After the nurse implements diet instruction for a client with heart disease, the client can explain the information but fails to make the recommended dietary changes. Which of the following statements reflects the correct evaluation of the intervention?
- A. Learning did not occur because the client's behaviour did not change.
- B. Choosing not to follow the diet is the behaviour that resulted from learning.
- C. The nursing responsibility for helping the client make dietary changes has been fulfilled.
- D. The teaching methods were ineffective in helping the client learn the dietary information.
Correct Answer: B
Rationale: Although the client's behaviour has not changed, the client's ability to explain the information indicates that learning has occurred and the client is choosing at this time to continue with the previous diet. The client may be in the contemplation or preparation state in the Transtheoretical Model. The nurse should reinforce the need for change and continue to provide information and assistance with planning for change.
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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.
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.
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.
When assessing a client's readiness to learn before planning teaching activities, which question should the nurse ask?
- A. What kind of work and leisure activities do you do?
- B. What information do you think you need right now?
- C. Do you have any religious beliefs that are inconsistent with the treatment?
- D. Can you describe the types of activities that help you learn new information?
Correct Answer: B
Rationale: Motivation and readiness to learn depend on what the client values and perceives as important. The other questions are also important in developing the teaching plan, but do not address what information most interests the client at present.
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.
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