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A nurse is beginning to use patient-centered careand cultural competence to improve nursing care. Which step should the nurse takefirst?
- A. Assessing own biases and attitude
- B. Learning about the world view of others
- C. Understanding organizational forces
- D. Developing cultural skills
Correct Answer: A
Rationale: Assessing own biases and attitudes is the first step a nurse should take when beginning to use patient-centered care and cultural competence to improve nursing care. By becoming more aware of one's biases and attitudes about human behavior, the nurse can enhance self-awareness and self-reflection. This self-awareness is vital in understanding one's own perspectives, beliefs, and values that may influence interactions with patients from different cultural backgrounds. It also allows the nurse to identify areas that may require improvement or further education. Understanding and addressing personal biases is fundamental to providing patient-centered care and avoiding potential cultural misunderstandings that may arise in the healthcare setting.
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A patient is on a full liquid diet. Which food item choice by the patient will cause the nurse to intervene?
- A. Custard
- B. Frozen yogurt
- C. Pureed vegetables
- D. Mashed potatoes and gravy
Correct Answer: D
Rationale: Mashed potatoes and gravy are not appropriate for a full liquid diet. A full liquid diet consists of foods that are liquid at room temperature or melt into liquid form at body temperature. Mashed potatoes and gravy are not in liquid form and therefore should not be consumed by a patient following a full liquid diet. The nurse should intervene and provide education about the correct food choices allowed on a full liquid diet, such as custard, frozen yogurt, and pureed vegetables.
The nurse is caring for a patient receiving total parenteral nutrition (TPN). Which action will the nurse take?
- A. Run lipids for no longer than 24 hours.
- B. Take down a running bag of TPN after 36 hours.
- C. Clean injection port with alcohol 5 seconds before and after use.
- D. Wear a sterile mask when changing the central venous catheter dressing.
Correct Answer: D
Rationale: When caring for a patient receiving total parenteral nutrition (TPN), it is crucial to maintain strict aseptic technique to prevent infection. Wearing a sterile mask when changing the central venous catheter dressing helps to reduce the risk of introducing pathogens into the catheter site, which can lead to serious bloodstream infections. It is essential to use sterile gloves, a sterile mask, and to assess the insertion site for any signs or symptoms of infection during central venous catheter dressing changes. Additionally, to prevent infection, TPN infusion tubing should be changed every 24 hours, and no single container of TPN should be hung for longer than 24 hours, with lipids not running for longer than 12 hours.
A nurse is examining a patient who has been diagnosed with a fibroadenoma. The nurse should recognize what implication of this patients diagnosis?
- A. The patient will be scheduled for radiation therapy.
- B. The patient might be referred for a biopsy.
- C. The patients breast mass is considered an age-related change.
- D. The patients diagnosis is likely related to her use of oral contraceptives.
Correct Answer: B
Rationale: A fibroadenoma is a benign breast tumor commonly found in young women. In most cases, a fibroadenoma does not require radiation therapy. However, the patient might be referred for a biopsy to confirm the diagnosis and rule out any potential malignancy. While fibroadenomas can be related to hormonal changes in the body, they are not directly linked to the use of oral contraceptives. Recognizing this implication of the patient's diagnosis is essential for providing appropriate care and follow-up.
A patient has been discharged home after a total mastectomy without reconstruction. The patient lives alone and has a home health referral. When the home care nurse performs the first scheduled visit this patient, what should the nurse assess? Select all that apply.
- A. Adherence to the exercise plan
- B. Overall psychological functioning
- C. Integrity of surgical drains
- D. Understanding of cancer E) Use of the breast prosthesis
Correct Answer: B
Rationale: B. Overall psychological functioning: It is crucial for the home care nurse to assess the patient's overall psychological functioning after a total mastectomy without reconstruction. The patient may be experiencing emotional distress, body image disturbances, anxiety, or depression related to the surgery and changes in physical appearance. The nurse should evaluate the patient's coping mechanisms, emotional well-being, and any signs of psychological implications to provide appropriate support and referral for mental health services if needed.
To honor cultural values of patients from different ethnic/religious groups, which actions demonstrate culturally sensitive care by the nurse? (Select allthat apply.)
- A. Allows fasting on Yom Kippur for a Jewish patient
- B. Allows caffeine drinks for a Mormon patient
- C. Serves no ham products to a Muslim patient
- D. Serves kosher foods to a Christian patient
Correct Answer: A
Rationale: A. Allowing fasting on Yom Kippur for a Jewish patient demonstrates culturally sensitive care by respecting and accommodating the religious practices of the patient. Yom Kippur is an important day of fasting and repentance in the Jewish faith, and by allowing the patient to observe this practice, the nurse shows understanding and support.