The nurse learns about cultural issues involvedin the patient’s health care belief system and enables patients and families to achieve meaningful and supportive care. Which concept is the nurse demonstrating?

Correct Answer: D

Rationale: The correct answer is D: Culturally congruent care. This concept refers to providing care that aligns with the patient's cultural beliefs and practices. By learning about cultural issues and enabling patients to receive care that is meaningful and supportive within their cultural context, the nurse is demonstrating culturally congruent care. A: Marginalized groups - This refers to groups in society who are disadvantaged and face discrimination. While understanding cultural issues may be important when caring for marginalized groups, it is not the main concept demonstrated in this scenario. B: Health care disparity - This refers to differences in access to healthcare and health outcomes among different populations. While cultural competence can help address healthcare disparities, it is not the concept being demonstrated here. C: Transcultural nursing - This refers to providing care across different cultures. While related, it does not specifically address the nurse's role in understanding and enabling culturally appropriate care for individual patients and families.

Correct Answer: A

Rationale: The correct answer is A: Abdominal palpation. Palpating the abdomen can potentially cause rupture of the liver in patients with HELLP syndrome due to increased risk of liver hematoma. This can lead to severe bleeding and compromise the patient's condition. Checking deep tendon reflexes (C), auscultation of the heart and lungs (D), and venous sample of blood (B) are safe assessments that do not pose a risk of exacerbating the patient's condition. It is crucial to prioritize patient safety and avoid interventions that can harm the patient, making avoiding abdominal palpation the correct choice in caring for a patient with HELLP syndrome.

Correct Answer: B

Rationale: The correct answer is B: Uses humility. Critical thinking in nursing involves being open-minded, self-aware, and willing to consider different perspectives. Humility allows nurses to acknowledge their limitations, seek feedback, and continuously learn and improve. Instilling faith (A) may be important but does not directly relate to critical thinking standards. Self-confidence (C) can be beneficial, but excessive confidence can lead to closed-mindedness. Supportiveness (D) is valuable in patient care but does not specifically demonstrate critical thinking standards. In summary, humility enables nurses to approach patient communication with an open and reflective mindset, essential for applying critical thinking standards effectively.

Correct Answer: A

Rationale: The correct answer is A: Sit or stand in front of the patient when speaking. This choice is correct because it allows the patient with otosclerosis to directly see the nurse's face and lip movements, aiding in lip-reading and understanding speech. Sitting or standing in front of the patient also ensures better eye contact and reduces background noise interference. Choice B is incorrect because exaggerated lip and mouth movements may distort speech and make it harder for the patient to understand. Choice C is incorrect because standing in front of a light or window can create glare and make it difficult for the patient to see the nurse's face clearly. Choice D is incorrect because saying the patient's name loudly before starting to talk does not directly address the communication needs of a patient with otosclerosis.

Correct Answer: B

Rationale: The correct answer is B: Does she have a sense of peace of mind and a purpose to her life? This question is crucial during a spiritual assessment because it addresses the patient's emotional well-being and coping mechanisms in the face of a terminal diagnosis. It helps assess the patient's spiritual beliefs, values, and sources of strength, which can impact their ability to find meaning and comfort during difficult times. It also provides insights into the patient's resilience and ability to navigate their emotions and find peace amidst uncertainty. Choice A is incorrect because it focuses on the patient's ability to deliver negative news to her family, which is important but not as central to the patient's spiritual well-being in this context. Choice C is incorrect as it assumes the patient needs to let go of her husband, which may not be relevant to her spiritual assessment. Choice D is incorrect as it centers on bargaining with God for a cure, which may not be reflective of the patient's spiritual beliefs or needs.

Correct Answer: A

Rationale: The correct answer is A: Have you ever experienced claustrophobia or feelings of anxiety while in enclosed spaces? This question is important because electronystagmography involves the patient being placed in a confined space with sensors attached to monitor eye movements. Claustrophobia or anxiety can significantly impact the patient's ability to tolerate the test, affecting its accuracy. Choice B: Do you currently take any tranquilizers or stimulants on a regular basis? While relevant in some cases, it is not as crucial as ensuring the patient can tolerate the test environment. Choice C: Do you have a history of falls or problems with loss of balance? While relevant to Mnire's disease, it is not directly related to the preparation for electronystagmography. Choice D: Do you have a history of either high or low blood pressure? While monitoring blood pressure is important for some procedures, it is not a primary concern for electronystagmography.

Correct Answer: C

Rationale: The correct answer is C: Reduce environmental noise and distractions before communicating. This intervention is most likely to facilitate effective communication with a hearing-impaired patient because it creates an optimal environment for the patient to better focus on the communication. By reducing noise and distractions, the patient can more easily concentrate on the conversation and lip reading, if needed. This approach demonstrates sensitivity to the patient's needs and enhances the chances of successful communication. The other choices are incorrect because: A: Asking the patient to repeat what was said may cause frustration and does not address the environmental factors that can hinder communication. B: Standing directly in front of the patient to facilitate lip reading may help, but it does not address the impact of environmental noise and distractions on communication. D: Raising the voice to project sound at a higher frequency is not effective as it can distort speech and may not necessarily improve understanding for a hearing-impaired patient.

Correct Answer: B

Rationale: The correct answer is B. Stress, like having three final examinations on the same day, can lead to increased peristalsis due to the activation of the sympathetic nervous system. This can result in faster movement of food through the digestive system. The other choices are incorrect because: A - Ignoring the urge to defecate does not directly relate to increased peristalsis. C - Major depressive disorder is more likely to be associated with decreased peristalsis due to the effects of stress on the body. D - Elderly individuals tend to have reduced peristalsis due to age-related changes in the digestive system.

Correct Answer: A

Rationale: The correct answer is A: Previous birth of large infant. This factor increases the risk of gestational diabetes mellitus due to a history of delivering a large baby, indicating a higher likelihood of insulin resistance in subsequent pregnancies. Maternal age younger than 25 years (B) is not a known risk factor for gestational diabetes. Being underweight prior to pregnancy (C) is actually associated with a decreased risk of gestational diabetes. A previous diagnosis of type 2 diabetes mellitus (D) is a separate condition and does not directly increase the risk of gestational diabetes.