Chapter 9: Teaching and Counseling

A nurse forms a contractual agreement with a morbidly obese patient to achieve optimal weight goals. Which statement best describes the nature of this agreement? "This agreement forms a legal bond between the two of us to achieve your weight goals." "This agreement will motivate the two of us to do what is necessary to meet your weight goals." "This agreement will help us determine what learning outcomes are necessary to achieve your weight goals." "This agreement will limit the scope of the teaching session and make stated weight goals more attainable."

"This agreement will motivate the two of us to do what is necessary to meet your weight goals." A contractual agreement is a pact two people make, setting out mutually agreed-on goals. Contracts are usually informal and not legally binding. When teaching a patient, such an agreement can help motivate both the patient and the teacher to do what is necessary to meet the patient's learning outcomes. The agreement notes the responsibilities of both the teacher and the learner, emphasizing the importance of the mutual commitment.

10. Which of the following strategies might a nurse use to increase compliance with teaching? A) Include the patient and family as partners. B) Use short, simple sentences for all ages. C) Provide verbal instruction at all times. D) Maintain clear role as the authority.

A) Include the patient and family as partners.

8. According to Rosenstock, which of the following are health beliefs critical for patient motivation? Select all that apply. A) Patients view themselves as susceptible to the disease in question. B) Patients view the disease as a serious threat. C) Patients believe there are actions they can take to reduce the probability of contracting the disease. D) Patients believe the threat of taking these actions is greater than the disease itself. E) Patients view themselves as victims of the disease in question. F) Patients feel powerless to modify their perception of disease susceptibility.

A) Patients view themselves as susceptible to the disease in question. B) Patients view the disease as a serious threat. C) Patients believe there are actions they can take to reduce the probability of contracting the disease.

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. Explanation: 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. Chapter 9: Teaching and Counseling - Page 189

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 Explanation: Andragogy is the art and science of helping adults learn. Pedagogy is the academic discipline that deals with the theory and practice of teaching and how these influence student learning. Psychomotor learning is demonstrated by physical skills such as movement. Affective learning is growth in feelings or emotional areas (attitude or self). Chapter 9: Teaching and Counseling - Page 198-199

The nurse is teaching a client with diabetes how to inject daily insulin. Which method is most effective in evaluating the teaching? Ask the client to repeat the steps of injection in order. The nurse uses a brochure to explain how to give an injection. Ask the client to demonstrate how to self-inject the morning insulin. Provide a teaching session that includes a question and answer discussion.

Ask the client to demonstrate how to self-inject the morning insulin. Explanation: By using the teach-back method, the nurse teaches and demonstrates a skill, then the client returns the skill as if teaching the nurse how it is done. This is an effective way to determine the client's ability to independently perform a skill. Asking the client to repeat the steps is good, but self-administering the injection is a better indicator. A brochure could be used as a teaching aid, but it is not the most effective means of determining if the client can perform the skill. Providing a teaching session that includes questions and answers should be done; however, the client should demonstrate the skill. Chapter 9: Teaching and Counseling - Page 191-199

2. A nurse in a neighborhood clinic is conducting educational sessions on weight loss. What aim of nursing is met by these educational programs? A) practicing advocacy B) preventing illness C) restoring health D) facilitating coping

B) preventing illness

12. A young mother asks the nurse in a pediatric office for information about safety, diet, and immunizations for her baby. Which nursing diagnosis would be appropriate for this patient? A) Knowledge Deficit: Infant care B) Impaired Health Maintenance C) Readiness for Enhanced Parenting D) Readiness for Enhanced Coping

C) Readiness for Enhanced Parenting

16. A mother of a toddler wants to learn how to do CPR. What teaching strategy would be most effective in helping her learn? A) lecture B) discussion C) demonstration D) discovery

C) demonstration

7. What patient characteristic is important to assess when using the health belief model as the framework for teaching? A) developmental level B) source of information C) motivation to learn D) family support

