Diversity, Equity & Inclusion
A client with the beta-thalassemia trait plans to marry a person of Italian ancestry who also has the trait. Which client statement indicates understanding of the teaching provided by the nurse? "If my fiancé was of Middle Eastern descent, I wouldn't be worried about having children." "We should never plan to have children." "I need to learn how to give myself vitamin B12 injections." "We'll need more genetic counseling in the future."
"We'll need more genetic counseling in the future." Explanation: Two people with the beta-thalassemia trait have a 25% chance of having a child with thalassemia major, a potentially life-threatening disease. Vitamin B<!sub>12!sub> injections are used to treat pernicious anemia, not thalassemia. Thalassemia occurs primarily in people of Italian, Greek, African, Asian, Middle Eastern, East Indian, and Caribbean descent. The client needs to know the risks before starting a family.
A client with obsessive-compulsive disorder eats slowly and is always the last to finish lunch, which makes it difficult for the group to start at 1300. Which approach would be the best plan of action for this problem? Change the time of the group to accommodate the client. Arrange for the client to start eating earlier than the others. Inform the client that they will have to eat faster so the group can begin on time. Begin the group without the client so that they will have ample time for their lunch.
Arrange for the client to start eating earlier than the others. Explanation: Letting the client eat earlier meets their needs for more time and also the group's need to start on time. It also protects the client from being resented by others and lets them be included in the group activity.Changing the time of an activity to meet one client's needs is undesirable and may be impractical as well.Beginning the group activity without the client will result in decreasing the client's self-esteem and increasing anxiety and the need to maintain their symptoms.Telling the client they will have to eat faster blames the client and results in increased anxiety and guilt and further reinforces the need for compulsive behavior.
A nurse is providing client care on a rehabilitation unit that has an increasingly diverse population. What nursing actions would be appropriate when providing care to clients? Select all that apply. Ask the client if they require any special diet or interventions while they are in the hospital. Utilize family members to translate any medical information when explaining care to a client. Keep in mind that clients may be members of multiple religious or cultural groups at the same time. Provide no special interventions as it is crucial to treat these clients the same as everyone else. Review available information and health practices of the common cultures in that area.
Review available information and health practices of the common cultures in that area. Ask the client if they require any special diet or interventions while they are in the hospital. Keep in mind that clients may be members of multiple religious or cultural groups at the same time. Explanation: The ANA Code of Ethics for Nurses requires nurses to provide culturally competent care to clients. Clients may be members of multiple religious or cultural groups at the same time. Cultural diversity includes people of varying cultures, racial and ethnic origin, religion, language, physical size, gender, sexual orientation, age, disability, socioeconomic status, occupational status, and requires special nursing interventions and assessment in order to provide the best nursing care to these clients. Communication with the client is crucial to individualized and culturally competent care. Family members are not appropriate interpreters to use when explaining care to a client.
In addressing health promotion for a client who is a member of another culture, the nurse should be guided by which principle? Health promotion is a concept that is largely exclusive to American culture. The client may have a very different understanding of health promotion. A culture's conceptualization of health promotion is a result of that culture's level of socioeconomic development. The nurse should avoid performing health promotion education if this is not a priority in the client's culture.
The client may have a very different understanding of health promotion. Explanation: As a component of cultural assessment, the nurse should seek to understand the cultural lens through which the client may understand health promotion. Health promotion is not a concept exclusive to Western cultures, though it may be considered differently among non-Western cultures. Even if health promotion is not a priority in a client's culture, this does not necessarily mean that the nurse should not address issues related to health promotion in a respectful and relevant manner. Health promotion is not directly linked to socioeconomic development levels.
A client is experiencing uncontrollable back pain and a physical therapist suggests a back massage. The client asks the nurse how massage will help the pain. What is the best response by the nurse? "Massage is an alternative therapy that uses herbal supplements." "A massage will relax muscles but does not work on ligaments and tendons." "Massage is point stimulation used for orthopedic and neurological conditions." "Massage is widely practice by all hospitalized clients."
