The nurse is preparing a teaching plan for a client who is learning to use the incentive spirometer. The nurse identifies the following action as part of the evaluation step in the teaching plan.

Assess the clients pain level

Ask the client to demonstrate use of the incentive spirometer

Develop a short-term goal for the client

Provide instructions on how to use the incentive spirometer

Answer and Explanation

The Correct Answer is B

A. Assess the client's pain level: Assessing the client's pain level is part of the assessment step, not the evaluation step.
B. Ask the client to demonstrate use of the incentive spirometer: Asking the client to demonstrate use of the incentive spirometer is a way to evaluate whether the client has understood and can perform the skill.
C. Develop a short-term goal for the client: Developing a short-term goal is part of the planning step, not the evaluation step.
D. Provide instructions on how to use the incentive spirometer: Providing instructions is part of the implementation step, not the evaluation step.

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Correct Answer is C

Explanation

A. "The vital signs are stable." This statement belongs in the Assessment (A) step, as it provides information about the client’s current clinical condition.
B. "The client has a history of high blood pressure." This statement belongs in the Background (B) step, providing relevant medical history.
C. "The client is disoriented. Pupils are slow to respond to light." The S (Situation) step involves stating the immediate problem or reason for the communication. Describing the client's disorientation and pupil response directly addresses the current issue that prompted the call.
D. "The client should be seen by a neurologist." This statement belongs in the Recommendation (R) step, suggesting the next course of action.

A. decreased vision but the client is wearing glasses B. Hearing loss, hearing aids are functioning well C. Language and no access to an interpreter D. The client's culture

Correct Answer is C

Explanation

A. Decreased vision but the client is wearing glasses: As long as the client is wearing glasses and can see adequately, decreased vision is not a barrier to learning that would require postponing teaching.
B. Hearing loss, hearing aids are functioning well: With functioning hearing aids, the client should be able to hear and understand the discharge instructions, so this is not a barrier to learning that requires postponement.
C. Language and no access to an interpreter: Without an interpreter, the client may not understand the instructions, which is a significant barrier to learning. This requires postponing the teaching until an interpreter is available.
D. The client's culture: While cultural differences can influence learning, they do not inherently create a barrier that necessitates postponing teaching unless they directly affect comprehension or communication.

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The nurse is preparing a teaching plan for a client who is learning to use the incentive spirometer. The nurse identifies the following action as part of the evaluation step in the teaching plan.

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is planning to use the SBAR communication tool when calling a provider. Which of the following statements should the nurse include in the S step?

Correct Answer is C

Explanation

A nurse is completing discharge instructions. Which of the following barriers to learning should the nurse interpret as a need to postpone the teaching?

Correct Answer is C

Explanation

Determine which of the following goals is a SMART goal

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