Deck 13: Nurses,patients Families: Caring at the Intersection of Health,Illness Culture

Question 1

A patient tells the nurse,"I'll let you do whatever you think is best for me." The patient does very little independently without calling for assistance.The nurses conclude that the patient is demonstrating which personality characteristic?

A) Acceptance
B) Sense of control
C) Coping
D) Dependence

Answer 1

Dependence

Question 2

Which of the following is an appropriate intervention for the nursing diagnosis of spiritual distress?

A) Never pray with patients or share readings that can have a religious connection.
B) Inform patients of the prevalent religious beliefs that exist in the locale where they are being treated.
C) Consider patients' religious beliefs when planning care.
D) Reassure patients that they should not blame God for their illness.

Answer 2

Consider patients' religious beliefs when planning care.

Question 3

Which illness has the characteristics of an acute illness?

A) Exercise-induced asthma
B) Type 2 diabetes
C) Influenza
D) Cleft palate

Answer 3

Influenza

Question 4

A Caucasian nurse is caring for a Native American after a stroke.The nurse finds the patient sleeping while holding several small feathers bound by a beaded leather thong.The nurse should consider the possibility that this is

A) an interesting trinket to brighten the environment.
B) a gift from his grandchildren to make him feel closer to the family.
C) an important item used in native healing practices.
D) an item that might introduce microorganisms into the hospital environment.

Question 5

What is the primary difference between acute illness and chronic illness?

A) In acute illness, symptoms begin suddenly, progress quickly, and subside quickly.
B) In acute illness, symptoms begin suddenly, progress gradually, and do not subside.
C) In chronic illness, symptoms begin gradually, progress suddenly, and subside quickly.
D) In chronic illness, symptoms begin suddenly, require ongoing management, and subside quickly.

Question 6

A contemporary view of the sick role includes

A) patient as partner with the health care provider.
B) patient as submissive to the health care provider.
C) patient noncompliant with the health care provider.
D) moving away from cultural values when making health care decisions.

Question 7

A patient in whom metastatic cancer is diagnosed tells the nurse,"God has never let me down before.I'll pray for strength." This patient's illness behavior is being influenced by

A) resiliency.
B) sense of control.
C) spirituality.
D) depression.

Question 8

A patient states,"I do not understand why I keep getting these headaches.I have seen a nurse practitioner and two specialists.I have taken several medications,but the headaches keep coming back." In which stage of illness is the patient?

A) Disbelief and denial
B) Irritability and anger
C) Attempting to gain control
D) Acceptance and participation

Question 9

A patient states,"There is no hope.They're going to keep me here until I die.Can't you give me my medication more often? I'm going to die anyway." In which stage of illness is this patient?

A) Disbelief and denial
B) Irritability and anger
C) Attempting to gain control
D) Depression and grief

Question 10

A patient states,"I am so upset that I need a knee replacement.I should have done those exercises that the physical therapist told me to do years ago." In which stage of illness is the patient?

A) Disbelief and denial
B) Irritability and anger
C) Attempting to gain control
D) Depression and despair

Question 11

A patient states,"I have knowledge about my diet and how to do my insulin injections,so I can get on with my life." In which stage of illness is this patient?

A) Disbelief and denial
B) Irritability and anger
C) Attempting to gain control
D) Acceptance and participation

Question 12

A young girl from a Middle Eastern country is in the process of dying.Her parents ask the nurses to allow her to be prepared for death by being dressed in a specific garment and headdress every day.The parents cannot be there every day to do this and ask the nurses to apply the attire.Which actions by the nurses demonstrate culturally competent care?

A) Allowing the parents to dress the patient in the garment and headdress when they are by her side
B) Consulting the chaplain as to the meaning of the ritual in the Middle East
C) Informing the parents that hospital policy requires all patients to wear hospital garments
D) Learning how to apply the garment and headdress properly

Question 13

A patient with diabetes who refuses to change eating patterns may be in which stage of adjustment?

A) Denial and disbelief
B) Irritability and anger
C) Attempting to gain control
D) Acceptance and participation

Question 14

Which statement about acute illness is true?

A) Most people with acute illness develop chronic illness.
B) Most people with acute illness return to their previous level of wellness.
C) All people with an acute illness need medical care.
D) Acute illnesses are usually catastrophic in nature.

Question 15

A patient in whom cancer has just been diagnosed tells the nurse,"Just get out of here and leave me alone! Let me suffer alone.God is punishing me." The nurse determines that the most appropriate nursing diagnosis for this patient is

A) risk for loneliness.
B) powerlessness.
C) dysfunctional grieving.
D) spiritual distress.

Question 16

A patient diagnosed with breast cancer responded by gathering information about treatment options and becoming involved in a self-help group.The nurse assesses that the patient is demonstrating which personality characteristic?

