Health Disparities - LP 6

A young adult student has gone to the university's health center for a physical examination. The nurse conducting the initial interview is looking for possible lifestyle risk factors. The nurse is specifically alerted to the student's: 1. mild hypertension. 2. mountain climbing hobby. 3. family history of diabetes. 4. part-time job at the auto factory.

2. mountain climbing hobby.

Which statement made by a new graduate nurse about the teach-back technique requires intervention and further instruction by the nurse's preceptor? 1. "After teaching a patient how to use an inhaler, I need to use the teach-back technique to test my patient's technique." 2. "The teach-back technique is an ongoing process of asking patients for feedback." 3. "Using teach-back will help me identify explanations and communication strategies that my patients will most commonly understand." 4. "Using pictures, drawings, and models can enhance the effectiveness of the teach-back technique."

1. "After teaching a patient how to use an inhaler, I need to use the teach-back technique to test my patient's technique." Teach-back is not a testing of patient knowledge or ability to use devices but is a confirmation of how well a nurse explains concepts to patients.

The nurse is caring for a patient who has just had a near-death experience (NDE) following a cardiac arrest. Which intervention by the nurse best promotes the spiritual well-being of the patient after the NDE? 1. Allowing the patient to discuss the experience 2. Referring the patient to pastoral care 3. Having the patient talk to another patient who had a NDE 4. Offering to pray for the patient

1. Allowing the patient to discuss the experience Patients who experience a near-death experience (NDE) are often reluctant to speak of the experience. Allowing the patient to discuss the experience helps the patient find acceptance and meaning of the event. Allowing the patient to speak of the event helps the patient to explore what happened and promotes spiritual well-being.

Which priority nursing intervention is most important to help a patient meet the goal of smoking cessation? 1. Determine if the patient wants to stop smoking. 2. Provide information on the health risks caused by smoking. 3. Include a psychologist to help with implementing this major lifestyle change. 4. Suggest the patient use nicotine-replacement therapy to help with nicotine cravings.

1. Determine if the patient wants to stop smoking. Helping patients change behaviors can be challenging. The most important nursing intervention is to determine if a patient is willing to change. Patients typically will not be successful in making a change unless they see the need to change and they are motivated to change

The patient is told by a family member that it doesn't look like the treatments are working. What aspect of spiritual health is being threatened? 1. Hope 2. Vocation 3. Connectedness 4. Transcendence

1. Hope

A 35-year-old woman has Medicaid coverage for herself and 2 young children. She missed an appointment at the local health clinic to get an annual mammogram because she has no transportation. She gets the annual screening because her mother had breast cancer. Which of the following are social determinants of this woman's health? (Select all that apply.) 1. Medicaid insurance 2. Annual screening 3. Mother's history of breast cancer 4. Lack of transportation 5. Woman's age

1. Medicaid insurance 4. Lack of transportation 5. Woman's age Social determinants of health are the conditions in which persons are born, grow, live, work, and age. The social determinants of health are mostly responsible for health disparities. Examples include age, race and ethnicity, socioeconomic status (as reflected by the woman's insurance), access to nutritious food, transportation resources, religion, sexual orientation, level of education, literacy level, disability (physical and cognitive), and geographic location (e.g., access to health care)

During a nursing assessment a patient displayed several behaviors. Which behavior suggests the patient may have a health literacy problem? 1. Patient has difficulty completing a registration form at a medical office 2. Patient asks for written information about a health topic 3. Patient speaks Spanish as primary language 4. Patient states unfamiliarity with a newly ordered medicine

1. Patient has difficulty completing a registration form at a medical office Behaviors that might reflect a health literacy deficit include having difficulty completing registration forms or health histories, failing to make follow-up appointments, and asking few questions during a nursing history or physical examination

Some nursing students are giving flu vaccines to older adults at a retirement village. What level of prevention are the students providing? 1. Primary prevention 2. Secondary prevention 3. Tertiary prevention 4. Rehabilitation

1. Primary prevention Primary prevention prevents disease. Giving flu vaccines protects patients from getting the flu. Thus these students are practicing primary prevention

For a patient with a diagnosis of a chronic disease, a nurse wishes to encourage feelings of hope. The nurse recognizes that hope provides a(n): 1. meaning and purpose for the patient. 2. organized approach to dealing with the disease process. 3. connection to the cultural background of the patient. 4. binding relationship with the divine being of the patient's religion.

1. meaning and purpose for the patient.

A patient who is of the Jewish faith is admitted to the long-term care facility. A nurse seeks to provide sup-port of the usual health practices that are part of this religion. The nurse learns that one component of usual Jewish tradition states that: 1. no euthanasia should be used. 2. a faith healer will be involved. 3. modern medical treatment should be refused. 4. physical exams should be performed only by individuals of the same sex.

1. no euthanasia should be used.

Health care organizations must provide which of the following based on Federal civil rights laws? (Select all that apply.) 1. Provide language assistance services at all points of contact free of charge 2. Provide auxiliary aids and services, such as interpreters, note takers, and computer-aided transcription services 3. Use patients' family members to interpret difficult topics 4. Ensure that interpreters are competent in medical terminology 5. Provide language assistance to all patients who speak limited English or are deaf

1. Provide language assistance services at all points of contact free of charge 2. Provide auxiliary aids and services, such as interpreters, note takers, and computer-aided transcription services 4. Ensure that interpreters are competent in medical terminology 5. Provide language assistance to all patients who speak limited English or are deaf The CLAS standards include standards for communication and language assistance, including providing language assistance free of charge, auxiliary aids and services, interpreters competent in medical terminology, and language assistance for patients with limited English or who are deaf.

A volunteer disaster nurse is helping a family at the scene of a house fire that has destroyed all their belongings. What are the priority nursing interventions? (Select all that apply.) 1. Secure a place to stay such as a hotel or a family member's house right now. 2. Provide care for the family members who have signs of burns and smoke inhalation. 3. Suggest the family attend a support group meeting for people who have experienced fires. 4. Give the family vouchers to pay for food and medications for the next 3 days. 5. Provide a consultation to a psychologist to help the children adapt to their loss. 6. Help the family find a new house to live in while their house is being repaired.

1. Secure a place to stay such as a hotel or a family member's house right now. 2. Provide care for the family members who have signs of burns and smoke inhalation. 4. Give the family vouchers to pay for food and medications for the next 3 days. According to Maslow's hierarchy of needs, basic physiological needs such as oxygen, water, food, and sleep must be met before you can satisfy higher level needs. In this case, the family's basic needs include securing food, shelter, and medications for the immediate future. The family members who are experiencing physiological results from the fire also need to be treated immediately. Meeting the family's psychosocial needs and helping them secure long-term housing are higher needs and can be addressed later.

