(1) Culture & Spirituality, (2) Chapter 14- Cultural & Spiritual Aspects of Patient Care, (3) ATI: Video Case Study RN: Cultural Diversity, (4) Cultural Awareness and Health Practices, (5) Chapter 21: Cultural and Spiritual Awareness, (6) Sociocultur...

What response is most appropriate for the nurse if a patient prefers to seek acupuncture for pain relief before taking prescribed medication?

Recognize that alternative forms of treatment can be effective.

If a patient's primary language differs from that of the health care professionals providing care, which action is most appropriate for the nurse to take?

Recognize that continuous affirmative answers by the patient require verification of understanding.

Hmong patient asks to eat 1 day after a minor surgery. What is your response?

Suggest that the family bring the patient some favorite food

The nurse is teaching a clinic patient about hypertension. Which statement by the patient suggests that he is present-oriented?

"I know I need to give up foods that contain a lot of salt, but with teenagers in the house it is very difficult."

Which statement by a patient best illustrates reflection on a spiritual need?

"I need to think a little more about how I feel about undergoing this treatment."

A Haitian patient diagnosed with depression tells the nurse, "There's nothing you can do. This is a punishment. The only thing I can do is see a healer." The culturally aware nurse assesses that the patient:

may believe the distress is the result of a curse or spell.

The nurse should be particularly alert to somatization of psychological distress among patients whose cultural beliefs include: (select all that apply)

mental illness reflects badly on the family. & mental illness shows moral weakness. & the mind, body, and spirit are merged.

Orthodox Jews should never be served which two items at the same meal?

milk and meat

In African American culture, who is the head of the household?

mother

A nurse speaks with family members of a Chinese American parent recently diagnosed with major depression. Which comment by the nurse will the family find most comforting? "The nursing staff will:

take good care of your parent."

Knowing who is the dominant person in the family is important because the dominant person does what?

tends to make health care decisions

Culturally competent care would encourage which action by a patient's family?

Asking the family's spiritual advisor to visit the patient

A white patient of German descent rocks back and forth, grimaces, and rubs both temples. What is the nurse's best action?

Assess the patient for pain.

You are the nurse caring for a patient who is an English-speaking Afghan. Before providing your patient with discharge papers and education materials, what is one important thing you must assess?

Assess the patient's English literacy.

A nurse is counseling a couple who is Japanese and whose daughter is a client in an acute-care facility following a suicide attempt. When providing culturally sensitive care to this family, which of the following beliefs in traditional Japanese culture should the nurse consider?

Suicide is an act of honor.

Which meal tray should nurse deliver to the client of Orthodox Judaism faith who follows kosher diet?

Sweet and sour chicken with rice and vegetables, mixed fruits and juice. & dairy-meat combination is unacceptable, along with shellfish.

What aspect of culture is a full-time employed granddaughter of an elderly Asian female exhibiting if she asks the social worker to place her grandmother in an extended-care facility against the wishes of her parents?

System change

home health nurse is visiting a client 60 years of age. During the initial visit, the client's husband answers all of the questions. What would the nurse assess based on this behavior?

The husband is the dominant member of the family.

The nurse has an adequate understanding of Japanese culture when stating which of the following? (Select all that apply.)

"The Japanese believe that contact with blood, skin diseases, and corpses causes illness." & "The Japanese believe in healers and herbalists." & "The Japanese have high regard for physicians." & "The Japanese tend to not question the care of the physician."

A patient who is Islamic says she cannot sign the surgical consent form without her husband's consent. You would respond:

"Call me when your husband gets here and you have spoken with him."

A nurse is educating a patient's family on holistic nursing. The nurse judges the teaching as effective when the family states all of the following except:

"Holistic nursing focuses on healing the system causing ailment."

The nurse is caring for a Catholic patient who is going to surgery tomorrow. The patient states that she is afraid and asks the nurse to pray with her, although the nurse is not religious. What is the most appropriate response by the nurse?

"I am uncomfortable praying. May I call the chaplain for you?"

While caring for a patient with cholera, the nurse finds that the patient has a biomedical perspective. Which statement by the patient is consistent with this perspective?

"I'm ill because I was in an unhygienic environment."

A nurse is attending a lecture on health disparities. The education has been effective when the nurse states:

"Inequalities in income and education are the root of many health disparities."

A patient who had surgery 8 hours ago has not voided. The physician has prescribed that an indwelling urinary catheter be inserted. Which of the following statements should the nurse use to describe the procedure to the patient? "I need to:

"Insert a tube into your bladder to drain the urine because you haven't urinated since surgery"

A manager is educating a group of nurses on the importance of cultural competence. The manager knows that the teaching has been effective when one of the nurse's states:

"Lack of cultural competence leads to suboptimal patient outcomes."

A black patient, originally from Haiti, has a diagnosis of depression. A colleague tells the nurse, "This patient often looks down and is reluctant to share feelings. However, I've observed the patient spontaneously interacting with other black patients." Select the nurse's best response.

"The patient may have difficulty communicating in English. Have you considered using a cultural broker?"

Alcoholism is a major and growing national health problem in Russians. As a nurse, the cause of this may be: (Select all that apply)

The inheritance of a Mongolian gene that creates greater susceptibility to alcoholism & Chronic Stress & Depression

A Chinese American patient diagnosed with an anxiety disorder says, "My problems began when my energy became imbalanced." The nurse asks for the patient's ideas about how to treat the imbalance. Which comment would the nurse expect from this patient?

"My family will bring special foods to help me get well."

In initiating care for a client from a different culture than the nurse, which of the following would be an appropriate statement?

