Chapter 025

Potter & Perry: Fundamentals of Nursing, 7th Edition
Test Bank
Chapter 25: Client Education
MULTIPLE CHOICE
1. The client has been informed that he can be discharged once he can irrigate his colostomy
independently. The client requests the nurse to observe his irrigation technique. Which of
the following learning motives is the client displaying?
1. Physical need
2. Social activity
3. Task mastery
4. Evaluation stance
ANS: 3
Task mastery motives are based on needs such as achievement and competence. The
client who must demonstrate irrigating his colostomy independently in order to be
discharged is displaying the learning motive of task mastery. A physical motive may be
seen in the client who desires to return to a level of physical normalcy. A social motive is
the need for connection, social approval, or self-esteem. An evaluation stance would be
determining whether the outcomes of the teaching-leaning process met the clients goal.
Evaluation is not a learning motive.
DIF: A
REF: 366-367
OBJ: Comprehension
TOP: Nursing Process: Evaluation
MSC: NCLEX test plan designation: Safe, Effective Care Environment
2. An industrial nurse is planning to give an informative talk on hypertension to employees
in honor of heart month. He plans to teach individuals how to take their blood pressure
measurements. Which information is important for him to ask the planning committee
before this presentation?
1. Ages of all employees involved
2. Names of employees who are married
3. Number of employees with high blood pressure
4. Type of room available and number of participants
ANS: 4
The number of persons being taught, the need for privacy, the room temperature, the
room lighting, noise, the room ventilation, and the room furniture are important factors
when choosing the setting. The ideal setting helps the client focus on the learning task.
Knowing the specific ages of all the people involved is not as important as providing an
environment conducive to learning. It is not necessary to know the names of employees
who are married to teach individuals how to take their blood pressure. Whether an
employee has high blood pressure should not be as important to the teacher as providing
an environment conducive to learning. Having high blood pressure may be a motivating
factor for employees to learn how to take their blood pressure, because of its personal
relevance.
Mosby items and derived items 2009, 2005 by Mosby, Inc., an affiliate of Elsevier Inc.
Test Bank
25-2
DIF: A
REF: 369
OBJ: Comprehension
TOP: Nursing Process: Planning
3. The nurse established the following objective for the client who was unable to void: The
clients intake will be at least 1000 mL between 7 AM and 3:30 PM. Feedback showing
success is indicated by the client:
1. Voiding at least 1000 mL during the shift
2. Verbalizing abdominal comfort without pressure
3. Having adequate fluid intake and urinary output
4. Drinking 240 mL of fluid five or six times during the shift
ANS: 4
The nurse evaluates success by observing the clients performance of each expected
behavior. Feedback indicating success in this situation is the client drinking 240 mL of
fluid five or six times during the shift. This would be a fluid intake of 1200-1440 mL,
meeting the objective of at least 1000 mL during the designated time period. Voiding at
least 1000 mL is not the objective. The objective is to have the client drink at least 1000
mL. Verbalizing abdominal comfort without pressure is not an evaluation of the objective
regarding specific fluid intake. Having adequate intake and output is not accurate
feedback indicating success. The term adequate is not quantified.
DIF: A
REF: 381
OBJ: Comprehension
4. There are a variety of teaching methodologies fro a nurse to choose from to use with
clients. For a toddler, the nurse should use:
1. Role-playing
2. Problem-solving
3. Independent learning
4. Simple explanations and pictures
ANS: 4
Effective teaching methodologies for the toddler include simple explanations and picture
books that describe a story of children in a hospital or clinic. Role-playing is an
appropriate teaching methodology for the preschooler. Problem-solving is an appropriate
teaching methodology for the adolescent. Independent learning is best used as a teaching
methodology for the young or middle adult.
