NRN Theory 161 concept 6 (ethics), 7 (diversity)

According to the United States Census (2000), what percentage of people are diagnosed with a disability? 20 10 14 5

20 Explanation: The U.S. Census, last conducted in 2000, indicates that 20% of people have a disability and 10% have a severe disability. The other numerical values are incorrect

Which organization first adopted an international code of ethics in 1953? Canadian Nurses Association American Hospital Association American Nurses Association International Council of Nurses

International Council of Nurses Explanation: An international code of ethics for nurses was first adopted by the International Council of Nurses in 1953. It has been revised and reaffirmed at various times since

A nurse has recently completed a seminar on cultural diversity. Which statement regarding development of cultural knowledge indicates a need for additional teaching? "Members of minority cultures are often hesitant to discuss beliefs due to past experiences." "It is important to listen closely to clients to acquire knowledge of culture." "Be sure to convey sincerity and respect when assessing culture." "The more curious the nurse is about the client's culture, the more the client will want to share

"The more curious the nurse is about the client's culture, the more the client will want to share." Explanation: Clients often respond negatively to probing curiosity with regard to cultural assessment. A sincere, honest, respectful conversation is more appropriate. The other options are all true regarding cultural knowledge

A nurse has completed 4 hours of his 8-hour shift on a medicalsurgical unit when he receives a phone call from the nursing supervisor. The nursing supervisor informs the nurse that he needs to give a report to the other two nurses on the medicalsurgical unit and immediately report to the telemetry unit to assist with staff needs on that unit. The nurse informs the supervisor that he has been busy with his patient assignment and feels this will overwhelm the nurses on the medicalsurgical unit. The supervisor informs the nurse that the need is greater on the telemetry unit. This is an example of which type of ethical problem? Deception Conflicts concerning new technology Advocacy in a market-driven environment Allocation of scarce nursing resources

Allocation of scarce nursing resources Explanation: This is a clear example of ethical issues surrounding the allocation of scarce nursing resources and involves distributing nursing care

A Malaysian client is admitted to the health care facility with complaints of cramping pain in the abdomen and loose stools. Where should the nurse be seated when interviewing the client? At more than one arm's distance In one corner of the room Behind the client Alongside the client

At more than one arm's distance Explanation: While interviewing the Malaysian client, the nurse should sit at a distance of more than one arm's length from the client. The nurse should not sit alongside the client, as he may feel uncomfortable. If the nurse sits at the back of the client, the nurse may not be able to observe the client's body language. If the nurse sits in a corner of the room, communication may not be effective

Which of the following behaviors by the nurse is stereotyping? Avoiding clients who are elderly because their care is time consuming. Grouping care assignments to allow ample time to care for complex clients. Openly ridiculing the practice of acupuncture. Explaining to others that Western medicine is always superior

Avoiding clients who are elderly because their care is time consuming. Explanation: Avoiding elderly clients because their care is time consuming is stereotyping. This is a mistaken belief and an overgeneralization. Some elderly clients are very healthy. Ridiculing acupuncture is cultural conflict. Assuming that Western medicine is superior is cultural blindness. Grouping care assignments to allow ample time to provide care is an appropriate strategy in time management

Which of the following theories of ethics most highly prioritizes the nurse's relationship with patients and the nurse's character in the practice of ethical nursing? Care-based ethics Deontology Principle-based ethics Utilitarianism

Care-based ethics Explanation: Central to the care-based approach to ethics is the nurse's relationships with patients and the nurse's "being," or character and identity. Deontology, utilitarianism, and principle-based ethics each prioritize goals and principles that exist beyond the particularities of the nursepatient relationship

When a home-bound patient expresses her past-oriented ancestral heritage and family rituals, the nurse recognizes that the patient is expressing her Race Ethnic identity Subculture Assimilation

Ethnic identity Explanation: Ethnicity or ethnic identity refers to self-conscious, past-oriented form of identity based on a notion of shared cultural and perhaps ancestral heritage, and current position in larger society. Race is based on biologic characteristics; assimilation refers to new customs and attitudes that are acquired through contact and communication among persons of a particular culture; and a subculture refers to group of people within a culture who have ideas and beliefs which are different from the rest of that society

A nursing instructor invites a nurse specialist on healing touch to her classroom to discuss with students the effect healing touch has on pain management. This is an example of Evaluating the effect of healing touch on her students Instructing students so they can use healing touch Familiarizing students with CAM modalities Allowing for discussion about adjuvant therapy

Familiarizing students with CAM modalities Explanation: Some nurses may choose to become trained in particular CAM modalities and then integrate them into their own practice

A nurse is administering evening medications and notices that a medication was omitted during the day shift. Which of the following statements demonstrates the principle of accountability? Filling out an occurrence report and notifying the health care provider Telling the client that the medication will be given the following morning Documenting a narrative note in the chart about the occurrence Administering the medication with the other evening medications

Filling out an occurrence report and notifying the health care provider Explanation: When an untoward occurrence occurs, the nurse will be considered to be accountable when the proper actions are taken. In this instance, an occurrence form is filled out for follow-up, and the provider is notified. The other choices are incorrect actions

A nurse is caring for a client who also works in the hospital. The client has recently received a diagnosis of genital herpes and is being treated for a urinary tract infection (UTI). While on lunch break in the cafeteria, the nurse sees the client's coworkers, who voice concern over his condition. The nurse's best response would be: "The antibiotics are really helping with his UTI. He should be back to work in no time." "He's really upset about his medical condition. I'll get you the chart so you can review his laboratory values." "I'll be sure to tell him you're thinking of him." "He must be upset that everyone knows he has herpes.

