EXAM 6 questions

A client dies during surgery, and the family members ask that the hospital not conduct autopsy examinations. Which religion might the nurse expect this family to practice? 1:islam 2:hinduism 3:buddhism 4:christianity

1

When preparing a client for a diagnostic procedure, which action would the nurse take if the client is wearing a religious symbol dangling from a necklace? 1:ask the client about the religious symbol and significance of removing it 2:explain to the client that the religious symbol must be removed immediately 3:call the radiologist performing the procedure to obtain an order to keep the necklace in place 4:say nothing to the client, remove the necklace, and give it to a family member for safekeeping

1

Which explanation provided by the nurse is the most accurate meaning for "providing culturally congruent care"? 1. It fits the patient's valued life patterns and set of meanings. 2. It is the same set of values as those of the health care team member providing daily care. 3. It holds one's own way of life as superior to those of others. 4. It redirects the patient to a more socially expected set of values.

1 rationale: The ongoing process of cultural competence refers to the need of the health care professional to be culturally sensitive in providing culturally appropriate care specific to the needs of the patient, family, and community.

Which point would the nurse keep in mind when caring for a client who belongs to a different culture? (select all that apply) 1:be aware of the nurses own cultural values and behavior patterns 2:focus on understanding the clients traditions, values, and beliefs 3:understand that unique cultural perceptions exist regarding health practices 4:know that every client strictly adheres to their cultural beliefs and traditions 5:understand that a clients cultural background does not influence the nurse client relationship

1,2,3

Which statements made by the client would the nurse consider as an influence of spirituality on health beliefs? (select all that apply) 1:my faith prohibits the use of a donors sperm 2:Dont administer nasal drops now because it will break my fast 3: i do not believe in surrogacy because this is not permitted in our community 4:I am not worried about my surgery because I have undergone several surgeries in the past 5:I am not able to meed my basic needs. How do you expect me to buy costly medicine

1,2,3

When planning care for a dying patient, which interventions promote the patient's dignity? (Select all that apply.) 1. Providing respect 2. Viewing the patient as a whole 3. Providing symptom management 4. Showing interest 5. Being present 6. Inserting a straight catheter when the patient has difficulty voiding

1,2,4,5 rationale: A sense of dignity includes a person's positive self-regard, the ability to find meaning in life, to feel valued by others, and by how one is treated by caregivers.

Which nursing intervention(s) best promote(s) effective sleep in an older adult? (Select all that apply.) 1. Limit fluids 2 to 4 hours before sleep. 2. Ensure that the room is completely dark. 3. Ensure that the room temperature is comfortably cool. 4. Provide warm covers. 5. Encourage walking an hour before going to bed.

1,3,4 rationale: Limiting fluids reduces incidence of nocturia. For safety reasons complete darkness should be avoided. A soft nightlight lessens the chance of a fall should the patient require ambulation to the bathroom during the night. Older adults sometimes require extra blankets or covers to achieve a comfortable sleeping temperature. Keeping the bedroom temperature at a cooler, comfortable temperature is conducive to sleep.

Which physiological symptom would the nurse associate with a clients sleep deprivation? (select all that apply) 1:ptosis and blurred vision 2:agitation and hyperactivity 3:confusion and disorientation 4:increased sensitivity to pain 5:decreased auditory alertness

1,5 rationale: ptosis may result from a loss of elasticity of the eyelids, which is a physiologic symptom of sleep deprivation. Decreased auditory alertness and blurred vision are also physiologic symptoms -agitation, hyperactivity, confusion, disorientation, and increased sensitivity to pain are psychologic symptoms of sleep deprivation

The nurse is caring for a patient who is very depressed and decides to complete a spiritual assessment using the FICA tool. Using the FICA assessment tool, match the criteria on the left with the appropriate assessment question on the right. 1.Faith 2:importance 3:community 4:address interventions of spiritual needs a: tell me if you have a higher power or authority that helps you act on your beliefs b:describe which activities give you comfort spirituality c:to whom do you go for support in times of difficulty d:your illness has kept you from attending church. Is that a problem for you

1a 2d 3c 4b

An adult child of a dying clients says to the nurse, "I am so upset because my parent is always angry at me." which would be the correct response by the nurse? 1:your parent is frightened by impending death 2:your parent is working through acceptance of the situation 3:your parent is attempting to reduce your need for dependency 4:your parent is hurt that you will not provide physical care at home

2

What are the physical circulatory changes that occur as death approaches? 1. Skin irritation 2. Mottling 3. Increased urine output 4. weakness

2 rationale: Patients experience circulatory changes resulting in mottling(blotchy skin color). Weakness, skin irritation, and incontinence are some of the physical changes that occur as death nears but are not related to circulatory changes.

Traditional Chinese medicine (TCM) is used by many patients. Which statement most accurately describes intervention(s) offered by TCM providers? 1. Uses acupuncture as its primary intervention modality 2. Uses many modalities based on the individual's needs 3. Uses primarily herbal remedies and exercise 4. Is the equivalent of medical acupuncture

2 rationale: TCM practitioners use a variety of interventions that are based on individual patient assessment findings and needs. Modalities include herbal therapies, acupuncture, moxibustion, cupping, prescribed exercise such as tai chi or qi gong, and lifestyle changes. Although acupuncture is often confused with TCM, when it is used alone, acupuncture is not a whole system of medicine. Rather the National Institutes of Health/National Center for Complementary and Alternative Medicine considers it to be a mind-body technique that is often referred to as medical acupuncture. Although herbal therapies and exercise are considered to be part of the treatment repertoire of the TCM provider, these modalities are not considered to be primary interventions.

Which nursing intervention would the nurse implement to promote sleep for a client in a health care setting? (select all that apply) 1:restrict visitors 2:reduce lighting 3:provide activities during the day 4:decrease the sounds of the infusion alarms 5:increase the dosage of pain medications at night

2,3

When taking the history for a client who is being treated for obstructive sleep apnea, which findings would the nurse expect? (select all that apply) 1:daytime hypoxemia 2:chronic fatigue 3:enlarged tonsils 4:subcutaneous emphysema 5:poor concentration

2,3,5

A terminally ill client is visited frequently by the spouse and teenage children. Which nursing intervention would the clients plan of care include? 1: foster self care by the client whenever possible 2:plan care to be completed at one time followed by a long rest 3:teach family members how to assist with the clients basic care 4:limit visiting to evening hours before the client goes to sleep

3

During an assessment, which client statement may indicate to the nurse that the client is experiencing spiritual distress? 1: I want to find out whether any divine force truly exists in this world 2: I am sure that God is with me; otherwise I could have suffered alot more 3:I deserve a better life than this. I dont understand why God decided to make me ill 4:I wish I didnt need help with daily activities, but I am grateful the universe gave me a strong support system

3

Which phenomenon would the nurse suspect when a toddlers parent reports that the child wakes up screaming at night and then suddenly stops crying with no memory of what was wrong? 1:nightmares 2:sleep apnea 3:sleep terrors 4:nighttime fears

3 rationale: sleep terrors are a partial arousal from very deep sleep that causes screaming and crying and a lack of memory to why they were crying -nightmares are scary dreams that occur during rapid eye movement sleep and the child is usually reassured by parents presence

Meditation may intensify the effects of which of these medications? (Select all that apply.) 1. Steroid medications 2. Insulin 3. Thyroid-regulating medications 4. Cough syrups 5. Antihypertensive medications

3,5 rationale: Mind-body techniques, including meditation, create physiological responses in the cardiovascular and respiratory systems. These responses may include decreased blood pressure, reduced heart rate, and slowed respirations. They decrease the need for antihypertensive and other cardiac regulators and thyroid-regulating medications.

Which interventions would the nurse perform while caring for an actively dying client? (select all that apply) 1:admit the client in hospice care 2:perform aggressive lab tests 3:provide client and family reassurance 4:keep the client undisturbed for long periods of time 5:offer symptom management to the client

3,5 rationale: the nurse would provide comfort care in an actively dying client. In comfort care, the nurse would reassure the client and family to reduce their emotional anxiety.

Which caring intervention helps comfort, dignity, respect, and peace to a client? 1:listening 2:spiritual caring 3:providing presence 4:relieving pain and suffering

4

Which diet need would the nurse and nutritionist consider when planning meals for a client who practices the Russian Orthodox faith? 1:no pork or shellfish 2:no blood containing food 3:vegetarian diet 4:no meat on wednesdays and fridays

4 rationale: -jewish avoid pork and shellfish as apart of a kosher diet -jehovah witness avoid blood containing food -hindu follow strict vegetarian diet

A nurse has the responsibility of managing a patient's postmortem care. What is the proper order for postmortem care when there is no autopsy ordered? 1. Bathe the body of the deceased. 2. Collect any needed specimens. 3. Remove all tubes and indwelling lines. 4. Position the body for family viewing. 5. Speak to the family members about their possible participation. 6. Ensure that the request for organ/tissue donation and/or autopsy was completed. 7. Notify support person (e.g., spiritual care provider, bereavement specialist) for the family. 8. Accurately tag the body, including the identity of the deceased and safety issues regarding infection control. 9. Elevate the head of the bed.

