Exam 2 Culture and Spirituality
Which is the first stage of sexual arousal? 1) Desire 2) Excitement 3) Stimulation 4) Orgasm
1) Desire
Which statement best describes theology? 1) Discussions and theories related to God and His relation to the world 2) Doctrines about the human soul and its relation to eternal life 3) A lifelong journey involving accumulation of experience and understanding 4) Codes of conduct that integrate beliefs and values
1) Discussions and theories related to God and His relation to the world
Which of the following is considered a religious denomination within the tradition of Christianity? 1) Buddhism 2) Rastafarianism 3) Mormonism 4) Islam
3) mormonism
List the six cultural specifics affecting health.
Communication Space Social organization Time orientation Environmental control Biological variations
What is Painful intercourse called?
Dyspareunia
What is it called when someone exposes genitals to an unsuspecting person?
Exhibitionism
List three core issues of spirituality.
Faith Hope Love
What religion uses five pillars of faith; forbidden to eat pork?
Islamic
What religion will not accept whole blood transfusions but will allow the administration of albumin?
Jehovah's Witness
What is Libido?
Sex drive or desire
18. In which culture is the father more likely to be expected to participate in the labor and delivery? a. Asian-American b. African-American c. European-American d. Hispanic
c. European-American
racism can be defined in 3 ways
individual institutional cultural
A person who spends a great deal of time reviewing his belief system and comparing and contrasting it with alternatives is experiencing which of the following? A. Spiritual growth B. Religiosity C. Religious struggle D. Spiritual distress
C. Religious struggle
A male clinical instructor tells a female nursing student that she will definitely pass her clinical rotation if she agrees to go on a date with him. This is an example of which of the following? A. Date rape B. Negative intimate relationship C. Sexual harassment D. Sexual masochism
C. Sexual harassment
A nurse is caring for a client who shares the nurse's religious background. Which of the following information should the nurse anticipate? A. Members of the same religion share similar feelings about their religion B. A shared religious background generates mutual regard for one another C. The same religious beliefs can influence individuals differently D. The nurse and client should discuss the differences and commonalities in their beliefs
C. The same religious beliefs can influence individuals differently
A
Campinha-Bacote's model of culturally competent care encourages health care providers to: A. Seek cultural encounters, obtain cultural knowledge, develop skills to conduct culturally sensitive assessments, and develop self-awareness B. Define circumstances that affect a person's cultural worldview C. Use a culturally holistic perspective to provide culturally congruent care D. None of the above
False
Children and family members should be encouraged to serve as interpreters (T/F)
What religion teaches reliance on God for healing rather than medicine or surgery?
Christian Scientist
D
Collecting data helps a health care organization do which of the following? A. Monitor quality of care and outcome patterns B. Assess needs for language services and health literacy assistance C. Build an epidemiological profile of the community D. All of the above
False
Community members should not be involved in reviewing translated materials because they do not have the requisite medical knowledge to appropriately judge the translations (T/F)
14. Which statement about family systems theory is inaccurate? a. A family system is part of a larger suprasystem. b. A family as a whole is equal to the sum of the individual members. c. A change in one family member affects all family members. d. The family is able to create a balance between change and stability.
b. A family as a whole is equal to the sum of the individual members.
19. Which statement about cultural competence is not accurate? a. Local health care workers and community advocates can help extend health care to underserved populations. b. Nursing care is delivered in the context of the client's culture but not in the context of the nurse's culture. c. Nurses must develop an awareness of and sensitivity to various cultures. d. A culture's economic, religious, and political structures influence practices that affect childbearing.
b. Nursing care is delivered in the context of the client's culture but not in the context of the nurse's culture.
4. The nurse should be aware that the criteria used to make decisions and solve problems within families are based primarily on family: a. Rituals and customs. b. Values and beliefs. c. Boundaries and channels. d. Socialization processes.
b. Values and beliefs.
3. Health care functions carried out by families to meet their members' needs include: a. Developing family budgets. b. Socializing children. c. Meeting nutritional requirements. d. Teaching family members about birth control.
c. Meeting nutritional requirements.
13. A traditional family structure in which male and female partners and their children live as an independent unit is known as a(n): a. Extended family. b. Binuclear family. c. Nuclear family. d. Blended family.
c. Nuclear family.
5. Using the family stress theory as an intervention approach for working with families experiencing parenting, the nurse can help the family change internal context factors. These include: a. Biologic and genetic makeup. b. Maturation of family members. c. The family's perception of the event. d. The prevailing cultural beliefs of society.
c. The family's perception of the event.
7. The nurse's care of a Hispanic family includes teaching about infant care. When developing a plan of care, the nurse bases interventions on the knowledge that in traditional Hispanic families: a. Breastfeeding is encouraged immediately after birth. b. Male infants typically are circumcised. c. The maternal grandmother participates in the care of the mother and her infant. d. Special herbs mixed in water are used to stimulate the passage of meconium.
c. The maternal grandmother participates in the care of the mother and her infant.
nurse supports and facilitates clients in their use of cultural practices when they are not harmful to clients examples
cultural accommodation home burial of the placenta setting up place for people to pray in hospitals
ethnocentrism contrasts with
cultural blindness
tendency to ignore all differences among cultures, to act as though these differences do no exist
cultural blindness
Advocating, mediating, negotiating, and intervening between the client's culture and the biomedical health care culture on behalf of clients examples
cultural brokering migrant workers being taught prevention, health maintenance, environmental sanitation and pesticides, nutrition because they don't come to doctor unless urgent so this may be the only time to educate them
percieved threat that may arise from a misunderstanding of expectations between clients and nurses when either groups is. not aware of cultural differences
cultural conflict
nurses intrinsic motivation to provide culturally competent care
cultural desire
5th construct of cultural competence
cultural desires
the fourth construct essential to becoming culturally competent; it refers to the process that permits nurses to seek opportunities to engage in cross-cultural interactions
cultural encounter
involves the belief in one's own s superiority, or ethnocentrism and the act of imposing one's values on others
cultural imposition
information about organizational elements of diverse cultures and ethnic groups
cultural knowledge
the nurse supports and facilitates the use of scientifically supported cultural practices from a person's culture along with those from the biomedical health care system examples of these
cultural preservation accupuncture acupressure
recognizing that clients have different approaches to their health, and that each culture should be judged on its own merit and not on the nurse's personal beliefs
cultural relativsim
nurse works with clients to help them reorder, change, or modify their cultural practices when these practices are harmful to them example?
cultural repatterining weight management with Mexican client while respecting their cultural traditions
feeling of hopelessness, discomfort, and disorientation experienced by an individual attempting to understand or effectively adapt to another cultural group that differs in practices, values, beliefs
cultural shock
refers to the effective integration of cultural awareness and cultural knowledge to obtain relevant cultural data and meet the needs of culturally diverse clients
cultural skill
9. The nurse should be aware that during the childbearing experience an African-American woman is most likely to: a. Seek prenatal care early in her pregnancy. b. Avoid self-treatment of pregnancy-related discomfort. c. Request liver in the postpartum period to prevent anemia. d. Arrive at the hospital in advanced labor.
d. Arrive at the hospital in advanced labor.
6. While working in the prenatal clinic, you care for a very diverse group of patients. When planning interventions for these families, you realize that acceptance of the interventions will be most influenced by: a. Educational achievement. b. Income level. c. Subcultural group. d. Individual beliefs.
d. Individual beliefs.
17. When attempting to communicate with a patient who speaks a different language, the nurse should: a. Respond promptly and positively to project authority. b. Never use a family member as an interpreter. c. Talk to the interpreter to avoid confusing the patient. d. Provide as much privacy as possible.
d. Provide as much privacy as possible.
2. In what form do families tend to be most socially vulnerable? a. Married-blended family b. Extended family c. Nuclear family d. Single-parent family
d. Single-parent family
11. The patient's family is important to the maternity nurse because: a. They pay the bills. b. The nurse will know which family member to avoid. c. The nurse will know which mothers will really care for their children. d. The family culture and structure will influence nursing care decisions.
d. The family culture and structure will influence nursing care decisions.
____________ reflects cultural membership and is based on individuals sharing similar cultural patterns (beliefs, customs, behaviors, traditions, etc.)
ethnicity
shared feeling of peoplehood among a group of individuals
ethnicity
type of cultural prejudice at the population level, the belief that one's own group determines the standards for behavior by which all other groups are to be judged
ethnocentrism
Advocating, mediating, negotiating, and intervening between the client's culture and the biomedical health care culture on behalf of clients.
five principles of a culturally competent organizational model
not a citizen but allowed to both live and work in the U.S.
legal immigrant (lawful permanent residents) aka green card holder
admitted to the U.S. for a limited duration and specific purpose (students/tourists, artists, entertainers, diplomats, business executives, reporters, etc.)
nonimmigrants
being viewed negatively because of your skin color
prejudice
having a deeply held reaction, often negative, about another group or person.
prejudice
belief that person who are born into a particular group are inferior
racism
form of prejudice
racism
admitted outside the usual quota restrictions based on fear of persecution due to their race, religion, nationality, social group, or political views
refugee
the grounds for a ______ for seeking asylum must be one of the five person's race religion nationality social group political opinion national origin
refugee
the way in which a cultural group structures itself around the family to carry out role functions
social organization
"all asian people are hardworking"
stereotype
attributing certain beliefs and behaviors about a group to an individual without giving adequate attention to individual differences
stereotyping
Undocumented immigrants or illegal aliens are individuals who have crossed a border into the United States illegally or whose legal permission to stay in the United States has expired. They are eligible only for emergency medical services, immunizations, treatment for the symptoms of communicable diseases, and access to school lunches. t/f
true
covert vs overt
Covert: unobservable *O*vert: *O*bservable
True
Cultural and linguistic competency is a set of congruent behaviors, attitudes, and policies that come together in a system, in an agency, or among professionals (T/F)
False
Cultural competency within an organization results from a linear process of systemically working through checklists (T/F)
A
Culturally competent organizations should ensure that patients receive which of the following types of care? A. Effective, understandable, and respectful care B. Low-cost primary care for patients with limited English proficiency C. Wellness interventions for conditions under which health disparities exist D. Care from nurses who share the patient's language and culture
A family from Mexico comes to the public health department. No one in the family speaks English, and nobody at the health department speaks Spanish. Which of the following actions should be taken by the nurse? a. Attempt communication using an English-Spanish phrase book. b. Call the local hospital and arrange a referral. c. Emphatically state, "No hablo Español" (I don't speak Spanish). d. Obtain an interpreter to translate.
