Nokea
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.
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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.
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.
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 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.
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.