Health Assessment for Nursing Practice 6th Edition Wilson Test Bank

1. What are the characteristics of one’s culture? a. Color of skin and hair b. System of beliefs and practices c. Food preferences d. Language and religion ANS: B System of beliefs and practices is part of the definition of culture. Skin and hair color are examples of racial characteristics based on genetics. Food preferences are an example of ethnicity. Language and religion are examples of ethnicity. DIF: Cognitive Level: Remember REF: p. 48 TOP: Nursing Process: Assessment MSC: NCLEX Patient Needs: Psychosocial Integrity: Cultural Diversity 2. Which example below best characterizes a patient’s race? a. The language spoken in the patient’s home is Tagalog. b. The patient’s family follows a kosher diet. c. The patient and his family have blonde hair and fair skin. d. The patient’s grandparents came to the United States from Germany. ANS: C Blonde hair and fair skin indicate genetics and race. The language spoken at home refers to ethnicity. A kosher diet refers to ethnicity. Although the patient and grandparents may share the same race, that the grandparents came to the United States from Germany does not relate to race. DIF: Cognitive Level: Understand REF: p. 48 TOP: Nursing Process: Assessment MSC: NCLEX Patient Needs: Psychosocial Integrity: Cultural Diversity 3. A Hispanic patient tells an African-American nurse, “You are African-American and can’t possibly understand how a person like me feels.” What is an appropriate response by the nurse at this time? a. Find a nurse who is not African-American to interview the patient. b. Ask the patient, “Why do you think that, since we just met?” c. Note that the patient is very defensive about being racially different. d. Encourage the patient to describe what he means by his statement. ANS: D NURSINGTB.COM Health Assessment for Nursing Practice 6th Edition Wilson Test Bank This study source was downloaded by from CourseH on :46:57 GMT -05:00 Your text here 1 NU RS IN GT B.CO M By encouraging the patient to describe what he means by his statement, the nurse is demonstrating cultural awareness and sensitivity by gathering more data about the unique beliefs and value systems of this patient. Finding a nurse who is not African-American to interview the patient is neither necessary nor practical. Asking the patient “Why do you think that, since we just met?” sounds defensive and may not facilitate further communication. Making an assumption “that the patient is very defensive about being racially different” is not based on any data. DIF: Cognitive Level: Apply REF: p. 50 TOP: Nursing Process: Assessment MSC: NCLEX Patient Needs: Psychosocial Integrity: Cultural Diversity 4. A male nurse is assigned to the care of a gay male with alcoholism. This sexual orientation is inconsistent with the beliefs of the nurse. What actions, if any, can the nurse take to provide patient-centered care to this patient? a. No action is necessary at this time. b. Examine his own feelings about alcoholism and homosexuality. c. Determine the patient’s degree of risk for contracting the human immunodeficiency virus. d. Discuss homosexuality and alcoholism with the patient. ANS: B Examining one’s own feelings about alcoholism and gay men specifically and identifying one’s own beliefs and values generally is part of the process for developing cultural competence, which should allow one to recognize the uniqueness of patients and to demonstrate respect for individuals. Not acting will not facilitate patient-centered care. The nurse needs to reflect on his feelings about this patient. Determining the patient’s degree of risk for contracting the human immunodeficiency virus is based on an assumption that because the patient is gay, he has or will have the human immunodeficiency virus. A discussion with the patient may help the nurse understand him, but will not necessarily provide insight into the nurse’s beliefs and feelings. DIF: Cognitive Level: Apply REF: p. 50 TOP: Nursing Process: Assessment MSC: NCLEX Patient Needs: Psychosocial Integrity: Cultural Diversity 5. Which nursing behaviors indicate culturally competent care? a. Recognizing that there are different definitions of health and illness b. Complying with the stated plan of treatment despite the patient’s differing opinion c. Understanding that there is diversity even among people of the same cultural group d. Helping patients of different cultures adopt the beliefs and behaviors of the dominant culture ANS: C NURSINGTB.COM Health Assessment for Nursing Practice 6th Edition Wilson Test Bank This study source was downloaded by from CourseH on :46:57 GMT -05:00 NU RS IN GT B.CO M Understanding that there is diversity even among people of the same cultural group prevents assumptions and stereotypes that inhibit culturally competent care. Recognizing that there are many different definitions of health and illness is not sufficient for culturally competent care. Complying with the stated plan of treatment despite the patient’s differing opinion is not a culturally competent behavior. The patient needs to understand, support, and participate in the plan of care. Helping patients of different cultures adopt the beliefs and behaviors of the dominant culture is an example of the opposite of cultural competence; it assumes that all persons should adopt certain beliefs and behaviors. DIF: Cognitive Level: Understand REF: p. 50 TOP: Nursing Process: Assessment MSC: NCLEX Patient Needs: Psychosocial Integrity: Cultural Diversity 6. A nurse is conducting an assessment of an American Indian woman who has come to the clinic complaining of persistent headaches. The patient tells the nurse that the medicines prescribed by the tribal healer have done “some good.” What is the appropriate response of the nurse at this time? a. “I advise you to stop taking those medicines from the tribal healer.” b. “Perhaps