16 - Changing Health Behavior Using Health Education with Individuals, Families, and Groups

Question 1

What is the purpose of providing education across the three levels of prevention? Education:

a. ) enables clients to attain optimal health.
b. ) identifies and treats health problems early to eliminate disability.
c. ) enables populations to break into individuals.
d. ) teaches people about Healthy People 2020.

Answer 1

a.) enables clients to attain optimal health.

Health education enables clients to attain optimal health, prevent health problems, and identify and treat health problems early to minimize disability. Elimination of disability may not be possible. Health education does not teach about the Healthy People 2020 document or break populations into individuals.

Question 2

Which statement about education is true?

a. ) It emphasizes the provider of knowledge and skills.
b. ) It emphasizes the recipient of knowledge and skills.
c. ) It is a process of gaining knowledge and expertise.
d. ) It results in behavioral change.

Answer 2

a.) It emphasizes the provider of knowledge and skills.

Education is the establishment and arrangement of events to facilitate learning. Education emphasizes the provider’s role in providing knowledge and skills. Learning emphasizes the recipient of knowledge and skills. Education does not necessarily result in change, as change is typically not easy for most people. Education is designed to effect changes in the knowledge, skills, and attitudes, not necessarily expertise.

Question 3

A nurse uses Healthy People 2020 as a guide when planning health education in the community. Which of the following actions would be taken by the nurse?

a. ) Focus on avoiding cigarette smoking and using alcohol in moderation
b. ) Educate clients using primary and secondary levels of prevention
c. ) Use Bloom’s taxonomy when planning educational objectives
d. ) Design health fairs aimed at individuals

Answer 3

b.) Educate clients using primary and secondary levels of prevention

Healthy People 2020 focuses on implementing health promotion in priority areas using primary and secondary prevention. Understanding the three learning domains is crucial in providing effective health care. Health fairs targeted at specific populations can provide a venue for providing primary and secondary prevention.

Question 4

The cognitive domain includes:

a. ) changes in attitudes and the development of values.
b. ) the performance of skills.
c. ) memory, recognition, understanding, reasoning, and problem solving.
d. ) memorization of one set of skills before moving on to the next.

Answer 4

c.) memory, recognition, understanding, reasoning, and problem solving.

The cognitive domain includes memory, recognition, understanding, reasoning, and problem solving. The affective domain includes changes in attitudes and the development of values. The psychomotor domain includes the performance of skills that require some degree of neuromuscular coordination and emphasizes motor skills. Memorization of skills is only one part of the cognitive domain.

Question 5

A nurse is teaching a client about how to complete a wound dressing change. Which of the following conditions must be met before learning will occur?

a. ) Must be able to memorize the instructions, relay this information to a partner, and demonstrate the dressing change
b. ) Must master the dressing change at the time it is taught, repeat the demonstration for the nurse, and teach another person
c. ) Must be able to speak the language of the nurse, have time to practice the dressing change, and master the dressing change in a short time
d. ) Must have the necessary ability, a sensory image of how to carry out the dressing change, and an opportunity to practice the dressing change

Answer 5

d.) Must have the necessary ability, a sensory image of how to carry out the dressing change, and an opportunity to practice the dressing change

Before psychomotor learning occurs, the learner must have the necessary ability, a sensory image of how to carry out the skill, and an opportunity to practice the skill. This is the only option that contains all of the necessary requirements of the learner.

Question 6

A health educator is trying to change a client’s attitudes about smoking. Which of the following domains would be used?

a. ) Cognitive
b. ) Affective
c. ) Psychomotor
d. ) Developmental

Answer 6

b.) Affective

The affective domain is used to attempt to influence what individuals, families, communities, and populations feel, think, and value.

The cognitive domain includes memory, recognition, understanding, reasoning, and problem solving.

The psychomotor domain includes the performance of skills that require some degree of neuromuscular coordination and emphasizes motor skills.

Developmental domain is not one of the domains of learning.