6,9,2,5,7,3,1,4,8 6. ensure that the request for donation and autopsy was completed 9. elevate head of bed 2.collect any needed specimens 5.speak to the family members about their participation 7.notify support person for family 3.remove all tubes and indwelling lines 1.bathe the body of the deceased 4.position the body for family viewing 8.correctly tag the body, including identity and safety issues regarding infection control

A client suffering from cancer is near the end of life. Which action would be performed by the nurse to support the clients family members (select all that apply) 1: helping the family set up hospice 2:taking time to make sure that the family understands care options 3:staying with the client in the absence of family members 4:giving the family info about the dying process 5:making sure that the family knows what to do at the time of death

All of these are correct

A nurse is assessing a patient's ethnohistory. Which question should the nurse ask? a. What language do you speak at home? b. How different is your life here from back home? c. Which caregivers do you seek when you are sick? d. How different is what we do from what your family does when you are sick?

b

A patient asks about the new clinic in town that is staffed by allopathic and complementary practitioners. Which response from the nurse is best? a. It is probably an ayurvedic clinic. b. It is probably a homeopathic clinic. c. It is probably an integrative medical clinic. d. It is probably a naturopathic medical clinic.

c ationale: An integrative medical program allows health care consumers to be treated by a team of providers consisting of both allopathic and complementary practitioners. -Several therapies are always considered alternative because they are based on completely different philosophies and life systems from those used by allopathic medicine. Alternative therapies include ayurvedic, homeopathic, and naturopathic.

A nurse is providing different types of therapies to a patient with excessive fatigue and cancer. Which technique will cause the nurse manager to intervene? a. Meditation b. Guided imagery c. Passive relaxation d. Active progressive relaxation

d rationale: The nurse manager needs to intervene if the nurse uses active progressive relaxation. Active progressive relaxation is not appropriate for patients with advanced disease or decreased energy reserves. Passive relaxation or guided imagery or meditation is more appropriate for these individuals.

A nurse is emphasizing the use of touch to decrease "skin hunger" in caring for patients. Which age group is the nurse primarily describing? a. Infants b. Children c. Middle age d. Older adults

d rationale: Touch is a primal need, as necessary as food, growth, or shelter. Touch is like a nutrient transmitted through the skin, and "skin hunger" is like a form of malnutrition that has reached epidemic proportions in the United States, especially among older adults. While infants, children, and middle age may be affected, it is the older adult who is most affected.

Which statement about sleep pattern of teenagers indicates adequate learning? (select all that apply) 1:teenagers often have reduced hours of sleep 2:teenagers often suffer from restless leg syndrome 3:teenagers get an average of 7.5 hours of sleep each night 4:twenty percent of a teens sleep cycle is rapid eye movement (REM) sleep 5:teenagers resist sleeping because they are unaware of fatigue

1,3 rationale: The typical adolescent is subject to a number of changes, such as school demands, after-school social activities, and part time jobs, all which reduce the time spent sleeping. -teenagers get about 7.5 hours of sleep per night and preschoolers sleep an average 12 hours a night -restless leg syndrome is common in young adults, not teenagers -young adults, not teenagers, have 20% of their sleep time in REM sleep

A client says, "None of the medications will work on me because I am away from my holy land."Which course of action would the nurse take to comply with teamwork and collaboration competency according to QSEN 1:provide care to the client with respect to diversity, values, and beliefs 2:approach the agency chaplain to discuss the spiritual needs of the client 3:conduct thorough research on the effect of emotional distress on the clients health 4:use the flow chart data to provide the best care and monitor the outcome of care processes

2 rationale: according to QSEN competency, the nurse complies with teamwork and collaboration competency to function effectively within the nursing and interprofessional teams. To show teamwork, the nurse would work with the chaplain.

A nurse is teaching a patient about meridians. Which technique is the nurse preparing the patient to receive? a. Acupuncture b. Naturopathic c. Latin American traditional healing d. Native American traditional healing

a rationale: Acupuncture regulates or realigns the vital energy (qi), which flows like a river through the body in channels that form a system of 20 pathways called meridians. -Naturopathic therapeutics include herbal medicine, nutritional supplementation, physical medicine, homeopathy, lifestyle counseling, and mind-body therapies with an orientation toward assisting the person's internal capacity for self-healing (vitalism). -tribal traditions are individualistic, but similarities across traditions include the use of sweating and purging, herbal remedies, and ceremonies in which a shaman (a spiritual healer) makes contact with spirits to ask their direction in bringing healing to people to promote wholeness and healing.

A nurse is providing postmortem care. Which action will the nurse take? a. Leave dentures in the mouth. b. Lower the head of the bed. c. Cover the body with a sterile sheet. d. Remove all tubes for an autopsy.

a rationale: Leave dentures in the mouth to maintain facial shape. Raise the head of the bed as soon as possible after death to prevent discoloration of the face. Cover the body with a clean sheet. Autopsy often does not allow removal of tubes, equipment, and indwelling lines.

A nurse is using caring-healing relationships to support whole person/whole systems healing. Which type of nursing is the nurse using? a. Holistic nursing b. Integrative nursing c. Interprofessional nursing d. Complementary and alternative nursing

b

A nurse is working at a health fair screening people for liver cancer. Which population group should the nurse monitor most closely for liver cancer? a. Hispanic b. Asian Americans c. Non-Hispanic Caucasians d. Non-Hispanic African-Americans

b rationale: While Asian Americans generally have lower cancer rates than the non-Hispanic Caucasian population, they also have the highest incidence rates of liver cancer for both sexes compared with Hispanic, non-Hispanic Caucasians, or non-Hispanic African-Americans.

A nurse is teaching about the therapy that is more effective in treating physical ailments than in preventing disease or managing chronic illness. Which therapy is the nurse describing? a. Complementary b. Allopathic c. Alternative d. Mind-body

b rationale: Despite the success of allopathic or biomedicine (conventional Western medicine), many conditions such as chronic back and neck pain, arthritis, gastrointestinal problems, allergies, headache, and anxiety continue to be difficult to treat. Complementary, alternative, and mindbody types of medicines can be used in tandem with allopathic medicines but are distinctly different.

The nurse is caring for a patient with a terminal disease. The nurse sits down and lightly touches the patient's hand. Which technique is the nurse using? a. "Doing for" b. Establishing presence c. Offering transcendence d. Providing health promotion

b rationale: Establishing presence by sitting with a patient to attentively listen to his or her feelings and situation, talking with the patient, crying with the patient, and simply offering time are powerful spiritual care approaches.

A nurse makes a connection with the patient when providing spiritual care. Which type of connectedness did the nurse experience? a. Intrapersonal b. Interpersonal c. Transpersonal d. Multipersonal

b rationale: Interpersonal means connected with others and the environment. Intrapersonal means connected within oneself. Transpersonal means connected with God or an unseen higher power. There is no such term as multipersonal for connectedness.

The nurse is caring for an Islam patient who wants a snack. Which action by the nurse is most appropriate? a. Offers a ham sandwich b. Offers a beef sandwich c. Offers a kosher sandwich d. Offers a bacon sandwich

b rationale: Islam religion does allow beef. Islam does not allow pork or alcohol. Ham and bacon are pork. Kosher is allowed for Judaism.

A co-worker asks the nurse to explain spirituality. What is the nurse's best response? a. It has a minor effect on health. b. It is awareness of one's inner self. c. It is not as essential as physical needs. d. It refers to fire or giving of life to a person.

b rationale: Spirituality is often defined as an awareness of one's inner self and a sense of connection to a higher being, to nature, or to some purpose greater than oneself. Spirituality is an important factor that helps individuals achieve the balance needed to maintain health and well-being and to cope with illness.

A nurse is using core measures to reduce health disparities. Which group should the nurse focus on to cause the most improvement in core measures? a. Caucasians b. Poor people c. Alaska Natives d. American Indians

b rationale: To improve results, the nurse should focus on the highest disparity. Poor people received worse care than high-income people for about 60% of core measures.

