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Test Bank Lewis Medical Surgical 9th Edition

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Chapter 2: Health Disparities and Culturally Competent Care
Test Bank

MULTIPLE CHOICE

1. The nurse is obtaining a health history from a new patient. Which data will be the focus of patient teaching?
a. Age and gender
b. Saturated fat intake
c. Hispanic/Latino ethnicity
d. Family history of diabetes

ANS: B
Behaviors are strongly linked to many health care problems. The patient’s saturated fat intake is a behavior that the patient can change. The other information will be useful as the nurse develops an individualized plan for improving the patient’s health, but will not be the focus of patient teaching.

DIF: Cognitive Level: Apply (application) REF: 31
TOP: Nursing Process: Planning MSC: NCLEX: Health Promotion and Maintenance

2. The nurse works in a clinic located in a community with many Hispanics. Which strategy, if implemented by the nurse, would decrease health care disparities for the Hispanic patients?
a. Improve public transportation to the clinic.
b. Update equipment and supplies at the clinic.
c. Obtain low-cost medications for clinic patients.
d. Teach clinic staff about Hispanic health beliefs.

ANS: D
Health care disparities are due to stereotyping, biases, and prejudice of health care providers. The nurse can decrease these through staff education. The other strategies also may be addressed by the nurse but will not directly impact health disparities.

DIF: Cognitive Level: Apply (application) REF: 24-25
TOP: Nursing Process: Planning MSC: NCLEX: Health Promotion and Maintenance

3. What information should the nurse collect when assessing the health status of a community?
a. Air pollution levels
b. Number of health food stores
c. Most common causes of death
d. Education level of the individuals

ANS: C
Health status measures of a community include birth and death rates, life expectancy, access to care, and morbidity and mortality rates related to disease and injury. Although air pollution, access to health food stores, and education level are factors that affect a community’s health status, they are not health measures.

DIF: Cognitive Level: Understand (comprehension) REF: 19
TOP: Nursing Process: Assessment MSC: NCLEX: Health Promotion and Maintenance

4. The nurse is caring for a Native American patient who has traditional beliefs about health and illness. Which action by nurse is most appropriate?
a. Avoid asking questions unless the patient initiates the conversation.
b. Ask the patient whether it is important that cultural healers are contacted.
c. Explain the usual hospital routines for meal times, care, and family visits.
d. Obtain further information about the patient’s cultural beliefs from a family member.

ANS: B
Because the patient has traditional health care beliefs, it is appropriate for the nurse to ask whether the patient would like a visit by a shaman or other cultural healer. There is no cultural reason for the nurse to avoid asking the patient questions because they are necessary to obtain health information. The patient (rather than the family) should be consulted about personal cultural beliefs. The hospital routines for meals, care, and visits should be adapted to the patient’s preferences rather than expecting the patient to adapt to the hospital schedule.

DIF: Cognitive Level: Apply (application) REF: 26
TOP: Nursing Process: Implementation MSC: NCLEX: Psychosocial Integrity

5. The nurse is caring for an Asian patient who is being admitted to the hospital. Which action would be most appropriate for the nurse to take when interviewing this patient?
a. Avoid eye contact with the patient.
b. Observe the patient’s use of eye contact.
c. Look directly at the patient when interacting.
d. Ask a family member about the patient’s cultural beliefs.

ANS: B
Observation of the patient’s use of eye contact will be most useful in determining the best way to communicate effectively with the patient. Looking directly at the patient or avoiding eye contact may be appropriate, depending on the patient’s individual cultural beliefs. The nurse should assess the patient, rather than asking family members about the patient’s beliefs.

DIF: Cognitive Level: Apply (application) REF: 28 | 31
TOP: Nursing Process: Implementation MSC: NCLEX: Psychosocial Integrity

6. A female staff nurse is assessing a male patient of Arab descent who is admitted with complaints of severe headaches. It is most important for the charge nurse to intervene if the nurse takes which action?
a. The nurse explains the 0 to 10 intensity pain scale.
b. The nurse asks the patient when the headaches started.
c. The nurse sits down at the bedside and closes the privacy curtain.
d. The nurse calls for a male nurse to bring a hospital gown to the room.

ANS: C
Many males of Arab ethnicity do not believe it is appropriate to be alone with any female except for their spouse. The other actions are appropriate.