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. An elderly Mexican-American woman with traditional beliefs has been admitted to an inpatient care unit. A culturally-sensitive nurse would:

• A. contact the hospital administrator about the best course of action.
• B. automatically get a curandero for her because it is not culturally appropriate for her to request one.
• C. further assess the patient's cultural beliefs and offer the patient assistance in contacting a curandero or priest if she desires.
• D. ask the family what they would like to do because Mexican-Americans traditionally give control of decisions to their families.

Correct answer: C

Rationale: When caring for a patient with traditional beliefs, especially one belonging to a culture like Mexican-American where folk or religious healers are important, a culturally-sensitive nurse should assess the patient's beliefs and preferences. By offering assistance in contacting a curandero or priest, the nurse acknowledges and respects the patient's cultural practices and provides holistic care that aligns with the patient's values. This approach helps build trust and ensures the patient receives care that is culturally appropriate and respectful. Choice A is incorrect as contacting the hospital administrator may not directly address the patient's cultural needs. Choice B is inappropriate as assuming the patient needs a curandero without assessment disregards individual preferences. Choice D is incorrect because while family involvement is valued in Mexican-American culture, the primary focus should be on the patient's individual preferences and autonomy.

3. During an interview, the nurse states, 'You mentioned shortness of breath. Tell me more about that.' Which verbal skill is used with this statement?

• A. Reflection
• B. Facilitation
• C. Direct question
• D. Open-ended question

Correct answer: D

Rationale: The nurse's statement, 'Tell me more about that,' is an example of an open-ended question. Open-ended questions encourage the interviewee to provide detailed information and expand on their responses. This type of question is useful for gathering narrative information and allows the interviewee to express themselves freely. Reflection involves restating or paraphrasing the client's words, facilitation encourages the client to say more, and direct questions typically elicit specific, close-ended responses, unlike open-ended questions.

4. An individual who takes the magicoreligious perspective of illness and disease is likely to believe that his or her illness was caused by:

• A. germs and viruses.
• B. supernatural forces.
• C. eating imbalanced foods.
• D. an imbalance within his or her spiritual nature.

Correct answer: B

Rationale: The magicoreligious perspective of illness and disease is based on the belief that supernatural forces play a significant role in causing health problems. Individuals holding this perspective may believe that their illness was caused by curses, evil spirits, or other supernatural factors rather than conventional explanations like germs or viruses. This worldview influences how they perceive and seek treatment for their health conditions. Therefore, the correct answer is B) supernatural forces. Choices A, C, and D are incorrect because they do not align with the supernatural beliefs associated with the magicoreligious perspective. This perspective focuses on attributing illness to supernatural causes rather than biological, dietary, or spiritual imbalances.

5. The healthcare professional is reviewing concepts of cultural aspects of pain. Which statement is true regarding pain?

• A. All individuals will behave the same way when in pain.
• B. Just as individuals vary in their perceptions of pain, they will also vary in their expressions of pain.
• C. Cultural norms play a significant role in determining pain tolerance, as it is always biologically determined.
• D. A patient's expression of pain is largely dependent on the amount of tissue injury associated with the pain.

Correct answer: B

Rationale: Patients vary in their perceptions of pain, which can be influenced by cultural factors, personal experiences, and psychological aspects. As a result, individuals will also vary in how they express their pain. Cultural norms, social environment, and individual differences all play a role in how pain is experienced and communicated. Therefore, it is important for healthcare professionals to recognize and respect these variations in order to provide appropriate pain management and support for patients. Choice A is incorrect because individuals do not behave the same way when in pain. Choice C is incorrect because pain tolerance is not solely biologically determined; cultural norms and individual differences also influence it. Choice D is incorrect because a patient's expression of pain can be influenced by various factors beyond the amount of tissue injury, such as emotional state and cultural beliefs.

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