A nurse is teaching patients about health care information. Which patient will the nurse assess closely for health literacy? a. A patient 35 years old b. A patient 68 years old c. A patient with a college degree d. A patient with a high-school diploma

b rationale: patients who are especially vulnerable are the elderly (age 65+), immigrants, persons with low incomes, persons who do not have a high-school diploma or GED, and persons with chronic mental and/or physical health conditions

A nurse is using the explanatory model to determine the etiology of an illness. Which questions should the nurse ask? (Select all that apply.) a. How should your sickness be treated? b. What do you call your problem? c. How does this illness work inside your body? d. What do you fear most about your sickness? e. What name does it have?

b,c,e

A female nurse is called into the supervisor's office regarding her deteriorating work performance since the loss of her spouse 2 years ago. The woman begins sobbing and says that she is "falling apart" at home as well. Which type of grief is the female nurse experiencing? a. Normal grief b. Perceived grief c. Complicated grief d. Disenfranchised grief

c rationale: In complicated grief, a person has a prolonged or significantly difficult time moving forward after a loss. -Normal grief is the most common reaction to death; it involves a complex range of normal coping strategies. -Disenfranchised grief involves a relationship that is not socially sanctioned. -Perceived grief is not a type of grief; perceived loss is a loss that is less obvious to other people.

A patient is taking an antidepressant medication. The nurse discovers that the patient uses herbs. Which herb will cause the nurse to intervene? a. Aloe b. Garlic c. Chamomile d. Saw palmetto

c rationale: Potential drug interactions with chamomile include drugs that cause drowsiness like antidepressants. Aloe, garlic, and saw palmetto do not interfere with antidepressants

The nurse is caring for a patient who is an agnostic. Which information should the nurse consider when planning care for this patient? a. The patient is devoid of spirituality. b. The patient does not believe in God. c. The patient believes there is no known ultimate reality. d. The patient finds no meaning through relationship with others.

c rationale: Some people do not believe in the existence of God (atheist), or they believe that there is no known ultimate reality (agnostic).

The nurse is caring for a Chinese patient using the Teach-Back technique. Which action by the nurse indicates successful implementation of this technique? a. Asks, "Does this make sense?" b. Asks, "Do you think you can do this at home?" c. Asks, "What will you tell your spouse about changing the dressing?" d. Asks, "Would you tell me if you don't understand something so we can go over it?"

c rationale: The Teach-Back technique asks open-ended questions, like what will you tell your spouse about changing the dressing, to verify a patient's understanding. When using the Teach-Back technique do not ask a patient, "Do you understand?" or "Do you have any questions?"

A nurse is caring for a patient in the last stages of dying. Which finding indicates the nurse needs to prepare the family for death? a. Redness of skin b. Clear-colored urine c. Tense muscles tone d. Cheyne-Stokes breathing

d rationale: Altered breathing such as Cheyne-Stokes pattern, apnea, labored, or irregular breathing is a sign of impending death. -Cyanotic, pallor, or mottling of skin occurs. -Urine is decreased and a dark color. -Decreased muscle tone, relaxed jaw muscles, and sagging mouth also occur

A nurse is teaching a patient about the use of biofeedback. Which goal should the nurse add to the care plan? a. Opens emotional channels b. Uses music to calm the mind c. Holds various postures with breathing d. controls autonomic physiological functions

d rationale: Biofeedback is a process providing a person with visual or auditory information about autonomic physiological functions of the body such as muscle tension, skin temperature, and brain wave activity through the use of instruments. Breathwork can open emotional channels. Music therapy uses music to address physical, psychological, cognitive, and social needs of certain individuals. Yoga focuses on body musculature, holding of postures, and proper breathing mechanisms

A client says "Do not cut the thread on my wrist before sending me for surgery because the thread is a blessing from God." Which internal variable influences the client's health belief in this scenario? 1:spiritual factors 2:emotional factors 3:developmental stage factors 4:intellectual background factor

1 rationale: religious practices are one way in which people exercise spirituality. In this given scenario, the client ask s the nurse to refrain from cutting the religious thread, which is an example of spiritual factor.

What is true regarding a toddlers sleep? 1:total sleep averages 12 hours a day 2:in the awake period, a toddler exhibits sleepwaking 3:a toddler normally takes several naps during the day 4:it is uncommon for toddlers to awaken during the night

1 rationale: -preschoolers exhibit brief crying, walking around, unintelligible speech, sleepwalking, or bedwetting -infants normally take several naps during the day and average 8-10 hours during night -it is common for toddlers to awake during the night

A client who has liver failure says, "I have complete trust in God, and I am sure he will take care of my family even if I am not here." which concept would this exemplify? 1:faith 2:religion 3:connectedness 4:transcendence

1 rationale: -religion: if the client carried out specific rituals/practices to cope -connectedness: finding comfort through ones relationship with oneself, other people, or a higher power -transcendence: belief in a greater force outside of the material world

Which of the following statements best explains therapeutic touch (TT)? 1. Intentionally mobilizes energy to balance, harmonize, and repattern the recipient's biofield 2. Intentionally heals tissue damage or corrects certain disease symptoms 3. Is overwhelmingly effective in many conditions 4. Is completely safe and does not warrant any special precautions

1 rationale: TT is focused on healing the whole person and providing energy to the body that supports innate healing responses. The research literature is questionable; systematic analyses claim that the research designs are too weak for any conclusive evidence to be identified with confidence. Although TT is relatively safe and there have been very few negative events associated with its use, all therapies (complementary or conventional) should be used with caution in certain populations.

Which statement made by a new graduate nurse about the teach-back technique requires intervention and further instruction by the nurse's preceptor? 1. "After teaching a patient how to use an inhaler, I need to use the teach-back technique to test my patient's technique." 2. "The teach-back technique is an ongoing process of asking patients for feedback." 3. "Using teach-back will help me identify explanations and communication strategies that my patients will most commonly understand." 4. "Using pictures, drawings, and models can enhance the effectiveness of the teach-back technique."

1 rationale: Teach-back is not a testing of patient knowledge or ability to use devices but is a confirmation of how well a nurse explains concepts to patients

When the nurse labeled an African American client as a drug abuser for requesting pain medication, which behavior did the nurse demonstrate? 1:ethnocentrism 2:multiculturalism 3:cultural encounter 4:cultural imposition

1 rationale: ethnocentrism is the tendency of a person to hold their own beliefs superior to those of other people. Ethnocentrism causes biases and prejudices in regard to people from other groups. This practice is transmitted by cultural groups from one generation to another.

The nurse provides care for a Chinese client who is experiencing leg pain. The client states, "I dont want to take any medication that I may get addicted to." Which is the correct nursing intervention in this situation? 1:give ibuprofen to the client with hot tea 2:give morphine to the client with hot tea 3:give acetaminophen to the client with cold water 4:postpone medication administration to the client

1 rationale: people of Chinese descent may prefer to take medication with hot tea because of cultural beliefs that hot (yang) foods have healing properties. Ibuprofen does not pose an addiction risk

A client has terminal cancer after 7 years of chemotherapy and surgeries. The nurse enters the clients room and finds the client crying. Which the correct intervention by the nurse? 1:sit down quietly next to the bed and allow the client to cry 2:pull the curtain and leave the room to provide privacy for the client 3:explain to the client that these feelings are expected and they will pass with time 4:observe the length of time the client cries and document the clients difficulty in accepting impending death

1 rationale: sitting down quietly next to the bed and allowing the client to cry demonstrates acceptance of the clients behavior and provides an opportunity for the client to verbally express feelings if desired

Which nursing action establishes the nurse as a caregiver for a client in spiritual distress? 1:provides therapeutic treatment to the client 2:teaches the client about signs of spiritual distress 3:communicates the wishes of the client to family members 4:collaborates with the agency chaplain to pursue the best treatment plan

1 rationale: the nurse serves as a caregiver by meeting all the health care requirements of the client by providing measures that restore a clients emotional, spiritual, and social well being. -educator: teaches about signs -advocate: communicates the wishes of the client to family -accountability: collaborating with the chaplain

A client in the ICU tells the nurse, "No matter how much you try, I will not be able to recover. No one can change my destiny." Which religion might the nurse expect the client to practice? 1:islam 2:judaism 3:Buddhism 4:christianity

1 rationale: this client may be muslim because muslims believe that time of death is fixed and cant be changed

Which nurse statement reflects positive cultural sensitivity to help reduce potential health disparities? 1:which type of food do you usually eat at home 2:you need to ask your family to bring food of your choice 3:the hospital staff will not be able to cook food with your requirements 4:you need to eat the food that the hospital provides

1 rationale: when the nurse asks about the type of good the client eats at home, it shows cultural sensitivity

Which comments to a patient by a new nurse regarding palliative care needs are correct? (Select all that apply.) 1. "Even though you're continuing treatment, palliative care is something we might want to talk about." 2. "Palliative care is appropriate for people with any diagnosis." 3. "Only people who are dying can receive palliative care." 4. "Children are able to receive palliative care." 5. "Palliative care is only for people with uncontrolled pain."

