Health Assessment- PrepU Chapter 11 Assessing Culture

Which statement by the nurse demonstrates a cultural bias? "I don't understand how a woman would be sexually interested in another woman." "The client is Muslim, so I'll need to arrange care around his need to pray five times a day." "American healthcare is really so much better than that provided by any other country." "The client is old and wouldn't be able to understand the discharge instructions."

"American healthcare is really so much better than that provided by any other country." A bias is based on the practice of applying one's own cultural beliefs and values when interpreting and judging the value of something. A prejudice is disapproving or negative attitude that is not rooted in fact or accurate information. Stereotyping involves a uniform image of one group that is believed by another group or a fixed, overgeneralized belief about a particular group.

The nurse is assessing a client in the emergency department who appears to be confused and unable to follow commands. When obtaining the client's social history, which of the following questions should the nurse ask first? "Do you live in low-income housing?" "Are you able to afford your medications?" "Have you consumed any alcohol today?" "Are you married?"

"Have you consumed any alcohol today?" Nurses should use their judgement regarding the appropriate timing of a social assessment considering the health encounter, and only ask the questions that are essential. Asking about drug and alcohol use is a priority as the client is confused and unable to follow commands. Determining housing status, ability to purchase medications, and marital status are not immediately essential questions to ask.

During a client interview, the nurse is focusing on cultural influences particularly when assessing: (Select all that apply.) Health care beliefs and practices Nutrition High-risk behaviors Cardiovascular status Employment history

Health care beliefs and practices Nutrition High-risk behaviors Aspects of culture that are relevant to the health assessment include health care beliefs and practices, nutrition, and high-risk behaviors. Aspects of culture that are not necessary relevant to the health assessment include the cardiovascular status and employment history.

When caring for a client from a culturally different background, what is the goal for incorporating the client's health beliefs and practices into the nursing plan of care? To enhance the client's social system To enhance cultural connectedness Improvement of the client's health outcomes Improvement of communication with the client and family

Improvement of the client's health outcomes Consideration of the client's cultural background and incorporating health beliefs and practices in care plans contribute to enhanced client experiences with health care and improve health outcomes. Incorporating the client's health beliefs and practices will not enhance this client's social system or cultural connectiveness, nor will it improve communication with the family.

A nursing student is caring for an older adult from a different cultural background. The nurse's preceptor asks the student what would be an important assessment to make to provide quality nursing care for this client. What would be the student's most appropriate response? transcultural assessment respiratory assessment mobility assessment family assessment

transcultural assessment A specific example of a comprehensive nursing assessment that attends to both social and cultural dimensions is the transcultural assessment. A respiratory assessment would be important if the client had a respiratory problem. Mobility and family assessments could be useful, but these aspects can also be addressed through a transcultural assessment.

What aspects of culture are relevant when conducting a health assessment on a foreign-born client admitted for surgery? Select all that apply. whether there are any existing language barriers nutritional or dietary considerations alternative medicine practices reasons for immigrating to the United States age when immigration to the United States occurred

whether there are any existing language barriers nutritional or dietary considerations alternative medicine practices Aspects of culture relevance to a health assessment include communication and language, nutrition, and health care beliefs and practices. The remaining questions relate to the social aspects of a cultural assessment.

A nursing instructor is teaching students about communication in different cultures. When discussing the meaning of hand gestures and body language in different cultures, the nurse realizes that further instruction is necessary when a student makes which statement? "There are many different elements of body language and hand gestures." "If any hand gesture is used, always clarify if there seems to be a strange reaction on the other's part." "I can make a circle with my thumb and forefinger and people of all cultures know it means OK." "A major hand gesture is one for indicating height."

"I can make a circle with my thumb and forefinger and people of all cultures know it means OK." There are many different elements of body language and hand gestures among different cultures. Using the hand to indicate height is a common gesture of Americans and Latins. Making a circle with the thumb and forefinger can mean OK for Americans but can be a definite and serious insult in many cultures. Therefore, if any hand gesture is used, the nurse should always clarify if there seems to be a strange or unexpected outcome on the other person's part.

A nurse has a regular client who is an immigrant from China and who follows the traditional medical system of that culture. To improve the ability to understand and work with this client, the nurse researches this client's cultural view of health. Which of the following would the nurse most likely discover? A focus on maintaining balance between yin and yang Respect for nature and use of masks and sand paintings Prayers to God and saints for spiritual reparations for sins Use of herbs, roots, talismans, and amulets

A focus on maintaining balance between yin and yang Asian traditions of medicine include Chinese medical practitioners and herbalists who focus on maintaining balance between yin and yang. Native American and Alaska Native traditions include respect for nature and avoidance of evil spirits, along with use of masks, herbs, sand paintings, and amulets. Hispanic traditions include prayers to God and saints for spiritual reparations for sins. African traditions include use of magic, herbs, roots, rituals, talismans, and amulets.

