NCLEX cultural-Spirituality questions
Which most essential element should the nurse consider to promote client adherence to care recommendations? 1.Following the client's medication regimen 2.Adhering to the client's cultural preferences 3.Following the client's pain management goal 4.Using the client's communication preferences
2 - Rationale:The client's care should encompass her or his perspective and beliefs about health. Understanding the client's cultural preferences will allow the nurse to create a plan of care that is realistic and acceptable to the client. Although options 1, 3, and 4 are important, they are not the most essential.
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 - Rationale:In the African American culture, it is considered to be intrusive to ask personal questions on the initial contact or meeting. African Americans are highly verbal and express feelings openly to family or friends, but what transpires within the family is viewed as private. The psychosocial assessment would be of lowest priority during the initial admission assessment. Additionally, because cardiovascular, renal, and gastrointestinal assessments are physiological, they are the priority assessments.
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 1 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 Spanish-language teaching brochure and gives it to the client.
2 - Rationale:Using the services of a professional interpreter is the most effective way to provide preoperative instructions. Asking a family member to interpret is not acceptable because that client may interpret different or erroneous meanings from the nurse's instructions. Non-Spanish-speaking nurses should never attempt to do the teaching themselves with only the help of a Spanish dictionary. A Spanish-language brochure may be given to the client as an adjunct to interpreted verbal instructions but would not be adequate by itself.
The charge nurse is educating a new nurse on culturally competent communication techniques. Which response(s) made by the new nurse indicates a need for follow-up? Select all that apply. 1."I should identify the clients' needs to create the plan of care." 2."I should use a language interpreter for all culturally diverse groups." 3."I should use the client's perspective on health to help lead the conversation." 4."I should use a communication style that promotes optimal health outcomes." 5."I should recognize my own biases and address known stereotypes with the client."
2, 5 - Rationale:Knowing and understanding the client's needs and his or her beliefs about health help to guide the plan of care. Health care providers should know the client's perspectives and cultural preferences to create a treatment plan that is realistic, acceptable, and individualized for each client. Communicating in a professional and respectful manner will optimize client outcomes. A language interpreter may not be necessary for some ethnic groups that speak English. It is also important to have self-awareness about any biases or misconceptions regarding other ethnic groups. It is not appropriate to address these directly with the client.
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 primary health care provider (PHCP). 4.Tell the client that if he takes the herbal substance he will need to have his blood pressure checked frequently.
3 - Rationale:Although herbal substances may have some beneficial effects, not all herbs are safe to use. Clients who are being treated with conventional medication therapy should be encouraged to avoid herbal substances because the combination may lead to an excessive reaction or to unknown interaction effects. The nurse should advise the client to discuss the use of the herbal substance with the PHCP. Therefore, options 1, 2, and 4 are inappropriate nursing actions.
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 - Rationale:Among Jehovah's Witnesses, surgery is not prohibited, but the administration of blood and blood products is forbidden. For a Jehovah's Witness, administration of medication is an acceptable practice except if the medication is derived from blood products. This religious group believes that the soul cannot live after death. Jehovah's Witnesses avoid foods prepared with or containing blood.
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 in (5 to 10 cm) from the body.
4 - Rationale:During therapeutic touch, nurses use their hands to assess the client's energy field. Hands are positioned 2 to 4 in (5 to 10 cm) from the body. The energy field is assessed for bilateral similarities or differences in the flow of energy. The next step is clearing and balancing the energy field. Nurses then redirect energy through their own intentionality. The session ends with a smoothing of the energy. Therefore, the remaining options are incorrect.
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 1 time. 2.Inform the family that emotional outbursts are to be avoided. 3.Contact the primary 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 - Rationale:In Hispanic cultures, loud crying and other physical manifestations of grief are considered socially acceptable. Of the options provided, the correct choice is the only one that identifies a culturally sensitive approach on the part of the nurse. The remaining options are inappropriate nursing interventions.
The nurse educator asks a student to list the 5 main categories of complementary and alternative medicine (CAM), developed by the National Center for Complementary and Alternative Medicine. Which statement, if made by the nursing student, indicates a need for further teaching regarding CAM categories? 1."CAM includes biologically based practices." 2."Whole medical systems are a component of CAM." 3."Mind-body medicine is part of the CAM approach." 4."Magnetic therapy and massage therapy are a focus of CAM."
