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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.
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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.
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.
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.
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 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.