The nurse manager of a unit is asked by a family member of a dying Native American patient if it is possible to have the patient's eight-member family recite the rosary by the bedside. The manager responds affirmatively.
The nurse manager is most likely exhibiting behavior related to:
Cultural sensitivity.
Cultural diversity.
Ethnocentricity.
Acculturation.
The Correct Answer is A
Choice A rationale
Cultural sensitivity involves the recognition and appreciation of the diversity of various cultural groups, combined with a willingness to adapt care to meet their specific needs. By allowing the Native American family to perform a religious ritual like the rosary at the bedside, the manager demonstrates respect for their spiritual practices during the dying process. This behavior acknowledges the importance of cultural traditions in providing holistic and compassionate end-of-life care. It requires the manager to value the family's perspective over rigid hospital policies.
Choice B rationale
Cultural diversity refers to the existence of a variety of cultural or ethnic groups within a society or organization. It is a demographic fact rather than a specific behavioral response or management action. While the nurse manager is operating within a diverse environment, the act of affirmatively responding to a request is an application of sensitivity rather than just the existence of diversity itself. Recognizing that a unit has patients from different backgrounds is the first step toward the active sensitivity demonstrated here.
Choice C rationale
Ethnocentricity is the belief that one's own culture, ethnic group, or traditions are superior to those of others. An ethnocentric manager might have denied the family's request, viewing the rosary or the presence of eight family members as a disruption to the standard medical protocol or as an "incorrect" way to handle death. This perspective limits the quality of care by ignoring the patient's and family's cultural values. The manager's affirmative response is the opposite of ethnocentric behavior, as it embraces external cultural values.
Choice D rationale
Acculturation is the process by which members of a cultural group adopt the beliefs, values, and behaviors of another group, often the dominant culture. This term describes a long-term sociological change in an individual or group rather than a single supportive action by a manager. In this scenario, the family is maintaining their own traditions rather than necessarily adopting those of the hospital. The manager's role is to facilitate the family's existing culture, not to oversee their transition into a different cultural framework.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["B","C","D"]
Explanation
Choice A rationale
Notifying the provider of noncompliance is medically inaccurate and clinically inappropriate in this context. The patient is not choosing to be noncompliant but is instead facing significant socioeconomic barriers including food insecurity and lack of refrigeration. Labeling a patient as noncompliant fails to address the underlying social determinants of health. Nurses must identify these external stressors to provide equitable care rather than attributing systemic poverty to a personal failure of the patient.
Choice B rationale
Medication management must be tailored to the patient's environment to ensure safety and efficacy. Many insulin formulations require refrigeration for long term stability, which is impossible for this patient. Exploring alternatives like oral glucose lowering agents or medications with longer room temperature stability prevents drug degradation. Addressing the lack of a refrigerator is a direct intervention for a social determinant of health that impacts the biochemical management of type 2 diabetes and prevents hypoglycemia.
Choice C rationale
Transportation is a major social determinant of health that directly impacts clinical outcomes and patient safety. Without reliable transport, the patient cannot attend follow up appointments for hemoglobin A1c monitoring, which should remain below 7 percent. Lack of access to healthcare facilities leads to poorly managed blood glucose levels and increased risk for chronic complications like nephropathy or retinopathy. Assessing this need allows the nurse to coordinate with community resources to ensure continuity of care.
Choice D rationale
Social services play a critical role in addressing food insecurity, which is a primary social determinant of health. Food insecurity leads to unpredictable caloric intake, making it dangerous to administer medications like sulfonylureas that can cause severe hypoglycemia. Referrals to assistance programs ensure the patient has access to consistent nutrition. Stabilizing food access allows for a predictable dietary pattern, which is essential for maintaining blood glucose levels within the target range of 70 to 130 mg/dL.
Choice E rationale
Reinforcing a diet without considering the patient's financial circumstances is an ineffective and dismissive nursing action. It ignores the reality of the patient's situation and fails to provide a realistic plan for health promotion. Quality care requires the nurse to adapt education to the patient's specific socioeconomic status. Simply repeating instructions that the patient has already stated they cannot follow does not improve safety and ignores the barriers identified during the initial nursing assessment.
Correct Answer is ["A","B","C","D","E"]
Explanation
Choice A rationale
Measuring intake and output is a basic data collection task that does not require nursing judgment or clinical analysis. Under the principles of delegation, a UAP can perform this task for stable patients. The RN remains responsible for analyzing the numerical data to evaluate the effectiveness of rehydration therapy. Dehydration involves fluid volume deficit where normal urine output is typically 30 mL to 60 mL per hour.
Choice B rationale
Assisting with ambulation is a standard task for UAPs and LPNs when the patient is clinically stable. Postoperative knee replacement patients require movement to prevent venous thromboembolism. If the patient is early in their recovery or unstable, the RN must perform the initial assessment. However, routine assistance with walking is appropriate for delegation as it focuses on physical support rather than complex clinical assessment of the surgical site.
Choice C rationale
Reinforcing teaching is a specific competency within the LPN scope of practice. While the RN must perform the initial education and assessment of the patient's learning needs regarding heart failure and sodium restrictions, the LPN can remind the patient of these instructions. This reinforcement helps solidify the patient's understanding of dietary triggers for fluid retention and exacerbation of heart failure symptoms, supporting the overall plan of care.
Choice D rationale
Monitoring a stable patient is within the scope of both LPNs and UAPs, depending on the specific observation required. For a patient with a history of seizures who is currently stable after a procedure, the LPN can monitor for signs of seizure activity or changes in consciousness. The RN must still perform the primary neurological assessments, but the delegation of routine observation ensures patient safety while the RN manages more complex tasks.
Choice E rationale
Administering oral medications to stable patients is a core function of the LPN. The LPN is trained to verify the five rights of medication administration and monitor for basic side effects. In a postoperative context, once the patient is stable and cleared for oral intake, the LPN can safely provide scheduled medications. The RN retains the responsibility for managing intravenous medications, blood products, and any complex titration required by the patient.
Choice F rationale
Changing a central venous catheter dressing is a sterile, complex procedure that is generally reserved for the RN in many facility policies due to the high risk of central line associated bloodstream infections. This task involves assessing the insertion site for signs of infection and maintaining strict aseptic technique. Because of the potential for significant complications and the need for advanced clinical judgment, it is not typically delegated to UAPs or LPNs.
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