Chapter 24: Client Education Nursing School Test Banks

Potter & Perry: Fundamentals of Nursing, 6th Edition

MULTIPLE CHOICE

MULTIPLE CHOICE

1. The client has been informed that he can be discharged once he can irrigate his colostomy independently. The client requests the nurse to observe his irrigation technique. Which of the following learning motives is the client displaying?

a.

Physical need

b.

Social activity

c.

Task mastery

d.

Evaluation stance

ANS: c

c. Task-mastery motives are based on needs such as achievement and competence. The client who must demonstrate irrigating his colostomy independently to be discharged is displaying the learning motive of task mastery.

a. A physical motive may be seen in the client who desires to return to a level of physical normalcy.

b. A social motive is the need for connection, social approval, or self-esteem.

d. An evaluation stance would be determining whether the outcomes of the teaching-learning process met the clients goal. Evaluation is not a learning motive.

REF: Text Reference: p. 456

2. An industrial nurse is planning to give an informative talk on hypertension to employees in honor of Heart Month. He plans to teach individuals how to take their blood pressures. Which information is important for him to ask the planning committee before this presentation?

a.

Specific ages of all of the people involved

b.

Names of employees who are married

c.

Number of employees with high blood pressure

d.

Type of room available and number of participants

ANS: d

d. The number of persons being taught, the need for privacy, the room temperature, the room lighting, noise, the room ventilation, and the room furniture are important factors when choosing the setting. The ideal setting helps the client focus on the learning task.

a. Specific ages of all the people involved is not so important for providing education on how to take a blood pressure as is providing an environment conducive to learning.

b. It is not necessary to know the names of employees who are married to teach individuals how to take their blood pressure.

c. Whether the employee has high blood pressure or not should not be so important to the teacher as providing an environment conducive to learning. Having high blood pressure may be a motivating factor for the employees to learn how to take their blood pressure, because of its personal relevance.

REF: Text Reference: p. 459

3. The nurse established an objective for the client who was unable to void. The clients

intake will be at least 1000 ml between 7 AM and 3:30 PM. Feedback indicating

success is indicated by the client:

a.

Voiding at least 1000 ml during the shift

b.

Verbalizing abdominal comfort without pressure

c.

Having adequate intake and output

d.

Drinking 240 ml of fluid, 5 or 6 times during the shift

ANS: d

d. The nurse evaluates success by observing the clients performance of each expected behavior. Feedback indicating success in this situation is the client drinking 240 ml of fluid, 5 or 6 times during the shift. This would be a fluid intake of 1200- to 1440 ml, meeting the objective of at least 1000 ml during the designated period.

a. Voiding at least 1000 ml is not the objective. The objective is to have the client drink at least 1000 ml.

b. Verbalizing abdominal comfort without pressure is not an evaluation of the objective regarding specific fluid intake.

c. Having adequate intake and output is not accurate feedback indicating success. The term adequate is not quantified.

REF: Text Reference: p. 472

4. The nurse selects a variety of teaching methods to use with clients. For a toddler, the nurse should use:

a.

Role playing

b.

Problem solving

c.

Independent learning

d.

Simple explanations and pictures

ANS: d

d. Effective teaching methods for the toddler include simple explanations and picture books that describe a story of children in a hospital or clinic.

a. Role playing is an appropriate teaching method for the preschooler.

b. Problem solving is an appropriate teaching method for the adolescent.

c. Independent learning is best used as a teaching method for the young or middle adult.

REF: Text Reference: p. 459

5. The nurse has important information to share with a parent who has brought his child to the emergency department. The nurse discovers that the parent, who appears very anxious, has just learned his son will require surgery. The most effective teaching approach in this situation is:

a.

Telling

b.

Entrusting

c.

Participating

d.

Group teaching

ANS: a

a. The telling approach is useful when limited information must be taught. If a client is highly anxious, but it is vital for information to be given, telling can be effective.

b. The entrusting approach provides the client the opportunity to manage self-care. The nurse observes the clients progress and remains available to assist without introducing more new information. This would not be the most effective teaching approach in this situation.

c. Participating involves the nurse and client setting objectives and becoming involved in the learning process together. This would not be the most effective teaching approach in this emergency situation.

d. Group teaching would not be the most effective teaching approach in this situation. A person who is anxious would benefit more from individual instruction.

