Chapter 6: Prep U

The nurse is caring for a client who is postoperative 24 hours from an appendectomy. The client is hesitant to get out of bed. How should the nurse respond?

"Can you describe what you are feeling when you try to move?

The nurse is caring for a client who is admitted for hypertension (HTN). The nurse notes that the client has not been eating the food provided, and family members have brought in homemade food. What would be the best response by the nurse?

"Can you tell me what foods you prefer to eat & what your family is bringing you?"

The nurse is admitting a client with uncontrolled hypertension and diabetes. During the initial assessment, the client informs the nurse that he has been seeking assistance and care from the shaman in the community. The nurse recognizes that the client's blood pressure and blood sugar are elevated upon admission. What is the nurse's best response?

"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."

Nursing students are reviewing information about biological variations among population groups. The students demonstrate understanding of this information when they state:

"Individuals of Asian ancestry do not metabolize alcohol as quickly as individuals of African ancestry do."

The nurse is collecting the health history of a client and notes the client is apprehensive in answering questions. The client states, "My spiritual healer will be here soon." What is the bestresponse by the nurse?

"We can wait until your spiritual healer arrives & work together to answer these questions."

The nurse is caring for a client 4 days after total hip arthroplasty and notes the client has lost weight. The unlicensed assistive personnel reports the client's food intake has decreased. Which question will the nurse ask the client to determine if cultural causes are responsible for the weight loss?

"What type of food do you like to eat at home?"

The nurse is caring for a client who practices Catholicism and was newly diagnosed with cancer. The client states, "God is punishing me for my past sins." How should the nurse respond?

"You sound upset. Would you like to talk about it?"

A labor and delivery nurse cares for a client who recently immigrant from Japan and is in labor. During shift report, which statement by the nurse will another nurse challenge?

"the client is stoic & will not complain at all."

Which stereotypical ideas about older adult clients does the nurse associate with the concept of ageism?

- physically impaired - burdensome to family - uninterested in intimacy

A nurse is performing an admission assessment with a client who speaks another language. Which action(s) can the nurse take to enhance communication?

- use an electronic translator - contact a telephone-based medical interpreter - request assistance from an agency interpreter

Ethnocentrism

Belief in the superiority of one's nation or ethnic group.

Which is a cultural norm of the health care system?

There is the use of a systematic approach & problem solving methodology

Upon moving to another country, a college student is very confused by many local customs. He is especially bothered by the custom of men and women eating in separate areas and it makes him angry and resentful of the new culture. What are the feelings experienced by this student?

culture shock

The charge nurse overhears two new graduate nurses talking in the break-room. One graduate nurse states, "I hate getting reports from the older nurses; they are just too slow." The charge nurse understands that the nurse is demonstrating what?

ageism

A nurse has been cautioned by a nursing educator to ensure that stereotyping does not influence the nurse's beliefs, behaviors, and interactions with clients from other cultures. What action by the nurse would be considered stereotyping?

ascribing attributes to members of a particular culture that are unsupported by facts

The nurse is caring for a client of a different culture and strives to deliver culturally sensitive care. Which action by the nurse is most appropriate?

ask inquisitive questions regarding the client's cultural practices

The cardiologist advises the client to undergo angioplasty, a procedure to clear blocked coronary arteries. The client refuses the procedure and the nurse later discovers that the client believes in naturopathy and is taking herbal extracts to clear the coronary arteries. Which action should the nurse take?

ask the client to opt for herbal therapy & also undergo the procedure

The nurse is preparing the discharge plan for a new mother and her newborn son. Which new teaching should the nurse ensure is included after noting the family is Jewish?

care following the scheduled circumcision

A nurse engages in professional rituals as a means to standardize practice and ensure efficiency. In doing so, the nurse integrates understanding of:

common & observable expressions of culture

Have you experienced flashbacks to your military years?

cultural sanctions/ restrictions

Are you part of a faith community?

cultural sanctions/restrictions

How do you express emotions or feelings?

cultural sanctions/restrictions

An immigrant lives with relatives in a community with many households from the country of origin. The client is taken to the emergency department following a fall at work and is admitted to the hospital for observation. The nurse is aware that this client is at risk for:

culture shock

The emergency department nurse is caring for a client injured in a motor vehicle collision. The client recently immigrated to the country. The nurse should implement interventions aimed at addressing which issue?

culture shock

The nurse is caring for a client who is postoperative 3 days from coronary artery bypass graft. The client has a prescription to ambulate. What is the best action by the nurse?

discuss w/ the client the need for assistance during ambulation

The client is admitted to the hospital with a ruptured ovarian cyst. The client has expressed that it is very important that the spouse be present to receive all medical information. Using the concepts of culturally competent care, which is the best response?

