Chapter 2 PrepU

A nurse is uncomfortable caring for a pregnant client who is married to her female life partner. The best advice another nurse can give her would include which statement? "Maybe you should take another nursing course that focuses on cultural competencies; then you might have a better feeling caring for this family." "Maybe it would be best if you don't care for this group of families and focus on caring for the classic husband and wife team." "If you can just put on your happy face and focus on the baby rather than the parents, you will be able to care for all families." "Spend some time self-reflecting why this family difference might be bothering you."

"Spend some time self-reflecting why this family difference might be bothering you." - There are some major barriers for health care providers when caring for individuals who are different from them. One of these barriers is the potential for personal bias. This barrier can only be addressed through self-reflection, trying to understand why these differences might be bothersome, and setting those feelings aside while taking care of clients. A cultural nursing course might be beneficial, but it will not help in the meantime. Pretending to be okay with the family differences will not deal with the problem. Ignoring feelings by working only with traditional family units will not solve the problem in the long term.

A nurse is visiting the home of a mother and her newborn. The woman's family members are present when the nurse arrives. What is the nurse's best approach to the situation? Reschedule the assessment visit for another time without family present. Do brief maternal and infant assessments with the family members present. Assess the family members' interactions with the newborn and one another. Ask the family to leave to meet to perform the assessments privately.

Assess the family members' interactions with the newborn and one another. -The philosophy of family-centered care recognizes the family as the constant. The health and functioning of the family affect the health of the client and other members of the family. Family members support one another well beyond the health care provider's brief time with them, such as during the birth process or during a child's illness.

A clinical nurse specialist is conducting a review class for a group of nurses about cultural competence and cultural diversity. Which term reflects the view of the world and set of traditions of a specific social group passed down through generations? ethnicity values culture race

culture - Culture consists of the world view and group of traditions shared by a social group and passed down through generations.

A nurse is caring for a Turkish American client. The nurse understands that there could be major cultural differences between the nurse and the client. The nurse contemplates assigning this client to a staff member who is of the same culture as the client. What is a potential consequence? building a better nurse-client relationship ensuring better care and understanding stereotyping of the client helping in assessing client's culture

stereotyping of the client - A nurse who thinks stereotypically may assign a client to a staff member who is of the same culture as the client because the nurse assumes that all people of that culture are alike. The nurse also may believe that clients with the same skin color may react in the same manner in similar social situations. Because stereotypes are preconceived ideas unsupported by facts, they may not be real or accurate. In fact, they can be dangerous because they are dehumanizing and interfere with accepting others as unique individuals.

A female-to-male (FTM) transgender individual who has undergone top surgery wants to become a parent. Which necessary step must be taken by the FTM client in order to achieve the goal of pregnancy?

stopping current testosterone hormone therapy -FTM transgender individuals may seek pregnancy and find it difficult to obtain an understanding provider, one whom they can trust and who can care for the specific needs related to pregnancy, gender dysphoria, and lactation. It is necessary to stop testosterone hormone therapy to successfully carry a pregnancy. The cessation of testosterone and the changes that occur with pregnancy can cause huge shifts in an individual's mental well being and can lead to increased gender dysphoria. However, medications should not be prescribed as a preventive measure because the medications can affect the fetus. "Top surgery" means the breasts were removed as part of the transitioning; therefore, there will be no leakage of milk with pregnancy. Transgender women face victimization at twice the rate that cisgender women do; however, there is no indication that this is a problem in this scenario.

A nurse is teaching a new mother about self-care measures. Which action would the nurse do as the final step in this process? -prescribing anti-anxiety medication for their gender dysphoria discussing safety concerns if victimization occurs stopping current testosterone hormone therapy discussing how to deal with leakage of milk from nipples

document the teaching and effectiveness

A nurse is providing care to a postpartum woman, her partner, and their neonate and is assessing their preparedness for discharge. Which question(s) would be appropriate for the nurse to ask? Select all that apply. "Are you having any pain or cramping?" "How comfortable are you with feeding your neonate?" "Can you tell me who will be at home to help you out." "Are you feeling overwhelmed and tired?" "Tell me how you plan to get rest once you are at home."

