Chapter 4- Patient and Family Education in Critical Care(FREE) My Nursing Test Banks

 

1.

An elderly man whose wife has just been admitted to the ICU following congestive heart failure is concerned about how passage of the Affordable Care Act will impact the care of his wife. Which of the following are expected outcomes of this legislation that it would be appropriate for the nurse to share with the man? Select all that apply.

A)

The new legislation will result in a shortage of experienced critical care nurses.

B)

The new legislation will require health care workers to meet higher quality standards related to patient care.

C)

The new legislation will make it more challenging to meet the educational goals of patients and families.

D)

The new legislation will increase the length of stay of patients in the hospital.

E)

The new legislation will shift the payment structure for hospitals and health care providers from a traditional fee-for-service model to an incentive model.

2.

A young couple whose 5-year-old daughter has been admitted to the ICU approaches the nurse with looks of concern on their faces. They express frustration to the nurse that they have not been able to speak with either the physician or the surgeon and are confused as to what the next steps are for their daughters treatment. What would be the best intervention for the nurse to make in this situation?

A)

Offer to get ice chips for the couple to give to their daughter to empower them.

B)

Make sure that they have the cell phone numbers of the physician and surgeon.

C)

Teach the couple about the pathophysiology of the daughters disease.

D)

Arrange a patient care conference with the couple and the health care team.

3.

A nurse sees a group of physicians who are making teaching rounds in the hall of the ICU heading toward the room of one of her patients. The patient, who currently has a visitor, has given approval in the past to have teaching groups visit. What should the nurse do in this situation?

A)

Explain to the group of physicians that the patient currently has a visitor and ask whether they could come by later.

B)

Ask the visitor to leave so that the teaching group can discuss the patients case.

C)

Allow the teaching group to enter the patients room, as he has already given approval for them to visit.

D)

Instruct the physicians to give clear explanations of the medical jargon they use.

4.

The nurse is working with a patient from India who is recovering from a myocardial infarction. When the nurse asks the patient whether she has had a myocardial infarction before, the patient seems confused and appears not to understand the nurse, although the patient does speak English. Which of the 4 Cs of Culture should the nurse use to better communicate with this patient?

A)

Call

B)

Cause

C)

Cope

D)

Concern

5.

A nurse needs to obtain informed consent from a deaf patient before a spinal tap procedure is performed. Which of the following would be the best method for the nurse to use to ensure effective communication?

A)

Explain the procedure verbally, speaking slowly so that the patient can read lips.

B)

Have a trained oral interpreter interpret for the nurse.

C)

Have the patient carefully read a printed copy of the informed consent document.

D)

Use diagrams to explain to the patient the details of the procedure.

6.

A nurse is explaining to a patient how radiation therapy works to kill cancer cells. She begins by explaining how there are different types of cells in the body that reproduce at different rates. She then explains what cancer cells are and how they reproduce. Finally, she explains how radiation therapy uniquely targets cancer cells. This approach takes advantage of which domain of learning?

A)

Affective

B)

Psychomotor

C)

Cognitive

D)

Demonstration/return demonstration

7.

A young man is recovering from anaphylactic shock caused by a bee sting. The nurse is trying to instruct the patient on how to use an epinephrine autoinjector (EpiPen), but the patient seems uninterested in learning. The nurse then explains how having the EpiPen with him at all times and knowing how to use it could not only save his life someday but also will give him a greater sense of security and safety. Which adult learning principle is the nurse using? Select all that apply.

A)

The learners self-concept

B)

The learners life experience

C)

Readiness to learn

D)

Motivation to learn

E)

The need to know

8.

In attempting to teach a patient how to clean around the surgical sutures on his abdomen upon discharge to home, the nurse determines that applying the principle of the learners self-concept would be most effective with this patient. Which of the following is the best example of an application of that principle in this situation?

A)

Relating to the patient a story about another patient who failed to properly clean his sutures and the outcome

B)

Explaining that failure to properly clean around the suture site could result in serious infection

C)

Commenting that learning to properly clean his suture site could give the man skills that would better prepare him for a career in health care

D)

Mentioning to the patient that, if he would prefer, he can watch a video on the hospitals website on how to clean around a suture site

9.

A nurse needs to explain to a patient about the possible side effects the patient may experience related to the pain medication she is now beginning while in the ICU and which she will be continuing upon discharge. Which method would be the most effective way to teach this to the patient?