The nurse is reviewing the chart notes (see above) for a client newly admitted to the hospital. Which of the following is a priority for the nurse when first meeting this client? Obtain the client's blood glucose level. Offer to speak with the client's adult child as an intermediary. Ask for more information about the client's treatment preference. Obtain assistance from an interpreter.

Ask for more information about the client's treatment preference. When first meeting a client, establishing a positive nurse-client relationship is essential. Attributes and behaviors of a nurse practicing effective care within the client's cultural context include taking a genuine interest in a patient's culture and treatment preferences. The client's vital signs were within normal limits and there is no indication that the blood glucose is not managed. Because the client can speak English, obtaining assistance from an interpreter is not a priority, unless the client were to request one. The nurse should speak directly to the client and not the adult child, as there is no indication that the client wants or needs a family member to act as an intermediary.

A woman newly immigrated to the United States is admitted to the obstetric unit. While doing a transcultural assessment, how would the nurse individualize questions for this client? Assessing if the client speaks and understands English Realizing that some women are not allowed an education in their home country Requesting a professional translator fluent in the woman's language Directing assessment questions only to the client's partner or family members

Assessing if the client speaks and understands English To best address individualization during a transcultural assessment with this client, the nurse must determine the degree to which the client effectively speaks and understands English. The nurse would need this information prior to asking for a translator, assuming the client was not allowed an education, or talking only with the partner or family members.

In preparing to assess a client from a different culture, a nurse is aware that one needs to assess both factors that affect the client's approach to providers and factors that affect the client's disease, illness, and health state. Which of the following is a factor the nurse should consider that primarily affects the client's approach to providers? Death rituals Body language Pain Pregnancy and childbearing

Body language Elements of communication—including time, space, eye contact and face positioning, body language and hand gestures, silence, and touch—are all examples of factors that affect the client's approach to providers. Health care beliefs—such as causes of illness, culture-bound syndromes, culture-based treatments, death rituals, pregnancy and child-bearing, pain, and blood products and transfusions—are examples of factors that primarily affect the client's disease, illness, or health state.

A nurse demonstrates cultural skill by which of the following? Interpreting data accurately based on a client's culture Interacting in a face-to-face manner with someone from another culture Examining his or her own biases about other cultural groups Being aware of cultural differences among groups

Interpreting data accurately based on a client's culture Cultural skill involves learning how to complete cultural assessments and culturally based physical assessments and to interpret the data accurately. Interacting face-to-face with someone from another culture refers to a cultural encounter. Examining one's own biases, and being aware of cultural differences, reflects cultural awareness.

Which of the following statements is true about biologic variation? Both genetics and environment produce biologic variation. Cultural practices produce biologic variation. Race is based on physical variations. Drug metabolism differences are not culture based.

Both genetics and environment produce biologic variation. Some aspects of biologic variation affect and are affected by cultural beliefs and behaviors. Genetics and environment, and their interaction, cause humans to vary biologically.

A client comes to the ED with lower abdominal pain. She is extremely emotional and moving wildly on the gurney. A nurse says to another nurse that the client is "way overdoing it." What action should the nurse take to best provide care for this client? Conduct a cultural assessment to better understand the client's perception of pain and illness. Tell the physician the client is not hurting as much as she lets on Move the client so she will not bother other clients in the department Talk to the client's family to find out if this is the normal behavior for this client

Conduct a cultural assessment to better understand the client's perception of pain and illness. Some cultures encourage sick clients to be pampered and express pain freely. Whatever the situation, nurses must display a nonjudgmental attitude, provide facts, and use a culturally specific approach when administering prescribed treatments. They must never interpret the client's inactivity and dependence as apathy, depression, or "being difficult" without first conducting a cultural assessment and gaining insight into the client's medical diagnosis and behavior. It is not appropriate for the nurse to tell the physician that the client is not in as much pain as she is letting on, to move the client away from other clients in the department, or to talk to the client's family to find out if this is the normal behavior for this client.

The nurse is caring for a client who is from another country, and states to the charge nurse, "I just don't know if the client really understands what I am saying, and I am not understanding the client either, even though he speaks English." What stage of cultural awareness is the nurse experiencing? Unconscious incompetence Conscious incompetence Conscious competence Unconscious competence

Conscious incompetence Conscious incompetence is the awareness that one lacks knowledge about another culture; aware that cultural differences exist but not knowing what they are or how to communicate effectively with clients from different cultures.

A new graduate nurse from a small community college is going to work in an urban setting. She embraces the thought of working in a more diverse setting and wants to learn about different cultures. What behavior is this nurse exhibiting? Cultural desire Cultural knowledge Cultural skill Conscious incompetence

Cultural desire Cultural desire is the motivation to engage in intercultural encounters and acquire cultural competence. The starting point of cultural competence is cultural desire.

