Culture

The charge nurse on the pediatric floor has assigned a 6-year-old girl with newly diagnosed type 1 diabetes and an 8-year-old girl recovering from ketoacidosis to the same semiprivate room. The 6-year-old's birth parent is upset because the parent staying with the other child is male, and the girl's parent believes the arrangement violates their social norms. What should the nurse do? Offer the parent another place to sleep. Explain to the parents that this room arrangement facilitates teaching. Reassign the children to different rooms. Refer the parent to the customer service representative.

Reassign the children to different rooms. Explanation: Sleeping in the same room with a person of the opposite sex may be viewed as a violation of norms by persons of conservative faiths. If at all possible, the charge nurse should reassign the family to a different room. While it makes sense to have two clients with similar educational needs in the same room, it is likely that the arrangement would be distressing enough to create a learning barrier. Offering the parent another place to sleep deprives the child of their parent at night. The customer service representative would only need to be involved if it became impossible to accommodate the parent's needs.

A client's husband has asked that his wife be cared for exclusively by female nurses, a request with which the client herself agrees. What action would the care team take in response to this request? Determine whether the request is rooted in culture or whether it is a personal preference. Teach the couple that the male nurses on the unit are empathetic, trustworthy, and competent. Assess the couple's rationale for making the request. Take a reasonable measure to accommodate the request.

Take a reasonable measure to accommodate the request. Explanation: While cultural assessment in a tactful and respectful manner is likely appropriate in this situation, the care team's guiding principle and obligation in this situation is to accommodate and respect the couple's request. It would be inappropriate for the care team to attempt to convince the couple to change their minds.

The nurse is preparing to perform a cultural assessment of a new client. How should the nurse best perform this assessment? Draw conclusions based on previous interactions with members of the same cultural group. Perform a systematic assessment using a recognized cultural assessment instrument. Ask a staff member who is from the same cultural background as the client to perform the assessment. Observe the client passively and draw conclusions accordingly.

Perform a systematic assessment using a recognized cultural assessment instrument. Explanation: Cultural assessment is best facilitated by using an assessment instrument designed for the purpose. It is inaccurate to make assumptions based on previous interactions with other individuals. It is not possible to perform a thorough assessment solely through passive observation. Input from a colleague can be helpful, but it does not replace the need for a valid assessment instrument.

When conducting preoperative preparations, the nurse determines that the client speaks only Spanish, a language the nurse does not understand. The surgeon needs to obtain the client's informed consent. What is the best way for the nurse to facilitate having the client sign an informed consent? Notify the surgical charge nurse of the situation. Have the client call a family member to act as an interpreter. Call the Spanish language interpreter to translate the surgeon's explanation of the procedure, risks, and alternatives to obtain the client's consent and answer the client's questions. Have the client sign the Spanish language surgical consent form.

Call the Spanish language interpreter to translate the surgeon's explanation of the procedure, risks, and alternatives to obtain the client's consent and answer the client's questions. Explanation: The surgeon is required to give the client explanations and have questions answered. The nurse has no way of assessing the client's understanding without the interpreter. The client should sign the Spanish consent form only after receiving an explanation of the procedure, its risks, and alternatives. A family member cannot be relied on to translate the surgeon's instructions. The nurse is commonly asked to witness the explanation and obtain the client's signature on the informed consent form. Informed consent is the provision of information concerning the procedure and its risks, not obtaining the client's signature on the form. The surgical charge nurse does not need to be notified.

The nurse on the postpartum unit is caring for four couplets. There will be a new admission in 30 minutes. The new client is gravida 4 para 4 (G4 P4), speaks only Spanish, and has an infant who is in the special care nursery (SCN) for respiratory distress. The nurse should place the new client in a room with which client? G6 P6 who gave birth 4 hours ago by cesarean birth for fetal distress; infant at the bedside G1 P1 who is 1 day postpartum with an infant in the SCN G4 P4 who is 2 days postpartum with an infant and who speaks Spanish only G1 P1 who is a non-English-speaking client with an infant in the SCN for fetal distress

G4 P4 who is 2 days postpartum with an infant and who speaks Spanish only Explanation: The ability to communicate with a person of the same language would be an advantage because it is an opportunity for socialization and support for the new birth parent who speaks Spanish. If a Spanish-speaking birth parent were placed with the client who also had a baby in the SCN, they would have no communication opportunity, and the same would apply to rooming with the client who has had a cesarean birth. The language of the client who is non-English speaking has not been identified, and the nurse cannot assume that it is Spanish.

