Chap 4-Health Education and Promotion
What percentage of people older than 65 years have one or more chronic disease(s)? a) 50 b) 80 c) 70 d) 60
b) 80
Which of the following is a leading health indicator to be used to measure the health of the nation? a) Overweight and obesity b) Cultural awareness c) Religion d) Intelligence
a) Overweight and obesity
Which phase of the nursing process encompasses the establishment of expected outcomes? a) Assessment b) Evaluation c) Implementation d) Planning
d) Planning
Which phase of the nursing process encompasses the establishment of expected outcomes? a) Evaluation b) Assessment c) Planning d) Implementation
c) Planning
The nurse establishes a learning contract with an overweight client. The contract is best if it a) has an overall goal of 30-pound weight loss in six months b) is an oral contract between the nurse and the client c) contains an agreement to ingest a well-balanced diet d) includes an incremental goal of 1-2 pound weight loss this week
d) includes an incremental goal of 1-2 pound weight loss this week
Question: A nurse is planning a smoking-cessation program for a client and incorporates stages from the Transtheoretical Model of Change in the program. For the client to be successful, the client follows the stages in this order from steps 1 to 5: 1 Works to prevent relapse of smoking 2 Takes steps to stop smoking 3 Makes a plan to cease smoking 4 Thinks about smoking cessation 5 Resists relapsing into smoking
4 Thinks about smoking cessation 3 Makes a plan to cease smoking 2 Takes steps to stop smoking 1 Works to prevent relapse of smoking 5 Resists relapsing into smoking
Which of the following teaching strategies would benefit a patient with an output disability? a) Use of audiotapes b) Use of computers c) Modeling d) Use of hand gestures
d) Use of hand gestures
Which of the following are effective teaching strategies for elderly persons? Select all that apply. a) Use of reinforcement techniques b) Frequent repetition c) Slow-paced presentation d) Use of written materials e) Use of distraction to improve concentration
a) Use of reinforcement techniques b) Frequent repetition c) Slow-paced presentation d) Use of written materials
Which of the following would be incorporated as a teaching strategy for a hearing-impaired person? a) Use slow, directed, and deliberate speech b) Have the person perform a return demonstration c) Use large-print materials d) Arrange materials in a clockwise pattern
a) Use slow, directed, and deliberate speech
A nursing student observes the home care nurse provide education to a patient with congestive heart failure (CHF). The nurse teaches the patient how to read food labels and calculate sodium content. The nursing student recognizes that the home care nurse is aware of which of the following basic principles of patient education? a) The home care nurse has a physician order to teach a 2-g sodium diet b) Patients are required to learn about their therapeutic nutritional regimen c) The home care nurse is providing hospital discharge instructions d) Patient instruction related to self-care activities promotes patient independence
d) Patient instruction related to self-care activities promotes patient independence
Evelyn, a 27-year-old stockbroker, is a regular smoker and is diabetic. She has been diagnosed with hypertension. She says she finds it cumbersome and time consuming to visit the doctor regularly just to check her blood pressure. As the nurse, which of the following aspects of patient teaching would you recommend? a) Discussing methods for stress reduction b) Advising smoking cessation c) Administering glycemic control d) Purchasing a self-monitoring cuff
d) Purchasing a self-monitoring cuff
When a person works to prevent relapse and to sustain the gains made from the actions taken, he or she is in which stage of the Transtheoretical Model of Change? a) Contemplative b) Action c) Maintenance d) Termination
c) Maintenance
The nurse is providing discharge instructions to an elderly client. The nurse hands the client a paper about a new medication. The client cannot read. Learning does not occur. In this situation the nurse has failed to assess the a) Appropriateness of teaching techniques b) Physical readiness of the client c) Past experiences of the client d) Client's social and cultural patterns
a) Appropriateness of teaching techniques
According to the American Academy of Family Physicians, prostate examination should be done at which of the following intervals? a) Yearly b) Monthly c) Every 6 months d) As needed
a) Yearly
A hospitalized client reports right lower quadrant abdominal pain at a level of 8 on a 0 to 10 scale. The client is scheduled for an appendectomy. The nurse is teaching the client about use of the incentive spirometer postoperatively verbally and by demonstration. The client is on his side, clutching his abdomen. Learning is not occurring. The nurse has primarily failed to consider the client's a) Physical readiness b) Emotional readiness c) Experiential readiness d) Learning environment
a) Physical readiness
Which of the following patient statements indicates the patient's experiential readiness to learn? a) "Do you have a video about my disease? I don't like to read." b) "Can we take a minute to pray before learning about my treatment plan?" c) "Now that I am more comfortable, I am ready to learn about pain management techniques." d) "I understand that I have diabetes and will need to learn how to administer my daily insulin injections."
