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NR 222 Final Exam – Question and Answers

1. A 6-month-old child from Guatemala was adopted by an American family in Indiana. The child’s socialization into the American midwestern culture is best described as:
2. A 46-year-old woman from Bosnia came to the United States 6 years ago. Although she did not celebrate Christmas when she lived in Bosnia, she celebrates Christmas with her family now. This woman has experienced assimilation into the culture of the United States because she:
3. Cultural awareness is an in-depth self-examination of one’s own background, recognizing biases and prejudices and assumptions about other people. To enhance their cultural awareness, nursing students need to make an in-depth self-examination of their own:
4. Which of the following is required in the delivery of culturally congruent care?
5. Nurses need to avoid stereotypes or unwarranted generalizations about any particular group that prevents further assessment of the individual’s unique characteristics.
6. Prejudices associate negative permanent characteristics with people who are different from the valued group. When a person acts on these prejudices, discrimination occurs.When action is taken on one’s prejudices:
7. Health disparity populations are populations that have a significant increased incidence or prevalence of disease or that have increased morbidity, mortality, or survival rates compared to the health status of the general population.
   A nursing student is doing a community health rotation in an inner-city public health department. The student investigates sociodemographic and health data of the people served by the health department, and detects disparities in health outcomes between the rich and poor. This is an example of a(n):
8. Patients suffer cultural pain when health care providers disregard values or cultural beliefs. Culture strongly influences pain expression and need for pain medication. However, cultural pain is:
9. Informed consent and advance directives protect the right of the individual to know and make decisions ensuring continuity of individual autonomy and self-determination. Which of the following best represents the dominant values in American society on individual autonomy and self-determination?
10. In an Asian culture spoken messages often have little to do with their meanings. It is important for the nurse to clarify how much salt the patient is consuming in his diet. The nurse at an outpatient clinic asks a patient who is Chinese American with newly diagnosed hypertension if he is limiting his sodium intake as directed. The patient does not make eye contact with the nurse but nods his head. What should the nurse do next?
11. Present-time orientation is in conflict with the dominant organizational norm in health care that emphasizes punctuality and adherence to appointments. Nurses need to expect conflicts and make adjustments when caring for ethnic groups.
    A female Jamaican immigrant has been late to her last two clinic visits, which in turn had to be rescheduled. The best action that the nurse could take to prevent the patient from being late to her next appointment is:
12. Certain genetic disorders are linked with specific ethnic groups such as malignant hypertension among African Americans. A nursing student is taking postoperative vital signs in the postanesthesia care unit. She knows that some ethnic groups are more prone to genetic disorders. Which of the following patients is most at risk for developing malignant hypertension?
13. In some African cultures such as in Ghana and Sierra Leone some women will not resume sexual relations with their husbands until the baby is weaned. A community health nurse is making a healthy baby visit to a new mother who recently emigrated to the United States from Ghana. When discussing contraceptives with the new mom, the mother states that she won’t have to worry about getting pregnant for the time being. The nurse understands that the mom most likely made this statement because:
14. Culture is the context in which groups of people interpret and define their experiences relevant to life transitions. This includes events such as birth, illness, and dying. It is the system of meanings by which people make sense of their experiences.
    During their clinical post-conference meeting, several nursing students were discussing their patients with their instructor. One student from a middle-class family shared that her patient was homeless. This is an example of caring for a patient from a different:
15. Obtain information about folk remedies and cultural healers that the patient uses. Assessment data yield information about the patient’s beliefs about the illness and the meaning of the signs and symptoms. When interviewing a Native American patient on admission to the hospital emergency department, which questions are appropriate for the nurse to ask? (Select all that apply.)
