Answer to Question 1
A
Dietary habits are particularly difficult to change because food is often imbued with social and cultural meaning. Furthermore, if the patient is the person doing the cooking for the family, the dietary choices affect all members, who may also not like the prescribed regimen. The nurse could assess the meaning that food has for this patient and make alterations in the recommendations so that special foods can be enjoyed in their traditional manner on limited occasions.
People respond much more favorably to messages about the benefits that accrue from making changes; they do not respond as well to threats of vague future repercussions.
Keeping a food log does help patients lose weight, but finding out whether certain foods have special meanings would be more helpful than just having the patient keep a journal of what foods were eaten.
The patient may have some misunderstandings in regard to the dietary teaching, but the nurse should assess for these, not assume they exist.
Answer to Question 2
C
Some cultures include a dependent sick role, and patients from such a culture would consider an instruction to perform self-care as inappropriate. The nurse would be well advised to assess the patient's cultural beliefs regarding health and wellness first.
It is easier to effect change when the nurse can tie the need for change to a motivating factor in the patient's life. However, this answer does not account for cultural diversity.
The patient may well be confused or unsure of what to do, but this answer does not account for cultural diversity.
The patient may not be emotionally or physically ready to learn self-care measures, but this option does not account for cultural diversity.