Homework Lance
1.A nurse has been asked to prepare patient education for Spanish-speaking patients regarding diabetes. This information will be available to patients in the diabetes clinic. What is the primarygoal for this patient education?
a.
To reduce the legal liability of the clinic
b.
To teach Spanish-speaking patients some English
c.
To assist Spanish-speaking patients to reach optimal health
d.
To provide information so they can make a decision between oral and injectable medications
ANS: C
The goal of patient education is to assist individuals, families, communities, or populations in achieving optimal levels of health, safety, and independence. The goal of patient education is not to reduce the legal liability, teach English, or make decisions about the different types of medications.
PTS:1DIF:Cognitive Level: Applying (Application)
REF:203OBJ:Identify the purposes of patient education.
TOP:Nursing Process: Planning
MSC: NCLEX: Health Promotion and Maintenance
2.A patient with newly diagnosed diabetes is being discharged from the hospital. The patient will be going to an outpatient diabetic center to learn more about diet, exercise, disease management, and insulin administration. Which statement made by the patient indicates that effective teaching can take place?
a.
“I don’t want to get sick again so I will do what is needed.”
b.
“I am so happy to be going home so I don’t have to eat hospital food anymore.”
c.
“I will be glad when they find a cure for diabetes.”
d.
“I don’t think I will need to take insulin for very long because I already feel better.”
ANS: A
Generally teaching and learning begin when a person identifies a need for knowing or acquiring an ability to do something. Focusing on hospital food, finding a cure, and not taking medications because feeling better indicate the patient is not motivated to learn at this time.
PTS:1DIF:Cognitive Level: Analyzing (Analysis)
REF:204
OBJ:Differentiate factors that determine readiness to learn from those that determine ability to learn.TOP:Nursing Process: Evaluation
MSC: NCLEX: Health Promotion and Maintenance
3.The parents of a 3-month-old infant are preparing to take their child home from the hospital. Before being discharged, the parents must be educated on infant CPR. What is the mostappropriate learning objective for this situation?
a.
The parents will be able to understand CPR skills.
b.
The parents will demonstrate infant CPR skills.
c.
The infant will not require further hospitalization.
d.
The parents will call the hospital for help.
ANS: B
A learning objective describes what the patient or guardian(s) will be able to do after successful instruction. The objective contains an active verb describing what the learner will do after the objective is met (demonstrate). Understand does not specify the behavior or content to be learned and is not an active verb. The learning objectives should focus on the parents as they are the learners; it should not focus on the infant. The parents should call the hospital for help but this does not relate to the skill being taught, CPR.
PTS:1DIF:Cognitive Level: Analyzing (Analysis)
REF:204-205 | 213
OBJ:Compare the nursing and teaching processes. Write learning objectives for a teaching plan.TOP:Nursing Process: Planning
MSC: NCLEX: Health Promotion and Maintenance
4.Which finding will best indicate to the nurse that the teaching about a dressing change was successful?
a.
The patient understands how to change an abdominal dressing.
b.
The patient acknowledges the principles of an abdominal dressing change.
c.
The patient correctly demonstrates an abdominal dressing change as taught.
d.
The patient states, “Yes, I know how to change the dressing.”
ANS: C
Demonstration is the best method to evaluate a psychomotor skill. Examples of evaluating the effectiveness of teaching include having patients show how to perform a newly learned skill (e.g., self-catheterization) or asking patients to explain how they will incorporate newly ordered medications into their daily routines. Evaluating the effectiveness of teaching for a psychomotor skill includes a demonstration, not understanding or acknowledging. Just stating, “Yes” does not indicate learning like a demonstration does.
PTS:1DIF:Cognitive Level: Analyzing (Analysis)
REF:204OBJ:Identify methods for evaluating learning.
TOP: Nursing Process: Evaluation MSC: NCLEX: Basic Care and Comfort
5.A patient recently had a stroke and suffered right-sided weakness. The patient is being discharged from a rehabilitation hospital after learning to use a walker. Which learning domain was primarily used to teach the patient to be independent with the walker?
a.
Psychomotor
b.
Affective
c.
Cognitive
d.
Motivational
ANS: A
Psychomotor learning occurs when patients acquire skills that require the integration of knowledge and physical skills. Examples of psychomotor learning include learning to walk with a walker or giving an insulin injection. Affective learning includes the patient’s feelings, attitudes, opinions, and values. Cognitive learning includes what the patient knows and understands. All intellectual behaviors are in the cognitive domain. Motivation is an internal impulse, such as an emotion or need, which prompts, guides, and sustains human behavior.
