Fundamentals of Nursing 1st Edition Wilkinson Van Leuven Test Bank
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Chapter 24 Teaching Clients
|1.||Which teaching technique is best for teaching a nursing assistant how to perform bedside fingerstick glucose testing?|
|A)||Provide a manufacturer’s pamphlet that provides detailed instruction|
|B)||Explain how to perform testing|
|C)||Demonstrate the procedure; then ask for a return demonstration|
|D)||Suggest that the assistant watch a video|
|2.||The physician prescribes a new drug with which the nurse is unfamiliar. She consults the hospital formulary to learn about the drug. Which learning domain is the nurse utilizing? __________________|
|3.||A patient with a heel wound will need to perform dressing changes after discharge. When should the nurse schedule the teaching session(s)?|
|A)||Immediately before his next dose of pain medication|
|B)||After the patient’s afternoon nap|
|C)||Before the surgeon débrides the wound|
|D)||Before the patient undergoes flow studies of his affected leg|
|4.||Which intervention by the nurse would be best to motivate a patient newly diagnosed with hypertension to learn about the prescribed treatment plan?|
|A)||Explain that, when left untreated, hypertension may lead to stroke|
|B)||Tell the patient that he should let the nurse know when he is ready to learn|
|C)||Inform the patient that his blood pressure is severely elevated and that he needs to learn about treatment immediately|
|D)||Explain that as long as he follows some aspects of the treatment plan he should be fine|
|5.||Assume that all of the following written instructions about digoxin provide correct information about the drug. Which one is best worded for patient understanding?|
|A)||Obtain your radial pulse every morning before taking the tablet|
|B)||Return for monthly laboratory studies of your digoxin levels|
|C)||Call the doctor if objects look yellow or green|
|D)||Always take the same brand of medication because certain brands may not be interchangeable|
|6.||Which teaching strategy is effective with large groups and stimulates both sight and hearing?|
|A)||Distributing printed materials|
|B)||Using audiovisual materials|
|C)||Providing programmed instruction|
|D)||Using computer-assisted instruction (CAI)|
|7.||A patient with attention deficit disorder is admitted to the hospital with type 1 diabetes. Which nursing diagnosis should be avoided for this patient (assume there are data to support all the diagnoses)?|
|A)||Deficient Knowledge (disease process)|
|B)||Impaired ability to learn related to fear and anxiety|
|C)||Difficulty learning related to cognitive developmental level|
|D)||Lack of motivation to learn related to feelings of powerlessness|
|8.||Which is stated as a teaching goal (as compared with an objective) for a patient who underwent bowel resection with creation of a colostomy? The patient:|
|A)||Empties the colostomy appliance when it is half filled|
|B)||Performs skin care around the stoma site|
|C)||Will perform ostomy self-care within 3 days|
|D)||Applies a new ostomy appliance, making sure it adheres properly|
|9.||During advanced cardiac life support training, a nurse performs defibrillation on a model. Which teaching strategy is being employed?|
|10.||During assertiveness training, nurses rehearse responses to real-life situations to improve their assertiveness skills. What is a disadvantage of this teaching strategy?|
|A)||Some nurses may feel self-conscious|
|B)||Nurses may be unaware of this type of teaching|
|C)||Some participants may not enjoy the competitive atmosphere|
|D)||This strategy is not as effective as lecture or reading|
|11.||A patient who underwent bowel resection 3 days ago is recovering from surgery. He ambulates in the hallway and requires nothing for pain. During the physician’s morning rounds, the physician informs the patient that the lesion removed was cancerous. Which factor will probably be the biggest barrier for learning in this patient when the nurse is doing his discharge teaching?|
|A)||His physical condition|
|B)||The negative environmental influence|
|C)||Anxiety associated with his diagnosis|
|D)||Lack of willingness to learn|
|12.||How can the nurse best provide teaching for a patient whose primary language is not the same as hers?|
|A)||Provide written materials in the patient’s primary language|
|B)||Make arrangements to teach using an interpreter|