a) "Do you have a video about my disease? I don't like to read."
The nurse is teaching a 72-year-old client about heart failure. To enhance learning, the nurse a) Frequently repeats the provided information b) Provides the necessary information in one teaching session c) Sits in a chair 10 feet away from the client d) Looks at notes to ensure all information is covered
a) Frequently repeats the provided information
The nurse is performing discharge teaching for an elderly client with mild visual impairment. The nurse provides written instructions with large print and highlighted parts. The nurse also sits near the client, faces the client, and speaks in a lower-pitched voice. When the client arrives home, the client has difficulty following instructions. The nurse erred in teaching by a) Providing written instructions that are highlighted b) Sitting near and facing the client c) Using instructions with large print d) Speaking in a lower-pitched voice
a) Providing written instructions that are highlighted
The nurse is developing a health-promotion program at a company in which many employees are women in their 20s and 30s. For this population, the nurse plans to include information about a) Bone-density screening b) Values training c) Mammography d) Parenting issues
d) Parenting issues
The nurse is teaching a client with diabetes how to perform checks of blood glucose level. To optimize learning, it is best for the nurse to a) Verbally tell the client. b) Have the client return demonstrate. c) Provide written instructions. d) Demonstrate to the client.
b) Have the client return demonstrate.
The nurse develops a program of increased ambulation for a patient with an orthopedic disorder. This is an example of what component of the nursing process? a) Assessment b) Planning c) Evaluation d) Implementation
b) Planning
Which step of the nursing process determines whether the client understands the health teaching that is provided? a) Implementation b) Evaluation c) Assessment d) Planning
b) Evaluation
A 35-year-old client with a developmental age of 10 years is being taught to take medication every morning. The nurse assesses that the client brushes his teeth every morning. For learning to occur, which of the following techniques should the nurse employ? Select all answers that apply. a) Provide written 8th-grade level information. b) Look directly at the client when speaking. c) Repeat information frequently. d) Encourage the client to take the medication after brushing his teeth. e) Use simple explanations.
b) Look directly at the client when speaking. c) Repeat information frequently. d) Encourage the client to take the medication after brushing his teeth. e) Use simple explanations.
Based on the nurse's knowledge of nonadherence to therapeutic regimens which of the following nurses needs to place extra emphasis on adherence to the treatment plan? a) The nurse planning to teach a group of children about healthy eating b) The nurse planning to teach adults age 65 about congestive heart failure (CHF) management c) The nurse planning to teach teenagers about mononucleosis d) The nurse planning to teach middle-aged adults about stress management
b) The nurse planning to teach adults age 65 about congestive heart failure (CHF) management
A nurse is teaching a client taking digoxin about checking the pulse rate daily. The client counts her radial pulse as 64 beats/min. The nurse counts at the same time and assesses the rate as 58 beats/min. When evaluating response to treatment, the nurse would chart that the client a) Demonstrates adequate knowledge of the skill b) Needs a family member to perform this skill c) Cannot satisfactorily learn the skill d) Requires another opportunity for practice
d) Requires another opportunity for practice
The nurse is administering a new medication to an elderly male client and begins instruction about the medication. The client states, "Tell my wife. She takes care of all this kind of stuff." The nurse replies a) "It is necessary that you learn about this medication." b) "When your wife comes in to visit, I will return and provide the information to both of you." c) "I will print the information about this medication and leave it with you to give to her." d) "I guess I will have to return when she arrives."
b) "When your wife comes in to visit, I will return and provide the information to both of you."
