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Foundations for Population Health in Community Public Health Nursing 5th Edition Stanhope Test Bank

Chapter 11: Using Health Education and Groups in the Community Stanhope: Foundations for Population Health in Community/Public Health Nursing, 5th Edition MULTIPLE CHOICE 1. A member of a community weight-loss group has maintained a healthy weight for 2 years

through healthy eating and daily exercise. Which of the following steps of the affective domain is this participant demonstrating? a. Analysis b. Application c. Evaluation d. Knowledge ANS: C

Steps in the affective domain have the learner doing the following in this sequence: knowledge, comprehension, application, analysis, synthesis, and evaluation. During evaluation, the learner adopts behaviors consistent with the new values. In this example, the individual has adopted the behavior and this has resulted in the ability to maintain the value of a healthy weight. Steps in the affective domain have the learner doing the following in this sequence: (1) knowledge: receives the information; (2) comprehension: responds to what is being taught; (3) application: values the information; (4) analysis: makes sense of the information; (5) synthesis: organizes the information; (6) evaluation. 2. A nurse just finished teaching breast self-examination to a large group of women at a

professional conference. During the session, she distributed literature and used culturally appropriate visual aids. However, the session was not as effective as it could have been. Which of the following was the most important thing omitted by the nurse? a. Time for audience members to ask questions and clarify the information b. Explanation of why culturally appropriate images are more acceptable c. Opportunity for the women to practice what they learned d. Use of simple language instead of printed material ANS: C

The learner must have opportunities to practice the new skills being learned. Provide practice sessions during the program because many people may not have the time, facilities, motivation, and/or support to practice at home what they have learned. Because breast self-examination is a psychomotor skill, the emphasis should be placed on the learner having the ability to perform the skill after the conference. The most important aspect should be the time for practice in this situation, and not on the time for questions. The nurse would not need to explain to the audience why culturally appropriate images are acceptable, rather these should have been incorporated into the session. Having printed materials is important so that the learner has a reference after leaving the conference. 3. A nurse is providing an educational program about testicular self-examination (TSE). Which

of the following would be the best learning objective for this program? a. Each participant will state why TSE is important and explain how to do it. b. Each participant will describe how to do TSE and discuss the dangers of testicular

cancer.

Foundations for Population Health in Community Public Health Nursing 5th Edition Stanhope Test Bank c. 90% of the men will correctly demonstrate testicular self-examination. d. 100% of the men will do a testicular examination correctly on a model. ANS: C

If the goal is to learn TSE, the best goal is for the person to be able to do TSE correctly. Being able to state why it is important is a helpful first step, as is practice on a model, but to be sure the person can really do the procedure, you need to allow practice time and feedback until the person can demonstrate the procedure properly. 4. A nurse planned a presentation about the latest trends in disaster planning for the senior

nursing students at the local college. However, when the nurse began to share the information, the students were talking to one another and essentially ignoring the nurse. Which of the following actions should be taken by the nurse? a. Ask the students why they are being so rude. b. Explain why the information is crucial to their current clinical practice. c. Nothing; let the instructor of the course handle the problem. d. Tell a joke to get the students’ attention. ANS: B

Before learning can take place, you need to gain the learner’s attention. One way to do this is by convincing the learner that the information about to be presented is important and beneficial to them personally. Asking the students why they are being so rude would not be a professional response by the nurse. The nurse should take responsibility for gaining the attention of the audience and not expect the instructor to do so. Gaining the students can best be accomplished by telling the students why it is important rather than telling a joke. 5. A nurse is using the technique of motivational interviewing when working with a client.

Which of the following statements by the client indicates the client is ready to make the change? a. “I should change.” b. “I am willing to change.” c. “It’s important to change.” d. “I want to change.” ANS: B

Motivational interviewing uses the term “change talk” to refer to statements by the client that he or she is motivated and willing to make change. An easy to use mnemonic is “DARN-CAT” which refers to desire, ability, reason, need, activation, commitment, and taking steps. “I am willing to change” demonstrates activation, a client who is ready, prepared, and willing to make the change. The incorrect statements refer to the client who is preparing to make the change, but not yet ready to implement the change. 6. A nurse uses lecturing as the primary method of educating clients. Which part of the

education process is missing? a. Evaluation b. Experience c. Participation d. Understanding ANS: C

Foundations for Population Health in Community Public Health Nursing 5th Edition Stanhope Test Bank Educators should include participation. Lack of participation is a barrier to learning. Merely sitting and listening to someone lecture are not as effective as discussion, even when the presentation is stimulating, interesting, and dynamic. Evaluation occurs at the end of the education, evaluation is not necessarily missing when an educator uses lecture as the primary method of education. The nurse may be able to include experiences as part of the lecture when educating clients. It may be difficult to assess understanding if lecture is the primary method of education; however, the nurse should be able to use nonverbal clues to assess understanding. Also, the use of lecture does not mean that understanding is missing from the process. 7. The nurse gives a very informative and engaging presentation and then gives everyone in the

audience a handout that outlines the presentation. Later, the nurse discovers that many of the handouts were thrown away before the audience left the building. Which of the following educational principles has the nurse forgotten? a. Audiences expect PowerPoint or video presentations, not lectures. b. Many Americans do not have a high reading level. c. People want photographs and images, not wordy outlines. d. The nurse gave them too much information too fast for them to want to cope with it all. ANS: B

