Nurs 333 Exam 3 WKU, Nursing 333, Fundamentals, Exam 3, Chapters 42, 16, 17, 18, 19, 20, 26, 36, 35, 9, and terms

A 6-month-old child from Guatemala was adopted by an American family in Indiana. The child's socialization into the American midwestern culture is best described as: A) Assimilation. B) Acculturation. C) Biculturalism. D) Enculturation. Enculturation. A 46-year-old woman from Bosnia came to the United States 6 years ago. Although she did not celebrate Christmas when she lived in Bosnia, she celebrates Christmas with her family now. This woman has experienced assimilation into the culture of the United States because she: A) Chose to be bicultural. B) Adapted to and adopted the American culture. C) Had an extremely negative experience with the American culture. D) Gave up part of her ethnic identity in favor of the American culture. Adapted to and adopted the American culture. 00:02 01:10 To enhance their cultural awareness, nursing students need to make an in-depth self-examination of their own: A) Motivation and commitment to caring. B) Social, cultural, and biophysical factors. C) Engagement in cross-cultural interactions. D) Background, recognizing her biases and prejudices. Background, recognizing her biases and prejudices. Which of the following is required in the delivery of culturally congruent care? A) Learning about vast cultures B) Motivation and commitment to caring C) Influencing treatment and care of patients D) Acquiring specific knowledge, skills, and attitudes Acquiring specific knowledge, skills, and attitudes A registered nurse is admitting a patient of French heritage to the hospital. Which question asked by the nurse indicates that the nurse is stereotyping the patient? A) "What are your dietary preferences?" B) "What time do you typically go to bed?" C) "Do you bathe and use deodorant more than one time a week?" D) "Do you have any health issues that we should know about?" "Do you bathe and use deodorant more than one time a week?" When action is taken on one's prejudices: A) Discrimination occurs. B) Delivery of culturally congruent care is ensured. C) Effective intercultural communication develops. D) Sufficient comparative knowledge of diverse groups is obtained. Discrimination occurs. A nursing student is doing a community health rotation in an inner-city public health department. The student investigates sociodemographic and health data of the people served by the health department, and detects disparities in health outcomes between the rich and poor. This is an example of a(n): A) Illness attributed to natural and biological forces. B) Creation of the student's interpretation and descriptions of the data. C) Influence of socioeconomic factors in morbidity and mortality. D) Combination of naturalistic, religious, and supernatural modalities. Influence of socioeconomic factors in morbidity and mortality. Culture strongly influences pain expression and need for pain medication. However, cultural pain is: A) Not expressed verbally or physically. B) Expressed only to others from a similar culture. C) Usually more intense than physical pain. D) Suffered by a patient whose valued way of life is disregarded by practitioners. Suffered by a patient whose valued way of life is disregarded by practitioners. Which of the following best represents the dominant values in American society on individual autonomy and self-determination? A) Physician orders B) Advance directive C) Durable power of attorney D) Court-appointed guardian Advance directive The nurse at an outpatient clinic asks a patient who is Chinese American with newly diagnosed hypertension if he is limiting his sodium intake as directed. The patient does not make eye contact with the nurse but nods his head. What should the nurse do next? A) Ask the patient how much salt he is consuming each day B) Discuss the health implications of sodium and hypertension C) Remind the patient that many foods such as soy sauce contain "hidden" sodium D) Suggest some low-sodium dietary alternatives Ask the patient how much salt he is consuming each day A female Jamaican immigrant has been late to her last two clinic visits, which in turn had to be rescheduled. The best action that the nurse could take to prevent the patient from being late to her next appointment is: A) Give her a copy of the city bus schedule. B) Call her the day before her appointment as a reminder to be on time. C) Explore what has prevented her from being at the clinic in time for her appointment. D) Refer her to a clinic that is closer to her home. Explore what has prevented her from being at the clinic in time for her appointment. A nursing student is taking postoperative vital signs in the postanesthesia care unit. She knows that some ethnic groups are more prone to genetic disorders. Which of the following patients is most at risk for developing malignant hypertension? A) Ashkenazi Jew B) Chinese American C) African American D) Filipino African American Upgrade to remove ads Only $35.99/year A community health nurse is making a healthy baby visit to a new mother who recently emigrated to the United States from Ghana. When discussing