Module 41 Teaching and Learning: Nursing: A Concept-Based Approach To Learning, 2e (Pearson)

Nursing: A Concept-Based Approach to Learning, 2e (Pearson)
Module 41 Teaching and Learning
The Concept of Teaching and Learning
1) A nurse is preparing to discharge a client who has experienced a myocardial infarction. The
client will have to make many lifestyle changes and the nurse is instructing the client on how to
implement a heart-healthy lifestyle. The nurse knows that client education is a(n):
A) Dependent function of nursing that needs a healthcare provider's order to implement.
B) Important independent nursing function.
C) Activity nurses learn on the job.
D) Way to establish the client's dependence on the nurse.
Answer: B
Explanation:
A) State nurse practice acts include client teaching as a function of nursing, thereby making
teaching a legal and professional responsibility. Nurses seek to help clients manage their health
independently. Nurses begin to learn about teaching during their training. Nurses are not
dependent on healthcare providers when determining the learning needs of the client.
B) State nurse practice acts include client teaching as a function of nursing, thereby making
C) State nurse practice acts include client teaching as a function of nursing, thereby making
D) State nurse practice acts include client teaching as a function of nursing, thereby making
Page Ref: 2501
Cognitive Level: Applying
Client Need: Health Promotion and Maintenance
Nursing Process: Implementation
Learning Outcome: 1. Discuss the importance of the teaching role of the nurse.
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2) The nurse is caring for a client who has been diagnosed with high cholesterol. When the nurse
plans topics to teach, it is important to keep in mind that adult learners:
A) Are more oriented to learning when the material is useful immediately.
B) Are more likely to adhere to a regimen than are children.
C) Usually can find information on their own.
D) Do not need to be evaluated for understanding as children do.
Answer: A
Explanation:
A) When teaching a client, the nurse considers that most people learn and retain information if
the information is immediately useful. Some clients can find information on their own; however,
not all information that the client can find is factual. All clients need to be evaluated to ensure
that the right information was retained. Adults will not necessarily adhere to a regimen more than
children will. It is the effective teaching and the client's readiness to learn that helps with
adherence.
B) When teaching a client, the nurse considers that most people learn and retain information if
adherence.
C) When teaching a client, the nurse considers that most people learn and retain information if
adherence.
D) When teaching a client, the nurse considers that most people learn and retain information if
adherence.
Page Ref: 2502
Client Need: Physiological Integrity
Learning Outcome: 2. Describe attributes of learning.
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3) A nurse is preparing to teach a group of college students about organ donation. What should
the teaching include to follow andragogic concepts?
A) Directions about how to become an organ donor
B) Past statistics about organ donors
C) Information on how this group can influence their parents about organ donation
D) Written pamphlets on organ donation
Answer: A
Explanation:
A) An adult is more oriented to learning when the material is useful immediately, not sometime
in the future. For this audience, giving clear directions on how to become an organ donor would
be more helpful than providing information about past or future activities, such as influencing
their parents. Written information may or may not be helpful, depending on what types of
learners are included in the group.
B) An adult is more oriented to learning when the material is useful immediately, not sometime
C) An adult is more oriented to learning when the material is useful immediately, not sometime
D) An adult is more oriented to learning when the material is useful immediately, not sometime
Page Ref: 2502
Cognitive Level: Analyzing
Learning Outcome: 3. Distinguish andragogy, pedagogy, and geragogy.
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4) A nurse is working in a neonatal intensive care unit. The nurse wants to teach a mother of a
premature baby how to give her baby a bath. Which statement by the mother reflects a readiness
to learn?
A) "You'll give us written instructions before we go home, correct?"
B) "When my baby is just a little bigger, I'll feel more comfortable giving him a bath."
C) "I want to make sure my husband is here, in case I don't hear everything that's said."
D) "I'm so afraid I'll hurt my baby with all these tubes and wires."
Answer: C
Explanation:
A) Readiness to learn is the demonstration of behaviors or cues that reflect a learner's motivation,
desire, and ability to learn at a specific time. The client who wants her husband involved is
demonstrating motivation and willingness, but also wants support from the spouse. Statements
about fear of the situation need to be addressed so the fear will not inhibit the learning process.
Wanting to wait until discharge or at least until the baby is older reflects uncertainty and possibly
fear and should be addressed before learning can occur.
B) Readiness to learn is the demonstration of behaviors or cues that reflect a learner's motivation,
C) Readiness to learn is the demonstration of behaviors or cues that reflect a learner's motivation,
D) Readiness to learn is the demonstration of behaviors or cues that reflect a learner's motivation,
Page Ref: 2502
Nursing Process: Evaluation
Learning Outcome: 4. Summarize the characteristics of adult learners.
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5) A nursing student has been assigned to present a teaching project to the class, using each of
Bloom's domains. The student has planned several activities to include when presenting the
project to the class. Which activity or activities are within the affective domain?
Select all that apply.
A) Class members must read a paragraph about a new clinical trial, summarize the information,
and present it to the rest of the class.
B) Class members must list the technical skills they have learned.
C) Class members must demonstrate a favorite nursing skill for the class.
