Care of Special Populations Practice Test

The nurse educator is providing an in-service education to the nursing staff regarding transcultural nursing care. A staff member asks the nurse educator to describe the concept of acculturation. Which response is appropriate? "It is a group that shares some of the characteristics of the larger population group of which it is a part." "It is a subjective perspective of the person's heritage and a sense of belonging to a group." "It is a group of individuals in a society that is culturally distinct and has a unique identity." "It is a process of learning a different culture to adapt to a new or changing environment."

Acculturation is a process of learning a different culture to adapt to a new or changing environment. Ethnic identity is the subjective perspective of belonging to the group of one's heritage. An ethnic group is a group of persons in a society that is culturally distinct and has a unique identity. A subculture is sharing some of the characteristics of a larger population group.

Why would the nurse who is focusing on facilitating positive outcomes regarding health care services become familiar with the cultural beliefs and practices of a childbearing woman? Culture can have a dramatic impact on an individual's sexual practices. Understanding the cultural beliefs and practices of one's clients is a nursing responsibility. A culturally diverse woman may have beliefs that impact the delivery of health care services. Safe sex practices are not universally implemented transculturally.

The nurse providing care for women in their childbearing years must be familiar with the cultural framework within which the client lives and operates. Once this is achieved, appropriate communication techniques can be used to facilitate client assessment and care and to identify health promotion educational strategies and delivery of services. A client is more able to trust a nurse or primary health care provider who understands the woman's cultural beliefs regarding health care. Culture, including ethnicity and religious affiliation, may affect sexual practices, including those identified as safe sex practices. It is the responsibility of the nurse to become familiar with and understand the cultural beliefs of the clients being cared for.

The nurse is preparing a session regarding nutrition for a group of culturally diverse pregnant women. The nurse determines that the priority nursing intervention includes which action? Describe the importance of avoiding eating at fast-food restaurants. Identify the cultural food preferences of each client. Obtain the weight of each client. Determine the socioeconomic status of each client.

The priority nursing intervention is to identify the cultural food preferences of each client. This information is needed in order to adequately provide information regarding appropriate nutrition. The socioeconomic status may be an important component, particularly when the nurse is determining whether a client's financial situation permits the purchase of appropriate food items. A baseline weight also may be important. Encouraging appropriate nutrition and the need to avoid fast-food restaurants is also important. However, an adequate nutritional plan can be formulated only if cultural food preferences are identified.

The nurse is discussing intervention strategies with a parent of a child with a developmental disability. Which of the following describes a family system program as an intervention strategy? Implements problem-behavior prevention strategies Focuses on teaching the parents methods to promote the child's developmental skills Focuses on teaching the parents how to set up and positively respond to role-play situations that promote increased social interaction for the child Focuses on the parents' internal factors that affect the quality of parenting

A family systems program focuses on the parents' internal factors, including stress, depression, or coping. This system is based on the belief that variations in these factors have a direct impact on the quality of parenting. Implementing problem-behavior prevention strategies describes positive behavior support as an intervention strategy. Teaching the parents methods to promote the child's developmental skills describes instructional programs as an interventional strategy. Teaching the parents how to set up and positively respond to role-play situations that promote increased social interaction describes interactional programs as an interventional strategy.

The nurse working in a pediatric office is assisting with the intake assessment on a young child, when the mother states, "It is very challenging to manage all parenting responsibilities on my own." Based on this statement, which referral would the nurse consider? Case manager Child care service Clinical psychologist Respite service

Access to community resources helps single parents in many ways, such as with child care, food security, employment, health care, and more. A case manager is someone who can assist in coordinating access to these needs based on the individual circumstances.

The nurse is discussing with another nurse how health outcomes in the socioeconomically disadvantaged population are influenced by different health factors. Which health factors would the nurse identify as being related to the physical environment? Select all that apply. Income and employment Housing and transit Diet and exercise Access to care and quality of care Alcohol and drug use Air and water quality

Health factors related to the physical environment consist of the housing and transit systems in the community, as well as air and water quality. Diet and exercise and alcohol and drug use are classified as health behaviors. Income and employment and access to care and quality of care are classified as clinical care factors and are not related to the physical environment.

The correctional nurse is assisting in developing an in-service for new correctional nurses. The nurse would suggest to include which at-risk health disparities that occur in the prisoner population, when compared to the general population? Select all that apply. Asthma Hepatitis C Hypertension Lupus Drug dependence

Prisoners are at an elevated risk for certain health problems leading to health disparities when compared to the general population. Conditions may include drug dependence and chronic conditions such as asthma, hepatitis C, and hypertension. Lupus is not specifically associated with the prison population.