A new graduate nurse, attending a hospital orientation, is asked to explain the goals of a cultural assessment. What would be the graduate nurse's best answer? Developing and implementing a culturally congruent plan of care Comparing social care needs of the specific person Acquiring knowledge about the community's cultural beliefs and practices Comparing social and health beliefs of public health agencies

Developing and implementing a culturally congruent plan of care The specific aim of cultural assessment is to provide an all-inclusive picture of the client's culture-based health care needs by (1) gaining knowledge about the client's cultural beliefs and practices; (2) comparing culture care needs of the specific person with the general themes of those of a similar cultural background; (3) identifying similarities and differences among the cultural beliefs of the client, health care agency, and nurse; and (4) generating a holistic picture of the client's care needs, upon which a culturally congruent nursing care plan is developed and implemented. The remaining options are associated with components of an effective cultural assessment.

A nurse is assessing a client from India who complains of panic, sexual dysfunction, fatigue, weakness, and loss of appetite. Which culture-bound syndrome should the nurse suspect in this client? Dhat Latah Wind illness Koro

Dhat Dhat is a culture-bound syndrome of India and includes symptoms of panic, sexual complaints, fatigue, weakness, loss of appetite, guilt, and sexual dysfunction with no physical findings. Latah is a culture-bound syndrome of Malaysia that occurs after a traumatic episode or surprise. Symptoms include an exaggerated startle response (usually in women), screaming, cursing, dancing, hysterical laughter, imitation of people, and hyper-suggestibility. Wind illness is a culture-bound syndrome of Asia that features symptoms including fear of wind or cold exposure causing a loss of yang energy. Koro is a culture-bound syndrome of Malaysia and Southeast Asia that features a fear that genitalia will retract into the body, possibly leading to death.

A nurse recognizes that the belief that one's worldview is the only acceptable truth and that one's beliefs, values, and sanctioned behaviors are superior to all others is called what? Ethnocentrism Stereotyping Egocentrism Ethnicity

Ethnocentrism Ethnocentrism is the belief that one's worldview is the only acceptable truth and that one's beliefs, values, and sanctioned behaviors are superior to all others. Stereotyping is expecting group members to hold the same beliefs and behave in the same way. Egocentrism is the tendency to perceive, understand, and interpret the world in terms of the self and the inability to see other people's viewpoints. Ethnicity describes subgroups that have a common history, ancestry, or other cultural identity and may relate to geographic origin.

A client requests to be cared for by a nurse who is a member of his own culture. The nurse recognizes that which barrier exists in regards to this client's nursing care? Ethnicity Prejudice Stereotype Ethnocentrism

Ethnocentrism Ethnocentrism is the barrier that the nurse identifies in this client's nursing care. The perception that one's beliefs, values, and sanctioned behaviors are superior to all others is termed as ethnocentrism. Ethnicity refers to a socially, culturally, and politically constructed group of individuals that holds a common set of characteristics not shared by others with whom they come in contact. Prejudice is based on preconceived notions about certain groups of people. Stereotype refers to accepting that there are people from other cultures, having different beliefs and values, but not recognizing the variation that can exist within any cultural group.

Sickle cell disease and other hemoglobinopathies such as thalassemia are often found in persons originating from which geographical regions? Central and South America. Northern and Central Europe. Mediterranean and Africa. Australia and New Zealand.

Mediterranean and Africa. Drug metabolism differences, lactose intolerance, and malaria-related conditions—such as sickle cell disease, thalassemia, glucose-6-phosphate dehydrogenase (G6PD) deficiency, and Duffy blood group—are considered biochemical variations. The malaria-related conditions would obviously occur in populations living in or originating from mosquito-infested locales such as the Mediterranean and Africa.

The nurse is assessing a client and notices that when being asked questions, the client does not make eye contact. The nurse should include what in the plan of care? History of abuse Minimal eye contact due to culture Fear of authority Uncomfortable answering questions.

Minimal eye contact due to culture Some cultures make minimal eye contact out of respect. There is no indication the client is fearful of authority, uncomfortable answering questions or has been abused.

As a novice nurse caring for a client from a different culture, what may the nurse find confusing or upsetting? Patient's level of motivation Patient's nonverbal communication Patient's family members Patient's ethnicity

Patient's nonverbal communication A client's nonverbal communication may confuse or upset a novice nurse when it is different from the nurse's culture.

After reviewing the nursing notes (above), the nurse should do which of the following? Demonstrate for the parents how to weigh diapers. Provide education related to infant formula consumption and overfeeding. Demonstrate for the parents how to burp the infant to reduce vomiting. Provide education related to preventing constipation in infants.

