Ch. 5 Cultural Diversity

A nurse overhears another nurse make a statement that indicates racism. The nurse makes this determination based on which characteristic indicative of social value? A. Language B. Skin color C. Dress D. Size

B. Skin color Racism uses skin color, not size, language or dress, as the primary indicator of social value.

When an American client states, "I only want an American doctor," the client is expressing: A. cultural relativity. B. ethnocentrism. C. cultural pervasiveness. D. racism.

B. ethnocentrism. Viewing one's own culture as superior to all others is ethnocentrism. Cultural relativity is the belief that to understand a person, you must understand that person's cultural context. Cultural pervasiveness refers to how widespread the effects of a culture are. Racism is the belief that one's race is superior to others.

What is the priority assessment for the nurse when developing a plan of care for a client living in poverty? A. Access to financial assistance B. Access to affordable housing C. Access to care D. Access to health insurance

C. Access to care Poverty has long been a barrier to adequate health care. If clients cannot access health care, it does not matter if they have affordable housing, health insurance, or financial assistance. It is not possible to create a plan of care with client involvement without adequate support and access to care.

Which questions may help the nurse assess his or her ability to relate to various groups in society? Select all that apply. A. "Can I genuinely try to help this person and be comfortable enough to listen?" B. "Do I have the experience to help this person?" C. "Can I allow my son/daughter to date this person?" D. "Can I welcome this person sincerely?" E. "Can I have dinner with this person comfortably?"

A. "Can I genuinely try to help this person and be comfortable enough to listen?" B. "Do I have the experience to help this person?" D. "Can I welcome this person sincerely?" When assessing how you relate to various groups in society, it is important to assess from a professional standpoint. Sincerity, listening, and experience are all components of a professional nature. Having dinner or considering a person as a mate brings about a personal element that may create bias; this has no place in the professional realm.

A nurse who usually works on the surgical unit is asked to float to the oncology unit because of staffing needs. Which statement by the nurse indicates the possibility of the nurse experiencing culture shock? A. "I am very stressed now because I do not understand how things work on this unit." B. "Can someone please give me an orientation to this unit?" C. "The way we do things on the surgical unit are so much better than the procedures of this unit." D. "I was expecting all the clients on the oncology unit to be depressed."

A. "I am very stressed now because I do not understand how things work on this unit." The nurse is experiencing culture shock because of the new environment. When the culture one has learned differs from the culture in one's environment, a person can become disoriented and stressed. The acute experience of not comprehending the culture of the current environment is called culture shock. Asking for an orientation to a new unit is proper procedure for a float nurse. The third statement indicates ethnocentrism, not culture shock. The fourth statement indicates stereotyping.

While performing the initial assessment of an infant, the nurse notes a soiled string of yarn around the infant's neck. Which response from the nurse would facilitate culturally competent care? A. "I see you have a string tied to your child's neck. Can you explain why you do this?" B. "I noticed the string around your child's neck. Why do you include this practice in your child's health care?" C. "I see the sacred string is dirty. In your culture, is it okay that I clean it?" D. "I noticed a ritual string on your child. Is this a cultural practice to protect the child's health?"

A. "I see you have a string tied to your child's neck. Can you explain why you do this?" The culturally competent nurse would ask the parent the meaning of the string and if it can be placed elsewhere on the body to prevent injury to the infant. The nurse does not presume the string or such practices are specifically related to health care and doing so could be considered stereotyping or demonstrate cultural incompetence. Washing the string with soap and water does not address the purpose of the string or safety. Asking yes and no questions (close-ended questions) does not facilitate communication with the client and/or the parents and thus does not facilitate culturally competent care.

Which statement by the nurse demonstrates ethnocentrism? A. "That client needs to learn that pain is best managed with traditional medications like morphine." B. "That client is so whiny. I am so tired of hearing the client complain about pain." C. "That client is unlike any other Muslim client I have had in the past." D. "That client is too old to learn how to eat gluten free."

A. "That client needs to learn that pain is best managed with traditional medications like morphine." Ethnocentrism is the belief that the practice in one's own culture is superior to another. Traditional pain management with morphine may not be the best option for the client. Assuming the client is too old to learn is stereotyping. The other options are assumptions or generalizations in the provision of care and are not examples of ethnocentrism.

A nurse has recently completed a seminar on cultural diversity. Which statement regarding development of cultural knowledge indicates a need for additional teaching? A. "The more curious the nurse is about the client's culture, the more the client will want to share." B. "Be sure to convey sincerity and respect when assessing culture." C. "Members of minority cultures are often hesitant to discuss beliefs due to past experiences." D. "It is important to listen closely to clients to acquire knowledge of culture."

A. "The more curious the nurse is about the client's culture, the more the client will want to share." Clients often respond negatively to probing curiosity with regard to cultural assessment. A sincere, honest, respectful conversation is more appropriate. The other options are all true regarding cultural knowledge.

Which questions should the nurse include in a cultural assessment? Select all that apply. A. "What religion do you belong to?" B. "What do you think about religions other than your own?" C. "What do you do to promote good health?" D. "Do have a particular name for this illness?" E. "What do you think is causing your illness?"

A. "What religion do you belong to?" C. "What do you do to promote good health?" D. "Do have a particular name for this illness?" E. "What do you think is causing your illness?" Transcultural assessment encompasses a number of considerations surrounding illness, such as causation, naming, prevention, and health promotion. In addition, it is significant and appropriate to ask what religion or religious group a client identifies with. However, it is likely unnecessary and possibly inappropriate to elicit the client's views of those who belong to other religious groups.

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? A. "What type of food do you eat at home?" B. "Are you aware that you are losing weight?" C. "Why aren't you eating your food?" D. "Don't you like what is on your food tray?"

A. "What type of food do you eat at home?" Cultural food preferences often put the client at risk for inadequate nutrition. By exploring what foods the client eats at home, the nurse can assess the client's cultural dietary preferences and work to incorporate these foods into the meal plan. The other choices are judgmental and indicate that the client should eat what is presented regardless of cultural preference.

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? A. "What type of food do you like to eat at home?" B. "Can you ask your family to bring you something you like?" C. "Is there something wrong with the food?" D. "Would you like to speak with a nutritionist?"

A. "What type of food do you like to eat at home?" The culturally sensitive nurse will determine the type of food a client prefers to eat. The nurse should try to accommodate a client's food preferences. Asking if there is something wrong with the food is confrontational and does not address the problem. There is no need to consult a nutritionist unless a client has special food preferences or dietary concerns. The nurse will need to assess a client's preferences before determining if it would be helpful for the family to bring the client food.

