Nursing Elites

1. A gerontological nurse is conducting an in-service program for a group of nurses who work with a wide range of culturally diverse older adults. After teaching the group about the impact of culture on health and illness, the nurse determines that the teaching was successful when the group identifies which reason as underlying the need to understand culture?

• A. Ensure that clients receive the respect customary in their own ethnic group
• B. Provide individualized and culturally sensitive care
• C. Ensure that medical treatments align with cultural expectations
• D. Increase compliance among minority clients

Correct answer: B

Rationale: The correct answer is B because understanding the impact of culture on health and illness enables nurses to provide individualized and culturally sensitive care to older adults from diverse backgrounds. This approach ensures that the cultural, religious, and sexual orientation differences of older adults are acknowledged, respected, and factored into their care. Choice A is not as comprehensive as B, as the goal goes beyond just respecting customary practices. Choice C, while important, is more focused on medical treatments rather than holistic care. Choice D is not the primary reason for understanding culture; the main goal is to provide personalized care that respects individual differences.

2. An older adult client tells the nurse that blockage of qi in one of the body's meridians is causing severe headaches. The health care provider has diagnosed migraines and has prescribed a triptan drug. Which action would be most appropriate for the nurse to implement?

• A. Suggest that the prescribed medicine may stimulate the flow of qi
• B. Explain the vasoconstrictive and serotonin-moderating action of triptan
• C. Instruct the client to take as many doses as needed for relief
• D. Caution the client that the headaches will grow worse if the client fails to take the medication

Correct answer: A

Rationale: Qi is the life force that circulates through the body in invisible pathways called meridians. In this scenario, the client believes that the blockage of qi is causing severe headaches. While explaining the scientific principles underlying the drug action could be valuable, it's crucial to consider the client's belief system. Therefore, the most appropriate response is to suggest that the prescribed medicine may stimulate the flow of qi, aligning with the client's perspective. Choice B, explaining the vasoconstrictive and serotonin-moderating action of triptan, does not address the client's concerns about qi blockage. Choice C, instructing the client to take as many doses as needed, can lead to potential medication misuse. Choice D, cautioning the client about worsening headaches without medication, may induce fear and hinder effective communication with the client.

3. A nurse is reviewing the client population of a local community health center and identifying the health care needs of the group. The nurse decides to develop a screening program for hypertension. Which client population would the nurse most likely be working with?

• A. A seniors' group based at a Jewish community center.
• B. A Native American reservation/Canadian aboriginal reserve.
• C. A predominantly Chinese-American neighborhood.
• D. A minimum-security prison serving young, rehabilitating offenders.

Correct answer: B

Rationale: Hypertension is disproportionately high among Native American/First Nations clients. This condition is not noted to be a major health problem among Jewish Americans, prisoners, or Americans of Chinese ancestry. Developing a screening program for hypertension in a Native American reservation/Canadian aboriginal reserve would be most appropriate based on the prevalence of the condition in this population.

4. To receive government funding, a county hospital must provide demographic statistics on its client population. When selecting the box labeled Hispanic on the forms, what characteristic of the client population would a worker consider?

• A. immigrant workers who entered the United States and their descendants
• B. immigrants who have a Spanish accent
• C. native Spanish-speaking people living in the United States
• D. persons with brown skin and dark hair

Correct answer: C

Rationale: The correct answer is C because the term 'Hispanic' includes Spanish-speaking individuals from various countries like Spain, Cuba, Mexico, and Puerto Rico. It is essential to understand that Hispanic does not solely refer to individuals with brown skin, dark hair, or those with a Spanish accent. Therefore, choices A, B, and D do not accurately represent the characteristic of the client population that would be classified as Hispanic.

5. How can the nurse best respond to this situation?

• A. The nurse should accept that the relationship plays a positive role for the man.
• B. The nurse should organize a family meeting that includes both the children and the man's partner in an effort to facilitate reconciliation.
• C. The nurse should document the children's concerns and investigate the truth of their claims.
• D. The nurse should ask the partner to demonstrate that she is not a negative influence on the resident.

Correct answer: A

Rationale: In this scenario, the nurse should respect the father's perspective and accept that the relationship with his common-law partner may indeed be positive and beneficial for him. The nurse's role is to support the patient's autonomy and decisions, especially when there are no legal concerns or signs of abuse. Organizing a family meeting (Choice B) might be premature without first acknowledging the father's viewpoint. Documenting concerns and investigating (Choice C) may create unnecessary conflict and breach the father's trust. Asking the partner to prove herself (Choice D) could strain the relationship further and is not within the nurse's role unless there are clear signs of harm or abuse.

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