Chapter 7 Psych nursing, Mental Health: Chapter 7: Client's Response to Illness, Chapter 7, NU245- Chapter 7: Client's Response to Illness

A client who recently immigrated from Eastern Europe comes to the clinic for an evaluation. During the assessment, the nurse notes that the client has adopted the local area's mannerisms and dress. The nurse interprets this as what? Acculturation Cultural identity Linguistic competence Cultural competence

Acculturation

The nurse educator is providing education to the nursing staff regarding culturally appropriate nursing care. A nursing student asks the nurse educator to describe the concept of acculturation. Which statement by the nurse is the appropriate response? "It involves adopting aspects of a different culture in when in a new environment." "It is integrating a set of values that belong to a group or culture." "It involves identifying with a group of individuals who have culturally specific beliefs and identifies." "It is a process of completely converting to another belief system."

"It involves adopting aspects of a different culture in when in a new environment."

Cultural Factors: -Culturally competent nursing care means being sensitive to issues related to culture, race, gender, sexual orientation, social class, economic situation, and other factors. -___ about causes of illness -Factors in cultural ___ 1. 2. 3. 4. 5. 6. -Socioeconomic status, social class

-Beliefs -Assessment 1. Communication 2. Physical space or distance 3. Social organization 4. Time orientation 5. Environmental control 6. Biologic variations

Nurse's Role in Working with Patient from Various Cultures: -Knowledge seeking about a patient's ___, ___, and health practices -___ as best source of information -General cultural knowledge to guide nurse in ___, decisions about what questions to ask -Preferences, health practices, beliefs -General knowledge not replacement for patient assessment -___ variations in individuals in culture

-Cultural values -Beliefs -Patient -Initial meeting -Wide

Cultural Patterns and Differences: -Knowledge of ___ cultural patterns as starting point when relating to people from different ___. -___ variations among people from any culture.

-Expected -Ethnic backgrounds -Wide

Physical Space or Distance: -In the United States and many other Western cultures, ___ to ___ feet is a comfortable distance. Latin Americans and people from the Middle East tend to ____ to one another than do people in Western cultures. People from ___ and ___ cultures are usually more comfortable with distances greater than __ to ___ feet.

-2 to 3 feet -Stand closer -Asian -Native American's -2 to 3 feet

Individual Factors: -___, ___, ___ -Effect on coping with illness -Expression of illness -Erikson's states of psychosocial development; each stage dependent on successful completion of previous one -Adult developmental tasks

-Age -Growth -Development

Self-Awareness Issues: -Limited personal experience can cause ___: -Saying the "___" -Doing something ___ or ____ -Frequently review for stereotypical biases: -Approach with a ___ caring attitude -Ask the client preferences and ___, ___, and health practice needs -Recognize any ___ feelings or ____ and discuss them with a colleague to dispel myths and misconceptions -Remember that a wide variety of factors influence the client's complex response to illness

-Anxiety -"Wrong thing" -Offensive -Disrespectful -Genuine -Spiritual -Religious -Negative -Stereotypes

Individual Factors: -___, ___ factors -Physical health, health practices -Healthier= ___ -Response to drugs -Differences in ___ groups related to ___, efficacy -Slow metabolism = ___

-Genetics -Biological -Better coping with stress or illness -Ethnic -Metabolism -Need for lower doses

Self-Awareness Issues: -Maintain ___, caring ____ -Ask how nurse can promote or assist with ____, ___, ____ practices -Recognize own ___, possible ___ -Remember that patient's response to illness is ___, ___

-Genuine -Attitude -Spiritual -Religious -Health -Feelings -Prejudices -Complex -Unique

Individual Factors: -___: the belief that personal abilities and efforts affect the events in our lives. -Hardiness: -Three components: ___, ___, ___ -___: having healthy responses to stressful circumstances or risk situations -Resiliency is ___; can be stressful to one, but not to another. -___: involving using problem-solving abilities and believing that one can cope with adverse or novel situations. -___: the essence of a person's being and his/her beliefs about the meaning of life and the purpose for living.

-Self-efficacy -Commitment -Control -Challenge -Resilience -Subjective -Resourcefulness -Spirituality

Interpersonal Factors; -___: the feeling of being connected with or involvement in a social system or environment of which a person feels as integral part. -Feeling ___, and like he/she "___" -Social networks, social support -Perception of support system, ___ of support system -Family support

-Sense of belonging -Valued -"Fits" -Responsiveness

Hardiness has three components: 1. 2. 3.

