Deck 13: Psychosocial, Gender, and Cultural Influences on Pharmacotherapy

Question 1

The client is diagnosed with cancer.The health care provider has recommended chemotherapy, which would likely save the client's life.The client tells the nurse, "This is a punishment from God for the sins I have committed; some of the women at my Church say so." What is the best plan of action for the nurse based obtaining the consent of the client?
1)Plan to contact the client's minister to discuss the client's perspective about cancer.
2)Plan to meet with family members to discuss the client's perspective about cancer.
3)Plan to bring the case before the hospital's board of ethics.
4)Plan to involve a hospital minister to discuss the client's perspective about cancer.

Answer 1

1

Question 2

The nurse is conducting a holistic assessment of a client with alcoholism.What are the priority questions that the nurse should include in the assessment? (Select all that apply)
1)"Have you ever been in alcohol rehabilitation before?"
2)"Are any of your blood relatives been addicted to alcohol?"
3)"Have you ever attended Alcoholic Anonymous meetings?"
4)"Did you see your parents drink alcohol when you were growing up?
5)"How is drinking alcohol viewed by your culture?"

Answer 2

2, 4, 5

Question 3

The nurse is doing a holistic assessment on a client prior to the initiation of antihypertensive medication.What factors would be included in a holistic assessment? (Select all that apply).
1)Blood pressure
2)Mood
3)Level of education
4)The cause of the hypertension
5)Belief in a higher power

Answer 3

1, 2, 3, 5

Question 4

An African-American client had an myocardial infarction, and is receiving atorvastatin (Lipitor).The nurse caring for the client is Caucasian.The nurse assesses the client's diet to be very high in fat.What is the best teaching plan by the nurse to improve the client's diet and reduce the risk for additional medications?
1)Plan to ask an African-American nurse to speak to her about low-fat diets.
2)Ask the health care provider for a consult by dietary services so a dietician can teach the client about low-fat diets.
3)Discuss her diet with whomever prepares meals for the family.
4)Give the client information specific to African-Americans about low-fat diets.

Question 5

The client is from an Arab culture and is in labor and delivery.Her husband insists he must stay with her, and will not allow her to receive any analgesia during the experience.What is
The best action by the nurse?
1)Inform the husband that it is his wife's choice whether to receive analgesia.
2)Allow this request, and be available in the event the request changes.
3)Allow the request, but inform the husband that the primary health care provider will make the final decision regarding analgesia.
4)Inform the husband that he must sign a release of responsibility to avoid future litigation against the hospital.

Question 6

An adolescent Hispanic male has been diagnosed with Attention Deficit Hyperactivity Disorder (ADHD), and is taking methylphenidate (Ritalin).Even though the drug helps
Him with focusing and grades, the adolescent will not go to the school nurse at noon for his medication.Which statement best describes the result of the nurse's evaluation?
1)The adolescent really does not need an additional dose of methylphenidate (Ritalin)at school.
2)The adolescent has developed alternative coping mechanisms to increase his focus during classes.
3)The adolescent is fearful that this drug might be a "gateway drug" and he will abuse other substances.
4)The adolescent is embarrassed about having to take medicine at school; it is a social stigma.

Question 7

The nurse is assessing a client using the human integration model as a conceptual framework.How does this model assist the nurse in dealing holistically with the client's
Problems?
1)Levels of the pyramid are independent and unconnected.
2)Ensures that pharmacotherapy is only treating the symptoms.
3)All levels of the pyramid are interconnected and interdependent.
4)It's a useful approach in addressing the medical needs of the client.

Question 8

The nurse is caring for an Asian-American client with terminal cancer.What is an important factor for the nurse to consider in giving adequate pain control to the client?
1)All ethnic groups respond to medications in the same manner.
2)Asians respond differently only to antidepressants.
3)Drug metabolism is affected differently only in African-Americans.
4)Opioids are metabolized differently in individuals of Asian and Native American descent.

Question 9

The nurse is providing group education about warfarin (Coumadin)to a group of Asian- and African-American clients who have experienced strokes.The nurse determines that learning has occurred when the clients make which statement?
1)"We might need less medication than other ethnic groups."
2)"We might need to have more frequent blood tests."
3)"We might need more medication than other ethnic groups."
4)"We might need to have less frequent blood tests."

Question 10

The nurse is teaching a class on how to prevent heart attacks to clients.It is a mixed-gender class.What important factor does the nurse need to include in the teaching plan related to gender?
1)Heart disease affects men and women equally.
2)All medications used to prevent heart attacks affect men and women the same.
3)Certain medications, such as aspirin, are more effective in preventing heart attacks in men than in women.
4)Certain medications, such as aspirin, are more effective in preventing heart attacks in women than in men.

Question 11

The client is a Native American admitted to the hospital for chemotherapy.At any given time, five family members are in the client's private room.The nurse tells the client that according to hospital policy, only two visitors at a time are allowed.What is the nurse manager's analysis of the situation?
1)The nurse was following protocol by informing the client about hospital policy.
2)The nurse should have assessed the client's preference about how many family members he wanted to be present.
3)The nurse should have allowed the client to have as many family members as he wanted to be present.
4)The nurse should have called the health care provider and obtained an order for additional
Family members to be present.

Question 12

The primary health care provider has prescribed isoniazid (INH)for a client of Japanese descent diagnosed with tuberculosis.What important factor must the nurse take into consideration in regard to the therapeutic effectiveness of this drug?
1)Clients of Japanese descent are known as slow acetylators.
2)Clients of Japanese descent are usually allergic to isoniazid.
3)Clients of Japanese descent are known as rapid acetylators.
4)Clients of Japanese descent do not need medication to treat their tuberculosis.

Question 13

A male client comes into the Emergency Department with chest pain; his blood pressure is 210/100 mm/Hg.The client's wife says to the nurse, "He has not been taking his blood pressure medication, and we can afford it." What should the best plan of action for the nurse include?
1)Plan to teach the client the importance of taking his medication.
2)Plan to design a teaching plan about medication that includes the client's wife.
3)Plan to assess the client for any cultural concerns about the medication.
4)Plan to assess the client for sexual side effects such as erection difficulty.