When creating a plan of care for a patient with a new below-the-knee amputation, the nurse will consider which factors? (Select all that apply.) 1. The patient and family may grieve the loss of the leg. 2. The patient may have difficulty coping with the change in the appearance of his body. 3. The patient may experience a change in self-concept that will lead to conflict within the family. 4. The patient and family will adjust very quickly and will experience no changes in family dynamics. 5. The loss of the leg will affect only the patient, as the patient is most affected by the change in health status.

1. The patient and family may grieve the loss of the leg. 2. The patient may have difficulty coping with the change in the appearance of his body. 3. The patient may experience a change in self-concept that will lead to conflict within the family. A major change in a patient's health status such as the loss of a limb affects the entire family. Expect patients and families to go through the grieving process. Also expect that changes in body image and selfconcept will create conflict within the family and possibly affect family dynamics. Loss of a limb is a major alteration in health that will challenge coping skills, and a longer period of time will be required to adapt to the changes caused by the surgery

The nurse is assessing the spiritual beliefs of a 15-yearold patient. Based on the patient's developmental stage, what should the nurse expect to see? 1. The patient questions why prayer is needed. 2. The patient values the support of peers. 3. The patient feels guilty for missing church. 4. The patient requests to speak to the chaplain

1. The patient questions why prayer is needed. According to Erickson's developmental stages, 15-year-olds (adolescents) are in the "Identity versus identity confusion" stage. In this stage, the adolescent questions spiritual practices and often questions or discards parents' beliefs. They begin to form their own opinions on multiple topics including religion and spirituality

When caring for a 12-year-old patient with asthma, which variables will influence the patient's health beliefs and practices? (Select all that apply.) 1. The patient's developmental stage 2. The parent's health practices 3. The patient's genetic makeup 4. The information the patient knows about asthma 5. The patient's immunization history

1. The patient's developmental stage 2. The parent's health practices 4. The information the patient knows about asthma A person's health beliefs depend on multiple factors including the person's developmental stage; the information a person knows about an illness; and the family's attitudes, opinions, and beliefs about health and illness.

A nurse is working with a patient who is experiencing chronic joint pain. To assist the patient to man-age or reduce the pain, the nurse decides to use a holistic health approach. With this in mind, the nurse specifically elects to include: 1. aroma therapy. 2. wound care. 3. hygienic care measures. 4. analgesic medications.

1. aroma therapy.

According to Erikson's stages of psychosocial devel-opment, with regard to spiritual beliefs it is expected that a 6-year-old child will: 1. begin to ask about a god or supreme being. 2. have spiritual well-being provided by the parents. 3. interpret meanings literally. 4. begin to learn the difference between right and wrong.

1. begin to ask about a god or supreme being.

The community center where a nurse volunteers has a culturally diverse population. The nurse wants to promote communication with all the patients from different cultures. A beneficial technique for the nurse is to: 1. explain nursing terms that are used. 2. use constant eye contact and touch with all patients. 3. call patients by their first names to establish rapport. 4. expect responses to all questions that are asked.

1. explain nursing terms that are used.

A nurse recognizes that primary prevention is a critical aspect in health care. The target group for a pro-gram on hand hygiene for this level of prevention is: 1. fourth-grade children at the elementary school. 2. patients in a cardiac rehabilitation program at the medical center. 3. parents of a child with a congenital heart defect. 4. patients with diabetes at the outpatient clinic.

1. fourth-grade children at the elementary school.

In preparing to teach a community group about general health promotion, the nurse recognizes that the program should focus on: 1. providing ways for individuals to achieve control of their lives. 2. helping people to avoid functional declines. 3. motivating the group to reach more stable levels of wellness. 4. giving information about specific disease processes

1. providing ways for individuals to achieve control of their lives.

A nurse recognizes an environmental risk for illness upon learning that the patient: 1. works in a chemical plant. 2. has a history of heart disease. 3. admits to intermittent substance abuse. 4. is older than 65 years of age.

1. works in a chemical plant.

Which of the following questions asked by the nurse assesses the patient's fellowship and community? 1. "How happy are you with your life?" 2. "Who was your greatest support while you were recovering from your previous surgery?" 3. "How has your illness impacted your life?" 4. "What spiritual practices can I help you continue while you are in the hospital?"

2. "Who was your greatest support while you were recovering from your previous surgery?" Fellowship and community are focused on the relationships that individuals have with other people. This includes family, close friends, church members, coworkers, and neighbors. There is a sense of community in these relationships. Asking about social support during illness or other challenging situations assesses fellowship and community.

A young adult is diagnosed with a very aggressive form of cancer. He yells at the nurse, "Why did this happen to me?" The nurse's best response is: 1. "Do you think that you did something wrong?" 2. "You sound upset about your situation. Let's talk about it." 3. "Tell me why you think this is unfair." 4. "What makes you say that?"

2. "You sound upset about your situation. Let's talk about it."

Which of the following is an example of a health disparity? (Select all that apply.) 1. A patient who has a homosexual sexual preference 2. A patient unable to access primary care services 3. Patients living with a chronic disease 4. A family who relies on public transportation 5. A patient who has had a history of smoking for 10 years

2. A patient unable to access primary care services 3. Patients living with a chronic disease 5. A patient who has had a history of smoking for 10 years Poor health status (chronic disease), disease risk factors (smoking history), poor health outcomes, and limited access to health care (unable to access primary care) are types of health disparities

The nurse is caring for a woman who is recovering from a total hip replacement. During the assessment, the nurse learns that the patient is Roman Catholic. The patient tells the nurse is she very nervous about starting therapy. Based on this information, which of the following interventions does the nurse implement to enhance the patient's spiritual health? (Select all that apply.) 1. Giving the patient an antianxiety medication 2. Asking the patient if she would like to pray with the nurse 3. Asking the patient if she would like pastoral care to visit 4. Providing the patient privacy while she is praying the rosary 5. Telling the patient that therapy will help her get home

2. Asking the patient if she would like to pray with the nurse 3. Asking the patient if she would like pastoral care to visit 4. Providing the patient privacy while she is praying the rosary Praying with someone, encouraging participation in spiritual rituals, and establishing presence with a person have the potential to decrease anxiety and enhance spiritual health.

