Chapter 7

A female client of Arab descent comes into the clinic with depression. The client states, "I am a burden and failure as a woman in my culture." Which question by the nurse is priority?

"Are you having thoughts of harming yourself or of suicide?"

An important part of cultural competence includes the capacity to communicate effectively and convey information that is easily understood. When providing care the nurse should know that cultural competence includes which example?

linguistic competence

An adult client is admitted with depression and malnutrition. The client has been on the unit for 3 days and has been eating about 25% of meals. Which statement made by the nurse to the client would be most appropriate?

"Do you follow any dietary restrictions or preferences?"

The nurse is caring for a client of Native American/First Nations heritage. The client tells the nurse, "I would like a shaman at my bedside to tell me if I will heal from this disease." Which response by the nurse best demonstrates cultural competence for this client?

"Do you have a way to contact your shaman?"

A client being evaluated in the clinic for depression lacks ambition and is unemployed. The client states, "Even if I tried to get a job, nobody would want to hire me." What statement made by the nurse would be empowering for the client?

"Have you known anyone who had challenges, but overcame those challenges?"

An emergency department nurse cares for a client. At the initial meeting, which statement made by the nurse demonstrates diversity acceptance of the client?

"How would you like to be cared for?"

The nurse has been working with a client to develop self-efficacy. What client statement would most likely suggest to the nurse that self-efficacy is improving?

"I have decided to apply for a promotion at work."

The nurses on the psychiatric-mental health unit care for many diverse clients and receive an in-service education on cultural humility. Which statement by the nurse would indicate teaching was effective?

"I will remain open and honest about self-reflection, because I know that even with training, I could have stereotypes and biases."

An adult Hispanic client is admitted to the psychiatric-mental health unit for depression and anxiety. The client states, "I'm fine. I'm not crazy. I'm not weak and I do not need treatment." Which statement by the nurse would be most therapeutic?

"Tell me about feeling weak and crazy."

A client diagnosed with bipolar disorder has stopped taking their medications due to "having a lot of side effects." What action made by the provider would the nurse anticipate for the client?

lowering the dose of the medication

Which statement made by the client demonstrates hardiness when faced with a health issue?

"What do I need to do to manage this illness?"

A nurse is conducting a developmental assessment of an older adult client who has come to the clinic for a check-up. Which statement(s) made by the client indicates to the nurse that the developmental task for this age group is met? Select all that apply.

-"I retired 3 years ago, and I have been keeping busy every since." -"I am looking forward to moving into an independent living program at the end of the year."

The nurse is performing an initial assessment and interview with a client reporting high levels of stress related to employment. Which statement(s) will the nurse identify as negatively influencing the client's ability to cope with this stress? Select all that apply.

-"I wake up several times at night and have trouble falling back to sleep." -"I have been too busy to cook lately and eating a lot of fast foods." -"I used to exercise regularly and haven't been active for about 6 months."

The nurse is caring for a client with cancer that has very strong religious beliefs. How will the nurse expect the client's beliefs to affect their health outcomes for physical and psychosocial healing? Select all that apply.

-The client will retain hope for the possibility of recovery. -The client will depend on faith to overcome obstacles in healing. -The client will rely on religious beliefs for support.

A client has come to the mental health center for an initial visit. The nurse has little experience with the client's culture, having cared for only one other client with a similar background. When assessing the new client, which approaches would be best for the nurse to use to provide culturally competent care? Select all that apply.

-Use the new client as the primary source of information. -Demonstrate genuine interest in learning about the new client. -Ask the new client about personal beliefs and practices.

A nurse is preparing an educational program identifying the major barriers experienced by culturally diverse populations when accessing mental health services. Which information should the nurse include? (Select all that apply.)

-client and health care provider do not share a common language -health care beliefs are not shared by both client and health care provider -group value systems are not mutually accepted

A new nursing graduate is assessing cultural factors among their group of clients. Which factor(s) would be involved in a cultural assessment of a client? Select all that apply.

-communication -environmental control -biologic variations -physical distance or space

A nurse is teaching a class on culture in healthcare to a group of nursing students. Which scenario discussed by the nurse demonstrates the concept of acculturation?

A Japanese family emigrated to another country several years ago and have now adopted some aspects of that country's culture.

The nurse who is preparing a Native American client for surgery notes that the client is wearing a medicine bag. What intervention should the nurse implement to best address the client's spiritual needs with respect to presurgical care needs?

Ask the client how the medicine bag can be respected while preparing for surgery.

Which approach to care best reflects cultural competence?

Assess the culturally mediated beliefs of each client on an individual basis.

Which statement about culture is true?

Cultural identity reflects what determines behavior.

Which represents the best brief definition of culture?

Culture is shared attitudes, customs, and beliefs.

An older adult client in the hospital has not had a bowel movement for 3 days and the nurse planned to give the client a stool softener this morning. The client declined the medication, however, stating that the client's spouse will be bringing the client a herbal medication later in the day that is often used by members of their ethnic group. Which reaction demonstrates cultural care accommodation/negotiation?

Documenting the client's wishes and informing the client's care team what the client will be taking

In order to help preserve and maintain a client's cultural belief regarding the need for "hot foods," which action should the culturally competent nurse take?

Educate the staff to help them assist the client in selecting food choices from the client's menu that supports this belief

Personal space and distance is a cultural perspective that can impact nurse-client interactions. What is the best way for the nurse to interact physically with a client who has a different cultural perspective on space and distance than the client?

Explain that physical contact is necessary and ask about the client's cultural personal space preferences.

Nurses cannot learn all the variations in culturally mediated beliefs. Which approach would be most helpful when caring for clients from other cultures?

Explore the client's personal values and traditional care constructs for health and illness.