Which scenario is an example of cultural competence in nursing? A. Attending a conference for cultural diversity B. Assuming the provider and the client share beliefs and values C. Attending one's own church D. Assessing the rate at which an illness causes death in a culture

A. Attending a conference for cultural diversity Cultural competence can be shown by actively learning about culture through attending a conference. Assessing the rate at which an illness leads to death does not develop cultural competence. One's own church is a familiar culture, and attending it does not breed cultural expansion or competence. The provider should never assume that beliefs or values are shared.

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? A. Cultural blindness B. Cultural diversity C. Ethnocentrism D. Stereotyping

A. Cultural blindness The nurse is demonstrating cultural blindness, which occurs when one ignores differences and proceeds as though they do not exist.

The nurse is caring for the teenage child of immigrants. The teenager voices distress because after living in the country for several years, he no longer wants to participate in some of the tradition religious rituals that are important to his parents. What is the teenager experiencing? A. Cultural change B. Cultural relativity C. Culture shock D. Cultural ethnocentrism

A. Cultural change The teenager is experiencing cultural change. This often occurs when a person changes upon coming into contact with new beliefs and ideas. Culture shock is a stress response that involves being unable to comprehend the culture that one is immersed in. Viewing one's own culture as the only correct standard by which to view people of other cultures is ethnocentrism. Cultural relativity refers to an understanding that cultures relate differently to the same given situations.

The nurse caring for several clients on a hospital unit notices that one client makes eye contact with the staff, while another client from a different ethnic background does not make eye contact when speaking to the staff. What cultural concept explains this difference? A. Cultural relativity B. Cultural negativity C. Cultural neutrality D. Cultural dissonance

A. Cultural relativity Cultural relativity refers to the concept that cultures relate differently to the same situations, such as the meaning of eye contact. Some cultures view eye contact as demonstrating engagement in a conversation, whereas other cultures view avoidance of eye contact with a "superior" (the nurse in this scenario) as a sign of respect. Cultural dissonance, cultural negativity, and cultural neutrality do not apply to this scenario involving eye contact.

When providing care to a client, the nurse refers to the client's ethnic group. Which aspects would the nurse include as pertaining to this concept? Select all that apply. A. Religious beliefs B. Shared beliefs of origin C. Eye shape D. Language E. Skin color

A. Religious beliefs B. Shared beliefs of origin D. Language Although the terms race and ethnic group sometimes refer to the same people, race takes biologic characteristics as the markers of separate social status, and ethnic group takes social characteristics (such as language, religious tenets, shared beliefs of origin) as markers of cultural identity.

A nurse is caring for a 79-year-old client who is new to a long-term care facility. Previously, the client lived in a rural community in a household consisting of the client and an adult child. The child is no longer able to care for the client. The client appears disoriented and reports being bothered by the "bright lights and constant activity." The nurse appropriately documents what condition in the chart? A. Culture shock B. Culture blindness C. Culture assimilation D. Culture disorientation

A. Culture shock Culture shock is a feeling a person experiences when placed in a different culture perceived as strange. Culture shock may result in psychological discomfort, or disturbances, as the patterns of behavior a person found acceptable and effective in his or her culture may not be adequate or even acceptable in the new culture. Cultural assimilation is a process in which a minority group begins to adapt their own cultural characteristics to the new culture in which they are living. Cultural blindness is when one ignores differences in another's culture and proceeds as though the differences do not exist.

Which examples are considered acceptable cultural norms in health care? Select all that apply. A. Defining diabetes mellitus as a metabolic disorder characterized by elevated blood sugar B. Arriving late for a scheduled appointment C. Following a specific regimen for cardiac rehab D. Documenting pain with every client assessment E. Encouraging adult women to conduct self-breast exams once a month

A. Defining diabetes mellitus as a metabolic disorder characterized by elevated blood sugar C. Following a specific regimen for cardiac rehab D. Documenting pain with every client assessment E. Encouraging adult women to conduct self-breast exams once a month Standardized definitions of health and illness as well as maintenance and prevention of illness are considered acceptable cultural norms in the health care system. Thorough documentation is a cultural habit, as is using a systematic approach (such as cardiac rehab) to problem-solve. Tardiness is not an acceptable cultural norm in the health care system.

Which examples are considered acceptable cultural norms in health care? Select all that apply. A. Documenting pain with every client assessment B. Arriving late for a scheduled appointment C. Following a specific regimen for cardiac rehab D. Encouraging adult women to conduct self-breast exams once a month E. Defining diabetes mellitus as a metabolic disorder characterized by elevated blood sugar

A. Documenting pain with every client assessment C. Following a specific regimen for cardiac rehab D. Encouraging adult women to conduct self-breast exams once a month E. Defining diabetes mellitus as a metabolic disorder characterized by elevated blood sugar Standardized definitions of health and illness as well as maintenance and prevention of illness are considered acceptable cultural norms in the health care system. Thorough documentation is a cultural habit, as is using a systematic approach (such as cardiac rehab) to problem-solve. Tardiness is not an acceptable cultural norm in the health care system.

The nurse is caring for a client from another culture who is diagnosed with lung cancer. Which nursing action best demonstrates culturally sensitive care? A. Incorporating the client's need for daily prayer into the nursing care plan. B. Implementing a standardized care plan for the client with lung cancer after explaining the procedure in the client's native language. C. Treating all clients the same based on the diagnosis to demonstrate unbiased care. D. Explaining the biomedical culture to the client.

A. Incorporating the client's need for daily prayer into the nursing care plan. Nurses should be culturally competent and sensitive to provide care that respects (not just not offends) and incorporates the client's culture. Incorporating the client's culture creates an individual plan of care and not a treatment plan for all clients with the same diagnosis. The nurse should not use unmodified standardized care plans that do not account for cultural differences. Explaining the biomedical culture to the client does not ensure culturally sensitive care. The nurse should attempt to understand the client's culture, not have the client understand the culture of the health care system.

Which nursing intervention reflects practice according to Madeline Leininger's transcultural nursing theory? A. Incorporating the client's request for complementary treatment therapy B. Planning dietary interventions according to physiological condition C. Contacting a chaplain for every client D. Providing the same care to each client who has had a myocardial infarction

A. Incorporating the client's request for complementary treatment therapy Leininger's theory of transcultural nursing includes assessing a cultural nature, accepting each client as an individual, having knowledge of health problems that affect particular cultural groups, and planning of care within the client's health belief system to achieve the best health outcomes. Therefore, incorporating the client's request for complementary treatment therapy is an example of this theory. The others do not support this theory.

