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A nurse is providing care to a client who speaks and minimally understands, but whose primary language is different from, the dominant language. The client is accompanied by the spouse, who speaks and understands the dominant language well. The client requires surgery and will need to sign consents for treatment. Which is the best action for the nurse to take to ensure the client understands the plan of care?
- A. Ask the spouse to act as an interpreter for the client.
- B. Rely on nonverbal communication to be understood.
- C. Use an interpreter, preferably of the same sex, to explain the plan of care.
- D. Use simple yes-or-no questions to make understanding easier for the client.
Correct Answer: C
Rationale: To ensure the client understands the plan of care, the nurse should use an interpreter who is preferably the same sex as the client to explain the plan of care. Asking the spouse to act as an interpreter is not the best option because the spouse may not feel comfortable with or may have limited experience with medical terminology, which can cause miscommunication. Relying on nonverbal communication is not the best option for communicating because some aspects of the plan may be lost in the communication. Using yes-or-no questions, in this case, would not be the best option because they would provide minimal information to the nurse.
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A client of Japanese descent describes a family trait of having less relief from analgesics than a friend of German descent. Which statement best describes this client's situation?
- A. The client should be assessed for concurrent use of herbal preparations.
- B. The client's racial background can affect drug metabolism.
- C. This type of medication should not be prescribed to this client.
- D. Biocultural ecology is the study of biologic cultural differences.
Correct Answer: B
Rationale: The client's racial background can influence many things including drug metabolism, which would explain why the client reports receiving less relief from analgesics than a friend from another racial background. The client should be assessed for the use of herbal preparations but that does not necessarily explain the client's reaction to analgesics. There is no indication that analgesics should not be prescribed to the client. It is correct that biocultural ecology is the study of biologic cultural differences, but this option is not the best description of the client's situation. It just provides a definition of biocultural ecology.
The nurse walks into the client's room and finds a shaman 'fluffing the aura' of the client. What is the best action of the nurse?
- A. Leave the room and provide privacy to the client.
- B. Call the health care provider to report the findings.
- C. Ask the shaman to stop to allow the nurse to change IV tubing.
- D. Notify security of the activity in progress.
Correct Answer: A
Rationale: By leaving the room and providing privacy the nurse supports the client in the quest to practice health practices within their culture and beliefs. Documentation of the activity is appropriate. Notifying the health care provider will not stop or support the belief. Notifying security and/or asking the shaman to leave may anger the client and violate the practice of a religious/cultural ritual.
The nurse is caring for a client who avoids looking the nurse straight in the eye. Which consideration(s) should the nurse account for when providing care for the client? Select all that apply.
- A. Avoiding eye contact may be a sign of respect.
- B. Direct eye contact may be viewed as an invasion of privacy.
- C. Standing directly in front of the client's gaze when speaking may encourage attentiveness.
- D. Using stereotyping may help the nurse avoid incorrect assumptions about the client's behavior.
- E. Determining the cause of the client's behavior may be accomplished by generalization.
Correct Answer: A,B
Rationale: The possibilities that avoiding eye contact may be a sign of respect, and that direct eye contact may be viewed as an invasion of privacy, are considerations the nurse should account for when providing care of the client who avoids looking the nurse straight in the eye. Standing directly in front of the client's gaze when speaking does not convey a desire to understand the client's behavior or provide a comfortable climate for the client. The nurse should avoid stereotyping and making assumptions about the client's behavior. Generalization should not be used to determine the cause of the client's behavior. Instead, generalization should be used to identify common trends in a group while recognizing that more information is needed; it does not describe an individual client.
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.
The nurse is completing a cultural heritage assessment. Which item(s) will be included in this portion of the health assessment? Select all that apply.
- A. Religion
- B. Participation in religious traditions
- C. Health history
- D. Hygiene practices
- E. Use of tobacco
- F. Management of symptoms
Correct Answer: A,B,D,F
Rationale: Health-related beliefs and practices (such as religious traditions, hygiene practices, and management of symptoms) can reflect the cultural heritage of the client. Asking questions can assist in determining cultural heritage. Tobacco use and/or health history assists in the health history but does not reflect upon heritage or culture.