Question 7

The nurse is teaching a new diabetic client how to give himself an insulin injection. Which of the following domains would be used?

a. ) Developmental
b. ) Cognitive
c. ) Affective
d. ) Psychomotor

Answer 7

d.) Psychomotor

The psychomotor domain includes the performance of tasks that require some degree of neuromuscular coordination and emphasizes motor skills. Developmental domain is not one of the domains of learning. The cognitive domain includes memory, recognition, understanding, reasoning, and problem solving. The affective domain is used to attempt to influence what individuals, families, communities, and populations feel, think, and value.

Question 8

A nurse is teaching a postpartum mother how to breastfeed her infant. The nurse notes that the mother is alert and agrees that breastfeeding is important to her and beneficial to her baby. The nurse outlines the expectations of breastfeeding for the mother and the baby. Considering the events of instruction, which of the following should the nurse do next?

a. ) Ask the mother about her previous experience with breastfeeding
b. ) Demonstrate how to position the baby for breastfeeding
c. ) Show the mother a video about breastfeeding
d. ) Have the mother demonstrate breastfeeding

Answer 8

a.) Ask the mother about her previous experience with breastfeeding

Asking the mother about her previous experience with breastfeeding identifies her educational needs. Using the TEACH mnemonic, the first thing the nurse should do is “Tune in”: listen before starting to teach; the client’s needs should direct the content. Thus, this should be done before the nurse does any demonstration, showing of audiovisual resources, or return demonstration.

Question 9

A nurse has evaluated the learning needs of a community support group. Which of following steps should the nurse take when developing an educational program for them?

a. ) Consider any potential barriers to learning
b. ) Establish goals and objectives for the program
c. ) Select appropriate materials for the program
d. ) Assess the dynamics of the group

Answer 9

b.) Establish goals and objectives for the program

Instructional objectives need to be evaluated before a teaching program is designed. The five steps of the educational process are: (1) identifying educational needs, (2) establishing educational goals and objectives, (3) selecting appropriate educational methods, (4) implementing the educational plan, and (5) evaluating the educational process.

Question 10

A nurse is developing a goal for a client who is learning how to care for an ostomy. Which of the following would be most appropriate to develop?

a. ) The client will look at his stoma without disgust each time his ostomy bag comes off.
b. ) The client will be able to independently take care of his ostomy bag within three months.
c. ) The client will gather all ostomy supplies correctly each time his ostomy bag needs to be changed.
d. ) The client will successfully describe to the nurse how to care for his ostomy when he is asked.

Answer 10

b.) The client will be able to independently take care of his ostomy bag within three months.

Goals are broad, long-term expected outcomes. The correct answer describes something that will happen over a long period of time. The other choices describe objectives.

Question 11

A community health nurse is writing an objective. Which of the following would be most appropriate for the nurse to write?

a. ) Each member of the family will give an insulin injection to the client with accurate dosage 100% of the time for 10 consecutive trials.
b. ) The client will perform a blood sugar test on herself with an accurate blood sugar reading.
c. ) The community will take their children to receive immunizations within 1 month of the immunization due date.
d. ) Fifty percent of the eligible women seen in the clinic will return for their scheduled

mammogram appointment.

Answer 11

a.) Each member of the family will give an insulin injection to the client with accurate dosage 100% of the time for 10 consecutive trials.

Objectives are specific, short-term criteria that need to be met as steps toward achieving the long-term goal. They are written as statements of an intended outcome or expected change in behaviors and should be defined in measurable terms. The objective “each member of the family will give an insulin injection to the client with accurate dosage 100% of the time for 10 consecutive trials” contains the components of a written objective. “The client will perform a blood sugar test on herself with an accurate blood sugar reading” does not provide any measureable terms. “The community will take their children to receive immunizations within 1 month of the immunization due date” does not provide a measurable percentage of the members of the community. “Fifty percent of the eligible women seen in the clinic will return for their scheduled mammogram appointment” focuses on a long-term goal, rather than a short-term objective and does not provide a time frame for when this would be measured.

Question 12

A nurse is using the educational process of selecting appropriate educational methods when planning a community health program. Which of the following steps of the nursing process does this action most resemble?

a. ) Assessment
b. ) Evaluation
c. ) Implementation
d. ) Planning

Answer 12

d.) Planning

Assessment would be identifying educational needs, evaluation would be evaluating educational process, and implementation would be implementing the educational plan. Planning is similar to selecting appropriate educational methods.