A diabetic patient is reviewing the hospital menu to order lunch. The client asks the nurse for suggestions for "cold" foods to order. What is the nurse's understanding of why the client asking about suggestions for "cold" foods? The client is balancing the disease with cold foods. The client is warm and wants to cool off. The client is cold and wants to warm up. The client is concerned about the temperature in the room.

The client is balancing the disease with cold foods. Explanation: The client is using traditional Chinese medicine and balancing of the yin and yang. Diabetes is considered a hot disease, and the balance is finding foods that are cold. The client is not cold or warm, nor concerned about the temperature in the room.

A primiparous client is on a regular diet 24 hours postpartum. The client's parent asks the nurse if they can bring some "special foods from home." The nurse responds, based on the understanding of which principle? Foods from home are generally discouraged on the postpartum unit. This is permissible as long as the foods are nutritious and high in iron. The parent can bring the client any foods that they desire. The client's health care provider (HCP) needs to give permission for the foods.

The parent can bring the client any foods that they desire. Explanation: On most postpartum units, clients on regular diets are allowed to eat whatever kinds of food they desire. Generally, foods from home are not discouraged. The nurse does not need to obtain the HCP's permission. Although it is preferred, the foods do not necessarily have to be high in iron. In some cultures, there is a belief in the "hot-cold" theory of disease: certain foods (hot) are preferred during the postpartum period, and other foods (cold) are avoided. Therefore, the nurse should allow the parent to bring the client "special foods from home." Doing so demonstrates cultural sensitivity and aids in developing a trusting relationship.

A client who does not speak English is to be discharged from the hospital following outpatient surgery. Using an interpreter, the nurse reviewed all postoperative instructions, including the need to come in for the follow-up appointment in 2 weeks. The nurse also explained the reconciled medication list, including when to resume taking each medication and the signs and symptoms that would require a call to the health care provider. To ensure the client will continue ongoing care management, the nurse should do what next? Provide a copy of the discharge materials to the interpreter. Schedule follow-up visits, and inform the client of dates and times. Provide the reconciled client medication list. Obtain the client's signature following receipt of discharge materials.

Schedule follow-up visits, and inform the client of dates and times. Explanation: Making appointments and navigating the health care system is a major obstacle for non-English-speaking clients. To support ongoing care management, the nurse can help the client by making the appointment for the follow-up visit, and providing dates and times. Providing the reconciled medication list and obtaining the client's signature are part of the discharge process. Providing a copy of the discharge materials to the interpreter is not part of the discharge process and would be a violation of the Health Insurance Portability and Accountability Act (HIPAA).

A nurse is completing an admission assessment. The nurse asks the client about social support systems and the client asks the nurse to explain social support systems. Which statement describes a social support system? "It is a source of payment options to aid in the hospital bill of the client." "It is a group of health care providers who are available to assist with care needed for the client's family." "It is a health care system with a variety of educators available in the community." "It is a group of friends and colleagues at home and in the community that help a client in times of need."

"It is a group of friends and colleagues at home and in the community that help a client in times of need." Explanation: Support systems can be family members as well as community members who are available to assist with any need of the client. Health care systems are support systems of health care. Health care providers are also part of the health care support system. Support systems are not payment options.

Which statement is a correct reason for nurses to become culturally sensitive and develop their cultural competency skills? It is important to facilitate the process of acculturation for people of different cultures. There are many subcultures in our country, and it is important to know about these cultures and their practices. Cultural sensitivity and consideration of client diversity are necessary to provide ethical nursing care. The code of ethics challenges nurses to practice in an ethical and caring way.

Cultural sensitivity and consideration of client diversity are necessary to provide ethical nursing care. Explanation: Becoming sensitive to clients of different cultural backgrounds is necessary in order to provide ethical care. In addition, nurses must develop cultural competency to care for these clients effectively. People of different cultures make the decision of acculturation or preservation of their own culture. A nurse cannot be familiar with beliefs of all subcultures; however, it is important to have a framework for better understanding and appreciating persons from different cultures. Codes of ethics challenge nurses to provide ethical care, but this does not explain the relationship between ethical care and culturally sensitive care.

A 3-year-old child of Vietnamese descent with a fever, decreased urine output, wheezing, and coughing is brought to the emergency department. On examination, the nurse discovers red, round, welt-like lesions on the child's upper back and chest. Which question should the nurse ask next? "Are you aware of any child abuse?" "Has your child been exposed to shingles?" "Can you tell me about any cultural practices in your family?" "Does your child have any allergies?"

