Theory final PrepU ch. 21
When a patient says, "I don't care if I get better; I have nothing to live for, anyway," which type of counseling would be appropriate? a) Professional counseling b) Long-term counseling c) Short-term counseling d) Motivational counseling
Motivational counseling Explanation: The most appropriate counseling for the situation at hand would be motivational counseling. With motivational counseling, the nurse would discuss feelings and incentives with the client. Short-term counseling focuses on the immediate problem or concern of the patient or family. It can be a relatively minor concern or a major crisis, but in any case, it needs immediate attention. Long-term counseling extends over a prolonged period. A patient might need the counsel of the nurse at daily, weekly, or monthly intervals. A patient experiencing a developmental crisis, for example, might need long-term counseling. Professional counseling is a general term.
When a nurse is planning for learning, who must decide who should be included in the learning sessions? a) The nurse and the patient b) The doctor and nurse c) The health care team d) The patient and the patient's family
The nurse and the patient Explanation: The nurse and the client should be the individuals who decide who should be included in the learning sessions. The nurse cannot assume that family members are wanted by the client to be included. The client must always be included in the learning session
The nurse is visiting a client who was released from inpatient rehabilitation 6 weeks ago after a 5-month recovery after a motor vehicle accident that left him immobile. As the nurse enters the home, the client braces his hands on the arms of his chair to rise and uses crutches to walk across the room. What is the best response by the nurse? a) "You have made an amazing recovery." b) "Those physical therapists work wonders. c) "Let me document that you can walk." d) "Are you supposed to be out of the wheelchair?"
"You have made an amazing recovery." Explanation: Reinforcement of learning shows that the nurse supports and wants to encourage the client. Giving credit where it is due communicates these values. Documenting is necessary, but stating this does not show interest in the client's progress. Crediting the therapists does not encourage the client. Asking about permission to ambulate negates the goal for improving wellness
The nurse observes that a client responds better to health education when the nurse motivates him and assures him about the benefits of the teaching. In which of the following learning domains does the client's learning style fall? a) Psychomotor domain b) Affective domain c) Cognitive domain d) Interpersonal domain
Affective domain Explanation: Since the client responds better to health education when he is motivated and is assured about its benefits, the client's learning style falls into the affective domain. The affective domain is a style of processing that appeals to a person's feelings, beliefs, or values. This learning style would be suitable for this client. The cognitive domain is a style of processing information by listening to, or reading, facts and descriptions. The psychomotor domain is a style of processing that focuses on learning by doing. The interpersonal domain is a style of processing that focuses on learning through social relationships
The nurse is assigned to a newly wounded soldier who lost a leg in combat and is coming to the unit after surgery. Which learning diagnosis is most important for this client? a) Knowledge deficient: Ineffective health maintenance related to altered fluid balance. b) Knowledge deficient: Ineffective therapeutic regimen related to leg amputation. c) Knowledge deficient: Risk for falls related to traumatic amputation. d) Knowledge deficient: Non-compliance related to risk-taking behaviors.
Knowledge deficient: Risk for falls related to traumatic amputation. Explanation: Ineffective health maintenance and altered fluid balance are two separate nursing diagnoses, and therefore are separate problems. Because the client is coming out of surgery, it is too soon to determine compliance, behaviors, or efficacy of therapy. Safety is always priority, and a client who has experienced a traumatic amputation may not be aware of the missing limb. Therefore, fall-risk issues must be addressed to maintain the client's safety.
A nurse may attempt to help a patient solve a situational crisis during what type of counseling session? a) Professional counseling b) Long-term counseling c) Motivational counseling d) Short-term counseling
Short-term counseling Explanation: Short-term counseling would help a client solve a situational crisis. A patient 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 patient. Professional counseling is a general term
A client is reluctant to learn to do finger sticks for her home INR monitoring. What is the best statement by the nurse? a) Most people are afraid of sticking themselves. b) Why don't you want to do this? c) Tell me what you know about these tests. d) Are you worried about the pain?
Tell me what you know about these tests. Explanation: Saying something to encourage the client to openly discuss personal issues is the best option. Assessing worry about pain narrows the client's answer to only addressing pain. Asking "why" questions may be considered probing or accusatory and tends to block communication. Grouping the client into generalizations is belittling. Assessing the client's perceptions about checking the INR opens up the discussion about the client's barrier to learning to perform this test
