Question 1

A theoretical foundation for the use of teaching methodologies in which a learner-centered approach engages clients as active partners in the learning process and helps them to take responsibility for their own learning to whatever extent possible is known as

Accepted Answer

Carl Rogers' (1983)ideas provide a theoretical foundation for the use of teaching methodologies in client-centered health teaching.Rogers emphasizes the primacy of the teacher-learner relationship as the means through which learning occurs.He describes learner-centered teaching as an interactive process.Applied to health care,a learner-centered approach involves engaging clients as active partners in the learning process and helping them take responsibility for their own learning to whatever extent possible.Rogers insists that the teacher must start where the learner is,structuring the learning process to support the learner's natural desire to learn and being mindful of learner characteristics that enable or impede the process.

Question 2

When assessing teaching and learning needs at discharge,the nurse should focus on which of the following?

Accepted Answer

Assessing teaching and learning needs at discharge includes asking the following questions: What potential problems are likely to prevent a safe discharge? What potential problems are likely to cause complications or readmission? What prior knowledge or experience does the client and family have with this problem? What skills and equipment are needed to manage the problem at home? Who (what agency)will assume responsibility for continuing care? The client's ability to pay for hospitalization should not be a focus of teaching and learning needs at discharge.If the client has concerns about ability to pay for hospitalization,the nurse can ask a case manager to visit with the client.

Question 3

The concept that "the teacher must start where the learner is" was proposed by whom?

Accepted Answer

Rogers insists that the teacher must start where the learner is,structuring the learning process to support the learner's natural desire to learn and being mindful of learner characteristics that enable or impede the process.

Question 4

The nurse is teaching a support group about schizophrenia.The format includes a 20-minute video,a didactic portion,and a discussion period.The nurse recognizes that

Accepted Answer

An initial quote at the beginning capturing the meaning of the presentation or a humorous opening grabs the audience's attention.In a group presentation,the nurse will need to establish rapport with the audience.Preparation and practice can ensure that the presentation is clear,concise,and well spoken.The nurse should make eye contact immediately and continue to do so throughout the presentation.Extension of eye contact to all participants communicates acceptance and inclusion.

Question 5

The nurse is caring for a client who is suffering from schizophrenia and cocaine abuse.The client remains isolated in his room,refusing to attend unit activities.When implementing a behavioral approach,what is the first step the nurse should take?

Accepted Answer

A behavioral approach starts with a careful description and quantification of a concrete behavior requiring change.During the third step of implementing a behavioral approach,the nurse and client reframe the problem as a solution statement (e.g.,"The client will attend all scheduled unit activities.").If the problem and solution are complex,the nurse can break them down into simpler definitions,beginning with the simplest and most likely behavior to stimulate client interest.The nurse should identify the tasks in sequential order; define specific consequences,positive and negative,for behavioral responses; and solicit the client's cooperation.

Question 6

Accurate documentation of client health teaching is a critical component of quality care.When documenting in the client's chart about health teaching for a client admitted for alcoholism,the nurse should write

Accepted Answer

The Joint Commission requires written documentation of all client health teaching.Notes about the initial assessment should be succinct,but comprehensive and objective.Teaching content should be linked to assessment data,including client preferences,previous knowledge,and values.Included in the documentation are the teaching actions,the client response,and any clinical issues or barriers to compliance.If family members are involved,you should identify their role,content provided,and teaching outcomes in your documentation.Accurate documentation helps ensure continuity and prevents duplication of teaching efforts.The client's record informs other health care providers of what has been taught and what areas need further work.

Question 7

When initiating health teaching,the nurse recognizes that readiness to learn

Accepted Answer

Rather than challenge the client's learning pattern,the nurse needs to understand it and incorporate it into new opportunities for learning.Readiness to learn is not the same as the cognitive ability to learn.Nurses need to remember that learning is never smooth or linear in its development.Rather than challenge the client's learning pattern,the nurse needs to understand it and incorporate it into new opportunities for learning.

Question 8

When planning an education class for clients suffering from addiction,the nurse recognizes that a format that encourages empowerment is an important goal of health teaching.Which of the following is a strategy that could be viewed as disempowering?

Accepted Answer

A highly participative learning environment,in which the nurse provides the teaching while the learner assumes primary responsibility for the learning process,encourages empowerment.Empowerment strategies include providing sufficient information,specific instructions,and emotional support-but no more than is required-to allow each client to take charge of his or her health care to whatever extent is possible.Client-centered strategies place the learner in charge of his or her learning and build on personal strengths to achieve learning objectives.

Question 9

A client requires health teaching for exercises related to an arthritic shoulder.During an assessment,the client tells the nurse she is a kinetic learner.What teaching resource should the nurse recommend to this client?

Accepted Answer

The kinetic learner learns best with hands-on involvement.The visual learner would use books and videos.An exercise audiotape would benefit the auditory learner.

Question 10

A client is newly diagnosed with diabetes mellitus.When planning a teaching session to review insulin administration with this client,the nurse should

Accepted Answer

Teaching interventions should never be eliminated because the nurse lacks time,but they can be streamlined.Even in the most limited situation,the nurse should schedule a block of time for health teaching.The nurse should pick times for teaching when energy levels are high,the client is not distracted by other things,it is not visiting time,and the client is not in pain.People have saturation points as to how much they can learn in one time period.Since even under the best of circumstances,people can absorb only so many details and fine points,the nurse should limit information to two or three points at a time.The nurse should keep the teaching session short,interesting,and to the point.Ideally,teaching sessions should last no longer than about 20 minutes,including time for questions.Otherwise the client may tire or lose interest.Scheduling shorter sessions with time in between to process information helps prevent sensory overload and reinforces teaching points.

