Download Culturally Competent Nursing Care and more Exams Nursing in PDF only on Docsity!
Exam 2 study guide- care management Week 5
Exam 2 2024
Hello Students in an effort to prepare you for Week 5 Exam 2 below is the exam study guide to follow. Chapter 5,6,11,12,27,33 will be tested a total of 50 multiple choice questions will be on the exam. Cultural shock- *Feelings a person experiences when placed in a different culture
- may result in psychological discomfort or disturbances NCLEX
- Upon moving to China, an American-college student is experiencing many new feelings that she associates with her placement in a different culture. What are the feelings experienced by this student? a) Stereotyping b) ethnocentrism c) culture shock d) cultural assimilation Cultural Assimilation: Also called acculturation. When many members LOSE the cultural characteristics that once made them different. Minorities living within a dominant group lose the characteristics that made them different. *Values replaced by those of dominant culture NCLEX
- The nurse practitioner sees patients in a community clinic that is located in a
predominately White neighborhood. After performing assessments on the majority of the patients visiting the clinic, the nurse notes that many of the minority groups living within the neighborhood have lost the cultural characteristics that made them different. What is the term for this process? a. Cultural assimilation b. Cultural imposition c. Culture shock d. Ethnocentrism
- Which of the following occurs when members of a minority group, living with a dominant group, begins to blend in and lose the characteristics that made them distinct? a. Cultural imposition b. Cultural conflict c. Cultural assimilation d. Cultural shock Cultural Conflict People become aware of differences and feel threatened Response- ridiculing belief and traditions of others to make themselves feel more secure Cultural conflict occurs when a nurse ridicules a patient by telling another nurse that Jewish diet restrictions are just a way for Jewish patients to get a special tray of their favorite foods. Cultural Imposition The belief that everyone else should conform to your own belief system
Stereotyping : When one assumes that ALL members of a culture, ethnic group or race act alike NCLEX
- A nurse states, "That woman is 78 years old—too old to learn how to change a dressing." What is the nurse demonstrating? a. Cultural imposition b. Clustering c. Cultural competency d. Stereotyping
- Tell if the following statement is true or false. Stereotyping occurs when people ignore difference in the cultures in which they live and proceed as if they do not exist. a. True b. False pain assessment a cultural consideration ex. Hispanic culture “ men don’t cry” Eye contact as it pertains to culture: 5 Cultures where Direct Eye Contact is Considered Rude or Offensive 1.) Asians 2.) Native Americans 3.) Indochinese 4.) Arabs
5.) Appalachian Americans care considerations for patient on fixed income and limited income
- Feelings of despair, resignation + fatalism
- Day-to-day attitude toward life, with no hope for the future
- Unemployment + need for financial or government aid
- Unstable family structure, possibly characterized by abusiveness + abandonment
- Decline in self-respect + retreat from community involvement Valuing Process: Seven Steps of the Valuing Process = values clarification process
- Choosing freely
- Choosing from alternatives
- Choosing after consideration of the consequences
- Prizing with pride and happiness
- Prizing with public affirmation
- Acting with incorporation of the choice into one's behavior
- Acting with consistency and regularity on the value maleficence non maleficence: The avoidance of harm or hurt. NCLEX
- When a nurse provides the information and support that patients and their families need to make the decision that is right for them, he/she is practicing which of the following principles of bioethics? a. Autonomy b. Nonmaleficence
1. A nurse administers the wrong medication to a patient and the patient is harmed. The physician who ordered the medication did not read the documentation that the patient was allergic to the drug. Which statement is true regarding liability for the administration of the wrong medication? A. The nurse is not responsible, because the nurse was merely following the doctor's orders B. Only the nurse is responsible, because the nurse actually administered the medication C. Only the physician is responsible, because the physician actually ordered the drug D. Both the nurse and the physician are responsible for their respective actions advocacy: Primary commitment to the patient Priority to good of individual patient rather than society in general Evaluation of competing claims of patient's autonomy and patient well- being Three Areas of Concern for Patient Advocates:
- Representation of patients
- Promoting self-determination
- Being politically active NCLEX
- Nurses who value patient advocacy follow which of the following guidelines? a. They value their loyalty to an employing institution or to a colleague over their commitment to their patient. b. They give priority to the good of the individual patient rather than to the good of society in general. c. They choose the claims of the patient's well-being over the claims of the patient's autonomy.
d. They make decisions for patients who are uninformed concerning their rights and opportunities.