"Please let me know if I do anything that is not acceptable in your culture."

A nurse has an adequate understanding of the barriers to cultural competence when making which of the following statements?

"Systems barriers exist when an agency's structure and policies are not designed to support cultural diversity."

A patient says to the nurse, "Is God punishing me with all this pain?" To continue with a spiritual assessment, the nurse could best respond what?

"Tell me what you believe about God."

The nursing student tells her instructor, "My patient is Jewish and when I tried to teach her about her antihypertensive medication she said, 'I'd rather eat chicken soup than take those medications.'" What is the most appropriate response by the instructor?

"This is common folk medicine among some Jewish people. You can talk to her about taking her medications and eating chicken soup."

The nurse is caring for a 16-year-old boy receiving chemotherapy for testicular cancer. He says that his parents are religious and left a cross next to his bed for "good luck." What is the most appropriate response by the nurse?

"What helps you get through tough times?"

As a nursing student and nurse, you will encounter many patients from diverse cultures. When caring for a culturally diverse patient, what initial question can you ask your patient that will best assist you to improve your cultural competency?

"What matters most to you about your illness and treatment?"

The nurse is beginning her assessment on a 35-year-old woman. The patient appears to be of Asian descent. As part of the nurse's cultural assessment, what question is most appropriate for the nurse to ask pertaining to race prior to documenting the patient's race?

"What race do you identify with and what name do you call it?"

You are caring for an 8-year-old who is receiving an intramuscular injection. The patient says, "You hurt me all the time. What did I do wrong?" What is your best response?

"Why do you think you did anything wrong?"

Which question should the nurse include in the assessment to determine a patient's religious practices?

"Would you like to tell me about your religion?"

You are caring for a 65-year-old man with severe heart disease who is awaiting a heart transplant. It is during the Christmas season and he must stay in the hospital until the surgery or his death. His wife and physician consistently reinforce the severity of the situation and that he must stay in the hospital for tests. You are working the p.m. shift and he breaks down crying saying he doesn't want this and just wants to go home. What do you say?

"You don't have to do this. What do you want to do?"

A nurse manager is educating unit staff on cultural competence. The manager knows that the teaching has been effective when one of the staff members states that cultural competence is (Select all that apply.)

"accepting and respecting cultural differences." & "demonstrating knowledge of the patient's culture." & "demonstrating an understanding of the patient's culture." & "adapting care to be congruent with the patient's culture."

What is an example of a system barrier to cultural competence?

A strict and enforced policy against more than one visitor in the ICU

Which patient characteristics comprise "culture"?

A system of beliefs and practices

A nurse wants to engage an interpreter for a severely anxious 21-year-old male who immigrated to the United States two years ago. Of the four interpreters below who are available and fluent in the patient's language, which one should the nurse call?

24-year-old male professional interpreter

An outcome of achieving national cultural health goals would be which of the following? 1. All cultures receive the same health care. 2. All people have the same life expectancy. 3. All U.S. residents have access to the same quality of health care. 4. All cultures are fully assimilated into the dominant society.

3. Rationale: National cultural health goals include providing equal access to quality health care for everyone

Which statement(s) is/are most accurate regarding values and beliefs? Select all that apply.

A value is a standard or principle that has meaning and worth to an individual. & A belief is something one accepts as true.

A patient of Japanese heritage avoids asking for narcotics for pain relief. The nurse writes a nursing diagnosis of Pain related to reluctance to take medication secondary to cultural beliefs. If the cultural archetype is true for this particular patient, this probably means that the patient views pain as:

A virtue and a matter of family honor

The nursing instructor asks a student to define culture. Which response by the student is best?

A complex system that includes knowledge, beliefs, and customs of a group

The nurse is caring for a Mexican American who is Catholic. The nurse wishes to learn more about the culture by consulting a key informant. Which of the following religious practitioners would be most knowledgeable about the beliefs held by individuals of Mexican ethnicity?

A curandera

Determine which of the following situations would be a provider barrier to the nurse developing cultural competence?

A nurse who is unaware of personal biases to other ethnic groups

Which statement(s) is/are most true about the concept of acculturation?

A person who accepts both his own culture and a new culture and adopts elements of each has been acculturated. & It is theorized that it can take years and even generations for an immigrant group to acculturate. & Acculturation is the outgrowth of a minority group's need to survive and flourish in a new culture.

The nurse educator is providing in-service education to the nursing staff regarding trans-cultural nursing care; a staff member asks the nurse educator to provide an example of the concept of acculturation. The nurse educator should make which MOST APPROPRIATE response?

A person who moves from China to the USA and learns about and adapts to the culture of the US.

A nurse is caring for a fifty-year-old brain-dead Japanese woman who is about to be taken off her ventilator. The nurse talks to the family and discovers they seem sad but not worried about her upcoming death. This may be because may Japanese...

Accept death as a part of life and are less likely to do life saving measures

Immigrants who begin to use technology while continuing to adhere to their traditional mode of dress are exhibiting what aspect of cultural identity?

Acculturation

A client incorporates alternative healthcare into her regular health practices. For which alternative therapy should the patient visit a formally trained practitioner?

Acupuncture

While working in a clinic, the nurses notices the Afghan-American clients frequently arrive for appointments 30 minutes late. What is the most culturally competent response of the nurse to her frustrated colleagues?

Afghan culture is present-oriented and focuses more on relationships and hospitality than adhering to a strict time schedule.

A cultural group in which families are often matriarchal is what?

African American

Sickle-cell disease is ag genetically transmitted disorder. Sickle-cell trait is most prevalent among __________________.

