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ADN 451 EXAM 2 HEALTH SYSTEM CONCEPTS NEWEST ACTUAL EXAM 2025 QUESTIONS AND DETAILED CORRECT ANSWERS WITH RATIONALES | A+ GRADE
Typology: Exams
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A 51-year-old male patient will need to change a dressing on an open leg wound after discharge. Which strategy should the nurse use to evaluate if the patient is able to perform the dressing change? 1 have the patient complete the dressing change on a model 2 ask the patient to write down each step of the dressing change 3 observe the patient completing the dressing change on himself 4 provide printed instructions with pictures of how to do his dressing change Correct Answer 3 observe the patient completing the dressing change on himself What would be the priority teaching goal for a middle-aged Hispanic woman regarding methods to relieve symptoms of menopause? a. Prevent the development of future disease. b. Maintain the patient's current state of health. c. Change the patient's cultural belief regarding the use of herbs. d. Provide information for selection and use of treatment options. Correct Answer d. Provide information for selection and use of treatment options.
When planning teaching with consideration of the diverse learning needs of adults, the nurse's best approach would include a. presenting material in an efficient lecture format. b. recognizing that adults enjoy learning regardless of the relevance to their personal lives. c. providing opportunities for the patient to learn from other adults with similar experiences. d. postponing practice of new skills until the patient can independently practice the skill at home. Correct Answer c. providing opportunities for the patient to learn from other adults with similar experiences. Which is the priority patient teaching strategy when limited time is available? a. Setting realistic goals that have high priority for the patient b. Referring the patient to a nurse educator in private practice for teaching c. Observing more experienced nurse-teachers to learn how to teach faster and more efficiently d. Providing reading materials for the patient instead of discussing information the patient needs to learn Correct Answer a. Setting realistic goals that have high priority for the patient The nurse needs to include caregivers in patient teaching primarily because (select all that apply) a. they provide most of the care for patients after discharge.
b. they might feel rejected if they are not included in the teaching. c. patients have better outcomes when their caregivers are involved. d. the patient may be too ill or too stressed to fully understand the teaching. e. caregivers are responsible for the overall management of the patient's care. Correct Answer c. patients have better outcomes when their caregivers are involved. d. the patient may be too ill or too stressed to fully understand the teaching. Which technique is most appropriate when using motivational interviewing with a patient who tells you that he is ready to start a weight loss program? a. Confirm that the patient is serious about losing weight b. Insist that the patient consider an organized group weight loss program. c. Focus on the patient's strengths to support his optimism that he can successfully lose weight. d. Ask a prescribed set of questions to increase the patient's awareness of his dietary behaviors. Correct Answer c. Focus on the patient's strengths to support his optimism that he can successfully lose weight. Which patient characteristic enhances the teaching- learning process? a. Moderate anxiety b. High self-efficacy c. Being in the precontemplative stage of change
d. Being able to laugh about the current health problem Correct Answer b. High self-efficacy A patient tells the nurse that she enjoys talking with others and sharing experiences, but easily falls asleep when reading. Which teaching strategy would be most effective with this patient? a. Role b. Group teaching c. Lecture-discussion d. Discussion supplemented with computer programs Correct Answer b. Group teaching The nurse has taught a patient's caregiver how to administer insulin to her husband. Evaluation of the nurse's teaching effectiveness before discharge would include a. arranging for follow-up with a home care nurse. b. monitoring the patient's glucose readings before discharge. c. asking the caregiver to "show back" her ability to administer insulin. d. asking the caregiver what she found helpful about the teaching experience Correct Answer c. asking the caregiver to "show back" her ability to administer insulin. A patient needs to learn to use a walker. Which domain is required for learning this skill? 1 Affective domain 2 Cognitive domain 3 Attentional domain
4 Psychomotor domain Correct Answer 4 Psychomotor domain The nurse is planning to teach a patient about the importance of exercise. When is the best time for teaching to occur? (Select all that apply.) 1 When there are visitors in the room 2 When the patient's pain medications are working 3 Just before lunch, when the patient is most awake and alert 4 When the patient is talking about current stressors in his or her life Correct Answer 2 When the patient's pain medications are working 3 Just before lunch, when the patient is most awake and alert A patient newly diagnosed with cervical cancer is going home. The patient is avoiding discussion of her illness and postoperative orders. What is the nurse's best plan in teaching this patient? 1 Teach the patient's spouse 2 Focus on knowledge the patient will need in a few weeks 3 Provide only the information that the patient needs to go home 4 Convince the patient that learning about her health is necessary Correct Answer 3 The school nurse is about to teach a freshman-level high school health class about nutrition. What is the best instructional approach to ensure that the students meet the learning outcomes?
