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You are the nurse planning to teach tracheostomy care to a patient who will be discharged home following a spinal cord injury. When preparing your teaching, which of the following is the most important component of your teaching plan?
- A. Citing the evidence that underlies each of your teaching points
- B. Alleviating the patients guilt associated with not knowing appropriate self-care
- C. Determining the patients readiness to learn new information
- D. Including your nursing colleagues in the planning process
Correct Answer: C
Rationale: Assessment in the teaching-learning process is directed toward the systematic collection of data about the person and family's learning needs and readiness to learn. Patient readiness is critical to accepting and integrating new information. Unless the patient is ready to accept new information, patient teaching will be ineffective. Citing the evidence base will not likely enhance learning. Patient guilt cannot be alleviated until the patient understands the intricacies of the condition and his physiologic response to the disease. Inclusion of colleagues can be beneficial, but this does not determine the success or failure of teaching.
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An elderly female patient has come to the clinic for a scheduled follow-up appointment. The nurse learns from the patients daughter that the patient is not following the instructions she received upon discharge from the hospital last month. What is the most likely factor causing the patient not to adhere to her therapeutic regimen?
- A. Ethnic background of health care provider
- B. Costs of the prescribed regimen
- C. Presence of a learning disability
- D. Personality of the physician
Correct Answer: B
Rationale: Variables that appear to influence the degree of adherence to a prescribed therapeutic regimen include gender, race, education, illness, complexity of the regimen, and the cost of treatments. The ethnic background of the health care provider and the personality of the physician are not considered variables that appear to influence the degree of adherence to a prescribed therapeutic regimen. A learning disability could greatly affect adherence, but cost is a more likely barrier.
An adult patient will be receiving outpatient intravenous antibiotic therapy for the treatment of endocarditis. The nurse is preparing to perform health education to ensure the patients adherence to the course of treatment. Which of the following assessments should be the nurses immediate priority?
- A. Patients understanding of the teaching plan
- B. Quality of the patients relationships
- C. Patients previous medical history
- D. Characteristics of the patients culture
Correct Answer: D
Rationale: Before beginning health teaching, nurses must conduct an individual cultural assessment instead of relying only on generalized assumptions about a particular culture. This is likely a priority over previous medical history and relationships, though these are relevant variables. The teaching plan would not be created at this early stage in the teaching process.
A gerontologic nurse has observed that patients often fail to adhere to a therapeutic regimen. What strategy should the nurse adopt to best assist an older adult in adhering to a therapeutic regimen involving wound care?
- A. Demonstrate a dressing change and allow the patient to practice.
- B. Provide a detailed pamphlet on a dressing change.
- C. Verbally instruct the patient how to change a dressing and check for comprehension.
- D. Delegate the dressing change to a trusted family member.
Correct Answer: A
Rationale: The nurse must consider that older adults may have deficits in the ability to draw inferences, apply information, or understand major teaching points. Demonstration and practice are essential in meeting their learning needs. The other options are incorrect because the elderly may have problems reading and/or understanding a written pamphlet or verbal instructions. Having a family member change the dressing when the patient is capable of doing it impedes self-care and independence.
A nurse recognizes that individuals of different ages have specific health promotion needs. When planning to promote health among young adults, what subject is most likely to meet this demographic groups learning needs?
- A. Family planning
- B. Management of risky behaviors
- C. Physical fitness
- D. Relationship skills training
Correct Answer: A
Rationale: Because of the nationwide emphasis on health during the reproductive years, young adults actively seek programs that address prenatal health, parenting, family planning, and womens health issues. The other options are incorrect because they are not health promotion classes typically sought out by young adults.
Positive patient outcomes are the ultimate goal of nurse-patient interactions, regardless of the particular setting. Which of the following factors has the most direct influence on positive patient-care outcomes?
- A. Patients age
- B. Patients ethnic heritage
- C. Health education
- D. Outcome evaluation
Correct Answer: C
Rationale: Health education is an influential factor directly related to positive patient-care outcomes. The other options are incorrect because ethnicity, the patients age, and outcome evaluation are less influential factors related to positive patient-care outcomes, though each factor should be considered when planning care.