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A year ago
A female nurse is caring for an older woman from the Hasidic Jewish community. The woman's son is at the patient's bedside.
 
  The nurse notes that when she communicates with the patient and her son, the son does not maintain eye contact with her and also notes that he withdraws when she attempts to shake his hand. The best response by the nurse is to:
  a. carry on conversation with the patient on-ly, ignoring the son.
  b. continue conversing with both the patient and the son.
  c. ask the son to leave since he is not com-fortable with her.
  d. ask the patient why the son will not en-gage with her.

Question 2

An older patient learns that he has metastatic cancer. The patient states: I must have angered God. This is an example of which type of belief?
 
  a. Biomedical
  b. Magico-religious
  c. Naturalistic
  d. Ayurvedic

Question 3

A home care nurse is caring for an older patient from a different culture who is bed-bound and high risk for development of a pressure ulcer.
 
  The nurse discusses the plan of care with the patient's daughter, emphasizing the importance of turning every 2 hours and posts a turning clock on the wall. When the nurse returns later in the week, the turning clock has been removed, and the patient's daughter reports that she turns her mother occasionally. She states, I am taking very good care of my mother. You just don't un-derstand; our ways do not involve doing things on schedules. The best response by the nurse is:
  a. You must follow my guidelines and turn her every 2 hours, or I will not be able to take care of her.
  b. I understand that you value your culture, but culture cannot stop you from provid-ing good care to your mother.
  c. I understand that you care very much for your mother. Perhaps caring for her is too much for you.
  d. How can we best work together to pro-vide the best care for your mother?

Question 4

Regarding health care disparities, it is true that older adults of color have:
 
  a. equal risk factors for vulnerability as do all older adults.
  b. equal risk factors for vulnerability as do the young adults of color.
  c. increased risk factors for vulnerability if they are female.
  d. an increase in risk factors for vulnerability if care is provided by public facilities.

Question 5

An older female patient tells a nurse the following: In my culture, women are the silent partner in the family. Men make all of the decisions. However, when we came to the United States, all that changed.
 
  I became an American. I am in charge of my family just like my husband. This is an example of:
  a. enculturation.
  b. acculturation.
  c. ethnicity.
  d. culture competence.

Question 6

Gerotranscendence theory posits that: (Select all that apply.)
 
  a. older adults withdraw from society in or-der to allow the transfer of power to younger individuals.
  b. older adults withdraw from society in or-der to give the individual an opportunity for self-reflection and self-exploration.
  c. time and superficial relationships become less important.
  d. material possessions have less meaning.
  e. status and value of elders is lost because their contributions are no longer valued.
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A year ago
Answer to #1

ANS: B
In some cultures, direct eye contact or contact between men and women is seen as a sexual ad-vance. This is true in the Hasidic culture. Options A and C are disrespectful to the patient and her son. Option D may put the son in an uncomfortable position.

Answer to #2

ANS: B
Magico-religious: views illness as caused by actions of a higher authority.
Biomedical: views disease as a result of abnormalities in structure and function and disease caused by intrusion of pathogens into the body.
Naturalistic: based on the concepts of balance. Health is seen as a sign of balance.
Ayurvedic: the oldest known paradigm in the naturalistic system. Illness is seen as an imbalance.

Answer to #3

ANS: D
In providing cross-cultural care it is important that the nurse work with the patient and family and listen carefully and find a way to include the values and beliefs of the patient in the plan of care.

Answer to #4

ANS: C
Older females of color have an added risk factor for vulnerability (gender) than do males of the same age and ethnic group. Ethnicity is an added factor for vulnerability. Age is an additional risk factor for vulnerability. Health care disparities are found across a wide range of clinical set-tings.

Answer to #5

ANS: B
Enculturation is defined as cultural beliefs passed down from one generation to the next. Accul-turation is the process by which persons from one culture adapt to another. Ethnicity is defined as the cultural group that one identifies with. Cultural competence involves stepping outside our own biases and understanding that others bring a different set of values.

Answer to #6

ANS: B, C, D
Disengagement theory posits that older adults withdraw from society in order to allow the trans-fer of power to younger adults. Gerotranscendence theory posits similarly that older adults with-draw from society, but for different reasons. These reasons include giving the individual the op-portunity for self-reflection and exploration. Time, material possessions, and superficial relation-ships have less meaning. The modernization theory posits that the status and value of elders is lost because their contributions are no longer valued.
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