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Clayton: Basic Pharmacology for Nurses, 15th Edition
Chapter 5: Patient Education and Health Promotion
Test Bank
MULTIPLE CHOICE
1.The nurse is educating a 13-year-old boy newly diagnosed with diabetes and his parents about diet and glucose monitoring. Which domain of learning is represented when the patient expresses concern about feeling different from his peers?
| A. | Cognitive |
| B. | Psychomotor |
| C. | Affective |
| D. | Learning style |
ANS: C
| Feedback | |
| A | The cognitive domain relates to basic factual knowledge. |
| B | The psychomotor domain relates to kinesthetic knowledge, implemented in performance and skills requiring coordination. |
| C | The affective domain is characterized by conduct that expresses feelings, needs, beliefs, values, and opinions. |
| D | Learning style is not one of the three domains of learning. |
DIF:Cognitive Level: ComprehensionREF:53
TOP:Nursing Process Step: Assessment
MSC: NCLEX Client Needs Category: Safe, Effective Care Environment
2.The nurse has taught a patient’s spouse to administer an injectable medication. After the spouse completed a return demonstration of the injection in the hospital, the nurse does not feel confident that this can be carried out independently at home and requests referral for a home health nurse. The nurse is using which phase of the nursing process?
| A. | Assessment |
| B. | Implementation |
| C. | Planning |
| D. | Evaluation |
ANS: D
| Feedback | |
| A | The nurse is not assessing the situation because she is not at the beginning of the process. |
| B | The nurse is past implementation in the timeline of the process. |
| C | The nurse has already planned and implemented interventions. |
| D | The nurse has evaluated the injection technique of the patient’s spouse and determines additional instruction is needed. |
DIF:Cognitive Level: ApplicationREF:57
TOP:Nursing Process Step: Evaluation
MSC: NCLEX Client Needs Category: Safe, Effective Care Environment
3.In preparing for health teaching with a patient who has an auditory learning style, which would be most appropriate?
| A. | Pamphlets from a pharmaceutical company |
| B. | Models of equipment used in a procedure |
| C. | Verbal description of the steps of a procedure |
| D. | A workbook with space to record actions and results |
ANS: C
| Feedback | |
| A | Pamphlets from a pharmaceutical company would be suitable for a patient who has a visual learning style. |
| B | Models of equipment would be suitable for a patient with a psychomotor learning style. |
| C | Hearing the nurse present the information optimizes the patient’s perception of the data. |
| D | A workbook would be suitable for a patient who has a visual learning style. |
DIF:Cognitive Level: AnalysisREF:54
TOP:Nursing Process Step: Evaluation
MSC: NCLEX Client Needs Category: Safe, Effective Care Environment
4.Which is the most intangible portion of the learning process?
| A. | Cognitive |
| B. | Affective |
| C. | Psychomotor |
| D. | Eminent |
ANS: B
| Feedback | |
| A | The cognitive domain is the level at which basic knowledge is learned and stored; it is the thinking portion of the learning process. |
| B | The affective domain concerns feelings, needs, beliefs, values, and opinions. |
| C | The psychomotor domain involves learning new procedures or skills; it is often referred to as the “doing domain.” |
| D | Eminent domain in common law legal systems is the lawful power of the state to expropriate private property without the owner’s consent, either for its own use or on behalf of a third party. |
DIF:Cognitive Level: KnowledgeREF:53
TOP:Nursing Process Step: Assessment
MSC: NCLEX Client Needs Category: Physiological Integrity
5.Which would positively affect readiness to learn?
| A. | Fear and denial |
| B. | Willingness to attain an optimal level of health |
| C. | Poor cognitive and motor development |
| D. | Lack of trust and confidence in the staff |
ANS: B
| Feedback | |
| A | In fear and denial the patient is neither prepared nor willing to accept the limitations imposed by the disease process and learn to manage lifestyle changes. |
| B | Readiness or the ability to engage in learning depends on motive, relevant preparatory learning, and physiological maturation. |
| C | Poor cognitive and motor development handicap the patient’s willingness and ability to learn. |
| D | Trust is essential in the process of patient education. The patient must have confidence in the staff in order to be receptive to teaching efforts. |
DIF:Cognitive Level: ComprehensionREF:54-55
TOP:Nursing Process Step: Assessment
MSC: NCLEX Client Needs Category: Physiological Integrity
6.Which represents the psychomotor domain of learning?
