Teaching - Foundations
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 will be doing well if I lose between 5 and 10 lb (2.3 and 4.5 kg) per week." "Osteoarthritis in my knees may be because of my weight." "I can lower my blood pressure by losing 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."
how to assess psychomotor learing
by return demonstration
Negative Reinforcement
criticism or punishment
Affective Learning
includes changes in attitudes, values, and feelings
Cognitive Learning
involves the storing and recalling of new knowledge and information in the brain (acquisition of knowledge, comprehension, analysis, synthesis, and evaluation)
Psychomotor Learning
learning a physical skill involving the integration of mental and muscular activity
how to assess cognitive learning
oral questioning
Teaching
planned method or series of methods used to help someone learn
Learning
process by which the person acquires or increases knowledge or changes behavior in a measurable way as a result of an experience.
how to assess affective learning
through the patients response
Positive Reinforcement
to affirm the efforts of patients who have mastered new knowledge, attitudes, or skills
Basic purpose of teaching
to help patients and families develop the self-care abilities (knowledge, attitude & skills) that enable them to maximize their functioning and quality of life.
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? "I notice that you do not have the dressing secured. Place a piece of tape on the wrap." "Let's see how you irrigate the wound with saline." "I would like you to demonstrate how to change the dressing on your leg." "Tell me about what signs of infection you will report to the health care provider."
"Tell me about what signs of infection you will report to the health care provider."
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." -"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?"
"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 flash cards and writing pads." "Encourage family members to increase their vocal pitch." "Limit communication to avoid frustration." "Use words that begin with 'f,' 's,' 'k,' and 'sh' to communicate."
"Use flash cards and writing pads."
The nurse is teaching an 80-year-old client how to instill eye drops for glaucoma. The client's daughter asks, "How do you know that my mother understands what to do?" What is the appropriate nursing response? "After I demonstrate it once, your mother will be able to do it." "When 15 minutes have passed, I will ask your mother to show me how to instill the drops." "We can never be completely sure that your mother understands instructions." "I will have you bring your mother back next week to see how things are going."
"When 15 minutes have passed, I will ask your mother to show me how to instill the drops."
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? "Are you supposed to be out of the wheelchair?" "You have made an amazing recovery." "Those physical therapists work wonders. "Let me document that you can walk."
"You have made an amazing recovery."
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? 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.
Allow ample time for psychomotor skills.
4 assumptions concerning adult learners
As a person matures, his or her self-concept is likely to move from dependence to independence The previous experience of the adult is a rich resource for learning The readiness to learn in an adult is often related to a developmental task or a social role Most adults' orientation to leaning is that material should be useful immediately, rather than at some time in the future
The nurse must instruct a 35-year-old client with Down syndrome about the use of an albuterol rescue inhaler. Which documentation demonstrates appropriate individualization of the education plan for this client? -Assessed the client's understanding of health and answered questions on an age-appropriate level while the television was on in the room -Assessed the client's understanding of illness; assessed motor skills and developmental stage; provided clarification -Taught lesson at an adult developmental level (age 35) using short sentences and assessed motor skills -Taught lesson at a school-age developmental level in an authoritarian style while the client was at meal time
Assessed the client's understanding of illness; assessed motor skills and developmental stage; provided clarification
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
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? Psychomotor Cognitive Affective Interpersonal
Cognitive
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? Psychomotor Affective Cognitive Interpersonal
Cognitive
When deciding what information the client needs to meet the learner objectives successfully, the nurse is formulating which part of the teaching plan? Learning domains Teaching strategies Content Learning activities
Content
A client diagnosed with type 2 diabetes has been prescribed insulin therapy in conjunction with an oral agent because the client has been experiencing difficulty controlling blood sugar levels with an oral agent alone. The nurse is preparing a teaching plan for this client. Which intervention would the nurse include in the teaching plan to address the psychomotor domain? -Demonstrating the technique for insulin self-injection -Reviewing with the client appropriate foods to eat -Describing the signs and symptoms of low blood sugar -Explaining what to do if hypoglycemia occurs
Demonstrating the technique for insulin self-injection
The nurse is teaching a client about enoxaparin sodium for the first time. This client has never given a self-injection before. Which actions are appropriate for the nurse to take? Select all that apply. Weigh the client to select needle size. Gather all necessary supplies for injection teaching. Have the client demonstrate the proper technique for injection. Review medication data sheets to ensure correct dosage. Print out injection rotation diagrams.