DIF: A
REF: 368
OBJ: Comprehension
Test Bank
25-3
5. The nurse has important information to share with a parent who has brought his child to
the emergency department. The nurse discovers that the parent, who appears very
anxious, has just learned his son will require surgery. The most effective teaching
approach in this situation is:
1. Telling
2. Trusting
3. Participating
4. Group teaching
ANS: 1
The telling approach is useful when limited information must be taught. If a client is
highly anxious but it is vital for information to be given, telling can be effective. The
entrusting approach provides the client the opportunity to manage self-care. The nurse
observes the clients progress and remains available to assist without introducing more
new information. This would not be the most effective teaching approach in this situation.
Participating involves the nurse and client setting objectives and becoming involved in
the learning process together. This would not be the most effective teaching approach in
this emergency situation. Group teaching would not be the most effective teaching
approach in this situation. A person who is anxious would benefit more from individual
instruction.
DIF: A
REF: 376
OBJ: Comprehension
6. A client, after being taught of the clinical manifestations of inflammation to enable early
detection of a complication of a surgical wound states, I will look at the wound four
times a day and tell my surgeon if it looks red or swollen. Her statement is an example
of:
1. Attitudes
2. Application
3. Analysis
4. Evaluation
ANS: 2
Application involves using abstract, newly learned ideas in a concrete situation. The
client who is taught the clinical manifestations of inflammation and who will assess for
signs such as redness or edema is using newly learned information in a concrete manner.
Attitude has to do with affective learning. The client is not expressing an attitude, but is
applying new knowledge in a concrete way. Analysis involves breaking down
information into organized parts. The client is not demonstrating analysis. Evaluation is a
judgment of the worth of a body of information for a given purpose. The client is not
expressing judgment.
DIF: A
REF: 365
OBJ: Comprehension
Test Bank
25-4
7. The client continues to ask questions about a surgical wound. The client states, I think I
would like help the first time I look at my wound. This is an example of:
1. Adaptation
2. Perception
3. Organizing
4. Guided response
ANS: 4
A guided response is the performance of an act under the guidance of an instructor. The
client who is seeking help is demonstrating a guided response. Adaptation occurs when a
person is able to change a motor response when unexpected problems arise. The client is
not exhibiting adaptation. Perception is being aware of objects or qualities through the
use of sense organs. This situation is not an example of perception. Organizing is
developing a value system by identifying and organizing values and resolving conflicts.
This situation is not an example of organizing.
DIF: C
REF: 449
OBJ: Comprehension
TOP: Nursing Process: Assessment
8. There are many factors are assessed before teaching the client to learn insulin injection
sites, but the most important factor for the nurse to assess first is the:
1. Previous knowledge level of the client
2. Willingness of the client to want to learn the injection sites
3. Financial resources available to the client for the equipment
4. Intelligence and developmental level of the individual client
ANS: 2
If a person does not want to learn, it is unlikely that learning will occur. Motivation is the
first factor the nurse should assess before teaching. To determine learning needs, the
nurse should assess the clients previous knowledge level. However, this would not be the
most important factor for the nurse to assess first. Assessing the financial resources
available to the client for obtaining equipment is important; however, it is not the most
important factor for the nurse to assess first. Assessing the clients physical and cognitive
ability to learn is important. However, it is not the most important factor for the nurse to
assess first.
DIF: A
REF: 364
OBJ: Comprehension
9. The nurse is demonstrating to the client how to put on anti-embolitic stockings. In the
middle of the lesson the client asks, Why have my feet been swelling? The nurse stops
and responds to the client. Which of the following is the teaching principle that the nurse
should follow?
1. Timing
Test Bank
25-5
2. Setting priorities
3. Building on existing knowledge
4. Organizing the teaching materials
ANS: 1
The nurse who stops a demonstration of applying anti-embolitic stockings to answer a
clients question is following the teaching principle of timing. If the client has a question,
it is important to answer the question immediately, so the client may return his or her
focus to the task being taught. Setting priorities is important to conserve the time and
energy of the client and nurse. The nurse who stops to answer a question is not setting
priorities. A client learns best on the basis of preexisting cognitive abilities and
knowledge. This situation is not an example of building on existing knowledge.
Organizing teaching materials means the nurse considers the order of information to
present. This is not an example of organizing teaching materials.
