Iggy 4-5-9 Flashcards
To become culturally competent when working with Hispanic clients, which action should the nurse take first?
A) Identify the cultural practices of your own culture. B) Learn how to say some health care terms in Spanish. C) Find out how to use telephonic interpretation services. D) Study common folk medicines used by Hispanic people.
A
Correct: Becoming culturally competent requires nurses to become familiar with their own cultural heritage.
What is the goal of the Healthy People 2020 program?
A) Ensuring that everyone lives a healthy life B) Improving cultural sensitivity C) Increasing the quality of a healthy life and eliminating health disparities D) Providing research on healthy lifestyles
C
Correct: The goal of Healthy People 2020 is to decrease disparities in health and health care by eliminating differences in the health status of racial and ethnic minorities while trying continually to improve the overall health of all American people.
In caring for the American Indian client, which principle does the nurse adopt to respect the client’s cultural practices?
A) Allows the client to wear the "hand of God" amulet B) Limits direct eye contact with the client C) Ensures that the client's caregivers are female D) Allows the client's family to make all decisions
B
Correct: Eye contact may be interpreted differently depending on the client’s cultural background. American Indians may find it offensive to make direct eye contact.
The student nurse assumes that all American Indian clients would prefer folk medicine. What is this student nurse lacking?
A) Culture B) Cultural diversity C) Cultural competence D) Cultural sensitivity
D
Correct: Cultural sensitivity refers to an awareness and appreciation of cultural differences, thus avoiding stereotyping and biased, negative, impolite, and offensive language and actions when interacting with people of diverse cultures.
In assessing the new client, which question accurately assesses important cultural practices?
A)"Do you avoid certain foods in your culture?" B) "What role does spirituality play in your life?" C) "What is your culture?" D)"Do you have a living will?"
B
Correct: This question is appropriately open-ended, does not address the client’s culture directly, and allows the client to provide only as much information as he or she wishes.
Certain health care issues are often overlooked for lesbian women because of health care provider discrimination. Which assessment question addresses an overlooked issue for the lesbian client who is being assessed as part of an occupational health review?
A) "Do you practice safe sex?" B) "Do you smoke?" C) "When was your last flu shot?" D) "When was your last Pap test?"
D
Correct: Women who identify as lesbians report experiencing health care provider discrimination and therefore may avoid routine preventive care such as Pap smears and mammograms.
Which groups may not respond as therapeutically as expected to thiazide diuretic therapy to lower blood pressure?
A) African Americans B) Alcoholics C) Euro-Americans D) Older adults
B
Correct: Alcoholics may have lower levels of electrolytes due to the chronic alcohol in the blood; they may have a negative response to use of thiazide diuretics when administered.
The Christian client is struggling with a diagnosis and says, “Why is life so unfair?” What health care team member does the nurse ask to provide support?
A) Client's family B) Physician C) Hospital chaplain D) Psychiatrist
C
Correct: Chaplains have the time and expertise to manage spiritual distress, no matter what the client’s religious preference.
Which folk medicine treatment does the nurse expect to see while caring for clients in West Virginia?
A) Acupuncture B) Wearing the hand of God amulet C) Use of clay for healing D) Use of curanderos
C
Correct: Use of clay for healing is common in some parts of southeastern United States and Appalachia (e.g., West Virginia).
Which type of communication practice is acceptable when caring for clients who do not speak English?
A) Ask a family member to translate. B) Arrange for an interpreter to communicate with the client. C) Enunciate carefully and speak slowly. D) Stand close to the client when speaking to him or her.
B
Correct: Interpreters who are familiar with health and health care are the best communication resource for non-English-speaking clients.
In the role of client advocate, what does the nurse do first for a client who reports pain?
A) Administers pain medication B) Assesses the level of pain C) Believes the client's report of pain D) Calls the provider for a medication order
C
Correct: The nurse’s primary role in pain management is to advocate for the client by believing reports of pain.
A nurse is preparing a client for home care pain management following discharge. Which intervention does the nurse implement?
A) Discusses pain-relieving strategies on the day of discharge B) Discusses home care only with the client's family, not with the client C) Offers flexibility in home management of the client's current regimen D) Offers information about end-of-life pain control management
C
Correct: The nurse’s primary role in pain management is to advocate for the client by believing reports of pain.
A client being discharged after hip replacement says, “I am going to use hypnosis instead of medication to manage my pain. I believe in mind over body.” How does the nurse respond?
A)"I will cancel your medication order." B) "That sounds like a great plan; can you tell me more about it?" C) "That sounds like a wonderful idea; and I think it will definitely work!'' D) "Your plan will not work; people with your type of pain need narcotics.''"
B
Correct: Complementary and alternative therapies should supplement, not replace, medication management. The nurse needs to obtain more data about the client’s plan.
When assessing a client for pain, acute or chronic, what question does the nurse ask the client to obtain the most data?
A) "Did someone do this to you?" B) "Does it hurt badly?" C) "Is the pain really that bad?" D) "When does it hurt?"
