NCLEX Challenge - Culture, Spirituality, and Alternative/Complementary Modalities
A nurse is making a home visit to a client who is receiving chemotherapy as part of the treatment plan for cervical cancer. The client reports nausea as a side effect of treatment. The client asks the nurse, "I do not want to put any other medicines in my body. Do you have any suggestions for a natural remedy to help with my nausea?" Which suggestion would the nurse most likely make? Select all that apply. lavender ginger peppermint chamomile melatonin
lavender ginger peppermint
A client who is likely to become a candidate for dialysis treatment tells the nurse, "I must talk to my family." Recognizing the cultural preferences and beliefs of the client, what question must the nurse first answer before disclosing health care information? How many people does the client actually define as family? What is the appropriate client information to tell the family? Who is responsible for making client treatment decisions? Will the family protect the client from hearing bad news?
Who is responsible for making client treatment decisions?
A nurse is completing an admission assessment. Which question is most appropriate for a nurse to use for a spiritual screening during admission? "Can you tell me more about your religion?" "How can we support your spiritual beliefs and practices?" "How has prayer affected your illness?" "What do you see as the purpose or mission for your life?"
"How can we support your spiritual beliefs and practices?"
The family member of a client diagnosed with dissociative identity disorder (DID) asks a nurse if hypnotic therapy might help the client. How should the nurse respond? "No, hypnosis is a controversial treatment." "No, hypnosis is rarely used in the treatment of DID." "Yes, but only after other types of therapy have failed." "Yes, a client is often not consciously aware of alter personalities."
"Yes, a client is often not consciously aware of alter personalities."
A client in home hospice care verbalizes to the caregiver a desire to meet with the client's minister. The caregiver does not want the minister to visit or to interact with the minister because of different values and beliefs and asks the home health nurse how to handle this situation. To prevent further disagreement between the client and caregiver, what is the best recommendation for the nurse to implement? Explain to the caregiver how to be assertive without being insensitive to the client's wishes. Arrange for an alternative caregiver to be available for the client when the minister visits. Discuss other options for spiritual counseling that may be appropriate to the client and caregiver. Resolve with the client and caregiver the concerns related to the minister making a home visit.
Arrange for an alternative caregiver to be available for the client when the minister visits.
In the hospital setting, the child of a client who is dying tells the nurse, "It is hard to just sit here for hours and not say or do anything." As the nurse responds to the child's statement, what issue is most important for the nurse to focus on during their discussion? Provide background music of familiar songs. Think about ways to complete unfinished business. Perform actions that facilitate comfort measures. Know that being present with the person is important.
Know that being present with the person is important.
The nurse is working with a client who is distraught after being diagnosed with late-stage pancreatic cancer. In addition to practicing active listening, what nursing action is most appropriate? Offer to facilitate a referral to spiritual care. Assure the client that survival rates for pancreatic cancer are now measured in decades. Teach the client progressive relaxation techniques and guided imagery. Ask the provider to temporarily prescribe lorazepam as needed.
Offer to facilitate a referral to spiritual care.
The client is discussing the client's medication history with the nurse. During the discussion, the client pulls out a list of the prescribed medications, which include fish oil and St. John's Wort. What is the nurse's understanding of why these alternative therapies are used by the client? The client has a history of depression. The client has a history of coronary diseases. The client has a history of digestive issues. The client has a history of diabetes.
The client has a history of depression.
A client discusses with the nurse the possibility of using alternative therapies for management of hypertension and diabetes. Which is an expected alternative therapy used by the client? kava jojoba ginseng melatonin
ginseng
The nurse is providing care for a client who is a Muslim. The client has recently received a diagnosis of type 1 diabetes and is receiving health education. What statement by the nurse best addresses this client's religious beliefs? "Insulin used to be derived from pigs, but now it is produced synthetically." "Diabetes likely will not have any bearing on the practices of fasting that you have followed in the past." "You might have to begin eating some foods that are contrary to Islam in order to maintain stable blood glucose." "You will be able to manage your diabetes while maintaining a vegetarian diet, but it requires careful management."
"Insulin used to be derived from pigs, but now it is produced synthetically."
