Chapter 8 Client teaching

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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 of the following as a characteristic of an adult learner?
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Their readiness to learn is often related to a developmental task or social role.
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A male client age 61 years has been admitted to a medical unit with a diagnosis of pancreatitis secondary to alcohol use. Which of the client’s following statements suggests that nurses’ education has resulted in affective learning?
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“I’m starting to see how my lifestyle has caused me to end up here.”
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A nurse is preparing to teach a 6 year old with a broken arm and her mother about cast care. Which statement reflects the best teaching plan for these clients?
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Include the child in teaching; ask questions of both mother and child
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A nurse is working with a client and suspects the client might have a literacy problem. What question would the nurse ask initially to get a better sense of the situation?
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“How do you learn best?”
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Which of the following guidelines is most important for the nurse to keep in mind when planning to teach an exercise class to a group of older adults?
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Allow ample time for psychomotor skills
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A nurse is preparing a teaching plan for an older adult. Which of the following would be least appropriate for the nurse to include in this plan?
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Scheduling teaching sessions to last 45 minutes
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An elderly female client post stroke is scheduled to be transferred to the rehabilitation unit in the morning. She is tearful and verbalizes that she feels lonely and abandoned in the hospital unit. The nurse noticed that family visits daily and that there are flowers and cards 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 patient?
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Ineffective coping; verbalizes support systems.
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A nurse is teaching a patient with a new diagnosis of diabetes. Which example demonstrates cognitive learning by the patient?
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The patient describes signs and symptoms of hypoglycemia.
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Which of the following developmental considerations is a nurse assessing when he or she determines that an 8-year-old boy is not equipped to understand the scientific explanation of his disease?
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Intellectual development
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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?
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Have client rate pain level and reschedule the teaching session
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An experienced nurse is educating a client about his disease and how best to promote his optimal health. The nurse is focusing the education on the cognitive domain of learning. The nurse would focus the education on which of the following?
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Critical thinking
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A 20-year-old client reads the nutritional chart and follows it accurately. The nurse also notes that the client understands the need of a balanced diet and its relationship with a quick recovery. Which domain correctly identifies the client’s learning style?
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Cognitive domain
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Which example of nursing documentation is the most appropriate concerning a teaching session?
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Family requested education on turning client. Explanation of use of draw sheet and body mechanics provided. Family coached through turning and repositioning client. Members state confidence and understanding.
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The nurse must instruct a 35-year-old client with Down syndrome about use of an albuterol rescue inhaler. Which of the following demonstrates individualization of the teaching plan for this client?
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Client understanding of illness, motor skills and developmental stage assessed, clarification provided.
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Which of the following is an activity of a psychomotor learner?
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Assembling
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The nurse has educated the client on the pathophysiology of osteoarthritis and degenerative joint disease. This is an example of what learning theory?
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Cognitive learning theory
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A client 36 years of age is able to understand the health education when she is given the opportunity to put the education into practice. The nurse helps the client to self-administer the medication dosage before the client is discharged from the health care facility. Which domain correctly identifies the client’s learning style?
answer

