Clinical Guidelines in Family Practice 5th Edition Uphold Graham - Test Bank

Clinical Guidelines in Family Practice 5th Edition Uphold Graham – Test Bank

 

Instant Download – Complete Test Bank With Answers

 

 

Sample Questions Are Posted Below

 

Chapter 1 Health maintenance

MULTIPLE CHOICE

1.A client is reviewing a videotape without the assistance of the nurse for instruction. The type of

teaching strategy this client is using is considered:

1. demonstration.
2. slides.
3. programmed instruction.
4. discussion.

ANS: 3

Programmed instruction is often referred to as canned presentation and is intended for use

without the nurse. Demonstration, slides, and discussion require a nurse to be present.

PTS: 1 DIF: Analyze REF: Teaching Strategies: Programmed Instruction

2.The nurse is instructing a client regarding food safety, injury prevention, and occupational

health. Which of the following Healthy People 2010 objectives is the nurse instructing the client?

1. Promote healthy behaviors
2. Promote healthy and safe communities
3. Improve systems for personal health and public health
4. Prevent and reduce diseases and disorders

ANS: 2

This objective addresses instruction that focuses on the health and safety of communities such as

food safety, prevention of injury, and occupational health. Promoting healthy behaviors would

include weight reduction and smoking cessation. Improve systems for personal health and public

health would include immunization programs. Prevent and reduce diseases and disorders would

 

include instruction on screening programs, physician visits, and routine health maintenance care.

PTS: 1 DIF: Analyze REF: Health Promotion on a Global Level

3.A client has inadequate resources and impairment of personal support systems. Which nursing

diagnosis would apply to this patient?

1. Noncompliance
2. Deficient knowledge
3. Ineffective health maintenance
4. Health-seeking behavior

ANS: 3

Defining characteristics for ineffective health maintenance includes impairment of personal

support systems, observed inability to take responsibility for meeting basic health practices,

demonstrated lack of knowledge, failure to recognize important symptoms reflective to altered

health status, lack of health-seeking behaviors, and inadequate resources. Inadequate resources

and impairment of personal support systems would not support the nursing diagnoses of

Noncompliance, Deficient Knowledge, or Health-Seeking Behavior.

PTS:1DIF:Apply

REF: Box 3-3 Defining Characteristics for Ineffective Health Maintenance

4.While planning care for a client, the nurse identifies content that would address the clients

diagnosis of Deficient Knowledge. The nurse will ensure time is allocated for client instruction

because:

1. the client cannot be discharged without it.
2. it is a legal component of the nursing process.
3. it is a nice thing to do for a client.
4. the physician has written an order for instruction.

 

ANS: 2

Patient education is a legal component of the nursing process that was identified in the Patients

Bill of Rights. Patient education is a necessary function of nursing care. The client could be

discharged without receiving instructions. Education is not done because it is a nice thing to do

for a client. Client education does not necessitate a physicians order.

PTS:1DIF:ApplyREFatient Education

5.The nurse is engaged in an information teaching session with a client. Which of the following

would be appropriate to instruct during an informal teaching session?

1

.

Expected effects of a new medication

2

.

Instruction on leg exercises to be used after surgery

3

.

How to use an incentive spirometer

4

.

Diet and medications to manage a new diagnosis of diabetes mellitus

ANS: 1

Instruction can be either informal or formal. Informal instruction occurs intermittently and

frequently during the course of client care. These instructions are simple, relate to the disease

process, and answer client questions. Providing the expected effects of a new medication is a

type of information instruction. Formal instructions are deliberate with specific goals and an

evaluation process. Instructing on postoperative leg exercises, the use of an incentive spirometer,

and diet and medications to manage a new health diagnosis are all examples of formal

instruction.

PTS: 1 DIF: Apply REF: Formal and Informal Patient Education

6.The nurse is planning a presentation to a group of senior citizens as part of a wellness program.

Which of the following topics would be appropriate for the nurse to instruct this client

population?

 

1. Importance of taking medications as prescribed
2. Ways to follow a physicians treatment plan
3. Ease of changing an abdominal dressing
4. Strategies to reduce salt in the diet and increase activity

ANS: 4

Some educational topics can be instructed in a group setting. Strategies to reduce salt intake and

increase activity are two topics that would be appropriate for a group instruction. The other

choices are appropriate for individual instruction.

