PNU 133 Honan PrepU Teaching & Learning / Patient Education
The nurse is preparing the client with an abdominal incision for discharge. Which statement by the client indicates that further teaching is required?
"I can resume my usual activities as soon as I get home."
The nurse is caring for a patient who had a total laryngectomy and has drains in place. When does the nurse understand that the drains will most likely be removed?
When the patient has less than 30 mL for 2 consecutive days
The nurse reviews a client's lab results and notes a serum calcium level of 7.9 mg/dL. It is mostappropriate for the nurse to monitor the client for what condition?
Impaired myocardial contractility
A patient recently diagnosed with pericarditis asks the nurse to explain what area of the heart is involved. How does the nurse best describe the pericardium to the client?
Thin fibrous sac that encases the heart.
A client is diagnosed with rheumatic endocarditis. What bacterium is the nurse aware causes this inflammatory response?
Group A, beta-hemolytic streptococcus
A 58-year-old male patient with a 60 pack-year history of cigarette smoking and a history of heavy alcohol use has been diagnosed with laryngeal cancer following a physical examination and endoscopy. The patient has been scheduled for a partial laryngectomy and is highly anxious about the consequences of this surgery. What patient education should the nurse provide for this man?
"A partial laryngectomy has the advantage of having only a minimal effect on your speech."
The nurse is caring for a client scheduled for urodynamic testing. Following the procedure, which information does the nurse provide to the client?
"Contact the primary provider if you experience fever, chills, or lower back pain."
A client with a conductive hearing disorder caused by ankylosis of the stapes in the oval window undergoes a stapedectomy to remove the stapes and replace the impaired bone with a prosthesis. After the stapedectomy, the nurse should provide which client instruction?
"Don't fly in an airplane, climb to high altitudes, make sudden movements, or expose yourself to loud sounds for 30 days."
A client has had an echocardiogram to measure ejection fraction. The nurse explains that ejection fraction is the percentage of blood the left ventricle ejects upon contraction. What is the typical percentage of blood a healthy heart ejects?
55%
Which clinical manifestation is not associated with hemorrhage?
Bradycardia
There are many goals for health teaching. Which of the following is the primary goal of family and patient education?
Improve patient outcomes
The nurse is providing information to a client about the safe use of a newly prescribed medication. The first question the nurse should ask is
Is the client ready to learn?
A client has a serum study that is positive for the rheumatoid factor. What will the nurse tell the client about the significance of this test result?
It is suggestive of rheumatoid arthritis.
After teaching a client how to self-administer epinephrine, the nurse determines that the teaching plan has been successful when the client demonstrates which action?
Jabs the autoinjector into the outer thigh at a 90-degree angle
A 63-year-old woman has been diagnosed with polycythemia vera (PV) after undergoing a series of diagnostic tests. When the woman's nurse is providing health education, what subject should the nurse prioritize?
Lifestyle modifications and techniques for preventing thromboembolism
A client has been diagnosed with peripheral arterial occlusive disease. Which of the following instructions is appropriate for the nurse to give the client for promoting circulation to the extremities?
Participate in a regular walking program.
You are physically preparing a client for surgery and instruct the person to remove any jewelry. The client refuses to remove a wedding band. What should you do in this situation with approval from your facility?
Place gauze under and over the ring and apply adhesive tape over it.
The school nurse informs the mother of a second-grade student that lice were found in the child's hair. The mother explains to the nurse that she has another child to pick up and cannot stay to receive education related to the treatment of lice at this time. The mother reassures the nurse that she will "look up treatment options on the Internet and take care of the child." What would be the best action of the school nurse in this situation?
Provide the mother with a list of credible websites related to the treatment of lice
A patient exhibited signs of an altered ventilation-perfusion ratio. The nurse is aware that adequate ventilation but impaired perfusion exists when the patient has which of the following conditions?
Pulmonary embolism
A nurse is aware that the patient's heart rate is influenced by many factors. The nurse understands that the heart rate can be decreased by:
Stimulation of the vagus nerve.
A patient will be having an endoscopic procedure with a diagnostic biopsy. What type of biopsy does the nurse explain will remove an entire piece of suspicious tissue?
Excisional biopsy
A computed tomography (CT) scan has detected a "spot" on a patient's liver, and a subsequent liver biopsy has revealed cancer and been submitted for staging and grading. The patient has asked you about the purpose of staging, stating that her oncologist's explanation left her somewhat confused. How could you best respond to this patient's question?
"Staging allows the care team to determine how large and extensive your tumor is."
The nurse is caring for a client who is scheduled for chemotherapy. Which is the best statement the nurse can make about the client experiencing chemotherapy-induced alopecia?
"The hair loss is usually temporary."
The nurse is caring for a client who had a permanent pacemaker surgically placed and is now ready for discharge. What statement made by the client indicates the need for more education?
"We will be getting rid of our microwave oven so it will not affect my pacemaker."
A client with a mechanical valve replacement asks the nurse, "Why do I have to take antibiotics before getting my teeth cleaned?" What is the nurse's best response?
"You are at risk of developing an infection in your heart."
A client from a low socioeconomic background was diagnosed with a chronic health problem. The client states, "Everyone has to die of something." What is the most appropriate response for the nurse?
"You can do some things to minimize the effects of this disease on your health."
A nurse is teaching a client about body keratin composition. What body structures would the nurse include in the teaching? Select all that apply.
Fingernails Hair Skin
Which would the nurse stress as a periodic lifelong necessity for a client managing infective endocarditis?
