NR222 Exam 2 Unit 6 (Addition Q&A): Chamberlain College Of Nursing(Verified answers, download to score A)

Document Content and Description Below

NR 222 Exam 2 Unit 6 (Addition Q&A): Chamberlain College Of Nursing NR222 Exam 2 Unit 6 (Addition Q&A): Chamberlain College Of Nursing 1. While caring for a Native American client, the nurse notices t... hat the client does not make contact. Even when the nurse is providing education. The nurse responds appropriately to the behavior by doing which of the following? a. Being aware that eye contact may be culturally determined and adjusting her teaching accordingly b. Asking the client to look at the nurse during the education session c. Assuming that perhaps some form of abuse may be the cause for this behavior d. asking a family member why the client avoids eye contact 2. The nurse is caring for a patient who speaks only Spanish. To facilitate communication, which of the following is an appropriate action by the nurse? a. Follow the agency’s policies to obtain an interpreter b. Obtain an order form the physician for an interpreter c. Ask a relative of the patient to act as an interpreter d. Find a Spanish-speaking employee to be the interpreter 3. The nurse is admitting an Asian-American patient to the medical-surgical floor. When calling the dietary department, the nurse tells the dietitian that all Asians eat rice. What attitude is the nurse displaying? a. Ethnocentrism b. Cultural sensitivity c. Cultural humility d. Stereotyping 4. Which of the following concepts characterizes transcultural nursing? a. Performing health-related activities restoring wellness b. Acknowledging clients with the same skin have similar social situations c. Planning care compatible with the client’s health belief system d. Influencing culture by specific conditions related to an environment 5. Which term refers to Leininger’s description of the learned and transmitted knowledge about values, beliefs, rules of behavior and lifestyle practices that guide designated group in thinking and acting in patterned ways? a. Culture b. Minority c. Race d. Subculture 6. Which of the following is a process by which a nurse consistently works in the cultural context of the client, family and community? a. Stereotyping b. Ethnicity c. Cultural competence d. Subculture 7. What is the process by which members of a cultural group adapt or learn how to take on the behaviors of another group? a. Acculturation b. cultural blindness c. cultural taboos d. cultural imposition 8. The nurse caring for a Hispanic client is performing a cultural assessment. Which of the following statements or questions avoids stereotyping? a. “How do you celebrate Thanksgiving?” b. “I will ask the dietitian if any Hispanic items are on the menu today.” c. “Tell me about your cultural preferences d. “When did you arrive in this country?” 9. A Nurse is taking a history. The client has limited English proficiency. When communicating with this client the nurse should: a. Speak slowly (not loudly) use simple words and short sentences, and avoid jargon. b. record each session to avoid any later confusion or disputes over what was said c. include someone on staff with teaching experience d. speak slowly and loudly and use broad hand gestures or expensive body language as necessary 10. SBAR (Situation, Background, Assessment and Recommendation) communication, which of the following is the correct order? 1. “She is a 53-year old female who was admitted 2 days ago with pneumonia and was started on Levaquin at 5 pm yesterday. She complains of a poor appetite”. 2. “The patient reported feeling very nauseated after her dose of Levaquin an hour ago”. 3. “Would you like to make a change in antibiotics, or could we give her nutritional supplement before her medication?” 4. “The patient started complaining of nausea yesterday evening and has vomited several times during the night.” a. 1,3,4,2 b. 4,1,2,3 c. 2, 1, 3, 4 d. 4,2,1,3 11. The quality improvement team at a large, urban hospital has recognized the need to better integrate the principles of transcultural nursing into patient care. When explaining the concept of transcultural nursing to uninitiated nurses, how should the team members describe it? a. Transcultural nursing is the comparative analysis of the health benefits and risks of recognizable ethnic groups b. Transcultural nursing refers to research-focused practice that focuses on patient-centered, culturally, competent nursing c. Transcultural nursing refers to a systematic and evidence-based effort to improve health outcomes in patients born outside of the United States. d. Transcultural nursing is a term used to describe interventions that seek to address language barriers in nursing practice. 12. A nurse would expect that a woman from which of the following would want only female physician to examine her a. Arab b. Asian c. Japanese d. Latin American 13. A nurse is caring for an elderly woman who predominantly identifies with an East Asian culture. How can the nurse best demonstrate an awareness of culturally congruent care? a. Maintain eye contact at all times b. Try to speak the patient’s native language c. Use touch when communicating d. Establish effective communication 14. It is important for the nurse to acknowledge cultural differences that many influence the delivery of healthcare. In order to do this, the nurse must do which of the following? a. Be clear with the client about the nurse's own cultural perspective b. Comfort the nurse’s own bias and influence on his or her culture c. talk to the client about the nature's own cultural heritage d. be aware that ethnic culture does not change 15. Of the following nurse theorists, which one is considered the founder of transcultural nursing? a. Dorthea Orem b. Madeline Leininger c. Jean Watson d. Patricia Benner 16. Which is the best thing the nurse can do to provide culturally sensitive care? a. Become familiar with physical differences among ethnic groups. b. Provide the proper food for nourishment c. Accept each client as a unique individual d. facilitate rituals that bring comfort to the client 17. The nurse is preparing to educate a patient about the home care of an abdominal wound. What patient behaviors does the nurse notice that demonstrate readiness to learn? (Select all that apply.) a. The patient shows the motivation to learn b. The patient has accepted the therapeutic regimen c. the patient is unable to look at the wound d. the patient tells the nurse the family member will take care of it e. The patient request a contact number if there are questions. 18. Since normal aging results in changes in cognition, how should the nurse teach an elderly patient to administer insulin? a. Repeat the information frequently for reinforcement b. present all the information at one time so that the patient is not confused by the pieces of information c. speed up the demonstration because the patient will tire easily d. the elderly patient is not capable of learning self-administration and someone else should be instructed. 