Culture

Which instruction would be most beneficial for an aging African-American client with hypertension? "Check the pulse daily." "Have an annual urinalysis." "Record blood pressure weekly." "Visit an ophthalmologist monthly."

"Have an annual urinalysis."

T/F: we can provide cultural care without cultural knowledge

False without cultural knowledge is it hard to provide cultural care

what is a taboo? what is an example?

illness with a stigma (ex: mental illness)

we develop __ through family, friends, community, peers, schooling, media, work, religious institutions, government, legal system, health care system

socialization

what is biculturalism?

someone who belongs to two cultures (ex: someone who immigrated from China, but they live in America now - they have practices involved for each culture)

What is ethnicity/ethnic identity?

we have a common ancestry; where we have originated

A nurse hired to work in a metropolitan hospital provides services for a culturally diverse population. One of the nurses on the unit says it is the nurses' responsibility to discourage "these people" from bringing all that "alternative medicine stuff" to their family members. Which response by the recently hired nurse is most appropriate? "Hospital policies should put a stop to this." "Everyone should conform to the prevailing culture." "Nontraditional approaches to health care can be beneficial." "You are right because they may have a negative impact on people's health."

"Nontraditional approaches to health care can be beneficial."

What is the goal of transcultural nursing? Provide an example.

-Provide culturally congruent care, or care that fits a person's life patterns, values, and system of meaning Ex: if a couple walks into the hospital and do not want to be treated by a nurse of the opposite gender -Providing culturally congruent care bridges cultural gaps to provide meaningful and supportive care for all clients

why should you not use a family member as an interpreter?

-Unable to ensure accuracy of interpretation -May not have knowledge of medical terminology

What are some examples of aspects of life that culture impacts?

Diet, hygiene, family dynamics, work life, medicine in healthcare, how people carry themselves, how people dress

A nurse understands that when a client is a member of a different ethnic community it is important to do what? Ensure that the nurse's biases are understood by the family. Make plans to counteract the client's misconceptions about therapies. Offer a therapeutic regimen compatible with the lifestyle of the family. Recognize that the client's responses will be similar to other clients' responses.

Offer a therapeutic regimen compatible with the lifestyle of the family.

What is the relationship of cultural competence to quality nursing practice?

The more competent you are the better quality care you will receive

T/F: Most aspects of a person's world view are actually beneath the surface, not always above

true

During a routine checkup a client reports concerns over weight gain despite trying juice cleanses and other trend diets. The nurse records the client's weight and BMI at a healthy range, but the client states, "I wish I were as thin as my co-workers." The client is at risk for what culturally-bound condition? Neurasthenia Anorexia nervosa Shenjing shuairuo Ataque de nervios

Anorexia nervosa

The nurse leader is teaching the staff that the health care provider continuously strives to work effectively within the cultural context of a client. Which cultural principle is the nurse leader explaining? Cultural diversity Cultural sensitivity Cultural imposition Cultural competence

Cultural competence

What does the professional nurse consider to be the center of decision-making when providing client care? Ethics of care Nursing skills Analytical skills Research based practice

Ethics of care A professional nurse always follows the ethics of care and considers caring to be the center of decision-making. The nurse must know what behavior is ethically appropriate while caring for a client. A nurse's effectiveness in performing tasks is important to client care; however, client satisfaction comes from the effective dimension of care. Because ethics of care are unique to each client, the nurse should not base decision-making only on analytical skills. The nurse should not provide client care based only on intellectual principles or research knowledge. Caring is the most important factor because it considers client preferences and values.

____ initiative to eliminate health disparities

Healthy People 2020

A client in the intensive care unit tells the nurse, "No matter how much you try, I will not be able to recover. No one can change my destiny." Which religion might the nurse expect the client to practice? Islam Judaism Buddhism Christianity

Islam

A nurse caring for a client from another country asks about the client's healthcare traditions. Which Quality and Safety Education for Nurses (QSEN) competency does the nurse comply with? Safety Informatics Patient-centered care Teamwork and collaboration

Patient-centered care

A foreign language-speaking client needs to undergo chemotherapy; a signed consent form is required. What should the nurse do to explain the terms of the consent to the client? Seek the help of an official interpreter. Seek the help of the primary healthcare provider to assist the client. Seek help from the client's family friend who speaks the client's language. Seek help from the client's caregiver who speaks the same language as the client.