1,2,4 rationale: palliative care is available to all patients regardless of age, diagnosis, and prognosis

A nurse is caring for a patient with chronic arthritis pain. The patient wants to add some complementary therapies to help with pain management. Which therapies might be most effective for controlling pain (Select all that apply): 1. Biofeedback 2. Acupuncture 3. Therapeutic touch 4. Chiropractic therapy 5. Herbal medicines

1,2,3 rationale: Biofeedback is a mind-body technique that promotes relaxation and muscle tension and, in turn, reduces pain. Acupuncture modifies the body's response to pain and over time can reduce pain. Therapeutic touch is effective in reducing the pain response in patients with chronic illnesses. Chiropractic therapy realigns structure and reduces pain when the pain is the result of structural abnormality, not inflammation. Meditation assists in relaxing the body and stilling the mind. It allow a person to cope with stress, reduce anxiety, and feel at one with God and the universe. Herbal therapies are often used to prevent disease and promote health.

Which alternative treatments would a nurse recommend to help ease a young childs pain at home? (select all apply) 1:yoga 2:biofeedback 3:guided imagery 4:spinal manipulation 5:herbal supplements

1,2,3 rationale: children should not use supplements and spinal manipulation because of higher risk of complications

Which statement by the nurse reflects an understanding of culturally congruent care? (select all that apply) 1:this type of care is the main goal of transcultural nursing 2:this care is provided through cultural competence 3:care is provided in accordance with set criteria 4:it is bound to the professional health care system 5:it depends on the patterns and needs of an individual

1,2,5 rationale: The main goal of transcultural nursing is to provide culturally congruent care. Cultural competence is applied to ensure the delivery of this care. Culturally congruent care is provided in accordance with peoples life patterns, values, and beliefs

Which statements from a patient indicate an understanding of behaviors that will promote sleep? (Select all that apply.) 1. "I will not watch television in bed." 2. "I will not drink caffeine later in the day." 3. "A short nap late in the evening will lead to a more restful night of sleep." 4. "I am going to start eating dinner closer to my bedtime" 5. "I will start to exercise regularly during the day."

1,2,5 rationale: To promote sleep, you should not watch television in bed. The noise of television can be disruptive and adds stimulation that is disruptive to sleep. Caffeine should not be consumed late in the day because it can cause wakefulness at bedtime. A regular exercise program completed in the morning is part of sleep hygiene practices and can help promote sleep. Exercise or eating a meal should not be done right before bed because sleep can be disrupted

Which clients are using complementary and/or alternative medicine (CAM) to treat their symptoms of emotional distress and psychiatric illness? (select all that apply) 1:client practices meditation to reduce anxiety in addition to outpatient counseling 2:client uses massage, lavender, and chamomile to decreases stress and anxiety 3:client undergoes electroconvulsive therapy and taken an antidepressant medication 4:client takes prescribed antianxiety medication and sees a psychiatrist for psychotherapy 5:client with depression takes an omega-3 fatty acid supplement and an antidepressant

1,2,5 rationale: complementary therapies involve the use of alternative therapies together with traditional treatment modalities. Alternative refers to the use of these therapies in place of conventional treatment.

The nurse asks a client from Southeast Asia if there is any reason for her fatigue. Which statements are culturally consistent with a client from the Southeast Asian culture? (select all that apply) 1:im tired bc i have less blood in my body 2:im tired bc my blood vessels are weak 3:im tired bc i have no time to myself at work or home 4:im tired bc im usually a bit depressed during the winter 5:im tired bc i havent been eating right lately

1,2,5 rationale: different cultures may have different explanations for sickness or fatigue. Many southeast asian woman believe that fatigue occurs of Ayurveda, or the balance of different energies in the body. -european americans may give a biomedical explanation for fatigue such as stress, family issues, or depression

The nurse is caring for a 50-year-old woman visiting the outpatient medicine clinic. The patient has had type 1 diabetes since age 13. She has numerous complications from her disease, including reduced vision, heart disease, and severe numbness and tingling of the extremities. Knowing that spirituality helps patients cope with chronic illness, which of the following principles should the nurse apply in practice? (Select all that apply.) 1. Pay attention to the patient's spiritual identity throughout the course of her illness. 2. Select interventions that you know scientifically support spiritual well-being. 3. Listen to the patient's story each visit to the clinic, and offer a compassionate presence. 4. When the patient questions the reason for her long-time suffering, try to provide answers. 5. Consult with a spiritual care adviser, and have the adviser recommend useful interventions.

1,3 rationale: A person's spiritual well-being can change over time; therefore, it is important to pay attention to it over the course of his or her illness. Listening is a powerful way to support a patient's spirituality. Evidence-based interventions are preferred, but they must be agreed on by the patient and tailored to his or her perspectives and not just those of the nurse. Patients are not looking for answers. What is spoken as a spiritual question is most often an expression of spiritual pain. Using spiritual care advisers is a valuable resource but should be selected by the patient, not independently by the nurse, and any interventions should be mutually agreed on among nurse, patient, and adviser

Which complementary therapies are most easily learned and applied by a nurse? (Select all that apply.) 1. Therapeutic massage therapy 2. Traditional Chinese medicine 3. Progressive relaxation 4. Breathwork and guided imagery 5. Therapeutic touch

1,3,4 rationale: These are nurse-accessible complementary therapies. A simple back rub can be administered by nurses. Therapeutic massage therapists are licensed by local governmental agencies, and additional educational preparation is required to practice. Traditional Chinese medicine practitioners also attend training/educational programs, typically accredited by the Accreditation Commission for Acupuncture and Oriental Medicine.

A 35-year-old woman has Medicaid coverage for herself and two young children. She missed an appointment at the local health clinic to get an annual mammogram because she has no transportation. She gets the annual screening because her mother had breast cancer. Which of the following are social determinants of this woman's health? (Select all that apply.) 1. Medicaid insurance 2. Annual screening 3. Mother's history of breast cancer 4. Lack of transportation 5. Woman's age

1,4,5 rationale: Social determinants of health are the conditions under which persons are born, grow, live, work, and age. The social determinants of health are mostly responsible for health disparities. Examples include age, race and ethnicity, socioeconomic status (as reflected by the woman's insurance), access to nutritious food, transportation resources, religion, sexual orientation, level of education, literacy level, disability (physical and cognitive), and geographic location (e.g., access to health care)

A nurse is developing a plan for a patient who was diagnosed with narcolepsy. Which interventions should the nurse include on the plan? (Select all that apply.) 1. Take brief, 20-minute naps no more than twice a day. 2. Drink a glass of wine with dinner. 3. Eat a large meal at lunch rather than dinner. 4. Establish a regular exercise program. 5. Teach the patient about the side effects of modafinil.

1,4,5 rationale: Taking short naps, no longer than 20 minutes, during the day, and regular exercise are management strategies that help reduce the feeling of sleepiness. Modafinil is a stimulant used to treat narcolepsy; therefore, it is important for patients to understand its side effects

Which sleep disorder is an example of dyssomnia? (select all that apply) 1:insomnia 2:nightmares 3:sleep terrors 4:restless leg syndrome 5:obstructive sleep apnea

1,4,5 rationale: dyssomnia is trouble falling asleep or staying asleep. The most well know dyssomnia is sleep apnea -parasomnias: brain is partially awake and occurs between sleep and wakefulness (sleep terrors and nightmares)

match the cultural concepts to the correct definitions: 1:etic world view 2:world view 3:cultural desire 4:intersectionality 5:emic world view a: factor that shapes how people perceive others and how they relate to reality b: insiders perspective in an intercultural encounter c: a policy model that describes factors and power structures that shape and influence life d: an outsiders perspective in an intercultural encounter e: the motivation of a health care professional to "want to" engage in cultural competency

1d 2a 3e 4c 5b

A nurse desires to communicate with a young woman who is Serbian and who has limited experience with being in a hospital. The nurse has 10 years of experience caring for Serbian women. The patient was admied for a serious pregnancy complication. Apply the LEARN model and match the nurse's behaviors with each step of the model. 1. L 2. E 3. A 4. R 5. N a. The nurse notes that she has learned that fathers can visit mothers at any time in both Serbia and the united states b. The nurse shares her perception of the womans experiences as a patient c. the nurse asks the patient how she can maintain bed rest when she returns home d. the nurse attends to the patient and listens to her story about hospitals in Serbia e. The nurse involves the patient in a discussion of the treatment options for her condition

1d 2b 3a 4e 5c rationale: Listen with empathy and understanding to patient perception of the problem; Explain your perceptions of the problem (physiological, psychological, spiritual, and/or cultural; Acknowledge and discuss cultural differences and similarities between you and your patient; Recommend treatment (involving the patient); and Negotiate agreement (incorporate selected aspects of the patient's culture into patient-centered care).

