Culture- nurse client

A nurse is caring for a patient who practices Mormonism. The nurse should expect the patient to study religion from the Holy Bible and the ____________________.

ANS: Book of Mormon Members of the Mormon faith read from the Book of Mormon, which contains accounts of ancient peoples in America. This book is considered complementary scripture to the Bible.

The process of giving up parts of one's own culture and adopting parts of the culture of the dominant group is called ____________________.

ANS: assimilation

A patient whose religion is listed as Seventh-Day Adventist is admitted to the unit just before lunch. The patient is being examined, and the nurse does not want to interrupt to ask about lunch preferences. A good choice would be to order a ________________ meal.

ANS: vegetarian Many Seventh-Day Adventists are vegetarians. When dietary preferences are unknown, this choice would be safe.

Which of the following would indicate that the nurse has established a level of mutual problem solving? a. The nurse helps the patient develop questions to ask the health care provider. b. The nurse tells the patient what needs to be done to resolve health problems. c. The nurse is seen as the authority when it comes to health care issues. d. The nurse excludes the family from health discussions to protect privacy.

ANS: A A caring nurse helps hospitalized patients understand how to think about their health and illness and to figure out questions to ask of their health care providers. In addition, a caring nurse helps patients explore options for resolving health problems and provides information and instruction. Using evidence in practice is an aspect of mutual problem solving, with a nurse continuously learning and engaging patients and families in discussions about their health issues. Basic to nursing practice is the inclusion of family members in a patient's care.

Which statement by a health care worker can the nurse identify as a stereotype? a. "People over 65 are poor drivers." b. "Assimilation requires adopting part of the dominant culture." c. "All individuals have common basic daily needs." d. "Most people perceive themselves as members of the middle class.

ANS: A A stereotype is a false assumption about all members of a specific group. Saying people over 65 are poor drivers is an inaccurate generalization about a specific group of people. The other options do not fit the definition of a stereotype.

Which is the most appropriate therapy for the nurse to suggest for a patient with chronic low back pain from osteoarthritis? a. Acupuncture b. Aromatherapy c. St. John's wort d. Magnetic therapy

ANS: A Acupuncture may be useful in the treatment of chronic low back pain from osteoarthritis. The other therapies are not used to treat pain.

Nurses care for a variety of patients. What is an activity that best demonstrates the caring role of a nurse? a. Staying with a patient and developing a plan of care before surgery b. Performing IV insertion with confidence c. Assessing the patient's entire health history d. Inserting a urinary catheter using aseptic technique

ANS: A Caring is highly relational. A nurse and a patient enter into a relationship that is much more than one person simply "doing tasks for" another. There is a mutual give-and-take that develops as nurse and patient begin to know and care for one another. As a nurse-patient relationship forms, a nurse becomes a coach and partner rather than a detached provider of care. Performing an IV insertion, assessing a health history, and inserting a catheter are all tasks that can be accomplished with or without a caring nurse-patient relationship being developed.

How would a culturally competent care plan differ from a standard care plan? a. It would contain adaptations that recognize the patient's cultural preferences. b. It would follow the legal mandates for providing care regardless of culture. c. It would provide information about nonjudgmental behaviors to use. d. It would focus on the nurse's values, assumptions, and health beliefs.

ANS: A Culturally competent care involves continuous attempts by staff to use knowledge and skills to effectively provide care for patients of different cultures. Adapting standard care to meet the specific cultural preferences of the patient is part of a culturally competent care plan. The other options would not be contained in a culturally competent plan of care.

A new mother on the OB unit refuses to allow her newborn to wear disposable diapers. She insists on applying cloth diapers without safety pins, because this is how her culture applies diapers. During break, the nurse discusses the patient's strange diapering technique compared with the excellent American method of diapering. Besides violating confidentiality, the nurse is displaying a. ethnocentrism. b. stereotyping. c. unusual behavior during break. d. lack of adherence to hospital policy on diapering.

ANS: A Ethnocentrism is the belief that one's way of doing things is better than the ways of people of different cultures. Stereotyping is making false assumptions about others based on inaccurate generalizations. Discussing the patient's diapering technique during break is unethical. It is unlikely that there is a policy on diapering.

Which statement by a nurse demonstrates cultural competence? a. "Without knowledge of cultural diversity, misunderstandings arise between patient and nurse." b. "Nurses who assume care for persons of different cultures need to assume those beliefs as their own in order to give good care." c. "Women of most cultures have adopted assertive communication." d. "Traditional healing practices should not be combined with Western medicine to treat a patient."

ANS: A Failure to develop cultural sensitivity to patients of diverse cultural backgrounds may create misunderstandings between nurse and patient. Data may be misinterpreted. Implementation of plans and patient compliance with plans may be sabotaged if the nurse does not understand the culture of the patient. The statement, "Nurses who assume care for persons of different cultures need to assume those beliefs as their own in order to give good care" is unnecessary and impractical. It is not true that women of most cultures have adopted assertive communication. Traditional healing practices and Western medicine may be used in combination with good results.

The nurse teaches a patient about Healing Touch. Which statement by the nurse is the most appropriate? a. "This therapy will realign your energy flow." b. "I will start by manipulating your muscles and soft tissues." c. "Pressure will be applied to body points where energy is obstructed." d. "The treatment consists of passively moving joints through full range of motion."

ANS: A Healing Touch involves the use of the practitioner's hands to realign the patient's energy flow. The other options describe other complementary and alternative therapies (CATs) such as massage, chiropractic therapy, and acupressure.

The nurse is performing a cultural assessment on a patient. What does the nurse know about cultural assessments? a. They are intrusive and time consuming. b. They are not dependent on a trusting relationship. c. They are rarely plagued by miscommunication. d. They are based in similarities of behavior.

ANS: A In contrast to other types of interviews, cultural assessment is intrusive and time consuming and requires a trusting relationship between participants. Miscommunication commonly occurs in intercultural transactions. This is because of language communication differences between and among participants and differences in interpreting each other's behaviors. Nurses use transcultural communication skills to interpret a patient's behavior within his or her own context of meanings and to behave in a culturally congruent way.

A religion that was founded by Joseph Smith in the nineteenth century is a. Mormonism. b. Catholicism. c. Lutheranism. d. Mennonite.

ANS: A In the nineteenth century, Joseph Smith founded the Mormon Church.

The nurse performs a preoperative assessment on a patient before surgery. Which finding would require immediate follow-up by the nurse? a. The patient uses several herbal remedies routinely. b. The patient recently visited a chiropractor for back pain. c. The patient has used acupressure to relieve postoperative nausea in the past. d. The patient expresses a wish to use acupuncture for postoperative pain control.

ANS: A Many herbs prolong bleeding time, so further assessment of the types of herbs that are used and how recently they were used is needed before the patient has surgery. The other information given by the patient also requires further assessment, but will not affect the timing of the patient's surgery.

Which action by a new staff nurse indicates that further teaching about complementary and alternative therapy may be needed? a. The nurse massages the legs of a patient who has a left foot stasis ulcer. b. The nurse checks a blood glucose on a patient with diabetes who takes aloe. c. The nurse suggests the use of acupressure to a patient with tension headaches. d. The nurse shows a family how to use hand massage to calm an agitated patient.

ANS: A Massage should not be done for a patient with open wounds. The other actions by the new nurse are appropriate

The nurse who is preparing a Muslim female for a physical examination is told by the patient, "I cannot undress completely." The nurse will appropriately choose interventions based on the knowledge that Muslim women a. observe standards of modesty requiring coverage from head to ankle. b. speak openly to women but are silent in the presence of men. c. wear writings from the Koran on the neck, arm, or waist. d. are given alcoholic beverages with each meal.

ANS: A Modesty standards in Islam may require the women to have her body covered from head to ankle. If this is the case, the nurse should arrange for the individual to be draped and able to expose one body part at a time for examination

A patient has a small piece of paper on which unfamiliar symbols are written hanging on a black string around the neck. To prepare the patient for the operating room (OR) the nurse should a. allow the patient to wear the item, but make note of it for the OR staff to see and reposition if needed. b. insist that the patient take off the item and leave it in the bedside stand. c. remove the item and tie it to the foot of the patient's bed. d. place the item in a plastic bag and lock it in the narcotics cabinet.