PTS: 1 DIF: Apply REF: Individual and Group Patient Education

7.A client is considering several changes in personal habits to improve his health. Which of the

following critical thinking strategies can the nurse use to help this client?

1

.

Ask the client to identify his goals to improve his health.

2

.

Remind the client that the physician has to approve all changes in his health

improvement plan.

3

.

Suggest the client wait until he is discharged before planning to make personal

habit changes.

4

.

Recommend that immediate changes are made to confuse the bodys responses.

ANS: 1

Critical thinking is a self-directed, deliberate, self-corrected, results-oriented reasoning process

that strives to problem-solve client care issues by combining logic, intuition, and creativity. The

goal of critical thinking is to assist clients to use what they already know and work with the

client to make changes that they identify through self-discovery. Asking the client to identify

goals to improve health is one strategy that the nurse can use when implementing critical

thinking with client education. The other choices do not support critical thinking with client

 

education.

PTS: 1 DIF: Apply REF: Critical Thinking and Patient Education

8.A client has several identified learning needs. Which of the following should the nurse assess

prior to planning instruction for this client?

1. Home address
2. Clients learning style
3. Living arrangements
4. Financial resources

ANS: 2

Areas to include in the assessment of a clients learning needs include the clients ability to learn,

style of learning, information about a health condition, cultural background, and other

information as required. The clients home address, living arrangements, and financial resources

are not a part of a clients assessment of learning needs.

PTS: 1 DIF: Apply REF: Patient Education and the Nursing Process

9.Which of the following teaching strategy would best support a client who needs to learn how to

self-administer insulin injections?

1. Discussion
2. Role-playing
3. Demonstration
4. Programmed instruction

ANS: 3

Demonstration is a practical strategy used when teaching a new skill such as self-injection of

insulin. Discussion is an exchange of information and does not provide an opportunity for the

client to learn a new skill. Role playing allows the client to apply knowledge in a simulated

 

environment. This strategy does not support learning a new skill. Programmed instruction is

intended for use without the nurse. This strategy does not support learning a new skill.

PTS:1DIF:ApplyREF:Teaching Strategies

10.A client tells the nurse that she uses audio CDs in her vehicle when driving to and from work

to keep current with educational requirements for her job. The nurse would assess this client as

preferring which type of learning style?

1. Auditory
2. Visual
3. Kinesthetic
4. Anesthetic

ANS: 1

The client who learns by hearing prefers an auditory learning style. The client who learns by

reading uses a visual learning style. The client who learns by doing or touching is using a

kinesthetic learning style. Anesthetic is not a type of learning style but rather a medication used

for surgery.

PTS:1DIF:AnalyzeREF:Teaching Strategies

11.The nurse is attempting to instruct a client on ways to eliminate smoking. The client tells the

nurse that he has no health problems because of smoking and does not understand why he needs

to quit. Which of the following is interfering with the nurses ability to instruct the client in health

promotion behaviors?

1. Motivation
2. Perception
3. Self-image
4. Maintenance

 

ANS: 2

Perception is a clients sense and understanding of his current health status. If the client does not

perceive a problem with current health maintenance activities, the nurse should not intervene at

this time. Motivation is the internal drive or external stimulus to perform an action or thought.

Maintenance is practicing a new behavior for an extended period of time. The clients self-image

is not interfering with the nurses ability to instruct the client in health promotion behaviors.

PTS: 1 DIF: Analyze REF: Characteristics of Health Maintenance

12.The nurse is planning instruction to support health promotion behaviors. Which of the

following clients would benefit the most from these instructions?

1. 60-year-old client diagnosed with type 2 diabetes mellitus
2. 83-year-old client with hypertension
3. 75-year-old client recovering from a total hip replacement
4. 35-year-old client desiring to begin an exercise program

ANS: 4

Health promotion interventions are for healthy individuals and are intended to maximize their

health status. The 35-year-old client who wants to begin an exercise program would benefit from

health promotion instruction. The other clients are considered to be ill and would not benefit

from instruction in health promotion behaviors.