Seek the help of an official interpreter.

The preschool-age client is learning sociocultural mores. What should this imply to the nurse regarding this client? The child is developing a conscience. The child is learning about gender roles. The child is developing a sense of security. The child is learning about the political process.

The child is developing a conscience.

What are the attributes of culture?

culture is learned, changing and adapting, shared

Among which group of women are breast cancer death rates the lowest? Hawaiian Puerto Rican Asian American African American

Asian American

Which of these cultural groups is known to practice Ayurveda to prevent and treat illness? East Asian Hispanic Asian Indian Native American

Asian Indian

The nurse on the postpartum unit is providing postpartum care instructions to a 21-year-old Inuit woman who delivered her first baby yesterday without complications. Her husband, mother, and other family members have been with her since delivery. The mother speaks and understands very little English; however, her husband and sister speak some English. What is the best way to ensure that the client and her family understand what is being taught? Providing the teaching to all family members and the client Asking the client and her family to nod their heads to verify understanding Asking the client and her family members to say yes to verify understanding Asking the client and family members to repeat, in their own words, what they have been told

Asking the client and family members to repeat, in their own words, what they have been told

The nurse is assessing a Latino-Caribbean client who was brought to the hospital by family members. The family reports the client started crying, shouting, trembling, had uncontrolled jerking of the extremities, and then fell into a trance-like state. What condition does the nurse suspect? Bulimia nervosa Anorexia nervosa Shenjing shuairuo Ataque de nervios

Ataque de nervios Ataque de nervios is a Latino-Caribbean culture-bound syndrome that usually happens in response to specific stressors. This culture-bound syndrome is characterized by crying, uncontrollable spasms, trembling, shouting, dissociation, and trance-like states. Bulimia nervosa and anorexia nervosa are culture-bound syndromes in the form of eating disorders, but they are not characterized by crying, spasms, and shouting. Shenjing shuairuo is not associated with the Latino-Caribbean culture; instead, it is associated with Chinese culture.

How can the lines of communication be improved in a healthcare organization during the process of delegation? By considering all aspects of client care By selecting experienced nursing assistants as delegatees By appreciating and valuing each other's cultural perspectives By selecting a delegatee having similar strengths as that of the delegator

By appreciating and valuing each other's cultural perspectives The lines of communication in a healthcare organization can be improved by appreciating and valuing each other's cultural perspectives, which balances strengths between the delegator and delegatee and improves client care outcomes. Considering all aspects of client care ensures that all of the client care needs are addressed. Selecting experienced nursing assistants as delegatees increases the chances of the delegatee to adapt to changing situations. Selecting a delegatee having similar strengths as that of the delegator may decrease the lines of communication because the delegatee might do the task of the delegator.

A nurse is helping a client who observes the traditional Jewish dietary laws to prepare a dietary menu. What considerations should the nurse make? Eating beef and veal is prohibited. Consumption of fish with scales is forbidden. Meat and milk at the same meal are forbidden. Consuming alcohol, coffee, and tea are prohibited.

Meat and milk at the same meal are forbidden. Jewish dietary laws prohibit any combination of milk and meat at the same meal. The Hindu, not Jewish, religion prohibits the ingestion of beef and veal; many Hindus believe that the cow is sacred. Fish that have scales and fins are considered clean, and therefore allowed in the diet. Seventh Day Adventists, Baptists, Mormons, and Muslims prohibit some or all of the beverages alcohol, coffee, and tea.

A new mother said to the nurse, "I would like to care for my baby independently rather than depending on the baby's grandparents." What does the nurse infer from this information? The client is of Asian culture. The client is of African culture. The client is of North American culture. The client is of Latin American culture.

