Prep U: Culture, Spirituality, Etc.

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?

** "What are the beliefs that guide your daily decisions?" - "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?"

The nurse is providing care for a client who was prescribed escitalopram three weeks ago. What statement by the client should be of greatest concern to the nurse?

- "I have read a lot about the possible benefits of acupuncture online, so I think I will try it." - "I know that a lot of people who have depression are vitamin deficient, so I am taking a multivitamin each morning." - "My sister recommended doing a colon cleanse, so I am planning on doing it next weekend." ** "I have started taking St. John's wort because I have read it can help my mood."

A nurse is completing an admission assessment. The nurse asks the client about social support systems and the client asks the nurse to explain social support systems. Which statement describes a social support system?

** "It is a group of providers at home and in the community that help a client in times of need."

A birthing couple informs the nurse that they would like to have the placenta after the baby is born. What is the nurse's best response?

- "Why would you want to do that?" ** "Let me check about how to go about doing this." - "Centers for Disease Control and Prevention policy does not allow the hospital to give the parents the placenta." - "This should be a decision between the physician and couple."

Which questions should the nurse ask when completing a cultural assessment for a new client? Select all that apply.

** "What are some of your health-related beliefs and practices?" - "What is your address?" - "What is your age?" ** "What are your spiritual beliefs?" ** "What are some of your personal values?"

A nurse is conducting an assessment of a client admitted to the health care facility for cardiac surgery. Which question would be most appropriate for the nurse to ask when assessing the client's spirituality?

** "What gives meaning to your life?" - "Do you consider yourself a spiritual person?" - "What religion do you practice?" - "How often do you go to church?"

A client admitted with acute pyelonephritis now reports having a severe migraine, but declines PRN analgesics. What should the nurse discuss with this client? Select all that apply.

** Alternative therapies such as relaxation or music can help. - Short-term use of opioids has a high addiction risk. - Using opioids will prolong the inpatient hospital stay. - The client with pyelonephritis cannot use analgesics. ** Ask the client which migraine treatments are helpful when at home.

The nurse teaches a client with a pain disorder a progressive relaxation exercise. What client statement indicates the goal of progressive relaxation was attained?

- "Everyone here is so nice to me." - "My arm hurts more than ever." ** "My pain is better, and now I feel relaxed." - "I don't really understand why I'm here."

The nurse is assessing a client who is in her first trimester of pregnancy. The client states that her nausea has been problematic at times, but says that she is able to partially control it using ginger supplements. What is the nurse's best response?

- "Take the lowest dose that you can because it can make your blood glucose levels fluctuate." - "Have you spoken with your care provider about the possibility of taking doxylamine?" - "Where did you first learn that ginger might be helpful for treating your nausea?" ** "Have you let your care provider know that you are taking ginger?"

A client is 2 days postoperative of a hip replacement. The prescriber removed the gauze dressing and gave the patient and nurse instructions to keep the site open to air. In the afternoon, the nurse observed the client rubbing an oil on the surgical site. What is likely the client's rationale regarding the application of the complementary oil?

- Antiperspirant will aid with vasoconstriction. - Fish oil has antiviral properties. ** Tea tree oil has antibacterial properties. - Baby oil can assist with smooth skin.

The nurse is providing care for a client who immigrated three months ago. The nurse observes that the client is reluctant to make eye contact when responding to the nurse's questions. What is the nurse's best response?

- Arrange for the client to receive care from a nurse who is from a similar culture. - Avoid making eye contact with the client. - Assess the client for potential culture-bound syndromes. ** Consider the norms around nonverbal communication in the client's culture.

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. ** Let the parent express the parent's own spiritual beliefs and wishes. - Apologize for the nurse's behavior and assign another nurse to this client. - Explain that the nurse is only trying to determine the parent's wishes.

A Jehovah's Witness client is admitted after a serious car accident and continues to experience severe anemia after significant blood loss. The family remains adamantly opposed to blood product support. What is the nurse's best intervention?

- Continue to reinforce the need for and benefit of transfusion. - Provide a range of literature to address their religious conflict. - Request a consultation with the hospital chaplaincy department. ** Offer the client alternative treatment options to consider.

A deceased client is a member of a culture where the family is expected to bathe the body after death. What should the nurse do to support the client and family at this time?

- Explain that facility personnel are responsible for the task of bathing. - Ask the family to observe the nurse bathing the body. ** Provide the needed supplies to the family. - Participate with the family when bathing the body.

The nurse is admitting a hospital client who does not speak English and who is accompanied by the client's school-aged child. The client appears to be in pain, but the nurse is unable to assess the character or history of the client's pain. How should the nurse best communicate with the client?

- Have a hospital interpreter come to the assessment; defer the assessment if none is available. ** Enlist the help of a hospital interpreter; ask the son to translate if none is readily available. - Ask the client's child to describe the client's pain to the best of the client's ability. - Perform as many components of the assessment as possible, and arrange for an older, English-speaking family member to come in.

An alert and oriented adult client who is a Jehovah's Witness refuses a life-saving blood transfusion. The client's partner, who is not a Jehovah's Witness, requests that the client receive the blood. Which is the most appropriate action by the nurse?

