Psychosociocultural Nursing Care
3. Anxiety is a common and universal response to a threat. Every time people
experience something new that is a threat to the identity or self-esteem, they may feel anxious. Anxiety is a psychosocial response to an unknown stress; it may be a vague sense of apprehension at one extreme to impending doom at the other extreme.
4. Anxiety is a response to a threat to the ego, not the id.
38. 1. This is an example of rationalization.
Rationalization is used to justify in some socially acceptable way ideas, feelings, or behavior through explana- tions that appear to be logical.
2. This is not an example of sublimation.
Sublimation is the channeling of primitive sexual or aggressive drives into activities or behaviors that are more socially accept- able, such as sports or creative work.
3. This is not an example of undoing.
Undoing is use of actions or words in an attempt to cancel unacceptable thoughts, impulses, or acts. This reduces feelings of guilt through reparation (atonement, retribution).
4. This is not an example of denial. Denial is an unconscious protective response that involves a person’s ignoring or refusing to acknowledge something unacceptable or unpleasant to reduce anxiety.
39. 1. This statement best reflects the dimen- sion of self-esteem. Self-esteem is a person’s self-evaluation of one’s own worth or value. A person whose
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Teaching and Learning
KEYWORDS
The following words include nursing/medical terminology, concepts, principles, and information relevant to content specifically addressed in the chapter or associated with topics presented in it.
English dictionaries, nursing textbooks, and medical dictionaries, such as Taber’s Cyclopedic Med- ical Dictionary, are resources that can be used to expand your knowledge and understanding of these words and related information.
Behavior modification
Continuing education program Feedback
Focus group
Inservice education program Learning domains:
Affective:
Receiving Responding Valuing Organizing Characterizing Cognitive:
Acquisition Comprehension Application Analysis Synthesis Evaluation Psychomotor:
Set
Guided response Mechanism
Complex overt response Adaptation
Origination
Locus of control:
External Internal Motivation
Orientation program Pre-test/Post-test Readiness Reading level Reinforcement Teaching:
Formal Informal Teaching methods:
Active learning Audiovisual aids Case study
Computer-assisted instruction Demonstration
Discussion Lecture
Programmed instruction Return demonstration Role-playing
Simulation Written material
QUESTIONS
1. A nurse is evaluating a patient’s learning regarding nutrition. Which behavior reflects the highest level of learning in the cognitive domain?
1. Modifies favorite recipes by eliminating foods that have to be avoided 2. Evaluates the benefits associated with avoidance of certain foods 3. States why a mother’s diet may affect breast-feeding
4. Identifies a list of foods to be avoided
2. What is the primary reason why nurses attend continuing education programs?
1. Update professional knowledge 2. Network within the nursing profession 3. Fulfill requirements for an advanced degree 4. Graduate from an accredited nursing program
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3. A nurse is designing a teaching-learning program for a patient who is to be dis- charged from the hospital. What should the nurse do first?
1. Identify the patient’s locus of control
2. Use a variety of teaching methods appropriate for the patient 3. Formulate an achievable, measurable, and realistic patient goal 4. Assess the patient’s current understanding of the content to be taught 4. A nurse is to provide nutritional counseling for an older adult. What should the
nurse do first?
1. Plan educational sessions in the late afternoon 2. Speak louder when talking
3. Provide large-print books 4. Assess for readiness
5. A nurse is teaching an older adult how to perform a dressing change. Which nursing action is most important to address a developmental stress of aging?
1. Speak louder when talking to the patient 2. Use terminology understandable to the patient 3. Have the patient provide a return demonstration 4. Allow more time for the patient to process information
6. A nursing instructor is evaluating a student nurse’s knowledge. Which student behavior indicates that learning has occurred in the highest level of learning in the cognitive domain?
1. Identifies the expected properties of urine 2. Explains the importance of producing urine 3. Recognizes when something is contaminated
4. Interprets laboratory results of diagnostic urine testing
7. A patient asks the nurse, “What does 96 indicate when my blood pressure is 140 over 96?” What is the best response by the nurse?