I'll be sure to tell him you're thinking of him." Explanation: Offering to tell the client that his coworkers are thinking of him is the only appropriate response. Discussing his diagnosis or condition violates his right to privacy

In the delivery of care, the nurse acts in accordance with nursing standards and the code of ethics and reports a medication error that she has made. The nurse is most clearly demonstrating which of the following professional values? Social justice Integrity Altruism Human dignity

Integrity Explanation: The nurse is demonstrating integrity, which is defined as acting in accordance with an appropriate code of ethics and accepted standards of practice. Seeking to remedy errors made by self or others is an example of integrity. Altruism is a concern for the welfare and being of others. Social justice is upholding moral, legal, and humanistic principles. Human dignity is respect for the inherent worth and uniqueness of individuals and populations

A patient says to the nurse, "Why don't you wear a white cap like nurses do on the soap operas?" This is an ethnocentric statement based on the Past history Media Genetics Nursing personality

Media Explanation: Ethnocentrism is a way of looking at the world through a personal lens that has been influenced by personality, genetics, family/relationships, and media

An Asian client is admitted to the unit. What cultural assessment might the nurse anticipate? Loud, aggressive response to pain Nonverbal expressions of pain Excessive verbal reports of extreme pain Refusal of pain medication

Nonverbal expressions of pain Explanation: While every client is unique, it is important to have a basic understanding of cultural tendencies. In the Asian culture, complaining is uncommon. As a result, Asian clients may not report pain and the nurse must be careful to observe for nonverbal signs of discomfort. The other answer selections are not typical cultural considerations within the Asian culture

A nurse obtains an order for a bed alarm for a confused client. This is an example of which of the following ethical principles? Conflict Confidentiality Paternalism Deception

Paternalism Explanation: Making a decision for a client who is confused to prevent an injury is an example of paternalism. Deception and conflict would not promote the safety of a client who is unable to make safe decisions and confidentiality does not apply in this instance

Which of the following statements best conveys the relationship between race and ethnicity? Race is based on an individual's cultural history and is independent of ethnicity. Race denotes physical characteristics while ethnicity is rooted in a common heritage. Race and ethnicity can be considered to be synonymous in the context of healthcare. Race and ethnicity are both culturally determined concepts

Race denotes physical characteristics while ethnicity is rooted in a common heritage. Explanation: The term "race" is usually used in reference to particular physical characteristics, while ethnicity is an identification with a cultural group that is often based on a common heritage. Because it is rooted in objective physical traits, race is usually considered to be somewhat independent of culture

A new client comes to the primary care clinic and asks for help treating head lice. The nurse assesses that the client lives in low-income housing, and nine other people live with her in a one-bedroom apartment. Which of the following is a primary nursing concern? The client does not have running water. The client receives government assistance. The client has no hope for the future. The client does not have air-conditioning

The client does not have running water. Explanation: The priority in this poverty situation is the lack of running water. The already challenging task of eradicating head lice in a crowded living space is worsened by the lack of running water. The feelings of hopelessness need to be addressed, but the need for water is the first priority

The nurse is assessing a client of Middle Eastern descent. The nurse finds that the client is standing at a distance of approximately 1.5 feet while speaking to the nurse. What should the nurse interpret from this behavior? The client likes to be spoken to from a close distance. The client is behaving in a manner that is culturally acceptable. The client wants to develop a social relationship with the nurse. The client is trying to invade the nurse's personal space

The client is behaving in a manner that is culturally acceptable. Explanation: People of the Middle Eastern culture have a tendency to stand closer while speaking to people. The client is not trying to invade the nurse's personal space. This behavior does not indicate that the client likes to be spoken to at a close distance or wants to develop a social relationship with the nurse

A female Asian client is admitted to the emergency department with a fractured femur. What cultural factor might affect nursing care? The client may overreact to any procedure. The client may not report pain. The illness may be perceived as a sign of punishment. A male provider may not be allowed

The client may not report pain. Explanation: While every client is unique, it is important to have a basic understanding of cultural tendencies. In the Asian culture, complaining is uncommon. As a result, Asian clients may not report pain and the nurse must be careful to observe for nonverbal signs of discomfort. The other answer selections are not typical cultural considerations within the Asian culture

A nurse is admitting a client to the unit. Which cultural question is most appropriate? "What are your dietary needs and preferences?" "Do you have food restrictions?" "Will you be making requests for special food based on your religion?" "Will you be able to eat the normal food provided?

What are your dietary needs and preferences?" Explanation: By asking about dietary needs and preferences, the nurse can have insight into religious and cultural dietary practice. Asking about "normal" foods assumes that a cultural dietary request is abnormal. The other options will produce limited insight and imply that a cultural dietary need is a restriction or hindrance

A nurse who works on a palliative care unit has participated in several clinical scenarios that have required the application of ethics. Ethics is best defined as: Moral values are considered to be universal. The principles that determine whether an act is right or wrong. The relationship between law and culture. The laws that govern acceptable and unacceptable behavior

The principles that determine whether an act is right or wrong. Explanation: Ethics involves moral or philosophical principles that direct actions as being either right or wrong. Laws are often rooted in ethics, but the two terms are not synonymous. Similarly, morals and values are closely associated with ethics but these do not constitute the definition of ethics. Ethics are not universally agreed upon, as many different applications exist

Which of the following are examples of virtues that can exemplify character and conduct as a professional nurse? Select all that apply. Conflict Trustworthiness Compassion Deception Humility

Trustworthiness Humility Compassion Explanation: Trustworthiness, humility, and compassion are all examples of professional virtues and cultivated dispositions of character and conduct that motivate and enable us to be good human beings. Deception and conflict are not positive examples so are not correct choices

During a physical examination, the nurse observes a copper bracelet on a client's wrist. The client states that she is wearing it to treat her arthritis. The nurse should: tell the client that wearing the bracelet is a form of quackery and not to use the bracelet as a treatment. inform the client that this is a not a helpful practice and ask her to remove the bracelet. continue to wear the copper bracelet because this is a medically supported treatment for arthritis. recognize that the client is wearing a protective object she believes wards off illness

recognize that the client is wearing a protective object she believes wards off illness. Explanation: The client might wear objects as a 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 her health care provider (HCP). 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 has just attended a seminar on concepts of cultural diversity. Which statement made by the nurse would require further education? ?Culture helps to define identity within specific groups of people.? ?Language is the primary way that people share their culture.? ?Culture cannot be influenced, and you are born with your culture.? ?Culture can be seen in attitudes and institutions of certain populations.

