Chapter 16 Flashcards
- A nurse diabetic educator who recently returned from a professional conference decides to present current best practices and research findings at a gathering of newly diagnosed diabetic clients. In adopting this approach, the nurse may fail to provide health education effectively. This failure would relate to which domain of learning?
a. Affective
b. Cognitive
c. Psychomotor
d. Practice
ANS: B : Cognitive
The domains of learning are the cognitive, affective, and psychomotor domains. For health education to be effective, the community-oriented nurse must first assess the cognitive abilities of the learner, so that the nurse’s expectations and plans are directed to the correct level. Teaching above or below the client’s level of understanding may lead to frustration and discouragement.
- 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 and presents the material. In terms of the sequencing of instruction, what 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. Have the mother demonstrate breastfeeding
d. Show the mother a video about breastfeeding
ANS: A : Ask the mother about her previous experience with breastfeeding
To facilitate skill learning, the nurse should teach and demonstrate the skill. The educator should allow learners to practice and immediately correct any errors in performing the skill. The basic sequence of instruction includes nine steps: gain attention, inform the learner of the objectives, stimulate recall of prior learning, present the material, provide learning guidance, elicit performance, provide feedback, assess performance, and enhance retention and transfer of knowledge.
- Which objective includes all of the critical elements of an educational objective?
a. After attending the diabetic education class, the client will prepare a meal plan.
b. At the end of self-management training, the client will prepare a daily food plan that meets the 1800-calorie per day American Diabetes Association (ADA) diet guidelines.
c. The diabetic client will prepare a list of the five food groups and the number of servings from each group that are necessary for an 1800-calorie diet following ADA guidelines.
d. The client and his wife will attend all of the diabetic education classes to learn to prepare meals consistent with ADA diet guidelines.
ANS: B : At the end of self-management training, the client will prepare a daily food plan that meets the 1800-calorie per day American Diabetes Association (ADA) diet guidelines.
Objectives are specific, short-term criteria that need to be met as steps toward achieving a long-term goal. Objectives are written statements of an intended outcome or expected change in behavior and should define the minimum degree of knowledge or ability needed by the client. They must be stated clearly and defined in measurable terms. Objectives are different from goals, which are broad, long-term, expected outcomes.
- A nurse integrates a structured exercise into her classroom presentation on effective handwashing that assists students in demonstrating and modeling good handwashing techniques. The principle followed by an effective educator that is best demonstrated by this approach is:
a. create the best learning environment.
b. encourage participatory learning.
c. organize the learning experience.
d. select the learning format.
ANS: B : encourage participatory learning
There are six principles that guide the effective educator: send a clear message, select the learning environment, create the best learning experience, organize the learning experience, encourage participatory learning, and provide evaluation and feedback. People learn better when they are actively involved in the learning process. Participation increases motivation, flexibility, and the learning rate.
- A clinic-based public health nurse (PHN) has launched an aggressive community health education media campaign to increase the number of fully immunized children within the health district. Which evaluation process would best assess the impact of this strategy at the overall community level?
a. Analysis of the immunization clinic appointment rate over the next few months
b. Analysis of the trend in childhood immunization rates for the health district
c. Assessment of the immunization status of each child who visits the clinic
d. Determination of the budgetary impact of the media campaign on the clinic’s operations
ANS: B : Analysis of the trend in childhood immunization rates for the health district
The evaluation of health and behavioral changes can focus on both short-term and long-term effects. Long-term evaluation is geared toward following and assessing the lasting effects of the education program. Long-term evaluation is often the approach used by community health nurses to analyze the effectiveness of an education program for the entire community, not the health status of a specific individual client. Understanding the impact of the educational program in producing change in the community health status allows the health district to make wise choices in addressing the community’s needs.