REF: Text Reference: p. 467

6. A client is taught the clinical manifestations of inflammation to allow early detection of a complication of a surgical wound. The client states, I will look at the wound 4 times a day and tell my surgeon if it looks red or swollen. Her statement is an example of:

a.

Attitudes

b.

Application

c.

Analysis

d.

Evaluation

ANS: b

b. Application involves using abstract, newly learned ideas in a concrete situation. The client who is taught the clinical manifestations of inflammation and assess for signs such as redness or edema is using newly learned information in a concrete manner.

a. Attitude has to do with affective learning. The client is not expressing an attitude but is applying new knowledge in a concrete way.

c. Analysis involves breaking down information into organized parts. The client is not demonstrating analysis.

d. Evaluation is a judgment of the worth of a body of information for a given purpose. The client is not expressing judgment.

REF: Text Reference: p. 455

7. The client continues to ask questions about a surgical wound. The client states, I think I would like help the first time I look at my wound. This is an example of:

a.

Guided response

b.

Adaptation

c.

Perception

d.

Organizing

ANS: a

a. A guided response is the performance of an act under the guidance of an instructor. The client who is seeking help is demonstrating a guided response.

b. Adaptation occurs when a person is able to change a motor response when unexpected problems arise. The client is not exhibiting adaptation.

c. Perception is being aware of objects or qualities through the use of sense organs. This situation is not an example of perception.

d. Organizing is developing a value system by identifying and organizing values and resolving conflicts. This situation is not an example of organizing.

REF: Text Reference: p. 455

8. The nurse assesses the clients readiness to learn insulin injection sites. Many factors are assessed before teaching, but the most important factor for the nurse to assess first is the:

a.

Previous knowledge level of the client

b.

Willingness of the client to want to learn the injection sites

c.

Financial resources available to the client for the equipment

d.

Intelligence and developmental level of the client

ANS: b

b. If a person does not want to learn, it is unlikely that learning will occur. Motivation is the first factor the nurse should assess before teaching.

a. To determine learning needs, the nurse should assess the clients previous knowledge level. However, this would not be the most important factor for the nurse to assess first.

c. Assessing a clients financial resources for obtaining equipment is important; however, it is not the most important factor for the nurse to assess first.

d. Assessing the clients physical and cognitive ability to learn is important. However, it is not the most important factor for the nurse to assess first.

REF: Text Reference: p. 456

9. The nurse is demonstrating to the client how to put on anti-embolytic stockings. In the middle of the lesson, the client asks, Why have my feet been swelling? The nurse stops and responds to the client. Which of the following is the teaching principle that the nurse should adhere to?

a.

Timing

b.

Setting priorities

c.

Building on existing knowledge

d.

Organizing teaching materials

ANS: a

a. The nurse who stops a demonstration of applying antiembolytic stockings to answer a clients question is following the teaching principle of timing. If the client has a question it is important to answer the question right away, so the focus may return to the task being taught.

b. Setting priorities is important to conserve the time and energy of the client and nurse. The nurse who stops to answer a question is not setting priorities.

c. A client learns best on the basis of preexisting cognitive abilities and knowledge. This situation is not an example of building on existing knowledge.

d. Organizing teaching material means the nurse considers the order of information to present. This is not an example of organizing teaching materials.

REF: Text Reference: p. 465

10. The nurse is evaluating the responses of clients to teaching sessions. An example of an evaluation of a psychomotor skill is:

a.

Client is able to state side effects of medication.

b.

Client responds appropriately to eye contact.

c.

Client planned an exercise program.

d.

Client uses the cane correctly.

ANS: d

d. Determining whether the client is able to demonstrate a newly learned skill is an example of an evaluation of a psychomotor skill. Psychomotor learning involves acquiring skills that require the integration of mental and muscular activity, such as walking with a cane.

a. Having the client state side effects of medication is an example of an evaluation of cognitive learning.

b. Determining whether a client responds appropriately to eye contact is an example of evaluation of affective learning.

c. The client who planned an exercise program is demonstrating cognitive learning.