D
A health care worker tells a nurse, "It does no good to try to teach those Medicaid clients about nutrition because they will just eat what they want to no matter how much we teach them." Which of the following is being demonstrated by this statement? a. Cultural imposition b. Ethnocentrism c.. Racism d. Stereotyping
D
A male nurse had a habit of sitting with the lower part of one leg resting over the knee of his opposite leg when collecting a client's history. He stopped doing this around Muslim clients after being told that Muslims were offended when he exposed the sole of his foot (shoe) to their face. Which of the following was exhibited by the nurse when he changed his behavior? a. Cultural accommodation b. Cultural imposition c.. Cultural repatterning d. Cultural skill
D
The nurse practitioner (NP) discovered that an immigrant client is not taking the penicillin prescribed because his illness is "hot" and he believes that penicillin, a "hot" medicine, will not provide balance. Which of the following terms best describes the action taken by the NP when the client's prescription is changed to a different yet equally effective antibiotic? a. Cultural awareness b. Cultural brokering c. Cultural knowledge d. Cultural skill
D
A patient arrives at the emergency room with respiratory distress. The nurse needs to get essential information for the planning of the patient's care. Based on the patient's condition, what should the nurse do? A) Offer information B) Ask open-ended questions C) Begin a detailed interview D) Ask closed-ended questions
D) Ask closed-ended questions Closed-ended question focus on seeking a particular answer and require a one- or two-word response, which is appropriate for a patient who is in respiratory stress. The goal is to get information that is essential for the development of the patient's plan of care. Offering information before the problem is identified is inappropriate. Asking open-ended questions and performing a detailed interview are not recommended because the patient's condition may be life-threatening.
A Native American patient comes to the emergency center. A culturally sensitive nurse would limit eye contact based on what principle? A) It indicates an intent to communicate B) Eye contact would indicate sexual advances. C) Eye contact indicates a desire for confrontation. D) Eye contact is perceived as impolite, aggressive, and improper.
D) Eye contact is perceived as impolite, aggressive, and improper. Some cultures such as Arabic or Native American cultures view eye contact as impolite, aggressive, or improper. Eye contact generally indicates intent to communicate, not sexual advances or a desire for confrontation.
A nurse has been interviewing a patient for over an hour. To ensure that important information was collected, the nurse should use which communication technique? A) Touch B) Humor C) Silence D) Summarizing
D) Summarizing Summarizing provides a review of the main points covered during interaction. In this case, the interview has been ongoing for the past hour and much has been discussed. Summarizing gives the interviewer one last opportunity to ensure that the important information that can affect the plan of care has been received. Touch, humor, and silence, although positive, are inappropriate at this time.
A nurse demonstrating caring, sincerity, empathy, and trustworthiness is considered to be engaging in what type of relationship? A) Verbal B) Nourishing C) Nonverbal D) Therapeutic
D) Therapeutic
Mr. Jones, a former patient who survived a serious illness, comes to your patient care unit on Saturday afternoon. He has packets of literature about his religion; its philosophy, values, meeting places; and some prayers. He asks if he can place the information in the family waiting area. What is your best response? A. "Yes, this would be helpful for many of the families. B. "No, hospital policy doesn't allow for it." C. "I would be happy to do it for you. Let's place the literature in the staff lounge." D. "I will need to check the hospital's policy and discuss your request with my manager."
D. "I will need to check the hospital's policy and discuss your request with my manager."
Of the following cultural groups, which is at high risk for sickle cell anemia? A. Alaskan Native B. Pacific Islander C. Hispanic D. African American
D. African American
A nurse is caring for a client who is a Jehovah's Witness and is scheduled for surgery as a result of a motor vehicle crash. The surgeon tells the client that a blood transfusion is essential. The client tells the nurse that based on his religious values and mandates, he cannot receive a blood transfusion. Which of the following responses should the nurse make? A. I believe in this case you should really make an exception and accept the blood transfusion B. I know your family would approve of your decision to have a blood transfusion C. Why does you religion mandate that you cannot receive any blood transfusions? D. Let's discuss the necessity for a blood transfusion with your religious and spiritual leaders and come to a reasonable solution.
D. Let's discuss the necessity for a blood transfusion with your religious and spiritual leaders and come to a reasonable solution.
False
Developing cultural and linguistic competency is a specific achievement (T/F)
True
Developing cultural competency and providing culturally and linguistically appropriate services should be included as an integral objective in health care organizations' strategic plans (T/F)
What three key dimensions are assessed with the JAREL spiritual well-being scale?
Faith/belief Life/self-responsibility Life satisfaction/self-actualization
True or False? A nurse and client of the same race who speak the same language will not experience problems in communication.
False
True or False? After having surgery for benign prostatic hypertrophy, a male patient will always experience impotence.
False
True or False? Shared touch can be a way to maintain celibacy.
False
True or False? The nursing diagnosis Ineffective Sexuality Patterns can be used when describing vaginismus.
False
What is it called when someone is born with ambiguous sex organs?
Hermaphrodite
False
It is important for nurses and patients to communicate in the same language because a common language ensures cultural understanding (T/F)
What religion observes strict dietary laws, wears skull cap (yarmulke or kippah) and follows written law (Torah)?
Jewish
Beginning of menstruation is called?
Menarche
Follows strict health code; avoids alcohol, tea, coffee, and smoking
Mormon
False
National CLAS Standards 1-3 provide recommendations on implementing language assistance services (T/F)
What religion believes all harmony and disease is based in spirituality?
Native American
False
Only nursing encounters with racial/ethnic minority patients are considered "cross-cultural" encounters (T/F)
False
Partnerships with minority communities should mainly involve soliciting input (T/F)
C
The BATHE model helps nurses to A. Determine the patient's level of literacy B. Define circumstances that affect the patient's cultural worldview C. Elicit the psycho-social context of the patient's experience with illness D. Experiment with communication tools
B
The SMOG formula determines: A. The patient's literacy level B. The readability level of written materials C. The patient's language needs D. The nature of language assistance services
D
The continuous improvement cycle includes which of the following steps? A. Assessment B. Planning C. Evaluation D. All of the above
False
The explanatory model is the belief system that reveals the patient's perspective on the interaction with health care providers (T/F)
D
To advocate effectively for cultural competency, nurses need the following skills: A. Willingness to serve as a change agent B. Commitment to diversity and provision of quality of care to all, regardless of personal characteristics C. Ability to work collaboratively to promote change D. All of the above
True or False? A stereotype is a preconceived and untested belief about people or groups of people.
True
True or False? An important issue about sexually transmitted infections is that many patients are asymptomatic.
True
True or False? Race is defined as the physical characteristics that are shared by a specific ethnic group.
True
False
Unless he or she is a supervisor, a nurse's only role in supporting organizational cultural and linguistic competency is advocacy (T/F)
NANDA-I has two nursing diagnoses for describing sexual problems: Ineffective Sexuality Patterns and Sexual Dysfunction. How would you determine which diagnosis to use on a client? 1) Use Ineffective Sexuality Patterns when the patient expresses concern about the ability to achieve his perceived sex role. 2) Use Ineffective Sexuality Patterns when the patient is seeking confirmation of desirability. 3) Use Sexual dysfunction when the patient is experiencing values conflicts in the area of sexuality. 4) Use Sexual Dysfunction when the patient expresses dissatisfaction with an actual change in sexual functioning.
Use Sexual Dysfunction when the patient expresses dissatisfaction with an actual change in sexual functioning (e.g., difficulty maintaining an erection).
B
When a person believes that other groups have "natural" cultural characteristics and there are no variations within a specific culture, this person displays which of the following? A. Ethnocentrism B. Essentialism C. Power differentials D. None of the above
C
Which of the following four statements best describes the relationship between the knowledge-centered and skill-centered approaches to delivering culturally and linguistically competent care? A. The knowledge-centered approach should be given preference, because specific knowledge about culture or ethnic groups helps nurses define their patients who come from these groups. B. The skill-centered approach should be given preference, because no nurse can remember all of the facts relating to multiple cultures. C. Knowledge-centered and skill-centered approaches should be balanced. D. The knowledge-centered approach presents patients as cultural stereotypes and should not be used
D
Which of the following is a factor that contributes to successful partnerships? A. Mutual trust, respect, and commitment B. Identified strengths and assets C. Clear and accessible communication D. All of the above
D
Which of the following is not a critical domain for measuring organizational cultural competency? A. Values and attitudes B. Community involvement C. Training and staff development D. Number of bilingual staff
B
Which of the following is not a requirement for a qualified translator? A. Previous education, experience, and training in translation B. Membership in the cultural group for which the translation is being done C. Command of both English and the language into which the material will be translated D. Familiarity with medical terminology
C
Which of the following is not a transcultural communication technique? A. Explaining to the patient that they can and need to speak freely about their symptoms and fears B. Providing the patient with a quiet setting C. Examining your stereotypes and biases D. Listening to what your patients are trying to tell you about their symptoms
D
Which of the following is the most effective way to identify patients with limited literacy skills? A. Assess their physical appearance B. Determine their educational level C. Ask if they can read D. None of the above
C
Which of the following is the preferred role of medical interpreters? A. Advocate B. Clarifier C. Conduit D. Culture broker
C
Which of the following, if any, encompasses the definition of patient-centered care? A. The nurse provides as many services as possible directly to the patient, without relying on other health care providers. B. The health care team meets with the patient and his or her family to develop a treatment plan for the patient. C. The nurse is aware of the role of cultural health beliefs and practices in the person's health-seeking behavior and is able to negotiate treatment options appropriately and in a culturally sensitive way. D. None of the above.
C
Which of the following, if any, is the definition of "illness"? A. Physiological and psychological processes that affect a person's health B. Diseases of the human body C. The psycho-social meaning and experience of the perceived disease for the individual, the family, and those associated with the individual D. None of the above
Which statement by the LPN is an example of using assertiveness?
"It is time for you to go to physical therapy (PT). Do you want to walk part way or do you think you're strong enough to walk all the way?"
C
"Triadic" refers to which of the following relationships in a nursing interview setting? A. Nurse, patient, family member B. Nurse, doctor, patient C. Nurse, interpreter, patient D. Patient, interpreter, family member
A nurse is preparing to care for her newly admitted patient. The person who accompanied the patient informs her that he is from the Middle East and speaks very little English. He is unsure of the patient's primary language. The hospital has no interpreters available who speak any Middle Eastern language. List at least four alternative interventions the nurse can use to communicate with the patient.
-Greet the client with respect, and be aware of nonverbal cues. If you are able to identify one, use a third language or one that is similar to their spoken language (e.g. French is spoken by some Vietnamese). -Speak in English slowly and clearly, using simple sentences to talk about one problem or need at a time, using gestures. -Restate information in different words if it appears the client does not understand your initial attempts. -Use pictures or diagrams. -Use written language in short, simple sentences. -Use the Internet or computer software to translate words into the Middle Eastern language. -Have the patient type information in his native language, using the Internet or computer software, and convert it into English.