ANS: A Muslim patients often wear writings from the scriptures tied to their bodies. They should be allowed to remain on the patient. Making a note of the location of the writing is appropriate, so the OR staff can reposition it, if necessary, for the surgical procedure. The remaining options are incorrect, because the patient should be allowed to wear the writing.

A nurse is caring for a Sunni Muslim patient. The nurse demonstrates cultural sensitivity by understanding that the patient would likely pray to a. Allah. b. Islam. c. Buddha. d. Jesus Christ.

ANS: A Muslims believe in one God, Allah. The word Islam implies peace. In the sixth century AD, the prophet Muhammad founded Islam in Arabia. Followers of Islam are called Muslims. Siddhartha Gautama (Buddha) founded Buddhism in the sixth century BC in India. Christianity is based on a belief in Jesus Christ as the Son of God.

When dealing with cultural awareness, the nurse realizes that the term oppression involves which of the following? a. Maintaining advantages based on social group membership b. Systems that maintain disadvantages aimed purely at individuals c. Intentional discrepancies alone d. Issues at institutional levels independent of individual or cultural factors

ANS: A Oppression involves systems that maintain advantages and disadvantages based on social group membership and operate intentionally and unintentionally, at individual, cultural, and institutional levels.

A patient tells the nurse that she is accustomed to adhering to a strict schedule for meals and sleep. The nurse reports that the patient a. follows clock time. b. lives on linear time. c. is obsessive-compulsive. d. will complain if medications and treatments are not performed on time.

ANS: A People who follow clock time eat, sleep, work, and engage in recreational activities at definite times each day. People who live on linear time eat when they are hungry and sleep when tired, without regard to the clock. The assessment that the patient is obsessive-compulsive cannot be made with the provided information. The report that the patient will complain if medications and treatments are not performed on time cannot be concluded from the information provided.

Recently a community has experienced an influx of individuals from Afghanistan. What action should the nurse suggest to modify the agency environment to better accommodate these culturally diverse patients? a. Provide handouts and patient teaching materials in appropriate languages. b. Hold meetings in the community to explain the Afghan culture. c. Provide reference guides about Far Eastern cultures to all nursing staff. d. Use the cookbook method of learning to accommodate this immigrant group

ANS: A Providing information in the language of the culturally diverse group indicates that the agency is interested in serving individuals in the group. Ensuring understanding may also foster compliance by the individual. The other options would not help to accommodate the individuals from this group

A registered nurse who worked in an extended care facility could see that a patient was in the process of dying. The lab technician came to draw his blood. The nurse requested that the blood draw be postponed for a while so that the patient's wife, who was at his bedside, could spend some quiet time with her husband. This is an example of which caring behavior? a. Providing presence b. Encouraging manner c. Healing environment d. Affiliation needs

ANS: A Providing presence is a person-to-person encounter conveying closeness and a sense of caring. Presence occurs within an atmosphere of intimacy and sensitivity and is characterized by open and honest interactions. An encouraging manner occurs when a nurse is poised and cheerful and points out the good in a difficult situation, patients perceive these behaviors as caring. Having an encouraging manner also involves helping patients deal with bad feelings. A healing environment, for example, is one in which nurses check patients frequently, respect patient privacy, reduce noise, and treat the body carefully. Attending to affiliation needs occurs in nursing practice with the inclusion of family members in a patient's care. It is a key element in discharge planning. Hospitalized patients perceive nurses as caring when they are responsive to patients' families and allow them to be involved in the patient's health care situation. Often these behaviors overlap.

A religion in which members believe they receive Divine Truth from "inner" light supplied by the Holy Spirit is a. Quaker. b. Episcopalian. c. Seventh-Day Adventist. d. United Church of Christ.

ANS: A Quakers believe they receive Divine Truth from "inner" light supplied by the Holy Spirit.

5.When caring for patients, a nurse must understand the difference between religion and spirituality. Religious care helps patients maintain their faithfulness to: a.their belief systems and worship practices. b.a relationship to a higher being or life force. c.a sense of connectedness. d.the awareness of one's inner self.

ANS: A Religious care helps patients follow their belief systems and worship practices. Spirituality is an awareness of one's inner self and a sense of connection to a higher being, nature, or some purpose greater than oneself. Spirituality offers a sense of connectedness. Spirituality is unique for each person. It is a unifying theme in life and a state of being.

1.An elderly patient is dying, and begins talking to loved ones who have died before him. The nurse feels a sense of inner peace as his patient quietly dies. What is the best term for this feeling of peace? a.Self-transcendence b.Intrapersonal connectedness c.Interpersonal connectedness d.Transpersonal connectedness

ANS: A Self-transcendence refers to connecting to your inner self, which allows you to go beyond yourself to understand the meanings of experiences, whereas transcendence is the belief that there is a positive force outside of and greater than oneself that allows you to develop new perspectives that are beyond physical boundaries. Examples of transcendent moments include the feelings of awe when holding a new baby or watching the sun rise over the mountains. Spirituality offers a sense of connectedness intrapersonally (connected with oneself), interpersonally (connected with others and the environment), and transpersonally (connected with God, the unseen, or a higher power)

A religion that was founded by Siddhartha Gautama in the sixth century BC in India is a. Buddhism. b. Hinduism. c. Mormonism. d. Catholicism

ANS: A Siddhartha Gautama (Buddha) founded Buddhism in the sixth century BC in India.

The nurse is attempting to teach a patient how to perform wound care for when he goes home. Using the "teach back" method the nurse should do which of the following? a. Repeat the instructions until the patient understands. b. Present the information and clarify with closed-ended questions. c. Ask the patient if he understands the instructions. d. Ask if the patient has any questions about the technique

ANS: A The "teach back" technique is an ongoing process of asking patients for feedback, through explanation or demonstration, and presenting information in a new way until you feel confident that you communicated clearly and patients have a full understanding of the information presented. Using teach back can also help you identify explanations and communication strategies that patients most commonly understand. When using the "teach back" technique, do not ask the patient, "Do you understand? or "Do you have any questions?" Instead you should ask open-ended questions to verify the patient's understanding.

A religion that began in Scotland and evolved from John Calvin in the sixteenth century is known as a. Presbyterianism. b. Episcopalian. c. Seventh-Day Adventist. d. United Church of Christ

ANS: A The Presbyterian religion began in Scotland and evolved from John Calvin in the sixteenth century.

Which statement about culture will help the nurse implement culturally competent care? a. Each culture measures other cultures using its own ways as the norm. b. Culture is primarily based on genetic inheritance. c. Stereotypes about cultures can be accepted as true. d. Cultural diversity is based entirely on race.

ANS: A The worth of everything, within or outside the group, depends on whether it fits the world view of the cultural group. The other options are untrue statements. Culture is the total of all the ideas, beliefs, values, attitudes, communication, customs, traditions, and objects a group of people possess. A stereotype is an assumption used to describe all members of a specific group without exception. It is an expectation that all individuals in a group will act exactly the same in a situation just because they are members of that group. Cultural diversity refers to the many differences in the elements of culture in groups of people in American and Canadian society.

Which complementary and alternative therapy should the nurse suggest to a patient who has elevated triglyceride levels? a. Fish oil b. Milk thistle c. Saw palmetto d. Ginkgo biloba

ANS: A There is scientific evidence that fish oil is helpful in treating hypertriglyceridemia. The other therapies will not be helpful to lower the triglyceride levels in this patient.

The ANA, National League for Nursing, AONE, and American Association of Colleges of Nursing recommend strategies to reverse the current nursing shortage. A number of the strategies have potential for creating work environments that enable nurses to demonstrate more caring behaviors. Which of the following provisions is advocated to create a more desirable work environment? a. Provide nurses with autonomy over their practice. b. Increase the rigor in the work environment structure. c. Increase the availability of technology. d. Stress the cost-effectiveness of health care.