16. Resiliency is the ability of the family to cope with the unexpected. In this scenario the family used resources to provide some short-term solutions for the adult child’s return home. The Collins family includes a mother, Jean; stepfather, Adam; two teenage biological daughters of the mother, Lisa and Laura; and a biological daughter of the father, 25-year-old Stacey. Stacey just moved home following the loss of her job in another city. The family is converting a study into Stacey’s bedroom and is in the process of distributing household chores. When you talk to members of the family, they all think that their family can adjust to lifestyle changes. This is an example of family:
17. This new parenting responsibility is caused by a number of societal factors: the increase in the divorce rate, dual-income families, and single parenthood. But most often it is a consequence of legal intervention when parents are unfit or renounce their parental obligations. The most common reason grandparents are called on to raise their grandchildren is because of:
18. The ability of families to meet health care, education, and basic needs is often affected by the economic resources of the family. A family’s access to adequate health care, opportunity for education, sound nutrition, and decreased stress is affected by:
19. David’s economic status is stretched. He has multiple resources for his son, but he is not insured. Thus, as a result, there is a potential that David does not follow through with personal health promotion activities. Although asthma is a chronic illness, this is well managed, and there is adequate health care for his son. David Singer is a single parent of a 3-year-old boy, Kevin. Kevin has well-managed asthma and misses day care infrequently. David is in school studying to be an information technology professional. His income and time are limited, and he admits to going to fast-food restaurants frequently for dinner. However, he and his son spend a lot of time together. David receives state-supported health care for his son, but he does not have health insurance or a personal physician. He has his son enrolled in a government-assisted day care program. Which of the following are risks to this family’s level of health? (Select all that apply.)
20. Blended families result when two people who have children from a previous marriage/relationship marry. The Cleric family, which includes a mother, stepfather, two teenage biological daughters of the mother, and a biological daughter of the father is an example of a(n):
21. Clear and direct family communication assists the family in creating goals, decision making, progressing through the family development cycle, and coping with stressors. Which of the following are possible outcomes with clear family communication? (Select all that apply.)
22. Communication is a component of family functioning, whether that be setting goals, coping, or establishing discipline. Family functioning is what the family does, and communication is an important component of function.
    Communication among family members is an example of family:
23. Family hardiness is the internal strengths and durability of the family unit. It includes a sense of control over the outcome of life, a view of change as beneficial and growth producing, and an active orientation (such as family meetings) rather than passive orientation in adapting to stressful events. Family meetings, understanding of roles, and adaptation to stressors along with a willingness to change affect family hardiness. Which of the following contribute to family hardiness? (Select all that apply.)
24. Family resiliency is the ability to cope with expected and unexpected stressors. Resiliency helps to evaluate healthy responses when individuals and families are experiencing stressful events. Which of the following demonstrate family resiliency? (Select all that apply.)
25. When you view the family as context, the primary focus is on the health and development of an individual member existing within a specific environment (i.e., the patient’s family). Although the focus is on the individual’s health status, assess how much the family provides the individual’s basic needs. When nurses view the family as context, their primary focus is on the:
26. When the family as patient is the approach, family processes and relationships (e.g., parenting or family caregiving) are the primary focuses of nursing care. Diane is a hospice nurse who is caring for the Robinson family. This family is providing end-of-life care for their grandmother, who has terminal breast cancer. When Diane visits the home 3 times a week, she focuses on symptom management for the grandmother and assists the family with coping skills. Diane’s approach is an example of which of the following?
27. Cultural practices help identify culturally related health practices, diets, and religious practices. Decision making provides information as to how the family copes and meets challenges related to changes in family life or dynamics. Rituals and celebrations address how a family celebrates accomplishments and how they deal with challenges. Neighborhood crime data are relevant for community assessment, but they do not give sufficient information about family function.
    Which of the following are included in a family function assessment? (Select all that apply.)
28. This relationship includes multiadult households, “skip-generation” families, communal groups with children, “nonfamilies,” cohabitating partners, and homosexual couples. Karen Johnson is a single mother of a school-age daughter. Linda Brown is also a single mother of two teenage daughters. Karen and Linda are active professionals, have busy social lives, and date occasionally. Three years ago they decided to share a house and housing costs, living expenses, and child care responsibilities. The children consider one another as their family. This family form is considered a(n):
29. Health promotion activities focus on interventions designed to maintain the physical, social, emotional, and spiritual health of the family unit. They can include information about specific health behaviors, family coping techniques, and growth and development. During a visit to a family clinic the nurse teaches the mother about immunizations, car seat use, and home safety for an infant and toddler. Which type of nursing interventions are these?
30. Family caregiving involves the routine provision of services and personal care activities for a family member by spouses, siblings, or parents. Caregiving activities include finding resources, personal care (bathing, feeding, or grooming), monitoring for complications or side effects of illness and treatments, providing instrumental activities of daily living (shopping or housekeeping), and the ongoing emotional support and decision making that is necessary.
    Which best defines family caregiving? (Select all that apply.)
