Chapter 09: Patient Teaching for Health Promotion My Nursing Test Banks

Chapter 09: Patient Teaching for Health Promotion

Test Bank

MULTIPLE CHOICE

1. Before beginning to teach a patient to give himself insulin, the nurse asks, Have you ever known anyone who gave himself insulin injections? This question is primarily designed to:

a.

assess the patients learning needs.

b.

stimulate the patient to focus on the teaching goal.

c.

reduce the patients anxiety relative to insulin injection.

d.

reduce the amount of information the nurse has to provide.

ANS: A

Assessing a patients previous experience (as well as education, learning mode, and motivation) gives the nurse valuable information in developing a teaching plan tailored to the individual. It may reduce the amount of information needed, or it may increase it if some of what the patient knows is erroneous.

DIF: Cognitive Level: Analysis REF: p. 119 OBJ: Theory #3

TOP: Assessing Learning Needs KEY: Nursing Process Step: Assessment

MSC: NCLEX: Physiological Integrity: basic care and comfort

2. The nurse uses a syringe and vial of insulin to show how to draw up the correct dose while she explains the procedure to the patient. To best promote learning, her next step should be to:

a.

give the patient written materials to study and learn the procedure.

b.

have the patient explain the procedure to the nurse to assess understanding.

c.

give the patient a day to allow him to process and absorb the information.

d.

have the patient practice the procedure with the nurse helping.

ANS: D

Kinesthetic, or hands-on, learning reinforces the visual demonstration. Immediate handling of the materials reduces anxiety. Giving the patient reading materials or asking the patient to explain verbally will not be as effective as the kinesthetic application.

DIF: Cognitive Level: Application REF: p. 116 OBJ: Theory #3

TOP: Modes of Learning KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity: basic care and comfort

3. In teaching an 82-year-old patient to perform a dressing change to be done at home after discharge, the nurse would adjust the teaching session to:

a.

include another person in the instruction because an 82-year-old person will be unable to master the technique.

b.

slow the pace and frequently ask questions to assess comprehension.

c.

speed through the details because age and experience will shorten learning time.

d.

provide written material and diagrams alone.

ANS: B

The older patient needs to have the pace slowed and have time to ask questions to confirm comprehension. The inclusion of written materials to reinforce teaching is also good, but should not be the only method of instruction.

DIF: Cognitive Level: Application REF: p. 118 OBJ: Theory #5

TOP: Factors Affecting Learning KEY: Nursing Process Step: Planning

MSC: NCLEX: Physiological Integrity: basic care and comfort

4. An 80-year-old patient is to be taught the process of colostomy irrigation and reattachment of the colostomy bag. The nurses initial assessment prior to instruction should address the patients:

a.

understanding of the process of irrigation.

b.

familiarity with the irrigation materials.

c.

manual dexterity.

d.

motivation to learn.

ANS: D

The patients motivation to learn a new skill is essential to the success of the instruction. Some patients need to see the advantage of independence to motivate them to learn. Manual dexterity and basic understanding of materials and process are important, but initially the motivation needs to be assessed.

DIF: Cognitive Level: Analysis REF: p. 119 OBJ: Clinical Practice #1

TOP: Motivation KEY: Nursing Process Step: Assessment

MSC: NCLEX: Physiological Integrity: basic care and comfort

5. The nurse can assess her patients ability to read and comprehend written instructions by doing which of the following?

a.

Asking the patient, Did you graduate from high school?

b.

Giving the patient a printed instruction sheet and saying, Some people have difficulty with written instructions. Others find them helpful. Would these be helpful to you?

c.

Asking the patient, Are you able to read?

d.

Giving the patient some printed materials and saying, After you have read this, Ill ask you some questions about whats in them, to see if youve learned it.

ANS: B

Graduation from high school does not guarantee reading comprehension. Actually reading allows the nurse to know if the patient can read as well as comprehend.

DIF: Cognitive Level: Application REF: p. 119 OBJ: Theory #3

TOP: Assessing Literacy KEY: Nursing Process Step: Assessment

MSC: NCLEX: Physiological Integrity: basic care and comfort

6. A patient being assessed for pre-operative learning needs says his mother had the same surgery by the same surgeon 3 years ago. The nurse should design the teaching plan to:

a.

do a brief review of the preoperative teaching, because the patient is already familiar with the procedure.

b.

teach thoroughly as the procedure may have changed.

c.

simply give the patient a written list of preoperative instructions.

d.

explore with the patient what he knows about the proposed surgery and add or correct where necessary.

