Question 1

An immigrant Chinese nurse begins working on a medical unit. The new nurse's preceptor is explaining the unit routines, including the medication administration system. When the preceptor asks if the nurse understands, the answer is always: "Yes, I understand." What is the best way to tell if the nurse really understands?

Accepted Answer

Having the nurse demonstrate the procedures is the best way to tell if the nurse really understands. This will allow the preceptor to observe the nurse actually carrying out the tasks and identify any areas where additional instruction is needed. Simply repeating the information or asking about the difficulties may not reveal whether or not the nurse truly comprehends the medication administration system. Giving a medication quiz could be helpful but may not be as comprehensive as seeing the nurse perform the tasks in real life.

Question 2

A 32-year-old Guatemalan mother brings her 10-day-old infant to a clinic for a well-baby checkup. To promote healing, she has a coin taped to the infant's umbilicus. How should the nurse respond?

Accepted Answer

B

Question 3

An unidentified comatose patient is brought to the emergency department by the paramedics. Tied to the right wrist is an emblem that looks as if it might be a religious talisman. Which of the following nursing actions is best?

Accepted Answer

It is important to leave the talisman in place as it may hold cultural or religious significance for the patient or their family. Taping it in place ensures that it remains with the patient and is not lost or damaged during care.

Question 4

One state's law requires that all female patients be offered a Papanicolaou smear when admitted to the hospital. A 43-year-old Egyptian patient refuses the test. Which action by the nurse is appropriate first?

Accepted Answer

It is important to respect the patient's autonomy and provide education about the importance of the test. The nurse should explain the rationale and benefits of the test to the patient, answering any questions she may have, and then document the patient's refusal in her medical records. The other options may be appropriate in certain situations but are not the best immediate action in this case.

Question 5

A 76-year-old Muslim patient is approaching death. The family says the patient's bed should be turned toward the opposite wall so it can face Mecca to ensure an easier passage into the next life. The wall they want the bed to face has wall suction and oxygen, which the patient is using. Which of the following actions by the nurse is appropriate?

Accepted Answer

The nurse should accommodate the family's request to turn the bed toward Mecca, as it is an important religious practice for Muslims. This can be done by rearranging the furniture or using longer tubing for the oxygen and suction if necessary.

Question 6

A 72-year-old Arabian American patient has just been diagnosed with cancer of the colon. The family does not want the patient to be told about the diagnosis. Which action by the nurse is best initially?

Accepted Answer

The nurse should respect the family's wishes but also explore their reasons for wanting to withhold the information. The nurse should also educate the family about the patient's right to know about their condition and the potential consequences of not sharing this information. However, the nurse must ultimately prioritize patient autonomy and informed decision-making.

Question 7

A 35-year-old woman accompanies a neighbor to the clinic for a monthly diabetes checkup. It is 35 miles to the closest health clinic, and the patient does not own an automobile. On this occasion, the clinic intake nurse discovers that the woman has never had a Papanicolaou test because of lack of time and transportation. She is agreeable to the examination. Which of the following actions should the clinic nurse take?

Accepted Answer

Encouraging the gynecological clinic to perform the Papanicolaou test on the same day is the best choice as it ensures that the patient receives the necessary care in a timely manner without the need for additional transportation or scheduling. It also helps mitigate the risk of the patient forgetting or being unable to attend a future appointment.

Question 8

A 52-year-old Haitian patient with heart failure wants to have a voodoo practitioner visit and say prayers. How should the nurse respond?

Accepted Answer

It is important to respect the patient's cultural and religious beliefs, and allowing a voodoo practitioner to say prayers is not harmful to the patient's health or safety. As long as it does not interfere with medical treatment or hospital policy, the nurse should support the patient's request.

Question 9

A white female nurse is discussing a patient from another culture at the nurse's station. She says, "Why does he have to see his own health practitioner? Doctors are good enough for the rest of us." What characteristic is she exhibiting?

Accepted Answer

The nurse is exhibiting ethnocentrism by believing that her own culture's way of seeking medical care is superior to the patient's culture.

Question 10

The nurse notes that an Arabian patient is not eating anything on the meal trays. What is the best way to remedy this situation?

Accepted Answer

Asking if the patient has special food preferences allows the nurse to address any cultural or religious dietary needs the patient may have. This can help the nurse provide appropriate meal options for the patient. Contacting the dietitian or consulting with an Arabian physician may also be helpful, but it is best to first communicate directly with the patient to address their individual needs and preferences. Waiting for the patient to ask for specific foods may result in the patient not receiving adequate nutrition and can lead to other health problems.

Question 11

The nurse is caring for a 32-year-old male patient who refuses personal care from a female nursing assistant. Which of the following approaches by the nurse is best?

