Maternal and Child Nursing Care 5th Edition London Test Bank

Maternal and Child Nursing Care 5th
Edition London Test Bank

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Chapter 8 Physical and Psychologic Changes of Pregnancy
1) While auscultating fetal heart tones, a client who is at 37 weeks’ gestation and is in the
supine position is experiencing dizziness, lightheadedness, and clammy skin. Which nursing
action is the most appropriate?
1. Administer supplemental oxygen.
2. Help the client turn onto her right side.
3. Place a wedge beneath the client’s right hip.
4. Prepare for administration of packed red blood cells (PRBCs).
Answer: 3
Explanation:
1. Supplemental oxygen is not required for supine hypotension syndrome.
2. Positioning the client on her right side would likely exacerbate the reduction in right atrial
blood flow.
3. The client is verbalizing symptoms consistent with supine hypotension syndrome, in which
compression of the vena cava by the uterus reduces right atrial blood flow. Signs and
symptoms include decreased blood pressure, dizziness, pallor, and clamminess. Appropriate
interventions include having the woman lie on her left side, or placing a pillow or wedge
under her right hip as she lies in a supine position.
4. Packed red blood cell infusion is not required to treat supine hypotension syndrome.
Page Ref: 158
Cognitive Level: Applying
Client Need/Sub: Physiological Integrity/Reduction of Risk Potential
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of client
centered care │ AACN Essential Competencies: IX.3. Implement holistic, client-centered care that
reflects an understanding of human growth and development, pathophysiology, pharmacology,
medical management and nursing management across the health-illness continuum, across lifespan,
and in all healthcare settings│ NLN Competencies: Context and Environment; Practice; conduct
population-based transcultural health assessments and interventions │ Nursing/Integrated Concepts:
Implementation
Learning Outcome: 8.1 Describe the anatomic and physiologic changes that occur during pregnancy.
MNL Learning Outcome: 2.7.1. Contrast the various hypertensive disorders in pregnancy and
appropriate nursing care.
2) A client with a normal prepregnancy weight asks why she has been told to gain 25 to 35
pounds during her pregnancy, but her underweight friend was told to gain 28 to 40 pounds.
What should the nurse explain as being the recommended weight gain during pregnancy?
1. More than 25 to 35 pounds for an overweight client
2. More than 25 to 35 pounds for an underweight woman
3. 25 to 35 pounds, regardless of a client’s prepregnancy weight
4. The same for a normal-weight woman as for an overweight woman
1
Copyright © 2017 Pearson Education, Inc.
Answer: 2
Explanation:
1. Overweight women should gain 15 to 25 pounds during pregnancy.
2. Underweight women are encouraged to gain 28 to 40 pounds during pregnancy
3. Prepregnancy weight determines the recommended weight gain during pregnancy. Women
of normal weight should gain 25 to 35 pounds during pregnancy for optimal fetal outcome.
4. Overweight women should gain 15 to 25 pounds during pregnancy.
Page Ref: 159
Client Need/Sub: Health Promotion and Maintenance
centered care │ AACN Essential Competencies: IX.4. Communicate effectively with all members of
the healthcare team, including the client and the client’s support network│ NLN Competencies:
Context and Environment; Practice; conduct population-based transcultural health assessments and
interventions │ Nursing/Integrated Concepts: Implementation
MNL Learning Outcome: 2.3.3. Implement client teaching that promotes health maintenance during
pregnancy.
3) The nurse is reviewing the assessment findings of a client who is at 35 weeks’ gestation.
Which data suggest the need for further investigation?
1. Glycosuria
2. Funic souffle
3. Pseudoanemia
4. Melasma gravidarum
Answer: 1
Explanation:
1. Glycosuria (glucose in the urine) during pregnancy may be normal or may indicate
gestational diabetes, so it always warrants further testing.
2 Funic souffle is a normal assessment finding associated with the pulsing of blood through
the umbilical cord.
3. Physiologic anemia of pregnancy or pseudoanemia is common during pregnancy and is an
expected finding.
4. Facial chloasma or melasma gravidarum (also known as the “mask of pregnancy”) is a
harmless darkening of the skin over the cheeks, nose, and forehead that sometimes
accompanies pregnancy.
Page Ref: 158
Cognitive Level: Analyzing
centered care │ AACN Essential Competencies: IX.1. Conduct comprehensive and focused physical,
2
behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and
illness parameters in clients, using developmentally and culturally appropriate approaches│ NLN
Competencies: Context and Environment; Practice; conduct population-based transcultural health
assessments and interventions │ Nursing/Integrated Concepts: Assessment
MNL Learning Outcome: 2.2.2. Assess maternal assessment data for potential risk factors.
