Nursing In a Diverse Culture

The nurse is caring for the following obstetric clients. Which action(s) demonstrates the proper use of transcultural nursing theoretical foundations? Select all that apply.

- Instruct on ways to modify dishes from the client's culture to achieve a healthy glucose level with a client diagnosed with gestational diabetes. - Assess the client traveling to other countries for potential exposure to illness and signs and symptoms of illness.

The nurse is caring for women in a rural community. Which action(s) should the nurse provide to decrease health disparities? Select all that apply.

- Perform a cultural assessment of the various cultural groups within the community. - Evaluate factors inhibiting the women to access health care resources in the community. - Perform a literature review of the represented population groups related to health outcomes.

A local hospital group is creating a local transcultural health care team to assist with the health care of the community that has seen an influx of refugees from other countries. Which will be necessary for each team member to possess to be a part of the team? Select all that apply.

- Proof of formal academic preparation at an accredited institution - Appropriate licensure as required by the state - Official certification from the TCNS

Which nursing intervention demonstrates one of the strengths of the transcultural nursing Theory of Culture Care Diversity and Universality?

Assessing for stress factors affecting a client of Haitian descent as well as the immediate family

Which component of transcultural nursing has been greatly supported through the research conducted by anthropologists?

Assessment of woman's ability to function successfully in her role within the family

Just as it is important for each nurse to determine and reflect on his or her own cultural assessment, it is also important for each organization to be aware of its own transcultural position. Which would indicate an organization is meeting the standards for cultural competence?

The organization that has a defined set of principles written down and followed by each staff member

Which statement demonstrates the nurse's ability to communicate sincerely and respectfully with a culturally diverse client population?

"I'm always careful to apologize when I'm having difficulty understanding a client."

Which question asked during the assessment process of a client from a Native American/First Nations population is directed by currently accurate information regarding that culture's risk for a specific disease?

"Have you ever been told you have a problem with drinking too much alcohol?"

Which assessment question shows an understanding of the impact of cultural beliefs and behaviors on a client's demonstration of pain?

"How can I help you deal with the pain you are experiencing?"

Which response is most appropriate when a client describes the alternative medicine therapy he or she has been using to treat his or her "stomach problems"?

"Most alternate medicine therapies have not been researched for either safety or effectiveness."

The nurse is searching for the best evidence to make culturally sensitive changes with care for the clients from Hmong culture in a United States hospital using Leininger's theory. Based upon the following (fictitious) research studies, which should the nurse use as bestevidence to improve care?

"Perceptions of client form Hmong culture accessing health care in the United States: A transcultural nursing approach"

Which question would best assist a nurse in determining the health beliefs of a culturally diverse client who has a history of hypertension?

"What have you been doing to help control your high blood pressure?"

Which questions should the nurse ask the client when assessing culturally based care factors using Leininger's transcultural nursing principles? Select all that apply.

- "In your culture, what do you do to stay healthy?" - "How is death handled in your culture?" - "In your culture, what do you do when you are sick?

Many challenges still exist in adequately providing proper health care to many of the world's population; however, the 21st century is providing new choices and changes that were not previously available. The nurse must be aware and prepared to deal with these changes and be able to communicate effectively to be able to provide the best health care the individual requires and desires. Which client(s) may represent a cultural challenge for which the nurse should be prepared? Select all that apply.

- A 65-year-old Canadian gentleman traveling to the United States for knee replacement surgery - A 24-year-old Black female traveling to Mexico for cancer treatment - A 30-year-old Somalian mother who is seeking asylum in the United States

Which nursing action is required when it is determined that a client is self-administering ginseng for back pain?

Assessing and documenting the client's blood pressure

Evidence-based research has demonstrated differences among the world's cultures, which the nurse can utilize when conducting a health history and physical examination. Which would be considered an expected average norm?

A bottle-fed infant weighing more than a breast-fed infant

Which activity would best support the goals of transcultural nursing?

A multidisciplinary research project on the effects of culture on pain management plans

Health care organizations are expected to be culturally competent. Which service shows the ability to best manage the difference in cultural values and practices?

Ability to adapt special diets to meet client cultural dietary needs

The nurse is caring for an older client from Japan who requires treatment for an enlarged prostate, and the primary care provider offered several treatment options. Which is the best next action to take?