Which statement made by a mother being discharged to home with her newborn infant indicates that she understands the discharge teaching related to best sleep practices? 1. "I'll give the baby a bottle to help her fall asleep." 2. "We'll place the baby on her back to sleep." 3. "We put the baby's stuffed animals in the crib to make her feel safe." 4. "I know the baby will not need to be fed until morning."

2 rationale: This is based on the current evidence that shows that parents need to place an infant on his or her back to prevent suffocation. Bottles, stuffed animals, and pillows should not be placed in the bed with an infant.

A client reports overwhelming and irresistible attacks of sleep. Which sleep disorder is the client describing? 1:insomnia 2:narcolepsy 3:sleep terror 4:sleep apnea

2 rationale: narcolepsy is overwhelming sleepiness that results in attacks of sleep, loss of muscle tone, and hallucinations or sleep paralysis at the beginning or end of sleep episodes. The person usually awakens from the sleep feeling refreshed

A client reports sleeping until noon everyday and taking frequent naps during the rest of the day. Initially, which action would the nurse take? 1:encourage the client to exercise during the day 2:arrange a referral for a thorough medical evaluation 3:explain that this behavior is an attempt to avoid facing daily responsibilities 4:identify that the client is describing clinical findings associated with narcolepsy

2 rationale: this behavior is a sign of hypersomnia, and the client needs a medical assessment

A 44-year-old male patient has just been told that his wife and child were killed in an auto accident while coming to visit him in the hospital. Which of the following statements are assessment findings that support a nursing diagnosis of Spiritual Distress related to loss of family members? (Select all that apply.) 1. "I need to call my sister for support." 2. "I have nothing to live for now." 3. "Why would my God do this to me?" 4. "I need to pray for a miracle." 5. "I want to be more involved in my church."

2,3 rationale: Patients most likely to have a diagnosis of Spiritual Distress are facing loss or terminal or serious illness and have poor personal relationships. Indicating that there is nothing to live for now and wondering why God would do this to him reflect dispiritedness (e.g., expressing lack of hope, meaning, or purpose in life; anger toward God). The other responses show a potential for enhancement of spiritual well-being.

A nurse is preparing to teach an older adult who has chronic arthritis how to practice meditation. Which of the following strategies are appropriate? (Select all that apply.) 1. Encourage family members to participate in the exercise. 2. Have patient identify a quiet room in the home that has minimal interruptions. 3. Suggest the use of a quiet fan running in the room. 4. Explain that it is best to meditate about 5 minutes 4 times a day. 5. Show the patient how to sit comfortably with the limitation of his arthritis and focus on a prayer.

2,3,5 rationale: A quiet room with no distractions is conducive to meditation. The low buzz of a fan also blocks distractive noises. A patient should relax comfortably during meditation. Meditation is usually recommended 10 to 20 minutes twice a day. The activity should be conducted alone without distraction

Which of the following is an example of a patient with a health disparity? (Select all that apply.) 1. A patient who has a homosexual sexual preference 2. A patient unable to access primary care services 3. A patient living with a chronic disease 4. A family who relies on public transportation 5. A patient who has had a history of smoking for 10 years

2,3,5 rationale: Poor health status (chronic disease), disease risk factors (smoking history), poor health outcomes, and limited access to health care (unable to access primary care) are types of health disparities.

Which interventions does a nurse implement to help a patient at the end of life maintain autonomy while in a hospital? (Select all that apply.) 1. Use therapeutic techniques when communicating with the patient. 2. Allow the patient to determine timing and scheduling of interventions. 3. Allow patients to have visitors at any time. 4. Provide the patient with a private room close to the nurses' station. 5. Encourage the patient to eat whenever he or she is hungry

2,3,5 rationale: allowing patients to make choices about their care and end of life experience provides opportunities for them to maintain their autonomy

A nurse is caring for a patient experiencing a stress response. The nurse plans care with the knowledge that systems respond to stress in what manner? (Select all that apply.) 1. Always fail and cause illness and disease 2. Cause negative responses over time 3. React the same way for all individuals 4. Protect an individual from harm in the short term 5. Tolerate the stress response indefinitely

2,4 rationale: In the beginning stress responses serve as a warning and physiological "alarm" of sorts, preparing the person to respond to harm. In this way they can be a protective mechanism. However, stress that continues unmitigated for long periods of time creates states of "exhaustion" that translate ultimately into negative physiological and psychological events

Which nursing interventions are appropriate to include in a plan of care to promote sleep for patients who are hospitalized? (Select all that apply.) 1. Give patients a cup of coffee 1 hour before bedtime. 2. Plan vital signs to be taken before the patients are asleep. 3. Turn television on 15 minutes before bedtime. 4. Have patients follow at-home bedtime schedule. 5. Close the door to patients' rooms at bedtime.

2,4,5 rationale: Bedtime routines relax patients in preparation for sleep. Patients in the hospital should follow their at-home bedtime routine. Taking vital signs before sleep onset prevents disruption of sleep and improves sleep duration and quality. Closing the door to patients' rooms decreases noise that can disrupt sleep. Noise is one of the main factors contributing to poor sleep in hospitalized patients. Excessive stimulation, such as watching television, should be avoided close to bedtime

The nurse is contacting the health care provider about a patient's sleep problem. Place the steps of the SBAR (situation, background, assessment, recommendation) in the correct order. 1. Mrs. Dodd, 46 years old, was admied 3 days ago following a motor vehicle accident. She is in balanced skeletal traction for a fractured left femur. She is having difficulty falling asleep. 2. "Dr. Smithson, this is Pam, the nurse caring for Mrs. Dodd. I'm calling because Mrs. Dodd is having difficulty sleeping." 3. "I'm calling to ask if you would order a hypnotic such as zolpidem to use on a prn basis." 4. Mrs. Dodd is taking her pain medication every 4 hours as ordered and rates her pain as 2 out of 10. Last night she was still awake at 0100. She states that she is comfortable but just can't fall asleep. Her vital signs are BP 124/76, P 78, R 12 and T 37.1°C (98.8°F).

2-1-4-3

Which cultural group adopts a combination of dietary, herbal, and other naturalistic therapies to prevent and treat illness? 1:east asian 2:hispanic 3:asian indian 4:native american

3 rationale: asian indians rely on a combination of dietary, herbal, and other naturalistic therapies to prevent and treat illness. -east asians use yin (which uses needles to restore balance and flow of qi) and yang (which uses moxibustion or heat with acupuncture to restore the yin/yang balance) -hispanics use a combination of prayers, herbs, and other rituals to treat traditional illnesses. -native americans rely on a combination of prayers, chanting, and herbs to treat illnesses caused by supernatural, psychological, and physical factors

A daughter of a Chinese speaking client approaches the nurse and ask multiple questions while maintaining direct eye contact. Which culturally related concept would the daughters behavior reflect? 1:prejudice 2:stereotyping 3:assimilation 4:ethnocentrism

3 rationale: assimilation involves incorporating the behaviors of a dominant culture. Maintaining eye contact is characteristic of the American or Canadian culture and not of Asian cultures. -prejudice: negative belief about another person or group -stereotyping: perception that all members of a group are alike -ethnocentrism: perception that ones beliefs are better than others

The nurse advises a client with anxiety to focus on a positive scene. Which relaxation technique is the nurse using? 1:biofeedback 2:meditation 3:guided imagery 4:progressive muscle relaxation

3 rationale: guided imagery is the process of using pleasant images to help reduce stress and anxiety levels.

Which response would the nurse provide to a client who states that St. Johns Wort seems to help increase the effect of an antidepressant during a medication management session for clients with mental illness living in the community? 1:I am glad you have found it helpful, but there is no research support your claim 2:many people do find it to be helpful; just make sure you only take the minimum recommended dose 3:St johns wort taken with antidepressants can cause a life threatening issue; they should not be take together 4:have you discussed this information with your provider to make sure it is okay for you take St Johns Wort?

3 rationale: herbal remedies such as St johns wort may not be effective and may in some cases cause life threatening issues; thus the nurse should provide the client with this information.

When would a medical examiner decide whether a postmortem examination needs to be conducted? 1: a death under normal circumstances 2:a client dies more than 48 hours after admission to the hospital 3:death within 24 hours of admission to the hospital 4:a client gives a written consent before death for an autopsy to be performed

3 rationale: if a client dies within 24 hours of admission to the hospital, the medical examiner is required to decide whether a postmortem examination will be conducted.

