is the one who 1- Has tuberculosis and is taking multiple antitubercular medications 2- Has pneumonia and is prescribed an oral antibiotic 3- Had abdominal surgery and will be changing the dressing daily 4- Has a duodenal ulcer and is prescribed a histamine-2 receptor blocker

1

A nurse is planning a health education program for a group of high school students regarding the dangers of texting and driving. Which action by the nurse illustrates the understanding of health education as a primary nursing responsibility? 1- The nurse gathers evidenced-based information related to texting and driving and coordinates the education with the school. 2- The nurse obtains the name of the school's medical director and obtains a health care provider's order to conduct the education program. 3- After consulting the literature and preparing the educational program, the nurse contacts the school's medical director for approval of the planned educational program. 4- The nurse prepares a permission slip for all students to have signed by their parents, allowing the student to participate in the educational program.

1

A nurse is preparing an in-service education program for a group of nurses involved in health education. When describing the connection between health teaching and health promotion, which information would the nurse most likely include? 1- Both are linked by the common goal of achieving high-level wellness. 2- Health teaching goals are achieved before those for health promotion. 3- Health teaching, not health promotion, is the major determinant of health policy. 4- Health care professionals are the primary managers of health conditions addressed by health teaching.

1

A patient with a visual impairment would benefit from which of the following teaching strategies? 1- Magnifying lenses 2- Sign language 3- Telecommunication devices 4- Captioned videos

1

In many situations, measurement of which of the following is the most accurate measurement technique to identify changes in patient behavior? 1- Direct observation of behavior 2- Use of rating scales 3- Use of checklists 4- Anecdotal notes

1

Which of the following is a nursing diagnosis related to health education? 1- Ineffective health maintenance 2- Ineffective airway clearance 3- Altered nutrition, less than body requirements 4- Self-esteem disturbance

1

Which phase of the nursing process encompasses the establishment of expected outcomes? 1- Planning 2- Assessment 3- Implementation 4- Evaluation

1

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. 1- Use simple explanations. 2- Repeat information frequently. 3- Encourage the client to take the medication after brushing his teeth. 4- Provide written 8th-grade level information. 5- Look directly at the client when speaking.

1,2,3,5

Which of the following is a leading health indicator to be used to measure the health of the nation? 1- Overweight and obesity 2- Intelligence 3- Cultural awareness 4- Religion

1

what is the key to motivating patients to learn?

begin with easy to master facts and skills

four settings rt's would be likely to function as individual counselor/health advocate

worksites, schools, community, home care

When providing discharge instructions, the nurse recognizes that which client is most likely to comply with the therapeutic treatment regimen? 1- The client with pneumonia who requires 1 week of oral antibiotics 2- The patient with newly diagnosed type 2 diabetes who requires nutritional counseling 3- The client with a positive tuberculosis skin test who requires 9 months of isoniazid T 4- he client with kidney failure who requires hemodialysis

1

Which action would be incorporated in a teaching strategy for a hearing-impaired client? 1- Use of slow, directed, and deliberate speech 2- Use of large-print materials 3- Arrangement of materials in a clockwise pattern 4- Having the person perform a return demonstration

1

Which is an example of a direct measurement technique used to evaluate the teaching-learning process? 1- Behavioral observation 2- Patient satisfaction surveys 3- Attitude surveys 4- Instruments that evaluate specific health status variables

1

An example of a nursing action that modifies a teaching program because a learner is not experientially ready is: 1- Changing the wording in a teaching pamphlet so that a patient with a fourth-grade reading level can read and understand the sentences. 2- Contacting family members to assist in goal development to help stimulate motivation. 3- Postponing the session with a patient until all major distractors have been eliminated (i.e., pain, noise). 4- Preventing a detailed outline of the content to be discussed prior to the teaching session.

