ADN 001 Ch 5: Cultural Diversity

A nurse is working in a clinic that serves a community with a high population of immigrants. Which nursing assessment is the priority?

Language assessment

The nurse is caring for a client who perceives time differently. What action should the nurse take for this client?

Maintain flexibility when the client requests interventions at specific times.

A client believes that the illness is caused by an imbalance of yin and yang. The nurse states, "You can call it whatever you believe, but you have a metabolic disorder." What is this nurse demonstrating?

cultural blindness The nurse is demonstrating cultural blindness, which occurs when one ignores differences and proceeds as though they do not exist.

Cultural blindness occurs when

one ignores a cultural difference. Cultural diversity encompasses culture, race, ethnicity, religion, language, gender, socioeconomic status, and more.

A client refuses to allow any healthcare worker of Asian descent to provide care. This client is demonstrating what practice?

racism Explanation: Racism usually involves negative thoughts or actions against another individual based on skin color or ethnicity

Cultural conflict

ridicule of other cultures because of a perceived threat to one's own culture; response is characterized by ridiculing beliefs and traditions of others to make themselves feel more secure

Race is typically based on specific characteristics such as:

skin pigmentation, body stature, facial features, hair texture

stereotyping

the assumption that all members of a culture or ethnic group act alike; may be positive or negative Negative includes racisms, ageism and sexism

cultural blindness

when one ignores differences and proceeds as though they do not exist

cultural imposition

when one pushes one's cultural beliefs onto another person.

The clinic nurse is obtaining demographic data from a client. The client states, "Why do you need to know what my ethnicity is?" How should the nurse respond?

"Collecting this information allows us to develop a personalized plan of care to meet your needs."

A nurse who usually works on the surgical unit is asked to float to the oncology unit because of staffing needs. Which statement by the nurse indicates the possibility of the nurse experiencing culture shock?

"I am very stressed now because I do not understand how things work on this unit."

The nurse is collecting the health history of a client and notes the client is apprehensive in answering questions. The client states, "My spiritual healer will be here soon." What is the best response by the nurse?

"We can wait until your spiritual healer arrives and work together to answer these questions."

Race is split into five major categories:

1. American Indian or Alaska Native 2. Asian 3. Black or Afr.-Am. 4. Native Hawaiian or other Pac. Isl. 5. White

Minority group

A physical or cultural characteristic identifies the people as different from dominant group

The community health nurse is developing a workshop for a group of Native American/First Nation clients. Which topic should the nurse teach?

Alcohol use disorder

A nurse is providing care to a client from a culture different from the nurse's own. The nurse is having difficulty relating to the client. What intervention by the nurse is most appropriate?

Ask the client how the client wants to be treated based on the client's values and beliefs. Explanation: The best way to provide culturally appropriate care is to ask the client what the client values and believes and how the client would like to be treated

When completing a transcultural assessment of communication, which assessment by the nurse is most appropriate?

Assessment of eye contact, personal space, and social taboos

A staff nurse meets with the charge nurse and is reporting that all the new nurses are leaving messes on the unit. The staff nurse states, "These youngsters think they can waltz in here and get our jobs." What is this nurse demonstrating?

Cultural conflict Explanation: Cultural conflict occurs when people become aware of cultural differences (the younger nurses) and feel threatened (most likely by their younger age) and respond by ridiculing the beliefs or actions of others to make themselves feel more secure

cultural pervasiveness

Cultural pervasiveness refers to how widespread the effects of a culture are

The emergency department nurse is caring for a client injured in a motor vehicle collision. The client recently immigrated to the country. The nurse should implement interventions aimed at addressing which issue?

Culture shock Explanation: Culture shock is bewilderment over behavior that is culturally atypical for the client. The client who recently immigrated from another country would experience culture shock over being in a new culture, including a new culture of health care in the new country of residence.

Groups in society are split between

Dominant groups and minority groups

A nurse is caring for a postoperative client after knee arthroplasty. The nurse plans to help the client ambulate but is aware that the client may feel threatened by physical closeness because the client is from a culture that tends to prefer more personal space when interacting with others. Using the principles of culturally competent care, what would be the most appropriate nursing action?

Explain the purpose and need for assistance during ambulation.

How is culture learned by each new generation?

Formal and informal experiences Explanation: Culture includes the beliefs, habits, likes, dislikes, customs, rituals, and ethnic heritage that are learned through formal and informal experiences within one's family and within the cultural group to which one belongs.

Dominant group

Group that has most authority to control values and sanctions of society

Which disorders might a nurse screen for in a black client, based on race? Select all that apply.

Keloid formations Lactase deficiency Sickle cell anemia

cultural assimilation (acculturation)

Minorities living within a dominant group lose the characteristics that made them different. Values replaced by those of dominant culture

A client has recently immigrated and is exhibiting symptoms of culture shock. The client reports feeling unaccepted in the new culture. The client states, "I can't do anything right here." What is the priority nursing diagnosis?