"How comfortable are you with feeding your neonate?" "Can you tell me who will be at home to help you out." "Tell me how you plan to get rest once you are at home." - The key to assessing a family's preparedness for their new role as parents and in caring for their new neonate is for the nurse to ask open-ended questions in a sensitive manner to identify gaps in knowledge and areas of concerns. The questions related to the level of comfort in feeding the neonate, support persons, and plans for rest are open-ended and allow the woman to share feelings and concerns as well as help in identifying areas of needed instruction. The questions related to pain, cramping, feelings of being overwhelmed, and fatigue are closed-ended questions that do not allow the woman to elaborate. In addition, they focus on the nurse's concerns and not the woman's concerns.

After teaching a pregnant woman about using complementary and alternative medicine (CAM) therapies, the nurse determines that the teaching was successful based on which client statement? -"It is okay to combine more than one remedy with another." "I just need to check the label for ingredients to make sure it is okay." "I can use remedies that are listed as natural because they are safe." "I need to talk with my provider before I try using any therapy."

"I need to talk with my provider before I try using any therapy." -If a client is considering the use of or is using CAM therapies, the nurse will suggest the client check with the health care provider before taking any substance, even if it is natural. The client needs to know that even if a remedy is listed as natural, it does not mean that it is safe. The package label should list all ingredients, including the amounts of each. Mixing of remedies is unsafe and may result in harm.

A pregnant woman arrives in the L & D unit following premature rupture of membranes along with her spouse who insists on being present and demands only female nurses assess his wife. When obtaining history and assessment data, the spouse provides all the answers. What is the best approach for the nurse to handle this situation? Act as an advocate for the woman who has a male dominant partner. Evaluate whether it is essential to stand up to the spouse or pacify him. Call security and then inform the spouse that the staff need to speak with the woman alone. Educate the spouse about his expected role in the birthing process.

Act as an advocate for the woman who has a male dominant partner. -In many cultures, the man is the dominant figure. In a strongly male-dominant culture, if approval for hospital admission or therapy is needed, the man would prefer to give this approval. Since the woman is a nondominant member of the family, the nurse may have to act as an advocate for her with a more dominant partner. Security would be viewed as a threat and not appropriate at this time. To gain information from the woman, the nurse may need to confront the spouse about his role in the birthing process. It is not appropriate to educate the spouse because this is a long-standing family environment, and this is not the time to try to change the family culture toward females.

The home care nurse visits a client who is 32 weeks' gestation on bed rest and reporting a severe headache. Which intervention should the nurse implement first? Ask the client if she has taken any acetaminophen for the headache. Assess the client's vital signs and conduct a quick, focused assessment. Assess the client's pain level on a 0 to 10 pain scale. Determine the anxiety level of the client related to home care.

Assess the client's vital signs and conduct a quick, focused assessment. -By assessing the client's vital signs and conducting a focused assessment, the nurse will obtain objective data of the client's health status. Severe headache is a sign of high blood pressure.

The nurse in a free clinic is caring for a 1-year-old girl and her single mother. Which nursing intervention would most likely be needed initially? -Discussing family beliefs. -Providing a list of low-cost child care centers. -Assessing the child's nutritional status. -Obtaining food stamps for the family.

Assessing the child's nutritional status. - A single mother using a free clinic probably means that the two are living in poverty. The child could be malnourished. This would affect all aspects of the child's growth and development. Obtaining food stamps may be a partial solution to a nutritional problem if this is confirmed following assessment. Family beliefs are important but not the first concern. Good child care promotes healthy growth and development. This can be addressed later.

Advocacy for the client is an important aspect of community-based nursing. What is one way a nurse can advocate for a pediatric client? Report a new case of whooping cough to the county health authorities. Assist the family to apply for Medicaid or other forms of health care reimbursement. Assure a young mother that the nurse will not report the suspicious bruises on her toddler to social services. Arrange for educational events for the local hospital staff.

Assist the family to apply for Medicaid or other forms of health care reimbursement. - The nurse working in a community setting may often develop a long-standing relationship with families because of the continuous nature of client contact in an outpatient, school, or other setting. This type of relationship may allow the nurse to advocate for the client on a broader scale in health and welfare issues. Examples of interventions include helping the family apply for Medicaid or other forms of health care reimbursement. Reporting new cases of whooping cough is done to state authorities, not county authorities, and is not considered advocating for a client. Arranging educational events for the local hospital staff is not a community-based function. Assuring a mother that the bruises on her toddler will not be reported to social services—when it is mandated that any suspected case of child violence be reported—is not advocating for the child.