31. Currently, emerging populations include ethnic minorities and persons who are homeless. Ethnic minority populations could include Asian Americans/Pacific Islanders, Blacks/African Americans, Latinos/Hispanic Americans, Native Americans, and Arab Americans. The increasing population of immigrants has been a significant contributor to the presence of increasing numbers of major ethnic groups in the United States. The increasing number of ethnic groups in the United States has been influenced by what?
32. A minority group may be perceived as consisting of people who receive less than their share of the wealth, power, or social status The U.S Department of Health and Human Services and the Institute of Medicine have well documented that racial and ethnic minorities have less access to health care, receive lower-quality health care, and have higher rates of illness, injury, and premature death. Race has been viewed as capturing biological variations within human populations. It emphasizes the physical and biological heredity. An ethnic group is a group that is set apart by insiders or outsiders primarily on the basis of cultural or national origin characteristics subjectively selected. Ethnic groups are socially organized with salient differences compared with other groups in society. The nurse recognizes that a minority group is perceived as:
33. There is limited health information about Arab Americans who suffer from chronic health problems such as diabetes and coronary artery disease. Several factors put Arab Americans at high-risk for developing adult onset diabetes and cardiovascular disease including obesity, age, gender, and low employment rates. Health concerns on the rise for Arab Americans include mental illness and tobacco consumption among adolescents. Which of the following diseases are Arab Americans at the highest risk for?
34. Asian Americans have a high prevalence and risk factors of chronic obstructive pulmonary disease, hepatitis B, HIV/AIDS, smoking, tuberculosis, and liver disease. Asian American/Pacific Islander women are less likely to die of breast cancer, and infant mortality rates are lower compared with other ethnic groups. They have lower rates of being overweight, lower rates of hypertension, and are less likely to be cigarette smokers. Priority nursing assessments of Asian Americans/Pacific Islanders should be on which disease process?
35. Cardiovascular disease is the number one cause of morbidity and mortality among Latino/Hispanic Americans. Cancer is the second most prevalent cause of morbidity and mortality. Diabetes is twice as prevalent in Latino/Hispanics as in non-Hispanic White Americans. Priority nursing assessments of Latino/Hispanic Americans should focus on what disease process, because of its higher incidence in this population?
36. Currently, emerging populations in the United States include ethnic minorities, and persons who are homeless. Ethnic minority populations could include Asian Americans/Pacific Islanders, Blacks/African Americans, Latinos/Hispanic Americans, Native Americans, and Arab Americans. The increasing population of immigrants has been a significant contributor of the presence of increasing populations of major ethnic groups in the United States. Older Americans and baby boomers do not comprise emerging populations in the United States. What two groups comprise emerging populations in the United States? (select two that apply)
37. Ethnicity focuses on differences in meaning, values, and ways of living. Ethnicity is defined as a dynamic set of historically derived and institutionalized ideas and practices that allows people to identify or be identified with groupings of people on the presumed basis of commonalities in language, history, nation or region of origin, customs, ways of being, religion, names, physical appearance, and/or genealogy or ancestry. A minority group consists of people who are living within a society which is usually disadvantaged in relation to power, control of their own lives, and wealth. Race and ethnicity are different but somewhat alike. Race is associated with power and indexes the history or ongoing imposition of one group’s authority above another. Which of the following statements accurately describe race and ethnic categories in the United States as defined by the Office of Management and Budget? (select all that apply)
38. Culture is an element of ethnicity that refers to patterns of human behavior that include the language, thoughts, communications, actions, customs, beliefs, values, and institutions of racial, ethnic, religious, or social groups. Values are beliefs about the worth of something and serve as standards that influence behavior. Value orientations reflect the personality type of a particular society. Culture is shaped by values, beliefs, norms, and practices that are shared by members of the same cultural group. Ethnic groups have unique beliefs and attitudes about health and health care services. Beliefs are generally incongruent with health care providers and prove to be major barriers to improving the health status of ethnic group members.