An interprofessional health care team is developing a health education program for a middle school. Which health topics are consistent with the goals of Healthy People 2020? (Select all that apply.) 1. Determining the best treatment for strep throat 2. Explaining why it is important to get immunizations as scheduled 3. Teaching about healthy snacks 4. Describing why genetically modified foods are controversial 5. Teaching different ways to fit exercise into the daily routine 6. Explaining the problems related to lead exposure in the environment

2. Explaining why it is important to get immunizations as scheduled 3. Teaching about healthy snacks 5. Teaching different ways to fit exercise into the daily routine 6. Explaining the problems related to lead exposure in the environment Healthy People 2020 provides objectives to help people in the United States achieve higher quality lives free of disease, disability, injury, and premature death. Teaching about immunizations, teaching about healthy nutrition, teaching about exercise, and teaching about environmental safety all meet the goals of Healthy People 2020. Determining treatment for strep throat and talking about why genetically modified foods are controversial do not fit within the Healthy People 2020 goals.

A nurse caring for a patient who recently was diagnosed with cancer assesses the patient's spiritual, emotional, social, and physical needs. Then the nurse teaches the patient how to use breathing exercises to manage anxiety. What health model is the nurse using in this patient's plan of care? 1. Healthy promotion model 2. Holistic health model 3. Health belief model 4. Maslow's hierarchy of needs

2. Holistic health model The holistic health model views all aspects of a patient's health including spiritual, emotional, social, and physical. Nurses who use this model engage patients in their own care and recovery. The nurse in this question is applying all these aspects of the holistic health model to this patient's care.

Which of the following questions is appropriate to use to determine the patient's parenting style/family roles? 1. Are there particular methods being used for treat-ment of illness? 2. Who makes the decisions in the family? 3. Is there a religion or faith to which the patient adheres? 4. Is touch an acceptable form of communication?

2. Who makes the decisions in the family?

At the tertiary level of prevention, a nurse would prepare an educational program for a group requiring: 1. chemotherapy. 2. cardiac rehabilitation. 3. genetic screening. 4. sex education.

2. cardiac rehabilitation.

A nurse is completing an assessment for a patient who has gone to a medical clinic. Variables that influence the patient's health beliefs and practices are being determined. The nurse is aware that an internal variable for this patient is the: 1. way in which the patient celebrates family occasions. 2. manner in which the patient deals with stress on the job and at home. 3. frequency of the family's visit to the health care agency. 4. amount of insurance coverage that is provided by the patient's employer.

2. manner in which the patient deals with stress on the job and at home.

The nurse is assessing a patient who has decided to begin running and exercising regularly. Which patient statement reflects the action phase? 1. "I really need to start working out and running to improve my health." 2. "I went to a gym to talk with a personal trainer and have developed a fitness plan I think will work for me." 3. "I have been getting up early at least 3 days a week for the past month to exercise for at least 30 minutes every day." 4. "Now that I have been exercising regularly for the past 7 months, I can tell I have a lot more energy and I have lost weight."

3. "I have been getting up early at least 3 days a week for the past month to exercise for at least 30 minutes every day." The action phase occurs when a patient is actively engaged in strategies to change behavior. This stage can last up to 6 months. Exercising regularly for a month demonstrates commitment of time and energy to the change.

To determine a patient's stage in the process of changing behaviors in response to being diagnosed with diabetes, a nurse can conclude that the patient is in the maintenance stage on the basis of which response? 1. "I don't believe I need injections because I feel okay." 2. "I may need to adjust my diet a little." 3. "I take my insulin daily as ordered." 4. "I have been trying to learn the diet plan."

3. "I take my insulin daily as ordered."

You are completing a spiritual assessment on a 27-yearold man admitted to the hospital following a spinal cord injury. When you ask him if he prays to God, he replies, "I don't pray to God because I don't know if he exists." Based on his reply, this man most likely is an: 1. Agenic. 2. Atheist. 3. Agnostic. 4. Anarchist

3. Agnostic. Individuals who believe that ultimate reality is unknown or unknowable are agnostics. These individuals do not necessarily believe in a higher being. Rather, agnostics question whether a higher being exists and believe that it cannot be known whether or not that higher being exists. Agnostics believe that we bring meaning to what we do

The nurse provides care to an infant, born to Orthodox Jewish parents, who had a circumcision 8 days after his birth. The nurse recognizes that this best describes what component of spirituality? 1. Fellowship and community 2. Connectedness 3. Ritual and practice 4. Life satisfaction

3. Ritual and practice Rituals and practices help you to understand an individual's spirituality. Each religious group has its own rituals and practices. Circumcision for male infants 8 days after birth is practiced by individuals of the Orthodox and Conservative Jewish faith.

A public health nurse is caring for a new mother who just gave birth to her second child. The nurse identifies which risk factor for postpartum depression as modifiable? 1. The mother experienced postpartum depression with her first pregnancy. 2. The mother's sister has bipolar disorder. 3. The mother is not eating or sleeping well because of high levels of stress. 4. The mother experienced depression during this pregnancy.

3. The mother is not eating or sleeping well because of high levels of stress. Modifiable risk factors can be changed. The only risk factor on this list that the nurse can change is to help the new mother cope with her stress. The other risk factors this mother has for postpartum depression cannot be changed; they are nonmodifiable.

A nurse working in a large occupational health clinic knows that many of the workers at her company are marginalized and at risk for poor health outcomes. Which of the following individuals are most likely to be marginalized? 1. Wives of the employees 2. The head supervisors of the company 3. Workers who have a high school education 4. Workers employed for less than a year at the company

3. Workers who have a high school education Examples of marginalized groups include people who are gay, lesbian, bisexual, or transgender; people of color; people who are physically and/or mentally challenged; and people who are not college educated

A nurse is reviewing the plan of care for a 66-year-old home-care patient who is experiencing the begin-ning stages of Alzheimer disease. The nurse believes that the patient may need to be assessed for spiritual needs based on discovering: 1. memory problems. 2. a difficulty with ADLs. 3. an inability to cope with the illness. 4. a family history of the disease.

3. an inability to cope with the illness.

When working with an interpreter for a patient who speaks another language, the nurse should: 1. direct questions to the interpreter. 2. expect word-for-word translation. 3. ensure that the interpreter speaks the patient's dialect. 4. ask the interpreter to evaluate the patient's non-verbal behaviors.

3. ensure that the interpreter speaks the patient's dialect.

A nurse is leading a group of community members who are trying to quit smoking. In the precontemplation phase of health behavior change, the nurse anticipates that the group members will respond by: 1. discussing previous attempts at quitting. 2. recognizing the benefits of not smoking. 3. expressing irritation when the topic of quitting is introduced. 4. requesting phone numbers of support people who have participated in the group.

3. expressing irritation when the topic of quitting is introduced.

At the secondary level of prevention, the intervention that a nurse expects to assist with or provide instruction for is: 1. immunization. 2. bathing a newborn. 3. performance of a blood test for lipid levels. 4. referral to outpatient therapy for monitoring.

3. performance of a blood test for lipid levels.