ANS: D

Assessing a patients experience and knowledge allows the nurse to tailor the teaching to the individual. The nurse should never assume that a patient knows what he is supposed to know and that teaching again what the patient already knows is a waste of time or insults the patients intelligence and experience. Giving a list of preoperative instructions is simply impossible.

DIF: Cognitive Level: Analysis REF: p. 119 OBJ: Theory #4

TOP: Assessing Learning Needs KEY: Nursing Process Step: Assessment

MSC: NCLEX: Physiological Integrity: basic care and comfort

7. The nurse is aware that the knowledge deficit of a postpartum patient with her first child that can be safely addressed by the community nurse after discharge is:

a.

weaning the child from breast-feeding.

b.

care of the patients surgical incision.

c.

feeding the baby by breast or bottle.

d.

recognizing signs or symptoms of infection.

ANS: A

Priority teaching needs prior to discharge are those that have to do with physiologic or safety needs. Thus feeding the baby, care of the incision (prevent infection), and recognition of signs that affect safety must be addressed before discharge. Weaning will not occur until much later and can be addressed safely by the home health nurse.

DIF: Cognitive Level: Comprehension REF: p. 116 OBJ: Theory #8

TOP: Prioritizing Learning Needs KEY: Nursing Process Step: Planning

MSC: NCLEX: Health Promotion and Maintenance: prevention and early detection of disease

8. The nurse evaluates the effectiveness of teaching relative to how to use an eye shield after eye surgery is to:

a.

have the patient tell the nurse what he is going to do.

b.

have the patient demonstrate that he can secure the eye shield.

c.

ask the patient if he has any questions related to the use of the shield.

d.

call the patient at home in 3 days and ask if he has been wearing the shield.

ANS: B

A return demonstration and explanation by the patient will evaluate whether the patients learning needs are met. Having the patient describe the process and ask questions might be helpful but does not show that the patient can place the shield correctly (a psychomotor skill). Evaluation of teaching should be done to allow time to revise the teaching plan if the patient is unable to meet the behavioral objectives. Calling after discharge is too late to correct problems.

DIF: Cognitive Level: Application REF: p. 120 OBJ: Theory #2

TOP: Evaluation of Learning KEY: Nursing Process Step: Evaluation

MSC: NCLEX: Physiological Integrity: basic care and comfort

9. The nurse will choose the best time to continue postoperative teaching regarding wound care and dressings, which would be:

a.

immediately after the patient has been medicated for pain.

b.

just before the patient is discharged, so the information is current.

c.

when the patient is comfortable and receptive to the teaching.

d.

the last thing in the evening, after visitors have left, before bedtime.

ANS: C

A patient who is in pain, sedated from pain medication, or fatigued at the end of the day after visitors leave will not be receptive to teaching. Teaching should begin before discharge to improve learning.

DIF: Cognitive Level: Comprehension REF: p. 119 OBJ: Theory #3

TOP: Readiness to Learn KEY: Nursing Process Step: Planning

MSC: NCLEX: Physiological Integrity: basic care and comfort

10. A nurse plans to teach a 4-year-old about what to expect after his broken arm has been casted by:

a.

bringing a doll and casting materials to the room, showing the casting materials and actually casting the dolls arm, and explaining the purpose of the cast.

b.

telling the child that while he is asleep, the doctor will take off his arm and wrap it up.

c.

breaking up the teaching sessions into two separate 5-minute sessions.

d.

being treated as an adult because this approach helps the child to feel grown up.

ANS: C

Children benefit from teaching that is geared toward their age and level of understanding. Teaching in short sessions, allowing for the childs brief attention span, will enhance teaching. Children are very literal and improbable stories will be believed.

