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Concept 5: Motivation
1. The nurse is assessing a patients personal traits using the Influential Characteristics on Motivation tool. What assessment parameters will be included in this assessment?
Developmental, cognitive, and educational levels; emotional readiness; actual or perceived state of health or illness
Psychologic availability, readiness of health care system, and level of difficulty and ambiguity of task
Cultural expectations and customs and emotional ties such as love, intimacy, and sexual gratification
Available human and physical resources and accessibility of health care facility
Developmental, cognitive, and educational levels; emotional readiness; and actual or perceived state of health or illness are all personal motivational traits. Psychologic availability, readiness of health care system, and level of difficulty and ambiguity of task are environmental factors. Cultural expectations and customs and emotional ties such as love, intimacy, and sexual gratification are relationship motivators. Available human and physical resources and accessibility of health care facility are environmental motivators.
REF: 44 OBJ: NCLEX Client Needs Category: Psychosocial Integrity
2. The nurse is developing a plan of care for a newly diagnosed hypertensive patient who is being discharged on medications and given the Dietary Approaches to Stop Hypertension (DASH) diet to follow. What statement by the patient signals to the nurse that the patient is motivated to learn?
I am sure the medications will help to bring down my blood pressure.
I cant wait to try the new recipes, and Im hopeful I will lose weight.
Do I really need to follow the diet and take medications?
I have my parents to blame for this. They both have high blood pressure.
A patient who is motivated will see what the benefits of following the teaching will do for them. The patient who believes medications are the only solution may not be motivated to follow the prescribed diet. Blaming the parents for their condition does not show accountability or motivation for change.
OBJ: NCLEX Client Needs Category: Physiological Integrity and Physiological Integrity: Physiological Adaptation
3. The nurse is assessing intrinsic motivational levels of a patient who just had knee replacement surgery. Which behaviors would indicate that the patient is intrinsically motivated?
Agrees to take blood thinners as prescribed because that is what the doctor prescribed
Verbalizes an understanding of taking blood thinners postop to reduce risk of clotting
Knows that exercise and physical therapy (PT) will help speed recovery
Enjoys exercise and PT, asks for pamphlets to learn about rehab techniques
A patient who enjoys exercise is intrinsically motivated. Taking medication as prescribed and verbalizing an understanding are extrinsic motivators. Exercising to promote healing is an example of extrinsic motivation.
REF: 41 OBJ: NCLEX Client Needs Category: Physiological Adaptation
4. The nurse is trying to help an obese diabetic patient who has 30 pounds to lose. The nurse is setting weight loss goals that the patient will attain. Which goals would most likely cause an increase in motivation in this patient?
Follow American Diabetic Diet, lose 2 pounds a week, and 20 pounds in 2 months.
Follow American Diabetic Diet, lose .5 pounds a week, and 5 pounds in 2 months.
Follow American Diabetic Diet, lose 1 pound a week, and 10 pounds in 2 months.
Follow American Diabetic Diet, lose 3 pounds a week, and 30 pounds in 2 months.
Losing 1 pound a week is a moderately hard goal which should motivate the patient. Two pounds is too hard and may cause the patient to become discouraged. Half a pound is too easy and may not be perceived as a challenge. Three pounds is too hard, and the patient may become discouraged.
REF: 42 OBJ: NCLEX Client Needs Category: Health Promotion and Maintenance
5. The nurse is working with the interprofessional team to develop a plan of care for a patient who had a myocardial infarction 5 days ago and is about to go home. The team has decided to focus in-home rehabilitation on medications, regaining strength, and losing weight. What interventions will be in the initial plan of care if this patient is motivated by power?
Develop a plan of exercise and weight loss that is assertive and entails beating the previous weeks goal.
Develop a plan of exercise and weight loss that is slow and gradually increases.
Develop a plan of exercise and weight loss that enacts consequences if the plan is not followed.
Develop a plan of exercise and weight loss that involves rewards and positive reinforcement from the health care team.
It is important to be assertive with persons who are power motivators, because this will increase their chances of successful rehabilitation. Affiliative motivation is geared towards rewards and support and also slow, gradual changes. Avoidance motivation entails showing the person what will happen if they do not follow the treatment plan.
OBJ: NCLEX Client Needs Category: Physiological Integrity: Reduction of Risk Potential
6. A patient expresses a strong interest in returning to their work, family, and hobbies after having a stroke. Which theory type would the nurse use to develop a plan of care for the best results of this patients motivation style?
Cognitive theorists believe that attention, relevance, confidence, and satisfaction (ARCS) are the conditions that, when integrated, motivate someone to learn. Field theorists place significance on how achievement, power, the need for affiliation, and avoidance motives influence individual behavior. Sociologic theories are not involved in motivation.
REF: 44-45 OBJ: NCLEX Client Needs Category: Health Promotion and Maintenance
7. The nurse is assessing a patients readiness to be discharged. What is the most appropriate question for the nurse to ask to determine the patients learning needs before planning teaching activities?
What are your hobbies and occupation?
What do you need to know before you go home from the hospital?
Do you have any cultural or religious beliefs that you would like incorporated into your plan of care?
What were your grades and learning style when you were in school?
Motivation and readiness to learn depend on what the patient values. The other questions are also important but do not address what information interests the patient most at present.
REF: 45 OBJ: NCLEX Client Needs Category: Health Promotion and Maintenance
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