A patient reports experiencing gas, abdominal bloating, and diarrhea after consuming milk or cheese. Lactose intolerance might immediately be suspected if the patient is of which heritage? 1) African American 2) Mexican American 3) European American 4) Arab American
1) African American
The nurse is admitting a Roman Catholic adult patient who is critically ill. Based on her knowledge of the patient's religion, for which religious practice should she expect to notify the hospital chaplain? 1) Anointing of Sick 2) Baptism 3) Eucharist 4) Sacrament of Reconciliation
1) Anointing of Sick
A Muslim client has asked the nurse to pray with her. Which item should the nurse anticipate that the patient may request before praying? 1) Bathing water 2) Rosary beads 3) Mala beads 4) Prayer cloth
1) Bathing water
A 17-year-old woman with Down syndrome is brought to the emergency department by her parents after an incident of sexual assault by her uncle. What would you do when providing care to her after the incident? Select all that apply. 1) Document pregnancy status with a urine or blood sample. 2) Advise parents to have her tested for STIs 1 week after the incident. 3) Administer the hepatitis B and HPV vaccines, as ordered. 4) Refer the victim to a sexual assault center for further information and counseling.
1) Document pregnancy status with a urine or blood sample 2) Advise parents to have her tested for STIs 1 week after the incident 3) Administer the hepatitis B and HPV vaccines, as ordered
Which core issue of spirituality includes a patient's basic human need for achievement? 1) Hope 2) Faith 3) Love 4) Forgiveness
1) Hope
A patient who came from Central America is admitted with diabetes mellitus. The nurse is collecting biographical information. Which information provided by the patient represents his ethnicity? 1) Latino 2) Catholic 3) White 4) Teacher
1) Latino
A Hispanic patient is frustrated because the healthcare team does not understand the importance of hot and cold therapies. Which nursing diagnosis is most appropriate for this patient? 1) Powerlessness 2) Impaired Verbal Communication 3) Spiritual Distress 4) Risk for Noncompliance
1) Powerlessness
You are caring for 35-year-old man who tells you that he feels distress about being a male, and ever since he was a young child has thought of himself as a female. He describes the isolation he feels and concern about fitting in socially and at work because of these recurrent thoughts. How would you respond to your patient? 1) Provide information about support groups and other community resources for transsexual people. 2) Reassure him that he is normal, saying there are more people than we know who feel this way. 3) Share with him that you personally have had thoughts like this but have coped with these thoughts. 4) Suggest your patient seeks mental health care for medication to help him deal with his anxiety.
1) Provide information about support groups and other community resources for transsexual people
An agnostic nurse is caring for a devoutly religious patient. The client says, "I am so frightened. Please say a prayer with me." The patient begins praying aloud. What should the nurse do? 1) Remain quietly beside the bed until the client finishes the prayer. 2) Walk quietly from the room while the client is praying. 3) Stop the client and say, "I am not comfortable with prayer. I will get someone to join you." 4) Stay during the prayer and say "Amen" at pauses and when the prayer is finished.
1) Remain quietly beside the bed until the client finishes the prayer
three stages of cultural competence and three dimensions of each stage
1. Culturally incompetent 2. Culturally sensitive 3. Culturally competent cognitive, affective, psychomotor
A patient is prescribed a low-sodium, low-fat diet. How can the nurse best ensure that the patient follows the prescribed diet during hospitalization? 1) Make sure dietary services sends a low-sodium, low-fat meal tray. 2) Arrange for meals that accommodate his cultural dietary practices and specified diet. 3) Ask the patient's family to bring in from home the foods he typically eats. 4) Sit with the patient while he eats to make sure he consumes the prescribed diet.
2) Arrange for meals that accommodate his cultural dietary practices and specified diet
During the admission assessment, a patient tells the nurse that he does not believe there is a God. The nurse should document his religious affiliation as: 1) Agnostic 2) Atheist 3) Christian Scientist 4) Rastafarianism
2) Atheist
A long-term care facility has started a program to increase the cultural competence of its employees. When notified of this, a nurse thinks to himself, "I don't have time for this nonsense. I already know all I need to about culture, and I don't really like taking care of so many different kinds of people anyway." This most clearly illustrates the nurse's lack of cultural: 1) Awareness 2) Desire 3) Exposure 4) Knowledge
2) Desire
North American healthcare culture typically reflects which culture? 1) Asian 2) European American 3) Latino 4) African American
2) European American
The nurse is caring for a 42-year-old, Chinese American patient who underwent emergency coronary artery bypass graft surgery. He is self-employed and has no health insurance. Each day members of his family spend hours at his bedside. Which is the most important factor for the nurse to focus on when planning the patient's discharge? 1) Ethnic background 2) Family support 3) Employment status 4) Healthcare coverage
2) Family support
A 65-year-old widow is being given an annual physical exam. She states she has been dating a widowed man for 9 months and that the relationship is fulfilling in most areas. However, she is unable to have sexual relations because she feels she is "cheating" on her husband, who died 5 years ago. Her partner is very understanding, although her inability to have sexual relations is becoming a strain on their relationship. What is an appropriate nursing diagnosis for this woman? 1) Sexual Dysfunction related to conflicted sexual orientation 2) Ineffective Sexuality Patterns related to values conflicts 3) Ineffective Sexuality Patterns related to impaired relationship with partner 4) Sexual Dysfunction related to fear of the unknown
2) Ineffective sexuality patterns related to values and conflicts
Which topic is most important to include when educating all clients about sexuality? 1) Contraception 2) Sexually transmitted infections (STIs) 3) Sexual orientation 4) Sexual identity
2) Sexually transmitted infections (STIs)
A patient of Mormon faith is admitted to the hospital with new onset diabetes mellitus. Based on his religious affiliation, which item(s) should the nurse remove from the patient's dinner tray? Select all that apply. 1) Pork 2) Tea 3) Meat 4) Coffee
2) Tea 4) Coffee
The nurse preparing a Latino patient for a diagnostic procedure states, "After the cardiac catherization, you will need to be supine. We will also assess you for a thrombus." Which statement below is true? 1) The statements are appropriate to teach the patient about the procedure. 2) The nurse is using healthcare jargon in her explanation to the patient. 3) The nurse should use an interpreter to explain the procedure to the patient. 4) The information will have to be repeated to a family member, when he/she arrives.
2) The nurse is using healthcare jargon in her explanation to the patient
Which of the following questions would provide information about "O" in a HOPE assessment and "S" in a SPIRIT assessment? 1) Do you have any dietary restrictions or needs on religious holidays? 2) What is your religion or what church do you go to? 3) How comfortable are you with discussing spirituality? 4) Do you have an advance directive?
2) What is your religion or what church do you go to?
Which of the following is a DSM category of sexual deviation that a client might require mental health care? 1) Homosexuality 2) Voyeuristic disorder 3) Bisexuality 4) Transgenderism
2) voyeuristic disorder
A patient who moved to the United States from Italy comes to the clinic for medical care. The patient has been in this country for several years and has adopted some elements of her new country. Yet, she still retains some customs from her homeland. This patient is experiencing: 1) Assimilation. 2) Socialization. 3) Acculturation. 4) Immigration.
3) Acculturation
Based on a nursing diagnosis of Ineffective Sexuality Patterns related to values conflicts, what would be the most effective nursing intervention for a patient? 1) Educate the patient about sexual orientation and function. 2) Encourage the patient to discuss relationship problems with her partner. 3) Advise the patient to discuss her value conflict with a counselor. 4) Instruct the patient on effective methods to identify fears.
3) Advise the patient to discuss her value conflict with a counselor
When taking a cultural history, all of the following are important. Which one is most important to later plan for patient safety? 1) Obtain data directly from the patient. 2) Show empathy and respect; build rapport. 3) Ask about use of alternative medicine and folk remedies. 4) Ask open-ended questions when beginning the assessment.
3) Ask about use of alternative medicine and folk remedies
An 18-year-old high-school senior comes to the local family planning clinic requesting birth control pills. When discussing sexual health with the adolescent girl, your first nursing priority would be to do which of the following? 1) Urge the teen to practice healthful sexual behaviors. 2) Inform her about the risk of pregnancy and STIs. 3) Assess the teen's knowledge of sexuality and reproduction. 4) Provide detailed information about birth control pills.
3) Assess the teen's knowledge of sexuality and reproduction
A patient of Scandinavian heritage is admitted for observation after sustaining injuries in a motor vehicle accident. The nurse expects that he may endure pain stoically, without grimacing or vocalizing. The nurse's thinking is an example of a/an: 1) Archetype 2) Bias 3) Prejudice 4) Stereotype
3) Prejudice
When performing a spiritual assessment, who is the preferred source of information? 1) Durable power of attorney 2) Next of kin 3) Patient 4) Patient's clergy person
3) patient
You are caring for a healthy 28-year-old man with a fractured tibia (bone in the lower leg). The patient has asked you to place his penis in the urinal and hold it while he voids. You should: 1) assist the patient as he has requested. 2) immediately leave the room. 3) tell him his behavior is inappropriate. 4) report him to your supervisor.
3) tell him his behavior is inappropriate
A patient remarks to the nurse, "What's the point of going through all these medical treatments? They make me feel so bad, and I will never be well anyway." What is the most helpful action for the nurse to take? 1) Explore with the patient what has triggered his emotions. 2) Treat the patient with dignity and respect. 3) Pray with the patient in a private setting. 4) Assist the patient to identify areas of hope in life.
4) Assist the patient to identify areas of hope in life
Which of the following is the most important information to collect at a women's health examination for a 52-year-old woman? 1) Age at first sexual encounter 2) History of PMS 3) Birth control method used 4) Date of last menstrual period
4) Date of last menstrual period
Because of religious beliefs, which of the following patients will most likely refuse a blood transfusion? One who is affiliated with? 1) Islam 2) Mormonism 3) Hinduism 4) Jehovah's Witnesses
4) Jehovah's witness
Which intervention by the nurse best indicates that she values a Native American patient's beliefs and indigenous healthcare system? 1) Incorporating Native American practices into care based on consultation with a cultural resource book 2) Explaining the values and beliefs of the traditional healthcare system to the patient so that the patient understands what is occurring 3) Contacting a Native American resource group for information about the culture 4) Planning how to incorporate traditional practices and beliefs through discussion with the patient
4) Planning how to incorporate traditional practices and beliefs through discussion with the patient
While admitting a patient with a particular religious heritage, the nurse comments to another nurse, "This is going to be a pain. This kind of patient always has a million family members in and out, and they're always so noisy and demanding." This illustrates: 1) Discrimination 2) Sexism 3) Ethnocentrism 4) Prejudice
4) Prejudice
Which factor is held in common by many of the world religions? 1) Strict health code, including dietary laws 2) Belief that one must submit to a god or supernatural being 3) Rules prohibiting alcohol consumption 4) Sacred writings that reveal the nature of the Supreme Being
4) Sacred writings that reveal the nature of the supreme being
What is the term for a person who feels a personal identity as the opposite gender for which he or she was born? 1) Transvestite 2) Intersexual 3) Homosexual 4) Transsexual
4) Transsexual
What do shared touching, celibacy, masturbation, and developing intimate relationships have in common? They are all: 1) forms of sexuality or sexual orientation. 2) cues to use in formulating a nursing diagnosis. 3) important in the development of sexual identity. 4) forms of sexual expression.
