Chapter 9 PrepU Questions - Teaching and Counseling

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? A. "Use words that begin with 'f,' 's,' 'k,' and 'sh' to communicate." B. "Use flash cards and writing pads." C. "Limit communication to avoid frustration." D. "Encourage family members to increase their vocal pitch."

B. "Use flash cards and writing pads."

The client reports to the clinic as ordered by the primary care provider for counseling on weight loss to improve overall health. The client received printed information in the mail to review before the session, and reports having read through it before the appointment. Which client statement alerts the nurse to a need for clarification and further education? A. "I can lower my blood pressure by losing weight." B. "Osteoarthritis in my knees may be because of my weight." C. "I can monitor my caloric intake by measuring portions." D. "I will be doing well if I lose between 5 and 10 lb (2.3 and 4.5 kg) per week."

D. "I will be doing well if I lose between 5 and 10 lb (2.3 and 4.5 kg) per week."

A client is experiencing difficulty in adjusting to a new prosthesis despite conscientious client education by numerous members of the health care team. How should the team respond to the client's lack of learning to this point? A. Revise the education plan that has guided education. B. Refer the client to outside sources of information. C. Explore alternatives to prosthesis. D. Scale back the scope and detail of client education.

A. Revise the education plan that has guided education.

A client has received a temporary ostomy during treatment for colon cancer. Which information would the nurse prioritize in client teaching regarding changes in the elimination pattern? A. The type and location of the client's ostomy B. How often the ostomy should be changed C. When the client should expect reversal of the ostomy D. Where to purchase ostomy care products

A. The type and location of the client's ostomy

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? A. Their readiness to learn is often related to a developmental task or social role. B. Peer group acceptance is a critical issue for this age group. C. The material presented should focus on future application. D. Previous experiences have little impact on learning.

A. Their readiness to learn is often related to a developmental task or social role.

A nurse is working with the Red Cross to assist a family whose home was destroyed by fire. Which statement is most appropriate to assist with this situational crisis? A. "Over time this will all just be a memory. You will adjust to the changes." B. "You have had a tremendous loss. What are your plans for shelter tonight?" C. "You have lost everything. I guess family will be taking you in for a while." D. "I cannot believe the destruction. I would not know where to begin to rebuild."

B. "You have had a tremendous loss. What are your plans for shelter tonight?"

Which statement made by a client who was recently admitted to the medical unit with a diagnosis of pneumonia indicates a physical inability to learn? A. "May I have something to eat?" B. "The pain in my chest has gone." C. "I am having difficulty breathing." D. "Finally, I am getting medical attention."

C. "I am having difficulty breathing."

The nurse is preparing to teach four clients. Which client will the nurse plan to teach using principles associated with gerogogy? A. 4-year-old who likes to play with blocks B. 31-year-old who continuously used the internet C. 56-year-old who likes to take notes on paper D. 79-year-old who has slight cognitive changes

D. 79-year-old who has slight cognitive changes

A client diagnosed with type 2 diabetes has been prescribed insulin therapy in conjunction with an oral agent because the client has been experiencing difficulty controlling blood sugar levels with an oral agent alone. The nurse is preparing a teaching plan for this client. Which intervention would the nurse include in the teaching plan to address the psychomotor domain? A. Demonstrating the technique for insulin self-injection B. Describing the signs and symptoms of low blood sugar C. Explaining what to do if hypoglycemia occurs D. Reviewing with the client appropriate foods to eat

A. Demonstrating the technique for insulin self-injection

An older adult client who is recovering from a stroke is scheduled to be transferred to the rehabilitation unit in the morning. The client is tearful and reports feeling lonely and abandoned in the hospital unit. The family visits daily, and flowers and cards are in the room. Documentation in the chart indicates that the client's pastor has been by twice in the past week to visit. Which nursing diagnosis and outcome criteria need to be addressed immediately for this client? A. Ineffective Coping; verbalizes support systems. B. Impaired Walking; unilateral neglect. C. Altered Mobility; able to tie shoes. D. Dysfunctional Family Processes; family contact daily.

A. Ineffective Coping; verbalizes support systems.

The nurse is planning client education based on the developmental stage of the client. Which nursing actions best reflect this consideration? Select all that apply. A. The nurse directs the health education for a 3-year-old to the parents. B. The nurse provides lengthy explanations of a procedure to a preschool child. C. The nurse includes a school-age child in the teaching and learning process. D. The nurse determines the learning needs of the client. E. The nurse avoids relating education for an adult to a social role. F. The nurse provides material that is useful immediately to adult clients.

A. The nurse directs the health education for a 3-year-old to the parents. C. The nurse includes a school-age child in the teaching and learning process. D. The nurse determines the learning needs of the client. F. The nurse provides material that is useful immediately to adult clients.