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. A. Information regarding minorities within the community B. Ethnic identities within subcultures in the community C. Identifying groups that are disadvantaged within the community D. Pointing out groups within the community that possess less power E. Differences in beliefs within a particular culture

A. Information regarding minorities within the community C. Identifying groups that are disadvantaged within the community D. Pointing out groups within the community that possess less power The term minority refers to a group of people within a society whose members have different ethnic, racial, national, religious, sexual, political, linguistic, or other characteristics from the majority of that society. Racial and ethnic minorities continue to have higher rates of disease, disability, and premature death than nonminorities; therefore, these are key points that the nurse should present. This would include identifying those who are disadvantaged and lack power in the community. Differences within a given culture or subculture are not relevant to health disparities between or among different cultures.

A nurse is conducting a seminar for a group of nurses about the cultural competency in nursing. When describing culture, which terms would be appropriate for the nurse to use? Select all that apply. A. Pervasive B. Holistic C. Ritualistic D. Recognizable E. Unsettling

A. Pervasive B. Holistic C. Ritualistic D. Recognizable Culture is stabilizing, not unsettling, in that it makes human responses generally predictable, relative to socio-ecological context, pervasive and holistic, recognizable in patterns at many levels, and ritualistic.

A new client comes to the primary care clinic and asks for help treating head lice. The nurse assesses that the client lives in low-income housing, and nine other people live with her in a one-bedroom apartment. Which of the following is a primary nursing concern? A. The client does not have running water. B. The client has no hope for the future. C. The client receives government assistance. D. The client does not have air-conditioning.

A. The client does not have running water. The priority in this poverty situation is the lack of running water. The already challenging task of eradicating head lice in a crowded living space is worsened by the lack of running water. The feelings of hopelessness need to be addressed, but the need for water is the first priority.

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. A. The nurse consults clergy for assistance in the provision of care. B. The nurse objectively assesses personal beliefs prior to the provision of culturally competent care. C. The nurse will accommodate cultural dietary preferences as much as possible. D. The nurse carefully assesses the decision maker in the care environment. E. The nurse should use curiosity and ethnocentrism when assessing the client's cultural practices. F. The nurse explains how culture does not affect the overall plan of care.

A. The nurse consults clergy for assistance in the provision of care. B. The nurse objectively assesses personal beliefs prior to the provision of culturally competent care. C. The nurse will accommodate cultural dietary preferences as much as possible. D. The nurse carefully assesses the decision maker in the care environment. A nurse who is culturally competent has the knowledge and skills to adapt nursing care to cultural similarities and differences. Cultural competence takes time. It involves developing awareness, acquiring knowledge, and practicing skills. This includes objectively assessing personal beliefs, consulting clergy, and assessing familial roles and dietary preferences. When assessing cultural practices, using genuine interest is appropriate versus curiosity with the tone of cultural superiority (ethnocentrism). Culture should be a part of the care plan.

Which stereotypical ideas about older adult clients does the nurse associate with the concept of ageism? Select all that apply. A. Uninterested in intimacy B. Cognitively enhanced C. Burdensome to family D. Physically impaired E. Financially independent

A. Uninterested in intimacy C. Burdensome to family D. Physically impaired Ageism, a form of negative stereotypical thinking about older adults, promotes false beliefs about older adults being physically and cognitively impaired, lacking interest in sex, and being burdensome to families and society. Ageism is not associated with concepts of cognitive enhancement or financial independence.

A client who immigrated from another country informs the nurse of dietary requests. The nurse responds to the special dietary needs by stating, "You are now living here, and you should try to start eating those foods common to our diet." This inappropriate response is an example of: A. cultural imposition. B. cultural diversity. C. cultural assimilation. D. cultural blindness.

A. cultural imposition. The nurse's response is an example of cultural imposition, which is defined as the belief that everyone should conform to the majority belief system. Cultural blindness is the result of ignoring differences and proceeding as though they do not exist. In this situation, the nurse did not ignore the request but inappropriately responded to it. Cultural diversity is defined as a diverse group in society, with varying racial classifications and national origins, religious affiliations, languages, physical sizes, genders, sexual orientations, ages, disabilities, socioeconomic statuses, occupational statuses, and geographic locations. Cultural assimilation occurs when members of a minority group live within a dominant group and lose the cultural characteristics that make them different.

Healthcare facilities that sponsor health promotion activities only in affluent areas are considered: A. culturally blind. B. culturally different. C. culturally sensitive. D. culturally affluent.

A. culturally blind. Cultural blindness is a process of ignoring cultural differences and proceeding as if they do not exist. It can also reflect a lack of capacity to reach out effectively to minorities or culturally stigmatized groups. Cultural sensitivity is an awareness of and respect for the differences between one's own culture and another. Healthcare facilities are not described as culturally different or affluent.

Within a culture, the world becomes predictable and coherent for its inhabitants. This predictability has been defined as: A. habituation. B. normalization. C. stereotypical. D. desensitization.

A. habituation. Culture is habituated; it reflects a usual way of doing things that people learn through socialization as they may mature and become deeply involved in different subcultures. Cultural habituation is advantageous. Any behavior or situation can be normalized, for short or long durations or when it should not be accepted as such. Stereotypical behaviors are not consistent among people or situations. Desensitization is a term used to reduce response to a behavior or situation and does not apply here.

Persistent gaps between the health status of minorities and non-minorities are defined as: A. health disparities. B. racism. C. ethnocentrism. D. cultural relativity.

A. health disparities. Despite continued advances in health care and technology, racial and ethnic minorities continue to have higher rates of disease, disability, and premature death than non-minorities. These differences are known as health disparities. Racism is the belief that one's race is superior to another. Ethnocentrism is the belief that one's culture is superior to another. Cultural relativity is the belief that an understanding of a person's behavior depends, at least in part, on an understanding of that person's cultural context.

A nurse is working with a culturally diverse group of clients. The nurse understands that cultural norms: A. require an individualized approach by the nurse. B. are fairly consistent across cultural groups. C. can be generalized to anyone of that culture. D. allow nurses to predict a client's response.

A. require an individualized approach by the nurse. Knowing a cultural norm does not enable one to predict a person's response. Generalizing about cultural norms in contemporary societies is inappropriate because people belong to more than one subcultural group and are influenced uniquely by multiple and diverse groups. Exceptions to cultural norms always exist. Therefore the nurse needs to approach each person as an individual.

