Teaching and Learning

A nurse is teaching an assistive personnel (AP) how to obtain a capillary finger-stick blood sample. Which of the following actions by the AP requires the nurse to intervene? 1. Elevating the finger above heart level. 2. Rubbing the fingertip with an alcohol pad. 3. Puncturing the side of the fingertip. 4. Wrapping the finger in a warm cloth.

1. The nurse should intervene if the client elevates the finger above the level of the heart. Holding the figure below the level of the heart in a dependent position will help increase blood flow to the area and ensure an adequate specimen for collection.

A nurse is providing teaching about proper care to a client who has a new colostomy. Which of the following pieces of information should the nurse include in the teaching? 1. Change the colostomy bag following 2. Cleanse the skin around the stoma with warm water. 3. Change the pouch every day. 4. Place an aspirin in the astronomy pouch to decrease odor.

2. The nurse should instruct the client to cleanse the skin around the stoma with warm water, as using soap can leave residue on the skin and cause poor adherence of the pouch.

A nurse is providing discharge, teaching to a client who does not speak the same language as the nurse. The clients neighbor who speaks both the clients native language, and the nurses arrives to drive the client home. Which of the following actions should the nurse take? 1. Ask the client's neighbor to call family member to interpret 2. Ask the clients neighbor to translate the information 3. Obtain the services of an interpreter. 4. Document the inability to provide discharge instructions.

Federal mandates require that a professional medical interpreter translate, the clients healthcare information into the clients native language

perceived benefits

Risk will be reduced by specific behavior change

The Health Belief model

perceived susceptibility, perceived severity, perceived benefits, perceived barriers

A nurse is planning weight-loss strategies for a group of clients who are obese. Which of the following actions will improve the client's commitment to a long-term goal of weight loss 1. Attempting to increase the clients self-motivation 2. Keep detailed records of each client's progress 3. Test clients learning after each teaching session 4. Avoids discussing topics that may increase a client's anxiety

1. Motivation to learn is a key part of improving a client's commitment to achieving a health goal, as well as increasing the amount and speed of learning

A nurse is planning a teaching plan for an older adult. Which common factor among older adult clients must be considered? Select all that apply. 1. _____ Sensory decline occurs as one ages. 2. _____ Learning may require more energy. 3. _____ Intelligence decreases as people age. 4. _____ Older adults rely more on visual rather than auditory learning. 5. _____ Older adult clients are more resistant to change that accompanies new learning.

1. Sensory impairment results from the aging process, which must be considered when planning a teaching plan for an older adult. Aging causes such changes as a reduced ability to focus or accommodate because of reduced elasticity of the lens of the eye; a narrowing of the visual field; increased opacification of the lens, which causes cataracts, with accompanying blurring of vision and increased sensitivity to glare; a decrease in the ability to hear high-frequency sounds; and an increase in the keratin content of cerumen that causes an accumulation of cerumen in the middle ear and thus endangers hearing. 2. Various physiological changes of aging have an impact on the rate of learning (e.g., declines in sensory perception and speed of mental processing and more time needed for recall). These changes require the use of multisensory teaching strategies and a repetitive approach. In addition, older adults may have less physical and emotional stamina because of more chronic illnesses, so they may require shorter and more frequent learning sessions.

A nurse is to teach a client how to change a dressing and irrigate a wound that resulted from the separation of wound edges of an incision and that is healing by secondary intention. The nurse reviews the primary health-care provider's prescriptions, obtains the client's vital signs, and assesses the client. Which should the nurse do next? 1. Administer the prescribed pain medication, and reassess the client in 30 minutes. 2. Teach the client how to irrigate the wound and change the dressing. 3. Notify the primary health-care provider of the client's status. 4. Wait 15 minutes, and retake the client's vital signs.

1. The client's pulse, respirations, and blood pressure are all slightly increased. These adaptations probably are being caused by the release of catecholamines resulting from the pain the client is experiencing. Moderate to severe pain will interfere with learning. The client will have difficulty concentrating on the task at hand. The nurse should postpone the teaching session, administer the prescribed pain medication, and reassess the client in 30 minutes. The teaching session can be reinstituted after the pain is reduced.

A nurse is providing discharge teaching to a client who has a prescription for daily wound care via home health services. Which of the following statements by the client indicates an understanding of the teaching? 1. "A nurse will show me how to care for my wound" 2. A nurse will stay with me at home during the day" 3. "I will call the nurse to change my bed linens" 4. "I will call the nurse to help me bathe in the morning"

1. The home health nurse will provide wound care as prescribed and educate the client about wound care and illness management

A nurse must implement a teaching plan for a client recently diagnosed with heart failure. Which should the nurse do first? 1. Identify the client's level of recognition of the need for learning. 2. Frame the goal within the client's value system. 3. Determine the client's preferred learning style. 4. Assess the client's personal support system.

1. The learner must recognize that the need exists and that the material to be learned is valuable. Motivation is the most important factor influencing learning.

A nurse is teaching a client about the use of a straight-legged cane. Which of the following client actions indicates an understanding of the teaching? 1. The client holds the cane on the unaffected side. 2. The client walks by stepping in with the unaffected leg before the affected leg. 3. The client holds the cane directly next to the foot. 4. The client holds the cane with a straight elbow.

1. The nurse should instruct the client to hold a cane on the unaffected side to prove a wide base of support and stability.