African Americans

A nurse is caring for a client who is Mexican and gave birth vaginally to a newborn 2 hr ago. When planning culturally sensitive care for this client, which of the following beliefs in Hispanic cultures should the nurse incorporate?

Allow the client to rest in bed for the remainder of her hospital stay.

Which action by the nurse shows cultural competence of Native American culture? (Select all that apply.)

Allow the family to bring in a medicine man for healing. & Allow the family and patient time for prayer. & Provide space for rituals. & Work hard to gain trust.

Which of the following is considered a "practice" (as opposed to a belief or value)?

Always drinking water after exercise

Cultures that view foods as "hot" or "cold" based on their effect in the body are who?

Arab American, Asian, Hispanic

A male nurse is preparing to take the vital signs of a female patient. Which ethnic group would consider this improper?

Arab Muslim

If you have a Chinese patient, what is an appropriate question to determine religious practices?

Are there any religious practices I need to know about to help care for you?

The nurse is assessing a geriatric patient with severe fever and reddish discoloration of the tongue. The patient tells the nurse, "I'm sick because of imbalance in yin and yang." Which cultural group shares the same beliefs as this patient?

Asian

The nurse knows that in this culture the older adult is respected and makes the decisions.

Asian

When caring for patients who are Jewish, how best can the nurse address their religious needs?

Ask about religious practices affecting care.

Your client comes in talking about "the wind getting her" and covered in infected scraping wounds. You should:

Ask more questions to determine what she is referring to and how the injuries happened.

A nurse is preparing to explain a treatment plan to a client who is Asian. The client does not speak the same language as the nurse and requires a medical interpreter. Which of the following actions should the nurse take when working with the client and the interpreter?

Ask questions and make statements to the client.

Your Hmong patient's family comes to visit him unannounced after surgery. How do you respond?

Ask the patient if he would like to see his family now

A Hmong patient nods when you explain how to change her dressing. How should you respond?

Ask the patient to demonstrate how to do the dressing change

An Asian American male client is operated on for gallstones. On the postoperative night, the nurse finds that the client is not sleeping and is tossing and turning. When asked about analgesics, the client expresses that he does not have pain. What nursing action is most appropriate?

Assessing for non-verbal expressions of pain

You are caring for a 28-year-old married man diagnosed with leukemia. He is hospitalized on reverse isolation. It is his anniversary and his wife is planning to visit. What would be appropriate nursing care to promote spiritual health?

Assist him in planning a celebration of his anniversary.

Your 45-year-old, mentally competent patient is having excessive blood loss from surgery. She is a Jehovah's Witness and refuses a blood transfusion. Her blood pressure has been falling, and she has a rapid heart rate. What would an appropriate nursing intervention be?

Assist the RN in administering IV fluid boluses and medications to support the blood pressure

An Irish American patient on hospice care is being visited by several family members. The nurse observes that no one is interacting with the patient. The nurse's best action would be to:

Assist the family in expressing love and affection to the patient

How best can a nurse evaluate goal attainment for a patient with a culturally diverse background?

Base decisions on feedback from the patient and the nurse's professional judgment.

All of the following are factors to consider when caring for clients with limited income. Which one is the most important?

Basic human needs may go unmet

A group activity on an inpatient psychiatric unit is scheduled to begin at 1000. A patient, who was recently discharged from United States Marine Corps, arrives at 0945. Which analysis best explains this behavior?

The military culture values timeliness. The patient does not want to be late.

Culturally competent care is best defined as what?

Care adapted to the patient's cultural beliefs and values.

The nurse is admitting a client from China to the medical-surgical unit with a diagnosis of cancer. While doing the client's assessments, the client speaks of her naturalistic beliefs related to health care and the importance of the yin/yang theory. Based on her cancer diagnoses, the idea that cancer is considered a cold illness in the culture, and her yin/yang beliefs, which meal will the patient most likely order for lunch?

Chicken noodle soup with crackers, fruit crisp, and hot tea

What is a common food for postpartum Hmong women?

Chicken, rice, and hot water for 30 days

A father, mother, grandmother, and three school-aged children have immigrated to the United States from Thailand. Which member(s) of the family are likely to learn to speak English more rapidly?

Children

Certain groups tend to have a genetically based lactase deficiency. Lactase deficiency is prevalent among ________________.

Chinese

In African American culture, what is the primary religion?

Christian

A religious group that does not believe in using the services of physicians in most instances is what?

Christian scientists

Your Russian American patient needs a skin assessment during your shift, as the nurse, you should prepare your patient by:

Clearly explaining the assessment and the need for it before beginning

The nurse understands that the following organization believes that cultural competence in nursing is necessary?

Code of Ethics of the American Nurses Association

You have a new elderly male patient assigned to you who is on comfort care and is believed to be dying. Each night multiple members of the family sleep in the room. You suggest they take turns so they can have the opportunity to get a good night's sleep and they decline. What part of their culture do you think influences this decision?

Commitment to family is more important than the individual's preference

A nurse engages in professional rituals as a means to standardize practice and ensure efficiency. In doing so, the nurse integrates understanding of which of the following as a characteristic?

Common and observable expressions of culture

A nursing is assessing an Afghan-American patient for jaundice. Where is it most effective to look for jaundice?

Conjunctivae

Despite the presence of a large number of elderly residents of Asian heritage, a long-term care facility has not integrated the Asian concepts of hot and cold into meal planning. Which of the following should the nurses at the facility recognize this as an example of?

