Nursing Elites

1. During an assessment, the nurse notices that a patient is handling a small charm that is tied to a leather strip around his neck. Which action by the nurse is appropriate?

• A. Ask the patient about the item and its significance.
• B. Ask the patient to lock the item with other valuables in the hospital's safe.
• C. Tell the patient that a family member should take valuables home.
• D. No action is necessary.

Correct answer: A

Rationale: The appropriate action for the nurse in this situation is to ask the patient about the charm and its significance. This helps the nurse understand the patient's cultural beliefs, personal values, and any potential significance the charm holds for the patient. It also shows respect for the patient's personal belongings. Asking about the charm can help establish rapport and cultural competence in the nurse-patient relationship. Choices B and C do not address the patient's attachment to the charm or provide an opportunity for cultural understanding. Choice D is incorrect as it dismisses the importance of acknowledging and respecting the patient's personal belongings.

2. When conducting an interview in an outpatient clinic using a computer to record data, what is the best use of the computer in this situation? Select all that apply.

• A. Collect the patient's data in a direct, face-to-face manner.
• B. Enter all the data as the patient states it.
• C. Ask the patient to wait as the data is entered.
• D. Type the data into the computer after establishing a connection.

Correct answer: A

Rationale: A. Collect the patient's data in a direct, face-to-face manner: When conducting an interview in an outpatient clinic, it is essential to engage with the patient face-to-face to establish a rapport, gather their narrative, and ensure accurate data collection. Entering all the data as the patient states it (choice B) may lead to missing important details or misinterpretation. Asking the patient to wait as the data is entered (choice C) can create a disconnect in communication and reduce patient engagement. Typing the data into the computer after establishing a connection (choice D) is not ideal as it is important to collect data actively while interacting with the patient.

3. When an American Indian seeks help at the clinic for regulating her diabetes, the nurse can expect that she:

• A. will comply with the treatment prescribed.
• B. has not necessarily given up her beliefs in naturalistic causes of disease.
• C. may also be seeking the assistance of a shaman or medicine man.
• D. may need extra help in dealing with her illness and may be experiencing a crisis of faith.

Correct answer: C

Rationale: It is important to recognize that individuals from American Indian cultures may incorporate traditional healing practices, such as seeking the assistance of a shaman or medicine man, alongside biomedical treatments. This holistic approach to health and healing is a significant aspect of their cultural beliefs and practices. Choice A is incorrect because compliance with treatment may vary among individuals and cannot be generalized. Choice B is incorrect as it assumes that seeking traditional help means giving up beliefs in naturalistic causes of disease, which is not necessarily the case. Choice D is incorrect as it makes assumptions about the patient's emotional state and crisis of faith without evidence. Overall, understanding and respecting the integration of traditional healing practices is key to providing culturally sensitive care.

4. During an interview, the interviewer is using open-ended questions. Which of the following statements are true regarding open-ended questions? Select all that apply.

• A. They elicit cold facts.
• B. They allow for self-expression.
• C. They build and enhance deviation from topic
• D. They leave interactions neutral.

Correct answer: B

Rationale: Open-ended questions are designed to encourage the interviewee to express themselves freely, leading to more detailed and insightful responses. These questions help build rapport by showing interest in the interviewee's thoughts and feelings. By allowing for self-expression, open-ended questions facilitate a deeper and more meaningful conversation, making them a valuable tool in conducting interviews. Choice A is incorrect because open-ended questions aim to gather detailed and subjective information, not just cold facts. Choice D is incorrect as open-ended questions often lead to more engaging interactions rather than leaving them neutral.

5. When providing culturally competent care, how should nurses incorporate cultural assessments into health assessments? Which statement is most appropriate when initiating an assessment of cultural beliefs with an elderly American Indian patient?

• A. "Are you of the Christian faith?"
• B. "Do you want to see a medicine man?"
• C. "How often do you seek help from medical providers?"
• D. "What cultural or spiritual beliefs are important to you?"

Correct answer: D

Rationale: The most appropriate statement to initiate an assessment of cultural beliefs with an elderly American Indian patient is to ask, "What cultural or spiritual beliefs are important to you?" This question encourages the patient to share their personal beliefs without assuming stereotypes or making generalizations. It allows the patient to express their individual cultural and spiritual practices, enabling nurses to deliver more personalized and culturally competent care. Choices A, B, and C are not as suitable. Choice A assumes a specific faith without considering the patient's actual beliefs. Choice B relies on a stereotype about American Indian culture, and Choice C focuses more on seeking medical help rather than exploring cultural beliefs.

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