Cultural and Ethnic Considerations

MULTIPLE CHOIC E Dircctions •• Sel•.с t 1,,,е Ьest answer(s) 2. The nurse observes а young, friendJy unli­ censed assistive personл.el (UAP) giving the "thurnbs up" hand gesture as he passes Ьу the doorway of his assigned patients. What should the nurse do first? (100) 1. Ask the patients what they think about the "thumbs up" gesture. 2. Suggestthat the UAP talk to the charge nurse before someone complains. 3. Observe the UAP for evidence of additionа1 cuJturally Ьiased behavior. Ask the UAP about the hand gesture and tl1e response from the patients. З. А nursing student has to rely on puЫic trans­ portation and she is late several times for class and clinical. Тhе instructor is very unhappy with the tard.iness. Wnat sl10u!d the student do first? (101) 1. Promise never to Ье late for the rema.inder of ilie semester. 2. Ask for а transfer to another instmctor and а different clinical site. Explain transportation issues and ask for help to proЫem-solve. 4. Ask for lenience and offer to do additional make-up assignrnents. 0 G) 4. 5. . · for each of tlie Jo/lo.vmg questions. Which behavior most strongly suggests that е patient has а future .tirne orientation? (101) � Patient declines а recommended cancer screening test Ьecause she has no family history of cancer. 2. Patient goes to the emergency department for acute-onset abdomjлal pain. 3. Patient asks the nurse if his daughter can stay ovemight with him in the hospital. 4. Patient initiates а program of regular exer­ cise and healthy eating hablts. �ich sj�at!o� ��st �trop�ly ii;idic�tes а pa­ �chal fanuly structure? (101) \:.) Oldest son makes merucal decisions fo;r older adult father and provides emotional support for his mother. 2. Family requests that diagnosis of cancef Ье withheld from the patient,"who is an older adult f�male. 3. Feпiale family members sit at the patient' s bedside; male members sit in the waiting room. 4. At immunization ciinic, mother gives her son emotionaJ support and comfort. 6. Based on the nurse' s knowledge of health di orders found among persons of N ative Atner5: can ancestry, which question is fue nurse m osti. likely to ask? (107) 1. "Have you experienced any unintentiona \ weight loss?" 2. "Has anyone in your family ever been to]d tl1ey have diaЬetes? 3. "When was the last time you had а сощ. plete physkal?" 4. "Do you know if you have а fam.ily histo ry of sickle cell disease?" G 7. Тhе nurse is assisting а patient to change posi­ tion in bed. The patient has а limited under­ standing of English. What should the nurse do? (98) 1. Speak loudly to emphasize key informa­ tion. 2 Кеер instructions brief and simple. Wait for а�, interpret�r. . . 4. Provide d1rections w1tl1 deta,led ratюnale. iJ} 8. What cultural difference(s) does the nurse need to Ье aware of when caring for an older adult? Select all that apply. (98) 1. They are usually more tolerant of other cultures. They may say hurtful things if cognitive impairment is present. They are more likely to Ье rigid in their practices. 4. They are less likely to use home remedies. ф They re]y more on traditional religious • practices. 6. They are less likely to Ье well-educated. @ @ 9. Тhе surgeon informs the patient that there is а risk of b(ood loss duriцg the planned surgical procedure, but the'patient is а Jehovah' s Wit. ness, so she.refu,ses to sign the.consent form. Which nursing action is in the best interest of the patient? (I 04) 1. Support the patient' s dedsion to refuse the procedure. . , . ,-;:;\ \:;,) Discuss realistic alternatives to Ыооd trans­ fusion with the surgeon. . 3. Document the patient' s decision in the medical record. 4., ; Contact the risk; manager for advice aЬout c_onvincing the patient. 10. А patient ,vho is Mustim dies during th • ht То respect the patient's religious belief/;'h�t .,,;qould thenurse do first? (103) (J) Contact the fa_mily Ьefore giving any post­ mortem care. 2. Stay with the deceased until а family mem­ Ьer arr1ves. З. Wait at least 30 minutes before giving post1nortem care. 4. Contact the organ transplant team because donation is likely. 