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What aspects of patient care may be most influenced by diverse cultural perspectives?
- A. Pharmacokinetics and pharmacodynamics
- B. Monitoring fluid balance
- C. Monitoring food intake
- D. Obtaining informed consent
Correct Answer: D
Rationale: Many aspects of care may be influenced by the diverse cultural perspectives held by health care providers, patients, families, or significant others. One example is the issue of informed consent and full disclosure. The other aspects of care can also be influenced by cultural differences, but most often to a lesser degree.
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How can the nurse best demonstrate an awareness of culturally congruent care?
- A. Maintain eye contact at all times.
- B. Try to speak the patients native language.
- C. Use touch when communicating.
- D. Establish effective communication.
Correct Answer: D
Rationale: Establishment of an environment of culturally congruent care and respect begins with effective communication, which occurs not only through words, but also through body language and other cues, such as voice, tone, and loudness. Not all cultures are comfortable with eye contact. Unless you are fluent in the patients native language, trying to communicate in that language would not be effective communication. Not all cultures incorporate touch while communicating.
What factor should the nurse consider in light of the patients sustained high blood pressure?
- A. The patients culture may not prioritize taking a medication on a regular basis.
- B. Biologic variations may be influencing the effectiveness of the medication.
- C. The patients culture may not acknowledge symptom-free problems such as blood pressure.
- D. The patients diet may be negatively affecting the effectiveness of the medication.
Correct Answer: B
Rationale: Biologic variations can be highly significant, particularly in the use of antihypertensives in African American patients. This is more likely than culturally mediated views on medication adherence, symptom-free diseases, or diet.
What would be the best intervention you could make on behalf of this patient?
- A. Discourage the use of incense in the hospital.
- B. Ask the family to have the ceremony off the unit.
- C. Arrange for the ceremony to occur after notifying all departments affected.
- D. Encourage the family to conduct the ceremony elsewhere because it may affect other patients in the unit.
Correct Answer: C
Rationale: Culturally competent policies are developed to promote an environment in which the traditional healing, spiritual, and religious practices of patients are respected and encouraged and to recognize the special dietary practices of patients from selected cultural groups. To promote spirituality and transcultural nursing, the nurse should make or help to make the arrangements. The nurse should not attempt to dissuade the family or to relegate the ceremony to a site outside the hospital.
When using this model in the care of a patient who has had a transurethral prostate resection (TUPR), what area of care would be influenced most directly?
- A. Transferring the patient from a stretcher to a bed
- B. Documenting the patients vital signs and level of consciousness
- C. Administering a scheduled dose of acetaminophen
- D. Explaining the rationale for continuous bladder irrigation (CBI)
Correct Answer: D
Rationale: Giger and Davidhizar identified communication, space, time orientation, social organization, environmental control, and biologic variations as relevant phenomena. Explaining CBI requires clear communication. Transferring a patient to a bed, administering Tylenol, or documenting are nursing responsibilities that are less directly relevant to this model.
How should the nurse best understand the patients behavior?
- A. The patients sense of humor is culturally mediated and may be unfamiliar to the nurse.
- B. The patient may believe that she has sufficient knowledge and skill to empty the drain.
- C. The patient may be unable to fully comprehend the information the nurse is trying to convey.
- D. Individuals from the patients culture may not normally explain and demonstrate at the same time.
Correct Answer: C
Rationale: Inappropriate laughter can signal a lack of understanding. This is more likely than the presence of a culture-specific sense of humor in this particular context. It is unlikely that there is a prohibition against simultaneous explaining and demonstrating. Laughing is unlikely to suggest that teaching and learning are unnecessary.