| A. | The patient draws up insulin in a syringe. |
| B. | The patient expresses a belief about medication use. |
| C. | The patient is able to verbalize foods that should be avoided. |
| D. | The patient relates past experience with smoking cessation. |
ANS: A
| Feedback | |
| A | The psychomotor domain involves the learning of a new procedure and is usually done by demonstration of the task. |
| B | The patient expressing beliefs is an example of the affective domain. |
| C | The patient verbalizing foods to be avoided is an example of the cognitive domain. |
| D | The patient relating past experiences is an example of the affective domain. |
DIF:Cognitive Level: ApplicationREF:53
TOP:Nursing Process Step: Assessment
MSC: NCLEX Client Needs Category: Physiological Integrity
7.Which is an example of ethnocentrism?
| A. | A 5-year-old Native American child colors in a book about diabetes. |
| B. | A 14-year-old African American attends a support group to learn about disease management. |
| C. | A 36-year-old Asian prefers to take herbs instead of an oral medication. |
| D. | A 72-year-old Hispanic asks questions about potential adverse effects to a newly prescribed medication. |
ANS: C
| Feedback | |
| A | This is not an example of ethnocentrism; this is an example of age-appropriate learning process. |
| B | This is not an example of ethnocentrism; this is an example of developmental impact on learning. |
| C | Ethnocentrism is the assumption that one’s culture provides the right way, and taking herbs instead of the medication exemplifies this belief |
| D | This is not an example of ethnocentrism; this is demonstrating learning readiness. |
DIF:Cognitive Level: ApplicationREF:56
TOP:Nursing Process Step: Assessment
MSC: NCLEX Client Needs Category: Physiological Integrity
8.What is the most important nursing consideration when teaching an older adult patient about a newly prescribed medication?
| A. | Provide detailed information. |
| B. | Lengthen the time of each teaching session. |
| C. | Present information slowly. |
| D. | Limit discussion on the necessity of learning the information. |
ANS: C
| Feedback | |
| A | Older adults process information more slowly because of limited short-term memory. Detailed information may be too overwhelming. |
| B | The length of sessions should be limited for the older adult patient. |
| C | When teaching older adults, it is important to slow the pace of the presentation. |
| D | Adults need to understand why they must learn something before they undertake the effort to learn. |
DIF:Cognitive Level: ApplicationREF:55
TOP:Nursing Process Step: Assessment
MSC: NCLEX Client Needs Category: Physiological Integrity
MULTIPLE RESPONSE
1.Which is characteristic of the cognitive domain level of learning? (Select all that apply.)
| A. | A patient’s opinion regarding wellness |
| B. | Basic mathematical formulas learned in grade school |
| C. | Incorporation of a person’s previous experiences and perceptions |
| D. | Skill demonstration using a step-by-step approach |
| E. | Relationship between prior experiences and new concepts |
ANS: B, C, E
| Feedback | |
| Correct | Basic mathematical formulas previously learned characterize the cognitive domain level of learning.
Incorporating a person’s previous experiences and perceptions characterizes the cognitive domain level of learning. A relationship between prior experiences and new concepts characterizes the cognitive domain level of learning. |
| Incorrect | A patient’s opinion regarding wellness is an example of the affective domain.
Skill demonstration using a step-by-step approach is an example of the psychomotor domain. |
DIF:Cognitive Level: ComprehensionREF:53
TOP:Nursing Process Step: Assessment
MSC: NCLEX Client Needs Category: Safe, Effective Care Environment
2.The nurse is preparing to instruct a patient and his wife on technique and importance of assessing pulse prior to taking heart medication. Which are appropriate principles of learning in this situation? (Select all that apply.)
| A. | The learning environment |
| B. | The patient’s and wife’s learning styles |
| C. | The objectives/goal statements listed on the patient’s care plan |
| D. | The patient’s financial ability to purchase the medication |
| E. | The patient’s understanding of the seriousness of his illness |
ANS: A, B, C, E
| Feedback | |
| Correct | Learning environment is a principle of learning.
