Chapter 14 Yoost Study Materials with Textbook Questions PDF

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Yoost & Crawford: Fundamentals of Nursing: Active Learning for Collaborative Practice, 2nd Edition Chapter 14: Health Literacy and Patient Education Review Questions 1. The nurse is caring for a 6-year-old patient in the emergency department who just had a full left leg cast placed for a fracture. As the nurse is reviewing the discharge instructions with the patient's mother, she states, “You don't have to go over those—I’ll read them at home.” What should the nurse do? a. Contact the physician immediately. b. Consider the possibility of health literacy limitations and assess further. c. Stop the teaching, because the mother obviously has taken care of casts before. d. Explain to the mother that reading the instructions with her is required.

2. A 58-year-old man is admitted for a small-bowel obstruction late Saturday night. The nurse obtains admitting orders, which include the need to place a nasogastric (NG) tube to low intermittent suction. During the assessment, the nurse determines that the patient does not speak English. Which action(s) should the nurse do before placing the NG tube? a. Take two additional staff members into the room when placing the tube so the patient can be restrained if needed. b. Request an interpreter per facility protocol. c. Do not place the NG tube because the physician would not want to frighten the patient. d. Document the inability to place the NG tube due to lack of ability to communicate.

3. Which nursing diagnoses are used in developing a patient teaching plan? (Select all that apply.) a. Moral Distress b. Ready to Learn c. Difficulty Coping d. Literacy Problem e. Anxiety Ready to Learn and Literacy Problem are appropriate nursing diagnoses for use in developing a patient teaching plan. Moral Distress is a nursing diagnosis for those facing ethical decisions. Difficulty Coping is not a nursing diagnosis used in developing a teaching plan, but if a patient is not coping effectively, it may affect the ability to learn. A nursing diagnosis of Anxiety may affect the patient's ability to learn but is not directly related to developing a teaching plan.

4. Which nursing diagnosis is appropriate if a patient expresses an interest in learning? a. Ready to Learn b. Lack of Knowledge c. Effective Information Processing d. Health-Seeking Behaviors

5. A 61-year-old man is undergoing an emergency cardiac catheterization when the nurse gives his wife a packet of registration paperwork and asks her to complete the forms. Which observed actions may indicate a health literacy issue? (Select all that apply.) a. Putting on glasses before beginning the paperwork. b. Asking someone in the waiting area to read the forms to her “because I need to get new glasses—these just don't work.” c. Waiting until her daughter arrives to begin the paperwork so that her daughter can complete the forms. d. Setting the clipboard aside and staring tearfully out the window. e. Returning the forms only partially filled out, with missing or inaccurate information.

6. Teaching a patient to use an incentive spirometer by demonstration, with a return demonstration by the patient is an example of teaching based on which domain of learning? a. Psychomotor b. Affective c. Psychosocial d. Cognitive

7. The nurse is providing home care to a 62-year-old woman who was recently diagnosed with insulin-dependent diabetes mellitus. What is the most important reason for the nurse to document the teaching session? a. The patient's insurance company requires documentation. b. The nurse's employer requires documentation of home care sessions. c. Other members of the health care team need to know the patient's progress. d. Insulin is a potentially dangerous medication and needs to be documented. Although the remaining options may be true, the primary reason for specific documentation of a patient's progress in a teaching plan is to ensure that other nurses or members of other disciplines can pick up the teaching plan and know precisely what the patient has accomplished and where to begin additional sessions.

8. Written instructions showing pictures of the steps necessary to test blood glucose, along with demonstration and a return demonstration of the steps, would most benefit which learners? a. Affective b. VARK c. Psychomotor d. Cognitive

9. The nurse is providing care to an 88-year-old male patient who just returned from the recovery room after a right hip replacement. The nurse plans to teach the patient prevention techniques for deep vein thrombosis. What is the best time to provide teaching? a. Do it right before the patient's next intravenous pain medication. b. Wait until tomorrow morning because he is in too much pain today. c. Leave written materials on his over-the-bed tray that he can read at his convenience. d. Wait until 10 to 15 minutes after his next intravenous pain medication

10. Which is true about patient teaching sessions? a. Present all of the information so the patient can learn all that is needed. b. Present the patient with one idea at a time. c. Ensure the presence of a family member at each session. d. End with a written quiz to ensure understanding of the information.

