Ch 9: Teaching and Counseling

The nurse is preparing to teach a client from Generation X about hypertension. Which teaching approach should the nurse plan to implement? a) Provide brochures about low-sodium foods. b) Ask a family member to do meal planning to alleviate the burden for the client. c) Demonstrate the MyFoodPyramid phone app, to show the best food choices on a lunch tray. d) Have the client repetitively choose appropriate foods from various menus.

c) Demonstrate the MyFoodPyramid phone app, to show the best food choices on a lunch tray.

Which nursing action is applicable to the psychomotor domain of learning when conducting a teaching session for breastfeeding mothers? a) Telling the mothers to avoid taking over-the-counter drugs while breastfeeding b) Showing charts to the mothers that illustrate the types of breast milk c) Observing a mother expressing the breast milk d) Advising the mothers to drink plenty of water

c) Observing a mother expressing the breast milk

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

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? a) Role play b) Lecture/discussion c) Demonstration d) Test taking

b) Lecture/discussion

Which learning domain is the focus for instruction when the nurse educates a new mother about the breast and its role in milk production for feeding the newborn? a) Affective b) Psychomotor c) Cognitive d) Behavioral

c) Cognitive

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 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

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? a) Long-term counseling b) Motivational counseling c) Short-term counseling d) Professional counseling

b) Motivational counseling

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? a) Affective b) Psychomotor c) Cognitive d) Interpersonal

c) Cognitive

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

d) Have the client rate pain level, and reschedule the teaching session.

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? a) Allow ample time for psychomotor skills. b) Keep the session at 2 to 3 hours. c) Allow for long-term memory loss. d) Provide information in a structured format.

a) Allow ample time for psychomotor skills.

The nurse has provided education to a client about home care for an open surgical wound on the lower left extremity. When evaluating learning through the cognitive domain, what statement by the nurse would be appropriate? a) "Tell me about what signs of infection you will report to the health care provider." b) "I would like you to demonstrate how to change the dressing on your leg." c) "Let's see how you irrigate the wound with saline." d) "I notice that you do not have the dressing secured. Place a piece of tape on the wrap."

a) "Tell me about what signs of infection you will report to the health care provider."

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? a) Focus mainly on the mother; ask the child a couple of simple questions. b) Provide the mother with written materials; teach the child about keeping the cast dry. c) Include the child in the education; ask questions of both the mother and the child. d) Separate the mother and the child; teach the mother and then let the mother teach the child.

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

The nurse is providing instructions to a client about performance of breast self-examination. What learning outcome would be most appropriate regarding this education? a) The client will demonstrate self-efficacy and improved body image. b) The client will have restoration of breast function. c) The client will be able to perform proper breast self-examination for breast cancer detection and prevention. d) The client will demonstrate improved coping skills.

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

When a nurse is planning for learning, who must decide who should be included in the learning sessions? a) The health care team b) The doctor and nurse c) The nurse and the client d) The client and the client's family

c) The nurse and the client

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

d) Tell me what you know about these tests.

The nurse has educated the client on the pathophysiology of osteoarthritis and degenerative joint disease. This type of teaching best illustrates which learning theory? a) Adaptive learning theory b) Behavioral learning theory c) Cognitive learning theory d) Developmental learning theory

c) Cognitive learning theory

The nurse is caring for a client who demonstrates a health literacy concern. The nurse adjusts client teaching in which way? a) uses medical terminology to help the client feel smarter b) provides general teaching instead of specificity regarding diagnosis c) gives instructions in multiple ways so the client will understand d) uses videos, diagrams, and pictures rather than focusing on verbal teaching

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

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 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 d) Contemplation

a) Preparation

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.

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.

The nurse is teaching an 80-year-old client how to instill eye drops for glaucoma. The client's daughter asks, "How do you know that my mother understands what to do?" What is the appropriate nursing response? a) "After I demonstrate it once, your mother will be able to do it." b) "When 15 minutes have passed, I will ask your mother to show me how to instill the drops." c) "We can never be completely sure that your mother understands instructions." d) "I will have you bring your mother back next week to see how things are going."

b) "When 15 minutes have passed, I will ask your mother to show me how to instill the drops."

