Nokea
A client with poor circulation to the feet requires teaching about foot care. Which learning goal should the nurse include in the teaching plan?
- A. The nurse will demonstrate the proper technique for trimming toenails.
- B. The client will list three ways to protect the feet from injury by discharge.
- C. The nurse will instruct the client on appropriate foot care before discharge.
- D. The client will understand the rationale for proper foot care after instruction.
Correct Answer: B
Rationale: Learning goals should state clear, measurable outcomes of what is to be accomplished from the learning process. Demonstrating a proper technique or providing instruction are actions that the nurse will take, rather than behaviours that would indicate if client learning has occurred. Having the client understand the rationale for proper foot care after instruction is an example of a learning outcome.
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The nurse is preparing written handouts to be used as part of the standardized teaching plan for clients who have been recently diagnosed with diabetes and requires an awareness of literacy levels. Which of the following literacy levels is generally reflective of students who graduate from high school?
- A. 1
- B. 2
- C. 3
- D. 4
Correct Answer: C
Rationale: People with Level 3 literacy have the minimum skills necessary for everyday life in a complex society, such as graduation from high school. People with Level 1 literacy have very poor skills; for example, they were unable to determine the correct dose of medication from information on the package. People with Level 2 literacy require material to be simple and clearly laid out, and only tasks that are not too complex are to be included in learning material. People with Levels 4 and 5 literacy had higher order skills in information processing.
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.
An older-adult client is seen at the health clinic and diagnosed with protein malnutrition. Which of the following actions is priority to be included in the teaching plan?
- A. Suggest the use of liquid supplements as a way to increase protein intake.
- B. Encourage the client to increase the dietary intake of meat, cheese, and milk.
- C. Ask the client to record the intake of all foods and beverages for a 3-day period.
- D. Focus on the use of combinations of beans and rice to improve daily protein intake.
Correct Answer: C
Rationale: Assessment is the first step in assisting a client with health changes. The other answers may be appropriate for the client, but the nurse will not be able to determine this until the assessment of the client is complete.
When using the Transtheoretical Model of Health Behaviour Change during client teaching, the nurse identifies that the client who states, 'I told my wife that I was going to start exercising, and I think I will join a fitness club,' is in which of the following stages?
- A. Preparation
- B. Termination
- C. Maintenance
- D. Contemplation
Correct Answer: A
Rationale: The client's statement indicating that the plan for change is being shared with someone else indicates that the preparation stage has been achieved. Contemplation of a change would be indicated by a statement like 'I know I should exercise.' Maintenance of a change occurs when the client practises the behaviour regularly. Termination would be indicated when the change is a permanent part of the lifestyle.
The nurse is caring for a client who has been newly diagnosed with diabetes. The client tells the nurse, 'I want to know how to give my own insulin.' Which initial action will the nurse take when implementing the standardized diabetic teaching plan?
- A. Demonstrate how to draw up and administer insulin.
- B. Discuss the use of exercise to decrease insulin needs.
- C. Teach about differences between the various types of insulin.
- D. Provide handouts about therapeutic and adverse effects of insulin.
Correct Answer: A
Rationale: Adult education is most effective when focused on information that the client thinks is needed right now. All of the indicated information will need to be included when planning teaching for this client, but the teaching will be most effective if the nurse starts with the client's stated priority topic.