contraceptives with the new mom, the mother states that she won't have to worry about getting pregnant for the time being. The nurse understands that the mom most likely made this statement because: A) She won't resume sexual relations until her baby is weaned. B) She is taking the medroxyprogesterone (Depo-Provera) shot. C) Her husband was recently deployed to Afghanistan. D) She has access to free condoms from the clinic. She won't resume sexual relations until her baby is weaned. During their clinical post-conference meeting, several nursing students were discussing their patients with their instructor. One student from a middle-class family shared that her patient was homeless. This is an example of caring for a patient from a different: A) Ethnicity. B) Culture. C) Heritage. D) Religion. Culture. When interviewing a Native American patient on admission to the hospital emergency department, which questions are appropriate for the nurse to ask? (Select all that apply.) A) Do you use any folk remedies? B) Do you have a family physician? C) Do you use a Shaman? D) Does your family have a history of alcohol abuse? Do you use any folk remedies? Do you have a family physician? Do you use a Shaman? Acculturation Process of adapting to and adopting a new culture. Assimilation To become absorbed into another culture and adopt its characteristics. Culture Integrated patterns of human behavior that include the language, thoughts, communications, actions, customs, beliefs, values, and institutions of racial, ethnic, religious, or social groups. Cultural care accommodation or negotiation Adapting or negotiating with the patient/families to achieve beneficial or satisfying health outcomes. Cultural care preservation or maintenance Retaining and/or preserving relevant care values so patients are able to maintain their well-being, recover from illness, or face handicaps and/or death. Cultural care repatterning or restructuring Reordering, changing, or greatly modifying a patient's/family's customs for a new, different, and beneficial health care pattern. Cultural competence Process in which the health care professional continually strives to achieve the ability and availability to work effectively with individuals, families, and communities. Cultural imposition Using one's own values and customs as an absolute guide in interpreting behaviors. Cultural pain Feeling that a patient has after a health care worker disregards the patient's valued way of life. Culturally congruent care Care that fits people's valued life patterns and sets of meanings generated from the people themselves. Sometimes this differs from the professionals' perspective on care. Emic worldview Insider or native perspective. Ethnicity Shared identity related to social and cultural heritage such as values, language, geographical space, and racial characteristics. Ethnohistory Significant historical experiences of a particular group. Ethnocentrism Tendency to hold one's own way of life as superior to that of others. Etic worldview Outsider's perspective. Fictive Nonblood kin; considered family in some collective cultures. Matrilineal Kinship that is limited to only the mother's side. Subcultures Various ethnic, religious, and other groups with distinct characteristics from the dominant culture. Transcultural nursing Distinct discipline developed by Leininger that focuses on the comparative study of cultures to understand similarities and differences among groups of people. What is the dominant culture in the United States? Anglo-American with origins from Western Europe Enculturation Socialization into one's primary culture as a child Biculturalism occurs when an individual identifies equally with two or more cultures Cultural awareness An in-depth self-examination of one's own background, recognizing biases, prejudices, and assumptions about other people Cultural knowledge Obtaining sufficient comparative knowledge of diverse groups, including their indigenous values, health beliefs, care practices, worldview, and bicultural ecology Cultural skills Being able to assess social, cultural, and biophysical factors influencing treatment and care of patients Cultural encounters Engaging in cross-cultural interactions that provide learning of other cultures and opportunities for effective intercultural communication development Cultural desire The motivation and commitment to caring that moves an individual to learn from others, accept the role as learner, be open and accepting of cultural differences, and build on cultural similarities Naturalistic practitioners attribute illness to natural, impersonal, and biological forces that cause alteration in the equilibrium of the human body. Healing emphasizes use of naturalistic modalities, including herbs, chemicals, heat, cold, massage, and surgery. Personalistic practitioners believe that an external agent, which can be human (i.e., sorcerer) or nonhuman (e.g., ghosts, evil, or deity), causes health and illness. Emphasize the importance of humans' relationships with others, both living and deceased, and with their deities. Culture bound syndromes Illnesses restricted to a particular culture