"Massage is point stimulation used for orthopedic and neurological conditions." Explanation: Massage uses point stimulation of pushing and pulling of the skin, muscles, tendons, and ligaments to relieve orthopedic and neurological conditions. Massage will relax muscles, ligaments, and tendons. Massage is not widely used by hospitalized clients nor does it include the use of herbal supplements.
The nurse is in the process of assessing a non-English-speaking client, communicating through an interpreter. To facilitate communication, what should the nurse do first? Direct all questions to the interpreter. Request all family members leave the room. Ask client how the client wishes to be addressed. Offer the client a cold drink.
Ask client how the client wishes to be addressed. Explanation: Some cultures have no first or last names, and it is a sign of respect to ask the client how they wish to be addressed. Directing questions to the interpreter is culturally incongruent behavior. The interpreter will coach the nurse to direct questions to the client. The family should stay with the client so the nurse can determine who is the decision maker in the family. In some cultures, the matriarch or patriarch may be the designated decision maker and should be involved in decisions about the client's care. Some cultures believe health is a holistic balance between hot and cold. Therefore, before providing hot drinks or cold drinks, the nurse should determine the client's preferences.
The charge nurse on the pediatric floor has assigned a 6-year-old girl with newly diagnosed type 1 diabetes and an 8-year-old girl recovering from ketoacidosis to the same semiprivate room. The 6-year-old's birth parent is upset because the parent staying with the other child is male, and the girl's parent believes the arrangement violates their social norms. What should the nurse do? Reassign the children to different rooms. Offer the parent another place to sleep. Explain to the parents that this room arrangement facilitates teaching. Refer the parent to the customer service representative.
Reassign the children to different rooms. Explanation: Sleeping in the same room with a person of the opposite sex may be viewed as a violation of norms by persons of conservative faiths. If at all possible, the charge nurse should reassign the family to a different room. While it makes sense to have two clients with similar educational needs in the same room, it is likely that the arrangement would be distressing enough to create a learning barrier. Offering the parent another place to sleep deprives the child of their parent at night. The customer service representative would only need to be involved if it became impossible to accommodate the parent's needs.
During a physical examination, the nurse observes a copper bracelet on a client's wrist. The client states that they are wearing it to treat their arthritis. What should the nurse do? Encourage the client to continue wearing the copper bracelet because this is a medically supported treatment for arthritis. Inform the client that this is not a helpful practice, and ask the client to remove the bracelet. Recognize that the client is wearing a protective object they believe prevents illness. Tell the client that wearing the bracelet is a form of quackery and not to use the bracelet as a treatment.
Recognize that the client is wearing a protective object they believe prevents illness. Explanation: The client might wear objects as protection against specific medical disorders. Typically, these practices bring no harm to the client and should not be discouraged. The client should continue to be encouraged to follow the medical guidance of the health care provider. If the practice is not harming the client, it is inappropriate to label it quackery and demand that the client discontinue it. There is no medical evidence to support the wearing of a copper bracelet.
The nurse is caring for four clients who will all be undergoing moderate sedation procedures today. The health care provider (HCP) has ordered midazolam to be given to all four clients. The nurse notifies the HCP to clarify the prescription for which client? a 42-year-old Black client a 30-year-old client who is pregnant a 74-year-old client who has arthritis a 4-year-old client who has an autism spectrum disorder
a 30-year-old client who is pregnant Explanation: Midazolam is a benzodiazepine commonly used for moderate sedation procedures. It is contraindicated in pregnancy because it causes a predictable syndrome of cleft lip or palate, inguinal hernia, cardiac defects, pyloric stenosis, or microcephaly when given in the first trimester, and can cause sedation and withdrawal symptoms in the neonate in later pregnancy. Midazolam can be given to a pediatric client, but special care should be taken when calculating the weight-based dosage. Older adult clients can be given midazolam with caution, because they may have unpredictable reactions to the medication, and they may have renal or hepatic dysfunction that would alter the metabolism and excretion of the medication. Black clients can be given midazolam, but special care should be taken. In Black Americans, 15% to 20% are genetically predisposed to have delayed metabolism of benzodiazepines, causing an increased risk of oversedation and adverse reactions. Arthritis and autism spectrum disorders are not contraindications to midazolam usage, nor do they require extra caution to be taken.