DIF: Cognitive Level: Comprehension REF: p. 118 OBJ: Theory #5

TOP: Teaching a Child KEY: Nursing Process Step: Planning

MSC: NCLEX: Physiological Integrity: basic care and comfort

11. The best way for a nurse to reinforce learning during a return demonstration by the patient is for the nurse to:

a.

give recognition and praise for the parts the patient does well and to assist or teach when the patient becomes confused or forgetful.

b.

watch quietly until the return demonstration is finished and then list the errors.

c.

instruct the patient to read the written material again when an error is made.

d.

stop the patient each time he makes a mistake and have him start again after the nurse reviews the procedure with him.

ANS: A

Praise and walking through the procedure reinforces learning.

DIF: Cognitive Level: Application REF: p. 117 OBJ: Theory #3

TOP: Teaching Methods KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity: basic care and comfort

12. A patient states, I dont think Ill ever be able to give myself an injection. The best reply by the nurse is:

a.

Everyone feels like that at first. Youll get over it.

b.

Dont be afraid. Its an easy skill for anyone to learn.

c.

What bothers you most about the idea of giving yourself an injection?

d.

I know just how you feel. I would have trouble giving myself an injection.

ANS: C

When a patient lacks self-confidence, the nurse needs to explore the patients feelings.

DIF: Cognitive Level: Application REF: p. 117 OBJ: Theory #4

TOP: Confidence and Abilities KEY: Nursing Process Step: Assessment

MSC: NCLEX: Physiological Integrity: basic care and comfort

13. The nurse takes into consideration that when using printed material for teaching a 65-year-old Middle-Eastern patient who speaks perfect English, the nurse should:

a.

use teaching material printed in English.

b.

determine if the patient can read English.

c.

engage a translator to read the English material to the patient.

d.

use English material that is printed in bold type on white paper.

ANS: B

Determine if the patient is literate in English. If not, a translator may be able to rewrite the instructions in the preferred language. Simply reading the English version is not helpful if the patient is to refer to the material after discharge. Bold print will not help a person who does not read English.

DIF: Cognitive Level: Application REF: p. 119 OBJ: Theory #3

TOP: Using Printed Materials KEY: Nursing Process Step: Assessment

MSC: NCLEX: Physiological Integrity: basic care and comfort

14. Because a person may learn best in a particular manner, to improve patient teaching, the nurse should:

a.

ask the patient whether he learns best visually, aurally, or kinesthetically.

b.

use a hands-on approach, because it works best for most people.

c.

test the patients reading comprehension before using visual handouts.

d.

use a combination of the three modes of learning to enhance learning.

ANS: D

Many people do not know which mode of learning is their dominant one, and most people learn best with a combination of teaching/learning techniques.

DIF: Cognitive Level: Knowledge REF: p. 116 OBJ: Theory #3

TOP: Learning Modalities KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity: basic care and comfort

15. Once a teaching plan is formulated and placed in the nursing care plan for a hospitalized patient:

a.

one nurse will be designated to teach the plan on a priority basis.

b.

behavioral objectives are used to identify expected outcomes.

c.

it is printed and given to the patient as a guide for learning.

d.

it outlines all that will be taught before the patient is discharged.

ANS: B

Behavioral objectives identify actions that can be measured; thus they serve as evaluation tools of expected outcomes. Many people are involved in a teaching plan, with responsibility designated in the plan. Not all of the teaching plan may be accomplished during the hospital stay. Priorities identify which learning needs are most important to teach before discharge and which can be taught by the community nurse after discharge.

DIF: Cognitive Level: Comprehension REF: p. 119 OBJ: Clinical Practice #2

TOP: Behavioral Objectives KEY: Nursing Process Step: N/A

MSC: NCLEX: Health Promotion and Maintenance: prevention and early detection of disease

16. In a skilled nursing home, a newly admitted resident becomes terminally ill following a cerebrovascular accident (CVA). To diminish the familys anxiety, the nurse teaches the family members about activities that are being performed to provide care and comfort to their loved one. This teaching is provided in order to:

a.

reduce the likelihood of a lawsuit over the anticipated death.

b.

decrease the familys needs in the expression of their grief.

c.

increase the familys comfort in their affective domain.

d.

enable the family to be better prepared for the approaching death.

ANS: C

Teaching that addresses a persons feelings, beliefs, or values addresses the affective domain.