1. Commitment 2. Control 3. Challenge

Which of the following is most influential in determining health beliefs and practices? A. Cultural factors B. Individual factors C. Interpersonal factors D. All of the above are equally influential

A.

28. A client from which of the following cultural groups is likely to prefer closeness in personal space? A) Arab Americans B) Chinese C) Cubans D) African Americans

Ans: A Feedback: Arab Americans prefer closeness in personal space. Chinese keep respectful distance. Cubans have greatly varying preferences for personal space. African Americans respect privacy and use a respectful approach.

5. Which one of the following statements about the roles that biologic makeup plays in a client's emotional responses is most accurate? A) Biologic differences can affect a client's response to treatment with psychotropic drugs. B) Biologic differences do not affect a client's response to treatment with psychotropic drugs. C) Heredity and biologic factors are under voluntary control. D) Persons cannot change their health status and improve the ability to cope.

Ans: A Feedback: Biologic differences can affect a client's response to treatment with psychotropic drugs. Heredity and biologic factors are not under voluntary control. Persons can change their health status and improve their ability to cope.

4. Genetics have been shown to play which of the following roles in a person's mental and emotional health? A) Several mental disorders appear to run in families. B) Specific genes have been linked to certain mental disorders. C) Biologic factors can be modified to change the influence on emotional health. D) Psychiatric treatment is effective regardless of an individual's biologic influences.

Ans: A Feedback: Heredity and biologic factors are not under voluntary control. We cannot change these factors. Research has identified genetic links to several disorders. Although specific genetic links have not been identified for several mental disorders (e.g., bipolar disorder, major depression, and alcoholism), research has shown that these disorders tend to appear more frequently in families. Genetic makeup tremendously influences a person's response to illness and perhaps even to treatment.

3. Which one of the following statements is most accurate regarding the age at onset of a mental illness such as schizophrenia? A) Persons who are diagnosed at a younger age will more likely have a poorer outcome. B) Persons who are diagnosed at a younger age will more likely have a better outcome. C) Age at diagnosis is not related to outcomes. D) Younger clients have more experiences that will help them.

Ans: A Feedback: Persons who are diagnosed with schizophrenia at a younger age at onset have poorer outcomes, such as more negative signs and less effective coping skills, than do people with a later age at onset. A possible reason for this difference is that younger clients have not had experiences of successful independent living or the opportunity to work and be self-sufficient and have a less well-developed sense of personal identity than older clients.

19. Which of the following situations would most likely provide social support to a client? A) A friend who will share his or her perspective on an issue B) The transportation service that provides access to daily rehabilitation services C) Fellow teammates participating in a community softball league D) The teacher assisting a client to obtain a GED

Ans: A Feedback: Social support is emotional sustenance that comes from friends, family members, and even health-care providers who help a person when a problem arises. It is different from social contact, which does not always provide emotional support. An example of social contact is the friendly talk that goes on at parties.

33. Which of the following questions best encourages the client to disclose information the nurse must assess to provide culturally competent care? A) ìHow do you want me to help you?î B) ìDo you want me to contact your preacher?î C) ìWhat special dietary preferences do you have?î D) ìWhich family members do you want to receive calls from?î

Ans: A Feedback: To provide culturally competent care, the nurse must find out as much as possible about a client's cultural values, beliefs, and health practices. Often, the client is the best source for that information, so the nurse must ask the client what is important to him or her. An open and objective approach to the client is essential. Clients will be more likely to share personal and cultural information if the nurse is genuinely interested in knowing and does not appear skeptical or judgmental. Assuming the client wants a preacher or has dietary preferences is assuming the client's values. Asking about preferred family members does little to assess the nature of family relationships

32. Which of the following cultural phenomena that should be assessed by the nurse includes preference such as touch and eye contact? A) Communication B) Social organization C) Environmental control D) Biologic variations

Ans: A Feedback: Communication involves verbal and nonverbal communication. Social organization refers to family structure and organization, religious values and beliefs, ethnicity, and culture. Environmental control refers to a client's ability to control the surroundings or direct factors in the environment.