1

Based on the nurse's knowledge of nonadherence to therapeutic regimens, which nurse needs to place extra emphasis on adherence to the treatment plan? 1- The nurse planning to teach adults aged 65 about congestive heart failure management 2- The nurse planning to teach a group of children about healthy eating 3- The nurse planning to teach middle-aged adults about stress management 4- The nurse planning to teach teenagers about mononucleosis

1

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? 1- assessment 2- planning 3- implementation 4- evaluation

1

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? 1- Motivation 2- Self-esteem 3- Cost of medication 4- Education level

1

A health care provider asked a nurse to teach a patient how to self-administer subcutaneous insulin. After collecting her assessment data and drafting her plan, the nurse selected the teaching strategy that research has indicated has the highest chance of reinforcing knowledge. Which of the following strategies did the nurse select? 1- Providing reading materials with illustrations of how to perform the injection 2- Showing the equipment and explaining the procedure 3- Asking the patient to hold the syringe and insulin while viewing a slide show about the process 4- Assisting the patient to perform the skill in a simulated setting

4

A nurse is providing feedback to a client who demonstrates how to use an incentive spirometer. What primary role does feedback have in the adult learning process? 1- Increases self-esteem 2- Decreases questions 3- Enhances nurse-client relationship 4- Motivates learning

4

A nursing student observes the home care nurse provide education to a client with congestive heart failure (CHF). The nurse teaches the client how to read food labels and calculate sodium content. The nursing student recognizes that the home care nurse is aware of which basic principle of patient education? 1- Patient instruction related to self-care activities promotes patient independence 2- Patients are required to learn about their therapeutic nutritional regimen 3- The home care nurse has a physician order to teach a 2-g sodium diet 4- The home care nurse is providing hospital discharge instructions

1

The nurse develops outcome criteria for a patient with chronic obstructive pulmonary disease. Which outcome criteria are appropriate for this patient? 1- The patient will have the ability to climb a flight of stairs without experiencing difficulty in breathing. 2- The patient will not experience an alteration in skin integrity. 3- The patient will perform passive range-of-motion exercises once daily. 4- The nurse will obtain a pulse oximetry reading twice a day.

1

What is the priority responsibility for the nurse providing patient teaching? (Select all that apply.) 1- Determining individual needs for teaching 2- Motivating each person to learn 3- Giving a test at the end of a teaching session 4- Waiting until the patient expresses a desire to learn 5- Presenting information at the level of the learner

1,2,5

The nurse is developing a health-promotion program at a company in which many employees are women in their 20s and 30s. For this population, the nurse plans to include information about 1- Bone-density screening 2- Parenting issues 3- Mammography 3- Values training

2

The nursing instructor has given an assignment to a group of nurse practitioner students. They are to break into groups of four and complete a health-promotion teaching project and present a report back to their fellow students. What project is the best example of health-promotion teaching? 1- Demonstrating an injection technique to a patient for anticoagulant therapy 2- Explaining the side effects of a medication to an adult patient 3- Discussing the importance of preventing sexually transmitted infections (STIs) to a group of 12th-grade students 4- Instructing an adolescent patient about safe food preparation

3

The process of health education closely parallels the nursing process with its discrete phases of assessment, diagnosis, planning, implementation, and evaluation. What activity would the nurse perform during the planning phase of health education? 1- Determining the patient's current knowledge level and willingness to learn 2- Identifying the patient's learning needs 3- Documenting the goals of the health education 4- Demonstrating a necessary technique for the patient

3

Which of the following is an accurate statement with regard to adult learner readiness? 1- Learning readiness is based solely on past life experiences. 2- Physical skills play little role in learner readiness. 3- Experimental readiness is not related to emotional readiness. 4- Learner readiness is based on culture, attitude, and personal values.

4

The home health nurse reviews a medication administration calendar with an elderly patient. In order to consider sensory changes that occur with aging, how should the nurse proceed? 1- Print directions in large, bold type, preferably using black ink. 2- Highlight or shade important dates and times with contrasting colors. 3- Use several different colors to emphasize special dates. 4- Type out the information on the computer.

1

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:

1- Thinks about smoking cessation 2- Makes a plan to cease smoking 3- Takes steps to stop smoking 4- Works to prevent relapse of smoking 5- Resists relapsing into smoking

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? 1- "You will need to ingest an 1800-calorie diet every day." 2- "Exenatide (Byetta) is prescribed twice a day." 3- "Checks of blood glucose level are to be done ac and hs." 4- "Avoid alcohol ingestion while taking glimeperide."

