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Exam View - Chapter 25
Fundamentals of Nursing (NUR100)
Fortis College
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Chapter 25: Patient Education
Potter et al.: Fundamentals of Nursing, 10th Edition
MULTIPLE CHOICE
- A nurse is teaching a patient’s family member about permanent tube feedings at home. Which purpose of patient education is the nurse meeting? a. Health promotion b. Illness prevention c. Restoration of health d. Coping with impaired functions ANS: D Teach family members to help the patient with health care management (e., giving medications through gastric tubes and doing passive range-of-motion exercises) when coping with impaired functions. Not all patients fully recover from illness or injury. Many have to learn to cope with permanent health alterations. Health promotion involves healthy people staying healthy, while illness prevention is prevention of diseases. Restoration of health occurs if the teaching is about a temporary tube feeding, not a permanent tube feeding.
DIF: Understand (comprehension) OBJ: Identify the purposes of patient education. TOP: Teaching/Learning MSC: Basic Care and Comfort
- A nurse is teaching a group of healthy adults about the benefits of flu immunizations. Which type of patient education is the nurse providing? a. Health analogies b. Restoration of health c. Coping with impaired functions d. Promotion of health and illness prevention ANS: D As a nurse, you are a visible, competent resource for patients who want to improve their physical and psychological well-being. In the school, home, clinic, or workplace, you promote health and prevent illness by providing information and skills that enable patients to assume healthier behaviors. Injured and ill patients need information and skills to help them regain or maintain their level of health; this is referred to as restoration of health. Not all patients fully recover from illness or injury. Ma ny have to learn to cope with permanent health alterations; this is known as coping with impaired functions. Analogies supplement verbal instruction with familiar images that make complex information more real and understandable. For example, when explaining arterial blood pressure, use an analogy of the flow of water through a hose.
DIF: Understand (comprehension) OBJ: Identify the purposes of patient education. TOP: Teaching/Learning MSC: Health Promotion and Maintenance
- A nurse’s goal is to provide teaching for restoration of health. Which situation indicates the nurse is meeting this goal? a. Teaching a family member to provide passive range of motion for a stroke patient b. Teaching a woman who recently had a hysterectomy about possible adoption c. Teaching expectant parents about changes in childbearing women d. Teaching a teenager with a broken leg how to use crutches ANS: D Injured or ill patients need information and skills to help them regain or maintain their levels of health. An example includes teaching a teenager with a broken leg how to use crutches. Not all patients fully recover from illness or injury. Many have to learn to cope with permanent health alterations. New knowledge and skills are often necessary for patients and/or family members to continue activities of daily living. Teaching family members to help the patient with health care management (e., giving medications through gastric tubes, doing passive range-of-motion exercises) is an example of coping with long-term impaired functions. For a woman with a hysterectomy, teaching about adoption is not restoration of health; restoration of health in this situation would involve activity restrictions and incision care if needed. In childbearing classes, you teach expectant parents about physical and psychological changes in the woman and about fetal development; this is part of health maintenance.
DIF: Apply (application) OBJ: Identify the purposes of patient education. TOP: Teaching/Learning MSC: Basic Care and Comfort
- A nurse attends a seminar on teaching/learning. Which statement indicates the nurse has a good understanding of teaching/learning? a. “Teaching and learning can be separated.” b. “Learning is an interactive process that promotes teaching.” c. “Teaching is most effective when it responds to the learner’s needs.” d. “Learning consists of a conscious, deliberate set of actions designed to help the teacher.” ANS: C Teaching is most effective when it responds to the learner’s needs. It is impossible to separate teaching from learning. Teaching is an interactive process that promotes learning. Teaching consists of a conscious, deliberate set of actions that help ind ividuals gain new knowledge, change attitudes, adopt new behaviors, or perform new skills.