The nurse starts a new job and recognizes that the patient population is very diverse. What action will help the nurse to provide culturally competent care? 1. Read about all of the cultural groups in the local population. 2. Treat all of the patients the same, regardless of their cultural background. 3. Increase self-awareness of cultural identity, cultural knowledge, and potential biases. 4. Attempt to remain culturally neutral while treating patients of a different culture.

3 rationale: providing culturally competent care is an essential skill for any nurse. It is helpful for nurses to be self aware of their own cultural identities and assess their cultural knowledge because doing so may help them recognize and overcome any cultural biases that affect client care.

Which member of the interprofessional team is appropriate for the nurse to ask for support in informing and consoling the family of a terminally ill client who has died? 1:primary health care provider 2:pharmacist 3:social worker 4:occupational therapist

3 rationale: social workers on the interprofessional team helps the family members prepare for the clients death during the grief and bereavement process.

A nurse hired to work in a metropolitan hospital provides services for a culturally diverse population. One of the nurses on the unit says it is the nurses' responsibility to discourage "these people" from bringing all that "home medicine stuff" to their family members. Which response by the recently hired nurse is most appropriate? 1. "Hospital policies should put a stop to this." 2. "Everyone should conform to the prevailing culture." 3. "Nontraditional approaches to health care can be beneficial." 4. "You are right because they may have a negative impact on people's health."

3 rationale: studies demonstrate that some nontraditional therapies are effective. Culturally competent professionals should be knowledgeable about other cultures and beliefs. Many health care facilities are incorporating both western and nontraditional therapies

Which type of response would the nurse expect the dying client to exhibit at the point of acceptance? 1:apathy 2:euphoria 3:detachment 4: emotionalism

3 rationale: when an individual reaches the point of being intellectually and psychologically able to accept death, anxiety is reduced and the individual becomes detached from the environment.

When assessing a client who is receiving palliative care, which question regarding spiritual health is correct? 1: "are you afraid of death" 2:"after hearing about you condition, didnt u lose faith" 3:"what is your source of spiritual strength during hard times" 4:"may I ask the chaplain to visit you to help you cope"

3 rationale: when assessing a pt., you must first ask what their source of spiritual strength is

A mother is concerned about her child's flulike symptoms. You learn from the health assessment that the mother practices use of "hot" and "cold" foods to treat ailments. Which of the following foods do you expect the mother to use to treat her child? 1. Chicken 2. Yogurt 3. Fresh fruits 4. Eggs

4 rationale: Certain cultures believe in the importance of balance and harmony in health. Natural or holistic balance is believed to be achieved by using "hot" and "cold" foods as remedies to treat illness

A nursing student is developing a plan of care for a 74-year-old- female patient who has spiritual distress over losing a spouse. As the nurse develops appropriate interventions, which characteristics of older adults should be considered? (Select all that apply.) 1. Older adults do not routinely use complementary medicine to cope with illness. 2. Older adults dislike discussing the afterlife and what might have happened to people who have passed on. 3. Older adults achieve spiritual resilience through frequent expressions of gratitude. 4. Have the patient determine whether her husband left a legacy behind. 5. Offer the patient her choice of rituals or participation in exercise.

3,4,5 rationale: Older-adult patients achieve spiritual resiliency in expressing gratitude and finding ways to maintain purpose in life. Leaving legacies maintains a connection between the person left behind and the lost loved one. Older adults frequently use complementary medicine, rituals, and exercise to cope with illness and pain. Belief in the afterlife grows with aging

Which statement made by a patient who is recovering after recently experiencing third-degree burns shows connectedness? 1. "My pain medicine helps me feel beer." 2. "I know I will get beer if I just keep trying." 3. "I see God's grace and become relaxed when I watch the sun set at night." 4. "I feel so much closer to God after I read my Bible and pray."

4 rationale: Connectedness is a dimension of spirituality that is related to the human need of belonging. Individuals can be connected to themselves, others, God or another Supreme Being, or nature. Individuals often stay connected to God through prayer

When planning patient education, it is important to remember that patients with which of the following illnesses often find relief in complementary therapies? 1. Lupus and diabetes 2. Ulcers and hepatitis 3. Heart disease and pancreatitis 4. Chronic back pain and arthritis

4 rationale: Evidence supports the use of many complementary therapies for chronic pain syndromes, particularly pain that is unremitting and unresponsive to conventional allopathic therapies.

Which action indicates the nurse is meeting a primary goal of cultural competent care for patients? a. Provides care to transgender patients b. Provides care to restore relationships c. Provides care to patients that is individualized d. Provides care to surgical patients

a rationale: Although cultural competence and patient-centered care both aim to improve health care quality, their focus is slightly different. The primary aim of cultural competence care is to reduce health disparities and increase health equity and fairness by concentrating on people of color and other marginalized groups, like transgender patients.

A nurse is caring for a dying patient. When is the best time for the nurse to discuss end-of-life care? a. During assessment b. During planning c. During implementation d. During evaluation

a rationale: Because most deaths are now "negotiated" among patients, family members, and the health care team, discuss end-of-life care preferences early in the assessment phase of the nursing process. Doing so during the planning, implementation, and evaluation phases is too late.

A nurse is beginning to use patient-centered care and cultural competence to improve nursing care. Which step should the nurse take first? a. Assessing own biases and attitude b. Learning about the world view of others c. Understanding organizational forces d. Developing cultural skills

a rationale: Becoming more aware of your biases and attitudes about human behavior is the first step in providing patient-centered care, leading to culturally competent care. It is helpful to think about cultural competence as a lifelong process of learning about others and also about yourself. Learning about the world view, developing cultural skills, and understanding organizational forces are not the first steps.

The mother of a child who died recently keeps the child's room intact. Family members are encouraging her to redecorate and move forward in life. Which type of grief will the home health nurse recognize the mother is experiencing? a. Normal b. End-of-life c. Abnormal d. Complicated

a rationale: Family members will grieve differently. One sign of normal grief is keeping the deceased individual's room intact as a way to keep that person alive in the minds of survivors. This is happening after the family member is deceased, so it is not end-of-life grief. It is not abnormal or complicated grief; the child died recently.

A patient asks the nurse for a nonmedical approach for excessive worry and work stress. Which therapy should the nurse recommend? a. Meditation b. Acupuncture c. Ayurvedic herbs d. Chiropractic care

a rationale: Meditation is indicated for stress-related illness and is a nonmedical approach. In addition, meditation increases productivity, improves mood, increases sense of identity, and lowers irritability. -Acupuncture, ayurvedic, and chiropractic are all medical approaches.

The group leader is overheard saying to the gathering of patients, "Focus on your breathing once again .... Notice how it is regular .... Now focus on your left arm .... Notice how relaxed your left arm feels .... Notice the relaxation going down the left arm to the hand." A patient asks the nurse what the group is doing. What is the nurse's best response? a. It is progressive relaxation training. b. It is group biofeedback. c. It is guided imagery. d. It is meditation.

a rationale: Progressive relaxation training teaches the individual how to effectively rest and reduce tension in the body. The technique used in this scenario involves the use of slow, deep abdominal breathing while tightening and relaxing an ordered succession of muscle groups. Although meditation does include abdominal breathing, along with guided imagery and biofeedback, it does not include tightening and relaxing of muscle groups in an ordered succession.

A nurse is assessing the patient's meaning of illness. Which area of focus by the nurse is priority? a. On the way a patient reacts to disease b. On the malfunctioning of biological processes c. On the malfunctioning of psychological processes d. On the way a patient reacts to family/social interactions

a rationale: To provide culturally congruent care, you need to understand the difference between disease and illness. Illness is the way that individuals and families react to disease, whereas disease is a malfunctioning of biological or psychological processes. The way a patient interacts to family/social interactions is communication processes and family dynamics.

A nurse is assessing the health care disparities among population groups. Which area is the nurse monitoring? a. Accessibility of health care services b. Outcomes of health conditions c. Prevalence of complications d. Incidence of diseases

a rationale: while health disparities are the differences among populations in the incidence, prevalence, and outcomes of health conditions, diseases and related complications, health care disparities are differences among populations in the availability, accessibility, and quality of health care services (e.g. screening, diagnostic, treatment, management, and rehabilitation) aimed at prevention, treatment, and management of diseases and their complications.

A nurse is using Campinha-Bacote's model of cultural competency. Which areas will the nurse focus on to become competent? (Select all that apply.) a. Cultural skills b. Cultural desire c. Cultural transition d. Cultural knowledge e. Cultural encounters

a,b,d,e rationale: Campinha-Bacote's model of cultural competency has five interrelated components: cultural awareness; cultural knowledge; cultural skills; cultural encounters; and cultural desire.