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 describes the person who is likely the most motivated to learn? a) A 29-year-old male whose significant other is insisting on the client receiving the education b) A 70-year-old female who is the client's spouse and is learning the care so the client can come home c) A 52-year-old male who has been hired to drive the client home from the clinic d) A 25-year-old female who just completed a course of physical therapy

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

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? a) Observe the change in client's behavior for a month. b) Ask the client to recall after approximately 15 minutes. c) Test the client on the health education and information imparted. d) Ask the client to administer the doses of drug himself.

b) Ask the client to recall after approximately 15 minutes.

Before starting the education process, the nurse should determine the preferred learning style, age and developmental level, capacity to learn, motivation level, readiness to learn, and learning needs of the client. How does this help the nurse in the client's health education? a) By fulfilling the client's requirements b) By implementing effective teaching c) By assisting the client's learning d) By reducing chances of any miscommunication

b) By implementing effective teaching

Which strategy should the nurse use when providing education to the older adult client? a) Avoid the use of colorful materials and keep the session short. b) Remain calm and conduct the teaching session in a quiet environment. c) Teach in a monotone voice in a quiet environment. d) Teach from books only and remain calm.

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

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."

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?"

A nurse may attempt to help a client solve a situational crisis during what type of counseling session? a) Long-term counseling b) Motivational counseling c) Short-term counseling d) Professional counseling

c) Short-term counseling

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? a) Nurses are experts who generously bestow knowledge upon clients. b) Nurses barter knowledge of medication with the client for compliance. c) The nurse and client relationship is based on mutual sharing and negotiation. d) Nurses have control over the client because of their knowledge and expertise.

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

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

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

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? a) Tell the client how to move the walker as the client ambulates. b) Explain how the walker supports the client's lower extremities. c) Fully discuss the rationale for using the walker. d) Describe how the walker can improve the client's quality of life.

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

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 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.

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? a) Asking only the client's parents to be present at the education session b) Including a note about who was taught this new information in the client's chart c) Assuring the client that the conversation is confidential except under extreme circumstances d) Answering questions openly and honestly

a) 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? a) Assess for cultural differences. b) Boost the morale of the client. c) Delegate the health education to a colleague. d) Replace one-on-one teaching with written materials.

a) Assess for cultural differences.

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?"

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) Describing the signs and symptoms of low blood sugar b) Explaining what to do if hypoglycemia occurs c) Reviewing with the client appropriate foods to eat d) Demonstrating the technique for insulin self-injection

d) Demonstrating the technique for insulin self-injection

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? a) Intellectual development b) Motor development c) Emotional maturity d) Psychosocial development

a) Intellectual development

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: a) critical thinking. b) emotions or feelings. c) muscular movements. d) physical demonstration.

a) critical thinking.

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."

A client is meeting with the nurse to discuss options for smoking cessation. Which statement by the nurse is most appropriate for this client? a) "There are many options available. Which options have you previously tried?" b) "What do you see as your biggest hurdle to stopping?" c) "Some people find that reducing cigarette consumption slowly over time is an effective option." d) "Most clients are successful when they use over-the-counter nicotine patches or gum."

b) "What do you see as your biggest hurdle to stopping?"

A nurse assisting a new mother in the act of breastfeeding represents which form of learning? a) Affective b) Psychomotor c) Cognitive d) Simplistic

b) Psychomotor

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.

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

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

Which documentation example best reflects the complexity of client teaching by the nurse? a) "Told client to take antibiotic as ordered." b) "Client return demonstrated how to use glucometer." c) "Taught client about peak flows; client verbalized understanding." d) "Client and spouse taught how to use phone app to count carbohydrates; client return demonstrated carb counting for a hypothetical meal."

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