Nokea
The nurse is caring for an older adult client of an unfamiliar ethnic culture. The nurse shows an understanding of the general principles of culturally sensitive interaction when implementing which interventions? Select all that apply.
- A. Addressing the client by his full surname in order to display respect
- B. Maintaining eye contact with the client so as to show respect for the client's age
- C. Utilizing the position of authority nurses hold to provide explanation of facility rules
- D. Touching the client only when necessary and only after explaining the need to do so
- E. Avoiding any frequent engagement with the client in conversation of a personal nature
Correct Answer: A,E
Rationale: Although cultural sensitivities vary, it is generally prudent to show respect for an older client of any ethnic background by using his or her formal name. Personal conversations not required as part of the assessment process should be avoided, as should a show of authority. Maintaining eye contact is not universally taken to be a positive behavior and so may be limited until it is determined to be acceptable by the client. Physical touching by strangers is not readily accepted in many cultures and should be engaged in cautiously and only when necessary and with permission from the client.
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The hospice nurse is caring for five clients from various religious backgrounds. Which observations should the nurse expect for the clients of the various religious backgrounds? Select all that apply.
- A. A client of the Muslim faith having his bed positioned toward Mecca
- B. A priest hearing the confession of the client who is of the Methodist faith
- C. An Asian client's family desiring the client to be moved to a room number of 4
- D. Meals on Friday do not include warm-blooded meats for the client of the Baptist faith
- E. A Hindu believing that the family arranges to have the client's body cremated within 24 hours of death
Correct Answer: A,E
Rationale: Those of the Muslim faith desire their body to be facing Mecca. Those of the Hindu faith believe in cremation within 24 hours to release their soul from earthly attachments. A priest hears confessions of the Catholic faith, not the Methodist faith. The number 4 is avoided by those of an Asian background because it symbolizes death. Catholics, not Baptists, avoid warm-blooded meats on Fridays.
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.
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 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 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.