DIF: A
REF: 375
OBJ: Comprehension
TOP: Nursing Process: Implementation
10. Clients give various responses to teaching sessions. For the nurse, an example of an
evaluation of a psychomotor skill is:
1. Client states side effects of a medication
2. Client responds appropriately to eye contact
3. Client independently plans an exercise program
4. Client demonstrates the proper use of a walking cane
ANS: 4
Determining whether the client is able to demonstrate a newly learned skill is an example
of an evaluation of a psychomotor skill. Psychomotor learning involves acquiring skills
that require the integration of mental and muscular activity, such as walking with a cane.
Having the client state side effects of a medication is an example of an evaluation of
cognitive learning. Determining whether a client responds appropriately to eye contact is
an example of evaluation of affective learning. The client who planned an exercise
program is demonstrating cognitive learning.
DIF: A
REF: 366
OBJ: Comprehension
11. Different topics are presented in the information sessions that are held in the outpatient
clinic. In planning for a session on health maintenance/illness prevention, the nurse
should select a topic on:
1. Use of assistive devices, such as canes
2. Self-help devices for post-CVA clients
3. Stress management techniques for working parents
4. Environmental alterations for clients in wheelchairs
ANS: 3
Test Bank
25-6
Stress management techniques for working parents is an appropriate topic for health
maintenance/illness prevention. Use of assistive devices, such as canes, is not a health
maintenance/illness prevention topic. It is a coping with impaired function topic. Selfhelp devices for post-CVA clients is not a health maintenance/illness prevention topic. It
is a coping with impaired function topic. Environmental alterations for clients in
wheelchairs is not a health maintenance/illness prevention topic. It is a coping with
impaired function topic.
DIF: A
REF: 362
OBJ: Comprehension
12. The nurse is evaluating the responses of clients to teaching sessions. An example of an
evaluation of a clients attainment of a cognitive skill is:
1. Client explains that the medication should be taken with meals
2. Client looks at the surgical incision without requiring prompting
3. Client uses crutches appropriately to move both up and down stairs
4. Client independently capable of dressing self after eating breakfast
ANS: 1
The client who is able to explain that the medication should be taken with meals is
demonstrating attainment of a cognitive skill. The client who is able to look at the
surgical incision without prompting is demonstrating attainment of affective learning.
The client who uses crutches appropriately is demonstrating attainment of a psychomotor
skill. The client who dresses self after breakfast is most likely demonstrating attainment
of psychomotor learning.
DIF: A
REF: 365
OBJ: Comprehension
13. The nurse evaluates which of the following statements as an indication that the client is
not ready to learn at this time?
1. I need to understand more about the reason for the colostomy.
2. I will find out more about that when the support group meets.
3. Theres no sense in showing me that now. Im too sick right now.
4. Please be sure to tell me if I am completing all the steps correctly.
ANS: 3
Readiness to learn is related to the stage of grieving. This response by the client is
demonstrating anger. The client is unwilling to learn at this time. The client has not yet
reached the acceptance state of grieving in which learning can occur. This statement
indicates the client is ready to learn and desires to find out more to gain understanding.
This statement indicates the client is willing to learn. The client who requests feedback is
expressing readiness to learn.
DIF:
REF: 362
OBJ: Comprehension
Test Bank
25-7

14. In planning to teach an older adult client, the nurse should incorporate which teaching
method or principle into the plan?
1. Keep teaching sessions short.
2. Teach in the early morning or late evening.
3. Put as much as possible into each teaching session.
4. Focus on teaching a family member or caregiver instead.
ANS: 1
Keeping teaching sessions short is an appropriate method when teaching an older adult
client. The older adult should be taught when the client is alert and rested, not early
morning or late evening. The teaching session should not be filled with numerous topics.
The older adult client is capable of learning and should be the focus. A family member or
caregiver may be included in teaching, but the older adult client should not be excluded.
DIF: A
REF: 376
OBJ: Comprehension
15. The nurse has completed an assessment on the client and identified the following nursing
diagnoses. Which one of the following nursing diagnoses indicates a need to postpone
teaching that was planned?