PTS:1DIF:Cognitive Level: Applying (Application)
REF:206OBJ:Describe the domains of learning.
TOP: Nursing Process: Assessment MSC: NCLEX: Basic Care and Comfort
6.Which patient is the most likely to be motivated to learn?
a.
A 23-year-old smoker being taught about weight control
b.
A 45-year-old man being taught about importance of prostate cancer screening
c.
A 63-year-old knee replacement patient being taught postsurgical knee rehabilitation
d.
A 15-year-old girl being taught about safe sex
ANS: C
Motivation to learn is often dependent on the patient’s situation, needs, previous knowledge, attitudes, and sociocultural factors. For example, patients who need knowledge for survival or to return to a previous level of functioning (knee replacement for knee rehabilitation) have a stronger motivation to learn than patients who need knowledge for promoting health. Weight control, prostate cancer screening, and safe sex are all related to promoting health rather than survival or returning to a previous level of functioning.
PTS:1DIF:Cognitive Level: Analyzing (Analysis)
REF:206
OBJ:Differentiate factors that determine readiness to learn from those that determine ability to learn.TOP:Nursing Process: Assessment
MSC: NCLEX: Health Promotion and Maintenance
7.A postsurgical patient is being taught about wound care before being discharged from the hospital and is in a semiprivate room with another patient. The other patient is upset with a family member and is crying. The television is on to try to provide some distraction from the roommate. Which action should the nurse take to best facilitate patient education for wound care?
a.
Explain to the patient that everything is in the handout.
b.
Take the patient to a quiet area to do the patient teaching.
c.
Ask the roommate to please be considerate of the patient because patient education is occurring.
d.
Request that a home health nurse follow up with the patient at home to teach about wound care.
ANS: B
A quiet area is needed for learning. Before learning anything, patients must be able to pay attention to or concentrate on the information they will learn. Physical discomfort, anxiety, and environmental distractions make it more difficult for a patient to concentrate. It is not appropriate to refer the patient to a handout. Asking the roommate to be considerate is inappropriate because the roommate is distraught. Home health nursing is not needed at this time.
PTS:1DIF:Cognitive Level: Analyzing (Analysis)
REF:206 | 209
OBJ: Describe the characteristics of an environment that promotes learning.
TOP: Nursing Process: Implementation MSC: NCLEX: Psychosocial Integrity
8.A nurse will be teaching a prepared childbirth class for the first time at a neighborhood church. The nurse has gone to the church to determine which room would be best suited to teach a group of six couples. Which room configurations would be most appropriate for teaching this group?
a.
A small carpeted room with no furniture
b.
A large auditorium with a stage and theater-style seating
c.
A lunchroom with stationary tables and chairs
d.
A Sunday-school classroom with tables and chairs
ANS: D
A Sunday-school classroom allows everyone to be seated comfortably and within hearing distance of the teacher and, the room can comfortably hold all members of the group. Arranging the group to allow participants to observe one another (e.g., in a circle) further enhances learning. A small carpeted room would not allow much room for six couples. A large auditorium is too big. Stationary tables and chairs do not allow for rearranging if needed, and a lunchroom is usually too big.
PTS:1DIF:Cognitive Level: Analyzing (Analysis)
REF:209
OBJ: Describe the characteristics of an environment that promotes learning.
TOP:Nursing Process: Assessment
MSC: NCLEX: Health Promotion and Maintenance
9.A patient who is a migrant farm worker did not graduate from high school and speaks English as a second language. The nurse will be providing discharge teaching after a hysterectomy. The nurse is concerned about the patient’s ability to understand the discharge instructions. Which of the following should be of most concern in this situation?
a.
Motivation
b.
Developmental stage
c.
Health literacy
d.
Psychomotor learning
ANS: C
Health literacy includes patients’ reading and math skills, comprehension, the ability to make health-related decisions, and successful functioning as a consumer of health care. It is a strong predictor of health status and patient outcomes. Psychomotor learning occurs when patients acquire skills that require the integration of knowledge and physical skills. Developmental stage is not as important as health literacy and developmental stage is more important when teaching children. Motivation is an internal impulse, such as an emotion or need, which prompts, guides, and sustains human behavior.
PTS:1DIF:Cognitive Level: Analyzing (Analysis)
REF:211
OBJ: Discuss ways to adapt teaching approaches for patients with low health literacy.
TOP:Nursing Process: Assessment
MSC: NCLEX: Health Promotion and Maintenance
10.A patient was recently diagnosed with heart failure. The health care provider has ordered a low-sodium diet. A nurse is planning patient education for diet instruction. Which information should the nurse present first?
a.
