ch 9; culture

Which question does the nurse ask a patient to assess the beliefs and practices of the patient? 1. "What caused your problem?" 2. "What is your main source of income?" 3. "What do you do to keep yourself well?" 4. "How should we address you or what should we call you?"

"What do you do to keep yourself well?" Ratiionale: Asking the patient about what he or she does to keep well indicates that the nurse is assessing the beliefs and practices of the patient. Asking the patient what caused the problem indicates assessment of bicultural ecology. Questioning the patient about the main source of income indicates assessment of socioeconomic status. Asking the patient how to address him or her indicates that the nurse is assessing language and communication.

The registered nurse is evaluating the statements of a student nurse after teaching about cultural assessment models. Which statement by the student nurse needs correction? 1. "Cultural assessment models are used to stereotype a particular group of patients." 2. "Cultural assessment models help focus on the information relevant to a patient's problem." 3. "Cultural assessment models can be used to understand a patient's religious beliefs." 4. "Cultural assessment models help one to understand the complex factors that influence a patient's cultural world view."

1. "Cultural assessment models are used to stereotype a particular group of patients." Rationale : Stereotyping is generalizing a patient based on his or her cultural group. Cultural assessment models are used to understand the cultural beliefs of a patient and are not used to generalize (stereotype) the patient. Cultural assessment models help focus on the information relevant to a patient's problem by providing a world view. Cultural assessment models are used to understand patient's religious beliefs and the complex factors that influence a patient's cultural world view.

While assessing a patient of a different culture, the nurse wants to know the patient's perception of the etiology of the disease. Which is the most appropriate question asked by the nurse using a patient's explanatory model? 1."What do you call your problem?" 2. "Why do you think it started when it did?" 3. "What do you think your sickness does to you?" 4. "What are the chief problems your sickness has caused you?

1. "What do you call your problem?" Rationale: A patient's explanatory model is an effective approach to assess the disease condition by asking questions of a patient belonging to a different culture. Asking the patient what he or she calls the problem can help identify the cause of the disease. Questioning the patient about why he or she thinks the disease started will help identify the time and onset of the disease. Asking the patient what he or she thinks the disease does to him or her will help the nurse understand the pathophysiology of the disease. Questioning the patient about the chief problems the disease has caused him or her will help the nurse understand the course of illness of the disease.

Which concept of intersectionality refers to limited access to certain facets of society? 1. Marginalization 2. Under inclusion 3. Social inequality 4. Matrix of domination

1. Marginalization Rationale: Marginalization is a concept of intersectionality that refers to groups that are left out of or have limited access to certain facets of society. Under inclusion involves the concept of overlooking a particular group. Social inequality refers to unequal access to positions and services by certain groups. Matrix of domination refers to the privilege and support of powerful segments of society.

What is the goal of culturally congruent care? 1.To provide care to fit a patient's own values, beliefs, and traditions 2. To help recognize biases, prejudices, and assumptions about other people 3. To assess social, cultural, and biophysical factors that influence patient treatment and care 4. To motivate the nurse to learn from others, accept the role as a learner, and be open to and accepting of cultural differences

1. To provide care to fit a patient's own values, beliefs, and traditions Rationale: The goal of culturally congruent care is to provide care to fit the patient's own values, beliefs, and traditions. Cultural awareness is required to recognize biases, prejudices, and assumptions about other people. Cultural skill helps assess social, cultural, and biophysical factors that influence patient treatment and care. Cultural desire involves the motivation to learn from others, accept the role as a learner, and be open to and accepting of cultural differences.

What factor is the nurse least likely to associate with health disparities among marginalized groups? 1. Self-care 2. Quality of health care 3. Public and health policy 4. Complex interaction among individual genetics

1. self care Rationale: The nurse is least likely to associate self-care with health disparities. Self-care is not a factor that contributes to health disparities among marginalized groups. People in marginalized groups lack access to good quality health care, which predisposes them to health disparities. Public and health policy also causes health disparities in these groups. Complex interactions between individual genetics and behaviors is also responsible for health disparities in these groups.

What is the similarity between patient-centered care and cultural competence? 1. Both involve individualized care. 2 Both improve health care quality. 3 Both emphasize personal relationships. 4 Both concentrate on the qualities of disadvantaged groups.

2 Rationale: Both patient-centered care and cultural competence aim to improve health care quality. Patient-centered care aims to provide individualized care and emphasize personal relationships. Cultural competence concentrates on the qualities of disadvantaged groups to reduce disparities.

A patient is diagnosed with a diabetic ulcer with gangrene to his foot. The health care provider advises surgery, but the patient refuses because removal of a body part is not permitted according to his or her religion. Which concept justifies this scenario? 1. Marginalization 2. Iceberg analogy 3. Intersectionality 4. Health disparity

2. Ice berg analogy Rationale: The concept of the iceberg analogy helps in understanding the visual and virtual aspects of the way humans perceive things. The patient may have come to get relief from symptoms. However, the health care provider may think that the patient should consider undergoing surgery. These differences in perception reflect the iceberg analogy. Marginalization is the segregation of patients on the basis of political systems, labor markets, and positions of power. Intersectionality refers to the division of patients on the basis of gender, sexual orientation, occupation, class, and immigration status. Health disparity refers to the differences in health caused by social, economic, and/or environmental disadvantages.