?Culture cannot be influenced, and you are born with your culture.? Explanation: Culture is learned through life experiences from one generation to the next. The other answer selections are correct options, as these are all components that define culture.

You are a community health nurse who provides care to a group of Hispanic people living in an area that is heavily populated by white people. What are the Hispanic people in this community an example of? A minority A subgroup A subculture A majority

A minority Explanation: The term minority refers to a group of people whose physical and cultural characteristics differ from the majority of people in a society. Subcultures are relatively large groups of people who are members of an even larger cultural group but who have certain ethnic, occupational, or physical characteristics that are not common to that larger group. A subgroup is a division of a group that is in some way distinguished from the larger group. A majority is most of the people in a large group.

Nurses use social media to share ideas, develop professional connections, access educational offerings and forums, receive support, and investigate evidence-based practices. What is an example of the proper use of social media by a nurse? A nurse describes a patient on Twitter by giving the room number rather than the name of the patient. A nurse posts pictures of a patient who accomplished a goal of losing 100 pounds and later deletes the photo. A nurse describes a patient on Twitter by giving the patient's diagnosis rather than the patient's name. A nurse uses a disclaimer to verify that any views expressed on Facebook are his or hers alone and not the employer's

A nurse uses a disclaimer to verify that any views expressed on Facebook are his or hers alone and not the employer's. Explanation: A proper use of social media by a nurse would be the use of a disclaimer to verify that any views expressed on Facebook are the nurse as an individual and not the employer's. The nurse should not use social media in any way to describe a client by room number, medical diagnosis, or by accomplished medical goal of any type. Serious consequences can result from a nurse not using social media correctly

A nurse is performing nutritional assessments of new residents of a long-term care facility. Which resident would the nurse assess as being at greater risk for having lactose intolerance? White Caucasian female Native American male Alaskan native female African American male

African American male Explanation: Certain populations are more prone to certain health conditions. The African American population, along with Hispanics and Asians, are at greater risk for having lactose intolerance, compared to other populations. It is important to use the knowledge of such risk factors when interviewing a client to complete a health history

When talking with a client, the nurse notes that the client keeps backing up. What would be the most appropriate cultural response? Back away from the client. Ask the client why he is backing away. Move closer to the client. Ask the client about his personal space preferences.

Ask the client about his personal space preferences. Explanation: It is most appropriate to ask the client what he prefers in regard to personal space. If the nurse needs to invade the client?s personal space, it is important to discuss the matter. It is not appropriate to back away without assessing preference. It may make the client feel judged if the nurse asks him why he is backing away. Moving closer to the client just perpetuates the problem

A nurse is providing care to a client from a different culture. The nurse is having difficulty relating to the client. What intervention by the nurse is most appropriate? Ask another nurse to take over the client?s care. Look up the standards issued by the Office of Minority Health to help in the provision of care. Look up the client?s culture online and try to figure out methods to relate. Ask the client how she wants to be treated based on her values and beliefs.

Ask the client how she wants to be treated based on her values and beliefs. Explanation: The best way to provide culturally appropriate care is to ask the client what she values and believes and how she would like to be treated. Asking another nurse to take over care will not help to identify the cultural care needs. Looking up the client?s culture online or the Minority Health standards may be helpful as a learning experience later, but it doesn?t help immediately in the provision of care. Also, remember that information about any culture is general and must be individualized

A nurse wants to ensure inclusiveness in language regarding family when developing a plan of care for a client. Which of the following is the most important action 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 family recently emigrated from Haiti to the United States. The mother reports that her teenage daughter is showing signs of fear, has vague reports of stomach pain, and feels humiliated by her peers because of her culture. What is the priority assessment for the nurse? Assess for culture shock. Assess for cultural assimilation. Assess for cultural blindness. Assess for cultural imposition

Assess for culture shock. Explanation: The client is experiencing symptoms associated with culture shock. Culture shock occurs when a person is immersed in a different culture that is perceived as strange. The person may feel foolish, fearful, incompetent, or humiliated, and these feelings can lead to frustration and anxiety. Cultural assimilation is when one begins to assume some characteristics of a culture outside of one?s own. Cultural blindness occurs when cultural differences are ignored. Cultural imposition occurs when one pushes his or her beliefs onto another person

A Muslim client is admitted to the hospital. What cultural considerations might the nurse include in the plan of care? (Select all that apply.) Assign care providers of the same sex. Avoid touching clients of the opposite sex. Provide a diet that is rich in all types of protein. Note that Muslims fast from sunrise to sunset. Make accommodations for the prayer needs of the client.