1 Provide information using a lecture 2 Use simple words to promote understanding 3 Develop topics for discussion that require problem solving 4 Complete an extensive literature search focusing on eating disorders Correct Answer 3 Develop topics for discussion that require problem solving A patient with chest pain is having an emergency cardiac catheterization. Which teaching approach does the nurse use in this situation? 1 Telling approach 2 Selling approach 3 Entrusting approach 4 Participating approach Correct Answer 1 A patient needs to learn how to administer a subcutaneous injection. Which of the following reflects that the patient is ready to learn? 1 Describing difficulties a family member has had in taking insulin 2 Expressing the importance of learning the skill correctly 3 Being able to see and understand the markings on the syringe 4 Having the dexterity needed to prepare and inject the medication Correct Answer 2 Expressing the importance of learning the skill correctly A nurse is going to teach a patient about hypertension. Which action should the nurse implement first? a. Set mutual goals for knowledge of hypertension.
b. Teach what the patient wants to know about hypertension. c. Assess what the patient already knows about hypertension. d. Evaluate the outcomes of patient education for hypertension. Correct Answer ANS: C Assessment is the first step of any teaching session, then diagnosing, planning, implementation, and evaluation. An effective assessment provides the basis for individualized patient teaching. Assessing what the adult patient currently knows improves the outcomes of patient education. A patient had a stroke and must use a cane for support. A nurse is preparing to teach the patient about the cane. Which learning objective/outcome is most appropriate? a. The patient will walk to the bathroom and back to bed using a cane. b. The patient will understand the importance of using a cane. c. The patient will learn how to use a cane. d. The patient will know the correct use of a cane. Correct Answer ANS: A Outcomes often describe a behavior that identifies the patient's ability to do something on completion of teaching such as will empty colostomy bag, or will administer an injection. Understand, learn, and know are not behaviors that can be observed or evaluated.
Three types of reinforcers are social, material, and activity. When a nurse works with a patient, most reinforcers are social and are used to acknowledge a learned behavior (e.g., smiles, compliments, words of encouragement). Examples of material reinforcers include food, toys, and music. Activity reinforcers rely on the principle that a person is motivated to engage in an activity if he or she has the opportunity to engage in a more desirable activity after completion of the task. The entrusting approach is a teaching approach that provides the patient the opportunity to manage self-care. It is not a type of reinforcement. A patient with heart failure is learning to reduce salt in the diet. When would be the best time for the nurse to address this topic? a. At bedtime, when the patient is relaxed b. At lunchtime while the nurse is preparing the food tray c. At bath time, when the nurse is cleaning the patient d. At medication time, when the nurse is administering patient medication Correct Answer ANS: B Appropriate times to talk about food/diet changes during routine nursing care are at breakfast, lunch, and dinner times or when the patient is completing the menu. Many nurses find that they are able to teach more effectively while delivering nursing care. For example, while hanging blood, you explain to the patient why the blood is necessary and the symptoms of a transfusion reaction that need to be reported immediately. In this situation, because the teaching is about food, coordinating it with routine nursing care that involves food can be effective. At
bedtime would be a good time to discuss routines that enhance sleep. At bath time would be a good time to describe skin care and how to prevent pressure ulcers. At medication time would be a good time to explain the purposes and side effects of the medication. A nurse is teaching a patient who has low health literacy about chronic obstructive pulmonary disease (COPD) while giving COPD medications. Which technique is most appropriate for the nurse to use? a. Use complex analogies to describe COPD. b. Include the most important information on COPD at the beginning of the session. c. Ask for feedback to assess understanding of COPD at the end of the session. d. Offer pamphlets about COPD written at the eighth grade level with large type Correct Answer ANS: B Include the most important information at the beginning of the session for illiterate patients or patients with a learning disability. Also, use visual cues and simple, not complex, analogies when appropriate. Another technique is to frequently ask patients for feedback to determine whether they comprehend the information. Additionally, provide teaching materials that reflect the reading level of the patient, with attention given to short words and sentences, large type, and simple format (generally, information written on a fifth grade reading level is recommended for adult learners).
