Community: Chapter 20 Health Teaching

: p. 514 17. Which of the following would be the best question for a nurse to ask to determine whether an educational intervention had any effect? a. "Are you interested in any other topics for me to teach?" b. "Did you find this program useful to you?" c. "Do you understand the material I presented?" d. "How are you going to apply these ideas at home?"

: D Only "How are you going to apply these ideas at home?" will elicit responses that demonstrate whether the learner understood what was said and is willing to use the information in his or her life. It is also an excellent discussion question. Assessment of learner outcomes has traditionally been based on achievement of the behavioral objectives. DIF: Cognitive Level: Application

1. For whom are patient education programs very helpful? a. Adults and families who can learn to avoid health problems b. Adults and families, who will all be clients in the future c. People who wish to learn how best to use the health care system d. People with an identified health problem

: D Patient education describes teaching-learning activities for people with an identified alteration in health. Health education focuses on helping healthy groups maintain or improve their health. DIF: Cognitive Level: Knowledge

: p. 509 10. The nurse distributed written materials with culturally appropriate pictures to the small groups in the audience and began to lecture on the important content before the planned discussion period. However, no one was listening. What should the nurse have done differently? a. Created a more interesting and entertaining lecture b. Withheld the written materials until after the lecture c. Let the audience discuss the material as a whole, not in small groups d. Skipped the lecture and went directly to the discussion period

: B Wait to make group assignments and to give handouts for group activity until after you have given the final instructions; otherwise, people will be reading instead of listening to you. DIF: Cognitive Level: Application

: p. 512 11. Which of the following statements best demonstrates an appropriately written behavioral objective? a. "The learner will be able to verbally explain the need for political action." b. "The panel of experts will have discussed knowledge, assumptions, and cultural values." c. "The participant will understand the material presented." d. "The teacher will distribute and collect evaluation forms."

: A Behavioral objectives focus on the learner and what the learner demonstrates in terms of knowledge, attitudes, or beliefs. Understanding is not observable, whereas an accurate verbal explanation is observable. DIF: Cognitive Level: Application

: p. 509 7. Which of the following factors most influences a client's ability to learn from a health education program? a. Client's belief that the information will be useful or enjoyable b. Handouts given to the client c. Nurse's ability to teach d. Setting in which the educational program is given

: A Learning depends primarily on emotional readiness, which is reinforced primarily by internal motivation. The learner must be willing to put forth the effort needed to learn. Internal motivation is self-directive and long lasting and is based on the belief that the client's action will be useful or enjoyable. DIF: Cognitive Level: Comprehension

: p. 515 18. Which audience comment best demonstrates self-efficacy? a. "I believe I can learn to do this." b. "I think the nurse is a real expert in this stuff." c. "Those computer graphics really make it clear how people can do this." d. "Wow. The nurse really expects us to do this."

: A Self-efficacy is the belief that the learner is capable of engaging in the desired action. Stating "I believe I can learn to do this" demonstrates the belief by the learner that implementation is possible. DIF: Cognitive Level: Analysis

: pp. 512-515 16. Which comment to the nurse best demonstrates a successful health education program? a. "I'm going to take a 30-minute walk each day." b. "I certainly enjoyed the program, and thank you for the freebies." c. "You gave me so much new information; thank you so much." d. "Wow! I learned many things that I can use in my daily activities."

: A The overall goal is to teach a health-promoting activity that can be incorporated into the learner's lifestyle. Assessment of learner outcomes has traditionally been based on achievement of the behavioral objectives. If the objectives are properly written, each objective is measurable. Planning to take a daily walk demonstrates intention to incorporate the program content into personal lifestyle. DIF: Cognitive Level: Application

: pp. 521-522 MULTIPLE RESPONSE 1. Which of the following actions should be considered when a nurse provides an educational program to adults? (Select all that apply.) a. Encouraging the learner to share resources with the group during the program b. Focusing on the content that needs to be presented c. Providing a detailed overview of the program before starting the formal education d. Teaching what the learner wants to know before continuing the instruction e. Establishing an ongoing support group for the participants f. Relating the content to life experiences

: A, D, F When a nurse is teaching adults, a few of the strategies that should be included are encouraging the learner to share resources with the group during the program, teaching what the learner wants to know before continuing the instruction (otherwise the learner will not be able to focus on instruction if a question is not answered), and relating the content to life experiences. Because the learner's needs should be addressed throughout the program, the focus should not be solely on delivering necessary content. An overview of the program is a good idea before the education is started; however, this does not need to be detailed. An ongoing support group may be appropriate for some participants depending on the nature of the presentation, but it is not necessary for some topics and groups. DIF: Cognitive Level: Comprehension