Learning style is a principle of learning. Listing clear objectives and goal statements is a principle of learning. Understanding the seriousness of the situation is a principle of learning. |
| Incorrect | Financial ability is not a principle of learning, but should be an important consideration and assessment when preparing for discharge of the patient and future compliance of the treatment regimen. |
DIF:Cognitive Level: AnalysisREF:53-58
TOP:Nursing Process Step: Assessment
MSC: NCLEX Client Needs Category: Physiological Integrity
3.The nurse is writing a teaching plan for a 30-year-old patient who has AIDS. Which objectives are written in the correct format? (Select all that apply.)
| A. | The patient will state adverse effects of the daily medications before discharge. |
| B. | The patient will correctly fill the daily medication pillbox with the correct medications in the appropriate time slots prior to discharge. |
| C. | The patient will adjust the medications accordingly. |
| D. | The patient will schedule an appointment with the infectious disease physician before discharge. |
| E. | The patient will have lab tests performed regularly. |
ANS: A, B, D
| Feedback | |
| Correct | This objective is measurable and specific.
This objective is measurable and specific. This objective is measurable and specific. |
| Incorrect | This objective is neither measurable nor specific.
This objective is neither measurable nor specific. |
DIF:Cognitive Level: AnalysisREF:54
TOP:Nursing Process Step: Planning
MSC: NCLEX Client Needs Category: Physiological Integrity
4.Which actions by the nurse can foster patient responsibility for adhering to the therapeutic regimen? (Select all that apply.)
| A. | Assessing the patient’s readiness to learn |
| B. | Determining the patient’s level of understanding of content |
| C. | Determining the patient’s education level and learning style |
| D. | Maintaining an aloof attitude toward presented content |
| E. | Documenting expected outcomes independently |
ANS: A, B, C
| Feedback | |
| Correct | The nurse should assess the patient’s readiness to learning when teaching the patient.
The nurse should determine the patient’s level of understanding of the content when teaching the patient. The nurse should determine the patient’s education level and learning style when teaching the patient. |
| Incorrect | The nurse should portray a positive attitude when teaching the patient.
Goals should be mutually written with the patient. |
DIF:Cognitive Level: ComprehensionREF:53-55
TOP:Nursing Process Step: Assessment
MSC: NCLEX Client Needs Category: Safe, Effective Care Environment
5.Which should the nurse include during discharge in addition to verbal instructions? (Select all that apply.)
| A. | Written instructions for the patient’s reference |
| B. | A phone number of the provider or hospital unit for follow-up questions |
| C. | Written instructions for monitoring of parameters used to evaluate therapy |
| D. | Documentation in the nurse’s discharge notes of the nursing and collaborative problems that require continued monitoring and intervention |
| E. | Identification of the patient’s unreasonable expectations of therapy |
ANS: A, B, C, D
| Feedback | |
| Correct | Learning is an ongoing process. Verbal instructions should be followed up with instructions in writing.
Patients should be given a contact number for future reference. Written instructions for monitoring of parameters used to evaluate therapy should be given to the patient. Documentation is an essential part of validating the patient’s understanding of the instructions provided. |
| Incorrect | Although these observations will affect the outcome, they are not part of the discharge planning documentation. |
DIF:Cognitive Level: ApplicationREF:60
TOP:Nursing Process Step: Evaluation
MSC: NCLEX Client Needs Category: Safe, Effective Care Environment
6.Which are reliable ways to determine a patient’s mastery of a psychomotor skill? (Select all that apply.)
| A. | Describe the process verbally. |
| B. | Write a description of the process. |
| C. | Give a reciprocal demonstration of the process. |
| D. | Ask questions about the process. |
| E. | Demonstrate the process to another person while the nurse supervises. |
| F. | State whether the patient feels the process has been mastered. |
ANS: C, E
| Feedback | |
| Correct | Having the patient demonstrate the process to the nurse or to another person is the best way to ensure that he can perform the skill correctly.
Having the patient demonstrate the process to the nurse or to another person is the best way to ensure that he can perform the skill correctly. |
| Incorrect | Having the patient describe the process is not sufficient.
Having the patient write a description of the process is not sufficient. Asking questions may reinforce learning but may also mask some deficiencies. Asking the patient whether he feels he has mastered the process is not sufficient. |
DIF:Cognitive Level: ComprehensionREF:54
TOP:Nursing Process Step: Evaluation
MSC: NCLEX Client Needs Category: Physiological Integrity
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