"Can you tell me about any cultural practices in your family?" Explanation: The nurse should consider that the lesions may be caused by cultural practice. Many Vietnamese people perform coining, a cultural practice in which a coin is repeatedly rubbed lengthwise on the oiled skin to rid the body of a disease. Coining can produce welt-like lesions on the child's back or chest, and children subjected to the practice are commonly thought to have been abused. Interviewing the family and assessing its cultural background can help distinguish between abuse and culture practice. Shingles, a form of herpes zoster, is a communicable disease usually affecting immunocompromised individuals and older adults. The disease produces small crusty pustules on the lower back and trunk. The description of the lesions doesn't fit those produced by an allergic reaction.

The nurse is assessing the pain level in a client who typically gives a stoic response to describing the pain. Which comment from this client is expected? "This pain is killing me." "I can't go on in pain like this any longer." "Enduring pain is a part of God's will." "I've got to see a health care provider (HCP) right away."

"Enduring pain is a part of God's will." Explanation: Although individuals differ in their response to pain, the most likely attitude of a client who typically responds to pain stoically, is to endure pain as a part of God's will, and to delay requesting pain medication. The nurse can validate the client's response and respect his or her choice about receiving pain medication.

The nurse is caring for an 8-year-old with a life-threatening illness. The parents do not speak the native language and want the child discharged so they can pursue alternative therapies that they believe will be less expensive. What is the most important action taken by the nurse to help the family and the child? Contact a clergy member to administer last rites to the child. Arrange to have a translator present when talking with the parents. Notify the healthcare provider that treatment will no longer be necessary. Have a social worker help the family with the financial burden.

Arrange to have a translator present when talking with the parents. Explanation: A translator is an immediate priority. No effective health teaching or social intervention will be effective until there is an established means of communication with the family.

To which unlicensed assistive personnel should the nurse assign a male orthodox Muslim client who needs complete morning care? Joe, who has one client requiring complete morning care Jim, who has five clients requiring partial morning care Judy, who has two other clients requiring complete morning care Jill, who has four clients requiring partial morning care

Explanation: The nurse should assign the Muslim male client who needs complete morning care to Joe. Muslim men cannot be cared for by female nurses. The nurse must also consider workload, and Joe has the lightest assignment.

A student nurse is accompanying a community health nurse for the day. The RN asks the parents at the home visit if the student can be present for the breastfeeding assessment. The mother's partner declines this opportunity. What is the nurse's most appropriate response? Ask the partner to leave the premises. Honor the partner's preference. Reassure the partner that the student nurse will be professional. Ask the partner about any concerns.

Honor the partner's preference. Explanation: When providing services such as a postpartum visit in someone's home, the nurse needs to respect the culture, values, and personal preferences of the resident family members. The other responses are negating of the family's wishes and could be seen as confrontational and not client centered.

The nurse is caring for a laboring client fluent in English, but the client defers to her mother-in-law when asked to sign the hospital consent forms. Which of the following factors contributes to the challenges the nurse faces in obtaining consent? Influence of the extended family Patterns of verbal communication Religious beliefs Gender identity

Influence of the extended family Explanation: The influence of the extended family is the cultural factor that is causing the nurse's dilemma. It is common for English-speaking women to defer to an extended family member in both formal and informal decision-making situations. Language barriers may present challenges at times, but translators may be involved in particular when discussing health-related decisions to ensure understanding.

A client of Anglo-Saxon descent (e.g., Anglo-American or English Canadian) reports to the primary healthcare facility with symptoms of fever, cough, and running nose. While interviewing the client, which points should the nurse keep in mind? Maintain eye contact while talking. Do not ask very personal questions. Sit at the other corner of the room. Do not probe into emotional issues.

Maintain eye contact while talking. Explanation: While interviewing a client of Anglo descent, the nurse should maintain eye contact because it indicates openness and sincerity. Such clients freely express positive and negative feelings; therefore, the nurse may probe into emotional issues. Anglo culture is an open culture and members of this culture don't mind providing personal information. Also, clients of Anglo descent are not threatened by closeness so the nurse does not have to sit in another corner of the room.

The nurse has recently accepted a position in a community with an ethnically and culturally diverse population. What action should the nurse first perform in order to enhance cultural competence? Ask clients from other ethnicities for suggestions on how to become more culturally aware. Thoughtfully reflect on the characteristics of their own culture. Make an effort to learn a language that is commonly spoken in the community. Ask several colleagues about the culture with which they most closely identify.

