Nokea
A visiting nurse becomes concerned about a caregiver daughter. Although she does not seem overburdened, she may be drinking too much. The recycling bin contains many wine bottles, and visitors come to the home. What action should the nurse take?
- A. Direct the daughter to a local Alcoholics Anonymous chapter
- B. Ignore the signs unless they interfere with caregiving
- C. Find a new caregiver in the family or outside of it
- D. Assess the daughter's motivation and ability to provide care
Correct Answer: D
Rationale: The correct action for the nurse to take in this situation is to assess the daughter's motivation and ability to provide care. The nurse should not jump to conclusions based solely on the presence of wine bottles in the recycling bin. It is important to understand the daughter's overall capacity for caregiving and if her potential alcohol consumption is affecting her ability to provide care. Directing the daughter to Alcoholics Anonymous without a thorough assessment may not be appropriate at this stage. Ignoring the signs or immediately finding a new caregiver without understanding the daughter's situation may not address the underlying issue. Therefore, assessing the daughter's motivation and caregiving capabilities is the most appropriate initial step for the nurse.
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A nurse at a rehabilitation center is preparing a care plan for a 71-year-old post-stroke patient who has shown significant improvement in function and who is ready to return to the community. In the nurse's efforts to mobilize family caregiving, which of the following statements provides the most accurate criterion for inclusion in the category of 'family'?
- A. The patient's spouse, biological children, and closest friends
- B. Any unpaid person who has expressed sincere interest in the patient's condition and provided hands-on care since his admission to the facility
- C. Anyone who self-identifies as being a member of the patient's family
- D. Any individual who fulfills the patient's family functions
Correct Answer: D
Rationale: The most accurate criterion for inclusion in the category of 'family' when mobilizing family caregiving is identifying individuals who fulfill family functions. Choice D is the correct answer as it emphasizes the importance of individuals who perform essential family functions for the patient. This criterion is crucial as it prioritizes the practical support and care provided by individuals over biological relationships (Choice A), self-identification (Choice C), or willingness to provide care (Choice B), which may not always translate to fulfilling necessary family functions.
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.
How might the nursing home's social worker help Ms. O's friends in visiting her?
- A. The social worker should defer to the nursing staff
- B. Help her friends find easier transportation
- C. Tell her to make friends at the dialysis center
- D. Ask other residents' families to bring her friends with them
Correct Answer: B
Rationale: The correct answer is B. Ms. O's friends, who are elderly and cannot drive, ride buses to visit her. The social worker can help by finding easier transportation options for them. Not having family around, friends' visits can significantly impact Ms. O's well-being. It may be challenging for the friends to ask for help themselves, so the social worker can reach out to volunteer groups for assistance. Making friends at the dialysis center might not be feasible due to the nature of treatments. Asking other residents' families to bring her friends could burden them further and might deter them from helping. It's important to consider the friends' convenience and emotional support for Ms. O.
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.
A nurse is determining ways to address ethnic diversity among clients being provided care. Which action would be the most direct way for the nurse to do this?
- A. Explain how cultural backgrounds influence health beliefs and practices.
- B. Provide culturally sensitive care that respects clients' traditions.
- C. Listen to the life stories of clients to understand their cultural influences.
- D. Participate in cultural competency training and workshops.
Correct Answer: C
Rationale: Listening to the life stories of clients is an effective way for nurses to understand the cultural influences that shape their beliefs and practices. By actively listening, nurses can gain insight into the clients' backgrounds, values, and preferences, allowing them to provide more personalized and culturally sensitive care. Choices A, B, and D are not as direct as listening to the life stories of clients. While explaining how cultural backgrounds influence health beliefs and practices is important, directly listening to clients' life stories provides a deeper understanding of their individual cultural influences.