Which statement is true regarding the goal of core measures? 1. They help recognize prejudices and assumptions about other people. 2. They help reduce mortality, complications, and inpatient readmissions. 3. They help provide care that fits with the patient's own values, beliefs, and traditions. 4. They help assess social, cultural, and biophysical factors that influence patient treatment and care.

2. They help reduce mortality, complications, and inpatient readmissions. Rationale: Core measures help reduce mortality, complications, and inpatient readmissions. Cultural awareness helps the nurse recognize prejudices and assumptions about other people. Culturally congruent care helps provide care that fits with patients' own values, beliefs, and traditions. Cultural skills help assess social, cultural, and biophysical factors that influence patient treatment and care.

The nurse has to examine a patient and administer an intravenous medication that is not a lifesaving drug. The patient is a devout Muslim. When the nurse goes to administer the medication, the nurse finds that patient is getting ready for namaz (prayers). The nurse understands that the patient prays at certain times, as specified in his culture. What should the nurse do in this scenario? 1. Administer the drug while the patient prays. 2. Ask the patient to pray after the medication is administered. 3. Allow the patient to pray and come back later to administer the medication. 4. Tell the patient that the nurse has other patients to look after and cannot come later.

3. Allow the patient to pray and come back later to administer the medication. Rationale: The nurse should respect the patient's religious beliefs. Muslims offer namaz, or prayers, at specific times of the day. The nurse should let the patient complete the prayers and then administer the medication. It would be inappropriate to administer the drugs while the patient is praying because that would show disrespect to the patient. It would be inappropriate for the nurse to ask the patient to delay prayer because his culture dictates that he pray at specific times. The nurse should not refer to responsibilities with other patients.

What concept of intersectionality addresses the fact that some groups have limited access to certain facets of society such as the labor market? 1. Overinclusion 2. Social location 3. Marginalization 4. Social inequality

3. Marginalization Rationale: Marginalization is the concept of intersectionality that includes the fact that some groups have limited access to certain facets of society such as the labor market. Overinclusion is the idea that many groups have been overlooked in research and the design of interventions. Social location is the concept that one's place in society is based on membership in a social group that determines access to resources. Social inequality is the concept that groups have unequal access to resources, services, and positions.

The senior nurse observes that a newly appointed nurse is having trouble relating to a patient from a different culture. What advice can the senior nurse give this nurse to enhance cultural competency? 1. Obtain in-depth knowledge about medical concepts and nursing care. 2. Learn at least three foreign languages. 3. Obtain sufficient knowledge about a patient's cultures and beliefs. 4. Learn about various dialects prevalent in the country.

3. Obtain sufficient knowledge about a patient's cultures and beliefs. R: It is extremely important for the nurse to be culturally competent. The nurse should try to obtain knowledge about various cultures and cultural practices prevalent in the population because this will help the nurse understand the patients better and provide better care. The nurse already has medical and nursing knowledge. It is not mandatory for nurses to know foreign languages, although that may be helpful in the long term. Knowledge about languages and dialects is not sufficient; the nurse should learn about and respect the culture.

The nurse is caring for a Korean woman who has just delivered her first baby. Which soup would the nurse anticipate the family to provide as the first meal to the woman? 1. Tomato soup 2. Sweet corn soup 3. Seaweed soup 4. Hot garlic soup

3. Seaweed soup Rationale: Koreans believe that seaweed soup should be given to a woman immediately postpartum because it cleans the blood and helps healing and lactation. Tomato, sweet corn, and hot garlic soups can be given later but are not specifically part of the Korean culture.

What is the primary goal of patient-centered care? 1. To provide care that fits a patient's own values, beliefs, and traditions 2. To help recognize biases, prejudices, and assumptions about other people 3. To provide individualized care and restore an emphasis on personal relationships 4. To assess social, cultural, and biophysical factors that influence patient treatment and care

3. To provide individualized care and restore an emphasis on personal relationships Rationale: The primary goal of patient-centeredness is to provide care and restore an emphasis on personal relationships. The goal of transcultural nursing is to provide care that fits with the patient's own values, beliefs, and traditions. Cultural awareness would help in recognizing biases, prejudices, and assumptions about other people. Cultural skills help assess social, cultural, and biophysical factors that influence patient treatment and care.

Which student nurse statement regarding cultural competence indicates a need for further teaching? 1. "Culturally competent organizations adapt to diversity." 2. "Culturally competent organizations conduct cultural self-assessment." 3. "Culturally competent organizations institutionalize cultural knowledge." 4. "Culturally competent organizations manage the dynamics of homogeny."

4. "Culturally competent organizations manage the dynamics of homogeny." r: Culturally competent organizations manage the dynamics of difference, not homogeny. A culturally competent organization adapts to diversity to provide meaningful and supportive care for all patients. It encourages the health care providers to conduct cultural self-assessment to understand patients' world views. A culturally competent organization also institutionalizes cultural knowledge to gain sufficient comparative knowledge of diverse groups, including the values, health beliefs, care practices, world views, and bicultural ecologies commonly found within each group.