A nurse is providing health teaching for a client with a cognitive deficit. Which intervention by the nurse will support this client's learning? Select all that apply. 1. _____ Using simple vocabulary and syntax 2. _____ Establishing a structured environment 3. _____ Asking that unclear words be repeated 4. _____ Speaking directly in front of the client 5. _____ Making a referral for a hearing evaluation

1. Using a simple vocabulary with as few syllables as possible, along with using short, simple sentences, is less confusing for a client with a comprehension deficit. 2. For people who have a cognitive deficit, participating in a learning program often makes them feel overwhelmed and threatened. The teacher should provide a structured environment in which variables are controlled to reduce anxiety and support comprehension. The nurse should minimize ambiguity, provide a familiar environment, teach at the same time each day, limit environmental distractions, and provide simple learning materials. 3. Clarifying unclear words stated by the client helps the nurse understand what the client is saying. Client concerns and questions must be addressed by the nurse.

A nurse is teaching a client about how to remove a soil dressing. Which of the following statements by the client indicates an understanding of the teaching. 1. " I'll wear non-sterile gloves." 2. " I'll use adhesive remover each time." 3. " I'll take my pain pill after I change the dressing." 4. " I'll fold the dressing with the soil surface, facing outward."

1. Wearing gloves prevents the spread of microorganisms outside of the dressings onto the clients hand. The gloves the client uses can be clean and do not need to be sterile unless the provider specifically prescribes sterile gloves for the dressing changes.

A nurse is caring for a middle-aged client. The nurse should identify which of the following statements as an indication that the client has completed, Erickson's developmental task for her age group. 1. "I am comfortable with my decision to choose a lifelong partner" 2. " I think I have done a good job with my children since they are all independent now." 3. " as I look back over my life I can see that I have achieved most of my goals, except for myself" 4. "I love my work so much that it is difficult to think about retirement."

2. According to Erikson, the developmental task for middle adults is generatively vs. stagnation. Middle adults help shape the future generations through community involvement, parenting, mentoring, and teaching. This statement about helping her children achieve. Independence indicates that the client has accomplished this developmental task.

A community health nurse is caring for a client who has a pressure ulcer and requires assistance with bathing, grooming, and toileting. Docusate sodium, daily weights, and a dressing change of the wound twice a day are prescribed. Which nursing intervention should the nurse perform while educating the client about docusate sodium? Select all that apply. 1. _____ Bathing 2. _____ Toileting 3. _____ Daily weights 4. _____ Wound treatment 5. _____ Medication administration

2. An excellent time for the nurse to teach the client about docusate sodium, a medication that promotes bowel elimination, is when the client is being assisted to the toilet.

A nurse is assessing the results of dietary teaching for a client with diabetes mellitus. Which client behavior indicates that learning occurred in the affective domain? Select all that apply. 1. _____ Discusses which food on the prescribed diet must be avoided 2. _____ Eats only food approved on the prescribed special diet 3. _____ Lists foods that are permitted on the diet 4. _____ Asks about which foods can be eaten 5. _____ Identifies foods that are high in sugar

2. Eating food on the prescribed diet is an example of learning in the affective domain. When learning is incorporated into the learner's behavior because it is perceived as important, learning has occurred in the affective domain. Affective learning involves the expression of feelings and the changing of beliefs, attitudes, or values.

A nurse is planning an in-service training session about various dietary practices, which of the following pieces of information should the nurse include in the teaching? 1. Ovo-vegetarian diet excludes eggs 2. Kosher diet have restrictions regarding how the food must be prepared 3. Macrobiotic diet are plant-based and exclude all animals and seafood. 4. Flexitarian diets exclude the consumption of dairy products.

2. Kosher diets are guided by a set of laws regarding the processing, preparation, and eating of food.

A nurse is providing nutritional teaching to a group of clients. Which of the following definitions for the recommended dietary allowance (RDA) should the nurse include in the teaching? 1. The RDA is a comprehensive term that includes various dietary standards and scales 2. The RDA defines the level of nutrient intake that meets the needs of healthy people in various groups. 3. The RDA defines the levels of nutrients that should not be exceeded to prevent adverse heath effects. 4. The RDA is the daily percentage of energy intake values for fat, carbohydrate, and protein.

2. The RDA represents daily requirements considered adequate for healthy people. RDAs are based in estimated amounts for each nutrient, including additional amounts for individuals such as women or infants

A nurse is teaching about crutches to a client who has a fracture of the right foot. Which of the following instructions should the nurse include? 1. "When you go up a flight of stairs, place your right foot on the first step" 2. "Keep the rubber crutch tips securely in place" 3. "When standing, keep the crutches 12 inches in front of you and 12 inches to the side" 4. "Place your weight on the crutch pads at your armpits

2. The client should never use crutches without the rubber crutch tips. The client should inspect the tips regularly, replace them when they show signs of wear, and remove and dry them thoroughly with paper towels if they become wet.

A nurse is teaching a client who is recovering from gallbladder surgery how to use an insensitive spirometer. Which of the following pieces of information should the nurse include in the teaching? 1. Exhale slowly to reach goal volume 2. Hold breath for 5 seconds after goal volume is reached 3. Continue to breath deeply between each cycle 4. Limit the repeat pattern of breathing to 5 breaths

2. The nurse should instruct the client to hold their breath for 3-5 seconds after reaching maximal inspiratory volume. This decreases the collapse of alveoli, which helps prevent the risk of atelectasis and pneumonia

A nurse is providing discharge, teaching to an older adult client about personal safety. Which of the following statements by the client indicates the understanding of the teaching 1. "I will have the steps to my house painted a dark color" 2. "I will put a night light in the hallway." 3. "I will put socks on when I get out of bed." 4. "I will secure any wires in my home under rugs."

