Nurs 211: Chapter 9: Teaching and Counseling

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? "May I have something to eat?" "The pain in my chest has gone." "I am having difficulty breathing." "Finally, I am getting medical attention."

"I am having difficulty breathing."

A nurse is reviewing the teaching plan about heart failure with a client. The nurse determines that learning in the affective domain has been achieved based on which client statement? "I realize now just how important it is to watch how much salt I use." "I can identify the signs or symptoms of heart failure." "I understand why I need to take a water pill." "I know to call my provider if my ankles swell."

"I realize now just how important it is to watch how much salt I use."

The nurse is discussing the use of the patient-controlled analgesia pump with the postoperative patient. Which statement by the patient indicates a need for additional education? "I am able to push the button when I am in pain." "The dose is set so I cannot overdose myself." "I should not press the button more often than every 3 to 4 hours." "The medicine will help me control my pain."

"I should not press the button more often than every 3 to 4 hours."

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? Select all that apply. "Why are you repeatedly holding the injection at the wrong angle?" "Lots of people have the same concern." "You've just about figured out how to give yourself an injection." "It will be better if you ask someone responsible to administer the injection." "Try to angle the syringe a little more this way."

"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."

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

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

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

"Use flash cards and writing pads."

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?" "Support groups are for people like you who are depressed." "I am sure you would feel better if you joined a support group." "I am going to sign you up for a support group."

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

"You have made an amazing recovery."

Which client would be the best candidate for the nurse to engage in motivational interviewing? A 38-year-old client training to walk a half marathon A 44-year-old client who brought a food log to weight loss counseling A 66-year-old client who is showing improvement in range of motion A 28-year-old client with elevated blood glucose for 8 months

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

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 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 25-year-old female who just completed a course of physical therapy

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

A client states to the nurse, "I understand that I need a mastectomy for the treatment of my breast cancer, but I am fearful of learning about the drains I will need to empty." When responding to the client, the nurse will need to address which type of learning? Affective Psychomotor Cognitive Behavioral

Affective

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.

Allow ample time for psychomotor skills.

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 Pedagogy Psychomotor Affective

Andragogy

The nurse is planning to provide teaching to a client who is recovering from abdominal surgery. When is the most appropriate time to teach the client? When the meal tray arrives As the client is sitting quietly, reading a book At the time of pain medication administration Immediately before discharge to home

As the client is sitting quietly, reading a book

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

Ask the client to recall after approximately 15 minutes

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

Ask the client to recall after approximately 15 minutes.

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 Assuring the client that the conversation is confidential except under extreme circumstances Answering questions openly and honestly

Asking only the client's parents to be present at the education session

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. Labeling a diagram Assembling blocks Identifying the caregiver Watching television Building a house with popsicle sticks Removing the toys from the toy box

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

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 Eicit-provide-elicit Evoking change talk Prioritizing

Assessing importance

A nurse is preparing to educate about the importance of contraception and safe-sex practices to a group of college students. Which factors can affect the nurse's teaching strategies? Select all that apply. Availability of resources Learning style preferences of students Literacy level of target audience Family background of target audience Economic status of target audience

Availability of resources Learning style preferences of students Literacy level of target audience

The nurse uses the acronym TEACH when planning care for clients on a busy hospital ward. Which interventions accurately represent aspects of this acronym? Select all that apply. T—The nurse turns to the doctor for support. E—The nurse educates the client before treatment. A—The nurse acts on every teaching moment. C—The nurse clarifies often. H—The nurse helps the client cope when education fails. H—The nurse honors the client as a partner in the education process.

A—The nurse acts on every teaching moment. C—The nurse clarifies often. H—The nurse honors the client as a partner in the education process

The nurse is caring for a 60-year-old client with an improper bowel movement regimen. Which is the most appropriate method for the nurse to use in teaching this client? Refer the client to internet resources on proper bowel health. Have the client join a small group of other clients with the same problem and facilitate group discussions. Begin the session with a reference to the client's actual experience. Talk to the client's relatives and get a detailed account of the client's history.

Begin the session with a reference to the client's actual experience.

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

Blocking 30 minutes of time for skill 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 Developmental screening Immunizations Health education for children with autism

Car seat restraints Bicycle helmets Immunizations

Which statement about providing client education before discharge is most accurate? Client education focuses on identified home needs. Client education opens up communication with the community. Standardized plan of care is emphasized in client education. A client's beliefs and culture can hinder the success of education.

