Chapter 05: Cultural Diversity

During a family assessment, a teenage girl alludes to the fact that her grandfather used to touch her in a sexual manner. What is the nurse's primary responsibility when learning this information?

Promptly report the allegations to authorities.

During report for a 42-year-old Hispanic client who is 10 hours postoperative from an appendectomy, the day shift nurse states, "The client states the pain is 10 on a 0 (no pain) to 10 (severe pain) scale, but you know how those people exaggerate their pain." What would best describe the nurses's action?

stereotyping

The nursing instructor is discussing holistic health care with her nursing students. The instructor talks about the different factors the nurse must consider when creating a holistic plan of care. What are these factors? (Mark all that apply.)

•The patient's developmental life stage •The patient's emotional context •The patient's physiologic health condition

The nurse is caring for a client of Asian descent and is post-operative 24 hours from an appendectomy. The client is hesitant to get out of bed. How should the nurse respond?

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

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

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

A nurse is caring for a female patient of Hawaiian descent. Which interview question would be appropriate based on the cultural beliefs of Hawaiians?

"Do you use any medicinal plants or minerals?"

Which are examples of cultural competence? Select all that apply.

•Attending a cultural diversity lecture series in the community •Making arrangement for an acupuncturist to come to the hospital and provide pain relief for the client •Having a one-on-one conversation with a Muslim client regarding prayer needs and practices •Performing a self-assessment of one's own personal biases

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

"Ethnicity and race are the same thing and are affected by cultural practice.

A nurse has responded to a patient's request for hot water rather than ice water at the bedside. The nurse's colleague states, "They have all kinds of bizarre ideas about healing, like thinking that cold water will make you sick." How should the nurse best respond to this colleague's statement?

"It's different from what you or I might choose, but it's not right to characterize it as bizarre."

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

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

An Appalachian male 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 the client wants to leave. What is the most appropriate cultural response by the charge nurse?

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

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 Muslim-Arab woman refuses to make eye contact with her male nurse. Assumption: She is being modest.

A nurse considers the culture of an Appalachian woman when counseling her about contraceptives. Which beliefs are consistent with this culture? Select all that apply.

•Belief is in a divine existence rather than attending a particular church. •Isolation is an accepted way of life. •Feelings about losses or death may be fatalistic. •Independence and self-determination are valued.

The wife of a client asks the nurse if she could bring in a cream from home to apply to her husband's skin. She says, "Whenever anyone gets sick we always use this cream." The nurse interprets this as:

ritual

While performing the initial assessment of an infant, the nurse notes a soiled string of yarn around the infant's neck. What action should the nurse take?

Ask the parent the purpose of the string and if it can be placed elsewhere on the infant's body.

A client from Malaysia is admitted to the health care facility with reports of cramping pain in the abdomen and loose stools. Where should the nurse be seated when interviewing the client?

At more than one arm's distance

Which is an example of cultural competence in nursing?

Attending a conference for cultural diversity

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

Evil forces caused a client to develop schizophrenia.

A young couple who have been married less than a year are having difficulty with adjusting to parenting. What is a contributing factor to this level of maladjustment?

Limited time in learning to be a marital partner

During the patient assessment, the client shares that the family attends church nearly every Sunday. Which function of the family does this represent?

Socialization

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

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

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

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

A client who speaks only Japanese has been admitted to the health care facility reporting chest pain. Since the assigned nurse does not know the client's language, what would be the most appropriate solution in this case?

The nurse should request the help of a professional interpreter.

An elderly woman has been admitted to the hospital for the treatment of an acute illness and has received only one visitor in the several days since admission. The student nurse asks the patient about her relationship to this individual and the patient states, "In reality, she's my best friend but I consider her to be my family, even though I have a daughter somewhere." What foundational belief of family nursing should most influence the student's interactions with the patient?

The patient can define who is and who is not part of her family.

The nurse on the elective surgery floor receives a report that describes the client's abdominal wound dressing as having a moderate amount of yellowish and bloody drainage on it and a very foul smell. In planning for a dressing change, it is most important for the nurse to perform which action?

Wash her hands before and after the dressing change.

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?

ageism

Nurses are responsible for delivering culturally competent care for all clients. Culturally competent care does not account for:

client's height.

When a client states, "I only want a white doctor," the client is expressing cultural:

ethnocentrism.

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:

media.

The parents of a blended family have a baby boy age six months who is due for immunizations. The clinic closest to their home has recently closed, and they feel intimidated by the prospect of going to the large, university hospital near their home. Which of the following factors is the primary influence on this aspect of the family's health?

Community health care structure

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

Cultural blindness

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

Cultural conflict

A nurse is developing a care plan for a Hispanic client who has diabetes. What cultural intervention is most appropriate?

Dietary counseling, as Hispanic diets are often high in carbohydrates

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

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

A family that consists of two homosexual parents and three children living in the same house is an example of which type of family?

Nuclear

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

"What are your dietary needs and preferences?"

A nursing student is critically examining her own social position. In this process, the student should prioritize what reflective question?

"What factors have contributed to my own social position?"

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

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

A nurse is assessing a family and is establishing baselines for planning subsequent interventions. What question best facilitates this aspect of care?

"When we talk about 'health', what exactly does that mean to you?"