Nokea
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.
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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 hospice nurse is caring for five clients from various religious backgrounds. Which observations should the nurse expect for the clients of the various religious backgrounds? Select all that apply.
- A. A client of the Muslim faith having his bed positioned toward Mecca
- B. A priest hearing the confession of the client who is of the Methodist faith
- C. An Asian client's family desiring the client to be moved to a room number of 4
- D. Meals on Friday do not include warm-blooded meats for the client of the Baptist faith
- E. A Hindu believing that the family arranges to have the client's body cremated within 24 hours of death
Correct Answer: A,E
Rationale: Those of the Muslim faith desire their body to be facing Mecca. Those of the Hindu faith believe in cremation within 24 hours to release their soul from earthly attachments. A priest hears confessions of the Catholic faith, not the Methodist faith. The number 4 is avoided by those of an Asian background because it symbolizes death. Catholics, not Baptists, avoid warm-blooded meats on Fridays.
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 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.
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.