A) Independence
B) Hardiness
C) Self-control
D) Tolerance

Question 17

An English-speaking nurse gave a non-English-speaking Asian patient instructions about preparing an abdominal surgical site.The nurse showed the patient how the bottle of povidone-iodine was to be used in cleansing the area.The patient smiled and nodded throughout the instructions.The patient did not respond when asked if he had any questions.When the nurse left the room,the patient promptly drank the bottle of povidone-iodine.Which action would be most effective in preventing this error?

A) Giving the patient written instructions in his language
B) Using a medical interpreter to give the preoperative instructions
C) Having the patient sign a statement that he understood the instructions
D) Using illustrations to show the patient the procedure

Question 18

A patient was diagnosed with ovarian cancer 5 years ago.She underwent chemotherapy and radiotherapy,but cancer returned 2 years ago with metastases to the bone and possibly the lung.She says the cancer is "no longer curable,but treatable." During this time the patient's daughter was critically injured in a car accident and now lives with a traumatic brain injury,needing round-the-clock care.Her husband had an affair.She continues to work and volunteers with various community groups.Which phenomenon is the patient demonstrating?

A) Resourcefulness
B) Independence
C) Acceptance
D) Resilience

Question 19

Which illness has the characteristics of a chronic illness?

A) Lupus
B) Bronchitis
C) Chickenpox
D) Gastroenteritis

Question 20

A patient is in the intensive care unit after a myocardial infarction and refuses to stay in bed,saying,"I have to be up and walking around.When I stayed in bed after having my babies 40 years ago,I got so weak I could hardly move." This patient's illness behavior is being influenced by

A) hardiness.
B) past experiences.
C) culture.
D) role expectations.

Question 21

Which questions will aid the nurse in planning culturally congruent care?

A) "What do smiles, nods, and hand gestures mean?"
B) "How are you usually addressed?"
C) "How many health care professionals have you seen?"
D) "What is eaten when one is sick?"
E) "Who is involved in making decisions about health care?"

Question 22

A patient recently lost a job as a salesperson.Which behaviors would indicate that the patient is experiencing stress?

A) Patient describes the desire to sleep a great deal due to fatigue.
B) Patient states a decrease in participating in usual church activities.
C) Patient seems to have difficulty selecting items from a menu.
D) Patient is reading the newspaper and online job listings daily.
E) Patient continues to spend time with her dog at the dog park.

Question 23

Why is a basic understanding of ethnopharmacology part of being a culturally competent nurse?

A) Significant differences among ethnic groups have been found in relation to the effects of medications.
B) Ethnopharmacology is a new area of study important to all nurses.
C) Nurses should know how medications may affect individual patients to properly administer the medication.
D) Pharmacology is a significant aspect of nursing practice.

Question 24

The nurse finds a patient sitting in bed,rocking back and forth,wringing her hands and repeating rapidly,"I can't breathe.My heart is pounding.I think I'm going to die." Her physician is called to the bedside and tells the nurse,"She is having an anxiety attack." What assessment can be made by the nurse?

A) Severe anxiety is present in this patient.
B) Cultural factors control anxiety levels.
C) Focusing on discharge instruction will ease the anxiety.
D) The level of anxiety cannot be determined at this point.

Question 25

Nurses can best help patients deal with stress by

A) helping patients eliminate all stress from their lives.
B) helping patients communicate their stress better to friends and family.
C) helping patients evaluate their lifestyles for areas of potential stress.
D) intervening in the family system to reduce family stress.

Question 26

When planning for patient teaching,the nurse is aware that which of the following factors create(s)a barrier to learning?

A) Mild anxiety
B) Pain and fatigue
C) Family presence
D) Patient autonomy

Question 27

A patient has been diagnosed with angina.As he talks with the nurse,he asks several good questions about angina and seems able to concentrate on the explanations.He seems eager to learn how to manage his condition.What assessment can be made by the nurse?

A) Severe anxiety is present.
B) Mild anxiety is present.
C) Moderate anxiety is present.
D) The level of anxiety cannot be determined.

Question 28

Which of the following are characteristic of compassion fatigue?

A) Increased energy
B) Burnout
C) Being prone to accidents
D) Poor judgment
E) Increased interest in reflection

Question 29

The parents of a 4-year-old diabetic have become increasingly argumentative especially about whether the father helps enough with child care and housekeeping.He works two jobs which leaves little time to help his stay-at-home wife.Which nursing intervention is most appropriate for this family?

A) Referring the parents to a marriage counselor
B) Discussing with the parents the stresses they perceive in the situation
C) Suggesting that the father give up one of his jobs
D) Identifying a way to reallocate the child's diabetes care between the parents

Question 30

The best definition of ethnocentrism is

A) a tendency to compare the behavior of others with your own cultural values.
B) an astute awareness of your own personal biases regarding other cultures.
C) a tendency to view your own culture as superior to others.
D) the ability to incorporate patients' cultural beliefs and values into health teaching.