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A nurse is teaching patients of all ages in a hospital setting. Which teaching examples are appropriate for the patient's developmental level? Select all that apply.
- A. The nurse plans long teaching sessions to discuss diet modifications for an older adult diagnosed with type 2 diabetes.
- B. The nurse recognizes that a female adolescent diagnosed with anorexia is still dependent on her parents and includes them in all teaching sessions.
- C. The nurse designs an exercise program for a sedentary older adult male patient based on the activities he prefers.
- D. The nurse includes an 8-year-old patient in the teaching plan for managing cystic fibrosis.
- E. The nurse demonstrates how to use an inhaler to an 11-year-old male patient and includes his mother in the session to reinforce the teaching.
- F. The nurse continues a teaching session on STIs for a sexually active male adolescent despite his protest that 'I've heard enough already!'
Correct Answer: C,D,E
Rationale: Successful teaching plans for older adults incorporate extra time, short teaching sessions, accommodation for sensory deficits, and reduction of environmental distractions. Older adults also benefit from instruction that relates new information to familiar activities or information. School-aged children are capable of logical reasoning and should be included in the teaching-learning process whenever possible; they are also open to new learning experiences but need learning to be reinforced by either a parent or health care provider as they become more involved with their friends and school activities. Teaching strategies designed for an adolescent patient should recognize the adolescent's need for independence, as well as the need to establish a trusting relationship that demonstrates respect for the adolescent's opinions.
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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.
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.
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 nurse is planning teaching strategies in the affective domain of learning for patients with alcohol use disorders. Which teaching-learning activities will the nurse use? Select all that apply.
- A. Preparing a lecture on the harmful long-term effects of alcohol on the body
- B. Asking the patient to discuss reasons people with alcohol use disorders drink and exploring other methods of coping with problems
- C. Requesting that patients perform a return demonstration for using relaxation exercises to relieve stress
- D. Helping patients to reaffirm their feelings of self-worth and relate this to their alcohol use disorder
- E. Using a pamphlet to discuss the tenets of the Alcoholics Anonymous program with patients
- F. Reinforcing the mental benefits of gaining self-control over a substance use disorder
Correct Answer: B,D,F
Rationale: Affective learning includes changes in attitudes, values, and feelings (e.g., the patient expresses renewed self-confidence to be able to give up drinking). Cognitive learning involves the storing and recalling of new knowledge in the brain, such as the learning that occurs during a lecture or by using a pamphlet for teaching. Learning a physical skill involving the integration of mental and muscular activity is called psychomotor learning, which may involve a return demonstration of a skill.