The nurse asks the parent of a terminally ill infant if the parent would like the child to be baptized. The parent becomes upset and asks to speak to the nurse-manager. What is the nurse-manager's best response? Ask the on-duty chaplain to talk to the parent. Explain that the nurse is only trying to determine the parent's wishes. Apologize for the nurse's behavior and assign another nurse to this client. Let the parent express the parent's own spiritual beliefs and wishes.
Let the parent express the parent's own spiritual beliefs and wishes.
The nurse is assessing a client whose history includes type 2 diabetes and atrial fibrillation, treated with warfarin. The client tells the nurse that the client began taking ginseng supplements several days ago in an effort to boost the immune system. After providing health education, what is the nurse's priority action? Collaborate with the care team to have the client's prothrombin time and international normalized ratio (INR) assessed. Assess the client's random glucose level, and administer antihyperglycemics as prescribed. Assess the client for signs and symptoms of hypokalemia, and collaborate with the care team to have cardiac telemetry ordered. Assess the client for Chvostek's sign or Trousseau's sign.
Collaborate with the care team to have the client's prothrombin time and international normalized ratio (INR) assessed.
A client is admitted for an exacerbation of irritable bowel syndrome who insists on being allowed to keep a head covering on at all times. What is the best response by the nurse? "It's strictly against our hospital policy." "Hats are a great infection control risk." "Please help me to understand this practice." "Tell me why is this so important to you."
"Please help me to understand this practice."
The nurse is setting goals for end-of-life care with a client who states, "I'm not a religious person, but I consider myself a spiritual person." Based on this conversation, what is the best question to ask about the client's spirituality? "Have you ever practiced a particular spiritual tradition?" "Are there rituals that you observe during parts of the year?" "Do you think about things as being right or wrong?" "What are the beliefs that guide your daily decisions?"
"What are the beliefs that guide your daily decisions?"
The nurse is admitting a new client and is assessing the client's spirituality. What assessment question best addresses the client's spirituality? "Are you a member of any particular church or temple?" "What is it that most provides you with meaning in your life?" "Would you describe yourself as being Catholic, Protestant, or Orthodox?" "Do you have any particular beliefs about the afterlife?"
"What is it that most provides you with meaning in your life?"
A client is experiencing inadequate pain control. The client consulted with the healthcare provider to bring in a licensed acupuncturist to the hospital to perform a treatment. What action does the nurse take? Educate the client about potential risks associated with acupuncture. Teach the client about the risks of infection that accompany acupuncture. Assist the client as needed in facilitating the acupuncturist's visit. Document the client's request for alternative therapies in the client's health record.
Assist the client as needed in facilitating the acupuncturist's visit.
A client diagnosed with chronic back pain asks the nurse for alternatives besides pain medication for the treatment of back pain. Which alternatives can the nurse suggest? Select all that apply. chiropractic therapy traditional Chinese medicine therapeutic touch deep breathing exercises dance therapy
chiropractic therapy traditional Chinese medicine therapeutic touch deep breathing exercises
A nurse is conducting a spiritual assessment on a client admitted for surgery and developing a plan of care based on this assessment. To help ensure that the nurse is most successful in meeting the client's spiritual needs and promote a comfortable working relationship with the client, which aspect would be most important initially for the nurse? developing an awareness of one's own beliefs about the connection between spirituality and health identifying the impact on health by the client's primary religious beliefs and practices incorporating the client's participation and role as a member of a specific religious community making referrals to the appropriate spiritual resources identified as important by the client
developing an awareness of one's own beliefs about the connection between spirituality and health
A nurse is working in a rural health clinic that serves a large Amish population. The nurse is developing a program to address common health promotion strategies. Which aspect would be most important for the nurse to integrate into the program to promote its success? Select all that apply. importance of the extended family in providing support focus on being in tune with nature for health maintenance limited involvement of community members for assistance need to ask for permission before physically touching a client role of females in being the primary decision makers for the family
importance of the extended family in providing support focus on being in tune with nature for health maintenance need to ask for permission before physically touching a client
A nurse is teaching a client about adequate nutritional intake during pregnancy. The client has recently emigrated to the United States from Haiti. Based on the client's cultural background, what foods would the nurse expect her to eat during pregnancy? Select all that apply. rice plantains red fruits milk fish eggplant
rice plantains red fruits
The single parent of a young teenager is being treated for complicated bronchitis at a small rural hospital. The parent does not live in the area and has a poor command of English. The facility is experiencing delays in accessing a translator. In considering whether to allow the teenager to translate medical information for his parent, the nurse should consider that: it depends on which language, and how long the delay will be. these circumstances may allow the child to translate. the child may not be allowed to translate for the parent's care. an adult friend or family member must be located to translate.
the child may not be allowed to translate for the parent's care.
