Module 10- Cultural Considerations, Spirituality, Loss & Grief

The nurse is admitting a client and knows that clients typically share information about herbal supplements or therapies only if they are specifically asked. What are some additional things the nurse needs to do when dealing with this topic with clients? Select all that apply. 1.Use open-ended questions. 2.Ask the client where she bought the supplements. 3.Respond to clients with comments that invite an open-minded discussion. 4.Ask the client if the health care provider knows the client is taking these. 5.Document the use of any herbal product(s) or dietary supplements in the client record. 6.Create an accepting and nonjudgmental attitude when assessing use of or interest in herbal products or dietary supplements.

1.Use open-ended questions. 3.Respond to clients with comments that invite an open-minded discussion. 5.Document the use of any herbal product(s) or dietary supplements in the client record. 6.Create an accepting and nonjudgmental attitude when assessing use of or interest in herbal products or dietary supplements.

Which is the best nursing intervention regarding complementary and alternative medicine? 1.Advising the client about "good" versus "bad" therapies 2.Discouraging the client from using any alternative therapies 3.Educating the client about therapies that he or she is using or is interested in using 4.Identifying herbal remedies that the client should request from the health care provider

3.Educating the client about therapies that he or she is using or is interested in using

The nurse is caring for a slightly intoxicated newly admitted Native American client with gallbladder disease. Based on the client's diagnosis, what dietary issue could be causing this client's problem? 1.Vitamin D deficiency 2.History of alcohol abuse 3.Fried bread and mutton prepared in lard 4.Corn as an important component of the diet

3.Fried bread and mutton prepared in lard

The nurse is examining a Hispanic American child who was brought to the clinic by the mother. Which are appropriate nursing actions? Select all that apply. 1.Admiring the child 2.Taking the child's vital signs 3.Asking questions about the child 4.Obtaining an interpreter if necessary 5.Maintaining eye contact with the mother

2.Taking the child's vital signs 3.Asking questions about the child 4.Obtaining an interpreter if necessary

A clinic nurse is performing an admission assessment on an African American client scheduled for cataract removal with intraocular lens implantation. Which question should the nurse avoid asking on the initial assessment? 1."Do you have any family problems?" 2."Do you ever experience chest pain?" 3."Do you have any problems urinating?" 4."Do you frequently have episodes of constipation?"

1. "Do you have any family problems?"

The nurse is reviewing the plan of care with an Asian American client. The client frequently nods the head during the review. Based upon this behavior, what should be the nurse's next action? 1. Contact a qualified medical interpreter. 2. Give corresponding written information to the client. 3. Check to see if the client has an English-speaking family member. 4. Ignore the behavior and start to review the plan of care with the client.

1. Contact a qualified medical interpreter.

The nurse is providing discharge instructions to a Chinese American client regarding prescribed dietary modifications. During the teaching session, the client continuously turns away from the nurse. The nurse should implement which best action? 1.Continue with the instructions, verifying client understanding. 2.Walk around the client so that the nurse constantly faces the client. 3.Give the client a dietary booklet and return later to continue with the instructions. 4.Tell the client about the importance of the instructions for the maintenance of health care.

1. Continue with the instructions, verifying client understanding.

The nurse is collecting data from an African American client scheduled for surgery. Which questions would be most appropriate for the nurse to ask on initial assessment? Select all that apply. 1."Do you ever experience chest pain?" 2."Do you have any difficulty breathing?" 3."How many people live in your house?" 4."Do you have a close family relationship?" 5."Do you frequently have episodes of headache?"

1."Do you ever experience chest pain?" 2."Do you have any difficulty breathing?" 5."Do you frequently have episodes of headache?"

A critically ill Hispanic client tells the nurse through an interpreter that she is Roman Catholic and firmly believes in the rituals and traditions of the Catholic faith. Based on the client's statements, which actions by the nurse demonstrate cultural sensitivity and spiritual support? Select all that apply. 1.Ensures that a close relative stays with the client 2.Makes a referral for a Catholic priest to visit the client 3.Removes the crucifix from the wall in the client's room 4.Administers the sacrament of the sick to the client if death is imminent 5.Offers to provide a means for praying the rosary if the client wishes 6.Reminds the dietary department that meals served on Fridays during Lent do not contain meat

1.Ensures that a close relative stays with the client 2.Makes a referral for a Catholic priest to visit the client 5.Offers to provide a means for praying the rosary if the client wishes

Which clients have a high risk of obesity and diabetes mellitus? Select all that apply. 1.Latino American man 2.Native American man 3.Asian American woman 4.Hispanic American man 5.African American woman

1.Latino American man 2.Native American man 4.Hispanic American man 5.African American woman

The nurse is conducting an admission assessment on an African American client scheduled for a hernia repair. Which assessment data are of least importance during the initial assessment? 1.Respiratory assessment data 2.Psychosocial assessment data 3.Neurological assessment data 4.Cardiovascular assessment data

2.Psychosocial assessment data

The nurse is providing care to a Puerto Rican-American client who is terminally ill. Numerous family members are present most of the time, and many of the family members are very emotional. What is the most appropriate nursing action for this client? 1. Restrict the number of family members visiting at one time. 2. Inform the family that emotional outbursts are to be avoided. 3. Make the necessary arrangements so that family members can visit. 4. Contact the health care provider to speak to the family regarding their behaviors.

