,Chapter 1: Health Maintenance Guidelines
Multiple-Choice Questions (50 Questions)
1. The nurse is preparing to teach a patient of Asian culture to perform postoperative dressing changes
at home after discharge. Which statement made by the nurse indicates cultural competence?
A. “Tell me how you feel about your surgery.”
B. “Asian people are smart, so this should be easy for you to understand.”
C. “American surgeons are highly qualified; I’m sure you will heal quickly.”
D. “Will you tell me about any traditional healing practices that you would like to use?”
Correct Answer: D
Rationale: Asking about traditional healing practices demonstrates cultural competence by
acknowledging and respecting the patient’s cultural beliefs while integrating them into the care plan.
Options B and C contain cultural stereotypes and ethnocentric assumptions .
2. An unconscious victim of a house fire is brought to the emergency department by paramedics. Tied to
the right wrist is an emblem that appears to be a religious talisman. Which action should the nurse take?
A. Tape it in place.
B. Do nothing with it.
C. Remove it and lock it up for safekeeping.
D. Place it in a clothing bag with the rest of the patient’s belongings.
Correct Answer: A
Rationale: Religious items should be respected and kept with the patient whenever possible. Taping it in
place protects the item while respecting the patient’s religious beliefs .
3. A 43-year-old patient of Arab descent is admitted to the hospital. To comply with state laws of the
organization, the nurse offers the patient a Papanicolaou smear, which she refuses. Which action should
the nurse take first?
A. Notify the physician.
B. Report the refusal to the supervisor.
C. Explain the rationale for and benefits of the test.
D. Tell her it is state law and that she does not have a choice.
Correct Answer: C
Rationale: The nurse should first educate the patient about the rationale and benefits of the test. If the
patient continues to refuse, the refusal should be documented and the physician notified. Telling the
patient she has no choice is inappropriate and violates patient autonomy .
4. A patient who is a Jehovah’s Witness has severe gastrointestinal bleeding and a dangerously low
hemoglobin level. The patient is fully alert and competent and refuses to accept the blood transfusion
,ordered by the physician. Which action by the nurse is most appropriate? A. Obtain a court order to give
the blood.
B. Administer the blood while the patient is sleeping.
C. Have the patient’s spouse sign the consent to have the blood administered.
D. Ensure the patient understands possible consequences and then respect the patient’s wishes.
Correct Answer: D
Rationale: Competent adults have the right to refuse treatment, including blood transfusions, based on
religious beliefs. The nurse should ensure informed refusal (understanding consequences) and respect
the patient’s autonomy. Court orders, administering without consent, and having a spouse sign violate
patient rights .
5. A patient of Mexican descent sees a curandero for asthma; the curandero has prescribed a special tea
to be taken four times a day to open the airways. How should the nurse respond to this situation? A.
Encourage the patient to continue drinking the tea.
B. Encourage the patient to drink only one cup of the tea each day.
C. Ask the patient to bring in the tea package and have the pharmacist check the ingredients.
D. Advise the patient to stop drinking the tea because of potential interactions with other medications.
Correct Answer: C
Rationale: The nurse should respect the patient’s use of traditional healing while ensuring safety. Having
the tea ingredients checked by a pharmacist allows for evaluation of potential interactions with
prescribed medications. Discouraging traditional practices can damage trust and adherence .
6. The nurse is caring for a young adult male patient who refuses personal care from a female nursing
assistant. Which approach by the nurse is best?
A. Encourage the patient’s family to talk with him about his care.
B. Have a registered nurse (RN) help with his personal care.
C. Assign a male assistant to help with his personal care if one is available.
D. Explain to him that males and females take care of both genders in this hospital.
Correct Answer: C
Rationale: Accommodating the patient’s preference for a same-gender caregiver respects cultural,
religious, or personal modesty values. Option D disregards the patient’s expressed preference .
7. The nurse is providing medication instructions to a 45-year-old patient who does not maintain eye
contact. What should this patient’s behavior indicate to the nurse? A. The patient is not interested.
B. The nurse threatens the patient’s ego.
C. The nurse is in a hierarchical position.
, D. The patient’s behavior is culturally appropriate and may indicate respect.