ANS: A To create environments conducive to caring, health care organizations must introduce greater flexibility into the work environment structure, reward experienced nurse mentors, offer programs for compassion fatigue, improve nurse staffing, and provide nurses with autonomy over their practice. A reliance on technology and cost-effective health care strategies and efforts to standardize and refine work processes all undermine the nature of caring.

. When individuals become ill, there may be a story about the meaning of the illness. When a nurse listens, the patient is: a. able to break the distress of illness. b. unable to express what he actually needed when he was ill. c. usually not able to determine what is at stake because of his illness. d. able keep the nurse from prying into his more personal life.

ANS: A When an individual becomes ill, he or she usually has a story to tell about the meaning of the illness. Being able to tell that story helps a patient break the distress of illness. He needs to be able to express what he needs when ill. The personal concerns that are part of a patient's illness story determine what is at stake for the patient. Caring through listening enables you to participate in a patient's life

1.Interventions a nurse can use to establish presence with a patient include which of the following? (Select all that apply.) a.Giving attention b.Answering questions c.Listening d.Administering medication e.Speaking with the family

ANS: A, B, C Behaviors that establish your presence include giving attention, answering questions, listening, and having a positive and encouraging (but realistic) attitude. Presence is part of the art of nursing that involves "being with" a patient versus "doing for" a patient, as in administering medication and speaking with the family. Presence is being able to offer closeness with the patient, which helps to prevent emotional and environmental isolation.

Mrs. X is a patient from South Korea. She has never experienced Western medical care. She is hospitalized with hepatitis C. Which measures will lead to successful negotiation of a treatment plan with this culturally diverse patient? (Select all that apply.) a. Encourage the patient to explain her views about the cause of illness. b. Explain the biomedical point of view of the health problem. c. Support beliefs and practices the patient sees as helpful and that do no harm. d. Realize that it is impossible to prevent a patient's use of harmful health practices.

ANS: A, B, C Encouraging the patient to explain her views about the cause of illness is necessary to understand her health beliefs. Explaining the biomedical point of view of the health problem allows the patient to compare her belief system with the biomedical explanation and to find common ground. It also helps the patient understand the rationale for treatment. This is part of the process of negotiating treatment plans with the patient. Many alternative healing practices are known to be beneficial (acupuncture), and others may do no harm if used (diet based on hot and cold principles). The nurse is participating in preserving helpful beliefs and practices. The nurse can participate in repatterning by counseling against harmful practices and supporting alternatives offered in the care plan.

Health disparities are unequal burdens of disease morbidity and mortality rates experienced by racial and ethnic groups that are often exacerbated by which of the following? (Select all that apply.) a. Social status b. Economics c. Environment d. Improved access to health care

ANS: A, B, C Healthy People 2020 defines a health disparity as "a particular type of health difference that is closely linked with social, economic, and/or environmental disadvantage." Poor access to health care is one social determinant of health that contributes to health disparities

Which statements about emotions and their expression can provide a basis for providing care to culturally diverse patients? (Select all that apply.) a. In some cultural groups, people do not display emotions openly in public. b. Emotions are universal, but cues to those emotions vary. c. Culture provides guidelines for approved ways of responding to pain. d. Silence has various culturally determined meanings.

ANS: A, B, C, D Each of the statements is correct and should be considered when planning care for patients of the majority culture and for culturally diverse patients.

A patient who uses multiple herbal products is scheduled for knee replacement surgery. Which herbal products should the nurse instruct the patient to discontinue at least 2 to 3 weeks before surgery (select all that apply)? a. Garlic b. Ginger c. Feverfew d. Echinacea e. Ginkgo biloba

ANS: A, B, C, E Feverfew, ginger, garlic, and ginkgo biloba all prolong bleeding time and should be discontinued 2 to 3 weeks before surgery. Echinacea is usually safe to continue, but if the patient has an upper respiratory tract infection, he or she probably should not have surgery.

Health care regulatory agencies, national think tanks, and government agencies expect health care organizations to incorporate cultural competence into policies and practices to ensure effective communication, patient safety and quality, and patient-centered care. Some examples of such organizational policies and practices include which of the following? (Select all that apply.) a. Instituting a requirement for all staff to be trained in cultural competence b. Maintaining the traditional description of family in written policies c. Enforcing strict visitation policies and practices d. Ensuring that persons who are deaf or speak limited English have access to an interpreter e. Embedding health literacy principles in written and verbal communication

ANS: A, D, E Health care regulatory agencies, national think tanks, and government agencies expect health care organizations to incorporate cultural competence into policies and practices to ensure effective communication, patient safety and quality, and patient-centered care. Some examples of such organizational policies and practices include: instituting a requirement for all staff to be trained in cultural competence, embedding a broad description of family in written policies, expanding visitation policies and practices to include a patient's preferences, requiring nursing staff to conduct and document a cultural assessment on all patients within the clinical documentation system, ensuring that persons who are deaf or speak limited English have access to an interpreter, and embedding health literacy principles in written and verbal communication.

Nurses demonstrate caring behaviors when they do which of the following? (Select all that apply.) a. Give clear explanations. b. Make the patient do everything for himself or herself. c. Tell the patient that getting pain medication depends on his or her cooperation. d. Share information about the patient's responses with other staff members. e. Ask permission before doing something to the patient.

ANS: A, E Caring behaviors include being honest, advocating for the patient's care preferences, giving clear explanations, keeping family members informed, asking permission before doing something to a patient, and providing comfort: Offering a warm blanket, finding food a patient can swallow, rubbing a patient's back, reading patients passages from religious texts, a favorite book, cards or mail, providing for and maintaining patient privacy, assuring patients that nursing services will be available, helping patients to do as much for themselves as possible, and teaching families how to keep patients physically comfortable.

To implement effective patient care, which patients would the nurse identify as non-Christian? (Select all that apply.) a. Mr. A, who is Jewish b. Miss B, who is Presbyterian c. Mrs. C, who is Roman Catholic d. Mr. D, who is Eastern Orthodox e. Miss E, who is Seventh-Day Adventist f. Mr. F, who is Buddhist

ANS: A, F Jewish patients believe in God but not Christ. Buddhist patients follow the teaching of Siddhartha Gautama rather than the teachings of Jesus. The remaining options are Christian religious groups.

A patient undergoing chemotherapy complains of nausea and asks the nurse whether there are any complementary and alternative therapies that may help. Which therapy should the nurse recommend to the patient? a. Green tea b. Acupuncture c. Black cohosh d. Chiropractic therapy

ANS: B Acupuncture may be helpful in decreasing chemotherapy-induced nausea. The other therapies are not used to treat nausea

The nurse is caring for a patient of a culture different from her own. To provide culturally competent care for this patient, what does the nurse need to do? a. Not be curious about other ways of being in the world b. Understand the forces that influence her own world view c. Recognize that she must not hold any bias toward the patient d. Have no predispositions relative toward the patient's culture

ANS: B Although curiosity about other ways of being in the world is an important attitude for cultural competence, it is also important for a nurse to understand the forces that influence his or her own world view. Everyone holds biases about human behavior. Bias means a predisposition to see people or things in a certain light, positive or negative (Aguilar, 2006). Becoming more aware of one's biases and attitudes about human behavior is the first step on the ladder of cultural competence that can lead to positive change.

The nurse who states, "I believe in the uniqueness and value of human beings" is basing care on the philosophy of a. cultural competence. b. individual worth. c. assimilation. d. cultural diversity.

ANS: B Belief in the uniqueness and value of each human being, regardless of differences that may be observed or perceived in that individual, is called the philosophy of individual worth. The other options do not identify this belief. Cultural competence is the continuous attempt of LPNs/LVNs to gain the knowledge and skills that will allow them to effectively provide care for patients of different cultures. Assimilation is the process of a group giving up parts of their own culture and adopting parts of the culture of the dominant group. Cultural diversity refers to the many differences in the elements of culture in groups of people in American and Canadian society.

A patient who practices Buddhism tells the nurse, "My pain is the result of things I have done in the past." The nurse, who wishes to be supportive, should respond a. "Are you saying you have been a bad person?" b. "This understanding helps give meaning to your pain." c. "Perhaps you could ask God to help you bear the pain." d. "Pain can be an enlightening experience."