2. The nurse should instruct the client to use a nightlight in and around the home as an important safety measure to reduce the risk of falls in the home. Physiological changes associated with aging can affect an older adult clients ability to see surroundings. Older adults and infants are at an increased risk of serious injury from falls, and most falls occur in the clients home.

A nurse is teaching a newly licensed nurse about pain management in clients age 65 and older. Which of the following pieces information should the nurse include in the teaching? 1. Clients who are age 65 or older experience with decreased ability to perceive pain compared to young adult clients. 2. Clients who are age 65 or older or reluctant to report pain 3. Clients were age 65 or older should not receive opioid narcotics. 4. Clients who are 65 or older experience, a shorter duration of action with medication than young adult clients.

2. The nurse should instruct the newly licensed nurse that clients age 65 and older frequently can be reluctant to report pain because they might not want to bother her anger caregivers, and might believe that pain is expected

A nurse is teaching a client with a hearing impairment. Which should the nurse do to facilitate the teaching-learning process? Select all that apply. 1. _____ Limit educational sessions to ten minutes. 2. _____ Provide information in written format. 3. _____ Use at least two teaching methods. 4. _____ Face the client when talking. 5. _____ Teach in group settings.

2. Written materials augment verbal teaching. The client can review the written materials during and after the teaching session. 3. Varieties of teaching methods facilitate learning because multiple senses are stimulated. When we see, hear, and touch, learning is more effective than when we see or hear alone. In addition, research demonstrates that we remember only 10% of what we read, 20% of what we hear, 30% of what we see, 50% of what we see and hear, and 80% of what we say and do. 4. Some clients who are hearing-impaired lip-read. Facing the client enables the client to see the nurse's lips clearly.

A nurse educator designed various educational programs that employ role-playing as a teaching strategy. Which group of people should the nurse anticipate will benefit the most from role-playing? 1. Older adults preparing to retire from the workforce 2. Men unwilling to admit that they have a drinking problem 3. Adolescents learning to abstain from recreational drug use 4. Middle-age adults preparing for total-knee replacement surgery

3. A group of adolescents learning how to abstain from recreational drug use should benefit most from role-playing. Role-playing provides a safe environment in which to practice interpersonal skills. It enables individuals to rehearse what should be said, learn to respond to the emotional environment, and experience the pressures of the person playing the peer using drugs.

A nurse is providing teaching to a client regarding protein intake. Which of the following foods should the nurse include as an example of an incomplete protein? 1. Eggs 2. Soybeans 3. Lentils 4. Yogurt

3. Incomplete proteins are missing 1 or more of the essential amino acids necessary for the synthesis of protein in the body. Examples of incomplete proteins include lentils, vegetables, grains, nuts, and seeds.

A nurse if teaching a group of unit nurses about the experiences of clients who are having surgery. In which phase of care is the client transferred to the surgical suite table before being transferred to the PACU? 1. Preoperative 2. Postoperative 3. Intraoperative 4. Admission

3. Intraoperative care begins when the client is transferred to the surgical suite table and ends when the client is admitted to the PACU

A school nurse is teaching a class of adolescents about avoiding smoking and includes role-playing as a creative learning activity. Which is the primary reason for using role-playing? 1. Provides more fun than other methods 2. Eliminates the need for media equipment 3. Requires active participation by the learner 4. Gives the learner the opportunity to be another person

3. Learning activities that actively engage the learner have been shown to be more effective as well as more fun than methods that do not actively engage the learner. When learners are actively involved, they assume more responsibility for their own learning and develop more self-interest in learning the content.

After assessing a client's learning needs, abilities, and motivation and identifying client goals, the nurse must formulate a teaching plan. Place the following steps in the order in which they should be implemented. 1. Choose teaching strategies to be employed. 2. Evaluate the effectiveness of the teaching plan. 3. Identify the information that the learner must learn. 4. Organize the information in the sequence that information is to be presented. 5. Develop instructional materials that will reinforce and supplement information provided in the class.

3. The first step in designing a teaching plan is to identify the information that the learner must acquire. This step is accomplished by formulating realistic, measurable learning goals. 4. The second step in designing a teaching plan is organizing the information in an appropriate sequence to be presented. 1. The third step in designing a teaching plan is the selection of the teaching strategies to be employed based on the advantages and disadvantages of each strategy and which is best to achieve the learning goals. 5. The fourth step in designing a teaching plan is to develop instructional materials that will reinforce and supplement information provided in the class. 2. The teacher should develop a method to evaluate whether learning goals are met. Post-tests, written exercises, questionnaires, surveys, and direct observation of performance are some examples of evaluation methods.

A nurse is planning to teach a client how to self-administer a colostomy irrigation. Place the following actions that the nurse should employ in the order in which they should be implemented. 1. Identify the client's readiness to learn. 2. Involve the client in learning activities. 3. Identify the client's motivation to learn. 4. Repeat essential concepts to reinforce learning. 5. Evaluate the client's learning versus desired outcomes.