The client is of North American culture.

What points should a nurse keep in mind when caring for a client who belongs to a different culture? Select all that apply. The nurse should be aware of his or her own cultural values and behavior patterns. The nurse should focus on understanding the client's traditions, values, and beliefs. The nurse should understand that unique cultural perceptions exist regarding health practices. The nurse should know that every client strictly adheres to his or her cultural beliefs and traditions. The nurse should know that a client's cultural background does not influence the nurse-client relationship.

The nurse should be aware of his or her own cultural values and behavior patterns. The nurse should focus on understanding the client's traditions, values, and beliefs. The nurse should understand that unique cultural perceptions exist regarding health practices.

self-awareness is directly related to ..?

bias

What interrelated constructs facilitate a nurse to become culturally competent?

cultural desire, knowledge, skill, and self-awareness

we develop ___ through shared experiences and commonalities that have developed and continue to evolve in relation to changing social and political contexts

culture

what is enculturation?

process by which a person learns norms, values, and behaviors of another culture (ex: high school student spending a semester in another country)

what is assimilation?

the person gives up his or her original identity or culture and develops a new cultural identity (ex: a Native American losing their native identity after living in Chicago for 10 years)

what is acculturation?

the process fro acquiring new attitudes, roles, customs, behaviors (ex: immigrant from china develops a preference to western foods and culture)- adopt a new culture

what type of communication should be used in the event that an interpreter is not readily available?

use non-verbal communication

The nurse is caring for a client who self-identifies as having a strong Hispanic heritage. According to transcultural nursing researchers, what should the nurse ask when assessing a woman with depression for the risk of self-harm who also identifies as having Hispanic ethnicity? "When did you last spend time with friends?" "How do you express yourself when you're angry?" "What made you first notice that you were depressed?" "Do you have many interests outside your work and home?"

"How do you express yourself when you're angry?"

A woman who has just delivered an infant asks to take the placenta home with her upon discharge. What is the most appropriate response by the nurse? "I'll wrap that right up for you." "I'm sorry, but you can't do that." "I'll give it to you for your husband to take home now." "I need to check the hospital protocol for our policy on that practice."

"I need to check the hospital protocol for our policy on that practice." The placenta is a part of the body and therefore contains body fluids. It must first be assessed by the healthcare provider to be sure that it is not infected and to be sure that all parts of the placenta have been accounted for. The nurse must follow hospital policy regarding the release of the placenta to the family. All necessary documentation must be signed and the policies must be followed before the release of the placenta to the family.

What statements about culturally congruent care by the student nurse are correct? Select all that apply. "It is the main goal of transcultural nursing." "It is provided through cultural competence." "It is provided in accordance with set criteria." "It is bound to the professional health care system." "It depends on the patterns and needs of an individual."

"It is the main goal of transcultural nursing." "It is provided through cultural competence." "It depends on the patterns and needs of an individual."

An African-American woman is diagnosed with primary hypertension. She asks, "Is hypertension a disease of African-American people?" What is the nurse's best response? "The prevalence of hypertension is about equal for women of all races." "The higher-risk population is composed of African-American men and women." "The highest-risk population consists of older Caucasian-American men and women." "The prevalence of hypertension is greater for African-American men than for African-American women."

"The higher-risk population is composed of African-American men and women."

A newly immigrated older Chinese adult is brought to a mental health clinic when family members become concerned that their parent is depressed. In an attempt to conduct a culturally competent assessment interview, the nurse asks certain questions. Which questions does the nurse ask? Select all that apply. "What brought you here for treatment today?" "What do you believe is the cause of your depression?" "Does religion have a role in your perception of health and wellness?" "Do you have insurance that includes coverage of mental health issues?" "Have you ever sought treatment for a mental health problem before?"

"What brought you here for treatment today?" "What do you believe is the cause of your depression?" "Does religion have a role in your perception of health and wellness?" "Have you ever sought treatment for a mental health problem before?"

