Patient’s adjustment to hospital-person, socio-economic and cultural background
Time: 15:00
Which of the following is a common personal reaction to hospitalization that a nurse should anticipate in most adult patients?
[a] A feeling of empowerment and increased self-esteem.
[b] A sense of losing control, identity, and independence.
[c] An immediate feeling of relief from all life responsibilities.
[d] A complete indifference to their surroundings and diagnosis.
A patient expresses significant anxiety about the cost of their hospital stay and how they will pay their bills. This concern is primarily rooted in their:
[a] Personal coping style.
[b] Cultural background.
[c] Socio-economic background.
[d] Previous medical history.
When a patient's family plays a dominant role in making all healthcare decisions, the nurse should recognize this as potentially reflecting the patient's:
[a] Lack of interest in their own health.
[b] Cultural or familial norms.
[c] Inability to understand medical information.
[d] Mistrust of the nursing staff.
An adolescent patient recovering from surgery is withdrawn and unwilling to see friends. This behavior most likely indicates a struggle with adjusting to:
[a] The financial implications of the surgery.
[b] An altered body image and fear of social rejection.
[c] The bland hospital food.
[d] A culturally-based need for isolation.
A nurse carefully explains a procedure using simple terms and a diagram. This approach is particularly helpful for a patient whose adjustment may be challenged by a low level of:
[a] Social support.
[b] Financial resources.
[c] Cultural assimilation.
[d] Health literacy.
A patient from a stoic cultural background verbally denies having pain but is grimacing and guarding their incision. The nurse's best interpretation is that:
[a] The patient does not understand the pain scale.
[b] The patient is likely not in significant pain.
[c] Non-verbal cues are critical and may indicate more pain than is reported.
[d] The patient is seeking attention through non-verbal behavior.
The term "depersonalization" in the context of hospitalization refers to the feeling that one is:
[a] Being treated as a diagnosis or room number rather than an individual.
[b] Separated from one's cultural support system.
[c] Unable to afford the care being provided.
[d] Experiencing a normal adjustment to the hospital routine.
Discharge planning for a patient who is homeless is complex primarily because their socio-economic status creates a significant barrier to:
[a] Understanding discharge instructions.
[b] Forming a therapeutic relationship with the nurse.
[c] Adhering to cultural dietary restrictions.
[d] Securing a safe environment for recovery and follow-up care.
To respect a female patient's culturally-based need for modesty during an examination, the most appropriate nursing action is to:
[a] Ask her husband to perform the examination.
[b] Complete the examination as quickly as possible without draping.
[c] Ensure she is adequately draped, exposing only the area being assessed.
[d] Explain that hospital policy requires full exposure for all exams.
A patient's past negative experiences with hospitals can affect their current adjustment by:
[a] Making them more appreciative of the current care.
[b] Increasing their anxiety and distrust of the healthcare team.
[c] Having no impact on their current hospital stay.
[d] Reducing their financial concerns.
A lack of a strong social support network (a socio-economic factor) can negatively impact a patient's hospital adjustment by:
[a] Causing allergic reactions to medications.
[b] Making them disagree with their cultural norms.
[c] Increasing feelings of loneliness and reducing emotional support.
[d] Guaranteeing a quicker discharge.
A patient who speaks a different language requires education on a new medication. To ensure understanding, the nurse's best course of action is to:
[a] Use a family member to translate complex medical terms.
[b] Request a certified medical interpreter provided by the facility.
[c] Speak loudly and use many hand gestures.
[d] Give the patient a pamphlet written in English.
How does a patient's age (a personal factor) influence their adjustment to hospitalization?
[a] Age is not a significant factor in hospital adjustment.
[b] All age groups react to hospitalization in the same way.
[c] Different developmental stages (e.g., child, adolescent, older adult) present unique challenges and fears.
[d] Only older adults have difficulty adjusting to the hospital.
A patient refuses a prescribed pork-based medication due to religious beliefs. The nurse's first action should be to:
[a] Insist the patient take the medication for their health.
[b] Acknowledge the belief and notify the physician and pharmacist to seek an alternative.
[c] Explain that religious rules do not apply in a medical emergency.
[d] Document the refusal and take no further action.
A patient's ability to obtain and pay for prescriptions after discharge is a key component of their:
[a] Personal pain tolerance.
[b] In-hospital adjustment.
[c] Socio-economic background.
[d] Cultural communication style.
A young child's primary source of anxiety during hospitalization is often:
[a] Concern over the cost of care.
[b] Fear of losing their job.
[c] Dislike of the hospital decor.
[d] Separation from their parents or primary caregivers.
A patient avoids direct eye contact during conversations. Before assuming the patient is disinterested or dishonest, the nurse should first consider:
[a] The patient may have a vision impairment.
[b] This may be a normal and respectful behavior within their culture.
[c] The patient is not paying attention to the nurse.
[d] The patient is likely anxious and requires medication.
Losing the role of a parent, spouse, or employee while in the hospital is a challenge to a patient's:
[a] Financial status.
[b] Personal sense of identity.
[c] Physical mobility.
[d] Cultural beliefs.
A patient who is a refugee may have a difficult time adjusting to the hospital due to past trauma, language barriers, and unfamiliarity with the Western medical system. These factors relate to a combination of:
[a] Personal and financial background only.
[b] Socio-economic and age-related background only.
[c] Personal, socio-economic, and cultural background.
[d] Cultural and genetic background only.
A patient's family brings in a traditional herbal remedy. The nurse's most appropriate and safe response is to:
[a] Immediately discard the remedy as it is against hospital policy.
[b] Allow the family to use it, as it is part of their culture.
[c] Acknowledge its importance and ask for details to check for potential drug interactions.
[d] Ignore the remedy and pretend not to see it.
A patient who meticulously organizes their bedside table and asks for a detailed schedule is likely using which personal coping mechanism to adjust?
[a] Denial.
[b] Avoidance.
[c] Emotional expression.
[d] Seeking to establish control over their environment.
The most significant socio-economic barrier that prevents individuals from seeking early treatment, often leading to more acute hospitalizations, is:
[a] Lack of adequate health insurance and high cost of care.
[b] A personal preference for home remedies.
[c] A cultural dislike of doctors.
[d] A busy work schedule.
The belief that an illness is a punishment for a past misdeed is an example of a:
[a] Medically proven etiology.
[b] Socio-economic reality.
[c] Personal or cultural belief about illness.
[d] Symptom of a psychological disorder.
A nurse can best support a patient's overall adjustment to the hospital, regardless of their background, by:
[a] Focusing only on the physical aspects of care.
[b] Building a therapeutic, respectful, and trusting relationship.
[c] Limiting visitors to allow the patient more rest.
[d] Following the physician's orders without question.
A patient from a patriarchal culture defers all questions to her husband. The culturally competent nurse should:
[a] Ignore the husband and direct all questions only to the patient.
[b] Ask the husband to leave the room so the patient can speak freely.
[c] Respect the family dynamic by including the husband, while still attempting to involve and assess the patient's understanding.
[d] Address all communication exclusively to the husband.
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