Chapter 1. Health Maintenance Guidelines
L L L L L
Multiple Choice L
Identify the choice that best completes the statement or answers the question.
L L L L L L L L L L L
1. The nurse is preparing to teach a patient of the Asian culture to perform postoperative
L L L L L L L L L L L L L L L L
dressing changes at home after discharge. Which statement made by the nurse indicates cultural
L L L L L L L L L L L L L L
competence?
a. Tell me how you feel about your surgery.
L L L L L L L
b. Asian people are smart, so this should be easy for you to understand.
L L L L L L L L L L L L
c. American surgeons are highly qualified; Im sure you will heal quickly.
L L L L L L L L L L
d. Will you tell me about any traditional healing practices that you would like to use?
L L L L L L L L L L L L L L
2. An unconscious victim of a house fire is brought to the emergency department by the
L L L L L L L L L L L L L L L L
paramedics. Tied to the right wrist is an emblem that appears be a religious talisman. Which
L L L L L L L L L L L L L L L L
action should the nurse take?
L L L L
a. Tape it in place. L L L
b. Do nothing with it.
L L L
c. Remove it and lock it up for safekeeping. L L L L L L L
d. Place it in a clothing bag with the rest of the patients belongings.
L L L L L L L L L L L L
3. A 43-year-old patient of Arab descent is admitted to the hospital. To comply with the
L L L L L L L L L L L L L L L L
state laws of the organization, the nurse offers the patient a Papanicolaou smear, which she
L L L L L L L L L L L L L L L
refuses. Which action should the nurse take first?
L L L L L L L
a. Notify the physician. L L
b. Report the refusal to the supervisor. L L L L L
c. Explain the rationale for and benefits of the test.
L L L L L L L L
d. Tell her it is state law and that she does not have a choice.
L L L L L L L L L L L L L
4. A patient who is a Jehovahs Witness has severe gastrointestinal bleeding and a
L L L L L L L L L L L L L L
dangerously low hemoglobin level. The patient is fully alert and competent and refuses to accept
L L L L L L L L L L L L L L L
the blood transfusion ordered by the physician. Which action by the nurse is most appropriate?
L L L L L L L L L L L L L L
a. Obtain a court order to give the blood.
L L L L L L L
b. Administer the blood while the patient is sleeping. L L L L L L L
c. Have the patients spouse sign the consent to have the blood administered.
L L L L L L L L L L L
,d. Ensure the patient understands possible consequences and then respect the patients wishes.
L L L L L L L L L L L
5. A patient of Mexican descent sees a curandero for asthma; the curandero has prescribed a
L L L L L L L L L L L L L L L L
special tea to be taken four times a day to open the airways. How should the nurse respond to
L L L L L L L L L L L L L L L L L L L
this situation?
L
a. Encourage the patient to continue drinking the tea. L L L L L L L
b. Encourage the patient to drink only one cup of the tea each day. L L L L L L L L L L L L
c. Ask the patient to bring in the tea package and have the pharmacist check the ingredients.
L L L L L L L L L L L L L L L
d. Advise the patient to stop drinking the tea because of potential interactions with other
L L L L L L L L L L L L L L
medications.
6. The nurse is caring for a young adult male patient who refuses personal care from a
L L L L L L L L L L L L L L L L L
female nursing assistant. Which approach by the nurse is best?
L L L L L L L L L
a. Encourage the patients family to talk with him about his care. L L L L L L L L L L
b. Have a registered nurse (RN) help with his personal care.
L L L L L L L L L
c. Assign a male assistant to help with his personal care if one is available.
L L L L L L L L L L L L L
d. Explain to him that males and females take care of both genders in this hospital.
L L L L L L L L L L L L L L
7. The nurse is providing medication instructions to a 45-year-old patient who does not
L L L L L L L L L L L L L L
maintain eye contact. What should this patients behavior indicate to the nurse?
L L L L L L L L L L L
a. The patient is not interested.
L L L L
b. The nurse threatens the patients ego.
L L L L L
c. The nurse is in a hierarchical position.
L L L L L L
d. The patient does not intend to follow the instructions.
L L L L L L L L
L L L 8. The nurse is caring for a patient of Spanish descent who is experiencing pain, but does
L L L L L L L L L L L L L L L L L
not speak English. An interpreter is located to help with the assessment. What should the nurse
L L L L L L L L L L L L L L L L
do to facilitate communication with this patient?
L L L L L L
a. Use hand signals to determine the cause of the pain.
L L L L L L L L L
b. Ensure the interpreter is not left alone with the patient.
L L L L L L L L L
c. Maintain eye contact with the patient and the interpreter.
L L L L L L L L
d. Use only physical examination data; do not rely on verbal communication.
L L L L L L L L L L
9. A new mother of Guatemalan descent brings her 10-day-old infant to a clinic for a well-
L L L L L L L L L L L L L L L L
baby checkup. To promote healing, she has a coin taped to the infants umbilicus. What should
L L L L L L L L L L L L L L L L
the nurse do about this situation?
L L L L L
a. Teach the mother how to clean the coin daily and reapply it.
L L L L L L L L L L L
b. Explain to the mother that the coin is not necessary for healing.
L L L L L L L L L L L
,c. Tell the mother to remove the coin, because it could cause an infection.
