Question 1

To teach effectively,nurses must recognize that:

Accepted Answer

To teach effectively,nurses must recognize that patients of all ages come from diverse cultural and socioeconomic backgrounds.Each has a different ability to comprehend health care information.Results of the NAAL research indicate that among American adults,30 million (14%)had below basic health literacy in English and 47 million (22%)had basic health literacy.This means that 77 million (36%)American adults possessed very rudimentary literacy skills that allowed them to read only short,simple printed and written materials.Although discussion of Nightingale's work often focuses on her efforts to distinguish nursing as a profession and address the impact of sanitation on health,she advocated exploring all aspects of the patient.She thought that patients needed care that is "delicate and decent" and that demonstrates "the power of giving real interests to the patient." Exploring patients' interests and abilities was an early acknowledgment that nurses must be aware of patients' ability to comprehend the health care information provided.Often,health care professionals assume that the explanations and instructions given to patients and families are readily understood.In reality,research has shown that these instructions are frequently misunderstood,sometimes resulting in serious errors.

Question 2

The nurse is preparing to teach a 90-year-old patient.In teaching an elderly patient,the nurse realizes that:

Accepted Answer

Teaching should be tailored to elderly patients.Reports indicate that two thirds of U.S.adults 66 years old and older have inadequate or marginal literacy skills,and 81% of patients 60 years old and older at a public hospital could not read or understand basic materials such as prescription labels.Although each patient must assessed individually,cognitive and sensory alterations often occur with aging,and the teaching materials should be adjusted accordingly.

Question 3

In addressing patient education,the nurse recognizes that patient education is a process involving: (Select all that apply. )

Accepted Answer

Assessment of health literacy occurs with each patient encounter.On completion of assessment,a nursing diagnosis relevant to the educational needs of the patient or caregiver can be determined.After working with the patient or caregiver to determine the appropriate nursing diagnosis,the next step is developing the patient education plan.In all patient education situations,a return demonstration by the patient (i.e. ,repeating what has been taught)helps the nurse to assess the level of learning that has taken place.Although evidence-based practice is important,it is sometimes insufficient when making patient care decisions.

Question 4

Which of the following patients would most likely need to have adjustments made to the education plan for discharge because of role function?

Accepted Answer

Exploration of the patient's roles is an important task that must be done before development of a patient education plan.For example,a 32-year-old,single mother of five young children who has just undergone a hysterectomy may require a different perspective in her discharge instructions than that in the instructions of a 67-year-old female living with her husband who recently retired after 35 years as a family practice physician.The first patient may have less support and less flexibility regarding rest,lifting limitations,and cost of prescriptions than the second.It is important not to stereotype and assign roles but rather to develop a plan in collaboration with the individual.The patient's support system should be taken into consideration when the nurse plans patient education.

Question 5

According to the Healthy People 2020 initiative,health information and the associated access issues have become more complicated.There are many considerations when determining whether an individual has proficient health literacy.The patient should be able to: (Select all that apply. )

Accepted Answer

The patient should be able to exhibit certain competencies such as reading and identifying credible health information,understanding numbers in the context of the patient's health care,making appointments,filling out forms,gathering health records and asking appropriate questions of physicians,advocating for appropriate care,navigating complex insurance programs (Medicare or Medicaid,and other financial assistance programs),and using technology to access information and services.Interpreting EKGs and X-rays is beyond this scope.

Question 6

The nurse is admitting a patient who has cystic fibrosis.During the admission interview,it is apparent that the patient is well versed in most aspects of his illness.When asked about where he learned so much,the patient responds,"I learned most of it myself.I looked things up on the Internet and read books.You have to know what's wrong with you to be sure that you're being treated right." This is an example of:

Accepted Answer

Informal education is usually learner or patient directed.Formal patient education is delivered throughout the community in the form of media,in a variety of educational and group settings,or in a planned,goal-directed,one-on-one session with a patient in the acute care setting.The psychomotor domain incorporates physical movement and the use of motor skills in learning.Teaching the newly diagnosed diabetic how to check blood sugar is an example of a psychomotor skill.Affective domain learning recognizes the emotional component of integrating new knowledge.Successful education in this domain takes into account the patient's feelings,values,motivations,and attitudes.