Question 13

A nurse is teaching a group of clients newly diagnosed with diabetes how to give themselves injections. Which of the following formats would be most appropriate for the nurse to use?

a. ) Demonstration
b. ) Health fair
c. ) Lecture
d. ) Non-native language session

Answer 13

a.) Demonstration

Demonstration also includes return demonstration. Giving injections can best be learned by seeing the behavior being done. Health fairs target specific populations and are held in a variety of locations. Non-native language sessions are a way to adapt the health fair to a population that does not speak English. Lecture is a non-interactive method of teaching.

Question 14

A nurse is implementing an educational program about the importance of being physically active. Which of the following steps would the nurse complete first?

a. ) Provide learning guidance
b. ) Present the stimulus
c. ) Gain the learner’s attention
d. ) Ask learners to recall prior learning

Answer 14

c.) Gain the learner’s attention

Gaining the learner’s attention must happen first before learning can take place. The following steps of implementation include telling the learners the objectives of the instruction, asking learners to recall previous knowledge, presenting the essential materials, helping the learners apply the information, encouraging learning to demonstrate what they have learned, and providing feedback to help learners improve their knowledge and skills.

Question 15

A nurse is implementing a community health education program at a local church. Which of the following educational principles should the nurse implement when providing this education?

a. ) Refer to trustworthy sources
b. ) Use an active voice
c. ) Create the best learning environment
d. ) Accentuate the positive health behaviors of the participants

Answer 15

c.) Create the best learning environment

The environment must be conducive to learning for educational programs to be effective. The environment should be free of distractions and consistent with the message. The other strategies may assist with the educational program, but are not one of the major educational principles discussed in the textbook.

Question 16

A nurse is working with a group of clients diagnosed with diabetes and is teaching a class about avoiding the long-term effects of diabetes. The nurse begins the class by reviewing the basic physiology of diabetes, which was taught the week before. Which of the following principles of effective education is the nurse using?

a. ) Stimulating recall of prior learning
b. ) Gaining attention
c. ) Presenting the material
d. ) Providing learning guidance

Answer 16

a.) Stimulating recall of prior learning

The educator should have the learners recall previous knowledge related to the topic of interest. The principle of gaining attention should have been applied as the program started the week before. Recall should be done before new material is presented and before learning guidance is provided.

Question 17

During a class on newborn care given at a local health department, a nursing student asks the participants to practice with baby dolls. Which of the following steps of promoting effective education is the student using?

a. ) Eliciting performance
b. ) Assessing performance
c. ) Enhancing retention and transfer of knowledge
d. ) Gaining attention

Answer 17

a.) Eliciting performance

The step of eliciting performance includes encouraging the learners to demonstrate what they have learned. Gaining attention occurs at the beginning of the program. Assessing performance occurs at the end of the program. Enhancing retention and transfer of knowledge occurs as the learners are asked to apply the information to their lives and situations (not to the care of the dolls).

Question 18

A nurse prepares for a presentation to a group of adults using strategies appropriate for adult learning. Which of the following concepts is being applied?

a. ) Authoritarianism
b. ) Learning style
c. ) Pedagogy
d. ) Andragogy

Answer 18

d.) Andragogy

Andragogy is a term and model developed by Malcolm Knowles to describe learning strategies for adult learners.

In pedagogy the teacher assumes full responsibility for making decisions about what will be learned, and how and when it will be learned.

In authoritarianism the leader controls group movement and progress through interpersonal power.

Learning style refers to how someone learns best.

Question 19

A nurse is working for a public health department as the community health educator. Which of the following is a potential barrier that a nurse may experience?

a. ) Working with clients with a low literacy level
b. ) Memorizing the information that is to be taught
c. ) Having a limited vocabulary
d. ) Lacking knowledge about how to gain participation

Answer 19

d.) Lacking knowledge about how to gain participation

Educators may lack knowledge about how to gain participation. Participation can be fostered by asking open-ended questions, inviting participation, and planning small-group activities whereby a person responds based on the group rather than presenting his own information. Clients with low literacy levels and limited vocabularies are considered to be a learner-related barrier, not a barrier of the educator. Memorizing the information to teach may cause problems with the presentation but would not be a barrier for the educator.