Antibiotic therapy
When teaching a client with newly diagnosed hypertension about the pathophysiology of this disease, the nurse states that arterial baroreceptors, which monitor arterial pressure, are located in the carotid sinus. Which other area should the nurse mention as a site of arterial baroreceptors?
Aorta
While caring for a patient who has had radical neck surgery, the nurse notices an abnormal amount of serosanguineous secretions in the wound suction unit during the first postoperative day. What does the nurse know is an expected amount of drainage in the wound unit?
Approximately 80 to 120 mL
A client undergoes a biopsy of a suspicious lesion. The biopsy report classifies the lesion according to the TNM staging system as follows: Tis, N0, M0. What does this classification mean?
Carcinoma in situ, no abnormal regional lymph nodes, and no evidence of distant metastasis
The nurse has been asked to provide health information to a female patient diagnosed with a urinary tract infection. What appropriate instructions will the nurse provide? Select all that apply.
Cleanse around the perineum and urethral meatus after each bowel movement to reduce pathogens. Drink liberal amounts of fluid to flush out bacteria. Void every 2-3 hours to prevent overdistention of the bladder
The nurse is performing discharge teaching for an elderly client with mild visual impairment. The nurse provides written instructions with large print and highlighted parts. The nurse also sits near the client, faces the client, and speaks in a lower-pitched voice. When the client arrives home, the client has difficulty following instructions. What error in teaching did the nurse commit?
Providing written instructions that are highlighted
A nurse is developing a teaching plan for a client with asthma. Which teaching point has the highest priority?
Take ordered medications as scheduled.
The nurse is caring for a young client who has agammaglobulinemia. The nurse is teaching the family how to avoid infection at home. Which statement by the family indicates that additional teaching is needed?
"I can take my child to the beach, as long as we play in the sand rather than swim in the water."
When teaching a client with rheumatic carditis and a history of recurrent rheumatic fever, which statement by the client indicates that teaching has been successful?
"I may have to take prophylactic antibiotics for up to 10 years."
The nurse has been educating a client newly diagnosed with MS. Which statement by the client indicates an understanding of the education?
"I will stretch daily as directed by the physical therapist."
The nurse has been teaching a client with genital herpes how to care for the lesions. Which of the following statements by the client indicates that she needs additional instruction?
"I'll wear occlusive underwear to prevent transmission of the virus."
Which client statement indicates a good understanding of the nutritional modifications needed to manage hypertension?
"Limiting my salt intake to 2 grams per day will improve my blood pressure."
You are the nurse working in an ambulatory surgery center. A teenage son of your clients ask you why so many people have surgery. What would be your best reply?
"Many people have diagnostic or short therapeutic surgical procedures."
A client newly diagnosed with COPD tells the nurse, "I can't believe I have COPD; I only had a cough. Are there other symptoms I should know about"? Which is the best response by the nurse?
"Other symptoms you may develop are shortness of breath upon exertion and sputum production."
The nurse is conducting a community education program on chronic illness. The nurse evaluates that additional education is needed when the participants make which statement?
"Out-of-pocket expenses for chronic illness are low."
Which stage of the transtheoretical model occurs when the patient has serious consideration of change, but it is sometime in the future?
Contemplation
When providing discharge instructions, the nurse recognizes that which client is most likely to comply with the therapeutic treatment regimen?
The client with pneumonia who requires 1 week of oral antibiotics
The nurse is teaching a class on diseases of the ear. What would the nurse teach the class is the most characteristic symptom of otosclerosis?
A progressive, bilateral loss of hearing
A client has been reporting regularly to the health care unit for blood pressure monitoring. The health care provider diagnoses the client with essential hypertension after analyzing the readings over two or more sessions. What options will the nurse use to inform the client about next steps for blood pressure care? Select all that apply.
Advise the client to begin an exercise regimen based on the approval of the health care provider. Ask the client to follow a diet that is low in saturated fats and sodium and high in fiber. Advise the client to purchase a self-monitoring cuff or use an automatic cuff at a local pharmacy. Educate the client about the correct position to measure blood pressure, as the position may affect readings.
A nurse practitioner would be applying the pre-trajectory model of chronic illness when she:
Advised a woman, whose mother has Huntington's chorea, and who is considering pregnancy, to get genetic testing.
A client with challenging menopausal symptoms has discussed treatment options with the physician and now has some questions for the nurse. The client asks, "What are the potential risks of hormone replacement therapy?" What is the best answer?
All options are correct.
The nurse working on a gerontology unit admits a 77-year-old with recent shortness of breath. The nurse knows that the amount of respiratory dead space increases with age. What do these changes result in?
Decreased diffusion capacity for oxygen
A client is in end-stage chronic renal failure and is being added to the transplant list. The nurse explains to the client how donors are found for clients needing kidneys. Which statement is accurate?
Donors are selected from compatible living or deceased donors.
What information should the nurse include in the teaching plan for a client being treated for diverticulosis?
Drink at least 8 to 10 large glasses of fluid every day
The nurse is caring for a client diagnosed with rhinosinusitis. The physician has ordered the client to receive four sprays of budesonide (Rhinocort) in each nostril every morning. The nurse informs the client that a common side effect of this medication is
Epistaxis
A client has just been diagnosed with early glaucoma. During a teaching session, the nurse should:
demonstrate eyedrop instillation.
A client is undergoing diagnostics due to a significant drop in renal output. The physician has scheduled an angiography. This test will reveal details about:
renal circulation.