Assign care providers of the same sex. Avoid touching clients of the opposite sex. Make accommodations for the prayer needs of the client. Explanation: A Halal diet that is free of pork or pork products is appropriate. Muslims fast from sunrise to sunset only during Ramadan. All other options are appropriate cultural considerations

Which questions may help the nurse assess his or her ability to relate to various groups in society? (Select all that apply.) "Can I welcome this person sincerely?" "Do I have the experience to help this person?" "Can I have dinner with this person comfortably?" "Can I genuinely try to help this person and be comfortable enough to listen?" "Can I allow my son/daughter to date this person

Can I welcome this person sincerely?" "Can I genuinely try to help this person and be comfortable enough to listen?" "Do I have the experience to help this person?" Explanation: When assessing how you relate to various groups in society, it is important to assess from a professional standpoint. Sincerity, listening, and experience are all components of a professional nature. Having dinner or considering a person as a mate brings about a personal element that may create bias that has no place in the professional realm

An Asian client believes that her illness is caused by an imbalance of yin and yang. The nurse states, ?You can call it whatever you believe, but you have a metabolic disorder.? What is this nurse demonstrating? Cultural blindness Ethnocentrism Stereotyping Cultural diversity

Cultural blindness Explanation: The nurse is demonstrating cultural blindness, which occurs when one ignores differences and proceeds as though they do not exist

An Asian client believes that her illness is caused by an imbalance of yin and yang. The nurse states, ?You can call it whatever you believe, but you have a metabolic disorder.? What is this nurse demonstrating? Ethnocentrism Stereotyping Cultural diversity Cultural blindness

Cultural blindness Explanation: The nurse is demonstrating cultural blindness, which occurs when one ignores differences and proceeds as though they do not exist

A nurse has migrated to a different country and started working there. Which of the following factors is important for effective functioning? Stereotype Cultural habituation Ethnocentrism Culture shock

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

A parent informs the nurse that immunizations are against her cultural and religious beliefs and she does not want her child to receive immunizations. The nurse proceeds to inform the parent that the child will be ill all their life and will not be allowed to start school unless they are immunized. The nurse also informs the parent that she had all of her children vaccinated. What is the nurse's behavior an example of? Cultural blindness Cultural imposition Stereotyping Cultural conflict

Cultural imposition Explanation: The nurse's behavior is an example of cultural imposition, defined as the tendency to impose one's cultural beliefs, practices, and values on a person from a different culture. Stereotyping is when one assumes that all members of a culture, ethnic group, or race act alike. Cultural blindness occurs when one ignores differences and proceeds as though they do not exist. Cultural conflict occurs when people become aware of cultural differences, feel threatened, and respond by ridiculing the beliefs and traditions of others to make themselves feel more secure in their own values

A nurse is caring for a 79-year-old Appalachian woman who is placed in a long-term care facility by her son, who is no longer able to care for her. She appears disoriented and complains of the "bright lights and constant activity." The nurse appropriately documents what condition in the patient chart? Culture assimilation Culture blindness Culture disorientation Culture shock

Culture shock Explanation: Culture shock is a feeling a person experiences when placed in a different culture perceived as strange. Culture shock may result in psychological discomfort, or disturbances, as the patterns of behavior a person found acceptable and effective in the client's culture may not be adequate or even acceptable in the new culture. Culture assimilation is a process where a minority group begins to replace their own cultural characteristics to the new culture in which they are living. Cultural blindness is when one ignores differences in another's culture and proceeds as though the difference do not exist

A nursing student is studying the principle of autonomy. Which of the following examples most accurately depicts this principle? Transporting a client to a scheduled physical therapy appointment Administering a morning dose of insulin before breakfast Changing a dressing on a wound as needed Describing surgery to a client before the consent is signed

Describing surgery to a client before the consent is signed Explanation: Describing surgery to a client before a consent is signed provides the client with all of the information needed to make an informed decision, thus an autonomous one. The other choices are not reflective a client decision making

A nurse is acting inappropriately and has an odor of alcohol. This behavior breaches which of the following? Autonomy Beneficence Fidelity Ethical conduct

Ethical conduct Explanation: Ethical conduct dictates that a nurse acts in a professional, safe, competent manner. The foregoing behavior breaches that concept. Beneficence is for the good of the client and preventing harm, fidelity is keeping promises, and autonomy is the right to self-determination ? thus these choices are not correct.

When reviewing the chart of an elderly client, the nurse notes that the client identifies herself as Hispanic American. The nurse realizes the client is referring to which factor? Ethnicity Values Race Ethnocentrism

Ethnicity Explanation: Ethnicity refers to a common bond of kinship with country of origin. Race refers to biologic differences. Ethnocentrism is the belief that one?s personal heritage is superior to others, while values are beliefs and attitudes that are important to a person

When reviewing the chart of an elderly client, the nurse notes that the client identifies herself as Hispanic American. The nurse realizes the client is referring to which factor? Race Ethnicity Ethnocentrism Values

Ethnicity Explanation: Ethnicity refers to a common bond of kinship with country of origin. Race refers to biologic differences. Ethnocentrism is the belief that one?s personal heritage is superior to others, while values are beliefs and attitudes that are important to a person

A client is scheduled to have an elective surgical procedure performed and cannot decide if he wants to do it or not. He asks the nurse to help him make the decision because he does not feel that he knows enough about the procedure. Which of the following is the best way for this nurse to advocate for this client? Call the surgeon and have him explain the procedure again. Facilitate the client's decision by allowing him to verbalize his feelings and by providing information to help him assess his options. Refer the client to the social worker so that she can call in the people who need to help him make his decision. Refuse to help the client and state that he must make the decision on his own

Facilitate the client's decision by allowing him to verbalize his feelings and by providing information to help him assess his options. Explanation: Nurses as advocates must realize that they do not make decisions for their clients, but they can facilitate decision making by allowing the client to verbalize his feelings and by providing information to help him assess his options. This is not an appropriate time to call in the surgeon or the social worker, and refusing to help the client is not the best example of patient advocacy performed by a nurse

A nurse is caring for patients in a predominantly African American community. What are values or beliefs commonly shared by members of this culture? (Select all that apply.) Praise of self or others considered poor manners Clergy members highly respected Youth valued over age Respect given according to sex (male) Frequently highly religious Oriented to the present

Oriented to the present Frequently highly religious Clergy members highly respected Explanation: It is common to find individuals in the African American community more oriented to the present, often highly religious, and have high respect for their clergy members. The other factors listed are not usually attributed to the African American community

