A nurse is using the domains of learning to provide teaching to a client who has diabetes mellitus. Which of the following actions should the nurse take to utilize psychomotor learning?

Assist the client in discussing their feelings about having diabetes mellitus.

Ask the client to attend a class about following a diabetic diet.

Show the client a video about self-administration of insulin.

Observe the client practice self-monitoring of blood glucose levels.

Answer and Explanation

The Correct Answer is D

Rationale

A. Assist the client in discussing their feelings about having diabetes mellitus: This action targets the affective domain of learning, which focuses on emotions, attitudes, and values. It helps the client process feelings about their diagnosis but does not develop hands-on skills or motor abilities.

B. Ask the client to attend a class about following a diabetic diet: Attending a class primarily addresses the cognitive domain by providing knowledge about nutrition and meal planning. It supports understanding but does not involve practicing physical skills or motor tasks.

C. Show the client a video about self-administration of insulin: Demonstrating a skill via video engages the cognitive and observational aspects of learning, but it does not ensure the client can perform the skill. Psychomotor learning requires active hands-on practice.

D. Observe the client practice self-monitoring of blood glucose levels: Observing and guiding the client as they perform the task addresses the psychomotor domain, which involves acquiring and demonstrating physical skills. Hands-on practice with feedback ensures the client develops competence in self-care activities.

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Correct Answer is C

Explanation

Rationale

A. Poor skin turgor: Poor skin turgor is typically a sign of fluid volume deficit, not excess. In fluid overload, the skin may appear edematous or stretched rather than dehydrated. Assessing turgor helps differentiate between dehydration and overhydration.

B. Thready pulse: A thready, weak pulse is often associated with hypovolemia due to reduced circulating volume. In fluid volume excess, pulses are usually full and bounding because of increased intravascular pressure. Pulse quality provides insight into circulatory status.

C. Crackles in lung bases: Crackles heard in the lower lung fields indicate pulmonary fluid accumulation, a common finding in fluid volume excess. Excess intravascular fluid can leak into the alveoli, causing impaired gas exchange and respiratory symptoms. Auscultation of crackles helps identify pulmonary edema early.

D. Flat neck veins: Flat neck veins are associated with low central venous pressure, typically seen in dehydration or hypovolemia. In fluid overload, neck veins are often distended due to increased venous pressure. Jugular vein assessment is a key indicator of intravascular volume status.

A. Advance the needle-6 mm (1/4 in) below the skin's surface. B. Insert the needle at a 20° angle to the client's skin. C. Point the bevel of the needle upward prior to insertion. D. Administer the injection on the dorsal forearm.

Correct Answer is C

Explanation

Rationale

A. Advance the needle 6 mm (1/4 in) below the skin's surface: The needle should not be advanced below the dermis because intradermal injections require placement within the superficial skin layers. Advancing too deeply can result in subcutaneous injection, which may produce a false-negative result.

B. Insert the needle at a 20° angle to the client's skin: Intradermal injections should be administered at a very shallow angle, typically 5–15°, to ensure proper placement just under the epidermis. A 20° angle risks injecting too deeply and compromising test accuracy.

C. Point the bevel of the needle upward prior to insertion: Keeping the bevel upward allows for smooth entry into the dermis and helps form a visible wheal, which is necessary to confirm correct intradermal placement. This technique minimizes tissue trauma and ensures the test can be accurately read.

D. Administer the injection on the dorsal forearm: The recommended site for a tuberculin skin test is the inner surface of the forearm, not the dorsal side. The inner forearm provides a flat, easily accessible area that allows for accurate observation and measurement of induration.

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A nurse is using the domains of learning to provide teaching to a client who has diabetes mellitus. Which of the following actions should the nurse take to utilize psychomotor learning?

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