1. Activity intolerance related to pain
2. Ineffective management of treatment regimen
3. Noncompliance with prescribed exercise plan
4. Knowledge deficit regarding impending surgery
ANS: 1
Pain, fatigue, or anxiety can interfere with the ability to pay attention and participate. The
nursing diagnosis of activity intolerance related to pain indicates a need to postpone
teaching. Teaching may be delayed until the nursing diagnosis is resolved or the health
problem is controlled. Ineffective management of treatment regimen does not indicate a
need to postpone teaching. Ineffective management of treatment regimen reinforces the
need for teaching. Noncompliance with prescribed exercise plan does not indicate a need
to postpone teaching. The client who is noncompliant may require further teaching.
Knowledge deficit regarding impending surgery does not indicate a need to postpone
teaching. A knowledge deficit reinforces the need for teaching.
DIF: A
REF: 366
OBJ: Comprehension
16. There are a variety of teaching methodologies that may be utilized to meet the clients
needs. Which teaching method is best applied to a cognitive learning need?
1. Modeling of behavior
Test Bank
25-8
2. Discussion of feelings
3. Computer-assisted instruction
4. Demonstration of a procedure
ANS: 3
An independent project such as computer-assisted instruction is an appropriate teaching
method for cognitive learning. Modeling of behavior is an appropriate teaching method
for psychomotor learning. Discussion of feelings is an appropriate teaching method for
affective learning. Demonstration is an appropriate teaching method for psychomotor
learning.
DIF: A
REF: 365
OBJ: Comprehension
17. For a functionally illiterate client, the nurse particularly focuses on:
1. Using intricate analogies and examples
2. Avoiding lengthy return demonstrations
3. Incorporating familiar nonmedical terminology
4. Providing longer learning sessions with the client
ANS: 3
When teaching a functionally illiterate client, the nurse should use simple terminology,
avoiding medical jargon. The nurse should incorporate familiar terminology to enhance
the clients understanding. The nurse should use simple analogies and real life examples.
The nurse should ask for return demonstrations as this provides the opportunity to clarify
instructions and time to review procedures. Although teaching sessions may be kept
short, they should be scheduled at more frequent intervals.
DIF: A
REF: 378-379
OBJ: Comprehension
18. In preparing a teaching plan for adult clients in a cancer support group, the nurse
incorporates evidence-based information. The nurse recognizes that evidence obtained
about adult learners has identified that this group prefers:
1. Computer-assisted instruction
2. Traditional classroom settings
3. Long sessions with plenty of technical information
4. Interesting personal communication techniques
ANS: 4
Test Bank
25-9
Adults have a wide variety of personal and life experiences to employ. Therefore adult
learning is enhanced when they are encouraged to use these experiences to solve
problems. Evidence-based information indicates that adult clients prefer interactive,
personal communication with nurses or physicians. Evidence-based information indicates
computer-assisted learning is not a preferred method of instruction by many adult
learners. As clients become more comfortable with computers, this preference may
change. Evidence-based information indicates that not all clients are comfortable in class
settings or in support groups. Other educational opportunities should be available. Adult
learners prefer short teaching sessions without a great deal of technical information.
DIF: A
REF: 369
OBJ: Comprehension
19. While teaching the client about management of his heart disease, a nurse might use a
strategy that is implemented to promote learning in the affective domain such as:
1. Asking the client what he believes he needs to know about the diagnosis
2. Providing brochures both on current exercises and on nutrition guidelines
3. Encouraging the client to personally discuss his feelings about his health status
4. Having the client return-demonstrate self-measurement of his own blood pressure
ANS: 3
An intervention to promote learning in the affective domain would be encouraging the
client to discuss his feelings about his health status. Asking the client what he believes he
needs to know about the diagnosis would be an intervention to promote learning in the
cognitive domain. Providing brochures on current exercises and nutrition guidelines
would be an intervention to promote learning in the cognitive domain. Having the client
return-demonstrate self-measurement of his blood pressure would be an intervention to
promote learning in the psychomotor domain.