In many situations, measurement of which of the following is the most accurate measurement technique to identify changes in patient behavior? a) Use of rating scales b) Direct observation of behavior c) Use of checklists d) Anecdotal notes
b) Direct observation of behavior
Nonadherence to therapeutic regimens is a significant problem especially in the elderly population, leading to which of the following outcomes? a) Decreased morbidity b) Increased cost of treatment c) Decreased chronic illness d) Increased compliance with medical regimen
b) Increased cost of treatment
A patient has been reporting regularly to the healthcare unit to get his blood pressure monitored. The physician diagnoses him with essential hypertension after analyzing his readings over two or more sessions. As the nurse, which of the following options would you inform the patient about on priority? Select all that apply. a) Educate him about the correct position to measure blood pressure, as the position may affect readings. b) Advise him to begin an exercise regimen based on the approval of the physician. c) Inform him about the various methods that are available to assist with smoking cessation. d) Advise him to purchase a self-monitoring cuff, or use an automatic cuff at a local pharmacy. e) Ask him to follow a diet that is low in saturated fats and sodium and high in fiber.
b) Advise him to begin an exercise regimen based on the approval of the physician. c) Inform him about the various methods that are available to assist with smoking cessation. e) Ask him to follow a diet that is low in saturated fats and sodium and high in fiber.
The nurse is planning to teach a client who was recently diagnosed with migraine headaches. It is best to teach the client a) During the headache recovery phase b) In a quiet room c) Immediately following a headache experience d) With her spouse and children present
b) In a quiet room
When a person works to prevent relapse and to sustain the gains made from the actions taken, he or she is in which stage of the Transtheoretical Model of Change? a) Termination b) Maintenance c) Contemplative d) Action
b) Maintenance
Health education of the patient by the nurse a) must focus on wellness issues. b) must be approved by the physician. c) is an independent function of nursing practice. d) requires a physician's order.
c) is an independent function of nursing practice.
The entire planning phase of the teaching-learning process concludes with which of the following? a) Enhancement of learning b) Response to teaching c) Changes need in teaching plan d) Documentation
d) Documentation
The practice of nursing care is multifaceted in its scope and delivery. Which of the following activities describe the role of nursing? Select all that apply.
-Promoting health -Preventing illness -Health education and maintenance
The termination stage of the Transtheoretical Model of Change occurs when a) the person has the ability to resist relapsing back to unhealthy behavior. b) the person takes steps to operationalize the plan of action. c) the person constructs a plan to change behavior. d) the person is not thinking about making a change.
a) the person has the ability to resist relapsing back to unhealthy behavior.
The nurse is educating the client about management of diabetes. An inappropriate statement by the nurse is a) "Checks of blood glucose level are to be done ac and hs." b) "Avoid alcohol ingestion while taking glimeperide (Amaryl)." c) "Exenatide (Byetta) is prescribed twice a day." d) "You will need to ingest an 1800-calorie diet every day."
a) "Checks of blood glucose level are to be done ac and hs."
Which of the following teaching strategies may be used with a patient diagnosed with a developmental disability? Select all that apply. a) Demonstrate information followed by return demonstration. b) Use nonverbal cues as needed. c) Use simple explanations. d) Encourage active participation. e) Base information on chronologic age.
a) Demonstrate information followed by return demonstration. b) Use nonverbal cues as needed. c) Use simple explanations. d) Encourage active participation.