DIF: Understand (comprehension) OBJ: Describe the similarities and differences between teaching and learning. TOP: Evaluation MSC: Health Promotion and Maintenance
- A nurse is determining if teaching is effective. Which finding best indicates learning has occurred? a. A nurse presents information about diabetes. b. A patient demonstrates how to inject insulin. c. A family member listens to a lecture on diabetes. d. A primary care provider hands a diabetes pamphlet to the patient.
ANS: B Learning is the purposeful acquisition of new knowledge, attitudes, behaviors, and skills: patient demonstrates how to inject insulin. A new mother exhibits learning when she demonstrates how to bathe her newborn. A nurse presenting information and a primary care provider handing a pamphlet to a patient are examples of teaching. A family member listening to a lecture does not indicate that learning occurred; a change in knowledge, attitudes, behaviors, and/or skills must be evident.
DIF: Apply (application) OBJ: Describe the similarities and differences between teaching and learning. TOP: Teaching/Learning MSC: Basic Care and Comfort
- A nurse is teaching a patient about the Speak Up Initiatives. Which information should the nurse include in the teaching session? a. If you still do not understand, ask again. b. Ask a nurse to be your advocate or supporter. c. The nurse is the center of the health care team. d. Inappropriate medical tests are the most common mistakes. ANS: A If you still do not understand, ask again is part of the S portion of the Speak Up Initiatives. Speak up if you have questions or concerns. You (the patient) are the center of the health care team, not the nurse. Ask a trusted family member or friend to be your advocate (advisor or supporter), not a nurse. Medication errors are the most common health care mistakes, not inappropriate medical tests.
DIF: Understand (comprehension) OBJ: Identify the role of the nurse in patient education. TOP: Teaching/Learning MSC: Safety and Infection Control
- A nurse teaches a patient with heart failure healthy food choices. The patient states that eating yogurt is better than eating cake. Which element represents feedback? a. The nurse b. The patient c. The nurse teaching about healthy food choices d. The patient stating that eating yogurt is better than eating cake
ANS: D Feedback needs to demonstrate the success of the learner in achieving objectives (i., the learner verbalizes informati on or provides a return demonstration of skills learned). The nurse is the sender. The patient (learner) is the receiver. The teaching is the message.
DIF: Understand (comprehension) OBJ: Describe appropriate communication principles when providing patient education. TOP: Teaching/Learning MSC: Basic Care and Comfort
- While preparing a teaching plan, the nurse describes what the learner will be able to accomplish after the teaching sess ion about healthy eating. Which action is the nurse completing? a. Developing learning objectives b. Providing positive reinforcement c. Presenting facts and knowledge d. Implementing interpersonal communication ANS: A Learning objectives describe what the learner will exhibit as a result of successful instruction. Positive reinforcement follows feedback and reinforces good behavior and promotes continued compliance. Interpersonal communication is necessary for the teaching/learning process but describing what the learner will be able to do after successful instruction constitutes le arning objectives. Facts and knowledge will be presented in the teaching session.
DIF: Understand (comprehension) OBJ: Describe appropriate communication principles when providing patient education. TOP: Planning MSC: Health Promotion and Maintenance
- After a teaching session with a nurse, a patient learns that a normal adult heartbeat is 60 to 100 beats/min. In which domain did learning take place? a. Kinesthetic b. Cognitive c. Affective d. Psychomotor
ANS: B The patient acquired knowledge, which is cognitive. Cognitive learning includes all intellectual skills and requires thi nking. In the hierarchy of cognitive behaviors, the simplest behavior is acquiring knowledge. Kinesthetic is a type of learner who lea rns best with a hands-on approach. Affective learning deals with expression of feelings and development of attitudes, beliefs, or values. Psychomotor learning involves acquiring skills that require integration of mental and physical activities, such as the a bility to walk or use an eating utensil.