Cultural blindness

What is the term that describes the inability of a person to recognize his or her own values, beliefs, and practices as well as those of others, because of strong ethnocentric tendencies?

Cultural blindness

A nurse is providing care for a Cambodian client. The nurse says, "You have to get up and walk whether you want to or not." What is this statement an example of?

Cultural imposition

A Mexican immigrant who migrated to the United States and lives in a Spanish-speaking community with other relatives is taken to the ER following a fall at work. He is admitted to the hospital for observation. The nurse is aware tht this client is at risk for:

Cultural shock

A nurse walks by a client's room and observes a Shaman performing a healing ritual for the client. The nurse then remarks to a coworker that the ritual is a waste of time and disruptive to the other clients on the floor. What feelings is this nurse displaying?

Culture conflict

Which statement(s) about culture is/are true? Select all that apply.

Culture exists on both material and nonmaterial levels. & Cultural customs change over time at different rates. & Culture is learned through life experiences shared by other members of the culture.

When you are doing a skin assessment on a Russian American patient, you notice red, circular bruises all over your patient's back. As a culturally competent nurse, you know those spots could be cause by:

Cupping

An antihypertensive medication has been prescribed for a client with HTN. The client tells the clinic nurse that he would like to take an herbal substance to help lower his BP. The nurse should take which action?

Encourage the client to discuss the use of herbal substance with the HCP.

In reviewing your patient's chart, you see that she has 9 a.m. lab draws. As his/her nurse, you would

Explain that the body regenerates blood and they take only as much as is needed.

According to Afghans, which belief of death is most accurate?

Death is the beginning of a new and better life.

The major factor contributing to the increased emphasis on the need for proficiency in cultural nursing practice in the United States is which of the following?

Demographic changes

A nurse is gathering data on a patient of a different culture. Which action can the nurse take to enhance communication while gathering cultural data?

Determine the patient's level of fluency in English.

A nurse is caring for a patient experiencing spiritual distress. What nursing intervention would be appropriate for this patient?

Developing a trusting relationship with the patient

Which Western cultural feature may result in establishing unrealistic outcomes for patients of other cultural groups?

Direct confrontation to solve problems

Which behavior is an initial step in culturally responsive nursing practice?

Discuss the meaning of the medical regimen with the client.

The nurse is caring for a patient of Japanese heritage who refuses opioid pain medication despite the nurse's explaining its importance in the healing process. Which intervention(s) by the nurse is/are appropriate for this patient? Select all that apply.

Document in the record that the patient does not want to take opioids. & Use nonpharmacological measures to help control the patient's pain.

The nurse is providing home care for a client who traditionally drinks herbal tea to treat an illness. How should the nurse respond to a request for the herbal tea?

Let me check with the doctor to make sure it is okay to drink the tea with your medicines.

After delivery, the nurse assesses the newborn and finds flat, gray-blue spots on the baby's skin. Based on her cultural knowledge the nurse...

Documents the finding as normal

Tay-Each's disease, a genetic disorder, is more common among who?

Eastern European Jews

Which is the best nursing intervention regarding complementary and alternative medicine? .

Educating the client about therapies that he or she is using or is interested in using.

A 26-year-old man of Mexican heritage is admitted for observation after sustaining injuries in a motor vehicle accident. When assessing this patient, the nurse must consider that he may possess which view of pain? He may:

Endure pain longer and report it less frequently than some patients do

Asian American culture believe that health is dependent on the flow of what?

Energy (Chi'i)

A Spanish-speaking patient in the hospital is getting ready surgery and needs to sign the surgical consent form. Existing regulations determine the healthcare organization's responsibility for obtaining informed consent from this patient. The healthcare organization is required to do which of the following?

Ensure adequate resources to comply with informed consent requirements

A nurse is caring for an elderly woman from a far eastern culture. How does the nurse demonstrate awareness of culturally competent care?

Establishing effective communication.

Which statement best serves as a guide for nurses seeking to learn more about ethnicity?

Ethnicity is based on cultural similarities and differences in a society.

Which of the following statements about race and ethnicity is/are true? Select all that apply.

Ethnicity refers to groups whose members share a common and social heritage that is transmitted to the next generation. & Race primarily reflects biology and refers to grouping of people based on biological similarities.

A client who has difficulty sleeping expresses to the nurse that watching television may help him relax and get sleep. The nurse disregards the client's concern and suggests drinking warm milk before going to bed. Which cultural characteristic is the nurse demonstrating?

Ethnocentrism

At a clinical post conference, a nursing student states, "I had a Chinese patient today and while I understand some of her cultural practices, she needs to understand that she is in the United States now and should follow our practices because we use scientific evidence." Which cultural barrier is the student demonstrating?

Ethnocentrism

A nurse is planning care for several clients who have different cultural backgrounds from the nurse's. To practice effective cultural competence, which of the following steps should the nurse take?

Examine her own cultural background, beliefs, and assumptions.

The nurse has been caring for a patient who just died. The patient's daughter is crying uncontrollably, saying, "She was my best friend. I thought she would make it! I don't know what I am going to do." What is the nurse's best response?

Express sympathy, and ask if she would like to talk with a chaplain.

What is spirituality?

Expressing meaningful aspects of self

True or False. Asian Americans believe that good eye contact shows respect?

False

If you have a patient of Indian heritage who is Hindu, what religious practices would affect nursing care?

Family may bring in hot or cold food and drink from home to help remove toxins

A client who speaks limited English requires instructions for a test. No one at your agency speaks the person's language. What is the nurse's best approach?

Locate a professional interpreter.

An Asian American client is experiencing a fever. The nurse plans care so that the client can self-treat the disorder using which method?