C) motivation to learn

22. An elderly patient is very stressed about who will care for his pets while he is hospitalized for a fall that caused a fractured hip and hospitalization. What type of counseling would the nurse conduct? A) none B) long-term C) short-term D) motivational

C) short-term

When caring for a client, the nurse observes that the client enjoys reading books and magazines. In which learning domain does the client's learning style fall? Cognitive Affective Psychomotor Interpersonal

Cognitive Explanation: As the client enjoys reading books and magazines, the client's learning style would fall in the cognitive domain, where information is processed by listening or reading facts and descriptions. The affective domain is a style of processing that appeals to a person's feelings, beliefs, or values. 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. Chapter 9: Teaching and Counseling - Page 199

6. A nurse is designing a teaching program for individuals who have recently immigrated to the United States from Iraq. Which of the following considerations is necessary for culturally competent patient teaching? A) Use materials developed previously for U.S. citizens. B) Use all visual materials when teaching content. C) Use a lecture format to teach content with few questions. D) Develop written materials in the patients native language.

D) Develop written materials in the patients native language.

21. What word or phrase best describes an effective counselor? A) technically skilled B) knowledgeable C) practical D) caring

D) caring

A nurse is preparing to teach a patient with asthma how to use his inhaler. Which teaching method would be the BEST choice to teach the patient this skill? Demonstration Lecture Discovery Panel session

Demonstration Demonstration of techniques, procedures, exercises, and the use of special equipment is an effective patient-teaching strategy for a skill. Lecture can be used to deliver information to a large group of patients but is more effective when the session is interactive; it is rarely used for individual instruction, except in combination with other strategies. Discovery is a good method for teaching problem-solving techniques and independent thinking. Panel discussions can be used to impart factual material but are also effective for sharing experiences and emotions.

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 client is not ready or able to learn and is reporting a need that first must be met. Assessing the client's knowledge of self-care or redirecting the client to discuss self-care only delays the care that must be done before the client is able to learn. Although providing written materials is an excellent supplement to a teaching session, it does not replace teaching the client. It is best to address the physical needs before attempting to educate the client. Chapter 9: Teaching and Counseling - Page 187

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 Explanation: Observing is one of the levels of psychomotor skills, which involves watching an experienced person perform a physical skill. Telling, showing, and advising are examples of addressing the cognitive domain, which helps the mothers process information by listening or reading facts. Chapter 9: Teaching and Counseling - Page 204

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

Past interventions for weight loss Explanation: Gaining insight into the client's knowledge of obesity and family history of obesity may be helpful, but they do not address the client's statement of not knowing how to lose weight. Dietary intake for one day is not as helpful as a daily log, which gives a better overview of dietary habits. Assessing the client's past actions for weight loss addresses the client's immediate concern, takes advantage of a teachable moment, and helps establish a baseline of what the client understands about weight loss. With this understanding, the nurse has a starting point to begin educating the client. Chapter 9: Teaching and Counseling - Page 194

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 Explanation: Knowing about the client's orthopedic history, religious beliefs, and barriers to mobility in the home are all helpful for an overall plan of care, but do not address individualism. Gaining insight into the client's own perceptions of health and aging, however, will allow the nurse to tailor the plan of care to the client's personal needs. Chapter 9: Teaching and Counseling - Page 208

A nurse is teaching first aid to counselors of a summer camp for children with asthma. This is an example of what aim of health teaching? Promoting health Preventing illness Restoring health Facilitating coping

Preventing illness Teaching first aid is a function of the goal to prevent illness. Promoting health involves helping patients to value health and develop specific health practices that promote wellness. Restoring health occurs once a patient is ill, and teaching focuses on developing self-care practices that promote recovery. When facilitating coping, nurses help patients come to terms with whatever lifestyle modification is needed for their recovery or to enable them to cope with permanent health alterations.