D) Class members must reflect on how they felt the first time they provided direct client care.
E) Class members must identify two attitudinal changes that have occurred in their lives since
beginning their nursing education.
Answer: D, E
Explanation:
A) The affective domain of Bloom's theory of learning is also known as the "feeling" domain. It
includes emotional responses to tasks such as feelings, emotions, interests, attitudes, and
appreciations. Listing technical skills and reading or summarizing information is part of the
"thinking" domain, which includes knowing, comprehending, application, analysis, synthesis,
and evaluation. The psychomotor domain is the "skill" domain and includes hands-on motor
skills, such as demonstration.
B) The affective domain of Bloom's theory of learning is also known as the "feeling" domain. It
C) The affective domain of Bloom's theory of learning is also known as the "feeling" domain. It
D) The affective domain of Bloom's theory of learning is also known as the "feeling" domain. It
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E) The affective domain of Bloom's theory of learning is also known as the "feeling" domain. It
Page Ref: 2503
Learning Outcome: 5. Compare the three domains of learning.
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6) A nurse is caring for a group of clients who are recovering in a rehabilitation hospital
following total hip replacements. Which client is exhibiting the highest motivation to learn?
A) A client who has been there the longest and is a great "coach" for newcomers
B) A client who has been struggling with following nursing directives regarding discharge goals
C) A client who is excited to learn ambulation techniques
D) The client who has just moved in and is already eager for discharge
Answer: C
Explanation:
A) Motivation is the desire to learn and influences how quickly and to what extent an individual
learns. It is generally greatest when an individual recognizes a need and believes the need will be
met through learning. The client who is excited to learn about ambulation techniques understands
that learning about it will help take his recovery to a high level. Motivation must be experienced
by the client, not by someone else (as in being a "coach" for newcomers). Clients who struggle
with rules or following prescribed courses of treatment are not motivated to learn the best reason
for their particular plan of action; they may be "bucking" the system. The client who is already
waiting to go home may be eager for that to occur, but not necessarily to the extent of being
ready to learn how to achieve this end.
B) Motivation is the desire to learn and influences how quickly and to what extent an individual
C) Motivation is the desire to learn and influences how quickly and to what extent an individual
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D) Motivation is the desire to learn and influences how quickly and to what extent an individual
Page Ref: 2505
Nursing Process: Assessment
Learning Outcome: 6. Identify factors that affect learning.
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7) A nurse educator is discussing the use of the internet in nursing care. The educator is
preparing to teach a group of nursing students how to navigate the internet for researching
healthcare information. What does the educator plan to include during lecture?
A) A directory of campus internet sites of interest
B) How to search for and evaluate health information
C) A directory of libraries
D) Information technology instruction
Answer: B
Explanation:
A) Campus health centers that use the internet as a tool for health education must train nursing
students regarding how to search for and evaluate the health information they find. Sites of
interest for the campus would not directly impact the nursing program. Information technology is
a subject that teaches nurses how to use technology for the delivery of care and communication.
Libraries are important, but knowing about them would not be a part of this presentation.
B) Campus health centers that use the Internet as a tool for health education must train nursing
C) Campus health centers that use the internet as a tool for health education must train nursing
D) Campus health centers that use the internet as a tool for health education must train nursing
Page Ref: 2508
Nursing Process: Planning
Learning Outcome: 7. Discuss the implications of using the Internet as a source of health
information.
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Exemplar 41.1 Client/Consumer Education
1) A client who had outpatient surgery is given an instruction sheet in preparation for discharge.
When the nurse asks if the instructions are clear, the client says, "I'll read them later when I have
my glasses; besides, you told me everything I need to know." Based on these statements, what
would the nurse suspect?
A) The client may be unable to read the instructions.
B) The client already knows the information.
C) The client does not want the written information.
D) The client is ready to learn.
Answer: A
Explanation:
A) The client who refuses to read instructions may not be able to read. The nurse should assess
the client's ability to read to ensure proper treatment and to evaluate the client's understanding of
the information. It is unlikely that the client does not want the information. Although the nurse
did provide verbal instruction, often clients forget portions due to the amount of information
presented at discharge. The client may be ready to learn, but the client's inability to read may be
masking that fact.
B) The client who refuses to read instructions may not be able to read. The nurse should assess
masking that fact.
C) The client who refuses to read instructions may not be able to read. The nurse should assess
masking that fact.
D) The client who refuses to read instructions may not be able to read. The nurse should assess
masking that fact.
Page Ref: 2514
Learning Outcome: 1. Assess learning needs of learners and the learning environment.
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2) A home health nurse is working with a client who has chronic obstructive pulmonary disease.
What nursing diagnosis will take the highest priority for implementing client education?
A) Impaired Gas Exchange
B) Ineffective Breathing Pattern
C) Anxiety
D) Activity Intolerance
Answer: A
Explanation:
A) All of these nursing diagnoses are appropriate for the client who is experiencing chronic
obstructive pulmonary disease, but the priority for the nurse to address is impaired gas exchange.