According to Erikson's stages of psychosocial devel-opment, with regard to spiritual beliefs it is expected that a middle-aged person will begin to: 1. reflect on inconsistencies in religious stories. 2. form independent beliefs and attitudes. 3. review value systems during a crisis. 4. sort fantasy from fact.

3. review value systems during a crisis.

A patient who is recovering after recently experiencing third-degree burns shows connectedness when she states: 1. "My pain medicine helps me feel better." 2. "I know I will get better if I just keep trying." 3. "I see God's grace and become relaxed when I watch the sun set at night." 4. "I feel so much closer to God after I read my Bible and pray."

4. "I feel so much closer to God after I read my Bible and pray." Connectedness is a dimension of spirituality that is related to the human need of belonging. Individuals can be connected to themselves, others, God or another Supreme Being, or nature. Individuals often stay connected to God through prayer.

The nurse is caring for a patient with obesity and a family history of type 2 diabetes. Which patient statement reflects the contemplation phase of behavior change? 1. "I am happy with my health. I really don't need to make any changes." 2. "I tried to exercise more about a year ago, but it really didn't work." 3. "I made an exercise plan that I think I'll start in a couple of weeks. Can you look at it with me?" 4. "I know I have to make a change. I think I'll start exercising more in 2 months when I have more time."

4. "I know I have to make a change. I think I'll start exercising more in 2 months when I have more time." Patients in the contemplation stage are considering making a change within the next 6 months. Patients will often state they know they have a problem and they are in the process of making a plan for change.

While caring for a patient in the intensive care unit, the patient has a cardiac arrest. The patient is successfully resuscitated. After this near-death experience, the patient is progressing physically, but appears withdrawn and concerned. The nurse assists the patient by stating: 1. "The experience that you had is easy to explain and understand." 2. "That was a very close call. It must be very frightening for you." 3. "Other people have had similar experiences and worked through their feelings." 4. "If you would like to talk about your experience, I will stay with you."

4. "If you would like to talk about your experience, I will stay with you."

A patient is admitted to a medical center for surgery to repair a fractured hip. Upon reviewing the patient's admission history, a nurse finds that the patient at-tends religious services routinely. The nurse supports the patient's needs by stating: 1. "Do you really go to services often?" 2. "Don't worry. God will take care of you." 3. "I'll call your minister and have him stop by to see you." 4. "Is there any way that I may be able to help you with your spiritual needs?"

4. "Is there any way that I may be able to help you with your spiritual needs?"

The patient's family wants to bring in food that is approved for their religion. Which of the following is the best response by the nurse? 1. "The patient cannot have foods that are brought in from outside of the hospital." 2. "That would be great. Bring in anything that the patient likes to eat." 3. "The most important thing is to make sure that everything is cooked well." 4. "What type of food are you going to bring? Let's make sure that it fits with the prescribed diet."

4. "What type of food are you going to bring? Let's make sure that it fits with the prescribed diet."

A Puerto Rican mother is concerned about her child's flulike symptoms. You learn from the health assessment that the mother practices use of "hot" and "cold" foods to treat ailments. Which of the following foods do you expect the mother to use to treat her child? 1. Chicken 2. Yogurt 3. Fresh fruits 4. Eggs

4. Eggs Eggs are the only "hot" food that would be used to treat flu, which is considered a "cold" condition

The nurse is caring for a patient who had a stroke and has some right-side paralysis. The patient states, "I have been praying to God and I know that he will help me cope with my problems and give me the courage to face my challenges in rehabilitation." Which nursing diagnosis is this patient likely experiencing? 1. Spiritual Distress 2. Ineffective Coping 3. Risk for Spiritual Distress 4. Readiness for Enhanced Spiritual Well-Being

4. Readiness for Enhanced Spiritual Well-Being The diagnosis of Readiness for Enhanced Spiritual Well-Being is used when a patient expresses meaning and purpose in life through connectedness with a power greater than self, which can be strengthened. Patients who experience readiness for enhanced spiritual wellbeing express a desire to enhance prayerfulness and to enhance connectedness to a higher power.

The nurse is caring for a hospitalized patient who is of the Hindu faith. Which action by the nursing assistive personnel (NAP) required the nurse to intervene? 1. The NAP gives the patient privacy during a prayer ritual. 2. The NAP plans care around the patient's purity rituals. 3. The NAP encourages the patient's family to visit with the patient. 4. The NAP tells the patient that he or she must remove the amulet while in the hospital.

4. The NAP tells the patient that he or she must remove the amulet while in the hospital. Individuals who practice Hinduism allow time for prayer and purity rituals. In the practice of Hinduism, the use of amulets, rituals, and symbols is common. The nurse needs to intervene when the NAP tells the patient that he or she must remove the amulet. Asking the patient to give up an important spiritual symbol is not providing patient-centered care

According to Maslow's hierarchy of needs, a patient's priority should be: 1. physical safety. 2. psychological safety. 3. self-esteem. 4. adequate nutrition.

4. adequate nutrition.

A nurse is meeting a patient for the first time for the admission interview. There are eight family members sitting around the patient's bed. After introductions, the most appropriate nursing action is to: 1. come back at another time. 2. proceed with the admission interview. 3. ask the family members to leave immediately. 4. ask the patient if he or she wants a family member present.

4. ask the patient if he or she wants a family member present.

What is intersectionality?

A policy model that describes factors and power structures that shape and influence life

What is ernic world view?

An outsider's perspective in an intercultural encounter

What is etic worldview?

An outsider's perspective in an intercultural encounter

Interrelated concepts regarding patient attributes that a nurse manager would consider when addressing concerns about the quality of health promotion include which type of attribute? a) Culture b) Evidence c) Health policy d) Nutrition

a) Culture Culture, development, adherence, and motivation are patient attribute concepts. Interrelated concepts regarding professional nursing include evidence, health care economics, health policy, and patient education. Nutrition is a health and illness concept.

Cultural competence is a process of ___________ culturally competent, not ___________ culturally competent

Becoming, being. Cultural competence is a process of becoming culturally competent, not being culturally competent. The development of cultural competence is a lifelong experience.

What is world view?

Factor that shapes how people perceive others and how they relate to reality

True or False Patients who are not practicing a specific religion do not have spiritual needs

False

What is the LEARN model?

L - Listen to what the patient has to say E - Explain your perception of the problem A - Acknowledge the similarities and differences of perception R - Recommend a plan of action that takes into account both perspectives N - Negotiate a plan that is mutually acceptable

What is cultural desire?

The motivation of a health care professional to "want to" engage in cultural competency.

