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. 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.

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?

• 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.

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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