A client from Pakistan informs the nurse of cultural dietary requests. The nurse responds to the special dietary needs by stating, "You are now living in the United States and you should try to start eating those foods common to an American diet." This inappropriate response is an example of cultural imposition. cultural diversity. cultural assimilation. cultural blindness.
cultural imposition. Explanation: The nurse's response is an example of cultural imposition, which is defined as the belief that everyone should conform to the majority belief system. Cultural blindness is the result of ignoring differences and proceeding as though they do not exist. In this situation, the nurse did not ignore the request but inappropriately responded to it. Cultural diversity is defined as a diverse group in society, with varying racial classifications and national origins, religious affiliations, languages, physical sizes, genders, sexual orientations, ages, disabilities, socioeconomic statuses, occupational statuses, and geographic locations. Cultural assimilation occurs when members of a minority group live within a dominant group and lose the cultural characteristics that make them different.
After discussing preconception needs with a nulliparous client who eats a primarily Asian diet, which client statement indicates the need for further instruction? "If I become pregnant, I can continue to eat sushi twice a week." "Eating soy products can increase my protein levels once I am pregnant." "I should continue to steam my vegetables rather than cooking them for a long time." "I should take folic acid supplements before I get pregnant."
"If I become pregnant, I can continue to eat sushi twice a week." Explanation: The client needs further instructions when she says, "If I become pregnant, I can continue to eat sushi twice a week." Raw fish, including tuna, should be avoided while the client is pregnant because of the risk of contamination with mercury and other potential teratogens. Folic acid supplements taken before the client gets pregnant and during pregnancy can help reduce the risk of neural tube defects. Steaming vegetables reduces the risk that vitamins will be lost in the cooking water. Soy products can increase the client's protein levels. Add a Note
A nurse wants to ensure inclusiveness in language regarding family when developing a plan of care for a client. Which action is the most important for the nurse to take to ensure that the plan is inclusive? Ask the client who is legally related. Ask the client for a list of blood relatives. Ask the client who is living in the same household. Ask the client to identify who is considered family.
Ask the client to identify who is considered family. Explanation: In a client's plan of care, family consists of people identified by the client as family members. The other options may be accurate, too, but in order to create a client-centered care plan, all members identified by the client should be included as family.
A client at a mental health clinic who has recently emigrated from another country identifies isolation and loneliness as current stressors. The client describes being withdrawn but does not know how to change the situation. Which is the most appropriate step for the nurse to take to help the client? Model culturally appropriate interactional skills. Support the client in developing attainable socialization goals. Have the client plan a social activity for the upcoming weekend. Refer the client to special interest clubs for newcomers.
Support the client in developing attainable socialization goals. Explanation: Supporting the client in goal-setting around social interaction is the first step in promoting change for wellness. Merely referring a client to a social activity is only a short-term solution, and may not be an intervention desired by the client. Modeling is important; however, interactional skills are individualized and must be authentic to be successful for the client. Suggesting solutions such as planning a specific activity with anyone is not appropriate to social wellness.
A nurse is performing an admission assessment on a client newly admitted to the hospital and has documented the client as being a member of the Native American subculture. Which of these best describes a subculture? a cultural group with values that are incongruent with those of the dominant culture a unique cultural group with unspecified geographic origins a unique cultural group that exists within the larger culture a cultural group with fewer than 5 million members in the United States
a unique cultural group that exists within the larger culture Explanation: Subcultures are unique cultural groups that coexist within the dominant culture of the United States. Subcultures are not defined according to the size of their membership or the lack of specific geographic origins. Subcultures may have some values that differ from those of the dominant culture but this is not their defining characteristic.