- is the protection and support of another's rights. ANS: Advocacy
- The patient tells the nurse that she is afraid to speak up regarding her desire to end care for fear of upsetting her husband and children. Which principle in the nursing code of ethics ensures that the nurse will promote the patient's cause? A. Responsibility B. Advocacy C. Confidentiality D. Accountability Common Modes of Value Transmission
- Modeling
- Moralizing
- Laissez-faire
- Rewarding and punishing
- Responsible choice Modeling: role model Moralizing: taught by school or church with little room for choice responsible choice: Encourage exploration of competing values and weigh consequences
NCLEX
The nurse questions a physician's order to administer a placebo to the patient. The nurse's action is based on which ethical principle? A. Autonomy B. Beneficence C. Justice D. Fidelity fidelity: keep promises continuity of care healthcare providers must give appropriate uninterrupted care and give a smooth transition to each pt between health care settings essential to current system emphasis on health promotion and illness prevention must teach and refer must collaborate with other healthcare team members. A process by which healthcare providers give appropriate, uninterrupted care and facilitate the patients transition between different settings an levels of care. It ensures a smooth transition between healthcare settings. (i.e. ambulatory to acute, home healthcare, or others) Important roles of the nurse in continuity of care: Teacher , Collaborator, Advocate ambulatory care facilities -Patient receives healthcare services but does not remain overnight. -In most offices and clinics, patients complete a short health history. -In same-day surgery facilities, screening tests, teaching and admission usually take place before
patients enter the setting. -Goal is to provide healthcare services to patient who are able to provide self-care at home. Individuals go to ambulatory settings for health promotion, health maintenance, or medical or surgical treatment. SBAR what is when do we use “Situation, Background, Assessment, Recommendations.” It's the best practice for nurses to communicate info to physicians and other health professionals. ... You'll also find an SBAR PDF form for use in any healthcare communication situ NCLEX
- What is an advantage for using SBAR during staff communication? A. Improves verbal communication and reduces medical errors B. Provides a complete patient health history C. Focuses on a comprehensive physical examination D. Avoids making recommendations
- The nurse is calling the health care provider about a patient's changing condition. Which of the following would be included in the SBAR communication? A. Situation, background, assessment, and recommendation B. Subjective information, background, assessment, and revisions needed C. Situation, background, all vitals, and review of orders D. Summary, better plan, accurate diagnosis, and rights
- RNs are of benefit because they can do more than an MA (in most states) to assist you and free you up to be seeing other patients simultaneously. RNs can also see patients for follow up of these procedures, report findings to you, and let you know if there are post- procedure reasons to see the patient.
- If you have multiple MAs in your clinic, then a clinician with a higher license (RN or LPN/VN) level is needed to write policies and procedures and supervise the MA staff. The RN can directly supervise the MAs instead of having the physician stop the flow of clinic to supervise.
- If you have a busy telephone triage situation in your office where your patients call frequently with in depth questions, an RN can take most of that off of your hands, simply from their more in-depth knowledge base, and legal ability to teach patients about disease processes and discuss test results. outpatient care, also called ambulatory care, is anything that doesn’t require hospitalization. An annual exam with your primary care physician and a consultation with your neurologist are both examples of outpatient care. But emergent cases can also be considered outpatient care. If you leave the emergency department the same day you arrive, you’re still considered an outpatient. And of course, any appointment at a clinic or specialty facility outside the hospital is considered outpatient care. effects of stress
- irritability
- anxiety
- depression
- headaches
- insomnia care considerations for Diabetic Patients with loss of sensation lower extremities
- A patient is diagnosed with type 1 diabetes. What clinical characteristics does the nurse expect to see in this patient? (select all that apply) a. Ketosis-pron b. Little endogenous insulin c. obesity at diagnosis d. younger than 30 years of age e. Older than 65 years of age
- When the nurse is caring for a patient with type 1 diabetes, what clinical manifestation would be a priority to closely monitor? a. hypoglycemia b. hyponatremia c. ketonuria d. polyphagia
- The nurse is preparing to administer intermediate-acting insulin to a patient with diabetes. Which insulin will the nurse administer?
-under PA law, health professionals are mandated reporters for abuse or neglect (which means you MUST report any abuse) -Elder abuse can be reported to the Older Adults Protective Service Act or PA Department of Aging care safety Patient safety was defined by the IOM as “the prevention of harm to patients.”^1 Emphasis is placed on the system of care delivery that (1) prevents errors; (2) learns from the errors that do occur; and (3) is built on a culture of safety that involves health care professionals, organizations, and patients. fall prevention interventions Nursing History: -Assess for history of falls/accidents -Note assistive devices (walkers, canes, crutches) -Be alert to history of drug or alcohol abuse -Obtain knowledge of family support systems Physical Exam: -Assess mobility status
-Asses ability to communicate -Assess level of awareness or orientation -Assess sensory perception -Identify potential safety hazards -Recognize signs of domestic violence or neglect Describe strategies to reduce risks in the home -Declutter the house to have more free space -Assure carbon monoxide & fire detectors are working -Avoid rugs -Avoid having too many electrical cords -Organize meds & label -Toddler gate -Crib rails care consideration for client with paraplegia
1. A patient with a spinal cord injury at the T1 level complains of a severe headache and an "anxious feeling." Which is the most appropriate initial reaction by the nurse? 1. Try to calm the patient and make the environment soothing. 2. Assess for a full bladder. 3. Notify the healthcare provider. 4. Prepare the patient for diagnostic radiography.
- A hospitalized patient with a C7 cord injury begins to yell "I can't feel my legs anymore." Which is the most appropriate action by the nurse?
- Which patient is at highest risk for a spinal cord injury?
- 18-year-old male with a prior arrest for driving while intoxicated (DWI)
- 20-year-old female with a history of substance abuse
- 50-year-old female with osteoporosis
- 35-year-old male who coaches a soccer team
- A patient with a spinal cord injury (SCI) has complete paralysis of the upper extremities and complete paralysis of the lower part of the body. The nurse should use which medical term to adequately describe this in documentation?
- hemiplegia
- paresthesia
- paraplegia
- Quadriplegia
- Which of the following nursing actions is appropriate for preventing skin breakdown in a patient who has recently undergone a laminectomy?
- Provide the patient with an air mattress.
- Place pillows under patient to help patient turn.
- Teach the patient to grasp the side rail to turn.
- Use the log roll to turn the patient to the side. fowlers vs semi fowlers, and low fowlers – fowler’s- 30-45% HOB elevation semi fowlers- 30% HOB elevation High Fowler's- 45-90% HOB elevation
- The nurse is preparing to insert a nasogastric tube into a client. The nurse should place the client in which position for insertion.
- Right side
- Low Fowler's
- High Fowler's
- Supine with the head flat