What is a key element of providing family-centered care? Give only the health information that is necessary while providing care. Be in control of the way care is given. Communicate specific health information. Avoid cultural issues by providing care in a standardized fashion.

Communicate specific health information. -Key elements in the provision of family-centered care include demonstrating interpersonal sensitivity, providing general health information and being a valuable resource, communicating specific health information, and treating people respectfully. Giving as much control as possible to the client and his or her family is essential in family-centered care. The nurse should give all the health information, both good and bad, that the client or the family requests and be culturally sensitive to the client and the family.

A nurse working at a women's health center is engaged in secondary prevention activities. With which activity(ies) would the nurse be involved? Select all that apply. - pregnancy testing breast examinations osteoporosis screening immunizations family planning

Correct response: pregnancy testing breast examinations osteoporosis screening -Health screenings are the mainstay of secondary prevention. Pregnancy testing, blood pressure evaluations, cholesterol monitoring, fecal occult blood testing, breast examinations, mammography screening, hearing and vision examinations, osteoporosis screening, and Papanicolaou (Pap) tests are examples of this level of prevention. Immunizations and family planning are examples of primary prevention activities.

A homeless client diagnosed with human papillomavirus (HPV) is seen in the maternity clinic requesting a pregnancy test. Which nursing action would be the best example of the secondary level of prevention? - Send a referral to social work for adequate housing assessment. Suggest she have a Papanicolaou (Pap) smear. Discuss with her the need for folic acid supplementation. Arrange for her to have the HPV vaccination.

Suggest she have a Papanicolaou (Pap) smear. -Secondary prevention is the early detection and treatment of adverse health conditions and is aimed at halting the disease. Health screenings are the mainstay of secondary prevention. Papanicolaou (Pap) smears are at this level of prevention. Primary prevention encompasses immunizations, and as she is already infected with HPV, the vaccine would not be effective. The referral for social work and the use of folic acid supplements while pregnant are examples of primary prevention.

The nurse instructs a client who is at 28 weeks' gestation on the correct use of the fetal heart monitor at home. Which observation indicates that teaching has been effective? -The client has two rhythm strips to share with the nurse during the home visit. The client has a log with the date, time, and number of fetal heart beats counted. The client cannot locate the device during a routine home visit. The device is sitting on the kitchen table.

The client has a log with the date, time, and number of fetal heart beats counted. -Fetal heart rate monitoring can be taught to the client, including how to record the findings. The client that has a log with the date, time, and number of fetal heartbeats counted indicates that teaching has been effective. Fetal heart monitoring should be conducted in the reclining position and the device should not be on the kitchen table. The client who is unable to locate the device is not performing the assessment as instructed. The client who has two rhythm strips to share with the nurse may or may not be performing the assessment as instructed.

The community health nurse is seeing a mother and newborn for the first home visit. Which information best indicates an understanding of visiting clients in their home? The home visits are much more cost-effective than office visits. The home visit places the newborn at risk of acquiring an infection from the nurse. The home visits are essential only for those clients in high risk situations. The home visit is a way of monitoring the well-being of all family members.

The home visit is a way of monitoring the well-being of all family members. -Home visits offer services similar to those offered at a scheduled clinic visit, but they also give the nurse an opportunity to assess the family's adaptation and dynamics and the home environment. The other statements do not indicate the best understanding of home visits.

The obstetrical nurse notes that a Muslim client has not been eating any of the meals supplied to her. Which actions performed by the nurse best demonstrate cultural competence? The nurse recognizes that Muslim clients do not have an interest in food. The nurse recognizes that Muslim clients prefer rest, which encourages appetite. A referral will be made to the dietitian to assess the Muslim client's preferences. The nurse becomes familiar with the Muslim client's meal practices.

The nurse becomes familiar with the Muslim client's meal practices. -The steps to developing cultural competence is to acquire cultural knowledge about the group. Nurses can obtain this knowledge by reading about different cultures, attending continuing education courses on different cultures, accessing websites, and attending cultural diversity conferences. It is not true that after delivery Muslim clients have no interest in food as they will be hungry nor is it true that rest will encourage appetite. A referral is not always necessary as the nurse should be able to coordinate foods that the client will eat after finding out or discussing with the client.