The nurse is assessing learning needs for a patient who has coronary heart disease. The nurse finds that the patient has recently made dietary changes to decrease fat intake and has stopped smoking. The best initial response by the nurse at this time is a) "You did an excellent job of changing your eating habits and quitting smoking. This is so important for your heart health. Nice work!'' b) "Although the changes you made are important, it is essential that you make other changes, too." c) "Which additional changes in your lifestyle would you like to implement at this time?" d) "Are you having any difficulty in maintaining the changes you have already made?"

a) "You did an excellent job of changing your eating habits and quitting smoking. This is so important for your heart health. Nice work!'' The perceived behavioral expectations (normative beliefs) of family, friends, coworkers, and health care providers influence an individual's motivation to comply with the perceived social pressures from these groups (subjective norm) to behave in a certain way. Responses B, C, and F are appropriate, but A is the best initial response.

A patient is being treated for tuberculosis (TB) with a standard four-drug regimen but continues to have positive sputum smears for acid-fast bacilli. Which actions should the nurse implement? (Select all that apply.) a) Assist the patient with short-term goals and plan teaching according to these goals. b) Provide the patient with all the educational materials about drug-resistant TB. c) Refer the patient to a pulmonary specialist, who can assist the patient with the treatment regimen. d) Ask the patient about any barriers to obtaining medications/Ask the patient whether medications have been taken as directed.

a) Assist the patient with short-term goals and plan teaching according to these goals. b) Provide the patient with all the educational materials about drug-resistant TB. d) Ask the patient about any barriers to obtaining medications/Ask the patient whether medications have been taken as directed. The first action should be to determine whether the patient has been compliant or encountered any barriers with completing the drug therapy regimen; because negative sputum smears would be expected if the TB bacillus is susceptible to the medications and if the medications have been taken correctly. Obtaining medications may be a factor in whether the client is taking medications as prescribed. Depending on whether the patient has been compliant or not, goals should be established and different medications or directly observed therapy may be indicated. The nurse is responsible and capable of providing education to patients regarding medication regimens and illness pathology. Referring the patient will not help with determining compliance.

A patient is admitted to the long-term care setting. The nurse notes that the patient does not read or write well. Which nursing actions are priority while developing a teaching plan to increase adherence? (Select all that apply.) a) Determine the patient's motivation and readiness to learn. b) Assess what the patient knows about their health issues. c) Include the family in the orientation to the unit and include them in the teaching process. d) Assess what grade level the patient can read and write and tailor teaching strategies accordingly. e) Give the patient brochures with more pictures and explanations with short sentences.

a) Determine the patient's motivation and readiness to learn. b) Assess what the patient knows about their health issues. c) Include the family in the orientation to the unit and include them in the teaching process. d) Assess what grade level the patient can read and write and tailor teaching strategies accordingly. It is most important to determine the level at which the patient will understand then the nurse can avoid teaching over the patient's level of understanding. Motivation is an important component to learning new information. Assessing what the patient does know will help determine what areas still need to be addressed. Including the family will aid in the teaching process. The patient may not be able to read even short sentences. The priority is to assess the patient's reading level first, then choose appropriate teaching tools.

The nurse assesses that a patient has not been taking antihypertension medication as prescribed. How should the nurse proceed? (Select all that apply.) a) Evaluate the teaching plan to determine if there is a need to reeducate the patient. b) Assess the patient's perception and attitude towards the risks associated with missing doses of medication. c) Review and reinforce the need to take the medication as prescribed. d) Ask the provider to prescribe a different medication because the patient does not want to take this medication. e) Emphasize the risk of stroke or heart attack if the patient does not adhere to the treatment plan.

a) Evaluate the teaching plan to determine if there is a need to reeducate the patient. b) Assess the patient's perception and attitude towards the risks associated with missing doses of medication. c) Review and reinforce the need to take the medication as prescribed. The patient may need additional information. Assessing what the patient's perceptions are will provide the nurse with insight on how to proceed next. Reviewing and reinforcing will reaffirm the importance of taking the medication which leads to adherence. The nurse should first explore why the patient is not taking the medication before requesting a different medication order from the provider. Scare tactics may cause the patient to become defensive and may lead to nonadherence.

A 15-year-old pregnant patient asks the nurse how she can take care of herself and her baby at home. What education should the nurse include in this patient's teaching plan? (Select all that apply.) a) Healthy diet b) Physical activity c) Taking prenatal d)vitamins e) Avoiding alcohol f) Infant bathing

a) Healthy diet b) Physical activity c) Taking prenatal d)vitamins e) Avoiding alcohol Regular prenatal care helps to inform women about the steps they can take to ensure a healthy pregnancy. These include: consuming a safe and healthy diet, taking a prenatal vitamin with minimum daily folic acid requirements, getting regular exercise, avoiding an exposure to harmful environmental substances, avoiding alcohol and drugs, and managing pre-existing conditions. Knowledge of infant bathing does not enhance or hinder the patient from experiencing a healthy pregnancy and is not relevant at this time.

The nurse should identify which factors that put a patient diagnosed with diabetes at risk for inadequately self-managed blood glucose levels? (Select all that apply.) a) Obesity b) Desk job c) New car d) Busy lifestyle e) Regular exercise

a) Obesity b) Desk job d) Busy lifestyle Effective self-management of diabetes is essential for patients to avoid complications. Several factors that put a client at risk for inadequately controlled blood glucose levels include: being overweight, sedentary lifestyle (desk job), and non-compliance with medication and self-monitoring. Important factors in the successful self-management of diabetes include regular visits to a provider, medication adherence, and setting realistic goals for engaging in health-promoting lifestyle behaviors (i.e., exercise and healthy diet). A new car indicates this patient has transportation to attend regular provider appointments. A busy lifestyle could hinder a patient from regularly checking blood sugar levels and attending office appointments.

The school nurse incorporates seatbelt and helmet use in a high school class on health promotion as examples of which strategies? a) Primary prevention b) Rehabilitation c) Secondary prevention d) Tertiary prevention

a) Primary prevention Seatbelt and helmet use are considered primary prevention measures, or strategies aimed at optimizing health and disease prevention in general. Rehabilitation strategies are tertiary prevention measures, which minimize the effects of disease and disability. Secondary prevention strategies are measures designed to identify individuals in an early stage of a disease process so that prompt treatment can be started.