A nursing faculty is discussing laissez-faire values with students. Which of the following is an example of those values? Modeling healthy behaviors for teenagers Telling a child an injection will feel like a pinch Parents allowing a child to decide not to have an intravenous line inserted Teaching children right from wrong

Parents allowing a child to decide not to have an intravenous line inserted Explanation: A laissez-faire environment is one that allows others, especially children, to make decisions without guidance, resulting in a decision that may not be a sound one. The other choices are not reflective of the definition of a laissez-faire environment

Which of the following nursing situations is an example of an ethical dilemma? Discussing care of a comatose client with the family Transferring a client to a step-down unit Administering pain medication as ordered Performing cardiac compressions when a signed Do Not Resuscitate order (DNR) is not available

Performing cardiac compressions when a signed Do Not Resuscitate order (DNR) is not available Explanation: An ethical dilemma occurs when it is difficult for a decision to be made. If there is no signed DNR, then legally cardiac compressions must be started. Administering pain medication as ordered, transferring a client to a step-down unit, and discussing the care of a comatose client with the family are all within the ethical scope

Which of the following is a true statement regarding placebos? Placebos should never be used to test the person's truthfulness about pain. A placebo should be used as the first line of treatment for the patient. A positive response to a placebo indicates that the person's pain is not real. A placebo effect is an indication that the person does not have pain

Placebos should never be used to test the person's truthfulness about pain. Explanation: Perception of pain is highly individualized. A placebo effect is a true physiologic response. A placebo should never be used as a first line of treatment. The American Society for Pain Management Nurses (2009) contends that placebos should not be used to assess or manage pain in any patient, regardless of age or diagnosis. Reduction in pain as a response to placebo should never be interpreted as an indication that the person's pain is not real

A nurse working in the operating room is assigned to the suite where therapeutic abortions are to be performed throughout the day. The nurse feels that participation in these procedures conflicts with personal religious beliefs. What should the nurse do after notifying the operating room supervisor? Complete a work refusal form and leave the surgical suite immediately. Continue working in the suite because that is the assignment for the shift. Remain in the operating room suite until another nurse arrives to take that assignment. Contact the local right-to-life association and inform them of the procedures

Remain in the operating room suite until another nurse arrives to take that assignment. Explanation: If nursing care is requested that is contrary to the nurse's personal values, the nurse must provide appropriate care until alternative care arrangements are in place to meet the client's needs. The other options are not correct, and if the nurse left the suite, it could result in the accusation that the nurse abandoned the client. The nurse should be aware of potential conflicts before accepting an assignment

A nurse is caring for an older adult who has cancer and is experiencing complications requiring a revision of the plan of care. The nurse sits down with the client and the family and discusses their preferences while sharing her judgments based on her expertise. Which of the following types of health care decision making does this represent? Shared decision making Paternalistic model Ethical decision making Patient sovereignty model

Shared decision making Explanation: Shared decision making is recommended by most Ethicists and involves the client?s preferences and the nurse?s expertise to make the best decision. The Paternalistic model involves the clinician making the decisions and the Patient Sovereignty model involves the patient making all the decisions without input from the clinician

What would be an example of the nurse practicing fidelity? The nurse: Regulates visitors Withholds information as requested Stays with the patient during his or her death as promised Provides continuity of care

Stays with the patient during his or her death as promised Explanation: Fidelity requires the nurse to keep promises made and to be faithful to one's commitments.

A newly hired young nurse overheard the charge nurse talking with an older nurse on the unit. The charge nurse said, ?All these young nurses think they can come in late and leave early.? What cultural factor can the new nurse assess from this conversation? Cultural conflict Cultural imposition Cultural blindness Stereotyping

Stereotyping Explanation: The charge nurse is clearly exhibiting ageism, which is a form of stereotyping. Cultural assimilation is when one begins to assume some characteristics of a culture outside of one?s own. Cultural blindness occurs when cultural differences are ignored. Cultural imposition occurs when one pushes his or her beliefs onto another person

The younger nurses who seem to adapt easily to the new technology presented are perceived as threatening by two nurses who have worked on the unit for years. The older nurses begin to ridicule the younger nurses, saying, ?You might be able to work a computer, but we know how to provide real care.? How should the charge nurse respond? The charge nurse should demonstrate cultural blindness and pretend that the issue does not exist. The charge nurse should discuss the concept of cultural conflict and help both parties see their respective value to the unit. The charge nurse should recognize that this is cultural imposition and the younger nurses are forcing new technology on the older nurses. The charge nurse should understand that this is stereotyping in the form of racism and intervene immediately.

The charge nurse should discuss the concept of cultural conflict and help both parties see their respective value to the unit. Explanation: The scenario presents a classic example of cultural conflict. The older nurses feel threatened by those who are technologically savvy and try to prove their value so that they feel more secure. Both parties have value and the charge nurse can use her knowledge of diversity to help bring cohesion to the unit. The other answers are incorrect because they are not appropriate responses to the scenario

A nurse is aware that the principle of autonomy is being applied in which of the following situations? The family is discussing care with the physician. An order for an antibiotic is being written in the chart. The client has decided to stop chemotherapy treatments. A hospice consult is ordered by the nurse.