Social isolation related to culture shock and feelings of low self-worth

In addressing health promotion for a client who is a member of another culture, the nurse should be guided by which principle?

The client may have a very different understanding of health promotion. Explanation: As a component of cultural assessment, the nurse should seek to understand the cultural lens through which the client may understand health promotion

Culture shock

The feelings a person experiences when placed in a different culture. May result in a psychological discomfort or disturbances

The nurse is using an interpreter to communicate with a client who speaks a different language. What would be the best way to choose an interpreter for this client?

The interpreter should understand the health care system.

A nurse has recently completed a seminar on cultural diversity. Which statement regarding development of cultural knowledge indicates a need for additional teaching?

The more curious the nurse is about the client's culture, the more the client will want to share." Explanation: Clients often respond negatively to probing curiosity with regard to cultural assessment. A sincere, honest, respectful conversation is more appropriate.

A nurse is assigned to care for a client who does not speak the dominant language. An interpreter has been contacted and will be at the bedside shortly. Which action by the nurse would be most effective in reassuring the client until the interpreter arrives?

Using reassuring body language and making eye contact to assess needs

The nurse is providing discharge teaching for a client who is from a different culture. The nurse notes that the client will look away from the nurse and does not maintain eye contact. What would be the most appropriate action by the nurse, with regard to culturally competent care?

Utilize a key informant and continue with the teaching, verifying the client's understanding through open-ended questions. Explanation: utilizing a key informant or interpreter will help with interpreting nonverbal behavior and ensure teaching is completely translated and understood.

Cultural diversity

a diverse group in society, with varying racial classifications and national origins, religious affiliations, languages, physical sizes, genders, sexual orientations, ages, disabilities, socioeconomic statuses, occupational statuses, and geographic locations.

Cultural competence can be shown by

actively learning about culture through attending a conference i.e. Attending a conference for cultural diversity

A nurse is working with a culturally diverse group of clients. The nurse understands that cultural norms require

an individualized approach by the nurse

Cultural imposition

belief that everyone should conform to the majority belief system

A parent informs the nurse that immunizations are against the parent's cultural and religious beliefs and the parent does not want the child to receive immunizations. The nurse proceeds to inform the parent that the child will be consistently ill and will not be allowed to start school unless immunized. The nurse also informs the parent that the nurse had all of the nurse's own children vaccinated. The nurse's behavior an example of

cultural imposition

When a home-bound client expresses the client's past-oriented ancestral heritage and family rituals, the nurse recognizes that the client is expressing:

ethnic identity

"That client needs to learn that pain is best managed with traditional medications like morphine." is an example of

ethnocentrism

When an American client states, "I only want an American doctor," the client is expressing:

ethnocentrism

Persistent gaps between the health status of minorities and non-minorities are defined as:

health disparities

Nurses are socialized into the:

healthcare culture

Stereotyping

is applying a generalization to all members of a group and does not always involve negative thoughts against others

A client says to the nurse, "Why don't you wear a white cap like nurses do on the soap operas?" This is an ethnocentric statement based on the:

media. Explanation: Ethnocentrism is a way of looking at the world through a personal lens that has been influenced by personality, genetics, family/relationships, and media.

Cultural assimilation occurs when

one adapts to a new culture

Leininger's theory of transcultural nursing includes

assessing a cultural nature, accepting each client as an individual, having knowledge of health problems that affect particular cultural groups, and planning of care within the client's health belief system to achieve the best health outcomes. Therefore, incorporating the client's request for complementary treatment therapy is an example of this theory. (p. 91)

A client is admitted with end-stage pancreatic cancer and is experiencing extreme pain. The client asks the nurse whether an acupuncturist can come to the hospital to help manage the pain. The nurse states, "You won't need acupuncture. We have pain medications." Which characteristic has the nurse displayed?

cultural imposition

A client who immigrated from another country informs the nurse of dietary requests. The nurse responds to the special dietary needs by stating, "You are now living here, and you should try to start eating those foods common to our diet." This inappropriate response is an example of:

cultural imposition

Culture

shared system of beliefs, values, knowledge, and patterns of behavioral expectations that provides social structure for daily living. It includes the beliefs, habits, likes and dislikes, and customs and rituals learned from one's family

A newly hired young nurse overheard the charge nurse talking with an older nurse on the unit. The charge nurse said, "All these young nurses think they can come in late and leave early." What cultural factor can the new nurse assess from this conversation?

stereotyping

The labor and delivery nurse is getting report from the previous shift regarding a client with Asian heritage. The nurse is told that the client did not ask for pain medication because "Asian people can handle pain." The nurse receiving report understands that this an example of what?

stereotyping

Ethnocentrism

the belief that one's ideas, beliefs, practices and culture are superior to another

Cultural relativity

the belief that to understand a person, you must understand that person's cultural context