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When using the Transtheoretical Model of Health Behaviour Change during client teaching, the nurse identifies that the client who states, 'I told my wife that I was going to start exercising, and I think I will join a fitness club,' is in which of the following stages?
- A. Preparation
- B. Termination
- C. Maintenance
- D. Contemplation
Correct Answer: A
Rationale: The client's statement indicating that the plan for change is being shared with someone else indicates that the preparation stage has been achieved. Contemplation of a change would be indicated by a statement like 'I know I should exercise.' Maintenance of a change occurs when the client practises the behaviour regularly. Termination would be indicated when the change is a permanent part of the lifestyle.
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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.
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.
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 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.
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.