DIF: A
REF: 365
OBJ: Comprehension
20. The nurse is preparing to present a teaching session on skin protection for a group of
older adults at a senior center. A principle that has been found to be most effective in
teaching older adults is:
1. Moving the group along at a predetermined pace
2. Providing information in longer teaching sessions
3. Speaking very slowly and in a louder tone of voice
4. Beginning and ending each session with important information
ANS: 4
Test Bank
25-10
The nurse should begin and end each teaching session with important information
because clients are more likely to remember information that is taught early in the
teaching session, and key points can be summarized at the end. Repetition also reinforces
learning. The group should not be moved along at a predetermined pace. Clients may
have questions that would go unanswered if there were a predetermined pace. Or,
sometimes teaching sessions have to be stopped after the nurse observes a clients loss of
concentration such as nonverbal cues of poor eye contact or slumped posture. Shorter
(approximately 20 minutes), frequent sessions are more easily tolerated and retain the
clients interest in the material. The nurse should face the client and speak in a low tone
of voice for the older adult with a hearing problem.
DIF: A
REF: 380-381
OBJ: Comprehension
21. The nurse is preparing the discharge teaching materials on newly prescribed drugs to a
client diagnosed to be in the early stage of Alzheimers disease. The nurse best deals with
the clients cognitive deficits by:
1. Providing written material to supplement the discussion
2. Arranging for family to be present during the discussion
3. Presenting the material in two short but focused sessions
4. Requiring the client to restate the information in her own words
ANS: 2
The clients family needs to understand and accept many changes in the patients physical
and/or cognitive capabilities. The familys ability to provide support results in part from
education, which begins as soon as the nurse identifies the clients needs and the family
displays a willingness to help. The remaining options may support retention of material
but not as effectively as including family in the educational sharing.
DIF: C
REF: 381
OBJ: Analysis
22. The nurse recognizes that the clients teaching plan is most directly driven by:
1. The clients identified learning needs
2. The complexity of the clients health needs
3. The clients readiness and motivation to learn
4. The presence of cultural or physical barriers
ANS: 1
Teaching is most effective when it responds to the learners needs. While assessing and
diagnosing a clients health care problems, the nurse identifies the need for education that
in turn generates the teaching plan. The remaining options reflect factors that will affect
both the teaching plan and the clients learning.
DIF:
REF: 363
OBJ: Analysis
Test Bank
25-11

23. The nurse recognizes that the primary goal of a clients teaching plan is to:
1. Facilitate a knowledge-based client decision-making process
2. Provide information that brings about informed client consent
3. Enhance the clients sense of personal control regarding his or her health care
4. Therapeutically affect the clients health, wellness, and independence
ANS: 4
Creating a well-designed, comprehensive teaching plan that fits a clients unique learning
needs ultimately helps clients make informed decisions about their care and results in
clients becoming healthier and more independent. The remaining options affect the
primary goal by enhancing decision making, providing for informed consent, and
bringing about a sense of personal control.
DIF: C
REF: 363
OBJ: Analysis
24. Which of the following teaching topics is an example of health maintenance and
promotion and illness prevention?
1. Glucose monitoring at home
2. Living with rheumatoid arthritis
3. Stress managements impact on depression
4. What to expect after hip replacement surgery
ANS: 1
Promoting healthy behavior through education allows clients to assume more
responsibility for their health. Greater knowledge results in better health maintenance
habits. When clients become more health conscious, they are more likely to seek early
diagnosis of health problems. The remaining options address restoration of health and
coping with impaired functioning, whereas stress management is a topic that relates to the
promotion of health and the prevention of illness.
DIF: A
REF: 362-363
OBJ: Comprehension
25. Which of the following teaching topics is an example of restoration of health?
1. Glucose monitoring at home
2. Living with rheumatoid arthritis
3. Stress managements impact on depression
4. What to expect after hip replacement surgery
ANS: 4
Test Bank
25-12
Injured or ill clients need information and skills to help them regain or maintain their
levels of health. The remaining options address health maintenance and promotion and
illness prevention and coping with impaired functioning while what to expect after hip
replacement surgery is a topic that relates to the restoration of health and function.
