chpt 21 – Flashcard
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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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Which principle of teaching-learning is an accurate guideline for the nurse/teacher?
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The teaching-learning process can be facilitated by a helping relationship.
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The nurse is visiting a client who was released from inpatient rehabilitation 6 weeks ago after a 5-month recovery after a motor vehicle accident that left him immobile. As the nurse enters the home, the client braces his hands on the arms of his chair to rise and uses crutches to walk across the room. What is the best response by the nurse?
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"You have made an amazing recovery."
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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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The nurse and client relationship is based on mutual sharing and negotiation.
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A nurse has been working with a client whose vision has been deteriorating as a result of glaucoma. The client is reluctant to participate in education surrounding adaptations and home modifications that could aid in her adjustment to sensory loss, stating, "What's the point of even fighting the inevitable?" The nurse would recognize the potential for which of the following nursing diagnoses?
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Hopelessness
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A nurse has permission from the homebound client to educate any of the family members about providing care for the client. Which family member is the most appropriate choice?
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Brother who visits daily, does laundry, and cooks all meals for the client.
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What is the most appropriate teaching strategy for the nurse to use for a 1-hour presentation on the prevention of osteoporosis to a group of 30 college-age women?
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Lecture/discussion
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A 56-year-old executive meets with the nurse for education about recently diagnosed atrial fibrillation. He verbalizes concerns about the time he will spend away from his work, and that he is not sure it is necessary to have blood tests every week. He feels it is a waste of time when he does not have any symptoms. Which is the best motivational statement by the nurse for this client?
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"The medicine and blood work for atrial fibrillation can help prevent blood clots that have the potential to cause debilitating strokes. What have you heard about warfarin therapy?"
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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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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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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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The nurse is assigned to a newly wounded soldier who lost a leg in combat and is coming to the unit after surgery. Which learning diagnosis is most important for this client?
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Knowledge deficient: Risk for falls related to traumatic amputation.
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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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When caring for a diabetic client, the nurse notes that the client learns better when he practices the self-administration of the insulin injection by himself. In which of the following learning domains does this client's learning style fall?
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Psychomotor domain
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When a patient says, "I don't care if I get better; I have nothing to live for, anyway," which type of counseling would be appropriate?
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Motivational counseling
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Which developmental consideration is a nurse assessing when he/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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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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The nurse identifies which client response as a need for additional education?
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States, "I only have to worry about lowering the top number of my blood pressure."
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A nurse may attempt to help a patient solve a situational crisis during what type of counseling session?
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Short-term counseling
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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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A nurse is working with the Red Cross to assist a family whose home was destroyed by fire. Which statement is most appropriate to assist with this situational crisis?
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"You have had a tremendous loss. What are your plans for shelter tonight?"
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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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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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When a nurse is planning for learning, who must decide who should be included in the learning sessions?
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The nurse and the patient
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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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An active, otherwise healthy, older adult client presents to the clinic with severe osteoarthritis in the bilateral knees. The nurse knows this client does not want to be a burden on his family, and he remains stoic although he reports the pain as severe. He avoids the topic of surgery and attends church weekly. His family is supportive of any decisions he makes regarding his health. Which of the assessment data are most important to forming an individualized teaching plan for this client concerning treatment for his osteoarthritis?
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Personal perception of health and aging
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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?
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Deficient knowledge: Imbalanced nutrition: more than body requirements, and ineffective health maintenance.
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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 and client are working together to help the client with lifestyle changes to promote improved health. Which is the best statement about contractual agreements? Select all that apply.
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• "Our goals are defined, as are ways to meet them." • "With this contract, we show that we are both dedicated to helping you.
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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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When caring for a client, the nurse observes that the client enjoys reading books and magazines. In which of the following learning domains does the client's learning style fall?
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Cognitive domain
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A nurse evaluates whether a middle-aged client with chronic back pain has been performing the different exercises and physiotherapy procedures recommended by the physician. Which of the following would the nurse most likely use to evaluate the client?
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Return demonstration
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Which statement best demonstrates the client has improved health literacy using the teach-back method of client education?
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"I have diabetes and need to keep my blood sugar under control. I want to see my new granddaughter grow up and dance at her wedding."
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A nurse is counseling several clients for depression. Four of them do not seem to be improving, which leads the nurse to suggesting a referral to a psychiatric nurse practitioner. Which of these clients would be most likely to attend the scheduled appointment?
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A 28-year-old female; works nights, willing to try, asking about insurance coverage of appointment.
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A client with a body mass index 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?
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Past interventions for weight loss
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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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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
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The nurse knows which evaluation best represents that the client has learned a new skill?
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Organizes materials needed and gives return demonstration.
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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 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.