|C)||Provide a demonstration and request a return demonstration|
|D)||Use visual teaching aids|
|13.||A preschool-age child is scheduled for a tonsillectomy. Which strategy might help ease the child’s anxiety before surgery?|
|A)||Give the child a tour of the hospital a week before surgery|
|B)||Provide a detailed explanation of the procedure|
|C)||Allow the child to use computer-assisted instruction to teach him about the procedure|
|D)||Provide one-to-one instruction about his postoperative care|
|14.||The nurse manager is devising a teaching schedule for her staff who are about to begin using a new piece of equipment. The equipment is scheduled for implementation in 6 weeks. When is the best time for the manager to schedule the teaching sessions?|
|B)||4 weeks before implementation|
|C)||2 weeks before implementation|
|D)||1 week before implementation|
|15.||For which patient is the nursing diagnosis Deficient Knowledge most appropriate?|
|A)||21-year-old with Down’s syndrome and newly diagnosed with type 1 diabetes|
|B)||65-year-old admitted with acute renal failure who requires hemodialysis|
|C)||72-year-old with a long-standing history of type 1 diabetes admitted with a foot ulcer|
|D)||64-year-old with leukemia who requires another round of chemotherapy after already having several series of the treatment|
|16.||A patient who was prescribed digoxin (Lanoxin) must learn to take his radial pulse before discharge. Which action will best help the patient remember proper technique?|
|A)||Allowing the patient to check his radial pulse along with the nurse before administering each dose of the drug|
|B)||Providing feedback after the patient takes his radial pulse for the first time|
|C)||Instructing the patient about obtaining radial pulse rate|
|D)||Providing written instruction about obtaining radial pulse rate|
|17.||It is an extremely busy day on the medical surgical floor, and the nurse must teach a patient ready for discharge about his medications. How can the nurse most efficiently utilize her time and provide this teaching?|
|A)||Quickly write down instructions so the patient can take them home with him|
|B)||Hold a teaching session while assisting the patient with his bath|
|C)||Tell the patient about his medications as each one is given|
|D)||Call the patient on the phone at home after the shift|
|The best way to teach a psychomotor skill is to demonstrate the procedure and then ask for a return demonstration. Supplementary written information or a video can also be supplied to reinforce learning. However, they are not the best method for teaching a psychomotor skill.
(V1, pp. 530-531; V1, p. 544; V2, pp. 538-539)
|Learning through the use of reading materials utilizes the cognitive domain of learning. Learning a skill through mental and physical activity uses the psychomotor domain. The affective domain involves changing feelings, beliefs, attitudes, and values.
(V1, pp. 531-532)
|For learning to be effective, teaching must occur when the patient is ready. A patient is not able to learn when he is anxious about testing or treatment, tired, or in pain. Therefore, the best time to teach this patient is when he is rested, after his afternoon nap.
(V1, p 532, 537)
|A patient newly diagnosed with hypertension may not be motivated to learn because he most likely has not experienced any symptoms or complications. Therefore, the nurse should motivate the patient by pointing out potential, serious complications that might occur if the treatment plan is not followed. Although readiness is an important consideration (B), treatment might be delayed too long if the patient did not notify the nurse soon that he is ready to learn. (C) Informing the patient that his blood pressure is severely elevated and that he needs to learn about treatment immediately may cause severe anxiety, worsening blood pressure and interfering with the ability to learn. Option D diminishes the importance of learning and may take away the patient’s motivation to learn.
(V1, pp. 531-532, 537; V2, p. 538)
|The nurse should provide written instructions that contain short sentences and easy-to-read words. If instructions are written at too high a reading level, the patient may not understand and be unable to care for himself. Option C provides a short sentence written with easy words. Options A, B, and D contain words that require a higher level of reading; option 4 is too wordy.