The nurse working in an emergency department is collecting data on a female client that is a victim of domestic violence. The nurse understands that which of the following assessment findings are characteristics of the emotional effects of abuse? Select all that apply. The client states, "I always feel like I have no energy." The client's x-ray determines the client has a broken wrist. The client states, "I feel so hopeless about the future." The client states, "My menstrual period has been irregular." The client states, "I struggle to find the motivation to get my work done."

The effects of abuse can manifest as physical, mental, or emotional effects. Examples of emotional effects of abuse include feelings of fatigue, hopelessness, and lack of motivation. Therefore, the options that include the statements "I always feel like I have no energy," "I feel so helpless about the future," and "I struggle to find the motivation to get my work done" are correct. Options 3 and 4 describe physical effects of domestic violence: broken bones and irregular menstrual periods.

An older client has been prescribed digoxin. The nurse determines that which age-related change would place the client at risk for digoxin toxicity? Decreased cardiac output and decreased efficiency of blood return to the heart Decreased lean body mass and glomerular filtration rate Decreased muscle strength and loss of bone density Decreased salivation and gastrointestinal motility

The older client is at risk for medication toxicity because of decreased lean body mass and an age-associated decreased glomerular filtration rate. Although the other changes identify age-related changes that occur in the older client, they are not specifically associated with this risk.

The nurse is attending a presentation created by a nursing student on the impact of lack of health insurance on the individual. The nurse determines the nursing student has a need for further teaching if the student makes which statement? "Many uninsured individuals do not have a regular primary health care provider." "Uninsured individuals are more likely to seek preventive care." "Uninsured individuals are more likely to be hospitalized for chronic conditions." "Individuals in rural areas are at a disadvantage when it comes to the availability of care."

Uninsured and underinsured individuals are less likely to seek preventive care, therefore option 1 is the correct answer. Options 2, 3, and 4 are accurate statements in regard to uninsured individuals and individuals living in rural areas.

The nurse is working in an outreach clinic and is assisting in planning programs to help immigrants secure reliable transportation. Which resource would be most helpful to assist this population in obtaining a driver's license? Bus passes Social worker A proxy A translator

Obtaining a driver's license for immigrants or refugees is extremely challenging regardless of documentation status. For those who do not speak English, a translator is necessary. The person obtaining the driver's license also needs to be able to read in English. A proxy is helpful for health care needs or in situations where a person may not be able to speak on their own behalf. Bus passes may be helpful but are not directly related to obtaining a driver's license. A social worker may be able to help in securing resources but is also not specific to obtaining a driver's license.

The nurse is discussing the importance of the presence of a nurturing caregiver for healthy early brain development with a student. The nurse includes information on which special population that may be at risk for negative effects on brain development? Homebound elderly Homeschooled children Foster children Institutionalized adolescents

The effects on brain development are one poor outcome that foster children are known to be at risk for, and this is because of this critical time during infancy and early childhood for brain development. Early childhood trauma and adversity and lack of a responsive and nurturing caregiver are associated with changes in the neurobiology of the brain, such as lack of trust, self-esteem, empathy, and problem-solving.

The nurse is developing a teaching session for a group of older adults at a local senior center. Regarding sensory changes, which information would the nurse include in the session? Hearing loss is related solely to genetics and aging. Hearing loss is associated with heightened awareness and increased function. Diabetic retinopathy is not preventable. Visual impairment can lead to disability.

Visual impairment is known as a leading cause of age-related disability. The most common causes are age-related macular degeneration, cataracts, glaucoma, and diabetic retinopathy. Many causes of visual impairment, including diabetic retinopathy, are preventable, and so attention should be paid to preventing this complication throughout life. Hearing loss is a complex problem with multiple causes, including genetics, aging, environmental exposure, and lifestyle. Hearing loss results in decreased function as a result of diminished quality of life.

The nurse informs a nursing student about various concepts of traditional Chinese medicine (TCM). The nurse determines the nursing student has a need for further teaching if the nursing student states that which concept is related to TCM? Panchakarma Acupressure Acupuncture Yin-Yang

Traditional Chinese medicine (TCM) utilizes a variety of treatment modalities to heal the body. These include the Yin-Yang theory, acupuncture, and acupressure. Panchakarma is a component of Ayurveda medicine that is a traditional medicine that originated in India and is not a component of TCM.

