A healthy 60-year-old African-American woman regularly receives her health care at the clinic in her neighborhood

Question

She is due for a mammogram. At her previous clinic visit, her physician, concerned about the 3-week wait at the neighborhood clinic, made an appointment for her to have a mammogram at a teaching hospital across town. She did not keep her appointment and returned to the clinic today to have the nurse check her blood pressure. What would be the most appropriate statement for the nurse to make to this patient?
a. "Do you have transportation to the teaching hospital so that you can get your mammogram?"
b. "I'm concerned that you missed your appointment; let me make another one for you."
c. "It's very dangerous to skip your mammograms; your breasts need to be checked."
d. "Would you like me to make an appointment for you to have your mammogram here?"

Answer 1

ANS: D
This statement is nonjudgmental and gives the patient options as to where she may have her mammogram. Furthermore, it is an innocuous way to investigate the reasons the patient missed her previous appointment. African-American women often have the perception that they are treated with prejudice by health care providers. Questioning the potential lack of transportation may promote this perception. African-American women report not participating in early breast cancer screening because breast cancer comes by chance and getting it is determined by a higher power. Expressing concern and offering to schedule another appointment is a reflection of the nurse's beliefs, not those of the client. Suggesting that it is dangerous to skip a mammogram can be perceived as judgmental and derogatory. It may alienate and embarrass the patient.