Health Literacy & Patient Education Chapter 14 Unit 9/10 Flashcards
- The nurse understands the unique ability of the patient to understand and integrate health-related knowledge is known by which term?
a. Health literacy
b. Formal patient education
c. Informal patient education
d. Primary education
a. Health literacy
ANS: A
The unique ability of a patient to understand and integrate health-related knowledge is known as health literacy. Formal patient education may be delivered throughout the community in the form of media, in a variety of educational and group settings, or in a planned, goal-directed, one-on-one session with a patient in the acute care setting. Informal education is usually learner or patient directed. Many health care consumers begin receiving information as children through their primary education. Handwashing, proper dental care, and nutrition are examples of early instructions.
- The nurse is caring for a 6-year-old patient in the emergency department who just had a full left leg cast placed for a fracture. As the nurse is reviewing the discharge instructions with the patient’s mother, she states, “You don’t have to go over those—I’ll read them at home.” What should the nurse do?
a. Contact the physician immediately.
b. Consider the possibility of health literacy limitations and assess further.
c. Stop the teaching, because the mother obviously has taken care of casts before.
d. Explain to the mother that reading the instructions with her is required.
Answer: b
A patient’s mother may have limited reading skills or health literacy and should be further assessed. Contacting the physician in this situation would not be appropriate because ensuring that the patient and family understand discharge instructions is the responsibility of the nurse. Assuming that the mother has taken care of casts in the past may be inaccurate. Stating that reading the instructions with the nurse is a requirement does not ensure that the patient or mother comprehends the instructions.
- A 58-year-old man is admitted for a small-bowel obstruction late Saturday night. The admitting orders include the need to place a nasogastric (NG) tube to low intermittent suction. During the assessment, the nurse determines that the patient does not speak English. Which action should the nurse take first before placing the NG tube?
a. Use two additional staff members when placing the tube so the patient can be restrained if needed.
b. Request an interpreter per facility protocol.
c. Do not place the NG tube because the physician would not want to frighten the patient.
d. Document the inability to place the NG tube due to lack of ability to communicate.
Answer: b
An interpreter employed by the hospital would be the best choice so that someone in the room can communicate and provide comfort for the patient. Taking additional staff into the room may increase the patient’s anxiety, thereby decreasing his ability to comprehend the instructions. Although the physician would not want to frighten the patient, the physician ordered the nasogastric (NG) tube for the benefit of the patient; therefore, it needs to be placed. Documenting the inability to place the NG tube due to lack of means of communication is not acceptable and does not ensure that the patient gets the needed treatment.
- Which nursing diagnoses are used in developing a patient teaching plan? (Select all that apply.)
a. Moral Distress
b. Lack of Knowledge
c. Difficulty Coping
d. Teaching about Disease
e. Anxiety
Answers: b
Lack of Knowledge and Literacy Problem are appropriate nursing diagnoses for use in developing a patient teaching plan. Moral Distress is a nursing diagnosis for those facing ethical decisions. Difficulty Coping is not a nursing diagnosis used in developing a teaching plan, but if a patient is not coping effectively, it may affect the ability to learn. A nursing diagnosis of Anxiety may affect the patient’s ability to learn but is not directly related to developing a teaching plan. Teaching about Disease is not a nursing diagnosis. It is an intervention performed by the nurse.
- Which nursing diagnosis is appropriate if a patient expresses an interest in learning?
a. Ready to Learn
b. Lack of Knowledge
c. Effective Information Processing
d. Health-Seeking Behaviors
Answer: a
A patient’s expression of an interest in learning would indicate correct use of the nursing diagnosis, Ready to Learn. Lack of Knowledge would indicate the patient has a deficiency of knowledge on a particular subject. Effective Information Processing is the patient’s ability to acquire useful information. Health-Seeking Behaviors is active seeking by a person of ways to alter habits to enhance health.
- A 61-year-old man is undergoing an emergency cardiac catheterization. The nurse gives his wife the registration paperwork to complete. Which observed actions may indicate a health literacy issue? (Select all that apply.)
a. Putting on glasses before beginning the paperwork.
b. Asking someone in the waiting area to read the forms to her.
c. Waiting until her daughter arrives to begin the paperwork so that her daughter can complete the forms.
d. Setting the clipboard aside and staring tearfully out the window.
e. Returning the forms only partially filled out, with missing or inaccurate information.
