FUN 4

A nurse is providing teaching to student nurses about cultural blindness when caring for clients of diverse ethnicity. Cultural blindness is best described as: A. An inability to recognize cultural values and beliefs among different population B. treating people differently based on their cultural backgrounds C. a fixed or set belief about a group of people D. seeking more ways to reach out to people of other cultures and provide care as needed

A

What should a nurse do to decrease or control the sensory and cognitive disturbances that can occur after a client has open heart surgery? A. restrict family visits B. withhold analgesic medications C. plan maximum periods of rest D. keep the room light on most of the time

C

A nurse is teaching a Laotian client who has hypertension about selecting low-sodium food choices. Which of the following actions by the nurse demonstrates cultural competency? A. Asks the client what she likes to eat B. Instructs the client to use a salt-substitute C. Incorporates Buddhist concepts of diet into teaching D. Recommends selecting cured meats instead of fresh

A

A client has a hip fracture repair with a prosthetic implant placed. On the day after the implant, the nurse finds the client surrounded by papers from his briefcase and panning a phone meeting. The nurse plans to discuss activities with the client and should base the discussion on which information? A. Rest is an essential component of bone healing. B. Setting limits on a client's behaviors is a mandated nursing role. C. Not keeping up with his job will increase the clients stress level. D. Involvement in his job will keep the client from becoming bored.

A

A nurse is caring for patient on a mechanical ventilator and who receives nutrition through a feeding tube. Which position would most likely reduce the risk of the patient developing aspiration pneumonia? A) Supine with the head of the bed elevated 30 to 45 degrees. B) Right-side laying C) Left- side laying D) Supine with the head of the bed elevated 15 degrees.

A

A nurse is providing care to a client in her home who reports she has difficulty falling asleep at night. Which of the following would be the most helpful suggestion for the nurse to make? a. Drink warm milk before going to bed at night b. Exercise before going to bed c. Drink a cola beverage in the evening d. Watch television in bed

A

The nurse assess a new patient and finds the patient short of breath with a respiratory rate of 32 and lying supine in bed. What is the priority nursing action? A. Raise the head of the bed to 45 degrees or higher. B. Get the oxygen saturation with a pulse oximeter. C. Take the blood pressure and respiratory rate. D. Notify the health care provider of the shortness of breath.

A

Which of the following statements about nutrition, culture, and religion is accurate? a. Religious food practices can include vegetarianism among Seventh Day Adventists b. Members of ethnic minorities never retain their own cultural dietary practices and instead typically acculturate to the American lifestyle c. Cultural food preferences tend to be unhealthy and associated with weight gain and malnutrition d. Many people do not have access to needed supplies to continue with cultural food practices

A

A nurse is performing a home care assessment on a patient with a hearing impairment. The patient reports, "I think my hearing aid is broken. I can't hear anything." Which of the following teaching strategies does the nurse implement? (Select all that apply.) A. Demonstrate hearing aid battery replacement. B. Review method to check volume on hearing aid. C. Demonstrate how to wash the earmold and microphone with hot water. D. Discuss the importance of having wax buildup in the ear canal removed. E. Recommend a chemical cleaner to remove difficult buildup.

A, B, D

An RN is carrying for elderly client who has blindness as a result of glaucoma the nurse knows to implement which of the following interventions when caring for this client (select all that apply) A. Announce entry and exit from the room B. Instruct the client to use a cane with the non-dominant hand C. Orient the client to the placement of the items on the meal tray by using a clock-face description D. Stand close to the client and speak loudly to ensure her comprehension E. Ask the client spouse about the clients preferred arrangements of hygiene items

A, C

A patient is admitted through the emergency department (ED) after a serious car accident. The nurse assesses the patient and quickly learns that he speaks little English. Spanish is his primary language. The nurse speaks some Spanish. Which interventions would be most appropriate at this time? (Select all that apply). A. The nurse requests a professional interpreter. B. Since this is an emergent situation, the nurse will interpret and identify the patient's priority needs. C. The nurse determines the interpreter's qualifications and makes sure that the interpreter can speak the patient's dialect. D. The nurse uses short sentences to explain the treatments provided in the ED. E. The nurse directs questions to the patient by looking at the patient instead of at the interpreter.

