314 exam 2
The clinic nurse is obtaining demographic data from a client. The client states, "Why do you need to know what my ethnicity is?" How should the nurse respond?
"Collecting this information allows us to develop a personalized plan of care to meet your needs."
Which nursing intervention reflects culturally appropriate care when addressing a client?
"Good morning, Mr. Smith. I am your nurse, John."
A client inquires about the use of herbal therapy. Which statement by the nurse is most accurate?
"Herbs can have side effects and can interact with prescription medications.
The staff nurse overhears the charge nurse, who is of Italian heritage, talking to the unlicensed assistive personnel. Which statement made by the charge nurse is an example of ethnocentrism?
"Italians are best at everything."
The nurse is caring for a client diagnosed with pancreatic cancer. The client would like to use integrative care as a health care choice. What is the best response by the nurse?
"There are several alternative medicine modalities that could help with pain and relaxation during your treatment. I will get you some information on them."
Role of Hospice
-provide care for terminally ill-Treat symptoms & Px mgmt
Which client admitted to the emergency department might require the nurse to include interventions aimed at addressing culture shock in the plan of care?
A client who recently immigrated and fell from a ladder
The nurse is caring for several clients with chronic conditions that need to be evaluated for long-term care. After evaluating each client, the nurse determines which client is most appropriate to receive long-term care?
A client who suffered a stroke who has mobility issues and problems completing activities of daily living (ADLs).
A nurse demonstrates understanding of Healthy People 2030 by supporting which statement?
A client's health is affected by social, economic, and political factors.
A community health nurse is providing care to a group of Hispanic people living in an area that is predominantly populated by white people. What are the Hispanic people in this community an example of?
A minority
While assessing a client, the client tells the nurse that he is a follower of traditional Chinese medicine and the concept of qi. Based on the nurse's understanding of this concept, which treatment modality would the nurse expect the client to mention?
Acupuncture
A client diagnosed with fibromyalgia asks the nurse about acupuncture, stating, "I do not understand how sticking needles in me is going to help my chronic pain." Which explanation should the nurse provide to address the client's needs?
Acupuncture involves placing very fine needles along nerve tracts, called meridians, to restore positive energy and harmony in the body, ultimately redirecting pain signals.
A client is having problems with insurance reimbursement. The home health care nurse discusses the client's need for home health services with the insurance company. What role is the nurse demonstrating?
Advocate
Which government policy addresses penalizing hospitals for readmissions of clients with certain diagnoses within 30 days after discharge?
Affordable Care Act
What is the definition of wellness?
An active state of being healthy
The nurse discovers that a recently admitted client does not speak the same language as the nurse. Which action would the nurse take?
Arrange for a trained language interpreter.
The nurse is assessing an older adult who immigrated at the age of 3 years. The client speaks the same language as the nurse and lives in a neighborhood with many households from the country of origin. Which action by the nurse is most appropriate?
Ask the client about special cultural beliefs or practices.
Personal space and distance is a cultural perspective that can impact nurse-client interactions. What is the best way for the nurse to interact physically with a client who has a different cultural perspective on space and distance?
Know the client's cultural personal space preferences.
The nurse is preparing to administer prescribed medication to a client who is Native American/First Nations. The nurse enters the room and observes a shaman performing a healing ritual for the client. What action would be the most appropriate by the nurse?
Leave the room and return when the shaman is finished.
A nurse is assessing a client and determines that the client belongs to a minority group. Based on the nurse's understanding about marginalized identity groups, the nurse would anticipate that the client would likely experience which effects?
Less power and Health disparities
Which nursing activity reflects secondary prevention?
Making a referral for a mammogram
A nurse is providing care to a client who is from a different culture. Which aspect about culture would be most important for the nurse to integrate into the client's care?
Not all members of the same culture act and think alike.
In which way can nurses develop cultural self-awareness?
Objectively examine one's own beliefs, values, and practices.
The nurse is caring for several clients of different cultures. Which client situation would the nurse recognize as the client with highest risk of culture shock?
The client from Ethiopia states, "All these machines attached to me scare me and I need to get them off."
The spouse of a client asks the nurse whether the spouse may bring in a cream from home to apply to the client's skin. The spouse says, "Whenever anyone gets sick, we always use this cream." The nurse interprets this as
ritual
What is one of the most significant trends in health care today?
shift from hospitals to community-based care
A preconceived and untested belief about an individual or group of individuals is:
stereotyping
The nurse recognizes that the goals established for a client's discharge are more likely to be accomplished when
the client assists in developing the goals.
The growth in home health care is largely attributed to which factor?
Early discharge of clients from the hospital setting
The nurse is caring for a client 4 days after total hip arthroplasty and notes the client has lost weight. The unlicensed assistive personnel reports the client's food intake has decreased. Which question will the nurse ask the client to determine if cultural causes are responsible for the weight loss
"What type of food do you like to eat at home?"
A community health nurse has just completed a dressing change for a client with a complex wound. During the termination phase of the visit, the nurse will include what statement?