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. Explanation: Effective learning occurs when clients and health care professionals are equal participants in the teaching-learning process, not when the nurse is viewed as the expert. Although it is important for the nurse to be able to handle criticism and to understand and apply psychomotor concepts when teaching, these are not as important as viewing the client and nurse as equal participants. Chapter 9: Teaching and Counseling - Page 161-162

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. Explanation: The client's ability to describe the signs and symptoms of hypoglycemia demonstrates cognitive learning (the storing and recalling of new knowledge in the brain). Demonstrating a skill, such as insulin injection, is an example of psychomotor learning. Affective learning includes changes in attitudes, values, and feelings (e.g., desire to lose weight). Chapter 9: Teaching and Counseling - Page 185

A nurse is planning teaching strategies based on the affective domain of learning for patients addicted to alcohol. What are examples of teaching methods and learning activities promoting behaviors in this domain? Select all that apply. The nurse prepares a lecture on the harmful long-term effects of alcohol on the body. The nurse explores the reasons alcoholics drink and promotes other methods of coping with problems. The nurse asks patients for a return demonstration for using relaxation exercises to relieve stress. The nurse helps patients to reaffirm their feelings of self-worth and relate this to their addiction problem. The nurse uses a pamphlet to discuss the tenants of the Alcoholics Anonymous program to patients. The nurse reinforces the mental benefits of gaining self-control over an addiction.

The nurse explores the reasons alcoholics drink and promotes other methods of coping with problems. The nurse helps patients to reaffirm their feelings of self-worth and relate this to their addiction problem. The nurse reinforces the mental benefits of gaining self-control over an addiction. Affective learning includes changes in attitudes, values, and feelings (e.g., the patient expresses renewed self-confidence to be able to give up drinking). Cognitive learning involves the storing and recalling of new knowledge in the brain, such as the learning that occurs during a lecture or by using a pamphlet for teaching. Learning a physical skill involving the integration of mental and muscular activity is called psychomotor learning, which may involve a return demonstration of a skill.

A nurse is teaching patients of all ages in a hospital setting. Which examples demonstrate teaching that is appropriately based on the patient's developmental level? Select all that apply. The nurse plans long teaching sessions to discuss diet modifications for an older adult diagnosed with type 2 diabetes. The nurse recognizes that a female adolescent diagnosed with anorexia is still dependent on her parents and includes them in all teaching sessions. The nurse designs an exercise program for a sedentary older adult male patient based on the activities he prefers. The nurse includes an 8-year-old patient in the teaching plan for managing cystic fibrosis. The nurse demonstrates how to use an inhaler to an 11-year-old male patient and includes his mother in the session to reinforce the teaching. The nurse continues a teaching session on STIs for a sexually active male adolescent despite his protest that "I've heard enough already!"

The nurse designs an exercise program for a sedentary older adult male patient based on the activities he prefers. The nurse includes an 8-year-old patient in the teaching plan for managing cystic fibrosis. The nurse continues a teaching session on STIs for a sexually active male adolescent despite his protest that "I've heard enough already!" Successful teaching plans for older adults incorporate extra time, short teaching sessions, accommodation for sensory deficits, and reduction of environmental distractions. Older adults also benefit from instruction that relates new information to familiar activities or information. School-aged children are capable of logical reasoning and should be included in the teaching-learning process whenever possible; they are also open to new learning experiences but need learning to be reinforced by either a parent or health care provider as they become more involved with their friends and school activities. Teaching strategies designed for an adolescent patient should recognize the adolescent's need for independence, as well as the need to establish a trusting relationship that demonstrates respect for the adolescent's opinions.

A registered nurse assumes the role of nurse coach to provide teaching to patients who are recovering from a stroke. Which nursing intervention directly relates to this role? The nurse uses discovery to identify the patients' personal goals and create an agenda that will result in change. The nurse is the expert in providing teaching and education strategies to provide dietary and activity modifications. The nurse becomes a mentor to the patients and encourages them to create their own fitness programs. The nurse assumes an authoritative role to design the structure of the coaching session and support the achievement of patient goals.