The nurse is using an interpreter to communicate with a patient who does not speak English. Which action by the nurse may hamper the communication between the nurse and the patient? 1. Introducing the interpreter to the patient 2. Determining the interpreter's qualifications 3. Looking at the patient instead of the interpreter 4. Asking the patient's family members to serve as interpreters

4. Asking the patient's family members to serve as interpreters Rationale: Interpreters are used to communicate effectively with a patient of a different culture. The family members of the patient should not be asked to serve as interpreters because the patient may not be comfortable sharing certain information with them. The interpreter should be introduced to the patient for better understanding. The interpreter's qualifications should be determined for effective outcomes. While communicating with the patient, the nurse should look at the patient and not the interpreter to encourage the patient and to gain his or her trust and confidence.

How many interrelated components are present in Campinha-Bacote's model of cultural competency? Record your answer using a whole number. _________

5 RAtionale: Cultural awareness, cultural skills, cultural encounters, cultural knowledge, and cultural desire are the five interrelated components in Campinha-Bacote's model of cultural competency.

When the nurse has a prejudice against a particular culture, which type of behavior is likely to result? 1 Discrimination 2 Culturally congruent care 3 Effective intercultural communication 4 Sufficient knowledge of diverse groups

A: 1 r: Prejudices associate negative characteristics with people who are different from the valued group. When a person acts on these prejudices, discrimination occurs. Prejudices are not compatible with culturally congruent care, effective intercultural communication, or sufficient knowledge of diverse groups.

. An older Chinese woman is admitted to the hospital after a hip fracture. Once the fracture has healed, the nurse encourages the patient to walk around the room. The patient refuses to walk without her son. What should the nurse do in this scenario? 1 Leave the patient alone but understand that the patient has no self-confidence. 2 Respect the patient's wish and ask her to walk when her son is present. 3 Explain to the patient calmly that she cannot be dependent on her son. 4 Tell the patient that she needs to walk now, and that it is inappropriate to be dependent on her son.

A: 2 R: In some cultures, families make decisions together. This patient may only be comfortable when her son is present, so the nurse should respect her wishes and come back when the son is there. It would be wrong to describe the woman as lacking confidence. It is not therapeutic to speak sternly with the patient and tell her that she is dependent on others.

What does the nurse teach the student nurse about quality health care to prevent health disparities? 1 "Quality health care should be variable." 2 "Quality health care should be effective." 3 "Quality health care should be slow and thorough." 4 "Quality health care should be health care organization-centered."

A: 2 R: Quality health care should be effective. Although quality health care should be thorough, it should be timely, not slow. Quality health care should be equitable without any variations, and it should be patient-centered, not organization-centered.

Which type of cultural competency recognizes biases, prejudices, and assumptions about other people? 1 Cultural skills 2 Cultural desire 3 Cultural awareness 4 Cultural knowledge

A; 3 R: Cultural awareness refers to recognizing biases, prejudices, and assumptions about other people. Cultural skills assess social, cultural, and biophysical factors that influence patient treatment and care. Cultural desire describes the motivation to learn from others, accept the role as a learner, and be open to and accepting of cultural differences. Cultural knowledge includes sufficient comparative knowledge of diverse groups, including values, health beliefs, care practices, and world views.

Which concept of intersectionality involves unequal access to resources and services? 1. Overinclusion 2. Marginalization 3. Social inequality 4. Matrix of domination

Social inequality Social inequality is the concept of intersectionality that involves groups with unequal access to resources, services, and positions. Overinclusion addresses groups that have been overlooked in research and the design of interventions. Marginalization is the concept of intersectionality that provides limited access or exclusion from different facets of the society such as a political system, labor market, or positions of power. Matrix of domination is a concept of intersectionality that involves the groups with a larger system of power and more privileges than other groups in the society.

Which statement is true regarding the goal of core measures? 1. They help recognize prejudices and assumptions about other people. 2. They help reduce mortality, complications, and inpatient readmissions. 3. They help provide care that fits with the patient's own values, beliefs, and traditions 4. They help assess social, cultural, and biophysical factors that influence patient treatment and care.

They help reduce mortality, complications, and inpatient readmissions. Rationale: Core measures help reduce mortality, complications, and inpatient readmissions. Cultural awareness helps the nurse recognize prejudices and assumptions about other people. Culturally congruent care helps provide care that fits with patients' own values, beliefs, and traditions. Cultural skills help assess social, cultural, and biophysical factors that influence patient treatment and care.

How is cultural competence different from patient-centered care? Select all that apply. One, some, or all responses may be correct. 1 Cultural competence involves individualized care. 2 Cultural competence improves health care quality. 3 Cultural competence aims to increase health equity. 4 Cultural competence emphasizes reducing disparities. 5 Cultural competence concentrates on disadvantaged groups.

answer: 3, 4, 5 Rationale Cultural competence aims to increase health equity and to reduce disparities by concentrating on disadvantaged groups. Patient-centered care aims to provide individualized care. Both patient-centered care and cultural competence aim to improve health care quality.