PrepU Questions-- Week 14: Lifespan/Culture

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

Culture shock

A nurse is providing care to a client from a culture different from the nurse's own. The nurse is having difficulty relating to the client. What intervention by the nurse is most appropriate?

Ask the client how the client wants to be treated based on the client's values and beliefs.

A client has been admitted to the unit for chest pain. A nurse told the family that they could not be with the client. The family became very upset, and now the client wants to leave. What is the most culturally appropriate response by the charge nurse?

"Would you feel more comfortable with your family with you?"

A student nurse is not looking forward to clinical rotation on a geriatric unit, stating "How can I get them to move faster? They always seem so slow!" How should the instructor respond?

"Be careful of the negative attitude in your approach. How fast an individual moves will depend on physical ability not necessarily age."

A nurse who usually works on the surgical unit is asked to float to the oncology unit because of staffing needs. Which statement by the nurse indicates the possibility of the nurse experiencing culture shock?

"I am very stressed now because I do not understand how things work on this unit."

A nurse is teaching an elderly client's family about the causes of mental impairment. The nurse sees that the teaching has been effective when the family says which of the following?

"Sundowning is a common problem of dementia."

A nursing student is studying the normal physiologic changes of older adults. The faculty member knows that the student comprehends the information when the student makes which statements? Select all that apply.

-"Height may decrease 1 to 3 in (2.5 to 8 cm)." -"There is an increased sensitivity to glare." -"Fluids and electrolytes remain within normal ranges."

A nurse caring for clients in a culturally diverse neighborhood knows that culture affects the nurse's interactions with the client. Which are characteristics of culture? Select all that apply.

-Culture guides what is acceptable behavior for people in a specific group. -Cultural practices and beliefs mainly remain constant as long as they satisfy a group's needs. -Culture influences the way people of a group view themselves, have expectations, and behave.

When completing a transcultural assessment of communication, which assessment by the nurse is most appropriate?

Assessment of eye contact, personal space, and social taboos

A nurse is caring for a postoperative client after knee arthroplasty. The nurse plans to help the client ambulate but is aware that the client may feel threatened by physical closeness because the client is from a culture that tends to prefer more personal space when interacting with others. Using the principles of culturally competent care, what would be the most appropriate nursing action?

Explain the purpose and need for assistance during ambulation.

Which nursing intervention reflects practice according to Madeline Leininger's transcultural nursing theory?

Incorporating the client's request for complementary treatment therapy

Which nursing action displays linguistic competence?

Learning pertinent words and phrases in the client's language

The nurse is caring for a client who perceives time differently. What action should the nurse take for this client?

Maintain flexibility when the client requests interventions at specific times.

A nurse is preparing a presentation for families who are caring for older adults at home. Which information would the nurse most likely include about an older adult's cognition?

Many older adults retain full cognitive function into advanced age.

A nurse convinces a client who is a Jehovah's Witness that receiving blood products is more important than the legalistic components of religion. What client reaction may be expected following this mandated change?

The client states, "I feel like I abandoned my religion."

A client is seeking care at the local clinic. The nurse is completing a cultural assessment. Which scenario would demonstrate cultural assimilation?

The client's child learned the dominant language as a second language.

A healthy 52-year-old client asks the nurse what she can do to maintain her health. Which of the following does the nurse recommend?

Perform self-examination of the skin every month

The nurse is caring for several clients of different cultures. Which client situation would the nurse recognize as the client with highest risk of culture shock?

The client from Ethiopia states, "All these machines attached to me scare me and I need to get them off."

A nurse is preparing a presentation for a group of older adults about health promotion. Which statistic would the nurse need to keep in mind about this group?

The group experiencing the largest growth is those 85 years of age and older.

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

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

Most older adults gradually modify activities or lifestyle to accommodate for declines in strength and health. The nurse recognizes the need for older adults to maintain activity and exercise in order to preserve all physiologic functions. When encouraging activity, it is important to consider which of the following? Select all that apply.

-Chronic illness often accompanies aging. -There is an increased risk of sleep disorders. -Assistive devices help to maintain mobility and safety.

