Chapter 04: Patient and Caregiver Teaching
Lewis: Medical-Surgical Nursing in Canada,
MULTIPLE CHOICE
1. A client with newly diagnosed breast cancer has a nursing diagnosis of deficient knowledge
related to insufficient information (about breast cancer). When the nurse is planning teaching
for the client, which is the most important initial learning goal?
a. The client will select the most appropriate breast cancer therapy.
b. The client will state ways of preventing the recurrence of the tumour.
c. The client will demonstrate coping skills needed to manage the disease.
d. The client will choose methods to minimize adverse effects of treatment.
ANS: A
Adults learn best when given information that can be used immediately. The first action the
client will need to take after a cancer diagnosis is to choose a treatment option. The other
goals may be appropriate as treatment progresses.
DIF: Cognitive Level: Application TOP: Nursing Process: Planning
MSC: NCLEX: Health Promotion and Maintenance
2. After the nurse implements diet instruction for a client with heart disease, the client can
explain the information but fails to make the recommended dietary changes. Which of the
following statements reflects the correct evaluation of the intervention?
a. Learning did not occur because the client’s behaviour did not change.
b. Choosing not to follow the diet is the behaviour that resulted from learning.
c. The nursing responsibilityNU RSINGTthe
for helping
B.C OMmake dietary changes has been
client
fulfilled.
d. The teaching methods were ineffective in helping the client learn the dietary
information.
ANS: B
Although the client’s behaviour has not changed, the client’s ability to explain the information
indicates that learning has occurred and the client is choosing at this time to continue with the
previous diet. The client may be in the contemplation or preparation state in the
Transtheoretical Model. The nurse should reinforce the need for change and continue to
provide information and assistance with planning for change.
DIF: Cognitive Level: Application TOP: Nursing Process: Evaluation
MSC: NCLEX: Health Promotion and Maintenance
3. The nurse is caring for an adult client who has been diagnosed with type 2 diabetes mellitus
after being admitted to the hospital with an infected foot wound. When applying principles of
adult learning, which teaching strategy by the nurse is most likely to be effective?
a. Discuss the importance of blood glucose control in maintenance of long-term
health.
b. Demonstrate the correct method for cleaning and redressing the wound to the
client.
c. Assure the client that the nurse is an expert on management of diabetes
complications.
, d. Wait until after discharge and have a home health nurse teach about foot care and
diabetes management.
ANS: B
Principles of adult education indicate that readiness and motivation to learn are high when
facing new tasks (such as wound care) and when demonstration and practice of skills are
available. Although a home health referral may be needed for this client, teaching should not
be postponed until discharge. Adult learners are independent; the nurse should act as a
facilitator for learning, rather than as the expert. Adults learn best when the topic is of
immediate usefulness; long-term goals may not be very motivating.
DIF: Cognitive Level: Application TOP: Nursing Process: Planning
MSC: NCLEX: Health Promotion and Maintenance
4. A client admitted to the hospital with hyperglycemia and newly diagnosed diabetes mellitus is
scheduled for discharge the second day after admission. When implementing client teaching,
which is the best action for the nurse to take?
a. Instruct about the increased risk for cardiovascular disease.
b. Provide detailed information about dietary control of glucose.
c. Teach glucose self-monitoring and medication administration.
d. Give information about the effects of exercise on glucose control.
ANS: C
When time is limited, the nurse should focus on the priorities of teaching. In this situation, the
client should know how to test blood glucose and administer medications to control glucose
levels. The client will need further teaching about the role of diet, exercise, various
medications, and the many potential complications of diabetes, but these topics can be
addressed through planning forNUappropriate
RSINGTB.C OM
referrals.
DIF: Cognitive Level: Application TOP: Nursing Process: Implementation
MSC: NCLEX: Health Promotion and Maintenance
5. When using the Transtheoretical Model of Health Behaviour Change during client teaching,
the nurse identifies that the client who states, “I told my wife that I was going to start
exercising, and I think I will join a fitness club,” is in which of the following stages?
a. Preparation
b. Termination
c. Maintenance
d. Contemplation
ANS: A
The client’s statement indicating that the plan for change is being shared with someone else
indicates that the preparation stage has been achieved. Contemplation of a change would be
indicated by a statement like “I know I should exercise.” Maintenance of a change occurs
when the client practises the behaviour regularly. Termination would be indicated when the
change is a permanent part of the lifestyle.