19. Through which action does the nurse demonstrate the step of the nursing process that determines whether the client understands the health teaching that is provided? a. Watching a return demonstration of insulin administration from a client newly diagnosed with diabetes b. Asking a new diabetic, “what are your questions about giving yourself an insulin injection? c. starting short-term educational goals for the client newly diagnosed with diabetes d. teaching injection sites to a client newly diagnosed with diabetes 20. Which of the following is the goal of patient and family education? a. Improvement of patient outcomes b. Assumption of responsibility for care c. Lesson financial burden d. Decrease amount of healthcare services 21. A nurse is planning care for an older adult who lives with a number of chronic health problems. For which of the following nursing diagnosis would education of the patient be the nurse’s highest priority? a. Risk for impaired physical mobility related to joint pain b. Functional urinary incontinence related decreased mobility c. Activity intolerance related to contractures d. Risk for ineffective health maintenance related to nonadherence to therapeutic regimen 22. Which factor is a leading health indicator used to measure the health of the nation? a. Overweight and obesity b. intelligence c. cultural awareness d. religion 23. Positive patient outcomes are the ultimate goal of nurse-patient interactions, regardless of the particular setting. Which of the following factors has the most direct influence on positive patient-care outcomes? a. Patient’s age b. Patient’s ethnic heritage c. Health education d. outcome evaluation 24. The home health nurse reviews a medication administration calendar with an elderly patient. In order to consider sensory changes that occur with aging, how should the nurse proceed? a. Print directions in large, bold type, preferably using black ink b. Highlight or shade important dates and times with contrasting colors c. Use several different colors to emphasize special dates d. Type out the information on the computer. 25. Health education of a client by the nurse a. Is an independent function of nursing practice b. requires a physician’s order c. must be approved by the physician d. must focus on wellness issues. 26. The nurse is providing discharge instructions to an elderly client. The nurse hands the client a paper about a new medication. The client cannot read. Learning does not occur. In this situation the nurse has failed to assess the a. Physical readiness of the client b. Appropriateness of teaching techniques c. clients social and cultural patients d. past experiences of the client 27. The nurse is providing information to a client about the safe use of a newly prescribed medication. The first question the nurse should ask is a. Is the client ready to learn? b. what is the expected outcome? c. what teaching aids do I need? d. how do I evaluate client learning? 28. There are many goals for health teaching. Which of the following is the primary goal of family and patient education? a. Increase knowledge b. Motive people to learn c improve patient outcomes d. Establish trust 29. The nurse is planning to teach a 75-year-old patient with coronary artery disease about administering her prescribed antiplatelet medication. How can a nurse best enhance the patient ability to learn? a. Provide links to Web sites that contain-based information b. Exclude family members from the session to prevent distraction c. Use color-coded materials that are succinct and engaging d. Make the information directly relevant to the patient’s condition 30. A nurse is conducting a health assessment and interviewing a patient. Which of the following would be the most appropriate for the nurse to do? a. Avoid making direct eye contact with the patient b. Refrain from asking sensitive questions c. Use technical terms to describe the patient’s conditions d. Listen carefully to the patients responses 31. A client experiencing a Maine phase of bipolar disorder sustained cuts on the body from falling through a store window. The nurse is preparing to start an intravenous needle insertion and explain the procedure to the client. a. Using clear and simple terms b. standing next to the bed with arms crossed c. Interrupting the clients ravings d. ignoring the clients statement “I don't want this” 32. During unplanned, spontaneous moments, dying clients usually discuss fears or concerns that nurses should not ignore or rush. What is the nurse best response in such situations? a. Communicate interest and a willingness to listen by sitting down, leaning forward in the clients direction, and making direct eye contact B. call the clients family members and ask them to sit next to the client to listen. C. change the subject and talk about other things to distract the dying client D. offer the client a sedative to help them rest more easily. 33. A patient recovering from thoracic surgery on long-term mechanical ventilation and becomes very frustrated when he tries to communicate. What intervention should the nurse perform to assist the patient? a. Assure the patient that everything will be all right and that remaining calm is the best strategy b. Ask a family member to interpret what the patient is trying to communicate c. Ask the physician to wean the patient off the mechanical d. Express empathy and then encourage the patient to write, use a picture board, or spell words with an alphabet board. 34. A patient with otosclerosis has significant hearing loss. What should the nurse do to best facilitate communication with the patient? a. Sit or stand in front of the patient when speaking b. use exaggerated lip and mouth movements when talking c. stand in front of a light or window when speaking d. say the patient's name loudly before starting to talk. 35. The patient has been diagnosed with aphasia after suffering a stroke. What can the nurse do to best make the patient’s atmosphere more conductive to communication? a. Provide a broad of commonly used needs and phrases b. have the patient speak to loved ones on the phone daily. c. help the patient complete his or her sentences. d. speak in a loud and deliberate voice to the patient 36. A nurse has developed a plan of care for a patient with a nursing diagnosis of “risk for spiritual distress”. Which interventions would the plan most likely include? Select all that apply. a. Actively listening to the patient b. Demonstrate acceptance of the patient c. Limit the amount of time spent with the patient d. Encourage the patient to avoid usual rituals e. Encourage the patient to talk about his or her faith. 