7. The nurse is preparing to administer PRN medication to a client of a Japanese descent who is anxious. The prescription reads, ìAlprazolam (Xanax) 0.25 to 1.0 mg PO PRN.î The best dose for the nurse to give initially is A) 0.25 mg. B) 0.5 mg. C) 0.75 mg. D) 1.0 mg

Ans: A Feedback: In general, nonwhites treated with Western dosing protocols have higher serum levels per dose and suffer more side effects. Persons of Asian descent often metabolize drugs more slowly, requiring lower doses to produce therapeutic effects.

8. A client's prognosis is said to be good due to a high degree of self-efficacy. Which of the following is evidence of a high degree of self-efficacy? A) The client is self-motivated and asks for help when needed. B) The client is able to resist illness when under stress. C) The client responds well in stressful situations. D) The client uses good problem-solving abilities.

Ans: A Feedback: People with high self-efficacy set personal goals, are self-motivated, cope effectively with stress, and request support from others when needed. Hardiness is the ability to resist illness when under stress. Resilience is defined as having healthy responses to stressful circumstances or risky situations. Resourcefulness involves using problem- solving abilities and believing that one can cope with adverse or novel situations.

20. A holistic plan of recovery would be especially important to a client from which of the following cultural groups? A) American Indian B) African American C) Mexican American D) Arab American

Ans: A Feedback: The American Indians' concept of health is holistic and wellness oriented. African Americans and Mexican Americans value feelings of well-being, ability to fulfill role expectations, and being free of pain or excess stress. Arab Americans view health as a gift of God manifested by eating well, meeting social obligations, being in a good mood, and having no stressors or pain.

14. Which of the following statements about spirituality are true? Select all that apply. A) Many clients with mental disorders have disturbing religious delusions. B) Religious activities have been shown to be linked with better health and a sense of well-being. C) Spirituality only involves religion. D) Hope and faith are two critical factors in psychiatric and physical rehabilitation. E) Spirituality may include a relationship with the environment.

Ans: A, B, D, E Feedback: Many clients with mental disorders have disturbing religious delusions. Religious activities have been shown to be linked with better health and a sense of well-being. Spirituality involves the essence of a person's being and his or her beliefs about the meaning of life and the purpose for living. It may include belief in God or a higher power, the practice of religion, cultural beliefs and practices, and a relationship with the environment. Hope and faith are two critical factors in psychiatric and physical rehabilitation.

13. Which of the following personal characteristics influence a client's response to stressors? Select all that apply. A) Self-efficacy B) Sense of belonging C) Spirituality D) Hardiness E) Resilience F) Resourcefulness

Ans: A, C, D, E, F Feedback: Personal characteristics that influence a client's response to stressors include self- efficacy, spirituality, hardiness, resilience, and resourcefulness. Sense of belonging is an interpersonal factor that can influence a client's response to stressors.

24. Several family members arrive to visit an African American client. The nurse can best meet this client's need for socialization by providing the client and family which of the following? A) Individual visits to provide the client with a calm environment B) Group gatherings and open conversation C) Inclusion of ritualistic health practices with the family present D) A spiritual healer to remove the illness and protect the family

Ans: B Feedback: During illness, families are often a support system for the sick person. Families often feel comfortable demonstrating public affection such as hugging and touching one another. Conversation among family and friends may be animated and loud. Spiritual rituals are more prevalent in Native American cultures.

35. How might the nurse best provide culturally competent care? A) Behave as appropriate for the nurse's culture. B) Find out as much as possible about a client's cultural values, beliefs, and health practices. C) Know what to expect from many cultural groups. D) Validate knowledge about culture through continuing education.

Ans: B Feedback: Each client is an individual; the nurse can never assume that any individual client will fit the general preferences of his or her culture.

15. Individuals who grow up in ìat-riskî environments but are able to become productive, successful citizens are believed to possess which of the following characteristics? A) Hardiness B) Resilience C) Social skills D) Tolerance

Ans: B Feedback: Resilience is having healthy responses to stressful situations or risky environments. Hardiness is the ability to resist illness when under stress. Social skills are a type of coping strategy. Tolerance is the ability to deal with increasing levels of stress in an adaptive way.