REF: Text Reference: p. 455

11. Different topics are presented in the information sessions that are held in the outpatient clinic. In planning for a session on health maintenance/illness prevention, the nurse should select a topic on:

a.

Use of assistive devices, such as canes

b.

Self-help devices for post-CVA (cerebrovascular accident) clients

c.

Stress-management techniques for working parents

d.

Environmental alterations for clients in wheelchairs

ANS: c

c. Stress-management techniques for working parents is an appropriate topic for health maintenance/illness prevention.

a. Use of assistive devices, such as canes, is not a health maintenance/illness-prevention topic. It is a coping-with-impaired-function topic.

b. Self-help devices for postcerebrovascular accident (CVA) clients is not a health maintenance/illness-prevention topic. It is a coping-with-impaired-function topic.

d. Environmental alterations for clients in wheelchairs is not a health-maintenance/illness-prevention topic. It is a coping-with-impaired-function topic.

REF: Text Reference: p. 451

12. The nurse is evaluating the responses of clients to teaching sessions. An example of an evaluation of a clients attainment of a cognitive skill is:

a.

Client explains that the medication should be taken with meals

b.

Client looks at the surgical incision without prompting.

c.

Client uses crutches appropriately to go up and down stairs.

d.

Client dresses self after breakfast.

ANS: a

a. The client who is able to explain that the medication should be taken with meals is demonstrating attainment of a cognitive skill.

b. The client who is able to look at the surgical incision without prompting is demonstrating attainment of affective learning.

c. The client who uses crutches appropriately is demonstrating attainment of a psychomotor skill.

d. The client who dresses self after breakfast is most likely demonstrating attainment of psychomotor learning.

REF: Text Reference: p. 454

13. The nurse evaluates which of the following statements as an indication that the client is not ready to learn at this time?

a.

I need to understand more about the reason for the colostomy.

b.

I will find out when the support group meets.

c.

Theres no sense in showing me. Im too sick right now.

d.

Tell me if I am doing this correctly.

ANS: c

c. Readiness to learn is related to the stage of grieving. This response by the client demonstrates anger. The client is unwilling to learn at this time. The client has not yet reached the acceptance state of grieving in which learning can occur.

a. This statement indicates that the client is ready to learn and desires to find out more to gain understanding.

b. This statement indicates that the client is willing to learn.

d. The client who requests feedback is expressing readiness to learn.

REF: Text Reference: p. 457

14. In planning to teach an older adult client, the nurse should incorporate which teaching method or principle into the plan?

a.

Keep teaching sessions short.

b.

Teach in the early morning or late evening.

c.

Put as much as possible into each teaching session.

d.

Focus on teaching a family member instead.

ANS: a

a. Keeping teaching sessions short is an appropriate method when teaching an older adult client.

b. The older adult should be taught when the client is alert and rested, not in the early morning or late evening.

c. The teaching session should not be filled with numerous topics.

d. The older adult client is capable of learning and should be the focus. A family member may be included in teaching, but the older adult client should not be excluded.

REF: Text Reference: p. 459

15. The nurse has completed an assessment of the client and identified the following nursing diagnoses. Which one of the following nursing diagnoses indicates a need to postpone teaching that was planned?

a.

Knowledge deficit regarding impending surgery

b.

Activity intolerance related to pain

c.

Ineffective management of treatment regimen

d.

Noncompliance with prescribed exercise plan

ANS: b

b. Pain, fatigue, or anxiety can interfere with the ability to pay attention and participate. The nursing diagnosis of Activity intolerance related to pain indicates a need to postpone teaching. Teaching may be delayed until the nursing diagnosis is resolved or the health problem is controlled.

a. This nursing diagnosis does not indicate a need to postpone teaching. A knowledge deficit reinforces the need for teaching.

c. This nursing diagnosis does not indicate a need to postpone teaching. Ineffective management of treatment regimen reinforces the need for teaching.

d. This nursing diagnosis does not indicate a need to postpone teaching. The client who is noncompliant may require further teaching.

