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A nurse develops a contractual agreement with a morbidly obese patient to achieve optimal weight goals. Which statement best describes the nature of this agreement?
- A. This agreement forms a legal bond between the two of us to achieve your weight goals.
- B. This agreement will motivate the two of us to do what is necessary to meet your weight goals.
- C. This agreement will help us determine what learning outcomes are necessary to achieve your weight goals.
- D. This agreement will limit the scope of the teaching session and make stated weight goals more attainable.
Correct Answer: C
Rationale: A contractual agreement in a teaching plan helps to clarify and define the specific learning outcomes that both the nurse and patient aim to achieve, making the goals clear and measurable.
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A nurse is caring for a patient who is admitted to the hospital with traumatic injuries sustained in a motor vehicle accident. While hospitalized, the patient's spouse tells the patient that their house flooded, damaging their belongings. When the nurse notes that the patient is visibly upset by this news, the nurse suggests which type of counseling?
- A. Long-term developmental
- B. Short-term situational
- C. Short-term motivational
- D. Long-term motivational
Correct Answer: B
Rationale: Short-term counseling might be used during a situational crisis, which occurs when a patient faces an event or situation that causes a disruption in life, such as a flood. Long-term counseling extends over a prolonged period; a patient experiencing a developmental crisis, for example, might need long-term counseling. Motivational interviewing is an evidence-based counseling approach that involves discussing feelings and incentives with the patient.
A nurse is teaching an adult patient how to care for their new ostomy appliance. Which evaluation method is most appropriate to confirm that the patient has learned the information?
- A. Ask Me 3
- B. Newest Vital Sign (NVS)
- C. Teach-Back Method
- D. TEACH acronym
Correct Answer: C
Rationale: The Teach-Back Method tool is a method of assessing literacy and confirming that the learner understands health information received from a health professional. The Ask Me 3 is a brief tool intended to promote understanding and improve communication between patients and their providers. The NVS is a reliable screening tool to assess low health literacy, developed to improve communications between patients and providers. The TEACH acronym is used to maximize the effectiveness of patient teaching by tuning into the patient, editing patient information, acting on every teaching moment, clarifying often, and honoring the patient as a partner in the process.
A nurse is teaching first aid to counselors of a summer camp for children with asthma. This is an example of what aim of health teaching?
- A. Promoting health
- B. Preventing illness
- C. Restoring health
- D. Facilitating coping
Correct Answer: B
Rationale: Teaching first aid is a function of the goal to prevent illness. Promoting health involves helping patients to value health and develop specific health practices that promote and maintain wellness. Restoring health occurs once a patient is ill, and teaching focuses on developing self-care practices that promote recovery. When facilitating coping, nurses help patients come to terms with whatever lifestyle modification is needed for their recovery or to enable them to cope with permanent health alterations.
The nurse coach at a cardiac rehabilitation office is meeting with a patient who has learned they have heart failure. Which nursing actions might the nurse coach include in coaching sessions for this patient? (Select all that apply.)
- A. Provide education based on the patient's personal goals.
- B. Explore the patient's readiness for change.
- C. Assist the patient to determine progress toward goals.
- D. Direct the patient to exercise daily.
- E. Identify goals for the patient.
Correct Answer: A,B,C
Rationale: A nurse coach focuses on patient-centered actions, such as providing education aligned with personal goals, assessing readiness for change, and helping evaluate progress. Directing daily exercise or setting goals for the patient without their input does not align with the collaborative nature of coaching.
A nurse on the rehabilitation unit is counseling a young adult athlete who sustained a traumatic below-the-knee amputation following a motorcycle accident. The patient refuses to eat or ambulate, stating, 'What's the point? My life is over. I'll never be the football player I dreamed of becoming.' What is the nurse counselor's best response?
- A. You're young and have your whole life ahead of you. You should focus on your rehabilitation and make something of your life.
- B. I understand how you must feel. I wanted to be a famous singer, but I wasn't born with the talent to be successful at it.
- C. You should concentrate on other sports that you could play even with prosthesis.
- D. I understand this is difficult for you. Would you like to talk about it now or would you prefer me to make a referral to someone else?
Correct Answer: D
Rationale: This answer communicates respect and sensitivity to the patient's needs and offers an opportunity to discuss their feelings with the nurse or another health care professional. The other answers do not allow the patient to express their feelings and receive the counseling they need.