NU140- Chapter 5 Cultural Diversity

A nurse is conducting a cultural assessment of a client. Which person would the nurse identify as the expert?

Client

Which statement best conveys the relationship between race and ethnicity?

Race denotes physical characteristics, while ethnicity is rooted in a common heritage.

Personal space

external environment surrounding a person that is regarded as being part of that person

The nurse is caring for a client admitted with an upper respiratory infection. The client tells the nurse about following the holistic belief of hot/cold. Which food items should the nurse provide to the client based on this information?

Soup, hot tea, and toast

The nurse overhears a colleague state, "All people from that client's country are rude." What is the appropriate nursing response?

Respond by saying, "Stereotypes keep us from accepting others as unique individuals."

The public health nurse is preparing a presentation about disparities in health care in the community. What key concept(s) will the nurse include? Select all that apply.

Information regarding minorities within the community Identifying groups that are disadvantaged within the community Pointing out groups within the community that possess less power

A nurse overhears another nurse make a statement that indicates racism. The nurse makes this determination based on which characteristic indicative of social value?

Skin color

The nursing researcher is studying so-called "unnatural illnesses." What cause of such illnesses would be included in the study?

Witchcraft

A nurse is caring for a client with bacterial pneumonia and a temperature of 104°F (40.0°C). Yesterday, the client's temperature was 102°F (38.9°C). The health care provider on call prescribes cool compresses for the client to help lower the fever. The client insists that the nurse bring warm blankets because they will help the client to recover more quickly. The nurse recognizes that the client's request is an example of:

cultural ritual.

A preconceived and untested belief about an individual or group of individuals is:

stereotyping.

A client's spouse has asked that the client be cared for exclusively by female nurses. How should the nurse incorporate this request into the care plan?

Document the request and make all reasonable efforts to honor it

The nurse is caring for a client who is postoperative 24 hours from an appendectomy. The client is hesitant to get out of bed. How should the nurse respond?

"Can you describe what you are feeling when you try to move?"

The nurse has just attended a seminar on concepts of cultural diversity. Which statement made by the nurse would require further education?

"Culture cannot be influenced, and you are born with your culture."

A client is completing a health history form and asks the nurse, "Why does this ask for my ethnicity instead of my race?" What is the appropriate nursing response?

"Ethnicity is a social category that is being used to replace racial categories."

The staff nurse overhears the charge nurse, who is of Italian heritage, talking to the unlicensed assistive personnel. Which statement made by the charge nurse is an example of ethnocentrism?

"Italians are best at everything."

A nurse is demonstrating ethnocentrism. Which statement would reflect this concept?

"My Russian heritage is superior to all others."

The nurse is collecting the health history of a client and notes the client is apprehensive in answering questions. The client states, "My spiritual healer will be here soon." What is the best response by the nurse?

"We can wait until your spiritual healer arrives and work together to answer these questions."

A nurse is admitting a client to the unit. Which cultural question is most appropriate?

"What are your dietary needs and preferences?"

The unlicensed assistive personnel reports to the nurse that the client is refusing to eat the food on the meal tray. The nurse observes the client eating the food brought in by family members. How should the nurse respond?

"What type of food did your family prepare for you, and does it have special meaning?"

A client from a minority culture has been hospitalized for 6 days for postoperative infection. The client's weight is decreasing each day, and the nutritional intake is declining. Which nutritional assessment question is most appropriate?

"What type of food do you eat at home?"

The nurse is caring for a client 4 days after total hip arthroplasty and notes the client has lost weight. The unlicensed assistive personnel reports the client's food intake has decreased. Which question will the nurse ask the client to determine if cultural causes are responsible for the weight loss?

"What type of food do you like to eat at home?"

A client has been admitted to the unit for chest pain. A nurse told the family that they could not be with the client. The family became very upset, and now the client wants to leave. What is the most culturally appropriate response by the charge nurse?

"Would you feel more comfortable with your family with you?"