If the client's oxygen level is too low, or the carbon dioxide level is too high, the client's life may
be threatened. This client will also experience activity intolerance, anxiety, and, at times,
ineffective breathing patterns, but the priority diagnosis is Impaired Gas Exchange.
B) All of these nursing diagnoses are appropriate for the client who is experiencing chronic
C) All of these nursing diagnoses are appropriate for the client who is experiencing chronic
D) All of these nursing diagnoses are appropriate for the client who is experiencing chronic
Page Ref: 2515
Nursing Process: Diagnosis
Learning Outcome: 2. Identify nursing diagnoses that reflect the learning needs of clients.
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3) The nursing student is planning an educational program for a senior project. The program is
focusing on cancer detection education for a community group. What should the nursing student
plan to include in order to address the various learning styles of the target group?
A) A lecture using many examples for each learning need
B) Multicolored brochures with bright colors
C) A game board, with client matching terms
D) Audiovisuals, examples, group discussions, and activities
Answer: D
Explanation:
A) When teaching a group, utilize strategies to address visual, auditory, manipulative, group, and
problem-solving types of learners. Using different techniques and a variety of activities is a good
way to match the various learning styles of group participants. Multicolored brochures would
only address those learners who learn in the visual mode. Lecture may not meet the needs of the
entire group. Games are a useful teaching tool, but not useful when addressing a large group of
individuals with varying learning styles.
B) When teaching a group, utilize strategies to address visual, auditory, manipulative, group, and
C) When teaching a group, utilize strategies to address visual, auditory, manipulative, group, and
D) When teaching a group, utilize strategies to address visual, auditory, manipulative, group, and
Page Ref: 2513
Learning Outcome: 3. Describe the essential aspects of a teaching plan.
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4) The nurse is caring for a client who has recently received a permanent colostomy. The client
will be going home in several days and requires discharge teaching. What should the nurse do
when organizing the teaching experience?
A) Ask the client to tell the nurse what he or she knows about caring for the colostomy.
B) Make sure the client's spouse is present before the teaching session begins.
C) Start from the beginning and proceed through all steps required to perform colostomy care.
D) Break the information into small sessions to enhance learning.
Answer: A
Explanation:
A) The nurse should find out what the client knows, and then proceed to the unknown. This
gives the client confidence. This information can be elicited either by asking questions or by
having the client take a pretest or fill out a form. Going over information already learned is not
practicing good time management for the nurse or the client. Unless the client has attention
problems or is an older adult, breaking up the sessions is probably unnecessary. Having the
spouse present is always a good idea, but finding out what the client already knows is more
important when organizing teaching.
B) The nurse should find out what the client knows, and then proceed to the unknown. This gives
the client confidence. This information can be elicited either by asking questions or by having
the client take a pretest or fill out a form. Going over information already learned is not
C) The nurse should find out what the client knows, and then proceed to the unknown. This gives
the client confidence. This information can be elicited either by asking questions or by having
the client take a pretest or fill out a form. Going over information already learned is not
D) The nurse should find out what the client knows, and then proceed to the unknown. This
gives the client confidence. This information can be elicited either by asking questions or by
having the client take a pretest or fill out a form. Going over information already learned is not
Page Ref: 2518
Learning Outcome: 4. Discuss guidelines for effective teaching.
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5) A community health nurse runs a clinic that provides health screening mainly to Mexican
American and Filipino American clients. The nurse wants to have a class on smoking cessation
for interested adults of this group. What action should the nurse take to adjust their time
orientation?
A) Begin classes when a group of clients has gathered.
B) Mail letters ahead of time to make sure clients are informed about the upcoming class.
C) Make posters and place them in areas of the community frequented by these groups.
D) Make sure that the classes are held at specific times.
Answer: A
Explanation:
A) Cultures with a predominant orientation to the present include the Mexican American, Navajo
Native American, Appalachian, Eskimo, and Filipino American cultures. Schedules have to be
very flexible in present-oriented societies. Time constraints are not significant for cultures that
are oriented to the present, so advertising about specific classes may not be effective. The nurse
must be quite flexible, treat the culture's beliefs with respect, and not expect that cultural
practices will change to reflect the nurse's needs.
B) Cultures with a predominant orientation to the present include the Mexican American, Navajo
C) Cultures with a predominant orientation to the present include the Mexican American, Navajo
D) Cultures with a predominant orientation to the present include the Mexican American, Navajo
Page Ref: 2523
Learning Outcome: 5. Evaluate strategies to use when teaching clients of different cultures,
literacy or educational levels, or language skills.
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6) A nurse is providing a series of educational workshops for caregivers of clients enrolled in an
Alzheimer's day treatment program. What would be appropriate topics?
A) Understanding dementia behaviors
B) Caregiver stress relief
C) Safety precautions
D) Support service information
E) Methods for curing the disease
Answer: A, B, C, D
Explanation:
A) It is important for caregivers to learn about expected behavioral changes. Caregivers need
ways to help relieve stress, such as talking to friends or family, exercising, meditating, or
praying. Top unmet needs of caregivers include keeping care recipients safe at home. It is also
important to find other local support services. Although there is no known cure for Alzheimer's,
there are options for its management.
