Question 1

A newly diagnosed diabetic patient tells the nurse, "I want to know how to give my own insulin." Which action will the nurse take first when implementing the standardized diabetic teaching plan?

Accepted Answer

Adult education is most effective when focused on information that the patient thinks is needed right now. All of the indicated information will need to be included when planning teaching for this patient, but the teaching will be most effective if the nurse starts with the patient's stated priority topic.

Question 2

To assess a patient's readiness to learn before planning teaching activities, which question should the nurse ask?

Accepted Answer

Motivation and readiness to learn depend on what the patient values and perceives as important. The other questions are also important in developing the teaching plan, but do not address what information most interests the patient at present.

Question 3

The nurse develops a nursing diagnosis of ineffective health maintenance related to low motivation based on the finding that the diabetic patient

Accepted Answer

The patient's motivation to follow a diabetic diet will be decreased if the patient feels that dietary changes do not impact symptoms. The other responses do not indicate that the ineffective health maintenance is caused by lack of motivation.

Question 4

When using the Transtheoretical Model of Health Behavior Change during patient teaching, the nurse identifies that the patient who states, "I told my wife that I was going to start exercising, and I think I will join a fitness club," is in the stage of

Accepted Answer

The patient's statement indicating that the plan for change is being shared with someone else indicates that the preparation stage has been achieved. Contemplation of a change would be indicated by a statement like "I know I should exercise." Maintenance of a change occurs when the patient practices the behavior regularly. Termination would be indicated when the change is a permanent part of the lifestyle.

Question 5

A 73-year-old Hispanic/Latino patient is seen at the health clinic and diagnosed with protein malnutrition. The priority action in the nurse's teaching plan will be to

Accepted Answer

Assessment is the first step in assisting a patient with health changes. The other answers may be appropriate for the patient, but the nurse will not be able to determine this until the assessment of the patient is complete.

Question 6

When assessing a 22-year-old male patient, the nurse learns that he smokes a pack of cigarettes daily. The patient tells the nurse, "I enjoy smoking and have no plans to quit." Which nursing diagnosis is most appropriate?

Accepted Answer

The patient's statement indicates that he is not considering smoking cessation. Ineffective health maintenance is defined as the inability to identify, manage, and/or seek out help to maintain health.

Question 7

The patient's teaching plan includes this goal: "The patient will select a 2-gram sodium diet from the hospital menu for the next 3 days." Which evaluation method will be best for the nurse to use when determining whether teaching was effective?

Accepted Answer

All of the answers address the patient's sodium intake, but the desired patient behaviors in the learning objective are most clearly addressed by evaluation of the patient's menu choices.

Question 8

After the nurse implements diet instruction for a patient with heart disease, the patient can explain the information but fails to make the recommended dietary changes. The nurse's evaluation is that

Accepted Answer

Although the patient behavior has not changed, the patient's ability to explain the information indicates that learning has occurred and the patient is choosing at this time to continue with the previous diet. The patient may be in the contemplation or preparation state in the Transtheoretical Model. The nurse should reinforce the need for change and continue to provide information and assistance with planning for change.

Question 9

The nurse is preparing written handouts to be used as part of the standardized teaching plan for patients who have been recently diagnosed with diabetes. Which of the following statements would be appropriate to include in the handouts?

Accepted Answer

Reading level for patient teaching materials should be at the 5th grade level. The other responses have words with three or more syllables, use many medical terms, and/or are too long.

Question 10

A patient with poor circulation to the feet requires teaching about foot care. Which learning goal should the nurse include in the teaching plan?

Accepted Answer

Learning goals should state clear, measurable outcomes of the learning process. Options a and c describe actions that the nurse will take, rather than behaviors that indicate that patient learning has occurred. Option d is too vague and nonspecific to measure whether learning has occurred.

Question 11

While admitting a patient to the medical unit, the nurse learns that the patient does not read well. This information will guide the nurse in determining

Accepted Answer

The information that the patient is illiterate indicates that the nurse should avoid the use of written materials in teaching and choose other strategies. The patient does not indicate a lack of motivation or an inability to understand new information. The patient's lack of reading ability does not necessarily imply that the family must be included in the teaching process.

Question 12

Which action should the nurse take first when teaching a patient's spouse how to manage the blood pressure (BP) for a patient with newly diagnosed high BP?

Accepted Answer

Since adults learn best when given information that they view as being needed immediately, asking the caregiver and patient to prioritize learning needs is likely to be the most successful approach to home management of health problems. The other actions also may be appropriate, depending on what learning needs the caregiver and patient have, but the initial action should be to assess what the learners feel is important.

Question 13

A 43-year-old is diagnosed with type 2 diabetes mellitus after being admitted to the hospital with an infected foot wound. When applying principles of adult learning, which teaching strategy by the nurse is most likely to be effective?

Accepted Answer

Principles of adult education indicate that readiness and motivation to learn are high when facing new tasks (such wound care) and when demonstration and practice of skills are available. Although a home health referral may be needed for this patient, teaching should not be postponed until discharge. Adult learners are independent; the nurse should act as a facilitator for learning, rather than as the expert. Adults learn best when the topic is of immediate usefulness; long-term goals may not be very motivating.

Question 14

The nurse in the hospital has implemented a teaching plan to assist a patient with rheumatoid arthritis in accomplishing daily activities independently. To evaluate the patient's long-term response to the teaching, the best action by the nurse will be to

Accepted Answer

The patient's long-term response may need to be assessed after discharge; a home health referral would allow this to occur. The other actions allow evaluation of the patient's short-term response to teaching.

Question 15

A patient with newly diagnosed breast cancer has a nursing diagnosis of deficient knowledge about breast cancer. When the nurse is planning teaching for the patient, which is the most important initial learning goal?

Accepted Answer

Adults learn best when given information that can be used immediately. The first action the patient will need to take after a cancer diagnosis is to choose a treatment option. The other goals may be appropriate as treatment progresses.

Question 16

A patient admitted to the hospital with hyperglycemia and newly diagnosed diabetes mellitus is scheduled for discharge the second day after admission. When implementing patient teaching, which is the best action for the nurse to take?

Accepted Answer

When time is limited, the nurse should focus on the priorities of teaching. In this situation, the patient should know how to test blood glucose and administer medications to control glucose levels. The patient will need further teaching about the role of diet, exercise, various medications, and the many potential complications of diabetes, but these topics can be addressed through planning for appropriate referrals.

Question 17

When the nurse is planning teaching for a patient who needs to improve skills in being more assertive, the most effective teaching strategy will be

Accepted Answer

Role-playing allows the patient to practice assertive behavior and receive feedback about how the behavior is perceived. Lecture-discussion, peer-teaching, and printed materials are more useful for other learning needs.

Question 18

When assessing the learning needs for a patient who has coronary heart disease, the nurse finds that the patient has recently made dietary changes to decrease fat intake and has stopped smoking. The best initial statement by the nurse at this time is

Accepted Answer

Positive reinforcement of the learner's achievements is critical in making lifestyle changes. This patient is in the action stage of the Transtheoretical Model, when reinforcement of the changes being made is an important nursing intervention. The other responses are also appropriate, but are not the best initial response.

Quiz 4: Patient and Caregiver Teaching