Nokea
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.
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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.
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.
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.
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.
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.