    Ethnicity is evident in customs of particular groups. Which of the following statements accurately reflect the definitions of culture, values and value orientation? (select all that apply)
39. Cultural competency is one of the major elements in eliminating the health disparities and starts with an honest desire not to allow biases. Health care services should be provided that are respectful of and responsive to the diverse health beliefs of the client. It is very important for health care providers to be aware of how people interpret their health issues or illnesses and be capable to provide culturally competent care. Culture is an element of ethnicity that refers to patterns of human behavior that include the language, thoughts, communications, actions, customs, beliefs, values, and institutions of racial, ethnic, religious, or social groups. Values are beliefs about the worth of something and serve as standards that influence behavior. Value orientations reflect the personality type of a particular society. Culture is shaped by values, beliefs, norms, and practices that are shared by members of the same cultural group. Ethnic groups have unique beliefs and attitudes about health and health care services. Beliefs are generally incongruent with health care providers and prove to be major barriers to improving the health status of ethnic group members. Which of the following statements are true about cultural competency in health care? (select all that apply)
40. Severe high blood pressure is more common for African Americans in both men and women. African American adults are 40% more likely to have high blood pressure. The incidence of cancer and mortality rates for African Americans is higher than that for White Americans. African Americans are two times more likely to be diagnosed with diabetes than non-Hispanic whites, and they are more likely to suffer complications from diabetes. African Americans experience high infant and maternal mortality rates and they have the second-highest percentage of women who lack prenatal care in the first trimester of pregnancy. Nurses caring for the Black/African American population need to maintain an awareness of which of the following health-related cultural aspects of care? (select two that apply)

NR 222 Final Exam Set 2

1. The nurse incorporates cultural considerations into the health teaching plan by:
2. The communication of health information in a manner which is clear and understandable to the client is known as:
3. Nurses have a responsibility to ensure health literacy when providing health education. What are some strategies that nurses can use to promote health literacy? (select all that apply)
4. The nurse utilizes strategies associated with client-centered communication by doing which of the following? (select all that apply)
5. What are some ethical standards that nurses can utilize for interpersonal communications? (select all that apply)6. Which of the following scenarios best describes a nurse using metacommunication?
6. The nurse is teaching a class to students of pediatric nursing on comparing the concepts of growth and development. Which statement most accurately represents these concepts?
7. A nurse is attending a continuing education program about growth and development. Why is it necessary that nurses are well educated about this content? (Select all that apply)8. The school nurse is working on a campaign in the school to prevent adolescent pregnancies. Which of the following interventions should the nurse implement?
8. Which of the following is the third leading cause of death in adolescents between 10 and 24 years of age?
9. The nurse is preparing an educational activity for adolescents. The primary reason that emphasis is placed on teaching testicular self-examination is because:
10.  A nurse is planning a community health education program for young adults. Which of the following considerations should be made by the nurse?
11. A nurse is measuring an infant’s head circumference and height. Which area is the nurse assessing?
12. A mother has delivered a healthy newborn. Which action is priority?
13. A nurse is working in the delivery room. Which action is priority immediately after birth?
14. A mother expresses concern because her 5-year-old child frequently talks about friends who don’t exist. What is the nurse’s best response to this mother’s concern?
15. A nurse is giving a presentation about accident prevention to a group of parents of toddlers. Which of the following accident-prevention strategies should the nurse include? (Select all that apply).
16. Which statement, if made by a parent, will require further instruction from the nurse?
17. A nurse is assessing the risk of intimate partner violence (IPV) for patients. Which population should the nurse focus on most for IPV?
18. Which information from the nurse indicates a correct understanding of emerging adulthood?
19. A nurse determines that a middle-aged patient is a typical example of the “sandwich generation.” What did the nurse discover the patient is caught between?
20. A nurse is developing a plan of care for an older adult. Which information will the nurse consider?
21. A nurse is teaching a group of older-adult patients. Which teaching strategy is best for the nurse to use?
22. A nurse is caring for an older adult. Which goal is priority?
23. A nurse is discussing sexuality with an older adult. Which action will the nurse take
24. An older patient with dementia and confusion is admitted to the nursing unit after hip replacement surgery. Which action will the nurse include in the plan of care?
25. A nurse is reviewing car seat safety with the parents of a 1-month-old infant. When reviewing car seat use which of the following instructions should the nurse include?
26. A nurse is teaching a patient with a risk for hypertension how to take a blood pressure. Which action by the nurse is the priority?
27. Which behavior indicates the nurse is using a process recording correctly to enhance communication with patients?
28. A nurse is using Jean Piaget’s developmental theory to focus on cognitive development. Which area will the nurse assess in this patient?
29. A nurse works on a pediatric unit and is using a psychosocial developmental approach to child care. In which order from the first to the last will the nurse place the developmental stages?
30. According to Piaget, the school-age child is in the third stage of cognitive development, which is characterized by:
31. According to Kohlberg, children develop moral reasoning as they mature. Which of the following is most characteristic of a preschooler’ stage of moral development?
32. The nurse is caring for an infant. Which activity is most appropriate for the nurse to offer to the infant?