11. The nurse is from а small town in the United States and is starting а new job in а large urban area with а diverse popula tion. Wha t strategies ca.n the nurse use to develop cultu ral compe,,Щ_nce? Select all that apply. (96) \..!,) Perform а se!f-assessment of beliefs and practices. 2. Adapt personal be!iefs to match those of individual patients. Кеер a_n open mind about cultural differ­ ences. 4. Treat everyone equally and act the same toward all patients. 5. Ignore the differences and focus on exhiblt­ ing kindness and care. Understand own vaJues, preferences, and cu!tura] heritage. G) @ 12. Тhе nurse is caring for а patient who is dying. What does evidence-based practice indicate about cultшal beliefs and rituals that surround death? (97) 1. The family should Ье encouraged to pray at the bedside. Respect and protection of the dying per­ son' s soul are important. 3. Lack of religious preference increases prob­ lems with coping. 4. Rituals and ceremonies to delay or ward ф�coqr13-ge9. 1 off11eat!_ч,ho.u1d n is,in who t, 13. Тhе patie� _ ? appatent d�stresII �s accompar!Jed ta the climc Ъу severa1 Iaпuiy members who cluster around. All are attempt­ ing to talk to each other and the 'nurse at the same time. The nurse can hear а mixtш;e of Eng1ish and another lahguage beiflg spoken: \ ' What should thg nurse·do,first?. (101) 1. Try td determine who speaks tl;i.e best Eng, . . , • lish. 2. Take only the patienHo-an examiFщf;ion· room and shut the door. • ' � Project calm energy and try to identify the leader of the family. 4. Physically assess ili.e patient ari.d take vital signs to ascertain stability. @ 17� r,:.._ 14. А rnale patient says to the nurse regarctiлg the UAP, "Thatyoung Asian ,voman who h.elped me with my bath was really nice, but sbe seemed scared and never \ooked up; just kept her head down. Did Т do sornething to scare or offend her?" What should the nurse do first? (96) 1. Find the UAP and ask her to explain her behavior to the patient. 2. Reassure him that he did nothing ,vrong !':"\ and that th.e UAP's Ьehaviot is cultural. ф Tel1 the patient that you will check with the UAP and then get back to him. 4. Apologize to the patient and give then give feedback to the UAP. 15. The nurse is а happy and outgoing person, and �omes from а fa_mily where hugging, touch­ mg, pattmg, or playfully punching are part of normal everyday interaction. What is the best strategy for the nurse to comЬine her personal style witl1 giving culturally appropriate care? (96) 1. Assess her own behaviors and try to un­ derstand the origin of her personal style. Consider different patient care settings and observe interactions. 3. Learn which cultures ca_n accept touch Ьу health care personnel. 4. Request to care for patients who are from her own culture. @ 16. Тhе nurse is working in an assisted-living fa­ cility and most residents take their meals in а common dining area. What is the best method for seating the residents? (99) 1. Assign seating so that each resident has а consistent р]асе at mealtimes. 2. Encoшage the residents to continuously sit with someone new for stimulation. Observe how self-moЬile and ambulatory r�sidents seat and grpup themselves. 4. Ask each resident where he / she would like to sit а\ tЪie begiщun'g of eJch meal. ' Q) 17. The nurse is trying to give all of his patients the 9:00 лм med.ications. An older Нispanic woman needs 15 medications,�ve.ry morning ..', but 1 is• consistehtly preoccupied whenever the ·,' , nµrsejenters �h� rощц. What shouldJthe nurse • . ? (101) � Admirrister the med.icatio� to o1;her p a­ tients1first and then hei\P. this pat:J.ent. Give patient а 15-rninute wamiлg and then stick-to the promised time. , щan is so conЗ. Try to .futq QUt why the-.wQ , sistently preoccupied. . . ns at catю 4. Start giving this patient '111-е цiedi 8:00 АМ so there is extra time. ' 2. the' 1 18• Пlе nursing student is trying to explain the im­ portance of taking Ыооd pressure medication �very day to an older patient wl10 is on а fixed mcome. �hich �uestion from the patient is the Ъest mdication that his perception of time ��? to Ье present-orie�ted? (101) � Can 1 save the medication on the days when I feel okay?" 2. "What should I do if I am running out of mectication and have no money?" 