Most health information is printed at a tenth-grade reading level, which is too difficult for almost half of the adult readers in the United States. If people cannot read or understand the material, they discard it. Although visual images are certainly helpful, this does not explain why the handouts were discarded. Audience expectations of the use of PowerPoint or video presentations or receiving too much information too fast does not explain why the handouts were thrown away. If the nurse covered information too fast, it is likely that the participants may have been more inclined to keep the handout. 8. Which of the following statements regarding the Health Belief Model is accurate? a. Cues to action are an important component of the model. b. Multiple methods of education should be used when implementing this model. c. The first stage experienced in this model is the pre-contemplation stage. d. To successfully implement this model, ongoing maintenance of the behavior must

be considered. ANS: A

The Health Belief Model includes six components that attempt to answer the question of what motivates an individual to do something. These components are perceived susceptibility, perceived severity, perceived benefits, perceived barriers, cues to action, and self-efficacy. The Health Belief Model does not indicate the number of methods of education that should be used. The pre-contemplation stage is part of the Transtheoretical Model. Maintenance is part of the Precaution Adoption Process Model. 9. A nurse is planning an educational program about cardiovascular disease. Which of the

following would be the optimal time for the nurse to elicit feedback from program participants? a. At the beginning of the program b. At the program midpoint c. Immediately following program completion

Foundations for Population Health in Community Public Health Nursing 5th Edition Stanhope Test Bank d. Throughout the program ANS: D

Not only should learners receive feedback, but the educator should also elicit feedback from learners throughout the educational process. On the basis of the feedback that the educator receives from learners, the implementation and presentation of the educational program can be modified. Obtaining feedback only at one point in time during the program does not give the nurse enough feedback as to what is happening throughout the presentation. In order for the educator to modify the teaching process and better meet the learner’s needs, evaluation data should be obtained at multiple points in time. 10. When evaluating an educational program, the nurse discovers that only 25% of community

members met the learning objectives. Which of the following parts of the program should be improved? a. Educator b. Content c. Learners d. Objectives ANS: A

Ultimately, the educator is responsible for the success or failure of the educational process and the development of learner knowledge, skills, and abilities. If evaluation reveals that the learning objectives are not being met, the nurse must determine why the instruction is not effective. The educator is responsible for presenting the material creatively and meaningfully in new ways to increase learner retention and ability to apply the new knowledge. The educator determines how content can be tailored to the learner. The educator determines the objectives. 11. A man says, “I just can’t get myself to leave the house and go for a 30-minute walk each day.

I wish I could think of some way to motivate myself.” Which of the following would be the best action for the nurse to take? a. Establish a written contract between him and his employer that states walking is required each day. b. Recognize the reasons why 30 minutes of walking each day is one of the best health promotion activities he can choose. c. Join a group that walks early each morning. d. Set up rewards for himself, such as a nice snack after he gets back from walking. ANS: C

Health behavior is influenced by the groups to which people belong. Having someone else to walk with is an effective way to maintain the behavior. Group support often helps people make needed changes for health that they are unable to accomplish on their own or with the help of just one individual. The role of the employer is not to dictate employee health behaviors, so have a written contract would be inappropriate. The man may already recongize that walking is one of the best health promotion activities he can choose; however, he has expressed that he is lacking motivation. Setting up rewards for himself may be helpful; however, it may not be enough to get him motivated to take action. Group support may help him to get motivated.

Foundations for Population Health in Community Public Health Nursing 5th Edition Stanhope Test Bank 12. A nurse is meeting to discuss problems and solutions with a group of teenagers who have

been newly diagnosed with diabetes. One teenager states, “My mom found this particular brand of popcorn that has only 15 carbohydrates in the whole giant bag.” Which of the following best describes the group purpose that is being served by the teenager’s statement? a. Maintenance function of encouraging everyone to continue the discussion b. Maintenance function of helping everyone feel comfortable talking about food c. Task function of resolving problems about what to nibble during movies d. Task function of sharing information and resources ANS: D

A task function is anything a member does that deliberately contributes to the group’s purpose. Members with task-directed abilities are attractive to the group. These traits include strong problem-solving skills, access to material resources, and skills in directing. The teenager’s statement shared information about a good resource for the group. Maintenance functions help members affirm, accept, and support one another, resolve conflicts, and create social and environmental comfort. The teenagers comment does not support a maintenance function of the group, rather it focuses on a task function by contributing to the group’s purpose. 13. A nurse invited all the teenagers who were newly diagnosed with diabetes to a group meeting

to discuss issues they all had in common. One teenager replied, “I don’t know if I want to share all the problems I’m having with strangers.” Which of the following is the best nurse response? a. “Don’t share anything with anyone until you’re comfortable doing so.” b. “I can understand what you are saying.” c. “No one will require you to do anything you don’t want to do.” d. “The purpose of the group is to have a safe place to share problems with others who may be having similar problems.” ANS: D