A laboring client, 2 cm dilated and 50% effaced, is screaming in pain. The nurse caring for this client recognizes this woman's response to pain should be documented using which label? inappropriate response to pain lack of pain control low pain threshold high pain tolerance

low pain threshold - A person's response to pain is both individually and culturally determined. The pain threshold is the point at which the individual reports a stimulus is painful. Pain tolerance is the point at which an individual withdraws from a stimulus. Lack of pain control and inappropriate response to pain reflects the nurse's individual bias.

The nurse educator has completed a presentation on caring for babies born to mothers with a substance use disorder. Which statement by a participant would indicate the need for further education? "When a pregnant woman suffers from a substance use disorder, the child may suffer from withdrawal symptoms when born." "Babies born to mothers with a substance use disorder tend to be small for gestational age." "Babies born to a mother with a substance use disorder don't have any difficulty eating." "Mothers with a substance use disorder are at a higher risk for having a child with physical abnormalities."

"Babies born to a mother with a substance use disorder don't have any difficulty eating." -Babies born to mothers with a substance use disorder tend to be small for gestational age. They may also suffer from withdrawal symptoms and are at a higher risk for both physical and mental abnormalities. They may also suffer from problems eating, such as a decreased ability to suck. Some of the problems of the baby may not be immediately apparent, because these problems can also encompass cognitive and skill-attainment delays.

The nurse is caring for a child from a different culture. Which statement(s) by the nurse demonstrates an understanding of how culture impacts a client? Select all that apply.

"Culture can impact who a client chooses to see for health care needs." "Culture can impact the diet a client follows." "A client's cultural beliefs can impact spirituality and/or religion." "A client's cultural beliefs should be incorporated into the care a client receives. - Culture is a set of traditions and beliefs held by groups of people. Beliefs, diet, language, values, religion and spirituality are included in culture. Some cultures utilize folk healers to provide health care. The nurse should incorporate a client's beliefs as much as possible into care. When a client moves to a different location, the client tends to bring cultural beliefs and does not necessarily follow all the cultural practices of the new location.

A pregnant woman reports she does not see the value in attending prepared childbirth classes because she plans to have an epidural to manage the discomfort from the contractions. What information should be included in responses by the nurse? Select all that apply.

"There are many different topics included in prepared childbirth classes aside from pain management." "You can learn tools to assist you in the labor process both before and after your epidural." "Preparation for labor and birth can enhance your experience and coping abilities." - Prepared childbirth education courses provide information for prospective and expecting parents. The information in prepared childbirth education is not limited to pain management. Courses can include other topics such as potential procedures during the labor process, newborn care and postpartum care. Education and an accompanying understanding of the labor and birth experience can improve the coping skills of the mother and her partner. Advising the woman that she is limiting her options is argumentative and not appropriately stated.

The case manager is looking over the inpatient census on her floor to determine which client would be the best candidate for discharge with home health care follow-up. Which client would the case manager recommend to the physician for discharge? -Adolescent who was admitted in sickle cell crisis yesterday and rates his pain as an 8/10. 6-year-old asthmatic child who is wheezing and has an O2 saturation of 92%. 10-year-old boy with an infected laceration on his leg who has been treated with IV antibiotics for 3 days. 3-day-old infant with a bilirubin level of 20 who is currently under phototherapy.

10-year-old boy with an infected laceration on his leg who has been treated with IV antibiotics for 3 days. - The child with the infected laceration is on IV antibiotics and can safely be discharged to complete the medication at home with home health care. The 6-year-old is too unstable for discharge. The infant's bilirubin is too high for doing home health phototherapy and may need additional hydration. The adolescent is on sickle cell crisis and is not ready for discharge 1 day after admission.

The nurse is preparing to discuss birthing options with a 25-year-old female who is in a low-risk pregnancy with one older child. Which option will be best for the nurse to recommend for this client? Any birthing settings Hospital Home setting Birthing center

Any birthing settings -When a woman is low-risk and has no known medical needs, birth location is the choice of the mother. Home births attended with certified nurse midwives are less likely to have complications and require interventions. Birthing centers are an option for an alternative birth setting, and hospitals are required birth locations for women with potential needs or complications. The nurse should present the advantages and disadvantages of each option and allow the client to make the decision.