The nurse is assessing for oxygenation in a client with dark skin. Where will oxygenation be most evident on this client? skin nape of the neck buccal mucosa forehead
buccal mucosa Explanation: The nurse should examine the buccal mucosa, along with the conjunctiva and sclera, nail beds, palms, soles, lips, and tongue to assess for oxygenation in a client with dark skin.
A client who is black reports itching and rashes after consuming shellfish. On examination, the nurse finds a keloid on the client's back. What is the most appropriate action by the nurse? Request biochemical investigations. Inform the healthcare provider about it. Consider it as an allergic reaction to shellfish. Consider it as normal.
Consider it as normal. Explanation: The nurse should consider the appearance of keloids as normal in black clients. Keloids are irregular, elevated, thick scars found commonly in darker-skinned clients. Informing the healthcare provider or requesting biochemical investigations is inappropriate because this condition is not pathologic. Also, keloids are not the result of allergic reactions.
A client reports to the primary health care facility for routine physical examination after cardiac rehabilitation that followed myocardial infarction. Keeping in mind that the client speaks English as a second language, how should the nurse conduct the interview? The nurse should sit at a long distance from the client. The nurse should ask the client to express himself emotionally. The nurse should avoid using complex medical terminology. The nurse should ask closed-ended questions.
The nurse should avoid using complex medical terminology. Explanation: The nurse should avoid using medical terminology and make the examination as simple as possible. People who speak English as a second language may not understand medical terminology. They may feel embarrassed to ask the nurse to repeat the information again. It is not necessary to sit at a long distance and the questions may be either closed-ended or open-ended. The acceptability of emotion is rooted in culture not necessarily in language.
When providing care to Aboriginal clients, it may be important for the nurse to elicit help from the spiritual healer. preacher. priestess. rabbi.
spiritual healer. Explanation: Shamans and spiritual leaders are found among Aboriginal and many Southeast Asian groups.
What factor has the potential to lead to chronic respiratory acidosis in older adults? thoracic skeletal changes erratic meal patterns decreased renal function overuse of sodium bicarbonate
thoracic skeletal changes Explanation: Poor respiratory exchange as the result of chronic lung disease, inactivity, or thoracic skeletal changes may lead to chronic respiratory acidosis. Decreased renal function in older adults can cause an inability to concentrate urine and is usually associated with fluid and electrolyte imbalance. A poor appetite, erratic meal patterns, inability to prepare nutritious meals, or financial circumstances may influence nutritional status, resulting in imbalances of electrolytes. Overuse of sodium bicarbonate may lead to metabolic alkalosis. Add a Note
A nurse is caring for a client after internal fixation of a compound fracture in the tibia. The nurse finds that the client has not had dinner, seems restless, and is tossing on the bed. What is the most appropriate response by the nurse? "Do you need pain medication?" "Are you feeling all right?" "Tell me what you are feeling." "Are you having pain in your leg?"
"Tell me what you are feeling." Explanation: The nurse should ask the client to tell the nurse what they are feeling. Asking open-ended questions would encourage the client to verbalize pain. Some clients may not demonstrate their feelings or readily discuss their symptoms due to factors related to cultural norms. Closed-ended questions like "Are you having pain?", "Do you need pain medication?", and "Are you feeling all right?" may block communication.
A client with human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome confides that their employer does not know their HIV status. Which response by the nurse is best? "Would you like me to help you tell your employer?" "I must share this information with your employer." "I must share this information with your family." "The information you confide in me is confidential."
"The information you confide in me is confidential." Explanation: The nurse is responsible for maintaining the confidentiality of this disclosure by the client. The nurse cannot discuss the client's health problems with the family or employer. It is the client's responsibility to inform others if they choose to do so.
The nurse is in the process of assessing a non-English-speaking client, communicating through an interpreter. To facilitate communication, what should the nurse do first? Ask client how the client wishes to be addressed. Request all family members leave the room. Direct all questions to the interpreter. Offer the client a cold drink.