3. Make the necessary arrangements so that family members can visit.

The nurse consults with a nutritionist regarding the dietary preferences of an Asian American client. Which food should be included in the dietary plan? 1.Rice 2.Chili 3.Red meat 4.Fried foods

1.Rice

The nurse at a health care clinic is preparing to examine a Hispanic child who was brought to the clinic by the mother. During assessment of the child, the nurse should avoid which action? 1. Overly admiring the child 2. Taking the child's temperature 3. Obtaining an interpreter if necessary 4. Asking the mother questions about the child

1. Overly admiring the child

The nurse is caring for a non-English-speaking client and is attempting to integrate the client's cultural practices into Western medicine. What are some other aspects of culturally competent care the nurse can employ? Select all that apply. 1.Increasing client safety 2.Using spiritual practices 3.Reducing health disparities 4.Increasing client satisfaction 5.Maintaining eye contact when conversing with clients 6.Preventing misunderstandings between the nurse and the client

1.Increasing client safety 2.Using spiritual practices 3.Reducing health disparities 4.Increasing client satisfaction 6.Preventing misunderstandings between the nurse and the client

The nurse is developing a plan of care for a hospitalized Asian American client. The nurse should include which measures in the client's plan of care? Select all that apply. 1.Limit eye contact. 2.Clarify responses to questions. 3.Use hand gestures to communicate. 4.Maintain physical space with the client. 5.Hold the client's hand to provide comfort.

1.Limit eye contact. 2.Clarify responses to questions. 4.Maintain physical space with the client.

The ambulatory care nurse is discussing preoperative procedures with a Japanese American client who is scheduled for surgery the following week. During the discussion, the client continually smiles and nods the head. How should the nurse interpret this nonverbal behavior? 1.Reflecting a cultural value 2.An acceptance of the treatment 3.Client agreement to the required procedures 4.Client understanding of the preoperative procedures

1.Reflecting a cultural value

The nurse is caring for a newly admitted pregnant Hispanic client who refuses to eat her hot supper. What is the next best action by the nurse? 1.Replace her supper with cold foods. 2.Encourage the client to finish her meal. 3.Give the client a plate of different hot foods. 4.Remove the client's plate and assess what she eats at the next meal.

1.Replace her supper with cold foods.

The nurse is explaining a preoperative teaching plan to an English-speaking client. What are some other aspects of verbal communication? Select all that apply. 1.Timing 2.Volume 3.Voice tone 4.Eye contact 5.Hand gestures 6.Ability to share thoughts and feelings

1.Timing 2.Volume 3.Voice tone 6.Ability to share thoughts and feelings

The prenatal clinic nurse is performing an assessment on a culturally diverse client. Besides conversational style, what are some of the most important cultural and communication considerations the nurse must be aware of? Select all that apply. 1.Touch 2.Eye contact 3.Personal space 4.Family presence 5.Time orientation 6.Facial expression

1.Touch 2.Eye contact 3.Personal space 5.Time orientation

When communicating with a client who speaks a different language, which best practice should the nurse implement? 1. Speak loudly and slowly. 2. Arrange for an interpreter to translate. 3. Speak to the client and family together. 4. Stand close to the client and speak loudly.

2. Arrange for an interpreter to translate.

The nurse educator is providing in-service education to the nursing staff regarding transcultural nursing care; a staff member asks the nurse educator to provide an example of the concept of acculturation. The nurse educator should make which most appropriate response? 1."A group of individuals identifying as a part of the Iroquois tribe among Native Americans." 2."A person who moves from China to the United States (U.S.) and learns about and adapts to the culture in the U.S." 3."A group of individuals living in the Azores that identify autonomously but are a part of the larger population of Portugal." 4."A person who has grown up in the Philippines and chooses to stay there because of the sense of belonging to his or her cultural group."

2."A person who moves from China to the United States (U.S.) and learns about and adapts to the culture in the U.S."

The unlicensed assistive personnel (UAP) is assigned to care for a client who is of Asian heritage. The UAP tells the nurse, "I think that my assignment needs to be changed. Every time I try to talk, the client turns away." Which statement is the most appropriate teaching response from the nurse? 1."You are right. Your assignment needs to be changed." 2."If the client turns away, continue with the discussion." 3."If the client turns away, leave the room and return later to finish your care." 4."The client may have difficulty hearing. Speak up when talking to the client."