3. The first step of the options presented involves determining the client's desire to learn. If the client does not recognize that the learning is important, the client will not be invested in the learning process. 1. The second step of the options presented is determining if the client is ready to learn. The client may be motivated to learn, but if the client is in pain or fatigued, the client may not be able to focus on the learning. 2. The third step of the options presented is to implement a teaching plan by engaging the client in planned learning activities. 4. The fourth step of the options presented is related to the concept of repetition of essential concepts to facilitate retention of learned information. Practice of psychomotor skills along with feedback from the nurse strengthens the learning and encourages independence. 5. The fifth step of the options presented is the evaluation of the client's performance in light of stated goals. When evaluating a psychomotor skill, the nurse observes the client's implementation of the skill to ensure that steps in the skill (e.g., collects necessary equipment, follows standards of asepsis and safety, and recognizes and responds to problems associated with the procedure) are implemented according to principles.

A nurse is teaching a client who has asthma about the proper use of an albuterol inhaler. Which of the following client statements indicates an understanding of the teaching? 1. "I should rinse my mouth out right before I use the inhaler" 2. "After the first puff, I will wait 10 seconds before taking the second puff" 3. "I will shake the inhaler well right before I use it" 4. " I will tilt my head forward while inhaling the medicine"

3. The nurse should instruct the client to shake the inhaler vigorously for 3-5 seconds, which will mix the medication within the inhaler evenly.

Which of the following teaching-learning concepts that moves from one extreme to the other is basic to all teaching plans? 1. Cognitive to the affective domain 2. Formal to the informal 3. Simple to the complex 4. Broad to the specific

3. When moving from the simple to the complex, a person works at integrating and incorporating the less complex, new learning into one's body of knowledge and understanding before moving on to more complex information. Complex material is best learned when easily understood aspects of the topic are presented first as a foundation for the more complex aspects.

A nurse manager is providing teaching to a group of newly licensed nurses about ways that clients acquire health care-associated infections (HAIs). Which of the following routes of infection should the manager identify as an iatrogenic HAI? 1. Infection acquired from improper hand hygiene 2. Infection acquired by drug resistance 3. Infection acquired by inappropriate waste disposal 4. Infection acquired from a diagnostic procedure

4. Iatrogenic HAIs directly result from diagnostic or therapeutic procedures

A client who is learning how to use a syringe to self-administer insulin says, "This is so complicated. I'm never going to learn this." Which is an appropriate response by the nurse? 1. "A lot of people feel that way in the beginning." 2. "Let's have a family member give you your insulin." 3. "Most people learn how to do this well. It just takes a little time." 4. "Let's take one step at a time and master each step before we go on to the next."

4. This response addresses the client's immediate concern, plans to break the task into manageable steps, and ensures mastery of each step so that the client does not feel overwhelmed. In addition, it communicates to the client that the nurse is there for the client and that they will tackle the problem together.

A nurse is providing discharge, teaching to a client who is recovering from lung cancer. The provider instructed the client that he could resume low intensity activities of daily living. Which of the following activities should the nurse recommend to the client? 1. Sweeping the floor 2. Shoveling snow 3. Cleaning windows 4. Washing dishes

4. Washing dishes requires a low level of activity and is appropriate for this client

A nursing instructor is evaluating a student nurse's knowledge. Which student behavior indicates that learning has occurred in the highest level of learning in the cognitive domain? Select all that apply. 1. _____ Identifies the expected properties of urine 2. _____ Explains the importance of producing urine 3. _____ Recognizes when something is contaminated 4. _____ Compares achieved outcomes with planned outcomes 5. _____ Contrasts laboratory results of urine testing against the expected range

4. When a learner compares achieved outcomes with planned outcomes, the learner is evaluating the effectiveness of the learning. This activity is evaluation, which is the highest level of the cognitive domain. It requires the nurse to compare, contrast, and differentiate information. 5. This is the highest level of learning in the cognitive domain. Contrasting laboratory results of urine testing with the expected range reflects learning on the evaluation level, which is the sixth and highest level of learning in the cognitive domain.

perceived barriers

Barriers to change can be overcome and managed

The nurses role is to

Be a teacher, educator, and facilitator of interdisciplinary education

The nurse should set priorities of what

Needs to be known vs what is nice to know. Start with what they know and what is most important

perceived severity

One's opinion of how serious a condition and its consequences are The consequences are undesirable

To be most effective, at which grade reading level should the nurse prepare written educational medical material? 1. Fourth-grade 2. Eighth-grade 3. Tenth-grade 4. Sixth-grade

4. Randomized studies demonstrate that the average reading level of individuals who need health teaching is at six to seven grades of schooling.