1. “The 96 is the pressure within an artery when the heart is resting between beats.”
2. “The 96 reflects the lowest pressure within a vein when blood moves through it.”
3. “Everyone is different so it’s really relative to each individual what it means.”
4. “Let’s talk about the concerns you may have about your blood pressure.”
8. A nurse is planning a weight reduction program with an obese patient. What should the nurse anticipate will be the most important component that will determine the success or failure of this plan?
1. Rewarding compliant behavior with favorite foods 2. Encouraging at least 1 hour of exercise daily 3. Using an 800-calorie daily dietary regimen 4. Setting realistic goals
9. A nurse is providing health teaching for a patient with a comprehension deficit.
Which is the best intervention by the nurse that will support this patient’s learning?
1. Establishing a structured environment 2. Asking that unclear words be repeated 3. Speaking directly in front of the patient 4. Making a referral for a hearing evaluation
10. A nurse is teaching a patient recently diagnosed with diabetes mellitus the step-by- step procedure of administering an insulin injection. However, after two sessions the patient is still reluctant to self-administer the insulin. What should the nurse do?
1. Have the patient administer the injection to an orange 2. Keep reinforcing the principles that have been presented
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11. Every person who attended a smoking cessation educational program completed a questionnaire. What is this type of evaluation called?
1. Survey 2. Post-test 3. Case study 4. Focus group
12. A patient is readmitted to the hospital because of complications resulting from nonadherence to the prescribed health-care regimen. What should the nurse do first?
1. Encourage healthy behaviors 2. Develop a trusting relationship
3. Use educational aids to reinforce teaching
4. Establish why the client is not following the regimen
13. A nurse is teaching a patient with a hearing impairment. What should the nurse do?
1. Limit educational sessions to 10 minutes 2. Provide information in written format 3. Use at least 2 teaching methods 4. Teach in group settings
14. A nurse is assessing the results of dietary teaching for a patient with diabetes mellitus.
What patient behavior indicates that learning occurred in the affective domain?
1. Discusses which food on the ordered diet must be avoided 2. Eats the food on the special diet ordered by the physician 3. Compiles a list of foods that are permitted on the diet 4. Asks about which foods can be eaten
15. A nurse educator designed various educational programs that employ role-playing as a teaching strategy. Which group of people should the nurse anticipate will benefit the most from role-playing?
1. Older adults preparing to retire from the workforce
2. Men unwilling to admit that they have a drinking problem 3. Adolescents learning to abstain from recreational drug use 4. Middle-aged adults preparing for total-knee replacement surgery 16. To be most effective, at what grade reading level should the nurse prepare
educational medical material?
1. Fourth-grade 2. Eighth-grade 3. Tenth-grade 4. Sixth-grade
17. A nurse uses computer-assisted instruction as a strategy when providing preoperative teaching. The nurse explains to preoperative patients that the greatest advantage of computer-assisted instruction is that:
1. Learners can progress at their own rate 2. It is the least expensive teaching strategy
3. There are opportunities for pre- and post-testing 4. Information is presented in a well-organized format
18. Which behavior identified by the nurse indicates the highest level of learning in the psychomotor domain?
1. Demonstrating a well-balanced stance with crutches
2. Identifying the correct equipment that is needed for a colostomy irrigation 3. Performing a dry sterile dressing change without contaminating the equipment 4. Recognizing the difference between systolic and diastolic blood pressure sounds
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19. A nurse is assessing a patient’s readiness to learn about smoking cessation. Which patient factor does the nurse consider is most important when determining if a teaching program is needed by the patient?
1. Previous experience 2. Perceived need 3. Expectations 4. Flexibility
20. A nurse is teaching a preschool-age child. What teaching method is most appropriate for the nurse to use when teaching a child in this age group?
1. Demonstrations 2. Coloring books 3. Small groups 4. Videos
21. A nurse is attending a class about a new intravenous pump presented by the hospital staff education department. What is this type of educational program?