Foods considered to be Yin (because they are cold, Yang foods are hot)

A nurse is caring for a diabetic patient who frequently uses alternative medicine to manager ailments. The feels nauseous and requests ginger tea. What should the nurse be aware of before giving the patient ginger tea?

Ginger can cause blood glucose levels to decrease.

.While caring for a patient in the emergency department, what is an important intake question to ask someone of the Filipino culture?

Have you taken any supplements or tried home remedies to try and relieve your symptoms

The nurse caring for a Native American client plans care understanding that one belief of Native American healing practices is which of the following?

Healing takes time.

Which nursing action primarily supports restoring HEALTH using traditional methods?

Herbal teas

What type of context do Filipinos typically classify as?

High context

A nurse manager is looking for ways to improve the cultural competency of unit staff. Which action would help the manager accomplish this?

Hire bicultural clinical and administrative staff.

How do you best provide spiritual care to an infant?

Hold and rock the infant (to promote love and compassion)

Which of the following questions is/are appropriate to ask during a transcultural assessment? (Select all that apply.)

How do you act when you are angry? & What is your role in your extended family? & When communicating with friends, how close do you stand?

The nurse is preparing a plan of care for a client, and is asking the client about religious preferences. The nurse considers the clients religious preference as being characteristic of a Jehovah's Witness if which client is made?

I cannot have food containing or prepared in blood.

Vulnerable populations are those most likely to develop health problems and experience poorer outcomes because of limited access to care and a wide variety of other stressors. Therefore, when caring for a patient from a vulnerable group, it is most important for the nurse to focus on:

Identifying the patient's strengths and resources

A nurse assigned to the neonatal intensive care unit (NICU) has spent most of a day working with a critically ill infant, with the mother standing by. The infant experiences a cardiac arrest and does not survive. The mother spends an hour crying and holding the baby, saying good-bye. Which spiritual care intervention(s) is/are most appropriate for the nurse to implement? (Select all that apply.)

If desired, briefly hold the baby to say good-bye after the mother leaves. & Call the family spiritual adviser or the chaplain. & Ask the mother if you could call a family member or friend to be with her.

When providing care for a Japanese client who practices Shintoism the nurse remembers they probably believe...(SELECT ALL THAT APPLY)

Illness occurs from things like "blood, corpses, skin diseases" & Health is due to harmony and balance with the environment & Balance can be restored by acupuncture, acupressure, massage

Which of these nursing interventions would NOT be culturally appropriate when providing care for a Japanese client?

Including therapeutic touch

15. A patient in the emergency department shows a variety of psychiatric symptoms, including restlessness and anxiety. The patient says, "I feel sad because evil spirits have overtaken my mind." Which worldview is most applicable to this individual?

Indigenous/harmony

You have a male patient who is a follower of Islam. How would this affect your care?

Integrate prayer times around care.

Which behavior is most representative of a culturally competent nurse?

Interprets and validates beliefs of a client with African American heritage.

Which nursing diagnosis is most appropriate for a young Middle Eastern immigrant who expresses concern for the safety of his family members who were unable to relocate with him out of a war zone?

Interrupted Family Processes

An experienced psychiatric nurse plans to begin a new job in a community-based medication clinic. The clinic sees culturally diverse patients. Which action should the nurse take first to prepare for this position?

Investigate cultural differences in patients' responses to psychotropic medications.

Which intervention best demonstrates that a nurse correctly understands the cultural needs of a hospitalized Asian American patient diagnosed with a mental illness?

Involving the patient's family to assist with activities of daily living

Personal space and distance is a cultural perspective that can impact nurse-client interactions. What is the best way for the nurse to interact physically with a client who has a different cultural perspective on space and distance?

Know the client's cultural personal space preferences.

An Anglo American client reports to the primary health care facility with symptoms of fever, cough, and running nose. While interviewing the client, which of the following points should the nurse keep in mind?

Maintain eye contact while talking.

The nurse is obtaining a health history from a patient of Puerto Rican descent. Which of the following is most likely to be a health problem that has a cultural connection for this patient?

Lactose enzyme deficiency

Which clients have a high risk of obesity and DM? SELECT ALL THAT APPLY.

Latino, Native American, Hispanic, African

A Mexican American patient puts a picture of the Virgin Mary on the bedside table. What is the nurse's best action?

Leave the picture where the patient placed it.

When caring for a Japanese American client with a mental health diagnosis the nurse is aware that ...

Many Japanese see mental health disorders as a character flaw so the client is likely to delay seeking care

A Buddhist patient has end-stage pancreatic cancer. In what spiritual practice would this patient most likely engage?

Meditating on the meaning of life

Hindus believe that illness or disease is caused by what?

Misusing the body in some way and because of sin committed in a former life

In what culture is it very important for females to be evaluated by female health care providers?

Muslim

The nurse is admitting a new client to the unit. The nurse notes that this client would need an alternate meal choice when the menu specified pork for a meal. What cultural group would require an alternative meal choice?

Muslim

Your patient died unexpectedly following an automobile accident. You want to warn the transplant coordinator to be sensitive in approaching the patient's family, as their beliefs forbid organ donation. Which group does your patient belong to?

Muslim

Most nurses have been taught to maintain direct eye contact when communicating with clients. Some cultural groups would not value direct eye contact with the nurse. Which cultural group would consider the direct eye contact impolite?

Native Americans

When an Islamic Arab American dies in the hospital, you know to do what?

Not to touch the body before the family bathes it and to turn the bed so that the body faces Mecca.

