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The nurse is caring for a client who is of Asian descent and is assessing for client perceptions regarding nutrition. Which, in addition to the impact of food on disease and illness, should the nurse consider in order to provide culturally competent care?
- A. Educational background and employment history
- B. Familial support systems and financial well-being
- C. Client perception of body weight and size relative to culture
- D. Ability to purchase foods necessary for disease management
Correct Answer: C
Rationale: When addressing nutrition for clients with diverse cultural backgrounds, dietary preferences, the impact of food on disease and illness, and client perception of body weight and size relative to culture must be considered. For example, clients who are not part of the Western culture may not consider obesity to be a major health indicator; therefore, teaching regarding weight reduction may be difficult. The other options address social and financial status and are not directly related to cultural considerations with regard to nutrition.
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The nurse is caring for a Hispanic client who reports that she is a practicing Roman Catholic. Which actions by the nurse most demonstrate spiritual and cultural sensitivity? Select all that apply.
- A. Turn the client's bed toward the east, toward Mecca.
- B. Ensure that meals while hospitalized include Halal foods.
- C. Allow the client to observe communion daily if requested.
- D. Facilitate anointing of the client by the priest if requested.
- E. Advocate for the client in her choice to refuse blood products.
Correct Answer: C,D
Rationale: During response to illness, practicing Roman Catholics may request to be anointed while sick. They may also practice daily Holy Communion. Meals permissible by Muslims include Halal foods. Muslims also prefer to turn their bed toward the east, toward Mecca. Jehovah's Witness belief system includes refusal of blood products.
The nurse is caring for an older Hispanic client who is a migrant farm worker and has been admitted for asthma. The nurse is unfamiliar with the cultural and spiritual practices and beliefs of the client's homeland. Which questions are most appropriate for the nurse to ask during the admission process? Select all that apply.
- A. What do you believe is causing your illness?
- B. Why don't you take some asthma medication?
- C. Why do you wear that amulet around your neck?
- D. Are there any remedies you have used in the past?
- E. Who do you usually see for help when you are sick?
Correct Answer: A,D,E
Rationale: Assessment includes cultural and spiritual information. It includes questions regarding clients' health beliefs and practices, their health care providers, and their beliefs regarding the origin of illness. Option 2 may have an accusatory undertone. This type of question will not assist the nurse in developing a rapport. A person's reason for wearing an amulet is not relevant to this situation; this question may be perceived as intrusive.
The nurse is caring for a client who primarily speaks Spanish. An interpreter is currently unavailable. The nurse must perform a dressing change. What should the nurse do in order to enhance communication with this client prior to changing the dressing?
- A. Use relatives to interpret because an interpreter is unavailable.
- B. Speak slowly and allow the client time to interpret what is being said.
- C. Use many nonverbal cues and repetition to reinforce what is being said.
- D. Use common words in the nurse's language, because the client is likely to be familiar with them.
Correct Answer: B
Rationale: When caring for a client who speaks a language that is different from the nurse's, it is ideal for the nurse to call on a dialect-specific interpreter designated by the health care agency that is the same age and same gender as the client. If an interpreter is unavailable, the nurse should speak slowly and allow the client time to interpret what is being said. The nurse should avoid the use of relatives as interpreters to minimize bias and misinterpretation. The nurse should avoid using nonverbal facial expressions and body language, because they could be misinterpreted by the client. The nurse should use common words in the client's language if known; the nurse should become familiar with Spanish terms that are frequently used in health care.
The nurse is caring for a Jewish client who follows a kosher diet. Which foods should the nurse use in meal planning for the client? Select all that apply.
- A. Pork
- B. Tuna
- C. Apples
- D. Chicken
- E. Potatoes
Correct Answer: B,C,D,E
Rationale: Clients who follow a kosher diet avoid meat from carnivores, pork products, and fish without scales or fins. Fruits and vegetables are considered kosher. Tuna, chicken, potatoes, and apples are also considered kosher and appropriate.
The unit manager working on a medical-surgical unit is conducting an inservice session on the provision of spirituality and culturally competent care and factors that contribute to health disparities. Which factors does the manager incorporate into this teaching session? Select all that apply.
- A. Age
- B. Genetics
- C. Ethnicity
- D. Education
- E. Past medical history
- F. Health care provider attitudes
Correct Answer: A,C,D,F
Rationale: Many factors contribute to health disparities, including age; ethnicity, race, and culture; education; health care provider attitudes; geographic location; income; occupation; health literacy; and gender. Genetics and past medical history are not factors that influence health disparities.