ANS: B Buddhists believe pain and suffering are due to actions in this or a past life. The correct option accepts the patient's belief. The statement, "Are you saying you have been a bad person?" is probing. Encouraging a patient who practices Buddhism to ask God to help him or her bear the pain is inappropriate, because Buddhists do not believe in God. Enlightenment has a specific meaning to Buddhists; it refers to finding the truth of existence and should not be used as a general term.

A religion that was founded in the nineteenth century by Mary Baker Eddy is a. Mormonism. b. Christian Scientist. c. Jehovah's Witness. d. Seventh-Day Adventist.

ANS: B Christian Scientist (Church of Christ, Scientist) was founded in the nineteenth century by Mary Baker Eddy, who wrote Science and Health with Key to the Scriptures.

A patient who develops frequent upper respiratory infections (URIs) asks the nurse whether any herbal therapies might help. Which herbal supplement should the nurse recommend? a. Ginger b. Echinacea c. Ginkgo biloba d. St. John's wort

ANS: B Echinacea may have some benefit in reducing the incidence and duration of the common cold. Ginkgo biloba, ginger, and St. John's wort are useful for other conditions, but these therapies would not be helpful for this patient.

A nurse is caring for a patient with a debilitating chronic illness. The patient mentions several times that faith would guide her healing. The nurse knows that faith can best be defined as a: a.system of organized beliefs and worship. b.relationship with a higher power, authority, or spirit. c.source of energy needed to cope with difficult situations. d.multidimensional concept that gives comfort while a person endures hardship

ANS: B Faith is a relationship with a divinity, higher power, authority, or spirit that incorporates a reasoning faith (belief) and a trusting faith (action). Religion refers to the system of organized beliefs and worship that a person practices to outwardly express spirituality. Spirituality exists in all people regardless of their religious beliefs and it gives people the energy needed to maintain health and cope with difficult situations. Hope is multidimensional and gives comfort while a person endures hardship and personal challenges

The Jewish patient tells the nurse that he does not observe the Sabbath on Sundays. What other time interval would the nurse need to provide for patient Sabbath observances? a. Monday noon to Tuesday noon b. Friday sundown to after sunset Saturday c. Thursday midnight to Friday midnight d. Alternate Saturdays

ANS: B Jews celebrate the Sabbath from sunset Friday to sunset Saturday. The other options are not times religious groups celebrate the Sabbath

The LPN/LVN is preparing to educate a healthy patient regarding methods of birth control. The patient's history indicates she is a member of the Mormon church. The LPN/LVN is aware that education of this patient should include information related to a. oral contraceptives. b. natural family planning. c. barrier methods. d. spermicides.

ANS: B Mormon beliefs and practices allow natural methods of birth control. Artificial means may be used when the physical or emotional health of the woman is in question. Because the patient is healthy, educational information should relate to natural family planning methods.

. A nurse is caring for a patient who follows teachings from a holy book called the Koran. The nurse understands that this patient practices what religion? a. Hindu b. Islam c. Quaker d. Buddhism

ANS: B Muslims, who practice Islam, believe in one God, Allah. Salvation depends on one's commitment to Allah and his teachings in the Koran. This holy book contains the words of Allah as he spoke to Muhammad.

A nurse is working in a health care clinic. She loves her work because of all the different people she meets. She professes to care for all of them and states that she understands them because she realizes which of the following is true? a. Basically all patients are the same. b. Each person has a unique background. c. Caring for people requires very little experience. d. There are standard solutions to most health care problems.

ANS: B Patients are not all the same. Each person brings a unique background of experiences, values, and cultural perspectives to a health care encounter. Caring is always specific and relational for each nurse-patient encounter. As nurses acquire more experience, they learn that caring helps them to focus on the patients for whom they care. Caring facilitates a nurse's ability to know a patient, allowing the nurse to recognize a patient's problems and to find and implement individualized solutions.

A patient who is a member of the Church of Latter Day Saints (Mormon) must increase fluid intake. Which beverages should the nurse offer? a. Wine or beer b. Fruit juice, milk, or water c. Coffee, tea, or iced tea d. Unfermented or fermented apple juice

ANS: B Patients who are Mormon do not drink alcoholic beverages and usually avoid beverages that contain caffeine, making fruit juice, milk, or water the only correct answers.

1. For which patient should the nurse be most alert for emerging spiritual needs? a. Miss A, who has been given the diagnosis of gallbladder disease b. Mrs. B, who has been told she has metastatic cancer c. Mr. C, who has varicose veins d. Mr. D, who has herpes zoster

ANS: B Patients who have been given bad news are at high risk for experiencing spiritual distress. Of the options provided, only metastatic cancer is considered an incurable disease.

Data collection suggests that a patient's health beliefs are personalistic. Which statement by the patient would the nurse determine as consistent with personalistic health beliefs? a. "Please call my physician for me so I can discuss my symptoms." b. "I would like to wear the amulet that's in my bedside stand." c. "X-rays will find the cause of my back pain." d. "I hope the doctor will recommend surgery."

ANS: B Personalistic health beliefs suggest that illness is caused by magical powers and is cured by rituals. Wearing amulets offers protection from illness and may sometimes be considered curative. The other statements are consistent with beliefs in biomedicine

The nurse working in the neonatal intensive care unit would implement baptism for a baby not expected to live if the infant's religion is listed as a. Assembly of God. b. Roman Catholic. c. Mormon. d. Baptist

ANS: B Roman Catholic infants who are critically ill may be baptized by a nurse without a witness. Baptism is considered necessary for salvation and cleansing of all sin. The other Christian denominations do not practice infant baptism.

Which of the following is an example of the process of socialization? a. The student nurse assesses the needs of a patient who is a member of another culture. b. The student nurse learns how to think and act like a nurse. c. The student nurse uses cultural bias when evaluating the beliefs of a diverse culture. d. The student nurse demonstrates ethnocentrism related to health-illness beliefs

ANS: B Socialization is the process by which a person of one culture learns how to function within another culture. The other options are not examples of the socialization process but rather are merely statements that incorporate terms relating to culture.

. A nursing instructor is working with a Native-American student nurse. When the student is late for the first clinical day, the instructor states, "I'm not surprised she's late; Native-American students are always late." The instructor's statement is an example of a. prejudice. b. stereotyping. c. ethnocentrism. d. discrimination.

ANS: B Stereotyping is an assumption used to describe all members of a specific group without exception. It is an expectation that all individuals in a group will act exactly the same in a situation just because they are members of that group. Stereotyping ignores the individual differences that occur within every cultural group.

Which statement regarding cultural diversity can be used as a basis for caregiving? a. Silence should always be interpreted as an indication of the patient's dissatisfaction with care. b. Rules regarding the appropriate amount of eye contact vary among cultures. c. Personal space requirements are similar for all cultures. d. The germ theory of illness is universally accepted.

ANS: B The amount of eye contact that is desirable varies among cultures. The nurse should be aware of cultural norms for eye contact for culturally diverse groups. The other options are not true statements.

A nurse enters a patient's room and is very methodical in her assessment skills and in providing a safe environment, but only speaks with the patient when necessary to gather data. This nurse is: a. uncaring and probably always will be. b. most likely a product of a less caring environment. c. probably more caring with other patients. d. a product of a caring environment.

ANS: B There are no known ways that will ensure you will become a caring professional. For those who find caring a normal part of their life, caring is a product of their culture, values, experiences, and relationships with others. Persons who do not experience care in their lives often find it difficult to act in caring ways. As nurses deal with health and illness in their practice, most grow in the ability to care. Caring nurses use a caring approach in each patient encounter.

A patient refuses to remove a specific spiritual garment for daily bathing. The most appropriate action for the nurse would be to: a.remove the article anyway because the garment hinders daily care delivery. b.respect the patient's wishes and work around it. c.explain to the patient that the garment has no real spiritual value. d.identify the refusal as a sign of spiritual distress.

