Health Education PrepU
A client is experiencing difficulty in adjusting to a new prosthesis despite conscientious client education by numerous members of the health care team. How should the team respond to the client's lack of learning to this point? Revise the education plan that has guided education. Refer the client to outside sources of information. Explore alternatives to prosthesis. Scale back the scope and detail of client education.
If evaluation of client education indicates that client learning has not met outcomes, it is appropriate to revise the education plan. This does not necessarily entail reducing the detail or referring the client to outside information sources. Exploring alternatives to prosthesis does not address the client's learning needs.
What does the nurse understand is the single most important factor in determining health status and longevity? Adherence to a plan Good nutrition Motivation to change Stress reduction
It has been suggested that good nutrition is the single most significant factor in determining health status, longevity, and weight control.
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 Is the client ready to learn? What is the expected outcome? What teaching aids do I need? How do I evaluate client learning?
The nurse follows the nursing process when teaching a client. Probably the most important and first factor to assess is the client's readiness to learn. The other options are also components of the nursing process. The question what is the expected outcome is the goal of the nursing process. The use of teaching aids is part of the implementation process. Evaluating learning is the evaluation component of the nursing process.
Which documentation example best reflects the complexity of client teaching by the nurse? "Told client to take antibiotic as ordered." "Client return demonstrated how to use glucometer." "Taught client about peak flows; client verbalized understanding." "Client and spouse taught how to use phone app to count carbohydrates; client return demonstrated carb counting for a hypothetical meal."
The nurse should document who the teaching was provided to, what was taught, the teaching method, and the evidence of learning. The other answer choices are not as comprehensive and, therefore, are not the best examples of teaching.
There are many goals for health teaching. Which of the following is the primary goal of family and patient education? Increase knowledge Motivate people to learn Improve patient outcomes Establish trust
The primary goal of patient and family education is to achieve, improve, or alter behaviors that directly or indirectly change and improve patient outcomes.
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 Affective Psychomotor Interpersonal
Because the client learns better by practicing the self-administration of the insulin injection alone, the client's learning style falls in the psychomotor domain. The psychomotor domain is a style of processing that focuses on learning by doing. The client's learning style does not fall in the cognitive, affective, or interpersonal domain. The cognitive domain is a style of processing information by listening to, or reading, facts and descriptions. The affective domain is a style of processing that appeals to a person's feelings, beliefs, or values. The interpersonal domain is a style of processing that focuses on learning through social relationships.
Which of the following is an example of a direct measurement technique for evaluation of the teaching--learning process? Behavioral observation Patient satisfaction surveys Attitude surveys Instruments that evaluate specific health status variables
Direct measurement techniques include behavioral observation, checklists, and anecdotal notes to document the behavior. Patient satisfaction surveys, attitude surveys, and oral questioning, and instruments that evaluate specific health status variables are indirect measurements.
Which step of the nursing process determines whether the client understands the health teaching that is provided? Evaluation Assessment Planning Implementation
Evaluation includes observing the client, asking questions, and then comparing the client's behavioral responses with the expected outcomes. Assessment includes determining the client's readiness regarding learning. Planning includes identification of teaching strategies and writing the teaching plan. Implementation is the step during which the teaching plan is put into action.
Which of the nurse's actions is most likely to promote a client's compliance with their antiretroviral drug regimen for the treatment of human immunodeficiency virus (HIV)? Use interactive and learner-appropriate teaching techniques. Ensure that teaching materials are evidence-based and explicitly referenced. Emphasize the consequences of noncompliance at various points in client teaching. Refer to the characteristics of the HIV virus when explaining how antiretrovirals treat HIV.
Noncompliance has serious consequences for the health of clients. It can often be prevented by ensuring that client teaching is interactive and appropriate to the needs and development of each individual learner. Client education should indeed be evidence-based, but this does not necessarily enhance compliance. Overemphasizing the negative and grounding the education in virology or other forms of science will also not guarantee compliance. Using interactive and learner-appropriate teaching techniques to increase client compliance is the best available choice.
A nurse may attempt to help a client solve a situational crisis during what type of counseling session? Long-term counseling Motivational counseling Short-term counseling Professional counseling
Short-term counseling would help a client solve a situational crisis. A client experiencing a developmental crisis, for example, might need long-term counseling. Motivational counseling is an evidence-based counseling approach that involves discussing feelings and incentives with the client. Professional counseling is a general term.