Accepted Answer

The best approach is to assign a male assistant to help with his personal care if one is available. This respects the patient's preference while still ensuring that his needs are met. If a male assistant is not available, alternative options may need to be explored, such as having a male nurse or having a female nursing assistant work alongside a male colleague when providing personal care. It is important to respect the patient's wishes and ensure that he feels comfortable with his care.

Question 12

The mother of a 6-year-old Vietnamese child admitted with pneumonia is rubbing a coin on the child's back. The coin leaves red marks. Which of the following responses by the nurse is best?

Accepted Answer

Coining is a traditional healing practice in some cultures, including Vietnamese, where a coin is rubbed on the skin to relieve various ailments. It is important for healthcare providers to respect cultural practices that are not harmful. Adding a statement to the care plan acknowledges and respects the family's cultural practices without compromising the child's safety or well-being.

Question 13

The nurse is giving medication instructions to a 45-year-old patient who does not maintain eye contact. What is the most likely explanation for this behavior?

Accepted Answer

The lack of eye contact may indicate that the patient feels intimidated or uncomfortable with the hierarchical position the nurse holds in relation to the patient. This can create a power dynamic that makes the patient feel subordinate and less likely to engage in open communication.

Question 14

A 44-year-old Spanish-speaking Mexican American patient comes to the emergency department. The patient is exhibiting signs of severe pain but does not speak any English. A Spanish-speaking secretary from Peru offers to help with the translation. How can the nurse best facilitate the translation?

Accepted Answer

Maintaining eye contact with both the patient and the translator ensures that the patient feels respected and understood. It also helps the nurse to monitor the patient's nonverbal cues, such as body language and facial expressions, which can provide valuable information about the patient's condition. Option B is incorrect because it is important to establish trust with the translator and allow them to have private conversations with the patient. Option C is incorrect because relying solely on hand signals may not provide enough information about the patient's condition. Option D is incorrect because verbal communication is important in understanding the patient's medical history and current symptoms.

Question 15

The nurse is caring for a 65-year-old Jehovah's Witness who is having severe gastrointestinal bleeding. The patient's hemoglobin is dangerously low. The patient, who is fully alert and competent, refuses to accept the blood transfusion ordered by the physician. Which action by the nurse is most appropriate?

Accepted Answer

The nurse should ensure the patient fully understands the potential consequences of refusing the blood transfusion and then respect the patient's wishes since the patient is fully alert and competent. The nurse cannot proceed with administering the blood without informed consent since it violates the patient's autonomy and may lead to legal consequences. Obtaining a court order or having the patient's spouse sign the consent form without the patient's consent is also against ethical principles of respect for patient autonomy. Administering the blood while the patient is sleeping is also unethical and can lead to legal consequences.

Question 16

The nurse is caring for an Asian woman who recently had surgery and needs to learn to perform her own dressing changes. Which of the following statements by the nurse indicates the nurse is culturally competent?

Accepted Answer

Option A demonstrates cultural competence by acknowledging and respecting the patient's cultural beliefs and practices. The other options use inappropriate language or make assumptions about the patient's intelligence, feelings, or healthcare team.

Question 17

A 34-year-old Mexican patient admits to seeing a curandero for asthma. The curandero prescribes a special tea four times a day to open the airways. How should the nurse respond to this situation?

Accepted Answer

It is important for the nurse to gather more information about the tea and its ingredients to ensure the patient's safety. Asking the patient to bring in the tea package and having the pharmacist check the ingredients can help determine if there are any potential risks or interactions with other medications. It is not appropriate to simply encourage or discourage the patient from drinking the tea without further information.

Question 18

Which of the following terms implies an appreciation and attention to arts, music, crafts, clothing, and foods of a culture?

Accepted Answer

Cultural awareness involves an understanding and appreciation of the customs, traditions, arts, and beliefs of a particular culture. This includes an appreciation and attention to arts, music, crafts, clothing, and foods of a culture.

Question 19

A northern European patient had an abdominal aneurysm repaired 24 hours ago. Although the patient denies pain, vital signs show an elevated pulse and blood pressure, and the patient refuses to move in bed. Which of the following actions by the nurse would best ensure comfort and timely discharge?

Accepted Answer

Explaining that pain medicine will help prevent complications can encourage the patient to accept pain management, which is crucial for recovery and timely discharge.

Question 20

Which of the following activities might be practiced by individuals from cultures that are past-oriented?

Accepted Answer

Past-oriented cultures tend to value tradition and history, so worshipping ancestors and maintaining traditions would be a common activity.

Quiz 4: Cultural Influences on Nursing Care