4) forms of sexual expression
. For a bedridden Muslim patient, the nurse rearranges the room and moves the bed so that it faces toward Mecca for the patient's daily prayers. Which of the following is the nurse demonstrating through these actions? a. Accommodation b. Awareness c. Brokering d.. Imposition
A
A nurse is caring for a client of another culture. Which of the following actions would be most appropriate for the nurse to take? a. Alter personal nonverbal behaviors to reflect the cultural norms of the client. b. Keep all behaviors culturally neutral to avoid misinterpretation. c. Rely on friendly gestures to communicate caring for the client. d. Avoid any pretense of prejudice by treating the client in the same way as any other client.
A
A nurse says, "I'm not going to change the way I practice nursing based on where the client is from, because research shows that Western health care technology and research is best." Which of the following is being demonstrated by the nurse's statement? a. Ethnocentrism b. Prejudice c. Racism d. Stereotyping
A
A nurse who is explaining to a client why it is important to take medication states, "The medication takes a couple of weeks to be effective, but then you should feel better." When the client is next seen, no medication has been purchased. Which of the following is the most likely explanation? a. The nurse emphasized that eventually the client would feel better, but the client needed to feel better immediately so didn't bother with the drug. b. The medication required a trip to the pharmacy, and the client just hadn't had time to obtain the drug yet. c. The medication was too expensive for the client's family. d. The client really hadn't understood why the medication was important.
A
At a local hospital, postpartum care policy requires that nurses observe the mother during infant care to assess the mother's ability to care for the new baby and to promote bonding. A new mother expresses concern that in her country, all infant care is provided by other family members so that the mother can rest and recover. Which of the following actions would be taken by a culturally competent nurse? a. Allow family members to provide the newborn's care and assess the mother's knowledge of child care through discussion. b. Reinforce the importance of bonding and that all good mothers gladly assume these responsibilities. c. Explain that the process of postpartum recovery does not require this much rest and require that she provide infant care. d. State that she must abide by hospital policy because documentation of the mother's ability to give the infant care is required for discharge.
A
When teaching a nutrition class to a student group with a large Hispanic population, the school nurse incorporates foods such as salsa and other healthy dishes familiar to Hispanic students into the presentation. Which of the following best describes the action taken by the nurse? a. Primary prevention b. Secondary prevention c. Tertiary prevention d. Both primary and secondary prevention
A
Which of the following best describes most Americans' attitude toward immigrants? a. Ambivalence because there are no clear solutions about how to address their needs b. Strongly negative because immigrants take jobs that native-born Americans could have instead c. Strongly positive because immigrants bring useful job skills and often join previous family members already in the United States d. Strong opposition to further immigration because of the increasing population in the United States
A
A patient needs discharge instructions on how to administer heparin. After the nurse demonstrates injection techniques, the patient states, "I need a nurse, I can't do this." Which would be an INAPPROPRIATE response? A) "I can see that you're not trying." B) "Let's talk about how you're feeling." C) "I'll demonstrate as many times as needed." D) "Learning to give an injection may be frightening."
A) "I can see that you're not trying."
The nurse informs a patient, "I need to attend to another patient urgently. If you don't mind waiting, I will change your clothes at a later time or I can ask someone else to assist you." What kind of communication does the statement made by the nurse indicate? A) Assertive communication B) Aggressive communication C) Unassertive communication D) Non-therapeutic communication
A) Assertive communication The patient is informed that the nurse has to attend to an urgent situation; this information is conveyed in a polite manner without disturbing the patient's feelings. This type of communication is referred to as assertive communication. Aggressive communication is a type of communication in which one person tries to overpower another. In this situation, the nurse is not trying to be authoritarian. In non-assertive communication, a person uses vague statements that may be difficult for the other members to understand. Non-therapeutic communication is a type of communication that hampers the development of the nurse-patient relationship.
A nurse touches a patient warmly on the shoulder and states that it is good that the medicines have relieved his pain. What does this indicate? A) Caring B) Focusing C) Reflection D) General leads
A) Caring Touch indicates caring. Messages accompanied by touch add feelings of caring and comfort. Focusing involves goal-directed questions. The reflection technique involves reflecting received messages back to the patient. The general leads provided by the nurse encourage the patient to continue or to elaborate.
The nurse is caring for a patient on mechanical ventilation. The nurse learns that the patient is illiterate. What methods of communication should the nurse use while communicating with the patient? Select all that apply. A) Eye blink B) Magic slate C) Picture board D) Sign language E) Magnetic boards
A) Eye blink C) Picture board D) Sign language The patient on mechanical ventilation will be unable to speak due to the endotracheal tube. Eye blinking is an alternate method of communication in which the patient is told to use a signal system such as one eye blink for "yes" and two for "no." A picture board is a medium of communication by which the patient communicates by selecting pictures. Indicating something or using gestures is also a way to communicate nonverbally. The magic slate is a board on which the patient writes messages to communicate needs; because the patient is illiterate, this method of communication cannot be used. A magnetic board is a board with letters the patient moves to spell words or phrases, but cannot be used in this case used because the patient is illiterate.
Good communication skills help obtain detailed information about the patient. Which characteristics of communication help in effective patient care? Select all that apply A) Feedback B) Validation C) Expression D) Intonation E) Active listening
A) Feedback B) Validation E) Active listening Good communication plays a vital role in a patient-nurse relationship. It requires feedback, validation, and active listening. Timely feedback ensures correct interpretation of the message. Validation ensures that nonverbal cues are correctly assumed. Active listening focuses on what is being said. Expression and intonation are characteristics of nonverbal communication.
A patient is scheduled for chemotherapy. The nurse asks the patient whether he or she has any questions about chemotherapy. Which type of technique is used by the nurse? A) Focusing B) Reflection C) General leads D) Restatement
A) Focusing The nurse asks a goal-directed question to help the patient focus on key concerns. In the reflection technique, reflecting the received message back to the patient helps the patient understand his or her own thoughts. General leads encourage the patient to continue to elaborate on the topic. In the restatement technique, the nurse rephrases the same message and repeats it back to the patient.
Therapeutic communication is a key to providing the best care possible to patients. Identify the factors that negatively affect therapeutic communication. Select all that apply. A) Lack of trust B) Language barrier C) Indifferent attitude D) Cultural differences E) Use of active listening
A) Lack of trust B) Language barrier C) Indifferent attitude D) Cultural differences Language differences between the nurse and patient, an indifferent attitude from a nurse, a lack of trust between nurse and patient, and cultural differences all negatively affect therapeutic communication.
What interventions should the nurse take while caring for a comatose patient? Select all that apply. A) Talk to the patient about daily activities. B) Encourage the family members to talk to the patient. C) Explain the activity or procedure that involves the patient. D) Ask the family to talk about instances of illness or accidents. E) Discuss the patient's health status in the patient's presence.
A) Talk to the patient about daily activities. B) Encourage the family members to talk to the patient. C) Explain the activity or procedure that involves the patient. A comatose patient is usually unresponsive to any stimulus, but there have been instances in which patients recall the conversations made while comatose; therefore, there are chances the patient hears all that is said. The nurse should encourage family members to talk to the patient, because it may trigger a response in the patient. Talking about daily activities is beneficial to the patient, because the patient may hear and be kept aware of all developments. Involving the patient while engaged in an activity may make the patient feel normal, which is beneficial to the patient. Talking about illnesses or accidents responsible for the coma aggravates fear in patient, and should be avoided. Discussing the patient's health status in the patient's presence may cause anxiety and depression in the patient and may negatively affect the patient's health.
What is essential for the nurse to establish before a therapeutic relationship forms? A) Trust B) Belief C) Loyalty D) Content
A) Trust If the patient senses that the nurse is not being genuine in conveying feelings, a therapeutic trusting relationship does not develop. Loyalty, contentment, and belief are not essential or fundamental to the therapeutic relationship.
The nurse is communicating with a hearing-impaired patient. Which techniques should the nurse use for effective communication? Select all that apply. A) Use short and simple sentences. B) Avoid shouting at the patient. C) Speak directly into the patient's ear. D) Maintain the voice pitch at mid-range. E) Give the person time to respond to questions.
A) Use short and simple sentences. B) Avoid shouting at the patient. D) Maintain the voice pitch at mid-range. E) Give the person time to respond to questions. While communicating with the hearing-impaired person, care should be taken so that the patient understands the message. Some techniques promote comprehension for the patient. Using short and simple sentences makes it easy for the patient to understand. Shouting can distort speech; therefore, the nurse should avoid shouting at the patient. Maintaining voice pitch at mid-range helps the patient to hear clearly. Giving the person time to respond to questions helps the nurse to understand whether the patient has understood or not. Avoid speaking directly into the patient's ear. It can distort the message and hide all visual cues.
A nurse recognizes that although a patient speaks English, the patient is from a culture with which the nurse is unfamiliar. Therefore, a cultural assessment should be attempted. Which of the following questions should the nurse ask? (Select all that apply.) a. "Can you tell me where your family is from?" b. "Do you practice a particular religious faith?" c. "Have you ever been in an American hospital before?" d. "Is there anything special we need to know about your food preferences?"
A, B
20. The nurse is preparing for a home visit to complete a newborn wellness checkup. The neighborhood has a reputation for being dangerous. Identify which precautions the nurse should take to ensure her safety (Select all that apply). a. Having access to a cell phone at all times. b. Visiting alone due to the agency's staffing model. c. Carrying an extra set of car keys. d. Avoiding groups of strangers hanging out in doorways. e. Wearing her usual amount of jewelry.
