eBay:testbanks_and_xanax

8. The sibling of an Asian American patient tells the nurse, “My sister needs help for pain. She cries from the hurt.” Which understanding by the nurse will contribute to culturally competent care for this patient? Persons of an Asian American heritage a. often express emotional distress with physical symptoms. b. will probably respond best to a therapist who is impersonal. c. will require prolonged treatment to stabilize these symptoms. d. should be given direct information about the diagnosis and prognosis.

ANS: A

Asian Americans commonly express psychological distress as a physical problem. The patient may believe psychological problems are caused by a physical imbalance. Treatment will likely be short. The patient will probably respond best to a therapist who is perceived as giving. Asian Americans usually have strong family ties and value hope more than truth.

PTS: 1 DIF: Cognitive Level: Understand (Comprehension)

REF: Pages 5-10, 35 (Table 5-5) TOP: Nursing Process: Assessment

MSC: Client Needs: Psychosocial Integrity a. Open and friendly; ask direct questions; touch the patient’s arm or hand occasionally for reassurance. b. Frequent nonverbal behaviors, such as gestures and smiles; make an unemotional face to express negatives. c. Soft voice; break eye contact occasionally; general leads and reflective techniques. d. Stern voice; unbroken eye contact; minimal gestures; direct questions.

9. Which communication strategy would be most effective for a nurse to use during an assessment interview with an adult Native American patient?

ANS: C

Native American culture stresses living in harmony with nature. Cooperative, sharing styles rather than competitive or intrusive approaches are preferred; thus, the more passive style described would be best received. The other options would be more effective to use with patients of a Western orientation.

PTS: 1 DIF: Cognitive Level: Apply (Application)

REF: Pages 5-17, 29 (Table 5-2) | Page 5-31 (Table 5-3) | Page 5-37 (Box 5-1)

TOP: Nursing Process: Implementation MSC: Client Needs: Psychosocial Integrity a. Psychopharmacological and somatic therapies should be central techniques. b. Apply a psychoanalytical approach, focused on childhood trauma. c. Depression and alcohol abuse should be treated concurrently. d. Use a holistic approach, including mind, body, and spirit.

10. A Native American patient sadly describes a difficult childhood. The patient abused alcohol as a teenager but stopped 10 years ago. The patient now says, “I feel stupid and good for nothing. I don’t help my people.” How should the treatment team focus planning for this patient?

ANS: D

Native Americans, because of their beliefs in the interrelatedness of parts and about being in harmony with nature, respond best to a holistic approach. No data are present to support dual diagnosis, because the patient has resolved the problem of excessive alcohol use. Psychopharmacological and somatic therapies may be part of the treatment, but the focus should be more holistic. Psychoanalysis is a long-term expensive therapy; cognitive therapy might be a better choice.

PTS: 1 DIF: Cognitive Level: Apply (Application)

REF: Page 5-6 | Page 5-29 (Table 5-2) | Page 5-33 (Table 5-4)

TOP: Nursing Process: Planning/Outcomes Identification

MSC: Client Needs: Psychosocial Integrity a. Risk for other-directed violence b. Chronic low self-esteem c. Deficient knowledge d. Social isolation

11. A Native American patient describes a difficult childhood and dropping out of high school. The patient abused alcohol as a teenager to escape feelings of isolation but stopped 10 years ago. The patient now says, “I feel stupid. I’ve never had a good job. I don’t help my people.” Which nursing diagnosis applies?

ANS: B

The patient has given several indications of chronic low self-esteem. Forming a positive self-image is often difficult for Native American individuals because these indigenous people must blend together both American and Native American worldviews. No defining characteristics are present for the other nursing diagnoses.

PTS: 1 DIF: Cognitive Level: Apply (Application)

REF: Pages 5-6, 20

MSC: Client Needs: Psychosocial Integrity

TOP: Nursing Process: Diagnosis/Analysis a. The father is the authority figure. b. The mother is head of the household. c. Women should make their own decisions. d. Emotional communication styles are desirable.

12. Which viewpoint of an Asian American family will most affect decision making about care?

ANS: A

Asian American families traditionally place the father in the position of power as the head of the household. Mothers, as well as other women, are usually subservient to fathers in these cultures. Asian Americans are more likely to be reserved.

PTS: 1 DIF: Cognitive Level: Understand (Comprehension)

REF: Pages 5-6, 17, 35 (Table 5-5)

TOP: Nursing Process: Planning/Outcomes Identification

MSC: Client Needs: Psychosocial Integrity a. Encouraging the family to attend community support groups b. Involving the patient’s family to assist with activities of daily living c. Providing educational pamphlets to explain the patient’s mental illness d. Restricting homemade herbal remedies the family brings to the hospital

13. Which intervention best demonstrates that a nurse correctly understands the cultural needs of a hospitalized Asian American patient diagnosed with a mental illness?