Client education focuses on identified home needs.

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 -Affective -Psychomotor -Interpersonal

Cognitive

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? Affective Psychomotor Cognitive Behavioral

Cognitive

When deciding what information the client needs to meet the learner objectives successfully, the nurse is formulating which part of the teaching plan? Content Teaching strategies Learning activities Learning domains

Content

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

Deficient Knowledge: Imbalanced nutrition: more than body requirements, and ineffective health maintenance.

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

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

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

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

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

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

The nurse is caring for a client who has been admitted for a new diagnosis of hypertension. When should the nurse begin client teaching? -During the admission process -After all of the diagnostic testing has been completed -After having venipuncture for laboratory work -Immediately prior to discharge

During the admission process

A nurse is teaching a 5-year-old boy who was recently diagnosed with type 1 diabetes. The client's mother, who is the primary caregiver, informs the nurse of having a fear of needles. What acttions are appropriate for the nurse to take to ensure a successful education session? Select all that apply. Ensuring 20 minutes of uninterrupted teaching time Using a doll to demonstrate giving an insulin injection Providing the client's mother with an informational pamphlet about insulin injection Asking the client's mother to leave the room to avoid distractions

Ensuring 20 minutes of uninterrupted teaching time Using a doll to demonstrate giving an insulin injection Providing the client's mother with an informational pamphlet about insulin injection

A nurse is caring for an older adult client with arthritis. Which action is the priority for the nurse when conducting the health education for the client? Divide information into manageable amounts. Find out what the client wants to know. Provide an environment that promotes learning. Identify how long the education session will last.

Find out what the client wants to know.

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. -Focus mainly on the mother; ask the child a couple of simple questions. -Provide the mother with written materials; teach the child about keeping the cast dry. -Separate the mother and the child; teach the mother and then let the mother teach the child.

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

During the health education session at the health care facility, the nurse notes that a client is able to recognize, describe to others, and explain the information learned. What is the final learning stage of the client in this case? Recall of the information being taught Independent use of new learning Involvement in the education in an active way Repetition of information for memorization

Independent use of new learning

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. -Impaired Walking; unilateral neglect. -Altered Mobility; able to tie shoes. -Dysfunctional Family Processes; family contact daily.

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. Keep the lighting in the room dim. Tie in new information with things the group is familiar with.

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.

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? -Role play -Lecture/discussion -Demonstration -Test taking

Lecture/discussion

A new client comes into the urgent care center with the spouse with a report of severe itchy rash with small blisters on the arms and hands. The nurse is documenting assessment data for the client. What is the nurse's best assessment action? Ask the spouse about know allergies. Ask the client about known allergies. Make an open-ended statement to the client to elicit the history of the rash. Make an open-ended statement to the spouse to elicit the history of the rash.

Make an open-ended statement to the client to elicit the history of the rash.

The nurse is preparing discharge teaching for a client with diabetes. Which information should the nurse include? Select all that apply. Meal planning Community resources Appropriate use of a glucometer Instructions to follow up with the health care provider Ways to pay for hospitalization and outpatient care charges

Meal planning Community resources Appropriate use of a glucometer Instructions to follow up with the health care provider

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? Long-term counseling Motivational counseling Short-term counseling Professional counseling

Motivational Counseling

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? -Long-term counseling -Motivational counseling -Short-term counseling -Professional counseling

Motivational counseling

A client with a body mass index (BMI) of 40.3 kg/m2 states, "I know I need to get rid of this fat. I just don't know how." Which is the best assessment for the nurse to make at this time? The client's understanding of BMI Past interventions for weight loss Dietary intake of the client that day History of obesity in family members

Past interventions for weight loss

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

Psychomotor

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

Personal perception of health and aging

A school nurse is discussing bike and outdoor safety measures with a group of Boy Scouts. What type of health education and counseling is the nurse providing to this group of children? Preventing illness Promoting health Restoring health Facilitating coping

Preventing illness

The nurse completed education with a client. Which documentation entry represents the mostcomplete teaching plan? -Start warfarin therapy initiated as prescribed; instructed to return to clinic for testing in 2 weeks. -Written and oral instructions given. Return demonstration performed accurately. -Discussed "Therapeutic Lifestyle Changes," printed materials reviewed, follow-up scheduled. -Printed and verbal information provided on gluten-free diet. Questions answered. Verbalizes understanding. Follow-up scheduled.