The nurse is assessing spiritual needs for a patient who has been newly diagnosed with a chronic illness. Which are appropriate nursing interventions for the spiritual care of this patient? (Select all that apply.) a) Shared laughter b) Shared tears c) Listening to the patient d) Administering medication e) Praying with the patient f) Ambulating the patient

a) Shared laughter b) Shared tears c) Listening to the patient e) Praying with the patient Spiritual care involves recognizing and honoring the religious beliefs and practices of those in our care but it can also be shared laughter or tears or remembering a patient's birthday. Spiritual care can be keeping vigil with a family as a loved one struggles to recover. It can be crying with that same family. It can be supporting a chronically ill individual who is struggling to redefine his worth and personal meaning in light of the illness and its demands. It can be a gentle backrub coupled with soothing words that allows a worried patient to sleep. It can be a shared prayer or religious reading that has special meaning to the patient. Spiritual care cannot be boxed in and narrowly defined. Spiritual care is not limited to those who believe a certain way or who define God according to a specific doctrine. Administering medication and ambulating the patient better address the physical needs versus spiritual needs of this patient.

The nurse identifies which attributes and criteria of the concept of spirituality? (Select all that apply.) a) Sprituality is universal. b) Physical illness does not impact the spirit. c) Spirituality manifests whether a person acts on personal beliefs or not. d) Family and culture impact spiritual beliefs. e) Nurses should be aware of local community-based religious organizations.

a) Sprituality is universal. d) Family and culture impact spiritual beliefs. e) Nurses should be aware of local community-based religious organizations. Spirituality is universal. All individuals, even those who profess no religious belief, are driven to derive meaning and purpose from life. Illness impacts spirituality in a variety of ways. Some patients and families will draw closer to God or however they conceive that Higher Power to be in an effort to seek support, healing, and comfort. Others may blame and feel anger towards that Higher Power for any illness and misfortune that may have befallen a loved one or their entire family. Still others will be neutral in their spiritual reactions. There has to be willingness on the part of patient and/or family to share and/or act on spiritual beliefs and practices. The nurse needs to be aware that specific spiritual beliefs and practices are impacted by family and culture. Community-based religious organizations can provide supportive care to families and patients and nurses need to be aware of these resources.

The nurse should identify which potential health disparities when conducting an admission assessment on a hospitalized patient? (Select all that apply.) a) Unsatisfying, low-paying job b) Frequent smoker c) Comprehensive health insurance d) Recently divorced e) African-American male

a) Unsatisfying, low-paying job b) Frequent smoker d) Recently divorced e) African-American male Determinants of health disparities can assist the nurse in identifying patients at risk. Exposure to stressful living, such as financial insecurity due to a low paying job, is a risk factor for health disparity. Smoking is an example of an unhealthy behavior that is chosen. Being recently divorced places the patient at risk due to high stress. Natural, biological variations such as being African-American can be risk factors as African- Americans are more prone to hypertension. Lack of health insurance is a disparity; but comprehensive health insurance is a positive attribute leading to improved health.

A nursing instructor evaluates that a nursing student understands the concept of spirituality in nursing practice when the student makes which statement? a) A lack of spirituality theories has contributed to the omission of this aspect of care. b) A lack of spirituality assessment can have a negative impact on patient care. c) Spirituality assessment is not part of professional nursing care but should be included in holistic care. d) There are currently no nursing diagnoses addressing spirituality to include in the plan of care.

b) A lack of spirituality assessment can have a negative impact on patient care. Professional organizations have incorporated spirituality into holistic care and developed mandates to provide spiritual care because the lack of addressing spirituality may negatively impact patient care. Theory has contributed to the emphasis on spirituality in patient care and enhanced this concept in holistic care. Every professional document that focuses on standards of nursing practice includes a statement regarding nursing's responsibility to address spiritual concerns. In Nursing Intervention Classification, two standard nursing interventions are identified that directly relate to spiritual care.

Which tertiary prevention measure is included in the plan of care for a patient newly diagnosed with asthma? a) Cholesterol screening b) Eliminating allergens c) Glaucoma screening d) Safe sex practices

b) Eliminating allergens Eliminating allergens is considered a tertiary prevention measure, or one that minimizes the problems with asthma and potential responses to environmental triggers, effects of asthma disease and disability. Cholesterol screening is considered a form of secondary screening, which involves measures designed to identify individuals in an early stage of a disease process so that prompt treatment can be started. Glaucoma screening is also considered a form of secondary screening. Safe sex practices are considered a form of primary prevention, or strategies aimed at optimizing health and disease prevention in general and not linked to a single disease entity.

What is the process of enabling people to increase control over and improve their health? a) Community care b) Health promotion c) High-level wellness d) Primary prevention

b) Health promotion Health promotion is the process of enabling people to increase control over, and improve, their health, according to the World Health Organization. Community care refers to interventions directed at a community rather than a process. High-level wellness refers to a positive state of health for an individual, a family, or a community; it is not a process. Primary prevention refers to strategies aimed at optimizing health and disease prevention rather than a process.

The nurse is completing a health history on a Mexican-American patient who works odd jobs as available and lives with multiple family members ranging from infant to older adult ages. One vehicle is shared amongst the family members, and the family shares one bathroom in a two-room apartment. What possible health disparities should the nurse identify and explore for this patient? (Select all that apply.) a) Comprehensive insurance b) Low income c) Lack of self-grooming d) Inadequate sleep e) Educational level

b) Low income c) Lack of self-grooming d) Inadequate sleep e) Educational level Based on the patient's living arrangements and job status, the nurse should investigate possible health disparities such as low income, lack of grooming (only one bath available), inadequate sleep, and low educational level. Comprehensive insurance is not a health disparity but is an assess to ensure adequate health care.

Indicate which of the following statements about spirituality is/are correct. (Select all that apply.) a) Patients who identify a religious belief will all practice similar rituals. b) Promoting spirituality can help a patient cope with illness. c) Promoting a patient's spirituality may reduce the incidence of depression. d) The link between spirituality and physical health is well understood. e) Spirituality exists in all people regardless of their religious beliefs.

b) Promoting spirituality can help a patient cope with illness. c) Promoting a patient's spirituality may reduce the incidence of depression. e) Spirituality exists in all people regardless of their religious beliefs.

The nurse conducting research on health disparities applies the idea that the reality of life is based on a mental representation developed from socially shared understandings within a society. Which theoretical framework model is the nurse using? a) Cultural competence b) Structural-constructivist c) Cultural awareness d) Cultural proficiency

b) Structural-constructivist The structural-constructivist model is based on an assumption of dual nature of human existence. The model adopts a constructivist perspective that the reality of life is based on a mental representation constructed socially shared understandings within a society. This perspective/model strongly supports the idea of social and cultural construction of race/ethnicity that frequently results in health disparities observed in health care systems and gives direction for nursing research and practice in understanding health disparities in clinical settings and community settings.