DIF: Cognitive Level: Comprehension REF: p. 116 OBJ: Theory #3

TOP: Affective Domain KEY: Nursing Process Step: Implementation

MSC: NCLEX: Psychosocial Integrity: coping and adaptation

17. The nurse designing a teaching plan for a patient admitted to the hospital for treatment of a heart problem after years of treating the ailment at home with herbal remedies and practices common in his cultural group should:

a.

help the patient to see that using herbal remedies has not worked in the past.

b.

explain that cultural remedies may conflict with conventional medicine.

c.

help the patient to identify optimum outcomes that can be achieved through education and compromise.

d.

ask family members to intervene for the cessation of the use of cultural remedies.

ANS: C

A persons cultural values must be considered in formulating a nursing care plan. Working with the patient to identify what is of value to the patient can assist the nurse to plan care that meets the patients needs for education.

DIF: Cognitive Level: Application REF: p. 117 OBJ: Theory #4

TOP: Cultural Values and Expectations KEY: Nursing Process Step: Planning

MSC: NCLEX: Psychosocial Integrity: coping and adaptation

18. The nurse recognizes the American Indians need for the intervention of a shaman in dealing with illness because the shaman helps the patient in seeking:

a.

a sense of peace and harmony with nature.

b.

a spiritual route to healing.

c.

healing through the domination over evil.

d.

support from deceased ancestors.

ANS: B

The American Indian has a strong belief that spiritual healing is essential to physical health.

DIF: Cognitive Level: Knowledge REF: p. 117 OBJ: Clinical Practice #2

TOP: Cultural Values and Expectations KEY: Nursing Process Step: Planning

MSC: NCLEX: Psychosocial Integrity: coping and adaptation

19. The nurse appropriately begins discharge planning when:

a.

the physician writes orders to discharge the patient.

b.

the patient feels ready to be discharged home.

c.

it is anticipated the patient will be discharged in 8 hours.

d.

the patient is admitted to the health care facility.

ANS: D

Discharge planning requires looking ahead in order to meet the patients ongoing needs at home. It is a process that begins at the time of admission.

DIF: Cognitive Level: Comprehension REF: p. 119 OBJ: Theory #1

TOP: Discharge Planning KEY: Nursing Process Step: Implementation

MSC: NCLEX: Health Promotion and Maintenance: prevention and early detection of disease

20. A nurse is showing a diabetic patient how to draw insulin out of a syringe. The mode of learning that the nurse is using is _____ learning.

a.

auditory

b.

visual

c.

kinesthetic

d.

oral

ANS: B

Visual learning is based on learning through what the learner sees.

DIF: Cognitive Level: Comprehension REF: p. 116 OBJ: Theory #3

TOP: Modes of Learning KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity: basic care and comfort

21. The nurse will plan to offer the teaching session in a quiet area in order to:

a.

ensure that the patient can hear what the nurse says.

b.

reduce distractions.

c.

provide absolute privacy.

d.

make the environment more like a classroom.

ANS: B

Teaching sessions are best done in a quiet environment to reduce distractions.

DIF: Cognitive Level: Comprehension REF: p. 119 OBJ: Theory #4

TOP: Enhancing Learning KEY: Nursing Process Step: Planning

MSC: NCLEX: Physiological Integrity: basic care and comfort

22. When a nurse is talking through a procedure or assisting the patient to learn, the nurse encourages the patient to:

a.

close her eyes and envision the process.

b.

read the listed steps written on a poster board on the wall.

c.

write down the steps as she performs them.

d.

verbalize each step until the steps are memorized.

ANS: C

Writing down the steps as they are performed provides a guide in the patients own words that can be followed independently.

DIF: Cognitive Level: Application REF: p. 120 OBJ: Theory #3

TOP: Modes of Learning KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity: basic care and comfort

23. A nurse who is communicating with a school-age child about receiving anesthesia for surgery later this afternoon would best describe the process by saying:

a.

The doctor who will be wearing a mask will put a needle in your arm and then you go to sleep for a long time.

b.

You will just float off to dreamland and after you come back your tonsils will have been cut out.

c.

After the doctor puts medicine in your arm, you will ride on a pony to where fairies will take out your tonsils. Then you will ride right back here.

d.

You will be given a ride on a special bed to a big room where the doctor will give you some medicine that will make you very sleepy.

