Nokea
The nurse is planning a teaching session for a client who needs to improve skills in being more assertive. Which of the following is the most effective teaching strategy for this client?
- A. Role playing
- B. Peer teaching
- C. Printed materials
- D. Lecture-discussion
Correct Answer: A
Rationale: Role playing allows the client to practise assertive behaviour and receive feedback about how the behaviour is perceived. This strategy is most often used when clients need to examine their attitudes and behaviours; understand the viewpoints and attitudes of others, or practise carrying out thoughts, ideas, or decisions. Lecture-discussion, peer teaching, and printed materials are more useful for other learning needs.
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When assessing the learning needs for a client who has coronary heart disease, the nurse finds that the client has recently made dietary changes to decrease fat intake and has stopped smoking. Which of the following is the most appropriate initial statement by the nurse at this time?
- A. Although those are important, it is essential that you make other changes, too.
- B. Are you having any difficulty in maintaining the changes you have already made?
- C. You have already accomplished some changes that are important in heart health.
- D. Which additional changes in your lifestyle would you like to implement at this time?
Correct Answer: C
Rationale: Positive reinforcement of the learner's achievements is critical in making lifestyle changes. This client is in the action stage of the Transtheoretical Model, when reinforcement of the changes being made is an important nursing intervention. The other responses are also appropriate, but are not the best initial response.
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.
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.
The nurse is caring for an adult client who has been diagnosed with type 2 diabetes mellitus after being admitted to the hospital with an infected foot wound. When applying principles of adult learning, which teaching strategy by the nurse is most likely to be effective?
- A. Discuss the importance of blood glucose control in maintenance of long-term health.
- B. Demonstrate the correct method for cleaning and redressing the wound to the client.
- C. Assume the client that the nurse is an expert on management of diabetes complications.
- D. Wait until after discharge and have a home health nurse teach about foot care and diabetes management.
Correct Answer: B
Rationale: Principles of adult education indicate that readiness and motivation to learn are high when facing new tasks (such as wound care) and when demonstration and practice of skills are available. Although a home health referral may be needed for this client, teaching should not be postponed until discharge. Adult learners are independent; the nurse should act as a facilitator for learning, rather than as the expert. Adults learn best when the topic is of immediate usefulness, long-term goals may not be very motivating.
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.