Assess who makes health care decisions for the client.

Which nursing intervention demonstrates an avoidance of one of the cited criticisms of current transcultural nursing theories?

Asking a client who practices Judaism whether he or she will need a kosher diet menu

Which additional assessment should be conducted when monitoring a darkly pigmented person for cyanosis?

Asking the client to provide the location and date of his or her birth

The nurse is caring for a client with hearing impairment. The client communicates using American Sign Language. The client is a candidate for cochlear implants. What is the next best action the nurse should provide?

Assess the client's perception of self-identity and how the client sees his or her body.

Which nursing activity shows an understanding of the process of culturally competent nursing practice?

Attending two in-service programs yearly on attaining cultural competency

Which statement will be the basis for determining the target population for a community education program regarding hypertension?

Black females have a higher average systolic blood pressure than White females at every age.

Which intervention demonstrates an institution's willingness to provide a culturally sensitive environment?

Changing the lobby's artwork when its original pieces are identified as lacking in cultural diversity

A rural clinic provides health care to a community that consists heavily of people of Native Americans/First Nations heritage. The nursing staff is concerned that the needs of the local community are not being adequately met. They are aware that research has confirmed which is a potential obstacle?

Clients from various ethnic backgrounds are less likely to visit the clinic on a routine basis.

The nurse is caring for a client at 20 weeks' gestation after receiving a slightly higher than normal alpha-fetoprotein (AFP) level. Which action should the nurse implement first?

Determine the client's biocultural variations.

Which activity will best minimize the risk of allowing discrimination and prejudicial behaviors to impact personal nursing practice?

Engaging in regular reflective, cultural self-assessments

Not only is the nurse responsible for implementing cultural competence but the organization by which the nurse is employed also has certain responsibilities to ensure cultural competence to provide the best possible health care to the local community. Which is recognized as helping to achieve the goal of achieving organizational cultural competence?

Establishing methods of accountability to ensure that the goals and mission are being met

A nurse provides care to a vast culturally diverse population. How can the nurse best address the need to provide cultural congruent nursing care?

Master the skills required to perform an effective cultural assessment

In an effort to enhance and provide the best training, the Core Curriculum was developed to provide the best training in transcultural nursing for nurses and other members of the health care team. Which aspect(s) of the core of knowledge is used to develop this program? Select all that apply.

Natural science Medicine Philosophy Social work

What knowledge will best assist a nurse in providing nonprejudicial care that is sensitive to the beliefs and practices of a culturally diverse client population?

Nurses will not consciously question the bias of their own thinking and so must make a concerted effort to do so regularly

It is determined that an older, widowed client is a member of a familistic culture. Which intervention is best directed toward communicating effectively with the client?

Presenting information related to possible treatment modalities to the entire family

Which nursing activity has priority when providing culturally congruent care?

Self-reflection concerning beliefs associated with the client's culture

A client admitted to the hospital with seizures suddenly develops the following signs and symptoms: red macular rash over generalized body. Which action should the nurse implement first?

Stop the newly prescribed carbamazepine immediately.

Which organizational attitude demonstrates that the institution's culture is utilizing Leininger's Culture Care Diversity and Universality model in their organization?

The client's cultural folk medicine practices will be respected whenever possible.

Which nursing intervention demonstrates an understanding of the importance of managing assessment information in a culturally congruent manner?

The client's edema was documented as, "Client reports, 'My legs swell when I spend too much time standing'."

Which is the basis to support the need for transcultural nursing in a health care setting that serves a multicultural metropolitan community?

The diversity seen in the values, beliefs, behaviors, as well as physical and mental characteristics of the client population

What is the basis for assessing the economic status of a culturally diverse client population as a factor affecting the delivery of individualized health care services?

The general health of the members of the lower socioeconomic classes is poor.

Which consideration is the basis for the selection of an interpreter for an older client who has a limited ability to speak and understand the dominant language?

The interpreter should ideally be of similar age and of the same gender as the client.

Which nursing intervention demonstrates an understanding of the full scope on culturally sensitive nursing care?

When planning a teenaged focused educational program on sexuality, both homosexual and heterosexual lifestyle choices are discussed