The client has decided to stop chemotherapy treatments. Explanation: The principle of autonomy respects the client's right to make his or her own decisions. The other choices do not reflect this as the client is not making the decisions

A Hispanic woman is seeking care at the local clinic. The nurse is completing a cultural assessment. Which of the following would demonstrate cultural assimilation? The client speaks only Spanish and requires a translator. The client enjoys watching television from her home country in Spanish. The client and her daughter cook traditional Hispanic foods for the family. The client's daughter, who is with her, learned English as her second language

The client's daughter, who is with her, learned English as her second language. Explanation: The daughter is demonstrating an example of cultural assimilation by taking on the language of the dominant culture. When a minority group lives within a dominant group, its members may adapt some of their cultural practices that once made them different. This process is referred to as cultural assimilation. The other answer options clearly demonstrate the Hispanic culture and an attempt to bring the minority culture into the dominant culture

Which of the following is a cultural norm of the healthcare system? There is high flexibility in certain procedures attending birth and death. There is a tolerance of tardiness, disorderliness, and disorganization. The omnipotence of technology is yet to be recognized. There is the use of a systematic approach and problem-solving methodology

There is the use of a systematic approach and problem-solving methodology. Explanation: Cultural norms of the healthcare system include the use of a systematic approach and problem-solving methodology; the omnipotence of technology; the dislike of tardiness, disorderliness, and disorganization; and the use of certain procedures attending birth and death

A day-shift nurse gives a client an injection of pain medication. The nurse forgets to document the injection on the medication administration record (MAR). The day-shift nurse tells the evening-shift nurse that she gave the client 4 mg of morphine at 2 p.m. for postoperative pain but didn't document the injection. The evening-shift nurse puts the day-shift nurse's initials and the date and time the dose was administered in the appropriate area of the MAR. The evening-shift nurse's action is considered to be which type of documentation error? Unauthorized entry Late entry Omission Improper correction

Unauthorized entry Explanation: This action is an unauthorized entry. A nurse shouldn't document for another nurse, except for an authorized entry in an emergency. Omission is a documentation error in which information is missing from the medical record. In this scenario, the day-shift nurse omitted documenting her administration of pain medication. A late entry refers to an entry made later than it should have been. The nurse should identify a necessary late entry as a "late entry" and document the reference date and time. An improper correction is an entry corrected in an improper manner, such as by erasing, using correction fluid, or obliterating the error with a marking pen. The nurse should always follow her facility's documentation guidelines

What is the term for the beliefs held by the individual about what matters? Morals Ethics Values Bioethics

Values Explanation: Values are ideals and beliefs held by an individual or group; values act as a standard to guide one's behavior. Ethics are moral principles and values that guide the behavior of honorable people. A moral is a standard for right and wrong. Bioethics is related to ethical questions surrounding life and death and questions and concerns regarding quality of life as it relates to advanced technology.

A Hispanic client has been hospitalized for 6 days for postoperative infection. Her weight is decreasing each day, and her nutritional intake is declining. Which nutritional assessment question is most appropriate? "Why aren't you eating your food?" "Are you aware that you are losing weight?" "Don't you like what is on your food tray?" "What type of food do you eat at home?

What type of food do you eat at home?" Explanation: Cultural food preferences often put the client at risk for inadequate nutrition. By exploring what foods the client eats at home, the nurse can assess the client's cultural dietary preferences and work to incorporate these foods into the meal plan. The other choices are judgmental and indicate that the client should eat what is presented regardless of cultural preference

The nurse is caring for a 5-year-old Hispanic boy and his family. Which action best demonstrates cultural competence? discouraging use of complementary modalities coordinating care through the mother promoting good medicine over prayers checking with the father to approve care

coordinating care through the mother Explanation: In Hispanic families, the mother makes the decisions about health care, so all care should be coordinated through her. The father is the source of strength, wisdom, and self-confidence but would not be the person involved with health care decisions. Folk medicine practices and prayers, herbal teas, and poultices for illness treatment are used. Therefore, promoting good medicine over the power of prayer and discouraging the use of complementary modalities would be inappropriate

A patient from Pakistan informs the nurse of his 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 blindness. cultural assimilation. cultural diversity. cultural imposition

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

The nurse just attended a seminar on cultural diversity. Which statement by the nurse would require further education? ?Ethnicity and race are the same thing and are affected by cultural practice.? ?Ethnicity can often determine dialect and political interests." ?Ethnicity begins at birth or through adoption of characteristics.? ?People of the same ethnicity share many of the same cultural and social beliefs

?Ethnicity and race are the same thing and are affected by cultural practice.? Explanation: People are often born into an ethnic group, or ethnicity develops by immersion in a community. People of the same ethnicity often speak similar dialects and share similar values. Ethnicity and race are terms used interchangeably; however, they are not the same thing. Race refers specifically to physical characteristics

A nurse caring for patients of different cultures in a hospital setting attempts to make eye contact with patients when performing the initial assessment. What assumption might the nurse make based on common cultural practices? A Hasidic Jewish man listens intently to a male physician, making direct eye contact with him, but refuses to make eye contact with a female nursing student. Assumption: Jewish men consider women inferior to men. A Muslim-Arab woman refuses to make eye contact with her male nurse. Assumption: She is being modest. A Native American stares at the floor while talking with the nurse. Assumption: He is embarrassed by the conversation. An African American man rolls his eyes when asked how he copes with stress in the workplace. Assumption: He may feel he has already answered this question and has become impatient

A Muslim-Arab woman refuses to make eye contact with her male nurse. Assumption: She is being modest. Explanation: The American dominant culture emphasizes eye contact while speaking, but many other cultures regard this behavior in different ways. For example, direct eye contact may be considered impolite or aggressive by many Asians, Native Americans, Indochinese, Arabs, and Appalachians; these groups of people tend to avert their eyes while speaking. Hispanics may look downward in deference to age, gender, social position, economic status, or authority. Muslim-Arab women often indicate modesty by avoiding eye contact with men, and Hasidic Jewish men may avoid direct eye contact with women. The only option above that has the correct assumption is the option regarding a Muslim-Arab woman refusing to make eye contact with her male nurse due to modesty. The nurse must be aware of the cultural meaning eye contact in relationship to the healthcare situation