How much daily intake of sodium is recommended
b.
How to read food labels at the grocery store
c.
How to understand the metric system of measurement
d.
How to cook different meals with low-sodium foods
ANS: A
Present the daily intake of sodium first because material should progress from simple to complex because a person learns simple facts and concepts before learning how to make associations or complex interpretations of ideas. How to read food labels, the metric system, and how to cook different meals are more complex than the daily intake of sodium.
PTS:1DIF:Cognitive Level: Analyzing (Analysis)
REF: 215 OBJ: Identify the principles of effective teaching and learning.
TOP:Nursing Process: Implementation
MSC: NCLEX: Health Promotion and Maintenance
11.A nurse who works in a diabetes clinic has been asked to help a 12-year-old male patient learn to give his own insulin injections. The nurse demonstrates the technique on a teaching manikin and then asks the patient to demonstrate the task on the manikin while providing assistance. Which teaching approach did the nurse use?
a.
Entrusting
b.
Telling
c.
Participating
d.
Reinforcing
ANS: A
The entrusting approach provides the patient the opportunity to manage self-care. The patient accepts responsibilities and correctly performs the task while a nurse observes the patient’s progress and remains available for assistance. Telling involves explicit instructions with no feedback. Participating involves mutual goal setting with the patient helping decide the content. Reinforcing is using a stimulus that increases the probability of a response.
PTS:1DIF:Cognitive Level: Analyzing (Analysis)
REF:217
OBJ: Describe ways to adapt teaching for patients with different learning needs.
TOP:Nursing Process: Implementation
MSC: NCLEX: Health Promotion and Maintenance
12.A pediatric nurse who works evenings on a surgical floor in a children’s hospital has been working with a 5-year-old patient who has undergone abdominal surgery. The nurse gives the patient a sticker each time the incentive spirometer is used. What type of reinforcement did the nurse use?
a.
Social
b.
Material
c.
Activity
d.
Negative
ANS: B
Examples of material reinforcers are food, toys, and music. These work best with young children. Use social reinforcers (e.g., smiles, compliments, words of encouragement, or physical contact) to acknowledge a learned behavior. Activity reinforcers (e.g., physical therapy) rely on the principle that a person is motivated to engage in an activity if there is an opportunity to participate in more desirable activity upon completion of this first activity. Negative reinforcement (frowning) may work but people usually respond better to positive reinforcement.
PTS:1DIF:Cognitive Level: Applying (Application)
REF: 217 OBJ: Identify the principles of effective teaching and learning.
TOP:Nursing Process: Evaluation
MSC: NCLEX: Health Promotion and Maintenance
13.A nurse is preparing to take a 5-year-old child’s blood pressure. What is the best way for the nurse to reduce the child’s anxiety about this procedure?
a.
Do nothing because the more fuss that is made about a procedure, the more anxiety it causes the patient.
b.
Explain to the patient that the blood pressure is a vital sign that the doctor has ordered.
c.
Tell the child that the blood pressure cuff will “hug” the arm.
d.
Ask the child’s mother to step outside the room because children frequently do better when alone.
ANS: C
Describe physical sensations that will occur during the procedure by telling the child that the cuff will “hug” the arm. Providing information about procedures helps patients feel less anxious because they understand what to expect during the procedure. When preparatory instructions accurately describe the actual experience, the patient is able to cope more effectively with the stress from procedures and therapies. Doing nothing does not prepare the patient properly or address the anxiety. A 5 year old will not understand the term vital signs. Involve the parents with young children.
PTS:1DIF:Cognitive Level: Analyzing (Analysis)
REF:212 | 217
OBJ:Describe ways to incorporate teaching with routine nursing care.
TOP: Nursing Process: Implementation MSC: NCLEX: Psychosocial Integrity
14.An 8-year-old boy has been diagnosed with diabetes. A nurse is teaching his mother how to plan meals that are appropriate for him. The nurse asks the mother to put together
a 24-hour meal plan for her son and then reviews the plan with her. What type of teaching method did the nurse use?
a.
Simulation
b.
Role-play
c.
Analogy
d.
Demonstration
ANS: A
Simulation is a useful technique for teaching problem solving, application, and independent thinking. During individual or group discussion, the nurse presents a problem or situation pertaining to the patients’ learning for patients to solve. During role-play, your patients play themselves or someone else in the situation. Analogies add to verbal instruction by providing familiar images that make complex information more real and understandable. Demonstrations are useful methods for teaching psychomotor skills.
