Nokea
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.
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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.
The nurse has taught a patient with diabetes how to administer subcutaneous insulin injections. Which is the best strategy to evaluate if the teaching goal has been met?
- A. Ask the patient the insulin dose and times of day they will administer insulin.
- B. Observe the patient's technique in drawing up and administering insulin.
- C. Have the patient explain the skill they have just learned.
- D. Document the teaching session in the patient's electronic health record.
Correct Answer: B
Rationale: The nurse cannot assume that the patient has actually learned the content unless there is some type of proof of learning. The key to evaluation is ensuring the learner meets the outcomes stated in the teaching plan, in this case, by demonstrating the psychomotor skill.
A registered nurse acts as nurse coach to provide teaching to patients who are recovering from a stroke. Which statement directs the nurse in performing this role?
- A. The nurse uses discovery to identify the patients' personal goals and create a plan that will result in change.
- B. The nurse is the expert in providing teaching and education strategies to provide dietary and activity modifications.
- C. The nurse becomes a mentor to the patients and encourages them to create their own fitness programs.
- D. The nurse assumes an authoritative role to design the structure of the coaching session and support the achievement of patient goals.
Correct Answer: A
Rationale: A nurse coach establishes a partnership with a patient and, using discovery, facilitates the identification of the patient's personal goals and agenda to lead to change rather than using teaching and education strategies with the nurse as the expert. A nurse coach explores the patient's readiness for coaching, designs the structure of a coaching session, supports the achievement of the patient's desired goals, and with the patient determines how to evaluate the attainment of patient goals.
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.
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.