Psychomotor domain
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A Chinese client who was previously treated at the health care facility for an open wound has been re-admitted because the wound has become gangrenous. It has been identified that the client failed to understand proper wound care. Which of the following is the probable reason for the client failing to understand the instruction?
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The client belongs to a different culture.
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Which type of learner processes information more adequately by listening or reading facts?
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Cognitive
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Which statement best describes the client most motivated to learn?
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A 70-year-old female; learning care so spouse can come home.
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A client has just been taught about lowering cholesterol with diet and exercise. What is the best way to evaluate that the client understands the material?
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Ask direct questions about the teaching plan.
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While applying dressings to a client’s wound, the nurse teaches the client about his wound care. To promote the most effective teaching-learning relationship with this client, which of the following would be most important for the nurse to keep in mind?
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he nurse and client relationship is based on mutual sharing and negotiation.
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When establishing a teaching-learning relationship with a patient, it is most important for the nurse to remember that effective learning can best be achieved through which concept?
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The patient and the nurse are equal participants
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The client reports to the clinic as ordered by her 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 states having read through it before the appointment. Which of the client’s statements alerts the nurse to a need for clarification and further education?
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“I will be doing well if I lose between 5 and 10 pounds a week.”
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A client has been newly diagnosed with type 2 diabetes mellitus. As the diabetes educator on staff, which of the following do you recognize as the client’s learning needs?
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Desire to acquire new information
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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 device. The client states, “I’m just too old to learn.” Which of the following would be most appropriate for the nurse to do to motivate this client?
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Describe how the walker can improve the client’s quality of life.
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A nurse assisting a new mother in the act of breast feeding is represented by which form of learning?
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Psychomotor
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A nurse is forming a teaching plan for a client who is being discharged from the nursing unit after cardiac catheterization. What diagnosis and intervention is most appropriate for this client?
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Knowledge deficient: Risk for altered perfusion secondary to re-occlusion.
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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 client teaching?
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Develop written materials in the client’s native language.
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When is the best time to evaluate one’s own teaching effectiveness?
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Immediately after an education session
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You are the nurse planning to teach tracheostomy care to one of your patients. What is the most important variable in patient teaching that you need to utilize?
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Determining the patient’s readiness to learn new information
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The parents of an infant suffering from apnea need to be educated on the apnea monitor and cardiopulmonary resuscitation. What should the nurse assess first regarding the parents?
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Baseline knowledge of these concepts
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Which step of the nursing process determines if the patient understands the health teaching that is provided?
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Evaluation
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At completion of the health education for a client, the nurse documents the details of the health education in the client’s medical record. What can be determined by this documentation?
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Proof of compliance with education standards
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The nurse is planning to teach a 75-year-old patient about administering her medication. How can the nurse enhance the patient’s ability to learn?
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Make the information relevant to the patient’s condition
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A nurse enters a client’s hospital room to begin a teaching session. When the nurse enters, the client says, “Nurse, I am really cold–could you get me another blanket? My side is really aching, too, and I’m thirsty.” Based on this information, what should the nurse do next?
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Attend to the client’s needs for warmth, pain relief, and thirst.
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A client is reluctant to learn to do finger sticks for her home INR monitoring. What is the best statement by the nurse?
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Tell me what you know about these tests.
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A home health nurse states to her patient, “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 patient’s progress?
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Positive feedback
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A patient is experiencing difficulty in adjusting to a new prosthesis despite conscientious patient teaching by numerous members of the healthcare team. How should the team respond to the patient’s lack of learning to this point?
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Revise the teaching plan that has guided education.
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Before starting the teaching process, the nurse should determine the preferred learning style, age and developmental level, capacity to learn, motivation level, readiness to learn, and learning needs of the client. How does this help the nurse in the client’s health teaching?
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By implementing effective teaching
question

Which of the following refers to a person’s intellectual ability to remember and apply new information?
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Learning capacity
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A client, eager to go home from an acute care facility, calls out to have discharge education completed. The nurse is not able to get to the client’s room until an hour later, and finds the client asleep. The client’s significant other states, “She will be out for a couple hours after that pain medication.” Which of the following best describes what must happen with the teaching session?
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The client is not demonstrating readiness to learn due to the effects of medication.
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To meet accreditation standards regarding client care, a health care facility must show evidence of what?
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Client education documentation
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What is the most critical element of documentation of education?
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Evidence that learning has occurred
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A nurse is caring for a client 72 years of age with arthritis. Which action is the highest priority for the nurse when conducting the health education for the client?
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Find out what the client wants to know.
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Which learning domain is the focus for instruction when the nurse educates a new mother about the breast and its role in milk production for feeding the newborn?
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Cognitive
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The nurse completed teaching with a client. Which of the following documentation entries is the most complete teaching plan?
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Printed and verbal information provided on gluten-free diet.Questions answered. Verbalizes understanding. Follow-up scheduled.
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Which of the following means of comprehending new information best describes a cognitive learner?
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The learner processes information by listening to facts.
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The nurse is caring for a client with migraine, who is admitted to the health care facility for observation. How can the nurse ensure that the client’s learning needs are fulfilled?
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Begin teaching as soon as possible after admission
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A nurse is preparing to teach a client with a hearing impairment. Which of the following measures would the nurse employ to optimize the teaching experience? Select all that apply.
answer

– Use a magic slate, chalkboard, flash cards, or writing pads to communicate. – Try to select words that do not begin with “f,” “s,” “k,” and “sh.” – Insert a stethoscope into the client’s ears and speak into the bell with a low voice.
question

Which of the nurse’s following actions is most likely to promote a patient’s compliance with her antiretroviral drug regimen for the treatment of human immunodeficiency virus (HIV)?
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Use interactive and learner-appropriate teaching techniques.
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A client shares with the nurse how much she appreciates understanding the physiology of her breastfeeding. She states, “I felt very comfortable with what you explained to me and I feel I will be successful at breastfeeding.” In affective learning, this represents
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Creating an atmosphere for discussion of feelings
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The parents of a school-aged child are meeting with the nurse for health promotional education for their child. The child has the following assessment data: 7-year-old male, diabetes mellitus type 1 with a hemoglobin A1C of 8.3%, BMI of 31.7, BMI percentile of 99. What are the most appropriate learning diagnoses for this first session?
answer

Deficient knowledge: Imbalanced nutrition: more than body requirements, and ineffective health maintenance.
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What client characteristic is important to assess when using the health belief model as the framework for teaching?
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Motivation to learn
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Advocacy and support are activities associated with which learning style?
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Affective

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