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 nu
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Nursing Elites

HESI A2

HESI A2 Practice Test Anatomy and Physiology

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?

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:

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 a wellness workshop, a healthcare provider is collecting comprehensive health histories from attendees. One of the written questions on the history form states, 'You don't smoke, drink, or take drugs, do you?' This question is an example of:

Correct answer: C

Rationale: The question provided is an example of using biased or leading questions. It suggests that one answer is more socially acceptable or preferable than another, potentially pressuring the individual to respond in a specific way. This can result in inaccurate information being provided and may also evoke feelings of guilt or judgment, influencing the person's responses. Choices A, B, and D are incorrect as they do not accurately describe the nature of the question. The question does not involve talking too much, confrontation, or blunt language; instead, it leads the respondent towards a specific answer.

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?

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 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.

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.

Similar Questions

Before a child undergoes a tonsillectomy, what information should the nurse collect?
An individual who takes the magicoreligious perspective of illness and disease is likely to believe that his or her illness was caused by:
During an interview, the nurse states, 'You mentioned shortness of breath. Tell me more about that.' Which verbal skill is used with this statement?
When communicating with a patient who has a hearing impairment, what technique would be most beneficial?
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?

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