A nurse is providing teaching to clients in a short-term rehabilitation facility. Which examples are common teaching mistakes made by health care professionals? Select all that apply. A. The nurse fails to accept that clients have the right to change their minds. B. The nurse negotiates goals with the client. C. The nurse uses medical jargon frequently when discussing the teaching plan. D. The nurse ignores the restrictions of the client's environment. E. The nurse evaluates what the client has learned. F. The nurse reviews educational media when planning learner objectives.

A. The nurse fails to accept that clients have the right to change their minds. C. The nurse uses medical jargon frequently when discussing the teaching plan. D. The nurse ignores the restrictions of the client's environment.

An active, otherwise healthy, older adult client presents to the clinic with severe osteoarthritis in both knees. The nurse knows this client does not want to be a burden on the family, and the client remains stoic despite reporting the pain as severe. The client avoids the topic of surgery and attends church weekly. The client's family is supportive of any decisions the client makes regarding health. Which of the assessment data is most important to forming an individualized education plan for this client concerning treatment for osteoarthritis? A. Orthopedic surgical history B. Personal perception of health and aging C. Floor plan of the client's dwelling D. Formal religious beliefs

B. Personal perception of health and aging

A client, eager to go home from an acute care facility, calls out to have discharge education completed. The nurse is not able to get to the client's room until an hour later, and finds the client asleep. The client's significant other states, "She will be out for a couple hours after that pain medication." Which of the following best describes what must happen with the education session? A. The nurse cannot determine the subject matter to teach if the client is asleep. B. The client is not demonstrating readiness to learn due to the effects of medication. C. The significant other can be taught now, and then teach the client later on. D. The client can be awakened when she falls asleep during the session.

B. The client is not demonstrating readiness to learn due to the effects of medication.

A 56-year-old client meets with the nurse for education about a recently diagnosed atrial fibrillation. The client verbalizes concerns about being away from work too long and doubts about the necessity of having blood tests every week, as the client has no symptoms. Which is the best motivational statement by the nurse for this client? A. "Your doctor wants you to take your warfarin every day, go to the clinic every week to have blood drawn, and then wait for any dosage change. Do you understand?" B. "You have to take your warfarin and go to the clinic every week for a blood draw. It's not the most convenient way to live, but you have to do it." C. "The medicine and blood work can help prevent blood clots, which can lead to strokes. What do you know about warfarin therapy?" D. "Atrial fibrillation is when your upper heart beats ineffectively and blood clots can go to your brain. Would you like some printed information about this?"

C. "The medicine and blood work can help prevent blood clots, which can lead to strokes. What do you know about warfarin therapy?"

When preparing client teaching materials, how does the nurse best assess a client's preferred learning style? A. Observe the client's behaviors. B. Provide teaching that works for the broadest base of clients. C. Ask the client, "Do you learn best by observing, valuing, or doing?" D. Determine client learning needs based on age and ability to hear effectively.

C. Ask the client, "Do you learn best by observing, valuing, or doing?"

When the newly diagnosed client with insulin-dependent diabetes reports never having received instruction on the administration of injections, an appropriately stated nursing diagnosis for the client is: A. Self-care Deficit related to lack of knowledge about injections. B. Knowledge Deficit related to lack of knowledge about injections. C. Deficient Knowledge of Injection Administration as verbalized by the client, related to the lack of instruction and experience. D. Ineffective Health Care Maintenance related to diabetic instructions.

C. Deficient Knowledge of Injection Administration as verbalized by the client, related to the lack of instruction and experience.

When caring for a diabetic client, the nurse notes that the client learns better when practicing the self-administration of the insulin injection alone. In which learning domain does this client's learning style fall? A. Cognitive B. Affective C. Psychomotor D. Interpersonal

C. Psychomotor

When establishing a teaching-learning relationship with a client, it is most important for the nurse to remember that effective learning can best be achieved through which concept? A. The nurse is the expert in the teaching-learning environment. B. The nurse must be able to handle criticism during the process. C. The client and the nurse are equal participants. D, Assimilation and application of psychomotor concepts is essential.

C. The client and the nurse are equal participants.

A 46-year-old obese client has been diagnosed with hypertension and type 2 diabetes. The client acknowledges the need to lose weight. The client recently visited a local fitness club, obtained a membership, and has signed up for their next water aerobics class. According to the Transtheoretical Model of Change, what stage of change is this client in related to her weight loss? A. Preparation B. Maintenance C. Precontemplation C. Contemplation

A. Preparation

The nurse is visiting a client who was released from inpatient rehabilitation 6 weeks ago after a 5-month recovery from a motor vehicle accident that left the client immobile. As the nurse enters the home, the client braces hands on the arms of a chair to rise and uses crutches to walk across the room. What is the best response by the nurse? A. "Let me document that you can walk." B. "Those physical therapists work wonders. C. "You have made an amazing recovery." D. "Are you supposed to be out of the wheelchair?"