REF: Text Reference: p. 461, Text Reference: p. 462

16. The nurse recognizes that a variety of teaching methods may be implemented to meet the clients needs. Which teaching method is best applied to a cognitive learning need?

a.

Computer-assisted instruction

b.

Demonstration of a procedure

c.

Modeling of behavior

d.

Discussion of feelings

ANS: a

a. An independent project such as computer-assisted instruction is an appropriate teaching method for cognitive learning.

b. Demonstration is an appropriate teaching method for psychomotor learning.

c. Modeling of behavior is an appropriate teaching method for psychomotor learning.

d. Discussion of feelings is an appropriate teaching method for affective learning.

REF: Text Reference: p. 454

17. For a functionally illiterate client, the nurse particularly focuses on:

a.

Using intricate analogies and examples

b.

Avoiding return demonstrations

c.

Incorporating familiar terminology

d.

Spending less time with the client

ANS: c

c. When teaching a functionally illiterate client, the nurse should use simple terminology, avoiding medical jargon. The nurse should incorporate familiar terminology to enhance the clients understanding.

a. The nurse should use simple analogies and real-life examples.

b. The nurse should ask for return demonstrations, as this provides the opportunity to clarify instructions and the time to review procedures.

d. Although teaching sessions may be kept short, they should be scheduled at more frequent intervals.

REF: Text Reference: p. 470

18. In preparing a teaching plan for adult clients in a cancer support group, the nurse incorporates evidence-based information. The nurse recognizes that evidence obtained about adult learners identified that this group preferred:

a.

Computer-assisted instruction

b.

Traditional classroom settings

c.

Long sessions with lots of technical information

d.

Interesting personal communication techniques

ANS: d

d. Adults have a wide variety of personal and life experiences to draw on. Therefore adult learning is enhanced when adults are encouraged to use these experiences to solve problems. Evidence-based information indicates that adult clients prefer interactive, personal communication with nurses or physicians.

a. Evidence-based information indicates that computer-assisted learning is not a preferred method of instruction by many adult learners. As clients become more comfortable with computers, this preference may change.

b. Evidence-based information indicates that not all clients are comfortable in class settings or in support groups. Other educational opportunities should be available.

c. Adult learners prefer short teaching sessions without lots of technical information.

REF: Text Reference: p. 452, Text Reference: p. 458, Text Reference: p. 459

19. The nurse is teaching the client about management of his heart disease. A strategy that is implemented to promote learning in the affective domain is demonstrated by the nurse:

a.

Asking the client what he believes he needs to know about the diagnosis

b.

Providing brochures on current exercises and nutrition guidelines

c.

Encouraging the client to discuss his feelings about his health status

d.

Having the client return demonstrate self measurement of his blood pressure

ANS: c

c. An intervention to promote learning in the affective domain would be encouraging the client to discuss his feelings about his health status.

a. Asking the client what he believes he needs to know about the diagnosis would be an intervention to promote learning in the cognitive domain.

b. Providing brochures on current exercises and nutrition guidelines would be an intervention to promote learning in the cognitive domain.

d. Having the client return demonstration of self-measurement of his blood pressure would be an intervention to promote learning in the psychomotor domain.

REF: Text Reference: p. 466

20. The nurse is preparing to present a teaching session on skin protection for a group of older adults at a senior center. A principle that has been found to be most effective in teaching older adults is:

a.

Moving the group along at a pre-determined pace

b.

Providing information in longer teaching sessions

c.

Speaking very slowly and in a louder tone of voice

d.

Beginning and ending each session with important information

ANS: d

d. The nurse should begin and end each teaching session with important information because clients are more likely to remember information that is taught early in the teaching session, and key points can be summarized at the end. Repetition also reinforces learning.

a. The group should not be moved along at a predetermined pace. Clients may have questions that would go unanswered if there were a predetermined pace. Sometimes teaching sessions have to be stopped after the nurse observes a clients loss of concentration, such as nonverbal cues of poor eye contact or slumped posture.

b. Shorter (approximately 20 minutes), frequent sessions are more easily tolerated and retain the clients interest in the material.

c. The nurse should face the client and speak in a low tone of voice for the older adult with a nearing problem.

REF: Text Reference: p. 465

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