Printed and verbal information provided on gluten-free diet. Questions answered. Verbalizes understanding. Follow-up scheduled.

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

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

A pediatric nurse provides education to numerous clients. Which group of children benefits mostfrom being involved in the teaching-learning process? School-age children Infants Toddlers Preschoolers

School-age children

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

The nurse has completed teaching. Which client behavior demonstrates understanding within the affective domain? Provides return demonstration of use of an inhaler States, "I feel comfortable using my walker" Verbalizes key points of a brochure about diabetes that was read Provides a description of how appropriate wound healing should look

States, "I feel comfortable using my walker"

When teaching a client, the nurse notices the client tends to lose focus easily. The nurse would adapt client teaching in which way? -Request family members to serve as translators. -Provide less health teaching because of the language barrier. -Elongate the teaching session to be sure the client understands. -Talk with animation and vocal inflection to stimulate the client aurally.

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

When teaching a client, the nurse notices the client tends to lose focus easily. The nurse would adapt client teaching in which way? Request family members to serve as translators. Provide less health teaching because of the language barrier. Elongate the teaching session to be sure the client understands. Talk with animation and vocal inflection to stimulate the client aurally.

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

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

Tell me what you know about these tests.

Which observation during the nursing assessment of a client supports the documentation of low health literacy? The client is provides a coherent health history. The client's health forms are complete. The client complies with the medication regimen despite financial difficulties. The client avoids health care screenings and seeks care in the local emergency department.

The client avoids health care screenings and seeks care in the local emergency department.

A Chinese client who was previously treated at the health care facility for an open wound has been admitted again because the wound has become gangrenous. It has been identified that the client failed to understand proper wound care. What is the probable reason for the client failing to understand the instruction? -The client is not interested. -The client has a short attention span. -The client belongs to a different culture. -The client is a passive learner.

The client belongs to a different culture.

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

The client organizes materials needed and gives return demonstration.

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

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? -The health care team -The doctor and nurse -The nurse and the client -The client and the client's family

The nurse and the client

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 evaluates what the client has learned. 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 ignores the restrictions of the client's environment.

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 nurse writes one long-term objective for each diagnosis, followed by several specific objectives.

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

When admitting the client

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

When admitting the client

A client shares with the nurse how much the client appreciates understanding the physiology of breastfeeding. The client states, "I felt very comfortable with what you explained to me, and I feel I will be successful at breastfeeding." In affective learning, this represents the nurse: creating an educational opportunity for the future. creating an atmosphere for discussion of feelings. creating specific learning sessions for new information. creating an opportunity for rational thought and learning.

creating an atmosphere for discussion of feelings.

A nurse and client are working together to help the client make lifestyle changes to promote improved health. The nurse is having the client sign a contractual agreement for the work they will do together. Which statements by the nurse reflect the proper purposes of such agreements? Select all that apply. "When you sign this agreement, you must meet all goals." "This is a formal, legally binding document." "Our goals are defined, as are ways to meet them." "With this contract, we show that we are both dedicated to improving your health." "Because you signed this contract, you agree to follow the contract forever."

"Our goals are defined, as are ways to meet them." "With this contract, we show that we are both dedicated to improving your health."

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

Assess for cultural differences.

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

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

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 Cognitive Psychomotor Technical

Affective

When preparing client teaching materials, how does the nurse best assess a client's preferred learning style? Observe the client's behaviors. Provide teaching that works for the broadest base of clients. Ask the client, "Do you learn best by observing, valuing, or doing?" Determine client learning needs based on age and ability to hear effectively.

Ask the client, "Do you learn best by observing, valuing, or doing?"

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

Assess for cultural differences.

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

Deficient Knowledge: Imbalanced nutrition: more than body requirements, and ineffective health maintenance.

A couple has just learned that their newborn infant has a congenital cardiac anomaly that will require many lifestyle modifications, surgical corrections, and hospital stays. Place the following aspects of the couple's client education in the correct order that nurses should conduct them. 1. Determine their emotional readiness to learn. 2. Draft learning outcomes. 3. Select educational strategies. 4. Implement various educational techniques. 5. Revise the learning plan if needed

Determine their emotional readiness to learn. Draft learning outcomes. Select educational strategies. Implement various educational techniques. Revise the learning plan if needed.