Yoost: Fundamentals of Nursing, 2nd Edition Chapter 14: Health Literacy and Patient Education Case Study with Answers

Margaret is a first-semester nursing student who is doing her clinical rotation in an assistedliving care facility. She is assigned to Mr. Alfred Smith, an 81-year-old African-American male who has dementia. Mr. Smith’s family could no longer take care of him at home because he became combative in the evenings as a result of the effects of sundowner’s syndrome. To preserve his safety, Mr. Smith now lives on the locked unit at the assisted-living facility where one or more members of his immediate and extended family come to visit every day. In addition, Mr. Smith’s great niece, Harriet, works at the same facility and checks on Mr. Smith during each of her shifts. 1. Because of Mr. Smith’s progressing dementia, he has difficulty feeding himself. When Margaret prompts him to eat his oatmeal at breakfast, he just stares at his spoon. Margaret picks up his spoon and wraps his hand around the handle. For which psychomotor learning skill is Margaret trying to retrain Mr. Smith? A. Set B. Mechanism C. Perception D. Guided response Answer: C Rationale: Perception is the simplest behavior, which requires being aware of objects or qualities through the use of sense organs. Margaret tries to retrain Mr. Smith’s perceptions by having him hold his spoon.

2. Mr. Smith becomes agitated as Margaret tries to retrain him in his use of eating utensils. Margaret knows that, as his anxiety increases, his ability to pay attention also increases. A. True B. False Answer: B Rationale: As anxiety increases, the patient’s ability to pay attention often decreases, not increases. 3. Mr. Smith tells Margaret that he doesn’t think he can hold the spoon on his own and feed himself. Mr. Smith lacks self-efficacy. Self-efficacy comes from which of the following sources? (Select all that apply.) A. Enactive mastery experiences B. Vicarious experiences C. Auditory persuasion D. Physiological states Answer: A, B, D Rationale: Self-efficacy, which is the person’s perceived ability to successfully complete a task, comes from four sources: enactive mastery experiences, vicarious experiences, verbal persuasion, and physiological and affective states.

4. Mr. Smith constantly denies that he has dementia by stating, “I’m old. A little forgetfulness is normal.” Mr. Smith is in the _________ or _________ stage of grieving. Answer: Denial or disbelief

Yoost & Crawford: Fundamentals of Nursing: Active Learning for Collaborative Practice, 2nd Edition Chapter 14: Health Literacy and Patient Education Review Questions (Online-Only) MULTIPLE CHOICE

1. The student describes the “3 A’s of health information” identified by the National Action Plan to Improve Health Literacy. Which “A” demonstrates a need to review the information? a. Accessible b. Accurate c. Actionable

d. Appropriate Accessible, accurate and actionable are the 3 A’s of health information as identified by the National Action Plan to Improve Health Literacy.

2. Which following environmental situation would be the most beneficial in which to hold a patient teaching session? a. Waiting room of the provider’s office b. The nurse’s station c. The patient’s room d. The family visiting room 3. The nurse is providing discharge teaching to a patient who had a gallbladder removal yesterday. The nurse should consider further health literacy–related assessment when the patient states: a. “Can you read that to me? My spouse took my glasses home.” b. “I don’t understand what you are saying about what I can eat.” c. “Do I have to take the pain medicine even if I don’t feel I need it?” d. “Do I still need to use that breathing exerciser when I get home?” 4. The unique ability of the patient to understand and integrate health-related knowledge is known as: a. basic literacy. b. medical literacy. c. health literacy. d. consumer literacy. 5. The nursing student has assessed a patient’s health literacy prior to teaching. What consideration would indicate the student needs to review this information? a. Age and role b. Gender and IQ score c. Cultural diversity components d. Economic resources Neither a patient’s gender nor his/her IQ directly correlate to his/her health literacy whereby the other answers are relevant factors.

6. Which following factor should be considered first when developing a teaching plan? a. The patient’s priorities b. The patient’s stability c. The patient’s insurance coverage d. The patient’s economic resources Assisting the patient to identify his/her priorities in learning will help guide the teaching plan and keep the patient motivated and interested. The patient’s stability may be relevant in some instances but would be more related to timing of the teaching or environment rather than establishing the teaching plan. While the patient’s insurance coverage and economic resources may affect the interventions or number of teaching sessions, they would not direct the de-

velopment of the plan.