37. A nurse identifies a nursing diagnosis of anxiety related to hospitalization and uncertainty about diagnostic test results. “Which of the following actions by the nurse will be an attempt to decrease client anxiety? a. Giving the client space and asking only yes and no questions b maintaining eye contact and carefully listening to client responses and concerns c. Giving advice about ways to decrease anxiety d. Staying on task and completing the health history questions 38. Which communication technique is helpful in health teaching about relevant aspects of a client's well- being and a self -care? a. silence b. Reflection c. Informing d. Humor 39. The family members of a dying patient are finding it difficult to verbalize feelings and show tenderness for a dying person. Which of the following nursing interventions should a nurse perform in such situations? a. Encourage the family members to express their feelings and listen to them in their frank communication. b. Encourage conversations on the impending death of the patient c. Be a silent observer and allow the patient to communicate with the family members d. Encourage the patient’s family members to spend time with the patient 40. Which action by the nurse demonstrates an effective method to assess the client and the client’s family’s ability to cope with end-of-life interventions? a. Filling voids in conversation with information related to death and dying to avoid awkward moments during the admission interview b. Providing evidence-based-advice for end-of-life care based on the nurse’s experiences with previous clients in hospice c. Remaining silent, allowing the client and family to respond after asking a question related to end-of-life care d. Offering reassurance that the nurse has had 5 years of assisting clients in hospice and their families care for loved ones at the end of life 41. Which types of nurses make the best communication with patients? a. Those who learn affective psychomotor skills b. Those who develop critical thinking skills c. those who like different kinds of people d. Those who maintain perceptual biases 42. A Nurse wants to present information about flu immunizations to the community. Which type of communication should the nurse use? a. Public b. Small group c. interpersonal d. Intrapersonal 43. A nurse and a patient work on strategies to reduce weight. Which phase of the helping relationship is the nurse in with this patient? a. Pre Interaction b. orientation c. Working d. Termination 44. A nurse asks a patient where the pain is and the patient responds by pointing to the area of pain. Which form of communication did the patient use? a. Verbal b. Nonverbal c. infontation d. Vocabulary 45. A patient learns that a normal adult heartbeat is 60-100 beats/min after a teaching session with a nurse. In which domain did learning take place? a. kinesthetic b. Cognitive c. affective d. Psychomotor 46. A patient has heart failure and kidney failure. The patient needs teaching about dialysis. Which nursing action is most appropriate for assessing this patient’s needs? a. Assess the patient’s total health care needs. b. Assess the patient’s health literacy c. asses all sources of patients data d. Asses the goals of patient care 47. A nurse is using SOLER to facilitate active listening. Which technique should the nurse use for R? a. Relax b. Respect c. Reminisce d. Reassure 48. An older-adult patient is wearing a hearing aid. Which technique should the nurse use to facilitate communication? a. Chew gum b. Turn off the television c. speak clearly and loudly d. Use at least 14-point print. 49. A confused older-adult patient is wearing thick glasses and a hearing aid. Which intervention is the priority to facilitate communication? a. Focus on task to be completed b. Allow time for the patient to respond c. limit conversations with the patient d. Use gestures and other nonverbal cues 50. Which behavior indicates the nurse is using a process recording correctly to enhance communication with patients? a. Shows sympathy appropriately b. Uses automatic responses fluently c. Demonstrates passive remarks accurately d. self -examines personal communication skills In a small, rural hospital the nurse is caring for a patient who speaks a language other than English. The nurse needs to use an interpreter to communicate but the hospital does not have access to an interpreter who speaks the patient's language. When choosing another individual to interpret for this patient, what characteristic should the nurse prioritize? A) Interpreter should recognize the need to speak in a loud voice. B) Interpreter should be able to conduct the conversation quickly to avoid misinterpretation. C) Interpreter should be fluent in several dialects of the patient's language. D) Interpreter should know that repetition must be avoided while interpreting. B) Ans: C Feedback: Cultural needs should be considered when choosing an interpreter; for instance, fluency in varied dialects is beneficial. In choosing an interpreter, you do not want one who speaks in an excessively loud voice, conducts the conversation too quickly, or avoids repetition. 2. You are a community health nurse who provides care to a group of Hispanic people living in an area that is predominantly populated by Caucasian people. How would you characterize the Hispanic people in this community? A) An underclass B) A subgroup C) A minority D) An exception Ans: C Feedback: The term minority refers to a group of people whose physical and cultural characteristics differ from the majority of people in a society. There are four generally identified minority groups: Blacks/African Americans, Hispanics, Asian/Pacific Islanders, and Native Americans. Such groups are not referred to as exceptions or underclasses. A subgroup is a division of a group that is in some way distinguished from the larger group. Page 2 3. A nurse is caring for an elderly woman who predominantly identifies with an East Asian culture. How can the nurse best demonstrate an awareness of culturally congruent care? A) Maintain eye contact at all times. B) Try to speak the patient's native language. C) Use touch when communicating. D) Establish effective communication. Ans: D Feedback: Establishment of an environment of culturally congruent care and respect begins with effective communication, which occurs not only through words, but also through body language and other cues, such as voice, tone, and loudness. Not all cultures are comfortable with eye contact. Unless you are fluent in the patient's native language, trying to communicate in that language would not be effective communication. Not all cultures incorporate touch while communicating. 