Nursing Fundamentals 2nd Edition Daniels Grendell Wilkins Test Bank
Nursing Fundamentals 2nd Edition Daniels Grendell Wilkins Test Bank
Nursing Fundamentals 2nd Edition Daniels Grendell Wilkins Test Bank
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Chapter 28: Client Education
- The nurse documents in a patient’s chart: able to correctly change wound dressing. This is an example of learning in which domain?
Evidence of cognitive domain learning would be the patient’s ability to name and provide the purpose of medications or diagnostic tests. Evidence of affective domain learning would be that the patient accepts the diagnosis of a chronic illness. Evidence of learning in the psychomotor domain would be the patient’s ability to perform a skill using physical movement and motor skills, such as changing a dressing. Conditioning is not a domain of learning.
- Which of the following is an example of learning in the affective domain?
|a.||The patient plans a 1,000 mg sodium diet for 3 days.|
|b.||The patient accepts that he has a terminal illness.|
|c.||The patient walks with crutches using the correct gait.|
|d.||The patient gives himself an injection.|
Evidence of cognitive domain learning would be the patient’s ability to plan a low sodium diet for 3 days. Evidence of affective domain learning would be that the patient accepts the diagnosis of a terminal illness. Evidence of learning in the psychomotor domain would be the patient’s ability to perform a skill using physical movement and motor skills, such as crutch walking or giving himself an injection.
- The nurse shows the patient pictures of how his body functions in relation to his particular illness. This would appeal most to which type of learner?
Some people learn by processing information visually. Others learn by listening to words and are auditory learners. People who learn by doing are considered kinesthetic learners. There is not a multifocal type of learner.
- The patient is a kinesthetic learner. Which teaching method would be best to teach this patient about his newly prescribed diet?
|a.||Have him tell the nurse what foods he should eat.|
|b.||Show the patient pictures of the foods that are allowed and not allowed on his diet.|
|c.||Have the patient plan meals using food models.|
|d.||Give the patient a written description of the diet.|
A kinesthetic learner learns by doing. The nurse should have the patient plan meals using food modules. The other activities would support the visual and auditory learners.
- Which of the following should the nurse do to prepare a patient for discharge?
|a.||prepare instructions to be provided on the day of discharge|
|b.||begin planning for the patient’s discharge upon admission|
|c.||provide discharge instructions after the physician writes the order for discharge|
|d.||phone the patient at home after discharge|
Preparing the patient and family for discharge begins not at the time of hospital discharge but rather with the hospital admission. Discharge planning considers the current learning needs for patients and caregivers as well as potential needs after discharge.
- The nurse is teaching a 5-year-old in preparation for upcoming surgery. Which teaching method is most appropriate?
|a.||showing a videotape||c.||play using a doll|
|b.||group discussion||d.||giving the child a book to read|
The most appropriate strategy to use to teach a preschooler/school age child would be to encourage play with using a doll. The child is not developmentally ready to follow instructions on a videotape or participate in a group discussion. The child is only five, and so might not be able to read.
- The nurse is teaching a group of adolescents who have diabetes mellitus about coping with their condition. Which teaching approach is most appropriate?
|a.||Engage the adolescents in problem-solving activities.|
|b.||Use very simple language.|
|c.||Identify the problem areas and weaknesses, building the teaching plan around these.|
|d.||Follow precisely a preplanned outline.|
When teaching adolescents, the nurse should show respect, boost confidence, encourage the exploration of feelings, be sensitive to peer pressure, help identify positive qualities, use appropriate clear language, gear teaching to the developmental level, and engage in problem-solving activities to encourage independence and informed decision making.
- The nurse is teaching an older adult with a vision impairment. Which of the following can the nurse do to facilitate learning for this patient?
|a.||Use repetition.||c.||Speak loudly and slowly.|
|b.||Use simple terms.||d.||Use large print materials.|
For a visually impaired patient, the nurse can provide large printed materials, provide magnifying glasses, or provide audio-taped instructions. The use of repetition would assist the patient with a memory-impairment. The use of simple terms would assist the patient with a hearing impairment. Speaking loudly and slowly would not be beneficial for any type of impairment.
