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Intro to Med Surg
Cultural Aspects
100
What is the nurse’s first action when beginning client education? a. Begins teaching sessions as soon as possible prior to discharge to ensure adequate teaching time b. Determines the client’s interest in learning prior to initiation of teaching sessions c. Assesses client’s learning capabilities as well as those of his family members as a group d. If client shows no interest in learning, documents attempt and notifies physician
What is ANS: B The nurse should first assess the client’s learning needs and barriers to learning when initiating education. The nurse should not make assumptions and should assess each client individually. If the client has no interest in learning, the nurse should wait for another time or setting before beginning health teaching. Although important, scheduling teaching sessions as early as possible prior to discharge, determining the learning capabilities of the client, and notifying the physician of the client’s disinterest in learning would be less important.
100
The nurse is caring for a client of another culture. Which of the following would be the priority intervention of the nurse that would demonstrate an understanding of the need for cultural competence? a. Avoid assuming that members of the same culture all share the same beliefs and values. b. Develop an understanding of your own cultural heritage, feelings, and experiences. c. Become bilingual to communicate effectively with the population of clients served. d. Develop an understanding of the religious beliefs of clients served by the nurse.
What is ANS: B Becoming culturally competent first requires you to examine your feelings and experiences regarding diversity, starting with an understanding of your own heritage. General assumptions about cultural groups are similar to stereotyping and should be avoided. It is difficult to become fluent in many languages, because the area in which the nurse works may serve many different populations. After examining your own views, you’ll need to learn more about specific cultural differences so that you can develop an appreciation for the values and beliefs of clients and co-workers.
200
Which action demonstrates the nurse is using critical thinking when planning a menu for a Vietnamese client who is newly diagnosed with diabetes? a. Asking the client what food he would eat on a standard diabetic menu b. Asking family members to make selections for the client from a diabetic menu c. Calling a Vietnamese interpreter when teaching the client d. Researching the Vietnamese culture prior to discussing diabetic meal planning
What is ANS: D Critical thinking is best illustrated through the nurse researching Vietnamese culture and native cooking prior to discussing meal planning. This shows that the nurse is interested and involved in the client’s care. The nurse can then suggest foods from the standard diabetic menu to the client and his family. An interpreter could be called, if necessary, but does not show the use of critical thought.
200
The nurse is developing a teaching plan on cultural sensitivity for his colleagues who are caring for clients from other cultures. What intervention might a client of another culture interpret as culturally insensitive? a. The nurse makes sure that the Arab female client is covered during assessment. b. The nurse avoids making direct eye contact with the male American Indian client. c. The nurse does not encourage the Japanese-American client to express feelings openly. d. The nurse hugs an Egyptian-American female client who has received bad news.
What is ANS: D The nurse should avoid physical touch with clients of cultures other than his or her own because touch by strangers may be unacceptable, even in stressful situations. It is always acceptable practice to make sure that clients are completely covered when providing care and carrying out assessment. Although eye contact in American culture is a positive communication technique, it is viewed as disrespectful in other cultures. If a client is from another culture, it is good practice to research how he or she might respond to a specific intervention before implementation.
300
A middle-aged woman is referred for a mammogram. What level of illness prevention is being practiced in this situation? a. Primary prevention b. Secondary prevention c. Tertiary prevention d. Self-prevention
What is ANS: B Screening examinations are considered part of secondary prevention because some cases of disease will be uncovered with examinations that have normal results. In primary prevention, interventions are delivered to avoid or delay disease onset. Tertiary prevention involves rehabilitation that occurs after a disease state stabilizes.
300
The nurse is interacting for the first time with a new home health client. What information obtained by observation is considered part of cultural assessment? a. The client asks the nurse how to obtain assistance with his utility bills. b. The client’s wife reports that the children are having difficulty in school. c. The client tells the nurse that he or she would like to move into public housing. d. The client’s wife corrects the husband's response to questions about his parents.
What is ANS: D The interaction among family members can give important clues to culture and cultural influence. In many cultures, the husband is the authority of the household and wives do not express opinions or question the validity of the husband's statements.
400
Which action by the nurse demonstrates the best practice for nursing documentation on a computerized record? a. Deleting all documentation errors on the computerized record b. Using red color font to denote all significant events that have occurred c. Waiting until the end of the shift to record a summary of information d. Noting an error by putting one line through it and initialing
What is ANS: D The best practice for nursing documentation is to put one line through the error and initial it. The other practices listed are ineffective and are not recommended.
400
The client states, “I cannot receive blood transfusions, because it is against my beliefs. I am concerned about having this surgery.” What is the nurse’s best response? a. “You should allow the health care professionals to do whatever is needed to save your life.” b. “If you are worried about contamination, the blood supply in this country is the safest in the world.” c. “There really is nothing unacceptable about blood transfusion.” d. “There are good alternatives to transfusions if you should lose an excessive amount of blood.”
What is ANS: D The client's rights and wishes should be respected while providing accurate information for reassurance. In this case, stating that there are alternatives to transfusions is the best response. The health care provider should not attempt to persuade the client to go against his or her wishes or religious beliefs. Even though the blood supply is safe, the nurse should realize while working with the client that this is not the issue. The nurse should also not try to change the client’s views or practices.
500
Which activities are within the role of the case manager? (Select all that apply.) a. Gathering and organizing data about a client from client records and interviews b. Planning care for a client with emphasis on client satisfaction c. Coordinating care among a variety of health care professionals and settings d. Promoting the client's interests while negotiating necessary health care e. Advocating for the client and family throughout the continuum of care f. Using resources for appropriate client health care services
What is ANS: C, D, E, F The primary roles of the nursing case manager include wide-reaching assessment, planning for timely and cost-effective outcomes, facilitation, and advocacy. Roles of the nursing case manager do not include planning care for a client with emphasis on client satisfaction.
500
Which of the following methods of cultural assessment will provide long-term understanding of a particular culture? a. Interviewing a client b. Observation of a group c. Participation in the community d. Visitation of a group of clients
What is ANS: C Participating in a community that has a large number of members from a particular culture provides insight into the particular cultural group as a whole, rather than from an individual point of view. The nurse can learn about issues such as the buying and social habits of the group and its political views.