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chapter 1,6,17 very hard level

Total questions: 51

Worksheet time: 26mins

Name
Class
Date
1.

A patient newly admitted to a long-term care facility refuses to allow an LPN to perform hygiene care, stating “It’s degrading.” What should the LPN do first?

a)

Leave and notify the physician

b)

Respect the refusal and explore the patient’s concerns

c)

Document the refusal as noncompliance

d)

Ask the UAP to handle hygiene instead

2.

The nurse notices that a patient from a collectivist culture allows their adult child to answer all health questions. The best response is to:

a)

Require the patient to speak for themselves

b)

Ask the adult child to leave

c)

Assess the patient’s preference for family involvement

d)

Proceed with care as usual without asking

3.

A nurse overhears a colleague mocking a patient’s cultural healing beliefs. The most appropriate response is to:

a)

Confront the colleague immediately and loudly

b)

Report the incident to hospital security

c)

Speak privately and reinforce professional behavior

d)

Say nothing and continue your assignment

4.

A patient with dementia is resisting bathing and yelling. The LPN’s best action is to:

a)

Use two staff members to complete the task by force

b)

Document patient noncompliance and leave

c)

Attempt later, using calm voice and familiar cues

5.

A patient with a diabetic foot ulcer asks the LPN why they can’t soak their feet. The nurse’s best explanation is:

a)

Soaking is ineffective.

b)

Diabetic feet can be damaged by excessive moisture and heat.

c)

Your provider doesn’t allow it.

d)

Soaking will improve circulation.

6.

A patient says, “I only trust herbs, not your pills.” What’s the most culturally competent response by the nurse?

a)

That’s dangerous and outdated.

b)

Let’s talk about the herbs you use to ensure safety with your medications.

c)

We don’t support herbal therapy here.

d)

You should only take what’s prescribed.

7.

The LPN is assisting with plan of care development. Which activity is within their scope?

a)

Writing discharge instructions

b)

Collecting patient data and reporting to the RN

c)

Independently changing the care goals

d)

Initiating physician consults

8.

A patient’s culture believes that illness results from a spiritual curse. The nurse should:

a)

Notify psychiatry

b)

Document delusional behavior

9.

The most appropriate hygiene approach for an immunocompromised patient is to:

a)

Delay hygiene to avoid patient stress

b)

Use shared equipment

c)

Use fresh linens and individual bathing supplies

d)

Bathe only once per week

10.

The best response to a patient with expressive aphasia who needs assistance choosing breakfast is to:

a)

Skip the choice and make the decision

b)

Use a yes/no format and point to food pictures

c)

Wait for the patient to write answers

d)

Ask the UAP to decide

11.

A nurse trims the toenails of a diabetic patient using curved scissors. What error has occurred?

a)

The tool should be sterile

b)

The nurse should have used an emery board and filed straight

c)

Diabetic toenails should be rounded

d)

Foot care is not necessary daily

12.

A patient undergoing spiritual cleansing refuses morning meds. The nurse should:

a)

Notify pharmacy to discontinue meds

b)

Hold the dose and educate on timing options

13.

A nurse assisting a Native American patient with perineal care observes ritual beads tied at the waist. What should the nurse do?

a)

Remove them during the bath

b)

Ask the patient permission before touching the item

c)

Assume they’re irrelevant

d)

Call security

14.

A new LPN is confused about scope of practice. The correct understanding is:

a)

LPNs assess and evaluate independently

b)

LPNs do not require supervision

c)

LPNs collect data, assist with care, and report findings

d)

LPNs delegate physician orders

15.

A nurse uses a towel when brushing dentures over a sink. The rationale is:

a)

To absorb water

b)

To prevent breakage if dropped

c)

To prevent mess

d)

To sanitize the area

16.

Which action is inappropriate for an LPN providing hygiene care?

a)

Filing toenails straight

b)

Documenting skin breakdown

c)

Using gloves and warm water

17.

A Muslim patient asks for gender-congruent staff for hygiene care. The best nursing response is:

a)

We will try to accommodate your request.

b)

We don’t allow patient requests.

c)

That’s only for emergencies.

d)

You should not be embarrassed.

18.

A patient with severe arthritis cannot brush their teeth. What should the nurse prioritize?

a)

Encouraging independence

b)

Performing complete oral care

c)

Delaying oral hygiene

d)

Documenting refusal

19.

A patient who speaks little English nods during discharge teaching. What should the nurse do next?

a)

Assume understanding

b)

Use teach-back with a medical interpreter

c)

Provide a brochure

d)

Ask the family

20.

A cognitively impaired patient becomes combative during morning care. What is the priority nursing action?

a)

Restrain the patient

b)

Leave and document refusal

21.

A patient avoids eye contact and speaks in a quiet tone. Which cultural principle might explain this?

a)

Distrust of healthcare

b)

Passive behavior

c)

Cultural respect and humility

d)

Avoidance due to illness

22.

A nurse assesses dry, flaky skin in an older adult. What is the most appropriate intervention?

a)

Apply lotion immediately after bathing

b)

Bathe more often

c)

Use alcohol-based products

d)

Increase water temperature

23.

A patient refuses perineal care from a female nurse citing religious beliefs. What is the nurse’s priority?

a)

Report noncompliance

b)

Find a male staff member if available

24.

A patient insists on traditional herbal compresses. What is the best nurse response?

a)

Discourage the practice

b)

Approve it only if prescribed

c)

Explore ingredients and potential interactions

d)

Tell the patient to ask pharmacy

25.

