Week 7 | PrepU | Chapter 09 - ML 4 | 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?

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

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?

-Giving stickers as a reward for task completion -Blocking 30 minutes of time for skill teaching* -Ensuring the client's parents are present -Using dolls to demonstrate psychomotor skills

A nurse is preparing to teach a client about the importance of contraception and safe-sex practices. Which factors can most affect the nurse's teaching strategies for this client? Select all that apply.

-Learning style preferences* -Size of family -The client's job -Literacy level* -Available resources*

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

-Long-term counseling -Professional counseling -Short-term counseling* -Motivational counseling

The nurse is interacting with a new client who reported to the clinical facility for a health problem. Place the following statements by the nurse in the order of the nurse-client relationship. Use all options.

"Hello. I am the nurse assigned to you. My name is...." "What health problem are you seeking help for?" "This medication has been prescribed by the health care provider to treat your problem." "The health care provider has recommended you to return in 1 week."

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* -Including a note about who was taught this new information in the client's chart -Answering questions openly and honestly -Assuring the client that the conversation is confidential except under extreme circumstances

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?

-Situational -Long-term -Developmental -Motivational*

As the nurse enters the room to teach the client about self-care at home, the client states, "I am glad you are here. I need some pain medicine. I can't stand it anymore." What is the best action of the nurse?

-Have the client rate pain level, and reschedule the teaching session.* -Give written materials to the client and administer pain medication. -Redirect the client to learning about self-care and begin education. -Assess the client's understanding of self-care and administer medication.

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* -Maintenance -Contemplation -Precontemplation

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

-A 29-year-old male whose significant other is insisting on the client receiving the education -A 25-year-old female who just completed a course of physical therapy -A 52-year-old male who has been hired to drive the client home from the clinic -A 70-year-old female who is the client's spouse and is learning the care so the client can come home*

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?

-Are you worried about the pain? -Most people are afraid of sticking themselves. -Why don't you want to do this? -Tell me what you know about these tests.*

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?

-Using dolls to demonstrate psychomotor skills -Blocking 30 minutes of time for skill teaching* -Giving stickers as a reward for task completion -Ensuring the client's parents are present

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.* -emotions or feelings. -physical demonstration. -muscular movements.

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?

-"Those physical therapists work wonders. -"Let me document that you can walk." -"Are you supposed to be out of the wheelchair?" -"You have made an amazing recovery."*

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?

-Assimilation and application of psychomotor concepts is essential. -The nurse is the expert in the teaching-learning environment. -The client and the nurse are equal participants.* -The nurse must be able to handle criticism during the process.

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)?

-"If I stop coughing after 3 months, I can stop taking my TB medication because that means I no longer have the germ in my system." -"It is okay to skip some doses if I don't feel well or sick to my stomach." -"I will be taking the TB medication for at least 6 months, because it takes a long time to kill the TB germs."* -"I can't remember when I have to take my medications, so I have my son come and give me my pills."

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

-"Taught client about peak flows; client verbalized understanding." -"Told client to take antibiotic as ordered." -"Client and spouse taught how to use phone app to count carbohydrates; client return demonstrated carb counting for a hypothetical meal."* -"Client return demonstrated how to use glucometer."

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?"* -"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?" -"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?" -"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."

The nurse is readmitting a client who was discharged 1 week ago with complications from diabetes mellitus. The client states, "I really did not understand what I was supposed to do to care for myself from those papers that I was sent home with." What question will the nurse ask to promote the client's self-esteem?

-"What was so difficult about the discharge instructions?" -"How do you learn best and what can we do to provide you with that information?"* -"You understand that if you are not able to care for yourself, will you'll continue to be admitted?" -"Do you have a problem with reading?"

A nurse is showing an older adult client with severe diabetes the correct method of self-administering an insulin injection. What comment(s) is acceptable if the client continues making mistakes when learning how to self-administer an insulin injection? Select all that apply.

-"You have just about figured out how to give yourself an injection."* -"First-time learners often have this same concern."* -"Why are you repeatedly holding the injection at the wrong angle?" -"Try to angle the syringe a little more this way."* -"It will be better if you ask someone responsible to administer the injection."