B) It is important for caregivers to learn about expected behavioral changes. Caregivers need
C) It is important for caregivers to learn about expected behavioral changes. Caregivers need
D) It is important for caregivers to learn about expected behavioral changes. Caregivers need
E) It is important for caregivers to learn about expected behavioral changes. Caregivers need
Page Ref: 2520
Client Need: Safe and Effective Care Environment
Nursing Process: Teaching and Learning
Learning Outcome: 6. Summarize the impact of anticipatory guidance on health outcomes.
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7) The nurse is assigned to care for a client who will be going home on multiple new
medications. The nurse has just completed teaching the client regarding medication
administration. What statement by the client best illustrates compliance with the medication
plan?
A) "I think you should have waited until I was ready to go home. Maybe I'd remember better."
B) "I'm glad to know about my new medications. It makes taking them all a lot easier."
C) "If I take my medications as prescribed, I'll feel better."
D) "I already knew most of what you told me."
Answer: B
Explanation:
A) Compliance is best illustrated when the individual recognizes and accepts the need to learn,
then follows through with appropriate behaviors that reflect learning. Learning about the
medications helps the client understand why they are prescribed and improves the possibility for
following the prescribed regimen. Statements of prior knowledge do not necessarily lead to
compliance, and neither does merely restating the advice of the healthcare provider.
B) Compliance is best illustrated when the individual recognizes and accepts the need to learn,
C) Compliance is best illustrated when the individual recognizes and accepts the need to learn,
D) Compliance is best illustrated when the individual recognizes and accepts the need to learn,
Page Ref: 2523
Learning Outcome: 7. Identify methods to evaluate learning and teaching.
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8) The nurse is caring for a client with a new tracheostomy. After completing a teaching session
on tracheostomy care, what should the nurse include in the documentation?
A) The language used for teaching
B) The need for additional teaching
C) The client's questions after the teaching session
D) The supplies required for teaching
Answer: B
Explanation:
A) The parts of the teaching process that should be documented in the client's chart include the
need for additional teaching. Documenting the client's language is not necessary as it should
already be in the nursing history. Supplies required for teaching are not documented. The client's
questions are not documented, but the client's understanding at the end of the session is
documented.
B) The parts of the teaching process that should be documented in the client's chart include the
documented.
C) The parts of the teaching process that should be documented in the client's chart include the
documented.
D) The parts of the teaching process that should be documented in the client's chart include the
documented.
Page Ref: 2523-2524
Learning Outcome: 8. Demonstrate effective documentation of teaching-learning activities.
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9) A nurse is caring for a child who is hospitalized with asthma. The nurse is preparing discharge
teaching, as the client will be going home on nebulizer treatments and an inhaler. The family
members speak little English. In addition to enlisting an interpreter to help with the language
barrier, what should be a priority for the nurse?
A) Provide written instructions before discharge.
B) Make sure the parents can set up the treatments for their child.
C) Make sure the child comes back for the follow-up appointment.
D) Address any healing beliefs the family has.
Answer: D
Explanation:
A) The client who does not understand will learn little, and providing an interpreter to assist with
communication is extremely important in this situation. However, if the prescribed treatment
conflicts with the client/family's cultural healing beliefs, the client may not be compliant with the
recommended treatments. To be effective, nurses must deal directly with any conflicts and
differing values held by the client's parents. It is also important to provide written material and
assess the psychomotor skills of the child, but the first priority is ascertaining any belief conflicts
that may interfere with the treatment.
B) The client who does not understand will learn little, and providing an interpreter to assist with
C) The client who does not understand will learn little, and providing an interpreter to assist with
D) The client who does not understand will learn little, and providing an interpreter to assist with
Page Ref: 2522-2523
Learning Outcome: 5. Evaluate strategies to use when teaching clients of different cultures,
literacy or educational levels, or language skills.
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10) The nurse is caring for a client who has been diagnosed with diabetes mellitus. The client
must learn how to do his own finger stick blood sugar analysis as part of his treatment. The client
says, "I already know what you are attempting to teach because I looked everything up on the
internet." What is the best action by the nurse?
A) Document that the client understands teaching.
B) Teach the client's support system how to perform the procedure.
C) Give the client printed learning materials.
D) Watch the client perform a return demonstration of the skill.
Answer: D
Explanation:
A) The nurse is responsible for documenting that the client can perform the skill that has been
taught. Giving the client written directions or teaching the support individual does not meet the
requirement that the client will perform the skill. The nurse cannot document that the client
understands teaching until a return demonstration by the client is correctly performed.
B) The nurse is responsible for documenting that the client can perform the skill that has been
C) The nurse is responsible for documenting that the client can perform the skill that has been
D) The nurse is responsible for documenting that the client can perform the skill that has been
Page Ref: 2523
Learning Outcome: 2. Identify nursing diagnosis, outcomes, and interventions that reflect the
learning needs of clients.
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11) The nurse is teaching a client how to properly administer a new medication. The client goal
for this teaching is compliance with the medication regimen. What client statement best
illustrates compliance?