A family member cannot

Act as an interpreter

Motivation to learn

An internal impulse that causes a person to take action and address a person's desires to learn

Factors affecting motivation

Anxiety Health beliefs Readiness to learn Attitude Ability to learn

Don't assume that because someone is a nurse

That they know what they are doing

Education is a patient's

RIGHT

A nurse is providing teaching about food choices to a client who has a prescription for a clear liquid diet. Which of the following selections by the client indicates an understanding of the teaching? 1. Cream of rice 2. Cottage cheese 3. Gelatin 4. Ice cream

3. Foods allowed on a clear liquid diet are clear and liquid at room temperature

Failure to provide required client education, resulting in client injury

= NEGLIGENCE

percevied susceptibility

There is a risk for developing a specific condition

Knowle's Adult Learning Principles

-Adults learn best when there is a perceived need (need to know something) exists. - teaching of adults should progress from known to unknown (simpler to complex) - Adults learn best by using active participation - Adults need the behavior reinforced - Immediate feedback and correction of misconceptions increases learning

Factors to consider

-Developmental capabilities (are they old enough to understand) -Physical capabilities (can they manipulate a syringe) Age group (teach based on age group)

Assessment of learning needs

-Interview (ongoing activity, biggest concern?) -Motivation to learn -Ability to learn (coordination, sensory deficits, level of cognitive functioning, physical strength?) -Learning style (hands-on, listening, watching) -Readiness to learn - Cultural considerations- interpreter

Affective Domain (Attitude)

-Involves attitudes, beliefs, values, and feelings that will affect behavior - Examples would include discussion simulations and role-playing

psychomotor domain (physical skills (think skills lab))

-Physical skills a person needs for a procedure or technique -Taught by demonstrations, return demonstrations, and practice drills -examples would be dressing changes, insulin injection (can the patient preform the task?)

If it wasn't documented

IT WASNT DONE

A nurse is teaching a group of young adults. Which of the following to the nurse identify as an expected developmental task for this age group? 1. Independent moral development. 2. Acceptance of body changes. 3. Strengthening ties with the family of origin. 4. Development of concrete reasoning.

1. According to Kohlberg's theory of moral development, making individual decisions about moral issues is a function of the highest level of moral development, the post-conventional level. Young adults, who have reached this level, separate themselves from the rules and tenants of others and make their own decisions according to personal beliefs and principles.

A nurse is providing teaching to a client with heart failure about reducing his daily intake of sodium, which of the following factors is the most important in determining the clients ability to learn new dietary habits? 1. The involvement of the client in planning the change 2. The emphasis the provider places on the dietary changes 3. The learning theory the nurse uses to teach dietary changes. 4. The extent of the dietary changes planned for the client.

1. According to the evidence based practice, client involvement in planning dietary changes is the most important factor in the clients ability to learn new habits.

A nurse is teaching a client who has impaired vision to self-inject insulin. Which should the nurse do to facilitate the teaching-learning process? Select all that apply. 1. _____ Obtain a prescription for automatic-stop syringes. 2. _____ Provide written information in large print. 3. _____ Use audio learning materials. 4. _____ Speak in a normal volume. 5. _____ Talk at a regular rate.

1. An automatic-stop syringe ensures that an appropriate dose of insulin can be prepared despite a client's vision impairment. 2. Large print magnifies the written information to a size that may facilitate reading by the client who is vision impaired. 3. Audio learning materials use the sense of hearing rather than sight to promote the teaching-learning process. 4. Speaking in a normal volume is an appropriate intervention for a client who has a vision impairment. The client is visually impaired, not hearing impaired. 5. A client who has a visual impairment is able to follow a conversation spoken at a normal rate (not too fast or slow). Talking slowly is an appropriate intervention for a client who has a hearing, not a vision, impairment.

Which describes a client with an external locus of control? Select all that apply. 1. _____ Behaves appropriately to obtain the right to watch a television program 2. _____ Is self-motivated when implementing health promotion behaviors 3. _____ Adheres to a weight-loss diet in order to feel better 4. _____ Understands the expected outcome of therapy 5. _____ Is a self-actualized adult

1. The person with an external locus of control is motivated by rewards that center on privileges, incentives, or praise received from pleasing significant others or members of the healthcare team. Watching television is a privilege in this situation.

A nurse is teaching a middle-aged adult about health promotion and disease prevention. The nurse should inform the client that which of the following changes could occur? 1. Decreased estrogen and testosterone production 2. Increased tone of large intestines 3. Increased percentage of body's muscle mass 4. Decreased incidence of chronic illness

1. Both estrogen and testosterone start to decrease in middle age

Which is the primary reason why nurses attend continuing education programs? 1. Update professional knowledge. 2. Network within the nursing profession. 3. Fulfill requirements for an advanced degree. 4. Graduate from an accredited nursing program.

1. Continuing education programs are formal learning experiences designed to update and enhance professional knowledge or skills. This is necessary because of the explosion in information and technology within health care. Some states require evidence of continuing education units (CEUs) for license renewal.

A nurse uses computer-assisted instruction as a strategy when providing preoperative teaching. Which should the nurse explain to preoperative clients is the best advantage of computer-assisted instruction? 1. Learners can progress at their own rate. 2. It is the least expensive teaching strategy. 3. There are opportunities for pre- and post-testing. 4. Information is presented in a well-organized format.

1. Learners progress through a program at their own pace in viewing informational material, answering questions, and receiving immediate feedback. Some programs feature simulated situations that require critical thinking and a response. Correct responses are rationalized, praise is offered, and incorrect responses trigger an explanation of why the wrong answer is wrong and offer encouragement to try again. This is a superior teaching strategy for the learner who may find that group lessons are paced either too fast or too slowly for effective learning.

A nurse is assessing a client to determine educational needs. Which is most important for the nurse to consider? 1. Make no assumptions about the client. 2. Teaching may be informal or formal in nature. 3. The teaching plan should be documented on appropriate records. 4. A copy of the teaching-learning contract should be given to the client.