DIF: Cognitive Level: Comprehension TOP: Nursing Process: Assessment
MSC: NCLEX: Health Promotion and Maintenance
Lewis: Medical-Surgical Nursing in Canada,
MULTIPLE CHOICE
1. A client with newly diagnosed breast cancer has a nursing diagnosis of deficient knowledge
related to insufficient information (about breast cancer). When the nurse is planning teaching
for the client, which is the most important initial learning goal?
a. The client will select the most appropriate breast cancer therapy.
b. The client will state ways of preventing the recurrence of the tumour.
c. The client will demonstrate coping skills needed to manage the disease.
d. The client will choose methods to minimize adverse effects of treatment.
ANS: A
Adults learn best when given information that can be used immediately. The first action the
client will need to take after a cancer diagnosis is to choose a treatment option. The other
goals may be appropriate as treatment progresses.
DIF: Cognitive Level: Application TOP: Nursing Process: Planning
MSC: NCLEX: Health Promotion and Maintenance
2. After the nurse implements diet instruction for a client with heart disease, the client can
explain the information but fails to make the recommended dietary changes. Which of the
following statements reflects the correct evaluation of the intervention?
a. Learning did not occur because the client’s behaviour did not change.
b. Choosing not to follow the diet is the behaviour that resulted from learning.
c. The nursing responsibilityNU RSINGTthe
for helping
B.C OMmake dietary changes has been
client
fulfilled.
d. The teaching methods were ineffective in helping the client learn the dietary
information.
ANS: B
Although the client’s behaviour has not changed, the client’s ability to explain the information
indicates that learning has occurred and the client is choosing at this time to continue with the
previous diet. The client may be in the contemplation or preparation state in the
Transtheoretical Model. The nurse should reinforce the need for change and continue to
provide information and assistance with planning for change.
DIF: Cognitive Level: Application TOP: Nursing Process: Evaluation
MSC: NCLEX: Health Promotion and Maintenance
3. The nurse is caring for an adult client who has been diagnosed with type 2 diabetes mellitus
after being admitted to the hospital with an infected foot wound. When applying principles of
adult learning, which teaching strategy by the nurse is most likely to be effective?
a. Discuss the importance of blood glucose control in maintenance of long-term
health.
b. Demonstrate the correct method for cleaning and redressing the wound to the
client.
c. Assure the client that the nurse is an expert on management of diabetes
complications.
, d. Wait until after discharge and have a home health nurse teach about foot care and
diabetes management.
ANS: B
Principles of adult education indicate that readiness and motivation to learn are high when
facing new tasks (such as wound care) and when demonstration and practice of skills are
available. Although a home health referral may be needed for this client, teaching should not
be postponed until discharge. Adult learners are independent; the nurse should act as a
facilitator for learning, rather than as the expert. Adults learn best when the topic is of
immediate usefulness; long-term goals may not be very motivating.
DIF: Cognitive Level: Application TOP: Nursing Process: Planning
MSC: NCLEX: Health Promotion and Maintenance
4. A client admitted to the hospital with hyperglycemia and newly diagnosed diabetes mellitus is
scheduled for discharge the second day after admission. When implementing client teaching,
which is the best action for the nurse to take?
a. Instruct about the increased risk for cardiovascular disease.
b. Provide detailed information about dietary control of glucose.
c. Teach glucose self-monitoring and medication administration.
d. Give information about the effects of exercise on glucose control.
ANS: C
When time is limited, the nurse should focus on the priorities of teaching. In this situation, the
client should know how to test blood glucose and administer medications to control glucose
levels. The client will need further teaching about the role of diet, exercise, various
medications, and the many potential complications of diabetes, but these topics can be
addressed through planning forNUappropriate
RSINGTB.C OM
referrals.
DIF: Cognitive Level: Application TOP: Nursing Process: Implementation
MSC: NCLEX: Health Promotion and Maintenance
5. When using the Transtheoretical Model of Health Behaviour Change during client teaching,
the nurse identifies that the client who states, “I told my wife that I was going to start
exercising, and I think I will join a fitness club,” is in which of the following stages?
a. Preparation
b. Termination
c. Maintenance
d. Contemplation
ANS: A
The client’s statement indicating that the plan for change is being shared with someone else
indicates that the preparation stage has been achieved. Contemplation of a change would be
indicated by a statement like “I know I should exercise.” Maintenance of a change occurs
when the client practises the behaviour regularly. Termination would be indicated when the
change is a permanent part of the lifestyle.
DIF: Cognitive Level: Comprehension TOP: Nursing Process: Assessment
MSC: NCLEX: Health Promotion and Maintenance