Answers: b, c, e
Asking someone else to read the form, waiting for help with the forms, and partially or inaccurately filling out forms are behaviors indicative of potential health literacy issues. Needing glasses does not correlate directly with health literacy. A tearful spouse requires additional assessment to see whether health literacy is a problem. The wife may be overwhelmed and feel unable to complete the forms, or she may need to collect her thoughts in the midst of a stressful time.
LO: 14.7
- Teaching a patient to use an incentive spirometer by demonstration, with a return demonstration by the patient, is an example of teaching based on which domain of learning?
a. Psychomotor
b. Affective
c. Psychosocial
d. Cognitive
Answer: a
Demonstration along with a return demonstration by the patient is an example of psychomotor domain learning. Affective domain learning integrates new knowledge by recognizing an emotional component. Psychosocial is not one of the domains of learning. Cognitive domain learning is based on knowledge and material that is remembered, memorized, and recalled.
- The nurse is providing home care to a 62-year-old woman who was recently diagnosed with insulin-dependent diabetes mellitus. What is the most important reason for the nurse to document the teaching session?
a. The patient’s insurance company requires documentation.
b. The nurse’s employer requires documentation of home care sessions.
c. Other members of the health care team need to know the patient’s progress.
d. Insulin is a potentially dangerous medication and needs to be documented.
Answer: c
Although the remaining options may be true, the primary reason for specific documentation of a patient’s progress in a teaching plan is to ensure that other nurses or members of other disciplines can pick up the teaching plan and know precisely what the patient has accomplished and where to begin additional sessions.
- Written instructions showing pictures of the steps necessary to test blood glucose, along with demonstration and a return demonstration of the steps, would most benefit which learners?
a. Affective
b. VARK
c. Psychomotor
d. Cognitive
Answer: c
Psychomotor learning involves physical movement and the use of motor skills such as demonstration and return demonstration. The affective domain involves emotion, and the cognitive domain is memorization and recall. VARK (verbal, aural, read/write, kinesthetic) refers to a method of assessing learning style.
- The nurse is providing care to an 88-year-old male patient who just returned from the recovery room after a right hip replacement. The nurse plans to teach the patient prevention techniques for deep vein thrombosis. What is the best time to provide teaching?
a. Do it right before the patient’s next intravenous pain medication.
b. Wait until tomorrow morning because he is in too much pain today.
c. Leave written materials on his over-the-bed tray that he can read at his convenience.
d. Wait until 10 to 15 minutes after his next intravenous pain medication.
Answer: d
Patients in pain are unable to focus on learning. Waiting 10 to 15 minutes after the administration of intravenous pain medication allows it to provide relief, but the patient is not sedated or resting soundly. Waiting until the following day is inappropriate because early intervention and prevention are necessary to avoid the development of deep vein thrombosis. Leaving important information where it can be easily covered up, set aside, or overlooked is not an effective method of patient education. The nurse should remember the concepts of health literacy and consider the potential effects of visual impairments, reading ability, and pain level in ensuring patient comprehension.
- A nursing instructor is explaining the teach-back method to nursing students on a medical-surgical unit. The instructor asks the students to identify benefits of using this method of patient education. Which should the students include in their response to their instructor? (Select all that apply.)
a. The teach-back method allows the nurse to determine understanding of information taught and to reteach if necessary.
b. The nurse can rephrase information to the patient if the patient is unable to repeat the information correctly.
c. The nurse can ask the patient to repeat information until it is determined that the patient has verbalized understanding of the information taught.
d. The nurse can teach the patient using pictures, videos, and examples.
e. The teach-back method can be used in any health care setting.
Answer: a, b, c, d, e
The teach-back method allows the nurse to determine understanding of information taught and to reteach if necessary by rephrasing the information, using pictures, videos, and examples if the patient is unable to repeat the information correctly. The nurse can ask the patient to repeat information until it is determined that the patient has verbalized understanding of the information taught. The teach-back method can be used in any health care setting.
- The patient is reportedly well educated and employed as an engineer but is struggling to comprehend terms found in health-related literature given to explain his disease process. The nurse recognizes that this is evidence of what issue?
a. Low literacy
b. Psychomotor dysfunction
c. Affective domain deficiency
d. Low health literacy
ANS: D
Although low literacy and low health literacy are related terms, they are not interchangeable. Low health literacy is content specific, meaning that the individual may not have difficulty reading and writing outside the health care arena. These patients may struggle to comprehend the complicated, unfamiliar terms and ideas found in health-related materials or instructions. The psychomotor domain incorporates physical movement and the use of motor skills in learning. Teaching the newly diagnosed diabetic how to check blood sugar is an example of a psychomotor skill. Affective domain learning recognizes the emotional component of integrating new knowledge. Successful education in this domain takes into account the patient’s feelings, values, motivations, and attitudes.