DIF: A
REF: 363
OBJ: Comprehension
26. Which of the following actions is the primary nursing responsibility regarding client
education?
1. Providing accurate, current, relevant information
2. Answering the clients questions regarding health-related issues
3. Assessing the individual clients readiness and motivation to learn
4. Identifying areas where clients are in need of educational information
ANS: 1
Nurses have an ethical responsibility to teach their clients (Redman, 2005, 2007). The
information needs to be accurate, complete, and relevant to the clients needs. The
remaining options are factors that affect learning and so require the nurses attention but
are not as primary as providing information that is accurate, current, and relevant to the
clients needs.
DIF: C
REF: 363
OBJ: Analysis
27. When a client newly diagnosed with type 2 diabetes mellitus assumes responsibility for
checking her blood glucose level four times a day, this is an example of:
1. Cognitive learning
2. Affective learning
3. Impaired learning
4. Psychomotor learning
ANS: 4
Psychomotor learning involves acquiring skills that require the integration of mental and
muscular activity. The remaining options are involved with expression of feelings and
acceptance of attitudes, opinions, or values or the acquisition of knowledge. Impaired
learning involves alteration to the normal learning process that requires alterations in
methods and techniques.
DIF: A
REF: 366
OBJ: Comprehension
Test Bank
25-13
28. When a client newly diagnosed with type 2 diabetes mellitus selects a lunch menu that
correlates with the number of carbohydrates he is allowed for that meal, this is an
example of:
1. Cognitive learning
2. Affective learning
3. Impaired learning
4. Psychomotor learning
ANS: 1
Cognitive learning includes all intellectual behaviors and requires thinking. The
remaining options are involved with expression of feelings and acceptance of attitudes,
opinions, or values or acquiring skills that require the integration of mental and muscular
activity. Impairing learning involves alteration to the normal learning process that
requires alterations in methods and techniques.
DIF: A
REF: 365
OBJ: Comprehension
29. Which of the following statement best reflects the nurses appropriate attention to a
clients need for self-efficacy?
1. What can I do to help you lose the weight?
2. Are you really ready to start a regular exercise regimen?
3. After you watch me demonstrate this inhaler, you will have no problems using it
at all.
4. Come on; with all the self-help products out there, you will be able to stop
smoking.
ANS: 3
Self-efficacy refers to a persons perceived ability to successfully complete a task. When
people believe that they are able to execute a particular behavior, they are more likely to
actually perform the behavior consistently and correctly. Although the other options are
related to behavioral change to achieve a goal, they do not support the client by both
encouragement and providing the skills necessary to be successful.
DIF: C
REF: 367
OBJ: Analysis
30. A client has been recently told that the primary cancer has metastasized, and the cancer is
considered terminal. When the nurse offers to discuss palliative care options, the client
replies, Im going to have the reports reevaluated by another doctor; I feel fine and I
think a mistake has been made. The nurse recognizes this response as:
1. Anger
2. Disbelief
3. Bargaining
4. Acceptance
Test Bank
25-14
ANS: 2
In this example, the client avoids discussion of the illness, choosing to believe a mistake
has been made. The remaining options are other stages of the grieving process.
DIF: A
REF: 368
OBJ: Comprehension
31. A client has been recently told that the primary cancer has metastasized and the cancer is
considered terminal. When the nurse offers to discuss palliative care options the client
replies, I cant understand why you all want to upset me by bringing the topic up. Now
please just leave me alone. The nurse recognizes this response as:
1. Anger
2. Disbelief
3. Bargaining
4. Acceptance
ANS: 1
In this example, the client blames others and complains. The client often directs anger
toward the nurse or others. The remaining options are other stages of the grieving
process.
DIF: A
REF: 368
OBJ: Comprehension

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