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

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

The spouse of a client who has recently been diagnosed with early-stage Alzheimer's disease asks the nurse to recommend websites that may supplement the spouse's learning about this diagnosis. How should the nurse respond to the spouse's request? -Identify and recommend some credible websites appropriate to the spouse's learning needs. -Encourage the spouse to avoid online resources due to the unregulated nature of the Internet. -Direct the spouse to online databases such as the Cumulative Index to Nursing and Allied Health Literature. -Provide the spouse with print-based materials that are clearly referenced and reflect the spouse's learning style.

Identify and recommend some credible websites appropriate to the spouse's learning needs

The nurse has provided teaching for a client with a sinus infection who has been prescribed antibiotics and a decongestant. The client states, "I'm not sure how many days I'm supposed to take this antibiotic." What is the nurse's appropriate response? -Ask the client to restate the teaching that was provided. -Reteach the length of time to take the prescription. -Tell the client to take the antibiotic until symptoms subside. -Proceed with teaching about the decongestant.

Reteach the length of time to take the prescription.

Which diagnosis would best describe a situation in which a parent has a knowledge deficit concerning child safety for a toddler who is currently being treated for burns and was previously treated for a fracture from a fall? Knowledge Deficit: child safety, related to inexperience with the active developmental stage of a toddler Risk for Injury, related to mother's lack of knowledge about child safety Potential for Enhanced Parenting, related to child safety knowledge deficit Non-compliance: child safety, related to mother's lack of experience and socioeconomic level

Risk for Injury, related to mother's lack of knowledge about child safety

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

Tell me what you know about these tests.

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

The client and the nurse are equal participants.

A Chinese client who was previously treated at the health care facility for an open wound has been admitted again because the wound has become gangrenous. It has been identified that the client failed to understand proper wound care. What is the probable reason for the client failing to understand the instruction? The client is not interested. The client has a short attention span. The client belongs to a different culture. The client is a passive learner.

The client belongs to a different culture.

A nurse is educating a client with a new diagnosis of diabetes. Which example demonstrates cognitive learning by the client? -The client describes signs and symptoms of hypoglycemia. -The client demonstrates proper technique for injecting insulin. -The client expresses a desire to improve nutritional intake and lose weight. -The client prepares the skin for the administration of an insulin injection.

The client describes signs and symptoms of hypoglycemia.

A client, eager to go home from an acute care facility, calls out to have discharge education completed. The nurse is not able to get to the client's room until an hour later, and finds the client asleep. The client's significant other states, "She will be out for a couple hours after that pain medication." Which of the following best describes what must happen with the education session? The nurse cannot determine the subject matter to teach if the client is asleep. The client is not demonstrating readiness to learn due to the effects of medication. The significant other can be taught now, and then teach the client later on. The client can be awakened when she falls asleep during the session.

The client is not demonstrating readiness to learn due to the effects of medication.

Place the stages of learning in their order of progression. 1. The client reports the first symptom that appears. 2. A family member reminds the older adult to take pain relief medication on alternate days. 3. The client is now eating three servings of vegetables per day. 4. An adolescent organizes a "safe sex" seminar

The client reports the first symptom that appears. A family member reminds the older adult to take pain relief medication on alternate days. The client is now eating three servings of vegetables per day. An adolescent organizes a "safe sex" seminar.

A nurse is developing a contractual agreement with a client. Which statement is true of a contractual agreement? The contract serves to meet the client's learning outcomes. The contract is a formal agreement. The contract is legally binding. The contract serves to meet nursing goals.

The contract serves to meet the client's learning outcomes.

The nurse is planning client education based on the developmental stage of the client. Which nursing actions best reflect this consideration? Select all that apply. The nurse directs the health education for a 3-year-old to the parents. The nurse provides lengthy explanations of a procedure to a preschool child. The nurse includes a school-age child in the teaching and learning process. The nurse determines the learning needs of the client. The nurse avoids relating education for an adult to a social role. The nurse provides material that is useful immediately to adult clients.