You are working with a patient who has undergone transgender transformation to become a male. Western cultural masculine attributes to emphasize include a) harmonious relationships, modesty, and caretaking. b) achievement, material success, and recognition. c) fitness, fidelity, and stamina. d) generosity, sportsmanship, and leadership.

b) achievement, material success, and recognition. Masculinity versus femininity describes how gender roles are distributed and how greatly male and female roles differ. Some societies, such as Western societies, place a greater value on masculine attributes such as achievement, material success, and recognition than on more feminine attributes such as harmonious relationships, modesty, and taking care of others. Fitness, fidelity, stamina, generosity, sportsmanship, and leadership are not Western cultural masculine attributes that would be emphasized.

When providing nutritional education for a Mexican-American patient with newly diagnosed hypertension, the nurse notes that the patient is nodding "yes" to everything that is being said. With a better understanding of cultural interdependence, a nurse should immediately a) write everything down for the patient to refer to later. b) prompt the patient further to elicit additional questions or concerns. c) call the recognized elder for this patient. d) call the patient's oldest male relative for help with decision making.

b) prompt the patient further to elicit additional questions or concerns. The patient is nodding "yes" because it is a polite way of indicating that the power distance is too close for the patient. Acknowledging power distance is the way in which a less powerful member of an organization or institution (such as a family) accepts and indicates that power is being distributed unequally. Cultures that endorse a low power distance expect and accept power relations that are more consultative or democratic. People relate to one another more as equals, regardless of formal positions in the culture. Subordinates are more comfortable with and demand the right to contribute to and critique the decision making of those in power. In cultures that endorse a high power distance, less powerful persons accept power relations that are more autocratic and paternalistic. Subordinates acknowledge the power of others simply based on where they are situated in certain formal, hierarchical positions. When a nurse provides nutritional education for a patient who is from a culture that values a greater power distance, as does the Mexican-American culture, it might appear that the patient is willing to accept all that the nurse suggests; further prompting would elicit additional questions or concerns. A patient from a collectivist culture will usually consult family members about the best course of action. It is not acceptable for a nurse to take it upon herself or himself to call a recognized elder or oldest male relative for help with decision making. Although writing everything down may be acceptable in some cultures, with an Asian patient it may be best to prompt the patient further to elicit additional questions or concerns.

A patient who has recently moved to this country states he is frustrated about the pressure to give up his original identity and develop a new cultural identity. The nurse should use which term to best describe this type of cultural change? a) Biculturalism b) Acculturation c) Assimilation d) Ethnicity identification

c) Assimilation Assimilation is a process by which a person gives up their original identity and develops a new cultural identity by becoming absorbed into the more dominant cultural group. Acculturation is the process of acquiring new attitudes, roles, customs, or behaviors as a result of contact with another culture. Ethnicity refers to a common ancestry that leads to shared values and beliefs. It is transmitted over generations by one's family and community. Ethnicity is a powerful determinant of one's identity or ethnic identity. In the case of biculturalism, the individual has a duel pattern of identification and chooses which aspects of the new culture he/she wishes to adopt and which aspects of their original culture he/she wishes to retain.

The nurse is triaging a Latin-Caribbean patient who is behaving hysterically in the emergency room. The patient is crying, has uncontrollable spasms, and is trembling and shouting. It is important to identify the manifestation of illness in order to effectively treat a patient. The nurse identifies this as a culture-bound syndrome called a) Shenjing shaijo. b) Loco de la cabeza. c) Ataque de nervios. d) Neurasthenia.

c) Ataque de nervios. Ataque de nervios is a Latin-Caribbean culture-bound syndrome that usually occurs in response to a specific stressor and is characterized by dissociation or trance-like states, crying, uncontrollable spasms, trembling, or shouting. Shenjing shaijo refers to "weakness of nerves" in Chinese culture; it is caused by a decrease in vital energy that reduces the function of the internal organ systems and lowers resistance to disease. Loco de la cabeza is a Spanish phrase meaning "crazy in the mind," a condition that is not necessarily manifested by physical symptoms. Neurasthenia is used in Asian cultures to describe extreme fatigue after mental effort and bodily weakness of persistent duration.

When utilizing the social-ecological model, the nurse classifies physiological effects of aging within which system? a) Microsystem b) Mesosystem c) Chronosystem d) Exosystem

c) Chronosystem The social-ecological model aims to explain dynamic interrelations among various personal and environmental factors. The chronosystem could be either external or internal. For instance, the timing of a family member's death could be an external chronosystem, and physiological changes due to aging could be an internal chronosystem. The mesosystem is beyond the dyad or two-party relation, and link over two systems that a person lives. Also, mesosystems link the structures of the person's microsystem. This model basically evolved from the ecological systems theory of child development proposing five socially organized subsystems related to human development: microsystem, mesosystem, exosystem, macrosystem, and chronosystem.

A student nurse demonstrates effective understanding of health disparities when stating that which disparity is the most significant contributing factor to poor quality of care? a)Language barrier b) Lack of transportation c) Lack of health insurance d) Provider-patient communication

c) Lack of health insurance Health insurance is the most significant contributing factor to poor quality of care. Uninsured people are less likely to get adequate care for disease prevention (e.g., cancer screening, dental care, counseling about diet and exercise, and flu vaccination) and/or for disease management (e.g., diabetes care management) and more likely to visit the emergency department and be admitted to the hospital for ambulatory care-sensitive conditions. Many racial/ethnic, low socioeconomic status, and other minority groups lack adequate health insurance compared with their counterparts. For example, Hispanics and non-Hispanic African Americans have substantially higher uninsured rates, compared with Asian/Pacific Islanders and non-Hispanic whites. Also, minorities are disproportionately enrolled in lower-cost health plans that place greater per-patient limits on health care expenditures and available services.

A primary health care provider has recommended a mammogram and a Papanicolaou (pap) smear for a 50-year-old female patient. In response to questions, the nurse teaches the patient about health promotion activities, describing the mammogram and pap smear as which forms of prevention? a) Illness prevention b) Primary prevention c) Secondary prevention d) Tertiary prevention

c) Secondary prevention A mammogram and a pap smear are cancer screening measures. They are considered secondary prevention measures, which are designed to identify individuals in an early stage of a disease process so that prompt treatment can be started. Illness prevention is considered a primary prevention measure, or strategies aimed at optimizing health and disease prevention in general and not linked to a single disease entity. Tertiary prevention measures are strategies that minimize the effects of disease and disability.

The nurse wants to assist patients to achieve spiritual health. The nurse should: (Select all that apply.) a) solve their spiritual problems. b) employ his/her own personal religious practices with the patient. c) explore meditation with the patient to assist in reducing stress. d) integrate patient preferences into the plan of care. e) provide an environment for expression of beliefs. f) recognize that all patients experience spiritual problems.

c) explore meditation with the patient to assist in reducing stress. d) integrate patient preferences into the plan of care. e) provide an environment for expression of beliefs.