Select the nursing action that is least likely to motivate a person to learn. a) Emphasis on negative outcomes as a method to prevent learning incorrect practices b) The creation of an atmosphere in which the patient is encouraged to express anxiety c) The establishment of learning goals based on individual needs d) Constructive encouragement when a person has been unsuccessful in the learning process
a) Emphasis on negative outcomes as a method to prevent learning incorrect practices
A nurse is evaluating education provided to various clients being discharged to home. The nurse assesses that client most likely to be nonadherent with treatment is the one who a) Has tuberculosis and is taking multiple antitubercular medications b) Has pneumonia and is prescribed an oral antibiotic c) Has a duodenal ulcer and is prescribed a histamine-2 receptor blocker d) Had abdominal surgery and will be changing the dressing daily
a) Has tuberculosis and is taking multiple antitubercular medications
During a teaching session with a patient with a new walker the nurse provides frequent reinforcement to the patient to get up from a chair that has arms by holding the top of the chair arm with one hand. Once the patient is standing and stable, then she can grasp either the other side of the walker or both sides of the walker. The nurse knows that this educational strategy is most effective with which type of disability? a) Input disability b) Developmental disability c) Perceptual disability d) Output disability
a) Input disability
Which of the following is an example of adherence to treatment? Select all that apply. a) Maintaining a healthy diet b) Self-monitoring for signs and symptoms of illness c) Increasing daily activities d) Inability to comply with follow-up appointments e) Taking prescribed medications
a) Maintaining a healthy diet b) Self-monitoring for signs and symptoms of illness c) Increasing daily activities e) Taking prescribed medications
A nurse is teaching an older adult about a medication that the client will take at home. The nurse assesses which of the following factors as promoting adherence to the medication regimen? a) The client's daughter is present and provides care to the client at home. b) The client has Social Security benefits and no other source of income. c) The client asks for information in writing and states "I tend to forget things." d) The client has a hearing impairment and wears bilateral hearing aids.
a) The client's daughter is present and provides care to the client at home.
In which of the following actions is the nurse illustrating the step of the nursing process that determines if the patient understands the health teaching that is provided? a) Watching a return demonstration of insulin administration from a newly diagnosed diabetic b) Teaching injection sites to a patient newly diagnosed with diabetes c) Asking a new diabetic, "What are your questions about giving yourself an insulin injection?" d) Setting short-term educational goals for the patient newly diagnosed with diabetes
a) Watching a return demonstration of insulin administration from a newly diagnosed diabetic
An example of a behavior that facilitates health includes a) self-monitoring for signs and symptoms of illness. b) a sedentary lifestyle. c) noncompliance with a medication regimen. d) recreational drug use.
a) self-monitoring for signs and symptoms of illness.
Which stage of the transtheoretical model occurs when the patient has serious consideration of change, but it is sometime in the future? a) Action b) Maintenance c) Precontemplation d) Contemplation
d) Contemplation
Choose the nursing statement that would best reflect the final component of the "Ask-Tell-Ask-Close" technique of communication and demonstration. a) "Here are the written directions for changing your dressings." b) "Can you repeat for me the information I just reviewed about weighing food portions?" c) "Is this a good time for me to show you how to irrigate your colostomy?" d) "Do you understand how to take your blood pressure?"
b) "Can you repeat for me the information I just reviewed about weighing food portions?"
A patient and his wife are in his hospital room. The wife says to the nurse, "I looked up one of the new drugs he is taking on the Internet, gabapentin. It said it is for seizures. My husband has never had a seizure." A therapeutic response by the nurse would be which of the following? a) "I will get you a current drug handbook; you can look it up." b) "Gabapentin or Neurontin can also be used for leg pain associated with diabetes." c) "I cannot discuss the drugs which the physician has ordered. You need to call her to ask that question." d) "Why are you asking? Your husband's physician has probably told him the reason."
b) "Gabapentin or Neurontin can also be used for leg pain associated with diabetes."
Which of the following statements when made by the patient indicates understanding of the Centers for Disease Control and Prevention and U.S. Preventive Services Task Force, recommendation for prostate screening frequency? a) "I will make plans to see you every 6 months to keep an eye on my PSA levels." b) "I will see you next year for my prostate exam." c) "When I turn 50 I will need to have my PSA level checked every 5 years." d) "I will schedule my prostate exam every 3-5 years after I am 50."
b) "I will see you next year for my prostate exam."