A nurse who provides care in a large, urban hospital identifies the large influence of culture on health. Which action will the nurse take to integrate culture to enhance the delivery of care?

Incorporate beliefs, values, and behavioral traditions into care.

Which stage of Erikson's psychosocial development includes building confidence in one's own abilities?

Industry versus inferiority

A Native American client discusses cultural beliefs with the nurse providing care. In order to recognize any negative feelings or stereotypes the nurse has, which should the nurse do to ensure culturally competent nursing care can be provided?

Reflect on how the client's beliefs may have similarities and differences from the nurse's own culture.

The nurse is scheduled to begin a clinical rotation at an outpatient mental health clinic that is in a neighborhood with a large number of Asian residents. Since the nurse does not share this cultural background with the potential clients, which is the best way for the nurse to ensure cultural sensitivity in this setting?

Reflect on, analyze, and foster awareness of the nurse's own culture

When conducting an assessment with a client from another country, what can a nurse do to ensure the client receives culturally sensitive care?

Show genuine interest in the client's culture and personal life experiences.

The mental health nurse is interviewing a client of a different cultural background regarding the client's health care practices. The nurse understands that cultural competence is important in the care of this client. Cultural competence in health care can be best described as what?

The ability to understand and effectively interact with individuals or members of a community from diverse cultural or ethnic backgrounds

On assessment, the nurse finds that the client demonstrates low hardiness. Which can the nurse anticipate regarding the client based on this observation? Choose the best answer.

The client has difficulty in problem solving under stress.

The nurse is assessing executives in the corporate sector. Which characteristic of the executives would indicate a higher hardiness? Choose the best answer.

The executive has high stress and is more resistant to illnesses.

When caring for a group of clients, which client would the nurse anticipate may need more education regarding to adhering to the treatment plan?

a client who views that their illness is caused by a temperature imbalance

The nurse is caring for a client who was born and educated in southeast Asia. The client moved to the United States two years ago. The client wears Western clothing and eats fast food. Which answer describes what the client has modeled?

acculturation

For a client who belongs to an ethnic group that is known to have poor metabolism of psychotropic medications, the nurse should anticipate that the client may be at risk for which problem?

adverse drug effects

Which factor has the greatest impact on a person's ability to cope with illness?

age

A nurse is caring for a group of clients. Which client would the nurse recognize as being the highest risk of having poor outcomes?

an 11-year-old client diagnosed with schizophrenia

A student nurse is preparing a presentation regarding different cultures. Which definition of culture is most accurate?

belief system that guides behavior

The nurse is trying to effectively deal with the spiritual needs of a client. To best meet the client's need, what should the nurse do?

clarify own spiritual values and beliefs before exploring clients' beliefs

A client has disclosed to the nurse that they feel worried that their child will be hungry because they are unable to provide consistent food to the child. Which social determinants of health category should the nurse assess further?

economic stability

The nurse educator is discussing spirituality for nurses in a mental health class. The nurse educator asks a student nurse, "Which of the following is most consistent with spirituality?" The student nurse identifies which description?

feeling a connection to a higher power

A client being counseled for depression states to the nurse, "I just want to help others. I want to help shape the next generation." Based on the statement, which Erikson's stage of psychosocial development does the nurse identify that the client is in?

generativity versus stagnation

A psychiatric-mental health nurse is gathering a family history from a client. What individual factor to the client's response to illness and treatment is being assessed by the nurse?

genetics and biologics

A psychiatric-mental health nurse is conducting an initial interview with a client. The nurse investigates whether the client has medical insurance coverage. Which social determinant of health category is the nurse assessing?

health care access and quality

A young adult client who has come to the clinic for evaluation reports feeling anxious lately. During the interview, the client states, "I feel like I still don't know what I should be doing with my life." The nurse interprets this statement as most suggestive of a problem with which developmental task?

identity

An adolescent client is being counseled for anger management. The client states to the nurse, "I just don't fit in with my family or any kids at school. I am an outcast." What will be the nurse's focus of intervention for this client?

increasing a sense of belonging

A nurse counsels a pediatric client and family in psychosocial stages of development. The client is beginning to develop a conscience and learning to manage conflict and anxiety. Which Erikson stage of development is the child currently attempting to overcome?

initiative versus guilt

Which stage of psychosocial development involves establishing the next generation?

middle adult

Children of parents who abused alcohol and substances are able to develop self-esteem and self-efficacy by developing which characteristics?

resilience

Evaluating the cultural practices of others according to the nurse's own culture can be counteracted by the nurse's use of which practice?

self-assessment

Which characteristic would be most prevalent in an individual demonstrating low self-efficacy?

self-doubt

An adult Black single parent of three children is admitted for severe depression, anxiety, and substance use. The client reports that they are being evicted from their apartment because the client cannot pay rent. Which aspect of the client's life is priority to assess and intervene?

stable housing

The nurse caring for several clients on a surgical unit notes that one of the clients the nurse is caring for is Muslim. The nurse, without asking the client, decides to remove all pork from the client's meal tray prior to delivering it to the room. What best describes the nurse's action?

stereotyping

The nurse creates a community health fair in a rural area. Which topic would be most important for the nurse to cover?

suicide prevention

The nurse at a mental health clinic is performing the initial assessment of a client who emigrated from Mexico several years ago. The client, who seems reluctant to speak, is accompanied by their more talkative adult child. The nurse has never cared for someone of Mexican descent. Which individual should the nurse regard as the best source of information for providing competent care for the client?

the client

A client diagnosed with depression states to the nurse, "I can't rely on anyone. People just do what they want without thinking of other people." Which Erikson's stage of psychosocial development does the nurse identify for the client?

trust versus mistrust

All except which problem stem from attitudes in which the focus is on the nurse's beliefs and values rather than those of the client?

Treating the client as a source of cultural information