A nurse is working in a disaster area as a volunteer with the local ambulance agency. The nurse is providing care to a Spanish-speaking patient. What actions can be taken to properly care for this patient?

Obtain an interpreter.

An elderly Japanese patient who does not speak English is admitted to the surgical unit after major abdominal surgery, with no family member present. The nurse cannot speak the patient's language. To assess for pain, the nurse should do what?

Obtain the services of a translator to devise question-and-answer cards regarding pain

A psychoeducational session will discuss medication management for a culturally diverse group of patients. Group participants are predominantly members of minority cultures. Of the four staff nurses below, which nurse should lead this group?

Older, mature registered nurse (bc value age and wisdom)

A nurse is caring for a client from Taiwan who constantly requests pain medication. What should the nurse consider when assessing the client's pain?

Pain is what the client says it is.

Based on assessment data, the nursing diagnosis for a patient is spiritual distress related to loneliness or social alienation. What would be included in spiritual nursing interventions?

Participate in active listening

What time orientation were the first-generation Irish Americans?

Past

The nurse is caring for a patient who emigrated from Puerto Rico. She can best care for this patient by learning about the:

Patient's individual cultural beliefs

The nurse administers medications to a culturally diverse group of patients on a psychiatric unit. What expectation should the nurse have about pharmacokinetics?

Patients of different cultural groups may metabolize medications at different rates.

A nursing instructor has assigned a student to care for a client of Asian descent. The instructor reminds the student that personal space considerations vary among cultures. What personal space preferences are important for the student to consider when caring for this client?

People of Asian descent prefer some distance between themselves and others.

A nurse is caring for a client who practices Islam. Which of the following foods should the nurse notify the dietary department to eliminate from the client's menu plan?

Pork

The nurse is caring for a Native American in a rural rehabilitation facility. The nurse notices that the patient has eaten very little since his admission 10 days ago. When she asks the patient about his eating, he states, "I can't eat any of this food. It just isn't what I eat at home and we don't prepare our foods this way." The nurse explains that the patient is on a very specific cardiac diet as a result of his heart attack and that he has lost 7 pounds since admission. Based on this scenario, what is/are the most appropriate nursing diagnosis(es) for this patient? Select all that apply.

Possible Knowledge deficit related to disease process & Imbalanced nutrition: less than body requirement related to cultural dietary practices

What is the general time orientation of people from the Hmong culture?

Present-oriented

A Spanish patient who was in a car accident has severe leg pain. The patient refuses analgesics and will not undergo treatment. What is the best nursing intervention in this situation?

Provide alternative treatment according to the patient's culture

A patient who is Roman Catholic asks to have the priest come to hear her confession and administer communion before she goes to surgery. The priest arrives the evening before the patient is scheduled for the operating room but after normal visiting hours. The nurse should do what?

Provide privacy for the priest to hear confession and administer communion.

A nurse cares for a patient of Filipino origin. Based on her knowledge of the Filipino culture, the nurse will incorporate which of the following into her care?

Provide resources for extended family visits

What nursing intervention might be considered insensitive by some cultural groups?

Providing a pitcher of ice water at the bedside

Which action by a health care facility would demonstrate a commitment to providing culturally competent care?

Providing continuing education events focused on delivery of linguistic services

If your Jewish patient requested a religious advisor, you would call a what?

Rabbi

What is the best way to provide spiritual care to a 2-year-old patient?

Read a childhood story about good vs evil.

What are some strategies a new nurse can use to develop skills in achieving cultural competence? Select all that apply.

Read the literature and study nursing theories and principles pertaining to culture & Take advantage of as many opportunities as possible to interact with persons from diverse cultures

Which action by the nurse is essential to providing culturally congruent care?

Recognize one's own personal cultural heritage, patterns, and biases.

What is the most important aspect of providing spiritual care in nursing practice?

Recognize situations and patient behaviors indicating a spiritual need.

The ambulatory care nurse is discussing preop procedure with a Japanese American client who is scheduled for surgery the following week. During the discussion, the client continually smiles and nods the head. How should the nurse interpret this nonverbal behavior?

Reflecting a cultural value bc nodding or smiling by a Japanese American client may reflect only the cultural value of interpersonal harmony.

Which of the following actions cause health care disparities?

Refusal of treatment

How do people who participate in organized religion differ from nonreligious people?

Religious people express their spirituality through faith traditions.

An Irish American patient is in distress but can't specify any physical reason why. He keeps repeating, "I need to repent, I need to repent." What is the nurse's priority action?

Request that a Catholic priest visit the patient

Which of the following actions would have little to no impact in helping resolve health care disparities?

Research on life stressors

When the South Asian client arrives 25 minutes late to her appointment at the clinic, the nurse recognizes this as a sign of which of the following?

Respect

The nurse is developing a plan of care for a patient of Aleut descent who sustained a hip fracture. Which intervention by the nurse recognizes the patient's indigenous healthcare system and should be included in the plan of care?

Scheduling a visit from the local shaman

A nurse cares for a first-generation American whose family emigrated from Germany. Which worldview about the source of knowledge would this patient likely have?

Science is the foundation of knowledge and proves something exists.

The most important aspect of providing culturally competent care is exhibited through what action by the nurse?

Seeking to understand individual patient customs, beliefs, and values

An elderly patient tells the charge nurse that she wants another nurse to take care of her. When the charge nurse questions the patient, she states, "I don't want a man taking care of me." Which cultural barrier is this patient exhibiting?

Sexism

A person who is an Orthodox Jew may be hesitant to eat hospital food because of what?