A nurse is working with a culturally diverse patient population. Which strategy would the nurse most likely use to assist in recognizing cultural influences on pain perception? Select all that apply. Appreciate that the meaning of pain varies among cultures. Use an assessment tool (e.g., rating scale from 0 to 10) to assist in measuring the pain. Assume that everyone who is in pain will behave like they are in pain. Remember that if someone is in enough pain, he or she will inform others. Appreciate that not all people communicate or express their level of pain in the same way. Recognize that communication of pain may not even be acceptable within a culture. Develop an awareness of personal values and beliefs.

Appreciate that the meaning of pain varies among cultures. Use an assessment tool (e.g., rating scale from 0 to 10) to assist in measuring the pain. Appreciate that not all people communicate or express their level of pain in the same way. Recognize that communication of pain may not even be acceptable within a culture. Develop an awareness of personal values and beliefs. - Strategies to help recognize cultural influences on pain perception are to appreciate that the meaning of pain varies among cultures; appreciate that not all people communicate their level of pain the same way; recognize that communication of pain may not even be acceptable in a culture; develop an awareness of personal beliefs and your responses; and use an assessment tool to measure the degree of pain. The nurse should never assume that everyone will act like they are in pain, nor should he or she think that all people in pain will inform the nurse.

An 8-year-old with cystic fibrosis has had a noted decline on the growth chart. Which nursing intervention is best for maintaining adequate nutrition? -Limit sodium to a 2 gram sodium restricted diet Encourage high calorie, high protein snacks. Provide high caloric meals to the client's liking. Delay pancreatic enzymes until food enters the small intestine.

Encourage high calorie, high protein snacks. -The best nursing intervention is a high calorie, high protein snack. Calories can be obtained from non-nutritious foods. It is not only that the client needs calories for energy, but nutrition needs to be present. Pancreatic enzymes aid in digestion so they need to be available for foods; thus they are given prior to ingestion. Sodium is encouraged due to the high sodium loss.

A nursing instructor is teaching the class about community-based nursing. The instructor determines the session is successful when the students correctly choose which activity as an example of tertiary prevention? Identifying a child with pediculosis in an elementary school Reviewing dietary habits with parents of a slightly anemic child Ensuring the client attends physical therapy after orthopedic surgery Caring for new mothers and infants in a maternity clinic

Ensuring the client attends physical therapy after orthopedic surgery -Tertiary prevention focuses on rehabilitation activities and would be the focus of a nurse in an orthopedic clinic, aligning with the needs of the clients in that clinic. Orthopedic clients are typically recovering from injury or surgery and are in need of rehabilitation such as physical therapy. Secondary prevention includes health screening activities that aid in early diagnosis and encourage prompt treatment, such as screening for head lice in schools and reviewing dietary habits in individuals who are experiencing anemia. Primary prevention includes health promoting activities to prevent the development of illness or injury, such as new mothers bringing their infants to the clinic for follow-up well-child appointments.

A 4-year-old adopted child has begun to ask questions about when she was born. Which suggestions by the clinic nurse would be considered the most appropriate answer for this child related to her birth? Select all that apply. Explain to the child that she grew inside another woman, but after the birth she was given to her adoptive mom and dad to raise. Explain that her biological mom could not care for her so she was given away. Tell the child that her biological mom could not care for her after birth because she was HIV positive. Avoid criticizing the biological parents but reinforce how much the adoptive mom and dad love them. Inform the child that her biological mom was in prison and would not be able to care for her for a long time.

Explain to the child that she grew inside another woman, but after the birth she was given to her adoptive mom and dad to raise. Avoid criticizing the biological parents but reinforce how much the adoptive mom and dad love them. - At least by 4 years, children are old enough to fully understand the story of their adoption: they grew inside the body of another woman who, because she could not care for them after they were born, gave them to the adopting parents to raise and love. It is important for parents not to criticize a birth mother as part of the explanation because children need to know, for their own self-esteem, that their birth parents were good people and they were capable of being loved by them, but things just did not work out that way. At age 4, children do not understand HIV status, not being able to provide for the needs of an infant, or prison terms.