or group because of its psychosocial characteristics. Herbalist Combination of plant, animal, and mineral products in restoring balance based on yin/yang concepts Acupuncturist Yin treatment using needles to restore balance and flow of qi; yang treatment using moxibustion or heat with acupuncture possibly indicated to restore yin/yang balance Fortune Teller Consultation to foretell outcomes of plans and seek spiritual advice to enhance good fortune and deal with misfortune. Shaman Combination of prayers, chanting, and herbs to treat illnesses caused by supernatural, psychological, and physical factors Ayurvedic practitioner Combination of dietary, herbal, and other naturalistic therapies to prevent and treat illness Granny midwife Consultation in diagnosing and treating common illnesses and care of women in childbirth and children Spiritualist Spiritual advising, counseling, and praying to treat illness or cope with personal and psychosocial problems Voodoo practitioners Hougan (male) Mambo (female) Combination of herbs, drumming, and symbolic offerings to cure illness, remove curses, and protect a person Curandero/a Combination of prayers, herbs, and other rituals to treat traditional illnesses, especially in children Parteras Lay midwives Assistance for women in childbirth and newborn care Yerbero Consultation for herbal treatment of traditional illnesses Sabador Massage and manipulation of bones and joints used to treat a variety of ailments, including musculoskeletal conditions Espiritista Foretelling of future and interpretation of dreams; combination of prayers, herbs, potions, amulets, and prayers for curing illnesses, including witchcraft Santero/a Combination of prayers, symbolic offerings, herbs, potions, and amulets against witchcraft and curses Patrilineal Kinship that is limited to only the father's side. An emergency department nurse is caring for a patient who was severely injured in a car accident. The patient's family is in the waiting room. They are crying softly. The nurse sits down next to the family, takes the mother's hand, and says, "I can only imagine how you're feeling. What can I do to help you feel more at peace right now? " In this example the nurse is demonstrating: A) Prayer. B) Presence. C) Coaching. D) Instilling hope. Presence. A patient states that he does not believe in the existence of God. This patient most likely is an: A) Academic. B) Atheist. C) Agnostic. D) Anarchist. Atheist. As the nurse cares for a patient in an outpatient clinic, the patient states that he recently lost his position as a volunteer coordinator at a local community center. He expresses that he is angry with his former boss and with God. The nurse knows that the priority at this time is to assess the patient's spirituality in relation to his: A) Vocation. B) Life satisfaction. C) Fellowship and community. D) Connectedness with his family and co-workers. Vocation. A patient who is hospitalized with heart failure states that she sees her illness as an opportunity and a challenge. Despite her illness, she is still able to see that life is worth living. This is an example of: A) Hope. B) Faith. C) Values. D) Connectedness. Hope. Which of the following statements made by an older adult whose husband recently died most indicates the need for follow-up by the nurse? A) "I planted a tree at church in my husband's honor." B) "I have been unable to talk with my children lately." C) "My friends think that I need to go to a grief support group." D) "I believe that someday I'll meet my husband in heaven." "I have been unable to talk with my children lately." Which of the following nursing interventions support(s) a healing relationship with a patient? (Select all that apply): A) Praying with the patient B) Giving pain medications before a painful procedure C) Telling a patient that it is time to take a bath before family arrive to visit D) Making the patient's bed following hospital protocol E) Helping a patient see positive aspects related to a chronic illness Praying with the patient Helping a patient see positive aspects related to a chronic illness A patient expresses the desire to learn how to meditate. What does the nurse need to do first? A) Answer the patient's questions B) Help the patient get into a comfortable position C) Select a teaching environment that is free from distractions D) Encourage the patient to meditate for 10 to 20 minutes 2 times a day Select a teaching environment that is free from distractions An older adult is receiving hospice care. Which nursing intervention(s) help the patient cope with feelings related to death and dying? (Select all that apply.) A) Teaching the patient how to use guided imagery B) Encouraging the family to visit the patient frequently C) Taking the patient's vital signs every time the nurse visits D) Teaching the patient how to manage pain and take pain medications E) Helping the patient put significant photographs in a scrapbook for the family Teaching the patient how to use guided imagery Encouraging the family to visit the patient frequently Helping the patient put significant photographs in a scrapbook for the family Which of the