chapter 10 jensen

An instructor is emphasizing the need for nurses to be culturally sensitive and competent for which reason? Recognize that cultural diversity exists Understand individual differences Prevent offending the client Obtain accurate assessment data

Obtain accurate assessment data

The nurse is assessing a patient's ability to employ coping mechanisms when given a diagnosis of cancer. What type of assessment would be beneficial for the nurse to use? Spiritual assessment Cultural assessment Physical assessment Mini-Mental status assessment

Spiritual assessment

A nurse works in a health clinic with clients of diverse religious and spiritual beliefs. Which of the following would be more associated with spirituality than with religion? A couple attending prayers at a mosque A young woman attending synagogue by herself A young man seeking to connect with God by hiking in the mountains An older man undergoing baptism in a river as part of a church service

A young man seeking to connect with God by hiking in the mountains

What questions should be included in a spiritual assessment? Select all that apply. "Do you need a private place to pray?" "What gives you meaning to your life?" "I see you are Jewish, does that mean you do not eat pork?" "How does your spiritual practices help you to deal with pain? "Are you a practicing Catholic?"

"Do you need a private place to pray?" "What gives you meaning to your life?" "How does your spiritual practices help you to deal with pain?

A client expresses frustration that the nurse is assessing his spirituality, stating, "I thought I was here to have my tumor removed, not to figure out what I believe or don't believe about God." How should the nurse best justify the need for a spiritual assessment? "It's important that we plan to make sure that we don't offend you." "Spirituality actually has a significant effect on your overall health." "We need to make plans in case there are unexpected outcomes of your surgery." "Your beliefs determine whether we will focus more on your body or on your spirit."

"Spirituality actually has a significant effect on your overall health."

A nurse has a regular client who is an immigrant from China and who follows the traditional medical system of that culture. To improve the ability to understand and work with this client, the nurse researches this client's cultural view of health. Which of the following would the nurse most likely discover? A focus on maintaining balance between yin and yang Respect for nature and use of masks and sand paintings Prayers to God and saints for spiritual reparations for sins Use of herbs, roots, talismans, and amulets

A focus on maintaining balance between yin and yang

During a spiritual assessment the nurse realizes that personal beliefs differ significantly from those of the client. What should the nurse do? End the assessment Continue with the assessment Discuss the differences with the client Ask another nurse to complete the assessment

Continue with the assessment

When assessing a community, the nurse is reviewing statistics related to adult mortality in clients who are 65 years of age and older. The nurse would assess the community for health programs to address what as the major cause of death in this age group? Unintentional injuries Chronic lower respiratory diseases Heart disease Diabetes

Heart disease

Which does the nurse recognize as a core component of a community assessment? (Select all that apply.) Ethnicity Education Housing Review of systems Federally funded programs

Ethnicity Education Housing

A nurse's personal reflection reveals that the nurse tends to see their own culture as the "gold standard" to which all other cultures should aspire. This nurse should create learning goals to address what phenomenon? Ethnocentrism Unconscious incompetence Stereotyping Acculturation

Ethnocentrism

A nurse plans to utilize formal and informal channels of communication that exist within a community. The nurse should identify what as an example of informal communication? Newspaper Television Radio Fliers

Fliers

A nursing instructor is describing formal and informal channels of communication that occur within a community. The instructor determines that the teaching was successful when the students identify which of the following as an example of informal communication? Newspaper Television Radio Fliers

Fliers

When performing a spiritual assessment, what may help the nurse to identify related nursing diagnoses, needed interventions, and improve patient care? Gaining relevant information about the patient's spirituality. Gathering current objective data. Establishing a close nurse-patient relationship. Gathering information about the patient's mental status from the patient's family.

Gaining relevant information about the patient's spirituality.

Why is it important for a nurse to be aware of a client's environment and risk factors associated with the culture? Determine if beliefs will impact acceptance of care Gives clues to the current health status of an individual Understand the client's approach to health care providers Helps to clarify what disease processes are most likely to occur

Gives clues to the current health status of an individual

What model of health emphasizes the fulfillment of social roles by the person? Gordon's functional health model Biomedical model Complementary and alternative medicine model Eudaimonistic model of health

Gordon's functional health model

The nurse reviews data about a community's vital statistics. Which information indicates a lack of services? High death rates Employment statistics Number of pharmacies Locations for flu vaccinations

High death rates

The nurse is concerned with the rising unemployment rate of the community in which she lives. How will the nurse be affected by this problem? High unemployment rates mean that she could lose the job at the hospital. High unemployment rates mean there will be no raises for employees this year. High unemployment rates are associated with higher morbidity and mortality rates. There will be more suicides for the hospital to handle.

