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. In the majority culture of America, coughing, sweating, and diarrhea are symptoms of an illness. For some individuals of Mexican-American origin, however, these symptoms are a normal part of living. The nurse recognizes that this is true, probably because Mexican-Americans:

• A. have less efficient immune systems and are often ill.
• B. consider these symptoms a part of normal living, not symptoms of ill health.
• C. come from Mexico where coughing is normal and healthy.
• D. are usually in a lower socioeconomic group and are more likely to be sick.

Correct answer: B

Rationale: In Mexican-American culture, coughing, sweating, and diarrhea are often considered normal bodily functions and not necessarily indicative of illness. This cultural perspective shapes their understanding of health and illness, leading them to view these symptoms differently than the majority culture in America. Choice A is incorrect because it generalizes Mexican-Americans as having less efficient immune systems, which is not supported by evidence. Choice C is incorrect as it oversimplifies by attributing the perception solely to coming from Mexico. Choice D is incorrect as it makes unwarranted assumptions about the socioeconomic status and health status of Mexican-Americans.

4. When a nurse is performing a health interview on a patient with a language barrier and no interpreter is available, which of the following is the best example of an appropriate question for the nurse to ask?

• A. Do you take medicine?
• B. Do you sterilize the bottles?
• C. Do you have nausea and vomiting?
• D. You have been taking your medicine, haven't you?

Correct answer: A

Rationale: The best example of an appropriate question for the nurse to ask in this situation is 'Do you take medicine?' This question is clear, simple, and focused on one topic at a time, which is essential when there is a language barrier and no interpreter available. It follows the recommendation to use simple words, avoid medical jargon, contractions, and pronouns in such situations. Choices B, C, and D involve more complex language, unrelated topics, or assumptions about the patient's actions, making them less suitable for effective communication in this context.

5. When working with children from different cultural perspectives, the healthcare provider may find it particularly challenging because:

• A. children's spiritual needs are influenced by their stages of development.
• B. children's spiritual needs are direct reflections of what is happening in their homes.
• C. religious beliefs often impact the parents' views on the illness.
• D. parents are usually the decision-makers, but they may lack awareness of their children's spiritual needs.

Correct answer: A

Rationale: Children's spiritual needs are influenced by their stages of development, not just by what is happening in their homes. Understanding these needs requires knowledge of how children's spiritual beliefs evolve as they grow. Different cultural perspectives can bring varying beliefs and practices regarding children's spiritual development, which may challenge healthcare providers in addressing these needs effectively. Choice B is incorrect because children's spiritual needs are not solely reflections of their home environments but are shaped by various factors. Choice C is incorrect as it discusses the impact of parents' religious beliefs on illness views rather than focusing on children's spiritual needs. Choice D is incorrect as it addresses parental awareness of children's spiritual needs, which is not the primary challenge faced by healthcare providers in this context.

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