Thoughtfully reflect on the characteristics of their own culture. Explanation: Cultural competence begins with self-awareness. This should precede efforts such as learning languages or inquiring about colleagues' cultures. The nurse should seek to better understand clients' cultures, but it would not be appropriate to ask clients for advice about becoming more culturally aware in general.

During an admission history, the parents of a pediatric client explain that the family is Jewish and follows a kosher diet. Which food items would most likely be appropriate for the client? turkey sandwich and a glass of milk chicken, a cup of fruit, and a glass of water sausage and pepperoni pizza and a glass of milk bacon and eggs and a glass of orange juice"

chicken, a cup of fruit, and a glass of water Explanation: The kosher diet includes meat and fowl that are butchered using only humane methods. Meat and dairy may not be eaten together. Pigs are considered unclean and may not be eaten as part of a kosher diet. Chicken is kosher as long as it is butchered humanely. Fruits and vegetables are considered kosher as long as they are free from insects. Remediation:

The nurse manager is preparing to meet with several registered nurses (RNs) in the department to address practice issues. Which behavior by an RN will the nurse manager address as a violation of the RN's "duty to care"? declined assignment to care for a client with dementia who was incontinent of stool fabricated assessment results in the medical record for an admitted client shared confidential information about a hospitalized client on social media administered medications to a client in error that were intended for the client's roommate

declined assignment to care for a client with dementia who was incontinent of stool Explanation: The duty to care in nursing refers to the ethical obligation that nurses have to their clients. Nurses can refuse to care for clients on several grounds such as moral conflict, feeling unsafe, or lacking the skills needed to safely deliver care. The nurse cannot refuse care based on the client's health concerns. Falsifying medical records is a breach of the ethical duty to be truthful and accurate in communications. Sharing information on social media breaches the nurse's ethical duty to protect client confidentiality. Making a medication error is a question of competence related to this skill rather and is not related to the duty to care

The children of an elderly client who has suffered an ischemic stroke have informed the nurse that an herbalist will be coming to their parent's bedside tomorrow to make recommendations for client's care. Which considerations should the nurse prioritize in light of the practitioner's planned visit? ensuring that the care team does not impose their beliefs on the family or the complementary practitioner identifying whether the family would prefer to pursue alternative or conventional treatment for their parent ensuring any complementary therapies are safe when combined with his prescribed therapy taking measures to prevent cultural conflict when the practitioner comers to the hospital

ensuring any complementary therapies are safe when combined with his prescribed therapy Explanation: While it is important for the nurse and the other members of the care team to ensure that stereotypes or cultural imposition do not exist, the priority in all aspects of care is safety. Consequently, potential interactions between the complementary therapies and conventional hospital treatments are a priority. The family should not be required to forgo conventional treatment to pursue some aspects of culturally based, complementary care.

When assessing a dark-skinned client for cyanosis, what area of the body will best reveal cyanosis? inner aspects of the wrists retinas oral mucous membranes nail beds

oral mucous membranes Explanation: In dark-skinned clients, cyanosis can best be detected by examining the conjunctiva, lips, and oral mucous membranes. Examining the retinas, nail beds, or inner aspects of the wrists is not an appropriate assessment for determining cyanosis in any client.

The client is Asian and does not speak English. The nurse arranges for the interpreter who can speak the client's dialect and begins the health assessment. The client is describing symptoms as numbness, feeling "hot under the skin," and thinking too much. The nurse should next ask specific questions about which symptom? hunger depression constipation pain

pain Explanation: The client may be describing symptoms of pain. Culture specific symptoms for "feeling bad" include numbness, thinking too much, feeling hot under the skin. Asian clients may describe pain in terms of Yin and Yang (hot and cold). Nurse's knowledge of pain associated with health problems is necessary to assist this client manage pain. Clients from some cultures may associate mental health symptoms with evil spirits and will not report them as being unusual. Clients from Asian cultures may not describe symptoms locally but in a diffuse fashion.

A nurse is teaching a client about adequate nutritional intake during pregnancy. The client has recently emigrated to the United States from Haiti. Based on the client's cultural background, what foods would the nurse expect her to eat during pregnancy? Select all that apply. red fruits fish milk plantains eggplant rice

rice plantains red fruits Explanation: The client's Haitian culture has significant impact on the foods consumed. Childbearing women have certain food preferences (e.g., cornmeal porridge, bean sauce, rice, plantains, vegetables, and red fruits), and foods that are avoided are cold foods and white foods (e.g., lima beans, tomatoes, white beans, okra, lobster, fish, eggplant, milk, bananas, black peppers, and black mushrooms).