21. A nurse and a client of Chinese heritage are collaborating on treatment goals. The nurse would document which of the following as the client's priority goal? A) The client will be free of pain and excess stress. B) The client will express a feeling of balance and harmony. C) The client will be free of physical symptoms of illness. D) The client will express gratefulness to God for recovery

Ans: B Feedback: Chinese and many other Asian cultures view health as a balance of body, mind, and spirit. Pain-free is a major focus of African American culture. Russians and Latino cultures focus largely on physical aspects of health. Arab cultures view health as a gift of God.

25. A Filipino client meets the nurse for the first time. The client simply smiles at the nurse when introduced. The nurse interprets this behavior as A) a display of being shy and introverted. B) a typical greeting for a Filipino client. C) constricted verbal skills associated with the client's illness. D) a sign that the client may be suspicious of the nurse.

Ans: B Feedback: Smiles rather than handshakes are a common form of greeting in Pilipino culture. Filipino clients consider direct eye contact impolite, so there is little direct eye contact with authority figures such as nurses and physicians.

16. Which of the following factors would be the most influential in determining a client's response to a particular stressor? A) The client's experience with stress B) The client's perception of the stressor C) Duration of the stressor D) Severity of the stressor

Ans: B Feedback: The client will respond to the stressor based on his or her appraisal (perception) of the stressor. Resilience is related to positive outlook. The client's experience with stress, the duration of the stressor, and the severity of the stressor would not be the most influential in determining a client's response to a stressor.

34. The nurse is making a cultural assessment of a client. The most important data about a client's cultural beliefs are A) objective data about the culture. B) subjective data from the client. C) subjective data from the family. D) subjective data from society

Ans: B Feedback: The client's perception and description of cultural beliefs and values are most important.

10. It is recorded in the client's chart that the family is resilient. The nurse concludes which of the following characteristics about the family life of this client? Select all that apply. A) Family members are independent of one another. B) Family members spend time together. C) Family members engage in recreational activities together. D) Family members share the same personal goals. E) Family members allow individual members to develop unique daily routines.

Ans: B, C Feedback: Factors that are present in resilient families include positive outlook, spirituality, family member accord, flexibility, family communication, and support networks. Resilient families also spend time together, share recreational activities, and participate in family rituals and routines together. Personal goal setting reflects self-efficacy.

6. Which of the following individual factors can a person modify to improve mental and emotional health? Select all that apply. A) Serotonin deficiency B) Lack of exercise C) Poor nutrition D) Type I diabetes E) Sleeplessness

Ans: B, C, E Feedback: Personal health practices, such as exercise, poor nutritional status, lack of sleep, or a chronic physical illness, can influence the client's response to illness. Unlike genetic factors, how a person lives and takes care of himself or herself can alter many of these factors. For this reason, nurses must assess the client's physical health even when the client is seeking help for mental health problems. Serotonin deficiency and type I diabetes are not under voluntary control.

12. Which of the following statements about hope and symptoms of mental illness are true? Select all that apply. A) Hope is not realistic and therefore is not related to mental well-being. B) Persons having more hope experienced fewer actual symptoms. C) Hope is a cause of mental illness. D) There is not a significant relationship between hopelessness and increased symptoms. E) A possible way to help clients manage and decrease symptoms would be to support the development of hope.

Ans: B, E Feedback: Persons having more hope experienced fewer actual symptoms. A significant relationship between hopelessness and increased symptoms was also demonstrated. This may indicate that one of the ways to help clients manage and decrease symptoms is having a wellness plan that includes a positive future outlook and support for the development of hope.

1. The nurse is assessing the anxiety level of a young school-age child. The nurse encourages the child to express feelings through the use of toys in a play situation. The purpose for this approach to assessment is largely related to which of the following? A) The child has cognitive impairment and has limited vocabulary skills. B) The child has not been intellectually stimulated and can only express self through play. C) Children may not have developed the language to fully describe their feelings. D) Children will not express themselves openly unless instructed to do so by parents.

Ans: C Feedback: A client's age can influence how he or she expresses illness. A young child may lack the understanding and ability to describe his or her feelings, which may make management of the disorder more challenging. Nurses must be aware of the child's level of language and work to understand the experience as he or she describes it.