D
Correct: This response helps determine precipitating factors to identify the source of pain. It is an open-ended question that requires a descriptive response.
A postoperative client is requesting medication for pain every 4 hours. In planning effective pain management, what assessment question does the nurse ask the client before administering the medication?
A) "Are you bleeding?" B) "Are you really hurting every 4 hours?" C) "Is your pain controlled between doses?" D) "What do you do for pain when you're at home?"
C
Correct: Asking the client about the frequency of pain and how the pain is being controlled helps in formulating an effective pain management plan.
A client with extensive burn injuries is to be weaned from long-term opioid use. What type of opioid dependence does the nurse expect this client to have?
A) Addiction B) Equianalgesia C) Physical dependence D) Pseudoaddiction
C
Correct: Physical dependence occurs in everyone who takes opioids over a period of time. When it is necessary to discontinue opioid analgesia for the client who is opioid dependent, slow tapering (weaning) of the drug dosage lessens or alleviates physical withdrawal symptoms.
A client with cancer who is taking pain medication states, “I am still having pain.” During the assessment, the client does not exhibit any physical manifestations of pain. What does the nurse do next?
A) Decreases the client's standard pain medication dose B) Gives the client a placebo and monitors the outcome C) Gives the pain medication as requested D) Withholds the pain medication
C
Correct: Both types of chronic pain (chronic cancer pain and chronic non-cancer pain) do not cause sympathetic reactions. Therefore, some clients do not appear to be in pain, even when they are. Clients with cancer tend to know what medication works for them. The nurse needs to follow the protocol for the client regardless of the client’s responses when it is chronic cancer pain.
A client with cancer who is taking pain medication states, “I am still having pain.” During the assessment, the client does not exhibit any physical manifestations of pain. What does the nurse do next?
A) Decreases the client's standard pain medication dose B) Gives the client a placebo and monitors the outcome C) Gives the pain medication as requested D) Withholds the pain medication
A
Correct: Non-opioid analgesics such as Tylenol are the first line of therapy for mild to moderate pain.
A client had surgery two (2) days ago and reports having a moderate amount of pain, stating that it is “a 7 on a 1 to 10 scale” of intensity. What intervention has the highest priority in the client’s nursing care plan?
A) Encouraging diversional activities B) Incorporating ADLs as soon as possible C) Teaching key points of the relaxation response D) Using preemptive analgesia
D
Correct: Use of preemptive analgesia is a technique designed to decrease pain in the postoperative period, decrease the requirements for a postoperative analgesic, prevent morbidity, and decrease the hospital stay.
A cancer client is receiving low-dose oral morphine but is reporting both “breakthrough” pain and constipation. What intervention does the nurse implement?
A) Administers ordered docusate sodium (Colace) and gabapentin (Neurontin) B) Decreases the morphine (morphine sulfate) dosage for the client C) Gives the client a Fleet (sodium biphosphate) enema D) Records the client's bowel movements
A
Correct: Docusate is a stool softener, and gabapentin is an adjuvant for breakthrough pain.
A postoperative client is vomiting and states, “I am having a lot of pain-about a 7 on a scale of 1 to 10.” Which route of administration does the nurse choose to administer an analgesic to the client?
A) Intravenous B) Oral C) Rectal D) Transdermal
A
Correct: The intravenous route is the best choice for fast relief of nausea and pain.
A client with chronic pain feels no relief with high-dose opioids and says, “I just can’t manage living right now.” What intervention does the nurse anticipate the health care provider will order for this client?
A) Adding acetaminophen (Tylenol) B) Adding sertraline (Zoloft) as adjuvant therapy C) Increasing the opioid dose to control the pain D) Replacing the opioid with sertraline (Zoloft) for depression
B
Correct: Both tricyclic and other antidepressants such as sertraline (Zoloft) help treat the depression that can accompany chronic pain. They also stimulate the activity of endogenous opiates (endorphins and enkephalins) by increasing levels of the neurotransmitter serotonin. Perhaps the greatest advantage of this group of drugs is their sedative effect.
A client who is using patient-controlled analgesia (PCA) is asleep. The nurse observes a family member pushing the PCA button for the sleeping client. What does the nurse say to the visitor?
A) "Please allow the client to push the button when needed." B) "Please don't touch any equipment in the client's room." C) "Thank you. I am sure the client appreciated that." D) "The client is asleep and is not in pain."
A
Correct: The “PC” in “PCA” means “patient-controlled,” so having someone else push the button and administer analgesia defeats the purpose. More important, this action could cause oversedation and possible serious safety issues.
A postoperative client is receiving epidural analgesia and reports itching. What does the nurse do next?
A) Gives a small amount of naloxone (Narcan) B) Gives diphenhydramine (Benadryl) C) Gives an antiemetic D) Calls the surgeon
A
Correct: Pruritus (itching) is a common side effect of epidural opioids and is first treated with a small amount of naloxone (Narcan).
