201 Final Practice Questions

The nurse educator is providing in-service education to the nursing staff regarding transcultural nursing care; a staff member asks the nurse educator to provide an example of the concept of acculturation. The nurse educator should make which most appropriate response?

"A person who moves from China to the United States (U.S.) and learns about and adapts to the culture in the U.S."

Which statement made by a new graduate nurse about the teachback technique requires intervention and further instruction by the nurse's preceptor?

"After teaching a patient how to use an inhaler, I need to use the Teach Back technique to test my patient's understanding."

The nurse is preparing a plan of care for a client, and is asking the client about religious preferences. The nurse considers the client's religious preferences as being characteristic of a Jehovah's Witness if which client statement is made?

"I cannot have any food containing or prepared with blood."

The nurse educator asks a student to list the 5 main categories of complementary and alternative medicine (CAM), developed by the National Center for Complementary and Alternative Medicine. Which statement, if made by the nursing student, indicates a need for further teaching regarding CAM categories?

"Magnetic therapy and massage therapy are a focus of CAM."

A critically ill Hispanic client tells the nurse through an interpreter that she is Roman Catholic and firmly believes in the rituals and traditions of the Catholic faith. Based on the client's statements, which actions by the nurse demonstrate cultural sensitivity and spiritual support? Select all that apply.

1- Ensures that a close kin stays with the client. 2- Makes a referral for a Catholic priest to visit the client. 5- Offers to provide a means for praying the rosary if the client wishes.

Which clients have a high risk of obesity and diabetes mellitus? Select all that apply.

1- Latino American man 2- Native American man 4- Hispanic American man 5- African American woman

Which of the following are examples of problems with the health care system that contribute to health disparities? (Select all that apply.)

A health care provider assumes that the patient missed two appointments because the patient does not care about his or her health and does not inquire about the reasons for missed visits. A community hospital lacks an adequate staff of social workers who are able to ensure patients' access to resources they need to take care of their health. A hospital discharges a patient without ensuring that the patient has a primary care provider and has made a follow-up appointment. A nurse uses a family member as an interpreter to explain the patient's medications. The hospital conducts quality improvement without stratifying data by race, ethnicity, language, socioeconomic status, sexual orientation, and other axes of social group identities.

During an encounter with an elderly patient, the nurse recognizes that a thorough cultural assessment is necessary because the patient has recently come to the United States from Russia and has never been hospitalized before. The nurse wants to discuss cultural similarities between herself and the patient. Which step of the LEARN mnemonic is this?

Acknowledge

When communicating with a client who speaks a different language, which best practice should the nurse implement?

Arrange for an interpreter to translate.

The nurse is providing discharge instructions to a Chinese American client regarding prescribed dietary modifications. During the teaching session, the client continuously turns away from the nurse. The nurse should implement which best action?

Continue with the instructions, verifying client understanding.

Which is the best nursing intervention regarding complementary and alternative medicine?

Educating the client about therapies that he or she is using or is interested in using

An antihypertensive medication has been prescribed for a client with hypertension. The client tells the clinic nurse that he would like to take an herbal substance to help lower his blood pressure. The nurse should take which action?

Encourage the client to discuss the use of an herbal substance with the health care provider (HCP).

Which of the following changes can help create a more inclusive environment for lesbian, gay, bisexual, and transgender (LGBT) patients? (Select all that apply.)

Explicitly including sexual orientation and gender identity into nondiscrimination policies Displaying art that reflects LGBT community Modifying health care forms to provide opportunities for gender identity and sexual orientation disclosure Ensuring access to unisex or single-stall bathrooms

An Asian American client is experiencing a fever. The nurse plans care so that the client can self-treat the disorder using which method?

Foods considered to be yin

A nurse is preparing to perform a cultural assessment of a patient. Which of the following questions is an example of a contrast question?

How different is this problem from the one you had previously?

When you care for a patient who does not speak English, it is necessary to call on a professional interpreter. Which of the following are proper principles for working with interpreters? (Select all that apply.)

If you feel an interpretation is not correct, stop and address the situation directly with the interpreter. Pace a conversation so there is time for the patient's response to be interpreted. Ask the patient for feedback and clarification at regular intervals.

Which of the following are considered social determinants of health? (Select all that apply.)

Lack of primary health care providers in a zip code Poor-quality public school education that prevents a person from developing adequate reading skills Lack of affordable health insurance Employment opportunities that do not provide paid vacation or sick leave Neighborhood safety that prevents a person from walking around the block or socializing with neighbors outside of his or her home

In the United States, there has never been a president of Asian or Hispanic culture. This is an example of:

Marginalization

How can a nurse work on developing cultural awareness? (Select all that apply.)

Reflect on his or her past learning about health, illness, race, gender, and sexual orientation Develop greater self-knowledge about personal biases Recognize consciously the multiple factors that influence his or her own world view Engage in an in-depth self-examination of his or her own background

The ambulatory care nurse is discussing preoperative procedures with a Japanese American client who is scheduled for surgery the following week. During the discussion, the client continually smiles and nods the head. How should the nurse interpret this nonverbal behavior?

Reflecting a cultural value

Which meal tray should the nurse deliver to a client of Orthodox Judaism faith who follows a kosher diet?

Sweet and sour chicken with rice and vegetables, mixed fruit, juice (dietary kosher laws, the dairy-meat combination is unacceptable)

A new nurse is caring for a hospitalized obese patient who is homeless. This is the first time the patient has been admitted to the hospital, and the patient is scheduled for surgery. Which of the following is a universal skill that will help the nurse work effectively with this patient?

The nurse asks the patient, "Tell me about the main problems you have had with your health from not having a home."

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 appropriate at this time? (Select all that apply.)

The nurse requests a professional interpreter. The nurse determines the interpreter's qualifications and makes sure that the interpreter can speak the patient's dialect. The nurse uses short sentences to explain the treatments provided in the ED. The nurse directs questions to the patient by looking at the patient instead of at the interpreter.

A nurse has worked in a home health agency for a number of years. She goes to visit a patient who has diabetes and who lives in a public housing facility. This is the first time the nurse has cared for the patient. The patient has four other family members who live with her in the one-bedroom apartment. Which of the following, based on Campinha-Bacote's (2002) model of cultural competency, is an example of cultural awareness?

The nurse silently reflects about how her biases regarding poverty can influence how she assesses the patient.