Ch. 5 Cultural & Spiritual assessment

A nurse is teaching nursing students how to conduct a spiritual assessment. The nurse determines understanding when a student states which of the following?

"General introductory questions should be used to start the spiritual assessment."

A client who practices the Islamic faith informs the nurse that they are fasting for the holy days of Ramadan. The nurse understands this fast will last how many days?

29-30

The nurse is assessing a client in the emergency department who appears to be confused and unable to follow commands. When obtaining the client's social history, which of the following questions should the nurse ask first?

"Have you consumed any alcohol today?"

A client from Italy who became ill while visiting America is admitted to the medical floor. When admitting this client, the nurse should include which of the following questions?

"Do you use any special remedies or treatments back home?"

The nurse begins an assessment of a client's religion and spirituality. Which statement indicates that the client is spiritual?

"I am at peace when I spend time out of doors."

The nurse is concerned that a client is experiencing spiritual distress. Which client statement caused the nurse to have this concern?

"I want to just go home to die."

A client is scheduled for surgery. The client asks the nurse if they could speak to a priest before surgery. What is the best response of the culturally competent nurse?

"I will see if I can get a priest to visit you before surgery."

A nurse recognizes the need to assess a client's spirituality after the client has been admitted from the emergency department to the medical unit. How should the nurse best initiate this assessment?

"Would you describe yourself as being a religious or spiritual type of person?"

A family member of a dying client asks the nurse if they may perform certain rituals, such as praying and reading verses in the private hospital room. How should the nurse respond?

Allow the request.

A younger female nurse is assigned to an older Arab American client. The client tells the nurse that he is uncomfortable having her as his nurse. The client states that he is accustomed to same-gender nurses caring for him. How should the nurse respond?

Ask the charge nurse to assign the client to a male nurse.

A nurse is conducting a routine cultural assessment on a client of Asian descent for whom the dominant language is a second language. The client's spouse is of African descent. How should the nurse assess the client's cultural identity?

Ask the client what culture they identify with.

In preparing to assess a client from a different culture, a nurse is aware that one needs to assess both factors that affect the client's approach to providers and factors that affect the client's disease, illness, and health state. Which of the following is a factor the nurse should consider that primarily affects the client's approach to providers?

Body Language

The nurse documents which of the following objective findings of spiritual distress? Select all that apply.

Client appears depressed, crying in their room. Client is refusing to speak to church members, and is isolating self. Client appears to be anxious, pacing in their room with an increased heart rate and blood pressure.

A nurse is assigned to care for a client who practices a religion different from her own. After reading the client's medical record, the nurse takes time to talk with the client about how to make his hospital stay more comfortable. The nurse admits to the client that she is not familiar with his religion but would like to learn more. The nurse is in which stage of cultural awareness?

Conscious incompetence

A nurse is participating in an educational exercise in which she is conducting a self-examination of her own biases. This activity addresses what construct of cultural competence?

Cultural awareness

The nurse attends an Alcoholic Anonymous support group that is for members of a single culture other than her own, and develops close relationships with three group members. The nurse is demonstrating which of the following?

Cultural encounter

A new graduate nurse, attending a hospital orientation, is asked to explain the goals of a cultural assessment. What would be the graduate nurse's best answer?

Developing and implementing a culturally congruent plan of care

The culturally competent nurse knows that culture includes among its elements the following things: (Check all that apply.)

Family Structure Family Function Spirituality Religion Community

A nurse is assessing a client admitted with anorexia nervosa. The nurse expects which of the following signs and symptoms?

Fear of obesity, restricted food intake

A client states to the nurse, "I must have had bad Karma from a past life; that is why I have cancer." The nurse understands the client believes in which of the following faiths?

Hinduism

A nurse assesses spirituality in order to gain an understanding of what in relation to the client's life?

Identify possible coping mechanisms

A nurse assesses the spirituality of a client who is terminally ill with pancreatic cancer. Which of the following is the best rationale for this action, from the nurse's perspective?

Identifying possible coping mechanisms

When caring for a client from a culturally different background, what is the goal for incorporating the client's health beliefs and practices into the nursing plan of care?

Improvement of the client's health outcomes

A nurse is relying heavily on gestures and simplified language during the assessment of a client from another culture who speaks minimal English. During the lengthy assessment, the nurse asks the client if she is "okay" by making a circle with his thumb and forefinger. The nurse should be aware of which of the following?

In some cultures, this gesture is offensive.

What is an important part of being present with a client?

Listening

A nurse is performing a focused assessment on a newly admitted client. The client recently emigrated from Central America. The client is talking about the evil eye in a partial use of the dominant language. What is the best response of the nurse?

Obtain a translator

After completing an admission assessment the client asks if the room door can be closed so that the client can have silence when reading the Bible. What does this indicate to the nurse about the client's spirituality?