The nurse is performing an admission assessment of a new client. When assessing potential cultural influences on the client's care, the nurse should address what domains? Select all that apply. decision-making processes nutrition inflammation communication expressions of pain
decision-making processes nutrition communication expressions of pain
A nurse is making a home visit to a client with end-stage liver cancer who is experiencing significant pain without relief from usual methods. The nurse is preparing to use therapeutic touch with the client. Which action would the nurse do first? Focus attention inwardly on self. Place hands about 3 to 4 inches above the client. Scan the client's body for different flows of energy. Use a smoothing motion to clear the area.
Focus attention inwardly on self. When performing therapeutic touch, the nurse first engages in centering, that is, bringing their attention inward to a quiet, still peaceful state of consciousness. Then the nurse moves their hands 2 to 6 inches from the client's skin surface to gather information about the client's energy fields, as if listening with the hands. Finally the nurse unruffles the field, that is, uses a smoothing motion to clear any disruptions.
The nursing assistant moves the wheelchair of a client with a disability, and the client responds by saying, "Don't touch my wheelchair!" How would the nurse best begin to explain this situation to the nursing assistant? Be careful not to move the client's property except in an emergency. People with disabilities are often sensitive about their personal property. Sometimes improper handling of a wheelchair can cause damage to it. It is important to ask the client before repositioning the wheelchair.
It is important to ask the client before repositioning the wheelchair.
After unsuccessful CPR efforts, the nurse must prepare an Islamic client for the morgue. Which nursing action should the nurse take? asking the client's family if they want to perform the ritualistic washing doing nothing; the Burial Society will perform a ritual cleansing doing nothing; only the family and close friends may touch the body providing routine post-mortem care
asking the client's family if they want to perform the ritualistic washing
The client on hospice explains to the nurse, "I asked my child to pray with me because I am a very spiritual person, but my child declined and is not a believer anymore." Based on this conversation with the client, what is the best action for the nurse to initiate? Talk to the child in a private setting about the client's desires. Communicate with other family members about the client's request. Ask if the client would like to meet with the hospital chaplain. Suggest to the client that meditation may be a viable option.The client on hospice explains to the nurse, "I asked my child to pray with me because I am a very spiritual person, but my child declined and is not a believer anymore." Based on this conversation with the client, what is the best action for the nurse to initiate? Talk to the child in a private setting about the client's desires. Communicate with other family members about the client's request. Ask if the client would like to meet with the hospital chaplain. Suggest to the client that meditation may be a viable option.
Ask if the client would like to meet with the hospital chaplain.
Upon admission for a TURP, the nurse learns that this is the client's first hospital inpatient admission and the client always works the overnight shift. What should the nurse take into account when planning client care? Select all that apply. The client's circadian rhythms will be oriented to night shift. The client will automatically adapt to the hospital routine. The client cannot be treated in an inpatient environment. The client's ability to focus will be related to sleep hygiene. The client needs an orientation to the full hospital schedule.
The client's circadian rhythms will be oriented to night shift. The client's ability to focus will be related to sleep hygiene. The nurse should acknowledge that the client's habits and routines are associated with a life spent working at night. This can impact factors such as sleep, digestion and elimination, and ability to focus. It is unlikely that such a client will automatically adapt to the hospital routine; despite being a 24-hour continuous operation, activities such as tests, examinations, and treatments are oriented toward a daytime schedule. This client's work history and circadian cycles are not a contraindication to being treated successfully in the inpatient setting. First-time admissions do not require a special orientation.
A school nurse is called to assess a preadolescent, a newly immigrated Vietnamese person attending a new school. A teacher tells the nurse that the student sits in the back of the class and won't speak when spoken to, although the parents confirmed the student speaks English. Which assessment finding is most likely? The student is experiencing cultural shock. The student is developing a peer support system. The student is going through a socialization period. The student is becoming acculturated to the new school.
The student is experiencing cultural shock.