A, C, D
An undocumented immigrant comes to a physician's office to receive care. Which of the following services can the client receive? (Select all that apply.) a. Treatment for tuberculosis b. Treatment for Type 2 diabetes c. Immunization for polio d. Physical examination
A,C
The process a person goes through to adapt to a new culture is referred to as which of the following? A. Acculturation B. Cultural competence C. Culture shock D. Phenomena of culture
A. Acculturation
Stereotyping in nursing may result in which of the following? A. Inaccurate assessments and inappropriate interventions B. More frustration on the part of the nurse than the client C. Less frustration on the part of the nurse and the client D. Enhanced participation of family and patients
A. Inaccurate assessments and inappropriate interventions
Mr. Caruthers and Mrs. Duncan are older adults, widowed, and live in separate rooms in an assisted living facility. The nurse aide reports to the nurse that she has just seen the couple kissing and holding hands. The nurse aide then begins to laugh. What is the best nursing action? A. Instruct the nurse aide that older adults still experience sexual pleasure. B. Call the administrator and inform her of the couple's action. C. Tell the nurse aide to confront the couple and tell them to act their age. D. Laugh with the nurse aide, and tell her that nothing will happen anyway because the couple is old.
A. Instruct the nurse aide that older adults still experience sexual pleasure
3. The communication technique of __________ gives the caregiver the opportunity to ask and respond to questions.
ANS: ISBAR R ISBAR R format allows the opportunity to ask and respond to questions concerning patient care during the end of shift report. The initials stand for introduction, situation, background, assessment, recommendation, and readback.
1. Pain is often conveyed through nonverbal communication. Two other common, nonverbally expressed emotions are _________________ and ______________.
ANS: anxiety; fear Anxiety and fear can be expressed nonverbally by behaviors such as restlessness and picking at the bed covers.
2. To elicit more information from a patient, the nurse should ask questions that require more than a one-word answer. This type of question is called _______.
ANS: open ended Open-ended questions provide more information than can be gathered from closed questions.
6. A nurse using active listening techniques would: a. use nonverbal cues such as leaning forward, focusing on the speaker's face, and slightly nodding to indicate that the message has been heard. b. avoid the use of eye contact to allow the patient to express herself without feeling stared at or demeaned. c. anticipate what the speaker is trying to say and help the patient express herself when she has difficulty with finishing a sentence. d. ask probing questions to direct the conversation and obtain the information needed as efficiently as possible.
ANS: A Eye contact is a culturally learned behavior and in some cases may not be appropriate. Probing questions or finishing the patient's sentence is not part of active listening and is detrimental to an interview.
14. An aspect of computer use in patient care in which the LPN may need to be proficient includes: a. input of data such as requests for radiographs or laboratory services. b. programming the computer to record data from primary care provider and other health care workers. c. educating patients how to use hospital computers to access information such as discharge instructions or information relative to specific medications. d. scheduling admissions, discharges, and nurse staffing to keep the unit at the best occupancy and utilization.
ANS: A Facilities use computers for data entry relative to requesting radiograph, laboratory services, physical assessment and medication administration. Programming such computers is not a nursing task and patients need to have individualized information about discharge and medications.
39. The nurse is aware that the use of false reassurance is harmful to the nurse-patient relationship, because this communication block: a. discounts the patient's stated concerns. b. shows a judgmental attitude on the part of the nurse. c. summarizes the patient's concerns and closes communication. d. confuses the patient by giving information.
ANS: A Giving false reassurance is a block to effective communication in which the patient's feelings are negated and in which the patient may be given false hope, which, if things turn out differently, can destroy trust in the nurse.
25. While interviewing a Native American man for the admission history, the nurse should expect to: a. wait patiently through long pauses in the conversation. b. maintain eye contact with the patient. c. give the patient permission to speak. d. have another family member speak for the patient.
ANS: A Native Americans use long pauses in their conversation to better consider their answer and consider the question. The culturally sensitive nurse would wait quietly through the pauses.
45. The nurse is caring for a patient who is concerned about living alone. The best response by the nurse is: a. "Where have you considered living?" b. "Why don't you live with your family?" c. "I think you should live with your family." d. "If you were my mom, I'd have you live with me."
ANS: A Rephrasing will help the patient explore various alternatives. The nurse should not use phrases such as "Why don't you ..." "When that happened to me, I did ..." or "I think you should ..." Rephrasing, for example, "Have you thought of your options?" or "You might want to think about ..." or "Have you considered ...?" will help the patient explore various alternatives.
37. The nurse is caring for a patient who has just had a mastectomy (breast removal). The patient expresses concern that her husband will no longer find her attractive because of her mastectomy. The nurse appropriately responds: a. "You're concerned your husband will find you unattractive because of your mastectomy?" b. "You're a beautiful woman; of course your husband will find you attractive after your mastectomy." c. "Don't worry; when I had my mastectomy, my husband still found me very attractive." d. "You should leave your husband immediately if he thinks you're unattractive after a mastectomy."
ANS: A This is an example of restatement, which allows the patient to know her message was understood and encourages the patient to continue about her concerns on the topic.
21. The nurse chooses to use touch in the nurse-patient relationship because touch: a. can convey caring and support when words are difficult. b. should be avoided because of problems of cultural misinterpretation. c. is appropriate only in special circumstances, such as with young children. d. is a nursing intervention of choice in almost all situations.
ANS: A Touch is a powerful and supportive nonverbal communication in many situations. It is appropriate for all ages, but not in some situations. Careful assessment of the patient's situation and cultural values should determine its use, but it should not be avoided because of stereotypes.
30. When interacting with an older adult patient, the nurse would enhance communication by: a. speaking slowly in order to allow the patient to process the message. b. addressing him by his first name to encourage a therapeutic relationship. c. standing in the doorway rather than entering the room to give the older adult patient more privacy. d. speaking in simple sentences, as if to a child.
ANS: A When interacting with an older adult, the nurse should try not to speak too quickly or expect an immediate answer because the older adult may take more time to process the message. Do not use baby talk or speak to them as if they were children.
5. Behaviors that indicate to the patient that the nurse is inattentive to the patient's concerns are such activities as: (Select all that apply.) a. turning back to straighten the bedside table while the patient is talking. b. tapping feet or fingers. c. sitting down in a chair near the bed with arms crossed. d. leaving a hand on the door to go out. e. nodding and asking for elaboration.
ANS: A, B, C, D Turning from the patient, tapping the feet or fingers, sitting with arms crossed, and leaving the patient all indicate to the patient that his or her concerns are not important and the information is boring to the nurse. Nodding and asking for elaboration indicate that the nurse is attentive and focused on his or her concerns.
3. When using the telephone to communicate with a primary care provider about a patient, the student nurse should have ready: (Select all that apply.) a. current information relative to patient's condition change. b. assessment of vital signs. c. information on urinary output. d. patient's social security number or hospital identification number. e. medications received.
ANS: A, B, C, E As a rule, the primary care provider does not need to have the social security number or the hospital identification number, but does need information on the patient's condition, vital signs, urinary output, and medications received.
4. The nurse will appropriately and deliberately use the closed question technique when the patient is: (Select all that apply.) a. being asked for specific information. b. extremely anxious and unfocused. c. having difficulty expressing feelings. d. confused. e. angry and ranting about his lack of medical care.
ANS: A, B, D Closed questions are useful for gaining specific information such as age, address, and listing of allergies. Closed questions help the anxious, confused, and unfocused patient to respond. Patients who are having difficulty expressing feelings are not aided by closed questions. Angry patients need to be helped by silence or general leads.
2. During the initial interview of a patient, the nurse should: (Select all that apply.) a. assess the language capabilities of the patient. b. use open-ended questions. c. limit the interview to approximately 30 minutes. d. assess comprehension abilities of the patient. e. make the patient as comfortable as possible. f. obtain the patient's medical history from the primary care provider.
ANS: A, C, D, E During the initial assessment, the patient should be comfortable and the nurse should ask closed questions to elicit specific information. The interview should last approximately 30 minutes, and the nurse needs to evaluate the language and comprehension skills of the patient to ensure effective communication.
1. The nurse is alert to avoid using blocks to effective communication that include: (Select all that apply.) a. changing the subject. b. using nonjudgmental remarks. c. giving advice. d. asking probing questions. e. offering hope. f. using clichés.
ANS: A, C, D, F Such behavior as changing the subject, giving advice, asking probing questions that probe into a patient's motive, and using clichés all block communication. Offering hope and giving remarks that are nonjudgmental are appropriate forms of communication.
15. A patient with a nursing diagnosis of Sensory perception, disturbed auditory, would most appropriately require the nurse to: a. obtain a sign language interpreter when a family member is unavailable. b. speak slowly and distinctly, but not shout. c. provide bright lighting without glare and orient frequently. d. reorient frequently to time, place, staff, and events.
ANS: B A patient with disturbed auditory perception cannot hear well (or at all); therefore, speaking slowly and distinctly without shouting increases patient comprehension.
8. To begin talking with a newly admitted patient about pain management, the nurse would most appropriately state: a. "You look pretty comfortable. Are you having any pain?" b. "Tell me about the pain you've been having." c. "Is this pain the same as the pain you had yesterday?" d. "Don't worry; this pain won't last forever."
ANS: B An open-ended question allows the patient to express his or her feelings or needs.
19. When the patient says, "I get so anxious just lying here in this hospital bed. I have a million things I should be doing at home," the most empathetic response would be: a. "I'd feel the same way you do. I know just what you're going through." b. "It sounds like you're having a tough time dealing with this situation." c. "It's always darkest before the dawn. Hang in there; it will get better." d. "You sound pretty sorry for yourself. Why don't you look at the positives?"
ANS: B Empathy recognizes a patient's situation and encourages expression of feelings.
44. The nurse is caring for a patient with a diagnosis of lung cancer. The nurse states, "If I were you, I would have radiation therapy." The nurse's statement is an example of which type of communication block? a. Inattentive listening b. Giving advice c. Using clichés d. Defensive response
ANS: B Giving advice is a block to effective communication and tends to be controlling and diminishes patients' responsibility for taking charge of their own health.
40. A home health patient with a bleeding ulcer informs the nurse that she ate a bowl of chili with jalapenos. An inappropriate communication block with a judgmental tone by the nurse would be: a. "Well, you have had this problem long enough to know what will happen—you certainly can't blame me!" b. "I don't think that was a smart thing for you to do considering your ulcer." c. "Well, you better watch your stool for evidence of blood so you can notify your primary care provider." d. "Oh, poo! A bowl of chili every now and then won't make a lot of difference to your ulcer."
ANS: B Judgmental response is a block to effective communication in which the nurse is judging the patient's action. It implies that the patient must take on the nurse's values and is demeaning to the patient.
20. A patient asks the nurse, "What would you do if you had cancer and had to choose between surgery and chemotherapy?" The reply that can best help the patient is: a. "If I were you, I would choose surgery and then consider chemo afterward." b. "What solutions have you considered?" c. "I would talk it over with my friends first." d. "I don't know. I'm glad it isn't my decision."