The nurse has just attended a seminar on concepts of cultural diversity. Which statement made by the nurse would require further education? A. "Culture can be seen in attitudes and institutions of certain populations." B. "Culture cannot be influenced, and you are born with your culture." C. "Culture helps to define identity within specific groups of people." D. "Language is the primary way that people share their culture."

B. "Culture cannot be influenced, and you are born with your culture." Culture is learned through life experiences from one generation to the next. Culture helping to define identity, language being the primary way that people share their culture, and culture being seen in attitudes of certain populations are correct options; these are all components that define culture.

Which statement by the nurse is a culturally appropriate reaction to a client's perception of pain? A. "Males tend to overreact to pain for sympathy." B. "If a client needs to yell in pain, that is his or her right." C. "Asian clients have a high pain tolerance." D. "Some procedures hurt more and should have more pain reaction."

B. "If a client needs to yell in pain, that is his or her right." Clients have a right to respond to pain in their own manner. Pain reactions should not be stereotypical, such as males overreact or Asians have a higher pain tolerance. "Some procedures hurt more" is a nurse's perception of pain rather than the client's perception.

A nurse is admitting a client to the unit. Which cultural question is most appropriate? A. "Will you be able to eat the normal food provided?" B. "What are your dietary needs and preferences?" C. "Will you be making requests for special food based on your religion?" D. "Do you have food restrictions?"

B. "What are your dietary needs and preferences?" By asking about dietary needs and preferences, the nurse can gain insight into religious and cultural dietary practices. Asking about "normal" foods assumes that a cultural dietary request is abnormal. The other options will produce limited insight and imply that a cultural dietary need is a restriction or hindrance.

A nurse caring for clients of different cultures in a hospital setting attempts to make eye contact with clients when performing the initial assessment. What assumption might the nurse make based on common cultural practices? A. A Black man rolls his eyes when asked how he copes with stress in the workplace. Assumption: He may feel he has already answered this question and has become impatient. B. A Muslim-Arab woman refuses to make eye contact with her male nurse. Assumption: She is being modest. C. A Native American/First Nations man stares at the floor while talking with the nurse. Assumption: The client is embarrassed by the conversation. D. A Hasidic Jewish man listens intently to a male physician, making direct eye contact with him, but refuses to make eye contact with a female nursing student. Assumption: Jewish men consider women inferior to men.

B. A Muslim-Arab woman refuses to make eye contact with her male nurse. Assumption: She is being modest. The dominant culture in Western societies emphasizes eye contact while speaking, but many other cultures regard this behavior in different ways. For example, direct eye contact may be considered impolite or aggressive by many Asians, Native Americans/First Nations, Indochinese, Arabs, and Appalachians; these groups of people tend to avert their eyes while speaking. Hispanics may look downward in deference to age, gender, social position, economic status, or authority. Muslim-Arab women often indicate modesty by avoiding eye contact with men, and Hasidic Jewish men may avoid direct eye contact with women. The only option above that has the correct assumption is the option regarding a Muslim-Arab woman refusing to make eye contact with her male nurse due to modesty. The nurse must be aware of the cultural meaning of eye contact in relationship to the health care situation.

The nurse is caring for a terminally ill client who immigrated from Mexico. Which nursing intervention regarding spiritual care is appropriate? A. Inquire if the client desires the Sacrament of the Sick. B. Ask the client if a spiritual leader is desired. C. Do nothing unless the client requests spiritual assistance. D. Call a Roman Catholic priest to visit the client.

B. Ask the client if a spiritual leader is desired. The appropriate response is to ask the client if a spiritual leader is desired, which is observant of the client's preferences. The nurse should not generalize that a Latino client is Roman Catholic, nor should the nurse refrain from inquiring about spiritual needs.

The home health nurse is conducting the health history interview with a client who does not speak the dominant language. What would be the best action made by the nurse? A. Write out all questions using appropriate medical terms. B. Conduct the health history utilizing a telephonic interpreter (over-the-phone translation). C. Use simple words with simple actions. D. If the client does not answer, repeat the question again using a louder tone.

B. Conduct the health history utilizing a telephonic interpreter (over-the-phone translation). When speaking with a client who does not speak the dominant language, the nurse should use a trained or certified interpreter. If an on-site interpreter is unavailable, the nurse should other methods including bilingual staff, volunteers, webcam, or telephonic interpreting. The nurse should maintain a moderate, low tone in voice and avoid shouting or talking loudly. The nurse should avoid using medical terms. Because the client may not be able to read the dominant language, it is not appropriate to write out all questions using appropriate medical terminology. When asking questions, the nurse should discuss one topic at a time and avoid conjunctions.

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? A. Allow the client to slowly ambulate independently. B. Discuss with the client the need for assistance during ambulation. C. Obtain a prescription for physical therapy consult to ambulate the client. D. Instruct the family to assist the client with ambulation.

B. Discuss with the client the need for assistance during ambulation. For members of some cultures, providing care and performing nursing interventions can intrude into personal space. The nurse should discuss with the client the need for assistance during ambulation and prepare the client for potential closeness. The client may ambulate independently, but the nurse should still assist. Having the family or physical therapy ambulate the client does not address the issue related to culture and nursing interventions.

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? A. Bring the client's spouse into the hallway to discuss surgical options for the client. B. Document the client's request in the nursing care plan. C. Explain to the client that the client is required to make all decisions related to the client's own health care. D. Explain to the client that it is not a good idea to have the spouse in the room when discussing such a private matter.

B. Document the client's request in the nursing care plan. A culturally sensitive nurse is one who respects a client's requests while ensuring that the requests reflect safe medical practice. This client's request does not interfere with client safety. Thus, the request should be respected and communicated through documentation to other healthcare personnel. Telling the client that the client must make all health care decisions does not address the client's request. There is no need to move to the hallway to discuss the client's care with the client's spouse, and this would likely be offensive.

A nurse is providing care to a client who has limited understanding of the dominant language. Which strategy is best for the nurse to use to ensure that the client obtains the needed health information? A. Use a laboratory aide who is from the same country as the client B. Enlist the services of a qualified language interpreter C. Ask another nurse who speaks the client's language to interpret D. Ask a bilingual family member to translate

B. Enlist the services of a qualified language interpreter Hospitals are required to provide qualified language interpreters for the client who does not speak or understand the predominant language of the community. Obtaining qualified interpreters rather than bilingual members of the client's family or friends, however well-intentioned or convenient the latter might be, is important because interpretation of behavior goes beyond translation of words. Much medical vocabulary and terminology is difficult to translate into other languages, and another nurse who speaks the language or a laboratory aide from the same country as the client would not be trained to interpret.