PTS:1DIF:Cognitive Level: Analyzing (Analysis)
REF: 219 OBJ: Identify the principles of effective teaching and learning.
TOP:Nursing Process: Implementation
MSC: NCLEX: Health Promotion and Maintenance
15.A nurse is discharging a patient who required teaching about how to change a foot dressing. The nurse wants to ensure that the patient understands the signs and symptoms of infection and is preparing written materials the patient can take home and refer to as needed. Because the nurse does not know the patient’s reading ability, at which grade level should the nurse prepare the written materials?
a.
Fifth
b.
Sixth
c.
Eighth
d.
Ninth
ANS: A
Individualize teaching materials to meet the patient’s needs and match the patient’s reading level; if a nurse does not know the patient’s reading level, information should be provided at a fifth-grade or lower level. Sixth-, eighth-, and ninth-grade levels are too high.
PTS:1DIF:Cognitive Level: Applying (Application)
REF:219
OBJ: Describe ways to adapt teaching for patients with different learning needs.
TOP:Nursing Process: Implementation
MSC: NCLEX: Health Promotion and Maintenance
16.A 75-year-old patient who is being discharged home after a stroke has no use of the right hand. Which teaching strategy is best for the nurse to use for this patient?
a.
Provide all the teaching at once, immediately before going home so the patient will remember it.
b.
Teach the patient with the aid of a computer to demonstrate that the discharge instructions are on the hospital webpage.
c.
Teach the patient using generic patient discharge information about strokes.
d.
Provide information based on the patient’s needs in frequent sessions.
ANS: D
Effective teaching strategies for the older adult include providing individualized information that is based on what the patient needs to know and presenting information slowly in frequent sessions. Allow more time for older learners to demonstrate learning. Do not provide the teaching all at once; use frequent sessions. Because the patient has no use of the right hand, navigating the computer could be cumbersome. The older adult needs individualized, not generic, information.
PTS:1DIF:Cognitive Level: Applying (Application)
REF:218
OBJ: Describe ways to adapt teaching for patients with different learning needs.
TOP:Nursing Process: Assessment
MSC: NCLEX: Health Promotion and Maintenance
17.A nurse needs to begin teaching about crutch walking with a 14-year-old patient. Which action should the nurse take first?
a.
Motivate the patient to comply with the use of crutches.
b.
Prevent diseases and learn good health promotion activities for crutch walking.
c.
Allow the entire health care team to give the patient a variety of strategies for crutch walking.
d.
Determine the patient’s level of knowledge and perception of the learning needed for crutch walking.
ANS: D
Determining a patient’s level of knowledge is the first step. Assess the patient’s level of knowledge, intellectual skills, and literacy level before beginning a teaching plan. The first step is not to motivate a patient. A patient’s motivation to learn is an important factor; however, a patient’s motivation helps to determine if the patient is prepared and willing to learn, not what needs to be taught. Health education is not focused on disease prevention as a primary goal, but on assisting patients to achieve optimal levels of health. Although the entire health care team may be involved with patient education, the educator must select the appropriate teaching strategy for the patient’s ability to learn.
PTS:1DIF:Cognitive Level: Applying (Application)
REF: 207 OBJ: Use the nursing process to make a teaching plan of care.
TOP:Nursing Process: Implementation
MSC: NCLEX: Health Promotion and Maintenance
18.A patient needs to take daily injections of a blood thinner for 7 days after hospital discharge. The nurse observes the patient’s self-administration technique. What type of learning occurred?
a.
Affective
b.
Cognitive
c.
Motivational
d.
Psychomotor
ANS: D
Psychomotor learning occurs when patients acquire skills that require the integration of knowledge and physical skills. Affective learning includes the patient’s feelings, attitudes, opinions, and values. Cognitive learning includes what the patient knows and understands. All intellectual behaviors are in the cognitive domain. A patient’s motivation to learn is an important factor; however, it is not a type of learning; it helps to determine if the patient is prepared and willing to learn.
PTS:1DIF:Cognitive Level: Analyzing (Analysis)
REF:206OBJ:Describe the domains of learning.
TOP:Nursing Process: Evaluation
MSC: NCLEX: Health Promotion and Maintenance
19.A nurse is preparing to teach a patient about ostomy care. The patient appears anxious and is crying. What should the nurse do?
a.
Let the patient know it is time to learn about ostomy care.
b.
Postpone the teaching session about ostomy care.
c.
Show a video about ostomy care.
d.
Implement role-play.