26. Females from which of the following cultures are most likely to be expected to move in with husband's family? A) African Americans B) Mexican Americans C) South Asians D) Haitians

Ans: C Feedback: African Americans are more likely to have a nuclear family. Mexican Americans mostly live in nuclear families. South Asians expect the daughters to move in with the husband's family. Haitians may have an extended or a nuclear family.

18. A client reports feeling like he belongs among his peers with whom he shares a group home. The nurse incorporates this sense of belonging when formulating discharge plans because the nurse understands which of the following? A) Living with a peer group often increases anxiety. B) Peers may alienate the client from daily living activities. C) The client will likely feel needed by his peers. D) Peer groups often do too much for each other causing dependency.

Ans: C Feedback: An increased sense of belonging is associated with decreased levels of anxiety. Persons with a sense of belonging are less alienated and isolated, have a sense of purpose, believe they are needed by others, and feel productive socially.

23. A nurse is working with a Middle-Eastern client being treated for major depression. The client is expressing feelings of guilt for not being able to ìsnap out of it.î A therapeutic response by the nurse would be, A) ìYou have to keep trying to feel better.î B) ìWhat do you think could have caused your depression?î C) ìClinical depression is not something you have brought on yourself.î D) ìIt will take several weeks for your medicine to start to help you feel better.î

Ans: C Feedback: Arab Americans believe mental illness is something the person can control. Educating about the etiology reduces the guilt associated with having an illness. Suggesting the client keep trying or caused the depression in some way implies that the client is responsible for the illness. Informing about medication ignores the client's feelings of guilt.

29. Direct eye contact is preferred by which of the following cultures? A) Native Americans B) Cambodians C) Russians D) Chinese

Ans: C Feedback: Of these cultures, only Russians prefer direct eye contact. Native Americans communicate respect by avoiding eye contact. For Cambodians, eye contact is acceptable, but ìpoliteî women lower their eyes. For Chinese, eye contact is avoided with authority figures.

30. Beliefs about the causes of pain and illness vary among cultures. In the United States (Western culture), pain and illness are generally attributed to A) economic class. B) psychological influences. C) physiologic causes. D) sociocultural factors.

Ans: C Feedback: Usually, Americans believe that pain and illness arise from physical causes. Two prevalent types of beliefs about what causes illness in non-Western cultures are natural and unnatural or personal. Unnatural or personal beliefs attribute the causes of illness to the active, purposeful intervention of an outside agent, spirit, or supernatural force or deity. The natural view is rooted in a belief that natural conditions or forces, such as cold, heat, wind, or dampness, are responsible for illness.

27. Culture has the most influence on a person's health beliefs and practices. African Americans believe that the cause of mental illness occurs because of which of the following? A) Lack of harmony of emotions B) Supernatural causes C) Heredity D) Lack of spiritual balance

Ans: D Feedback: African Americans believe that mental illness is caused by lack of spiritual balance. Chinese believe that mental illness is caused by lack of harmony of emotions. Haitians believe that mental illness is caused by supernatural causes. Cubans believe that mental illness is hereditary.

2. A nurse is teaching decision-making skills to a client with dependent personality disorder. According to Erikson, the likely cause of the client developing dependent personality is failure to meet the critical task of which developmental stage? A) Trust B) Autonomy C) Initiative D) Industry

Ans: D Feedback: Failure to complete the critical task results in a negative outcome for that stage of development and impedes completion of future tasks. Tasks of trust versus mistrust include viewing the world as safe and reliable and viewing relationships as nurturing, stable, and dependable. In autonomy versus shame and doubt, children achieve a sense of control and free will. In initiative versus guilt, the child begins to develop a conscience, and learns to manage conflict and anxiety. Industry versus inferiority involves school-age children building confidence in their own abilities and taking pleasure in accomplishments.

9. A client is actively involved in community service activities. The benefit of involvement in meaningful daily activities will most directly contribute to which of the following attributes? A) Self-efficacy B) Resilience C) Resourcefulness D) Hardiness

Ans: D Feedback: Hardiness is the ability to resist illness when under stress. Hardiness has three components: commitmentóactive involvement in life activities; controlóability to make appropriate decisions in life activities; and challengeóability to perceive change as beneficial rather than just stressful. Self-efficacy is a belief that personal abilities and efforts affect the events in our lives. Resilience is defined as having healthy responses to stressful circumstances or risky situations. Resourcefulness involves using problem- solving abilities and believing that one can cope with adverse or novel situations.