3

The nurse is preparing discharge teaching for a patient diagnosed with urinary retention secondary to multiple sclerosis. The nurse will teach the patient to self-catheterize at home upon discharge. What teaching method is most effective for this patient? 1- Providing the most up-to-date information available 2- Alleviating the patient's guilt associated with not knowing appropriate self-care 3- Determining the patient's readiness to learn new information 4- Building on previous information

3

There are many goals for health teaching. Which of the following is the primary goal of family and patient education? 1- Increase knowledge 2- Motivate people to learn 3- Improve patient outcomes 4- Establish trust

3

A client with multiple sclerosis is learning to perform intermittent self-catherizations of the urinary bladder. The nurse obtains the following equipment for teaching. Select all that apply. 1- Forceps 2- Syringe with sterile water 3- Anatomically correct model 4- 16-French catheters 5- Foley bag

3,4

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? 1- "You did a really good job of emptying your drain. You'll do great when you get home." 2- "How did you feel about that?" 3- "You should be proud of yourself; this certainly isn't a skill that comes naturally to anyone." 4- "You kept the drain clean when you emptied it, and you restored the negative pressure effectively."

4

The Healthy People 2020 initiative targets the improvement of health for all. In addition to eliminating health disparities, what are the broad goals of this plan? 1- Increasing technological innovations 2- Preventing treatable problems 3- Applying a systematic approach to health improvement 4- Increasing the quality and length of a healthy life

4

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? 1- Providing written instructions that are highlighted 2- Speaking in a lower-pitched voice 3- Using instructions with large print 4- Sitting near and facing the client

1

A 51-year-old woman is distraught about her new diagnosis of multiple sclerosis (MS). During a recent discussion with her nurse, the nurse mentioned the concept of wellness, which prompted the patient to state, "How can you be talking about wellness at the same time that I've got MS?" Which of the following principles should underlie the nurse's response to the patient? 1- Wellness is synonymous with health. 2- Wellness involves maximizing function despite limitations. 3- Wellness is defined as acceptance of one's disabilities. 4- Wellness is a concept that is understood better by people who have chronic illnesses than by healthy individuals.

2

A nurse developed a program of increased ambulation for a patient with an orthopedic disorder. This goal setting is a component of the nursing process known as: 1- Assessment 2- Planning 3- Implementation 4- Evaluation

2

A nurse has been assigned to care for a client with newly diagnosed insulin-dependent diabetes mellitus. When teaching the client proper injection techniques, which statement will the nurse use to promote emotional readiness in the client? 1- "Do you feel comfortable with injections?" 2- "Can you teach me what I just showed you?" 3- "What scares you the most about this?" 4- "How do you feel about needles?"

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? 1- When a patient or patient's condition has a reasonable chance of resolution 2- During each contact that the nurse has with a health care consumer 3- When health education is specified in a health care consumer's plan of nursing care 4- When the nurse possesses advanced practice credentials in health education

2

A nurse is preparing teaching for a client with an auditory perceptual disorder. Which educational strategy will be most effective? 1- Explain important information verbally. 2- Repeat and reinforce words frequently. 3- Explain noises associated with procedures. 4- Avoid medical terminology.

2

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? 1- The client has a hearing impairment and wears bilateral hearing aids. 2- The client's daughter is present and provides care to the client at home. 3- The client has Social Security benefits and no other source of income. 4- The client asks for information in writing and states "I tend to forget things."

2

A nurse who works in a retirement village uses the Rapid Estimate of Adult Literacy in Medicine-Short Form (REALM-SF) to estimate a patient's ability to read and comprehend medication directions. A recent patient scored a grade of 3 on a scale of 0-7. Which of the following indicates the nurse's interpretation of that score? 1- Will need repeated oral instructions 2- May not be able to read prescription labels 3- Will struggle understanding most directions 4- May not be able to read most materials

2

An example of evidence-based practice would be: 1- Morning insulin coverage for hospitalized patients is given at 6:45 AM so report can be given before breakfast trays arrive. 2- Patients on bed rest are turned every 2 hours to prevent the formation of bedsores. 3- Shower baths are given to nursing home residents weekly so that total skin assessments can be performed. 4- Hospitalized patients are assisted out of bed to the chair for 60 minutes, twice daily, to promote increased gastrointestinal transit time.