C. "You have made an amazing recovery."

A nurse is counseling several clients for depression. Four of them do not seem to be improving, which leads the nurse to suggest a referral to a psychiatric nurse practitioner. Which of these clients would be most likely to attend the scheduled appointment? A. A 45-year-old female who is unsure of the benefit of psychiatric care, on a fixed income, and has good family support B. A 51-year-old male who walks to most places because of a lack of transportation, has a low income, and works days C. A 36-year-old male who uses public transportation, is unable to read, and wants to confer with a pastor D. A 28-year-old female who works nights, is willing to try, and asks about insurance coverage of the appointment

D. A 28-year-old female who works nights, is willing to try, and asks about insurance coverage of the appointment

A home health nurse states to her client, "I am very proud of you. You gave your first insulin injection without a problem. You have done wonderfully and are learning fast." What technique is the nurse using to compliment the client's progress? A. Reinforcement B. Motivation C. Health promotion D. Positive feedback

D. Positive feedback

A home health nurse is visiting a 40-year-old client who has had abdominal surgery. The client is unable to change a dressing because of obesity. The nurse is to instruct the client's spouse on the sterile dressing technique. During the visit, the nurse notes that the spouse has limited abilities due to mental disabilities. One assessment to determine the spouse's literacy would be: A. to assess her motivation to provide care. B. to assess her educational records. C. to assess her manner of speech. D. to assess her reading with WRAT.

D. to assess her reading with WRAT.

A nurse is educating a client with a new diagnosis of diabetes. Which example demonstrates cognitive learning by the client? A. The client describes signs and symptoms of hypoglycemia. B. The client demonstrates proper technique for injecting insulin. C. The client expresses a desire to improve nutritional intake and lose weight. D. The client prepares the skin for the administration of an insulin injection.

A. The client describes signs and symptoms of hypoglycemia.

The nurse is educating a client regarding a new skill. When evaluating the client's knowledge about the topic covered, which best represents that the client has learned a new skill? A. The client states understanding and passes a written test. B. The client organizes materials needed and gives return demonstration. C. The client verbalizes items needed and how to perform the skill. D. The client nods when asked about process and assists with cleanup.

B. The client organizes materials needed and gives return demonstration.

When teaching a client, the nurse notices the client tends to lose focus easily. The nurse would adapt client teaching in which way? A. Request family members to serve as translators. B. Provide less health teaching because of the language barrier. C. Elongate the teaching session to be sure the client understands. D. Talk with animation and vocal inflection to stimulate the client aurally.

D. Talk with animation and vocal inflection to stimulate the client aurally.

A nurse is educating a 4-year-old client about cast care following a tibia-fibula fracture. Which action is not developmentally appropriate to include in the nurse's teaching? A. Blocking 30 minutes of time for skill teaching B. Using dolls to demonstrate psychomotor skills C. Ensuring the client's parents are present D. Giving stickers as a reward for task completion

A. Blocking 30 minutes of time for skill teaching

A client reads the nutritional chart and follows it accurately. The nurse also notes that the client understands the need for a balanced diet and its relationship with a quick recovery. In which domain is the client demonstrating successful learning? A. Cognitive B. Affective C. Psychomotor D. Interpersonal

A. Cognitive

The nurse is completing documentation after an education session with a client. Which statement best demonstrates detailed documentation of an effective teaching plan? A. Demonstrated cord care to mother, who stated understanding and performed return demonstration using correct technique. B. Discussed wet-to-dry dressing changes, and client stated understanding. C. Spouse taught to flush feeding tube before and after medication. Denied further instruction needed. D. Lecture provided about infection, and client stated understanding what infection is.

A. Demonstrated cord care to mother, who stated understanding and performed return demonstration using correct technique.

The client is newly diagnosed with type 2 diabetes. After teaching the client about diabetes and how to self-administer insulin, the nurse identifies which client response as a need for additional education? A. The client gives a return demonstration of cleaning the side of the finger with alcohol before using a lancet. B. During the return demonstration, the client draws up insulin, leaving tiny bubbles in the syringe. C. Follow-up visit demonstrates a fasting blood glucose level of 89 mg/dl (4.94 mmol/l). D. The client reports being careful to rotate injection sites.

B. During the return demonstration, the client draws up insulin, leaving tiny bubbles in the syringe.

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? A. The nurse writes one or two broad objectives rather than several specific objectives. B. The nurse writes general statements for learner objectives that could be accomplished in any amount of time. C. The nurse plans learner objectives with another nurse before obtaining input from the client and family. D. The nurse writes one long-term objective for each diagnosis, followed by several specific objectives.

D. The nurse writes one long-term objective for each diagnosis, followed by several specific objectives.