A patient with dementia becomes tearful during shaving. What is the most therapeutic action?

a)

Stop and provide emotional reassurance

b)

Finish quickly

c)

Ask family to take over

d)

Postpone shaving permanently

26.

Which hygiene task should the nurse assign to a UAP for a patient with C. difficile precautions?

a)

Perineal care using soap and water

b)

Applying alcohol-based hand gel

c)

Using pre-moistened wipes

d)

Clipping fingernails

27.

A newly licensed LPN asks when oral care is most critical. The correct response is:

a)

When the patient complains of bad breath

b)

After every meal

28.

A patient becomes angry after receiving incorrect food due to a religious restriction. What should the nurse do?

a)

Ignore the complaint

b)

Re-educate dietary staff and apologize

c)

Explain hospital limitations

d)

Remove the tray and walk away

29.

Which nursing action violates patient rights during hygiene care?

a)

Not providing privacy

b)

Using gloves

c)

Asking permission before touching the patient

d)

Using a barrier towel

30.

Which patient statement reflects cultural competence by the nurse?

a)

We do things differently here.

b)

Let’s include your traditions in your care plan.

c)

Our way is the most effective.

d)

Forget those beliefs now.

31.

31. A patient refuses to let the nurse remove a spiritual bracelet before surgery. What’s the priority action?

a)

Respect the patient's wishes and cover the bracelet if possible.

b)

Remove the bracelet without the patient's consent.

c)

Call security to remove the bracelet.

d)

Ignore the patient's concerns and proceed with removal.

32.

An older adult with poor vision is brushing teeth and spills water. What should the nurse prioritize?

a)

Independence support

b)

Taking over hygiene

c)

Disciplinary report

d)

Immediate toileting

33.

A patient’s family insists on performing a cultural bathing ritual. What should the nurse do?

a)

Decline to maintain hospital control

b)

Allow with infection control guidance

c)

Leave the room

d)

Ask them to stop

34.

A confused patient becomes combative during mouth care. The nurse’s best response is to:

a)

Apply wrist restraints

b)

Return later with calm cues

c)

Delegate to security

d)

Skip care indefinitely

35.

______ is the nursing approach of accepting the patient’s cultural values even if they differ from one’s own.

a)

Cultural bias

b)

Cultural assimilation

c)

Cultural accommodation

d)

Cultural intolerance

36.

Which patient need reflects Maslow’s physiological tier during hygiene care?

a)

A patient embarrassed to undress

b)

A patient asking for pain relief

c)

A patient requesting clergy

d)

A patient requesting quiet time

37.

A patient with limited English nods after hearing medication instructions. The next action is to:

a)

Document understanding

b)

Use teach-back via interpreter

c)

Give written materials only

d)

Call the family

38.

What is the best indicator a patient understands personal hygiene instruction?

a)

Verbal agreement

b)

Independent performance

c)

Family nodding

d)

Smiling during teaching

39.

Which observation requires the most urgent response during a bed bath?

a)

Dry skin on the legs

b)

Small mole on the back

c)

Red area over the coccyx

d)

Long toenails

40.

A nurse tells a patient, “You should be grateful for what you have.” This is an example of:

a)

Therapeutic listening

b)

Encouragement

c)

Nontherapeutic response

d)

Validation

41.

Which nursing action reflects patient advocacy during cultural conflict?

a)

Explaining why the hospital does not allow rituals

b)

Recommending spiritual support services

c)

Ignoring beliefs for efficiency

d)

Stating “We don’t do that here”

42.

Which patient behavior indicates internalization of Western health beliefs?

a)

Belief in spiritual illness

b)

Use of folk remedies

c)

Requesting vaccines and routine screening

d)

Refusing blood transfusion

43.

Which of the following practices supports cultural humility?

a)

Memorizing each culture

b)

Asking respectful, open-ended questions

c)

Speaking slower and louder

d)

Using family to interpret

44.

During bathing, a patient with dementia starts crying. The LPN should:

a)

Stop and provide reassurance

b)

Increase speed

c)

Ask the UAP to finish

d)

Ignore the tears

45.

A patient says, “I don’t want anyone touching my body but my pastor.” What is the best nursing response?

a)

That’s not allowed.

b)

Let’s talk about what you’re comfortable with.

c)

We’ll skip bathing today.

d)

Your pastor can’t be in here.

46.

Which behavior by a nurse shows bias during care delivery?

a)

Supporting a patient’s customs

b)

Ignoring different health beliefs

c)

Using interpreter services

d)

Asking about dietary needs

47.

A nurse caring for a patient from a low-context culture should expect communication that is:

a)

Direct and explicit

b)

Indirect and implicit

c)

Highly emotional and nonverbal

d)

Ambiguous and context-dependent

48.

Which of the following best describes communication in low-context cultures?

a)

Implicit and nonverbal

b)

Direct, clear, and task-focused

c)

Symbolic

d)

Emotional and story-based

49.

When educating a patient with limited literacy, the nurse should use:

a)

Long educational pamphlets

b)

Simple visuals and verbal cues

c)

Only verbal instructions

d)

Online videos

50.

A patient refuses assistance during bathing and says, “I can do it myself.” The nurse should:

a)

Allow the patient to attempt while observing

b)

Do the bath anyway

c)

Leave the supplies and walk away

d)

Reassign to another nurse

51.

Which action best reduces aspiration risk during oral care in an unconscious patient?

a)

Supine positioning

b)

Side-lying with suction available

c)

Providing mouthwash only

d)

Limiting frequency