2."If the client turns away, continue with the discussion."

The nurse develops a plan of care for a White American client. The nurse considers the practices and preferences of the culture when planning the care, knowing that which are characteristics associated with this ethnic group? Select all that apply. 1.The man is always the dominant figure. 2.Community social organizations are important. 3.Health often is viewed as an absence of disease or illness. 4.The client will appear stoic when expressing physical concerns. 5.Members usually rely primarily on the modern Western health care delivery system.

2.Community social organizations are important. 3.Health often is viewed as an absence of disease or illness. 4.The client will appear stoic when expressing physical concerns. 5.Members usually rely primarily on the modern Western health care delivery system.

The nurse is caring for a Hispanic American client admitted with a diagnosis of diabetic ketoacidosis. Several family members are present. What examples of nonverbal communication would the nurse expect? Select all that apply. 1.Maintaining eye contact 2.Dramatic body language 3.Smiling and shaking hands 4.Avoiding any confrontations with staff 5.Consistently expressing negative feelings 6.Using gestures or facial expressions to express emotion or pain

2.Dramatic body language 3.Smiling and shaking hands 4.Avoiding any confrontations with staff 6.Using gestures or facial expressions to express emotion or pain

The nurse is preparing to provide preoperative teaching to a Spanish-speaking client and the client's family. Which nursing action would be most effective for teaching the client? 1.The nurse asks one of the client's English-speaking relatives to interpret. 2.The nurse secures the assistance of a professional interpreter to communicate with the client. 3.The nurse obtains a Spanish-language dictionary for help in conducting the teaching session. 4.The nurse obtains a preoperative teaching Spanish-language brochure and gives it to the client.

2.The nurse secures the assistance of a professional interpreter to communicate with the client.

When counseling a female Amish client regarding gallbladder disease, what action should the nurse take? 1.Ask the client's husband about her medical history. 2.Overenunciate medical terms to reinforce their meaning. 3.Tell the client that at some point the gallbladder may need to be removed. 4.Tell the client that gallbladder disease can take on two forms: one involves gallstones, and one involves inflammation of the gallbladder.

3.Tell the client that at some point the gallbladder may need to be removed.

An older client is seen in the clinic for a physical examination. Laboratory studies reveal that the hemoglobin and hematocrit levels are low, indicating the need for further diagnostic studies and a blood transfusion. The client is a Jehovah's Witness and refuses to have a blood transfusion. The nurse should take which most appropriateaction? 1. Try to convince the client of the need for the transfusion. 2. Speak to the family regarding the need for a blood transfusion. 3. Support the client's decision not to receive a blood transfusion. 4. Discuss with the client the results of the hemoglobin and hematocrit levels compared with normal levels.

3. Support the client's decision not to receive a blood transfusion.

The nurse manager is giving a staff in-service on providing culturally sensitive education to clients. Which statements indicate to the nurse manager that the staff understands providing culturally sensitive education? Select all that apply. 1."Educational topics are always determined by the nurse." 2."All clients view education about their health status as important." 3."The population served will determine the culturally sensitive resources to use for teaching." 4."Assessment of a client's preferred learning approach is essential to facilitate the learning process." 5."It is important to have an accurate translator when the nurse and client do not speak the same language."

3."The population served will determine the culturally sensitive resources to use for teaching." 4."Assessment of a client's preferred learning approach is essential to facilitate the learning process." 5."It is important to have an accurate translator when the nurse and client do not speak the same language."

What action should the nurse consider when counseling a client of the Amish tradition? 1.Speak only to the husband. 2.Use complex medical terminology. 3.Avoid using scientific or medical jargon. 4.Stand close to the client and speak loudly.

3.Avoid using scientific or medical jargon.

Nurses and other health care providers who have cultural ignorance or cultural blindness about differences generally resort to cultural imposition. They use their own values and lifestyles as the absolute guide in dealing with clients and interpreting their behaviors. 1.Cultural ignorance 2.Cultural blindness 3.Cultural imposition 4.Cultural transmission

3.Cultural imposition

An antihypertensive medication has been prescribed for a client with hypertension. The client tells the clinic nurse that he would like to take an herbal substance to help lower his blood pressure. The nurse should take which action? 1.Advise the client to read the labels of herbal therapies closely. 2.Tell the client that herbal substances are not safe and should never be used. 3.Encourage the client to discuss the use of an herbal substance with the health care provider (HCP). 4.Tell the client that if he takes the herbal substance he will need to have his blood pressure checked frequently.

3.Encourage the client to discuss the use of an herbal substance with the health care provider (HCP).