document the client's request in the nursing care plan

The nurse asks a client who has recently given birth to begin breastfeeding her infant. However, the client informs the nurse that she cannot breastfeed the infant for a day because she believes that the moth

educating the mother about the advantages of colostrum & breastfeeding

The community health nurse is assessing a home-bound client. The client expresses their own past-oriented ancestral heritage and family rituals. The nurse recognizes that the client is expressing:

ethnic identity

The nurse is caring for two clients with the same ethnic background but who appear to live out cultural practices in different ways. When understanding the needs of these clients and providing culturally safe care, the nurse should follow which principle?

ethnicity & culture & not synonymous

A client tells the nurse that the only thing that helps the client sleep is a glass of warm milk. The nurse caring for the client insists that this cultural practice is a myth and tries to convince the client that reading a book would be better. What is the nurse demonstrating?

ethnocentrism

Which area is typically included in a cultural assessment?

food preferences

How is culture learned by each new generation?

formal & informal experiences

How do you control your pain?

health beliefs/practices

How much alcohol do you use daily?

health beliefs/practices

The nurse is caring for a client from another culture who is diagnosed with lung cancer. Which nursing action best demonstrates culturally sensitive care?

incorporating the client's need for daily prayer into the nursing care plan

stoic

indifferent to pleasure or pain

An unlicensed assistive personnel (UAP) has made a disparaging comment about a client from another culture, stating that the client's hygiene practices are "oddly completed." When questioned by the nurse, it becomes clear that this characterization stems from differences between the client's culture and the UAP's culture. What is the nurse's best response?

initiate a dialogue w/ the UAP about the potential harms of ethnocenrism

Personal space and distance is a cultural perspective that can impact nurse-client interactions. What is the best way for the nurse to interact physically with a client who has a different cultural perspective on space and distance?

know the client's cultural personal space preferences

A client says to the nurse, "Why don't you wear a white cap like nurses do on the soap operas?" This is an ethnocentric statement based on the:

media

The nurse is assessing an infant of Asian descent and notes dark blue spots on the infant's lower back. What action should the nurse take next?

press lightly on the pigmented area & observe the infant's reaction

The nurse is caring for a client whose language skills are very limited in the language the nurse speaks, and an interpreter has been obtained. The interpreter appears to be telling the client more than the nurse is saying and possibly providing an opinion or medical advice. Which action is appropriate for the nurse to take?

speak privately w/ the interpreter & instruct them to only provide language interpretation

The labor and delivery nurse is getting report from the previous shift regarding a client with Asian heritage. The departing nurse states that the client did not ask for pain medication because "Asian people can handle pain." The nurse receiving report understands that this an example of what?

stereotyping

The nurse caring for several clients on a surgical unit notes that one of the clients has a surname associated with Arabic ancestry. The nurse decides to remove all pork from the client's meal tray prior to delivering it to the room. What best describes the nurse's action?

stereotyping

In addressing health promotion for a client who is a member of another culture, the nurse should be guided by which principle?

that the client may have a very different understanding of health promotion

A middle-aged female client visits the clinic to confirm pregnancy. "I cannot believe this is happening. I cannot be pregnant. My parents will kill me. I was raised in a strict Roman Catholic home. I was not supposed to get pregnant before marriage."

the client is exhibiting signs of spirtual guilt related to the inability to live up to devout practices

The home health nurse is conducting a health history interview with a client that immigrated 3 months ago. What action observed by the nurse would indicate that the client is adapting to the majority culture?

the client reads books in the language of the new country

The nurse obtains a health history interview on a client with lung cancer. The client states, "I became too focused at work; I did not have time to rest. I usually work 8 hours per day but, for the past few months, I have been spending at least 12 hours per day at the office. That is probably the reason why I was diagnosed with cancer. Maybe when I try to go back to my usual schedule, the cancer will go away. I did not want to be here but my wife is insistent. I do not think medications work. My brother-in-law died of cancer. He took a lot of medicines and prayed really hard, but he died just the same."

the nurse determines that the client believes in the holistic cause of illness as manifested by believing one can be cured of cancer by limiting work hours

The nurse is caring for a client who is terminally ill and recently immigrated to the country. The nurse understands that in order to provide quality end-of-life care for the client, what would be the priority action by the nurse?

understand the client's personal & cultural views regarding death & dying

A nurse is assigned to care for a client who does not speak the same language. An interpreter has been contacted and will be at the bedside shortly. Which action by the nurse would be mosteffective in reassuring the client until the interpreter arrives?

using reassuring body language & making eye contact to assess needs

The nurse is providing discharge teaching for a client who is from a different culture. The nurse notes that the client will look away from the nurse and does not maintain eye contact. What would be the most appropriate action by the nurse, with regard to culturally competent care?

utilize a key informant & continue with the teaching, verifying the client's understanding through open-ended questions