Provide education related to infant formula consumption and overfeeding. Some people believe that a fat infant is a healthy infant, and the parents may not understand that bottle feeding after breastfeeding may not be necessary and can lead to excessive weight gain and additional health risks. Based on the scenario there is no evidence that the infant is constipated, needs diapers weighed to assess for dehydration, or that needing to burp is the cause for the infant vomiting.

When the nurse asks a client of African origin for the reason for coming to the health clinic, the client responds by saying, "Bad blood." The nurse recognizes that the client is most likely referring to which of the following? Low blood volume due to diet High blood pressure Sexually transmitted infection Sudden collapse preceded by dizziness

Sexually transmitted infection For some people of African origin, "bad blood" refers to contamination of the blood, especially by a sexually transmitted infection. "Low blood" may refer to having not enough blood or weak blood due to diet. "High blood" can refer to high blood pressure but also to thick or excessive blood. A sudden collapse preceded by dizziness or a spinning sensation may be referred to as "falling out" or "blacking out."

When performing a cultural assessment on 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. 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. After the focused assessment, decide if a cultural assessment is necessary.

Show genuine interest in the client's culture and personal life experiences. Leininger suggests that the attributes and behaviors of a nurse practicing effective care within the client's cultural context include genuine interest in a client's culture and personal life experiences. They do not include developing a plan of care after talking with the client's family, developing a plan of care based on the nurse's knowledge of the client's culture, or deciding after the focused assessment if a cultural assessment is necessary.

The nurse is educating a client from another country about the medications they will be taking. The client continually interrupts the nurse during the conversation. When the nurse considers the many ways cultural differences can affect communication, how should the nurse interpret the client's interruptions? This client is impolite and does not know good manners. The client believes that what they have to say is more important than what the nurse is saying. The client is deeply engaged in the conversation. The client believes that they know more about the medications than the nurse does.

The client is deeply engaged in the conversation. In some cultures, it is common for speakers to interrupt one another in conversation. This provides for overlap in speech. In such cultures, this indicates that the persons are deeply engaged in the conversation. In other cultures this practice is perceived to be rude by other cultures. By practicing cultural awareness the nurse can prevent herself from perceiving negativity in this situation.

What must occur before a client will be willing to teach the nurse about her culture? The client's family must allow it The nurse needs to hide her biases The nurse needs to establish rapport and trust The nurse needs to establish a value-based partnership

The nurse needs to establish rapport and trust If the nurse has established rapport and trust, clients will be willing to teach about their cultures.

A male nurse is caring for an elderly woman who has become withdrawn and somewhat confused since the nurse has come on duty. When the nurse goes into the room to bathe the client, she refuses to allow it. The best explanation for her actions would be which of the following? confusion depression fear in strange surroundings cultural differences

cultural differences Many cultures restrict touch of females by males. Even male physicians in some cultures are not allowed to treat females. The client is not showing confusion, depression, or fear in her surroundings but instead is uncomfortable with a male wanting to care for her.

When the nurse tells the client that she will return in 1 hour to administer an intravenous antibiotic, the nurse is showing that she values time in which of the following orientations? future past present none of the above

future Cultural groups value time in the past, present, or future. Those who are future oriented place value on deferring pleasure for a later gain. They are the ones who will value the care and treatment in expectation of improvement. Those that focus on the past value practices unchanged from ancestors and are often resistant to new ways. Those focused on the present put what is going on now above what will occur in the future.

The nurse and a client are developing a transcultural nursing care plan related to hypertension. The nurse will include in the plan educational materials given to all clients with hypertension. nutritional information specifically for the client's culture. contact number for the cardiac rehabilitation program at the medical center. referral to a cardiac specialist.

nutritional information specifically for the client's culture. Compare the nutrients of foods not usual in the United States with nutrition charts to understand how healthy a diet is, especially with regard to diseases such as hypertension. It is very difficult to get a client to change usual dietary habits drastically, even with knowledge of the interaction of diet and disease.

A nursing student realizes that which of the following is an important variation of communication? silence beliefs spirituality death rituals

silence Silence is a very important variation of nonverbal communication. Beliefs, spirituality, and death rituals are considerations when doing cultural assessments but are not forms of communication.

The most effective way for a nurse to learn about an ethnic group within the community in which he/she practices is study transcultural nursing texts and articles about the group. interview the traditional healers within the group. do a community survey of the areas where the ethnic group lives. spend time with a variety of individuals of that ethnic group.

spend time with a variety of individuals of that ethnic group. Repeated face-to-face encounters help to refine or modify the nurse's knowledge of the culture. The nurse must seek out many such encounters with the desire to understand more about the culture.

When performing a cultural assessment, an important point to remember would be that definitions of family differ to use first names of those you are speaking to that alternative therapies are reasons for seeking care that the cultural/ethnic background is evident in the client's appearance

that definitions of family differ