1. Many variables influence an individual's willingness and ability to learn (e.g., readiness, motivation, physical and emotional abilities, education, age, cultural and health beliefs, cognitive abilities). Because everyone is unique with individual needs, the nurse must avoid making assumptions and generalizations.

A nurse is teaching a group of older adults about expected age-related changes. Which of the following statements by a group member indicates that the teaching has been effective? 1. "I should expect my heart rate to take longer to return to normal after exercise as I get older" 2. "Urinary incontinence is something I will have to live with as I get older" 3. "I can expect to have less ear wax as I get older" 4. "My stomach will empty more quickly after meals as I grow older"

1. Older adults experience decreased cardiac output, which causes an increase pulse rate during exercise. The pulse rate also takes longer to return to normal after exercise.

A nurse is caring for a client who has type one diabetes mellitus, and is resistant to learning how to self inject insulin. Which of the following statements should the nurse make? 1. " tell me what I can do to help you overcome your fear of giving yourself injections." 2. " your provider will not be pleased that you refuse to give yourself insulin injections." 3. " it's okay, I'm sure your partner will be able to learn how to give you the insulin injections." 4. " you won't be able to go home unless you learn to give yourself insulin injections

1. That's response illustrates a therapeutic communication technique of clarifying and offering self. The nurse should allow the client to express feelings and fears and support the client in learning how to give the injections.

Every person who attended a smoking cessation educational program completed a questionnaire. What is the name for this type of evaluation? 1. Survey 2. Post-test 3. Case study 4. Focus group

1. The terms questionnaire and survey are used interchangeably to describe a type of evaluation tool designed to gather data about a topic. This method is used to obtain information, such as feedback regarding an educational program.

A nurse is teaching a postoperative client deep breathing and coughing exercises. Which method of instruction is most appropriate in this situation? 1. Explanation 2. Demonstration 3. Video presentation 4. Brochure with pictures

2. A demonstration is the best strategy for teaching a psychomotor skill. A demonstration is an actual performance of the skill by the teacher, who is acting as a role model. A demonstration usually is followed by a return demonstration. The learner can imitate the teacher during a return demonstration, ask questions, and receive feedback from the instructor.

A nurse is teaching a preschool-age child. Which teaching method is most appropriate for the nurse to use when teaching a child in this age group? 1. Demonstrations 2. Coloring books 3. Small groups 4. Videos

2. Coloring books are the best approach because they require preschoolers to be active participants in their own learning and the child has a product to keep and be proud of. The use of coloring books reduces anxiety associated with learning because coloring is an activity most preschoolers are familiar with and the coloring task falls within a preschooler's cognitive level.

A nurse is attending a class about a new infusion pump presented by the hospital staff education department. What type of educational program is this? 1. Continuing education program 2. Inservice education program 3. Certification program 4. Orientation program

2. Inservice programs generally are provided by health-care agencies to reinforce current knowledge and skills or provide new information about such issues as policies, theory, skills, practice, or equipment.

A nurse is caring for a client who has type 1 diabetes and an ulcer on the big toe of the right foot. The nurse plans to review how to perform self-blood glucose monitoring, self-administer an injection, and apply a sterile dressing to the ulcer on the toe. The nurse identifies that the client is a kinesthetic learner. Which teaching strategy is most appropriate for the nurse to use with this client? 1. Give verbal instructions and encourage a discussion. 2. Provide occasions to touch and handle equipment. 3. Present pictures and illustrations. 4. Use models and videos.

2. Kinesthetic learners learn best when processing information by doing. Kinesthetic learners should be engaged in physical activities that allow them to touch and handle equipment.

A nurse is planning to engage a client in a program to learn about a newly diagnosed illness. Which psychosocial response to the illness will have the most impact on the client's future success of learning? 1. Fear 2. Denial 3. Fatigue 4. Anxiety

2. Of all the options presented, the client in denial is the person least ready and motivated to learn. The client in denial is unable to recognize the need for the learning.

A home health nurse is planning to provide health promotion activities for a group of clients in a community. Which of the following activities is an example of primary prevention? 1. Teaching clients to perform self examination of breasts and testicles. 2. Educating clients about the recommended immunization schedule for adults. 3. Teaching clients who have type one diabetes mellitus about the care feet. 4. Recommending that clients over the age of 50 have a fecal occult blood test annually.

2. Primary prevention includes health education about disease prevention.

A nurse is teaching a client colostomy care in relation to the affective domain. Which teaching method is most effective for this situation? 1. Discussing a pamphlet about colostomy care from the American Cancer Society 2. Exploring how the client feels about having a colostomy 3. Providing a demonstration on how to do colostomy care 4. Showing a videotape demonstrating colostomy care

2. This option reflects learning in the affective domain. Affective learning is concerned with feelings, emotions, values, beliefs, and attitudes about the colostomy.

A nurse is teaching a client who is postoperative about the importance of turning, coughing, and breathing deeply. Which of the following statements should the nurse identify as an indication that the client understands the instructions? 1. " if I do this often, I won't experience muscle wasting." 2. " if I do this often I won't get pneumonia." 3. " if I do this often I won't get constipation." 4. " if I do this often I won't have a fast heartbeat"

2. Turning, coughing, and breathing deeply help prevent respiratory complications, such as pneumonia by promoting lung expansion and secretion removal

A unit secretary tells the nurse that the primary health-care provider has just prescribed a low-calorie diet for a client who is overweight. Place these nursing interventions in the order in which they should be implemented. 1. Determine food preferences. 2. Verify the dietary prescription. 3. Teach specifics about a low-calorie diet. 4. Review a meal plan designed by the client. 5. Assess the client's motivation to follow the diet.