Cultural diversity

(1) coexistence of different ethnic, biological sex, racial, and socioeconomic groups within one social unit; (2) diverse groups in society, with varying racial classifications and national origins, religious affiliations, languages, physical size, biological sex, sexual orientation, age, disability, socioeconomic status, occupational status, and geographic location

The nurse is taking a client history. With which client is direct eye contact appropriate?

32-year-old white woman

A community health nurse is providing care to a group of Hispanic people living in an area that is predominantly populated by white people. What are the Hispanic people in this community an example of?

A minority

When providing culturally competent care to clients, a nurse understands that cultural competence involves which characteristics? Select all that apply.

A process that requires life-long learning A commitment to promoting health equity Knowledge of influences on the clients' beliefs Awareness of one's own influences on responses

The nurse correctly differentiates race from ethnicity by noting that race is based on which characteristics?

Biological

Cultural blindness

the process of ignoring differences in people and proceeding as though the differences do not exist

A client who does not speak the dominant language is admitted to the hospital. Which cultural intervention would be most appropriate by the nurse?

Call for an interpreter who is familiar with health care.

A client believes that the illness is caused by an imbalance of yin and yang. The nurse states, "You can call it whatever you believe, but you have a metabolic disorder." What is this nurse demonstrating?

Cultural blindness

A staff nurse meets with the charge nurse and is reporting that all the new nurses are leaving messes on the unit. The staff nurse states, "These youngsters think they can waltz in here and get our jobs." What is this nurse demonstrating?

Cultural conflict

The nurse is caring for a client who is postoperative 3 days from coronary artery bypass graft. The client has a prescription to ambulate. What is the best action by the nurse?

Discuss with the client the need for assistance during ambulation.

Classification of illness can occur with cultural practice. What is an example of an unnatural illness?

Evil forces caused a client to develop schizophrenia.

Which teaching statement best exemplifies cultural competence in relation to time for the American culture?

It is important to be on time for your health care appointment.

Culture shock

those feelings, usually negative, a person experiences when placed in a different culture

A nurse is working in a clinic that serves a community with a high population of immigrants. Which nursing assessment is the priority?

Language assessment

While caring for a client from a culture different from the nurse's, the nurse inadvertently offends the client. What is the best action by the nurse?

Learn from the mistake and do not repeat it.

Which nursing action displays linguistic competence?

Learning pertinent words and phrases in the client's language

The nurse is preparing to administer prescribed medication to a client who is Native American/First Nations. The nurse enters the room and observes a shaman performing a healing ritual for the client. What action would be the most appropriate by the nurse?

Leave the room and return when the shaman is finished.

A nurse is assessing a client and determines that the client belongs to a minority group. Based on the nurse's understanding about minority groups, the nurse would anticipate that the client would likely experience which effects? Select all that apply.

Less power Health disparities

The nurse is using an interpreter to communicate with a client who speaks a different language. What would be the best way to choose an interpreter for this client?

The interpreter should understand the health care system.

The nurse practitioner sees patients in a community clinic that is located in a predominately White neighborhood. After performing assessments on the majority of the patients visiting the clinic, the nurse notes that many of the minority groups living within the neighborhood have lost the cultural characteristics that made them different. What is the term for this process? a. Cultural assimilation b. Cultural imposition c. Culture shock d. Ethnocentrism

a. Cultural assimilation

A nurse is telling a new mother from Africa that she shouldn't carry her baby in a sling created from a large rectangular cloth. The African woman tells the nurse that everyone in Mozambique carries babies this way. The nurse believes that bassinets are safer for infants. This nurse is displaying what cultural bias? a. Cultural imposition b. Clustering c. Cultural competency d. Stereotyping

a. Cultural imposition

Linguistic competence

ability of caregivers and organizations to understand and effectively respond to the linguistic needs of patients and their families in a health care encounter

Ethnocentrism

belief that one's own ideas, beliefs, and practices are best, superior, or most preferred to those of others; using one's cultural norms as the standard to evaluate others' beliefs

A nurse is interviewing a newly admitted patient. Which question is considered culturally sensitive? a. "Do you think you will be able to eat the food we have here?" b. "Do you understand that we can't prepare special meals?" c. "What types of food do you eat for meals?" d. "Why can't you just eat our food while you are here?"

c. "What types of food do you eat for meals?"