She believes separate dishes and utensils should be used for meat and milk foods, and she is concerned that the hospital may not keep separate sets of dishes and utensils for this purpose.

The client in a rehabilitation unit is having a difficult time adjusting to the scheduled activities on the unit, as well as being dependent on others for meals and medications. Which word best describes what the patient is experiencing?

Shock

While performing an initial assessment on an Afghan patient, you notice her to be withdrawn and crying. What action by the nurse would be most appropriate at this time?

Sit beside her in silence.

Which strategy would most help an English-speaking nurse to communicate with a patient for whom English is a second language?

Slow down when speaking to articulate more clearly.

Which communication techniques would be most effective for a nurse to use during an assessment interview with an adult Native American patient?

Soft voice; break eye contact occasionally; general leads and reflective techniques

A Japanese patient, who is lactose intolerant, asks the nurse to list some options of foods high in calcium to include in his diet. Which of these foods could the nurse suggest?

Soybeans

The nurse is caring for a 45-year-old woman who is a breast cancer survivor. What activity associated with her cancer experience will promote this patient's spiritual well-being?

Speaking about her cancer experience to increase breast cancer awareness

By asking, "How has being sick affected your spiritual practices?" the nurse is trying to determine the need in what spiritual dimension?

Spirit-enhancing practices or rituals

A nurse prepares to teach important medication information to a patient of Mexican heritage. How should the nurse manage the teaching environment?

Stand very close to the patient while teaching.

A client with strong preferences for folk healing methods would prefer which of the following to treat a sinus infection?

Steam humidifier

When a labor and delivery nurse tells a coworker that an Asian client probably did not want any pain medication because "Asian women typically are stoic," the nurse is expressing a belief known as what?

Stereotype

Your Vietnamese patient is prescribed Amoxicillin to treat her pneumonia; she is instructed to take her medication until gone. She is likely to:

Stop taking the medicine once the symptoms have disappeared.

What spiritual practices would you incorporate in your care for an American Indian patient from a reservation?

Storytelling

An Irish American mother brings in their child with concerns of delayed development. The mother states the patient was crawling at 6 months, but now at 9 months has lost this ability. The nurse suspects this could be due to:

Tay-Sachs Disease

A nurse is caring for a client after internal fixation of a compound fracture in the tibia. The nurse finds that the client has not had his dinner, seems restless, and is tossing on the bed. Keeping in mind that the client is Latino, what is the most appropriate response by the nurse?

Tell me what you are feeling.

An Irish American client comes into the clinic for a yearly check up. On assessment, the nurse notes the client guarding his stomach and has a heart rate of 120. When asked about pain he says, "Oh, it's nothing." The nurse knows that Irish Americans:

Tend to underrate or ignore pain

You have met all of your patients and they are requesting to see you. Who do you see first?

The Russian American patient who has a medication due at 0900

The nurse is assessing an Islamic child with severe fever and insomnia. The nurse learns that the child has recently migrated to the United States and has had difficulty in adjusting to the Catholic culture of the school. What does the nurse anticipate from these findings?

The child is experiencing acculturative stress.

The parents of a child with chickenpox tell the nurse, "We want to take our child home and perform a ritual purification with sacred herbs and provide sweat therapy in a sweat lodge." What does the nurse anticipate from the parents' statement?

The child's parents are American Indians.

12. Which viewpoint of an Asian American family will most affect decision making about care?

The father is the authority figure.

A nurse assists in the labor and delivery of a baby and mother from the Philippines. It is important for the nurse to keep in mind that...

The father will probably not wish to be present at the delivery

An older adult woman of Chinese ancestry refuses to eat at the nursing home, stating, "I'm just not hungry." What factors should the staff assess for this problem?

The food served may not be culturally appropriate.

Which statement is most reflective of Madeleine Leininger's theory of cultural care?

The goal of her theory is to guide research that will assist nurses to provide culturally congruent care.

When providing care on an Indian reservation, the nurse has prioritized assessments for diabetes and fetal alcohol syndrome when working with residents of the reservation. How should this nurse's practice be best understood?

The nurse is correct in assessing for health problems that have a higher incidence and prevalence among this population.

A nurse in a large metropolitan city enjoys working in a health clinic that primarily serves Hispanic clients. What does this statement imply about the nurse?

The nurse respects and values providing culturally competent care.

A Vietnamese American patient has been recently diagnosed with hypertension. The patient is prescribed an anti-hypertensive medication and educated about hypertension and how to take the medication. The patient acknowledges understanding. At the two-month follow up for the patient, blood pressure is still significantly high. What is the most likely explanation regarding to the cultural influences?

The patient has been cutting the tablets in half and taking every other day because he feels the dose is "too strong" for him.

The nurse is creating a plan of care for a patient. Which would be important for to consider before implementing the plan? (Select all that apply.)

The patient's life style, value system, religious beliefs

The focal point of nursing is the nurse-client interaction. What must nurses consider when conducting the necessary assessment of their clients and significant others?

Their own cultural orientation.

A 40-year-old nurse is taking a health history from a Hispanic man aged 20 years. The nurse notes that he looks down at the floor when he answers questions. What should the nurse understand about this behavior?

This is culturally appropriate behavior.

What is the most productive method of gathering assessment data regarding heritage?

Traditional beliefs and practices checklist

A nurse in the hospital is caring for a Native American male. What person is most important to include in the care of the client?

Tribal medicine man

You have a patient from the Philippines who is admitted to the med-surg unit for infection of the coccyx. The entire family is visiting during your noon assessment. As the nurse what is the best response to the family?

Understand that space is limited and inward, so after discussing the assessment with the patient and family, make a plan that is appropriate for everyone.