4) A client in the prenatal clinic believes she is pregnant because she has not menstruated for 3
months, and her breasts are getting bigger. What response by the nurse is best?
1. “Lack of menses and breast enlargement are presumptive signs of pregnancy.”
2. “The changes you are describing are definitely indicators that you are pregnant.”
3. “Lack of menses can be caused by many things. We need to do a pregnancy test.”
4. “Breast and menstrual changes are positive signs of pregnancy. Congratulations.”
Answer: 3
Explanation:
1. Although this is true, amenorrhea and breast enlargement also can be caused by weight gain
and other conditions. A pregnancy test is needed to determine whether the client is
pregnant.
2. This statement is false because amenorrhea and breast enlargement are presumptive signs of
pregnancy because they can be caused by other conditions.
3. This is a true statement and addresses that these changes could be caused by things other
than pregnancy.
4. This statement is false because amenorrhea and breast enlargement are presumptive signs of
pregnancy. It is too early to determine if congratulations are in order.
Page Ref: 161
Learning Outcome: 8.3 Compare subjective (presumptive), objective (probable), and diagnostic
(positive) changes of pregnancy.
MNL Learning Outcome: 2.1.3. Differentiate between subjective, objective, and diagnostic indicators
of pregnancy.
5) The nurse has completed a presentation for newly pregnant women about the changes of
pregnancy. Which participant’s statement reflects accurate comprehension of the
information?
1. “Uterine souffle is a positive change of pregnancy.”
2. “A positive Goodell sign is a probable change of pregnancy.”
3. “Changes in the pelvic organs are presumptive signs of pregnancy.”
3
4. “Three positive pregnancy tests in a 1-week period is considered to be a positive change of
pregnancy.”
Answer: 2
Explanation:
1. Because uterine souffle can be objectively identified but may be caused by conditions other
than pregnancy, it is considered to be a probable change of pregnancy.
2. A positive Goodell sign can be objectively identified but may also be caused by conditions
other than pregnancy; therefore, it is considered to be a probable change of pregnancy.
3. Changes in the pelvic organs can be objectively identified; however, because some pelvic
organ changes may be associated with conditions other than pregnancy, they are considered
to be probable changes of pregnancy.
4. Because other conditions may cause elevated hCG, pregnancy tests are considered probable
changes of pregnancy.
Page Ref: 161
centered care │ AACN Essential Competencies: IX.7. Provide appropriate client teaching that
reflects developmental stage, age, culture, spirituality, client preferences, and health literacy
considerations to foster client engagement in their care│ NLN Competencies: Relationship Centered
Care; Practice; learn cooperatively, facilitate the learning of others │ Nursing/Integrated Concepts:
Evaluation/Teaching/Learning
of pregnancy.
6) A client who is experiencing her first pregnancy has just completed the initial prenatal
examination with a certified nurse–midwife. Which statement indicates that the client has a
correct understanding of her condition?
1. “The increased size of my uterus means that I am finally pregnant.”
2. “Because we heard the baby’s heartbeat, I am undoubtedly pregnant.”
3. “Since I haven’t felt the baby move yet, we don’t know if I’m pregnant.”
4. “My last period was 2 months ago, which means I’m 2 months along.”
Answer: 2
Explanation:
1. Increased uterine size is a probable, or objective, change and does not conclusively verify
pregnancy status.
2. Hearing the fetal heart rate is a positive, or diagnostic, change of pregnancy.
3. Fetal movement is a presumptive, or subjective, change of pregnancy. Absence or presence
of the sensation of fetal movement is not a conclusive indicator of pregnancy status.
4. Amenorrhea is a presumptive, or subjective, change and does not conclusively verify
pregnancy status.
4
Page Ref: 163
centered care │ AACN Essential Competencies: IX.9. Monitor client outcomes to evaluate the
effectiveness of psychobiological interventions│ NLN Competencies: Relationship Centered Care;
Practice; learn cooperatively, facilitate the learning of others │ Nursing/Integrated Concepts:
Evaluation
of pregnancy.
7) An adolescent client reports that her period is late but that her home pregnancy test is
negative. Which response is most appropriate?
1. “This means you are not pregnant.”
2. “We do not trust home tests. Come to the clinic for a blood test.”