A couple who has been married for 10 years chose to postpone having children until their professional careers were established. They now feel ready to start a family. After many months of trying, they are consulting with a fertility expert. The nurse should anticipate that this couple may be experiencing which NANDA due to the negative aspect of postponing pregnancy? Parental role conflict Ineffective childbearing process Risk for impaired attachment Ineffective relationship

Ineffective childbearing process - Ineffective childbearing process is the only NANDA that relates to the process by which human beings are produced. The other NANDAs listed relate to role relationships. Risk for impaired attachment is associated with family relationships (i.e., people who are biologically related). Parental role conflict and Risk for impaired attachment are associated with role performance or the quality of functioning in socially expected behavior patterns.

The nurse is asked to present an educational event to the local Junior League. While planning for the event, what is most important for the nurse to do? -Use posters that everyone in the group can read. Know the needs of the audience. Ask questions about the histories of those present. Tell the participants about the nurse's background.

Know the needs of the audience. -To teach a group successfully, it is important to know the needs of the target population and to have the appropriate teaching skills, strategies, and resources. Asking questions about the histories of those who will be attending the event comes under the category of the targeted group's demographics. While it is important to have these facts, it is not most important for the nurse to know. Using posters that everyone can read is part of the presentation strategy of the nurse, but it is not most important. Telling those present at the event a brief synopsis of the nurse's background is usually done by whomever introduces the nurse as the speaker. It is not usually an activity the nurse does herself or himself.

The nurse is preparing to teach a drug education class at a local elementary school. The nurse is focused on providing which type of care to the community? Tertiary prevention Primary prevention Preventive care Secondary prevention

Primary prevention -Primary prevention is promotion of healthy activities and includes education concerning safety, diet, rest, exercise, and disease prevention. Secondary prevention focuses on health screening activities that aid in early diagnosis and encourage prompt treatment. Tertiary prevention focuses on rehabilitation and instruction on ways to prevent further injury or illness. "Preventive care" is not considered a specific category but is a general function that encompasses all three levels.

The nurse caring for a woman in active labor notices a strange odor coming from some tea the family has brought. When questioned, the woman informs the nurse of herbs they have brewed in the tea to help lower the pain. Which intervention would be considered the mostappropriate for the nurse to take? Research the herbs in the tea and report the findings to the provider. Inform the family that herbs and conventional drugs are not compatible. Ask the family to remove the tea from the L & D department. Suggest the woman rely solely on herbal prep rather than conventional medications.

Research the herbs in the tea and report the findings to the provider. -The nurse should be aware when taking health histories that many people today from all cultures rely on complementary or alternative therapies. Knowing about these is a way to be certain a medication that has been prescribed will not counteract or be synergistic with what herbs are being used. Asking the family to remove the tea from the facility is nontherapeutic. Telling the woman that she will have to rely on their herbal prep solely is not true unless the herbs are contradicted with conventional medicines. Unless research is done, making a blanket statement that herbs and medications are incompatible is untrue.

Which intervention best demonstrates the L & D nurse is respectful of a client who is deaf and in early labor? Seek assistance from another health care professional who can converse in sign language. Utilize hand signals like in charades to try to communicate important pieces of information. Utilize the labor coach so he or she can interpret and relay information to the client. Write down information on a piece of paper that the client can keep.

Seek assistance from another health care professional who can converse in sign language. -Cultural differences occur across not only different ethnic backgrounds but also different sociodemographic groups. A parent who has been deaf since birth, for example, expects her deaf culture to be respected by having health care professionals locate a sign language interpreter for her while she is in labor. If an interpreter cannot be located, writing down questions and answers is an alternative, assuming the parent has the ability to read and comprehend while dealing with labor contractions. Use of friends and family members is not considered to be the best option since many family/friends find it difficult to interpret medical terms. Hand signals can help in an emergency; however, it not the best way to interpret questions/comments from a laboring woman who is deaf.

The camp nurse is reviewing the health information of the participants at a school-age summer camp for children with diabetes. What topic would be most appropriate for this group of campers? Long-term effects of diabetes Weight control measures Latest trends in medication delivery Self-administration of insulin

Self-administration of insulin -School-age children need to learn self-administration of insulin, along with how to check their blood sugar. Although weight control and diet are important, as are peer relationships and being current in available resources, they are not as important for the child's health as learning how to be independent in their insulin administration.