Question 11

An older adult client is hospitalized after a fall.The client states,"I want to return home because I like to be independent." The nurse notes that the client lives alone and will be required to attend physical therapy three times a week.Which of the following nursing diagnoses is appropriate for this client?

Accepted Answer

The client lives alone and requires physical therapy related to a fall.The client will require assistance with care.There is insufficient evidence to diagnose anxiety.The client states that he is independent,which indicates coping skills,and there is no evidence of impairment in home maintenance.

Question 12

A nurse is working with a client in a drug rehabilitation center.The nurse provides positive reinforcement each time the client demonstrates behavior that moves him closer to accomplishing the goal of remaining drug free.The nurse recognizes this type of reinforcement will motivate the client to engage in the desired behavior.This type of reinforcement is known as

Accepted Answer

Shaping refers to the reinforcement of successive approximations of the target behavior.The long-term goal is broken down into smaller steps.The person is reinforced for any behavior that gets him or her closer to accomplishing the desired behavior.Rewarding specific behaviors that move the person in the direction of the desired behavior (successive approximations)motivates the person to engage in the desired behavior.Steps build one upon the other,moving learners from the familiar to the unfamiliar as they progress toward meeting treatment goals.

Question 13

The nurse is preparing teaching material for a class of diabetic clients.The most important aspect when preparing a presentation with slides for group teaching is

Accepted Answer

Use slides to identify key points.Slides help you stay on track and move through the agenda.The font should be large enough to see from a distance (32 point is recommended).Include no more than four or five items per slide.Face the audience,not the slides.Practice your presentation to ensure that you keep within the time frame and allot time for short discussion points.It is up to you as the presenter to set the pace.No matter how interesting the presentation and dialogue that it stimulates,running out of time is frustrating for the audience.

Question 14

Educational standards requiring health care agencies to provide systematic health education and training for clients were established by

Accepted Answer

Health teaching is not an option.It is a legal and ethical responsibility.The Joint Commission has established educational standards requiring health care agencies to provide systematic health education and training for clients that is specific to the client's needs; sufficient for clients to make informed decisions and to take responsibility for self-management activities related to their needs; provided to clients in an understandable manner and designed to accommodate various learning styles; and reflected in documented evidence of the client's understanding and response to the medical information.Professional nursing standards,developed by the American Nurses Association (ANA),reinforce the importance of health teaching as an essential nursing intervention.State Nurse Practice Acts mandate health teaching as an independent professional nursing function.Medicare requirements portray health teaching as a skilled nursing intervention for reimbursement purposes.

Question 15

Which of the following statements is true related to home care?

Accepted Answer

In home care the nurse is a guest in the client's home.Part of the teaching assessment includes appraisal of the home environment,family supports,and resources,as well as client needs.The nurse should always call before going to the client's home.This is a common courtesy; it also protects the nurse's time if the client is going to be out.When in the home,it is important to model appropriate behaviors (e.g.,washing hands in the bathroom sink before touching the client).Simple strategies,like not washing one's hands in the kitchen sink where food is prepared,encourage the client to do likewise.

Question 16

When the nurse formulates a goal that "the client will be able to accurately draw up the correct dose of insulin," the nurse recognizes this goal as referring primarily to health teaching in which domain?

Accepted Answer

Health teaching is a dynamic process,which involves making relevant connections to meaning within three domains: (1)cognitive (understanding content); (2)affective (changing attitudes and promoting acceptance); and (3)psychomotor (hands-on skill development).Changing attitudes and promoting acceptance are in the affective domain.Understanding content occurs in the cognitive domain.

Question 17

Which of the following is an effective teaching objective? The client will be able to

Accepted Answer

Objectives are powerful guides to organizing content and suggesting appropriate planning activities.Each objective should describe an immediate action step that the client should take to accomplish relevant treatment outcomes.Teaching objectives should be modest and achievable in the time frame allotted.They should be logically organized and build on one another for maximum effectiveness.To determine whether an objective is achievable,the nurse should consider the client's level of experience,educational level,resources,and motivation; then the nurse should define each learning objective needed to achieve the health goal in specific,measurable behavioral terms.Ambulating short distances is not specific enough or measurable.Learning subcutaneous self-administration of insulin is not specific.Understanding diabetes and its lifestyle implications is not measurable.

Question 18

The nurse is caring for a client who has a history of alcohol abuse.When formulating a goal that "the client will be able to identify three physical effects of alcohol abuse," the nurse recognizes this goal as referring primarily to health teaching in which domain?

Accepted Answer

Health teaching is a dynamic process,which involves making relevant connections to meaning within three domains: (1)cognitive (understanding content); (2)affective (changing attitudes and promoting acceptance); and (3)psychomotor (hands-on skill development).Affective refers to changing attitudes and promoting acceptance.Psychomotor refers to hands-on skill development.Promoting acceptance refers to the affective domain of health teaching.

Quiz 15: Health Teaching and Coaching