3. “Most people do not use the tests correctly. Did you read the instructions?”
4. “You might be pregnant, but it might be too early for your home test to be accurate.”
Answer: 4
Explanation:
1. Although this might be true, this is not the best response because the pregnancy may not yet
be detectable through use of a urine pregnancy test.
2. This statement is not therapeutically worded. Additionally, this statement is not true because
home pregnancy tests are quite simple to use and quite accurate. A clinic pregnancy test is
usually a urine test. Blood tests are more invasive and more expensive.
3. This response does not address the issues presented in the client’s statement.
4. This is an accurate and appropriate response. Most home pregnancy tests have low false-
positive rates, but the false-negative rate is slightly higher. Repeating the test in 1 week is
recommended.
Page Ref: 163
Learning Outcome: 8.4 Contrast the various types of pregnancy tests.
MNL Learning Outcome: 2.2.1. Perform a comprehensive prenatal assessment.
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8) A 28-year-old client who is pregnant with her first child reports increased dental caries
(cavities) since becoming pregnant. How should the nurse explain the likely cause for this
change?
1. “Each woman experiences changes that affect her teeth while she’s pregnant.”
2. “When a woman is pregnant, her teeth lose calcium and she is more susceptible to getting
cavities.”
3. “During pregnancy, tooth enamel softens and the woman is more susceptible to getting
cavities.”
4. “It may be necessary to pay extra attention to dental care while you’re pregnant, especially
if you’re vomiting frequently.”
Answer: 4
Explanation:
1. No demonstrable changes occur in the teeth of pregnant women.
2. Calcium is not lost from the teeth during pregnancy.
3. Tooth enamel does not soften during pregnancy.
4. The dental caries that sometimes accompany pregnancy are probably caused by inadequate
oral hygiene and dental care, especially if the woman has problems with bleeding gums or
nausea and vomiting.
Page Ref: 159
MNL Learning Outcome: 2.2.1. Perform a comprehensive prenatal assessment.
9) A client at 30 weeks’ gestation is tearful at the time of her follow-up visit. She tells the
prenatal clinic nurse that she is excited to finally become a mother and that she has been
thinking about what kind of parent she will be. However, she is upset because her mother
has told her that she does not want to be a grandmother because she does not feel old
enough. Meanwhile, the client’s husband has said that the pregnancy does not feel real to
him yet and that he will become excited when the baby is actually here. What is the most
likely explanation for what is happening within this family?
1. Family members are adjusting to the role change at their own pace.
2. Her mother is rejecting the role of grandparent and will not help out.
3. Her husband will not attach with this child and will not be a good father.
4. The client is not progressing through the developmental tasks of pregnancy.
Answer: 1
Explanation:
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1. This is a true statement. When the other family members are at different stages of
adjustment to the pregnancy, conflict can ensue.
2. Adaptation to the role of grandparent is another life task that takes time. Younger
grandparents often have busy and full lives and view grandparenthood as a time for elderly
people who are retired and slowed down. The family will form a view of grandparenthood
within this family, in a way that works for them.
3. The husband’s statement is quite common. Partners often feel that a pregnancy is not real to
them because they are not experiencing any of the physical changes associated with
pregnancy.
4. This is a false statement. The client is at the stage of seeking acceptance of this child by
others, which first will be her partner and other family members.
Page Ref: 164
Client Need/Sub: Psychosocial Integrity
centered care │ AACN Essential Competencies: IX.1.Conduct comprehensive and focused physical,
behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and
illness parameters in clients, using developmentally and culturally appropriate approaches│ NLN
Competencies: Context and Environment; Practice; conduct population-based transcultural health
assessments and interventions │ Nursing/Integrated Concepts: Assessment
Learning Outcome: 8.5 Examine the emotional and psychologic changes that commonly occur in a
woman, her partner, and her family during pregnancy.
MNL Learning Outcome: 2.1.4. Assess the childbearing family’s psychosocial adaptation to
pregnancy.
10) The partner of a pregnant client at 16 weeks’ gestation accompanies her to the clinic. The
partner tells you that the baby just does not seem real to him, and he is having a hard time
relating to his partner’s fatigue and food aversions. Which statement would be best for the
nurse to make?
1. “Many men feel this way. Feeling the baby move will help make it real.”
2. “My husband had no problem with this. What was your childhood like?”
3. “You might need professional psychologic counseling. Ask your physician.”
4. “If you would concentrate harder, you would be aware of the reality of this pregnancy.”
