# Situation: The nurse coordinator of a hospital's bone health clinic plans an 8-session education program for 40 postmenopausal women with low bone mass. Most of the women are older adults, and several care for grandchildren at home. The program aims to reduce falls and fractures. All 8 sessions were held. Six months later, the nurse reviews the results by group. The behavior target was at least 60% of women exercising at home at least 3 times a week. - Women caring for grandchildren (16): attendance 88%, mean post-test 90%, correct return demonstration 94%, exercising at home 6% - Women not caring for grandchildren (24): attendance 84%, mean post-test 86%, correct return demonstration 88%, exercising at home 38% Which conclusion do these results BEST support?

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=630549  
> language: ko  
> subject: Nursing Practice IV — Care of Clients with Problems in Nutrition and Gastrointestinal, Metabolism and Endocrine, Perception and Coordination

## 문제

Situation: The nurse coordinator of a hospital's bone health clinic plans an 8-session education program for 40 postmenopausal women with low bone mass. Most of the women are older adults, and several care for grandchildren at home. The program aims to reduce falls and fractures.

All 8 sessions were held. Six months later, the nurse reviews the results by group. The behavior target was at least 60% of women exercising at home at least 3 times a week.
- Women caring for grandchildren (16): attendance 88%, mean post-test 90%, correct return demonstration 94%, exercising at home 6%
- Women not caring for grandchildren (24): attendance 84%, mean post-test 86%, correct return demonstration 88%, exercising at home 38%
Which conclusion do these results BEST support?

## 보기

1. The program has already lowered the women's risk of fractures overall
2. Both groups learned the exercises, but caregivers rarely practiced at home **✔ 정답**
3. Caregivers attended less often, so they learned fewer of the exercises taught
4. The women without caregiving duties reached the program's behavior target

**정답: 2**

## 해설

Reading across the rows, both groups attended well and reached high knowledge and skill scores, so learning was not the problem. Home practice was far lower among women caring for grandchildren (6% vs 38%), and neither group met the 60% target. Knowledge and skill do not guarantee behavior; the next plan should look at what keeps caregivers from practicing at home.

## 심화 해설

Read across the rows
The results compare two groups six months after the program. Both groups attended well (88% and 84%), scored high on the post-test (90% and 86%), and performed the exercises correctly in return demonstration (94% and 88%). Learning was clearly achieved. The difference appears in behavior: only 6% of the women caring for grandchildren exercise at home at least three times a week, compared with 38% of the others. Both groups learned the exercises, but caregivers rarely practiced at home.

Knowledge and skill do not guarantee behavior
The program reached its knowledge and skill outcomes but not its behavior outcome. Neither group met the target of at least 60% exercising at home. This gap is common in health education: people can know what to do and be able to do it, yet still not do it because of barriers in daily life. For the caregivers, likely barriers include lack of time, constant supervision of children, and putting the family's needs first. The next program cycle should explore these barriers, for example through a focus group, and adapt the plan, perhaps with short routines that can be done while minding children or exercises that include the grandchildren.

| Measure | Caregivers (16) | Non-caregivers (24) | Target |
| --- | --- | --- | --- |
| Attendance | 88% | 84% | – |
| Post-test | 90% | 86% | – |
| Return demonstration | 94% | 88% | – |
| Exercising at home | 6% | 38% | 60% |

Why the other conclusions are wrong
Saying the program already lowered fracture risk goes beyond the data: no falls, fractures, or bone measurements were collected, and the behavior target was not met. Saying caregivers attended less and learned less contradicts the numbers; they attended more and scored higher. Saying the non-caregivers reached the behavior target misreads 38% as success when the target was 60%; they did better than caregivers but fell well short.

Evaluation levels
This item illustrates levels of outcome: participation (attendance), learning (knowledge and skill), behavior change, and finally health impact (fewer falls and fractures). Each level must be measured separately, and success at one level does not prove success at the next.

Exam takeaway
Watch out In data interpretation items, choose the conclusion that the numbers directly support. High knowledge and skill with low practice points to barriers, not to a learning failure.

## 임상 시나리오

Reading Program Results by GroupLearning versus behavior
Both groups had high attendance, post-test, and return demonstration scores, so learning was achieved.

Home exercise was 6% among caregivers and 38% among others, and neither group met the 60% target.

The next cycle should explore what keeps caregivers from exercising at home and adapt the plan to their daily routines.

CautionDo not conclude that fracture risk fell. No fall or fracture data were collected, and the behavior target was not met.

## 핵심 개념

- **Return demonstration** — A learner performs a skill after teaching to show that it was learned correctly.
- **Behavioral outcome** — A measurable change in what learners actually do, such as exercising at home.
- **Post-test** — A test given after teaching to measure knowledge gained.
- **Barrier** — A factor, such as lack of time or caregiving duties, that prevents a person from performing a health behavior.

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