Deck 2 Module 24 Flashcards
The nurse is caring for an African-American client who had a myocardial infarction and is receiving atorvastatin (Lipitor). The nurse assesses the client’s diet to be very high in fat. Which is the best plan by the nurse to improve the client’s diet and reduce the risk that the client may need additional medications?
A) Ask another nurse to speak to him about a low-fat diet.
B) With the client’s permission, discuss the dietary with whoever prepares meals for the family.
C) Consult a dietician to teach the client about low-fat diets.
D) Give the client information specific to African Americans about low-fat diets.
B) With the client’s permission, discuss the dietary with whoever prepares meals for the family.
Rationale:
Every culture has culture-specific diets; the nurse must include the individual in the family who does the meal preparation if a different diet is to be successful. Asking the client about having an African-American nurse speak to him is racist and implies that the nurse cannot understand the dietary needs of an African-American client. At this point, a consult by dietary services is premature. Providing information is a good idea, but the nurse must also teach the client.
The nurse places a client, of Islamic descent, in a treatment room of the emergency department for treatment of abdominal pain and vaginal bleeding. The spouse, speaking for the client, asks that only a female provider examine his wife for the pelvic exam. Which is the most culturally-appropriate statement by the nurse?
A) “Your spouse will be covered with a sheet so it will not matter whether the examiner is male or female.”
B) “The male and female providers both respect privacy.”
C) “The request is unreasonable and cannot be honored.”
D) “Every attempt will be made to honor your request.”
D) “Every attempt will be made to honor your request.”
Rationale:
Many cultures have religious beliefs that prohibit examination by men of the reproductive areas of a female. To provide culturally appropriate care, the nurse must recognize this as a legitimate request and make every attempt to honor this request. Although both male and female staff have professional and ethical responsibilities to respect a client’s privacy, the nurse must still make efforts to meet the request of the client. The response of covering the client or stating the request is unreasonable shows insensitivity to the client’s cultural need.
The nurse is caring for a Chinese client who just had abdominal surgery. The client’s nonverbal cues indicate pain, but the client denies the need for pain medication. Which action by the nurse is appropriate?
A) Seek out a family member to convince the client to take the medication.
B) Consult with the healthcare provider about providing pain medication without the client’s knowledge.
C) Offer the pain medication to the client again, stating that providing comfort is the nurse’s most important responsibility.
D) Allow the client to suffer in silence.
C) Offer the pain medication to the client again, stating that providing comfort is the nurse’s most important responsibility.
Rationale:
Members of the Chinese culture will typically not complain of pain or physical problems because they are taught self-restraint and the priority of the group over individual needs. Many people of this culture will consider refusal of something offered as a gesture of courtesy. The nurse should take these into account and offer the pain medication to the client.
The nurse is reviewing the discharge instructions for administration of home medications with an older adult client. In considering the normal changes experienced with aging, which activity should the nurse incorporate into the teaching plan?
A) Giving written materials to compensate for short-term memory losses
B) Considering holding sessions for longer periods than usual so the client can learn
C) Using tools that repeat the information until the information is understood
D) Providing instruction to relatives so that the client will not need to learn everything
C) Using tools that repeat the information until the information is understood
Rationale:
Normal age-related changes include a slowing of information processing, which results in the need for repetition of information. Short-term memory, or primary memory, remains relatively stable. Assuming the client cannot learn everything is a stereotypical belief about the aging process. Another age-related change includes the inability to maintain sustained attention. Therefore, long teaching sessions would not be appropriate.
A male nurse enters the room of a female client to obtain the client’s vital signs. The client’s spouse appears uncomfortable with the nurse and moves closer to the client. Which action by the nurse is most appropriate?
A) Ask a female staff member to obtain the client’s vital signs.
B) Ask the client’s spouse to leave the client’s room.
C) Perform the intervention without discussion.
D) Explain the procedure to both the client and client’s family member.
D) Explain the procedure to both the client and client’s family member.
Rationale:
The nurse should explain the procedure to both the client and the client’s family member. Asking another staff member to obtain the client’s vital signs is inappropriate. The spouse does not need to leave the client’s room. Performing an intervention without first discussing it and asking for permission may be interpreted as assault. .