A, C, D, E

A nurse is caring for a client with a nursing diagnosis of impaired skin integrity, related to decreased mobility and mechanical factors. Which of the following interventions would be appropriate for this client? (Select all that apply) a. Encourage food and fluid intake b. Encourage chair sitting to keep the client out of bed c. Use talcum powder to keep skin dry d. Assist the client with ambulation and encourage mobility e. Assist the client to change positions every four hours

A, D

A nurse is caring for a client who is undergoing a skin graft using skin from his back. Which of the following is a skin graft that is taken from another portion of a client's own body? a. An allograft b. A xenograft c. An autograft d. A homograft

C

A nurse is caring for a client with pregnancy-induced hypertension who is scheduled for a cesarean section. In which position should the nurse place this client before she is transferred to the delivery suite? A. Supine B. Prone C. Left lateral D. Trendelenburg

C

What should a nurse do to decrease or control the sensory and cognitive disturbances that can occur after a client has open heart surgery? A. restrict family visits B. withhold analgesic medication C. plan maximum periods of rest D. keep the room light on most of the time

C

An elderly patient with bilateral hearing loss wears a hearing aid in her left ear. Which of the following approaches best facilitates communication with her? A. Talk to the patient at a distance so he or she may read your lips. B. Keep your arms at your side; speak directly into the patient's left ear. C. Face the patient when speaking; demonstrate ideas you wish to convey. D. Position the patient so the light is on his or her face when speaking.

C

What should a nurse do to decrease or control the sensory and cognitive disturbances that can occur after a client has an open heart surgery? A. Restrict family visits B. Withhold analgesic medications C. Plan maximum periods of rest D. Keep the room light on most of the time

C

A nurse is caring for a client with a traumatic spinal cord injury as a result of a driving accident. The client has lost motor function below the injury but has some preserved sensory function and below the level of the injury. How is this injury classified according to the American Spinal Injury Association's ASIA scale? A. grade A spinal cord injury B. grade B spinal cord injury C. grade C spinal cord injury D. grade D spinal cord injury

B

A nurse is providing teaching to a client who recently began chemotherapy and states that he can't taste food anymore and what he tastes does not taste normal. Which of the following recommendations should the nurse make to improve the client's enjoyment of the meal? A) "Avoid citrus juices." B) "Use plastic utensils to eat." C) "Eat foods that are warm." E) "Eat meat with something sour"

B

The nurse is providing instructions to a client and family regarding home care after left-eye cataract removal. The nurse tells the client and family about assuming which position during the postoperative period? A. Sleep only on the left side. B. Sleep on the right side or the back C. Bend below the waist as often as you are able D. Lower the head between the knees three times a day.

B

A client is critically ill and admitted to a step down unit. Which of the following nursing interventions promote normal rest patterns of sleep (select all that apply) A. Increase continuous infusion of IV sedation during evening and night time hours B. Open curtains in the morning C. Turn off equptment alarms in the room at night D. Dim the light at light E. Keep the client busy with scheduled tests and therapeutic activities during the day time

B, D, E

A man of Chinese descent is admitted to the hospital with multiple injuries after a car accident. His pain is not under control. The client states, "If I could be with my people, I could receive acupuncture for this pain." The nurse should understand that in the Asian culture, acupuncture is known to: A. Purge evil spirits B. Promote tranquility C. Restore the balance of energy D. Block nerve pathways to the brain

C

A man of Chinese descent is admitted to the hospital with multiple injuries after a car accident. His pain is not under control. The client states, "If I could be with my people, I could receive acupuncture for this pain." The nurse should understand that in the Asian culture, acupuncture is known to: a. Purge evil spirits b. Promote tranquility c. Restore the balance of energy d. Block nerve pathways to the brain

C

A nurse is assessing a client who has an NG tube in place that is set to low gastric suction for gastric decompression to treat abdominal distension. The client reports anxiety, discomfort, and bloating. Which of the following actions is the nurse's priority? A. Request an x-ray to verify NG tube placement B. Irrigate the NG tube with 30 mL of irrigant C. Check to see if the suction equipment is working D. Remove and reinsert the NG tube