Have the client demonstrate the proper technique for injection. Gather all necessary supplies for injection teaching. Review medication data sheets to ensure correct dosage.
The nurse is conducting a community health promotion class and has developed scenarios that will involve active participation by the class attendees. What type of education strategy is the nurse incorporating into this class? Programmed instruction Role-playing Panel discussion Role modeling
Role-playing
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? -Assess the client's understanding of self-care and administer medication. -Give written materials to the client and administer pain medication. -Have the client rate pain level, and reschedule the teaching session. -Redirect the client to learning about self-care and begin education.
Have the client rate pain level, and reschedule the teaching session.
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. 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. Focus mainly on the mother; ask the child a couple of simple questions.
Include the child in the education; ask questions of both the mother and the child.
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? Altered Mobility; able to tie shoes. Ineffective Coping; verbalizes support systems. Impaired Walking; unilateral neglect. Dysfunctional Family Processes; family contact daily.
Ineffective Coping; verbalizes support systems.
Which developmental consideration is a nurse assessing when determining that an 8-year-old child is not equipped to understand the scientific explanation of the child's disease? Intellectual development Psychosocial development Motor development Emotional maturity
Intellectual development
A pediatric nurse provides education to numerous clients. Which group of children benefits most from being involved in the teaching-learning process? Infants School-age children Preschoolers Toddlers
School-age children
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? Situational Long-term Motivational Developmental
Motivational
Which nursing action is applicable to the psychomotor domain of learning when conducting a teaching session for breastfeeding mothers? -Showing charts to the mothers that illustrate the types of breast milk -Observing a mother expressing the breast milk -Telling the mothers to avoid taking over-the-counter drugs while breastfeeding -Advising the mothers to drink plenty of water
Observing a mother expressing the breast milk
A nurse may attempt to help a client solve a situational crisis during what type of counseling session? Long-term counseling Professional counseling Short-term counseling Motivational counseling
Short-term counseling
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? Motivation Reinforcement Health promotion Positive feedback
Positive feedback
A nurse assisting a new mother in the act of breastfeeding represents which form of learning? Psychomotor Simplistic Cognitive Affective
Psychomotor
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
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. -Teach from books only and remain calm. -Avoid the use of colorful materials and keep the session short. -Teach in a monotone voice in a quiet environment.
Remain calm and conduct the teaching session in a quiet environment.
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? - Reteach the length of time to take the prescription. -Tell the client to take the antibiotic until symptoms subside. -Ask the client to restate the teaching that was provided. -Proceed with teaching about the decongestant.
Reteach the length of time to take the prescription.
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? Oral test Simulation Return demonstration Written test
Return demonstration
When teaching a client, the nurse notices the client tends to lose focus easily. The nurse would adapt client teaching in which way? Elongate the teaching session to be sure the client understands. Request family members to serve as translators. Provide less health teaching because of the language barrier. Talk with animation and vocal inflection to stimulate the client aurally.
Talk with animation and vocal inflection to stimulate the client aurally.
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 must be able to handle criticism during the process. -The client and the nurse are equal participants. -The nurse is the expert in the teaching-learning environment. -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 belongs to a different culture. The client has a short attention span. The client is not interested. 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 prepares the skin for the administration of an insulin injection. The client describes signs and symptoms of hypoglycemia. The client expresses a desire to improve nutritional intake and lose weight. The client demonstrates proper technique for injecting insulin.
The client describes signs and symptoms of hypoglycemia.
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 nods when asked about process and assists with cleanup. -The client verbalizes items needed and how to perform the skill.
The client organizes materials needed and gives return demonstration.
When a nurse is planning for learning, who must decide who should be included in the learning sessions? The health care team The nurse and the client The doctor and nurse The client and the client's family
The nurse and the client
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. The material presented should focus on future application. Peer group acceptance is a critical issue for this age group. Previous experiences have little impact on learning.
Their readiness to learn is often related to a developmental task or social role.
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: muscular movements. critical thinking. physical demonstration. emotions or feelings.
critical thinking.
The nurse needs to understand the teaching-learning process when administering psychosocial interventions. educational interventions. physician-initiated interventions. technical interventions.
educational interventions.
are you Legally responsible to document teaching in the patient's record
yes Should include: summary of the learning need the plan implementation of the plan evaluation results