Ask client how the client wishes to be addressed. Explanation: Some cultures have no first or last names, and it is a sign of respect to ask the client how they wish to be addressed. Directing questions to the interpreter is culturally incongruent behavior. The interpreter will coach the nurse to direct questions to the client. The family should stay with the client so the nurse can determine who is the decision maker in the family. In some cultures, the matriarch or patriarch may be the designated decision maker and should be involved in decisions about the client's care. Some cultures believe health is a holistic balance between hot and cold. Therefore, before providing hot drinks or cold drinks, the nurse should determine the client's preferences.
An adolescent client in labor is dilated 4 cm and asks for an epidural. For cultural reasons, the client's mother states that her daughter "has to bite the bullet, just like I did." What should the nurse do to make sure her client's request is honored? Request that an anesthetist administer the epidural because the client is uncomfortable. Honor the mother's request. Knowing the client's cultural background, suggest that the family call a meeting to make the decision. Ask the client in a nonthreatening way if she wishes to have an epidural, and then speak with the physician.
Ask the client in a nonthreatening way if she wishes to have an epidural, and then speak with the physician. Explanation: A pregnant adolescent is considered to be emancipated and entitled to make her own decisions. It's the adolescent's right to decide whether she wants to have an epidural. The nurse should act as the adolescent's advocate and ask her whether she wants an epidural and then speak with the physician. The adolescent's mother and other family members can't override her decision. The nurse may not request that an anesthetist administer the epidural without the adolescent's
On examination of a Black newborn, the nurse notes a macular, blue-black area of pigmentation near the buttocks. Which nursing action is appropriate? Consider the finding as normal in a Black client. Ask the mother about any complications in pregnancy. Inform the health care provider about the condition. Put a dressing over the pigmented area.
Consider the finding as normal in a Black client. Explanation: The nurse should consider the pigmented area as normal in Black newborns. These are called flat gray nevi (formerly called Mongolian spots), which are clusters of melanocytes. Asking the mother about complications in pregnancy, informing the health care provider about the condition, and putting a dressing over the pigmented area are inappropriate responses because the finding is normal.
A client of Anglo-Saxon descent (e.g., Anglo-American or English Canadian) reports to the primary healthcare facility with symptoms of fever, cough, and running nose. While interviewing the client, which points should the nurse keep in mind? Sit at the other corner of the room. Do not ask very personal questions. Do not probe into emotional issues. Maintain eye contact while talking.
Maintain eye contact while talking. Explanation: While interviewing a client of Anglo descent, the nurse should maintain eye contact because it indicates openness and sincerity. Such clients freely express positive and negative feelings; therefore, the nurse may probe into emotional issues. Anglo culture is an open culture and members of this culture don't mind providing personal information. Also, clients of Anglo descent are not threatened by closeness so the nurse does not have to sit in another corner of the room.
The nurse is working with a client with low proficiency in the dominant language. The client's spouse is fluent in both the client's language and the area's dominant language. What is the best action by the nurse when providing discharge education to the client and spouse? Speak slowly and face the client. Direct the teaching to the client's spouse. Obtain the services of a medical interpreter. Have the spouse act as the interpreter.
Obtain the services of a medical interpreter. Explanation: The best action by the nurse is to obtain the services of a medical interpreter. Speaking slowly and facing the client will not ensure that the client understands the information presented. Asking the spouse to act as an interpreter is not appropriate. Directing teaching to the spouse excludes the client and is, therefore, not appropriate.
The nurse has recently accepted a position in a community with an ethnically and culturally diverse population. What action should the nurse first perform in order to enhance cultural competence? Make an effort to learn a language that is commonly spoken in the community. Ask clients from other ethnicities for suggestions on how to become more culturally aware. Thoughtfully reflect on the characteristics of their own culture. Ask several colleagues about the culture with which they most closely identify.
