ch 52 Flashcards
The nurse is caring for a Chinese patient diagnosed with cancer who is suffering from pain, yet refuses analgesia administration. What type of health disparities is this patient exhibiting?
a. Avoidable and acceptable
b. Avoidable and unacceptable
c. Unavoidable and acceptable
d. Unavoidable and unacceptable
ANS: B
Health disparities that are avoidable and unacceptable unfortunately occur in healthcare settings and these are the targ ets of interventions. For example, a disparity in cancer pain management exists between Asians and Whites. This difference is attributable to Asian cultural values and attitudes related to cancer pain and pain medication distinguished from the cultural values of Whites. The disparity is avoidable if Asian cancer patients are adequately educated and instructed on cancer pain management strategies including pain medication and complementary and alternative medicine. Also, this disparity is unacceptable because this gives an unnecessary burden of pain to Asian cancer patients that could be easily managed by using existing strategies.
An experienced nurse tells the student nurse, “I have found that most Hispanic immigrants live in unsanitary conditions but are hard workers.” How should the student nurse best classify this statement?
a. Stereotyping
b. Prejudice
c. Discrimination
d. Misinformed
ANS: A
Stereotyping often leads to biased clinical decision making. Stereotyping refers to the process by which people use social categories (e.g., gender or race/ethnicity) in acquiring, processing, and recalling information about others. Both implicit and explicit negative attitudes and stereotypes of healthcare providers significantly shape interactions with patients, influence how information is recalled, and guide expectations and inferences in systematic ways. Stereotyping often occurs subconsciously, unlike prejudice or discrimination. Prejudice, which refers to unjustified negative attitudes based on a person’s group membership, is another source of biased clinical decision making. Discrimination refers to the actual mistreatment of individuals based on race, gender, ethnicity, etc. The nurse is not misinformed as the nurse has practiced for some time and made a statement based on observation and experience.
Which type of health disparities are most frequently encountered by nurses in clinical and community settings?
a. Avoidable and acceptable
b. Avoidable and unacceptable
c. Unavoidable and acceptable
d. Unavoidable and unacceptable
ANS: B
Although there are many types of health disparities, the avoidable and unacceptable health disparities are the ones that healthcare providers, including nurses, frequently encounter in clinical and community settings. Furthermore, these are the health disparities that healthcare providers need to target to intervene.
The nurse is caring for diverse population groups at a health clinic. Which of the following patients demonstrates a potential health disparity group?
a. A 26-year-old woman who is receiving follow-up after a car accident
b. A 30-year-old immigrant who does not speak English
c. A 28-year-old man who needs a tetanus booster
d. A 12-month-old with an appointment for immunizations
ANS: B
Poor health literacy skills are an example of a health disparity that limits an individual’s ability to access or communicate about healthcare needs. Patients who are receiving needed care are not experiencing a gap between health need and actual care.
Which is the best strategy the nurse manager should include when working to reduce healthcare disparities on a medical-surgical unit?
a. Less diverse workforce
b. Increase interpreter availability
c. Authoritarian leadership
d. Annual staff training
ANS: B
Key elements are cultural competence that can reduce health disparities including: a diverse workforce; interpreter availability; finding common ground versus authoritarian leadership; frequent staff training and updating staff as needed throughout the year.
A new nurse requires further teaching when failing to identify which practice as a health disparity?
a. Annual mammogram
b. Early prenatal care
c. Blood pressure screening
d. Frequent fast food meals
ANS: D
Preventive care, screening, and health promotion activities are not considered health disparities. Examples include mammograms, prenatal care, and blood pressure checks. Frequent fast food meals, containing high fat content, are considered a health disparity due to possible lack of money or access to healthy meals.
Before beginning work on a culturally diverse hospital unit, the nurse should perform which action first?
a. Improve self-awareness of one’s own biases.
b. Attend an anti-discrimination rally or march.
c. Build rapport and trust with the patients.
d. Take a foreign language class.
ANS: A
Before working with culturally diverse groups, the nurse should first identify own biases and assumptions in order to objectively and competently care for patients. Attending a rally or march may not raise awareness of various biases. The nurse should establish rapport and trust when working with patients, after self-awareness is appreciated. Taking a foreign language may be helpful; however the first step is self-awareness.
The nurse who has been hired to work on an oncology unit identifies which group of women as being at highest risk of developing breast cancer?
a. African
b. Caucasian
c. Asian
d. Hispanic
ANS: C
Breast cancer is the most common cancer in Asian women in the United States, but Asian women have relatively lower rates of breast cancer screening than African American and white women in the United States. Furthermore, disparities in breast cancer screening reportedly result from low income, lack of a local mammography center, lack of transportation to a mammography center, lack of a usual healthcare provider, lack of a recommendation from a healthcare provider to get mammography screening, lack of awareness of breast cancer risks and screening methods, and cultural and language differences.
A healthcare provider whose native country is India is explaining the treatment plan to a patient. The patient tells the nurse she is having trouble understanding the provider but is embarrassed about asking to repeat the information over and over. The nurse should assess for which results due to this disparity in provider-patient communication? (Select all that apply.)
a. Patient dissatisfaction
b. Optimal health outcome
c. Poor adherence
d. Increased patient confidence
e. Improved communication
ANS: A, C
When sociocultural differences between healthcare providers and patients are not appreciated or communicated effectively in clinical encounters, patient dissatisfaction, poor adherence, poorer health outcomes, and racial/ethnic disparities in healthcare easily happen.
The nurse in the immunization clinic should place emphasis on educating and reaching which groups about the disease preventing effects of immunizations? (Select all that apply.)
a. Caucasian
b. All individuals living below the federal poverty level regardless of race or ethnicity
c. Low income
d. Parents of children
e. High income
ANS: B, C, D
It is important to reach out to all individuals living below the federal poverty level (parents and children) as they are most likely not to have completed the specified immunization schedule. Research obtained from the Center for Disease Control (CDC) in 2014 suggests that those living below the federal poverty level were less likely to have the full series of vaccination coverage.