DIF: Understand (comprehension) OBJ: Describe the domains of learning. TOP: Teaching/Learning MSC: Health Promotion and Maintenance
- Which assessment finding will best indicate that the patient is ready to learn? a. The ability to grasp and apply the elastic bandage. b. Expresses the motivation to walk with an assistive device. c. Demonstrates sufficient coordination to handle a syringe safely. d. Has sufficient upper body strength to move from a bed to a wheelchair.
ANS: B Motivation underlies a person’s desire or willingness to learn. Motivation is a force that acts on or within a person (e .g., an idea, emotion, or a physical need) to cause the person to behave in a particular way. For example, a patient with a below-the-knee amputation is motivated to learn how to walk with assistive devices, indicating a readiness to learn. Do not confuse readiness to learn with ability to learn. All the other answers are examples of ability to learn because this often depends on the pa tient’s level of physical development and overall physical health. To learn psychomotor skills, a patient needs to possess a certain leve l of strength, coordination, and sensory acuity. For example, it is useless to teach a patient to transfer from a bed to a wheelchair if he or she has insufficient upper body strength. An older patient with poor eyesight or an inability to grasp objects tightly c annot learn to apply an elastic bandage or handle a syringe.
DIF: Analyze (analysis) OBJ: Differentiate factors that determine readiness to learn from those that determine ability to learn. TOP: Evaluation MSC: Health Promotion and Maintenance
- A nurse is teaching a patient with a risk for hypertension how to take a blood pressure. Which action by the nurse is the priority to assist learning? a. Assess laboratory results for high cholesterol and other data. b. Identify that teaching is the same as the nursing process. c. Perform nursing care therapies to address hypertension. d. Focus on a patient’s learning needs and objectives. ANS: D The teaching process focuses on the patient’s learning needs, motivation, and ability to learn; writing learning objecti ves and goals is also included. Nursing and teaching processes are not the same. Assessing laboratory results for high cholesterol and performing nursing care therapies are all components of the nursing process, not the teaching process.
DIF: Apply (application) OBJ: Compare and contrast the nursing and teaching processes. TOP: Implementation MSC: Health Promotion and Maintenance
- A patient diagnosed with both heart failure and kidney failure requires teaching about dialysis. Which nursing assessment is most appropriate for determining this patient’s learning needs? a. Total health care needs b. Health literacy c. Sources of patient data d. Goals of patient care ANS: B Because health literacy influences how you deliver teaching strategies, it is critical for you to assess a patient’s hea lth literacy before providing instruction. The nursing process requires assessment of all sources of data to determine a patient’s total health care needs. Evaluation of the teaching process involves determining outcomes of the teaching/learning process and the achievement of learning objectives; assessing the goals of patient care is the evaluation component of the nursing process.
DIF: Apply (application) OBJ: Compare and contrast the nursing and teaching processes. TOP: Assessment MSC: Health Promotion and Maintenance
- A nurse is teaching a patient about hypertension. In which order from first to last will the nurse implement the steps of the teaching
process?
- Set mutual goals for knowledge of hypertension.
- Teach what the patient wants to know about hypertension.
- Assess what the patient already knows about hypertension.
- Evaluate the outcomes of patient education for hypertension. a. 1, 3, 2, 4 b. 2, 3, 1, 4 c. 3, 1, 2, 4 d. 3, 2, 1, 4
ANS: C Assessment is the first step of any teaching session, then diagnosing, planning (goals), implementation, and evaluation.
DIF: Apply (application) OBJ: Identify the appropriate topics that address a patient’s health education needs. TOP: Teaching/Learning MSC: Health Promotion and Maintenance
- A nurse is preparing to teach the patient about cane use after a stroke. Which learning objective/outcome is most appropriate for the nurse to include in the teaching plan? a. The patient will walk to the bathroom and back to bed using a cane. b. The patient will understand the importance of using a cane. c. The patient will know the correct use of a cane. d. The patient will learn how to use a cane.
ANS: A Outcomes often describe a behavior that identifies the patient’s ability to do something on completion of teaching such as will empty a colostomy bag or will administer an injection. Understand, learn, and know are not behaviors that can be observed or evaluated.