The nurse uses discovery to identify the patients' personal goals and create an agenda that will result in change. A nurse coach establishes a partnership with a patient and, using discovery, facilitates the identification of the patient's personal goals and agenda to lead to change rather than using teaching and education strategies with the nurse as the expert. A nurse coach explores the patient's readiness for coaching, designs the structure of a coaching session, supports the achievement of the patient's desired goals, and with the patient determines how to evaluate the attainment of patient goals.

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. Explanation: 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. Chapter 9: Teaching and Counseling - Page 198

The nurse needs to understand the teaching-learning process when administering physician-initiated interventions. educational interventions. technical interventions. psychosocial interventions.

educational interventions. Explanation: Educational interventions require the application of the teaching-learning process. The other interventions listed would not, as their primary goal is not to educate the client. Chapter 9: Teaching and Counseling - Page 185

A nurse is counseling a 19-year-old athlete who had his right leg amputated below the knee following a motorcycle accident. During the rehabilitation process, the patient refuses to eat or get up to ambulate on his own. He says to the nurse, "What's the point. My life is over now and I'll never be the football player I dreamed of becoming." What is the nurse counselor's best response to this patient? "You're young and have your whole life ahead of you. You should focus on your rehabilitation and make something of your life." "I understand how you must feel. I wanted to be a famous singer, but I wasn't born with the talent to be successful at it." "You should concentrate on other sports that you could play even with prosthesis." "I understand this is difficult for you. Would you like to talk about it now or would you prefer me to make a referral to someone else?"

"I understand this is difficult for you. Would you like to talk about it now or would you prefer me to make a referral to someone else?" This answer communicates respect and sensitivity to the patient's needs and offers an opportunity to discuss his feelings with the nurse or another health care professional. The other answers do not allow the patient to express his feelings and receive the counseling he needs.

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 best motivational 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?" Explanation: Adults learn best when the information given to them will be used immediately, is presented as important to the client, and when the client's autonomy is preserved. As with all learners, the teaching approach must reflect respect for what the client already knows. By presenting the facts in a way that gives the client control over a health alteration, and by assessing current knowledge, these qualities that are important to forming a learning plan for an adult are met. When education plans take control out of the client's hands (such as stating the doctor wants compliance) or when the lifestyle change is presented as a burden, motivation may be low. If the nurse shows interest in working with and discussing issues with the client, a partnership is formed that can boost motivation. Chapter 9: Teaching and Counseling - Page 188-189

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." 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. Chapter 9: Teaching and Counseling - Page 204

23. A nurse is using motivational interviewing to find out why a patient refuses to participate in the recommended rehabilitation program. Which of the following is an example of using the skill of reflective listening to help motivate this patient? A) So, you feel that you are not ready to start a program this week? B) Why do you feel that you are not ready to start rehabilitation? C) I understand that you are afraid to start rehabilitation where do you see yourself in a week? D) Remember we discussed what needs to be done to get you back on your feet How do you feel about getting started?

A) So, you feel that you are not ready to start a program this week?

5. A nursing faculty member is teaching a class of second-degree students who have an average age of 32. What is important to remember when teaching adult learners? A) a focus on the immediate application of new material B) a need for support to reduce anxiety about new learning C) older students may feel inferior in terms of new learning D) all students, regardless of age, learn the same

A) a focus on the immediate application of new material

15. A nurse is writing learning outcomes for a patient recovering from severe burns. Which of the following verbs would be good choices to use when preparing outcomes related to learning how to change dressings? Select all that apply. A) assembles B) demonstrates C) gives examples D) identifies E) chooses F) values

A) assembles B) demonstrates

A diabetes nurse educator is teaching a patient, newly diagnosed with diabetes, about his disease process, diet, exercise, and medications. What is the goal of this teaching? A) to help the patient develop self-care abilities B) to ensure the patient will return for follow-up care C) to facilitate complete recovery from the disease D) to implement ordered teaching and counseling