A) "I already knew most of what you told me."
B) "If I take my medications as prescribed, I'll feel better."
C) "Knowing how to take a new medication properly makes the process much easier."
D) "I think you should have waited until I was ready to go home. Maybe I'd remember better."
Answer: C
Explanation:
A) Compliance is best illustrated when the individual recognizes and accepts the need to learn,
compliance, and neither does merely following the advice of the healthcare prescriber.
B) Compliance is best illustrated when the individual recognizes and accepts the need to learn,
C) Compliance is best illustrated when the individual recognizes and accepts the need to learn,
D) Compliance is best illustrated when the individual recognizes and accepts the need to learn,
Page Ref: 2523
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12) A home health nurse is admitting a new client to the agency. The client was discharged from
the hospital with a diagnosis of pulmonary fibrosis. What does the nurse recognize as a priority
for the client's initial follow-up care?
A) The client will be able to set up and administer a nebulizer treatment by the end of the day.
B) The client will be able to do activities of daily living (ADLs) without shortness of breath in 3
days.
C) The client will have a positive attitude about the diagnosis by the end of the month.
D) The client will have increased activity level by the end of the week.
Answer: A
Explanation:
A) Learning outcomes state the client behavior and are ranked according to priority. Nurses can
use theoretical frameworks such as Maslow's hierarchy of needs to establish priorities. In this
case, the physiological need of learning how to administer medication takes priority over activity
and attitudinal needs.
B) Learning outcomes state the client behavior and are ranked according to priority. Nurses can
C) Learning outcomes state the client behavior and are ranked according to priority. Nurses can
D) Learning outcomes state the client behavior and are ranked according to priority. Nurses can
Page Ref: 2517
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13) The nurse is conducting a class for a group of pregnant women. Which topic should the nurse
include in teaching this group with regard to safety of the fetus?
A) Pedestrian accidents
B) Suffocation in the crib
C) Alcohol consumption
D) Drowning
Answer: C
Explanation:
A) Alcohol consumption is a safety hazard for the fetus, and pregnant women should be educated
about the importance of not drinking alcoholic beverages while pregnant. Suffocation in the crib
is a safety hazard for both newborns and infants. Drowning is seen in toddlers and preschoolers,
and pedestrian accidents are seen in the older adult.
B) Alcohol consumption is a safety hazard for the fetus, and pregnant women should be educated
C) Alcohol consumption is a safety hazard for the fetus, and pregnant women should be educated
D) Alcohol consumption is a safety hazard for the fetus, and pregnant women should be educated
Page Ref: 2517
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14) The nurse is caring for a client who is prone to falls. Which nursing diagnosis would be most
appropriate for this client?
A) Risk for Injury
B) Risk for Suffocation
C) Deficient Knowledge
D) Risk for Disuse Syndrome
Answer: A
Explanation:
A) Risk for Injury is a state in which the individual is at risk as a result of environmental
conditions like a fall. Deficient Knowledge deals with injury prevention. Risk for Disuse
Syndrome is a deterioration of a body system as the result of prescribed or unavoidable
musculoskeletal inactivity. Risk for Suffocation occurs when inadequate air is available for
inhalation.
B) Risk for Injury is a state in which the individual is at risk as a result of environmental
inhalation.
C) Risk for Injury is a state in which the individual is at risk as a result of environmental
inhalation.
D) Risk for Injury is a state in which the individual is at risk as a result of environmental
inhalation.
Page Ref: 2515
Learning Outcome: 2. Identify nursing diagnoses, outcomes, and interventions that reflect the
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15) A nurse conducted a safety class for a group of elderly clients in the community on fall
prevention. The nurse determines that the clients understood safety teaching for the home when
the nurse visits and finds that a client has:
A) Placed all meat in the freezer.
B) Changed the locks on the doors.
C) Placed scatter rugs in the kitchen.
D) Installed safety strips in the shower.
Answer: D
Explanation:
A) Safety strips in the shower can prevent falls. The client who installs the strips has understood
the nurse's teaching. Changing the locks may promote safety if there have been frequent break-
ins, but there is no evidence of that. Scatter rugs in any area of the home are a safety hazard. The
nurse encourages the client to place perishable foods in the refrigerator when arriving home from
the store.
B) Safety strips in the shower can prevent falls. The client who installs the strips has understood
the store.
C) Safety strips in the shower can prevent falls. The client who installs the strips has understood
the store.
D) Safety strips in the shower can prevent falls. The client who installs the strips has understood
the store.
Page Ref: 2523
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16) A nurse educator is working with a group of nursing students in the lab on the application of
personal protective equipment (PPE). The educator emphasizes the importance of appropriate
technique when removing the face mask. Which response by the students indicates appropriate
understanding?
A) "I will touch the mask by the strings only."
B) "I will bend the strip at the top of the mask."
C) "I will tie the strings in a bow."
D) "I will loop the ties over the ears."
Answer: A
Explanation:
A) Touching the mask by the strings for both it putting on and taking it off is the appropriate
intervention because the mask is considered contaminated. Bending the strip at the top of the
mask, looping the ties over the ears, and tying the strings in a bow under the chin are all
interventions used when applying a mask.