A nurse is caring for a postoperative client after knee arthroplasty. The nurse plans to help the client ambulate but is aware that the client may feel threatened by physical closeness because the client is from a culture that tends to prefer more personal space when interacting with others. Using the principles of culturally competent care, what would be the most appropriate nursing action? A. Instruct family members to assist in ambulating the client. B. Explain the purpose and need for assistance during ambulation. C. Let the client ambulate slowly on his or her own when stable. D. Ambulate the client explaining it is an expected outcome of their treatment.

B. Explain the purpose and need for assistance during ambulation. The nurse should explain the purpose of ambulation and the need for assistance while ambulating to the client. This would relieve the client's anxiety associated with physical closeness. However, the client won't be able to ambulate without assistance. Even though the nurse can instruct a family member to ambulate the client, this is not an appropriate action. Ambulating the client without recognizing the cultural difference is nontherapeutic, as the nurse would be not be performing culturally competent care by not acknowledging cultural practice.

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? A. Ask the client why the client is so mad. B. Learn from the mistake and do not repeat it. C. Examine the interaction and focus on the majority culture. D. Recognize that there is a cultural bias that led to the mistake.

B. Learn from the mistake and do not repeat it. All nurses make mistakes at some time when caring for culturally diverse clients. The best action is to learn from the mistake and not repeat the offense. Although it may be appropriate to discuss with the client, asking why the client is so mad is aggressive and may make the situation worse. The mistake was inadvertent and may not be the result of cultural bias. Focusing on your own majority culture will not help bring about learning associated with the mistake.

A client refuses to allow any healthcare worker of Asian descent to provide care. This client is demonstrating what practice? A. Ethnic identification B. Racism C. Ethnocentrism D. Stereotyping

B. Racism Racism usually involves negative thoughts or actions against another individual based on skin color or ethnicity. Stereotyping is applying a generalization to all members of a group and does not always involve negative thoughts against others. Ethnocentrism and ethnic identification are beliefs one has about one's own culture and are not necessarily negative or directed toward others.

In addressing health promotion for a client who is a member of another culture, the nurse should be guided by which principle? A. A culture's conceptualization of health promotion is a result of that culture's level of socioeconomic development. B. The client may have a very different understanding of health promotion. C. Health promotion is a concept that is largely exclusive to Western cultures. D. The nurse should avoid performing health promotion education if this is not a priority in the client's culture.

B. The client may have a very different understanding of health promotion. As a component of cultural assessment, the nurse should seek to understand the cultural lens through which the client may understand health promotion. Health promotion is not a concept exclusive to Western cultures, though it may be considered differently among non-Western cultures. Even if health promotion is not a priority in a client's culture, the nurse should still address issues related to health promotion in a respectful and relevant manner. Health promotion is not directly linked to socioeconomic development levels.

The nurse is providing discharge teaching for a client who is from a different culture. The nurse notes that the client will look away from the nurse and does not maintain eye contact. What would be the most appropriate action by the nurse, with regard to culturally competent care? A. Change positions to promote eye contact with the client, asking open-ended questions to ensure understanding. B. Utilize a key informant and continue with the teaching, verifying the client's understanding through open-ended questions. C. Tell the client that it is important to pay attention to the teaching and ask if the client would like an interpreter. D. Continue with teaching and leave written instructions for the client to review.

B. Utilize a key informant and continue with the teaching, verifying the client's understanding through open-ended questions. Eye contact is a culturally variable nonverbal behavior. In some cultures, direct eye contact when speaking with others may be considered impolite or aggressive and clients may avert their eyes during the conversation. Therefore, utilizing a key informant or interpreter will help with interpreting nonverbal behavior and ensure teaching is completely translated and understood. Telling the client that it is important to listen implies that the client is not paying attention to the teaching. Changing positions to maintain eye contact is not culturally competent care and may make the client uncomfortable. Leaving the instructions for the client to review is not appropriate, as the nurse should finish the teaching and use teach-back to evaluate the learning.

A client believes in the use of herbal therapy and asks the nurse if he can continue to use a herbal tea therapy. What is the most culturally appropriate nursing response? A. "Herbal tea and medications do not mix well. I would avoid this practice." B. "Most of those teas have caffeine in them, and you don't need extra caffeine." C. "There is no reason the tea cannot be used as long as the ingredients do not interfere with the medication." D. "Avoid the use of herbal teas and consider trying acupuncture instead."

C. "There is no reason the tea cannot be used as long as the ingredients do not interfere with the medication." There is no reason herbal remedies cannot be used in conjunction with medications as long as the ingredients do not interfere with the action or absorption of the medication. The other options are judgmental and do not answer the client's question, which is specific to continued use of herbal tea.

The mother of a Black newborn asks the nurse about the bluish-black areas she noticed around the infant's lower back and buttocks. What is the nurse's best response? A. "It will be best if you have these areas treated with laser surgery." B. "This discoloration occurs in some infants and is usually permanent." C. "These areas are normal and should disappear by early childhood." D. "These spots will normally fade in about 2 weeks."

C. "These areas are normal and should disappear by early childhood." These types of discolored areas are referred to as Mongolian spots. The discolorations are clusters of melanocytes and appear as bluish-black areas typically found on Black infants' lower backs and buttocks, as well as on Native American/First Nations and Asian infants. They are normal, occur in 80% to 90% of infants these populations, and typically disappear by early childhood.

A client is admitted to the health care facility with hypoglycemia. After the client is stable, the nurse discovers that the client has not taken the prescribed medicines. The client believes that eating saffron will keep blood sugar under control. What is the most appropriate response by the nurse? A. "Saffron does not have any effect on blood sugar level." B. "Yes, I agree that you should continue taking saffron for diabetes." C. "What would you think about taking the medicines, too, and benefitting from both?" D. "Let me inform the health care provider that you are not taking your medicines."

C. "What would you think about taking the medicines, too, and benefitting from both?" Although the nurse may disagree with the client's beliefs concerning the cause of health or illness, respect for these beliefs helps the nurse to achieve health care goals. Asking the client to consider the benefits of medicine is appropriate because the nurse, without disrespecting the client's beliefs, persuades the client to have medicines also. Stating that saffron does not have any effect on blood sugar level is inappropriate, as it disregards the client's beliefs. Agreeing with the client may encourage him or her and indicate low faith in the present treatment. It is inappropriate to call the health care provider and report on the client.

While assessing an older adult client's upper back, the nurse notes round, raised red spots along the client's back. The client's daughter says, "Oh, that is just cupping." What action should the nurse take? A. Have the charge nurse assess the client's skin. B. Complete the assessment and document the findings. C. Ask about the practice of cupping. D. Contact social services to report potential abuse.