ANS: B To care for and meet the spiritual needs of your patients, it is essential to respect each patient's personal beliefs. People experience the world and find meaning in life in different ways and the spiritual garment has meaning for the patient. Caring for your patients' spiritual needs requires you to be compassionate and remove any personal biases or misconceptions. You need to recognize that not all patients have spiritual problems. Patients bring certain spiritual resources that help them assume healthier lives, recover from illness, or face impending death.

When Martin Luther separated from the Catholic Church because of scandals in the church, which religion was formed? a. Mormonism b. Lutheranism c. Scientology d. Jehovah's Witness

ANS: B When Martin Luther separated from the Catholic Church because of scandals in the church, this started the Reformation and the beginning of Lutheranism.

The patient was hospitalized with pneumonia. He had always been very healthy and was concerned that now his family would have to take care of him. During one conversation the nurse said to him, "This gives the ones who love you a chance to show you how much they care for you." The comment that the nurse made best demonstrated which behavior? a. Human respect b. Encouraging manner c. Healing environment d. Affiliation needs

ANS: B When a nurse remains poised and cheerful and points out the good in a difficult situation, patients perceive these behaviors as caring. Having an encouraging manner also involves helping a patient deal with negative feelings. Having an encouraging manner also involves helping patients deal with bad feelings. Human respect refers to nurses being able to appreciate the value of human beings and displaying behaviors that demonstrate value, such as accepting or paying attention to a patient. By showing respect, a nurse honors the worth of individuals. Although the nurse in this case is not disrespectful, the primary concept being demonstrated is an encouraging manner. It is important to note that concepts are not necessarily exclusive. A healing environment, for example, is one in which nurses check patients frequently, respect patient privacy, reduce noise, and treat the body carefully. Affiliation needs refer to the inclusion of family members in a patient's care. It is a key element in discharge planning. Hospitalized patients perceive nurses as caring when they are responsive to patients' families and allow them to be involved in the patient's health care situation. In this scenario, the patient's family is not involved.

A student nurse asks, "Does ethnocentrism have any negative consequences?" The most accurate reply is based on the understanding that a. discrimination is the basis for ethnocentrism and prejudice. b. ethnocentrism may give rise to prejudice, which may result in discrimination. c. prejudice has no relationship to ethnocentrism and discrimination. d. ethnocentrism has only positive consequences associated with ethnic pride.

ANS: B When ethnocentrism, the belief that one's culture is superior to other cultures, leads to intolerance of another culture, prejudice results. Discrimination results when rights and privileges are withheld from the other culture. The other options do not accurately explain the relationship.

Which nursing actions can the registered nurse (RN) delegate to a licensed practical/vocational nurse (LPN/LVN)? (select all that apply)? a. Ask a newly admitted patient about home use of herbal medications. b. Administer prescribed naproxen (Naprosyn) to a patient with osteoarthritis. c. Provide a gentle back rub to a patient who is having difficulty falling asleep. d. Teach a patient with heart disease about the benefits of fish oil supplements. e. Evaluate whether home use of aloe has affected a patient's electrolyte levels.

ANS: B, C LPN/LVN education and scope of practice includes administration of medications and therapies such as massage. Assessment, patient teaching, and evaluation of the effects of medications require more education and should be done by the RN.

A nurse is in the process of admitting an ethnically diverse patient. To plan culturally competent care, what must the nurse do? (Select all that apply.) a. Assume that cultural processes are the same within a social group. b. Conduct a systematic cultural assessment. c. Communicate effectively. d. Negotiate world view differences.

ANS: B, C, D Critical to success is your ability to conduct a systematic cultural assessment, communicate effectively, and have the skills to negotiate world view differences with others. Cultural processes frequently differ within the same social group (a family, a group of white people, a group of women friends, an immigrant family, a group of nurses) because of differences, for example, in age, gender, political association, class, or religion.

The LPN/LVN is providing care to a patient of the Roman Catholic (Western) faith. Necessary knowledge regarding beliefs, practices and nursing interventions for care of this patient would include which of the following? (Select all that apply.) a. Medicine cannot be taken before communion. b. The nurse may baptize a stillborn infant without a witness. c. Cremation is prohibited. d. Organ donation is allowed. e. Water may be taken before communion.

ANS: B, D, E People of the Roman Catholic faith may take medicine and water before communion. If the patient is a gravely ill infant, a stillbirth, or a fetus, the nurse may baptize without a witness. Cremation and organ donation are allowed.

A registered nurse who works for an orthopedic unit of an acute care hospital makes hourly rounds on his patients. He also closes the door and pulls the curtains around the beds of patients in semiprivate rooms before exposing them for treatments. This is an example of which of the following behaviors? a. Human respect b. Encouraging manner c. Healing environment d. Affiliation needs

ANS: C A healing environment, for example, is one in which nurses check patients frequently, respect patient privacy, and treat the body carefully. Such an environment leads patients to a sense of security and protection from harm. Human respect refers to nurses being able to appreciate the value of human beings and displaying behaviors that demonstrate value, such as accepting or paying attention to a patient. By showing respect, a nurse honors the worth of individuals. Having an encouraging manner also involves helping patients deal with bad feelings. Affiliation needs refers to inclusion of family members in a patient's care. It is a key element in discharge planning. Hospitalized patients perceive nurses as caring when they are responsive to patients' families and allow them to be involved in the patient's health care situation.

A female patient has just found a large lump in her breast. The health care provider needs to perform a breast biopsy. The nurse assists the patient into the proper position and offers support during the biopsy. What is the nurse doing? a. Creating a healing environment b. Fulfilling affiliation needs c. Providing a sense of presence d. Demonstrating an encouraging manner

ANS: C A sense of presence is something a nurse offers to patients with the purpose of achieving some goal, such as support, comfort, or encouragement; to diminish the intensity of unwanted feelings; or for reassurance. Establishing presence when patients are experiencing stressful events or situations is very important. A nurse's presence calms anxiety and fear related to stressful situations. Giving reassurance and thorough explanations about a procedure, remaining at a patient's side, and coaching a patient through the experience all convey a presence that is invaluable to a patient's well-being. A healing environment, for example, is one in which nurses check patients frequently, respect patient privacy, reduce noise, and treat the body carefully. Affiliation need in nursing practice occurs with the inclusion of family members in a patient's care. It is a key element in discharge planning. Having an encouraging manner occurs when a nurse is poised and cheerful and points out the good in a difficult situation. Patients perceive these behaviors as caring

When collecting data, which question provides the best understanding of the patient's culturally determined food patterns and assists with developing a culturally competent care plan? a. "What effect will hospitalization have on your family?" b. "What religious practices are important in your life?" c. "Do you use food to maintain health or treat illness?" d. "Describe the role of children in your family."

ANS: C Although each of the questions is appropriate to ask in order to increase understanding of cultural diversity, only one relates to food patterns.

A Hindu patient is admitted after a severe head injury and is near death. The organ procurement person tells the nurse, "I don't know much about the Hindu religion, and I have to talk to the family about organ donation. Can you give me any hints?" The best response for the nurse would be a. "Organ donation is prohibited by the religion." b. "The family is very concerned about where the patient's soul will go after death." c. "The religion permits organ donation, but you would have to ask the family their feelings about it." d. "It's hard to know what people who believe cows are sacred will think about organ donation."

ANS: C Although the religion permits organ donation, individuals or families may have differing viewpoints. Organ donation is not prohibited by religion, and the family would not be very concerned about where the patient's soul will go after death. The statement that "it's hard to know what people who believe cows are sacred will think about organ donation" is not culturally sensitive.

A nurse who works in a neonatal intensive care unit is caring for a critically ill infant with a poor prognosis. She is Christian and feels responsible to care for both the physical and spiritual needs of the infant and his parents. What is the best statement for the nurse to make to the parents of the infant? a."You should have the child baptized so that its soul will be saved." b."Would you like me to call the chaplain to christen your child at the bedside?" c."What can I do to support your spiritual needs?" d."I have asked my pastor to stop by and talk to you."

ANS: C Differentiate your personal spirituality from that of the patient. Your role is not to solve the spiritual problems of patients, but to provide an environment for your patients to express their spirituality. Having the child baptized or asking your pastor to come talk to the patient is applying your spiritual values on the patient. Asking permission to call the chaplain is assuming that the patient has value regarding that religious denomination.