- The nurse is preparing to instruct a patient on his prescribed medications. This topic would be considered:
|a.||Health promotion||c.||Disease/Injury prevention|
|b.||Health restoration||d.||Facilitating coping|
Health promotion topics would include parenting skills, nutrition, exercise, and family planning. Health restoration topics would focus on medication information, community resources, and treatment modalities. Disease/Injury prevention topics would include immunizations, health screenings, smoking cessation, breast self-examination, and safety measures. The topics within the Facilitating Coping category would include safe use of medical equipment, dietary modifications, information about the disease process, counseling related to anger, grief, self-esteem, and stress management.
- The nurse is documenting in a patient’s chart information about a teaching-learning session. Which of the following would not be necessary to include in this documentation?
|a.||learning objectives||c.||patient response|
|b.||teaching methods used||d.||location of the teaching|
Effective documentation should include the patient/family learning needs, readiness to learn, learning style, current knowledge base, learning objectives and goals, information and skills taught, teaching methods used, patient/family response, and evaluation of what the patient/family learned. The location of the teaching is not necessary to document.
- While planning for a teaching-learning session with a patient, the nurse reviews the steps of the nursing process. This activity is beneficial because:
|a.||There is little similarity between the two.|
|b.||The teaching-learning process is less complex than the nursing process.|
|c.||The two are very similar.|
|d.||They exist independently of one another.|
The teaching-learning process mirrors the steps of the nursing process: assessment, identification of learning needs, planning, implementation of teaching strategies, and evaluation of learner progress and teaching efficacy.
- A 30-year-old patient is pregnant and states “I don’t know how much longer I can stand this nausea and feeling so tired.” Which of the following learning needs should the nurse address initially?
|a.||need for daily vitamins||c.||labor and delivery|
|b.||infant care||d.||methods to cope with nausea|
If the patient sees the information as being personally valuable, the information is more likely to be learned. If the patient does not think that the content is relevant, learning is not likely to occur. Relevance is determined individually. The nurse must assess the personal meaning of learning content for each patient.
- The nurse determines that a patient is not ready to learn. Which behavior did the patient demonstrate?
|a.||asking the nurse why this information is important|
|b.||denial that he has the condition|
|c.||stating, “I want to get out of the hospital as soon as I can.”|
|d.||patient showing the nurse how he can change his own dressing|
Readiness to learn is one of the principles of learning. The patient should demonstrate behaviors that indicate ability and willingness to learn. Denying that a health condition exists would indicate that the patient is not ready to learn. Each of the other choices would indicate that the patient is ready to learn.
- The nurse would like to promote self-efficacy in a patient. Which of the following should the nurse do to accomplish this goal?
|a.||breaking the teaching content down into small steps|
|b.||emphasizing the importance of learning a large amount of information|
|c.||explaining that others have learned this information|
|d.||telling the patient this information will improve his well-being|
The concept of self-efficacy is a belief that one will succeed in attempts to change behavior. This concept has a profound effect on motivation. If a patient feels they will not achieve the goals, they will lack motivation to try. To maximize motivation, the nurse should keep the teaching-learning goals realistic, break the content down into small steps that are achievable, and provide feedback on the process.
- A patient is recovering from surgery and has several learning needs. When should the nurse teach this patient?
|a.||when the patient says, “What are those pills for?”|
|b.||following the administration of morning care|
|c.||immediately before discharge|
|d.||after the patient arrives home|
The patient’s question regarding medications would indicate that the patient is ready and motivated to learn. The patient might not be ready or willing to learn after the completion of morning care. Waiting to instruct the patient immediately before discharge would not provide enough time for learning to occur. Teaching the patient after the patient returns to home would not provide enough time for learning to occur and could lead to safety issues if the patient is not adequately prepared.
- Before beginning a teaching-learning session with a patient, the nurse assesses the patient’s behavior about learning. This nurse is implementing which of the following theories of learning?