4. Most nurses have been taught to maintain direct eye contact when communicating with patients. However, some cultural groups do not usually value direct eye contact when communicating with the nurse. Which cultural group would most likely consider the direct eye contact impolite? A) African Americans B) Hispanics C) Canadians D) Native Americans Ans: D Feedback: Eye contact is a culturally determined behavior. Although most nurses have been taught to maintain eye contact when speaking with patients, some people from certain cultural backgrounds may interpret this behavior differently. For example, some Asians, Native Americans, Indo-Chinese, Arabs, and Appalachians may consider direct eye contact impolite or aggressive, and they may avert their own eyes when talking with nurses and others whom they perceive to be in positions of authority. Page 3 5. An emergency department nurse is preparing to inspect and palpate the head and scalp of an older adult who experienced a fall. A member of which group would most likely consider this examination as a violation of norms? A) Jewish B) Asian American C) Islamic D) African American Ans: B Feedback: For many Asian Americans, it is impolite to touch the patient's head because the spirit is believed to reside in the head. Therefore, assessment of the head or evaluation of a head injury requires permission of the patient, or a family member if the patient is not able to give permission. This is not the case with the other listed groups. 6. The nurse is helping a patient choose her menu options for the following day. The nurse reads out the option of ham with scalloped potatoes and the patient states that her religion does not allow this. Which of the following is most likely the patient's religion? A) Roman Catholicism B) Buddhism C) Islam D) Mormonism Ans: C Feedback: Many Islamic people abstain from eating pork. Members of other religions also proscribe the consumption of meat in general, or pork in particular, but the other listed religions are not among these. 7. The nurse is preparing a discharge teaching session with an Asian patient to evaluate the patient's ability to change a dressing. The patient speaks and understands minimal English. What would be the best way to promote understanding during the teaching session? A) Ask the patient to repeat the instructions carefully. B) Write the procedure out for the patient in simple language. C) Use an interpreter during the teaching session. D) Have the patient demonstrate the dressing change. Ans: C Feedback: Policies that promote culturally competent care establish flexible regulations pertaining to visitors (number, frequency, and length of visits), provide translation services for nonñEnglish-speaking patients, and train staff to provide care for patients with different cultural values. Writing instructions, having the patient demonstrate the procedure, and asking the patient to repeat instructions do not adequately compensate for the communication barrier that exists. Page 4 8. You are the nurse caring for a patient who is a recent immigrant to the United States from Mexico. Which of the following variables would you prioritize when performing an assessment of the patient's cultural beliefs? A) Patient's previous medical history B) Patient's marital status C) Patient's age D) Patient's communication style Ans: D Feedback: Assessment of a patient's culture should include the patient's country of origin, language (communication style), food preferences or restrictions, health maintenance practices, and religious preferences and practices. This aspect of assessment does not explicitly include the patient's support systems, marital status, or age, though each of these parameters would be assessed at different points. 9. You are caring for a patient who is terminally ill whose family has requested to hold a spiritual ceremony during which they will be using incense. What would be the best intervention you could make on behalf of this patient? A) Discourage the use of incense in the hospital. B) Ask the family to have the ceremony off the unit. C) Arrange for the ceremony to occur after notifying all departments affected. D) Encourage the family to conduct the ceremony elsewhere because it may affect other patients in the unit. Ans: C Feedback: Culturally competent policies are developed to promote an environment in which the traditional healing, spiritual, and religious practices of patients are respected and encouraged and to recognize the special dietary practices of patients from selected cultural groups. To promote spirituality and transcultural nursing, the nurse should make or help to make the arrangements. The nurse should not attempt to dissuade the family or to relegate the ceremony to a site outside the hospital. Page 5 10. A parent informs the nurse that immunizations are contrary to her religious beliefs, and she does not want her child to receive immunizations. The nurse proceeds to inform the parent that the child will be in grave danger of illness all her life and will not be allowed to start school unless she is immunized. The nurse also informs the parent that she had all of her own children vaccinated with no adverse effects. The nurse's behavior is an example of what? A) Acculturation B) Cultural blindness C) Cultural imposition D) Cultural taboos Ans: C Feedback: The nurse's behavior is an example of cultural imposition, defined as the tendency to impose one's cultural beliefs, values, and patterns of behavior on a person from a different culture. Acculturation is the process by which members of a cultural group adapt to or learn how to take on the behaviors of another group. Cultural blindness is the inability of people to recognize their own values, beliefs, and practices and those of others because of strong ethnocentric tendencies. Cultural taboos are activities or behaviors that are avoided, forbidden, or prohibited by a particular cultural group. 11. An infant with a diagnosis of pyelonephritis is receiving care on the pediatric unit and the nurse's review of the child's electronic health record reveals that the infant has not received any of her scheduled immunizations. The mother informs the nurse that immunizations are against her cultural beliefs, and she does not want her child to receive immunizations. In this scenario, what do the mother's views on immunizations represent? A) Acculturation B) Cultural blindness C) A cultural imposition D) A cultural taboo Ans: D Feedback: Immunizations in this scenario are a cultural taboo. Cultural taboos are defined as activities or behaviors that are avoided, forbidden, or prohibited by a particular cultural group. Cultural imposition is defined as the tendency to impose one's cultural beliefs, values, and patterns of behavior on a person from a different culture. Acculturation is the process by which members of a cultural group adapt to or learn how to take on the behaviors of another group. Cultural blindness is the inability of people to recognize their own values, beliefs, and practices and those of others because of strong ethnocentric tendencies. Page 6 12. In planning the nursing care of a patient who lives with chronic pain, the nurse has included the intervention of therapeutic touch. When categorizing this particular complementary therapy, the nurse should identify it as which of the following? A) A biologically based therapy B) A mind-body intervention C) A manipulative and body-based method therapy D) An energy therapy Ans: D Feedback: Therapeutic touch is an example of an energy therapy. Biologically based therapies include herbal therapies, special diet therapies, orthomolecular therapies, and biologic therapies. Mind-body interventions include meditation, dance, music, art therapy, prayer, and mental healing. Manipulative and body-based methods include chiropractic, massage therapy, osteopathic manipulation, and reflexology. The other options are incorrect because they are not examples of energy therapy. 