11. Spirituality is especially important in helping people cope primarily for which of the following reasons? A) Spirituality helps people set personal goals. B) Spirituality gives people meaningful daily activities in which to participate. C) Spirituality provides a reliable support network. D) Spirituality guides beliefs about the meaning of life events.

Ans: D Feedback: Spirituality involves the essence of a person's being and his or her beliefs about the meaning of life and the purpose for living. Spirituality is a genuine help to many adults with mental illness, serving as a primary coping device and a source of meaning and coherence in their lives. It may also help to provide a social network, but it serves primarily as a belief system. Personal goal setting is a demonstration of self-efficacy. Hardiness is enhanced through commitment to meaningful daily activities.

22. The nurse is preparing to conduct an admission assessment interview with a Mexican American client. During the interview, the nurse should respect the client's culture through which behavior? A) Greet the client with a hug, B) Encourage direct eye contact during questioning C) Prohibiting the next of kin to remain present D) Introduce self with a handshake

Ans: D Feedback: With Mexican Americans touch by strangers is not appreciated, but a handshake is polite and welcomed. Nonverbal communication generally avoids direct eye contact with authority figures. Socially, contact with families comes first.

Which component of hardiness encompasses the ability to make appropriate decisions in life activities? Control Commitment Challenge Change

Control

31. The nurse considers cultural variations pertaining to a client's nonverbal communication. Which of the following is the primary rationale for considering alternative meanings of nonverbal communication? A) The nurse must become expert at interpreting the client's gestures. B) Nonverbal signs indicative of certain mental illnesses transcend cultural differences. C) Mental illnesses impair a client's ability to express nonverbal messages. D) Nonverbal messages have different meanings in various cultures.

Ans: D Feedback: The nurse should be aware that nonverbal communication has different meanings in various cultures. These differences are important to note because many people make inferences about a person's behavior. The nurse can never know all culturally relevant messages. All communication is culturally relative. Persons with mental illness are fully capable of nonverbal expression.

17. The client says to the nurse, ìI know I can learn to cope with my family situation. By getting help here at the clinic, I'll be able to deal with them more effectively, and I won't be so stressed out all the time.î This client is demonstrating a high level of A)Hardiness B)resilience C)sense of belonging D)self-efficacy

Ans:D Feedback: Self-efficacy is a belief that personal abilities and efforts affect the events in our lives. A person who believes that his or her behavior makes a difference is more likely to take action. Persons with high self-efficacy are self-motivated, get needed support, and cope effectively. Hardiness is the ability to resist illness when under stress. Resilience is defined as having healthy responses to stressful circumstances or risky situations. Sense of belonging is the client's place in the group, family, etc.

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? Remove the medicine bag and give it to a family member for safe keeping. Ask the client to provide information about his or her personal spiritual belief system. Ask the client how the medicine bag can be respected while preparing for surgery. Explain to the client that the medicine bag must be removed in order to minimize the risk of infection during the surgical procedure.

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

A handshake is considered an acceptable greeting for anyone in which of the following cultures? (Select all that apply) A. Filipino B. Haitian C. Mexican American D. Native American E. South Asian F. White European American

B C and F

Which of the following assessments indicates positive growth and development for a 30-year-old adult? A. Is dissatisfied with body image B. Enjoys social activities with three of four close friends C. Frequently changes jobs to "find the right one" D. Plans to move from parental home in near future

B.

Which of the following client statements would indicate self-efficacy? A. "I like to get several opinions before deciding a course of action." B. "I know if I can learn to relax, I will feel better." C. "I'm never sure if I'm making the right decision." D. "No matter who hard I try to relax, something always comes up."

B.

Which of the following states the naturalistic view of what causes illness? A. Illness is a natural part of life and therefore unavoidable. B. Illness is caused by cold, heat, wind, and dampness. C. Only natural agents are effective in treating illness. D. Outside agents, such as evil spirits, upset the body's natural balance.

B.