following questions would best assess a patient's level of connectedness? A) What gives your life meaning? B) Which aspects of your spirituality would you like to discuss right now? C) Who do you consider to be the most important person in your life at this time? D) How do you feel about the accomplishments you've made in your life so far? Who do you consider to be the most important person in your life at this time? A nurse is using the B-E-L-I-E-F tool to complete a spiritual assessment on a 12-year-old male who has recently been diagnosed with acute lymphocytic leukemia. Which of the following questions would the nurse use to assess the child's involvement in the spiritual community? A) Which church do you attend? B) Which sports do you like to play? C) Are there any foods you cannot eat? D) In which church activities do you participate? In which church activities do you participate? A nurse is caring for a patient who refuses to eat until after the sun sets. Which religion does this patient most likely practice? A) Islam B) Sikhism C) Hinduism D) Catholicism Islam A Catholic patient with diabetes receives the following items on his meal tray on the Friday before Easter. For which of the foods does the nurse offer to substitute? A) Apple sauce B) Cheese and crackers C) Spaghetti with meat sauce D) Tossed salad with ranch dressing Spaghetti with meat sauce A nurse is working in a health clinic on a Navajo reservation. He or she plans care for the patients knowing which of the following is true? A) The patients may not be on time for their appointments. B) The patients most likely do not trust the doctors and nurses. C) The patients probably are not comfortable if they have to remove their undergarments. D) Terminally ill patients probably want to receive the sacrament, the anointing of the sick. The patients may not be on time for their appointments. A 62-year-old male patient has just been told he has a terminal illness. Which of the following statements supports a nursing diagnosis of spiritual distress related to diagnosis of terminal illness? A) "I have nothing to live for now." B) "What will happen to my wife when I die?" C) "How much longer do I have to live?" D) "I need to go to church and pray for a miracle." "I have nothing to live for now." Which of the following would be the most appropriate outcome for a patient who has a nursing diagnosis of spiritual distress related to loneliness? A) Encourage the patient to meditate 2 to 3 times a week. B) The patient will set up a time to speak to a close friend in 1 week. C) Encourage the patient to phone his brother and set up a time to go out for dinner. D) The patient will experience greater connections with family members in 2 months. The patient will set up a time to speak to a close friend in 1 week. Agnostic Individual who believes that any ultimate reality is unknown or unknowable. Atheist Individual who does not believe in the existence of God. Connectedness Having close spiritual relationships with oneself, others, and God or another spiritual being. Faith Set of beliefs and a way of relating to self, others, and a Supreme Being. Holistic Of or pertaining to the whole; considering all factors. Hope Confident but uncertain expectation of achieving a future goal. Self-transcendence Sense of authentically connecting to one's inner self. Spiritual distress State of being out of harmony with a system of beliefs, a Supreme Being, or God. Spirituality Spiritual dimension of a person, including the relationship with humanity, nature, and a supreme being. Spiritual well being Individual's spirituality that enables a person to love, have faith and hope, seek meaning in life, and nurture relationships with others. Transcendence The belief that there is a force outside of and greater than the person that exists beyond the material world. Religion the system of organized beliefs and worship that a person practices to outwardly express spirituality Near Death Experience psychological phenomenon of people who either have been close to clinical death or have recovered after being declared dead. It is not associated with a mental disorder. BELIEF Assessment Belief system; Ethics or values; Lifestyle; Involvement in a spiritual community; Education; Future events Hinduism Allow time for prayer and purity rituals. Allow use of amulets, rituals, and symbols. Sikhism Provide time for devotional prayer. Allow use of religious symbols. Buddhism Health is an important part of life. Good health is maintained by caring for self and others. Medications are not always accepted because of belief that chemical substances in the body are harmful. Islam Women prefer female health care providers. During month of Ramadan Muslims do not eat until after the sun goes down. Health and spirituality are connected. Family and friends visit during time of illness. They usually do not consider organ transplantation or donation and postmortem examinations. Judaism Believe that it is important to stay healthy. They expect the nurse to provide competent health care. Allow patients to express their feelings. Allow family to stay with dying patient. Christianity Usually