13. You are admitting a patient who is a recent immigrant from China and who has a diagnosis of adenocarcinoma. During the patient's admission assessment, the patient speaks of her beliefs related to health care and indirectly references the yin/yang theory. Based on her cancer diagnosis and her yin/yang beliefs, which meal will the patient most likely order for lunch? A) Chicken noodle soup with crackers, fruit crisp, and hot tea B) Turkey sandwich, small tossed salad, and iced tea C) Chef's salad, bread, and water D) Fruit smoothie and granola bar Ans: A Feedback: Foods are classified as cold (yin) and hot (yang) in the naturalistic or holistic perspective. In this theory, foods are transformed into yin and yang energy when metabolized by the body. Hot foods are eaten when a person has a cold illness such a cancer, headache, stomach cramps, and a ìcold.î Based on this information, the patient would select chicken noodle soup with crackers, fruit crisp, and hot tea as these are hot foods. The other options are cold foods and are eaten when a patient has a hot illness such as a fever, rash, sore throat, ulcer, or infection. Page 7 14. The nurse is admitting a Native American patient with uncontrolled hypertension and type 1 diabetes to the unit. During the initial assessment, the patient informs the nurse that he has been seeking assistance and care from the shaman in his community. The nurse recognizes that the patient's blood pressure and his blood sugar level are elevated upon admission. What is the nurse's best response to the patient's indication that his care provider is a shaman? A) Thank you for providing the information about the shaman, but we will keep that information and approach separate from your current hospitalization.î B) It seems that the care provided by your shaman is not adequately managing your hypertension and diabetes, so we will try researched medical approaches. î C) Don't worry about insulting your shaman, as he will understand his approach to your hypertension and diabetes was not working after your doctor tells him how sick you were in the hospital.î D) I understand that you value the care provided by the shaman, but we would like you to consider medications and dietary changes that may lower your blood pressure and blood sugar levels.î Ans: D Feedback: Native American patients may seek assistance from a shaman or medicine man or woman. The nurse's best approach is not to disregard the patient's belief in folk healers or try to undermine trust in the healers. Nurses should make an effort to accommodate the patient's beliefs while also advocating the treatment proposed by health science. The nurse's best response incorporating these strategies is, ìI understand that you value the care provided by the shaman, but we would like you to consider medications and dietary changes that may improve your blood pressure and blood sugar levels.î 15. The nurse is providing care for an older adult patient who has a diagnosis of shingles. The nurse is aware that this health problem is attributable to the varicella zoster virus. This belief is an example of which paradigm explaining the cause of disease and illness? A) Biomedical B) Naturalistic C) Holistic D) Factual Ans: A Feedback: The biomedical or scientific perspective assumes that all events in life have a cause and effect and that all of reality can be observed and measured. One example of the biomedical or scientific view is the bacterial or viral explanation of communicable diseases. The naturalistic or holistic view states that forces of nature must be kept in natural balance or harmony. ìFactualî is not a recognized category of beliefs. Page 8 16. In your role as a community health nurse, you are focusing your current health promotion efforts on diseases that are disproportionately represented among ethnic and racial minorities. Which of the following diseases would you likely address? Select all that apply. A) Human immunodeficiency virus (HIV) B) Cancer C) Heart disease D) Chronic obstructive pulmonary disease (COPD) E) Alzheimer's disease Ans: A, B, C Feedback: Ethnic and racial minorities are disproportionately burdened with cancer, heart disease, diabetes, human immunodeficiency virus (HIV), infection/acquired immunodeficiency syndrome (AIDS), and other conditions. COPD and Alzheimer's disease are incorrect because health care disparities have not been noted with these two diseases. 17. Prior to planning health promotion interventions in your local community, you are appraising the key health care indicators in your region and comparing them with those in the nation as a whole. What do these key indicators reveal about the United States? A) A significant gap in health status between the overall population and people of specific ethnic backgrounds B) A significant gap in health care delivery between the overall population and subgroups of the minority populations C) A significant gap in health status between the Hispanic population and the Native American population D) A significant gap in health care delivery between the Asian American population and the Pacific Islander population Ans: A Feedback: Key health indicators in the United States reveal a significant gap in health status between the overall American population and people of specific ethnic backgrounds. Option B is incorrect because key health care indicators do not show a gap in health care delivery between the overall population and subgroups of minority populations; options C and D are incorrect because these ethnic populations are not singled out in these ways. Page 9 18. You are planning an educational inservice for your nursing colleagues with the goal of fostering culturally competent care. What outcome should you prioritize when planning this education? A) Participants will acknowledge and adapt to diversity among their colleagues. B) Participants will develop insight into the characteristics of their own culture. C) Participants will provide equal care to all patients, regardless of their background. D) Participants will evaluate their colleagues' levels of cultural awareness. Ans: A Feedback: The concept of culturally competent care applies to health care institutions, which must develop culturally sensitive policies and provide a climate that fosters the provision of culturally competent care by nurses. Nurses must learn to acknowledge and adapt to diversity among their colleagues in the workplace. This is not necessarily dependent on nurses examining their own cultures. Because patients' needs vary widely, care is not equal. Evaluating cultural awareness in others does not necessarily enhance one's own cultural competence. 