The nurse directs the health education for a 3-year-old to the parents. The nurse includes a school-age child in the teaching and learning process. The nurse determines the learning needs of the client. The nurse provides material that is useful immediately to adult clients.

When teaching an adult client how to control stress through relaxation techniques, the nurse should proceed on the basis of which assumption concerning adult learners? As an adult matures, self-concept becomes more dependent; therefore, this client must be made aware of the importance of reducing stress. The adult learner is not as concerned with the immediate usefulness of the material being taught as with the quality of the material. As clients, adults are the least likely to resist learning because of preconceived ideas about the teaching-learning process. The nurse should be able to draw from the previous experience of the client to emphasize the importance of stress reduction.

The nurse should be able to draw from the previous experience of the client to emphasize the importance of stress reduction.

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 nurse writes one long-term objective for each diagnosis, followed by several specific objectives.

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

Their readiness to learn is often related to a developmental task or social role.

The nurse has completed teaching. Which client behaviors demonstrate understanding within the cognitive domain? Select all that apply. Provides return demonstration of use of an inhaler States, "I feel comfortable using my walker" Verbalizes key points of a brochure about diabetes that was read Provides a description of what appropriate wound healing should look like Expresses a belief system in a higher power

Verbalizes key points of a brochure about diabetes that was read Provides a description of what appropriate wound healing should look like

An adolescent client is being taught about changing an abdominal dressing as part of the education for care at home. On removing the dressing and seeing the surgical incision, the client becomes tearful. Which statement by the nurse is most appropriate to address the client's distress? -Your incision may look bad, but it is not infected. The redness along the incision line is normal the day after surgery and there is no reason to worry about it. -I am sorry if it hurts. The next time the dressing needs to be changed, we will give you some pain medication before we do it. -Your incision may look bad right now, but when it heals you will have a small scar about 3 in (7.5 cm) long that will fade over time. -Changing the dressing may look hard, but it is something you can learn to do. Next time the dressing needs to be changed, you can do it yourself, and I will be here to help you.

Your incision may look bad right now, but when it heals you will have a small scar about 3 in (7.5 cm) long that will fade over time.

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

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

The nurse is using teach-back to evaluate the client's understanding of new information given during discharge. Which statement indicates the use of this technique? "Will you promise to read these instructions when you go home?" "Is someone able to review the instructions with you?" "Please repeat to me the different signs and symptoms of stroke." "Use the instructions on this paper to clean your wounds at home."

"Please repeat to me the different signs and symptoms of stroke."

A home health nurse is visiting a 40-year-old client who has had abdominal surgery. The client is unable to change a dressing because of obesity. The nurse is to instruct the client's spouse on the sterile dressing technique. During the visit, the nurse notes that the spouse has limited abilities due to mental disabilities. One assessment to determine the spouse's literacy would be: to assess her motivation to provide care. to assess her educational records. to assess her manner of speech. to assess her reading with WRAT.

to assess her reading with WRAT.

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."

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

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." "I would like you to demonstrate how to change the dressing on your leg." "Let's see how you irrigate the wound with saline." "I notice that you do not have the dressing secured. Place a piece of tape on the wrap."

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

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." -"I would like you to demonstrate how to change the dressing on your leg." -"Let's see how you irrigate the wound with saline." -"I notice that you do not have the dressing secured. Place a piece of tape on the wrap."

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

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

"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? -"There are many options available. Which options have you previously tried?" -"What do you see as your biggest hurdle to stopping?" -"Some people find that reducing cigarette consumption slowly over time is an effective option." -"Most clients are successful when they use over-the-counter nicotine patches or gum."

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

Which statements made by the nurse would facilitate a teaching session for adult clients? Select all that apply. -"Wait a moment please; let me see if we have covered the planned teaching content." -"Does anyone have any barriers that would make it difficult to see or hear the audiovisuals?" -"This will be a short presentation followed by 15 minutes of questions and answers." -"I am documenting the date, time, and content taught today." -"We will have our presentation in this room because it is quieter and has less distractions." -"This session will only last for 30 minutes."

-"Does anyone have any barriers that would make it difficult to see or hear the audiovisuals?" -"This will be a short presentation followed by 15 minutes of questions and answers." -"We will have our presentation in this room because it is quieter and has less distractions." -"This session will only last for 30 minutes."