in favor of organ donation. Health is important to maintain. Allow time for patients to pray by themselves, with family or friends. Navajos Prefer holistic approach to health care. They often are not on time for appointments. Promote physical, mental, spiritual, and social health of persons, families, and communities. Allow family members to visit. Provide teaching about wellness, not disease prevention, when possible. Appalachians They become anxious in unfamiliar settings. Encourage communication with family and friends when ill. Three factors are evident when a healing relationship develops between nurse and patient: Mobilizing hope for the nurse and patient Finding an interpretation or understanding of the illness, pain, anxiety, or other stressful emotion that is acceptable to the patient Helping the patient use social, emotional, and spiritual resources Regarding the request for organ and tissue donation at the time of death, the nurse needs to be aware that: A) Specially educated personnel make requests. B) Requests are usually made by the nurse caring for the patient at the time of death. C) Only patients who have given prior instruction regarding donation become donors. D) Professionals need to be very selective in whom they ask for organ and tissue donation. Specially educated personnel make requests. The nurse notes that a woman who recently began cancer treatment appears quiet and withdrawn, states that she does not believe the treatments will make any difference, does not ask about her progress, and missed two chemotherapy sessions. Based on the above assessment data, the nurse gathers more information to consider making which of the following nursing diagnoses? A) Anxiety B) Hopelessness C) Spiritual distress D) Complicated grieving Hopelessness A family member asks a home care nurse what he should do if the patient's serious chronic illness worsens even with increased medical interventions. How does the nurse best begin a conversation about the goals of care at the end of life? A) Encourage the family member to think more positively about the patient's new therapy B) Avoid the discussion because it has to do with medical, not nursing, diagnoses C) Initiate a discussion about advance directives with the patient, family, and health care team D) Begin the discussion by asking the patient to identify his or her beliefs about the goals of care while the family member is present Begin the discussion by asking the patient to identify his or her beliefs about the goals of care while the family member is present Which of the following nursing actions best reflects sensitivity to cultural differences related to end-of-life care? A) Practice honesty with everyone, telling patients about their illness, even if the news is not good. B) Ask family members if they prefer to help with the care of the body after death. C) Provide postmortem care at the time of death to relieve family members of this difficult job. D) Value patient self-determination, understanding that each person makes his or her own decisions. Ask family members if they prefer to help with the care of the body after death. A young man is diagnosed with a serious, life-changing illness. His conversations during his first 2 days of hospitalization are abrupt, superficial, and unrelated to his illness. What understanding about communication enhances your therapeutic communication with this patient? A) Younger patients are usually less talkative about their diagnosis. B) All patients benefit by talking about their feelings with another person. C) Avoid discussing illness-related topics with quiet patients. D) Remain alert for signals that the patient wants to discuss his illness. Remain alert for signals that the patient wants to discuss his illness. A woman experiences the loss of a very early-term pregnancy. Her friends do not mention the loss, and someone suggests to her that she can "always try again." The woman feels confusion over her sadness and stops talking about it with others. What type of grief response is she most likely experiencing? A) Delayed B) Anticipated C) Exaggerated D) Disenfranchised Disenfranchised A nurse has the responsibility of managing a deceased patient's post-mortem care. Arrange the steps for post-mortem care in the proper order. 1. Bathe the body of the deceased. 2. Collect any needed specimens. 3. Remove all tubes and indwelling lines. 4. Position the body for family visit/viewing. 5. Speak to the family members about their possible participation. 6. Confirm that request for organ/tissue donation and/or autopsy has been made. 7. Notify a support person (e.g., spiritual care provider, bereavement specialist) for the family. 8. Accurately tag the body, indicating the identity of the deceased and safety issues regarding infection control. 