7. The domain of learning directly related to a patient’s motivation to learn is: a. cognitive. b. psychomotor. c. affective. d. dependent on their reading level. The affective domain of learning considers feelings, values, motivation, and attitudes of the learner. Cognitive and psychomotor are not directly affected by the patient’s motivation. The patient’s reading level is not a domain of learning.

8. The nurse sees information from a VARK assessment and asks the mentor what the acronym stands for. What response from the mentor is best? a. Verbal, aural, read/write, and kinesthetic. b. Verbal, aural, readiness, and kinesthetic. c. Verbal, auditory, readiness, and kinesthetic. d. Verbal, auditory, read/write, and kinesthesia.

MULTIPLE RESPONSE 1. A nurse is determining the health literacy of a patient who is preparing to go home from the hospital. Which of the following attributes or abilities contribute to health literacy? (Select all that apply) a. Able to schedule appointments. b. Identifies credible health information. c. Advocates for appropriate care. d. Owns a source of technology to access information. e. Asks appropriate questions of providers.

YOOST- Chapter 14 Health Literacy and Patient Education

Affective domain

A form of learning that recognizes the emotional component of integrating new knowledge.

Cognitive domain

A form of learning based on knowledge and material that is remembered.

Health literacy

The ability of the patient to understand and integrate healthrelated knowledge.

Learning

Acquiring knowledge or skills through instruction or experience.

Multimodal learner

A person who does best when more than one teaching strategy is used or who is able to adapt to a variety of teaching strategies.

Psychomotor domain

A form of learning that incorporates physical movement and the use of motor skills into learning.

Teaching

Imparting knowledge or giving instruction.

 LO 14.1 Define health literacy: Health literacy refers to a patient's ability to seek and understand information related to health care, disease prevention, and treatment of illness. Patients are unique in their ability to comprehend health care information. Health literacy directly affects the patient's ability to comprehend and integrate knowledge.  LO 14.2 Explain the role of health literacy in nursing and patient education: Knowledge of a patient's health literacy level assists nurses in communicating instructions and educational information in an appropriate manner to ensure that the patient understands.  LO 14.3 Recognize the types of patient education and the settings in which patient education occurs: Patients are taught in formal settings, in which information is delivered, or in planned one-on-one sessions, and in informal settings, in which information is situation and patient specific.  LO 14.4 Differentiate among the three domains of learning: There are three domains of learning: cognitive, psychomotor, and affective. When developing effective teaching plans, the nurse must consider how the individual learns.  LO 14.5 Explain how learning styles affect patient teaching: Patient education should be conducted in the learning style preferred by the individual (i.e., verbal, aural, read/write, or kinesthetic or a combination of modes) and tailored to the patient's needs.

 LO 14.6 Describe factors affecting health literacy and patient education: Health literacy and patient education are affected by numerous factors, including cultural background, socioeconomic level, age or developmental stage, role, environment, and timing.  LO 14.7 Carry out an assessment of the patient's health literacy and education needs: An assessment must be done before developing a patient teaching plan and should take into consideration the learner and the learning level, educational needs, and previous experiences of the learner.  LO 14.8 Identify nursing diagnoses appropriate for use with patient education: Examples of nursing diagnoses appropriate for patients with learning needs are Lack of Knowledge, Ready to Learn, and Literacy Problem.  LO 14.9 Determine goals and outcome criteria for patient education: Goals are based on particular learning needs and established nursing diagnoses.  LO 14.10 Implement teaching plans and evaluate their effectiveness: The nurse maximizes implementation of teaching plans by choosing the best environment, pacing the sessions according to the patient's condition, and providing information that is accurate, accessible, and actionable. The nurse should ask the learner to repeat or perform what has been taught to evaluate what has been learned. The patient education session should be documented in the medical record.  LO 14.11 Recognize the role of technology in accessibility of health care information: Technology, including the Internet, is a rapidly expanding and vast resource for patients regarding most aspects of health care. The nurse should be cognizant of the benefits and risks of patients seeking information online....