High unemployment rates are associated with higher morbidity and mortality rates.

x A nurse has just learned that a community recreation league for youth has just been eliminated due to lack of funding. Which of the following results should the nurse suspect? Increased sports injuries Increased gang activity Increased unemployment Increased standardized testing scores

Increased gang activity

A nurse is obtaining data concerning public health services of a community. Which of the following should she realize as the greatest threat to public health services? Infant mortality rate Limited tax revenues Low rates of education in the members of the community Conflict between religious groups

Limited tax revenues

Sickle cell disease and other hemoglobinopathies such as thalassemia are often found in persons originating from which geographical regions? Central and South America. Northern and Central Europe. Mediterranean and Africa. Australia and New Zealand.

Mediterranean and Africa.

The nurse is gathering data about home health services in a community. The nurse would evaluate the community for which types of services? Select all that apply. Diagnostic services Homemaker services Nutritional consultation Substance abuse services Skilled care

Nutritional consultation Skilled care Homemaker services

The city police department has had to make significant budget cutbacks and have been forced to decrease their workforce. The nurse has seen in increase in injuries caused by violent crimes in the emergency department. What would be a priority nursing diagnosis for this issue? Risk for Ineffective Community Therapeutic Regimen Management Risk for Social Isolation related to insufficient police protection Other-Directed Violence related to insufficient police protection Risk for Impaired Community Processes related to subgroup of ethnic people

Other-Directed Violence related to insufficient police protection

While discussing care needs a client states the desire to be positive about the upcoming medical treatments and expect them to help cure the disease. Which nursing diagnosis should the nurse identify for this client? Hopelessness Spiritual distress Risk for spiritual distress Readiness for enhanced hope

Readiness for enhanced hope

As a novice nurse caring for a patient from a different culture, what may the nurse find confusing or upsetting? Patient's level of motivation Patient's nonverbal communication Patient's family members Patient's ethnicity

Patient's nonverbal communication

A patient asks the nurse if there are church services in the hospital because the patient attends mass every Sunday. The nurse realizes that this patient is demonstrating: Religion Culture Spirituality Recreation

Religion

In the assessment of a client, the nurse is having her complete a daily spiritual experiences self-assessment scale. Which of the following should the nurse mention to the client before giving her this assessment tool? She may substitute another word for God in the scale, if she would like. She should base her answers on whether she feels that she should have the indicated experiences. She should confirm all of her answers with a spiritual leader whom she trusts. She should not complete the scale if she is a member of an organized religion.

She may substitute another word for God in the scale, if she would like.

The nurse has identified a problem with communication in the community upon completing her community assessment. Traditional communication may not be enough due to which of the following reasons? Insufficient cable service. Some do not speak or understand English. Not everyone has a radio. Available interpreters.

Some do not speak or understand English.

During an interview, a patient tells the nurse about spending time out of doors and hiking to connect with the earth and observe the activities of small animals. The nurse would document this patient's hiking behavior as supporting: Exercise needs Religious activities Spirituality Relaxation

Spirituality

The school nurse is in the talking to a group of students about sexually transmitted diseases. One of the students says, "I know that most of the 10th grade has already had sex. There's drinking and parties, and this is where a lot of it happens." What type of data is the nurse collecting? Objective Subjective Formulative Summative

Subjective

The nurse is caring for a first-time mother and newborn in the postpartum unit. The nurse overhears the new mother ask family members to prepare the nursery and purchase clothing for the baby. What would the culturally sensitive nurse suspect? The new mother may believe buying infant clothing before the delivery is bad luck. The new mother is young, and the pregnancy was unexpected and the baby is unwanted. The new mother and requires education about how to prepare for the new baby. The mother is from a lower socioeconomic level and is not able to buy what is needed for the baby.

The new mother may believe buying infant clothing before the delivery is bad luck.

What outcome should the nurse prioritize when addressing a patient's social, cultural, and spiritual issues? The patient will express meaning and purpose in life. The patient will engage in interactions with others. The patient will express a sense of oneness with self and others. The patient will engage in worship weekly.

The patient will express a sense of oneness with self and others.

The nursing student asks the nurse what the purpose of the National Standards for Culturally and Linguistically Appropriate Services in Health Care is. What is the best response by the nurse? The standards require the provision of health care that considers the specific cultural and language background of the patient. The standards require health care agencies and nurses to treat all members of a culture similarly. The standards require health care agencies to employ a diverse staff reflective of the patient population. The standards require health care agencies to publicize to the community how CLAS standards are implemented.

The standards require the provision of health care that considers the specific cultural and language background of the patient.

A community nurse's assessment of a rural community reveals the presence of more cultural diversity than was previously thought. The presence of differences between cultures may have what effect on the health of the community? There may be a potential for conflicting views. There may be an unwillingness to change. There may be a lack of health services. There may be worse health outcomes than in a homogenous community.

