Nokea
The parents tell the nurse that their preschooler often awakes from sleep screaming in the middle of the night. The preschooler is not easily comforted and screams if the parents try to restrain the child. What should the nurse instruct the parents to do?
- A. Always read a story to the child before bedtime.
- B. Intervene only if necessary to protect the child from injury.
- C. Discuss counseling options with the primary health care provider.
- D. Try to wake the child and ask the child to describe the dream.
Correct Answer: B
Rationale: Waking up screaming from sleep at night indicates sleep terrors. The nurse would advise the parents to observe the child and intervene only if there is a risk for injury. Reading a story before bedtime helps calm the child before sleeping, but it does not ensure that the child will not have a sleep terror. There is no need for professional counseling because sleep terrors are a common phenomenon in preschool-age children. Trying to wake the child and asking the child to describe the dream is not appropriate as the child is not aware of anybody's presence during a sleep terror, and this may cause the child to scream and thrash more.
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An older Asian American patient tells the nurse that she has lived in the United States for 50 years. The patient speaks English and lives in a predominantly Asian neighborhood. Which action by the nurse is most appropriate?
- A. Include a shaman when planning the patient's care
- B. Avoid direct eye contact with the patient during care
- C. Ask the patient about any special cultural beliefs or practices
- D. Involve the patient's oldest son to assist with health care decisions
Correct Answer: C
Rationale: The most appropriate action for the nurse in this scenario is to ask the patient about any special cultural beliefs or practices. This allows for a better understanding of the patient's individual cultural background and preferences related to healthcare. It is important to gather this information to provide culturally sensitive care. Choices A, B, and D are not appropriate actions. Including a shaman without the patient's request or consent may not align with the patient's beliefs or practices. Avoiding direct eye contact can be perceived as disrespectful in some cultures but should not be assumed without confirmation from the patient. Involving the patient's oldest son without the patient's consent or preference may not be appropriate and assumes family dynamics that may not be accurate.
The nurse is caring for a Native American patient who has traditional beliefs about health and illness. Which action by the nurse is most appropriate?
- A. Avoid asking questions unless the patient initiates the conversation.
- B. Ask the patient whether it is important that cultural healers are contacted.
- C. Explain the usual hospital routines for meal times, care, and family visits.
- D. Obtain further information about the patient's cultural beliefs from a family member.
Correct Answer: B
Rationale: When caring for a patient with traditional health beliefs, it is essential to respect and address their cultural practices. Asking the patient whether it is important to involve cultural healers, such as a shaman, aligns with providing culturally sensitive care. Avoiding asking questions unless initiated by the patient may hinder effective communication and understanding of the patient's needs. Consulting a family member for cultural beliefs assumes that all family members share the same beliefs, which may not be accurate. Additionally, the patient's personal beliefs should be prioritized over family input. Explaining hospital routines without considering the patient's cultural preferences may lead to a lack of patient-centered care. Therefore, the most appropriate action is to inquire about the patient's preference regarding cultural healers.
The family of a child with cerebral palsy (CP) is at risk for difficult parenting issues. Which basis would the nurse conclude as the probable cause for this difficulty?
- A. Lack of social support
- B. Unrealistic expectations
- C. Loss of the expected healthy child
- D. Having a child with cognitive impairment
Correct Answer: C
Rationale: The correct answer is 'Loss of the expected healthy child.' Parents of a child with cerebral palsy often grieve the loss of the healthy child they expected, mourning what could have been and what may never be. While lack of social support can contribute to parenting difficulties, it is not the primary basis in this case. Unrealistic expectations may play a role for some parents, but not all. Additionally, it is important to note that not all children with cerebral palsy experience cognitive impairment; around 30% to 50% of children with cerebral palsy have cognitive challenges.
Which of the following outcomes is most appropriate during the crisis stage of caring for a victim of domestic violence?
- A. The client will verbalize community resources from which to seek shelter after discharge.
- B. The client will write a plan to keep herself and her children safe.
- C. The client will contact an attorney for help with pressing charges.
- D. The client will be safe and receive treatment for injuries.
Correct Answer: D
Rationale: During the crisis stage of caring for a victim of domestic violence, the immediate priority is ensuring the client's safety and providing treatment for any injuries sustained. This focuses on addressing the urgent physical and emotional needs of the victim. While options like verbalizing community resources or creating safety plans are important for long-term support, they are not the primary concerns during the crisis phase. Contacting an attorney for legal assistance, though vital in the future, is not the immediate priority during the crisis stage when the client's safety and health are at the forefront.
When performing a cultural assessment with a patient from a different culture, what action should the nurse take first?
- A. Request an interpreter before interviewing the patient
- B. Wait until a family member is available to help with the assessment
- C. Ask the patient about any affiliation with a particular cultural group
- D. Tell the patient what the nurse already knows about the patient's culture
Correct Answer: B
Rationale: When conducting a cultural assessment, the first step is to inquire if the patient has any affiliation with a specific cultural group. This helps the nurse understand the patient's background and beliefs. Requesting an interpreter before interviewing the patient may be necessary if language barriers exist. Waiting for a family member to assist with the assessment may delay the process and compromise patient confidentiality. Telling the patient what the nurse knows about their culture assumes knowledge and may lead to misunderstandings or inaccuracies.