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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.
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Which of the following are determinants of learning that require learning assessments?
- A. Learner needs
- B. Demonstrated learner behaviour
- C. Learner self-concept
- D. State of learner readiness
- E. Preferred learning style
Correct Answer: A,D,E
Rationale: The three determinants of learning that require learning assessments are learner needs, state of learner readiness, and the client's preferred learning style. Demonstrated learner behaviour is an evaluation of learning. Self-concept is not a determinant of learning.
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.
A young adult client tells the nurse, 'I enjoy smoking and have no plans to quit.' Which stage of the Transtheoretical Model of Health Behaviour Change does this example portray?
- A. Contemplation
- B. Precontemplation
- C. Preparation
- D. Maintenance
Correct Answer: B
Rationale: The precontemplation phase indicates that the client is not considering a change and is not ready to learn. In the contemplation phase, a change is being considered. The client starts gathering information for the change in the preparation stage. In the maintenance stage, the change has already occurred.
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.
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.