Question 7

The nurse is working with a diabetic patient,and is attempting to teach psychomotor skills.This is occurring when the nurse has the patient:

Accepted Answer

The psychomotor domain incorporates physical movement and the use of motor skills in learning.Teaching the newly diagnosed diabetic how to check blood sugar is an example of a psychomotor skill.Learners in the cognitive domain integrate new knowledge through first learning and then recalling the information.They then categorize and evaluate,making comparisons with previous knowledge that result in conclusions related to the new content.Affective domain learning recognizes the emotional component of integrating new knowledge.Successful education in this domain takes into account the patient's feelings,values,motivations,and attitudes.

Question 8

The patient is reportedly well educated and employed as an engineer,but is struggling to comprehend terms found in health-related literature given to explain his disease process.This is evidence of:

Accepted Answer

Although low literacy and low health literacy are related terms,they are not interchangeable.Low health literacy is content specific,meaning that the individual may not have difficulty reading and writing outside the health care arena.These patients may struggle to comprehend the complicated,unfamiliar terms and ideas found in health-related materials or instructions.The psychomotor domain incorporates physical movement and the use of motor skills in learning.Teaching the newly diagnosed diabetic how to check blood sugar is an example of a psychomotor skill.Affective domain learning recognizes the emotional component of integrating new knowledge.Successful education in this domain takes into account the patient's feelings,values,motivations,and attitudes.

Question 9

The nurse is preparing to teach a patient for the first time and needs to evaluate the health literacy of the patient.She uses the VARK assessment to:

Accepted Answer

Tools have been developed to help health care workers evaluate the health literacy of their patients.One such tool is the VARK (verbal,aural,read/write,kinesthetic)assessment of learning styles of people who are having difficulty learning.Individuals typically learn through more than one method.For example,a patient's VARK assessment may indicate learning through VAR or ARK.When the use of more than one style facilitates learning,the individual is considered a multimodal learner,meaning that the person does best when more than one teaching strategy is used or that the person is able to adapt to a variety of teaching strategies on the basis of what is being presented.Understanding how patients learn best makes collaborative learning plans most effective.It is good practice to provide multiple means of learning,because most individuals learn through more than one style and repetition enhances learning.

Question 10

The nurse is implementing a patient teaching plan regarding diabetes mellitus.One of the short-term goals of the plan is that the patient will be able to verbalize three symptoms of hypoglycemia.This is an example of:

Accepted Answer

Learners in the cognitive domain integrate new knowledge through first learning and then recalling the information.They then categorize and evaluate,making comparisons with previous knowledge that result in conclusions related to the new content.The psychomotor domain incorporates physical movement and the use of motor skills in learning.Teaching the newly diagnosed diabetic how to check blood sugar is an example of a psychomotor skill.Affective domain learning recognizes the emotional component of integrating new knowledge.Successful education in this domain takes into account the patient's feelings,values,motivations,and attitudes.Tools have been developed to help health care workers evaluate the health literacy of their patients.One such tool is the VARK (verbal,aural,read/write,kinesthetic)assessment of learning styles of people who are having difficulty learning

Question 11

The unique ability of the patient to understand and integrate health-related knowledge is known as:

Accepted Answer

The unique ability of a patient to understand and integrate health-related knowledge is known as health literacy.Formal patient education is delivered throughout the community in the form of media,in a variety of educational and group settings,or in a planned,goal-directed,one-on-one session with a patient in the acute care setting.Informal education is usually learner or patient directed.Many health care consumers begin receiving information as children through their primary education.Handwashing,proper dental care,and nutrition are examples of early instructions.

Question 12

The nurse is preparing to teach a 5-year-old child postoperative care that will be anticipated after a tonsillectomy.The nurse should:

Accepted Answer

Patient education provided for children should be age specific.Use pictures and simple words for young children.Use clear,simple explanations for school-age children.The patient's age directly affects the instructional methods and materials used.Effective patient education involving a child requires the presence of a parent or caregiver,who is likely the target of teaching.Children should not be excluded from the learning session unless exclusion is deemed appropriate by the parent or caregiver;a presentation using an age-appropriate strategy may complement the instructions reviewed with the adult.The stages of development should be explored as the foundation for the choice of educational materials.