DIF: Apply (application) OBJ: Write learning objectives for a teaching plan. TOP: Planning MSC: Management of Care
- Which learning objective/outcome has the highest priority for a patient with life-threatening, severe food allergies that requires epinephrine therapy? a. The patient will identify the main ingredients in several foods. b. The patient will list the side effects of epinephrine. c. The patient will learn about food labels. d. The patient will administer epinephrine.
ANS: D Once you assist in meeting patient needs related to basic survival (how to give epinephrine), you can discuss other topi cs, such as nutritional needs and side effects of medications. For example, a patient recently diagnosed with coronary artery disease has deficient knowledge related to the illness and its implications. The patient benefits most by first learning about the c orrect way to take nitroglycerin and how long to wait before calling for help when chest pain occurs. Thus, in this situation, the pat ient benefits most by first learning about the correct way to take epinephrine. “The patient will learn about food labels” is not obje ctive and measurable and is not correctly written.
DIF: Analyze (analysis) OBJ: Write learning objectives for a teaching plan. TOP: Evaluation MSC: Reduction of Risk Potential
- After a teaching session on taking blood pressures, the nurse tells the patient, “You took that blood pressure like an e xperienced nurse.” Which type of reinforcement did the nurse use? a. Social acknowledgment b. Pleasurable activity c. Tangible reward d. Entrusting
ANS: A Reinforcers come in the form of social acknowledgments (e., nods, smiles, words of encouragement), pleasurable activities (e., walks or play time), and tangible rewards (e., toys or food). The entrusting approach is a teaching approach that provides a patient the opportunity to manage self-care. It is not a type of reinforcement.
DIF: Apply (application) OBJ: Identify basic learning principles. TOP: Teaching/Learning MSC: Health Promotion and Maintenance
- A patient diagnosed with heart failure is learning to reduce salt in the diet. When will be the best time for the nurse to address this topic? a. At bedtime, while the patient is relaxed. b. At bath time, when the nurse is cleaning the patient. c. At lunchtime, while the nurse is preparing the food tray. d. At medication time, when the nurse is administering patient medication.
ANS: C In this situation, because the teaching is about food, coordinating it with routine nursing care that involves food can be effective. Many nurses find that they are able to teach more effectively while delivering nursing care. For example, while hanging blood, you explain to the patient why the blood is necessary and the symptoms of a transfusion reaction that need to be reported immediately. At bedtime would be a good time to discuss routines that enhance sleep. At bath time would be a good time to describe skin care and how to prevent pressure ulcers. At medication time would be a good time to explain the purposes and side effects of the medication.
DIF: Apply (application) OBJ: Include patient teaching while performing routine nursing care. TOP: Teaching/Learning MSC: Health Promotion and Maintenance
- A nurse is teaching a patient about healthy eating habits. Which learning objective/outcome for the affective domain will the nurse add to the teaching plan? a. The patient will state three facts about healthy eating. b. The patient will identify two foods for a healthy snack. c. The patient will verbalize the value of eating healthy. d. The patient will cook a meal with low-fat oil.
ANS: C Affective learning deals with expression of feelings and acceptance of attitudes, beliefs, or values. Having the patient value healthy eating habits falls within the affective domain. Stating three facts or identifying two foods for a healthy snack falls within the cognitive domain. Cooking falls within the psychomotor domain.
DIF: Analyze (analysis) OBJ: Write learning objectives for a teaching plan. TOP: Planning MSC: Health Promotion and Maintenance
- A nurse is assessing the ability to learn of a patient who has recently experienced a stroke. Which question/statement will best assess the patient’s ability to learn? a. “What do you want to know about strokes?” b. “Please read this handout and tell me what it means.” c. “Do you feel strong enough to perform the tasks I will teach you?” d. “On a scale from 1 to 10, tell me where you rank your desire to learn.”
