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During a nursing assessment, which question by the nurse allows for greater clarification and additional discussion with the patient?
- A. Are you allergic to iodine?
- B. What type of reaction did you have to penicillin?
- C. Have you had a reaction to this drug?
- D. Are you taking this medication with meals?
Correct Answer: B
Rationale: Asking 'What type of reaction did you have?' is an open-ended question that will encourage greater clarification and additional discussion with the patient. The other options are examples of closed-ended questions, which prompt only a 'yes' or 'no' answer and provide limited information.
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During an admission assessment, the nurse discovers that the patient does not speak English. Which is considered the ideal resource for translation?
- A. A family member of the patient
- B. A close family friend of the patient
- C. A translator who does not know the patient
- D. Prewritten note cards with both English and the patient's language
Correct Answer: C
Rationale: The nurse should communicate with the patient in the patient's native language if at all possible. If the nurse is not able to speak the patient's native language, a translator should be made available so as to prevent communication problems, minimize errors, and help boost the patient's level of trust and understanding of the nurse. In practice, this translator may be another nurse or health care professional, a nonprofessional member of the health care team, or a layperson, family member, adult friend, or religious leader or associate. However, it is best to avoid family members as translators, if possible, because of issues with bias, misinterpretation, and potential confidentiality issues.
When the nurse teaches a skill such as self-injection of insulin to the patient, what is the best way to set up the teaching/learning session?
- A. Provide written pamphlets for instruction.
- B. Show a video, and allow the patient to practice as needed on his own.
- C. Verbally explain the procedure, and provide written handouts for reinforcement.
- D. After demonstrating the procedure, allow the patient to do several return demonstrations.
Correct Answer: D
Rationale: Return demonstration allows the nurse to evaluate the patient's newly learned skills. The techniques in the other options are incorrect because those suggestions do not allow for evaluation of the patient's technique.
A patient with a new prescription for a diuretic has just reviewed with the nurse how to include more potassium in her diet. This reflects learning in which domain?
- A. Cognitive
- B. Affective
- C. Physical
- D. Psychomotor
Correct Answer: A
Rationale: The cognitive domain refers to problem-solving abilities and may involve recall and knowledge of facts. The affective domain refers to values and beliefs. The term physical does not refer to one of the learning domains. The psychomotor domain involves behaviors such as learning how to perform a procedure.
The nurse is setting up a teaching session with an 85-year-old patient who will be going home on anticoagulant therapy. Which educational strategy would reflect consideration of the age-related changes that may exist with this patient?
- A. Show a video about anticoagulation therapy.
- B. Present all the information in one session just before discharge.
- C. Give the patient pamphlets about the medications to read at home.
- D. Develop large-print handouts that reflect the verbal information presented.
Correct Answer: D
Rationale: Developing large-print handouts addresses altered perception in two ways. First, by using visual aids to reinforce verbal instructions, one addresses the possibility of decreased ability to hear high-frequency sounds. By developing the handouts in large print, one addresses the possibility of decreased visual acuity. Showing a video does not allow discussion of the information; furthermore, the text and print may be small and difficult to read and understand. Presenting all the information in one session before discharge also does not allow for discussion, and the patient may not be able to hear or see the information sufficiently. Because of the possibility of decreased short-term memory and slowed cognitive function, simply giving pamphlets to read without other teaching strategies may not be appropriate.
The nurse is reviewing the teaching plan for a clinic patient who was seen for a sinus infection. Which of these outcomes reflect the affective domain of learning?
- A. The patient will take the prescribed antibiotic for the full 14 days of the prescription.
- B. The patient will demonstrate correct nasal spray self-administration.
- C. The patient will list signs and symptoms that need to be reported immediately if they occur.
- D. The patient will list measures to take to reduce allergy triggers at home.
Correct Answer: A
Rationale: The affective domain is the most intangible component of the learning process. Affective behavior is conduct that expresses feelings, needs, beliefs, values, and opinions. Adhering to the prescribed medication regimen is an example of the affective domain. Demonstrating nasal spray self-administration reflects the psychomotor domain; listing signs and symptoms or measures to take both reflect the cognitive domain.