C. Ask about the practice of cupping. Complementary and alternative medicine are therapies that are used in addition to, or instead of, conventional medical treatment. Some cultures have specific health practices. The culturally competent nurse understands to assess different cultural practices before making conclusions or assumptions. The nurse should ask the client's adult daughter to explain the practice. The other options do not assess what cupping is and require further information before implementing.

A nurse is conducting an ethnographic interview with a client. Which step would the nurse do first? A. Identify clues to what may be important B. Request clarification of a key term C. Ask an open-ended, general question D. Document the client's view of self

C. Ask an open-ended, general question An ethnographic interview begins with an open-ended, general question. Then, based on the client's response, the nurse selects some key terms and asks for clarification, repeating the exact words and phrases that the client used. The terms are clues to what is important to the client, so the nurse asks the client to talk more about them. Finally, the nurse documents the information on the client's view of self or of the issue discussed.

A nurse is providing care to a client from a culture different from the nurse's own. The nurse is having difficulty relating to the client. What intervention by the nurse is most appropriate? A. Consult the Office of Minority Health Resource Center to help in the provision of care. B. Look up the client's culture online and try to figure out methods to relate. C. Ask the client how the client wants to be treated based on the client's values and beliefs. D. Ask another nurse to take over the client's care.

C. Ask the client how the client wants to be treated based on the client's values and beliefs. The best way to provide culturally appropriate care is to ask the client what the client values and believes and how the client would like to be treated. Asking another nurse to take over care will not help identify the cultural care needs. Researching the client's culture online and consulting the Minority Health Resource Center may be helpful as a learning experience later, but they do not help immediately in the provision of care. Also, remember that information about any culture is general and must be individualized.

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? A. Insist that only one family member can be in the room at a time. B. Explain to the family that too many visitors will tire the client. C. Assess the client's beliefs about family support during hospitalization. D. Allow all the visitors into the room.

C. Assess the client's beliefs about family support during hospitalization. Asking the client about the client's beliefs exemplifies that the nurse recognizes the importance of respecting differences rather than imposing standards. If the client believes family support is significant to health and recovery, the nurse should respect the client's beliefs and allow the visitors into the room.

Which behavior by the nurse is stereotyping? A. Explaining to others that Western medicine is always superior B. Grouping care assignments to allow ample time to care for complex clients C. Avoiding older adult clients because their care is time consuming D. Openly ridiculing the practice of acupuncture

C. Avoiding older adult clients because their care is time consuming Avoiding older adult clients because their care is time consuming is stereotyping. This is a mistaken belief and an overgeneralization. Some older adult clients are very healthy. Ridiculing acupuncture is cultural conflict. Assuming that Western medicine is superior is ethnocentrism. Grouping care assignments to allow ample time to provide care is an appropriate strategy in time management.

Which term describes the tendency to impose one's cultural beliefs, values, and patterns of behavior on a person from a different culture? A. Cultural blindness B. Cultural taboos C. Cultural imposition D. Acculturation

C. Cultural imposition Cultural imposition is the tendency to impose one's cultural beliefs, values, and patterns of behavior on a person from a different culture. Cultural blindness occurs when one ignores differences and proceeds as though they do not exist. Acculturation is the process by which members of a cultural group adapt to, or learn how to, take on the behaviors of another group. Cultural taboos are activities or behaviors that are avoided, forbidden, or prohibited by a particular cultural group.

When describing the concept of ethnicity, which statement would be most appropriate to use? A. Ethnicity is an alternative term that implies the same ideas as culture. B. Ethnicity is a present-oriented form of identity. C. Ethnicity allows people to define themselves and others to define them. D. Culture involves self-consciousness while ethnicity does not.

C. Ethnicity allows people to define themselves and others to define them. Ethnicity is a cluster of ways for people to define themselves and be defined by others. It involves the selection of certain shared cultural characteristics, such as symbols of a common group origin, history, or descent. Ethnicity is not culture. Ethnic identity is distinguished from culture in that ethnic identity is self-conscious about select symbolic elements that are taken as the emblem of group social identity. Ethnicity or ethnic identity refers to a self-conscious, past-oriented form of identity based on a notion of shared cultural (and perhaps ancestral) heritage, as well as current position within the larger society.

Which area is typically included in a cultural assessment? A. Ethics B. Marital status C. Food preferences D. Employment status

C. Food preferences Dietary tolerance is associated with both cultural food preferences and biologic variation. A client's marital status and employment status are aspects of demographic information recorded in the client's health record but would not be pertinent, in and of themselves, to a cultural assessment. Ethics would not be typically covered in a cultural assessment, although one's religious affiliation might be.

Which nursing intervention reflects practice according to Madeline Leininger's transcultural nursing theory? A. Providing the same care to each client who has had a myocardial infarction B. Contacting a chaplain for every client C. Incorporating the client's request for complementary treatment therapy D. Planning dietary interventions according to physiological condition

C. Incorporating the client's request for complementary treatment therapy Leininger's theory of transcultural nursing includes assessing a cultural nature, accepting each client as an individual, having knowledge of health problems that affect particular cultural groups, and planning of care within the client's health belief system to achieve the best health outcomes. Therefore, incorporating the client's request for complementary treatment therapy is an example of this theory. The others do not support this theory.

A nurse is working in a clinic that serves a community with a high population of immigrants. Which nursing assessment is the priority? A. Blood sugar assessment B. Spiritual assessment C. Language assessment D. Blood pressure assessment

C. Language assessment Although all of the assessments are appropriate, the priority assessment is communication. If clients do not speak the dominant language, it may be necessary to obtain an interpreter to provide culturally appropriate care.

The nurse is caring for a client who perceives time differently. What action should the nurse take for this client? A. Have the client set all times for the interventions. B. Perform interventions at random times during shift. C. Maintain flexibility when the client requests interventions at specific times. D. Set all interventions to be done at specific times.

C. Maintain flexibility when the client requests interventions at specific times. People view time differently. Social time can reflect attitudes regarding punctuality that vary among cultures. The nurse should maintain a flexible attitude and adapt the time of interventions to the client's needs and requests. It is not realistic to have the client set all the times for the interventions or to have the interventions at a specific time or interventions at random times during the shift.

A nurse is providing care to a client and has enlisted the help of a trained interpreter to assist in communicating with the client. Which action would the nurse do first? A. Tell the interpreter what the nurse wants to learn from the client. B. Explain what messages the nurse wants to convey to the client. C. Meet with the interpreter alone before a combined meeting with the client. D. Discuss any concerns about how to communicate with the client.