C

A nurse is caring for a Chinese American client who has a family history of hypertension. Which of the following cultural factors can place this client at an increased risk for this condition? A. use of dairy products B. consumption of raw fruits C. high sodium content of traditional diet D. large quantities of shellfish in traditional diet

C

A nurse is caring for a client who has excessive daytime sleepiness due to narcolepsy. Which nursing diagnosis is most appropriate? A. self care deficit related to inability to get out of bed in the morning B. impaired urinary elimination related to inability to hold urine C. risk of injury related to drowsiness D. knowledge deficit related to use of tools for activities of daily living

C

When assessing a child's cultural background, a nurse knows that which of the following is true? A. heritage is the primary determinant of shared group values B. culturally determined behaviors are limited to one generation C. physical characteristics are not a determinant of a child's cultural background D. cultural background is irrelevant to healthcare

C

Which client is most likely to suffer from the stigma of psychiatric illness, as a function of their culture? A. A female client B. A male client C. A Hispanic male client D. A Hispanic female client

C

Which of the following situations would contribute to sensorineural hearing loss (select all that apply)? a. cerumen impaction b. chronic ear infections c. exposure to loud noise d. acoustic neuroma e. use of ototoxic medications

C, D, E

A nurse is caring for client with angina, and the healthcare provider has written an order for application of nitroglycerin ointment. When the nurse is selecting a site for application to facilitate absorption what is the most important factor to consider for an enhanced absorption? A. The site should be near the heart B. The site should be over a bony prominence C. The site should be muscular if possible D. The site should not be hairy

D

A nurse is planning care for an elderly client who is complaining of sleeping disturbances. And intervention to include on the plan of care is: a. Nap during the day to make up lost sleep b. Exercise in the evening to increase fatigue c. Allow the client to sleep later d. Decrease intake of fluids 2-4 hours before going to bed

D

A nurse accidentally gives a patient the medications that were ordered for the patient's roommate. What is the nurse's first priority? A. Complete an occurrence report. B. Notify the health care provider. C. Inform the charge nurse of the error. D. Assess the patient for adverse effects.

D

A nurse is caring for a client status post craniotomy who has clear wound drainage of 60 mL during one shift from a drain placed during the procedure. Which of the following is the priority nursing intervention? A. Log-roll the client with operative side up B. Cleanse the wound site using sterile saline and apply a new dressing C. Mark the drainage saturation of the dressing and monitor q 12 hours D. Notify the HCP of the amount and color of drainage

D

A nurse is caring for a client whose healthcare provider has written a prescription for a sleep medication to be given at 10pm. The client refuses the sleep medication, stating he "never goes to sleep that early". Which of the following actions should the nurse take? A. Tell the client that hospital policy states all sleep medications must be given between 9 and 10 PM. B. Tell the client that his refusal will displease the healthcare provider C. Insist that the client take the medication at the time ordered by the health care provider D. As the client when he would like to prepare to sleep?

D

A nurse is preparing to perform a cultural assessment of a patient. Which of the following questions is an example of a contrast question? A. Tell me about your ethnic background. B. Have you had this problem in the past? C. Where do other members of your family live? D. How different is this problem from the one you had previously?

D

A nurse manager notes that 2 RNs assigned to the med-surg unit are new to this geographic region of the country and are unfamiliar with the cultural practices of clients in the local population. What should the nurse manager do in order to help the nurses develop cultural competency? A) Ask the charge nurse to assign them to culturally diverse group of clients for each shift. B) Ask them to research the various cultures encountered on that unit and to present a report to the staff. C) Assign them to a unit with less cultural diversity. D) Provide them with access to a continuing education program on diverse cultures in the area and follow-up with a discussion that allows for questions.

D

A nurse wakes a client who reports that he was having a disturbing dream. Which sleep stage was most likely occurring just before the client was awakened? A) Stage 2 non-REM sleep B) Stage 3 non-REM sleep C) Slow-wave sleep D) REM sleep

D