A client who is a member of The Church of Jesus Christ of Latter-day Saints has had abdominal surgery several days ago. The client's bowel function has returned, and the client is now advanced to a full liquid diet. When working with the nutritional staff to ensure that the client's meal trays include the appropriate food choices for the client's prescribed diet, which suggestion would be most appropriate for the nurse to include? Select all that apply. coffee with cream sherbet strained cream of chicken soup sweetened iced tea cranberry juice

sherbet strained cream of chicken soup cranberry juice Explanation: Based on the client's faith, the client is required to abstain from the ingestion of caffeinated products such as tea and coffee. Items such as sherbet, fruit juices, including cranberry juice, and strained cream soups would be appropriate for the client's religious beliefs as well as adhere to the prescribed full liquid diet.

A client who has just returned from a monthly visit home is admitted with an extremely prolonged bleeding time. The nurse observes the client to project a powerful odor of garlic on the breath, person, and clothing. What is the most important factor for the nurse to assess? the client's dietary habits the client's financial status the client's hygiene routine the client's housing standard

the client's dietary habits Explanation: The nurse should acknowledge that routine consumption of excess amounts of garlic by some cultures can exacerbate increased bleeding and delayed coagulation. In this case, assessing the client's dietary habits would be appropriate. It is judgmental to assume that this client experiences difficulties with hygiene, poverty, or restricted access to water.

The nurse is caring for a client who is a recent immigrant from China. Through the hospital interpreter, the client expresses an unwillingness to eat the fried fish that was on the meal tray, describing it as "too hot." What is the nurse's best action? Ask the interpreter to suggest culturally appropriate foods for the client. Ask the interpreter to ask the client to leave the food in the fridge for a few minutes before starting eating. Ask the interpreter to ask the client about the specific meaning of the description of "hot." Ask the interpreter to ask the client's family to bring a favorite food from home.

Ask the interpreter to ask the client about the specific meaning of the description of "hot." Explanation: In many Asian cultures, foods are categorized on a continuum of cold to hot that is independent of their physical temperature. Consequently, it is important for the nurse to assess the precise meaning of the client's statement before taking further action such as changing the client's diet. It is appropriate to assess the client's food preferences, but this data should come from the client, not the interpreter.

A woman who speaks Chinese only and is very upset brings her child to the clinic with bleeding from the mouth. Which is the appropriate first action by the nurse who does not speak Chinese? Grab the child, and take the child to the treatment room. Call for the interpreter. Give the ice to the mother, and demonstrate what to do. Immediately apply ice to the child's mouth.

Give the ice to the mother, and demonstrate what to do. Explanation: Any injury to the mouth results in copious amounts of blood because the mouth is a highly vascular area. Because the nurse does not know the mother and does not speak Chinese, the most appropriate action is to give the mother the ice and demonstrate what she is to do. The child will be less fearful if the ice is applied by the mother. Calling for an interpreter is appropriate after caring for the immediate need of the child. Grabbing the child away will probably upset the mother more, further adding to the stress experienced by the child.

A client doesn't make eye contact with the nurse during an interview. The nurse suspects that the client's behavior has a cultural basis. What should the nurse do first? Ask staff members of a similar culture about the client's behavior. Read several articles about the client's culture. Accept the client's behavior because it's probably culturally based. Observe how the client and the client's family and friends interact with one another and with other staff members.

Observe how the client and the client's family and friends interact with one another and with other staff members. Explanation: Assessing the client's interactions with others helps the nurse determine whether the behavior is part of a usual pattern. It also may help the nurse understand the meaning of the behavior for this particular client. Reading about a different culture, consulting other staff members, and talking with the client are helpful after the nurse has observed the client's interaction with others. The nurse must be able to accept the client as an individual but need not accept unhealthy or inappropriate behaviors. The nurse should work with the client to better understand the cultural differences.

The nurse is performing an admission assessment of a new client. When assessing potential cultural influences on the client's care, the nurse should address what domains? Select all that apply. communication nutrition expressions of pain inflammation decision-making processes

decision-making processes nutrition communication expressions of pain Explanation: Culture is a concept that encompasses nearly every dimension of the illness experience, including the way that decisions are made, communication, the way pain is expressed, and the role of nutrition and food preferences. Inflammation, however, is a physiologic concept that is not directly influenced by culture.