The nurse is preparing the discharge plan for a new mother and her newborn son. Which new teaching should the nurse ensure is included after noting the family is Jewish?

care following the scheduled circumcision

Cultural assimilation

process that occurs when a minority group, living as part of a dominant group within a culture, loses the cultural characteristics that made it different

Transcultural nursing

providing nursing care that is planned and implemented in a way that is sensitive to the needs of individuals, families, and groups representing the diverse cultural populations within our society

The nurse is educating a client of Chinese descent regarding the reduction and elimination of lactose in the diet. Which statement(s) made by the client indicates that the education was effective? Select all that apply.

"When I drink coffee or tea, I should use a non-dairy creamer instead of milk or cream." "I should replace 2% milk with lactose-free milk." "I can use kosher parve foods because they are prepared without milk."

The emergency department nurse is caring for a client injured in a motor vehicle collision. The client recently immigrated to the country. The nurse should implement interventions aimed at addressing which issue?

Culture shock

The client is admitted to the hospital with a ruptured ovarian cyst. The client has expressed that it is very important that the spouse be present to receive all medical information. Using the concepts of culturally competent care, which is the best response?

Document the client's request in the nursing care plan.

The nurse caring for several clients on a surgical unit notes that one of the clients is Muslim. The nurse 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

A nurse caring for culturally diverse patients in a health care provider's office is aware that patients of certain cultures are more prone to specific disease states than the general population. Which patients would the nurse screen for diabetes mellitus based on the patient's race? Select all that apply. a. A Native American patient b. An African-American patient c. An Alaska Native d. An Asian patient e. A White patient f. A Hispanic patient

a. A Native American patient c. An Alaska Native e. A White patient f. A Hispanic patient

Upon admission, the client noted practicing Orthodox Judaism. Upon receiving the meal tray, the client states, "I cannot eat this. Please remove the tray." Which item on the tray is the client referring to because of kosher dietary laws?

a baked pork chop with gravy

An older adult client who only speaks the nondominant language has been admitted to the emergency department after suffering a fall and suspected hip fracture in the home. Who is the best person to perform translation services for the client?

a hospital translator

Stereotyping

assigning characteristics to a group of people without considering specific individuality

A nurse is using the ESFT model to understand a patient's conception of a diagnosis of chronic obstructive pulmonary disease (COPD). Which interview question would be MOST appropriate to assess the E aspect of this model—Explanatory model of health and illness? a. How do you get your medications? b. How does having COPD affect your lifestyle? c. Are you concerned about the side effects of your medications? d. Can you describe how you will take your medications?

b. How does having COPD affect your lifestyle?

The nurse is teaching a family, who has recently learned a family member has a lactase deficiency, how to make healthier dietary choices to ensure the family member obtains enough calcium in their diet. The nurse determines the teaching was successful when they choose which menu as the best choice?

baked salmon patty, steamed spinach, sweet potato, salad with romaine lettuce, hard-boiled egg slices, carrots, celery, cucumber, and vinegar vinaigrette dressing, apple slices, ice tea

When a home-bound client expresses the client's past-oriented ancestral heritage and family rituals, the nurse recognizes that the client is expressing:

ethnic identity.

When reviewing the chart of an older adult client, the nurse notes that the client identifies as Japanese. The nurse realizes the client is referring to which ancestral and cultural factor?

ethnicity

Persistent gaps between the health status of minorities and non-minorities are defined as:

health disparities.

Nurses are socialized into the:

healthcare culture.

The spouse of a client asks the nurse whether the spouse may bring in a cream from home to apply to the client's skin. The spouse says, "Whenever anyone gets sick, we always use this cream." The nurse interprets this as:

ritual.

Which is a cultural norm of the health care system?

There is the use of a systematic approach and problem-solving methodology.

