Nokea
A nurse cares for an Asian American client with a fractured femur. During shift report, which statement by the nurse will another nurse challenge?
- A. The client has requested to wait to receive pain medication.
- B. The client does not want family to visit the room.
- C. The client is a recent immigrant to this country.
- D. The client is stoic and will not complain at all.
Correct Answer: D
Rationale: The correct answer is D. Stereotyping the client as stoic and unlikely to complain about pain is incorrect and can lead to inadequate pain management. It is essential for the nurse to assess and address the client's pain regardless of cultural background. Choices A, B, and C are not as critical as they respect the client's autonomy, cultural preferences regarding family visits, and provide relevant background information about the client's immigrant status.
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Nurse M obtains a signature on an informed consent form from Mr. Y, who is later shown to have a fluctuating level of mental competency. In this case, what is Nurse M's most likely legal position?
- A. Freedom from liability because Mr. Y signed the form
- B. Possibly liable for a violation of Mr. Y's rights
- C. Liable unless a malpractice insurance policy is in effect
- D. Not liable because no family member had a durable power of attorney
Correct Answer: B
Rationale: An informed consent may be considered invalid if the patient does not fully understand what he or she is signing. Patients with a fluctuating level of mental function are incapable of granting legally sound consent. Nurse M could be held liable for a violation of Mr. Y's rights as he did not have the capacity to provide informed consent. The presence of an insurance policy and the legal status of family members are irrelevant in this context and do not absolve Nurse M of potential liability.
A nurse is working in an assisted living facility that has a culturally diverse older adult population. Which statement by the nurse best demonstrates cultural sensitivity?
- A. We need to ensure that both the minority population and the majority population have their health needs met.
- B. It's important to remember that minority groups do not usually express their pain explicitly.
- C. We need to build our knowledge of clients who belong to cultural and ethnic groups that we're not familiar with.
- D. We need to teach all clients that their health problems are not necessarily the result of punishment.
Correct Answer: C
Rationale: The best demonstration of cultural sensitivity by the nurse is reflected in choice C. Building a knowledge base around cultural and ethnic groups is a crucial component of providing culturally sensitive care. Choice A creates an inaccurate dichotomy between 'minority' and 'majority' populations, which is not a culturally sensitive approach. Choice B incorrectly generalizes that minority groups do not usually express their pain explicitly, which is not true for all cultural groups. Choice D suggests imposing a different belief system on clients, which is not culturally sensitive and can undermine trust and rapport with older adult clients.
A nurse is reading a journal article about life expectancy and various cultural groups. The article describes statistics, stating that a baby born to a black American couple has a life expectancy lower than that of a baby born to a white American couple. The article goes on to describe the life expectancy as the babies get older. Which finding would the nurse most likely identify as reflecting the life expectancy of the baby born to the black American couple by the seventh decade?
- A. Beginning to equal that of similarly aged white elders
- B. Exceeding that of similarly aged white older adults
- C. Dropping to less than half that of similarly aged white older adults
- D. Rising above that of white older adults until age 75 and then dropping
Correct Answer: A
Rationale: Historically, black Americans have experienced a lower standard of living and less access to health care than their white counterparts, leading to a lower life expectancy. However, by the seventh decade of life, survival rates for black individuals begin to equal that of similarly aged white individuals. Choice B is incorrect as it indicates a higher life expectancy for black individuals, which is not supported by the information provided. Choice C is incorrect as it suggests a drastic decrease in life expectancy for black individuals, which is not in line with the trend described. Choice D is incorrect as it implies a temporary increase in life expectancy for black individuals until age 75, which is not supported by the information that survival rates begin to equal by the seventh decade.
A gerontological nurse is providing care at a local community health center that serves large black American and white American older adult populations. The nurse is working to develop culturally appropriate programs to meet each group's health needs and notes differences in health status between the groups. Which reason would the nurse most likely identify as accounting for the differences between the populations?
- A. High incidence of violent crime and sexually transmitted diseases in the black population
- B. Reliance on family for health care advice and rejection of formal service agencies in the white population
- C. Cultural preference for unconventional medical treatments like herbal remedies in the white population
- D. Lower standard of living and less access to health care services in the black population
Correct Answer: D
Rationale: The correct answer is D. Black older adults historically possess many health problems that have accumulated over a lifetime due to a poor standard of living and limited access to health care services. Option A is incorrect because it presents stereotypes about the black population that are not supported by evidence. Option B is incorrect because it generalizes the behavior of the white population without a strong basis. Option C is incorrect as it also generalizes the white population and does not address the disparities in health status between the two groups.
Which of the following statements most accurately captures an aspect of contemporary family caregiving in the United States?
- A. Women typically spend more time caring for aging parents than they did for their own children.
- B. The most common pattern of care involves an older man providing in-home care for his wife.
- C. The majority of care is now provided by public and private agencies rather than family members.
- D. A residential or institutional environment is now the most common venue for caregiving.
Correct Answer: A
Rationale: The correct answer is A. Today, on average, women spend more time providing care for their aging parents than they did for their own children. While some men provide care for their wives, it is not the most common pattern. Family members, rather than public or private agencies, still provide the majority of care in a non-institutional environment, making option C incorrect. Also, caregiving in a residential or institutional environment is not the most common venue, thus choice D is inaccurate.