A)

In a planned teaching session, in which the nurse covers medication-related side effects, dietary restrictions, and activity restrictions

B)

Via a brochure that the patient can take with her on discharge

C)

By briefly explaining the side effects while administering the medication to the patient

D)

By relating a story about another patient who had a severe adverse reaction to this medication

10.

A nurse needs to evaluate a patients understanding of how to administer an IV medication at home. Which of the following would be the best method for evaluation?

A)

The nurse explaining the procedure to the patient and family using diagrams

B)

The nurse having the patient and family members demonstrate the procedure themselves

C)

The nurse explaining the procedure while performing it on the patient

D)

The nurse referring the patient to a computer-based educational library that has an interactive program

11.

Teaching patients and families is an important part of critical care nursing. What factor in todays critical care unit is a barrier to this education function?

A)

Large numbers of inexperienced nurses

B)

Serious illness of patients

C)

Increased computer support

D)

Use of specialty educators

12.

The nurse is caring for a critically ill patient. On the previous shift, a nurse documented unable to teach due to critical illness. What is the best nursing action by the current nurse to address the patients teaching and learning needs?

A)

Realize that the patient is too ill to accept teaching at this time.

B)

Look for opportunities for teaching, such a procedure explanation.

C)

Focus all teaching efforts on the family to the exclusion of the patient.

D)

Alter the plan of care to delay teaching until transfer to step-down unit.

13.

After several weeks, a critically ill patient has progressed well and is being transferred to a step-down unit. What normal patient response does the nurse anticipate?

A)

Relief

B)

Thankfulness

C)

Anxiety

D)

Indifference

14.

The nurse is teaching a patient and family in the patients critical care room. The critical care unit is busy and noisy. What nursing action will best enhance learning?

A)

Explain the material simply using simple terms.

B)

Give all explanations via commercial teaching brochures.

C)

Close the door to the patients room.

D)

Ask the family not to interrupt with questions.

15.

The nurse is teaching a patient who is not a native English speaker. As the nurse gives complex explanations, the patient nods and smiles. What is the best nursing intervention to ensure patient understanding?

A)

Assume that the patients nods indicate understanding.

B)

Ask a family member to interpret to the patient.

C)

Use pictures whenever possible in the teaching.

D)

Ask the patient to restate the information conveyed.

16.

The nurse is teaching a patient newly diagnosed with diabetes mellitus how to manage a sliding-scale insulin protocol. What portion of this interaction indicates patient learning?

A)

The sliding scale insulin protocol

B)

Patients questions to the nurse

C)

Nurses demonstration of use of the protocol

D)

Patients verbalization of a flash of insight

17.

When teaching a patient and family, the nurse wishes to use the affective domain of learning. What nursing action is most likely to involve the affective domain?

A)

Presenting facts from simple to complex

B)

Giving clear directions about when to call the physician

C)

Using a nonthreatening approach

D)

Using demonstration/redemonstration approach

18.

The nurse is teaching a patient newly diagnosed with diabetes mellitus how to inject insulin and chooses to use a demonstration/redemonstration technique. What domain of learning is the nurse chiefly using?

A)

Cognitive

B)

Affective

C)

Psychomotor

D)

Educative

19.

The nurse is teaching a patient newly diagnosed with cardiovascular disease how to reduce risk factors. The nurse begins by explaining why this information is important for the patient. What principle of adult learning is the nurse applying?

A)

Need to know

B)

Learners self-concept

C)

Learners life experience

D)

Motivation to learn

20.

The nurse is teaching a group of patients newly diagnosed with cardiovascular disease. What action demonstrates application of the adult learning principle of learners life experience?

A)

Beginning with an explanation of why the material is important

B)

Creating a learning situation that is self-directed and independent

C)

Using case scenarios and problem-solving exercises

D)

Applying content to real-life situations and actions

21.

The nurse is assessing learning by a critically ill patient and family. What is the best method of assessment?

A)

Written test

B)

Specific questions

C)

Open-ended questions

D)

Literacy assessment

Answer Key

1.

B, E

2.

D

3.

A

4.

A

5.

B

6.

C

7.

D, E

8.

D

9.

C

10.

B

11.

A

12.

B

13.

C

14.

C

15.

D

16.

D

17.

C

18.

C

19.

A

20.

C

21.

C

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