Nokea
Which of the following question formats is the most appropriate for the nurse to ask when communicating with a patient that has limited English proficiency?
- A. Are you tired and in discomfort?
- B. You have taken your pills right?
- C. Are you alright?
- D. Are you in pain?
Correct Answer: D
Rationale: When communicating with a patient that has limited English proficiency the best questions to ask are ones that are in simple language a couple of words, plain simple terms, such as 'Are you in pain?' Asking about tiredness and discomfort in the same sentence should be avoided - ask one item at a time and use the term 'pain,' not discomfort. Asking the patient 'are you alright' is vague and will elicit a yes or no answer. 'You have taken your pills, right' is accusatory and should be avoided.
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When performing a cultural assessment with a patient of a different culture, which of the following actions is the initial action to be taken by the nurse?
- A. Wait until a cultural healer is available to help with the assessment.
- B. Obtain a list of any cultural remedies that the patient currently uses.
- 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: C
Rationale: An early step in performing a cultural assessment is to determine the cultural group with which the patient identifies. The other actions may be appropriate if the patient does identify with a particular culture.
An elderly Asian Canadian patient tells the nurse that she has lived in Canada for 50 years. The patient speaks English but lives in a predominantly Asian neighbourhood. Which of the following actions is most appropriate for the nurse?
- A. Arrange to have a folk healer available when planning the patient's care.
- B. Ask the patient about any special cultural beliefs or practices.
- C. Avoid making direct eye contact with the patient during care.
- D. Involve the patient's oldest son in making health care decisions.
Correct Answer: B
Rationale: Further assessment of the patient's health care preferences is needed before making further plans for culturally appropriate care. The other responses indicate stereotyping of the patient, based on ethnicity, and would not be appropriate initial actions.
A family member of an elderly Hispanic patient admitted to the hospital tells the nurse that the patient has traditional beliefs about health and illness. Which of the following actions is most appropriate for the nurse in this situation?
- A. Avoid asking any questions unless the patient initiates 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 the daughter.
Correct Answer: B
Rationale: Because the patient has traditional health care beliefs, it is appropriate for the nurse to ask whether the patient would like a visit from a cultural healer. Nurses ask key questions with regard to language, diet, religion, and acculturation and eliciting the patient's explanatory model of health and illness. There is no cultural reason for the nurse to avoid asking the patient questions, and questions may be necessary to obtain necessary health information. The patient (rather than the daughter) should be consulted about personal cultural beliefs. The hospital routines for meals, care, and visits should be adapted to the patient's preferences rather than expecting the patient to adapt to the hospital schedule.
When caring for an Indigenous patient, which of the following actions is the best initial approach in relation to eye contact for the nurse to take?
- A. Avoid all eye contact with the patient.
- B. Observe the patient's use of eye contact.
- C. Look directly at the patient when interacting.
- D. Ask the family about the patient's cultural beliefs.
Correct Answer: B
Rationale: Eye contact varies greatly among and within cultures so the nurse's initial action is to assess the patient's use of eye contact. Although nurses are often taught to maintain direct eye contact, patients who are Asian, Arab, or Indigenous may avoid direct eye contact and consider direct eye contact disrespectful or aggressive. Looking directly at the patient or avoiding eye contact may be appropriate, depending on the patient's individual cultural beliefs. The nurse should assess the patient, rather than asking family members about the patient's beliefs.
Equity in health care is concerned with creating equal opportunities for good health for everyone in which of the following ways?
- A. Decrease negative effect of social determinants of health.
- B. Increase awareness of acute care programs.
- C. Enhance access to services.
- D. Reduce exclusion.
- E. Decrease nonmodifiable risk factors.
Correct Answer: A,C,D
Rationale: Health equity is concerned with creating equal opportunities for good health for everyone in two ways: (a) decreasing the negative effect of the social determinants of health and (b) by improving services to enhance access and reduce exclusion.