C. Meet with the interpreter alone before a combined meeting with the client. The nurse should first meet with the interpreter before they meet with the client. During this meeting, it would be appropriate to tell the interpreter what the nurse wants to learn from the client and what messages the nurse wants to convey to the client. Also, the nurse should discuss any concerns about how to communicate with the client, and ask for feedback on how to help the interpreter reach a mutual understanding with the client.

A client has recently immigrated and is exhibiting symptoms of culture shock. The client reports feeling unaccepted in the new culture. The client states, "I can't do anything right here." What is the priority nursing diagnosis? A. Powerlessness related to the loss of familiar cultural practice B. Social isolation related to culture shock and feelings of low self-worth C. Situational low self-esteem related to culture shock and feelings of fear and incompetence D. Spiritual distress related to low self-esteem

C. Situational low self-esteem related to culture shock and feelings of fear and incompetence The client is experiencing low self-esteem, which is often associated with culture shock. It is situational in nature and will likely improve with cultural assimilation. The client does not indicate powerlessness, spiritual distress, or social isolation.

The labor and delivery nurse is getting report from the previous shift regarding a client with Asian heritage. The departing nurse states that the client did not ask for pain medication because "Asian people can handle pain." The nurse receiving report understands that this an example of what? A. Ageism B. Ethnocentrism C. Stereotyping D. Culture shock

C. Stereotyping Stereotyping is a fixed attitude about people who share common characteristics. Clients with Asian heritage often do not express pain or emotions. Therefore, the misconception is they do not feel pain. Culture shock is bewilderment over behavior that is culturally atypical for the client. Ethnocentrism is the belief that one's culture is better than other cultures. Ageism is a negative belief that older adults are physically and cognitively impaired.

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? A. Cultural imposition B. Cultural conflict C. Stereotyping D. Cultural blindness

C. Stereotyping The charge nurse is clearly exhibiting ageism, which is a form of stereotyping. Cultural assimilation is when one begins to assume some characteristics of a culture outside of one's own. Cultural blindness occurs when cultural differences are ignored. Cultural imposition occurs when one pushes one's cultural beliefs onto another person.

A nurse convinces a client who is a Jehovah's Witness that receiving blood products is more important than the legalistic components of religion. What client reaction may be expected following this mandated change? A. The client states, "Why isn't blood administration forced on all who need that treatment?" B. The client states, "I can't get over my feelings of legalism as a Jehovah's Witness." C. The client states, "I feel like I abandoned my religion." D. The client states, "I am glad that nurse told me what to do."

C. The client states, "I feel like I abandoned my religion." When clients are forced to participate in care that conflicts with their values, feelings of guilt and abandonment are likely. These feelings may deepen and threaten the client's well-being. The other answer choices are not related to mandated change.

Which nursing actions are appropriate when collecting a health history for a client whose primary language differs from the dominant language? Select all that apply. A. Speak in detailed sentences using exact medical terminology. B. Ask the client's adolescent child to answer questions. C. Use the facility telephonic interpreting system. D. Request assistance from a certified interpreter. E. Have a bilingual nurse assist with the health history.

C. Use the facility telephonic interpreting system. D. Request assistance from a certified interpreter. E. Have a bilingual nurse assist with the health history. When caring for a client whose primary language differs from that of the nurse, the nurse should first use a certified interpreter. If a certified interpreter is unavailable, the nurse should then use the telephonic interpreting system or a bilingual staff member. The nurse should never use children to interpret. The nurse should speak in short sentences, using simple terminology.

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. a trusted friend B. a family member C. a hospital translator D. a bilingual hospital employee

C. a hospital translator A qualified interpreter who is familiar with health care terminology is the best choice for providing translation for clients. Such a person is more likely to be objective and well versed in the requisite vocabulary than is a friend, family member, or hospital employee.

Nurses are responsible for delivering culturally competent care for all clients. Culturally competent care does not account for: A. available technology. B. developmental level. C. client's height. D. individual values.

C. client's height. In partnership with the person, family, and others; the nurse develops an individualized plan considering the person's characteristics or situation including but not limited to: values, beliefs, spiritual and health practices, preferences, choices, developmental level, coping style, culture, environment, and available technology. A physical characteristic such as one's height does not contribute to cultural competence.

A parent informs the nurse that immunizations are against the parent's cultural and religious beliefs and the parent does not want the child to receive immunizations. The nurse proceeds to inform the parent that the child will be consistently ill and will not be allowed to start school unless immunized. The nurse also informs the parent that the nurse had all of the nurse's own children vaccinated. The nurse's behavior an example of: A. stereotyping. B. cultural blindness. C. cultural imposition. D. cultural conflict.

C. cultural imposition. The nurse's behavior is an example of cultural imposition, defined as the tendency to impose one's cultural beliefs, practices, and values on a person from a different culture. Stereotyping is when one assumes that all members of a culture, ethnic group, or race act alike. Cultural blindness occurs when one ignores differences and proceeds as though they do not exist. Cultural conflict 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 in their own values.

A client says to the nurse, "Why don't you wear a white cap like nurses do on the soap operas?" This is an ethnocentric statement based on the: A. past history. B. nursing personality. C. media. D. genetics.

C. media. Ethnocentrism is a way of looking at the world through a personal lens that has been influenced by personality, genetics, family/relationships, and media. None of the remaining options play a role in the client's comment to the nurse.

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: A. stereotyping. B. subculture. C. ritual. D. ethnocentrism.

C. ritual. Rituals are common and observable expressions of culture in hospitals, clinics, homes, schools, and work settings. Clients and their families practice rituals that are intimately important to them, particularly during illness and hospitalization. Observance of rituals in times of stress and uncertainty helps restore a sense of control, competence, and familiarity, and to that extent it is a desirable adjunct to nursing care. Ethnocentrism is a way of looking at the world through a personal lens that has been influenced by personality, genetics, family/relationships, and media. In its mildest form, ethnocentrism presents as subconscious disregard for cultural differences; in its most severe form, it presents as authoritarian dominance over groups different from one's own. Stereotypes are preconceived and untested beliefs about people. They are exaggerated descriptors of character or behavior that are commonly reiterated in mass media, idiomatic expressions, and folklore. A subculture is "an ethnic, regional, economic, or social group exhibiting characteristic patterns of behavior sufficient to distinguish it from others."