During a discussion on cultural diversity, a nurse asks for an example of an ethnic group. The most accurate response would be a. Caucasians. b. Spanish-speaking. c. Irish-Americans. d. homosexuals.

ANS: C Ethnic groups are composed of people who are members of the same race, religion, or nation and speak the same language. Irish-Americans are an example of an ethnic group. Caucasian is a racial grouping. Spanish-speaking refers only to shared language, but the individuals might be from Mexico, Spain, or the West Indies, each of which is ethnically different. Homosexuals do not comprise an ethnic group.

A Native American patient keeps a small bunch of feathers on the over-the-bed table. They are in the way whenever the nurse serves a tray or sets up equipment for a treatment. A culturally competent action would be to a. throw them away while the patient is sleeping. b. move them to a place where they won't be in the way. c. leave them where the patient wishes to place them. d. ask why there are a bunch of feathers in a hospital room.

ANS: C Individuals of some cultures believe that amulets and charms are helpful in preventing or curing illness. It is likely that the small bunch of feathers serves this purpose. Leaving them where placed is the culturally sensitive thing to do. The nurse might also respectfully ask about the feathers to gather data about the patient's health beliefs and practices. The other options are not culturally competent behaviors.

The student nurse has been studying different cultures in relationship to nursing. She understands that transcultural nursing has been developed as a distinct discipline and can be defined as which of the following? a. Understanding that cultural patterns are generated from predetermined criteria b. Knowing that culturally congruent care is based on health care system values c. Understanding cultural similarities and differences among groups of people d. The realization that illness and disease are the same

ANS: C Leininger defines transcultural nursing as a comparative study of cultures to understand similarities (culture universal) and differences (culture-specific) across human groups. The goal of transcultural nursing is culturally congruent care, or care that fits a person's life patterns, values, and a set of meanings. Patterns and meanings are generated from people themselves rather than predetermined criteria. Culturally congruent care is sometimes different from the values and meanings of the professional health care system. To provide culturally congruent care, it is important for you to distinguish between disease and illness. Illness is the way that individuals and families react to disease, whereas disease is a malfunctioning of biological or psychological processes.

Patient A has terminal cancer, and Patient B has a bladder infection. They are sharing a hospital room. Neither patient is a member of the majority culture of the area. Patient A is quiet and rarely acknowledges pain. Patient B cries and moans loudly much of the day. What understanding will help the nurse provide culturally sensitive care for both patients? a. The better educated the person, the less likely the person is to openly express pain. b. A mentally unstable person is more likely to be noisy about pain sensations. c. People respond to the sensation of pain in culturally determined ways. d. People who distrust health care workers tend to be silent about their pain.

ANS: C One's culture influences both the definition of pain and provides guidelines for approved ways of expressing response to the sensation of pain. The other options are not true statements.

A nurse is caring for an Orthodox Jewish patient who has terminal cancer. The nurse demonstrates cultural sensitivity toward the patient by stating: a. "Would you like me to assist you in praying to Jesus?" b. "I'm sure you will go to heaven. You're a good person." c. "Would you like me to ask your rabbi to come to visit you?" d. "Would you like me to bring you a copy of the New Testament?"

ANS: C Orthodox Jews follow the traditional faith and strictly adhere to rituals. Jews believe in God but do not have a belief in Christ. A nurse should avoid making references to heaven or Jesus. Jewish clergy are called rabbis. The holy books of the Jews are the Torah and the Talmud.

A nurse is caring for a patient who refuses to consume meat on Ash Wednesday and all Fridays during Lent. The nurse understands that this patient is of what religion? a. Islam b. Mormonism c. Catholicism d. Presbyterianism

ANS: C Roman Catholics 14 years of age and older are to abstain from meat on Ash Wednesday and all Fridays during Lent. Catholics ages 14 to 59 are to fast (eat one full meal and two lighter meals) on Ash Wednesday and Good Friday. Fasting and abstaining are excused during hospitalization.

A nurse is preparing a presentation about spirituality and religion. To adequately prepare for peer questions, the nurse should know that the three major religious groups in the United States are the a. Lutherans, Catholics, and Presbyterians. b. Baptists, Assembly of God, and Lutherans. c. Roman Catholics, Protestants, and Jews. d. Protestants, Unitarians, and Catholics.

ANS: C Roman Catholics number more than 67 million members, all Protestant denominations combined have 66 million members, and Jews are estimated at 5.6 million members. The other options do not reflect current data.

A behavior to avoid when interacting with a person of a different culture is a. diversity. b. assimilation. c. stereotyping. d. behavior based on nonjudgmental attitudes.

ANS: C Stereotyping, which is making inaccurate generalizations about all members of a specific group without exception, is to be avoided. Stereotypes ignore individual differences. Diversity refers to the many differences in the elements of culture in groups of people in American and Canadian society. Assimilation is the process of a group giving up parts of their own culture and adopting parts of the culture of the dominant group. A nonjudgmental attitude involves being open-minded and taking difference at face value, accepting people as they are, and giving high-quality care.

Which information should the nurse include when discussing the use of herbal remedies with a patient? a. Many herbs are toxic and carcinogenic and should not be used. b. Frequent medical evaluation is required when a person uses herbs. c. Herbs should be purchased only from manufacturers with a history of quality control. d. Herbs are no better than conventional drugs in maintaining health and may be less safe.

ANS: C The quality of herb preparations can vary, so it is important that patients purchase herbal remedies from reputable manufacturers. When appropriately used, herbs are generally safe and have fewer side effects than conventional medications.

A patient following a kosher diet consumes a breakfast of toast, eggs, and turkey bacon. The LPN/LVN is aware that 6 hours must pass before the patient is offered a. water. b. juice. c. milk. d. coffee.

ANS: C With a kosher diet, meat may be consumed a few minutes after drinking milk, but 6 hours must pass after eating meat before drinking milk.

. A patient who uses the biomedical health belief system would be most likely to respond to interventions by a a. diviner. b. shaman. c. herbalist. d. physician

ANS: D A physician cures disease based on the biomedical health belief system. The other options refer to persons who cure disease based on the personalistic health belief system.

A nurse is caring for a 64-year-old patient who has survived cardiopulmonary resuscitation after a triple coronary artery bypass graft surgery. To help this patient cope with this experience, what is the best thing for the nurse to do? a.Recommend that the patient not discuss the experience with family. b.Assume that the near death experience was a positive experience. c.Explain that people who have not had that experience will not understand. d.Explore what happened with the patient.

ANS: D After patients have survived a near death experience (NDE), promote spiritual well-being by remaining open, giving patients a chance to explore what happened, and supporting patients as they share the experience with significant others. Patients who have an NDE are often reluctant to discuss it, thinking family or caregivers will not understand. Isolation and depression often occur. Furthermore, not all NDEs are positive experiences. However, individuals experiencing an NDE who discuss it openly with family or caregivers find acceptance and meaning from this powerful experience.

When a patient is asked about religious preference, she states, "I am agnostic." The nurse's best interpretation of this is a. the patient does not believe in God. b. the patient believes in God and supernatural powers. c. the patient does not believe that the supernatural exists. d. the patient believes that the existence of God can be neither proved nor disproved.

ANS: D Agnostics hold the belief that the existence of God can be neither proved nor disproved. Atheists do not believe that the supernatural exists, so they do not believe in God.

6.A patient who has been diagnosed with terminal liver cancer states that he does not believe in God, but he has had a meaningful life by contributing to the lives of those around him. This person is most likely which of the following? a.Buddhist b.Christian c.Agnostic d.Atheist

ANS: D Atheists search for meaning in life through their work and relationships with others. It is important for agnostics to discover meaning in what they do or how they live because they find no ultimate meaning for the way things are. They believe that we, as people, bring meaning to what we do. A Buddhist turns inward, valuing self-control, whereas a Christian looks to the love of God to provide enlightenment and direction in life.