There may be a potential for conflicting views.

Within all age groups from 1 to 44 years, a nurse knows that the most common cause of mortality is from what source? Unintentional injuries Suicide Malignant neoplasms Lower respiratory diseases

Unintentional injuries

What aspects of culture are relevant when conducting a health assessment on a foreign-born client admitted for surgery? Select all that apply. whether there are any existing language barriers nutritional or dietary considerations alternative medicine practices reasons for immigrating to the United States age when immigration to the United States occurred

alternative medicine practices whether there are any existing language barriers nutritional or dietary considerations

Which nursing intervention best demonstrates the nurse's attempt to provide effective spiritual care to a client in spiritual distress? assessing the spiritual needs of a client who is critical ill providing intense spiritual counseling for a client who has expressed hopelessness attending a religious service in the hospital's chapel with a client who is scheduled for surgery sharing a story related to one's own spiritual beliefs

assessing the spiritual needs of a client who is critical ill

A nurse has just completed a community assessment for a small rural town. Some data collected include the following: 11.8% unemployment, lack of medical care services, median income below the national average. Based on the limited data given, which of the following is the best nursing diagnosis? readiness for enhanced community coping social isolation risk for trauma related to high crime areas ineffective community coping related to unemployment

ineffective community coping related to unemployment

A client on hospice care tells his nurse that he is not afraid of death. He explains that this is because he believes he has lived a very good life and therefore his next life should be even better than this one, as all of his life actions will be carried into the next. The nurse recognizes this belief as which of the following? Ramadan Holy Trinity Kosher Karma

karma

The nurse and a client are developing a transcultural nursing care plan related to hypertension. The nurse will include in the plan educational materials given to all clients with hypertension. nutritional information specifically for the client's culture. contact number for the cardiac rehabilitation program at the medical center. referral to a cardiac specialist.

nutritional information specifically for the client's culture

Shared practices and rituals used to express one's faith can be called religion. spirituality. denomination. philosophy.

religion

A nurse is working with a client who does not own an automobile. The nurse understands that clients living in which type of area are most likely to face transportation challenges? Urban Small town Suburban Rural

Rural

A nursing instructor has just finished teaching about community assessment. The instructor realizes that the teaching has not been effective when the student states which of the following? "A community assessment can be done on a community such as Mothers Against Drunk Driving." "Community assessments can be done only by public health nurses." "The purpose of a community assessment is to determine the health-related concerns of its members." "Classification of community depends on its definition."

"Community assessments can be done only by public health nurses."

The nursing student needs further instruction on assessing communities when stating which of the following? "Community assessments include only subjective data." "Community assessments include both subjective and objective data." "Subjective data can be perceptions of the community by the nurse." "The nurse should spend time in the community to do an assessment."

"Community assessments include only subjective data."

The nurse appears before a community governance committee and encourages them to respond to the views of the citizens to prevent which likely reaction? Apathetic response Hostile response Reactive response Proactive response

Apathetic response

What intervention should a nurse implement to become culturally competent when assessing a client from another culture? Engage in intercultural encounters and cultural competence Become appreciative and sensitive to the values and beliefs of clients Seek and obtain a sound educational foundation of varied cultures Collect relevant cultural data of client's health history

Collect relevant cultural data of client's health history

A nurse is assigned to care for a client who practices a religion different from her own. After reading the client's medical record, the nurse takes time to talk with the client about how to make his hospital stay more comfortable. The nurse admits to the client that she is not familiar with his religion but would like to learn more. The nurse is in which stage of cultural awareness? Unconscious incompetence Conscious incompetence Conscious competence Unconscious competence

Conscious incompetence

The nurse is caring for a patient who is from another country, and states to the charge nurse, "I just don't know if the patient really understands what I am saying, and I am not understanding the patient either, even though he speaks English." What stage of cultural awareness is the nurse experiencing? Unconscious incompetence Conscious incompetence Conscious competence Unconscious competence

Conscious incompetence

A child is admitted to the hospital after an injury during a school field trip. The child's parents arrive shortly afterwards and refuse to allow their child to receive needed antibiotics to fight off infection and analgesics to lessen the child's severe pain. Which of the following should the nurse do? Administer the medications regardless of the parents' wishes Consult the hospital's ethics committee Follow the parents' wishes and try to comfort the child without use of medications Try to persuade the parents to allow administration of medications

Consult the hospital's ethics committee

A nurse is participating in an educational exercise in which she is conducting a self-examination of her own biases. This activity addresses what construct of cultural competence? Cultural desire Cultural knowledge Cultural skill Cultural awareness

Cultural awareness

The nurse prepares to complete a community assessment. What should the nurse recall as the reason for this assessment? Assess primary health problems of individuals Identify the number of families in the community Determine health-related concerns of community members Plan strategies to improve participation in health promotion activities

Determine health-related concerns of community members

A nurse is preparing to conduct a community assessment. Upon completing the assessment, what would the nurse expect as the primary outcome? Development of a common bond with community members Identification of health-related concerns in the community Creation of a partnership with local health care providers Increase in the number of health services provided

Identification of health-related concerns in the community

A nurse is working with a client who has received a terminal diagnosis. To help the nurse identify the client's possible coping responses, what would be most important for the nurse to understand about spirituality? It varies in different situations. It increases in significance with illness. It decreases in importance with age. It remains static throughout the lifespan.