A young Hispanic mother comes to the local clinic because her baby is sick. She speaks only Spanish and the nurse speaks only English. What is the appropriate nursing intervention? a. Use short words and talk more loudly. b. Ask an interpreter for help. c. Explain why care can't be provided. d. Provide instructions in writing.

b. Ask an interpreter for help.

Cultural competence

care delivered with an awareness of the aspects of the patient's culture

A nurse states, "That patient is 78 years old—too old to learn how to change a dressing." What is the nurse demonstrating? a. Cultural imposition b. Clustering c. Cultural competency d. Stereotyping

d. Stereotyping

Ethnicity

sense of identification that a cultural group collectively has; the sharing of common and unique cultural and social beliefs and behavior patterns, including language and dialect, religious practices, literature, folklore, music, political interests, food preferences, and employment patterns

Culture conflict

situation that occurs when people become aware of cultural differences, feel threatened, and respond by ridiculing the beliefs and traditions of others to make themselves feel more secure about their own values

Culture

sum total of human behavior or social characteristics particular to a specific group and passed from generation to generation or from one to another within the group

Cultural imposition

tendency of some to impose their beliefs, practices, and values on another culture because they believe that their ideas are superior to those of another person or group

Which behavior by the nurse is stereotyping?

Avoiding older adult clients because their care is time consuming

A nurse is providing care to a client who is from a different culture. Which aspect about culture would be most important for the nurse to integrate into the client's care?

Not all members of the same culture act and think alike.

In order to provide culturally competent care, nurses must be alert to factors inhibiting sensitivity to diversity in the health care system. Which nursing actions are examples of cultural imposition? Select all that apply. a. A hospital nurse tells a nurse's aide that patients should not be given a choice whether or not to shower or bathe daily. b. A nurse treats all patients the same whether or not they come from a different culture. c. A nurse tells another nurse that Jewish diet restrictions are just a way for them to get a special tray of their favorite foods. d. A Catholic nurse insists that a patient diagnosed with terminal bladder cancer see the chaplain in residence. e. A nurse directs interview questions to an older adult's daughter even though the patient is capable of answering them. f. A nurse refuses to care for a married gay man who is HIV positive because she is against same-sex marriage.

a. A hospital nurse tells a nurse's aide that patients should not be given a choice whether or not to shower or bathe daily. d. A Catholic nurse insists that a patient diagnosed with terminal bladder cancer see the chaplain in residence.

A nurse is teaching a novice nurse how to provide care for patients in a culturally diverse community health clinic. Although all these actions are recommended, which one is MOST basic to providing culturally competent care? a. Learning the predominant language of the community b. Obtaining significant information about the community c. Treating each patient at the clinic as an individual d. Recognizing the importance of the patient's family

c. Treating each patient at the clinic as an individual

Which behaviors demonstrated by the client would the nurse consider reflections of the client's pride in ethnicity? Select all that apply.

Requesting native cuisine Listening to folk music and dance Asking to wear unique clothing

The nurse is caring for a client who is admitted for hypertension (HTN). The nurse notes that the client has not been eating the food provided, and family members have brought in homemade food. What would be the best response by the nurse?

"Can you tell me what foods you prefer to eat and what your family is bringing you?"

A client is admitted to the hospital and the nurse is attempting to complete an admission assessment. The client reports that the spiritual healer will be coming in soon and is upset by the admission questions. What is the most appropriate response by the nurse?

"We can wait for your healer to come and then work together to answer these questions."

The nurse cares for clients in the emergency department (ED). Which statement made by a health care professional is an indication of racism in the ED?

"White people are superior to Black people."

Which client admitted to the emergency department might require the nurse to include interventions aimed at addressing culture shock in the plan of care?

A client who recently immigrated and fell from a ladder

The nurse is caring for a client who perceives time differently. What action should the nurse take for this client?

Maintain flexibility when the client requests interventions at specific times.

When talking with a client, the nurse notes that the client keeps backing up. What would be the most appropriate response?

Ask the client about personal space preferences.