2

The nurse is administering a new medication to an elderly male client and begins instruction about the medication. The client states, "Tell my wife. She takes care of all this kind of stuff." The nurse replies 1- "It is necessary that you learn about this medication." 2- "When your wife comes in to visit, I will return and provide the information to both of you." 3- "I will print the information about this medication and leave it with you to give to her." 4- "I will have to return when she arrives."

2

Which patient is most in need of health education by the nurse? 1- A 28-year-old female with abdominal pain 2- A 62-year-old male with chronic kidney injury 3- A 42-year-old male with acute pericarditis 4- A 72-year-old female with a respiratory infection

2

The nurse is to provide discharge teaching to a patient with newly diagnosed coronary artery disease. In what order should the following steps be prioritized and completed? 1- Implement teaching plan. 2- Collect and analyze data regarding the patient's knowledge of coronary artery disease. 3- Form nursing diagnoses related to patient teaching. 4- Reassess patient's knowledge as needed. 5- Develop teaching plan. 6- Identify learning needs. 7- Update and change plan.

2, 6, 3, 5, 1, 4, 7

Specifying the immediate, intermediate, and long-term goals of learning is an integral component of the teaching-learning process. Which of the following individuals should be included in this goal-setting process? Select all that apply. 1- An advanced practice nurse 2- The nurse who will conduct the teaching 3- The patient himself or herself 4- The patient's family members 5- The patient's primary care provider

2,3,4

A community health nurse is organizing community training on healthy behavior change. Which action will the nurse focus on when using the transtheoretical model of change as guidance for the teaching? 1- Resources of health 2- Determinants of health 3- Motivation of individuals 4- Reasons for choosing healthy behaviors

3

A hospitalized client reports right lower quadrant abdominal pain at a level of 8 on a 0 to 10 scale. The client is scheduled for an appendectomy. The nurse is teaching the client about use of the incentive spirometer postoperatively verbally and by demonstration. The client is on his side, clutching his abdomen. Learning is not occurring. The nurse has primarily failed to consider the client's 1- Emotional readiness 2- Learning environment 3- Physical readiness 4- Experiential readiness

3

A nurse is aware of the fact that nonadherence to prescribed therapy is both common and harmful. How can a nurse best promote adherence to therapeutic regimens among patients? 1- Establish a system of rewards and punitive measures that is linked to adherence 2- Provide examples of the harmful consequences of nonadherence to therapy 3- Help individuals be aware of the benefits of adhering to their prescribed therapy 4- Make adherence a requirement for treatment in early interactions with patients

3

A nurse is exploring various barriers to adult learning in order to promote and enhance learning readiness and comprehension. Which situation does the nurse recognize as being a potential experiential barrier to learning? 1- An older adult experiencing acute pain 2- An adolescent from another culture 3- An adult with no formal education 4- An adult who lacks motivation

3

A recommended approach to planning health teaching is applying the trans-theoretical model, which considers the stages of behavioral change. The stage in which the patient engages in calorie counting to reduce weight is called: 1- Contemplation 2- Preparation 3- Action 4- Maintenance

3

Health education is important for all patients and families. Of the four groups listed below, which group is most in need of health teaching? 1- Patients under 21 years of age, because new behaviors can be practiced for many years 2- Patients who are diagnosed with acute infections, because treatment and future prevention can be immediately addressed 3- Patients with chronic illnesses, because life-long interventions and adjustments can improve the quality of life 4- Patients with a terminal illness, because the process of dying can be managed with dignity

3

Research has shown that patient adherence to prescribed regimens is generally low, especially when the patient will have to follow the regimen for a long period of time. What is one diagnosis in which adherence rates are low? 1- Methicillin-resistant Staphylococcus aureus (MRSA) 2- Sudden acute respiratory syndrome (SARS) 3- Multiple sclerosis 4- Beta hemolytic strep infection

3

The nurse is discussing postoperative discharge instructions with an Asian American patient. The patient looks at the floor, smiles, and then nods his head. Using cultural awareness, how should the nurse interpret this behavior? 1- Acceptance of the instructions 2- Understanding of the material 3- A reflection of cultural values 4- The patient's ability to follow through on the instructions

3