B) Touching the mask by the strings for both it putting on and taking it off is the appropriate
C) Touching the mask by the strings for both it putting on and taking it off is the appropriate
D) Touching the mask by the strings for both it putting on and taking it off is the appropriate
Page Ref: 2523
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17) The nurse is providing discharge teaching to a client with a diabetic wound. The nurse
understands the importance of including what information?
A) What the client learned about changing the dressing while in the hospital
B) Teaching the client how to take blood sugars
C) The client's ability to self-administer insulin
D) The client's reaction to being a diabetic
Answer: A
Explanation:
A) Nurses need to provide client education that will ensure the client's safe transition from one
level of care to another and make appropriate plans for follow-up education in the client's home.
Discharge plans must include information about what the client has been taught before transfer
or discharge and what remains for the client to learn to perform self-care in the home or other
residence.
B) Nurses need to provide client education that will ensure the client's safe transition from one
residence.
C) Nurses need to provide client education that will ensure the client's safe transition from one
residence.
D) Nurses need to provide client education that will ensure the client's safe transition from one
residence.
Page Ref: 2518
Learning Outcome: 1. Identify nursing diagnoses, outcomes, and interventions that reflect the
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18) The nurse asks the client to repeat the information taught during the discharge teaching
session. The client states, "I have forgotten everything you just said." Which additional teaching
would help the client retain the information?
A) Writing down and repeating the information as the nurse teaches
B) Having the client wait to ask questions until after the presentation
C) Asking another nurse to provide the teaching for the client
D) Asking the client to provide more information on learning strategies
Answer: A
Explanation:
A) It is important for nurses to evaluate their own teaching and the content of the teaching
program, just as they evaluate the effectiveness of nursing interventions for other nursing
diagnoses. Both the client and the nurse should evaluate the learning experience. The client may
tell the nurse what was helpful, interesting, and so on. Feedback questionnaires and videotapes of
the learning sessions can also be helpful.
The nurse should not feel ineffective as a teacher if the client forgets some of what is taught.
Forgetting is normal and should be anticipated. Having the client write down information,
repeating it during teaching, giving handouts on the information, and having the client be active
in the learning process all promote retention.
B) It is important for nurses to evaluate their own teaching and the content of the teaching
C) It is important for nurses to evaluate their own teaching and the content of the teaching
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D) It is important for nurses to evaluate their own teaching and the content of the teaching
Page Ref: 2523
Client Need: Psychosocial Integrity
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Exemplar 41.2 Mentoring
1) A new graduate nurse has just finished a 12-week orientation period in a neurovascular
intensive care unit (ICU). The nurse would like a mentor on the unit to go to with questions or
concerns. The best nurse to use as a mentor would most likely be:
A) An informal leader on the unit.
B) A charge nurse.
C) A nurse with 1 year of experience.
D) The nurse manager.
Answer: A
Explanation:
A) The best people to use for mentoring are the recognized informal leaders on the unit. These
nurses are usually knowledgeable and respected and can offer the new nurse support. A nurse
with only 1 year of experience is still learning in this highly challenging setting and is generally
not ready to mentor others. A charge nurse can be a role model and a mentor for a nurse
interested in stepping into the charge nurse role. However, the demands on the time of charge
nurses make it more difficult for them to be mentors. It would not be appropriate for the manager
of the unit to be a mentor for a staff nurse as the manager's job is mainly administrative.
B) The best people to use for mentoring are the recognized informal leaders on the unit. These
C) The best people to use for mentoring are the recognized informal leaders on the unit. These
D) The best people to use for mentoring are the recognized informal leaders on the unit. These
Page Ref: 2525
Learning Outcome: 1. Differentiate between mentoring, precepting, coaching, and networking,
including indications for use of each.
29
2) A new graduate nurse has just completed orientation in the pediatric intensive care unit (ICU).
The nurse is striving to attain the required skill level to care for children returning from open-
heart surgery. The nurse asks her mentor what client assignments will help attain this goal. What
does the mentor advise the new graduate nurse to do?
A) Perform postoperative teaching for children who had heart surgery.
B) Care for critically ill children, as this will prepare you for those returning from open-heart
surgery.
C) Care for children who are recovering from heart surgery.
D) Participate in emergency resuscitations of postoperative heart surgery children.
Answer: C
Explanation:
A) While setting goals for the second phase of mentoring, the mentor might suggest that the
graduate nurse care for those children who have recovered from surgery but have not yet met the
criteria for discharge. This would enable the nurse to learn about the surgeries, goals, and
treatments for this group of clients. Having the graduate nurse care for critically ill children
would put the clients at risk as the new nurse has neither the knowledge nor skills to care for this
category of client need. The new nurse would not be entrusted with performing postoperative
teaching for the critically ill child until more knowledge has been gained. Certainly, the graduate
should observe emergency resuscitation with the goal of eventually taking more responsibility,
but this would not best facilitate the goal of caring for children immediately after open-heart
surgery.
B) While setting goals for the second phase of mentoring, the mentor might suggest that the
surgery.