L L L L L L L L L L L L
d. Teach the mother how to apply a dry sterile dressing in place of the coin.
L L L L L L L L L L L L L L
10. An older patient who follows the Muslim religion is approaching death. The family
L L L L L L L L L L L L L L
says the patients bed should be turned toward the opposite wall, so it can face Mecca to ensure
L L L L L L L L L L L L L L L L L L
an easier passage into the next life. The wall they want the bed to face has wall suction and
L L L L L L L L L L L L L L L L L L L
oxygen, which the patient is using. Which action by the nurse is appropriate?
L L L L L L L L L L L L
a. Get permission from the physician to move the bed.
L L L L L L L L
b. Rearrange the furniture to accommodate the request. L L L L L L
c. Tell them you will move the bed when the patient is closer to death.
L L L L L L L L L L L L L
d. Tell them it is impossible because of the short tubing on the oxygen and suction.
L L L L L L L L L L L L L L
L L 11. A patient of northern European descent recovering from surgery denies postoperative
L L L L L L L L L L L L
pain; however, vital signs indicate an elevated pulse and blood pressure. The patient refuses to
L L L L L L L L L L L L L L L
move in bed. Which nursing action would best ensure comfort and timely discharge?
L L L L L L L L L L L L
a. Give the pain medicine as prescribed.
L L L L L
b. Ask the physician to prescribe the analgesics around the clock.
L L L L L L L L L
c. Explain that the pain medicine will help prevent complications.
L L L L L L L L
d. Respect the patients denial of pain, and do not encourage the pain medicine.
L L L L L L L L L L L L
12. A nurse who emigrated from China begins working on a medical unit. The preceptor
L L L L L L L L L L L L L L L
explains the unit routines, including the medication administration system. When the preceptor
L L L L L L L L L L L L
asks if the nurse understands, the answer is always: Yes, I understand. What should the preceptor
L L L L L L L L L L L L L L L L
do to measure the nurses comprehension?
L L L L L
a. Give the nurse a medication quiz.
L L L L L
b. Have the nurse repeat the instructions.
L L L L L
c. Have the nurse demonstrate the procedures.
L L L L L
d. Ask the nurse which information is hard to understand.
L L L L L L L L
13. A 52-year-old from Haiti is hospitalized with heart failure and wants to have a voodoo
L L L L L L L L L L L L L L L L
practitioner visit to say prayers. How should the nurse respond to this request?
L L L L L L L L L L L L
a. Report the request to the physician immediately.
L L L L L L
b. Tell the patient that this is not permitted during hospitalization.
L L L L L L L L L
c. Tell the patient it is okay for the voodoo practitioner to say prayers.
L L L L L L L L L L L L
d. Have the patient meet with the voodoo practitioner in the hospital lobby.
L L L L L L L L L L L
14. The nurse is caring for a patient from a non-English speaking culture. While providing
L L L L L L L L L L L L L L L
care, the nurse shows an appreciation for and attention to arts, music, crafts, clothing, and foods
L L L L L L L L L L L L L L L
, belonging to the patients culture. What did the nurse demonstrate while caring for this patient?
L L L L L L L L L L L L L L
a. Cultural beliefs L
b. Cultural awareness L
c. Cultural sensitivity L
d. Cultural competence L
15. A female Caucasian nurse, overhead discussing a patient from another culture, asks
L L L L L L L L L L L L L
why the patient wants to see a practitioner from his own culture, since everyone sees physicians
L L L L L L L L L L L L L L L L
when they are ill. What characteristic is the nurse exhibiting?
L L L L L L L L L
a. Stereotyping
b. Ethnocentrism
c. Cultural sensitivity L
d. Cultural generalization L
16. During an assessment, the nurse determines that a patient from a non-English speaking
L L L L L L L L L L L L L L
culture practices activities that are past-oriented. What behavior did the nurse assess in this
L L L L L L L L L L L L L L
patient?
a. Investing time and money L L L
b. Enjoying each day as it comes L L L L L
c. Worshipping ancestors and maintaining traditions L L L L
d. Learning from the past to avoid making the same mistakes in the future
L L L L L L L L L L L L
17. The nurse notes that a patient of Arab descent is not eating anything on the meal trays.
L L L L L L L L L L L L L L L L L L
What should the nurse do about this situation?
L L L L L L L
a. Wait for the patient to ask for specific foods.
L L L L L L L L
b. Ask if the patient has special food preferences.
L L L L L L L
c. Consult with a physician of Arab descent on staff.
L L L L L L L L
d. Contact the dietitian to find out what patients of Arab descent patients like to eat.
L L L L L L L L L L L L L L
18. The mother of a 6-year-old Vietnamese child admitted with pneumonia is rubbing a
L L L L L L L L L L L L L L
coin on the childs back. The coin leaves red marks. What should the nurse do about this
L L L L L L L L L L L L L L L L L
observation?
a. Report the possibility of child abuse.
L L L L L
b. Do not allow the mother to be alone with her child.
L L L L L L L L L L
c. Explain to the mother that she cannot do this in the hospital.
L L L L L L L L L L L
d. Add a statement to the care plan that the family practices coining.
L L L L L L L L L L L
19. The family of an older Arab-American patient does not want the patient to be informed
L L L L L L L L L L L L L L L