ANS: B Nurses can help by reminding patients of alternatives open to them and should refrain from giving advice but can encourage the patient to consider options. The nurse may be glad not to face a decision a patient must, but it is not helpful to the patient to say this.
32. When a patient states, "I don't feel like walking today," the nurse's most therapeutic verbal response would be: a. "You have to walk today." b. "You don't want to walk today?" c. "I don't feel like walking today either." d. "Why don't you want to walk today?"
ANS: B Reflection is a way to restate the message. The idea is simply reflected back to the speaker in a statement to encourage continued dialogue on the topic.
36. The nurse is caring for a patient who states, "I tossed and turned last night." The nurse responds to the patient, "You feel like you were awake all night?" This is an example of: a. open-ended question. b. restatement. c. reflection. d. offering self.
ANS: B Restatement is a therapeutic communication technique in which the nurse restates in different words what the patient said. This encourages further communication on that topic.
33. When a patient states, "My son hasn't been to see me in months," the nurse's best verbal response is: a. "Don't worry; I'm sure your son will visit." b. "Your son hasn't been around much lately?" c. "My son doesn't come to visit me either." d. "How terrible that he doesn't visit you."
ANS: B Restating in different words what the patient said encourages further communication on that topic.
23. A patient who has had a stroke is unable to speak clearly and has right sided hemiplegia. The nurse will design the approach to the assessment interview by: a. asking questions and explaining procedures to the patient's daughter. b. speaking slowly and giving the patient time to respond. c. telling the patient he will get all necessary information from the daughter. d. prompting the answers and finishing the sentences for the patient.
ANS: B Speaking slowly recognizes that the patient may process (if able) information more slowly.
11. The nurse explains that the therapeutic nurse-patient relationship differs from the social relationship because: a. a social relationship does not have goals or needs to be met. b. the nurse-patient relationship ends when the patient is discharged. c. the focus is mainly on the nurse in the nurse-patient relationship. d. a social relationship does not require trust or sharing of life experiences.
ANS: B The nurse-patient relationship is limited to the patient's stay in the facility and is focused on the patient. A social relationship may have goals or needs and does require trust and sharing of life experiences.
7. When the patient says, "I don't want to go home," the nurse's best therapeutic verbal response would be: a. "I'm sure everything will be fine once you get home." b. "You don't want to go home?" c. "Doesn't your family want you to come home?" d. "I felt like that when I had surgery last year."
ANS: B The use of reflecting encourages the patient to expand on his or her feelings or thoughts.
. The nurse recognizes a verbal response when the patient: a. nods her head when asked whether she wants juice. b. writes the answer to a question asked by the nurse. c. begins sobbing uncontrollably when asked about her daughter. d. is moaning and restless and appears to be in pain.
ANS: B Verbal communication involves words, either written or spoken. Nodding, sobbing, and moaning are nonverbal communication.
47. When communicating with an aphasic patient, the nurse appropriately: a. speaks quickly and shouts so the patient can hear. b. assumes the patient can understand what is heard. c. speaks to the patient's caregiver about the patient. d. assumes the patient cannot understand what is heard.
ANS: B When communicating with an aphasic patient, the nurse assumes the patient can understand what is heard even though speech is jargon or the person is mute, unless deafness has been diagnosed. The nurse should talk to the patient, and not talk to someone else in the room about the patient. The nurse should speak slowly and distinctly and should not shout.
28. To convey the intervention of active listening, the nurse would: a. maintain eye contact by staring at the patient. b. prompt the patient when the patient stops talking for a moment. c. make a conscious effort to block out other sounds in the immediate environment. d. write down remarks on a clipboard to facilitate later topics of conversation.
ANS: C An active listener maintains eye contact without staring, gives the patient full attention, and makes a conscious effort to block out other sounds and distractions.
50. When communicating with an adolescent, the nurse should be very sensitive to avoid: a. asking embarrassing questions. b. offering advice. c. interrupting frequently. d. using active listening.
ANS: C An adolescent needs time to talk. The nurse should use active listening, avoid interrupting, and show acceptance. The nurse should try not to give advice.
38. A patient states, "I'm so worried that I might have cancer." The nurse responds, "It is time for you to eat breakfast." The nurse's response is an example of: a. using clichés. b. judgmental response. c. changing the subject. d. giving false reassurance.
ANS: C Changing the subject is a block to effective communication in which the patient is deprived of the chance to verbalize concerns.
3. The nurse recognizes the patient who demonstrates communication congruency when the patient: a. smiles and laughs while speaking of feeling lonely and depressed. b. wrings her hands and paces around the room while denying that she is upset. c. is tearful and slow in speech when talking about her husband's death. d. states she is comfortable while she frowns and her teeth are clenched.
ANS: C Congruent communication is the agreement of verbal and nonverbal messages.
41. A patient tells the nurse that she dislikes the food that is served in the hospital. The nurse responds, "Our cooks work very hard; the food that is served is very good." The nurse's response is an example of the communication block of: a. judgmental response. b. giving advice. c. defensive response. d. using clichés.
ANS: C Defensive response is a block to effective communication in which the nurse responds by defending the hospital food. This prevents the patient from feeling that she is free to express her feelings.
5. A nurse says to a patient, "I am going to take your TPR, and then I'll check to see whether you can have a PRN analgesic." In considering factors that affect communication, the nurse has: a. used terminology to clearly inform the patient of what she is doing. b. given information that is unnecessary for the patient to know. c. used medical jargon, which might not be understood by the patient. d. taken into consideration the patient's need to know what is happening.
ANS: C Medical jargon such as abbreviations or medical terminology is often misunderstood, even by well educated people.
16. When an office nurse asks the patient to repeat information that he has just given to the patient over the telephone, the nurse is: a. testing the patient's intelligence and memory. b. acting in a cautious way to avoid charges of negligence. c. verifying that the patient understands the information. d. saving the extra time it would take to mail the information.
ANS: C Obtaining feedback from a patient to ascertain that the patient understands instructions is an important part of the communication process, especially over the phone, when the nurse does not have nonverbal cues.
22. When the nurse makes the statement, "We can come back to that later—right now I need to know about when your symptoms started," the nurse is: a. letting the patient know that topic of conversation was inappropriate. b. setting limits on the expression of feelings. c. refocusing the patient to the issue at hand when the conversation has wandered. d. closing off the conversation by quickly getting to the point of the interview.
ANS: C Refocusing is often necessary to accomplish data collection. It does not block communication and is not used to close a conversation or stop an inappropriate topic.
18. When the nurse is giving direction to a nursing assistant who is being delegated part of the patient care, the nurse's most effective direction would be: a. "Do the morning care first on the patients in 205 and 206 who can't get out of bed." b. "You take care of all the patients in 205 and 206. Let me know how you're doing and whether you need any help." c. "Give the patient in 204A a shower after breakfast, and call me to check her feet before you get her dressed." d. "Take the vital signs on all the patients in the lounge and tell me whether there are problems."
ANS: C The clarity and brevity of the direction makes the delegated task clear and leaves the responsibility of assessment to the nurse.
26. The nurse is aware that the purpose of therapeutic communication is to: a. gather as much information as possible about the patient's problem. b. direct the patient to communicate about his deepest concerns. c. focus on the patient and the patient needs to facilitate interaction. d. gain specific medical information and history of illness.
ANS: C Therapeutic communication is a conversation that is focused on the patient and promotes understanding between the sender and the receiver.
13. A 67-year-old woman had major abdominal surgery yesterday. She has IV lines, a urinary catheter, and an abdominal wound dressing, and she is receiving PRN pain medication. The end of shift report that best conveys the patient status is: a. "Doing great, was up in the chair most of the day. No complaints of pain or discomfort. Voiding adequately." b. "Abdominal surgery yesterday, dressing is dry and intact, her IVs are on time and she's had pain meds twice. Vital signs stable." c. "Abdominal dressing dry, IVs—800 mL left in #6; NS running at 125 mL/hr; urine output 800 mL this shift; had morphine 15 mg for pain at 8:00 AM and at 1:30 PM. She's comfortable now. Vital signs are stable, no fever." d. "Unchanged since this morning. She wanted to know how soon she can have something to eat, so maybe you could check with her doctor this evening. Her husband has been visiting all day and will let you know if she needs anything."
ANS: C This brief clear report addresses the major concerns of the abdominal dressing, the status of the IV fluids, vital signs, and analgesia needs.
10. To enhance the establishment of rapport with a patient, the nurse should: a. identify himself by name and title each time he introduces himself. b. share his own personal experiences so that the patient gets to know him as a friend. c. act in a trustworthy and reliable manner; respect the individuality of the patient. d. share information with the patient about other patients and why they are hospitalized.
ANS: C Trust and reliability, as well as conveying respect for the individual, all promote rapport. Identifying oneself is important but in itself does not promote rapport. Sharing personal experiences or divulging the confidential nature of other patients' conditions is not appropriate in the nurse-patient relationship.
43. The nurse caring for a patient who is concerned about her 10-pound weight loss relative to her chemotherapy tells the patient, "Lucky you! Every cloud has a silver lining." The nurse's statement is an example of which type of communication block? a. Defensive response b. Asking probing questions c. Using clichés d. Changing the subject
ANS: C Using clichés is a block to effective communication in which the patient's individual situation is negated, and the patient is stereotyped. This type of response sounds flippant and prevents the building of trust between the patient and the nurse.
31. When the nurse observes a resident in a long-term facility pounding his fists on his legs and grinding his teeth, the nurse will validate her perception of the patient's nonverbal expression of anger by: a. documenting that the patient was agitated and appeared angry. b. asking the male nursing assistant if it is his perception that the patient appears angry. c. accessing the nursing care plan to ascertain if there is a nursing diagnosis relative to anger. d. sitting down near the patient and saying, "You seem upset...can I help?"
ANS: D All perceptions based on the observation of nonverbal behavior should be validated by consulting the patient.
34. An example of a nurse communicating with a patient using open-ended questions would be: a. "Is your pain less today than it was yesterday?" b. "Did you sleep all night without waking?" c. "How many bowel movements have you had today?" d. "What was your daughter's reaction to your desire for hospice?"
ANS: D An open-ended question is broad, indicating only the topic, and it requires an answer of more than a word or two. Use of an open-ended question or statement allows the patient to elaborate on a subject or to choose aspects of the subject to be discussed. Open-ended questions or statements are helpful to open up the conversation or to proceed to a new topic. They usually cannot be answered with one word or just "yes" or "no."