A) to help the patient develop self-care abilities

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 Explanation: A client is most ready to learn when the client is comfortable, nourished, pain-free, and has time to learn. It is not an appropriate time to educate the client when the meal tray arrives, at the time of pain medication administration, or immediately before discharge home, as the client may be distracted. Chapter 9: Teaching and Counseling - Page 184-205

A nurse is preparing to teach a client about the importance of contraception and safe-sex practices. Which factors can most affect the nurse's teaching strategies for this client? Select all that apply. Available resources Learning style preferences Literacy level Size of family The client's job

Available resources Learning style preferences Literacy level Availability of resources, learning style preference, and literacy level affect the planning of effective teaching strategies. The size of family and client's job would not be factors which the nurse should prioritize when planning this teaching session. They would only be considered if the nurse determined they could affect the outcome of the teaching session. Chapter 9: Teaching and Counseling - Page 187

11. A nurse teaching a new mother how to bathe her infant uses the acronym TEACH to maximize the effectiveness of the teaching plan. Which of the following are guidelines based on this acronym? Select all that apply. A) Tune out the individual patient. B) Edit patient information. C) Act on every teaching moment. D) Always refer a patient to counseling. E) Clarify often. F) Honestly answer patient questions.

B) Edit patient information. C) Act on every teaching moment. E) Clarify often.

9. The National Patient Safety Foundation recently collaborated with the Partnership for Clear Health Communication (2007) to create awareness of the need for improved health literacy and developed the Ask Me 3 tool. Which of the following is an Ask Me 3 question? Select all that apply. A) Who will be my healthcare provider? B) What is my main problem? C) What do I need to do? D) Where will I get help? E) Why is it important for me to do this? F) When will I start my program?

B) What is my main problem? C) What do I need to do? E) Why is it important for me to do this?

17. A nurse asks a patient to tell him the side effects of a medication. What learning domain is the nurse evaluating? A) affective B) cognitive C) psychomotor D) emotional

B) cognitive

13. Developing a teaching plan is comparable to what other nursing activity? A) documenting in the nurses notes B) formulating a nursing care plan C) performing a complex technical skill D) using a standardized form or format.

B) formulating a nursing care plan

18. When is the best time to evaluate ones own teaching effectiveness? A) during the teaching session B) immediately after a teaching session C) 1 week after the teaching session D) 1 month after the teaching session

B) immediately after a teaching session

A nurse has taught a patient with diabetes how to administer his daily insulin. How should the nurse evaluate the teaching-learning process? By determining the patient's motivation to learn By deciding if the learning outcomes have been achieved By allowing the patient to practice the skill he has just learned By documenting the teaching session in the patient's medical record

By deciding if the learning outcomes have been achieved The nurse cannot assume that the patient has actually learned the content unless there is some type of proof of learning. The key to evaluation is meeting the learner outcomes stated in the teaching plan.

4. Which of the following is an essential component of the definition of learning? A) increases self-esteem B) decreases stress C) can be measured D) cannot be measured

C) can be measured

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 Explanation: Cognitive learning theory is the result of people wanting to make sense of the world around them by assimilating and processing information to gain new understandings and insights. Developmental learning theory focuses on considering the client's physical maturation and abilities, psychosocial development, and cognitive capacity when providing education. Behavioral learning theory focuses on how one learns and unlearns behaviors. Adaptive learning theory explains how learning is optimized when teaching is adapted to the particular learning style of the learner. Chapter 9: Teaching and Counseling - Page 193-210

19. A 42-year-old male patient recovering from a MI is having difficulty following the care plan to stop smoking and exercise. What is the nurses best response to this patient? A) Praise him for any efforts he makes to improve his health. B) Tell him that he will have another MI and it will be his own fault. C) Tell him that his cigarettes will be taken away if he smokes again. D) Ignore the behavior and recommend a behavior modification program.