Which nursing assessment questions assess the faith, belief, fellowship, and community aspect of a client's spirituality? Select all that apply. "What gives meaning to your life?" "What is your source of power, hope, and belief during difficult times?" "In what way do your beliefs help or strengthen you for coping with illness?" "How has the illness affected your capability to express what is essential in life?" "How do you feel the changes caused by the illness are affecting or will affect your life?

"What gives meaning to your life?" "What is your source of power, hope, and belief during difficult times?" "In what way do your beliefs help or strengthen you for coping with illness?" A nurse can assess the faith, belief, fellowship, and community aspect of a client's spirituality by asking a client what gives meaning to his or her life, about his or her source of power, hope, or belief during difficult times, and about how his or her beliefs help or strengthen him or her for coping with illness. When a nurse asks the client in what way illness affects his or her capability to express what is essential in life, it helps in assessing the vocation aspect of spirituality. When a nurse asks the client how he or she feels about the changes that have been caused by the illness, it helps in assessing the life and self-responsibility aspect of spirituality.

what is culture?

-a pattern of shared attitudes, beliefs, self-definitions, norms, roles, and values that can occur among those who speak a particular language or live in a defined geographical region -forms a person's worldview, which in turn shapes his or her beliefs about health and illness

how does culture influence shared beliefs, values, and behaviors?

-belief: something that you believe to be is true -values: derived from beliefs (ex: respecting elders) -behaviors: (ex: "yes ma'am" "no ma'am")

what is transcultural nursing?

A comparison of cultures to understand their similarities and differences

A daughter of a Chinese-speaking client approaches a nurse and asks multiple questions while maintaining direct eye contact. What culturally related concept does the daughter's behavior reflect? Prejudice Stereotyping Assimilation Ethnocentrism

Assimilation Assimilation involves incorporating the behaviors of a dominant culture. Maintaining eye contact is characteristic of the American or Canadian culture and not of Asian cultures. Prejudice is a negative belief about another person or group and does not characterize this behavior. Stereotyping is the perception that all members of a group are alike. Ethnocentrism is the perception that one's beliefs are better than those of others.

A nurse understands that value clarification is a technique useful in therapeutic communication because initially it helps clients do what? Become aware of their personal values Gain information related to their needs Make correct decisions related to their health Alter their value systems to make them more socially acceptable

Become aware of their personal values

Which ethnic group has a greater incidence of osteoporosis due to musculoskeletal differences? Irish Americans African Americans Chinese Americans Egyptian Americans

Chinese Americans

A client who only speaks Spanish is being cared for at a hospital in which nursing personnel only speak English. What communication technique would be appropriate for the nurse to use when discussing healthcare decisions with the client? Contact an interpreter provided by the hospital. Contact the client's family member to translate for the client. Communicate with the client using Spanish phrases the nurse learned in a college course. Communicate with the client with the use of a hospital-approved Spanish dictionary.

Contact an interpreter provided by the hospital.

A pregnant immigrant notices cultural differences in the way that pregnant women are cared for where she now lives. Which component of cultural competence is being demonstrated when the nurse motivates the immigrant to accept these differences? Cultural desire Cultural awareness Cultural knowledge Cultural encounters

Cultural desire The nurse is using cultural desire as a part of cultural competence. This component is related to motivation and commitment towards the care of an individual. Through this, an immigrant may become open to cultural differences and accept them. Cultural awareness is an in-depth self-examination of backgrounds and recognizing biases and prejudices. Cultural knowledge is a comparative study about the beliefs and care practices of other cultures. Cultural encounter is about transcultural interactions for effective communication and development.

The nurse leader states, "The people in rural America dress and act differently from those in urban centers." What concept describes this statement? Acculturation Ethnocentrism Cultural imposition Cultural marginality

Cultural marginality Cultural marginality is defined as situations and feelings of passive betweenness when people exist between two different cultures. refers to adapting to a particular culture. It is a process by which a person becomes a competent participant in the dominant culture. Ethnocentrism refers to the belief that one's own ways are the best, most superior, or preferred ways to act, believe, or behave. Cultural imposition is defined as the tendency of an individual or group to impose their values, beliefs, and practices on another culture for varied reasons.