It is best for nurses to have a broad understanding of cultural influences on health care because of a) disability entitlements. b) requirements of the Health Insurance Portability and Accountability Act (HIPAA). c) increasing global diversity. d) litigious society.

c) increasing global diversity. Culture is an essential aspect of health care because of increasing global diversity. Disability entitlements are defined benefits for eligible mental or physically disabled beneficiaries for housing, employment, and health care. HIPAA requirements are found in the HIPAA Privacy Rule, which protects the privacy of individually identifiable health information; the HIPAA Security Rule, which sets national standards for the security of electronic protected health information; and the confidentiality provisions of the Patient Safety Rule, which protect identifiable information being used to analyze patient safety events and improve patient safety. A litigious society is one that is excessively ready to "go to the law" (indicating a system of regulations to govern the conduct of the people of a community, society or nation, in response to the need for regularity, consistency, and justice based upon collective human experience) or to initiate a lawsuit.

The nurse is caring for a Hispanic older adult in the emergency department who is intoxicated and was found unconscious on the ground outside of a local restaurant. The patient has a medical alert bracelet listing diabetes, hypertension, and epilepsy. Which health disparities in this patient does the nurse identify as unavoidable and acceptable? a) Alcohol use and ethnicity b) Diabetes and age c) Hypertension and gender d) Age and gender

d) Age and gender The health disparities that are unavoidable and acceptable should not be a concern for nurses. For example, in an emergency room, nurses could observe health disparities in emergency visits by age; in general, older people make more emergency visits compared with younger people. In this situation, age becomes a determinant of the disparity, and aging is unavoidable and acceptable. Gender is also unavoidable and acceptable. Alcohol use is avoidable. Diabetes and hypertension may be avoidable conditions dependent on the patient's lifestyle and diet choices.

The nurse identifies that which patient would best benefit from a plan of care including self-management? a) Patient hospitalized with femur fracture b) Patient diagnosed with pulmonary embolus c) Patient experiencing chest pain d) Patient with chronic heart failure

d) Patient with chronic heart failure Patients diagnosed with a chronic disease who are not suffering acute exacerbations are the best candidates for self-management. A patient with chronic heart failure can be educated about signs/symptoms and the treatment plan to manage the condition outside of the hospital. Patients with a femur fracture need acute care and assisted rehabilitation. Pulmonary embolism and chest pain are emergent conditions that require skilled, acute care.

A student nurse demonstrates understanding of managing patient care involving chronic disease when making which statement? a) Chronic disease management is best handled with one expert provider taking the lead role in the treatment plan. b) A care-giver centered approach is best for managing the complexities of chronic disease care. c) Current health care trends are evolving toward the paternalistic approach to care of the patient with chronic illness. d) The patient and family should develop a partnership when developing a plan of care for a loved one with a chronic illness.

d) The patient and family should develop a partnership when developing a plan of care for a loved one with a chronic illness. Data show that by 2020 approximately 80% of all health care expenditures will be for the prevention and treatment of chronic disease. This shift toward chronic disease care has required health care systems to revamp their approaches to medical treatment. The paternalistic approach, which views the provider as "expert" and the patient as "passive recipient" of medical advice, works well in acute illness but is largely ineffective at treating chronic diseases that require daily management by patients and their caregivers. Rather, evidence suggests that patient-centered approaches, which emphasize patient-provider partnerships where patients are active participants in their care, are most effective for addressing chronic disease.

A patient tells the nurse, "I am not a religious person. I believe things happen in life out of pure coincidence." Which evaluation of this patient's spirituality is true? a) This patient is not a spiritual person. b) This patient is more likely to suffer from depression. c) This patient will experience difficulty coping with life changes. d) This patient experiences emotion and should be asked about effects of health changes.

d) This patient experiences emotion and should be asked about effects of health changes. This patient will still experience emotions and effects of health changes even though he does not identify himself as spiritual. Every person is believed to have a spiritual nature, a sense that there is more than what is experienced day to day, month to month, year to year until death. Spirituality encompasses the mundane activities of life that keep us grounded as well as those magnificent times and experiences when our inner most spirit soars with any number of emotional responses including exquisite joy, dark and deep sorrow, laughter and fun, and all emotions in between . There is no direct evidence to believe this patient will suffer from depression or have difficulty coping. A patient may have healthy coping abilities without identifying with a religion.

As the profession of nursing evolved to incorporate evidence-based practice, which statement is true about spirituality? a) Evidence-based care focuses solely on the physical effects of health and illness. b) An emphasis was placed on spirituality as nursing education moved into colleges and universities. c) Spirituality was incorporated back into care when a concrete definition had been established. d) Spirituality commonly encompasses a concept or belief about God and the inner person.

d)Spirituality commonly encompasses a concept or belief about God and the inner person. The definitions of spirituality encompass the following: a principle, an experience, attitudes and belief regarding God, a sense of God, the inner person. According to Mary Elizabeth O'Brien, "Spirituality, as a personal concept, is generally understood in terms of an individual's attitudes and belief related to transcendence (God) or to the nonmaterial forces of life and of nature." O'Brien concluded that most descriptions of spirituality include not only transcendence but also the connection of mind, body, and spirit, plus love, caring, and compassion and a relationship with the Divine. Throughout history, spirituality has not been a focus of nursing care as evidence-based practice has emerged. However, spirituality and its significance were never totally removed from nursing practice. In the 1970s and 1980s, spirituality was virtually removed from nursing curricula as the education of nurses moved increasingly into colleges and universities. The concept of Spirituality is an elusive concept to define. Authors that write about spirituality in nursing advocate the position that a patient's quality of life, health, and sense of wholeness are affected by spirituality, yet still the profession of nursing struggles to define it.

The nurse is discharging a hospitalized patient to the home care setting. Place the following actions in order of priority. a. Arrange a physical therapy visit before the patient is discharged from the hospital. b. Assess the patient's ability to perform activities of daily living before discharge. c. Have the patient demonstrate the learned skills at the end of the teaching session. d. Determine if the patient has had home visits before and if the experience was positive.

d. Determine if the patient has had home visits before and if the experience was positive. b. Assess the patient's ability to perform activities of daily living before discharge. c. Have the patient demonstrate the learned skills at the end of the teaching session. a. Arrange a physical therapy visit before the patient is discharged from the hospital. To begin the assessment of adherence, it is first important to clarify with the patient their beliefs and perceptions about his health risk status, assessment of performing ADLs will assist in determining the number of visits needed or if the patient needs additional therapies. Demonstration of skills prior to discharge will ensure patient understands the teaching. Physical therapist can aid in evaluating the need for assistive devices in the home and also help the patient adhere to prescribed treatment plan.