Nokea
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.
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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.
Which of the following are determinants of learning that require learning assessments?
- A. Learner needs
- B. Demonstrated learner behaviour
- C. Learner self-concept
- D. State of learner readiness
- E. Preferred learning style
Correct Answer: A,D,E
Rationale: The three determinants of learning that require learning assessments are learner needs, state of learner readiness, and the client's preferred learning style. Demonstrated learner behaviour is an evaluation of learning. Self-concept is not a determinant of learning.
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.
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.
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.