Thoughtfully reflect on the characteristics of their own culture. Explanation: Cultural competence begins with self-awareness. This should precede efforts such as learning languages or inquiring about colleagues' cultures. The nurse should seek to better understand clients' cultures, but it would not be appropriate to ask clients for advice about becoming more culturally aware in general.
A client admitted with tuberculosis reports concerns about paying for needed medications. The nurse should: collaborate with the social worker to investigate possible availability of funds. coordinate with the pharmaceutical company for free samples. contact the community's free clinic for medications. call the public health nurse to research free medications.
collaborate with the social worker to investigate possible availability of funds. Explanation: The nurse should collaborate with the social worker about the client's financial concerns. This collaboration can be done independently without a physician's order. The physician must notify the public health department of the client's diagnosis, but a public health worker does not get involved with the client's financial concerns. The physician and home health nurse are not typically involved with the client's financial concerns until after the client is discharged.
Despite the presence of a large cohort of elderly residents of Asian heritage, a long-term care facility has not integrated the Asian concepts of hot and cold into meal planning. The nurses at the facility should recognize this as an example of what? cultural imposition stereotyping cultural blindness cultural assimilation
cultural blindness Explanation: Cultural blindness is characterized by ignoring cultural differences or considerations and proceeding as if they do not exist. This phenomenon may underlie the failure to incorporate cultural considerations into dietary choices. Stereotyping assumes homogeneity of members of other cultures while cultural assimilation involves the replacement of values with those of a dominant culture. Cultural imposition presumes that everyone should conform to a majority belief system.
A client tells a nurse that she's in a nontraditional same-sex relationship. The woman's partner is the healthcare surrogate for the client and her fetus. The sperm donor, who is their best friend, has waived parental rights. If the client can't make healthcare decisions for the fetus, who's responsible for making them? the client's partner the client's parents, because they're blood relatives the court system, because the client isn't married and is legally responsible for the neonate the client's best friend, who's the sperm donor
the client's partner Explanation: A legal document stating that the client's partner is the healthcare surrogate for the client and the fetus authorizes the partner to make decisions on behalf of the client or the fetus if the client isn't able to do so. Before insemination, a donor signs a legal document waiving rights to the child; therefore, the donor has no authority to make healthcare decisions on behalf of the client or the fetus. Pregnancy at any age results in emancipation; parents don't have rights to make healthcare decisions for pregnant adolescents. The court system wouldn't make the decision if the client has designated a legal healthcare surrogate.
The nurse examines a 6-week-old dark-skinned infant. There are large spots of deep blue pigmentation across the infant's buttocks. The nurse should identify this sign as characteristic of which finding? telangiectatic nevi infant milia Mongolian spots nevus flammeus
Mongolian spots Explanation: This finding describes Mongolian spots, or slate grey nevi, which are common in newborns of African, Asian, or Latin descent. Nevus flammeus, also known as "port-wine stain," is a permanent purple-red skin lesion made up of congested, dilated capillaries. Although they are typically found on the face, they may be found on other parts of the body. Telangiectatic nevi, or "stork bites," are pink lesions commonly found on the back of the neck. Milia are small white papules over the nose and cheek that indicate blocked sebaceous glands.
The nurse cares for a client who is 12 weeks pregnant and speaks Spanish only. Which intervention(s) should the nurse include in the plan of care at the client's initial visit? Select all that apply. Discuss contraception and options. Refer the client to a high-risk clinic. Discuss cultural differences, and emphasize the differences between cultures. Provide brochures in the client's native language. Review dietary intake, and discuss nutrition. Arrange for an interpreter for the client's appointments
Provide brochures in the client's native language. Arrange for an interpreter for the client's appointments. Review dietary intake, and discuss nutrition. Explanation: Providing culturally sensitive care includes providing printed material in the client's native language. There is nothing to indicate that this client is a high-risk pregnancy. Discussing cultural differences is not a priority or important at the first visit. Clients need to have an interpreter for each prenatal visit to translate and interpret questions. Contraceptive options are not a priority for the first prenatal visit. Reviewing dietary intake and discussing nutrition are important components of early prenatal care.