you should increase the frequency of the healer’s medicines.” c. “Tell me about these medicines and how often you are using them.” d. “Could your headaches be caused by the healer’s medicines?” ANS: C Asking the patient about the nature of these medicines and how often the patient uses them allows the nurse to collect data about the medicines and their uses, to learn more about the practices used by this patient to improve her health, and to check for potential drug interaction before prescribing other medications or treatment. Advising the patient to stop taking any nonprescription medicines is inappropriate until the nurse knows the details about all medicines used by the patient. Telling the patient to increase the frequency of the healer’s medicines is inappropriate until the nurse knows details about the medicines. Suggesting the patient’s headaches are caused by the healer’s medicines is inappropriate until the nurse knows details about the medicines. DIF: Cognitive Level: Apply REF: p. 51 TOP: Nursing Process: Assessment MSC: NCLEX Patient Needs: Psychosocial Integrity: Cultural Diversity 7. Which question is the most appropriate to learn about a patient’s religious practices? a. “How often do you go to church?” b. “Where is your church located?” c. “Do you mind telling me about your religion?” d. “Do you have any specific religious or spiritual practices or beliefs?” ANS: D “Do you have any specific religious or spiritual practices or beliefs?” is a broad, open-ended question that allows the patient to describe his or her religious beliefs. The question makes no reference to any particular faith. Asking the patient about his or her church makes the assumption that the patient worships in a church, which may not be correct. Asking the patient about the location of his or her church makes the assumption that the patient worships in a church, which may not be correct. The question is not an efficient way to learn about religious or spiritual practices. NURSINGTB.COM Health Assessment for Nursing Practice 6th Edition Wilson Test Bank This study source was downloaded by from CourseH on :46:57 GMT -05:00 NU RS IN GT B.CO M DIF: Cognitive Level: Apply REF: p. 51 | p. 52 TOP: Nursing Process: Assessment MSC: NCLEX Patient Needs: Psychosocial Integrity: Cultural Diversity 8. A patient tells the nurse that her religion prohibits her from eating food prepared outside of a special kitchen. What is the nurse’s appropriate action to meet this patient’s needs? a. Call the dietary department to cancel the patient’s meal tray. b. Tell the patient that her diet must be carefully monitored and prepared at the hospital. c. Tell the patient that because of her illness, a few changes to her religious requirements will be necessary. d. Ask the patient to describe the requirements for the special kitchen. ANS: D Asking the patient to describe the requirements for the special kitchen allows the nurse to collect more data about the needs of the patient. Canceling the patient’s food tray does not meet the patient’s needs. Telling the patient that her diet must be carefully monitored and prepared at the hospital is inappropriate because it does not consider the ethnicity of the patient and is not culturally competent care. Asking the patient to change her religious requirements does not respect her ethnicity and is not culturally competent care. DIF: Cognitive Level: Apply REF: p. 52 TOP: Nursing Process: Assessment MSC: NCLEX Patient Needs: Psychosocial Integrity: Religious and Spiritual Influences on Health 9. Which question is most effective in assessing a patient’s personal beliefs about health and illness? a. “What or who do you believe controls your health?” b. “Do you see your health care provider annually?” c. “Do you have specific beliefs about health and illness?” d. “Who makes the health decisions in your family?” ANS: A “What or who do you believe controls your health?” is a broad question that allows the patient to describe his or her beliefs. Asking if the patient visits his or her health care provider annually assumes the patient has a health care provider, and it is a closed-ended question that yields little data. “Do you have specific beliefs about health and illness?” will yield a “yes” or “no” answer, but does not provide information needed. “Who makes the health decisions in your family?” does not provide information about the beliefs of the patient. DIF: Cognitive Level: Understand REF: p. 51 TOP: Nursing Process: Assessment MSC: NCLEX Patient Needs: Psychosocial Integrity: Religious and Spiritual Influences on Health 10. An Asian woman comes to the clinic with a complaint of back pain. During the history, she tells the nurse that she usually uses acupuncture for her pain. What is the nurse’s best response? a. “When have you used acupuncture, and what effects did it have?” b. “Acupuncture is good for some problems, but for major illnesses it’s best to use medications.” NURSINGTB.COM Health Assessment for Nursing Practice 6th Edition Wilson Test Bank This study source was downloaded by from CourseH on :46:57 GMT -05:00 NU RS IN GT B.CO M c. “Why did you use acupuncture?” d. “I have heard that many Asian people use acupuncture.” ANS: A Asking about the use and effectiveness of acupuncture acknowledges the patient’s choice of treatment and allows the nurse to gather more data about its effectiveness for this patient. Asking “Why did you use acupuncture?” is a nontherapeutic response and questions the patient’s reason for her health care decisions. Asking “Why did you use acupuncture?” is a nontherapeutic response and questions the patient’s reason for her health care decisions. Commenting that, “I have heard that many Asian people use acupuncture” is an example of stereotyping. DIF: Cognitive Level: Apply REF: p. 51 TOP: Nursing Process: Assessment MSC: NCLEX Patient Needs: Psychosocial Integrity: Cultural Diversity