Nursing Elites

1. When communicating with a patient who has a hearing impairment, what technique would be most beneficial?

• A. Determine the communication method he prefers.
• B. Avoid using facial and hand gestures as they can be degrading to most hearing-impaired individuals.
• C. Request a sign language interpreter before meeting to facilitate communication.
• D. Speak loudly and with exaggerated facial movement, as this helps with lip reading.

Correct answer: A

Rationale: When communicating with a patient who has a hearing impairment, it is crucial to determine the preferred communication method, whether it involves signing, lip reading, or writing. By directly asking the patient for their preferred method of communication, the healthcare provider can ensure effective and respectful interaction tailored to the individual's specific needs and preferences. Option B is incorrect because using facial and hand gestures can actually aid in communication for some individuals with hearing impairments. Option C is not always necessary and may not be the preferred method for all patients. Option D is incorrect because speaking loudly and with exaggerated facial movements is not necessary and may not be preferred by the patient.

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. The healthcare professional is reviewing concepts of cultural aspects of pain. Which statement is true regarding pain?

• A. All individuals will behave the same way when in pain.
• B. Just as individuals vary in their perceptions of pain, they will also vary in their expressions of pain.
• C. Cultural norms play a significant role in determining pain tolerance, as it is always biologically determined.
• D. A patient's expression of pain is largely dependent on the amount of tissue injury associated with the pain.

Correct answer: B

Rationale: Patients vary in their perceptions of pain, which can be influenced by cultural factors, personal experiences, and psychological aspects. As a result, individuals will also vary in how they express their pain. Cultural norms, social environment, and individual differences all play a role in how pain is experienced and communicated. Therefore, it is important for healthcare professionals to recognize and respect these variations in order to provide appropriate pain management and support for patients. Choice A is incorrect because individuals do not behave the same way when in pain. Choice C is incorrect because pain tolerance is not solely biologically determined; cultural norms and individual differences also influence it. Choice D is incorrect because a patient's expression of pain can be influenced by various factors beyond the amount of tissue injury, such as emotional state and cultural beliefs.

4. 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.

5. When planning a cultural assessment, which component should be included?

• A. Family history
• B. Chief complaint
• C. Medical history
• D. Health-related beliefs

Correct answer: D

Rationale: When planning a cultural assessment, the nurse should include the component of health-related beliefs. Understanding a person's cultural background and beliefs about health and wellness is crucial for providing culturally competent care. Health-related beliefs can impact a person's attitudes towards illness, treatment preferences, and adherence to medical recommendations. Therefore, assessing health-related beliefs is essential for delivering effective and respectful healthcare services. Choices A, B, and C are important components of a comprehensive patient assessment but are not specific to cultural considerations. While family history, chief complaint, and medical history are pertinent to understanding a patient's health status, health-related beliefs focus specifically on the cultural aspect that influences an individual's health perceptions and behaviors.

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