Nokea
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.
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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 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 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 Orthodox Jewish client of the opposite sex whose condition is terminal. The nurse is implementing a plan of care and wishes to communicate this plan with the client and family. The nurse should be aware of what end-of-life spiritual and religious practices when planning and communicating with the client and family? Select all that apply.
- A. The client may demonstrate a high level of anxiety.
- B. Religious laws are suspended during times of severe illness.
- C. During the process of dying, visitors and conversation should be kept to a minimum.
- D. Family members may not shake hands or make direct eye contact with members of the opposite sex.
- E. Clients that are of the Orthodox Jewish faith are usually very quiet and do not express what they are thinking or feeling.
Correct Answer: A,B,D
Rationale: Outward expressions of anxiety are commonly seen among Orthodox Jewish members, especially older individuals. The Orthodox Jew strictly follows the laws of Judaism; however, during times of severe illness, Jewish laws are not observed if doing so will endanger the client's health. In the Orthodox Jewish faith, members generally will not shake hands or make direct eye contact with members of the opposite sex. During times of illness or death, the Orthodox Jewish community, including family and friends, will frequently visit and are considered the nucleus of the Jewish culture. Clients of the Orthodox Jewish faith are generally very verbal about what they are feeling, especially in the older population.