19. The nurse assessing health disparities in the community is focusing on disparities that exist apart from those between ethnic groups. In which of the following groups are these disparities most evident? A) Urban men B) People with disabilities C) People who are single D) Middle-aged adults Ans: B Feedback: Health disparities are noted among women, gays and lesbians, and people with disabilities. Specific health disparities have not been found among men, the middleaged, or single people. 20. You are performing a cultural nursing assessment of a newly admitted patient of Cuban descent. What would you include in your assessment? Select all that apply. A) Family structure B) Subgroups C) Cultural beliefs D) Health practices E) Values Ans: A, C, D, E Feedback: Cultural nursing assessment refers to a systematic appraisal or examination of individuals, families, groups, and communities in terms of their cultural beliefs, values, and practices. Subgroups are not a specific focus of this assessment. Page 10 21. The quality improvement team at a large, urban hospital has recognized the need to better integrate the principles of transcultural nursing into patient care. When explaining the concept of transcultural nursing to uninitiated nurses, how should the team members describe it? A) Transcultural nursing is the comparative analysis of the health benefits and risks of recognizable ethnic groups. B) Transcultural nursing refers to research-focused practice that focuses on patient centered, culturally, competent nursing. C) Transcultural nursing refers to a systematic and evidence-based effort to improve health outcomes in patients born outside the United States. D) Transcultural nursing is a term used to describe interventions that seek to address language barriers in nursing practice. Ans: B Feedback: Transcultural nursing, a term sometimes used interchangeably with cross-cultural, intercultural, or multicultural nursing, refers to research-focused practice that focuses on patient-centered, culturally competent nursing. It is not limited to language barriers and foreign-born patients. It does not focus solely on health risks and benefits in ethnic groups. 22. During an orientation class, the medical unit's nursing educator is presenting education on transcultural nursing to a group of new nursing graduates. What should the staff educator identify as the underlying focus of transcultural nursing? A) The underlying focus of transcultural nursing is to enhance the cultural environment of institutions. B) The underlying focus of transcultural nursing is to promote the health of communities. C) The underlying focus of transcultural nursing is to provide culture-specific and culture-universal care. D) The underlying focus of transcultural nursing is to promote the well-being of discrete, marginalized groups. Ans: C Feedback: The underlying focus of transcultural nursing is to provide culture-specific and culture universal care that promotes the well-being or health of individuals, families, groups, communities, and institutions. It is not limited to institutions, communities, or marginalized groups. Page 11 23. A hospital's written policies and procedures are being reviewed as part of an accreditation process. Which of the following policies are congruent with the principles of culturally competent nursing care? Mark all that apply. A) A policy that outlines the appropriate use of translation services B) A policy guiding staff in the care of patients with different values C) A policy that requires staff from different cultures on each unit D) A policy that establishes flexible regulations pertaining to visitors E) A policy that gives priority to patients born outside the United States Ans: A, B, D Feedback: Policies that promote culturally competent care establish flexible regulations pertaining to visitors (number, frequency, and length of visits), provide translation services for nonñEnglish-speaking patients, and train staff to provide care for patients with different cultural values. Cultural competence does not depend on culturally diverse staff on every unit and it does not necessarily prioritize the interests of individuals born outside the country. 24. Giger and Davidhizar (2012) created an assessment model to guide nurses in exploring cultural phenomena that might affect nursing care. When using this model in the care of a patient who has had a transurethral prostate resection (TUPR), what area of care would be influenced most directly? A) Transferring the patient from a stretcher to a bed B) Documenting the patient's vital signs and level of consciousness C) Administering a scheduled dose of acetaminophen D) Explaining the rationale for continuous bladder irrigation (CBI) Ans: D Feedback: Giger and Davidhizar identified communication, space, time orientation, social organization, environmental control, and biologic variations as relevant phenomena. Explaining CBI requires clear communication. Transferring a patient to a bed, administering Tylenol, or documenting are nursing responsibilities that are less directly relevant to this model. Page 12 25. A 56-year-old woman who emigrated from Vietnam as an adult was admitted with a urinary tract infection, but has now developed urosepsis. The nurse is in the process of changing the patient's plan of care accordingly. The nurse should consider what phenomenon that tends to occur in patients of all ages when they are ill? A) Tendency to regress in language skills B) Tendency to become more passive C) Tendency to become more involved in care D) Tendency to regress in age-appropriate behavior Ans: A Feedback: During illness, patients of all ages tend to regress, and the regression often involves language skills. The other tendencies do not apply in this case. 26. A nurse is auditing the care of a recently discharged patient and is appraising the patient's care in light of Leininger's theory of Culture Care Diversity and Universality. Specifically, the nurse is looking for evidence that caregivers implemented professional actions and decisions that helped the patient achieve a beneficial or satisfying health outcome. What aspect of Leininger's theory is the nurse addressing? A) Cross-care accommodation B) Culture care restructuring C) Cultural reordering D) Patient modification Ans: B Feedback: Culture care restructuring or repatterning refers to professional actions and decisions that help patients reorder, change, or modify their lifestyles toward new, different, or more beneficial health care patterns. The other listed options are not part of Leininger's theory. 