Nursing Elites

1. Which of the following may be a cultural barrier that impacts a healthcare provider's ability to provide care or education to the client?

• A. A healthcare provider offers educational materials to a client that are written at an 8th-grade reading level
• B. A Vietnamese woman wants to use steaming in addition to her prescription antibiotics
• C. A healthcare provider uses pantomime to explain a procedure to a deaf client
• D. A Native American client requests a healing ritual before considering surgery

Correct answer: C

Rationale: Cultural barriers can impede communication, hindering a healthcare provider's ability to provide education or instructions about a client's care. In the context of cultural sensitivity, using pantomime to explain a procedure to a deaf client can be ineffective and inappropriate. This approach implies a lack of recognition of the importance of proper communication methods, such as sign language interpreters, which are crucial for effective communication with individuals who are deaf. Miscommunication is likely to occur if the client does not understand the gestures and actions of the healthcare provider. This scenario highlights the significance of understanding and respecting different cultural practices and communication needs to deliver optimal care and education. Choice A is incorrect because offering educational materials at an appropriate reading level demonstrates consideration for the client's literacy level, which can enhance understanding and compliance with medical instructions. Choice B is incorrect as incorporating a client's cultural practices, such as steaming, alongside prescribed treatments can be a part of culturally competent care. Choice D is incorrect as respecting a client's request for a healing ritual aligns with providing patient-centered care that acknowledges and integrates cultural beliefs and preferences.

2. A patient born in 1955 had hepatitis A infection 1 year ago. According to Centers for Disease Control and Prevention (CDC) guidelines, which action should the nurse include in care when the patient is seen for a routine annual physical exam?

• A. Start the hepatitis B immunization series.
• B. Teach the patient about hepatitis A immune globulin.
• C. Ask whether the patient has been screened for hepatitis C.
• D. Test for anti-hepatitis-A virus immune globulin M (anti-HAV-IgM).

Correct answer: C

Rationale: The correct action for the nurse to include in care when the patient is seen for a routine annual physical exam, according to CDC guidelines, is to ask whether the patient has been screened for hepatitis C. CDC guidelines recommend screening patients born between 1945 and 1965 for hepatitis C due to the high prevalence of undiagnosed cases in this age group. Starting the hepatitis B immunization series is not necessary as the patient already had hepatitis A infection. Teaching the patient about hepatitis A immune globulin is not indicated in this scenario. Testing for anti-hepatitis-A virus immune globulin M (anti-HAV-IgM) is not needed as the patient has already had hepatitis A.

3. The client is being educated about depression by the nurse. Which statement by the client indicates that the teaching has been effective?

• A. ''All elderly individuals experience depression occasionally.''
• B. ''I'm relieved that I will improve within 2 or 3 days.''
• C. ''I never realized depression could occur without a specific cause.''
• D. ''Reducing stress in my life will alleviate the depression.''

Correct answer: C

Rationale: The correct answer, 'I never realized depression could occur without a specific cause,' demonstrates an understanding that depression can arise without a clear trigger, indicating effective teaching. Choice A is incorrect because not all elderly individuals experience depression, and this statement doesn't show understanding. Choice B is incorrect as it reflects a misconception about the quick resolution of depression. Choice D is incorrect as it oversimplifies the relationship between stress reduction and depression resolution.

4. The healthcare professional needs to validate which of the following statements pertaining to an assigned client?

• A. The client has a hard, raised, red lesion on his right hand.
• B. A weight of 185 lbs. is recorded in the chart.
• C. The client reported an infected toe.
• D. The client's blood pressure is 124/70.

Correct answer: C

Rationale: Validation is the process of confirming that data are actual and factual. Data that can be measured can be accepted as factual, as in options 1, 3, and 4. The weight, blood pressure, and physical appearance of a lesion can be objectively verified. However, option C, the client reporting an infected toe, requires the nurse to directly assess the client's toe to confirm the statement. This choice involves subjective data that needs to be validated through direct observation, making it the correct answer. Options A, B, and D provide data that can be measured objectively and verified without the need for further assessment.

5. What action by the nurse will be most effective in decreasing the spread of pertussis in a community setting?

• A. Providing supportive care to patients diagnosed with pertussis
• B. Teaching family members about the importance of careful handwashing
• C. Teaching patients about the necessity of adult pertussis immunizations
• D. Encouraging patients to complete the prescribed course of antibiotics

Correct answer: C

Rationale: The most effective action by the nurse to decrease the spread of pertussis in a community setting is to teach patients about the necessity of adult pertussis immunizations. The increased rate of pertussis in adults is often attributed to waning immunity after childhood immunization. Immunization is highly effective in protecting communities from infectious diseases. While teaching about handwashing is important for overall infection control, pertussis is primarily spread through respiratory droplets and contact with secretions. Providing supportive care does not significantly impact the disease course or transmission risk. Encouraging completion of antibiotics may help reduce transmission, but patients likely have already spread the disease by the time the diagnosis is made. Therefore, the emphasis should be on prevention through immunization to reduce the spread of pertussis.

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