Nokea
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.
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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.
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 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 conducting a cultural and spiritual assessment on a newly admitted client. Which factors specifically related to culture and spirituality should the nurse address? Select all that apply.
- A. Nutrition
- B. Communication
- C. Insurance coverage
- D. High-risk behaviors
- E. Health care practices
- F. Family roles and organization
Correct Answer: A,B,D,E,F
Rationale: When performing a cultural and spiritual assessment, the nurse should focus on the following factors: nutrition, communication, high-risk behaviors, health care practices, family roles and organizations, workforce issues, biocultural ecology, overview (e.g., heritage), pregnancy and childbirth practices, death rituals, spirituality preferences, and health care practitioners. Asking the client about insurance coverage is not specifically related to culture or spiritual practices.
The nurse is assessing a Southeast Asian woman who presented to the emergency department with complaints of a headache and nausea. The client is accompanied by her adult son. Upon assessment, the nurse notes long, pale red welts on both arms. Which actions should the nurse take next? Select all that apply.
- A. Ask if she has used any home remedies.
- B. Assess cultural health beliefs and practices.
- C. Report the use of coin rubbing to social services.
- D. Remove the adult son from the room immediately.
- E. Recognize the redness as a result of a traditional form of healing.
Correct Answer: A,B,E
Rationale: The nurse should ask the client if she has used any home remedies. The nurse should assess cultural health beliefs and practices and understand that 'coining or coin rubbing' is a traditional form of healing. The nurse should recognize the redness as a result of a traditional form of healing. Coining is an attempt to heal an illness and is not harmful to the client. The nurse should not report the use of coining to social services because the practice is not abuse. The son should not be removed from the room unless the client requests it.