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? Establish a system of rewards and punitive measures that is linked to adherence Provide examples of the harmful consequences of nonadherence to therapy Help individuals be aware of the benefits of adhering to their prescribed therapy Make adherence a requirement for treatment in early interactions with patients
There are numerous strategies and variables involved in promoting adherence. However, helping individuals be cognizant of the specific benefits of adherence is likely to achieve this goal. Negative examples and punitive measures are less effective, and ethically questionable. It is neither practical nor possible to make adherence a precondition for care.
A nurse is preparing teaching for a client with an auditory perceptual disorder. Which educational strategy will be most effective? Explain important information verbally. Repeat and reinforce words frequently. Explain noises associated with procedures. Avoid medical terminology.
When caring for a client with an auditory perceptual disorder, the nurse should repeat and reinforce words frequently. Explaining important information verbally may not work the best for a client with an auditory perceptual disorder. A client with a visual impairment should have noises explained. Nurses should avoid medical terminology with clients that have a cognitive disability.
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. Keep the session at 2 to 3 hours. Allow for long-term memory loss. Provide information in a structured format.
Older adults need more time to learn psychomotor skills. Sessions of 2 to 3 hours are too long; short-term rather than long-term memory loss affects older adults; and information can be structured or nonstructured, depending on the content.
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? When a patient or patient's condition has a reasonable chance of resolution During each contact that the nurse has with a health care consumer When health education is specified in a health care consumer's plan of nursing care When the nurse possesses advanced practice credentials in health education
Every contact an individual nurse has with a health care consumer, whether or not that person is ill, should be considered an opportunity for health teaching. Health education should not be limited to specific orders in care plans, diagnoses that are likely to resolve, or nurses who have advanced practice designations.
Which stage of the transtheoretical model occurs when the patient has serious consideration of change, but it is sometime in the future? Contemplation Precontemplation Action Maintenance
In the contemplation stage, the patient has serious consideration of change, but it is sometime in the future. When the patient is not considering any change in behavior in the next 6 months, he or she is in the precontemplation stage. During the action stage, concrete activities that lead to the desired change have been made for less than 6 months. During the maintenance stage, active efforts to sustain the changes made for more than 6 months.
The nurse is in the process of initiating and delivering a teaching-learning program. What is the strongest predictor of a client's health status? Life style High socio- economic level Health literacy skills Cultural skills
Lifestyle is the strongest predictor of a client's health status. Literacy means more than reading level, it requires a complex group of reading, listening, analytical, and decision-making skills,and the ability to apply these skills to health situations. People with low literacy have less knowledge about health problems, are less likely to seek help early in the course of a disease, have less knowledge of self-care instructions, are at a higher risk for hospitalization, and lack the skills needed to negotiate the health care system. Socio-economic status is not a predictor of health status. Cultural skils have no impact of health status.
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? Motivational Long-term Developmental Situational
Motivational counseling involves discussing feelings and incentives with the client. Long-term counseling extends over a period of time. Developmental counseling occurs when a client is going through a developmental stage or passage. Situational counseling occurs when a client faces an event or situational crisis.
A client is admitted to the health center with chronic diarrhea. When should the nurse begin imparting health teaching about the benefits of proper diet to the client so that the risk of diarrhea is minimized? When admitting the client When providing treatment When discharging the client When performing follow-up care
Potential teaching needs should be identified from the time when the client is admitted. The client would therefore need to be taught the benefits of a proper diet during admission so as to minimize the risk of diarrhea. There is a greater probability of the client retaining the teaching if the teaching starts during admission. The teaching may be amended during the caring, treatment, and discharge phases, as well as during any follow-up treatment.
The home health nurse is planning teaching for a client with COPD and a history of noncompliance to the medication regimen. Which factor does the nurse recognize as having the most influence to enabling complete adherence of a health regimen? Motivation Self-esteem Cost of medication Education level
The most influential factor that enables complete adherence of a health regimen is client motivation. The other answer choices may influence a client's motivation, but these are not the most influential.