The nurse is assessing an older adult who immigrated at the age of 3 years. The client speaks the dominant language and lives in a neighborhood with many households from the country of origin. Which action by the nurse is most appropriate?

Ask the client about special cultural beliefs or practices.

The nurse is caring for a terminally ill client who immigrated from Mexico. Which nursing intervention regarding spiritual care is appropriate?

Ask the client if a spiritual leader is desired.

The nurse admits a client to the critical care unit to rule out a myocardial infarction. The client has several family members in the waiting room. Which nursing action is most appropriate?

Assess the client's beliefs about family support during hospitalization.

A family recently immigrated to a new country. The parent reports that the teenager is showing signs of fear, has vague reports of stomach pain, and feels humiliated by peers because of their culture. What is the priority assessment for the nurse?

Culture shock

The nurse is caring for a client who does not speak the dominant language. In order to facilitate unencumbered communication with the client, the nurse will take which action(s)? Select all that apply.

Determine in which language the client communicates effectively. Review facility policy on communication with clients who do not speak the dominant language. Schedule a certified interpreter when collecting client health history.

The nurse is caring for a client whose language skills are very limited in the dominant language, and an interpreter has been obtained. The interpreter appears to be telling the client more than the nurse is saying and possibly providing an opinion or medical advice. Which action is appropriate for the nurse to take?

Speak privately with the interpreter and instruct them to only provide language interpretation.

A newly hired young nurse overheard the charge nurse talking with an older nurse on the unit. The charge nurse said, "All these young nurses think they can come in late and leave early." What cultural factor can the new nurse assess from this conversation?

Stereotyping

A family has immigrated and settled in a neighborhood that primarily speaks their native language. The nurse caring for this family recognizes that which family member will likely require the greatest amount of time to learn the dominant language?

The 45-year-old mother in the family who does not work outside the home

The younger nurses on a unit, who seem to adapt easily to the new technology presented, are perceived as threatening by two nurses who have worked on the unit for years. The older nurses begin to ridicule the younger nurses, saying, "You might be able to work a computer, but we know how to provide real care." How should the charge nurse respond?

The charge nurse should discuss the concept of cultural conflict and help both parties see their respective value to the unit.

The nurse is caring for several clients of different cultures. Which client situation would the nurse recognize as the client with highest risk of culture shock?

The client from Ethiopia states, "All these machines attached to me scare me and I need to get them off."

In addressing health promotion for a client who is a member of another culture, the nurse should be guided by which principle?

The client may have a very different understanding of health promotion.

Transcultural nursing is a specialty and formal area of practice. Which statements apply Dr. Madeleine Leininger's theory of Culture Care Diversity and Universality to nursing practice? Select all that apply.

The nurse objectively assesses personal beliefs prior to the provision of culturally competent care. The nurse consults clergy for assistance in the provision of care. The nurse carefully assesses the decision maker in the care environment. The nurse will accommodate cultural dietary preferences as much as possible.

A nurse is caring for patients of diverse cultures in a community health care facility. Which characteristics of cultural diversity that exist in the United States should the nurse consider when planning culturally competent care? Select all that apply. a. The United States has become less inclusive of same-sex couples. b. Cultural diversity is limited to people of varying cultures and races. c. Cultural diversity is separate and distinct from health and illness. d. People may be members of multiple cultural groups at one time. e. Culture guides what is acceptable behavior for people in a specific group. f. Cultural practices may evolve over time but mainly remain constant.

d. People may be members of multiple cultural groups at one time. e. Culture guides what is acceptable behavior for people in a specific group. f. Cultural practices may evolve over time but mainly remain constant.

Race

division of human beings based on distinct physical characteristics

Cultural respect

enables nurses to deliver services that are respectful of and responsive to the health beliefs, practices, and cultural and linguistic needs of diverse patients; critical to reducing health disparities and improving access to high-quality health care

Subculture

group of people with different interests or goals than the primary culture

A nurse is working with a culturally diverse group of clients. The nurse understands that cultural norms:

require an individualized approach by the nurse.