2.The nurse is caring for a patient who states that he does not believe in the existence of God. The nurse realizes that this person: a.is not a spiritual person. b.is an agnostic. c.believes that people bring meaning into the world. d.finds meaning in life through work and relationships.

ANS: D Atheists search for meaning in life through their work and relationships with others. Spirituality exists in all people regardless of their religious beliefs and it gives people the energy needed to maintain health and cope with difficult situations. Spirituality is an important concept for individuals who either do not believe in the existence of God (atheist) or who believe that any ultimate reality is unknown or unknowable (agnostic). It is important for agnostics to discover meaning in what they do or how they live because they find no ultimate meaning for the way things are. They believe that we, as people, bring meaning to what we do.

Madeleine Leininger identifies the concept of care as the essence and unifying domain that sets nursing apart from other health care disciplines. Which of the following is true in her view? a. Care and cure are synonymous. b. Care is designed to focus only on individuals. c. Caring acts are independent of patient values. d. Caring depends on communication.

ANS: D Caring is very personal. One challenge is to find ways to communicate with patients so as to learn the culturally specific behaviors and words that reflect human caring. Care is an essential human need, necessary for the health and survival of all individuals. Care, unlike cure, assists an individual or group in improving a human condition. A caring act depends on the needs, problems, and values of a patient.

Cultural competence is the ongoing process in which a health care professional continuously strives to achieve the ability to work effectively within the cultural context. To do this effectively, what must the nurse do? a. Understand the cultural norms of the patient's community. b. See herself or himself as being culturally competent. c. Face the reality that cultural competence can take up to a year to achieve. d. View herself or himself as becoming culturally competent.

ANS: D Cultural competence is the ongoing process in which a health care professional continuously strives to achieve the ability to work effectively within the cultural context of a patient (individual, family, and community). There are a variety of models for how to acquire cultural competence. One model requires nurses to see themselves as becoming culturally competent rather than being culturally competent. It is a developmental process that evolves over a lifetime. Cultural competence goes beyond just understanding cultural norms with a patient's community—this is only a component of competence.

A student nurse assigned to a female, observant Muslim patient noticed her discomfort with several of the male health care providers. She wonders if this discomfort is related to the patient's religious beliefs. In her preparation for clinical, she learned that Muslims differ in their adherence to tradition, but that modesty is the "overarching Islamic ethic" pertaining to interaction between the sexes (Rabin, 2010). The student nurse states which of the following to the patient? a. "I'm going to request that you only have female physicians see you. Does having male nurses bother you as well?" b. "I know that it's hard to get used to, but you just have to get used to it. That's how it is in America." c. "It must be difficult for people like you to adjust to our ways, but there are limitations for all of us." d. "I know that for many of our Muslim patients modesty is very important. Is there some way I can make you more comfortable?'

ANS: D Delivering culturally congruent care to individuals and communities requires specific knowledge, skills, and attitudes. Nurses who provide culturally competent care bridge cultural gaps to provide meaningful and supportive care for all patients. The student nurse states to the patient, "I know that for many of our Muslim patients modesty is very important. Is there some way I can make you more comfortable?" The student did not assume that the information will automatically apply to this patient. Instead, the student combined her knowledge about a cultural group with the attitude of helpfulness and flexibility so as to provide quality patient-centered culturally congruent care.

In what religion do adults abstain from food, drink, and sexual activity from dawn to sunset during the ninth month of their religious calendar? a. Buddhism b. Jehovah's witness c. Mormon d. Islam

ANS: D During Ramadan, the ninth month of the Islamic calendar, adult Muslims abstain from food, drink, and sexual activity from dawn to sunset.

6. Mrs. Lee tells the nurse who asks why she ate so little of the food on her tray that her condition requires "hot" foods, so she ate only the "hot" foods on the tray. The nurse notices that several items the patient left on the tray were served hot, and several of the foods the patient ate were served cold. The nurse should a. tell the dietary department to make sure Mrs. Lee's foods are hot when served. b. check Mrs. Lee's menu choices and change choices from cold entrees to hot entrees. c. tell Mrs. Lee that no hospital food service serves entrees as hot as she may fix at home. d. ask Mrs. Lee to make a list of foods she believes would help her condition.

ANS: D For this patient, "hot" and "cold" do not refer to the temperature at which food is served but rather to culturally determined properties of the food. Asking for a list of foods Mrs. Lee believes would help her condition is the most helpful action for the nurse to take. The other options do not demonstrate understanding the culturally diverse meanings of "hot" and "cold."

Which action is most appropriate for the nurse to take when a patient with a chronic wound voices the preference of taking herbs to boost immunity rather than prescribed antibiotics? a. Instruct the patient about the rationale for antibiotic use to treat infection. b. Remind the patient that the infection has not cleared with herbal treatment. c. Tell the patient that research shows that herbs are not effective in treating infection. d. Determine how the patient feels about using antibiotics in addition to herbal products.

ANS: D Further assessment of the patient's feelings about using conventional and natural therapies is needed before further action is taken. The patient may need instruction about antibiotics if further assessment indicates that the patient is receptive to antibiotic use. Pointing out that herbal therapy has not been successful is disrespectful to the patient's belief system. Although herbal therapy alone may not eradicate the infection, some herbal therapies do improve immune function

When admitting a patient who has diabetes and poorly controlled glucose levels, the nurse obtains the information shown in the accompanying figure about the patient's use of complementary and alternative therapies. Which information is most important to report to the health care provider? a. Takes zinc when cold symptoms occur b. Practices relaxation therapies frequently c. Takes multivitamin tablet every morning d. Uses glucosamine and ginkgo biloba daily

ANS: D Glucosamine and ginkgo biloba can affect blood glucose levels and may be contributing to the blood glucose instability for the patient. The other complementary and alternative therapies (CATs) will also be reported, but are not as pertinent for this patient.

4.A patient has been diagnosed with a terminal disease. Hope may be used effectively with this type of patient. Nurses can support a patient's use of hope because hope provides a: a.system of organized beliefs and worship. b.belief in a higher power, spirit guide, God, or Allah. c.cultural connectedness, structure, and guidance in difficult times. d.motivation to achieve and the resources to use toward that achievement.

ANS: D Hope is energizing, giving individuals a motivation to achieve and the resources to use toward that achievement. Religion refers to the system of organized beliefs and worship that a person practices to outwardly express spirituality. Faith involves a belief in a higher power, spirit guide, God, or Allah. Spirituality offers a sense of connectedness. Spirituality is unique for each person. It is a unifying theme in life and a state of being

Select the patient who would benefit least from the nurse reading from the New Testament. a. Mrs. A of the Assembly of God b. Mr. B, who is Roman Catholic c. Miss C, who is a Jehovah's Witness d. Mr. D, who is an Orthodox Jew

ANS: D Mr. D, an Orthodox Jew, does not believe in Jesus as the Messiah. New Testament readings are Christianity based. The other options identify patients who are Christians.

A nurse is caring for a Sunni Muslim patient. The nurse demonstrates cultural sensitivity by a. allowing the patient to pray three times daily. b. placing the patient's dinner tray on top of the Koran. c. offering the patient food and fluids during Ramadan. d. positioning the patient's bed in a southeast direction from the United States.

ANS: D Muslims are called to prayer five times a day. If a Muslim brings the Koran, the holy book of Islam, to the health care facility, the nurse should not touch it or place anything on top of it. During Ramadan, the ninth month of the Islamic calendar, adult Muslims abstain from dawn to sunset from food, drink, and sexual activity. If a patient requests to face Mecca, the holy city of Islam, a bed or chair may be positioned in a southeast direction from the United States.

To provide effective spiritual care for a Muslim patient, the nurse recognizes that those who believe in Islam refer to God as a. Brahma. b. Moroni. c. Redeemer. d. Allah.

ANS: D Muslims believe in one god, Allah. Brahma is the Hindu creator god. Moroni is the angel sent to reveal the Book of Mormon (Church of Jesus Christ of Latter Day Saints). Redeemer is a term used by Christians to refer to Jesus.