42. A nurse caring for a patient who fell off the roof while he was intoxicated asks the patient, "Why in the world were you on the roof when you had been drinking?" The nurse's statement is an example of which type of communication? a. Changing the subject b. Defensive response c. Inattentive listening d. Asking probing questions
ANS: D Asking probing questions is a block to effective communication in which the nurse pries into the patient's motives and therefore invades privacy.
24. When a nurse is conducting an assessment interview, the most efficient technique would be: a. explaining the purpose of the interview. b. excluding relatives and friends from the interaction. c. telling the patient what data are already available. d. asking closed questions to obtain essential information.
ANS: D Closed questions have a definite place when the nurse wants to obtain specific essential data. Closed questions force the patient to stick to the topic.
53. In order to safeguard patient information when using a computer, the nurse should: a. only use the computer located in the nurse's station. b. wait until the end of the shift and document all information at one time. c. use personal code words and abbreviations to disguise information. d. change the computer password frequently.
ANS: D Computerized patient information requires extra vigilance by the nurse to safeguard confidentiality. Changing personal passwords frequently helps safeguard information. When using the computer at a health care facility, the nurse must remember not to leave a computer screen open when he or she is finished. The nurse should always log out so that someone else cannot access information using his or her password and must not share his or her password with others. Computers in the nurse's station are not as convenient as those at the bedside or in the hall. Personal codes and abbreviations are not useful.
12. The nurse has selected an outcome for the patient to eat all of the food on the breakfast tray each day. Assessing that the patient has eaten all of the breakfast, the nurse would give positive feedback by saying: a. "Wow! That breakfast must have been pretty good." b. "I like pancakes too. Everyone on the hall seemed to enjoy them." c. "I hope you can keep all that breakfast down." d. "Hurray! You finished your whole meal! What would you like for tomorrow?"
ANS: D Giving positive feedback increases the likelihood of the desired behavior to be repeated. Commenting on the tastiness of the food or the fact that others liked it is not responding directly to the patient's having eaten the whole meal.
29. When the nurse enters the room, the patient is laughing out loud at something on TV. The patient stops and apologizes for the laughter, saying, "I guess I ought not be laughing at all since I am stuck here with two broken legs." The nurse can use evidence-based information when she responds: a. "Laughter is nearly always a cover up for anxiety when facing a long rehabilitation." b. "Long periods of laughter decrease the amount of oxygen available to your body for healing." c. "Laughter in a hospital is often distracting and depressing to other patients nearby." d. "Laughter truly is the best medicine as it has a positive effect on the immune system."
ANS: D Hasen and Hasen (2009) found that laughter and appropriate use of humor decreased stress and anxiety and had a positive effect on the immune system.
52. A nurse is delegating to a nursing assistant. The most appropriate form of this type of communication would be: a. "Let me know if Mr. Jones' temperature is high." b. "I need to know if Mr. Jones' blood pressure is elevated." c. "Come and get me if Mr. Jones has a high heart rate." d. "If Mr. Jones' heart rate is greater than 100, let me know."
ANS: D It is important to communicate well in order to assign tasks and delegate to others effectively. The nurse should give clear, concise messages that include the desired results.
9. When a patient begins crying during a conversation with the nurse about the patient's upcoming surgery for possible malignancy, the nurse's most therapeutic response would be: a. "Your surgeon is excellent, and I know he'll do a great job." b. "Oh, dear, your gown is way too big, let me get you another one." c. "Don't cry; think about something else and you'll feel better." d. "Here is a tissue. I'd like to sit here for a while if you want to talk."
ANS: D Offering self, or presence, and accepting a patient's need to cry is supportive.
4. A Hispanic patient approaches the Asian nurse and, standing very close, touches the nurse's shoulder during their conversation. The nurse begins to step back to 18 to 24 inches, while smiling and nodding to the patient. This situation is most likely an example of: a. the nurse's need to maintain a professional role rather than a social role. b. a patient's attempt to keep the nurse's attention. c. a nurse's need to establish a more appropriate location for conversation. d. a difference in culturally learned personal space of the nurse and the patient.
ANS: D Personal space between people is a culturally learned behavior; Asians, North American natives, and Northern European people generally prefer more personal space than people of Hispanic, Southern European, or Middle Eastern cultures.
35. The nurse tells a patient, "For the last 2 days we have talked about whether to notify your daughter of your upcoming surgery in 2 days. You have indicated you do not want to be a burden to her, but you also would like to have her here. You may have to decide rather quickly because of the time constraint." The nurse is using the technique of: a. focusing. b. reflection. c. restatement. d. summarizing.
ANS: D Summarizing presents the problem and possible solutions with the attendant difficulties. This technique "unclutters" the problem and presents it back to the patient for his or her choice of a solution.
17. A 36-year-old woman who is in traction for a fractured femur that she received in an auto accident is found crying quietly. The nurse can best address this situation by saying: a. "What's the matter? Why are you crying? Are you in pain?" b. "Stop crying and tell me what your problem is." c. "This could have been much worse. You're lucky no one was killed." d. "You are upset. Can you tell me what's wrong?"
ANS: D The nurse offers a general lead as to what is causing the distress. The other options are judgmental or clichéd or offer no opportunity for the patient to express feelings.
46. The characteristic that is representative of the nurse-patient relationship is that this relationship: a. focuses on the nurse's ability to build rapport. b. continues after discharge. c. does not include humor. d. focuses on the assessed patient health problems.
ANS: D The nurse-patient relationship focuses on the patient, has goals, and is defined by specific boundaries. The relationship takes place in the health care setting, and boundaries are defined by the patient's problems, the help needed, and the nurse's professional role. When the patient is discharged, the relationship ends.
51. The primary care provider informs the student nurse that he would like to give a telephone order. The best response by the student is: a. document the telephone order on the primary care provider's orders. b. ask another student to listen as a witness to the telephone order. c. tape record the primary care provider giving the order to the student nurse. d. ask the registered nurse to take the telephone order.
ANS: D The student nurse should have an instructor or another registered nurse standing by to take the new orders from the primary care provider because students cannot legally take telephone orders.
27. The practical nursing student who is engaged in a therapeutic communication with a patient will have the most difficulty with the technique of: a. closed questions. b. restating. c. using general leads. d. silence.
ANS: D The use of silence is the hardest for most students to develop because it makes them uncomfortable, so they tend to end it prematurely.
48. When communicating with a hearing impaired patient, the nurse appropriately: a. shouts repeatedly at the patient. b. speaks directly into the patient's ear. c. uses long, complex sentences. d. uses short, simple sentences.
ANS: D When communicating with a hearing impaired patient, the nurse appropriately uses short, simple sentences. The nurse should not shout because this can distort speech and does not make the message any clearer. The nurse should never speak directly into the person's ear. This can distort the message and hide all visual cues.
49. When communicating with a preschooler, the nurse should: a. use abstract explanations. b. use unfamiliar language. c. use long, complex sentences. d. consider the developmental level, using familiar words.
ANS: D When interacting with a toddler or a preschooler, the nurse should focus on the child's needs and concerns. The nurse should also use simple, short sentences and concrete explanations with familiar words.
A Buddhist patient enters the hospital for diagnostic testing just before lunch time. The nurse tells the aide to give a meal tray to the new patient, because no tests will be done until later that evening. The aide gives the patient a meal of Salisbury steak, bread, green beans, and potatoes with brown gravy. The patient eats nothing but a slice of bread and the green beans. Which of the following considerations was omitted by the nurse? a. The patient should not be served any food until a physician's order is obtained. b. The patient's Buddhist faith probably requires a vegetarian diet. c. The patient may be too frightened about the tests to want to eat very much. d. The patient may have diabetes or be allergic to some foods.
B
A nurse is about to despair. Earlier in the week, she carefully taught a patient from a different culture exactly how much medication to take and emphasized the importance of taking the correct amount. However, the patient is back in the hospital today with symptoms of an overdose, although the patient denies taking more than the label indicated. Which of the following is the most likely explanation? a. The patient was taking more mediation in the hope of getting well faster. b. The patient was also taking folk medicines that had many of the same effects and perhaps some of the same ingredients as the prescribed medication. c. The patient truly did not understand and thought the dose being taken was correct. d. The patient had a unique response to the medication and should have a smaller dose ordered.
B
A nurse states, "The best way to treat a client from another country is to care for them the same way we would want to be cared for. After all, we are all humans with the same wants and needs." What does this statement reflect in relation to culture? a. Awareness b. Blindness c. Knowledge d. Preservation
B
A nurse wishes to develop cultural competence. Which of the following actions should the nurse take first? a. Complete a survey of all the various ethnicities represented in the nurse's community. b. Consider how the nurse's own personal beliefs and decisions are reflective of his or her culture.. c. Invite a family from another culture to join the nurse for an event. d. Study the beliefs and traditions of persons living in other cultures.
B
During the interview the patient states, "I am so depressed and confused." What would be the most appropriate reply the nurse can give? A) "Depression can be confusing." B) "You are depressed and confused?" C) "Is your depression causing confusion?" D) "How is the confusion causing depression?"
B) "You are depressed and confused?" Restating to the patient what is believed to be the main point that the patient is trying to make is restating. When the nurse simply repeats the patient's comment, the patient is encouraged to open up further and provide more information. If made, the other statements could cause further misunderstanding.
A nurse is attempting to interview a patient in severe pain. In an effort to promote communication, what is the best action the nurse can take? A) Postpone the interview until the pain is manageable. B) Address the pain and then proceed with the interview. C) Ask the patient to ignore the pain during the interview. D) Promise the patient pain medication after the interview.
B) Address the pain and then proceed with the interview. Many physiologic factors may interfere with the patient's ability to communicate effectively. When a patient is experiencing pain, it is impossible for the patient to focus on anything other than the pain. The nurse should address the pain before trying to communicate with the patient.
Which nonverbal clue would send a negative message to a patient? A) Relaxed stance B) Crossed arms, legs C) Facing an individual D) Direct eye contact
B) Crossed arms, legs The way one sits, stands, and moves is posture. Posture has the ability to convey warmth and acceptance, as well as distance and disinterest. Crossed arms and legs are considered closed posture and create a more formal distance. People usually interpret this as disinterest, coldness, and nonacceptance. A relaxed stance while facing an individual and direct eye contact are open postures, equivalent to warmth and acceptance.
The nurse is communicating with a patient who lives next door to the nurse. How can the nurse maintain the social distance while communicating with the patient? A) Ask open-ended questions to the patient. B) Keep 4 to 12 feet distance between them. C) Maintain direct eye contact with the patient. D) Keep 18 inches to 4 feet distance between them.
B) Keep 4 to 12 feet distance between them. The norm for social distance is 4 to 12 feet with acquaintances. This social factor is different for each culture. Open-ended questions encourage the patient to talk and express concerns; it is not related to social distance. Maintaining direct eye contact with the patient helps in building trust, but is not related to social distance. Keeping 18 inches to 4 feet distance in between themselves and a new acquaintance is called personal space.
