# Situation: A 52-year-old delivery driver was diagnosed with type 2 diabetes mellitus 1 week ago. His glycated hemoglobin (HbA1c) is 8.4%, and he was started on metformin. He finished high school and reads well. He tells the nurse at the hospital's outpatient diabetes clinic, "My father had diabetes and lost a leg. I do not want that to happen to me." The nurse plans a series of teaching sessions for him. One of his learning objectives reads: "By the end of the third session, the client will assemble, from the clinic's food models and without assistance, a lunch plate that follows the plate method." At the third session, which observation shows that this objective has been met?

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=630350  
> language: ko  
> subject: Nursing Practice IV — Care of Clients with Problems in Nutrition and Gastrointestinal, Metabolism and Endocrine, Perception and Coordination

## 문제

Situation: A 52-year-old delivery driver was diagnosed with type 2 diabetes mellitus 1 week ago. His glycated hemoglobin (HbA1c) is 8.4%, and he was started on metformin. He finished high school and reads well. He tells the nurse at the hospital's outpatient diabetes clinic, "My father had diabetes and lost a leg. I do not want that to happen to me." The nurse plans a series of teaching sessions for him.

One of his learning objectives reads: "By the end of the third session, the client will assemble, from the clinic's food models and without assistance, a lunch plate that follows the plate method." At the third session, which observation shows that this objective has been met?

## 보기

1. He names the food groups and the share of each on the plate
2. He builds a correct plate once the nurse points to the vegetables
3. He says he feels confident he can plan a correct plate at work
4. He builds a correct plate by himself during the session **✔ 정답**

**정답: 4**

## 해설

A behavioral objective is evaluated against exactly what it states: the learner's behavior, the condition, and the criterion. Only building a correct plate with no help meets all three; stating the parts, needing a prompt, or reporting confidence falls short of the written objective.

## 심화 해설

A behavioral objective contains three components that must all be satisfied before the objective is considered met: the behavior (what the learner does), the condition (under what circumstances), and the criterion (how well or how independently it is performed). In this scenario, the written objective specifies that the client will assemble a lunch plate using the plate method, without assistance, by the end of the third session. The condition is the use of clinic food models, and the criterion is independence—no prompting or help from the nurse.

The plate method itself is a visual meal-planning tool in which a dinner plate is divided into sections to show the proportion of the plate that should be covered by different food groups [1]. This approach is especially useful for clients who may find traditional exchange-based meal planning confusing, because it converts abstract portion guidance into a concrete, image-based task [3]. For a client whose father experienced a diabetes-related amputation, the emotional weight of preventing complications can make a hands-on, demonstrable skill more meaningful than verbal recall alone.

When evaluating whether the learning objective has been met, each option must be checked against the exact wording of the objective.

| Option | What the client does | Does it meet the objective? |
| --- | --- | --- |
| 1. Names the food groups and the share of each on the plate | Verbalizes knowledge about plate proportions | No — the objective requires assembling a plate, not describing it. Knowledge recall is a lower-level outcome than the psychomotor behavior specified. |
| 2. Builds a correct plate once the nurse points to the vegetables | Assembles the plate but only after a prompt | No — the objective states “without assistance.” A cue from the nurse means the independence criterion is not met. |
| 3. Says he feels confident he can plan a correct plate at work | Reports self-efficacy or confidence | No — confidence is an affective outcome, not the behavioral performance required. The objective asks for demonstration, not a statement of belief. |
| 4. Builds a correct plate by himself during the session | Assembles the plate independently using the food models | Yes — this matches the behavior (assembling), the condition (clinic food models), and the criterion (without assistance). |

Watch out! In nursing education and on licensure exams, a behavioral objective is evaluated only by observing the exact behavior stated. A client who can explain a skill or who feels ready to perform it has not yet demonstrated the skill itself. The only observation that proves the objective is met is the client performing the task independently under the specified conditions.

The use of a portion-control or meal-plate tool has been associated with improvements in dietary behavior and glycemic outcomes in adults with diabetes, including those with elevated HbA1c at baseline . However, the educational evaluation question is not whether the plate method improves outcomes—it is whether the client’s observed behavior matches the written objective. The correct answer is therefore the option in which the client builds a correct plate by himself, because that is the only observation that satisfies the behavior, condition, and criterion stated in the objective.References (research sources)

- [1]The Plate Model: a visual method of teaching meal planning. DAIS Project Group. Diabetes Atherosclerosis Intervention Study.Research articleCamelon KM, Hådell K, Jämsén PT, Ketonen KJ, Kohtamäki HM, Mäkimatilla S (1998) · DOI: 10.1016/s0002-8223(98)00267-3

- [3]The healthy diabetes plate.Research articleRaidl M, Spain K, Lanting R, Lockard M, Johnson S, Spencer M (2007)

## 임상 시나리오

Evaluating Behavioral ObjectivesChecking Behavior, Condition, and Criterion
A behavioral objective is met only when the learner demonstrates the specified behavior under the stated condition and meets the criterion. For this client, the objective requires assembling a plate using the plate method without assistance.

Verbalizing knowledge, such as naming food groups, or reporting confidence does not demonstrate the skill. A prompt from the nurse also violates the independence criterion. Only direct observation of the client building a correct plate alone confirms the objective is met.

CautionDo not infer skill mastery from a client's verbal statements or self-reported confidence. Always evaluate against the exact wording of the written objective, especially the requirement for independent performance.

## 핵심 개념

- **Behavioral Objective** — A specific, measurable statement of what a learner will be able to do, including the behavior, condition, and criterion for success.
- **Plate Method** — A visual meal-planning tool that divides a plate into sections to guide portion sizes of vegetables, protein, and carbohydrates.
- **Criterion** — The standard or level of performance required in a behavioral objective, such as performing a task independently or with a certain degree of accuracy.
- **Condition** — The circumstances or context under which the learner's behavior is to be performed, such as using specific materials or without assistance.
- **Self-Efficacy** — An individual's belief in their own ability to succeed in specific situations or accomplish a task, often assessed through self-report rather than direct observation.

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