The nurse is caring for a client of Middle Eastern descent who has been newly diagnosed with type 2 diabetes. The client is insistent that the client's family provide all food. How should the nurse respond? By providing the client and the family with detailed instructions with the dietary requirements of the condition By explaning to the family that they must check with the staff before giving the client food and beverages By requesting a consultation with a dietitian By informing the client's health care provider of the client's reluctance to eat facility-prepared foods

By providing the client and the family with detailed instructions with the dietary requirements of the condition

Direct eye contact may be considered disrespectful in which of the following cultures? A. African American B. Arab Americans C. Chinese D. Russian E. South Asian F. Vietnamese

C E and F

Which of the following statements would cause concern for achievement of developmental tasks of a 55-year-old woman? A. "I feel like I'm taking care of my parents now." B. "I really enjoy just sitting around visiting with friends." C. "My children need me now just as much as when they were small." D. "When I retire, I want a smaller house to take care of."

C.

Ability to perceive change as beneficial rather than just stressful:

Challenge

Active involvement in life activities:

Commitment

Ability to make appropriate decisions in life activities:

Control

Which statement about culture is true? Cultures are static. Cultural identity reflects what determines behavior. Culture is based solely on a common purpose. Acculturation eventually leads to the emergence of the dominant culture.

Cultural identity reflects what determines behavior.

___: nursing care means being sensitive to issues related to culture, race, gender, sexual orientation, social class, economic situation, and other factors.

Culturally competent

A psychiatric-mental health nurse is working on developing cultural competence. Which would be most appropriate for the nurse to do? Research information about the cultures of the population being served after assessing the client. Recognize that one's own culture is the predominant way of addressing a client's health care needs. Assume that any individual of a racial or ethnic group is the same as another individual in that group. Demonstrate an appreciation of, and a genuine interest in, the individual and his or her cultural beliefs.

Demonstrate an appreciation of, and a genuine interest in, the individual and his or her cultural beliefs.

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 Discuss the possibility of the family providing the appropriate foods Ask for a dietary consult with an understanding of the "hot and cold food" belief Assure the client that these needs will be considered by the staff

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

___: refers to a client's ability to control the surrounding or direct favors in the environment.

Environmental Control

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. Realize that sitting close to the client is an indication of warmth and caring. Sit 3 to 6 feet away from the client in an attempt to not offend. Remember not to intrude into the personal space of the elderly.

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

Question #1: Is the following statement true or false? Cultural factors include hardiness and resilience.

False: Cultural factors include the patient's beliefs about health and illness. Hardiness and resilience are individual factors.

Children learn cultural characteristics as they associate with others. Which entity has the most profound influence on the development of traditional values and practices? Community Church Family School

Family

Is the ability to resist illness when under stress.

Hardiness

When providing care for a cognitively impaired client who is strongly tied to the client's culture of origin, the nurse supports these expectations by doing what? Including family when discussing new medication treatment options Encouraging the family to consider enrolling the client in an adult day care center Being careful to discuss the client's condition only with the client's spouse Providing family members with information regarding appropriate long-term care facilities

Including family when discussing new medication treatment options

The nurse is assessing a client who recently immigrated to the United States. The client is experiencing a high level of stress and reports that nobody in the workplace is willing to work with or talk to the client. What is the most likely cause of stress in the client? Low hardiness Low self-efficacy Low resilience Low sense of belonging

Low sense of belonging

A female nurse is conducting a family assessment of a Hispanic client. When the nurse asks questions about family problems, the nurse notices that the client is reluctant to answer. A possible cause for this behavior is that some members of the Hispanic culture believe what? Personal matters are considered to be family problems. Information should not be shared with females. Females are cultural leaders to be revered and not burdened with personal matters. Imbalances in yin and yang result in problems and this information is not to be shared with those outside the culture.

Personal matters are considered to be family problems.

The nurse is working in a mental health facility. The nurse ensures that all able-bodied clients in the facility participate in the group exercise program every morning. For which reasons would this intervention be beneficial for the clients with mental illness? Select all that apply. Physical activity improves mood and lowers anxiety. Physical activity increases the efficacy of the psychotropic drugs. Physical activity prevents medical conditions. Physical activity can foster a sense of well-being. Physical activity decreases the need for psychotherapy.

Physical activity improves mood and lowers anxiety. Physical activity prevents medical conditions. Physical activity can foster a sense of well-being.

The nurse in an psychiatric inpatient facility encourages clients to attend daily prayer sessions. What is the most likely reason for the nurse's action? Choose the best answer. Prayer helps in coping with stress. Prayer helps in curing illness. Prayer prevents the progression of the illness. Prayer helps in improving the effectiveness of therapy.

