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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.
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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 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 in the diabetes clinic initiates education for a patient with a new diagnosis of diabetes. The nurse notes the patient has completed 2 years of college. What action does the nurse select for the initial teaching session?
- A. Providing the patient with handouts related to blood-glucose management
- B. Demonstrating the use of the blood-glucose monitor and tool to record blood-glucose readings
- C. Assessing the patient's knowledge of diabetes and their ability to interpret the health information
- D. Explaining the dietary restrictions including foods that are prohibited
Correct Answer: C
Rationale: Assessing the patient's baseline knowledge and health literacy is critical before initiating education, especially for a patient with some college education, to tailor the teaching to their needs and avoid redundant or overly simplistic information.
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 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.