Lewis Test Bank - Medical-Surgical Nursing 10th Edition Chapter 4
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Course
Lewis medical surgical nursing 11th
Institution
Lewis Medical Surgical Nursing 11th
Chapter 04: Patient and Caregiver Teaching
Lewis: Medical-Surgical Nursing, 10th Edition
MULTIPLE CHOICE
1. A patient with newly diagnosed colon cancer has a nursing diagnosis of deficient knowledge
about colon cancer. The nurse should initially focus on which learning goal for this patient?
a...
1. A patient with newly diagnosed colon cancer has a nursing diagnosis of deficient knowledge
about colon cancer. The nurse should initially focus on which learning goal for this patient?
a. The patient will state ways of preventing the recurrence of the cancer.
b. The patient will explore and select an appropriate colon cancer therapy.
c. The patient will demonstrate coping skills needed to manage the disease.
d. The patient will choose methods to minimize adverse effects of treatment.
ANS: B
Adults learn best when given information that can be used immediately. The first action the
patient will need to take after a cancer diagnosis is to explore and choose a treatment option.
The other goals may be appropriate as treatment progresses.
DIF: Cognitive Level: Apply (application) REF: 47
TOP: Nursing Process: Planning MSC: NCLEX: Health Promotion and Maintenance
2. After the nurse provides diet instructions for a patient with diabetes, the patient can restate the
information but fails to make the recommended diet changes. How would the nurse best
evaluate the patient‘s situation?
a. Learning did not occur because the patient‘s behavior did not change.
b. Choosing not to follow the diet is the behavior that resulted from learning.
c. The nurse‘s responsibility for helping the patient make diet changes has been
fulfilled.
d. The teaching methods were ineffective in helping the patient learn about the
necessary diet changes.
ANS: B
Although the patient behavior has not changed, the patient‘s ability to restate the information
indicates that learning has occurred, and the patient is choosing at this time not to change the
diet. The patient may be in the contemplation or preparation stage 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: Apply (application) REF: 47
TOP: Nursing Process: Evaluation MSC: NCLEX: Health Promotion and Maintenance
3. A patient is diagnosed with heart failure after being admitted to the hospital for shortness of
breath and fatigue. Which teaching strategy, if implemented by the nurse, is most likely to be
effective?
a. Assure the patient that the nurse is an expert on management of heart failure.
b. Teach the patient at each meal about the amounts of sodium in various foods.
c. Discuss the importance of medication control in maintenance of long-term health.
d. Refer the patient to a home health nurse for instructions on diet and fluid
restrictions.
ANS: B
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Principles of adult education indicate that readiness and motivation to learn are high when
facing new tasks (e.g., learning about the sodium amounts in various food items) and when
demonstration and practice of skills are available. Although a home health referral may be
needed for this patient, 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: Apply (application) REF: 47
TOP: Nursing Process: Planning MSC: NCLEX: Health Promotion and Maintenance
4. A patient who was admitted to the hospital with hyperglycemia and newly diagnosed diabetes
mellitus is scheduled for discharge the second day after admission. When implementing
patient teaching, what is the priority action for the nurse?
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
patient should know how to test blood glucose and administer medications to control glucose
levels. The patient 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 for appropriate referrals.
DIF: Cognitive Level: Apply (application) REF: 49
TOP: Nursing Process: Implementation MSC: NCLEX: Health Promotion and Maintenance
5. A patient states, ―I told my husband I wouldn‘t buy as much prepared food snacks, so I will
go the grocery store to buy fresh fruit, vegetables, and whole grains.‖ When using the
Transtheoretical Model of Health Behavior Change, the nurse identifies that this patient is in
which stage of change?
a. Preparation c. Maintenance
b. Termination d. Contemplation
ANS: A
The patient‘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 patient practices the behavior regularly. Termination would be indicated when the
change is a permanent part of the lifestyle.
DIF: Cognitive Level: Understand (comprehension) REF: 48
TOP: Nursing Process: Assessment MSC: NCLEX: Health Promotion and Maintenance
6. While admitting a patient to the medical unit, the nurse determines that the patient has a
hearing impairment. How should the nurse use this information to plan teaching and learning
strategies?
a. Motivation and readiness to learn will be affected.
b. The family must be included in the teaching process.
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