Chapter 9 Teach & Counsel

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

Motivational counseling

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

A nurse is showing an older adult client with severe diabetes the correct method of self-administering an insulin injection. What should be the nurse's comment if the client continues making mistakes when learning how to self-administer an insulin injection

"Lots of people have the same concern." "You've just about figured out how to give yourself an injection." "Try to angle the syringe a little more this way."

Which client would be the best candidate for the nurse to engage in motivational interviewing?

A 28-year-old client with elevated blood glucose for 8 months

A nurse is counseling several clients for depression. Four of them do not seem to be improving, which leads the nurse to suggest a referral to a psychiatric nurse practitioner. Which of these clients would be most likely to attend the scheduled appointment?

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

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

The nurse is providing education to a group of clients with diabetes about the benefits of healthy food choices. What type of learning is the nurse using with this client group?

Affective

The nurse is caring for a 5-year-old child on the pediatric unit. Which activities would promote the psychomotor skills of this child? Select all that apply.

Assembling blocks Building a house with popsicle sticks Removing the toys from the toy box

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

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

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?

By implementing effective teaching

The nurse is providing education to parents at a preschool regarding child safety and primary prevention. Which topic(s) would the nurse choose to discuss with the parents to represent primary prevention? Select all that apply.

Car seat restraints Bicycle helmets Immunizations

An occupational health nurse is planning inservice training sessions for the employees. Which teaching topic would be most appropriate to cover with these clients?

Cardiopulmonary resuscitation

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

Cognitive learning theory

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

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

The client reports to the clinic as ordered by the primary care provider for counseling on weight loss to improve overall health. The client received printed information in the mail to review before the session, and reports having read through it before the appointment. Which client statement alerts the nurse to a need for clarification and further education?

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

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

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

An older adult client who is recovering from a stroke is scheduled to be transferred to the rehabilitation unit in the morning. The client is tearful and reports feeling lonely and abandoned in the hospital unit. The family visits daily, and flowers and cards are in the room. Documentation in the chart indicates that the client's pastor has been by twice in the past week to visit. Which nursing diagnosis and outcome criteria need to be addressed immediately for this client?

Ineffective Coping; verbalizes support systems.

A nurse is preparing a teaching session about heart failure for a group of older adults. When planning this session, which action would be important for the nurse to integrate into the session? Select all that apply.

Keep outside distractions to a minimum. Allow for extra time to answer questions. Plan sessions that are short in duration. Tie in new information with things the group is familiar with.

An active, otherwise healthy, older adult client presents to the clinic with severe osteoarthritis in both knees. The nurse knows this client does not want to be a burden on the family, and the client remains stoic despite reporting the pain as severe. The client avoids the topic of surgery and attends church weekly. The client's family is supportive of any decisions the client makes regarding health. Which of the assessment data is most important to forming an individualized education plan for this client concerning treatment for osteoarthritis?

Personal perception of health and aging

A home health nurse states to her client, "I am very proud of you. You gave your first insulin injection without a problem. You have done wonderfully and are learning fast." What technique is the nurse using to compliment the client's progress?

Positive feedback

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

Psychomotor

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

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

The 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?

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

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 bestmotivational statement by the nurse for this client?

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

A 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.

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

What do you know about support groups

The nurse is visiting a client who was released from inpatient rehabilitation 6 weeks ago after a 5-month recovery from a motor vehicle accident that left the client immobile. As the nurse enters the home, the client braces hands on the arms of a chair to rise and uses crutches to walk across the room. What is the best response by the nurse?

You have made an amazing recovery.