"Your wound is healing nicely. It is draining less and it is smaller by a half centimeter."
Assessment of a client during a home visit reveals the following: blindness, mild to moderate pain from arthritis, constipation, and weight loss. What would the nurse identify as the greatest threat to the client's independent functioning?
Blindness
A nurse is covering all aspects of admission procedures for a client who is receiving home health services. The nurse explains what procedures will be covered during the nurse's visits. Which aspect of the admission process does this represent?
Clearly defining the purpose and expectations of care
A nurse is conducting a cultural assessment of a client. Which person would the nurse identify as the expert?
Client
The home health care nurse is providing information to a client and family on medication changes. What role is the nurse performing?
Client and family educator
A single parent age 17 years, with one child and pregnant with a second, has the mental age of a 12-year-old. The home care nurse's greatest concern in caring for this client should be the client's ability to do which?
Cognitively understand how to care for the children
Which is the main focus of care for a school nurse?
Community care
Nurses in various health care settings provide services to prevent the fragmentation of care that is occurring as a health care trend in today's society. What role of the nurse is most important in preventing this effect?
Coordinator of care
Key Concepts of Leininger's Theory
Culture Care Diversity Universality World view Ethnohistory Sunrise Model
Upon moving to another country, a college student is very confused by many local customs. He is especially bothered by the custom of men and women eating in separate areas and it makes him angry and resentful of the new culture. What are the feelings experienced by this student?
Culture shock
The nurse is performing a routine assessment of a client who has a prosthetic arm as a result of a small plane crash many years earlier. How should the nurse best understand this client's health?
Despite the loss of a limb, the client may identify as being healthy.
A client's spouse has asked that the client be cared for exclusively by female nurses. How should the nurse incorporate this request into the care plan?
Document the request and make all reasonable efforts to honor it
The nurse is working with a client's family and social worker to select a home health care agency. Which question does the nurse state should be the family's priority when interviewing potential home health agencies?
Does the agency meet uniform standards for licensing, certification, and accreditation by state agencies and/or federal programs?
A nurse has an older adult home care client who lives alone with no family nearby. On a recent visit, the nurse notices that his clothes are very loose, and he has difficulty letting the nurse leave when the visit is ending. After talking with him, the nurse learns that he has not been cooking for himself and he can't get to the grocery store easily. What service could the nurse suggest as an immediate response until a long-term plan can be formed?
Enroll the client in Meals on Wheels.
A nurse is caring for an older adult. How does the nurse demonstrate awareness of culturally competent care?
Establishing effective communication
Which phrase best describes continuity of care?
Facilitating transition between settings
A client has a cerebrovascular accident (CVA), resulting in flaccidity of the right side with aphasia. For this client, which intervention constitutes tertiary prevention?
Gait training and speech therapy
A client is having an increasing amount of difficulty maintaining activities of daily living (ADL's) in the home alone following a below-the-knee amputation. The nurse's assessment reveals that the client may benefit from different assistive devices to facilitate ADL's. Which action would be the most appropriate for the nurse to take?
Have the occupational therapist assess the client's specific needs
The nurse is providing education and interventions on health promotion and prevention of disease in the community. When planning this care, the nurse will integrate what guiding principle?
Health education can benefit both individuals and groups
A client comes to the health center for a routine visit. During the visit, the client tells the nurse, "I'm motivated to do things now to make sure I'm the healthiest I can be." When planning this client's care, the nurse should focus on which area?
Health promotion
What is the primary focus of health care today?
Health promotion
Which model of health and illness places high-level health and death on opposite ends of a graduated scale?
Health-Illness Continuum
The nurse is caring for a client admitted to home care after total knee replacement surgery. Which home health care goal for the client will be the nurse's priority?
Help the client regain mobility and independence
Which of the following is a theory and philosophy that focuses on connections and interactions between parts of the whole?
Holism
A client living alone has degenerative joint disease, hypertension, and peripheral neuropathy. The client has challenges with activities of daily living, including hygiene. Which type of care would this client benefit from most?
Home care
A client who is immunocompromised knows that their body is constantly responding to potentially infectious challenges from the outside environment. The client's body is attempting to achieve what state?
Homeostasis
Which is the acute care setting for people who are too ill to care for themselves at home, are severely injured, or require surgery?
Hospitals
When doing discharge planning for an older adult client who had a stroke, what is the nursing priority?
Plan reachable goals with the client and family.
A nurse is giving a talk to a local community group on the importance of proper diet and regular exercise. This is an example of which type of health promotion?
Primary
A nurse is immunizing children against measles. This is an example of what level of preventive care?
Primary
A nurse is educating clients on the need for calcium intake to prevent bone loss. What level of prevention does this represent?
Primary prevention
The nurse is admitting a client for outpatient surgery. When the nurse asks what the client has been told about self-care following discharge, the client says, "No one has told me anything." Which nursing intervention is indicated?
Provide the teaching.