: pp. 512-513 15. A nurse educator wanted to be certain that the program participants not only learned the content but also had time to practice these new behaviors. Which of the following must the nurse be sure to include in the program? a. Providing positive praise for participation b. Allowing time for role-playing c. Engaging the audience in stress-reduction exercises d. Modeling the appropriate behaviors

: B All of the answers are positive teaching behaviors, but to most effectively help the participants change both their attitudes and their behaviors, role-playing provides exploration of attitudes and use of problem-solving skills. DIF: Cognitive Level: Application

: p. 515 19. The nurse had a peer evaluation completed in order to improve her teaching expertise. Which of the following best describes this evaluation? a. A summary of the evaluation that the audience completed at the end of the program b. Another nurse observing and providing feedback on the presentation c. Completion of an evaluation of their learning and satisfaction by participants d. Videotaping of the presentation for further review by the nurse and others

: B All of the options are possible evaluation mechanisms, but peer evaluation is having a peer—in this case, another professional nurse—observe and give feedback. DIF: Cognitive Level: Application

: p. 508 9. Behavioral objectives should be a. Comprehensive and complete. b. Observable, measurable, and clearly communicated. c. Specific and detailed. d. Written on the teaching plan.

: B Although all of the responses are consistent with careful planning, the plan will not be workable unless the objectives are measurable and the nurse is able to observe changes in learning, attitudes, or behavior. Because the objectives convey intent to other people, such as external evaluators, they must also be communicable. If clearly stated, the objectives can also be used for evaluation purposes. DIF: Cognitive Level: Knowledge

: p. 506 2. Toward which individuals and their families are health education programs primarily aimed? a. Those who are acutely ill and need information to help them recover and avoid further problems b. Those who are healthy and can support each other in maintaining healthy lifestyles c. Those who must cope with an ongoing chronic disease d. Those who have defined health problems and who can support each other in maintaining healthy lifestyles

: B Health education focuses on helping healthy groups maintain or improve their health. Patient education describes teaching-learning activities for people with an identified alteration in health. DIF: Cognitive Level: Knowledge

: p. 507 6. In what way is the Predisposing, Reinforcing, Enabling, Causes in Educational Diagnosis, and Evaluation (PRECEDE) model helpful when health education programs are implemented? a. It addresses the learning needs of ill individuals. b. It begins with examining an aggregate's general concerns and quality of life. c. It emphasizes the learning needs of families who have an ill member. d. It focuses primarily on environmental resources.

: B The PRECEDE model begins with the presence or absence of health problems that are linked to quality-of-life issues, with the question "What are the general concerns of the population?" Such assessment helps ensure that the intervention is based on diagnosis of the community's need. DIF: Cognitive Level: Comprehension

: p. 507 8. A nurse is teaching a client how to perform her own insulin injections. Which of the following should the nurse assess first to determine the client's experiential readiness to learn? a. Culture and ethnic background b. Educational ability c. Family structure d. Home environment

: B The client's ability to learn can most easily be assessed by determining the client's educational level. Direct questioning related to years of formal education is useful but does not always provide complete and accurate information. Reading ability and learning disabilities should also be considered. DIF: Cognitive Level: Application

: p. 511 12. A community/public health nurse is planning an educational program about healthy choices to prevent heart disease. Which of the following variables will be the primary influence as the nurse selects content for the program? a. Employing agency's preferences b. Needs of the high-risk target group c. Third-party payers' probable coverage of the educational program d. What the nurse feels most comfortable and skilled in teaching

: B The nurse certainly must function within the constraints of the health care system, including policies of the employing agency and third-party payers; in a specific planned program, however, the actual content depends on the learning needs of the target group, as determined by a needs assessment. DIF: Cognitive Level: Application

: p. 516 22. Which of the following activities would be important for the nurse to complete when planning an educational program? a. Avoid rehearsing the content or it will sound too practiced. b. Come early to set up the audiovisual materials. c. Remind all possible participants that early registration is required. d. Try to get as many free handouts and freebies as possible.

: B The nurse should visit the site to ensure the cleanliness, temperature, and lighting of the area; arrive early to set up the audiovisual materials; and bring extra supplies such as projector bulb and extension cord. Last-minute attendees should be welcomed. In addition, the nurse should practice the material until it is known forwards and backwards. DIF: Cognitive Level: Application

: p. 512 13. A nurse began by asking the audience, "What do you want me to discuss?" All responses were written on the chalkboard and then, as specific points were discussed, the nurse erased the item. However, the nurse often added material that was not requested. Why would the nurse add more content? a. Because the nurse believed the additional information was entertaining and lightened the mood b. Because the nurse knew, on the basis of personal experience, other relevant information that the audience needed c. Because the nurse knew so much about the subject and wanted to give all the details. d. Because the nurse was sure that the audience meant to ask about it

: B The presentation should include not only what the audience wants to learn but also what the nurse, on the basis of previous experience, knows would be useful to them. DIF: Cognitive Level: Application

: p. 515 20. In preparing to give a presentation on breast self-examination, a nurse went to the American Cancer Society and obtained a variety of handouts to use during the presentation. Which possibly erroneous assumption is the nurse making? a. Handouts are the best technique for emphasizing important points. b. Handouts will be easily read by people in the audience. c. People will appreciate the brochures and freebies such as shower hook reminders. d. People will use the reminders and put them in their bathrooms.