A nurse is developing a plan of care for a client of Muslim faith. Which action demonstrates an understanding of providing culturally competent care? -The client will be referred to the hospital chaplain for spiritual support. The client is asked if there are any meal preferences to be included in the care plan. The client's traditional healing and health practices will be assessed for implementation. The client is asked to encourage family members to bring in special foods.

The client is asked if there are any meal preferences to be included in the care plan. -It is important for all nurses to incorporate the client's traditional healing and health practices with conventional medicine. Some clients may prefer certain foods or drinks when they are ill. Diets may be different and need to be considered during the process of determining the appropriate course of treatment. Family members may not be able to bring in foods necessary for the client. Nurses should be competent in their ability to provide care to diverse populations without referrals.

The home care nurse visited a newly assigned primigravida client with preeclampsia. When conducting the assessment and teaching, the client continued to cry and state she was in disbelief this was happening to her. When should the nurse schedule the second visit with the client? -The next day; the client is not coping well. In five days; this will allow the client to adjust. In seven days; the order was for once a week. In three days; this is a halfway point in the week.

The next day; the client is not coping well. -The client is in a state of disbelief regarding the diagnosis. The nurse will need to assess to see if the teaching that was conducted was retained and to evaluate whether this client is an appropriate client for home care.

The nurse is caring for several clients in the prenatal clinic. Which action by the nurse demonstrates cultural competency? The nurse reminds the clients the clinic is not open on Sundays. The nurse requests that non-family members wait in the waiting room while the client is evaluated. The nurse asks each client about dietary restrictions and preferences during the postpartum period. The nurse informs each client of the clinic hours, phone number, and after-hours emergency number.

The nurse asks each client about dietary restrictions and preferences during the postpartum period. -Providing culturally competent nursing care involves seeking to understand the impact the client's culture will have on the client's beliefs, values, care, and actions. Because each culture varies, the nurse must ask the client for specific needs and wishes as they relate to the upcoming birth/postpartum stay in the hospital or home. Giving the clinic information to each client should be done regardless of culture. Asking non-family members to wait in the waiting room may go against some cultural beliefs concerning who is important to the client; the nurse should assess this first.

A woman who is from the Philippines becomes upset when the nurse brings in an interpreter, rather than using her cousin as the translator. Which would be the best reason for using an official interpreter in this case? Many English words have double meanings when clients try to make sense of what is being communicated. The woman was unable to pronounce the words the nurse had written down on a sheet of paper. There is no additional cost to the client when a professional interpreter is utilized. There may be cultural limitations that change how the information is being interpreted by the family.

There may be cultural limitations that change how the information is being interpreted by the family. -It is unacceptable to have a family member serve as an interpreter. There may be cultural limitations that change how the information the nurse is stating is being interpreted for a parent or partner. Additionally, the medical terminology used in the health care system is best translated by a trained professional interpreter.

A nurse is addressing a group of women on the issue of women's health during their reproductive years. Which reason does the nurse provide regarding the need for comprehensive, community-centered care to women during this time period? - Increased stress causes more health problems during their reproductive years. A woman's immune system weakens immediately after birth. Women's health care needs change with their reproductive goals. Women have more health problems during their reproductive years.

Women's health care needs change with their reproductive goals. - The nurse should inform the women that comprehensive community-centered care should be given to women during their reproductive years. This is because as their reproductive goals change, as does their health care needs. A woman's immune system does not weaken immediately after birth. Similarly, women do not have more health problems specifically during their reproductive years, nor are they more susceptible to stress during their reproductive years.

A community-based nurse has a different set of skills than those of counterparts who work in a hospital. Community-based nurses also face unique issues and challenges. What is one of the unique aspects of community-based nursing? less holistic disease-oriented teamwork autonomous

autonomous -Community-based nursing practice is autonomous. There are often no other members of the health care team to consult, or no members within the area to consult with. Teamwork is important in community-based nursing, but it is not a unique aspect of this type of nursing. Disease orientation is the medical model of health care. Community-based nursing takes in all aspects of the client, including community aspects such as education—not just the disease process. Therefore, it is more holistic rather than less holistic.