Watson believed that learning is a result of conditioning and experiences. Pavlov believed that the learner is passive and controlled by the environment. Skinner believed that teaching is the deliberate manipulation of the environment. Thorndike believed that learning can be transferred from one situation to another and that the assessment of the learner’s behavior is necessary.
- A patient tells the nurse “I know I have diabetes. I don’t like it but I know it.” The nurse realizes this patient has achieved learning in which of the following domains?
Evidence of cognitive domain learning would be the patient’s ability to name and provide the purpose of medications or diagnostic tests. Evidence of affective domain learning would be that the patient accepts the diagnosis of a chronic illness. Evidence of learning in the psychomotor domain would be the patient’s ability to perform a skill using physical movement and motor skills such as changing a dressing. There is not an intellectual domain of learning.
- The nurse has a variety of teaching strategies to use to instruct patients. Which of the following has been identified as the most beneficial strategy for learning to take place?
|b.||visual aids||d.||a combination of the above|
The nurse needs to be sensitive to all three learning domains when developing plans and using teaching strategies. Techniques to promote learning have to tap into all three domains. Depending upon the learning situation and the learner, the nurse can use a combination of role-play, visual aids, and programmed instruction to teach patients.
- Role-play becomes an effective teaching strategy starting at which developmental level?
Teaching strategies appropriate for a toddler include play, comfort toys, picture books, and dolls. Teaching strategies appropriate for a preschooler include play, coloring books, and music with audiotapes. For the school-age child, teaching strategies include toys, computer games, and role-play. For the adolescent, teaching strategies include printed material, role-play, and demonstration.
- The nurse is going to assess a patient for learning. Which of the following should be assessed first?
|d.||previous experience and knowledge base|
Several factors need to be considered during assessment of a patient for learning. These include: learning styles, learning needs, potential learning needs, ability to learn, readiness to learn, patient strengths, and previous experience and knowledge base.
- Which of the following would facilitate teaching a patient with a hearing impairment?
|a.||use long sentences||c.||use audiotapes|
|b.||sit next to the patient when speaking||d.||avoid exaggerating pronunciations|
Strategies to facilitate the teaching-learning experience for a patient with a hearing impairment include facing the patient when speaking, using short sentences, using common terminology, providing a quiet setting, avoiding the exaggeration of pronunciations, providing reading material, and offering a hearing-assisting device. The use of audiotapes would help facilitate learning for a patient who has a vision impairment.
- During a teaching-learning session, the patient tells the nurse that he’s tired and has “had enough” for today. The nurse realizes this patient is demonstrating:
Each individual has the capacity to learn, however learning ability varies from person to person and is situational. The pace of learning varies with each person. Learning is a continuous process and occurs in formal and informal settings. Learning is an individualized process. Motivation and readiness are necessary for learning to occur.
- The nurse is preparing reading materials for a patient. People typically read at which grade level below the achieved educational level?
|a.||one to two||c.||seven to ten|
|b.||three to five||d.||the same|
It is important for nurses to assess the reading and comprehension abilities of patients before using printed materials. It is a common mistake to equate the highest educational level achieved with reading level. Typically, individuals read at three to five grade levels lower than their achieved educational level.
- The nurse is identifying the learning needs for a patient. This step in the teaching-learning process would be equated with which of the following steps within the nursing process?
Identification of learning needs within the teaching-learning process can be equated with the nursing diagnosis step within the nursing process.
- The nurse is planning to instruct a patient on self-administration of insulin. It is documented in the chart that the patient is a kinesthetic learner. Which of the following methods should the nurse use to instruct this patient?
|a.||Show pictures of various methods to administer insulin.|
|b.||Have the patient listen to a lecture on insulin administration.|
|c.||Ask the patient to watch a videotape on insulin administration.|
|d.||Have the patient handle the supplies needed for insulin administration and practice the technique on an artificial surface.|
Showing pictures and watching a videotape would support the visual learner. Listening to a lecture would support the auditory learner. Handling the supplies and practicing the technique would support the kinesthetic learner.