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A client admitted to the hospital with hyperglycemia and newly diagnosed diabetes mellitus is scheduled for discharge the second day after admission. When implementing client teaching, which is the best action for the nurse to take?
- A. Instruct about the increased risk for cardiovascular disease.
- B. Provide detailed information about dietary control of glucose.
- C. Teach glucose self-monitoring and medication administration.
- D. Give information about the effects of exercise on glucose control.
Correct Answer: C
Rationale: When time is limited, the nurse should focus on the priorities of teaching. In this situation, the client should know how to test blood glucose and administer medications to control glucose levels. The client will need further teaching about the role of diet, exercise, various medications, and the many potential complications of diabetes, but these topics can be addressed through planning for appropriate referrals.
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While admitting a client to the medical unit, the nurse learns that the client has difficulty reading. This information will guide the nurse in determining which of the following strategies would be the most appropriate when planning for client teaching?
- A. Assessing the degree of client motivation and readiness to learn
- B. Deciding what information the client will be able to understand
- C. Ensuring that the family be included in the teaching process
- D. Choosing which instructional strategies should be used in teaching
Correct Answer: D
Rationale: The information that the client has poor health literacy skills indicates that the nurse should avoid the use of written materials in teaching and choose other strategies. The client does not indicate a lack of motivation or an inability to understand new information. The client's lack of reading ability does not necessarily imply that the family must be included in the teaching process.
A client with newly diagnosed breast cancer has a nursing diagnosis of deficient knowledge related to insufficient information (about breast cancer). When the nurse is planning teaching for the client, which is the most important initial learning goal?
- A. The client will select the most appropriate breast cancer therapy.
- B. The client will state ways of preventing the recurrence of the tumour.
- C. The client will demonstrate coping skills needed to manage the disease.
- D. The client will choose methods to minimize adverse effects of treatment.
Correct Answer: A
Rationale: Adults learn best when given information that can be used immediately. The first action the client will need to take after a cancer diagnosis is to choose a treatment option. The other goals may be appropriate as treatment progresses.
Which action should the nurse take first when teaching a client's spouse how to manage the blood pressure (BP) for a client with newly diagnosed hypertension?
- A. Teach the caregiver how to take the client's BP using a manual blood pressure cuff.
- B. Have the dietitian meet with the client and caregiver to discuss low sodium dietary choices.
- C. Ask the client and caregiver to select important information from a list of hypertension teaching topics.
- D. Provide written information about treatment and complications of hypertension for the client and caregiver.
Correct Answer: C
Rationale: Since adults learn best when given information that they view as being needed immediately, asking the caregiver and client to prioritize learning needs is likely to be the most successful approach to home management of health problems. The other actions also may be appropriate, depending on what learning needs the caregiver and client have, but the initial action should be to assess what the learners feel is important.
The client's teaching plan includes this goal: 'The client will select foods lower in sodium from the hospital menu for the next 3 days.' Which evaluation method will be best for the nurse to use when determining whether teaching was effective?
- A. Check the sodium content of the client's menu choices over the next 3 days.
- B. Ask the client to identify which foods on the hospital menus are high in sodium.
- C. Have the client list favourite foods that are high in sodium and foods that could be substituted for these favourites.
- D. Compare the client's sodium intake over the next 3 days with the sodium intake before the teaching was implemented.
Correct Answer: A
Rationale: All of the answers address the client's sodium intake, but the desired client behaviours in the learning objective are most clearly addressed by evaluation of the client's menu choices.
The nurse in the hospital has implemented a teaching plan to assist a client with rheumatoid arthritis in accomplishing daily activities independently. Which of the following actions is the best approach for the nurse to take in order to evaluate the client's long-term response to the teaching?
- A. Make a referral to the home health nursing department for home visits.
- B. Assess the client's ability to bathe without any assistance the next day.
- C. Have the client demonstrate the learned skills at the end of the teaching session.
- D. Arrange a physical therapy visit before the client is discharged from the hospital.
Correct Answer: A
Rationale: The client's long-term response may need to be assessed after discharge, long-term evaluation necessitates follow-up by the nurse, outpatient clinic, or outside agency. In this case, a home health referral would allow this to occur. The other actions allow evaluation of the client's short-term response to teaching.