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 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.

3. 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.

4. 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.

5. 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.

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