A nurse is teaching a culturally diverse patient about nutritional needs. What must the nurse do first before starting the teaching session? a. Obtain pictures of food. b. Get an interpreter. c. Establish a rapport. d. Refer to a dietitian. Correct Answer ANS: C Establishing a rapport is important for all patients, especially culturally diverse patients, before starting teaching sessions. Obtaining pictures of food, getting an interpreter, and referring to a dietitian all occur after rapport is established. A nurse is teaching an older adult patient about strokes. Which teaching technique is most appropriate for the nurse to use? a. Use a pamphlet about strokes with large font in blues and greens. b. Speak in a high tone of voice to describe strokes. c. Begin and end each teaching session with the most important information about strokes. d. Provide specific information about strokes in frequent, large amounts. Correct Answer ANS: C Begin and end each teaching session with the most important information when teaching older adult patients. Also, if using written material, assess the patient's ability to read and use information that is printed in large type and in a color that contrasts highly with the background (e.g., black 14-point print on buff-colored paper). Avoid blues and greens because they are more difficult to see. Speak in a low tone of voice (lower tones are easier to hear than
higher tones). Provide specific information in frequent, small (not large) amounts for older adult patients. A patient has been taught how to cough and deep breathe. Which evaluation method is most appropriate? a. Return demonstration b. Computer instruction c. Verbalization of steps d. Cloze test Correct Answer ANS: A To demonstrate mastery of the skill, have the patient perform a return demonstration under the same conditions that will be experienced at home or in the place where the skill is to be performed. Computer instruction is use of a programmed instruction format in which computers store response patterns for learners and select further lessons on the basis of these patterns (programs can be individualized). Computer instruction is a teaching tool, rather than an evaluation tool. Verbalization of steps can be an evaluation tool, but it is not as effective as a return demonstration when evaluating a psychomotor skill. The Cloze test, a test of reading comprehension, asks patients to fill in the blanks in a written paragraph A patient has been taught how to change a colostomy bag but is having trouble measuring and manipulating the equipment and has many questions. What is the nurse's next action? a. Refer to a mental health specialist. b. Refer to an ostomy specialist. c. Refer to a dietitian.
d. Refer to a wound care specialist. Correct Answer ANS: B Resources that specialize in a particular health need (e.g., wound care or ostomy specialists) are integral to successful patient education. A mental health specialist is helpful for emotional issues rather than for physical problems. A dietitian is a resource for nutritional needs. A wound care specialist provides complex wound care. A nurse has taught a patient about healthy eating habits. Which learning objective/outcome is most appropriate for the affective domain? a. The patient will state three facts about healthy eating. b. The patient will identify two foods for a healthy snack. c. The patient will verbalize the value of eating healthy. d. The patient will cook a meal with low-fat oil. Correct Answer ANS: C Affective learning deals with expression of feelings and acceptance of attitudes, opinions, or values. Having the patient value healthy eating habits falls within the affective domain. Stating three facts or identifying two foods for a healthy snack falls within the cognitive domain. Cooking falls within the psychomotor domain A nurse is assessing the ability to learn of a patient who has recently experienced a stroke. Which question/statement will best assess the patient's ability to learn? a. "What do you want to know about strokes?" b. "On a scale from 1 to 10, tell me where you rank your desire to learn."
c. "Do you feel strong enough to perform the tasks I will teach you?" d. "Please read this handout and tell me what it means." Correct Answer ANS: D A patient's reading level affects ability to learn. Reading level is often difficult to assess because patients who are functionally illiterate are often able to conceal it by using excuses such as not having the time or not being able to see. One way to assess a patient's reading level and level of understanding is to ask the patient to read instructions from an educational handout and then explain their meaning. Asking patients what they want to know identifies previous learning and learning needs and preferences; it does not assess ability to learn. Motivation is related to readiness to learn, not ability to learn. Just asking a patient if they feel strong is not as effective as actually assessing the patient's streng A nurse is preparing to teach a kinesthetic learner about exercise. Which technique should the nurse use? a. Let the patient touch and use the exercise equipment. b. Provide the patient with pictures of the exercise equipment. c. Let the patient listen to a podcast about the exercise equipment. d. Provide the patient with a case study about the exercise equipment. Correct Answer ANS: A Kinesthetic learners learn best while they are moving and participating in hands-on activities. Demonstrations and role playing work well with these learners. Patients who are visual learners learn best when you use pictures and
diagrams to explain information. Patients who prefer auditory learning are distracted by pictures and prefer listening to information (e.g., podcasts). Patients who learn best by reasoning logically and intuitively learn better if presented with a case study that requires careful analysis and discussion with others to arrive at conclusions. Which statements by the nurse indicate a good understanding of patient education/teaching? (Select all that apply.) a. "Patient education is a standard for professional nursing practice." b. "Patient teaching falls within the scope of nursing practice." c. "Patient education is an essential component of safe, patient-centered care." d. "Patient education is not effective with children." e. "Patient teaching can increase health care costs." f. "Patient teaching should be documented in the chart." Correct Answer ANS: A, B, C, F Patient education has long been a standard for professional nursing practice. All state Nurse Practice Acts acknowledge that patient teaching falls within the scope of nursing practice. Patient education is an essential component of providing safe, patient-centered care. It is important to document evidence of successful patient education in patients' medical records. Patient education is effective for children. Different techniques must be used with children. Creating a well-designed, comprehensive teaching plan that fits a patient's unique learning needs reduces health care costs, improves the quality of care,
and ultimately changes behaviors to improve patient outcomes.
