In the majority culture of America, coughing, sweating, and diarrhea are symptoms of an illness. For some individuals of Mexican-American origin, however, these symptoms are a normal part of living. The nurse recognizes that this is true, probably because Mexican-Americans:

Correct Answer: B

Rationale: In Mexican-American culture, coughing, sweating, and diarrhea are often considered normal bodily functions and not necessarily indicative of illness. This cultural perspective shapes their understanding of health and illness, leading them to view these symptoms differently than the majority culture in America. Choice A is incorrect because it generalizes Mexican-Americans as having less efficient immune systems, which is not supported by evidence. Choice C is incorrect as it oversimplifies by attributing the perception solely to coming from Mexico. Choice D is incorrect as it makes unwarranted assumptions about the socioeconomic status and health status of Mexican-Americans.

Correct Answer: A

Rationale: Note-taking during an interview can impede the nurse's ability to observe the patient's nonverbal behaviors, such as body language and facial expressions, which are important aspects of communication. It may break eye contact too often, shift attention away from the patient, interrupt the patient's narrative flow, and diminish the patient's sense of importance. Therefore, it is crucial for the nurse to balance the need for note-taking with maintaining active listening and observation skills to ensure effective communication and rapport building with the patient. Choices B, C, and D are incorrect because note-taking can actually hinder the patient's narrative flow, decrease the nurse's observation of nonverbal cues, and potentially make the patient feel less important or attended to due to distractions caused by the note-taking process.

Correct Answer: B

Rationale: The appropriate nursing response would be to assess the toddler's ear to determine if there is indeed an ear infection causing the earache. It is crucial to provide timely and suitable care for the child's pain and discomfort. Checking for an ear infection is a necessary step in evaluating the source of the toddler's earache. Choice A is incorrect as it assumes the earache is due to teething without proper assessment. Choice C questions the mother's report rather than focusing on the child's condition. Choice D is not as direct and focused as directly examining the ear for a possible infection.

Correct Answer: D

Rationale: The nurse's statement, 'Tell me more about that,' is an example of an open-ended question. Open-ended questions encourage the interviewee to provide detailed information and expand on their responses. This type of question is useful for gathering narrative information and allows the interviewee to express themselves freely. Reflection involves restating or paraphrasing the client's words, facilitation encourages the client to say more, and direct questions typically elicit specific, close-ended responses, unlike open-ended questions.

Correct Answer: A

Rationale: The appropriate action for the nurse in this situation is to ask the patient about the charm and its significance. This helps the nurse understand the patient's cultural beliefs, personal values, and any potential significance the charm holds for the patient. It also shows respect for the patient's personal belongings. Asking about the charm can help establish rapport and cultural competence in the nurse-patient relationship. Choices B and C do not address the patient's attachment to the charm or provide an opportunity for cultural understanding. Choice D is incorrect as it dismisses the importance of acknowledging and respecting the patient's personal belongings.

Correct Answer: A

Rationale: When communicating with a patient who has a hearing impairment, it is crucial to determine the preferred communication method, whether it involves signing, lip reading, or writing. By directly asking the patient for their preferred method of communication, the healthcare provider can ensure effective and respectful interaction tailored to the individual's specific needs and preferences. Option B is incorrect because using facial and hand gestures can actually aid in communication for some individuals with hearing impairments. Option C is not always necessary and may not be the preferred method for all patients. Option D is incorrect because speaking loudly and with exaggerated facial movements is not necessary and may not be preferred by the patient.

Correct Answer: A

Rationale: A. Collect the patient's data in a direct, face-to-face manner: When conducting an interview in an outpatient clinic, it is essential to engage with the patient face-to-face to establish a rapport, gather their narrative, and ensure accurate data collection. Entering all the data as the patient states it (choice B) may lead to missing important details or misinterpretation. Asking the patient to wait as the data is entered (choice C) can create a disconnect in communication and reduce patient engagement. Typing the data into the computer after establishing a connection (choice D) is not ideal as it is important to collect data actively while interacting with the patient.

Correct Answer: D

Rationale: The most appropriate statement to initiate an assessment of cultural beliefs with an elderly American Indian patient is to ask, "What cultural or spiritual beliefs are important to you?" This question encourages the patient to share their personal beliefs without assuming stereotypes or making generalizations. It allows the patient to express their individual cultural and spiritual practices, enabling nurses to deliver more personalized and culturally competent care. Choices A, B, and C are not as suitable. Choice A assumes a specific faith without considering the patient's actual beliefs. Choice B relies on a stereotype about American Indian culture, and Choice C focuses more on seeking medical help rather than exploring cultural beliefs.

Correct Answer: D

Rationale: The parent's sudden change in body language from an open position to crossing arms and legs suggests discomfort or defensiveness, particularly when discussing his son's treatment. This closed-off position indicates a lack of willingness to share information and potentially signals discomfort with the topic being discussed. Choice A is incorrect as the abrupt shift in body language indicates more than just a change in position. Choice B is incorrect because crossing arms and legs typically signal defensiveness or discomfort rather than comfort. Choice C is incorrect as there are specific body language cues indicating discomfort rather than just fatigue.