What is the nurses best response to the patients indication that his care provider is a shaman?
- A. Thank you for providing the information about the shaman, but we will keep that information and approach separate from your current hospitalization.
- B. It seems that the care provided by your shaman is not adequately managing your hypertension and diabetes, so we will try researched medical approaches.
- C. Dont worry about insulting your shaman, as he will understand his approach to your hypertension and diabetes was not working after your doctor tells him how sick you were in the hospital.
- D. I understand that you value the care provided by the shaman, but we would like you to consider medications and dietary changes that may lower your blood pressure and blood sugar levels.
Correct Answer: D
Rationale: Native American patients may seek assistance from a shaman or medicine man or woman. The nurses best approach is not to disregard the patients belief in folk healers or try to undermine trust in the healers. Nurses should make an effort to accommodate the patients beliefs while also advocating the treatment proposed by health science.
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When choosing another individual to interpret for this patient, what characteristic should the nurse prioritize?
- A. Interpreter should recognize the need to speak in a loud voice.
- B. Interpreter should be able to conduct the conversation quickly to avoid misinterpretation.
- C. Interpreter should be fluent in several dialects of the patients language.
- D. Interpreter should know that repetition must be avoided while interpreting.
Correct Answer: C
Rationale: Cultural needs should be considered when choosing an interpreter; for instance, fluency in varied dialects is beneficial. In choosing an interpreter, you do not want one who speaks in an excessively loud voice, conducts the conversation too quickly, or avoids repetition.
What would you include in your assessment? Select all that apply.
- A. Family structure
- B. Subgroups
- C. Cultural beliefs
- D. Health practices
- E. Values
Correct Answer: A,C,D,E
Rationale: Cultural nursing assessment refers to a systematic appraisal or examination of individuals, families, groups, and communities in terms of their cultural beliefs, values, and practices. Subgroups are not a specific focus of this assessment.
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.
The nurse should consider what phenomenon that tends to occur in patients of all ages when they are ill?
- A. Tendency to regress in language skills
- B. Tendency to become more passive
- C. Tendency to become more involved in care
- D. Tendency to regress in age-appropriate behavior
Correct Answer: A
Rationale: During illness, patients of all ages tend to regress, and the regression often involves language skills. The other tendencies do not apply in this case.
Which cultural group would most likely consider the direct eye contact impolite?
- A. African Americans
- B. Hispanics
- C. Canadians
- D. Native Americans
Correct Answer: D
Rationale: Eye contact is a culturally determined behavior. Although most nurses have been taught to maintain eye contact when speaking with patients, some people from certain cultural backgrounds may interpret this behavior differently. For example, some Asians, Native Americans, Indo-Chinese, Arabs, and Appalachians may consider direct eye contact impolite or aggressive, and they may avert their own eyes when talking with nurses and others whom they perceive to be in positions of authority.
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