ANS: B

The Asian community values the family in caring for each other. The Asian community uses traditional medicines and healers, including herbs for mental symptoms. The Asian community describes illness in somatic terms. The Asian community attaches a stigma to mental illness, so interfacing with the community would not be appealing.

PTS: 1 DIF: Cognitive Level: Apply (Application)

REF: Pages 5-6, 17, 35 (Table 5-5) TOP: Nursing Process: Implementation

MSC: Client Needs: Psychosocial Integrity

14. A nurse speaks with family members of a Chinese American parent recently diagnosed with major depressive disorder. Which comment by the nurse will the family find most comforting? “The nursing staff will a. take good care of your parent.” b. pray with your parent several times a day.” c. teach your parent important self-care strategies.” d. educate your parent about safety information regarding medication.”

ANS: A

Chinese Americans hold an Eastern (balance) worldview. Persons who are ill or need health care are vulnerable and need protection. The family will find comfort in a nurse’s statement that good care will be provided. The distracters apply to persons with a Western or indigenous worldview.

PTS: 1 DIF: Cognitive Level: Analyze (Analysis)

REF: Page 5-29 (Table 5-2) TOP: Nursing Process: Implementation

MSC: Client Needs: Psychosocial Integrity a. Eastern/balance b. Southern/holistic c. Western/scientific d. Indigenous/harmony

15. A patient in the emergency department shows a variety of psychiatrical symptoms, including restlessness and anxiety. The patient says, “I feel sad because evil spirits have overtaken my mind.” Which worldview is most applicable to this individual?

ANS: D

Persons of an indigenous worldview believe disease results from a lack of personal, interpersonal, environmental, or spiritual harmony and that evil spirits exist. The holism of body–mind–spirit is a key component of this view. If one believes an evil spirit has taken control, distress results. Western and Eastern worldviews do not embrace spirits. See relationship to audience response question.

PTS: 1 DIF: Cognitive Level: Understand (Comprehension)

REF: Page 5-29 (Table 5-2)

MSC: Client Needs: Psychosocial Integrity

TOP: Nursing Process: Assessment a. Stand very close to the patient while teaching. b. Maintain direct eye contact with the patient while teaching. c. Maintain a neutral emotional tone during the teaching session. d. Sit 4 feet or more from the patient during the teaching session.

16. A nurse prepares to teach important medication information to a patient of Mexican heritage. How should the nurse manage the teaching environment?

ANS: A

Latin American cultures use close personal space, closer than many other minority groups.

Standing very close to the patient frequently indicates acceptance. Direct eye contact should not be prolonged with this patient. Persons of this cultural heritage have high emotionality.

PTS: 1 DIF: Cognitive Level: Apply (Application)

REF: Page 5-31 (Table 5-3)

TOP: Nursing Process: Implementation

MSC: Client Needs: Health Promotion and Maintenance a. “My family will bring special foods to help me get well.” b. “I hope my health care provider will prescribe some medication to help me.” c. “I think I would benefit from talking to other patients with a similar problem.” d. “I would like to have a native healer perform a ceremony to balance my energy.”

17. A Chinese American patient diagnosed with an anxiety disorder says, “My problems began when my energy became imbalanced.” The nurse asks for the patient’s ideas about how to treat the imbalance. Which comment would the nurse expect from this patient?

ANS: A

The concept of energy imbalance as a source of illness is an explanatory model familiar to Asian cultures. A source of healing is dietary change to include either “hot” or “cold” foods to correct the imbalance. “Hot” and “cold” in this case do not refer to thermal properties of the foods. Medication would not be a treatment suggested by a patient with an Eastern worldview. Someone from an indigenous culture may suggest rituals. Group discussion of mental illness would not be appealing to a Chinese American.

PTS: 1 DIF: Cognitive Level: Apply (Application)

REF: Page 5-29 (Table 5-2) TOP: Nursing Process: Planning

MSC: Client Needs: Psychosocial Integrity a. Investigate cultural differences in patients’ responses to psychotropic medications. b. Contact the clinical nurse specialist for guidelines regarding cultural competence. c. Examine the literature on various health beliefs of members of diverse cultures. d. Complete an online continuing education offering about psychopharmacology.

18. An experienced psychiatric nurse plans to begin a new job in a community-based medication clinic. The clinic sees culturally diverse patients. Which action should the nurse take first to prepare for this position?

ANS: A

An experienced nurse working on a mental health inpatient unit would be familiar with the action and side effects of most commonly prescribed psychotropic medications. However, because the clinic serves a culturally diverse population, reviewing cultural differences in patients’ responses to these medications is helpful and vital to patient safety. The distracters identify actions the nurse would take later.

PTS: 1 DIF: Cognitive Level: Analyze (Analysis)

REF: Page 5-12 TOP: Nursing Process: Planning