9. Elevate the head of the bed. 6-9-2-5-7-3-1-4-8 A family member of a recently deceased patient talks casually with the nurse at the time of the patient ' s death and expresses relief that she will not have to visit at the hospital anymore. What theoretical description of grief best applies to this family member? A) Denial B) Anticipatory grief C) Dysfunctional grief D) Yearning and searching Anticipatory grief A self-care goal you set when caring for dying and grieving patients includes: A) Learning not to take losses so seriously. B) Limiting involvement with patients who are grieving. C) Maintaining life balance and reflecting on the meaning of your work. D) Admitting that you are not well suited to care for people who are grieving and asking the charge nurse not to assign you to care for these patients. Maintaining life balance and reflecting on the meaning of your work. A nurse is providing postmortem care. Which action is the priority? A) Locating the patient's clothing B) Providing culturally and religiously sensitive care in body preparation C) Transporting the body to the morgue as soon as possible to prevent body decomposition D) Providing all postmortem care to protect the family of the deceased from having to see the body Providing culturally and religiously sensitive care in body preparation Which approach to helping grieving people is most consistent with postmodern grief theories? A) Help the patient identify the tasks to be accomplished during his or her grief. B) Encourage people to recognize stages of grieving in anticipation of what is to come. C) Listen carefully to a person's story of how his or her grief experience is unfolding. D) Offer general grief timelines to help the person know when a phase will pass. Listen carefully to a person's story of how his or her grief experience is unfolding. A patient who has a serious, life-limiting chronic illness wants to continue to engage in self-care and live as normally as possible. Which of the following nursing responses reflect a helpful understanding of patient self-care at the end of life? A) "Learning to accept that you can't perform some activities anymore will bring you more acceptance and peace." B) "Which activities are most important to you, and how can you continue to do them?" C) "People in your life want to help you with things; allow them to do what they want for you." D) "Spending more of your time resting or reading will conserve your energy." "Which activities are most important to you, and how can you continue to do them?" The nurse suggests that a patient receive a palliative care consultation for symptom management related to anxiety and increasing pain. A family member asks the nurse if this means that the patient is dying and is now "in hospice." What does the nurse tell the family member about palliative care? (Select all that apply.) A) Hospice and palliative care are the same thing. B) Palliative care is for any patient, any time, any disease, in any setting. C) Palliative care strategies are primarily designed to treat the patient's illness. D) Palliative care interventions relieve the symptoms of illness and treatment. Palliative care is for any patient, any time, any disease, in any setting. Palliative care interventions relieve the symptoms of illness and treatment. You have identified three nursing diagnoses for a patient who is having anxiety and hopelessness as a result of a loss. Which general approach do you take to prioritize the nursing diagnoses? (Select all that apply.) A) Use family members and physician orders as primary resources for prioritizing your actions. B) Address the nursing diagnosis that most affects the medical diagnosis. C) Ask the patient to identify the most distressing symptom and first address that diagnosis. D) Use nursing knowledge to address the problem that is the underlying cause of other diagnoses. Ask the patient to identify the most distressing symptom and first address that diagnosis. Use nursing knowledge to address the problem that is the underlying cause of other diagnoses. Regarding grief in older adults, which understanding helps guide your relationship with an elderly patient? A) Older adults have usually sustained many losses in life, which influence the current loss. B) Older adults with a poor memory experience grief less intensely. C) Older adults generally handle loss better because they have more experience with it. D) Social support is less important because an older adult's circle of friends has become smaller. Older adults have usually sustained many losses in life, which influence the current loss. Actual loss Loss of an object, person, body part or function, or emotion that is overt and easily identifiable. anticipatory grief Grief response in which the person begins the grieving process before an actual loss. Bereavement Response to loss through death; a subjective experience that a person suffers after losing a person with whom there has been a significant relationship. Disorganized and despair One of Bowlby's four phases of mourning in which an individual endlessly examines how and why the loss occurred. grief Form of sorrow involving the person's thoughts, feelings, and behaviors that occurs as a response to an actual or perceived loss. Hope Confident but uncertain expectation of achieving a future goal. Hospice System of family-centered care designed to help terminally ill people be comfortable and maintain a satisfactory lifestyle throughout the terminal phase of their illness.