It varies in different situations.

After teaching a group of students about spirituality and religion, the instructor determines that the students need additional teaching when they state which of the following? Spirituality and religion are important factors that can affect health decisions and outcomes. Religion and spirituality are separate and distinct, but interrelated concepts. There has been a tremendous growth in the understanding of spirituality in the past 20 years. Nursing has only recently begun to incorporate spirituality into client care.

Nursing has only recently begun to incorporate spirituality into client care.

A nurse is assessing a community's environmental protection. What would the nurse address? Major local employers Local law enforcement agencies Sewage treatment facilities Educational facilities

Sewage treatment facilities

After completing an admission assessment the client asks if the room door can be closed so that the client can have silence when reading the Bible. What does this indicate to the nurse about the client's spirituality? The client has limited reading material The client reads the Bible instead of praying Reading the Bible provides comfort to the client Noise interrupts the client's ability to concentrate when reading

Reading the Bible provides comfort to the client

The nurse's assessment of a hospital client's spirituality reveals that the client will accept very few of the standard treatments for her health problems. What would the nurse do next? Report the finding to the appropriate supervisors. Prioritize complementary interventions in the client's care. Consult the client's clergy to weigh options. Document the client's nonadherence to treatment.

Report the finding to the appropriate supervisors.

When considering the various cultural aspects associated with death rituals, which of the following should guide a nurse's practice? Most cultures have similar durations for the length of time a person grieves. A person's view of death is likely to be different from the original ethnic group's practice. Responses to death and grief are fairly consistent among different cultures. Rituals for burial and bereavement are likely to reflect original cultural practices.

Rituals for burial and bereavement are likely to reflect original cultural practices.

A nurse is assessing a community's environmental protection. The nurse would focus on which of the following? Drug Abuse Resistance Education program Neighborhood Watch programs Sewage treatment facilities Domestic violence shelters

Sewage treatment facilities

A nurse recognizes the need to perform a spiritual assessment of a newly admitted hospital client, but the circumstances surrounding the client's diagnosis and family dynamics make this challenging. What variable is likely to have the greatest impact on enhancing the quality of data from the nurse's spiritual assessment? The nature of the nurse's spiritual beliefs The nurse's knowledge of major religions The quality of rapport between the nurse and the client The setting in which the assessment is performed

The quality of rapport between the nurse and the client

A patient is being educated on a new diagnosis of diabetes mellitus. The patient asks no questions during or after the session. What cultural consideration does the nurse understand may be the reason for the patient not asking questions? The patient has not understood enough about the education to ask a question. The patient does not believe that they have diabetes dellitus and refuses to listen. The patient already knows everything about diabetes mellitus and has no questions. The patient considers asking questions of the nurse a sign of mistrust in her abilities.

The patient considers asking questions of the nurse a sign of mistrust in her abilities.

The nurse is educating a client from another country about the medications they will be taking. The client continually interrupts the nurse during the conversation. When the nurse considers the many ways cultural differences can affect communication, how should the nurse interpret the client's interruptions? This patient is impolite and does not know good manners. The patient believes that what they have to say is more important than what the nurse is saying. The patient is deeply engaged in the conversation. The patient believes that they know more about the medications than the nurse does.

The patient is deeply engaged in the conversation

The nurse is setting an outcome with the patient experiencing social isolation. Which goal would be appropriate? The patient will initiate interaction with others. The patient will express feelings of connectedness with God. The patient will express meaning and purpose in life. The patient will attend a church event every week.

The patient will initiate interaction with others.

A Muslim teenager is in the hospital for surgical repair of a severe fracture in the leg during the month of Ramadan, which the client says he would like to observe during his stay. Which of the following interventions should the nurse be prepared for in caring for this client? Withhold all food and drink between sunrise and sunset Serve meals as normal, but do not include pork Serve only kosher meats at all three meals Do not mix dairy and meats together on the client's tray

Withhold all food and drink between sunrise and sunset

A patient who is terminally ill with cancer is discharged from the hospital to home. The physician orders home health care for the patient. For which other type of services in the community that might benefit this patient should the nurse assess? recreational areas hospice services types of churches types of grocery stores

hospice services