Nokea
When a female patient who does not speak English well requires an interpreter, what would be the most appropriate choice?
- A. A trained interpreter
- B. A male family member
- C. A female family member
- D. A volunteer college student from the foreign language studies department
Correct Answer: A
Rationale: To facilitate effective communication between a female patient with limited English proficiency and healthcare providers, the most appropriate choice is a trained interpreter. Trained interpreters, especially those familiar with medical terminology, ensure accurate transmission of information and maintain patient-provider confidentiality. Using a family member, whether male or female, can lead to misunderstandings, breaches of confidentiality, and potential biases. Volunteer college students may lack the necessary skills and experience to handle sensitive medical conversations professionally. Opting for a trained interpreter is crucial to enhance communication quality, promote understanding, and uphold patient care standards.
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When providing culturally competent care, how should nurses incorporate cultural assessments into health assessments? Which statement is most appropriate when initiating an assessment of cultural beliefs with an elderly American Indian patient?
- A. "Are you of the Christian faith?"
- B. "Do you want to see a medicine man?"
- C. "How often do you seek help from medical providers?"
- D. "What cultural or spiritual beliefs are important to you?"
Correct Answer: D
Rationale: The most appropriate statement to initiate an assessment of cultural beliefs with an elderly American Indian patient is to ask, "What cultural or spiritual beliefs are important to you?" This question encourages the patient to share their personal beliefs without assuming stereotypes or making generalizations. It allows the patient to express their individual cultural and spiritual practices, enabling nurses to deliver more personalized and culturally competent care. Choices A, B, and C are not as suitable. Choice A assumes a specific faith without considering the patient's actual beliefs. Choice B relies on a stereotype about American Indian culture, and Choice C focuses more on seeking medical help rather than exploring cultural beliefs.
During an interview, the nurse states, 'You mentioned shortness of breath. Tell me more about that.' Which verbal skill is used with this statement?
- A. Reflection
- B. Facilitation
- C. Direct question
- D. Open-ended question
Correct Answer: D
Rationale: The nurse's statement, 'Tell me more about that,' is an example of an open-ended question. Open-ended questions encourage the interviewee to provide detailed information and expand on their responses. This type of question is useful for gathering narrative information and allows the interviewee to express themselves freely. Reflection involves restating or paraphrasing the client's words, facilitation encourages the client to say more, and direct questions typically elicit specific, close-ended responses, unlike open-ended questions.
When a nurse is performing a health interview on a patient with a language barrier and no interpreter is available, which of the following is the best example of an appropriate question for the nurse to ask?
- A. Do you take medicine?
- B. Do you sterilize the bottles?
- C. Do you have nausea and vomiting?
- D. You have been taking your medicine, haven't you?
Correct Answer: A
Rationale: The best example of an appropriate question for the nurse to ask in this situation is 'Do you take medicine?' This question is clear, simple, and focused on one topic at a time, which is essential when there is a language barrier and no interpreter available. It follows the recommendation to use simple words, avoid medical jargon, contractions, and pronouns in such situations. Choices B, C, and D involve more complex language, unrelated topics, or assumptions about the patient's actions, making them less suitable for effective communication in this context.
During an interview, a parent of a hospitalized child is sitting in an open position. As the interviewer begins to discuss his son's treatment, however, he suddenly crosses his arms against his chest and crosses his legs. This would suggest that the parent is:
- A. just changing positions.
- B. more comfortable in this position.
- C. tired and needs a break from the interview.
- D. uncomfortable talking about his son's treatment.
Correct Answer: D
Rationale: The parent's sudden change in body language from an open position to crossing arms and legs suggests discomfort or defensiveness, particularly when discussing his son's treatment. This closed-off position indicates a lack of willingness to share information and potentially signals discomfort with the topic being discussed. Choice A is incorrect as the abrupt shift in body language indicates more than just a change in position. Choice B is incorrect because crossing arms and legs typically signal defensiveness or discomfort rather than comfort. Choice C is incorrect as there are specific body language cues indicating discomfort rather than just fatigue.
An elderly Mexican-American woman with traditional beliefs has been admitted to an inpatient care unit. A culturally-sensitive nurse would:
- A. contact the hospital administrator about the best course of action.
- B. automatically get a curandero for her because it is not culturally appropriate for her to request one.
- C. further assess the patient's cultural beliefs and offer the patient assistance in contacting a curandero or priest if she desires.
- D. ask the family what they would like to do because Mexican-Americans traditionally give control of decisions to their families.
Correct Answer: C
Rationale: When caring for a patient with traditional beliefs, especially one belonging to a culture like Mexican-American where folk or religious healers are important, a culturally-sensitive nurse should assess the patient's beliefs and preferences. By offering assistance in contacting a curandero or priest, the nurse acknowledges and respects the patient's cultural practices and provides holistic care that aligns with the patient's values. This approach helps build trust and ensures the patient receives care that is culturally appropriate and respectful. Choice A is incorrect as contacting the hospital administrator may not directly address the patient's cultural needs. Choice B is inappropriate as assuming the patient needs a curandero without assessment disregards individual preferences. Choice D is incorrect because while family involvement is valued in Mexican-American culture, the primary focus should be on the patient's individual preferences and autonomy.