Prayer helps in coping with stress.

When interviewing a Native American client, the nurse avoids which behavior because it is deemed unacceptable by the client's culture? Sitting in the presence of an elder Prolonged eye contact Strict attention to time commitments Expression of emotion or affection

Prolonged eye contact

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

Resilience

Is defined as having healthy response to stressful circumstances or risky situations.

Resilience

Involves using problem-solving abilities and believing that one can cope with adverse or novel situations.

Resourcefulness

Which characteristic would be most prevalent in an individual demonstrating low self-efficacy? Self-doubt Personal goals Self-motivation Stress management

Self-doubt

Is a belief that personal abilities and efforts affect the evens in our lives.

Self-efficacy

Is the feeling of connectedness with or involvement in a social system or environment of which a person feels an integral part.

Sense of belonging

When conducting an assessment with a client from another country, what can a nurse do to ensure the client receives culturally sensitive care? After the focused assessment, decide if a cultural assessment is necessary. Show genuine interest in the client's culture and personal life experiences. Develop a plan of care after talking to the client's family. Develop a plan of care based on the nurse's own knowledge of a client's culture.

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

Refers to family structures and organization, religious values and beliefs, ethnicity, and culture, al of which affect a person's role and, therefore, his or her health and illness behavior.

Social organizations

Is emotional sustenance that comes from friends, family members, and even health-care providers who help a person when a problem arises. It is different from social contact, which does not always provide emotional support.

Social support

___: refers to one's income, education, and occupation. It strongly influences a person's health, including whether or not the person has insurance and adequate access to health care or can afford prescribed treatment.

Socioeconomic status

Involves the essence of a person's being and his or her beliefs about the meaning of life and the purpose for living.

Spirituality

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 Racism Honoring rituals Transcultural nursing

Stereotyping

The nurse is performing a psychosocial assessment of a 30-year-old client who has recently moved back home. What developmental stressors may be noted in this client? Select all that apply. Stress related to health changes Stress related to career growth Stress related to moving out of parental home Stress related to the inability to look after self Stress related to reversing roles with parents

Stress related to career growth Stress related to moving out of parental home

The mental health nurse is interviewing a client of Asian descent 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 Knowing the characteristics of each individual cultural group in America A combination of a person's beliefs about cultural values and knowledge about his or her own culture The client's ability to tell the health care provider about his or her cultural beliefs and practices

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 low self-esteem. The client is not spiritually inclined. The client has reduced sense of belonging. The client has difficulty in problem solving under stress.

The client has difficulty in problem solving under stress.

Which culture is comfortable with making direct eye contact? Western Native American Asian Chinese

Western

The nurse is assessing a client of Middle Eastern descent. The nurse finds that the client is standing at a distance of approximately 1.5 feet while speaking to the nurse. What should the nurse interpret from this behavior? The client is behaving in a manner that is culturally acceptable. The client is trying to invade the nurse's personal space. The client likes to be spoken to from a close distance. The client wants to develop a social relationship with the nurse.

The client is behaving in a manner that is culturally acceptable.

The nurse is performing a psychosocial assessment of a client. Which behavior would indicate that the client has a high self-efficacy? The client is extremely ambitious. The client has anxiety and depression. The client has an increased sense of self-doubt. The client does not believe that others would help the client if needed.

The client is extremely ambitious.

___: or whether one views time as precise of approximate, differs among cultures.

Time orientation

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? Holding preconceived judgement about cultural groups Developing a general belief system about all people from the same culture Treating the client as a source of cultural information Viewing a specific client population from a stigmatized view

Treating the client as a source of cultural information

The client was born and educated in Japan. 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? cross culturalism ethnic mosaic acculturation inclusiveness

acculturation

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? have clergy come to see the client clarify own spiritual values and beliefs before exploring clients' beliefs ask the manager what to do have the healthcare provider deal with spiritual needs

clarify own spiritual values and beliefs before exploring clients' beliefs

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? closely intertwined with beliefs about health and mental illness living according to one's beliefs participation in common ways of worshiping feeling a connection to a higher power

feeling a connection to a higher power

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? dramatism linguistic competence negociation skills cultivation analysis

linguistic competence