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The nurse would identify an opportunity for a “teaching moment” in the situation of a patient who:

A.

is packing belongings in preparation for discharge.

B.

says, "How will I remember all the things about my new diet?"

C.

has just returned from surgery for a deviated septum.

D.

has just been told of the malignancy of his tumor.

Answer and Explanation

The Correct Answer is B

A. is packing belongings in preparation for discharge. Although discharge is an appropriate time for patient education, it may be too late to introduce complex information that requires practice or understanding. Teaching moments often occur earlier in the care process.

 

B. says, "How will I remember all the things about my new diet?" This is an ideal teaching moment as the patient is expressing concern and showing readiness to learn about the diet. The nurse can use this moment to provide guidance on strategies to remember dietary instructions.

 

C. has just returned from surgery for a deviated septum. Immediately post-surgery, the patient may be under the influence of anesthesia or pain medication, limiting their ability to absorb information. Teaching at this time may not be effective.

 

D. has just been told of the malignancy of his tumor. Right after receiving bad news, patients may experience shock, grief, or distress, making it difficult for them to process additional information. This may not be the right time for education.


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Correct Answer is D

Explanation

A. Actions of the nurse are appropriate since his neighbor is his confidante, and the neighbor has assured him the information provided will not be shared. Confidentiality must be maintained regardless of assurances from others; sharing patient information outside a professional context is a violation of privacy.

B. Nurse has not violated the confidentiality of the patient because the patient is terminal; sharing this information will not harm the patient. Confidentiality must be maintained regardless of the patient's condition. Privacy and confidentiality are ethical requirements for all patients, terminal or otherwise.

C. Nurse is actively promoting nursing as a profession, and it is important to share information that might encourage others to pursue a nursing career. While promoting the profession is valuable, using a patient’s personal information is inappropriate and unprofessional. There are ethical ways to promote nursing without breaching confidentiality.

D. Nurse has violated the confidentiality of the patient by discussing personal information about the patient with his neighbor. Sharing patient information with someone who is not involved in the patient’s care violates HIPAA and confidentiality standards. This action is unprofessional and unethical.

Correct Answer is D

Explanation

A. Include another person in the instruction because an 82-year-old person will be unable to master the technique. This is an assumption based on age and is incorrect. Age alone does not determine learning ability; many older adults are fully capable of learning new skills.

B. Provide written material and diagrams alone. While written materials are helpful, they should be supplemented with hands-on practice and guidance, especially for skill-based learning.

C. Speed through the details because age and experience will shorten learning time. Older adults may actually require a slower pace to absorb new information, particularly for complex tasks.

D. Slow the pace and frequently ask questions to assess comprehension. Slowing the pace and asking questions helps ensure the patient has the time needed to process the information and provides the nurse with feedback on understanding.

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