ANS: B A patient’s reading level affects ability to learn. One way to assess a patient’s reading level and level of understandi ng is to ask the patient to read instructions from an educational handout and then explain their meaning. Reading level is often difficult to assess because patients who are functionally illiterate are often able to conceal it by using excuses such as not having the ti me or not being able to see. Asking patients what they want to know identifies previous learning and learning needs and preferences; it does not assess ability to learn. Motivation (desire to learn) is related to readiness to learn, not ability to learn. Just askin g a patient if he or she feels strong is not as effective as actually assessing the patient’s strength.
DIF: Analyze (analysis) OBJ: Differentiate factors that determine readiness to learn from those that determine ability to learn. TOP: Assessment MSC: Health Promotion and Maintenance
- A nurse is preparing to teach a kinesthetic learner about exercise. Which technique will the nurse use? a. Let the patient touch and use the exercise equipment. b. Provide the patient with pictures of the exercise equipment. c. Let the patient listen to a video about the exercise equipment. d. Provide the patient with a case study about the exercise equipment. ANS: A Kinesthetic learners process knowledge by moving and participating in hands-on activities. Return demonstrations and rol e-playing work well with these learners. Patients who are visual-spatial learners enjoy learning through pictures and visual chart s to explain concepts. The verbal/linguistic learner demonstrates strength in the language arts and therefore prefers learning by lis tening or reading information. Patients who learn through logical-mathematical reasoning think in terms of cause and effect and respond best when required to predict logical outcomes. Specific teaching strategies could include open-ended questioning or problem- solving exercises, like a case study.
DIF: Apply (application) OBJ: Establish an environment that promotes learning. TOP: Teaching/Learning MSC: Health Promotion and Maintenance
MULTIPLE RESPONSE
- A nurse is asked by a co-worker why patient education/teaching is important. Which statements will the nurse share with the co-worker? ( Select all that apply. ) a. “Patient education is an essential component of safe, patient-centered care.” b. “Patient education is a standard for professional nursing practice.” c. “Patient teaching falls within the scope of nursing practice.” d. “Patient teaching is documented and part of the chart.” e. “Patient education is not effective with children.” f. “Patient teaching can increase health care costs.” ANS: A, B, C, D Patient education has long been a standard for professional nursing practice. All state Nurse Practice Acts acknowledge that patient teaching falls within the scope of nursing practice. Patient education is an essential component of providing safe, patient-centered care. It is important to document evidence of successful patient education in patients’ medical records. Patient educati on is effective for children. Different techniques must be used with children. Creating a well-designed, comprehensive teaching plan that fits a patient’s unique learning needs reduces health care costs, improves quality of care, and ultimately changes behaviors to improve patient outcomes.
DIF: Understand (comprehension) OBJ: Identify the role of the nurse in patient education. TOP: Evaluation MSC: Management of Care
- A nurse is preparing to teach patients. Which patient finding will cause the nurse to postpone a teaching session? ( Select all that apply. ) a. The patient’s pain is not controlled. b. The patient is reporting being fatigued. c. The patient is mildly anxious about their condition. d. The patient is asking numerous questions about their health status. e. The patient is currently febrile with an oral temperature of 101° F. f. The patient is in the acceptance phase of dealing with their medical diagnosis.
ANS: A, B, E Any condition (e., pain, fatigue) that depletes a person’s energy also impairs the ability to learn, so the session sh ould be postponed until the pain is relieved and the patient is rested. Postpone teaching when an illness becomes aggravated by complications such as a high fever or respiratory difficulty. A mild level of anxiety motivates learning. When patients are ready to learn, they frequently ask questions. When the patient enters the stage of acceptance, the stage compatible with learning, introduce a teaching plan.
DIF: Apply (application) OBJ: Discuss how to integrate education into patient-centered care. TOP: Teaching/Learning MSC: Basic Care and Comfort
Exam View - Chapter 25
Course: Fundamentals of Nursing (NUR100)
University: Fortis College
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