Nokea
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.
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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.
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.
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.
Which concept characterizes transcultural nursing?
- A. Performing health-related activities and restoring wellness
- B. Acknowledging that clients with the same skin tone have similar social situations
- C. Planning care compatible with the client's health belief system
- D. Influencing culture by specific conditions related to an environment
Correct Answer: C
Rationale: Planning care compatible with the client's health belief system is a characteristic of transcultural nursing. Acknowledging that clients with the same skin tone have similar social situations leads to stereotyping. Stereotyping can be dangerous because it is dehumanizing and also interferes in accepting others as unique individuals. Culture is influenced by specific conditions related to environment. Performing health-related activities and restoring wellness is an important aspect of nursing and does not only pertain to transcultural nursing.
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.