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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.
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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.
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.
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.
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.
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.