An Asian American client is experiencing a fever. The nurse plans care so that the client can self-treat the disorder using which method? 1.Prayer 2.Magnetic therapy 3.Foods considered to be yin 4.Foods considered to be yang

3.Foods considered to be yin

The nurse in a health care clinic is preparing to conduct a nutritional session with a group of culturally diverse pregnant women. At the first session the nurse will be meeting with each client individually. The nurse prepares a list of items to be included in the session and lists which item as the priority? 1.Discuss the costs of food items. 2.Review the MyPlate food guide. 3.Identify the food preferences and methods of food preparation for each client. 4.Weigh each client and ask the client to document the weight on a progress chart.

3.Identify the food preferences and methods of food preparation for each client.

Which meal tray should the nurse deliver to a client of Orthodox Judaism faith who follows a kosher diet? 1.Pork roast, rice, vegetables, mixed fruit, milk 2.Crab salad on a croissant, vegetables with dip, potato salad, milk 3.Sweet and sour chicken with rice and vegetables, mixed fruit, juice 4.Noodles and cream sauce with shrimp and vegetables, salad, mixed fruit, iced tea

3.Sweet and sour chicken with rice and vegetables, mixed fruit, juice

A Native American man comes to the clinic for a physical examination. When asked about mental status, the client acknowledges having visions of his deceased brother and speaks to him when he needs counsel. Which best describes the nurse's assessment of this client's behavior? 1.The client is exhibiting signs of delayed grief reaction. 2.The client lacks the intellectual competence to complete the interview. 3.The client is demonstrating behavior that may be regarded as normal within his culture. 4.The client should be referred to the health care provider (HCP) so antipsychotic medication can be prescribed.

3.The client is demonstrating behavior that may be regarded as normal within his culture.

The nurse is implementing the complementary therapy of therapeutic touch when caring for clients. The nurse should implement which action when performing therapeutic touch? 1.Apply heating pads to the back. 2.Vigorously massage bony prominences. 3.Position hands directly on the client's skin. 4.Position hands 2 to 4 inches (5 to 10 cm) from the body.

4.Position hands 2 to 4 inches (5 to 10 cm) from the body.

The nurse is caring for an Appalachian client. The nurse makes sure to have frequent contact with the client and to initiate many different conversations. What is the best reason why the nurse uses this approach? 1. The Appalachian client expects an impersonal relationship with the nurse. 2. The Appalachian client will not want to make any decisions regarding health care. 3. The Appalachian client is most comfortable with impersonal relationships with health care providers. 4. The Appalachian client may prefer personal relationships with health care providers and a desire for frequent communication.

4. The Appalachian client may prefer personal relationships with health care providers and a desire for frequent communication.

The nurse in an ambulatory care clinic is performing an admission assessment for an African American client who is scheduled for a cataract removal with intraocular lens implantation. Which question would be appropriate for the nurse to ask the client on an initial assessment? 1."Do you have well-behaved children?" 2."Do you have a close family relationship?" 3."Do you have specific religious practices?" 4."Do you have any breathing or heart problems?"

4."Do you have any breathing or heart problems?"

The nurse is preparing a plan of care for a client, and is asking the client about religious preferences. The nurse considers the client's religious preferences as being characteristic of a Jehovah's Witness if which client statement is made? 1."I cannot have surgery." 2."I cannot have any medicine." 3."I believe the soul lives on after death." 4."I cannot have any food containing or prepared with blood."

4."I cannot have any food containing or prepared with blood."

The nursing instructor is providing a session on cultural beliefs related to health and illness. At the end of the session, the instructor asks a nursing student to describe the beliefs of some African Americans in regard to illness. Which statement would be the best response by the student? 1."Illness may be a punishment for sins." 2."Illness may be caused by lack of exercise." 3."Illness may be caused by an imbalance between yin and yang." 4."Illness is a disharmonious state term-22that may be caused by demons and spirits."

4."Illness is a disharmonious state that may be caused by demons and spirits."

The nurse is developing a postoperative plan of care for a 40-year-old Filipino man scheduled for an appendectomy. What is the primary nursing action to include in the client's plan of care? 1.Inform the client to ask for pain medication when needed. 2.Offer pain medication when nonverbal signs of discomfort are identified. 3.Allow the client to maintain control and to request pain medication on his own. 4.For the first postoperative day, offer pain medication on a regular basis as prescribed.

4.For the first postoperative day, offer pain medication on a regular basis as prescribed.

The nurse is providing care to a Hispanic client who is terminally ill. Numerous family members are present most of the time, and many of the family members are very emotional. What is the appropriate action? 1.Restrict the number of family members visiting at one time. 2.Inform the family that emotional outbursts are to be avoided. 3.Contact the health care provider to speak to the family regarding their behavior. 4.Request permission to move the client to a private room and allow the family members to visit.

4.Request permission to move the client to a private room and allow the family members to visit.