A veteran is hospitalized after surgical amputation of both lower extremities owing to injuries sustained during military service. Which type of loss will the nurse focus the plan of care on for this patient? a. Perceived loss b. Situational loss c. Maturational loss d. Uncomplicated loss

b rationale: Loss of a body part from injury is a situational loss. -Maturational losses occur as part of normal life transitions across the life span. -Perceived loss is uniquely defined by the person experiencing the loss and is less obvious to other people. -Uncomplicated loss is not a type of loss; it is a description of normal grief.

A nurse is caring for an immigrant with low income. Which information should the nurse consider when planning care for this patient? a. There is a decreased frequency of morbidity. b. There is an increased incidence of disease. c. There is an increased level of health. d. There is a decreased mortality rate.

b rationale: Populations with health disparities (immigrant with low income) have a significantly increased incidence of disease or increased morbidity and mortality when compared with the general population.

A nurse works at a hospital that uses equity-focused quality improvement. Which strategy is the hospital using? a. Document staff satisfaction. b. Focus on the family. c. Implement change on a grand scale. d. Reduce disparities.

d rationale: Organizations can implement equity-focused quality improvement by recognizing disparities and committing to reducing them.

During a relaxation therapy skills group, the instructor discusses the cognitive skill of learning to tolerate uncertain and unfamiliar experiences. Which skill is the nurse describing? a. Passivity b. Focusing c. Mindfulness d. Receptivity

d rationale: Receptivity is defined as the ability to tolerate and accept experiences that are uncertain, unfamiliar, or paradoxical. Passivity is the ability to stop unnecessary goal-directed and analytical activity. Focusing is the ability to identify, differentiate, maintain attention on, and return attention to simple stimuli for an extended period. Mindfulness is not a cognitive skill needed in relaxation therapy but is needed for meditation.

The nurse learns about cultural issues involved in the patient's health care belief system and enables patients and families to achieve meaningful and supportive care. Which concept is the nurse demonstrating? a. Marginalized groups b. Health care disparity c. Transcultural nursing d. Culturally congruent care

d rationale: The nurse is demonstrating culturally congruent care. Culturally congruent care, or care that fits a person's life patterns, values, and system of meaning, provides meaningful and beneficial nursing care.

During a nursing assessment a patient displayed several behaviors. Which behavior suggests the patient may have a health literacy problem? 1. Patient has difficulty completing a registration form at a medical office 2. Patient asks for written information about a health topic 3. Patient speaks Spanish as primary language 4. Patient states unfamiliarity with a newly ordered medicine

1 rationale: Behaviors that might reflect a health literacy deficit include having difficulty completing registration forms or health histories, failing to make follow-up appointments, and asking few questions during a nursing history or physical examination

Which statement made by the patient indicates an understanding of sleep-hygiene practices? 1. "I usually drink a cup of warm milk in the evening to help me sleep." 2. "If I exercise right before bedtime, I will be tired and fall asleep faster." 3. "I know it does not matter what time I go to bed as long as I am tired." 4. "If I use hypnotics for a long time, my insomnia will be cured."

1 rationale: Drinking a warm beverage such as milk in the evening can help promote sleep. Milk contains l-tryptophan, which helps promote sleep. Other snacks that contain l-tryptophan, such as cereal and cheese and crackers, may also promote sleep. Exercising right before bedtime may prevent sleep. Good sleep hygiene includes going to bed and getting up at the same time daily. Hypnotics can help with insomnia but are not curative.

The nurse is caring for a patient who has just had a near-death experience (NDE) following a cardiac arrest. Which intervention by the nurse best promotes the spiritual well-being of the patient after the NDE? 1. Allowing the patient to discuss the experience 2. Referring the patient to pastoral care 3. Having the patient talk to another patient who had an NDE 4. Offering to pray for the patient

1 rationale: Patients who have a near death experience (NDE) are often reluctant to speak of the experience. Allowing the patient to discuss the NDE helps the patient find acceptance of and meaning from the event. It also allows the patient to explore what happened and promotes spiritual well-being.

Which sleep-hygiene actions at bedtime can the nurse delegate to assistive personnel? (Select all that apply.) 1. Giving the patient a back rub 2. Turning on quiet music 3. Dimming the lights in the patient's room 4. Giving a patient a cup of coffee 5. Monitoring for the effect of the sleeping medication that was given

1,2,3 rationale: Giving the patient a back rub, turning on quiet music, and dimming the lights are all appropriate sleep-hygiene measures. These activities are within the scope of practice for assistive personnel. Coffee, tea, cola, and chocolate act as stimulants, causing a person to stay awake or awaken throughout the night and should not be ingested before bedtime. Monitoring medication effect is a registered nurse activity

To best assist a patient in the grieving process, which factors are most important for the nurse to assess? (Select all that apply.) 1. Previous experiences with grief and loss 2. Religious affiliation and denomination 3. Ethnic background and cultural practices 4. Current financial status 5. Current medications

1,2,3 rationale: Previous experiences, religious affiliation, and cultural practices help individuals develop coping and can be a source of support at the end of life.

Which information would the nurse give to a client interested in Kava and valerian supplements for the treatment of anxiety and insomnia? (select all that apply) 1: valerian can cause restlessness and insomnia 2:both kava and valerian are contraindicated with liver disease 3:kava is contraindicated with Parkinson disease or depression 4:Kava can cause temporary yellow discoloration of the skin, hair, and nails 5:both kava and valerian can have adverse effects on the central nervous system

1,2,3,4

The nurse recognizes that which factors influence a person's approach to death? (Select all that apply.) 1. Culture 2. Spirituality 3. Personal beliefs 4. Previous experiences with death 5. Gender 6. Level of education

1,2,3,4 rationale: culture, spirituality, personal beliefs/values, and previous experiences with death influence how a person approaches death

The nurse manager of a community clinic arranges for staff in- services about various complementary therapies available in the community. What is the purpose of this training? (Select all that apply.) 1. Nurses play an essential role in the safe use of complementary therapies. 2. Nurses are often asked for recommendations and strategies that promote well-being and quality of life. 3. Nurses learn how to provide all of the complementary modalities during their basic education. 4. Nurses play an essential role in patient education to provide information about the safe use of these healing strategies. 5. Nurses appreciate the cultural aspects of care and recognize that many of these complementary strategies are part of a patient's life.

1,2,4,5 rationale: All of the statements are true except that nurses do not learn how to provide all of the complementary modalities during their basic education. Nurses play an essential role in the safe use of complementary therapies in our emerging health care system. They have an appreciation for many types of interventions and can understand the patient's need to become more involved in his or her health care decisions and choices. They also understand the patient's desire to take a more active role in his or her healing and health promotion processes. Culturally relevant care that uses a full complement of intervention strategies that are supported with evidence is a central tenet of contemporary nursing practice.

Which statements by the student nurse indicates an understanding of caring for clients of various cultures? (select all that apply) 1:the focus is on understanding the traditions, beliefs, and values of the clients culture 2:care would be provided strictly on the basis of the traditions, beliefs, and values of the clients community. 3:generalized education and info would be provided to clients belonging to a different community 4:the cultural background of the client has no effect on health, wellness, and illness 5:I will be aware of my own cultural background and beliefs when attending to clients who belong to different cultures

1,5 rationale: to provide individualized care to the client, the nurse would focus on the clients traditions, beliefs, and values. The nurse would also be aware of their own cultural background and beliefs to ensure that stereotypes and prejudices do not get in the way of client care.

A nurse is using Campinha-Bacote's model of cultural competency to improve cultural care. Which actions describe the components the nurse is using? a. In-depth self-examination of one's own background b. Ability to assess factors that influence treatment and care c. Sufficient comparative understanding of diverse groups d. Motivation and commitment to continue learning about cultures e. Cross-cultural interaction that develops communication skills 1. Cultural skills 2. Cultural desires 3. Cultural awareness 4. Cultural knowledge 5. Cultural encounters

1B. Cultural skills: Ability to assess factors that influence treatment and care 2D: Cultural desires: Motivation and commitment to continue learning about cultures 3A: cultural awareness: In-depth self-examination of one's own background 4C: cultural knowledge: Sufficient comparative understanding of diverse groups 5E: cultural encounter: Cross-cultural interaction that develops communication skills

A patient has just learned she has been diagnosed with a malignant brain tumor. She is alone; her family will not be arriving from out of town for an hour. The nurse has been caring for her for only 2 hours but has a good relationship with her. What is the most appropriate intervention for support of her spiritual well-being at this time? 1. Make a referral to a professional spiritual care adviser. 2. Sit down and talk with the patient; have her discuss her feelings and listen aentively. 3. Move the patient's Bible from her bedside cabinet drawer to the top of the over-bed table. 4. Ask the patient whether she would like to learn more about the implications of having this type of tumor.