For which client is the nursing assessment of pain most likely to result in undertreatment? an older adult who grimaces and states no pain after a gastrostomy tube placement a young adult who vomits and keeps eyes closed during a migraine headache attack a black adult who has a client-controlled analgesic I.V. following cardiac surgery a Asian American client who requests medication for pain following abdominal surgery

an older adult who grimaces and states no pain after a gastrostomy tube placement Explanation: Clients at risk for insufficient pain control are older adults and those of ethnic origins that hold the tradition of stoicism, such as many Asian and Hispanic cultures. The nurse must assess carefully to provide culturally appropriate care. Clients who request medication, or are allowed to regulate their own medications, are more likely to have their pain controlled.

A nurse is assessing the posterior lung fields for a client who is experiencing difficulty breathing. The nurse lifts off the shirt and notices red, circular areas along the mid-spine area. What type of therapy is this? massage cupping bleeding traditional Chinese medicine

cupping Explanation: Cupping creates a vacuum in a small glass by burning the oxygen out of it and then placing the glass on the person's skin surface. Cupping draws blood and lymph to the body's surface that is under the cup and is used to treat lung congestion of clients. Bleeding is done with leeches. Massage is done by using pushing and pulling for stimulation of orthopedic and neurological conditions.

Despite the presence of a large cohort of elderly residents of Asian heritage, a long-term care facility has not integrated the Asian concepts of hot and cold into meal planning. The nurses at the facility should recognize this as an example of what? cultural imposition stereotyping cultural blindness cultural assimilation

cultural blindness Explanation: Cultural blindness is characterized by ignoring cultural differences or considerations and proceeding as if they do not exist. This phenomenon may underlie the failure to incorporate cultural considerations into dietary choices. Stereotyping assumes homogeneity of members of other cultures while cultural assimilation involves the replacement of values with those of a dominant culture. Cultural imposition presumes that everyone should conform to a majority belief system.

A client from Pakistan informs the nurse of cultural dietary requests. The nurse responds to the special dietary needs by stating, "You are now living in the United States and you should try to start eating those foods common to an American diet." This inappropriate response is an example of cultural diversity. cultural assimilation. cultural imposition. cultural blindness.

cultural imposition. Explanation: The nurse's response is an example of cultural imposition, which is defined as the belief that everyone should conform to the majority belief system. Cultural blindness is the result of ignoring differences and proceeding as though they do not exist. In this situation, the nurse did not ignore the request but inappropriately responded to it. Cultural diversity is defined as a diverse group in society, with varying racial classifications and national origins, religious affiliations, languages, physical sizes, genders, sexual orientations, ages, disabilities, socioeconomic statuses, occupational statuses, and geographic locations. Cultural assimilation occurs when members of a minority group live within a dominant group and lose the cultural characteristics that make them different.

When the nurse is assessing a client's cultural adaptation, which statement is least sensitive to the client's needs? "Please tell me how you would like to be addressed." "Describe any health problems in your past." "What are some of your favorite foods?" "Your eyes look dark; is this normal for you?"

"Your eyes look dark; is this normal for you?" Explanation: The statement, "Your eyes look dark," is the least sensitive statement because it points out an obvious difference for no real purpose. The nurse has a reason to ask the client about favorite foods and needs to know about past health problems. Also, it is appropriate for the nurse to ask the client how she wishes to be addressed.

A birthing couple informs the nurse that they would like to have the placenta after the baby is born. What is the nurse's best response? "This should be a decision between the physician and couple." "Why would you want to do that?" "Let me check about how to go about doing this." "Centers for Disease Control and Prevention policy does not allow the hospital to give the parents the placenta."

"Let me check about how to go about doing this." Explanation: The nurse's best response is be sensitive to the client's desires and to check with the institutional policy. This is not a violation of the CDC policy. Asking the couple why they would want to do this disrespects their cultural background. The couple does not need to involve the physician in the decision.

A neonate born to a primipara at 36 weeks' gestation in a small, rural hospital is to be transferred by ambulance to a neonatal intensive care unit. To prepare the parents for the transfer, the nurse should include what measure in the plan of care? Allow the parents to touch the neonate before transfer. Instruct the parents that the neonate is in critical condition. Obtain the parents' consent for the neonate's transfer. Ask the parents if they desire to ride in the ambulance during the transfer.

Allow the parents to touch the neonate before transfer. Explanation: When a neonate is being transferred to a neonatal intensive care unit, the parents should be allowed to see and touch the neonate, if possible, before transfer. The parents should be given the location and telephone number of the unit to which the neonate is being transferred. This helps to keep the parents informed.The parents are already aware of the neonate's condition and should recognize that it is critical if the neonate is being transferred to a neonatal care center.Consent would be obtained upon initial admission, and further consent is not likely necessary.Asking whether the parents would like to ride in the ambulance with the neonate during the transfer is inappropriate. Most ambulances or transferring vehicles (e.g., helicopters, airplanes) do not allow family members to accompany the ill client. Space in the motor vehicle, helicopter, or plane is limited.