The charge nurse overhears two new graduate nurses talking in the break-room. One graduate nurse states, "I hate getting reports from the older nurses; they are just too slow." The charge nurse understands that the nurse is demonstrating what? A. ethnocentrism B. stereotyping C. cultural shock D. ageism

D. ageism Ageism is a negative belief that older adults are physically and cognitively impaired. Therefore, the statement about the older nurses demonstrates ageism. Stereotyping is a fixed attitude about people who share common characteristics. Cultural shock is bewilderment over behavior that is culturally atypical. Ethnocentrism is the belief that one's cultural is better than other cultures.

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? A. "I will leave the questionnaire here. Please fill it out when your spiritual healer arrives." B. "I can wait until your spiritual healer arrives, but you are the only one who can answer these questions." C. "These questions need to be answered so we can provide you with the best care." D. "We can wait until your spiritual healer arrives and work together to answer these questions."

D. "We can wait until your spiritual healer arrives and work together to answer these questions." The culturally sensitive nurse understands that some cultures rely on a spiritual healer to restore harmony and health. If the client requests the spiritual healer to be present, the nurse should respect the client's beliefs and decision. Leaving the questionnaire with the client is not acceptable because the nurse needs to make sure the questionnaire is completed with the client. Telling the client that he or she is the only one who can fill out the questionnaire is not necessary and rude. Telling the client that the questions need to be answered so the health care team can provide the best care is important, but recognizing and supporting the client and his or her beliefs is the priority.

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? A. "Why do you think you need to leave?" B. "Sometimes family can cause stress, and we try to maintain a stress-free care environment." C. "If you leave, you will be asked to sign a form indicating that you are leaving against medical advice." D. "Would you feel more comfortable with your family with you?"

D. "Would you feel more comfortable with your family with you?" Some cultures are very family oriented; others may have members who are skeptical of modern health care. The request for the client's family to leave most likely frightened the client. Asking the client how to make the client more comfortable is the best option. Asking the client why the client wants to leave is judgmental, implying there is no real reason to leave. Citing the hospital's policy regarding clients who leave against medical advice is not culturally sensitive and does not address the client's concerns. Clearly in this client's case, having the family present reduces, not causes, stress, so the comment about maintaining a stress-free environment is not valid.

The nurse is caring for a client who practices Catholicism and was newly diagnosed with cancer. The client states, "God is punishing me for my past sins." How should the nurse respond? A. "Why do you think God is punishing you?" B. "Would you like me to get someone from your church to visit you?" C. "You didn't get cancer as punishment." D. "You sound upset. Would like you to talk about it?"

D. "You sound upset. Would like you to talk about it?" The culturally sensitive nurse should provide the client with the opportunity to talk and express feelings in a nonjudgmental environment. Asking why God is punishing him or her or telling the client that cancer is not a punishment dismisses the client's feelings. Asking the client to get someone from church does not address the client's feelings.

The nurse is taking a client history. With which client is direct eye contact appropriate? A. 55-year-old Native American/First Nations woman B. 44-year-old woman of Asian descent C. 60-year-old woman of Arab descent D. 32-year-old white woman

D. 32-year-old white woman White Westerners generally make and maintain eye contact throughout communication. Although it may be natural for whites to look directly at a person while speaking, that is not always true of people from other cultures. It may offend clients of Asian descent or Native Americans/First Nations clients, who are likely to believe that lingering eye contact is an invasion of privacy or a sign of disrespect. Clients with Arab heritage may misinterpret direct eye contact as sexually suggestive.

A client is admitted with end-stage pancreatic cancer and is experiencing extreme pain. The client asks the nurse whether an acupuncturist can come to the hospital to help manage the pain. The nurse states, "You won't need acupuncture. We have pain medications." Which characteristic has the nurse displayed? A. Cultural conflict B. Culture shock C. Stereotyping D. Cultural imposition

D. Cultural imposition The nurse has demonstrated cultural imposition by assuming that traditional pain relief measures are superior and the client should conform to the nurse's belief regarding pain control. This is not an example of cultural conflict because the nurse did not ridicule the request; it was simply dismissed. The nurse is not stereotyping, as no generalization is made about a group of people. The nurse is not demonstrating culture shock because the view of pain medications that the nurse expresses is consistent with the majority, Western culture.

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? A. Fruit salad, apple juice, and pudding B. Chicken salad, water, and a frozen fruit juice bar C. Turkey sandwich, milk, and gelatin D. Soup, hot tea, and toast

D. Soup, hot tea, and toast The client believes in the hot/cold theory of disease, so the client needs to treat cold diseases with hot food and hot diseases with cold food. The most appropriate choice would be the soup, hot tea, and toast. The other options are all cold foods, which the client would not use to treat a cold disease such as an upper respiratory infection.

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? A. Use a computerized application to confirm what the interpreter is saying. B. Document in the medical record that the client is not making his own decisions. C. Continue with the method of communication because the nurse does not speak the language. D. Speak privately with the interpreter and instruct them to only provide language interpretation.

D. Speak privately with the interpreter and instruct them to only provide language interpretation. All clients have a right to proper communication with a healthcare provider. Obtaining a certified interpreter is the most appropriate way to ensure accurate communication between a client and the provider. However, the interpreter must have a clear understanding of their role as a language interpreter only and not provide medical information or advice. The nurse should speak privately with the interpreter if there is a suspicion that the interpreter is not respecting boundaries. Using a computerized application to identify key medical words does not allow full communication to take place, and thus, key health information can be missed.

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: A. ethnocentrism. B. cultural stereotyping. C. cultural competence. D. cultural ritual.

D. cultural ritual. Clients and families often express rituals, or practices habitually repeated in certain contexts, during times of stress, such as during an acute hospitalization. Keeping the body covered and warm is a home remedy used by many cultures to help heal the body. As in this example, cultural rituals may conflict with Western medical beliefs. Cultural competence is an approach to health care in which one is aware of one's one cultural beliefs and biases and understands the effects that a client's culture has on the client's health care. Stereotyping involves applying a preconceived and untested generalization to a whole group of people. Ethnocentrism is the belief that one's culture is superior to another.

When a home-bound client expresses the client's past-oriented ancestral heritage and family rituals, the nurse recognizes that the client is expressing: A. race. B. subculture. C. assimilation. D. ethnic identity.

D. ethnic identity. Ethnicity or ethnic identity refers to a self-conscious, past-oriented form of identity based on a notion of shared cultural (and perhaps ancestral) heritage and current position in larger society. Race is based on biologic characteristics; assimilation refers to new customs and attitudes that are acquired through contact and communication among persons of a particular culture; subculture refers to a group of people within a culture who have ideas and beliefs that are different from the rest of that society.