Nursing Elites

1. 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.

2. When evaluating the reliability of a patient's responses, which of these statements would be correct? The patient:

• A. has a history of drug abuse and therefore is not reliable.
• B. provided consistent information and therefore is reliable.
• C. smiled throughout the interview and therefore is assumed reliable.
• D. would not answer questions concerning stress and therefore is not reliable.

Correct answer: B

Rationale: In evaluating the reliability of a patient's responses, consistency in the information provided by the patient is crucial. When a patient provides consistent information, it indicates that their responses are trustworthy and reliable. In this scenario, the nurse can consider the patient as reliable based on the consistency of the information provided. Other factors such as a history of drug abuse, smiling behavior, or refusal to answer certain questions may not necessarily determine the reliability of the patient's responses. Therefore, the correct choice is B as consistency in responses is a more reliable indicator of trustworthiness than other factors mentioned in the choices.

3. During an interview, note-taking may impede the nurse's observation of the patient's nonverbal behaviors. Which statement is true regarding note-taking?

• A. Note-taking may impede the nurse's observation of the patient's nonverbal behaviors.
• B. Note-taking allows the patient to continue at their own pace as the nurse records what is said.
• C. Note-taking allows the nurse to shift attention away from the patient, resulting in an increased comfort level.
• D. Note-taking allows the nurse to break eye contact with the patient, which may increase their level of comfort.

Correct answer: A

Rationale: Note-taking during an interview can impede the nurse's ability to observe the patient's nonverbal behaviors, such as body language and facial expressions, which are important aspects of communication. It may break eye contact too often, shift attention away from the patient, interrupt the patient's narrative flow, and diminish the patient's sense of importance. Therefore, it is crucial for the nurse to balance the need for note-taking with maintaining active listening and observation skills to ensure effective communication and rapport building with the patient. Choices B, C, and D are incorrect because note-taking can actually hinder the patient's narrative flow, decrease the nurse's observation of nonverbal cues, and potentially make the patient feel less important or attended to due to distractions caused by the note-taking process.

4. What would be an appropriate nursing response when a mother reports that her 16-month-old toddler has an earache?

• A. Maybe the toddler is just teething.
• B. I will check her ear for an ear infection.
• C. Are you sure the toddler is really in pain?
• D. Please describe what the toddler is doing to indicate she is in pain.

Correct answer: B

Rationale: The appropriate nursing response would be to assess the toddler's ear to determine if there is indeed an ear infection causing the earache. It is crucial to provide timely and suitable care for the child's pain and discomfort. Checking for an ear infection is a necessary step in evaluating the source of the toddler's earache. Choice A is incorrect as it assumes the earache is due to teething without proper assessment. Choice C questions the mother's report rather than focusing on the child's condition. Choice D is not as direct and focused as directly examining the ear for a possible infection.

5. 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.

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