C) While setting goals for the second phase of mentoring, the mentor might suggest that the
surgery.
30
D) While setting goals for the second phase of mentoring, the mentor might suggest that the
surgery.
Page Ref: 2526
Learning Outcome: 2. Distinguish between each stage of the mentoring process.
31
3) A new graduate nurse is talking to her mentor regarding the benefits of joining a professional
organization. The mentor tells the nurse that the greatest benefit from becoming involved in a
professional organization is the opportunity to:
A) Establish networking to provide better client care.
B) Learn about new nursing products on the market.
C) Gain an appreciation of the history of nursing.
D) Increase knowledge of hospital policy.
Answer: A
Explanation:
A) Networking can help the nurse improve client care by learning techniques that other nurses
employ to achieve goals. New products on the market are usually introduced by the hospital,
although suggestions could be gleaned from others. Improved client care is the main goal. Other
nurses in a network are not likely to inform the nurse regarding hospital policy. The history of
nursing is interesting, but would not be the main reason for being involved in a professional
organization.
B) Networking can help the nurse improve client care by learning techniques that other nurses
organization.
C) Networking can help the nurse improve client care by learning techniques that other nurses
organization.
D) Networking can help the nurse improve client care by learning techniques that other nurses
organization.
Page Ref: 2527
Learning Outcome: 3. Describe the advantages of networking to the nurse.
32
4) The new nurse on the medical-surgical unit is chosen by the charge nurse as her protégé.
During lunch, the new grad explains about the knowledge and insightfulness of the charge nurse
to her peers. From her description, her peers know the mentor has which trait(s)?
A) The mentor is female.
B) The mentor has 10 years more experience.
C) The mentor sees leadership potential.
D) The mentor has a master's degree.
E) The mentor is promoting her influence.
Answer: A, B, C
Explanation:
A) Mentoring is widely used as a strategy for career development in nursing. The nurse being
mentored may not be a novice but may be early in his or her career development. Nurses who
wish to improve and advance their professional practice, whether in education, administration, or
clinical practice, should seek mentors to assist them. Mentors usually are of the same gender, 8-
14 years older, and have a position of authority in the organization. Most are knowledgeable
individuals who are willing to share their knowledge and experience. Mentors often choose
protégés because of the leadership or managerial qualities. Mentoring is a process that can
promote the personal and professional growth of both mentor and protégé.
B) Mentoring is widely used as a strategy for career development in nursing. The nurse being
C) Mentoring is widely used as a strategy for career development in nursing. The nurse being
D) Mentoring is widely used as a strategy for career development in nursing. The nurse being
33
E) Mentoring is widely used as a strategy for career development in nursing. The nurse being
Page Ref: 2525
including indications for the use of each.
34
5) The nurse on the intensive care unit (ICU) likes the fact that her nurse manager has helped
improve the overall performance of the unit by actively communicating during the performance
appraisal process. The nurse knows that the nurse manager is exhibiting which career
development strategy?
A) Coaching
B) Autocratic
C) Laissez-faire
D) Situational
Answer: A
Explanation:
A) Both beginning and more experienced nurses can benefit from mentoring and from other
career development strategies that involve repeated contact with other professional nurses. These
include precepting, coaching, and networking. Coaching involves improving performance and
resolving performance issues. The coach provides one-to-one leadership with frequent and
regular interaction. Through enhanced communication, the coach is able to resolve performance
issues by being actively involved in the performance appraisal process.
B) Both beginning and more experienced nurses can benefit from mentoring and from other
C) Both beginning and more experienced nurses can benefit from mentoring and from other
D) Both beginning and more experienced nurses can benefit from mentoring and from other
Page Ref: 2526
35
6) The nurse who is being mentored knows that which phase of the mentoring relationship deals
with plan implementation and achieving professional development goals?
A) Cultivation during years 2-5
B) Initiation during months 6-12
C) Redefinition during years 6-12
D) Separation during months 5-24
Answer: A
Explanation:
A) Participating in a mentoring relationship requires the work and time of both the mentor and
protégé involved. The mentee and mentor can follow four phases when working with each other
to achieve the best outcomes for both parties: initiation (6-12 months) where expectations are
discussed, goals and objectives are set, and a plan is developed; cultivation (2-5 years), where the
plan is implemented and assistance is received for achievement with professional development
goals and expectations; separation (6-24 months following relationship change), where the
relationship changes from protégé to peer, a job changes, independence occurs, or someone
moves away; and redefinition (follows separation) where the relationship is redefined and either
continues or slowly dissolves over time.
B) Participating in a mentoring relationship requires the work and time of both the mentor and
C) Participating in a mentoring relationship requires the work and time of both the mentor and
36
D) Participating in a mentoring relationship requires the work and time of both the mentor and
Page Ref: 2526
Learning Outcome: 2. Distinguish between each stage of the mentoring process.
7) What skills does the preceptor usually assist the new nurse in performing?