An Asian client arrives at the mental health clinic with symptoms of anxiety and panic. While speaking with the client, the nurse notes that the client makes very little eye contact. What does this assessment data suggest? Shyness Cultural variation Symptom of depression Shame regarding treatment

Cultural variation As a show of respect, people in Asian cultures tend to make little eye contact, particularly with people perceived as authority figures. A lack of eye contact may connote shyness in some clients, but further assessment is needed. A lack of eye contact may suggest a depressed mood; however, there is no indication of depression in this client. A lack of eye contact may indicate shame or low self-esteem in the American culture; however, it is important not to make this same interpretation of behavior for someone from another culture.

A 5-year-old child who is newly arrived from Latin America attends a nursery school where everyone speaks English. The child's mother tells the nurse that her child is no longer outgoing and has become very passive in the classroom. What is the probable reason for the child's behavior? Culture shock Social immaturity Experience of discrimination Lack of interest in school activities

Culture shock

Why is it important for a nurse in the prenatal clinic to provide nutritional counseling to all newly pregnant women? Most weight gain is caused by fluid retention. Different cultural groups favor different essential nutrients. Dietary allowances should not increase throughout pregnancy. Pregnant women must adhere to a specific pregnancy dietary regimen.

Different cultural groups favor different essential nutrients.

A multigravida of Asian descent weighs 104 lb (47.2 kg), having gained 14 pounds (6.4 kg) during the pregnancy. On her second postpartum day, the client is withdrawn and eating very little from the meals provided. Which intervention is most important for the nurse to implement? Report these findings to the healthcare provider. Encourage the family to bring in special foods preferred in their culture. Order a high-protein milkshake to supplement between meals. Call the dietitian to work with client to plan high calorie meals for the client to eat.

Encourage the family to bring in special foods preferred in their culture. In family-centered childbearing, care should be adapted to the client's cultural needs and preferences whenever possible. Discussing the problem with the healthcare provider is the nurse's responsibility but will not address the client's preferences. Ordering a high-protein milkshake as a between-meal snack may offer the client an option but is unlikely to meet the cultural preferences. Having the dietitian assist with planning meals does not address the underlying problem.

An African man presents to the emergency department to obtain pain medication. The nurse behaves judgmentally and labels the client a drug abuser. What is the nurse demonstrating? Ethnocentrism Multiculturalism Cultural encounter Cultural imposition

Ethnocentrism Ethnocentrism is the tendency of a person to hold his or her own beliefs superior to those of other people. It causes biases and prejudices in regard to people from other groups. This practice is transmitted by cultural groups from one generation to another. In multiculturalism, two cultures coexist and are accepted by the individual. In a cultural encounter, part of cultural competence, a nurse engages in cross-cultural interactions for effective communication. Cultural imposition occurs when a nurse or health care provider ignores the differences between his or her own culture and others and imposes his or her beliefs on people of other cultures.

Since giving birth 6 months ago, a new mother has breast-fed her infant. The woman becomes hysterical after learning that her husband has been seriously injured in an automobile accident. Culturally this woman believes that emotional stress while breast-feeding can "sour the milk," and she indicates that she must wean her infant immediately. What should the nurse do? Instruct the mother about formula feeding. Explain to the mother that these beliefs are wrong. Provide the mother with books indicating that the milk does not sour. Encourage the mother to take an antianxiety drug while continuing breast-feeding.

Instruct the mother about formula feeding.

What should a nurse consider about the past experiences of clients who have immigrated to this country? It affects all of their inherited traits. There will be little impact on their lives today. It is important that their values be assessed first. How they will interact is permanently established.