Nurses' observance of professional rituals helps standardize practice and ensure efficiency. Which is a characteristic of rituals? preconceived and untested beliefs about people viewing one's own culture as the only correct standard common and observable expressions of culture belief system held to varying degrees as absolute truth
common and observable expressions of culture Explanation: Rituals are common and observable expressions of culture. A preconceived and untested belief about people is called a stereotype. Viewing one's own culture as the only correct standard is ethnocentrism. A belief system held to varying degrees as absolute truth is referred to as culture.
A client who speaks little English has emergency gallbladder surgery. During discharge preparation, which nursing action would best help this client understand wound care instructions? asking an interpreter to relay the instructions to the client asking frequently whether the client understands the instructions demonstrating the procedure and having the client return the demonstration writing out the instructions and having a family member read them to the client
demonstrating the procedure and having the client return the demonstration Explanation: Demonstration by the nurse with a return demonstration by the client ensures that the client can perform wound care correctly. Asking whether the client understands the instructions isn't appropriate because clients may claim to understand discharge instructions when they don't. An interpreter or family member may communicate verbal or written instructions inaccurately
When assessing a dark-skinned client for cyanosis, what area of the body will best reveal cyanosis? retinas nail beds inner aspects of the wrists oral mucous membranes
oral mucous membranes Explanation: In dark-skinned clients, cyanosis can best be detected by examining the conjunctiva, lips, and oral mucous membranes. Examining the retinas, nail beds, or inner aspects of the wrists is not an appropriate assessment for determining cyanosis in any client.
A 57-year-old woman with breast cancer who does not speak English is admitted for a lumpectomy. Her daughter, who speaks English, accompanies her. What should the nurse do in order to obtain admission information from the client? Obtain a trained medical interpreter. Ask the client's daughter to serve as an interpreter. Use the limited knowledge of the client's language learned in high school along with nonverbal communication. Ask one of the unlicensed assistive personnel (UAP) to serve as an interpreter.
Obtain a trained medical interpreter. Explanation: A trained medical interpreter is required to ensure safety, accuracy of history data, and client confidentiality. The medical interpreter knows the client's rights and is familiar with the client's culture. Using the family member as interpreter violates the client's confidentiality. Using the UAP or limited Spanish and nonverbal communication do not ensure accuracy of interpretation and back-translation into English.
A nurse is caring for a client of African descent. Who should the nurse use as a key informant? curandera church mothers spiritist healers voodoo priests
church mothers Explanation: The nurse should use church mothers as key informants for the client. Voodoo priests are key informants for Haitians. For Mexicans and Roman Catholics, the curandera can serve as key informant. Spiritist healers are key informants for Puerto Ricans.
The nurse cares for a client of a different cultural background. What is the best way for the nurse to provide culturally competent care to the client? Ask the client to explain the reasons for certain cultural preferences. Assure the client that all cultural preferences will be respected by staff. Introduce the client to other clients on the unit who share the same culture. Plan and implement care in a way that is sensitive to the needs of the client.
Plan and implement care in a way that is sensitive to the needs of the client. Explanation: Providing culturally competent nursing care means that care is planned and implemented in a way that is sensitive to the needs of individuals, families, and groups from diverse cultural populations within society. To provide culturally competent care, the nurse does not need to ask the client to explain the reasons for the client's beliefs. Assuring the client that the client's cultural preferences will be respected is dismissive and presumes the behavior of others instead of actively creating culturally competent interventions in the plan of care. Introducing the client to other clients makes the assumption that clients of similar cultural backgrounds will share interests and a desire to interact with each other. Making such an assumption is not a culturally competent approach.