- See if the client has an advanced directive prior to making the decision. - Honor the partner's request because refusing the transfusion would be suicidal. - Contact the hospital administrator and take protective custody of the client. ** Respect the client's right to refuse the transfusion.

A diabetic patient is reviewing the hospital menu to order lunch. The client asks the nurse for suggestions for "cold" foods to order. What is the nurse's understanding of why the client asking about suggestions for "cold" foods?

- The client is cold and wants to warm up. ** The client is balancing the disease with cold foods. - The client is warm and wants to cool off. - The client is concerned about the temperature in the room.

The nurse is providing care for a client who is a recent immigrant. What principle should the nurse apply to the client's care?

- The client likely prefers the healthcare team to make decisions around care without involving the client. - The client likely has a limited understanding of health and illness. ** The client's preferences around touch and personal space may differ from the nurse's. - The client may mistrust the nurse's motives.

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 going through a socialization period. - The student is developing a peer support system. ** The student is experiencing cultural shock. - The student is becoming acculturated to the new school.

After nsuccessful CPR efforts, the nurse must prepare an Islamic client for the morgue. Which nursing action should the nurse take?

- 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 - doing nothing; the Burial Society will perform a ritual cleansing

A client has been prescribed valproic acid for the treatment of bipolar disorder. The client tells the nurse, "I know that vitamin B can help with depressive episodes, so I am going to give that a try." What is the nurse's best response?

** "Be sure to dialogue with your care provider before you start taking vitamin B supplements." - "Unfortunately, it is not safe to take supplements or herbal remedies while you are taking medications." - "Where did you first learn about the possible benefits of vitamin B?" - "Are you hoping that you will eventually be able to replace your medication with supplements?"

A client with diabetes comes to the clinic for a follow-up visit. During the visit, the client, who is Jewish, tells the nurse that a holiday will be coming up next week that requires the client to fast for the day. The client takes an oral antidiabetic medication daily and checks blood glucose levels twice a day. Which response by the nurse would be most appropriate?

- "You should not fast because it will cause your diabetes to go out of control." - "Take your medication, but check your glucose every 4 hours." ** "Tell me more about what is involved so we can plan for this better." -"Omit your medication on the day that you must fast."

The obstetrical nurse is caring for a client who is three hours postpartum. The client tells the nurse that nearly a dozen family members will be soon arriving to visit her and her infant. The client assures the nurse that this is the norm in her culture. What is the nurse's best action?

- Encourage the client to assert that the visit would be emotionally and physically tiring. ** Facilitate the visit, unless it is ruled out medically or logistically. - Communicate with a family member, and explain why having more than one visitor at a time is not permitted. - Make contact with a family member, and explain the client's need for rest.

A client who has been using benzodiazepines for anxiety wants to add an alternative therapy. The nurse suggests biofeedback. How will the nurse best describe biofeedback to the client?

- It is most helpful when used in conjunction with antianxiety medications. ** It is a way to concentrate on the body's response during a stressful situation. - It can balance the positive and negative energies emitted from the anxiety. - It is used to assist with controlling feelings and emotions toward others.

The parent of an Indonesian young adult reports through an interpreter to the nursing supervisor that the staff nurse sometimes shouts at the client. The nurse tells the supervisor that she has not been shouting at the client. What would the supervisor expect to note after observing a care interaction between the staff nurse and the young adult adolescent client?

- Loud music is playing in the room. - There is nurse-client conflict occurring. - The care procedures performed are painful. ** There is a language barrier present.

A client learns that she is pregnant, and asks the nurse for the names of abortion clinics. The nurse does not believe abortion is moral alternative. What is the most appropriate response by the nurse?

- Remind the client that abortion stops a beating heart. - Encourage the client to wait and think about it. - Tell the client that she will have to ask the health care provider. ** Give the client the available preprinted list of clinics.

The nurse is attending a family meeting where a recent immigrant's treatment plan is being discussed. The client is a retired English teacher and defers to the oldest son when the care team asks the client questions. How should the nurse best interpret the client's action?

- The client is likely emotionally and financially dependent on the son. - The client's actions are most likely the result of elder abuse. ** The client's action may reflect cultural and familial norms. - The care team should explain North American cultural norms about decision making.

An Orthodox Jewish pregnant woman comes to the labor and birth suite with her birth attendant. Her partner is also present in the room. The woman is about to give birth when the nurse observes the partner move to the head of the bed outside the view of the birth. The nurse interprets this action as:

- demonstrating a lack of interest in the birth of the baby. ** reflecting on the couple's religious beliefs and practices. - reflecting the cultural position of the husband as the head of the house. - indicating the husband's anxiety related to the process of labor and birth.

A client with a history of posttraumatic stress is panting and breathing heavily while shouting out some strange words. The nurse reviews the nursing assessment and understands that the client is practicing a form of relaxation called power breathing. The best action for the nurse to take is to:

- monitor the client for respiratory difficulties. ** allow privacy, but check on the client frequently. - contact the physician for a psychiatric consult. - arrange for a sitter so the client is not left alone.

A client has received lunch. The client is served soup with crackers, an apple, and salad. The client uses the nurse call light and asks the nurse to bring a warm beverage. What alternative therapy is the client likely using?

- therapeutic touch - yoga - chiropractic therapy ** traditional Chinese medicine