2 rationale: Establishing presence contributes to a patient's sense of well-being. It helps to prevent emotional and environmental isolation. Automatically making a referral to a spiritual care adviser might not be the patient's wish. She may not see an adviser as a resource. Reading a Bible can be an important ritual, but at this time the patient needs to make a connection with someone who can help minimize loneliness and powerlessness. Providing instruction will be important, but the patient is unlikely to be receptive at this time

In addition to a thorough patient assessment, when a nurse uses one of the nursing-accessible complementary therapies, he or she must ensure that which of the following has occurred? 1. The family has provided permission. 2. The patient has provided permission and consent. 3. The health care provider has given approval or provided orders for the therapy. 4. The nurse has received specialized training in the therapeutic technique.

2 rationale: Nurse-accessible therapies are independent nursing interventions. As long as the scope of practice identified by the nurse's State Board of Nursing permits this activity, you do not need to obtain permission from the patient's primary provider or his or her family members unless the patient is underage. An adult can provide consent. Specialized training is not required for nursing-accessible therapies.

A 72-year-old patient asks the nurse about using an over-the- counter antihistamine as a sleeping pill to help her get to sleep. What is the nurse's best response? 1. "Antihistamines are better than prescription medications because prescription medications can cause a lot of problems." 2. "Antihistamines should not be used because they can cause confusion and increase your risk of falls." 3. "Antihistamines are effective sleep aids because they do not have many side effects." 4. "Over-the-counter medications when combined with sleep- hygiene measures are a good plan for sleep."

2 rationale: Older adults should avoid the use of over-the-counter antihistamines. These medications have a long duration of action in older adults and can cause confusion, constipation, urinary retention, and an increased risk of falls.

A patient is receiving palliative care for symptom management related to anxiety and pain. A family member asks whether the patient is dying and now in "hospice." What does the nurse tell the family member about palliative care? (Select all that apply.) 1. Palliative care and hospice are the same thing. 2. Palliative care is for any patient, any time, any disease, in any setting. 3. Palliative care strategies are primarily designed to treat the patient's illness. 4. Palliative care relieves the symptoms of illness and treatment. 5. Palliative care selects home health care services.

2,4 rationale: palliative care and hospice care are different. Palliative care is available to all patients and focusing on management of symptoms.

Which education would the nurse provide the parent of a child with sleep terrors? (select all that apply) 1:sleep terrors are followed by full waking 2:sleep terrors usually occur 1-4 hours after falling asleep 3:it takes place during REM sleep 4:the child rapidly returns to sleep after an episode of sleep terrors 5:the child is aware of and reassured by another presence after an episode

2,4 rationale: sleep terrors occurs during deep sleep (stage IV)and it is difficult to keep the child awake, they fall back asleep fast -nightmares take place during REM sleep and children are often reassured and aware of the nightmare. Nightmares are followed by full waking. -after an episode of sleep terrors, the child is not aware of another presence, not comforted, and screams if restrained

When providing postmortem care, which actions are necessary for the nurse to complete? 1. Locating the patient's clothing 2. Calling the funeral home 3. Providing culturally and religiously sensitive care in body preparation 4. Providing postmortem care to protect the family of the deceased from having to view the body

3 rationale: A deceased person's body deserves the same respect and dignity as that of a living person and needs to be prepared in a manner consistent with the patient's cultural and religious beliefs.

A nurse is taking a sleep history from a patient. Which statement made by the patient needs further follow-up? 1. "I feel refreshed when I wake up in the morning." 2. "I use soft music at night to help me relax." 3. "It takes me about 45 to 60 minutes to fall asleep." 4. "I take the pain medication for my leg pain about 30 minutes before I go to bed."

3 rationale: Good sleep-hygiene practices indicate that individuals should fall asleep within 30 minutes of going to bed. Taking 45 to 60 minutes to fall asleep indicates a potential sleep problem and requires follow-up on sleep-hygiene practices. If an individual does not fall asleep within 30 minutes, encourage him or her to get out of bed and do a quiet activity until he or she feels sleepy

A nurse is caring for a patient who is Muslim and has diabetes. Which of the following items does the nurse need to remove from the meal tray when it is delivered to the patient? 1. Small container of vanilla ice cream 2. A dozen red grapes 3. Bacon and eggs 4. Garden salad with ranch dressing

3 rationale: Islam prohibits the consumption of pork.

A nurse working in a large occupational health clinic knows that many of the workers at her company are marginalized and at risk for poor health outcomes. Which of the following individuals are most likely to be marginalized? 1. Wives of the employees 2. The head supervisors of the company 3. Workers who have a high school education 4. Workers employed for less than a year at the company

3 rationale: Marginalized groups are more likely to have poor health outcomes and die earlier because of a complex interaction among their individual behaviors, environment of the communities in which they live, the policies and practices of health care and governmental systems, and the clinical care they receive. Examples of marginalized groups include people who are gay, lesbian, bisexual, or transgender; people of color; people who are physically and/ or mentally challenged; and people who are not college educated.

While planning care for a patient, a nurse understands that providing integrative care includes treating which of the following? 1. Disease, spirit, and family interactions 2. Desires and emotions of the patient 3. Mind-body-spirit of patients and their families 4. Muscles, nerves, and spine disorders

3 rationale: Mind-body spirit is the focus of holistic nursing

A new mother says to the nurse, "I would like to care for my baby independently rather than depending on the babys grandparents". From this information, which culture would the nurse infer that the new mother belongs to? 1:asian cultural 2:african culture 3:north american culture 4:latin american culture

3 rationale: People who belong to North American and Western European cultures generally possess individualistic characteristics. -those that belong to asian, african, and latin american cultures generally do not possess this; instead, they have a collectivistic approach.

A nurse used spiritual rituals as an intervention in a patient's care. Which of the following questions is most appropriate to evaluate its efficacy? 1. Do you feel the need to forgive your wife over your loss? 2. What can I do to help you feel more at peace? 3. Did either prayer or meditation prove helpful to you? 4. Should we plan on having your family try to visit you more often in the hospital?

3 rationale: Rituals include participation in worship, prayer, sacraments (e.g., baptism, Holy Eucharist), fasting, singing, meditating, scripture reading, and making offerings or sacrifices. When you include the use of rituals in a patient's plan of care, evaluate whether the patient perceived these activities as useful. If not, other interventions will be necessary

The nurse is caring for a client who believes that surgery contaminates the soul unless proper cleansing rituals are performed. Which nursing activity adheres to the Quality and Safety Education for Nurses (QSEN) competency patient centered care? 1:evaluating the effects of complying with a clients requests on psychological health 2:improving therapeutic communication skills to minimize the risk of emotional trauma 3:coordinating with appropriate spiritual practitioners to help perform the cleansing ritual before the clients surgery 4:conducting extensive research about the ritualistic practices of the clients community to formulate a care plan

3 rationale: patient centered care requires the nurse to understand that the client is the source of control when providing care. The nurse would observe and respect any of the clients needs, values, and preferences when delivering health care.

Which nursing interventions would help a terminally ill client cope with feelings related to death? (select all that apply) 1:providing medication and therapies for pain management 2:teaching the client about the importance of complementary medicine 3:helping the client find meaning and purpose in life by listening to concerns 4:allowing time for religious readings, spiritual visitations, or attendance at religious services 5:encouraging the client to pray if desired by facilitating privacy and a proper environment

3,4,5 rationale: feelings of connectedness are important for the client who is terminally ill

Which strategies would the nurse teach a client who says, "I have been having trouble sleeping and feel wide awake as soon as I get into bed?" (Select all that apply) 1:eating a heavy snack near bedtime 2:reading in bed before shutting out the light 3:leaving the bedroom when unable to sleep 4:drinking a cup of warm coffee with milk at bedtime 5:exercising in the afternoon rather than in the evening 6:drinking at least 1 glass of wine or other alcoholic beverage at bedtime

3,5

Which action is the priority when the preoperative nurse learns that a client is taking several herbal supplements? 1:provides the client with information about the usefulness of herbal therapies 2:inform the client about taking supplemental vitamins rather than herbs 3:teach the client about herbal supplements 4:ask the client which herbs have been taken

4 rationale: The nurse must find out which herbs the client has been taking because some herbs can prolong bleeding, and the health care provider may need to postpone the surgery until the client has been free of herbal supplements for a period of time.