- To teach effectively, nurses must recognize which concept?
a. Age and socioeconomic status play a large role in understanding.
b. Patients come from diverse cultural and socioeconomic backgrounds.
c. The ability to comprehend is a very new concept in health care.
d. Most health care teaching is effective and understood.
ANS: B
To teach effectively, nurses must recognize that patients of all ages come from diverse cultural and socioeconomic backgrounds. Each has a different ability to comprehend health care information
- The nurse is preparing to discharge a patient home. In providing instruction about the patient’s medications, the nurse should make which statement?
a. “Before taking Metoprolol, you need to take your BP and rate.”
b. “MS should be taken only when needed for pain.”
c. “Take 1 baby aspirin by mouth every morning.”
d. “Take your water pill bid and you should be fine.”
ANS: C
Do not use abbreviations or medical terminology when providing patients with instructions.
- The nurse has established a teaching plan including goals and identifies this type of education is termed by what term?
a. Formal teaching
b. Informal teaching
c. Psychomotor teaching
d. Affective teaching
ANS: A
Formal patient education is delivered throughout the community in the form of media, in a variety of educational and group settings, or in a planned, goal-directed, one-on-one session with a patient in the acute care setting. Informal education is usually learner or patient directed. The psychomotor domain incorporates physical movement and the use of motor skills in learning. Teaching the newly diagnosed diabetic how to check blood sugar is an example of a psychomotor skill. Affective domain learning recognizes the emotional component of integrating new knowledge. Successful education in this domain takes into account the patient’s feelings, values, motivations, and attitudes.
- The nurse is admitting a patient who has cystic fibrosis. During the admission interview, it is apparent that the patient is well versed in most aspects of his illness. When asked about where he learned so much, the patient responds, “I learned most of it myself. I looked things up on the Internet and read books. You have to know what’s wrong with you to be sure that you’re being treated right.” The nurse knows this is an example of what type of education/learning?
a. Formal education
b. Psychomotor learning
c. Informal education
d. Affective learning
ANS: C
Informal education is usually learner or patient directed. Formal patient education is delivered throughout the community in the form of media, in a variety of educational and group settings, or in a planned, goal-directed, one-on-one session with a patient in the acute care setting. The psychomotor domain incorporates physical movement and the use of motor skills in learning. Teaching the newly diagnosed diabetic how to check blood sugar is an example of a psychomotor skill. Affective domain learning recognizes the emotional component of integrating new knowledge. Successful education in this domain takes into account the patient’s feelings, values, motivations, and attitudes.
- During patient teaching led by the nurse with goals established through cooperation of the nurse and patient, the patient asks questions as needed and the nurse answers. The nurse understands that this is what type of teaching?
a. Formal teaching
b. Informal teaching
c. Both formal and informal teaching
d. Psychomotor teaching
ANS: C
Some patient education sessions have formal and informal elements, because the nurse and patient may set goals together before the nurse formulates and implements the plan of care, and the patient is free to ask questions that may direct the session. The health care information is considered informal because it is situation and patient specific. Formal patient education is delivered throughout the community in the form of media, in a variety of educational and group settings, or in a planned, goal-directed, one-on-one session with a patient in the acute care setting. Informal education is usually learner or patient directed. The psychomotor domain incorporates physical movement and the use of motor skills in learning. Teaching the newly diagnosed diabetic how to check blood sugar is an example of a psychomotor skill.
Which one of these individuals would have a Low health Literacy?
A. an adult with a 3rd grade education
B. A infant who just said his first word
C. A scientific engineer who was just diagnosed with rheumatoid arthritis and has no idea what treatment would look like
D. an elderly patient with severe Alzheimers disease
C. A scientific engineer who was just diagnosed with rheumatoid arthritis and has no idea what treatment would look like
WHAT LEARNING DOMAIN WOULD THIS BE?
A patient who readily receives the information taught, responds to the nurse with active participation, and values the importance of the teaching session is operating in the BLANK
affective domain.
Affective domain learning recognizes the emotional component of integrating new knowledge. Successful education in this domain takes into account the patient’s feelings, values, motivations, and a itudes. Exploring these patient-specific a ributes enhances the value of the learned information.