A client with severe congestive heart failure (CHF) has been referred to a long-term care facility. The nurse is transferring care from the hospital setting to a long-term care facility. Which action is a priority to ensure continuity of care for this client?
Providing accurate and complete communication to the new facility.
In preparation for discharge, the nurse is reviewing information related to new dietary guidelines with the client. This is an example of which step in discharge planning?
Providing client education
Which statement best conveys the relationship between race and ethnicity?
Race denotes physical characteristics, while ethnicity is rooted in a common heritage.
The nurse is providing hospice care for a client with brain cancer and bone metastases. What role will the nurse prioritize in this client's care?
Reducing or eliminating unpleasant symptoms in anticipation of death
A nurse is teaching a client how to perform meditation. Which would the nurse emphasize that the client do first?
Select an appropriate location
A client diagnosed with terminal leukemia is receiving home health care services to assist in the client's care. After assessing the client, the home health care nurse determines that the client is unable to afford needed medical supplies. Which is the best strategy for the nurse to implement to assist the client?
Refer the client to a social worker to determine eligibility for assistance.
Which is an example of tertiary health promotion?
Rehabilitation
Which principle does not encompass the basic goals of integrative medicine?
Reject allopathic medicine and embrace CAM practices
A nurse recommends palliative care for a client who is being discharged following a diagnosis of cancer. What is the chief focus of this type of care?
Relief from physical, mental, and spiritual distress
Which behaviors demonstrated by the client would the nurse consider reflections of the client's pride in ethnicity?
Requesting native cuisine Listening to folk music and dance and Asking to wear unique clothing
The nurse overhears a colleague state, "All people from that client's country are rude." What is the appropriate nursing response?
Respond by saying, "Stereotypes keep us from accepting others as unique individuals."
A nurse overhears another nurse make a statement that indicates racism. The nurse makes this determination based on which characteristic indicative of social value?
Skin color
The nurse is caring for a client newly diagnosed with diabetes mellitus. Which is an appropriate element of discharge planning for the nurse to use?
Teach the client about prescribed medications and how to monitor blood sugars.
A nurse practices holistic client care. Which of the following is a guiding principle of this practice?
The body is a unified, dynamic whole.
A group of nursing students is reviewing information about culture and its links to a wide variety of unique behaviors and events. The group demonstrates understanding of this concept when it identifies which behavior as culturally linked to autopsy for Western nurses?
The cause of death can be discovered.
One of the fastest growing venues of practice for the nurse is home health care. What is the basis for the growth in this health care setting?
The discharge home of clients who are more critically ill
An older adult client from a minority culture refuses to eat at the nursing home, stating, "I just do not like the food here." What factor should the staff assess for this problem?
The food served may not be culturally appropriate.
The nurse is using an interpreter to communicate with a client who speaks a different language. What would be the best way to choose an interpreter for this client?
The interpreter should understand the health care system.
Which is the best example of a nurse providing continuity of care?
The nurse collaborating with other members of the health care team in caring for a client
It is important for home health care nurses to remember which point?
The nurse is the guest in the client's home.
A nurse practitioner uses integrative care in the practice. What does this mean?
The nurse uses both allopathic medicine and complementary health approaches (CHAs).
A client was admitted to the hospital for treatment of pneumonia and was also diagnosed with mild dementia while in the hospital. In preparing for discharge, what should the nurse discuss with the family?
The possible need for home care
The nurse is conducting discharge education on dressing change to a postoperative client and the spouse. The client's spouse appears anxious about changing the dressing correctly. Which is the best indicator that the spouse is competent to perform the dressing change?
The spouse is able to correctly demonstrate performing the procedure.
The nurse is addressing primary prevention with a group of college students. Which promotional statement by the nurse would be the best example of a developmentally appropriate discussion?
Use of condoms can help prevent sexually transmitted infections and unwanted pregnancy.
The nurse in a free clinic caring for clients uses the Health Belief Model, which is based on three components. What is the main focus for this model?
What people believe to be true about their health
An older adult client who only speaks a different language than hospital staff has been admitted to the emergency department after suffering a fall and suspected hip fracture in the home. Who is the best person to perform translation services for the client?
a hospital translator
Subculture
an ethnic, regional, economic, or social group exhibiting characteristic patterns of behavior sufficient to distinguish it from others
Race
biologic characteristics as the marks of separate social status; based on physical characteristics
The community health nurse is assessing a home-bound client. The client expresses their own past-oriented ancestral heritage and family rituals. The nurse recognizes that the client is expressing:
ethnic identity.
Persistent gaps between the health status of minorities and non-minorities are defined as:
health disparities.
The home health nurse completes the Outcome and Assessment Information Set (OASIS) at the start of home care. This documentation:
includes assessment of core items for improving quality of care.
Which consideration should a nurse prioritize relating to the use of herbs and supplements by a client?
potential interactions with drugs
Public health nursing is the branch of nursing that:
provides health care for the community.
The nurse understands that planning for discharge actually begins at admission to the facility. The purpose of discharge planning is best described as:
providing continuity of care that is goal directed.