27. A nurse is caring for a child with a diagnosis of hemophilia. The child is in need of a blood transfusion, which her family's religious beliefs forbid. What term would best describe this religion's beliefs and their impact on health care for this child? A) Acculturation B) Cultural imposition C) Cultural taboo D) Cultural blindness Ans: C Feedback: Cultural taboos are activities or behaviors that are avoided, forbidden, or prohibited by a particular cultural group. The other answers do not apply. Page 13 28. A nurse has been having a number of challenging nurse ñ patient interactions when providing care for a patient whose surgery was complicated by a medical error. When interacting with patients and families, of what must the nurse be cognizant? A) Her own level of health B) The culture of the institution C) The need to promote acculturation D) Her own cultural orientation Ans: D Feedback: Because the nurse ñ patient interaction is the focal point of nursing, nurses should consider their own cultural orientation when conducting assessments of patients and their families and friends. The nurse's health is relevant, but secondary. Similarly, the institutional culture is not a priority. Acculturation is not actively promoted by the nurse. 29. After working with a patient who has human immunodeficiency (HIV) for several weeks, the nurse has become more aware of the role of health disparities. Which of the following variables are known to underlie health disparities? Select all that apply. A) Poverty B) Isolated geographic location C) Overdependence on publicly funded facilities D) Male gender E) Allergy status Ans: A, B, C Feedback: Many reasons are cited for these disparities, including low socioeconomic status, health behaviors, limited access to health care because of poverty or disability, environmental factors, and direct and indirect manifestations of discrimination. Other causes include lack of health insurance; overdependence on publicly funded facilities; and barriers to health care, such as insufficient transportation, geographic location (not enough providers in an area), cost of services, and the low numbers of minority health care providers. Male gender and a patient's allergy status are not identified as contributors to health disparities. Page 14 30. The future of transcultural nursing care lies in finding ways to promote cultural competence in nursing students. How can this goal be best accomplished? A) By offering multicultural health studies in nursing curricula B) By enhancing the content of community nursing classes C) By requiring students to care primarily for patients from other ethnic groups D) By screening applicants according to their cultural competence Ans: A Feedback: Nursing programs are exploring creative ways to promote cultural competence and humanistic care in nursing students, including offering multicultural health studies in their curricula. Enhancing the content of community nursing classes would not necessarily achieve this goal. Matching students to patients from other cultures is often impractical and applicants are not screened by their cultural competence. 31. A nurse provides care in an inner-city hospital that serves a culturally diverse population. When attempting to foster positive and therapeutic nurse ñ patient interactions, the nurse should recognize that these interactions are primarily dependent on what variable? A) The knowledge of patient tendencies during illness B) The nurse's ability to work with a multicultural health care team C) The ability to understand and be understood D) Cultural diversity among the unit staff Ans: C Feedback: Nurseñpatient interactions, as well as communications among members of a multicultural health care team, are dependent on the ability to understand and be understood. Nurseñpatient interactions are not dependent on the knowledge of patient tendencies during illness, the nurse's ability to work with a multicultural health care team, or cultural diversity among the staff on the unit. 32. A nurse who provides care on a busy medical unit is aware that his own beliefs do not always coincide with the beliefs of patients from some cultural backgrounds. What aspects of patient care may be most influenced by diverse cultural perspectives? A) Pharmacokinetics and pharmacodynamics B) Monitoring fluid balance C) Monitoring food intake D) Obtaining informed consent Ans: D Feedback: Many aspects of care may be influenced by the diverse cultural perspectives held by health care providers, patients, families, or significant others. One example is the issue of informed consent and full disclosure. The other aspects of care can also be influenced by cultural differences, but most often to a lesser degree. Page 15 33. Personal space and distance is culturally dependent and can impact nurseñpatient interactions significantly. What is the best way for the nurse to interact with a patient who has a different cultural perspective on space and distance? A) Allow the patient to adopt a position that is comfortable for him or her. B) Realize that sitting close to the patient is an indication of warmth and caring. C) Position yourself 10 to 12 feet from the patient to accommodate the most common cultural preferences. D) Remember not to intrude into the personal space of the elderly. Ans: A Feedback: If the patient appears to position himself or herself too close or too far away, the nurse should consider cultural preferences for space and distance. Ideally, the patient should be permitted to assume a position that is comfortable to him or her in terms of personal space and distance. Older adults do not share a common perspective on personal space. A distance of 10 to 12 feet is not normally necessary. Close proximity can be interpreting as being invasive by some individuals. 