Nokea
The nurse is preparing to care for a child with anemia from a culture that is different from the nurse's. Which is the best way to address the cultural needs of the child and family when the child is admitted to the health care facility?
- A. Address only those issues that directly affect the nurse's care of the child.
- B. Ask questions, and explain to the family why the questions are being asked.
- C. Explain that cultural practices need to be discontinued during hospitalization.
- D. Ignore cultural needs because they are not important to health care professionals.
Correct Answer: B
Rationale: When caring for individuals from a different culture, it is important to ask questions about their specific cultural needs and means of treatment. An understanding of the family's beliefs and health practices is essential to successful interventions for that particular family. Eliminate the options that ignore the cultural beliefs and values of the client.
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A pregnant client comes into the prenatal clinic accompanied by her spouse. The spouse states they were in a car accident and his wife's abdomen hit the steering wheel. The nurse observes the client wringing her hands and not making eye contact. The client's record shows two recently missed prenatal appointments. Which action does the nurse take?
- A. Make eye contact with the client and ask about the accident.
- B. Accompany the client into the restroom to obtain a urine sample.
- C. Ask the husband if the wife had been drinking alcohol.
- D. Escort the couple to an examining room to await the health care provider.
Correct Answer: D
Rationale: Escorting the couple to an examining room prioritizes a safe, private assessment of the client’s condition post-accident, especially given signs of possible abuse (missed appointments, anxiety). Direct questioning or accusations may escalate tension, and a urine sample is not the priority.
A client who has never been hospitalized before and is in a hospital room with a roommate is anxious and having trouble initiating a stream of urine. Knowing that there is no pathological reason for this difficulty, which nursing interventions should be included when assisting the client? Select all that apply.
- A. Catheterizing the client
- B. Running tap water in the sink
- C. Assisting the client to a commode behind a closed curtain
- D. Instructing the client to pour warm water over the perineum
- E. Closing the bathroom door and instructing the client to pull the call bell when done
Correct Answer: B,D,E
Rationale: A lack of privacy is a key issue that may inhibit the ability of the client to void in the absence of known pathology. Using a commode behind a curtain may inhibit voiding for some individuals, especially with a roommate present. The use of a bathroom is preferable, and this may be supplemented with the use of running water or pouring water over the perineum, as needed. Catheterization is not a nursing intervention and presents a risk of infection. If noninvasive techniques do not work, then the primary health care provider may prescribe that the client be catheterized.
Which psychosocial factor obtained during an assessment of an older client places the client most at risk for abuse?
- A. The client resides in an apartment in a low-income neighborhood.
- B. The client shows several signs and symptoms of clinical depression.
- C. The client is completely dependent on family members for both food and medicine.
- D. The client has been diagnosed with and is being treated for several chronic illnesses.
Correct Answer: C
Rationale: Elder abuse is sometimes the result of frustrated adult children who find themselves caring for dependent parents. Increasing demands by parents for care and financial support can cause resentment and a feeling of being burdened. The issues of abuse are not bound to socioeconomic status (option 1). Option 2 relates to depression rather than the risk for abuse. Option 4 relates to a physical factor rather than a psychosocial factor.
Following a train accident, the nurse triages a group of victims. When the nurse asks how one of the clients is feeling, the client states matter-of-factly, 'Look at all the rescue trucks. It's like watching a movie.' Which defense mechanism does the nurse identify that the client is using?
- A. Dissociation.
- B. Regression.
- C. Projection.
- D. Denial.
Correct Answer: A
Rationale: Dissociation involves detaching from reality to cope with trauma, as seen in the client’s detached, movie-like perception of the accident. Regression, projection, and denial involve different coping mechanisms not reflected in this statement.
The nurse provides care for a client diagnosed with bulimia. Which nursing action is most helpful in determining what precipitates the client'sEating disorder?
- A. Observe the family communication patterns at a monitored mealtime.
- B. Distract the client at mealtimes.
- C. Assign the client a food/feelings/thoughts action journal.
- D. Ask the client to write a history of eating behaviors.
Correct Answer: C
Rationale: A food/feelings/thoughts journal helps identify triggers and patterns associated with binge-purge behaviors, providing insight into precipitants. Observing family dynamics is useful but less direct, and distraction or history-writing are less focused on current triggers.