Which of the following is an example of a direct measurement technique for evaluation of the teaching--learning process? a) Attitude surveys b) Behavioral observation c) Patient satisfaction surveys d) Instruments that evaluate specific health status variables
b) Behavioral observation
A nurse is aware of both the importance of health education and the fact that it is an independent function of nursing practice. Under which of the following circumstances should a nurse consider providing health education? a) When the nurse possesses advanced practice credentials in health education b) During each contact that the nurse has with a health care consumer c) When health education is specified in a health care consumer's plan of nursing care d) When a patient or patient's condition has a reasonable chance of resolution
b) During each contact that the nurse has with a health care consumer
A nurse is aware of the fact that nonadherence to prescribed therapy is both common and harmful. How can a nurse best promote adherence to therapeutic regimens among patients? a) Make adherence a requirement for treatment in early interactions with patients b) Help individuals be aware of the benefits of adhering to their prescribed therapy c) Provide examples of the harmful consequences of nonadherence to therapy d) Establish a system of rewards and punitive measures that is linked to adherence
b) Help individuals be aware of the benefits of adhering to their prescribed therapy
A current trend in health education that significantly influences nursing practice is: a) Increased numbers of health care providers. b) Increased emphasis on patient involvement in their own care. c) Improved distribution of health information materials. d) Increased emphasis on the diversity of patient needs.
b) Increased emphasis on patient involvement in their own care.
The nurse is providing information to a client about the safe use of a newly prescribed medication. The first question the nurse should ask is a) What teaching aids do I need? b) Is the client ready to learn? c) How do I evaluate client learning? d) What is the expected outcome?
b) Is the client ready to learn?
Which of the following is accurate regarding wellness? Select all that apply. a) It just happens. b) It requires a conscious commitment. c) One tries to maximize one's own health. d) It is the result of adopting lifestyle behaviors for the attainment of one's highest potential. e) Is the same for every person.
b) It requires a conscious commitment. c) One tries to maximize one's own health. d) It is the result of adopting lifestyle behaviors for the attainment of one's highest potential.
When a person who has successfully completed a smoking cessation program removes ashtrays from their home and takes a short walk after work instead of joining the usual group of co-workers at the local hangout which stage of the Transtheoretical Model of Change is the patient portraying? a) Action b) Maintenance c) Contemplative d) Termination
b) Maintenance
Normal aging results in changes in cognition. Therefore, when teaching an elderly patient how to administer insulin, the nurse should: a) Speed up the demonstrations because the patient will tire easily. b) Repeat the information frequently for reinforcement. c) Present all the information at one time so that the patient is not confused by separate pieces of information. d) Speak in a raised voice to accommodate for hearing loss.
b) Repeat the information frequently for reinforcement.
The nurse is preparing to teach a client about a newly prescribed medication. The client lacks insurance. The medication costs approximately $100 per month. The client states, "I can't afford it." The nurse assesses a variable to successful education and health promotion for this client based on the Health Belief Model is a) Perceptual factors b) Resources c) Barriers d) Demographic and disease factors
b) Resources
A nurse knows that the use of a learning contract increases motivation and increases the likelihood of patient compliance with the treatment regimen. Which of client's goals best exemplifies a well-designed learning contract? a) The patient seeking alcohol treatment agreeing to stop drinking all forms of alcohol immediately and plans to chew a stick of gum when they experience the urge to have a drink. b) The patient who wishes to stop smoking agrees to cut back on one cigarette a day for the first week of treatment and then decrease smoking by two cigarettes the following week of treatment. c) The client that wishes to begin an exercise program agrees to participate in a 10K run 6 months after starting the new exercise regimen. d) The weight loss client that immediately reduces caloric intake to 1000 calories a day and agrees to keep on this diet plan until a 20-pound weight loss has been achieved.
b) The patient who wishes to stop smoking agrees to cut back on one cigarette a day for the first week of treatment and then decrease smoking by two cigarettes the following week of treatment.