ANS: B
Any condition (e.g., fatigue, breathing difficulty, or depression) that drains a person’s energy impairs the ability to learn. Postpone teaching when an illness becomes aggravated by complications such as pain, fever, or respiratory difficulty. Letting the patient know it is time to learn, implementing role-play, and showing a video will not enhance learning. The crying needs to be addressed first.
PTS:1DIF:Cognitive Level: Applying (Application)
REF:209
OBJ: Describe the characteristics of an environment that promotes learning.
TOP: Nursing Process: Implementation MSC: NCLEX: Management of Care
20.Which behavior by a new nurse will cause the nurse manager to intervene?
a.
Initiates teaching of a patient
b.
Uses discovery learning techniques with a patient
c.
Assigns nursing assistive personnel to teach a patient
d.
Implements the teach-back method to evaluate patient understanding
ANS: C
In most situations it is not appropriate to delegate educational interventions to nursing assistive personnel (NAP); therefore the nurse manager would have to intervene. Nurses should initiate teaching; that is a component of the nurse’s role. Discovery is a useful technique for teaching problem-solving application and independent thinking. Regardless of the method used to teach, use the teach-back method to evaluate the patient’s understanding of the material.
PTS:1DIF:Cognitive Level: Analyzing (Analysis)
REF: 215 OBJ: Identify the principles of effective teaching and learning.
TOP: Nursing Process: Evaluation MSC: NCLEX: Management of Care
21.A nurse tells a patient with a recent back injury that damage to the nerves is comparable to a water hose that has been pinched off and that time is needed to allow normal nerve transmission. Which technique did the nurse use?
a.
Analogy
b.
Discovery
c.
Role-playing
d.
Demonstration
ANS: A
Analogies add to verbal instruction by providing familiar images that make complex information more real and understandable. Discovery is a useful tool for teaching problem solving and is a technique for cognitive learning. During role-play your patients play themselves or someone else in the situation. Demonstrations are useful when teaching psychomotor skills.
PTS:1DIF:Cognitive Level: Analyzing (Analysis)
REF: 218 OBJ: Identify the principles of effective teaching and learning.
TOP:Nursing Process: Implementation
MSC: NCLEX: Health Promotion and Maintenance
MULTIPLE RESPONSE
1.A patient must learn to apply a lower leg orthotic device but has a minor paralysis of the right upper extremity. Before teaching this skill, the nurse must assess the patient’s physical capabilities. Which areas will the nurse assess? (Select all that apply.)
a.
Size
b.
Strength
c.
Coordination
d.
Sensory acuity
e.
Learning environment
ANS: A, B, C, D
The nurse is assessing physical capability, which includes size, strength, coordination, and sensory acuity. Size refers to height and weight. Strength refers to the patient’s ability to follow a regimen. Coordination refers to dexterity needed. Sensory acuity includes visual, auditory, tactile, gustatory, and olfactory sense. Although the learning environment should be assessed, it is not a component of a patient’s physical capabilities.
PTS:1DIF:Cognitive Level: Applying (Application)
REF: 209 OBJ: Use the nursing process to make a teaching plan of care.
TOP:Nursing Process: Assessment
MSC: NCLEX: Health Promotion and Maintenance
2.The nurse must teach grieving patients about future skills and knowledge. Which patients will most likely be ready to learn? (Select all that apply.)
a.
A patient in denial
b.
A patient in anger
c.
A patient in bargaining
d.
A patient in resolution
e.
A patient in acceptance
ANS: D, E
Patients in resolution and acceptance are ready to learn about future skills and knowledge. Patients in denial, anger, and bargaining should only be taught in the present tense (explain current therapy); they are not ready to accept future learning.
PTS:1DIF:Cognitive Level: Applying (Application)
REF:208
OBJ:Differentiate factors that determine readiness to learn from those that determine ability to learn.TOP:Nursing Process: Evaluation
MSC: NCLEX: Psychosocial Integrity
3.A nurse wants learning to take place in the affective domain of learning. Which techniques should the nurse implement that are the best for this type of learning? (Select all that apply.)
a.
Lecture
b.
Practice
c.
Discussion
d.
Role play
e.
Return demonstration
ANS: C, D
Teaching methods for affective learning include role-play and discussion. Lecture is effective for cognitive learning. Practice and return demonstration are best for psychomotor learning.
PTS:1DIF:Cognitive Level: Applying (Application)
REF:218OBJ:Describe the domains of learning.
TOP: Nursing Process: Implementation MSC: NCLEX: Psychosocial Integrity
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