Nokea
An older Asian American patient tells the nurse that she has lived in the United States for 50 years. The patient speaks English and lives in a predominantly Asian neighborhood. Which action by the nurse is most appropriate?
- A. Include a shaman when planning the patient's care
- B. Avoid direct eye contact with the patient during care
- C. Ask the patient about any special cultural beliefs or practices
- D. Involve the patient's oldest son to assist with health care decisions
Correct Answer: C
Rationale: The most appropriate action for the nurse in this scenario is to ask the patient about any special cultural beliefs or practices. This allows for a better understanding of the patient's individual cultural background and preferences related to healthcare. It is important to gather this information to provide culturally sensitive care. Choices A, B, and D are not appropriate actions. Including a shaman without the patient's request or consent may not align with the patient's beliefs or practices. Avoiding direct eye contact can be perceived as disrespectful in some cultures but should not be assumed without confirmation from the patient. Involving the patient's oldest son without the patient's consent or preference may not be appropriate and assumes family dynamics that may not be accurate.
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Which characteristic usually results in a behavior being viewed and accepted as normal?
- A. Fits within standards accepted by one's society
- B. Helps the person reduce the need for coping skills
- C. Allows the person to express feelings and thoughts
- D. Facilitates achievement of short-term and long-term goals
Correct Answer: A
Rationale: Behaviors that align with the standards accepted by a society are generally viewed as normal. Societal norms and values play a significant role in defining what is considered normal behavior. Choices B, C, and D may be important aspects of an individual's functioning, but they do not solely determine whether a behavior is viewed as normal. Coping skills, expressions of feelings, and goal achievement can vary in their cultural context and societal acceptance, therefore they are not definitive indicators of normalcy.
When performing a cultural assessment with a patient from a different culture, what action should the nurse take first?
- A. Request an interpreter before interviewing the patient
- B. Wait until a family member is available to help with the assessment
- C. Ask the patient about any affiliation with a particular cultural group
- D. Tell the patient what the nurse already knows about the patient's culture
Correct Answer: B
Rationale: When conducting a cultural assessment, the first step is to inquire if the patient has any affiliation with a specific cultural group. This helps the nurse understand the patient's background and beliefs. Requesting an interpreter before interviewing the patient may be necessary if language barriers exist. Waiting for a family member to assist with the assessment may delay the process and compromise patient confidentiality. Telling the patient what the nurse knows about their culture assumes knowledge and may lead to misunderstandings or inaccuracies.
Which approach is best to use with a client who is angry and agitated?
- A. Confront the client about the behavior.
- B. Turn on the television to distract the client.
- C. Maintain a calm, consistent approach with the client.
- D. Explain to the client why the behavior is unacceptable.
Correct Answer: C
Rationale: When dealing with an angry and agitated client, it is crucial to maintain a calm and consistent approach. Consistency allows the client to predict the caregiver's behavior, which can help reduce their anxiety and agitation. Confronting the client about their behavior may escalate the situation and increase their anger. Using distractions like turning on the television is not addressing the underlying issue and may not be effective in calming the client. Explaining to the client why their behavior is unacceptable is not suitable in the moment of agitation, as the client may not be in a state to attend to logical explanations and perceived criticisms should be avoided to prevent further escalation.
When performing a cultural assessment with a patient from a different culture, what action should the nurse take first?
- A. Request an interpreter before interviewing the patient
- B. Wait until a family member is available to help with the assessment
- C. Ask the patient about any affiliation with a particular cultural group
- D. Tell the patient what the nurse already knows about the patient's culture
Correct Answer: B
Rationale: When conducting a cultural assessment, the first step is to inquire if the patient has any affiliation with a specific cultural group. This helps the nurse understand the patient's background and beliefs. Requesting an interpreter before interviewing the patient may be necessary if language barriers exist. Waiting for a family member to assist with the assessment may delay the process and compromise patient confidentiality. Telling the patient what the nurse knows about their culture assumes knowledge and may lead to misunderstandings or inaccuracies.
The parents tell the nurse that their preschooler often awakes from sleep screaming in the middle of the night. The preschooler is not easily comforted and screams if the parents try to restrain the child. What should the nurse instruct the parents to do?
- A. Always read a story to the child before bedtime.
- B. Intervene only if necessary to protect the child from injury.
- C. Discuss counseling options with the primary health care provider.
- D. Try to wake the child and ask the child to describe the dream.
Correct Answer: B
Rationale: Waking up screaming from sleep at night indicates sleep terrors. The nurse would advise the parents to observe the child and intervene only if there is a risk for injury. Reading a story before bedtime helps calm the child before sleeping, but it does not ensure that the child will not have a sleep terror. There is no need for professional counseling because sleep terrors are a common phenomenon in preschool-age children. Trying to wake the child and asking the child to describe the dream is not appropriate as the child is not aware of anybody's presence during a sleep terror, and this may cause the child to scream and thrash more.