- A nurse is working with an established group of parents of children with special needs. Several parents continually express frustration with the health care system and feelings of powerlessness to address their needs. The nurse uses group techniques to validate their experiences and explore options for action. The nurse reacts in this way to conflict within the group because conflict:
a. means the group leader must ask the persons causing the conflict to excuse themselves from future meetings.
b. means those with the dissenting opinion will change their stand to be more in line with the rest of the group.
c. should be avoided.
d. supports individual and group growth and change.
ANS: D
The groups to which people belong influence health behavior. Through participation with others, meaning is confirmed, confounded, contradicted, or compromised. This is how social reality is created. Nurses frequently use groups to help individuals within a community. When conflict occurs in a group, the resulting tension can help move the group toward its goals. Group members are most effective and productive when conflict is acknowledged and individual concerns are expressed in a manner that respects other members of the group. Effective groups promote collaboration and support expression and resolution of conflict.
- The nurse recommends Parents Without Partners to a colleague who is experiencing the challenges of single parenthood in raising a teenager. The nurse is demonstrating an understanding of the group elements of:
a. cohesion and task functioning.
b. leadership and role structure.
c. member interaction and group purpose.
d. norms and maintenance.
ANS: C : member interaction and group purpose.
Health-promoting groups may form when people meet in community and health care settings and discover common challenges to their physical and mental well-being. People often make changes with the support of a group that they are unable to make independently. Health-promoting groups like Alcoholics Anonymous and Parents Without Partners improve members’ health and deal with specific threats to health.
- A nurse helping to form a group to deal with ongoing industrial pollution within a community understands that effective groups:
a. are larger and comprised of recognized community leaders.
b. can have individuals with diverse interests and yet be influential in changing the larger community.
c. must include members of all involved parties, including political, corporate, health, and environmental leaders.
d. should be small with informal leadership and relationships within the group.
ANS: B : can have individuals with diverse interests and yet be influential in changing the larger community.
Groups of individuals with diverse interests can influence and change the larger social community. Alliances or coalitions unite diverse interest groups who share a common interest in perceived threats to community health, and nurses may work with groups both for community analysis and vehicles for change.
- A group of six nurses is charged by the nurses’ manager with evaluating current unit policies. One month later, the manager determines that the group is ineffective because of lack of cohesiveness. Which of the following group concerns or behaviors would be indicative of lack of cohesion? (Select all that apply.)
a. Complaints about the degree of member participation
b. Dissatisfaction about demands on their schedules
c. Complaints about lack of administrative support
d. Lack of a work plan for accomplishing the task
e. Vying for leadership
ANS: A, B, C, D, E
Cohesion is the attraction between individual group members and between each member and the group that allows them to identify themselves as a unit and work toward common goals, endure frustration for the sake of the group, and defend the group against outside criticism. This attraction increases when members feel accepted and liked by others, see similar qualities in one another, and share similar attitudes and values. Members of a highly cohesive group work toward their common goal, identify with the group, are willing to endure frustration to meet their goals, and recognize the needs of individual members.
- A group’s culture is created by the combination of its norms. The nurse supports helpful rules, attitudes, and behaviors in the group because group norms do which of the following? (Select all that apply.)
a. Challenge the cohesiveness of the group
b. Ensure movement toward the group’s purpose and tasks
c. Identify message pathways and member participation
d. Influence members’ perceptions and interpretation of
reality
e. Maintain the group through various supports to members
ANS: B, D, E
Group norms set the standards for group members’ behaviors, attitudes, and perceptions. All groups have norms and mechanisms to accomplish conformity. Group norms serve three functions: they ensure movement toward the group’s purpose and tasks (task norms), they maintain the group through various supports to members (maintenance norms), and they influence members’ perceptions and interpretations of reality (reality norms). Group norms combine to create group culture. Nurses working with groups should not dictate norms but support helpful rules, attitudes, and behaviors within the group. The role of the nurse becomes one of providing accurate information, confirming the possibility/attainability of the group’s goals, and encouraging different/positive perspectives.
