Question 1

A patient requires health teaching for exercises related to an arthritic shoulder. During an assessment, the patient tells the nurse, "I'm is a kinetic learner". What teaching resource should the nurse recommend to this patient?

Accepted Answer

The kinetic learner learns best with demonstration and hands-on involvement. The visual learner would use books and videos. An exercise audiotape would benefit the auditory learner.

Question 2

What is defined as a major instructional strategy for making written and oral information easier to understand?

Accepted Answer

Plain language is an instructional strategy for making written and oral information easier to understand, especially for individuals with lower literacy capabilities, English as a second language and older adults. Self-management involves skill-enhancement strategies designed to optimize disease management in the home and community. Technology integration is simply involves the use of web-based information and cell phones in learning. Preferred learning styles refer to the three major types of learning styles: visual, auditory, and kinesthetic.

Question 3

A patient is newly diagnosed with diabetes mellitus. When planning a teaching session to review insulin administration with this patient, the nurse should implement what intervention?

Accepted Answer

Teaching interventions should never be eliminated because the nurse lacks time, but they can be streamlined. Even in the most limited situation, the nurse should schedule a block of time for health teaching. The nurse should pick times for teaching when energy levels are high, the patient is not distracted by other things, it is not visiting time, and the patient is not in pain. People have saturation points as to how much they can learn in one time period. Since even under the best of circumstances, people can absorb only so many details and fine points, the nurse should limit information to two or three points at a time. The nurse should keep the teaching session short, interesting, and to the point. Ideally, teaching sessions should last no longer than about 20 minutes, including time for questions. Otherwise the patient may tire or lose interest. Scheduling shorter sessions with time in between to process information helps prevent sensory overload and reinforces teaching points.

Question 4

What is factor that determines the appropriate use of either geragogy, pedagogy, or andragogy when teaching?

Accepted Answer

Andragogy refers to the "art and science of helping adults learn." Pedagogy describes the processes used to help children learn. Geragogy describes learning approaches in older adulthood. Neither type of illness, size of audience, nor teacher's preference is a factor in determining the appropriateness of a specific teaching process

Question 5

The nurse has formulated a goal that "the patient will be able to accurately draw up the correct dose of insulin". The nurse recognizes that this goal as referring primarily to health teaching in which domain?

Accepted Answer

Health teaching is a dynamic process, which involves making relevant connections to meaning within three domains: (1) cognitive (understanding content); (2) affective (changing attitudes and promoting acceptance); and (3) psychomotor (hands-on skill development). Changing attitudes and promoting acceptance are in the affective domain. Understanding content occurs in the cognitive domain.

Question 6

A theoretical foundation for the use of teaching methodologies in which a patient is engaged as active partners in the learning process and helps the patient take responsibility for his or her own learning is known by what phrasing?

Accepted Answer

Carl Rogers' (1983) ideas provide a theoretical foundation for the use of teaching methodologies in learner-centered health teaching. Rogers emphasizes the primacy of the teacher-learner relationship as the means through which learning occurs. He describes learner-centered teaching as an interactive process. Applied to health care, a learner-centered approach involves engaging patients as active partners in the learning process and helping them take responsibility for their own learning to whatever extent possible. Rogers insists that the teacher must start where the learner is, structuring the learning process to support the learner's natural desire to learn and being mindful of learner characteristics that enable or impede the process.

Question 7

Educational standards requiring health care agencies to provide systematic health education and training for patients were established by organization?

Accepted Answer

Health teaching is not an option. It is a legal and ethical responsibility. The Joint Commission has established educational standards requiring health care agencies to provide systematic health education and training for patients that is specific to the patient's needs; sufficient for patients to make informed decisions and to take responsibility for self-management activities related to their needs; provided to patients in an understandable manner and designed to accommodate various learning styles; and reflected in documented evidence of the patient's understanding and response to the medical information. Professional nursing standards, developed by the American Nurses Association (ANA), reinforce the importance of health teaching as an essential nursing intervention. State Nurse Practice Acts mandate health teaching as an independent professional nursing function. Medicare requirements portray health teaching as a skilled nursing intervention for reimbursement purposes.

Question 8

A nurse, working with a patient in a drug rehabilitation center, provides positive reinforcement each time the patient demonstrates behavior that moves him closer to accomplishing the goal of remaining drug free. The nurse recognizes this type of reinforcement will motivate the patient to engage in the desired behavior. This type of reinforcement is referred to as what?

Accepted Answer

Shaping refers to the reinforcement of successive approximations of the target behavior. The long-term goal is broken down into smaller steps. The person is reinforced for any behavior that gets him or her closer to accomplishing the desired behavior. Rewarding specific behaviors that move the person in the direction of the desired behavior (successive approximations) motivates the person to engage in the desired behavior. Steps build one upon the other, moving learners from the familiar to the unfamiliar as they progress toward meeting treatment goals.