PTS:1DIF:AnalyzeREF:Health Promotion

13.The nurse and client have determined that goals established for health maintenance behaviors

have not been achieved. In which step of the nursing process are the nurse and client working at

this time?

1. Evaluation
2. Assessment
3. Planning
4. Implementation

 

1. Evaluation
2. Assessment
3. Planning
4. Implementation

ANS: 1

The nurse and client together measure how well the client has achieved the goals for health

maintenance in the plan of care. Goals that have not been achieved are evaluated and adjusted.

This is an activity done during the evaluation step of the nursing process. Evaluation of goals is

not done during the assessment, planning, or implementation steps of the nursing process.

PTS: 1 DIF: Analyze REF: Evaluation of Outcomes

MULTIPLE RESPONSE

1.A client is demonstrating behaviors consistent with normal health maintenance. Which of the

following has this client demonstrated? (Select all that apply.)

1. Motivation
2. Health encouragement
3. Readiness
4. Maintenance
5. Health activities
6. Perception

ANS: 1, 4, 6

The three characteristics of health maintenance are: 1) perception, 2) motivation, and 3)

maintenance. Health encouragement, readiness, and health activities are not behaviors consistent

with normal health maintenance.

PTS: 1 DIF: Analyze REF: Characteristics of Health Maintenance

2.The nurse is planning an instructional session with a client. When planning this session, the

nurse should incorporate which teaching/learning principles? (Select all that apply.)

 

1. Assessment of how the client organizes knowledge
2. Motivation and self-efficacy
3. Setting goals
4. Developmental level of the client
5. Time management
6. Self-engagement

ANS: 1, 2, 3, 4, 6

Principles of the teaching/learning process include how knowledge is organized by the learner,

self-motivation and self-efficacy, setting measurable goals, developmental level of the learner,

and self-engagement. Time management is not a teaching/learning principle.

PTS:1DIF:Apply

REF: Patient Education and Teaching/Learning Principles

3.The nurse is planning client instruction interventions to support critical thinking. Which of the

following are characteristics of critical thinking in the client education process? (Select all that

apply.)

1. Organized
2. Clearly explained with examples
3. Vague
4. Task-oriented
5. Knowledge-oriented
6. Moral and ethically focused

ANS: 1, 2, 5, 6

Characteristics of critical thinking with client education include organized and clearly explained

with the use of examples, aimed at positive health outcomes, is knowledge-oriented, and is

 

focused on making moral and ethical decisions. Critical thinking is not vague nor task-oriented.

PTS: 1 DIF: Analyze REF: Table 3-1 What is Critical Thinking?

4.The nurse is utilizing the technique of motivational interviewing to instruct a client on ways to

limit alcohol intake. Which of the following are techniques used when implementing

motivational interviewing? (Select all that apply.)

1. Express empathy
2. Develop discrepancy
3. Avoid arguing
4. Roll with resistance
5. Support self-efficacy
6. Contract for goal achievement

ANS: 1, 2, 3, 4, 5

Motivational interviewing has five specific techniques: 1) expressing empathy, 2) developing

discrepancy, 3) avoiding argument, 4) rolling with resistance, and 5) supporting self-efficacy.

Contracting for goal achievement is not a technique of motivational interviewing.

PTS: 1 DIF: Apply REF: Motivational Interviewing

5.Which of the following self-examination techniques is a health maintenance behavior for the

nurse to instruct a client? (Select all that apply.)

1. Breast self-examination
2. Capillary blood glucose testing
3. Testicular self-examination
4. Skin examination
5. Application of hydrocortisone cream for a skin disorder
6. Elevating edematous lower extremities

 

3. Testicular self-examination
4. Skin examination
5. Application of hydrocortisone cream for a skin disorder
6. Elevating edematous lower extremities

ANS: 1, 3, 4

Physical self-examination is a health maintenance behavior that does not require any special

equipment but requires proper instruction on the correct procedure. Examples of selfexaminations

that a nurse can instruct a client include breast self-examination, testicular selfexamination,

and skin examination. Capillary blood glucose testing needs the use of a

glucometer. Application of hydrocortisone cream is a medication used for a diagnosed skin

disorder. Elevating edematous lower extremities is an intervention for a peripheral vascular or

cardiac disorder.