# Situation: A 69-year-old woman with newly diagnosed hypothyroidism will go home on a daily levothyroxine tablet in 3 days. She has mild cataracts and wears reading glasses. She speaks only a regional language that the ward nurse does not speak. Her 12-year-old grandson, who lives with her, speaks both languages. The nurse drafts learning objectives for her discharge. Which objective is BEST written?

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=630450  
> language: ko  
> subject: Nursing Practice IV — Care of Clients with Problems in Nutrition and Gastrointestinal, Metabolism and Endocrine, Perception and Coordination

## 문제

Situation: A 69-year-old woman with newly diagnosed hypothyroidism will go home on a daily levothyroxine tablet in 3 days. She has mild cataracts and wears reading glasses. She speaks only a regional language that the ward nurse does not speak. Her 12-year-old grandson, who lives with her, speaks both languages.

The nurse drafts learning objectives for her discharge. Which objective is BEST written?

## 보기

1. By discharge, the client will fill her 7-day pill organizer by herself without errors **✔ 정답**
2. By discharge, the client will understand how to fill her 7-day pill organizer correctly
3. The client will correctly fill her own 7-day pill organizer by herself, without errors
4. By discharge, the nurse will demonstrate filling the 7-day pill organizer for her

**정답: 1**

## 해설

A well-written behavioral objective is learner-centered and SMART: specific, measurable, achievable, realistic, and time-bound. Each of the other objectives lacks one feature: a measurable verb, a learner focus, or a time frame.

## 심화 해설

What makes an objective well written
A behavioral (learning) objective states what the learner will be able to do after teaching. A well-written objective is SMART: specific, measurable, achievable, realistic, and time-bound. In practice it contains an audience (the client), an observable behavior (an action verb), a condition under which the behavior occurs, a criterion for success, and a time frame. Option 1 contains every element: by discharge (time), the client (learner) will fill (observable verb) her 7-day pill organizer by herself (condition) without errors (criterion).

| Element | Option 1 | Option 2 | Option 3 | Option 4 |
| --- | --- | --- | --- | --- |
| Learner-centered | Yes | Yes | Yes | No (nurse) |
| Observable verb | Fill | Understand | Fill | Demonstrate (by nurse) |
| Condition and criterion | Yes | Partly | Yes | No |
| Time frame | By discharge | By discharge | None | By discharge |

Why each distractor fails
Option 2 uses understand, which cannot be seen or measured; the nurse cannot observe understanding directly, only a behavior that shows it. Option 3 has the behavior, condition, and criterion but no time frame, so it is not time-bound and the nurse does not know when to evaluate it. Option 4 describes what the nurse will do; it is a nursing intervention, not a learning objective, because objectives state the learner's behavior.

Why the details matter
Writing objectives precisely lets the nurse plan the teaching and evaluate it. For this client, filling a pill organizer is a psychomotor skill, so the nurse will teach by demonstration and evaluate by watching a return demonstration before discharge. If she makes errors, the nurse repeats the teaching, adapts it to her vision, and evaluates again. A vague or nurse-centered objective gives no clear standard for deciding whether she is ready to go home.

Watch out! Verbs such as know, understand, learn, and appreciate are common in distractors. Replace them with observable verbs such as state, list, demonstrate, fill, or perform.

Exam takeaway
Key point! A good objective is learner-centered with an observable verb, a condition, a criterion, and a time frame; missing any one of these makes it weaker.

## 임상 시나리오

Writing a Behavioral ObjectiveSMART and learner-centered
Best: By discharge, the client will fill her 7-day pill organizer by herself without errors. It has time, learner, observable verb, condition, and criterion.

Understand cannot be observed; an objective without a time frame is not time-bound; an objective about what the nurse will do is an intervention.

Evaluate a psychomotor objective such as this by return demonstration before discharge.

## 핵심 개념

- **Behavioral objective** — A statement of the specific, observable behavior a learner will perform after teaching.
- **SMART** — Specific, measurable, achievable, realistic, and time-bound: criteria for a well-written objective.
- **Return demonstration** — The learner performs a skill after being taught, so the nurse can evaluate it.
- **Pill organizer** — A container with compartments for each day that helps a client take medicines correctly.

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