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 45-year-old female who is unsure of the benefit of psychiatric care, on a fixed income, and has good family support -A 51-year-old male who walks to most places because of a lack of transportation, has a low income, and works days -A 36-year-old male who uses public transportation, is unable to read, and wants to confer with a pastor -A 28-year-old female who works nights, is willing to try, and asks about insurance coverage of the appointment

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

When preparing client teaching materials, how does the nurse best assess a client's preferred learning style? -Observe the client's behaviors. -Provide teaching that works for the broadest base of clients. -Ask the client, "Do you learn best by observing, valuing, or doing?" -Determine client learning needs based on age and ability to hear effectively.

Ask the client, "Do you learn best by observing, valuing, or doing?"

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 By fulfilling the client's requirements By assisting the client's learning By reducing chances of any miscommunication

By implementing effective teaching

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

Cognitive learning theory

The nurse is caring for a client who has been admitted for a new diagnosis of hypertension. When should the nurse begin client teaching? During the admission process After all of the diagnostic testing has been completed After having venipuncture for laboratory work Immediately prior to discharge

During the admission process

A nurse is forming an education plan for a client who is being discharged from the nursing unit after cardiac catheterization. Which diagnosis and intervention are most appropriate for this client? Knowledge Deficient: Risk for altered perfusion secondary to re-occlusion Knowledge Deficient: Altered urinary output related to catheterization Knowledge Deficient: Impaired mobility related to lying flat for 8 hours Knowledge Deficient: Risk for ineffective breathing pattern related to incisional pain

Knowledge Deficient: Risk for altered perfusion secondary to re-occlusion

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

Observing a mother expressing the breast milk

The nurse is preparing to teach a client about postsurgical care after a laparoscopic cholecystectomy. Which factor should the nurse most consider when determining whether the client is ready and able to learn? Physical condition Emotional health Social and economic stability Culture

Physical condition

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 Motivation Health promotion Positive feedback

Positive feedback

A client who recently underwent a coronary artery bypass graft is taking furosemide and metoprolol following the procedure. While developing a plan for a heart-healthy diet with the nurse, the client states that diet did not contribute to the heart disease and that the client should be fine just continuing to take the medications. According to the Transtheoretical Model of Change, which stage of change is the client in related to diet? Contemplation Preparation Precontemplation Maintenance

Precontemplation

A nurse evaluates whether a middle-age client with chronic back pain has been performing the different exercises and physiotherapy procedures recommended by the physician. What would the nurse most likely use to evaluate the client? -Written test -Oral test -Return demonstration -Simulation

Return demonstration

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

Their readiness to learn is often related to a developmental task or social role.

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."

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

A nurse is assessing a client who has come to the clinic for a follow-up appointment. The client was diagnosed with asthma several months ago and has missed several appointments since that time. The client also has not been following the medication plan and has not kept the appointment for allergy testing. The nurse suspects that the client may be experiencing problems with health literacy. The nurse teaches the client about the condition and prescribed treatment. Which question from the nurse would help to assess the client's health literacy about the condition? "Do you understand what asthma is?" "How are you supposed to take your medication?" "Are you having trouble getting your medications filled?" "Do you have any questions about what you are supposed to do?"

"How are you supposed to take your medication?"

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 can lower my blood pressure by losing weight." "Osteoarthritis in my knees may be because of my weight." "I can monitor my caloric intake by measuring portions." "I will be doing well if I lose between 5 and 10 lb (2.3 and 4.5 kg) per week."

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

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? "Over time this will all just be a memory. You will adjust to the changes." "You have had a tremendous loss. What are your plans for shelter tonight?" "You have lost everything. I guess family will be taking you in for a while." "I cannot believe the destruction. I would not know where to begin to rebuild."

"You have had a tremendous loss. What are your plans for shelter tonight?"

Which topics would the nurse be most likely to explore with a client with the aim of restoring health? Select all that apply. -Education of a client about living with a suprapubic catheter -Postoperative teaching for the client after prostate surgery -Informing the client regarding community resources -Instruction to a group of clients about performance of CPR -Orientation to treatment center and staff -The medical and nursing regimens and how the client can participate in care

-Education of a client about living with a suprapubic catheter -Postoperative teaching for the client after prostate surgery -Orientation to treatment center and staff -The medical and nursing regimens and how the client can participate in care