Unit 7.2: Health Promotion and Behaviour Change

• Topic 01

  Health Promotion Models

  45 questions
• Topic 02

  Brief Interventions

  48 questions
• Topic 03

  Motivational Interviewing Principles

  45 questions
• Topic 04

  Self-Management and Patient Education

  45 questions

A few questions from this unit, with the answer and a full explanation. The complete bank is available when you start practising.

1. A patient with heart failure has low health literacy and lives alone. Which combination of factors creates the most significant barriers to self-management that the nurse should prioritise addressing?

   • A
     Low functional health literacy (difficulty processing written information and instructions), social isolation (reduced peer support and practical help), and the complexity of heart failure monitoring (daily weighing, fluid restriction, multiple medications)
     Correct answer
   • B
     The patient's age and gender are the primary barriers; older male patients are known to have lower self-management capacity
   • C
     The primary barrier is the patient's unwillingness to engage; motivational interviewing should be used before any self-management education
   • D
     The main barrier is medication complexity; a medicines management review by a pharmacist would resolve all self-management difficulties
   Explanation

   This question requires integrating multiple barrier domains. Low health literacy means the patient cannot reliably read and process the written information typically provided about heart failure management (fluid restriction charts, weight monitoring diaries, medication schedules). Social isolation means there is no family or carer to support daily monitoring or recognise deterioration. The complexity of heart failure self-management (daily weight monitoring with a specific action threshold, fluid restriction, multiple medications with different dosing schedules) compounds both barriers.

   Effective nursing requires identifying and addressing all three domains through plain language, teach-back, social prescribing referrals, and action planning with confidence rating.

2. Which of the following best describes the teach-back method?

   • A
     The patient teaches the nurse about their own experience of managing their condition
   • B
     The nurse asks 'Do you understand?' after each piece of information to confirm comprehension
   • C
     The nurse asks the patient to explain the information back in their own words to confirm understanding, then re-explains if recall is incorrect
     Correct answer
   • D
     The nurse teaches the patient by demonstrating a skill, then asking the patient to repeat the demonstration
   Explanation

   The teach-back method involves asking the patient to explain back the information in their own words — for example, 'Just to make sure I explained this clearly, can you tell me how you would take this medication?' Incorrect recall prompts a re-explanation by the nurse, not blame of the patient.

   The method is also known as 'closing the loop.' Asking 'Do you understand?' is explicitly identified as an inadequate alternative because patients routinely answer yes even when they have not understood.

3. A nurse says to a patient 'You've shown real strength in coming in today to talk about something that clearly matters to you.' What MI skill is being used, and how does it differ from generic praise?

   • A
     Open question — the nurse is inviting the patient to elaborate on what matters to them
   • B
     Empathic statement — MI does not use the term affirmation; empathic statements are the correct terminology
   • C
     Simple reflection — the nurse is mirroring back the patient's own words without interpretation
   • D
     Affirmation — it is specific, genuine, and acknowledges the patient's personal quality (strength) and action (attending), unlike generic praise which is non-specific
     Correct answer
   Explanation

   This is an affirmation because it specifically acknowledges a genuine personal quality (strength) and a concrete action (attending the appointment).

   It is MI-consistent because it is specific and sincere, not a generic 'well done.' The distinction between affirmations and generic praise matters: generic praise is non-specific ('great job!') and can feel patronising. A complex reflection would reflect inferred emotion; a summary would collect multiple statements.