A nurse is instructing a client whose left leg is in a cast on how to use crutches. Which statement from the client indicates they have understood the instructions?

Choice A rationale: Group discussions represent the cognitive and affective domains of learning. They allow participants to share knowledge and feelings but do not involve the physical manipulation required for psychomotor skills.

Choice B rationale: Query and answer sessions focus on the cognitive domain. They address the learner's need for information and clarification of facts rather than the development of physical coordination or manual dexterity.

Choice C rationale: Practice sessions are the definitive psychomotor approach. They require the learner to physically perform a task, such as changing an ostomy appliance, to develop muscle memory and technical proficiency.

Choice D rationale: Role play primarily addresses the affective domain by exploring attitudes and behaviors. While it involves action, it focuses on social and emotional responses rather than specific technical or manual tasks.

Choice A rationale

The client was admitted three days ago. This statement is factual, but it does not directly address the current condition of the client’s pressure injury. The time of admission is not as relevant as the progression and treatment of the wound. Therefore, while this choice is accurate, it is not the most critical piece of information in this context.

Choice B rationale

The pressure injury was at stage 4. This is the correct answer. Stage 4 pressure ulcers involve full-thickness skin loss potentially extending into the subcutaneous tissue layer. Stage 4 pressure ulcers extend even deeper, exposing underlying muscle, tendon, cartilage or bone.

The presence of slough, eschar, and tunnels, as well as the size of the wound, are consistent with a stage 4 pressure ulcer. The treatment provided, including debridement and negative

pressure wound therapy, is also typical for this stage of pressure injury. Therefore, this choice accurately describes the client’s condition.

Choice C rationale

The client reported pain as a 2 on a scale from 0 to 10. While it’s important to monitor the client’s pain levels, this information alone does not provide a comprehensive understanding of the client’s condition. Pain can be subjective and varies from person to person. A score of 2 indicates minor pain, which is manageable and does not significantly interfere with the client’s daily activities. However, this does not negate the severity of a stage 4 pressure injury.

Choice D rationale

The dressing was reapplied and sealed. This statement describes one aspect of the wound care process. Negative pressure wound therapy involves the application of a vacuum through a special sealed dressing. The dressing is crucial in creating a moist healing environment, reducing edema, and promoting wound healing. However, the reapplication and sealing of the dressing alone do not provide a complete picture of the client’s condition or the severity of the pressure injury.