A nurse in a community clinic is caring for a female client who is Muslim. Which of the following actions should the nurse take?
Encourage cultural practices to be incorporated into their care.
Incorporate hot and cold practices into the client's care.
Acknowledge that the client may be cared for by a male provider.
Have the client remove any face coverings to obtain their history.
The Correct Answer is A
Rationale:
A. Encourage cultural practices to be incorporated into their care: Respecting and incorporating a Muslim client’s cultural and religious practices promotes culturally competent and patient-centered care. This approach fosters trust, comfort, and cooperation between the client and healthcare team.
B. Incorporate hot and cold practices into the client's care: Hot and cold theory is typically associated with Hispanic, Asian, and Middle Eastern folk medicine traditions, but not all Muslim clients follow this practice. Care should be based on the client’s individual beliefs.
C. Acknowledge that the client may be cared for by a male provider: Many Muslim women prefer to be cared for by female providers due to religious and cultural values of modesty. The nurse should make reasonable efforts to accommodate this preference whenever possible.
D. Have the client remove any face coverings to obtain their history: Muslim women who wear a niqab or hijab may choose to keep their face covered for modesty. The nurse should not insist on removal unless necessary for identification or assessment, and even then, it should be done privately with sensitivity to religious beliefs.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is {"dropdown-group-1":"A","dropdown-group-2":"A"}
Explanation
Rationale for Correct Choices:
• Serotonin syndrome: The client’s symptoms recent SSRI dose increase indicate possible serotonin toxicity. Serotonin syndrome occurs when excessive serotonin accumulates in the body, typically following dose escalation or interaction between serotonergic medications. It is a medical emergency that can progress to seizures or death if not promptly identified and treated.
• Adverse effects of paroxetine: The increase in paroxetine dosage one week prior likely triggered excessive serotonergic activity. Paroxetine, an SSRI, elevates serotonin levels, and dose escalation can precipitate serotonin syndrome.
Rationale for Incorrect Choices:
• Generalized anxiety disorder: Although the client has a history of anxiety, the acute onset of fever, disorientation, and autonomic instability points to a physiological reaction rather than worsening anxiety. Anxiety may cause restlessness but does not produce hyperthermia or confusion.
• Neuroleptic malignant syndrome: This condition is associated with antipsychotic drugs, not SSRIs like paroxetine. While both syndromes can present with fever and altered mental status, the client’s medication profile and timing support serotonin toxicity instead.
• Feelings of hopelessness: Although ongoing hopelessness is part of the client’s depression, it does not explain the acute physical manifestations. Emotional symptoms may persist with depression, but fever and disorientation indicate a pharmacologic rather than psychological cause.
• Anxiety: Anxiety alone cannot account for the client’s fever, disorientation, or abdominal pain. These findings suggest a systemic reaction consistent with serotonin excess, not a purely psychological state.
Correct Answer is {"dropdown-group-1":"B","dropdown-group-2":"C"}
Explanation
Rationale for Correct Choices
• Mastitis: The client is breastfeeding and presents with a visible cracked nipple, which provides an entry point for bacteria. Mastitis is a common postpartum infection of the breast tissue, particularly when nipple trauma or milk stasis is present, increasing the risk of inflammation and infection.
• Cracked nipple: The cracked nipple is a clear portal of entry for bacteria, especially Staphylococcus aureus. This physical finding directly predisposes the client to mastitis, making it the most immediate risk factor in this scenario.
Rationale for Incorrect Choices
• Perineal hematoma: A perineal hematoma typically occurs shortly after delivery due to trauma to the perineal blood vessels. This client is 2 weeks postpartum, with only mild perineal discomfort reported, making a hematoma unlikely at this stage.
• Endometritis: Endometritis usually presents within the first week postpartum with fever, uterine tenderness, and foul-smelling lochia. This client denies abdominal pain, has no fever, and reports normal lochia, making endometritis unlikely.
• Large for gestational age newborn: While the client delivered a newborn weighing 4,508 g, this factor primarily increases the risk for birth trauma, shoulder dystocia, or perineal injury. It does not directly predispose to mastitis.
• Group B streptococcus: Group B strep status primarily affects the newborn risk and prophylactic antibiotic decisions during labor. In the absence of postpartum infection symptoms in the mother, GBS is not the key factor contributing to mastitis in this client.
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