A) Clinical nursing skills
B) Routine unit activities
C) Policies and procedures
D) Feedback questionnaires
E) Leadership expectations
Answer: A, B, C
Explanation:
A) Preceptors usually are assigned to nurses who are new to the nursing unit to assist them in
learning routines, policies, and procedures and in improving clinical nursing skills and judgment
necessary for effective practice in their environment.
B) Preceptors usually are assigned to nurses who are new to the nursing unit to assist them in
C) Preceptors usually are assigned to nurses who are new to the nursing unit to assist them in
D) Preceptors usually are assigned to nurses who are new to the nursing unit to assist them in
E) Preceptors usually are assigned to nurses who are new to the nursing unit to assist them in
Page Ref: 2525-2526
37
Exemplar 41.3 Staff Development
1) The nurse manager of a neonatal intensive care unit (NICU) is planning continuing education
for the development of the staff. The manager is asking an expert to conduct a class regarding the
newest information on developmentally appropriate care. How does the manager determine that
goals have been met?
A) The staff can set up a developmentally appropriate incubator in the classroom.
B) The staff members state that they feel competent in providing developmentally appropriate
care to their clients.
C) The staff uses the information on the unit with a client successfully.
D) The unit educator states that the nurses passed the written exam.
Answer: C
Explanation:
A) The best way to know that staff development has been effective is to see the staff use the
knowledge to perform the function successfully on a client. Most nurses can demonstrate
competence immediately after a lecture; the real determinant of learning is whether they can use
the information in their practice. A nurse may be able to perform a procedure in the classroom
but may not be able to execute it 2 weeks later with a client. Feeling competent does not
necessarily mean that the nurse knows how to perform a procedure. Passing a written exam and
executing a skill are two different entities; nurses may have the knowledge but not be able to
perform the skill.
B) The best way to know that staff development has been effective is to see the staff use the
perform the skill.
C) The best way to know that staff development has been effective is to see the staff use the
perform the skill.
38
D) The best way to know that staff development has been effective is to see the staff use the
perform the skill.
Page Ref: 2530
Learning Outcome: 1. Explain the contribution of staff development to improving job
performance and patient outcomes.
39
2) Two nurses are discussing the need to have to retake CPR every year even though the
American Heart Association card states their CPR validation is good for 2 years. One nurse feels
that it is unnecessary to have to sit through and update and demonstrate skill competence every
year. What is the most appropriate response by the nurse?
A) "Our manager is very demanding, but we will know how to do it better."
B) "It's probably not necessary, but it gets us off the unit."
C) "It is important that we know the most up-to-date information that research provides."
D) "The hospital could get sued if a client dies."
Answer: C
Explanation:
A) Research is constantly finding that procedures do not often produce the desired results.
Nurses need to be able to adapt to new information, including new skills. The hospital could be
sued, but the reason to stay abreast is for the best care to be available to the client. The manager
is not demanding but is following the recommendations of the Joint Commission. It is necessary
to learn new and updated skills to remain competent.
B) Research is constantly finding that procedures do not often produce the desired results.
C) Research is constantly finding that procedures do not often produce the desired results.
D) Research is constantly finding that procedures do not often produce the desired results.
Page Ref: 2529
Learning Outcome: 2. Demonstrate how educational programs enhance the effectiveness of an
organization.
40
3) The professional development courses are offered on every shift so all nurses will have an
opportunity participate. The nurses on the unit know that which role is important for them?
A) Identifying strengths and areas of improvement
B) Offering support to one another
C) Providing peer feedback
D) The ability to trade shifts with one another
Answer: A
Explanation:
A) Staff education is a process of planned activities to enhance role performance and improve
patient outcomes and is often termed staff development or professional development. The nurse's
role in professional development includes: identifying strengths and areas to improve in personal
practice; setting goals; seeking out opportunities to grow and develop professionally and
personally; and reflecting, evaluating, and asking for feedback.
B) Staff education is a process of planned activities to enhance role performance and improve
C) Staff education is a process of planned activities to enhance role performance and improve
D) Staff education is a process of planned activities to enhance role performance and improve
Page Ref: 2528
Learning Outcome: 1. Explain the contribution of staff development to improving job
performance and patient outcomes.
41
4) The nurse manager on the unit involves his nurses in developing effective staff educational
programs based on topics they have chosen at staff meetings. The nurses on the unit realize that
being involved in staff education helps identify which responsibility?
A) Personal, peer, and staff learning needs
B) Effective teachers on the unit
C) The roles each nurse has on the unit
D) Improvements that need to be made
Answer: A
Explanation:
A) Staff education is essential in health care as learning needs are varied and health care is in
constant change. Effective staff educational programs are needed to address learning needs in
improving patient outcomes and organizational processes. Nurses have responsibilities in helping
to identify personal, peer, and staff learning needs; develop and implement a plan; and evaluate
the program; as well as participating in helping others to meet competency and role performance
standards.
B) Staff education is essential in health care as learning needs are varied and health care is in
standards.
C) Staff education is essential in health care as learning needs are varied and health care is in
standards.
D) Staff education is essential in health care as learning needs are varied and health care is in
standards.
Page Ref: 2528
Learning Outcome: 2. Demonstrate how educational programs enhance the effectiveness of an
organization.
42

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