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 Requires another opportunity for practice Demonstrates adequate knowledge of the skill Cannot satisfactorily learn the skill Needs a family member to perform this skill
The nurse needs to provide the client with ample opportunity for practice. Only one option represents this answer. The client did not demonstrate adequate knowledge in counting the radial pulse. She would have taken digoxin based on the pulse rate she counted. Insufficient data support that the client cannot learn the skill. Having a family member perform the skill does not ensure it will be done correctly.
When providing discharge instructions, the nurse recognizes that which client is most likely to comply with the therapeutic treatment regimen? The client with pneumonia who requires 1 week of oral antibiotics The patient with newly diagnosed type 2 diabetes who requires nutritional counseling The client with a positive tuberculosis skin test who requires 9 months of isoniazid The client with kidney failure who requires hemodialysis
Rates of adherence are generally low, especially when the regimens are complex or of long duration. One week of oral antibiotics has a higher likelihood of patient compliance. Nutritional education and compliance is long term and complex in nature; therefore, it entails a high risk for noncompliance. The 9-month duration of isoniazid therapy places this client in the high-risk category for noncompliance. Hemodialysis is long term and complex in nature; therefore, the client is at a high risk for noncompliance.
The nurse is coaching a client who stated a desire to stop smoking without medication. At several sessions to assess the client's success with agreed-upon interventions, the client reports barriers to each action and continues to smoke. What is the best action of the nurse? Inform the client that the results are disappointing. Refer the client for cognitive behavioral therapy. Discuss the client's case with a colleague. Inform the client that the client will be unable to quit without medication.
The focus is not to have the client please the nurse, but to improve client health behaviors. Telling a client that the client's efforts are disappointing is not an effective communication technique and can result in disruption of the therapeutic trust relationship between the nurse and client. The client does not necessarily need therapy just because initial attempts have been unsuccessful. The client desires not to have medication, so arranging for medications goes against the client's wishes in the plan of care. A colleague may shed light on additional actions based on experience with similar issues in the past.
In many situations, measurement of which of the following is the most accurate measurement technique to identify changes in patient behavior? Direct observation of behavior Use of rating scales Use of checklists Anecdotal notes
In many situations, measurement of actual behavior is the most accurate and appropriate technique. A variety of measurement techniques can be used to identify changes in patient behavior as evidence that learning has taken place. These techniques include directly observing the behavior; using rating scales, checklist, or anecdotal notes to document the behavior; and indirectly measuring results using oral questioning and written tests.
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? Intellectual development Motor development Emotional maturity Psychosocial development
Piaget's theory of intellectual development is a major learning theory. By understanding how children and adolescents develop learning abilities, the nurse can use this knowledge when teaching clients. School-age children are capable of logical reasoning and should be included in the teaching-learning process whenever possible. Teaching strategies that include clear explanations and reasons for procedures, stated in a simple and logical manner, are most successful. These children are open to new learning experiences but need learning to be reinforced by either a parent or health care personnel as they become more involved with their friends and school activities. Motor development would be focused on a hands-on skill for example, not the scientific explanation of the disease. Psychosocial development looks at stages of development and goals or tasks for different stages.
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 a school-age developmental level in an authoritarian style while the client was at meal time 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 Assessed the client's understanding of illness; assessed motor skills and developmental stage; provided clarification
Distractions to learning, such as the television being on or the client being at meal time, diminish the effectiveness of any education plan. An authoritarian style of teaching does not honor the client as a partner in the learning process. Age does not necessarily determine developmental stage. Assessing the client's developmental stage and understanding of the health problem, clarifying information that is difficult for the client to understand, and ensuring that the client is physically able to perform the task are all aspects of a well-planned education session for all clients.
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? The nurse writes one or two broad objectives rather than several specific objectives. The nurse writes general statements for learner objectives that could be accomplished in any amount of time. The nurse plans learner objectives with another nurse before obtaining input from the client and family. The nurse writes one long-term objective for each diagnosis, followed by several specific objectives.
The statement that best describes the proper method for writing objectives would be that the nurse writes one long-term objective for each diagnosis, followed by several specific objectives. The nurse would not use general statements that could be accomplished in any amount of time because this action is not addressing the specific needs of the client, and the setting in which the client is in. The nurse would not plan learner objectives with another nurse and would not always obtain input from the family of the client. The objectives need to be specific so the outcomes can be measured in the evaluation phase.