Correct Answer: D
Rationale: In many cultures, avoiding eye contact with authority figures is a sign of respect, not
disinterest or noncompliance. The nurse should recognize this as culturally appropriate behavior rather
than interpreting it negatively .
8. A 58-year-old male from a recent immigrant community presents for an annual exam. He prefers
traditional healers and declines colorectal screening citing cultural beliefs. He has controlled
hypertension and a family history of colon cancer. As the APRN, how do you proceed to best address
preventive care and cultural sensitivity?
A. Respectfully document refusal and schedule routine follow-up in one year.
B. Provide a culturally tailored explanation linking colon cancer risk to family history and offering a
choice of stool-based screening.
C. Insist on colonoscopy as standard of care and arrange immediate referral.
D. Explain risks and advise no screening unless symptoms develop.
Correct Answer: B
Rationale: Offering culturally tailored education and an alternative evidence-based screening
(stoolbased) balances respect and preventive care; it addresses family history risk while respecting
patient preferences and increases uptake. Family Practice Guidelines emphasize shared decision-making
and offering acceptable screening modalities .
9. A 34-year-old pregnant patient who speaks limited English declines influenza vaccine because of
misinformation from family members. She is G2P1 at 16 weeks with mild asthma. You suspect increased
maternal and fetal risk if unvaccinated. What is the APRN’s best immediate step? A. Defer vaccination
and provide a pamphlet in English.
B. Use a trained medical interpreter to address safety evidence and offer vaccination now.
C. Ask family to convince her since they influence decision-making.
D. Note refusal and revisit only in third trimester.
Correct Answer: B
Rationale: Using a trained interpreter ensures accurate communication; providing evidence of safety in
pregnancy and offering vaccination now addresses both cultural/language barriers and immediate
maternal–fetal risk (asthma increases influenza complications). FPG supports vaccination in pregnancy .
10. A 72-year-old woman with moderate cognitive impairment and multiple comorbidities presents for
annual preventive visit. She lives with daughter who handles medical decisions. Which preventive
interventions are high priority and align with life-span health maintenance? A. Initiate mammography
and colonoscopy screening per age cutoffs.
B. Focus on immunizations (influenza, pneumococcal, zoster) and fall-risk assessment.
C. Schedule routine bone density screening only.
Multiple-Choice Questions (50 Questions)
1. The nurse is preparing to teach a patient of Asian culture to perform postoperative dressing changes
at home after discharge. Which statement made by the nurse indicates cultural competence?
A. “Tell me how you feel about your surgery.”
B. “Asian people are smart, so this should be easy for you to understand.”
C. “American surgeons are highly qualified; I’m sure you will heal quickly.”
D. “Will you tell me about any traditional healing practices that you would like to use?”
Correct Answer: D
Rationale: Asking about traditional healing practices demonstrates cultural competence by
acknowledging and respecting the patient’s cultural beliefs while integrating them into the care plan.
Options B and C contain cultural stereotypes and ethnocentric assumptions .
2. An unconscious victim of a house fire is brought to the emergency department by paramedics. Tied to
the right wrist is an emblem that appears to be a religious talisman. Which action should the nurse take?
A. Tape it in place.
B. Do nothing with it.
C. Remove it and lock it up for safekeeping.
D. Place it in a clothing bag with the rest of the patient’s belongings.
Correct Answer: A
Rationale: Religious items should be respected and kept with the patient whenever possible. Taping it in
place protects the item while respecting the patient’s religious beliefs .
3. A 43-year-old patient of Arab descent is admitted to the hospital. To comply with state laws of the
organization, the nurse offers the patient a Papanicolaou smear, which she refuses. Which action should
the nurse take first?
A. Notify the physician.
B. Report the refusal to the supervisor.
C. Explain the rationale for and benefits of the test.
D. Tell her it is state law and that she does not have a choice.
Correct Answer: C
Rationale: The nurse should first educate the patient about the rationale and benefits of the test. If the
patient continues to refuse, the refusal should be documented and the physician notified. Telling the
patient she has no choice is inappropriate and violates patient autonomy .
4. A patient who is a Jehovah’s Witness has severe gastrointestinal bleeding and a dangerously low
hemoglobin level. The patient is fully alert and competent and refuses to accept the blood transfusion
,ordered by the physician. Which action by the nurse is most appropriate? A. Obtain a court order to give
the blood.