2. Verifying the prescription should be done first because a diet requires a primary health-care provider's prescription; following a specific diet is a dependent function of the nurse. 5. Assessing motivation is one of the most important factors influencing learning. The learner must recognize that the need exists and that the need will be addressed through the learning. 1. Determining food preferences is part of nursing assessment. Food preferences can then be included in the teaching plan about the low-calorie diet. 3. Details of the diet can be taught after the prescription is verified, motivation is determined, preferences and needs are identified, and a teaching plan is formulated. 4. Evaluation is the final step of teaching. A meal plan designed by the client requires not just an understanding of the information but an ability to apply the information.

A nurse in a providers office is teaching a client about foods that are high, in fiber, which of the following food choices made by the client indicates an understanding of the teaching? (select all that apply.) 1. Canned peaches 2. White rice 3. Black beans 4. Whole grain bread 5. Tomato juice

3. Dried peas and beans, including black beans are high in fiber. 4. Whole grains consist of the entire kernel are also high in fiber.

A nurse is planning to teach weight-reduction strategies for an obese client. Which should the nurse assess first before implementing the teaching plan? 1. Intelligence 2. Experience 3. Motivation 4. Strengths

3. If the client does not recognize the need to learn or value the information to be learned, the client will not be ready to learn.

A hospice nurse is reviewing a religious practice of a group of clients with a newly licensed nurse. Which of the following statements by the newly licensed nurse indicates an understanding of the teaching? 1. People who practice the Islamic faith pray over the deceased for a period of 5 days before burial. 2. People who practice the Hindu faith bury the deceased with their head facing north 3. People who practice Judaism stay with the body of the deceased until burial 4. People who are practicing the Buddhist faith have the female family members prepare the body following death.

3. In the Jewish faith, a family member often stays with the body until burial occurs

A nurse is providing teaching about nutrition diets to a group of adult woman. Which of the following statements should the nurse include? 1. "Include at least 3 g of sodium in your diet" 2. "Limit wine consumption to 230 mL daily" 3. "Include 2.5 cups of vegetables in your daily diet." 4. "Limit water and take to 1.5 L each day."

3. Nutritious diet contain a variety of foods, ensure that all required daily allowance of nutrient is ingested. The nurse should instruct the woman to include 2.5 cups of vegetables and 2 cups of fruit to their daily diets. Fruits and vegetables should be a variety of colors to provide an assortment of nutrients.

A nurse formulates teaching goals using action verbs. Which word is an example of a verb employed in a learning outcome in the psychomotor domain? Select all that apply. 1. _____ Accepts 2. _____ Explains 3. _____ Performs 4. _____ Assembles 5. _____ Demonstrates

3. Performing an activity indicates learning in the psychomotor domain. Learning in the psychomotor domain is related to mastering a skill and requires motor activity. 4. Assembling something indicates learning in the psychomotor domain. Learning in the psychomotor domain is related to mastering a skill and requires motor activity. 5. Demonstrating something indicates learning in the psychomotor domain. Learning in the psychomotor domain is related to mastering a skill and requires motor activity.

An assistive personnel (AP) is assisting a nurse with the care of a female client who has an indwelling urinary catheter. Which of the following actions by the AP indicates a need for further teaching? 1. The AP uses soap and water to clean the perineal area. 2. The AP tapes the catheter to the client's inner thigh 3. The AP hangs the collection bag at the level of the bladder 4. The AP ensures there are no kinks in the drainage tubing

3. The AP should place the drainage bag below the level of the bladder to ensure proper drainage by gravity

A nurse is teaching a middle-aged female client about disease prevention and health maintenance. Which of the following diagnostic tests should the nurse recommend as a part of this client's routine health screening? 1. Annual papanicolaou (PAP) testing 2. Mammogram every 2 years 3. Eye exam every 2 years 4. Annual colonoscopy

3. This is essential not only for monitoring vision but also checking for glaucoma. The client should have annual eye examinations from the age of 65 onward.

A nurse is providing discharge teaching to a client who has type 2 diabetes mellitus and will be caring for herself at home. The client expresses concerns about preparing an appropriate diet for her diabetes due to her cultural beliefs and preferences. Which of the following responses should the nurse offer? 1. "The home health dietitian will visit and help you learn to cook all over again" 2. "The dietitian will give you a list of foods and dietary choices to keep your diabetes under control" 3. "The dietitian will help you choose foods you are used to that also meet your health needs" 4. "It may be difficult, but I know you can change your eating and cooking habits with some help from the dietitian"

3. This response shows respect for the client's food preferences and cultural needs by offering choices from among the clients usual foods

A nurse is teaching a client recently diagnosed with diabetes mellitus the step-by-step procedure of administering an insulin injection by using an orange. However, after two sessions of practice, the client is still reluctant to self-administer the insulin. Which should the nurse do? 1. Keep reinforcing the principles that have been presented. 2. Have the client administer the injection to an orange again. 3. Give the client an opportunity to explore concerns about the injection. 4. Determine if a member of the family is willing to administer the insulin.