Answer: 1
Explanation:
1. Kicking and ultrasound visualization are concrete evidence of the baby’s existence and
often are turning points in acceptance for partners.
2. The ambivalence and disbelief occur across all socioeconomic groups, in both partners who
were fathered well and those who grew up without a father.
3. This reaction is not indicative of psychologic pathology.
4. Ambivalence is common among partners, especially prior to either seeing the baby on
ultrasound or feeling the baby kick and move.
Page Ref: 166
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pregnancy.
11) A 20-year-old client who is at 10 weeks’ gestation confides that the pregnancy was
unplanned and is unsure about continuing it or sharing news about it with her partner. How
should the nurse respond to this client?
1. “You should go to a pregnancy support group to be a good mother.”
2. “It’s common to feel ambiguous about pregnancy in the first trimester.”
3. “These thoughts are because your mother died when you were 4 years old.”
4. “It’s really unusual for a pregnant woman to feel this way early in the pregnancy.”
Answer: 2
Explanation:
1. No psychopathology is present, so a support group is not indicated.
2. Ambivalence toward the pregnancy is very common in the first trimester.
3. Loss of the client’s own mother at a young age would not affect the occurrence of
ambivalence in the first trimester.
4. Fathers might not be told immediately about the diagnosis of pregnancy.
Page Ref: 165
pregnancy.
8
12) During an interview the nurse asks the partner of a woman in the second trimester of
pregnancy what changes they have noticed during the pregnancy. Which answer would
indicate a typical response to pregnancy?
1. “She daydreams about what kind of parent she is going to be.”
2. “I have not noticed anything. I just found out she is pregnant.”
3. “She has been having dreams at night about misplacing the baby.”
4. “She has been more tense and anxious than usual, and she is not sleeping well.”
Answer: 1
Explanation:
1. The second trimester usually brings increased introspection and consideration of how she
will parent.
2. In the first trimester, pregnant women usually tell their partners of the pregnancy, explore
their relationship with their mother, and think about their own role as a mother.
3. The needs of the newborn typically are not considered until the third trimester, at which
time dreams of misplacing the baby or being unable to get to the baby also may be common.
4. During the third trimester, the woman typically experiences more anxiety and tension, as
well as increased discomfort and insomnia.
Page Ref: 165
centered care │ AACN Essential Competencies: IX.9. Monitor client outcomes to evaluate the
effectiveness of psychobiological interventions│ NLN Competencies: Context and Environment;
Practice; conduct population-based transcultural health assessments and interventions │
Nursing/Integrated Concepts: Assessment
pregnancy.
13) The mother of a client who is 14 weeks pregnant is uncertain about how to be a good
grandmother to this baby due to working full time and being so busy. How should the nurse
respond in this situation?
1. “How do you envision your role as grandmother?”
2. “Don’t worry. You’ll be a wonderful grandmother. It will all work out fine.”
3. “As long as there is another grandmother available, you do not have to worry.”
4. “Grandmothers are supposed to be available. You should retire from your job.”
Answer: 1
Explanation:
1. Supportive, nonjudgmental exploration of the client’s concerns is one component of
therapeutic communication and is appropriate.
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2. Casual and/or false reassurance is not appropriate. Effective therapeutic communication
requires supportive, nonjudgmental exploration of the client’s concerns.
3. Minimizing a client’s concern is not appropriate. Effective therapeutic communication
requires supportive, nonjudgmental exploration of the client’s concerns.
4. Assignment of guilt is not appropriate. Effective therapeutic communication requires
supportive, nonjudgmental exploration of the client’s concerns
Page Ref: 167
interventions │ Nursing/Integrated Concepts: Assessment
pregnancy.
14) A client in labor is a Lebanese immigrant, and she explains that in the Muslim faith, the
baby’s name is selected after delivery, as it is God’s will whether or not the baby will be
born. Which nursing response is appropriate?
1. “Are you afraid your baby will not live?”
2. “We have a very low rate of complications at this facility.”
3. “In the United States, you can feel free to choose your baby’s name prior to the delivery.”
4. “Thank you for explaining that to me. By sharing your cultural beliefs with me, you are
helping me to provide you with the best possible care.”
Answer: 4
Explanation:
1. The client is describing the application of a culturally based belief, not a fear-based concern.
2. The client is describing the application of a culturally based belief, not a concern about
complications.
3. It is neither realistic nor appropriate to assume that people of another culture will
automatically abandon their ways and adopt the practices of a dominant culture.