B. Administer the blood while the patient is sleeping.
C. Have the patient’s spouse sign the consent to have the blood administered.
D. Ensure the patient understands possible consequences and then respect the patient’s wishes.
Correct Answer: D
Rationale: Competent adults have the right to refuse treatment, including blood transfusions, based on
religious beliefs. The nurse should ensure informed refusal (understanding consequences) and respect
the patient’s autonomy. Court orders, administering without consent, and having a spouse sign violate
patient rights .
5. A patient of Mexican descent sees a curandero for asthma; the curandero has prescribed a special tea
to be taken four times a day to open the airways. How should the nurse respond to this situation? A.
Encourage the patient to continue drinking the tea.
B. Encourage the patient to drink only one cup of the tea each day.
C. Ask the patient to bring in the tea package and have the pharmacist check the ingredients.
D. Advise the patient to stop drinking the tea because of potential interactions with other medications.
Correct Answer: C
Rationale: The nurse should respect the patient’s use of traditional healing while ensuring safety. Having
the tea ingredients checked by a pharmacist allows for evaluation of potential interactions with
prescribed medications. Discouraging traditional practices can damage trust and adherence .
6. The nurse is caring for a young adult male patient who refuses personal care from a female nursing
assistant. Which approach by the nurse is best?
A. Encourage the patient’s family to talk with him about his care.
B. Have a registered nurse (RN) help with his personal care.
C. Assign a male assistant to help with his personal care if one is available.
D. Explain to him that males and females take care of both genders in this hospital.
Correct Answer: C
Rationale: Accommodating the patient’s preference for a same-gender caregiver respects cultural,
religious, or personal modesty values. Option D disregards the patient’s expressed preference .
7. The nurse is providing medication instructions to a 45-year-old patient who does not maintain eye
contact. What should this patient’s behavior indicate to the nurse? A. The patient is not interested.
B. The nurse threatens the patient’s ego.
C. The nurse is in a hierarchical position.
, D. The patient’s behavior is culturally appropriate and may indicate respect.
Correct Answer: D
Rationale: In many cultures, avoiding eye contact with authority figures is a sign of respect, not
disinterest or noncompliance. The nurse should recognize this as culturally appropriate behavior rather
than interpreting it negatively .
8. A 58-year-old male from a recent immigrant community presents for an annual exam. He prefers
traditional healers and declines colorectal screening citing cultural beliefs. He has controlled
hypertension and a family history of colon cancer. As the APRN, how do you proceed to best address
preventive care and cultural sensitivity?
A. Respectfully document refusal and schedule routine follow-up in one year.
B. Provide a culturally tailored explanation linking colon cancer risk to family history and offering a
choice of stool-based screening.
C. Insist on colonoscopy as standard of care and arrange immediate referral.
D. Explain risks and advise no screening unless symptoms develop.
Correct Answer: B
Rationale: Offering culturally tailored education and an alternative evidence-based screening
(stoolbased) balances respect and preventive care; it addresses family history risk while respecting
patient preferences and increases uptake. Family Practice Guidelines emphasize shared decision-making
and offering acceptable screening modalities .
9. A 34-year-old pregnant patient who speaks limited English declines influenza vaccine because of
misinformation from family members. She is G2P1 at 16 weeks with mild asthma. You suspect increased
maternal and fetal risk if unvaccinated. What is the APRN’s best immediate step? A. Defer vaccination
and provide a pamphlet in English.
B. Use a trained medical interpreter to address safety evidence and offer vaccination now.
C. Ask family to convince her since they influence decision-making.
D. Note refusal and revisit only in third trimester.
Correct Answer: B
Rationale: Using a trained interpreter ensures accurate communication; providing evidence of safety in
pregnancy and offering vaccination now addresses both cultural/language barriers and immediate
maternal–fetal risk (asthma increases influenza complications). FPG supports vaccination in pregnancy .
10. A 72-year-old woman with moderate cognitive impairment and multiple comorbidities presents for
annual preventive visit. She lives with daughter who handles medical decisions. Which preventive
interventions are high priority and align with life-span health maintenance? A. Initiate mammography
and colonoscopy screening per age cutoffs.
B. Focus on immunizations (influenza, pneumococcal, zoster) and fall-risk assessment.
C. Schedule routine bone density screening only.