A nurse has attended an in-service workshop to address the phenomenon of ageism in the healthcare system. Which practice is indicative of ageism? assessing the skin turgor of older adults differently than for younger adults providing slightly smaller servings of food for clients who are elderly speaking to older adults in a way one would with clients who have mild cognitive deficits implementing falls prevention measures in a setting where older adults receive care
speaking to older adults in a way one would with clients who have mild cognitive deficits Explanation: Accommodation of normal, age-related changes such as decreased skin turgor and slightly decreased nutritional needs is not an indication of ageism. Similarly, safety measures are unlikely to be motivated by ageist beliefs. Assuming that all older adults have cognitively deficits, however, is an indication of ageism.
A nurse has migrated to a different country and started working there. Which factor is important for effective functioning? cultural habituation stereotype culture shock ethnocentrism
cultural habituation Explanation: Cultural habituation reduces the extent to which people must take environmental cues into account; a predictable environment and being able to perceive the world as coherent are essential for human functioning. Assigning people to specific categories because of their culture, race, or ethnic emblems is stereotypical thinking; it is misleading and denies individuality. Ethnocentrism reflects a fear of difference from one's belief system, and consequent derision or disqualification of people and practices that do not conform to one's own view. Cultural shock is the acute experience of not comprehending the culture in which one is situated.
When providing nursing care to a client of African origin, which cultural factors should the nurse consider? Families are usually patriarchal. Family members are often highly competitive. Individuals often possess weak religious affiliations. Making eye contact may be considered rude.
Making eye contact may be considered rude. Explanation: Cultural factors that should be considered when providing care to a client of African origin include a tendency for eye contact to be viewed as disrespectful or presumptuous, for families to feel close-knit and for family members to cooperate, and for individuals to be highly religious and hold the clergy in high esteem. Families may be matriarchal or patriarchal depending on the culture of origin, so assumptions should not be made about gender roles in the family based only on the information that the client is of African origin.
Which questions should the nurse include in a cultural assessment? Select all that apply. "To what religion do you belong?" "What do you think about religions other than yours?" "Do you have a particular name for this illness?" "What do you do to promote good health?" "What do you think is causing your illness?"
"What do you think is causing your illness?" "To what religion do you belong?" "What do you do to promote good health?" "Do you have a particular name for this illness?" Explanation: Transcultural assessment encompasses several considerations surrounding illness, such as causation, naming, prevention, and health promotion. As well, it is significant and appropriate to ask with what religion or religious group a client identifies. However, it is likely unnecessary and possibly inappropriate to elicit the client's views of those who belong to other religious groups.
The children of an elderly client who has suffered an ischemic stroke have informed the nurse that an herbalist will be coming to their parent's bedside tomorrow to make recommendations for client's care. Which considerations should the nurse prioritize in light of the practitioner's planned visit? taking measures to prevent cultural conflict when the practitioner comers to the hospital ensuring any complementary therapies are safe when combined with his prescribed therapy identifying whether the family would prefer to pursue alternative or conventional treatment for their parent ensuring that the care team does not impose their beliefs on the family or the complementary practitioner
ensuring any complementary therapies are safe when combined with his prescribed therapy Explanation: While it is important for the nurse and the other members of the care team to ensure that stereotypes or cultural imposition do not exist, the priority in all aspects of care is safety. Consequently, potential interactions between the complementary therapies and conventional hospital treatments are a priority. The family should not be required to forgo conventional treatment to pursue some aspects of culturally based, complementary care.
A client has received lunch. The client is served soup with crackers, an apple, and salad. The client uses the nurse call light and asks the nurse to bring a warm beverage. What alternative therapy is the client likely using? traditional Chinese medicine therapeutic touch chiropractic therapy yoga
traditional Chinese medicine Explanation: Chinese medicine views health as a life in balance and uses the concept of yin and yang as a major influence. The client is balancing the meal with hot and cold items that are opposing yet complementary phenomena needed for dynamic equilibrium. Yoga is a discipline that focuses on muscles, posture, breathing, and consciousness. Therapeutic touch uses the energetic biofield of the client and recenters the energy of the client.