4 - Rationale:The 5 main categories of CAM include whole medical systems, mind-body medicine, biologically based practices, manipulative and body-based practices, and energy medicine. Magnetic therapy and massage therapy are therapies within specific categories of CAM.
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, 2, 3, 4, 6 - Rationale:Besides integrating cultural practices into Western medicine, other aspects of culturally competent care include the following: increasing client safety, reducing health disparities, increasing client satisfaction, and preventing misunderstandings between the nurse and the client. Incorporating spiritual practices as appropriate to the client's culture is also important. Maintaining eye contact when having a conversation with a client is not always part of culturally competent practices.
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, 2, 3, 5 - Rationale:The most important cultural and communication considerations the nurse must be aware of are touch, eye contact, personal space, and time orientation. Family presence and facial expression are not important concepts.
What elements are essential for the nurse to address to be able to deliver culturally competent care? Select all that apply. 1.Assessing the client's health preferences 2.Having knowledge of various racial and ethnic groups 3.Acknowledging personal misconceptions of various ethnic groups 4.Diagnosing health conditions commonly seen within the ethnic group 5.Recognizing that subcultures exist and not every characteristic of the cultural group is present
1, 2, 3, 5 - Rationale:The nurse always determines the client's health preferences in order to create an individualized plan of care. Health care providers must have awareness of their own beliefs and values, as well as being aware that others hold different values and beliefs based on personal preferences or ethnic, cultural, and racial backgrounds. Recognizing one's own biases and respecting all people despite differences can influence satisfaction in care. It is imperative for health care providers to understand that cultural groups share dominant characteristics; however, subcultures exist and stereotyping must be avoided. It is not within the nurse's role to diagnose health conditions.
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, 2, 3, 6 - Rationale:Verbal communication includes not only one's language or dialect but also voice tone, volume, timing, and ability to share thoughts and feelings. It does not include eye contact or hand gestures.
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 - Rationale:Arranging for an interpreter would be the best practice when communicating with a client who speaks a different language. Options 1 and 4 are inappropriate and ineffective ways to communicate. Option 3 is inappropriate because it violates privacy and does not ensure correct translation.
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 appropriate action? 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 - Rationale:A client's cultural and ethnic background influences the response to health, illness, surgery, and death. Awareness of cultural differences enhances the nurse's knowledge of how a health care experience may be perceived by the client or family. In the Jehovah's Witness religion, the administration of blood and blood products is forbidden; therefore, the nurse would support the client's decision. Trying to convince the client of the need for the blood transfusion is inappropriate and does not respect the client's cultural beliefs. Speaking to the family is a violation of the client's right to confidentiality; in addition, it does not respect the client's cultural beliefs. Discussing the results of laboratory values is an indirect way of trying to convince the client of the need for a blood transfusion, which again is inappropriate and does not respect the client's cultural beliefs.
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 primary health care provider
3 - Rationale:Complementary and alternative therapies include a wide variety of treatment modalities that are used in addition to conventional therapy to treat a disease or illness. Educating the client about therapies that he or she uses or is interested in using is the nurse's role. Options 1, 2, and 4 are inappropriate actions for the nurse to take because they provide advice to the client.
The nurse is annoyed by a healthy Hispanic American client who had minor abdominal surgery 2 days ago. The client claims he cannot get out of bed by himself, and the nurse lectures the client and tells him to try to be tough. What type of cultural behavior is this called? 1.Cultural ignorance 2.Cultural blindness 3.Cultural imposition 4.Cultural transmission
3 - Rationale:Nurses and other primary 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.
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 - Rationale:To determine each client's nutritional status and needs, the first priority of the nurse is to identify each client's food preferences. Cultural background and knowledge about nutrition are important factors influencing food choices and nutritional status. Although the remaining options may be a component of the sessions, the correct option is the first priority.
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, 4, 5 - Rationale:Providing culturally competent care or education is an important aspect of nursing. Care or education must be emphatically based on the client's culture; otherwise, the care or education is not specific to the client. The correct options address culturally specific and individualized care. Options 1 and 2 are not individually focused.