Question 9

Which statement is true related to the delivery of home health care?

Accepted Answer

In health teaching in the home, the nurse must keep in mind that he or she is a guest. Part of the teaching assessment includes appraisal of the home environment, family supports, and resources, as well as patient needs. The nurse should always call before going to the patient's home. This is a common courtesy; it also protects the nurse's time if the patient is going to be out. When in the home, it is important to model appropriate behaviors (e.g., washing hands in the bathroom sink before touching the patient). Simple strategies, like not washing one's hands in the kitchen sink where food is prepared, encourage the patient to do likewise.

Question 10

The concept that "the teacher must start where the learner is" was proposed by whom?

Accepted Answer

Rogers insists that the teacher must start where the learner is, structuring the learning process to support the learner's natural desire to learn and being mindful of learner characteristics that enable or impede the process.

Question 11

The nurse is caring for a patient who has a history of alcohol abuse. When formulating a goal that "the patient will be able to identify three physical effects of alcohol abuse," the nurse recognizes this goal as referring primarily to health teaching in which domain?

Accepted Answer

Health teaching is a dynamic process, which involves making relevant connections to meaning within three domains: (1) cognitive (understanding content); (2) affective (changing attitudes and promoting acceptance); and (3) psychomotor (hands-on skill development). Affective refers to changing attitudes and promoting acceptance. Psychomotor refers to hands-on skill development. Promoting acceptance refers to the affective domain of health teaching.

Question 12

What besides an individualized teaching approach is required to ensure successful learning outcomes?

Accepted Answer

Health teaching related to chronic conditions extends beyond simple medical and clinical data. Each teaching situation requires an individualized teaching approach and "learner buy in" to ensure successful outcomes. Assessment of a patient's readiness to learn, and learning style are important assessment details in developing tailored nursing approaches with patients and families.

Question 13

The nurse is teaching a support group about schizophrenia. The format includes a 20-minute video, a didactic portion, and a discussion period. The nurse recognizes what fact about this situation to help assure teaching success?

Accepted Answer

In a group presentation, a humorous opening grabs the audience's attention. In a group presentation, the nurse will need to establish rapport with the audience. Preparation and practice can ensure that the presentation is clear, concise, and well spoken. The nurse should make eye contact immediately and continue to do so throughout the presentation. Extension of eye contact to all participants communicates acceptance and inclusion.

Question 14

What is an important aspect to consider when preparing a presentation with slides for group teaching experience?

Accepted Answer

Use slides to identify key points. Slides help you stay on track and move through the agenda. The font should be large enough to see from a distance (32 point is recommended). Include no more than four or five items per slide. Face the audience, not the slides. Practice your presentation to ensure that you keep within the time frame and allot time for short discussion points. It is up to you as the presenter to set the pace. No matter how interesting the presentation and dialogue that it stimulates, running out of time is frustrating for the audience.

Question 15

Accurate documentation of patient health teaching is a critical component of quality care. When documenting in the patient's chart about health teaching for a patient admitted for alcoholism, What statement should the nurse make?

Accepted Answer

The Joint Commission requires written documentation of all patient health teaching. Notes about the initial assessment should be succinct, but comprehensive and objective. Teaching content should be linked to assessment data, including patient preferences, previous knowledge, and values. Included in the documentation are the teaching actions, the patient response, and any clinical issues or barriers to compliance. If family members are involved, you should identify their role, content provided, and teaching outcomes in your documentation. Accurate documentation helps ensure continuity and prevents duplication of teaching efforts. The patient's record informs other health care providers of what has been taught and what areas need further work.

Question 16

The nurse is caring for a patient who is diagnosed with both schizophrenia and cocaine abuse. The patient remains isolated in his room, refusing to attend unit activities. When implementing a behavioral approach, what is the first step the nurse should take?

Accepted Answer

A behavioral approach starts with a careful description and quantification of a concrete behavior requiring change. During the third step of implementing a behavioral approach, the nurse and patient reframe the problem as a solution statement (e.g., "The patient will attend all scheduled unit activities."). If the problem and solution are complex, the nurse can break them down into simpler definitions, beginning with the simplest and most likely behavior to stimulate patient interest. The nurse should identify the tasks in sequential order; define specific consequences, positive and negative, for behavioral responses; and solicit the patient's cooperation.

Question 17

Which of the following is an effective teaching objective?

Accepted Answer

Collaboratively developed objectives help organize learning content and identify logical action steps. They should describe an immediate action step-by-step plan for goal achievement based on the patient's most pressing clinical issues. Each action step should build on the previous one for maximum effectiveness and be achievable within the allotted time frame. They also should directly relate to medical and nursing diagnoses and support the overall health outcome. Ambulating short distances is not specific enough or measurable. Learning subcutaneous self-administration of insulin is not specific. Understanding diabetes and its lifestyle implications is not measurable.

Quiz 15: Communication in Health Teaching and Coaching