Formal patient education courses or classes would be the most appropriate strategy in which situation? a. Address needs common to a group. b. Explain self-directed learning. c. Describe nursing interventions. d. Respond to questions of a patient's family. Correct Answer a. Address needs common to a group. The nurse is teaching a parenting class to a group of pregnant adolescents. The nurse pretends to be the baby's father, and the adolescent mother is asked to show how she would respond to the father if he gave her a can of beer. Which teaching approach did the nurse use? Role play2 Discovery3 An analogy4 A demonstration Correct Answer 1 An older adult is being started on a new antihypertensive medication. In teaching the patient about the medication, the nurse:1 Speaks loudly.2 Presents the information once.3 Expects the patient to understand the information quickly.4 Allows the patient time to express himself or herself and ask questions Correct Answer 4 Allows the patient time to express himself or herself and ask questions When a patient tells the nurse about plans to do research about the patient's diagnosis and potential treatment on the Internet, what is the nurse's most appropriate initial response? a. Discount the reliability of the Internet.
b. Evaluate the patient's computer competency. c. Provide a list of recommended d. Teach about evaluation of Internet resources. Correct Answer d. Teach about evaluation of Internet resources. Interrelated concepts regarding patient attributes and preferences that a nurse would consider when addressing patient education include which concept? a. Adherence b. Health promotion c. Quality d. Technology Correct Answer a. Adherence To address administrative concerns about the effectiveness of staff nurses related to patient education, what is the nurse manager's first action? a. Assign one nurse to teach patients. b. Organize patient teaching resources. c. Post a teaching outline in the lounge. d. Survey nurses about patient teaching. Correct Answer d. Survey nurses about patient teaching. Which of the following is NOT true of the Healthy People 2020 Targets? a) The physical activity target has been met regarding aerobic physical activity and muscle strengthening activity. b) Daily vegetable intake target is 1/2 cup of vegetables per 1000 calories. c) 35.3% of adults were obese in 2009-12.
d) A 14.2% decrease in childhood obesity is the target for
c. Promotion of health and illness prevention d. Health analogies Correct Answer ANS: C As a nurse, you are a visible, competent resource for patients who want to improve their physical and psychological well-being. In the school, home, clinic, or workplace, you promote health and prevent illness by providing information and skills that enable patients to assume healthier behaviors. Injured and ill patients need information and skills to help them regain or maintain their level of health; this is referred to as restoration of health. Not all patients fully recover from illness or injury. Many have to learn to cope with permanent health alterations; this is known as coping with impaired functions. Analogies supplement verbal instruction with familiar images that make complex information more real and understandable. For example, when explaining arterial blood pressure, use an analogy of the flow of water through a hose.
New knowledge and skills are often necessary for patients and/or family members to continue activities of daily living. Teaching family members to help the patient with health care management (e.g., giving medications through gastric tubes, doing passive range-of-motion exercises) is an example of coping with long-term impaired functions. Injured and ill patients need information and skills to help them regain or maintain their levels of health. Some examples of this include teaching a woman who recently had a hysterectomy about her pathology reports and expected length of recovery and teaching a teenager with a broken leg how to use crutches. In childbearing classes, you teach expectant parents about physical and psychological changes in the woman and about fetal development; this is part of health maintenance.
change attitudes, adopt new behaviors, or perform new skills.
the health care team, not the nurse. Ask a trusted family member or friend to be your advocate (advisor or supporter), not a nurse. Medication errors are the most common health care mistakes, not inappropriate medical tests.
acknowledgment of new attitudes, behaviors, or knowledge. Interpersonal communication is necessary for the teaching/learning process, but describing what the learner will be able to do after successful instruction constitutes learning objectives. Facts and knowledge will be presented in the teaching session.
d. Question and answer session Correct Answer ANS: C Affective learning deals with expression of feelings and acceptance of attitudes, opinions, or values. Role play and discussion (one-on-one and group) are effective teaching methods for the affective domain. Lecture and question and answer sessions are effective teaching methods for the cognitive domain. Demonstration is an effective teaching method for the psychomotor domain.
When the nurse describes a patient's perceived ability to successfully complete a task, which term should the nurse use? a. Self-efficacy b. Motivation c. Attentional set d. Active participation Correct Answer ANS: A Self-efficacy, a concept included in social learning theory, refers to a person's perceived ability to successfully complete a task. Motivation is a force that acts on or within a person (e.g., an idea, an emotion, a physical need) to cause the person to behave in a particular way. An attentional set is the mental state that allows the learner to focus on and comprehend a learning activity. Learning occurs when the patient is actively involved in the educational session.
A toddler is going to have surgery on the right ear. Which teaching method is most appropriate for this developmental stage? a. Encourage independent learning. b. Use discussion throughout the teaching session.