An adolescent client in labor is dilated 4 cm and asks for an epidural. For cultural reasons, the client's mother states that her daughter "has to bite the bullet, just like I did." What should the nurse do to make sure her client's request is honored? Request that an anesthetist administer the epidural because the client is uncomfortable. Knowing the client's cultural background, suggest that the family call a meeting to make the decision. Honor the mother's request. Ask the client in a nonthreatening way if she wishes to have an epidural, and then speak with the physician.

Ask the client in a nonthreatening way if she wishes to have an epidural, and then speak with the physician. Explanation: A pregnant adolescent is considered to be emancipated and entitled to make her own decisions. It's the adolescent's right to decide whether she wants to have an epidural. The nurse should act as the adolescent's advocate and ask her whether she wants an epidural and then speak with the physician. The adolescent's mother and other family members can't override her decision. The nurse may not request that an anesthetist administer the epidural without the adolescent's consent.

A client gives birth to a neonate at 30 weeks' gestation. The neonate is stable on minimal ventilator settings. The client's previous infant, who was born at 24 weeks' gestation, did not survive. The family is Roman Catholic and requests that the neonate be baptized as soon as possible. What response by the nurse is most appropriate? "What would you like me to do to help arrange the baptism?" "Are you requesting the baptism because you are concerned that your infant might die?" "Your baby is much older and much more stable than the baby you lost." "We have a unit chaplain who rounds daily and can perform the baptism."

"What would you like me to do to help arrange the baptism?" Explanation: Patient-centered care involves honoring client preferences. It is common practice to baptize infants who are at risk for death in the Roman Catholic faith. While a 30-week gestation infant on minimal ventilator settings would be expected to survive, the family has had real experiences with neonatal death, and spiritual practices can provide comfort. The nurse should ask the family about their preferences and try to honor them. The family may indeed be requesting the baptism because they are fearful their infant might die. The nurse can reassure the family that the infant is doing well but must also respect the client's spiritual preferences. After the family shares their preferences, the nurse can offer the local chaplain as a resource.

A client of Asian descent has been laboring for 3 hours. The nurse notes that a laboring client's temperature is elevated and her mucous membranes are becoming dry. The client has been refusing sips of water and ice that have been offered to her. Which is the most appropriate nursing action at this time? Encourage client to drink the ice and water. Ask the client what fluids she prefers to drink. Offer the client hot beverages. Increase the IV oxytocin to 125 mL/hr for hydration.

Ask the client what fluids she prefers to drink. Explanation: Although it is common for Asian childbearing women to drink only hot beverages (birth philosophy related to yin and yang), it would be appropriate first to find out from the client what she wants to drink and determine her likes and dislikes. There is a reason she has chosen not to drink the cold beverages, so it is best to ask her what it is she does want. Increasing the oxytocin would likely increase her uterine contractions and is not appropriate practice for meeting the needs of hydration.

A young woman with an ovarian cyst who recently emigrated from Laos has been admitted to the hospital. The client and her husband both speak Lao exclusively, which has complicated the ability of the care team to obtain informed consent for surgery. What action would the care team take to communicate with the client? Communicate with the client and her husband nonverbally. Organize professional interpretation either in person or by telephone. Arrange for a trusted family member to come in to translate. Encourage the client to write out her concerns on paper.

Organize professional interpretation either in person or by telephone. Explanation: All clients have a right to unencumbered communication with a health provider; consequently, a professional interpreter is necessary. It is insufficient to communicate nonverbally, and it is usually inappropriate to have a family member translate. Having the client write her concerns does not resolve this problem.

A nurse is caring for a client 24 hours after an abdominal-perineal resection for a bowel tumor. The client's wife asks if she can bring him some of his favorite home-cooked Italian minestrone soup. What should the nurse do first? Ask the client if he feels hunger or gas pains. Encourage the wife to bring the soup. Auscultate for bowel sounds. Consult the dietician.

Auscultate for bowel sounds. Explanation: The nurse should perform a thorough assessment of the abdomen and auscultate for bowel sounds in all four quadrants. Clients who have gastrointestinal surgery may have decreased peristalsis for several days after surgery. The nurse should check the abdomen for distention and check with the client and the medical record regarding the passage of flatus or stool. Consulting a dietician would be inappropriate because the client must be kept on nothing-by-mouth status until bowel sounds are present. The nurse should explain to the wife that it is too soon after surgery for her husband to eat.