Reading the Bible provides comfort to the client

The nurse reviews the nursing notes (above) as well as the cultural assessment notes which indicate that the parents value high weights in infants. The nurse should do which of the following?

Provide education related to infant formula consumption and overfeeding.

Shared practices and rituals used to express one's faith can be called

Religion

A nurse cares for a client who practices Hinduism. The nurse understands that Hindus believe illness is caused by which type of behavior?

Result of past and current life actions

In the assessment of a client, the nurse is having her complete a daily spiritual experiences self-assessment scale. Which of the following should the nurse mention to the client before giving her this assessment tool?

She may substitute another word for God in the scale, if she would like.

When performing a cultural assessment on a client from another country, what can a nurse do to ensure the client receives culturally sensitive care?

Show genuine interest in the client's culture and personal life experiences.

The nurse prepares to assess a client's spiritual needs. What should the nurse keep in mind about suffering, beliefs, and spirituality when completing this assessment? Select all that apply.

Suffering is often associated with illness Beliefs about the cause and meaning of suffering affect illness Spiritual beliefs about the meaning of life affects the course of illness and reaction to suffering

A new nurse asks her preceptor if the new baby she is caring for is breast- or bottle-feeding. The preceptor tells the new nurse that the mother is Hispanic and to give the baby a bottle because Hispanics do both until the mother's milk comes in. This is an example of:

stereotyping

What outcome should the nurse prioritize when addressing a client's social, cultural, and spiritual issues?

The client will express meaning and purpose in life.

The nurse is caring for a first-time mother and newborn in the postpartum unit. The nurse overhears the new mother ask family members to prepare the nursery and purchase clothing for the baby. What would the culturally sensitive nurse suspect?

The new mother may believe buying infant clothing before the delivery is bad luck.

A nurse is caring for a client who is an immigrant and believes in the magicoreligious system. The nurse understands that the client believes which of the following affect(s) health?

supernatural forces

The nurse prepares to complete a spiritual assessment with a client. What should the nurse keep in mind when completing this assessment?

The reason is to better understand the client's spiritual perspective related to health

In the assessment of a Chinese client, a nurse asks the client several questions pertaining to the client's culture. The client asks the nurse why she is asking questions about her culture. Which of the following should the nurse mention? Select all that apply.

To learn about the client's beliefs and usual behaviors associated with health and illness To compare and contrast the client's beliefs and practices to standard Western health care To avoid stereotyping To assess the client's health relative to diseases prevalent in the client's cultural group

A nurse is conducting a cultural assessment. Which of the following should the nurse include in the assessment? Select all that apply.

Values Affiliations Communication

Spirituality can best be described as

a source of inner strength. Spirituality, in the most fundamental sense, pertains to matters of the human soul, be it a state of mind, a state of being in the world, a journey of self-discovery, or a place outside the five senses. Having faith in God and participating in organized religious life are important to people of diverse cultures and ethnicities and are often seen as a source of inner strength and spirituality.

The previous week a client from a non-English speaking culture desired time to say prayers before eating breakfast. Another client from the same culture is currently being admitted. What should the nurse do to support the new client's spiritual needs?

assess if the client would like time for prayers before breakfast

While providing spiritual care to clients, nurses must avoid

attempting to convert clients to your own beliefs.

When caring for a client from a culturally different background, what is the goal for incorporating the client's health beliefs and practices into the nursing plan of care?

outcomes

An instructor is teaching a group of students about culture. Which of the following would the instructor use to best define the term "culture"?

shared norms for behaviors, values, and beliefs

An instructor is describing culture and minority. Which statement would be most accurate for the instructor to include related to minority?

It means that a group has smaller population numbers.

A nurse is working with a client who has received a terminal diagnosis. To help the nurse identify the client's possible coping responses, what would be most important for the nurse to understand about spirituality?

It varies in different situations.

The nurse prepares to assess a client's spiritual needs. What environmental characteristic best supports the completion of this assessment? Select all that apply.

Joy Hope Creativity

A male nurse is caring for an elderly woman who has become withdrawn and somewhat confused since the nurse has come on duty. When the nurse goes into the room to bathe the client, she refuses to allow it. The best explanation for her actions would be which of the following?

cultural differences

The nurse spends a day off in a part of a non-English speaking community in order to learn more about the culture to improve interactions when providing client care. What cultural activity is this nurse demonstrating?

desire

A client of Native American/First Nations (Navajo) heritage is admitted to the hospital with dizziness, hallucinations, and loss of consciousness. The client is now awake, alert, and oriented. The nurse interviews the client and the client states he has been preoccupied with the death of someone close to him. The client's father states this reaction is common in his culture. Which of the following culture-bound syndromes is this client experiencing?

ghost sickness

Because the nurse realizes that spirituality varies, information gained will assist the nurse in

individualizing interventions to meet specific needs.