You are getting bedside report from the night nurse, how do you introduce yourself to the Russian American patient?

Use a firm handshake with an ungloved hand while making eye contact with your patient.

A Native American patient sadly describes a difficult childhood. The patient abused alcohol as a teenager but stopped 10 years ago. The patient now says, "I feel stupid and good for nothing. I don't help my people." How should the treatment team focus planning for this patient?

Use a holistic approach, including mind, body, and spirit

Which of the following factors are most likely to be influenced by culture as opposed to personal characteristics? Select all that apply.

Value of older people in society & Gender roles & Nonverbal gestures & Diet

When providing nursing care to an African American individual, which of the following cultural factors should the nurse consider?

Values and beliefs are often present oriented.

What are common beliefs and practices associated with the North American (Western) professional healthcare system? Select all that apply.

Values emphasize individualism and self-reliance. & Health is defined as absence or minimization of disease. & Reliance is on the biomedical system.

What action by the nurse would indicate cultural competence?

Wants to learn more about other ethnic group

A Vietnamese patient's family reports that the patient has wind illness. Which menu selection will be most helpful for this patient?

Warm broth

A patient who has been hospitalized for 3 days with a serious mental illness says, "I've got to get out of here and back to my job. I get 60 to 80 messages a day, and I'm getting behind on my email correspondence." What is this patient's perspective about health and illness?

Western, biomedical (be independent, self-reliant get up and get going)

Using a spiritual assessment tool helps the nurse gain more understanding of the patient. What would be the best question to assess a patient's inner strengths?

What brings you joy and peace in your life?

Which questions should the nurse ask to determine an individual's worldview? Select all that apply.

What is more important: the needs of an individual or the needs of a community? & How would you describe an ideal relationship between individuals? & Of what importance are possessions in your life?

The Russian American patient needs education on preventive health care. When should the nurse present this information?

When the patient has family members present

Do Asian Americans believe in the "hot" and "cold" theory of healing illness and disease?

Yes

A 32-year old Filipino recently moved to the United States and is having a general checkup. She is nervous because she has never been to an "American doctor". She decides to clean the house, talk to her sister on the phone who is not feeling well, and tend to her 6-year old's math homework. Is this behavior normal for a typical Filipino?

Yes, she is running on "Filipino time" since family is her priority right now.

Asian American culture believe in what as a harmony to remain healthy?

Ying & Yang

When communicating with a client who speaks a different language, which BEST practice should the nurse implement?

arrange for an interpreter to translate

What is the best way for the nurse to determine the religious affiliation of a patient?

by cultural assessment

A Native American patient describes a difficult childhood and dropping out of high school. The patient abused alcohol as a teenager to escape feelings of isolation but stopped 10 years ago. The patient now says, "I feel stupid. I've never had a good job. I don't help my people." Which nursing diagnosis applies?

chronic low self-esteem.

The nurse is caring for a surgical patient who speaks only Mandarin Chinese. The nurse will (Select all that apply.)

consider the body structure of the patient for rehabilitation needs. & use the translation services of the institution for communication of the care plan. & explore the cultural practices for foods, eye contact, and body space for care provision.

The nurse is providing discharge instructions to a Chinese american client regarding prescribed dietary modifications. During the teaching session, the client continuously turns away from the nurse. The nurse should implement which best action?

continue with the instructions, verifying client understanding

A nurse in the clinic has a full appointment schedule. A Hispanic American patient arrives at 1230 for a 1000 appointment. A Native American patient does not keep an appointment at all. What understanding will improve the nurse's planning? These patients are:

members of cultural groups that have a different view of time.

Family households where men and women share the responsibilities are called __________________.

egalitarian

A Chinese patient reports cardiac symptoms to the nurse. On reviewing the patient's diagnostic reports, however, the nurse finds that the patient does not have a cardiac disorder. On interacting with the patient, the nurse learns that the patient's parents recently died in an accident. Based on these findings, which condition does the nurse suspect in the patient?

emotional disharmony

A family where the female is the head of the family is considered what?

matriarchal

A nurse begins work in an agency that provides care to members of a minority ethnic population. The nurse will be better able to demonstrate cultural competence after:

exploring commonly held beliefs and values of the population.

In Hispanic Culture who is the head of the family?

father

American Indian culture believe that harmony should be kept between what two things?

humans and environment

To provide culturally competent care, the nurse should:

identify strategies that fit within the cultural context of the patient.

The sibling of an Asian American patient tells the nurse, "My sister needs help for pain. She cries from the hurt." Which understanding by the nurse will contribute to culturally competent care for this patient? Persons of an Asian American heritage:

often express emotional distress with physical symptoms.

A group within a larger culture that holds different beliefs, values, and attitudes is called a what?

subculture

Which condition is an Indian Hindu patient likely to consider a "hot" condition?

rash (earache, paralysis, and pneumonia = cold)

In Hispanic Culture, how does one achieve equilibrium?

received through prayer, religious objects or herbs and spices

Assuming that all African Americans like grits with their breakfast is an example of what?

stereotyping

A psychiatric nurse leads a medication education group for Hispanic patients. This nurse holds a Western worldview and uses pamphlets as teaching tools. Groups are short and concise. After the group, the patients are most likely to believe:

the nurse was uncaring

Culture is defined as what?

values, beliefs, and practices of a people

Many Hindus believe what?

what happens to them is the will of God

A nurse prepares to assess a newly hospitalized patient who moved to the United States 6 months ago from Somalia. The nurse should first determine:

whether an interpreter is needed.