A middle-aged female client is overweight and sedentary, has slightly elevated blood pressure, and is seeking ways to begin exercise. The client wishes to lose weight and improve her blood pressure. The nurse plans an exercise program in which the client a) Takes a 1-hour spinning class four times each week b) Walks for 30 minutes three times this week and is re-evaluated c) Lifts weights three times each week with increasing sets, repetitions, and weights d) Joins a local gym and obtains the services of a personal fitness trainer
b) Walks for 30 minutes three times this week and is re-evaluated
Which phase of the nursing process of patient teaching ends when the strategies have been completed and when the patient's responses to the actions have been recorded? a) Evaluation b) Planning c) Implementation d) Assessment
c) Implementation
Which of the following is the goal of patient and family education? a) Lessen financial burden b) Assumption of responsibility for care c) Improvement of patient outcomes d) Decrease amount of healthcare services
c) Improvement of patient outcomes
A program of weight loss and exercise is recommended for a client with type 2 diabetes. When teaching the client about lifestyle changes, what type of assessment would the nurse prioritize? a) Head-to-toe physical assessment b) Body mass index assessment c) Individual cultural assessment d) Braden scale assessment
c) Individual cultural assessment
Which of the following is a nursing diagnosis related to health education? a) Ineffective airway clearance b) Altered nutrition, less than body requirements c) Ineffective health maintenance d) Self-esteem disturbance
c) Ineffective health maintenance
A patient with a visual impairment would benefit from which of the following teaching strategies? a) Sign language b) Captioned videos c) Magnifying lenses d) Telecommunication devices
c) Magnifying lenses
A school nurse is developing a program about positive health practices for adolescents. The nurse includes information about a) Prenatal health b) Blood pressure control c) Self-esteem d) Chronic diseases
c) Self-esteem
The nurse is planning a health education program for a group of high school students regarding the dangers of texting and driving. Which of the actions by the nurse illustrates the nurses understanding of health education as a primary nursing responsibility? a) The nurse obtains the name of the school's medical director and obtains a physician's order to conduct the education program. b) After consulting the literature and preparing the educational program, the nurse contacts the school's medical director for approval of the planned educational program. c) The nurse gathers evidenced-based information related to texting and driving and coordinates the education with the school nurse. d) The nurse prepares a permission slip for all students to have signed by their parents allowing the student to participate in the educational program.
c) The nurse gathers evidenced-based information related to texting and driving and coordinates the education with the school nurse.
When providing discharge instructions, the nurse recognizes which of the following patients is most likely to comply with the therapeutic treatment regimen? a) The patient with a positive tuberculosis skin test requiring 9 months of isoniazid b) The patient with kidney failure that requires hemodialysis c) The pneumonia patient that requires 1 week of oral antibiotics d) The newly diagnosed type 2 diabetic that requires nutritional counseling
c) The pneumonia patient that requires 1 week of oral antibiotics
Therapeutic touch should be used in which of the following situations? a) When a patient needs to process information b) To provide a personal presence c) When a patient is sensory deprived d) To encourage a patient's verbal communication
c) When a patient is sensory deprived
Health education of a client by the nurse a) requires a physician's order. b) must focus on wellness issues. c) is an independent function of nursing practice. d) must be approved by the physician.
c) is an independent function of nursing practice.
A nurse developed a program of increased ambulation for a patient with an orthopedic disorder. This goal setting is a component of the nursing process known as: a) Implementation b) Evaluation c) Assessment d) Planning
d) Planning
The school nurse informs the mother of a second-grade student that she found lice in her child's hair. The mother explains to the nurse that she has another child to pick up and cannot stay to receive education related to the treatment of lice at this time. The mother reassures the nurse that she will "look up treatment options on the Internet and take care of the child." What would be the best action of the school nurse in this situation? a) Notify the social worker of suspected child neglect and make a referral to child protective services b) Perform hand hygiene and notify the second-grade teacher to wash down the classroom c) Instruct the mother to treat the other child for lice in the same manner as the second grade child d) Provide the mother with a list of credible Web sites related to the treatment of lice
d) Provide the mother with a list of credible Web sites related to the treatment of lice
Carla, a 42-year-old patient, displays symptoms that indicate a risk for developing hypertension. As the nurse, which of the following immediate measures would you recommend for her? a) Drug therapy b) Lifestyle modifications c) Patient teaching d) Routine screening and follow-up appointments
d) Routine screening and follow-up appointments
Outcome criteria are expressed as specific outcomes of patient behavior resulting from teaching strategies. Which of the following is an example of outcome criteria? a) Altered lifestyle resulting from inadequate lung expansion b) Potential oxygenation deficit related to ventilator insufficiency c) Inadequate ventilation associated with pulmonary congestion d) The ability to climb a flight of stairs without experiencing difficulty in breathing
d) The ability to climb a flight of stairs without experiencing difficulty in breathing