Teaching and Counseling

The nurse has completed teaching. Which client behaviors demonstrate understanding within the cognitive domain? Select all that apply.

Verbalizes key points of a brochure about diabetes that was read Provides a description of what appropriate wound healing should look like

Which documentation example best reflects the complexity of client teaching by the nurse?

"Client and spouse taught how to use phone app to count carbohydrates; client return demonstrated carb counting for a hypothetical meal."

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?

"I am having difficulty breathing."

The nurse is providing education for a client who will be providing self-care at home. The client states, "I just do not think I can do all of this. It is too much to learn." What is the best response by the nurse?

"I understand that you feel overwhelmed with all of the information. Tell me what I can do to help."

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?

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

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."

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?

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

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?

"You have made an amazing recovery."

A nurse caring for clients in a skilled nursing facility assesses client motivation to participate in care. Based on the health belief model, which clients would be most motivated? Select all that apply.

A client who views a disease as a serious threat A client who believes there are actions that will reduce the probability of contracting the disease A client who believes that the risks of taking action against a disease are not as great as the risks posed by the disease itself

Which guideline is most important for the nurse to keep in mind when planning to teach an exercise class to a group of older adults?

Allow ample time for psychomotor skills.

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.

The nurse is caring for a 70-year-old client with a fractured wrist. Which is the best method to determine whether the client has retained the information taught?

Ask the client to recall after approximately 15 minutes.

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

When caring for a client at the health care facility, the nurse observes that the client is having difficulty understanding the health education. Which action is most appropriate?

Assess for cultural differences.

The nurse must instruct a 35-year-old client with Down syndrome about the use of an albuterol rescue inhaler. Which documentation demonstrates appropriate individualization of the education plan for this client?

Assessed the client's understanding of illness; assessed motor skills and developmental stage; provided clarification

The nurse is caring for a 60-year-old client with an improper bowel movement regimen. Which is the most appropriate method for the nurse to use in teaching this client?

Begin the session with a reference to the client's actual experience.

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?

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?

Cognitive

The nurse has educated the client on the pathophysiology of osteoarthritis and degenerative joint disease. This type of teaching best illustrates which learning theory?

Cognitive learning theory

The nurse is documenting a teaching session with a client. Which nursing documentation is the most appropriate and detailed?

Family requested education on turning client. Explanation of use of draw sheet and body mechanics provided. Family coached through turning and repositioning client. Members state confidence and understanding.

The nurse is preparing discharge teaching for a client with diabetes. Which information should the nurse include? Select all that apply.

Meal planning Community resources Appropriate use of a glucometer Instructions to follow up with the health care provider

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?

Preparation

A nurse is conducting a teaching session with a client about heart-healthy nutrition. Which teaching strategy would be appropriate to foster learning in the affective domain? Select all that apply.

Role playing Discussion Printed materials

A client is reluctant to learn to do finger sticks for home international normalized ratio (INR) monitoring. What is the best statement by the nurse?

Tell me what you know about these tests.

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 nurse is providing instructions to a client about performance of breast self-examination. What learning outcome would be most appropriate regarding this education?

The client will be able to perform proper breast self-examination for breast cancer detection and prevention.

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.

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

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.

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.

The nurse needs to understand the teaching-learning process when administering

educational interventions.

The nurse is caring for a client who demonstrates a health literacy concern. The nurse adjusts client teaching in which way?

uses videos, diagrams, and pictures rather than focusing on verbal teaching

Which developmental consideration is a nurse assessing when determining that an 8-year-old child is not equipped to understand the scientific explanation of the child's disease?

Intellectual development

A pediatric nurse provides education to numerous clients. Which group of children benefits most from being involved in the teaching-learning process?

School-age children

An experienced nurse is educating a client about the client's disease and how best to promote optimal health. The nurse is focusing the education on the cognitive domain of learning. Given this focus, the nurse would incorporate the client's:

critical thinking.

The nurse will be caring for a client with a new diagnosis of hypertension. The client will be arriving for laboratory testing. When should the nurse begin client teaching?

during the admission process

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?

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

A nurse is trying to encourage a client with paraplegia who is depressed and not adhering to the treatment program to join a support group. Which statement by the nurse is most appropriate?

"What do you know about support groups?"

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?

Positive feedback

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?

Personal perception of health and aging

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

A nurse is preparing to teach a 6-year-old client with a broken arm and the client's mother about caring for the child's cast. Which statement reflects the best education plan for these clients?

Include the child in the education; ask questions of both the mother and the child.

What is the most appropriate teaching strategy for the nurse to use for a 1-hour presentation on the prevention of osteoporosis to a group of 30 college-age women?

Lecture/discussion

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.

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

Which response from the client enables the nurse to determine the effectiveness of a recent medication teaching session for an older adult client who is diagnosed with tuberculosis (TB)?

"I will be taking the TB medication for at least 6 months, because it takes a long time to kill the TB germs."

Which statement describes the person who is likely the most motivated to learn?

A 70-year-old female who is the client's spouse and is learning the care so the client can come home

When preparing client teaching materials, how does the nurse best assess a client's preferred learning style?

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

When a client says, "I don't care if I get better; I have nothing to live for, anyway," which type of counseling would be appropriate?

Motivational counseling

A nurse assisting a new mother in the act of breastfeeding represents which form of learning?

Psychomotor

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?

Psychomotor

When teaching a client, the nurse notices the client tends to lose focus easily. The nurse would adapt client teaching in which way?

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

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.

While applying dressings to a client's wound, the nurse teaches the client about wound care. To promote the most effective teaching-learning relationship with this client, what would be most important for the nurse to keep in mind?

The nurse and client relationship is based on mutual sharing and negotiation.

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

The nurse and the client

A client informs the nurse about being committed to quitting smoking to improve health. During discussion, the nurse asks the client "on a scale of 0 to 10, how likely are you to attend a support group?" Which strategy of motivational interviewing is the nurse using with the client?

Assessing importance

A nurse is discussing the benefits of smoking cessation with a client. The nurse informs the client that smoking cessation will reduce the client's risk for cancer, improve respiratory status, and enhance the quality of life. The nurse also shares a personal story of smoking cessation, provides information on other individuals who have successfully quit, and encourages the client to attend a support group for smoking cessation. The client discusses feelings on smoking cessation and verbalizes a desire to quit smoking. What type of counseling did the nurse provide to this client?

Motivational

Which strategy should the nurse use when providing education to the older adult client?

Remain calm and conduct the teaching session in a quiet environment.

A nurse evaluates whether a middle-age client with chronic back pain has been performing the different exercises and physiotherapy procedures recommended by the physician. What would the nurse most likely use to evaluate the client?

Return demonstration

The nurse is completing documentation after an education session with a client. Which statement best demonstrates detailed documentation of an effective teaching plan?

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

A nurse is working with an older adult client, educating the client on how to ambulate with the aid of a walker. The nurse notes that the client appears to lack the motivation to learn how to use the device. The client states, "I'm just too old to learn." What would be most appropriate for the nurse to do to motivate this client?

Describe how the walker can improve the client's quality of life.

The nurse has provided teaching for a client with a sinus infection who has been prescribed antibiotics and a decongestant. The client states, "I'm not sure how many days I'm supposed to take this antibiotic." What is the nurse's appropriate response?

Reteach the length of time to take the prescription.

A nurse may attempt to help a client solve a situational crisis during what type of counseling session?

Short-term counseling

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?

The client and the nurse are equal participants.