It is important that their values be assessed first. Past experiences are important and must be recognized because they help set the individual's values throughout life. Past experiences will not affect inherited traits. Past experiences play an important role in an individual's life. Nothing establishes how an individual responds forever; new experiences continue to influence future responses.

The nurse is caring for an Asian client who had a laparoscopic cholecystectomy six hours ago. When asked whether there is pain, the client smiles and says, "No." What should the nurse do? Monitor for nonverbal cues of pain Check the pressure dressing for bleeding Assist the client to ambulate around his room Irrigate the client's nasogastric tube with sterile water

Monitor for nonverbal cues of pain

A 15-year-old emancipated minor gave birth to a boy 36 hours ago and has requested a circumcision. What is the medical priority? Obtaining a physician's prescription for a lidocaine injection Educating the new mother about the circumcision procedure Obtaining an informed consent signed by the mother of the baby Obtaining an informed consent signed by the grandmother of the baby

Obtaining an informed consent signed by the mother of the baby

What data is collected as part of a Cultural Assessment?

Origins and Family: -where born -decisions made within family -cultural groups identify with; presence of social network -important cultural practices Communication: -language spoken at home -preferred methods to communicate (how to be addressed? with whom to direct questions to?) -ways respect is shown to others -eye contact, interpersonal space Personal beliefs about health and illness: -meaning and belief about cause of illness -perception of control over health -practices or rituals used to improve health -perception of severity of illness -expectations for treatment (use of folk remedies, alternative medicine) -practices that violate beliefs -concerns or fears about illness or process of treatment Daily Practices: -dietary practices and preferences; forbidden foods -beliefs about food that pertain to health and illness -spiritual beliefs; religious practices -special rituals

The nurse is caring for an Asian-American client with a diagnosis of depression. While interviewing this client the nurse notes that the client maintains traditional cultural beliefs and values. What is the most important information for the nurse to obtain about the client? Dietary practices Concept of space Immigration status Role within the family

Role within the family

A client with a terminal illness is grateful for the care received in the hospital and has slowly started to come to terms with imminent death. The nurse recognizes that the client's behavior and attitude is most consistent with which cultural group? German culture Somalian culture Ukrainian culture More secular culture

Somalian culture Terminally ill clients who belong to the Somalian culture may slowly accept their imminent death and have faith in God. Somalian clients will generally express their gratitude to the care received in the hospital. Clients who belong to the German and Ukrainian cultures may not accept their illness and may fight against the illness in them. Clients who belong to a more secular culture or are less identified by religious institutions may not accept their imminent death.

A nurse and a nutritionist are discussing the needs of a client who practices the Russian Orthodox faith. What should the nurse and the nutritionist consider when planning meals for this client? The client avoids pork and shellfish. The client avoids blood-containing food. The client follows a strict vegetarian diet. The client does not eat meat on Wednesdays and Fridays.

The client does not eat meat on Wednesdays and Fridays.

Obesity in children is an ever-worsening problem. What concept should a nurse consider when caring for school-aged children who are obese? Enjoyment of specific foods is inherited. There are familial influences on childhood eating habits. Childhood obesity is usually not a predictor of adult obesity. Children with obese parents are destined to become obese themselves.

There are familial influences on childhood eating habits.

A nurse is caring for an adult client who immigrated to this country 5 years ago. What does the nurse know about the past experiences of clients who have immigrated to this country? They affect their inherited traits. They have little effect on their lives today. They are important in assessment of their values. They establish personal interactions throughout life.

They are important in assessment of their values. Past experiences are important and must be recognized because they set the parameters for the individual's enduring values throughout life. Past experiences do not affect inherited traits. Past experiences play an important role in an individual's life. Nothing establishes how an individual responds over a lifetime; new experiences continue to influence future responses.

When compared with their non-Hispanic white counterparts, which factors contribute to the health disparities Hispanic older adults face? Select all that apply. Value differences Language barrier Lack of health care facility Inadequate health insurance Poor diet and nutrition

Value differences Language barrier Lack of health care facility Inadequate health insurance