During the first phase, potential participants do not know whether they can trust one another. The primary task of the leader at this point is to clarify the purpose. The response explaining that “the purpose is to have a safe place” both recognizes what was said and clarifies the purpose of the group. The statements of “Don’t share anything until you’re comfortable” and “No one will require you to do anything. . .” are supportive, but they does not recognize the phase of development of the group. The statement “I understand . . .” offers the client empathy but does not reinforce the purpose fo the group. 14. The leader of an Alzheimer’s support group surveys the members of the group to determine

the best time for the group to meet. Which of the following norms is being supported through this action? a. Group norms b. Task norms c. Maintenance norms d. Reality norms ANS: C

Foundations for Population Health in Community Public Health Nursing 5th Edition Stanhope Test Bank Maintenance norms create group pressure to affirm members and maintain their comfort. Maintenance behaviors include identifying the social and psychological tensions of members and taking steps to support those members at high-stress times. Maintenance norms often refer to things such as scheduling meetings at convenient times and in an accessible and comfortable space. Group norms set the standards for the group members’ behaviors, attitudes, and perceptions. Task norms are the commitmetn to return to the central goals of the group. Reality norms occur when members reinforce or challenge and correct their ideas of what is real. 15. A nurse established an ongoing group meeting of teenagers with diabetes. In the early stages,

the nurse was very directive in arranging location, providing low-carbohydrate drinks and snacks, steering the discussion, and trying to meet all the teenagers’ needs. After the group had been meeting for about 3 months, the nurse noticed that the group members no longer simply accepted everything the nurse suggested. Instead, the teenagers began making decisions themselves, and eventually, the nurse no longer controlled the group. Which of the following most likely happened to cause this shift? a. The group became cohesive enough to share leadership tasks. b. Teenagers don’t like feeling dependent on adults with power. c. Teenagers often rebel against adult authority. d. The nurse was overwhelmed and lost control of task process. ANS: A

In the beginning, the nurse used an authoritarian style because the nurse was responsible for the group direction. After a group is well established, nurses may best facilitate leadership by relinquishing central control and encouraging group members themselves to determine the norms for their group. As the group matured, continuing an authoritarian style would have resulted in low morale and lack of cohesion, not necessarily a rebellion against adult authority. The group naturally progressed to leading itself based on normal group development. This did not occur because of the teenagers’ attitudes, behaviors, or because of the feelings of the nurse. 16. A group of teenagers with diabetes become upset and angry because they cannot agree on

whether or not to have meetings during summer vacation. Which of the following should the nurse do to be effective in helping the teenagers resolve the conflict? a. Admit that it is difficult for everyone to agree on everything; then ask whether the group can try to decide how to agree on the issue. b. Assume adult authority and announce that meetings will be suspended until fall. c. Recognize that most of the teenagers want to have the meetings, but two are being stubborn; ask the two deviant members to leave the group. d. Suggest that the group avoid discussing it further but rather think about it over the next week and try to discuss the situation more rationally next week. ANS: A

Open communication and recognition that conflict is inevitable may allow the group to focus on a procedure for fairly resolving the conflict. If the nurse were to respond to conflict by avoiding (suggesting that they avoid further discussion), forcing with power (assuming adult authority), capitulating, or excluding some members (asking the deviant members to leave), the behavior would fail to satisfy the concerns of those involved. MULTIPLE RESPONSE

Foundations for Population Health in Community Public Health Nursing 5th Edition Stanhope Test Bank

1. The nurse is scheduled to teach carbohydrate counting to middle-aged adults newly diagnosed

with diabetes. Which of the following actions will the nurse need to take when teaching this population? (Select all that apply.) a. Appeal to the need for autonomy and choice. b. Emphasize that anyone with diabetes must know this information. c. Explain how to cope with being a guest at a dinner. d. Recognize that this audience will depend on the instructor to set goals for learning. ANS: A, C

Because the nurse is working with middle-aged adults, the assumption can be made that they are members of Generation X. This generation tends to be self-directed, likes to work with teams, and may need to develop skills because they are not as likely to be as tech savvy. Members of this group can tolerate delayed gratification; they want clear information with practical value; and they are able to have fun and engage in games and activities when appropriate. Because of this, the best approach will be to use adult experiences and practical problems as learning motivators—for instance, appealing to adults’ sense of autonomy and choice, basing examples on practical adult situations such as cooking meals or eating in restaurants, and discussing how clients can cope with possibly awkward situations such as being a guest at dinner but having diet restrictions. This generation tends to be self-directed so they most likely will not depend on the instructor to set goals for learning or need the instructor to emphasize how important it is to know this information. Members of this generation are likely to have the intrinsic motivation to acc...