One of the five caring processes described by Swanson (1991) is knowing the patient. The concept comprises both a nurse's understanding of a specific patient and subsequent selection of interventions. To become adept at knowing patients early, what should the nurse do? a. Check on patients at irregular times so they do not get used to a routine. b. Depend on other nurses' assessments to evaluate your own. c. Assume that your interventions are effective because they have been ordered. d. Reflect about your patient interactions and evaluations.

ANS: D Reflect about what you have learned, each time you either assess or evaluate a patient. Routinely round on patients at the beginning of a work shift and ongoing as appropriate. Do not depend on other's observations—be thorough and make your own assessment. Always go back and observe how a patient responded to your interventions.

a.recognizing that spirituality does not enhance therapeutic relationships. b.performing a definitive spiritual assessment once because spirituality does not vary. c.focusing the assessment on religious doctrine and faith. d.remembering that spirituality is very subjective

ANS: D Remember that spirituality is very subjective and has different meanings for different people. You are able to gather an accurate assessment of your patients' spirituality when you take time to build therapeutic relationships with them. Conduct an ongoing spiritual assessment the entire time you care for a patient. Focus your assessment on aspects of spirituality most likely to be influenced by life experiences, events, and questions in the case of illness and hospitalization.

A religion in which members observe the Sabbath from sunset on Friday to sunset on Saturday is a. Mormonism. b. Catholicism. c. Islam. d. Seventh-Day Adventist.

ANS: D Seventh-Day Adventists observe the Sabbath from sunset on Friday to sunset on Saturday. They do not pursue their jobs or worldly pleasures at this time.

The nurse is caring for an Orthodox Jewish patient who is close to death. An important intervention would be to find out whether the patient a. wishes to have the Sacrament of the Sick. b. has been baptized. c. wishes to have his Koran nearby. d. can be touched by the nurse after death.

ANS: D Some Jews may not want the nurse to touch the body of a deceased Jew. The nurse should respect this consideration. The other options refer to preferences of other religions.

A patient who is terminally ill describes himself as "agnostic." The nurse caring for this person can correctly assume that the patient a. does not possess spirituality. b. will not experience spiritual distress. c. will practice the rituals of a particular denomination. d. will benefit from general spiritual care interventions.

ANS: D Spiritual assessment and interventions are appropriate for agnostic patients, because all people have spirituality, even if they do not profess religious beliefs. Agnostic patients possess spirituality. Agnostics may experience spiritual distress. Agnostics do not practice the rituals of any religion

A patient tells the nurse, "I know my minister will visit me when he checks at the admissions desk and learns I'm a patient." The most facilitative response the nurse can make would be a. "I'm sure you can count on seeing your pastor within a day or two." b. "Because of a federal law, the hospital cannot make your name available to clergy." c. "Clergy rarely make calls to this hospital, so your pastor may not know you're here." d. "I can arrange for a phone so that you may call your minister and ask him to visit."

ANS: D The correct option provides an acceptable way of notifying the minister of the patient's desire for a visit without violating HIPAA privacy standards. Telling the patient that he can count on seeing his pastor within a day or two is false reassurance. It is true that due to federal law, the hospital cannot make the patient's name available to clergy, but that statement does nothing to help the patient make contact with the minister. Telling the patient that clergy rarely make calls to the hospital offers an explanation that is probably untrue.

Which statement by a nurse is an example of nonjudgmental thinking? a. "Hispanic-American patients live at the poverty level and don't have a chance." b. "Asian-American patients are unreadable. Nurses don't know what they're feeling." c. "Native-American patients could benefit from a lesson in assimilation." d. "Cultural diversity accounts for some African Americans thinking illness is caused by a curse."

ANS: D The correct statement makes no value judgments regarding whether this is good or bad. The other options make judgments

The current focus on promoting a culturally competent health care environment is on which of the following? a. The health care provider's efforts to become self-aware b. The health care provider learning about other cultures c. Avoiding the systematic provision of care d. Ensuring that cultural competence is integrated into administrative processes

ANS: D The current focus is toward systemic approaches to ensure that cultural competence is integrated into the administrative processes and the provision of care, rather than avoidance of systematic approaches. In the past, many of the methods to promote a culturally competent health care environment focused on health care providers' efforts to become self-aware and learn about other cultures.

The relief of pain and suffering give a patient comfort, dignity, respect, and peace. To enhance the therapeutic environment, what should the nurse do? a. Make the environment as noise free as possible. b. Remove personal items so that the environment is as clinical as possible. c. Focus on removing negative physical stimuli. d. Make the environment a place to soothe mind, body, and spirit.

ANS: D The relief of pain and suffering are caring nursing actions that give a patient comfort, dignity, respect, and peace. By ensuring that the patient care environment is clean, reasonably quiet, and pleasant and inclusive of personal items, you make the physical environment a place that soothes and heals the mind, body, and spirit.

The nurse assesses a patient with fibromyalgia and osteoarthritis. Which finding would indicate a need for patient teaching? a. The patient takes glucosamine daily for knee and hip pain. b. The patient attends a weekly yoga class to improve flexibility and balance. c. The patient states that prayer helps improve the pain and her ability to function. d. The patient obtains information about herbs from a salesperson at a health food store.

ANS: D The sales personnel at a health food store are not necessarily a reliable source of information. The patient may need some teaching about the safe use of herbal remedies. The other information given by the patient indicates appropriate use of complementary and alternative therapies.

The nurse sets a goal to avoid stereotyping culturally diverse patients. Which of the following measures will help the nurse attain this goal? a. Automatically apply all information known about a culture to patients of that cultural group. b. Assume that all individuals from Southeast Asia practice Buddhism. c. Refer to textbook information about cultural groups to predict individual behavior. d. Gather information about how the patient believes illness can best be treated.

ANS: D The treatments generally used by a patient will correspond to beliefs about illness causation and may reveal the expectation to combine Eastern and Western treatments. Automatically applying all information known about a culture to patients of that group, assuming that all individuals from Southeast Asia practice Buddhism, and referring to textbook information to predict individual behavior do not take into account the individual differences of patients from the same cultural groups.

The patient was admitted to the hospital with advanced-stage cancer. As the nurse was admitting her, the patient told her about how her little dog learned a new trick, and could play dead when she said "bang-bang." Why did the nurse listen attentively to the patient's story? a. She knew it was easy to do and she had nothing else to do at that time. b. It was little more than two people talking back and forth. c. She knew it was probably not going to affect the patient-nurse relationship. d. She knew it was a way to know and respond to what matters to the patient.

ANS: D True listening leads to knowing and responding to what really matters to a patient and family. Learning to listen to a patient is sometimes difficult. It is easy to become distracted by tasks at hand, colleagues shouting instructions, or other patients waiting to have their needs met. Caring is an interpersonal interaction that is much more than two persons simply talking back and forth. In a caring relationship a nurse establishes trust, opens lines of communication, and listens to what a patient has to say. Listening to the meaning of what a patient says creates a mutual relationship.

A religion that was formed in 1957 by merger of Congregational and Evangelical and Reformed Churches is a. Mormonism. b. Presbyterianism. c. Seventh-Day Adventist. d. United Church of Christ.

ANS: D United Church of Christ was formed in 1957 by merger of Congregational and Evangelical and Reformed Churches.

A student nurse is caring for a patient of Mexican descent. In an attempt to become culturally aware, the student should consciously think about which of the following? a. What people of Mexican descent believe b. The relationship between culture and ethnicity c. The fact that the patient belongs to an isolated social group d. Where the person is in the intersections of socially constructed categories

ANS: D We must understand a person's location in the intersections of socially constructed categories of privilege and oppression (e.g., race, class, gender, age, sexual orientation). This is necessary in order to, "fully understand a person's actions, choices and outcomes." Culture has historically been associated with norms, values, and traditions passed down through generations. Culture has also been perceived as synonymous with ethnicity, race, nationality, and language. These outdated ideas about culture lead to statements such as, "Mexicans believe this" or "Chinese patients are like this." In reality, culture is much more dynamic and includes race, ethnicity, gender, sexual orientation, class, immigration status, and other axes of identification. All of us are members of multiple social groups at the same time. These intersecting identities impact our experience of the world around us.