4. The identification of cultural values is useful in planning and providing culturally sensitive
care.
Page Ref: 168
centered care │ AACN Essential Competencies: VII.7. Collaborate with other healthcare
professionals and clients to provide spiritually and culturally appropriate health promotion and
disease and injury prevention interventions │ NLN Competencies: Context and Environment;
10
Relationship Centered Care; Knowledge; Health care approaches of other disciplines and other
cultures │ Nursing/Integrated Concepts: Implementation/Culture and Spirituality
Learning Outcome: 8.6 Summarize cultural factors that may influence a family’s response to
pregnancy.
MNL Learning Outcome: 1.1.1. Relate the effect of culture and family to the childbearing
experience.
15) The nurse is presenting an in-service to nursing staff regarding the provision of culturally
competent client care. Which statement should the nurse include in the presentation?
1. “Developed countries are becoming increasingly more ethnically diverse.”
2. “The rituals and customs of a group reflect the values of the dominant culture.”
3. “Identification of cultural values is a task that is unrelated to providing culturally sensitive
care.”
4. “Many immigrants to a new country will adopt the beliefs and practices of the dominant
culture.”
Answer: 1
Explanation:
1. In many developed countries such as, for example, the United States, Canada, England, and
Germany, populations are becoming more and more ethnically diverse as the number of
immigrants continues to grow.
2. The rituals and customs of a group are a reflection of the group’s values.
3. The identification of cultural values is useful in planning and providing culturally sensitive
care.
4. It is not realistic or appropriate to assume that people of another culture will automatically
abandon their ways and adopt the practices of the dominant culture.
Page Ref: 168
disease and injury prevention interventions; IX.7. Provide appropriate client teaching that reflects
developmental stage, age, culture, spirituality, client preferences, and health literacy considerations
to foster client engagement in their care │ NLN Competencies: Context and Environment;
cultures; Relationship Centered Care; Practice; learn cooperatively, facilitate the learning of others │
Nursing/Integrated Concepts: Implementation/Culture and Spirituality/Teaching/Learning
pregnancy.
experience.
11
16) The nurse notes that a client who is 10 weeks pregnant is experiencing changes to the upper
respiratory system. What should the nurse explain as being the reason for these changes? Select all
that apply.
1. Estrogen-induced edema
2. Hypersecretion of mucus
3. Decreased white blood cell production
4. Vascular congestion of the nasal mucosa
5. Amniotic fluid reducing total fluid volume
Answer: 1, 2, 4
Explanation:
1. Upper respiratory changes in the form of nasal stuffiness and epistaxis may occur because of
estrogen-induced edema.
hypersecretion of mucus.
3. There is no change in white blood cell production.
vascular congestion of the nasal mucosa.
5. Amniotic fluid is not reducing the client’s total fluid volume.
Page Ref: 157
interventions│ Nursing/Integrated Concepts: Implementation
Learning Outcome: 8.2 Relate the physiologic and anatomic changes that occur in the body systems
during pregnancy to the signs and symptoms that develop in the woman.
MNL Learning Outcome: 2.1.2. Explain the expected maternal physiologic adaptations to pregnancy.
17) The nurse suspects that a pregnant client is experiencing effects to the gastrointestinal system
because of elevated progesterone levels. What did the nurse assess to make this clinical
determination? Select all that apply.
1. Nausea
2. Bloating
3. Diarrhea
4. Vomiting
5. Constipation
Answer: 2, 5
Explanation:
12
1. Nausea is common during the first trimester and may result from several factors, including
elevated human chorionic gonadotropin (hCG) levels, relaxation of the smooth muscle of the
stomach, and changed carbohydrate metabolism.
2. Elevated progesterone levels cause smooth muscle relaxation, resulting in delayed gastric
emptying and decreased peristalsis. As a result the pregnant woman may complain of bloating.
3. Diarrhea is not an expected effect of pregnancy on the gastrointestinal system.
4. Vomiting is common during the first trimester and may result from several factors, including
elevated human chorionic gonadotropin (hCG) levels, relaxation of the smooth muscle of the
stomach, and changed carbohydrate metabolism
5. Elevated progesterone levels cause smooth muscle relaxation, resulting in delayed gastric
emptying and decreased peristalsis. As a result the pregnant woman may complain of constipation.