Question 20

A nurse is working with an individual who has a low literacy level. Which of the following barriers to learning should the nurse anticipate?

a. ) Asking for additional clarification of materials
b. ) Requesting to read the information later
c. ) Having a high level of anxiety
d. ) Being overly dependent on others

Answer 20

b.) Requesting to read the information later

Individuals with a limited literacy may have a limited vocabulary and general knowledge and do not ask for clarification. They may focus on details and deal in literal or concrete concepts versus abstract concepts. They may select responses on a survey without necessarily understanding them and may be unable to understand math. They may have a low motivation to engage in learning or may drop subtle clues that they cannot read by stating they will look at information later or take it home. The level of anxiety may vary among these individuals; it is more common for these individuals to request to read it later.

Question 21

A client diagnosed with diabetes reports to the nurse that she has been learning more about controlling her blood sugars by reading information found on the Internet. Which of the following statements by the nurse would be appropriate?

a. ) “Looking at the date the content was posted on the website is important.”
b. ) “The Internet is an unreliable source of information and should not be used.”
c. ) “The best sources of information are found on pharmaceutical websites.”
d. ) “Your physician will provide you better information than the Internet.”

Answer 21

a.) “Looking at the date the content was posted on the website is important.”

One of the ways to assess the reliability and validity of Internet sources is to look at its currency, including the dates when the content was posted and updated. The Internet has reliable information, but the quality of the information must be assessed. Pharmaceutical websites may have biased information. Physicians are another source of information, but this may or may not be better than what is found on the Internet.

Question 22

When a nurse is evaluating the components of an educational program. Which of the following best describes the action that is being taken by the nurse?

a. ) Short-term evaluation
b. ) Educational product
c. ) Process evaluation
d. ) Long-term evaluation

Answer 22

c.) Process evaluation

Process evaluation means looking at the components of an educational program. The educational product is the outcome of the educational process. Short-term evaluation evaluates the immediate effects of a health program. Long-term evaluation is geared toward following and assessing the status of an individual, family, community, or population over time.

Question 23

A nurse tells a coworker that she has been working on a regular basis with a group that demonstrates cohesion. Which of the following groups is the nurse most likely to describe?

a. ) A group with several leaders
b. ) A group with diverse attitudes and values
c. ) A group with a common goal
d. ) A group with efficient members

Answer 23

c.) A group with a common goal

Cohesion is the attraction between individual members and between each member and the group. Group effectiveness improves as members work together toward group goals while still satisfying the needs of individual members. A group with several leaders may have difficulty obtaining cohesion if each of the leaders has a different idea. Common attitudes and values among the group members will be important for the group to obtain cohesion. Efficiency does not play a role in developing cohesion.

Question 24

A nurse recognizes the importance of group norms when planning community health education. Which of the following provides the best explanation for why this is important?

a. ) Allow for creativity and variety among group members
b. ) Influence members’ perception of community
c. ) Are helpful in evaluating the effectiveness of the group
d. ) Maintain the group through various supports to members

Answer 24

d.) Maintain the group through various supports to members

Group norms serve to maintain the group through various supports to members. They are the standards that guide, control, and regulate individuals and communities. They suggest what a group believes is important, what it finds acceptable or objectionable, or what it perceives as of no consequence. Group norms may limit the creativity and variety among the group members. Members’ perception of the community could be influenced by group norms, but this is not why this consideration should be made when planning community health education. Group norms are not used to evaluate the effectiveness of the group.

Question 25

A group member has taken on the role of the “gatekeeper.” Which of the following actions would most likely be taken by this member?

a. ) Seek and accept the authority or direction of others
b. ) Guide and direct the group activity
c. ) Control outsiders’ access to the group
d. ) Focus the movement toward the main work of the group

Answer 25

c.) Control outsiders’ access to the group

The gatekeeper controls outsiders’ access to the group. The follower seeks and accepts the authority or direction of others. The leader guides and directs group activity. The task specialist focuses or directs movement toward the main work of the group.

