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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.
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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 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 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.
A nurse is preparing a teaching plan for a patient with asthma on the use of an inhaler. What teaching method is most appropriate for this patient?
- A. Demonstration
- B. Lecture
- C. Discovery
- D. Panel session
Correct Answer: A
Rationale: Demonstration of techniques, procedures, exercises, and the use of special equipment is an effective patient-teaching strategy for a skill. Lecture can be used to deliver information to a large group of patients but is more effective when the session is interactive; it is rarely used for individual instruction, except in combination with other strategies. Discovery is a good method for teaching problem-solving techniques and independent thinking. Panel discussions can be used to impart factual material but are also effective for sharing experiences and emotions.
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.