DeWit_s Fundamental Concepts and Skills for Nursing, 5th Edition By Patricia A. Williams -Test Bank

DeWit_s Fundamental Concepts and Skills for Nursing, 5th Edition By Patricia A. Williams -Test Bank

Chapter 09: Patient Education and Health Promotion
Williams: deWit’s Fundamental Concepts and Skills for Nursing, 5th Edition

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 patient’s learning needs.
b. stimulate the patient to focus on the patient education goal.
c. reduce the patient’s anxiety relative to insulin injection.
d. reduce the amount of information the nurse has to provide.

ANS: A
Assessing a patient’s previous experience (as well as education, learning mode, and motivation) gives the nurse valuable information in developing a patient education 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. 121 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. 121 OBJ: Theory #3
TOP: Modes of Learning KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity: Basic Care and Comfort

3. Patient education for 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 patient education is also good, but should not be the only method of instruction.

DIF: Cognitive Level: Application REF: p. 124 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 nurse’s initial assessment prior to instruction should address the patient’s:
a. understanding of the process of irrigation.
b. familiarity with the irrigation materials.
c. manual dexterity.
d. motivation to learn.

ANS: D
The patient’s 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. 122
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 patient’s 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, I’ll ask you some questions about what’s in them, to see if you’ve 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. 121 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 preoperative learning needs says his mother had the same surgery by the same surgeon 3 years ago. The nurse should design the patient education plan to:
a. do a brief review of the preoperative patient education, 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 patient’s experience and knowledge allows the nurse to tailor patient education 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 patient’s intelligence and experience. Giving a list of preoperative instructions is simply impossible.

DIF: Cognitive Level: Analysis REF: p. 121 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 breastfeeding.
b. care of the patient’s surgical incision.
c. feeding the baby by breast or bottle.
d. recognizing signs or symptoms of infection.

ANS: A
Priority patient education needs prior to discharge are those that have to do with physiological 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. 120 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 patient education 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 patient’s 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 patient education should be done to allow time to revise the education 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. 126 OBJ: Theory #2
TOP: Evaluation of Learning KEY: Nursing Process Step: Evaluation
MSC: NCLEX: Physiological Integrity: Basic Care and Comfort