The nurse is teaching a male adolescent recently diagnosed with type 1 diabetes mellitus (DM) about self-injecting insulin. Which approach is best for the nurse to use to evaluate the effectiveness of the teaching?

Rationale: A. Review his glycosylated hemoglobin level 3 months after the teaching session: HbA1c reflects long-term glucose control but is influenced by many factors beyond injection technique. It is not an immediate or specific indicator of how well the adolescent learned the injection procedure. B. Observe him as he demonstrates the self-injection technique to another diabetic adolescent: Direct observation allows the nurse to assess the adolescent’s actual skill performance, technique accuracy, and confidence. This provides the most immediate and practical measure of teaching effectiveness. C. Ask the adolescent to describe his level of comfort with injecting himself with insulin: Self-reported comfort is subjective and does not guarantee proper technique. The adolescent may feel comfortable but still make critical errors during injection. D. Have the adolescent list the procedural steps for safe insulin administration: Listing steps tests knowledge recall but not motor skills or application. The adolescent may know the steps but struggle with actual injection, making demonstration a more effective evaluation method.