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6th Edition by Jill C. Cash; Cheryl A. Glass;
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Jenny Mullen||Chapters 1 - 23
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,Chapter ss1. ssHealth ssMaintenance
ssGuidelinesM s ultiple ssChoice
Identify ssthe sschoice ssthat ssbest sscompletes ssthe ssstatement ssor ssanswers ssthe ssquestion.
ss 1. ssThe ssnurse ssis sspreparing ssto ssteach ssa sspatient ssof ssthe ssAsian ssculture ssto ssperform
sspostoperative ssdressing sschanges ssat sshome ssafter ssdischarge. ssWhich ssstatement ssmade ssby ssthe
ssnurse ssindicates ssculturalscompetence?
a. Tell ssme sshow ssyou ssfeel ssabout ssyour sssurgery.
b. Asian sspeople ssare sssmart, ssso ssthis ssshould ssbe sseasy ssfor ssyou ssto ssunderstand.
c. American sssurgeons ssare sshighly ssqualified; ssIm sssure ssyou sswill ssheal ssquickly.
d. Will ssyou sstell ssme ssabout ssany sstraditional sshealing sspractices ssthat ssyou sswould sslike ssto ssuse?
ss 2. ssAn ssunconscious ssvictim ssof ssa sshouse ssfire ssis ssbrought ssto ssthe ssemergency ssdepartment
ssby ssthesparamedics. ssTied ssto ssthe ssright sswrist ssis ssan ssemblem ssthat ssappears ssbe ssa ssreligious
sstalisman. ssWhich ssaction ssshould ssthe ssnurse sstake?
a. Tape ssit ssin ssplace.
b. Do ssnothing sswith ssit.
c. Remove ssit ssand sslock ssit ssup ssfor sssafekeeping.
d. Place ssit ssin ssa ssclothing ssbag sswith ssthe ssrest ssof ssthe sspatients ssbelongings.
ss 3. ssA ss43-year-old sspatient ssof ssArab ssdescent ssis ssadmitted ssto ssthe sshospital. ssTo sscomply
sswith ssthesstate sslaws ssof ssthe ssorganization, ssthe ssnurse ssoffers ssthe sspatient ssa ssPapanicolaou
sssmear, sswhich ssshe ssrefuses. ssWhich ssaction ssshould ssthe ssnurse sstake ssfirst?
a. Notify ssthe ssphysician.
b. Report ssthe ssrefusal ssto ssthe sssupervisor.
c. Explain ssthe ssrationale ssfor ssand ssbenefits ssof ssthe sstest.
d. Tell ssher ssit ssis ssstate sslaw ssand ssthat ssshe ssdoes ssnot sshave ssa sschoice.
ss 4. ssA sspatient sswho ssis ssa ssJehovahs ssWitness sshas sssevere ssgastrointestinal ssbleeding ssand ssa
ssdangerously sslow sshemoglobin sslevel. ssThe sspatient ssis ssfully ssalert ssand sscompetent ssand ssrefuses ssto
ssacceptsthe ssblood sstransfusion ssordered ssby ssthe ssphysician. ssWhich ssaction ssby ssthe ssnurse ssis ssmost
ssappropriate?
a. Obtain ssa sscourt ssorder ssto ssgive ssthe ssblood.
b. Administer ssthe ssblood sswhile ssthe sspatient ssis sssleeping.
c. Have ssthe sspatients ssspouse sssign ssthe ssconsent ssto sshave ssthe ssblood ssadministered.
, d. Ensure ssthe sspatient ssunderstands sspossible ssconsequences ssand ssthen ssrespect ssthe sspatients sswishes.
ss 5. ssA sspatient ssof ssMexican ssdescent sssees ssa sscurandero ssfor ssasthma; ssthe sscurandero sshas
ssprescribedsa ssspecial sstea ssto ssbe sstaken ssfour sstimes ssa ssday ssto ssopen ssthe ssairways. ssHow ssshould
ssthe ssnurse ssrespond ssto ssthis sssituation?
a. Encourage ssthe sspatient ssto sscontinue ssdrinking ssthe sstea.
b. Encourage ssthe sspatient ssto ssdrink ssonly ssone sscup ssof ssthe sstea sseach ssday.
c. Ask ssthe sspatient ssto ssbring ssin ssthe sstea sspackage ssand sshave ssthe sspharmacist sscheck ssthe ssingredients.
d. Advise ssthe sspatient ssto ssstop ssdrinking ssthe sstea ssbecause ssof sspotential ssinteractions sswith
ssothersmedications.
ss 6. ssThe ssnurse ssis sscaring ssfor ssa ssyoung ssadult ssmale sspatient sswho ssrefuses sspersonal sscare
ssfrom ssasfemale ssnursing ssassistant. ssWhich ssapproach ssby ssthe ssnurse ssis ssbest?
a. Encourage ssthe sspatients ssfamily ssto sstalk sswith sshim ssabout sshis sscare.
b. Have ssa ssregistered ssnurse ss(RN) sshelp sswith sshis sspersonal sscare.
c. Assign ssa ssmale ssassistant ssto sshelp sswith sshis sspersonal sscare ssif ssone ssis ssavailable.
d. Explain ssto sshim ssthat ssmales ssand ssfemales sstake sscare ssof ssboth ssgenders ssin ssthis sshospital.
ss 7. ssThe ssnurse ssis ssproviding ssmedication ssinstructions ssto ssa ss45-year-old sspatient sswho
ssdoes ssnotms aintain sseye sscontact. ssWhat ssshould ssthis sspatients ssbehavior ssindicate ssto ssthe
ssnurse?
a. The sspatient ssis ssnot ssinterested.
b. The ssnurse ssthreatens ssthe sspatients ssego.
c. The ssnurse ssis ssin ssa sshierarchical ssposition.
d. The sspatient ssdoes ssnot ssintend ssto ssfollow ssthe ssinstructions.
8. ssThe ssnurse ssis sscaring ssfor ssa sspatient ssof ssSpanish ssdescent sswho ssis ssexperiencing
ss ss ss ss ss ss ss ss ss
sspain, ssbut ssdoes ns ot ssspeak ssEnglish. ssAn ssinterpreter ssis sslocated ssto sshelp sswith ssthe ssassessment.
ssWhat ssshould ssthe ssnursesdo ssto ssfacilitate sscommunication sswith ssthis sspatient?
a. Use sshand sssignals ssto ssdetermine ssthe sscause ssof ssthe sspain.
b. Ensure ssthe ssinterpreter ssis ssnot ssleft ssalone sswith ssthe sspatient.
c. Maintain sseye sscontact sswith ssthe sspatient ssand ssthe ssinterpreter.
d. Use ssonly ssphysical ssexamination ssdata; ssdo ssnot ssrely sson ssverbal sscommunication.
ss 9. ssA ssnew ssmother ssof ssGuatemalan ssdescent ssbrings ssher ss10-day-old ssinfant ssto ssa ssclinic ssfor
ssa sswell-sbaby sscheckup. ssTo sspromote sshealing, ssshe sshas ssa sscoin sstaped ssto ssthe ssinfants ssumbilicus.
ssWhat ssshould ssthe ssnurse ssdo ssabout ssthis sssituation?
a. Teach ssthe ssmother sshow ssto ssclean ssthe sscoin ssdaily ssand ssreapply ssit.