The nurse educator is describing the yin and yang theory of the ancient Chinese philosophy of Tao to a group of nursing students. The nurse educator explains that in this theory, foods are classified as hot and cold and are transformed into yin and yang energy when metabolized by the body. The nursing student understands this theory when the student makes which statement? The client consumes hot foods when a "hot" illness is present. The client believes that yin foods are hot foods. The client consumes cold foods when a "hot" illness is present. The client believes that yang foods are cold foods.

In the yin and yang theory, health is believed to exist when all aspects of the person are in perfect balance. Foods are classified as hot or cold and are transformed into yin and yang energy when metabolized by the body. Yin foods are cold, and yang foods are hot. Cold foods are eaten when one has a hot illness and hot foods are eaten when one has a cold illness.

The nurse working in a military hospital determines that military veterans are at higher risk when compared to the general population for certain injuries. Which injuries would the nurse identify? Select all that apply. Brain injuries Lost limbs Arthritis Sprains Tinnitus Heart failure

Military veterans have different heath issues than the general population, or civilians. Due to the nature of their service, they are at risk for certain injuries that can happen during combat, or can be exposed to situations causing physical and emotional stress. Injuries may include shrapnel or gunshot wounds, lost limbs, head and brain injuries, tinnitus and hearing loss, sprains and strains, and limited range-of-motion, particularly in the ankles and knees.

A Spanish-speaking client arrives at the triage desk in the emergency department and states to the nurse, "No speak English, need interpreter." Which action should the nurse take? Seek an interpreter from the hospital's interpreter services. Have one of the client's family members interpret. Have the Spanish-speaking triage receptionist interpret. Obtain a Spanish-English dictionary and attempt to triage the client.

The nurse should have a professional hospital-based interpreter translate for the client. English-speaking family members may not appropriately understand what is asked of them and may paraphrase what the client is actually saying. Also, client confidentiality and accurate information may be compromised when a family member or a nonhealth care provider acts as interpreter. Using a Spanish-English dictionary is time-consuming and not the best action; accurate interpretation is best done by a professional hospital-based interpreter.

The nurse is talking to students during their psychiatric mental health clinical rotation. The nurse informs the students that which physical illnesses occur more frequently with severe mental illness? Select all that apply. Obesity Myocardial infarction Metabolic syndrome Skin disorders Hypertension Thyroid dysfunction

There are many different health problems that the general population is at risk for based on lifestyle choices. Those with severe mental illness tend to be impacted more significantly. These problems include tuberculosis, human immunodeficiency virus, hepatitis B and C, obesity-related cancer, osteoporosis and decreased bone mineral density, and poor dental status. Additional problems include impaired lung function, sexual dysfunction, obstetric complications, stroke, myocardial infarction, hypertension, other cardiac and vascular diseases, obesity, diabetes mellitus, metabolic syndrome, and hyperlipidemia.

A client is seen in the clinic for a physical examination. Laboratory studies are performed and reveal that the hemoglobin and hematocrit are low, indicating the need for further diagnostic studies and possibly a blood transfusion. The client is a Jehovah's Witness and states he will never have a blood transfusion. Which would be an appropriate action by the clinic nurse? Support the client's decision not to receive a blood transfusion. Try to convince the client of the need for the transfusion. Discuss with the client the results of the low hemoglobin and hematocrit levels. Speak to the family regarding the need for a blood transfusion.

Cultural and ethnic background influences an individual's response to health, illness, surgery, and death. Awareness of cultural differences enhances the nurse's knowledge of how a health care experience may be perceived by the client or family. In the Jehovah's Witness religion, the administration of blood and blood products is forbidden. Therefore, the nurse should support the client's decision. The nurse should respect the autonomy of the client and not try to convince the client or the family that a transfusion must be taken. The nurse may explain the laboratory tests, but this should not be done in an effort to convince the client of the need for a blood transfusion.

The nurse is preparing to deliver a food tray to a client whose religion is Judaism and follows kosher preferences. The nurse checks the food on the tray and notes that the client has received a roast beef dinner with whole milk as a beverage. Which action would the nurse take? Call the dietary department and ask for a new meal tray without the milk. Replace the whole milk with fat-free milk. Ask the dietary department to replace the roast beef with pork. Deliver the food tray to the client.

In following kosher preferences, the dairy-meat combination is not acceptable. Pork and pork products are not allowed in the traditional Jewish religion. If the client wants milk, it can be obtained from the unit's kitchen and served according to the client's preferences. Obtain a new meal tray that does not have both meat and milk. Delivering the tray as is, changing the milk product, and serving pork will violate kosher practice.