Nokea
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.
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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 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.
An Arab Muslim female client has been stabilized following an assault in the parking lot of a local restaurant. The nurse manager is making assignments for the oncoming shift. Which action by the nurse manager is the most appropriate to ensure the client's comfort?
- A. Assign the best male nurse to the client.
- B. Assign the client a female nurse for every shift.
- C. Allow the client to pick which nurses she would like to care for her.
- D. Remove all of the client's clothing each shift to perform a skin assessment.
Correct Answer: B
Rationale: Information about family and gender roles will greatly influence the nurse's plan of care. Arab Muslim women can only be cared for by a female. Assigning a male nurse to care for this client would be inappropriate. It would also be inappropriate to place the client in a position to choose which nurse will care for her. Unless medically necessary, the client should not need to have a skin assessment every shift. If it is required, a female must be present to assist in the skin assessment.
The nurse is caring for a new immigrant from the Philippines. The client is 4 cm dilated and 30% effaced. This is her first child. The mother is grimacing; her pulse, respiratory rate, and blood pressure are elevated. The nurse offers to call the health care provider for an epidural prescription. The mother declines. The nurse should hypothesize that the client declined the epidural for which reason? Select all that apply.
- A. Filipino mothers fear drug addiction.
- B. Filipino mothers decrease their pain through a verbal release.
- C. Filipino mothers prefer to accept treatments for pain from their parteras.
- D. Filipino mothers are often stoic and view childbirth pain as a normal part of life.
- E. Filipino mothers believe that pain is a form of spiritual atonement for one's past deeds.
Correct Answer: A,E
Rationale: Childbirth experiences differ among different nationalities. Filipino mothers fear drug addiction. They also believe that pain is a form of spiritual atonement. Hispanic and Arab-American mothers are more vocal during childbirth. Mexican mothers have parteras (specially trained persons) attend them during the childbirth process. Vietnamese mothers are quiet during childbirth and view it as a normal part of life.
The nurse is caring for a postoperative client with spiritual and culturally based eating and food requirements. Which interventions demonstrate the nurse's spiritual and cultural consideration of the client? Select all that apply.
- A. Encouraging the client to try new foods only until healing is complete
- B. Suggesting the substitution of similar foods for the culturally appropriate ones
- C. Asking the client to explain the factors that are important to his eating practices
- D. Including the family in discussions regarding the preparation of accepted foods
- E. Discussing the nutritional requirements the client currently has postoperatively
Correct Answer: C,D,E
Rationale: Spiritual and cultural consideration reflects attempts to maintain familiar customs to achieve the same healthy responses expected of our Western culture customs. Gaining knowledge of the customs and their importance to the client will be the basis for an understanding that allows for flexibility and compromise when necessary. Including the family in the discussion will assist with the process as will discussing the needs the client has at this particular time in order to formulate a plan to meet the needs while maintaining cultural customs. Encouraging new foods in place of the usual foods may be viewed as being insensitive and showing a lack of concern. Substitution is not always necessary.