Question 13

The nurse has established a teaching plan including goals.This type of education is termed:

Accepted Answer

Formal patient education is delivered throughout the community in the form of media,in a variety of educational and group settings,or in a planned,goal-directed,one-on-one session with a patient in the acute care setting.Informal education is usually learner or patient directed.The psychomotor domain incorporates physical movement and the use of motor skills in learning.Teaching the newly diagnosed diabetic how to check blood sugar is an example of a psychomotor skill.Affective domain learning recognizes the emotional component of integrating new knowledge.Successful education in this domain takes into account the patient's feelings,values,motivations,and attitudes.

Question 14

In determining patient goals,the nurse should:

Accepted Answer

As health care educators,nurses should allow patients to identify what is most important to them.If a newly diagnosed diabetic patient is interested in learning techniques of care that will allow discharge to home rather than to an extended care facility,the patient is more likely to be receptive to learning about self-monitoring blood sugar levels.After the learning goals related to the issues that the patient feels are a priority have been met,the patient may then be able to focus on health promotion and avoiding complications.

Question 15

During patient teaching led by the nurse with goals established through cooperation of the nurse and patient,the patient asks questions as needed and the nurse answers.This is known as:

Accepted Answer

Some patient education sessions have formal and informal elements,because the nurse and patient may set goals together before the nurse formulates and implements the plan of care,and the patient is free to ask questions that may direct the session.The health care information is considered informal because it is situation and patient specific.Formal patient education is delivered throughout the community in the form of media,in a variety of educational and group settings,or in a planned,goal-directed,one-on-one session with a patient in the acute care setting.Informal education is usually learner or patient directed.The psychomotor domain incorporates physical movement and the use of motor skills in learning.Teaching the newly diagnosed diabetic how to check blood sugar is an example of a psychomotor skill.

Question 16

The nurse is preparing a teaching plan and is applying evidence-based practice.To promote involvement,the nurse must:

Accepted Answer

To promote involvement,nurses must ensure that patients understand the information relevant to their care.Nurses need to provide patients with easy-to-understand information and speak in a clear,distinct voice,using short sentences and understandable terminology.Multiple teaching methods should be used to meet the needs of all types of learners.Patient education sessions should be reassessed after two to three key points to ensure that the patient is still engaged in learning and ready to assimilate more information.Information taught at previous sessions can be reviewed before proceeding with new key points.

Question 17

The nurse is preparing to discharge a patient home.In providing instruction about the patients medications,the nurse should state:

Accepted Answer

Do not use abbreviations or medical terminology when providing patients with instructions.

Question 18

The nurse is preparing to provide preoperative teaching to a patient who is deaf.To ensure proper learning,the nurse may:

Accepted Answer

Patients with hearing loss may not be able to hear and understand verbal instructions.Nurses should use other methods such as printed material,demonstration,recorded materials amplified through headsets,interpretation provided by a professional interpreter face-to-face with patients and families or by phone or video medical interpretation (VMI),and/or simulations,photos,drawings,or video to enhance understanding.

Question 19

Ongoing evaluation of patient education occurs by:

Accepted Answer

Ongoing evaluation of patient education occurs by each member of the health care team who provides teaching according to the patient's teaching plan.Having the learner repeat what has been learned can help the nurse evaluate the teaching plan and adjust the plan for future patient education sessions.Future sessions should review what was learned previously and continue to add to what has been taught.Health care team members can view documentation on the electronic health record (EHR)before beginning an education session to determine the patient's progress in meeting educational goals.

Question 20

As the health care community explores the concept of health literacy,many organizations recognize that:

Accepted Answer

As the health care community explores the concept of health literacy,many organizations recognize that before improvements can be made,operational definitions are imperative.The realization that consumers need to be able to understand the medical information delivered by health care providers has gained recognition at many governmental levels.The Healthy People 2020 publication describes a national movement that addresses the priorities of prevention and public health in the United States.Health literacy with its impact on this initiative is being recognized and has become a key component of the project.Although low literacy and low health literacy are related terms,they are not interchangeable.Low health literacy is content-specific,meaning that the individual may not have difficulty reading and writing outside the health care arena.Interest in effective patient education is not a phenomenon unique to the United States.The Institute of Medicine Roundtable on Health Literacy held a workshop in 2012 focused on international health literacy.

Quiz 14: Health Literacy and Patient Education