ANS: D

Children interpret language literally, so avoid idioms or stories that might be frightening because they can be easily misunderstood. Language should be tailored to the childs understanding.

DIF: Cognitive Level: Application REF: p. 118 OBJ: Theory #5

TOP: Communication with School-Age Child

KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity: basic care and comfort

24. When teaching an elderly patient about changing his dressing, the nurse would most appropriately:

a.

be certain the patient is wearing his glasses and/or hearing aid.

b.

talk through the process rapidly to keep the patient from becoming tired.

c.

wait for the patient to ask any questions about the procedure.

d.

point out each mistake during the return demonstration.

ANS: A

Special considerations when teaching the elderly include being certain the patient is wearing glasses and/or a hearing aid that is turned on and adjusted, if needed. Short sentences should be used, and the nurse should speak slowly. Pointing out mistakes without any praise can diminish the confidence of the patient.

DIF: Cognitive Level: Application REF: p. 118 OBJ: Theory #5

TOP: Communication with the Elderly KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity: basic care and comfort

25. The nurse would identify an opportunity for a teachable moment in the situation of a patient who:

a.

has just been told of the malignancy of his tumor.

b.

says, How will I remember all the things about my new diet?

c.

has just returned from surgery for a deviated septum.

d.

is packing belongings in preparation for discharge.

ANS: B

The teachable moment occurs when the patient is at an optimal level of readiness to learn and shows a willingness to apply that information.

DIF: Cognitive Level: Application REF: p. 115 OBJ: Theory #4

TOP: Teachable Moment KEY: Nursing Process Step: Assessment

MSC: NCLEX: Physiological Integrity: basic care and comfort

MULTIPLE RESPONSE

26. Continuous learning needs for the patient upon discharge should be communicated to the: (Select all that apply.)

a.

visiting nurse.

b.

family.

c.

primary care physician.

d.

pharmacy or medical supply facility.

e.

home health aide.

ANS: A, B, C

Health care entities that need to be aware of post-discharge continuous learning needs include the visiting home health nurse, the family, and the primary care physician. Pharmacies and medical supply facilities are not notified. The home health aide will not be instructed by the home health nurse.

DIF: Cognitive Level: Comprehension REF: p. 115 OBJ: Theory #8

TOP: Continued Teaching After Discharge

KEY: Nursing Process Step: Planning

MSC: NCLEX: Health Promotion and Maintenance: prevention and early detection of disease

27. The nurse reminds the patient that health instruction supports the goals of Healthy People 2020, which include: (Select all that apply.)

a.

promoting healthy behavior.

b.

increasing the life span.

c.

providing equipment for self-care.

d.

ensuring access to adequate health care.

e.

strengthening community relationships.

ANS: A, D, E

Health instruction supports the goals of Healthy People 2020, which include promoting healthy behaviors, protecting health, ensuring access to quality health care, and strengthening community health promotion programs.

DIF: Cognitive Level: Knowledge REF: p. 115 OBJ: Theory #2

TOP: Healthy People 2020 KEY: Nursing Process Step: Implementation

MSC: NCLEX: Health Promotion and Maintenance: prevention and early detection of disease

28. The nurse is aware that the major modes of learning are: (Select all that apply.)

a.

oral.

b.

tactile.

c.

auditory.

d.

kinesthetic.

e.

gustatory.

f.

visual.

ANS: C, D, F

Kinesthetic, auditory, and visual are the major modes of learning.

DIF: Cognitive Level: Knowledge REF: p. 116 OBJ: Theory #3

TOP: Modes of Learning KEY: Nursing Process Step: Planning

MSC: NCLEX: Physiological Integrity: basic care and comfort

29. The LPN/LVN is qualified to give patient teaching on information relative to: (Select all that apply.)

a.

disease process.

b.

postoperative care.

c.

prognosis.

d.

rehabilitation.

e.

disaster preparedness.

ANS: A, B, D, E

LPNs and LVNs are qualified to give teaching on topics relative to disease process, postoperative care, rehabilitation, and disaster preparedness. Information on prognosis is not appropriate.

DIF: Cognitive Level: Comprehension REF: p. 116 OBJ: Theory #1

TOP: Areas of Patient Teaching KEY: Nursing Process Step: N/A

MSC: NCLEX: N/A

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