Nursing Elites

1. 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.

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 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:

• A. talking too much.
• B. using confrontation.
• C. using biased or leading questions.
• D. using blunt language to address sensitive topics.

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. Before a child undergoes a tonsillectomy, what information should the nurse collect?

• A. The child's birth weight
• B. The age at which they crawled
• C. Whether they have had the measles
• D. Reactions to previous hospitalizations

Correct answer: D

Rationale: Before a child undergoes a tonsillectomy, it is crucial for the nurse to gather information on the child's reactions to previous hospitalizations. This data helps in assessing potential fears or anxiety and in providing the necessary support and preparation for the upcoming tonsillectomy. Understanding the child's past reactions is vital for ensuring their comfort and well-being during the hospital admission and procedure. The other options provided are not directly relevant to the child's upcoming tonsillectomy procedure. Birth weight (Choice A) is not typically a factor considered before a tonsillectomy. The age at which a child crawled (Choice B) is a developmental milestone but not pertinent to the tonsillectomy. Having had measles (Choice C) is important for overall health history but not specifically crucial before a tonsillectomy.

5. 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.

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