(V1, p. 536)
|Teaching with the aid of audiovisual materials stimulates sight and hearing and is effective with large groups. Printed materials help reinforce materials taught during a lecture but do not stimulate hearing. They also allow presentation of standardized information. Programmed instruction allows learners to proceed with learning at their own speed but does not stimulate hearing. CAI is more useful for individualized and independent learning than for large groups.
(V1, p. 545)
|Patients who have a learning disability should not have an identified nursing diagnosis of Deficient Knowledge; instead, they should have a diagnosis that accurately identifies their problem, such as Impaired ability to learn related to fear and anxiety, Difficulty learning related to delayed cognitive development, or Lack of motivation to learn related to feelings of powerlessness. Note that these are not NANDA diagnoses.
(V1, p. 538)
|Option C is an appropriate goal for a patient who needs to learn colostomy self-care. Options A, B, and D are specific learning objectives, not broad teaching goals.
(V1, p. 538)
|During simulation, an experience is created that is similar to an actual one but without the risks and consequences. Advanced cardiac life support training utilizes this strategy by creating a scenario using resuscitation dummies and allowing health care workers to respond as they would during a real resuscitation. (A) With one-to-one instruction, one instructor orally presents information to one student. (B) Programmed instruction consists of printed material that presents content, questions, and answers, which the learner completes individually. (C) In role modeling, the teacher teaches by example, demonstrating the behaviors that need to be learned.
(V1, p. 545)
|The teaching strategy described is role playing. Role playing may cause participants to feel self-conscious; to be effective, participants must be willing to participate as an observer or role player. With role playing, the participant may be unaware that teaching is taking place. Gaming creates a competitive atmosphere. Rehearsing real-life situations is as effective as lecture or reading.
(V1, pp. 545-546)
|Anxiety associated with the new diagnosis of cancer will most likely be a barrier to learning in this patient. The patient has been up ambulating and requiring no pain medication; therefore, his physical condition is probably not the biggest barrier to learning. There is nothing in this scenario to suggest that the patient is unwilling to learn.
(V1, p. 532; V2, p. 538)
|The nurse can best provide teaching for the patient whose primary language is not English by requesting aid of an interpreter. An interpreter can help the nurse assess learning needs, teach the patient, and evaluate learning. An interpreter also allows the patient to ask questions when necessary. Written materials in the patient’s primary language can help reinforce teaching. Demonstrating and requesting a return demonstration may be difficult if the patient does not understand English. Visual aids may also be helpful, but they should not be the primary method for teaching.
(V1, p. 535, 536)
|To reduce anxiety in a preschool-age child requiring surgery, schedule a tour of the hospital at least a week before surgery to reduce his anxiety. Provide simple, not detailed, explanations of procedures, and use pictures and concrete examples. Computer-assisted instruction and one-to-one instruction are teaching strategies effective with adults.
(V1, pp. 534-535)
|People retain information better when they have the opportunity to use it soon after it is presented. Therefore, the nurse manager should schedule teaching sessions 1 week before implementation of the equipment. If classes are scheduled too early, the nurses might forget how to use the equipment before it is implemented.
(V1, p. 532)
|The 65-year-old patient admitted with acute renal failure who needs hemodialysis will probably have Deficient Knowledge related to his treatment regimen. The 21-year-old patient with Down’s syndrome should have a nursing diagnosis of Impaired ability to learn. The patients in options C and D have a history of their illness and most likely will not have Deficient Knowledge because they have already learned about the disease and its treatment.
(V1, p. 538)
|Repetition increases the likelihood that the patient will retain information and incorporate it into his life. Therefore, allowing the patient to check his radial pulse before each dose of the drug will help the patient learn the skill and incorporate it into his life.
(V1, p. 544)
|Teaching does not have to be performed in formal sessions. The nurse can effectively manage her time by performing medication teaching during medication administration. Besides managing time, this method has the advantage of using the medications as visual aids during teaching. A teaching session about wound care would be appropriate during bathing but not medication teaching. Quickly handing the patient written instructions before discharge does not provide the patient with time to ask questions. The patient should not be discharged without instruction.
(V1, p. 540)