Page Ref: 157
centered care │ AACN Essential Competencies: IX.2. Recognize the relationship of genetics and
genomics to health, prevention, screening, diagnostics, prognostics, selection of treatment, and
monitoring of treatment effectiveness, using a constructed pedigree from collected family history
information as well as standardized symbols and terminology│ NLN Competencies: Context and
Environment; Practice; conduct population-based transcultural health assessments and
interventions│ Nursing/Integrated Concepts: Assessment
18) The nurse is reviewing with a pregnant client the skin changes that she might experience during
gestation. What should the nurse include in this discussion? Select all that apply.
1. Linea nigra
2. Spider nevi
3. Psoriatic lesions
4. Striae gravidarum
5. Melasma gravidarum
Answer: 1, 2, 4, 5
Explanation:
1. Changes in skin pigmentation occurring during pregnancy are thought to be stimulated by
increased estrogen, progesterone, and α-melanocytic–stimulating hormone levels. The skin in the
middle of the abdomen may develop a pigmented line, the linea nigra, which usually extends from
the pubic area to the umbilicus or higher.
2. Vascular spider nevi, small, bright-red elevations of the skin radiating from a central body, may
develop on the chest, neck, face, arms, and legs. They may be caused by increased subcutaneous
blood flow in response to elevated estrogen levels.
13
3. Psoriatic lesions are not typically associated with pregnancy.
4. Striae gravidarum, or stretch marks, may appear on the abdomen, thighs, buttocks, and breasts.
They result from reduced connective tissue strength because of elevated adrenal steroid levels.
5. Changes in skin pigmentation occurring during pregnancy are thought to be stimulated by
increased estrogen, progesterone, and α-melanocytic–stimulating hormone levels. Melasma
gravidarum, also known as the “mask of pregnancy,” a darkening of the skin over the forehead and
around the eyes, may develop. Melasma is more prominent in dark-haired women and is aggravated
by exposure to the sun.
Page Ref: 158–159
Implementation/Teaching/Learning
19) The nurse is preparing an educational program on the different types of pregnancy tests. What
should the nurse include about the β-subunit radioimmunoassay (RIA) test? Select all that apply.
1. It causes a color change.
2. It takes 2 to 3 hours to perform.
3. It is able to detect trophoblastic disease.
4. It is able to detect an ectopic pregnancy.
5. It is the same as an over-the-counter test.
Answer: 3, 4
Explanation:
1. Enzyme-linked immunosorbent assay (ELISA) uses a substance that results in a color change after
binding.
2. Fluoroimmunoassay (FIA) takes about 2 to 3 hours to perform.
3. β-Subunit radioimmunoassay (RIA) uses an antiserum with specificity for the β-subunit of hCG in
blood plasma. This test may not only detect pregnancy but also detect trophoblastic disease.
4. β-Subunit radioimmunoassay (RIA) uses an antiserum with specificity for the β-subunit of hCG in
blood plasma. This test may not only detect pregnancy but also detect an ectopic pregnancy.
5. Over-the-counter pregnancy tests are ELISA tests. This assay, which may be done on urine or
blood, is sensitive and quick. It can detect hCG levels as early as 7 to 9 days after ovulation and
conception, which is 5 days before the first missed period.
Page Ref: 163
14
Implementation/Teaching/Learning
Learning Outcome: 8.4 Contrast the various types of pregnancy tests.
of pregnancy.
20) The manager notes that a neonatal intensive care unit (NICU) nurse is practicing culturally
competent care. What did the manager observe to make this decision? Select all that apply.
1. Respects the rituals of the ethnic group of a new mother
2. Explains the processes that are followed in an American hospital
3. Speaks a few phrases in the language of a non–English-speaking client
4. Discusses the odd practices that a client from Europe wants to have done
5. Contacts an interpreter to facilitate communication with a Spanish-speaking client
Answer: 1, 3, 5
Explanation:
1. Evidence of cultural competence includes respecting the rituals of the client’s ethnic group.
2. Explaining the processes to be followed in an American hospital can be perceived as being
ethnocentric behavior.
3. Evidence of cultural competence includes learning the language, or at least several key phrases, of
at least one of the cultural groups with whom the nurse interacts.
4. Discussing a non-American client’s odd practices could be perceived as being ethnocentric
behavior.
5. Evidence of cultural competence includes providing for the services of an interpreter if a language
barrier exists.
Page Ref: 168
disease and injury prevention interventions │ NLN Competencies: Context and Environment;
cultures │ Nursing/Integrated Concepts: Evaluation/Culture and Spirituality
pregnancy.
15
experience.
16

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4. The same for a normal-weight woman as for an overweight woman

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