: B The use of handouts and other written materials is based on the assumption that the audience can read, but research has shown that approximately 50% of Americans lack basic literacy and math skills. DIF: Cognitive Level: Application

: p. 512 14. When teaching an educational program to an adult audience, which of the following actions should a nurse take to best meet their educational needs? a. Providing a specific, detailed explanation of each component of the program b. Using various methods of instruction, including lecture, discussion, and visual aids c. Providing an opportunity for participants to express their feelings about the program d. Using a PowerPoint presentation so that the audience can visualize the material

: B To best meet the needs of the audience, it is important to use different teaching methods so that each member of the audience can learn by his or her preferred method, whether that is hearing, reading, discussing, or another activity. Thus, the use of only a PowerPoint presentation may not meet the needs of all the members of the audience. In addition, it is helpful to include all three domains of learning, which is usually necessary to incorporate a new health behavior into the learner's life. The best choices include opportunities for learning the material by preferred learning style, expressing feelings, and applying material, which represent the cognitive, affective, and psychomotor aspects. DIF: Cognitive Level: Synthesis

: p. 521 23. A nurse was asked to select an appropriate site for a nursing education program for adults in the community. Which of the following characteristics is most important in choosing the site? a. Location in a building that does not charge rent for use of the space b. Lots of room for participants to stand, walk around the room, and socialize with other participants c. Accessibility to public transportation, location in a physically safe area, and accessibility for disabled participants d. Location next to a police station, fire station, or other community resource

: C Although all the criteria would be useful, the most crucial would be an area where prospective participants can get to the meeting while feeling safe doing so. Consequently, the site ideally should be in an area with public transportation, appropriate for people with disabilities, and in a safe (or at least safer) neighborhood. DIF: Cognitive Level: Application

: p. 507 5. What strategies will a nurse include when planning an educational program for adults that ensures student learning? a. Individual one-on-one tutorials to ensure maximum understanding b. Large group lectures with handouts of main points along with culturally appropriate pictures c. Small peer group discussions on how to apply the new knowledge with prompt feedback d. Use of multimedia technologies such as videotapes and PowerPoint presentations

: C Small group discussions help adults become actively involved, often with repetition of the information as they discuss how to apply the knowledge. Individual one-on-one tutorials are extremely expensive. Large group lectures, even with handouts and pictures, still are only effective for low-level cognitive learning, not application. Table 20-1 emphasizes that adults want application of the facts and real-life context. DIF: Cognitive Level: Application

: p. 506 4. How can nurses best help expand availability of health education programs? a. Being entrepreneurs and asking patients to pay what they think the educational program was worth b. Suggesting to their friends and neighbors that they lobby local health organizations to provide such health education programs c. Teaching health education programs as unpaid volunteers in the community d. Working politically to influence public policy regarding funding health education programs

: D Although nurses can volunteer, join other people in requesting health education programs, or teach such programs as nurse entrepreneurs, the best way to expand the availability of such programs is to influence public policy regarding development and funding of health education programs. Although it is not clearly stated in Chapter 20 (all the answers are recommended in the text), the book as a whole emphasizes the importance of political action for more extensive influence. DIF: Cognitive Level: Synthesis

: pp. 515-516 21. One of the adults at a health education program introduced a rather unorthodox suggestion, claiming, "I saw it on the Internet." Which of the following criteria is most important for laypeople to use in deciding whether to accept information on the Internet? a. The author of the information has written several books on the topic, all of which are for sale. b. The content of the site is supported by an international pharmaceutical company. c. The site is frequently referred to in magazine and TV advertisements. d. The site is maintained and frequently updated by a federal health agency.

: D In an Internet site, the authorship should be based on credentials and clinical reputation, preferably peer reviewed. The information should be written by staff at a reputable organization, preferably based on research, frequently updated, and not biased by being financially supported by companies or people attempting to sell products. DIF: Cognitive Level: Application

: p. 506 3. Which of the following criteria must be met in order for an educational program to receive third-party reimbursement? a. It must be provided to a geriatric population. b. It must be given by an advanced nurse practitioner. c. It must occur in a rural, underserved area. d. It must be prescribed by a physician for an ill client.

: D Insurance companies pay for illness, not wellness, and so they will pay for patient teaching regarding an existing illness only when it is prescribed by a physician. DIF: Cognitive Level: Comprehension