A Chinese client is admitted to the health care facility with blockage in the coronary arteries. The cardiologist advises the client to undergo angioplasty. The client refuses the procedure. Later the nurse discovers that the client believes in naturopathy and is taking herbal extracts to de-clog his coronary arteries. Which of the following suggestions should the nurse give to the client? Warn the client that majority of the herbalists are all quacks Ask the client to opt for herbal therapy and also undergo surgery Tell the client that herbal therapy has not proven to be ineffective Tell the client that herbal medicines could lead to other complications

Ask the client to opt for herbal therapy and also undergo surgery Explanation: The nurse should suggest that the client try both, the surgery as well as the herbal medicine. Considering the individuality of health beliefs and the risk of not getting operated on in a timely manner, the nurse should encourage the client to undergo the surgery and simultaneously continue his herbal extract treatment. In stating that herbs are not effective, the nurse does not respect the client's beliefs. Assuming that herbal medicines could lead to further complications is nontherapeutic because the nurse includes personal opinion in the discussion. The nurse should avoid showing disapproval of the client's choice of healing because this does not make for good communication

Which disorders might a nurse screen for in an African American man based on his culture? (Select all that apply.) Sickle cell anemia Tay-Sachs disease Lactase deficiency Gout Cystic fibrosis Keloid formations

Keloid formations Lactase deficiency Sickle cell anemia Explanation: The African American culture has a higher percentage of people who develop keloid formations, have lactase deficiency, and sickle cell anemia compared with the general population. The African American culture does not have a higher percentage of people who have Tay-Sachs disease, gout, or cystic fibrosis

Which of the following is an example of cultural competence in nursing? Assuming the provider and the client share beliefs and values Attending a conference for cultural diversity Attending one's own church Assessing the rate at which an illness causes death in a culture

Attending a conference for cultural diversity Explanation: Cultural competence can be shown by actively learning about culture through attending a conference. Assessing the rate at which an illness leads to death does not develop cultural competence. One's own church is a familiar culture, and attending it does not breed cultural expansion or competence. The provider should never assume that beliefs or values are shared

A nursing faculty is presenting a lecture on ethics. The correct definition of ethical distress is: Knowing the correct action, but unable to perform due to constraints. Being aware of the principles of right and wrong. Belief about worth as a standard to guide behavior. Supporting the rights of a client during hospitalization

Knowing the correct action, but unable to perform due to constraints. Explanation: Knowing the correct action but being unable to perform the action due to constraints is the definition of ethical distress. The other choices are incorrect

A patient rings the call bell to request pain medication. Upon performing the pain assessment, the nurse informs the patient that she will return with the pain medication. The nurse's promise to return with the pain medication is an example of which principle of bioethics? Justice Autonomy Fidelity Nonmaleficence

Fidelity Explanation: Fidelity is keeping one's promises and never abandoning a patient entrusted to your care without first providing for the patient's needs. Autonomy respects the rights of patients or their surrogates to make healthcare decisions. Nonmaleficence is avoiding causing harm. Justice involves giving each his or her due and acting fairly

You are caring for a patient who speaks a language other than English and are using an interpreter to communicate. What would be the best way to choose an interpreter for this patient? Interpreter should conduct the conversation quickly to avoid misinterpretation. Interpreter should speak in a loud voice. Interpreter should always make direct eye contact. Interpreter should understand the healthcare system

Interpreter should understand the healthcare system. Explanation: Obviously, nurses cannot become fluent in all languages, but certain strategies for fostering effective cross-cultural communication are necessary when providing care for patients who are not fluent in English. Cultural needs should be considered when choosing an interpreter; however, it is also important to use an interpreter who understands the healthcare system. Options A, B and D are incorrect because in choosing an interpreter you do not want one who speaks in a loud voice; conducts the conversation quickly, or always makes direct eye contact, as this action is regarded differently among cultures.

Which of the following nursing actions displays linguistic competence? Learning pertinent words and phrases in the client's language Repeating English statements to a client who speaks Spanish Speaking loudly to a client who speaks no English Asking a family member to translate for a Spanish-speaking client

Learning pertinent words and phrases in the client's language Explanation: Linguistic competence is best displayed by learning pertinent words or phrases in the client's language. Speaking loudly and repeating English words do not solve the communication barrier or show an effective response to a linguistic need. Asking the client's family to translate is discouraged because it is often unreliable and leads to confusion for the client and the nurse

The nurse is caring for a 17-year-old who is scheduled to undergo surgery. What are the nurse's responsibilities with regard to obtaining consent? (Select all that apply.) The nurse will ensure the parents understand the information contained in the consent. The nurse will ensure the parent signing the consent has the legal authority to do so. The nurse is responsible to providing a detailed description of the potential complications associated with the surgical procedure. The nurse will witness the parent sign the consent forms. The nurse is responsible for providing education to the parents and child about the surgery that is scheduled

The nurse will witness the parent sign the consent forms. The nurse will ensure the parents understand the information contained in the consent. The nurse will ensure the parent signing the consent has the legal authority to do so. Explanation: The informed consent process, which must be done before the procedure or specific care, addresses the legal and ethical requirement of informing the child and parent about the procedure. The physician or advanced practitioner providing or performing the treatment and/or procedure is responsible for informing the child and family about the procedure and obtaining consent by providing a detailed description of the procedure or treatment, the potential risks and benefits, and alternative methods available. The nurse is responsible for ensuring the legally responsible individual completes the consent form. The nurse is responsible for witnessing the form

An Appalachian male has been admitted to the unit for chest pain. A nurse told the family that they could not be with the client. The family became very upset and the client wants to leave. What is the most appropriate cultural response by the charge nurse? "Would you feel more comfortable with your family with you?" "Why do you think you need to leave?" "If you leave, you will be asked to sign a form indicating that you are leaving against medical advice." "Sometimes family can cause stress and we try to maintain a stress-free care environment?

