Nokea
You are the nurse caring for a patient who is Native American who arrives at the clinic for treatment related to type 2 diabetes. Which question would best provide you with information about the role of food in the patients cultural practices and identify how the patients food preferences could be related to his problem?
- A. Do you feel any of your cultural practices have a negative impact on your disease process?
- B. What types of foods are served as a part of your cultural practices, and how are they prepared?
- C. As a nonnative, I am unaware of your cultural practices. Could you teach me a few practices that may affect your care?
- D. Tell me about foods that are important in your culture and how you feel they influence your diabetes.
Correct Answer: D
Rationale: The beliefs and practices that have been shared from generation to generation are known as cultural or ethnic patterns. Food plays a significant role in both cultural practices and type 2 diabetes. By asking the question, Tell me about the foods that are important in your culture and how you feel they influence your diabetes, the nurse demonstrates a cultural awareness to the client and allows an open-ended discussion of the disease process and its relationship to cultural practice. An overemphasis on negatives can inhibit assessment and communication. Assessing the types and preparation of foods specific to cultural practices without relating it to diabetes is inadequate. The question, As a nonnative, I am unaware of your cultural practices. Could you teach me a few practices that may affect your care? focuses on care and fails to address the significance of food in cultural practice or diabetes.
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The nurse is completing a family history for a patient who is admitted for exacerbation of chronic obstructive pulmonary disease (COPD). The nurse should include questions that address which of the following health problems?
- A. Allergies
- B. Alcoholism
- C. Psoriasis
- D. Hypervitaminosis
- E. Obesity
Correct Answer: A,B,E
Rationale: In general, the following conditions are included in a family history: cancer, hypertension, heart disease, diabetes, epilepsy, mental illness, tuberculosis, kidney disease, arthritis, allergies ???¾?±?????²?µ?½?½?¾?¹, alcoholism, and obesity. Psoriasis and hypervitaminosis do not have genetic etiologies.
In your role as a school nurse, you are performing a sports physical on a healthy adolescent girl who is planning to try out for the volleyball team. When it comes time to listen to the students heart and lungs, what is your best nursing action?
- A. Perform auscultation with the stethoscope placed firmly over her clothing to protect her privacy.
- B. Perform auscultation by holding the diaphragm lightly on her clothing to eliminate the scratchy noise.
- C. Perform auscultation with the diaphragm placed firmly on her skin to minimize extra noise.
- D. Defer the exam because the girl is known to be healthy and chest auscultation may cause her anxiety.
Correct Answer: C
Rationale: Auscultation should always be performed with the diaphragm placed firmly on the skin to minimize extra noise and with the bell lightly placed on the skin to reduce distortion caused by vibration. Placing a stethoscope over clothing limits the conduction of sound. Performing auscultation is an important part of a sports physical and should never be deferred.
The nurse is performing the process of inspection during an assessment. What nursing action should the nurse include during this phase?
- A. Gather as many psychosocial details as possible.
- B. Pay attention to the details while observing.
- C. Write down as many details as possible during the observation.
- D. Do not let the patient know he is being assessed.
Correct Answer: B
Rationale: It is essential to pay attention to the details in observation. Vague, general statements are not a substitute for specific descriptions based on careful observation. It is specific information, not general information, that is being gathered. Writing while observing can be a conflict for the nurse. It is not necessary or appropriate to keep the assessment concealed from the patient.
You are admitting an elderly woman who is accompanied by her husband. The husband wants to know where the information you are obtaining is going to be kept and you follow up by describing the system of electronic health records. The husband states, I sure am not comfortable with that. It is too easy for someone to break into computer records these days. What is your best response?
- A. The Institute of Medicine has called for the implementation of the computerized health record so all hospitals are doing it.
- B. Weve been doing this for several years with good success, so I can assure you that our records are very safe.
- C. This hospital is as concerned as you are about keeping our patients records private. So we take special precautions to make sure no one can break into our patients medical records.
- D. Your wifes records will be safe, because only people who work in the hospital have the credentials to access them.
Correct Answer: C
Rationale: Nurses must be sensitive to the needs of the older adults and others who may not be comfortable with computer technology. Special precautions are indeed taken. Not every hospital employee has access and referencing the IOM may not provide reassurance.
A family whose religion limits the use of some forms of technology is admitting their grandfather to your unit. They express skepticism about the fact that you are recording the admission data on a laptop computer. What would be your best response to their concerns?
- A. Its been found that using computers improves our patients care and reduces their health care costs.
- B. We have found that it is easier to keep track of our patients information this way rather than with pen and paper.
- C. Youll find that all the hospitals are doing this now, and that writing information with a pen is rare.
- D. The government is telling us we have to do this, even though most people, like yourselves, are opposed to it.
Correct Answer: A
Rationale: Electronic health records are thought to improve the quality of care, reduce medical errors, and help reduce health care costs; therefore, their implementation is moving forward on a global scale. Electronic documentation is not always easier and most people are not opposed to it. Stating that all hospitals do this does not directly address their reluctance or state the benefits. The use of technology in health care settings is not specifically mandated by legislation.