The nurse is preparing to make a home visit to admit a new client to services. Which actions should the nurse take to ensure personal safety? Select all that apply. Using a map to avoid getting lost in a strange neighborhood Keeping the car doors unlocked Informing the agency of the estimated arrival time and expected return Parking the car in a well-lighted area Keeping the gas tank of the car full

eeping the gas tank of the car full Parking the car in a well-lighted area Using a map to avoid getting lost in a strange neighborhood Informing the agency of the estimated arrival time and expected return -Safety tips for making home care visits include keeping the gas tank full, parking in a well-lighted area, using a map to avoid getting lost, and informing the agency of the estimated arrival time and expected return. The nurse should keep the car doors locked for safety.

A primary care provider tells a pregnant woman with slightly elevated blood pressure to return home on bed rest until her next scheduled checkup. This is an example of which type of care? hospice care skilled home care home care community care

home care - This is an example of home care, or care of persons in their own home. Hospice care relates to end-of-life care and care of those with chronic illnesses who are not expected to get any better. Skilled care requires treatments such as administering IV medications, enteral feedings, and dressing changes. Community care relates to care of individuals and/or groups of people living in a specific geographical area.

A new mother tells the obstetrical nurse that her mother notices so much has changed in maternity care in recent years. One change she could likely be referring to is: - newborns stay at the mother's bedside with the family as long as it is well. infections are prevented as births happen in highly advanced, sterile rooms. the newborn stays in a newborn nursery for care to allow the mother to rest. the family is now allowed to visit at prescribed visiting hours.

newborns stay at the mother's bedside with the family as long as it is well. -There has been increased access to care for all women (regardless of their ability to pay) and many hospital redesigns of labor, birth, and recovery rooms and postpartum spaces aimed at keeping families together during the birth experience and minimizing interruptions. Rooming-in and liberal visiting policies allow parents and other family members to participate in the child's care. Births happen in birthing suites/rooms as opposed to sterile birth rooms. Family is allowed to visit at most times of the day and night. Rooming in with the newborn is considered standard care now.

When caring for woman who speaks a different language than one's own, the nurse must ask for an interpreter before having the client sign which forms to ensure clarity can be confirmed? Select all that apply. dietary preferences end-of-life care consent to blood transfusions smoking cessation policy surgical permit

surgical permit end-of-life care consent to blood transfusions - When caring for clients who speak a different dialect or language, the nurse should always ask them to repeat instruction to be certain it was interpreted correctly. The nurse should repeat what the client said so he or she can confirm understanding the nurse correctly. The nurse should not be reluctant to ask for an interpreter to help clarify forms, such as consent for blood transfusion, informed consent for surgery, or wishes regarding right-to-life care, as necessary. Dietary preferences and smoking cessation policy are not as important as the other forms that result in invasive procedures.

A nurse is providing home care to a pregnant woman who is on bed rest. The woman has two other children. During her assessment, the nurse asks the woman how she occupies her time. What is the best rationale for asking this question? -to build rapport with the client to learn about the client's hobbies to pick up tips to pass on to other clients who are on bed rest to ensure that the woman is not engaging in activities that would disrupt her rest

to ensure that the woman is not engaging in activities that would disrupt her rest - If bed rest is required, ask how the client occupies her time. A woman is not really resting if she is concerned about her family or finances, is caring for older children, or is so bored that she is frequently turning or sitting up. The other answers are legitimate reasons for asking the question but are not the best rationale for it.

A nurse encourages both partners in a lesbian family to come into the examining room with the newborn during a well-baby check. What type of nursing is the nurse practicing? transcultural nursing ethnic nursing stereotyping nursing community nursing

transcultural nursing -Transcultural nursing is care guided by cultural aspects and respects individual differences. Community nursing is nursing care that takes place for a group of people in a specific area. Ethnicity refers to the cultural group into which a person was born. Stereotyping means expecting a person to act in a characteristic way without regard to his or her individual traits.

The term used to guide the cultural aspects of nursing care and respect individual differences is: family nursing. transcultural nursing. ethnicity nursing. diversity nursing.

transcultural nursing. -Transcultural nursing is the nursing care method that is guided by cultural aspects and respects individual differences.