3. When a teaching plan is ineffective, the nurse must gather more data and revise the teaching plan to achieve the desired goal.

A nurse is providing teaching to a group of unit nurses about wound healing by secondary intention, which of the following pieces of information should the nurse include in the teaching 1. The wound edges are well-approximated 2. The wound is closed at a later date 3. A skin graft is placed over the wound to bed 4. Granulation tissue fills the wound during healing.

4. A beefy, red tissue called granulation tissue fills the wound during healing. The wound is left open to drain and heal by secondary intention, which should occur within 5 to 21 days. Open wounds increase the risk of wound infection.

A nurse is teaching a client about lifestyle changes to manage a chronic illness. Which of the following strategies should the nurse use first to help the client make a commitment to these lifestyle changes? 1. Identify the risks of nonadherence. 2. Schedule learning sessions to demonstrate the psychomotor skills the client will need. 3. Provide clearly written an easy to understand materials. 4 help the client identify ways these changes will result in positive personal outcomes.

4. According to evidence-based practice, the motivation to change must precede, taking steps to make the change. Therefore, helping clients identify ways that the changes will promote positive outcomes should precede other educational strategies for making the changes. The client should first see how the changes directly affect his/her life, thus enhancing the motivation to make the changes.

A charge nurse if providing teaching to a new licensed nurse about removing sutures from a client's laceration. Which of the follow statements by the newly licensed nurse indicates an understanding of the teaching 1. "I will use a staple remover and remove each suture individually" 2. "Bandage scissors are used to cut the sutures" 3. "Tweezers are necessary only for removing retention sutures" 4. "I will clip each suture close to the skin and pull it through the other side"

4. Clipping close to the skin and pulling the suture from the other side does not disrupt the wound-healing process

A nurse is designing a teaching-learning program for a client who is to be discharged from the hospital. After developing a nurse-client relationship, which should the nurse do next? 1. Identify the client's locus of control. 2. Use a variety of teaching methods appropriate for the client. 3. Formulate an achievable, measurable, and realistic client goal. 4. Assess the client's current understanding of the content to be taught.

4. Learners bring their own lifetimes of learning to the learning situation. The nurse must customize each teaching plan, capitalize on the client's previous experience and knowledge, and identify what the client still needs to know before teaching can begin.

A nurse is teaching an older adult how to perform a dressing change. Which nursing action is most important to address a developmental stress of older adults? 1. Speak loudly when talking to the client. 2. Use terminology understandable to the client. 3. Have the client provide a return demonstration. 4. Allow more time for the client to process information.

4. Reaction time will slow as one ages; therefore, older adults need more time to process and respond to information or perform a skill. In addition, some older adults may have less energy, experience more fatigue, and may need shorter, frequent learning sessions.

A nurse educator is teaching a class on problem-solving and reinforces the concepts of inductive and deductive reasoning using the attached illustration. Which is the most important reason why the nurse educator presented this illustration? 1. It appeals to students who are visual learners. 2. It employs the concept of positive reinforcement. 3. It stimulates learning in students with an internal locus of control. 4. It improves students' conceptual understanding of complex content.

4. Research demonstrates that when illustrations are used in conjunction with reading content, learners outperform students who just read the content. Illustrations attract attention, facilitate retention of information, and improve understanding of complex content by creating a context.

A nurse is planning a weight-reduction program with an obese client. Which should the nurse anticipate will be the most important component that will determine the success or failure of this program? 1. Rewarding compliant behavior with favorite foods 2. Encouraging at least 1 hour of exercise daily 3. Using an 800-calorie daily dietary regimen 4. Setting realistic goals

4. Setting realistic goals is important to the success of a weight-loss program. Because achieving success is dependent largely on motivation, the teacher and the client should design goals that demonstrate immediate progress or growth. One strategy is to design numerous realistic short-term intermediary goals that are achieved more easily than one long-term goal.

A nurse is teaching a client who is using a patient controlled analgesia (PCA) pump to deliver morphine for pain management. Which of the following statements should the nurse identify as an indication that the client understands the instructions? 1. " I'll limit pushing the button so I don't get an overdose" 2. " if I push the button and still have pain after 2 minutes, I'll push it again" 3. " I'll ask my niece to push the button when I am sleeping." 4. " I can still use my transcutaneous electrical nerve stimulation unit while I'm pushing the PCA button"

4. The nurse should encourage the client to utilize nonpharmacological methods of pain management such as transcutaneous electrical nerve stimulation (TENS) while using a PCA pump to reduce the amount of opioid dosing the client needs

A home health. Nurse enters the clients home and find a used insulin syringe without a cap on the table. Which of the following actions should the nurse take? 1. Recap the needle on the syringe 2. Schedule a nurse to administer further injections for this client. 3. Explain to the client at the syringe should be disposed of in the bathroom trashcan 4. Placed the syringe in a puncture proof of disposable container.

4. The nurse should place the uncapped syringe in a puncture proof, sharps, disposal, or a rigid plastic container to prevent a needlestick injury. The nurse should keep the syringe uncapped to prevent needlestick injury while placing a cap on the needle. Then the nurse should provide the client education on safety and proper disposal of the syringe.

learning depends on

Motivation, ability, environment

Documentation needs

Specific content Evaluation of learning Method of teaching

Cognitive Domain (Visual/Hearing)

Teaching strategies include: discussion, programed instruction, written information, audio, video tapes, and computer assisted instruction