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* -A 25-year-old female who just completed a course of physical therapy -A 29-year-old male whose significant other is insisting on the client receiving the education -A 52-year-old male who has been hired to drive the client home from the clinic

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 believes that doing nothing is preferable to painful treatments -A client who believes there are actions that will reduce the probability of contracting the disease* -A client who views a disease as a serious threat* -A client who does not view oneself as susceptible to the disease -A client who believes that noncompliance is not an option -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.* -Provide information in a structured format. -Keep the session at 2 to 3 hours. -Allow for long-term memory loss.

The nurse is assisting a client 55 years of age to understand the anatomy and physiology of the heart following a heart attack. What type of learning is taking place?

-Andragogy* -Affective -Pedagogy -Psychomotor

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* -Evoking change talk -Prioritizing -Elicit-provide-elicit

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?

-Cognitive -Psychomotor* -Affective -Interpersonal

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* -Psychomotor -Affective -Interpersonal

The parents of a school-age child are meeting with the nurse for health promotional education for their child. The child has the following assessment data: a 7-year-old male with diabetes mellitus type 1 with a hemoglobin A1C level of 8.3%, a body mass index (BMI) of 31.7, and a BMI percentile of 99. What are the most appropriate learning diagnoses for this first session?

-Deficient Knowledge: Imbalanced nutrition: more than body requirements, and ineffective health maintenance.* -Deficient Knowledge: Readiness for enhanced nutrition, and risk for disturbed body image. -Deficient Knowledge: Risk for imbalanced nutrition: more than body requirements, and sedentary lifestyle. -Deficient Knowledge: Risk for chronic low self esteem, and risk for unstable blood glucose level.

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?

-Formal religious beliefs -Orthopedic surgical history -Personal perception of health and aging* -Floor plan of the client's dwelling

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

-Provide teaching that works for the broadest base of clients. -Ask the client, "Do you learn best by observing, valuing, or doing?"* -Observe the client's behaviors. -Determine client learning needs based on age and ability to hear effectively.

When caring for a client, the nurse observes that the client enjoys reading books and magazines. In which learning domain does the client's learning style fall?

-Psychomotor -Cognitive* -Affective -Interpersonal

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?

-Reinforcement -Health promotion -Positive feedback* -Motivation

A nurse is preparing to teach a client about the importance of contraception and safe-sex practices. Which factors can most affect the nurse's teaching strategies for this client? Select all that apply.

-Size of family -Available resources* -Learning style preferences* -Literacy level* -The client's job

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?

-Taught lesson at an adult developmental level (age 35) using short sentences and assessed motor skills -Assessed the client's understanding of health and answered questions on an age-appropriate level while the television was on in the room -Taught lesson at a school-age developmental level in an authoritarian style while the client was at meal time -Assessed the client's understanding of illness; assessed motor skills and developmental stage; provided clarification*

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?

-Taught lesson at an adult developmental level (age 35) using short sentences and assessed motor skills -Taught lesson at a school-age developmental level in an authoritarian style while the client was at meal time -Assessed the client's understanding of illness; assessed motor skills and developmental stage; provided clarification* -Assessed the client's understanding of health and answered questions on an age-appropriate level while the television was on in the room

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?

-The client organizes materials needed and gives return demonstration.* -The client states understanding and passes a written test. -The client nods when asked about process and assists with cleanup. -The client verbalizes items needed and how to perform the skill.

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 negotiates goals with the client. -The nurse uses medical jargon frequently when discussing the teaching plan.* -The nurse ignores the restrictions of the client's environment.* -The nurse reviews educational media when planning learner objectives. -The nurse evaluates what the client has learned.

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 reviews educational media when planning learner objectives. -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 evaluates what the client has learned. -The nurse negotiates goals with the client. -The nurse ignores the restrictions of the client's environment.*

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 material presented should focus on future application. -Peer group acceptance is a critical issue for this age group. -Previous experiences have little impact on learning.

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

-psychosocial interventions. -technical interventions. -educational interventions.* -health care provider-initiated interventions.