D) Ignore the behavior and recommend a behavior modification program.

14. A student is developing a teaching plan for her assigned patient. The student wants to teach the patient about what symptoms to report after chemotherapy. What would the student need to do first? A) Ask other students what should be included in content. B) Ask the patient what he or she wants to know. C) Tell the instructor that this topic hasnt been covered yet. D) Review information available in writing and on the Internet

D) Review information available in writing and on the Internet

20. What is the most critical element of documentation of teaching? A) a summary of the teaching plan B) the implementation of the teaching plan C) the patient need for learning D) evidence that learning has occurred

D) evidence that learning has occurred

3. A nurse refers a patient with a new colostomy to a support group. This nurse is practicing which of the following aims of nursing? A) promoting health B) preventing illness C) restoring health D) facilitating coping

D) facilitating coping

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. Explanation: Motivating the older adult client can be done by showing the client how the new knowledge will improve the client's quality of life, regardless of how long that may be. It will also demonstrate how the new knowledge could improve the client's level of independence. Although demonstrating the use of the walker and explaining how the walker assists with ambulation (and the rationale for its use) can be used to educate the client, these actions would not promote motivation for the client to learn. Chapter 9: Teaching and Counseling - Page 194-195

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. Explanation: School-age children are able to make decisions and provide care for themselves. Focusing mainly or only on the mother fails to validate the child's abilities, and teaching the mother and the child separately does not make good use of time. Chapter 9: Teaching and Counseling - Page 210

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 Explanation: 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. Chapter 9: Teaching and Counseling - Page 208

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

Psychomotor 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. Chapter 9: Teaching and Counseling - Page 193-198-199

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

Psychomotor Psychomotor refers to the muscular movements learned to perform new skills and procedures, such as breastfeeding. Affective learning involves engagement of the client's emotions. Cognitive learning involves engagement of the client's critical thinking and reason. Simplistic is not a formal type of learning, and assisting a new mother with breastfeeding is not simplistic. Chapter 9: Teaching and Counseling - Page 193-211

A nurse is caring for a patient who is admitted to the hospital with injuries sustained in a motor vehicle accident. While he is in the hospital, his wife tells him that the bottom level of their house flooded, damaging their belongings. When the nurse enters his room, she notes that the patient is visibly upset. The nurse is aware that the patient will most likely be in need of which type of counseling? Long-term developmental Short-term situational Short-term motivational Long-term motivational

Short-term situational Short-term counseling might be used during a situational crisis, which occurs when a patient faces an event or situation that causes a disruption in life, such as a flood. Long-term counseling extends over a prolonged period; a patient experiencing a developmental crisis, for example, might need long-term counseling. Motivational interviewing is an evidence-based counseling approach that involves discussing feelings and incentives with the patient. A caring nurse can motivate patients to become interested in promoting their own health.

A nurse is teaching a 50-year-old male patient how to care for his new ostomy appliance. Which teaching aid would be most appropriate to confirm that the patient has learned the information? Ask Me 3 Newest Vital Sign (NVS) Teach-back method TEACH acronym

Teach-back method The teach-back tool is a method of assessing literacy and confirming that the learner understands health information received from a health professional. The Ask Me 3 is a brief tool intended to promote understanding and improve communication between patients and their providers. The NVS is a reliable screening tool to assess low health literacy, developed to improve communications between patients and providers. The TEACH acronym is used to maximize the effectiveness of patient teaching by tuning into the patient, editing patient information, acting on every teaching moment, clarifying often, and honoring the patient as a partner in the process.

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. emotions or feelings. muscular movements. physical demonstration.

critical thinking. Explanation: Cognitive learning refers to rational thought or critical thinking. Affective learning is influenced by emotions or feelings. Psychomotor learning refers to the muscular movements learned to perform new skills and procedures; for example, when a mother successfully and independently breastfeeds an infant, the mother has physically demonstrated psychomotor learning. Chapter 9: Teaching and Counseling - Page 193