A client's partner tells the nurse that he will remain in the waiting room while the client is in labor. The client's sister has been chosen to be her birth companion. Which of the following responses from the nurse would be most appropriate? Tell the partner that he will receive updates of the client's progress and be called as soon as the baby is born. Inform the client and her partner that only fathers can stay in the birthing room. Encourage the partner to stay with the client because, as the baby's father, he is the best birth companion. Ask the client if she agrees with her partner's desire to stay in the waiting room.

Tell the partner that he will receive updates of the client's progress and be called as soon as the baby is born. Explanation: This statement respects the decision of the family and facilitates open communication among the nurse, the client, and the client's partner during labor and birth.

In preparation for being discharged to home, the nurse is teaching a client with a chronic right ankle stasis ulcer about wound care. What statement by the client indicates a need for further teaching? "I'll eat a balanced diet." "I'll be patient with the healing process." "I'll make an appointment with a physical therapist." "I'll apply a home herb mixture to the wound to promote healing."

"I'll apply a home herb mixture to the wound to promote healing." Explanation: The nurse should first determine how the client will apply an herb mixture to the ulcer. The nurse should then encourage the client to consult the health care provider because home remedies may be beneficial or may interfere with the medical treatment plan. In many cultures, home remedies are commonly used and may be helpful. The nurse must be sensitive to these traditions and cultural beliefs. The other statements demonstrate that the client understands the plan of care for the ulcer.

A surgical nurse is caring for an older adult client who has never had surgery or been hospitalized. The client is experiencing culture shock after a colon resection today. What nursing actions could minimize the client's culture shock? Select all that apply. Explain all actions and procedures to the client to decrease anxiety. Encourage the client to share any cultural needs during the admission interview. Have the family bring photos or a favorite blanket from home. Discharge the client home later today with family care. Utilize an interpreter to make the client's needs known.

Have the family bring photos or a favorite blanket from home. Encourage the client to share any cultural needs during the admission interview. Discharge the client home later today with family care. Explain all actions and procedures to the client to decrease anxiety. Explanation: Culture shock may result in psychological discomfort or disturbances, as the patterns of behavior a person found acceptable and effective in one's own culture may not be adequate or even acceptable in the new one like the hospital. The person may then feel foolish, fearful, or incompetent. These feelings eventually can lead to frustration, anxiety, and loss of self-esteem. It is crucial that the nurse have family bring in personal items, encourage sharing of cultural practices, or take additional time to explain everything so that the client understands and does not feel overwhelmed and anxious. There is no need for an interpreter in this scenario although if the client does not speak the language this could be used. It is not appropriate to discharge a client after a colon resection to home on the same day to avoid culture shock. The client will need monitored from 24 to 72 hours after a colon resection.

Which statement best explains why the nurse should acknowledge differences between their culture and the client's culture? The nurse may hold values that could influence the care of the client. The nurse can determine which cultural groups will be noncompliant with their health care. The nurse can anticipate the client's response to nursing care. The nurse can alter their own beliefs to match the client's.

The nurse may hold values that could influence the care of the client. Explanation: To avoid ethnocentric behavior toward the client, it is important that nurses acknowledge what their cultural beliefs are and be careful not to impose them on the clients they care for because this could influence the quality of care. It is stereotypical for nurses to assume that they can determine which cultural groups will be noncompliant. It is stereotypical for nurses to anticipate the client's response to care based on the client's culture. Nurses need to be aware of their beliefs and not alter them to match the client's culture.

Which beliefs of traditional Chinese medicine found in Asian culture should the nurse consider when planning care for a follower of traditional Chinese medicine? Health is described as harmony between family members. Illness is caused by an imbalance of the yin and yang. Illness is caused by a change in eating habits. Exercise to the point of overexertion can improve health.

Illness is caused by an imbalance of the yin and yang. Explanation: Traditional Chinese medicine describes health as the balance of yin and yang. It describes health as harmony between the mind, body, and soul.

The nurse is preparing to take a meal tray to the client. The nurse understands that the client follows a kosher diet. Which foods noted on the tray would be of a concern to the nurse? sardines and wheat crackers salmon and broccoli turkey and cheese sandwich cream cheese and bagels

turkey and cheese sandwich Explanation: Meat and milk products cannot be on the same plate when maintaining a kosher diet. The other choices would be appropriate.