Would you feel more comfortable with your family with you?" Explanation: The Appalachian culture is very family oriented, and many members are skeptical of modern health care. The request for the client's family to leave most likely frightened the client. Asking the client how to make him more comfortable is the best option. Asking him why he thinks he needs to leave is judgmental, implying he has no real reason to leave.

A nurse who provides the information and support that patients and their families need to make the decision that is right for them is practicing what principle of bioethics? Justice Nonmaleficence Fidelity Autonomy

Autonomy Explanation: Autonomy, also known as self-determination, is respecting the rights of clients or their surrogates to make health care decisions. The nurse would provide the information and support the client and family need to make the decision that is right for them, including collaborating with other members of the health care team to advocate for the client. Nonmaleficence is avoiding causing harm. Justice is giving each individual their due and acting fairly. Fidelity is the keeping of promises

A 46-year-old patient has been diagnosed with cancer. He has met with the oncologist and is now weighing his options to undergo chemotherapy or radiation as his treatment. This patient is utilizing which ethical principle in making his decision? Autonomy Beneficence Confidentiality Justice

Autonomy Explanation: Autonomy entails the ability to make a choice free from external constraints. Beneficence is the duty to do good and the active promotion of benevolent acts. Confidentiality relates to the concept of privacy. Justice states that like cases should be treated alike

A staff nurse meets with the charge nurse and is reporting that all the new nurses are leaving messes on the unit. The staff nurse states, "These youngsters think they can waltz in here and get our jobs." What is this nurse demonstrating? Cultural blindness Cultural diversity Cultural assimilation Cultural conflict

Cultural conflict Explanation: Cultural conflict occurs when people become aware of cultural differences (the younger nurses) and feel threatened (most likely be their younger age) and respond by ridiculing the beliefs or actions of others to make themselves feel more secure. Cultural assimilation occurs when one adapts to a new culture. Cultural blindness occurs when one ignores a cultural difference. Cultural diversity encompasses culture, race, ethnicity, religion, language, gender, socioeconomic status, and more

Which of the following examples are considered acceptable cultural norms in health care? (Select all that apply.) Encouraging adult women to conduct self-breast exams once a month Following a specific regimen for cardiac rehab Arriving late for a scheduled appointment Defining diabetes mellitus as a metabolic disorder characterized by elevated blood sugar Documenting pain with every client assessment

Defining diabetes mellitus as a metabolic disorder characterized by elevated blood sugar Encouraging adult women to conduct self-breast exams once a month Documenting pain with every client assessment Following a specific regimen for cardiac rehab Explanation: Standardized definitions of health and illness as well as maintenance and prevention of illness are considered acceptable cultural norms in the health care system. Thorough documentation is a cultural habit, as is using a systematic approach (such as cardiac rehab) to problem-solve. Tardiness is not an acceptable cultural norm in the health care system

A family member of a resident in a long-term care facility reports to the nurse that her mother's diamond ring is missing. Another resident reported a day earlier that a twenty-dollar bill was missing from his/her night table. What should the nurse do in this situation? Notify the supervisor and call the police. Report the incidents to the facility's lawyer. Remind the residents and family members not to leave valuables unattended. Pass the information on to the doctor and the next shift staff

Notify the supervisor and call the police. Explanation: The supervisor should be made aware of the situation and the police should be called to investigate the potential theft. The other answers do not advocate for the clients and their families. It is the responsibility of the nurse to take action because the nurse was the person to receive the information. This is known as due diligence

In addressing health promotion for a patient who is a member of another culture, the nurse should be guided by which of the following principles? The patient may have a very different understanding of health promotion. The nurse should avoid performing health promotion education if this is not a priority in the patient's culture. A culture's conceptualization of health promotion is a result of that culture's level of socioeconomic development. Health promotion is a concept that is largely exclusive to American culture

The patient 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 patient 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 patient'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

Which of the following is a characteristic of the care-based approach to bioethics? The rightness or wrongness of an action is independent of its consequences The promotion of the dignity and respect of patients as people The need to emphasize the relevance of clinical experience The need for an orientation toward service

The promotion of the dignity and respect of patients as people Explanation: The care-based approach to bioethics focuses on the specific situations of individual patients and characteristics of this approach include promoting the dignity and respect of patients and people. The need to emphasize the relevance of clinical experience and the need for an orientation toward service are part of criticisms of bioethics. The deontologic theory of ethics says that an action is right or wrong independent of its consequences

A client believes in the use of herbal therapy and asks the nurse if he can continue to use an herbal tea therapy. What is the most culturally appropriate nursing response? "Avoid the use of herbal teas and consider trying acupuncture instead." "Herbal tea and medications do not mix well. I would avoid this practice." "There is no reason the tea cannot be used as long as the ingredients do not interfere with the medication." "Most of those teas have caffeine in them, and you don't need extra caffeine.

There is no reason the tea cannot be used as long as the ingredients do not interfere with the medication." Explanation: There is no reason herbal remedies cannot be used in conjunction with medications as long as the ingredients do not interfere with the action or absorption of the medication. The other options are judgmental and do not answer the client's question, which is specific to continued use of herbal tea

When conducting an in-service on Arab-American cultural attributes, the nurse correctly identifies which relevant factors? Select all that apply. Touch acceptable if done by same-sex health care practitioner Preference for Shaman rather than western medicine Females to avoid eye contact with males Sustained eye contact Belief in the ?hot-cold? theory of illness

Touch acceptable if done by same-sex health care practitioner Females to avoid eye contact with males Explanation: In the Arab-American culture women avoid eye contact with males and touch is acceptable if performed by a same-sex practitioner. Native American culture sustains eye contact and prefers a Shaman for healing. The ?hot-cold? theory of illness is found in the Hispanic community