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A nurse is completing discharge instructions for a client. The nurse can best evaluate the likeliness that the client will adhere to the instructions by the use of which action?
- A. Make the client promise to follow the instructions and adhere to the plan.
- B. Ask if the client agrees with the instructions that are outlined.
- C. Assess the client's beliefs regarding health maintenance, promotion, and remedies.
- D. Observe the client's face to see if the client is smiling, which can be interpreted as agreement.
Correct Answer: C
Rationale: Some individuals will not openly disagree with people in authority or who possess advanced education, so it is best for the nurse to assess the client's beliefs regarding health maintenance, promotion, and remedies. A client smiling, agreeing to, or promising to comply is not proof of agreement because the client may believe it impolite to disagree with someone seen as being in a position of authority.
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While providing personal care for a client, the nurse observes that the client is not comfortable with the close physical proximity. How will the nurse alleviate the discomfort of the client during personal care?
- A. Speak words or phrases in the client's style of speaking.
- B. Maintain sufficient distance.
- C. Ensure that the client's family member is present.
- D. Provide simple explanations of the need for physical proximity.
Correct Answer: D
Rationale: Simple explanations of the need for physical proximity during clinical procedures and personal care help alleviate the discomfort that the client may experience. Maintaining sufficient distance and ensuring that the client's family member is present may not help alleviate the discomfort the client is experiencing. Speaking words or phrases in the client's language will help in communicating with clients who do not speak the dominant language, but this action is not related to proximity.
How can the nurse best provide culturally sensitive care?
- A. Become familiar with physical differences among ethnic groups.
- B. Provide the proper food for nourishment.
- C. Accept each client as a unique individual.
- D. Facilitate rituals that bring comfort to the client.
Correct Answer: C
Rationale: Becoming familiar with physical differences, providing food that is customary to the culture, and facilitating rituals are all recommendations for enhancing transcultural sensitivity, but accepting each client as an individual is a characteristic that is found in the provision of culturally competent care.
Which describes the inability to recognize the values, beliefs, and practices of others because of one's strong ethnocentric preferences?
- A. Acculturation
- B. Cultural imposition
- C. Cultural blindness
- D. Cultural taboos
Correct Answer: C
Rationale: Cultural blindness is an inability to recognize the values, beliefs, and practices of others because of strong ethnocentric preferences. Cultural taboos are activities governed by rules of behavior that a particular cultural group avoids, forbids, or prohibits. Acculturation involves adapting to or taking on the behaviors of another group. Cultural norms are inclination to impose one's cultural beliefs, values, and patterns of behavior on people from a different culture.
A postpartum client requested the placenta be sent home with the spouse. The nurse is upset and disgusted by the request and shares this view with the charge nurse. What action should the charge nurse take?
- A. Report the situation to the nurse manager or nursing supervisor.
- B. Report the nurse for violation of HIPAA.
- C. Report the conversation to the client and apologize for the lack of sensitivity of the nurse.
- D. Use this as a teachable moment on cultural sensitivity and health practices.
Correct Answer: D
Rationale: Increasing one's awareness of cultural sensitivity and health practices is the first step toward transcultural nursing. The charge nurse should use this event as a teachable moment. The nurse's reaction is not a violation of HIPAA. Reporting the conversation to the client does not serve a purpose.
A nurse works in a health care setting that serves the Amish community. Members of this community look to the bishop who governs the community to make decisions about health care treatments. The nurse who provides extra time for a client from this community to select a treatment option and to discuss the situation with the community bishop is demonstrating which cultural concept?
- A. Ageism
- B. Stereotyping
- C. Generalization
- D. Ethnocentrism
Correct Answer: C
Rationale: Generalization is using the knowledge of the trends within a specific group or community to guide the care of the client without stereotyping. However, the nurse must recognize that generalization can lead to oversimplification and stereotyping. Stereotyping has an end point; the assumption prevents one from seeing another person as unique. Generalization acknowledges common trends in a group while recognizing that more information is needed. Ageism is the stereotyping of older adult behavior or vulnerability based on an individual's prior experiences or anticipation of behaviors. Ethnocentrism is the belief that one's own ethnic heritage is the 'correct' one' and superior to others.