1. Continuing education program 2. Inservice education program 3. Certification program 4. Orientation program
22. A nurse is planning teaching about weight reduction strategies to an obese patient.
Before implementing the teaching plan the nurse first should assess the patient’s:
1. Intelligence 2. Experience 3. Motivation 4. Strengths
23. A nurse is planning to engage a patient in a program to learn about a newly diagnosed illness. Which psychosocial response to the illness will have the greatest impact on the patient’s future success with learning?
1. Fear 2. Denial 3. Fatigue 4. Anxiety
24. A nurse must implement a teaching plan for a patient recently diagnosed with heart failure. What should the nurse do first?
1. Identify the patient’s level of recognition of the need for learning 2. Frame the goal within the patient’s value system
3. Determine the patient’s preferred learning style 4. Assess the patient’s personal support system
25. A teaching-learning concept basic to all teaching plans is to present content from the:
1. Cognitive to the affective domain 2. Formal to the informal
3. Simple to the complex 4. Broad to the specific
26. A nurse is planning a teaching plan for an older adult. Which common factor among older adult patients must be considered by the nurse?
1. Learning may require more energy 2. Intelligence decreases as people age
3. Older adults rely more on visual rather than auditory learning
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27. A nurse is teaching a postoperative patient deep breathing and coughing exercises.
Which method of instruction is most appropriate in this situation?
1. Explanation 2. Demonstration 3. Video presentation 4. Brochure with pictures
28. A nurse is teaching a patient colostomy care in relation to the affective domain.
Which teaching method is most effective for this situation?
1. Discussing a pamphlet about colostomy care from the American Cancer Society 2. Exploring how the patient feels about having a colostomy
3. Providing a demonstration on how to do colostomy care 4. Showing a videotape demonstrating colostomy care
29. A school nurse is teaching a class of adolescents about avoiding smoking and includes role-playing as a creative learning activity. What is the primary reason for using role-playing?
1. Provides more fun than other methods 2. Eliminates the need for media equipment 3. Requires active participation by the learner
4. Gives the learner the opportunity to be another person
30. A culturally competent nurse is planning to teach a patient about a new regimen of self-care. What must the nurse assess first about the patient before implementing the teaching plan?
1. Religious affiliation 2. Support system 3. National origin 4. Health beliefs
31. A nurse is assessing a patient to determine educational needs. Which is most important for the nurse to consider?
1. Make no assumptions about the patient 2. Teaching may be informal or formal in nature
3. The teaching plan should be documented on appropriate records 4. A copy of the teaching/learning contract should be given to the patient
32. A nurse is preparing a patient with a colostomy for discharge. What patient outcome indicates that learning has occurred in the psychomotor domain?
1. Accepts the need to have a colostomy
2. Understands why certain foods should be avoided 3. Verbalizes the rationale for daily colostomy irrigations 4. Changes a colostomy bag without contaminating the hands
33. Which word best describes the nurse’s role when functioning as a teacher?
1. Provide 2. Comfort 3. Empower 4. Collaborate
34. The unit secretary tells the nurse that the practitioner has just ordered a low-calorie diet for a patient who is overweight. Place these nursing interventions in the order in which they should be implemented.
1. Verify the dietary order 2. Determine food preferences
3. Teach specifics about a low-calorie diet 4. Review a meal plan designed by the patient 5. Assess the patient’s motivation to follow the diet Answer:
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35. Which best describes a patient with an external locus of control? Select all that apply.
1. _____ Behaving appropriately to obtain the right to watch a television program 2. _____ Is self-motivated when implementing health promotion behaviors 3. _____ Wants to please family members with efforts to get well
4. _____ Understands the expected outcome of therapy 5. _____ Is a self-actualized adult
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ANSWERS AND RATIONALES
3. Goal setting is accomplished after the nurse gathers essential information that will influence the goal, particularly in relation to the achievable and realistic factors of a goal.
4. Learners bring their own lifetimes of