34. Touch, to a great degree, is culturally determined. When providing care for a patient who belongs to a Hispanic culture, which of the following may be considered inappropriate in a health care setting? A) Grandmothers helping in the care of pediatric patients. B) Patients asking questions of health care providers. C) Health care information being given to a female member of the family. D) Males participating in health care activities. Ans: D Feedback: The meaning people associate with touching is culturally determined to a great degree. In some cultures (e.g., Hispanic, Arab), male health care providers may be prohibited from touching or examining certain parts of the female body. Similarly, it may be inappropriate for females to care for males. In the Hispanic culture, grandmothers often care for pediatric patients; the female of the family is often held responsible for the family's health care and health care information. Males of the Hispanic culture generally do not participate in health care activities when a member of their family is ill. There is no prohibition against asking questions. Page 16 35. A 54-year-old African American man has presented for a follow-up appointment shortly after being diagnosed with hypertension and being placed on an angiotensin converting enzyme (ACE) inhibitor. The nurse takes the patient's vital signs at the beginning of the appointment and obtains a blood pressure of 177/96 mm Hg. What factor should the nurse consider in light of the patient's sustained high blood pressure? A) The patient's culture may not prioritize taking a medication on a regular basis. B) Biologic variations may be influencing the effectiveness of the medication. C) The patient's culture may not acknowledge ìsymptom-freeî problems such as blood pressure. D) The patient's diet may be negatively affecting the effectiveness of the medication. Ans: B Feedback: Biologic variations can be highly significant, particularly in the use of antihypertensives in African American patients. This is more likely than culturally mediated views on medication adherence, ìsymptom-freeî diseases, or diet. 36. A nurse is planning the care of a 48-year-old woman who has just received a diagnosis of breast cancer. The patient has been explicit about her desire to integrate a variety of complementary therapies into her treatment regimen. What is the nurse's primary responsibility around the use of complementary therapies? A) To become skilled in administering as many complementary therapies as possible B) To liaise between practitioners of complementary therapies and the medical team C) To examine the evidence base underlying each of the patient's chosen complementary therapies D) To assess the patient's use of complementary therapies in order to promote safety Ans: D Feedback: Nurses must assess all patients for use of complementary therapies, be alert to the danger of herbñdrug interactions or conflicting treatments, and be prepared to provide information to patients about treatments that may be harmful. However, nurses must be accepting of patients' beliefs and right to autonomy (i.e., to control their own care). It is not the nurse's role to be the intermediary between practitioners and the medical team or to evaluate the effectiveness of therapies. The nurse is also not responsible for becoming skilled in administering as many complementary therapies as possible. Page 17 37. Agency policies are important to achieve culturally competent care. When reviewing a hospital's current policy framework, which of the following actions has the potential to improve the overall level of culture competence? A) Reducing the institution's dependence on English for communication B) Promoting members of minority groups to higher profile positions C) Eliminating written information from staff members' identification badges D) Creating greater flexibility in visiting hours Ans: D Feedback: Policies that promote culturally competent care establish flexible regulations pertaining to visitors, such as the number, frequency, and length of visits. Eliminating written information from staff members' identification badges is unnecessary and of little benefit. Cultural competence does not require a reduction in the use of English. Promoting members of minority groups to higher profile positions on the sole basis of ethnicity would be unethical. 38. A nurse is describing and demonstrating the technique for emptying a Vietnamese patient's surgical drain, knowing that the patient will soon be discharged home with the drain in place. As the nurse is explaining, the patient laughs at times that appear unrelated to what the nurse is saying or doing. How should the nurse best understand the patient's behavior? A) The patient's sense of humor is culturally mediated and may be unfamiliar to the nurse. B) The patient may believe that she has sufficient knowledge and skill to empty the drain. C) The patient may be unable to fully comprehend the information the nurse is trying to convey. D) Individuals from the patient's culture may not normally explain and demonstrate at the same time. Ans: C Feedback: Inappropriate laughter can signal a lack of understanding. This is more likely than the presence of a culture-specific sense of humor in this particular context. It is unlikely that there is a prohibition against simultaneous explaining and demonstrating. Laughing is unlikely to suggest that teaching and learning are unnecessary. Page 18 39. A nurse is providing care for a female patient who is Hispanic. The care team is discussing the patient's nutritional status and one of the nurse's colleagues states, I suppose we should try to get her some tacos or burritos since that's what she's probably used to. How should the nurse best interpret the colleague's statement? A) The colleague may have stereotypical views of Hispanics. B) The colleague is exemplifying the process of acculturation. C) The colleague is aware of the dietary characteristics of Hispanic culture. D) The colleague may harbor resentment against Hispanics. Ans: A Feedback: Presuming that Hispanics rely on tacos and burritos likely reflects a stereotype of this culture, but is less likely to be motivated by resentment. This statement does not demonstrate acculturation. The colleague's statement reflects a stereotype, not an accurate assessment of the patient's diet and culture. 40. Computed tomography of a 72-year-old woman reveals lung cancer with metastasis to the liver. The patient's son has been adamant that any bad news be withheld from his in order to protect her from stress, stating that this is a priority in his culture. How should the nurse and the other members of the care team best respond? A) Explain to the son the team's ethical obligation to inform the patient. B) Refer the family to social work. C) Have a nurse or physician from the patient's culture make contact with her and her son. D) Speak with the son to explore his rationale and attempt to reach a consensus. Ans: D Feedback: Nurses must promote open dialogue and work with patients, families, physicians, and other health care providers to reach the culturally appropriate solution for the individual patient. A referral to social work is not a sufficient response and enlisting a caregiver from the same culture may not be ethical or effective. [Show More]

Last updated: 1 year ago

Preview 1 out of 42 pages