A nurse is using Campinha-Bacote’s model of cultural competency. Which areas will the nurse focus on to become competent? (Select all that apply)

Choice A reason: Low blood pressure is not typically associated with prolonged stress. Chronic stress elevates cortisol, which can increase blood pressure via sympathetic activation. Hypotension may occur in acute stress response (e.g., shock), but prolonged stress more commonly causes hypertension, making this an incorrect condition to monitor.

Choice B reason: Prolonged stress suppresses immune function by elevating cortisol, reducing lymphocyte activity and increasing infection risk. Conditions like respiratory or urinary tract infections become more likely. Monitoring for infections is essential, as stress weakens the body’s ability to fight pathogens, making this a correct condition to assess.

Choice C reason: Alopecia, or hair loss, can result from prolonged stress due to elevated cortisol disrupting hair follicle cycles, leading to telogen effluvium. Stress-induced autoimmune conditions like alopecia areata may also occur. Monitoring for hair loss is appropriate, as it reflects stress’s physiological impact, making this a correct choice.

Choice D reason: Prolonged stress increases diabetes risk by raising cortisol and catecholamines, which elevate blood glucose and impair insulin sensitivity. This can exacerbate or precipitate type 2 diabetes. Monitoring glucose levels is critical, as stress contributes to metabolic dysregulation, making this a correct condition to assess.

Choice E reason: Chronic stress is linked to cancer through immune suppression and inflammation, which may promote tumor growth. Elevated cortisol and stress hormones can impair DNA repair mechanisms. Monitoring for cancer risk, especially in high-stress patients, is warranted, as stress is a known risk factor, making this a correct choice.

Choice A reason: Short naps (15-20 minutes) are recommended for narcolepsy to manage excessive daytime sleepiness without disrupting nighttime sleep. This aligns with evidence-based management, improving alertness. No intervention is needed, as this practice supports symptom control, enhancing daily function and reducing sleep attacks in narcolepsy patients.

Choice B reason: Taking antidepressants, like SSRIs or SNRIs, is standard for narcolepsy to manage cataplexy or sleep disturbances. This is appropriate and requires no intervention unless misuse occurs. The nurse would ensure proper dosing, as antidepressants support symptom control, improving quality of life without disrupting narcolepsy management strategies.

Choice C reason: Chewing gum regularly is benign and unrelated to narcolepsy management. It may help with alertness but doesn’t warrant intervention. Unlike environmental factors like room temperature, gum has no significant impact on sleep quality or narcolepsy symptoms, making it an irrelevant focus for nursing education or correction.

Choice D reason: Sleeping in a hot, stuffy room disrupts sleep quality, exacerbating narcolepsy symptoms like fragmented sleep or daytime sleepiness. The nurse intervenes to promote a cool, well-ventilated sleep environment, critical for optimizing rest. Poor sleep hygiene worsens narcolepsy, reducing treatment efficacy and increasing risks of sleep attacks or fatigue.