Nokea
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.
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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 participating in end-of-life care for a client who has recently immigrated from Vietnam. Which interventions should the nurse consider in the plan of care for this client? Select all that apply.
- A. Respect family wishes for use of herbal medicines.
- B. Recognize that the use of healers is a common practice.
- C. Have direct conversations with the matriarch of the family.
- D. Acknowledge that lack of eye contact does not mean disinterest.
- E. Allow someone from the family to stay with the body after death until burial.
Correct Answer: A,D
Rationale: Herbal medicine plays an important role in the care of the dying client, and family wishes to incorporate its use in care should be acknowledged and discussed with the primary health care provider. The nurse must realize that direct eye contact is considered impolite and should not be interpreted as a sign of disinterest. Southeast Asians have strong traditional families and extended families with male dominance. Healers are a practice of Native Americans. Staying with the body until burial is a practice associated with the Jewish religion.
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 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.