The nurse enters a patient's room and states, "You're up early." The patient laughs and replies, "I get up with the chickens." Which action is appropriate? A) Leave the room B) Laugh with the patient C) Explain that laughter is not allowed D) Indicate that this is an unusual occurrence
B) Laugh with the patient The power of humor during patient interaction should not be underestimated as an effective communication tool. Laughing is not a reason to leave the room. The statement that laughter is not allowed is not true. This is not an unusual occurrence.
A nurse is caring for a patient. Which type of communication can the patient use to express anxiety and fear? A) Verbal B) Nonverbal C) Intonation D) Active listening
B) Nonverbal Anxiety and fear are expressed using nonverbal cues. Nonverbal forms of communication involve body language. The patient expresses anxiety and fear through body movement or activities. Verbal communication happens through spoken words and sentences. Intonation is a characteristic of nonverbal communication. Active listening is an important factor required for good communication; however, it is not related to the expression of anxiety and fear.
Which nonverbal communication technique is therapeutic and effective but requires practice and a conscious effort by the nurse to use successfully?
B) Silence and timing. Listening, touch, and conveying acceptance are nonverbal therapeutic communications, but they do not always require a conscious effort for use.
A terminally ill patient has just died. The family members are upset and crying. What is the most appropriate action the nurse can take to convey support and compassion? A) Ask the family to leave, then provide postmortem care. B) Stay with the family and use silence and therapeutic touch. C) Immediately leave the room and allow the family to grieve. D) Begin to make funeral arrangements so the family can give approval.
B) Stay with the family and use silence and therapeutic touch. An example of effective use of silence is when a patient dies. The nurse can communicate support and compassion by remaining with the family. Allowing the family time to express their feelings while the nurse remains silent and using therapeutic touch communicate that the nurse cares for the family without trying to talk away the situation. Asking the family to leave, leaving, or making funeral arrangements at this point is inappropriate.
When a patient is giving his sexual history to the nurse, he states that he has a same-sex partner. What is the nurse's best response? A. "I have some material that will help you to overcome your condition." B. "Tell me about your partner." C. "I can put you in touch with a wonderful psychiatrist." D. "It will be better for you if you do not share that information with the rest of the staff."
B. "Tell me about your partner."
Mrs. Blankenship is a 52-year-old woman who has come to the clinic for her "well woman" check. She states to the nurse, "I think I'm beginning menopause." What is the nurse's best response? A. "Oh, it will be so wonderful for you not to be bothered by your monthly menses anymore." B. "What are your feelings about that?" C. "You will need to start taking hormone replacement therapy now." D. "Menopause is a normal occurrence, and you don't need to worry about it at all."
B. "What are your feelings about that?"
A nurse is using a interpreter to communicate with a client. Which of the following actions should the nurse use when communicating with a client and his family? Select all that apply. A. Talk to the interpreter about the family while the family is in the room B. Ask the family one question at a time C. Look at the interpreter when asking the family questions D. Use lay terms if possible E. Do no interrupt the interpreter and the family as they talk
B. Ask the family one question at a time D. Use lay terms if possible E. Do no interrupt the interpreter and the family as they talk
A nurse is planning care for a client who is a devout Muslim and is 3 days postoperative following a hip arthroplasty. The client is scheduled for two physical therapy sessions today. Which of the following statements by the nurse indicates culturally appropriate care to the client? A. I will make sure the menu includes kosher options B. I will discuss the daily schedule with the client to make sure the client will have time for prayer C. I will make sure to use direct eye contact when speaking with this client D. I will make sure daily communion is available for this client
B. I will discuss the daily schedule with the client to make sure the client will have time for prayer
. A client is crying softly and saying, "What did I do to deserve this punishment, Lord?" Which of the following responses by the nurse would be the most appropriate? a. "God doesn't punish people. You're sick just because of bad luck." b. "I can call the hospital chaplain to help you talk about these feelings" c.. "What can I do to be helpful to you right now?" d. "Would you like to confess your sins and repent so this illness will go away?"
C
A 40-year-old Bosnian, Muslim woman who does not speak English presents to a community health center in obvious pain. She requests a female health care provider. Through physical gestures, the woman indicates that the pain is originating in either the pelvic or genital region. Which of the following interpreters would be the most appropriate in this situation? a. A Bosnian male who is certified as a medical interpreter b. A female from the client's community c. A female who does not know the client d. The client's 20-year-old daughter
C
A nurse gives detailed information on how to apply for Medicaid to a new mother who moved to the United States from Russia about 10 years ago. The nurse's next client is an African-American mother of newborn twins who worked until the children were born. The nurse knows the woman is eligible to maintain her insurance after her employment was lost and does not discuss insurance options at all. Which of the following errors is being made by the nurse? a.. Covert intentional prejudice b. Covert unintentional prejudice c. Overt intentional prejudice d. Overt unintentional prejudice
C
Mexican immigrants who take metamizole ("Mexican aspirin") for pain may experience life-threatening agranulocytosis. Which of the following actions would be taken by a nurse who employs cultural repatterning? a. Complete a cultural assessment to identify any other dangerous medications that the client may be taking. b. Put this into perspective by considering that many drugs used in the United States cause agranulocytosis. c. Explain the harmful effects of metamizole and recommend an alternative medication for pain. d. Recognize that taking metamizole is common among persons living in Mexico and accept this as a cultural tradition.
C
1. The nurse can best ensure that communication is understood by: a. speaking slowly and clearly in the patient's native language. b. asking the family members whether the patient understands. c. obtaining feedback from the patient that indicates accurate comprehension. d. checking for signs of hearing loss or aphasia before communicating.
C The best way to determine understanding is to ask the patient. Factors such as anxiety, hearing acuity, language, aphasia, or lack of familiarity with medical jargon or routines can all contribute to misunderstanding.
10. To provide competent care to an Asian-American family, the nurse should include which of the following questions during the assessment interview? a. "Do you prefer hot or cold beverages?" b. "Do you want milk to drink?" c. "Do you want music playing while you are in labor?" d. "Do you have a name selected for the baby?"
a. "Do you prefer hot or cold beverages?"
16. The process by which people retain some of their own culture while adopting the practices of the dominant society is known as: a. Acculturation. b. Assimilation. c. Ethnocentrism. d. Cultural relativism.
a. Acculturation.
12. A mother's household consists of her husband, his mother, and another child. She is living in a(n): a. Extended family. b. Single-parent family. c. Married-blended family. d. Nuclear family.
a. Extended family.
15. A pictorial tool that can assist the nurse in assessing aspects of family life related to health care is the: a. Genogram. b. Family values construct. c. Life cycle model d. Human development wheel.
a. Genogram.
1. A married couple lives in a single-family house with their newborn son and the husband's daughter from a previous marriage. On the basis of the information given, what family form best describes this family? a. Married-blended family b. Extended family c. Nuclear family d. Same-sex family
a. Married-blended family
8. The woman's family members are present when the home care maternal-child nurse arrives for a postpartum and newborn visit. What should the nurse do? a. Observe the family members' interactions with the newborn and one another. b. Ask the woman to meet with her and the baby alone. c. Do a brief assessment on all family members present. d. Reschedule the visit for another time so that the mother and infant can be assessed privately.
a. Observe the family members' interactions with the newborn and one another.
A nurse is collecting data from a patient with a sexually transmitted disease. When asked about partners, the patient states, "There have been so many I lost count." Which statement made by the nurse conveys acceptance? A) "Having intercourse with that many partners is the reason you have this dirty disease." B) "That statement is not funny and it is inappropriate given the current circumstances." C) "Let's identify as many partners as possible so that they can get the treatment needed." D) "For once in your life you need to think about the innocent people you may have infected."
C) "Let's identify as many partners as possible so that they can get the treatment needed." Some patients are hesitant to give the nurse complete information, particularly because it relates to values, beliefs, lifestyles, and practices. Often this reluctance arises from fear of disapproval from the nurse with regard to the patient's values, beliefs, lifestyle, and practices, or even rejection of the individual as a person. The nurse's willingness to listen and respond to what the patient is saying without passing judgment on the patient is the key to the development of the therapeutic relationship. Working with the patient to find the sexual partner(s) conveys to the patient a feeling of acceptance and the willingness to help.
Every individual has his or her own set of boundaries for personal space. Which example best explains a nurse's respect for personal space? A) The insertion of a Foley catheter using sterile technique B) Talking to a group of patients from the front of a classroom C) Sitting in a chair beside the patient's bed with good eye contact D) Standing at the door and asking the patient what he or she had for breakfast
C) Sitting in a chair beside the patient's bed with good eye contact Personal space or zone is 18 inches to 4 feet; therefore this example falls within those boundaries.
A nurse is attempting to interview a patient who speaks a different language. The family member is the only person in the clinic who can translate; an interpreter is not available. In an effort to collect the needed data, what is the best strategy the nurse can use? A) Reschedule the interview for when a medical translator is available. B) Have the patient point to pictures that describe signs and symptoms. C) Use the family member as the translator while conducting the interview. D) Ask closed-ended questions to make communication easier for everyone.
C) Use the family member as the translator while conducting the interview. Language barriers can pose a major threat to effective communication and the development of a therapeutic nurse-patient relationship. If an interpreter cannot be found, the nurse can use the family member or friends to assist with communication. Postponing the interview can prolong needed care. Pointing to pictures may not convey true symptoms a patient may have. Asking closed-ended questions is insufficient because the patient does not understand the nurse's language.
Mary, a young adult female, has experienced a miscarriage after 10 weeks of pregnancy. She is crying and states that this probably happened because her husband does not believe in God. What is your best your best response to Mary? A. "God doesn't punish people for their beliefs." B. "Do you want to talk about your anger at your husband's lack of faith?" C. "You sound very upset. Would you like to talk about these feelings?" D. "You sound really upset. Would you like to see the hospital chaplain?"
C. "You sound very upset. Would you like to talk about these feelings?"
When a newborn baby is identified as a boy, we are noting the baby's A. gender role. B. gender identity. C. gender. D. gender choice.
C. Gender
You are assigned a patient who speaks Vietnamese. He is to begin chemotherapy in the morning. To explain his treatment to him, you will use which of the following people? A. Family member B. Asian staff member C. Hospital interpreter D. Friend of the patient
C. Hospital interpreter
A nurse is caring for a client who is crying while reading from his devotional book. Which of the following interventions should the nurse take? A. Contact the hospital's spiritual services B. Ask him what is making him cry C. Provide quiet times for these moments D. Turn on the television for a distraction
C. Provide quiet times for these moments