Question 26

A nurse uses the leadership behavior of reflecting when providing education to community members about how to lead healthy lifestyles. Which of the following actions is most likely being taken by the nurse?

a. ) Providing feedback on how behavior appears to others
b. ) Introducing new topics to the group
c. ) Verifying information through questions and restatement
d. ) Highlighting important points from the discussion

Answer 26

a.) Providing feedback on how behavior appears to others

Reflecting involves giving feedback on how behavior appears to others. Advising introduces new topics. Clarifying verifies new information. Summarizing highlights the important points.

Question 27

A leader controls members through rewards and often keeps members in the dark about the goals and rationale behind prescribed actions. What type of leadership does this describe?

a. ) Democratic
b. ) Patriarchal
c. ) Socialist
d. ) Paternal

Answer 27

b.) Patriarchal

Patriarchal is authoritative, whereas one may control members through rewards and threats. Paternal leaders win respect and dependence through parent-like devotion. Democratic leadership is cooperative in nature and promotes and supports members’ involvement in all aspects of decision making and planning. Socialist leadership supports community ownership and involvement of the community.

Question 28

An established group requests a teaching and learning session on hypertension. Which of the following should the nurse expect with this type of group?

a. ) The group membership will change from week to week.
b. ) The members all have the same interests.
c. ) They prefer lectures rather than demonstrations.
d. ) The group already has operating methods that have been successful.

Answer 28

d.) The group already has operating methods that have been successful.

Nurses working with established groups should know that this type of group has membership ties and an existing structure that has proven to be successful. An established group would have a stable group membership. Learning occurs better in all groups with demonstrations instead of lectures. In an established group, they may be together because of a common interest, but may not share all of the same interests.

Question 29

A nurse is working with a group focused on improving the health of the community. Which of the following interventions should be used by the nurse?

a. ) Make decisions for the group to move the process along
b. ) Invite business leaders to participate in the group process
c. ) Maintain members through recognition and encouragement
d. ) Teach topics that are of national importance

Answer 29

c.) Maintain members through recognition and encouragement

Maintaining members is an important intervention to facilitate group process. The topics that are taught should be of importance to the group. The group should be part of the decision-making process. The membership of the group should be maintained, inviting new members to the group may hinder the processes of the group.

Question 30

Which Core Competency of communication is used by nurses engaged in group work?

a. ) Soliciting input from individuals and organizations
b. ) Using simple language when presenting information
c. ) Asking the group to develop the program of interest
d. ) Presenting material to lay audiences

Answer 30

a.) Soliciting input from individuals and organizations

Soliciting input from individuals and organizations is a communication competency. Various strategies should be used to present the information. The group should assist in determining the topic, but not developing the program. The material should be presented to professional and lay audiences.

Question 31

A nurse is planning to evaluate an individual’s progress toward a health goal. Which of the following components should be included in the evaluative process?

a. ) Type of teaching strategy used
b. ) Recognition of accomplishments in the group
c. ) Conflict that occurred in the group
d. ) The type of leadership in the group

Answer 31

b.) Recognition of accomplishments in the group

Recognition of accomplishments in the group and of the group is built into the evaluative process. The type of teaching strategies used, types of leadership, and conflict are not part of the evaluative process of the group.

Question 32

A nurse is using basic educational principles when conducting an effective educational program. Which of the following principles would the nurse most likely be using? (Select all that apply.)

a. ) Use a clear, succinct style
b. ) Use an active voice
c. ) Refer to Internet sources
d. ) Use aids to highlight key points
e. ) Repeat information several times

Answer 32

a.) Use a clear, succinct style

b.) Use an active voice

d.) Use aids to highlight key points

Using a clear, succinct style, active voice, and using aids to highlight key points are all basic educational principles that should be used by the nurse. Reliable sources must be used, and information found on the Internet is not always reliable. Repeating information is not an education principle.