Which concepts are considered cultural norms of the health care system? Select all that apply.

-Frequent use of jargon and documentation -Professional deference to pecking order -Use of a problem-solving methodology

A nurse is assessing a 55-year-old female client. What is a normal physical change in the middle adult? Select all that apply.

-Hearing acuity diminishes. -Cardiac output begins to decrease. -There is a loss of calcium from bones.

Which aspects of nursing make it recognizable as a subculture? Select all that apply.

-Manner of dress -Language used -Rituals

A nurse is conducting a seminar for a group of nurses about the cultural competency in nursing. When describing culture, which terms would be appropriate for the nurse to use? Select all that apply.

-Pervasive -Holistic -Recognizable -Ritualistic

An older adult client is placed on an inpatient unit following a minor stroke after moving in with an adult child recently. The client states to the nurse, I have difficulty finding meaning in life." The nurse suspects that the client is suffering from depression. Which factors may contribute to this client's depression? Select all that apply.

-The depression may have gone undetected since it is an under diagnosed disorder. -The stroke may be a contributing factor. -A recent change in living environment can cause depression.

The nurse works in an urban hospital and cares for a diverse population of clients. Which action(s) by the nurse demonstrates the delivery of culturally sensitive care to clients? Select all that apply.

-asking the client questions regarding health care beliefs related to the client's culture -allowing the client to keep a religious necklace on until going into the operating room -integrating the client's cultural practices when assisting with the creation of the plan of care

A 45-year-old client who is hospitalized for the first time in the client's life is experiencing culture shock, not understanding what is going on with the client's body or in the hospital. Place the stages of culture shock listed below in the order in which the client will most likely experience them.

1. Honeymoon 2. Disenchantment 3. Beginning resolution 4. Effective function

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

Utilize a key informant and continue with the teaching, verifying the client's understanding through open-ended questions.

A 79-year-old female is admitted to a long-term care facility. She is incontinent of urine and feces and has impaired cognition. What is the best nursing intervention to prevent skin breakdown for this resident?

Assist her to the toilet every 2 hours and after meals

Which behavior by the nurse is stereotyping?

Avoiding older adult clients because their care is time consuming

A client is admitted with end-stage pancreatic cancer and is experiencing extreme pain. The client asks the nurse whether an acupuncturist can come to the hospital to help manage the pain. The nurse states, "You won't need acupuncture. We have pain medications." Which characteristic has the nurse displayed?

Cultural imposition

An older adult client enjoys good overall health, but has just been diagnosed with pneumonia and has begun receiving an intravenous (IV) antibiotic. Shortly after being administered the first dose, the client pulled out his IV line and is now attempting to scale his bed rails. Which of the following phenomena most likely underlies this change in the client's cognition?

Delirium

A client's spouse has asked that the client be cared for exclusively by female nurses. How should the nurse incorporate this request into the care plan?

Document the request and make all reasonable efforts to honor it

When describing the concept of ethnicity, which statement would be most appropriate to use?

Ethnicity allows people to define themselves and others to define them.

An elderly client is becoming progressively confused due to Alzheimer's disease. The family can no longer manage the client at home due to wandering. Which of the following living arrangements could the nurse recommend?

Extended-care facility

Mrs. Jimenez, age 79, became a widow earlier this year and now resides alone in the house that she and her husband shared for 30 years. Her children have encouraged her to move, but she expresses a desire to remain in her home, despite some slight mobility challenges. The nurse who provides occasional home healthcare for Mrs. Jimenez should first propose which of the following?

Home modification

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

Press lightly on the pigmented area and observe the infant's reaction.

An client 81 years of age is in a long-term-care facility. His family could no longer cope with his progressing senile dementia, including wandering away and unpredictable behavior. Late one night the nurse finds the client wandering in the hall. He says he is looking for his wife. What should the nursing approach should be?

Remind him of where he is and assess why he is having difficulty sleeping.

When the older adult faces illness, the greatest threat to health is:

loss of physiologic reserve of the organ systems.

When an American client states, "I only want an American doctor," the client is expressing:

ethnocentrism.