3. "Му wife takes Ыооd pressure 1nedicati.on too. Can I share her pills?" 4. "Wou.ld you take this medication if you were in my position?" 19. The nurse is discussing tl1e parents' beliefs алd use of folk medicine, which they would like to use to treat their child's respiratory infec­ tioп. Wluch l1ealth care practice is the cause for greatest concem? (107) 1. P\acing а religious medal оп the bedside tаЫе 2. Having а folk healer соте to heaJ with touch and faith Giving the child an herbal tea that gives strength and heaJth 4. Bathing at night instead of i.n the morning G) 20. 0n visiting _the l?atient at home, the nurse finds that the pat1ent 1s not following the dietary instructions. The nurse discovers that the if who shops and cooks, believes that her h� е, band needs "nutritious home-cooked meaI5from his native cou.ntry." What should the nurse do first? (107) 1. Change the dietary plan to meet the pa­ tient's and family's cu\tural preference 2. Consult а nutritionist for ways to adap�· thе wife's cooking to the dietary plan. З. Revise the patient's nutritional goal to in­ corporate the cultural dietary patterns. Ask the wife to descnbe а typical 24-hour day of meal preparation and snacks. 21. The nurse is assessing а patient \vho reports, "It feels like there is something inside me that wants to соте out." Wblch questions would the nurse ask to assess the patient' s belief sys­ tem? Select all that apply. (97) 1. "When did you first notice the feeling?�' "Why do you think this is happeniнg right now?" � "What do you think is causing the probJem?" h {) "Why do you tink this is happening to you?" "What do you think will help clear up ilie proЫem?" 6. "How long does the feeling last?" 0 Q) ® CRITICAL THINKING ACTIVITIES 22. Тhе nt1;se is ca.ring for an o!der patient who has recently emigrated from another country. The patient' 5 farru_ ly 1s at the b�ds1de and the nurse overhears them speaking in English and Spanish. The nurse's fust language 1s Engl1sh and she understands and speaks а little Spanish. а. Identify nursing iнterventions that may Ье used to communicate with а non-English- speaking patient. (98) ь. ]рР nш,5е can e1f.l<1tn -Ь� pt.· �-fом1\� 4:h3\ .She \\nьws а �!-\ of .Sran\ShJ btH I S :Ь \й::thero \.Dt>\'\J ВО Юtttptclev \� I\W€tt- ��ilie�:::��ё�;fes and disadvantages of using а family member to translat;and communicate V () 7' f' а: �е.. � \\1 D V l[\j 2 с. How shouJd the ш.use ask the patient aЬou t the following? ,. ii. Н:h (9 ) i � {)����е�� ���� ��U��oс �e - Lang uage :b� = HeaJth: 7 1) 7 , i� 1 = 23. Every morniлg the same day-shJft nurse is late for work, so giving handover report is aJways de]ayed. The nigh t -shJft nurses have _mentioned this to the nurse manager who has promised to take care of the proЫem, but the late behavюr contiлues. One of the night nurses, tries to taJk to the day-shift nurse about her Ьehavior, but the nurse says, "Oh you Americaлs are aJways so worried about time. Just re­ , Jax. You kпow I will always Ье here." AnaJyze this situation and make suggestions about how the proЬ­ lem сап Ье addressed.Ask your cl.inical instructor if you сап dJscuss this topic in а postconference. (101) 1± 6 е ero s 1D me :\:Ьоt +ье nur6es b-ave. St-ate.d 24. Nursing students who grow up and work in the United States sometimes have difficulty describing thei.r own culture and identifying how "American" culture is viewed Ьу people who dJd not grow up in the UnJted States. (95) а. Ь. W" �n Н you are an American who grew up in the UnJted States, describe the how "American" culture affects your values and be!ief system. 1 anu1rfi ') \S-1 0� Df' '{Q\.\�CВEЬе t;5J°�J-� D oes '/� -�-\D();i�__ �_е,?�_ speofк. r.em-clш 'уО\1 11se? ; е&) �- Familystruct�re:�g�f \� ,v. D,etary practices r -�-: f v. Useo folkmedicine:д;re±Ьere O:b\f who �:{ fJV+\l� U,�, If you are not originally from the Un.ited States, discuss how you view "American" culture and how being in that culture is currently affecting you.