Chapter 5: Cultural and Spiritual Assessment Quiz

A nursing instructor realizes that a student needs further instruction on giving culturally competent care when the student states which of the following? "I need to respect and be sensitive to the values, beliefs, and practices of different cultures." "I should use my own culture as the standard for all other cultures." "I need to collect cultural data when I take health history." "I need to seek out educational opportunities to learn about different cultures."

"I should use my own culture as the standard for all other cultures." Explanation: The student is correct when stating a need to respect the values and beliefs of different cultures as well as to seek out learning opportunities about many different cultures. Collecting cultural data during the health history is also correct. Using one's own culture as the gold standard for all other cultures is not part of giving culturally competent care.

A nurse is completing a comprehensive assessment of a client who has been referred to the clinic. Which of the following would be most appropriate for the nurse to ask when beginning to assess the client's spirituality? "Would you like to speak to a chaplain?" "What religion are you?" "What gives you hope or peace?" "Do you believe in God?"

"What gives you hope or peace?" Explanation: When beginning a spiritual assessment, the nurse needs to initiate the interaction by opening up a general dialogue about global concepts such as hope, peace, comfort, strength, love, and connection. The most useful techniques typically have general introductory questions, which then lead to more focused questions such as beliefs, formalized religion, and eventually questions about the client's desires related to accessing resources such as a chaplain or spiritual leader.

The "evil eye" is an example of what? A cultural-bound syndrome A spiritually defined illness An ethnic belief A psychosocial condition

A cultural-bound syndrome Explanation: There are cultural-bound syndromes, which are "illnesses" defined by a particular culture but that have no corresponding illness in Western medicine. For example, symptoms may be attributed to actions by another individual. This may be called "evil eye" or "mal ojo" in Spanish.

Based on a colleague's feedback, a nurse learns that she is aware of cultural differences in a general way but does not know what the specific differences are or how to communicate with a person of a specific culture. This nurse exhibits which of the following? Conscious competence Unconscious competence Unconscious incompetence Conscious incompetence

Conscious incompetence

A nurse is assigned to care for a client who practices a religion different from her own. After reading the client's medical record, the nurse takes time to talk with the client about how to make his hospital stay more comfortable. The nurse admits to the client that she is not familiar with his religion but would like to learn more. The nurse is in which stage of cultural awareness? Unconscious competence Unconscious incompetence Conscious competence Conscious incompetence

Conscious incompetence Explanation: The nurse is aware of the lack of knowledge about the client's religion. Unconscious incompetence is not being aware that one lacks cultural knowledge. Conscious competence involves learning about the differences and providing culturally relevant interventions. Unconscious competence is the ability to automatically provide culturally competent care.

During a spiritual assessment the nurse realizes that personal beliefs differ significantly from those of the client. What should the nurse do? Discuss the differences with the client Continue with the assessment Ask another nurse to complete the assessment End the assessment

Continue with the assessment Explanation: The nurse must always approach a client's spirituality with sensitivity and acceptance even if not in agreement with the client's expressed beliefs. To argue or discuss the differences in beliefs would add further stress to the client. The nurse should not end the assessment or ask another nurse to complete the assessment.

A nurse is participating in an educational exercise in which she is conducting a self-examination of her own biases. This activity addresses what construct of cultural competence? Cultural awareness Cultural knowledge Cultural skill Cultural desire

Cultural awareness

A new graduate nurse from a small community college is going to work in an urban setting. She embraces the thought of working in a more diverse setting and wants to learn about different cultures. What behavior is this nurse exhibiting? Cultural skill Cultural knowledge Cultural desire Conscious incompetence

Cultural desire

When performing a spiritual assessment, what may help the nurse to identify related nursing diagnoses, needed interventions, and improve client care? Establishing a close nurse-client relationship. Gathering information about the client's mental status from the client's family. Gaining relevant information about the client's spirituality. Gathering current objective data.

Gaining relevant information about the client's spirituality.

A nurse assesses the spirituality of a client who is terminally ill with pancreatic cancer. Which of the following is the best rationale for this action, from the nurse's perspective? Searching for meaning and purpose Defining the meaning of the afterlife Identifying possible coping mechanisms Finding common practices shared with a group

Identifying possible coping mechanisms Explanation: Religion and spirituality have been related to a client's well-being in the face or illness and disease. They can be powerful coping mechanisms when a client is facing end-of-life issues. The definition of spirituality is a search for meaning and purpose in life. Common practice shared by a group of persons defines a religion. Religion also helps to define the meaning of the afterlife.

A nurse is relying heavily on gestures and simplified language during the assessment of a client from another culture who speaks minimal English. During the lengthy assessment, the nurse asks the client if she is "okay" by making a circle with his thumb and forefinger. The nurse should be aware of which of the following? This gesture has meaning only in American cultures. In some cultures, this gesture denotes confusion. In some cultures, this gesture denotes pain. In some cultures, this gesture is offensive.

In some cultures, this gesture is offensive. Explanation: The way Americans sign "OK" by making a circle with the thumb and forefinger is a definite and serious insult in many cultures around the world.

An instructor is describing culture and minority. Which statement would be most accurate for the instructor to include related to minority? The members fail to act in appropriate ways. It refers to a group with less power or prestige in society. It means that a group has smaller population numbers. The group does not hold the accepted primary values.

It means that a group has smaller population numbers. Explanation: Minority commonly refers to a group that has less power or prestige within the society. However, the most accurate description is that minority actually means a group with smaller population numbers. The term has a negative meaning in most uses, indicating a group that does not hold the "majority" values or does not behave in "appropriate" ways.

What is an important part of being present with a client? Understanding Cultural knowledge Listening Spiritual awareness

Listening Explanation: Listening is an important part of being present with a client.

A nurse begins an interview with a client who is a Native American. The nurse should recognize that this client will display what type of behavior when responding to questions or engaging in conversation with the nurse? Stand to the side Interrupt frequently Look away Look down

Look down

A nurse is performing a spiritual assessment on a client that is diagnosed with aggressive form of lymphoma. What is the best intervention by the nurse to address the client's spiritual end of life issues if she is unable to? Tell the charge nurse that you do not want to be assigned to this client. Tell the client that you are not able to address these issues since you are both different religions. Make a referral to the appropriate professional. Do not interact with the client in a spiritual nature.

Make a referral to the appropriate professional. Explanation: Many hospitals have staff pastoral chaplains, and community resources of different faiths and are usually available through social work professionals. While nurses can assess and support many clients' spiritual needs, some situations are beyond the scope of nursing practice and require someone with more experience and knowledge about a particular faith.

Sickle cell disease and other hemoglobinopathies such as thalassemia are often found in persons originating from which geographical regions? Northern and Central Europe. Australia and New Zealand. Mediterranean and Africa. Central and South America.

Mediterranean and Africa. Explanation: Drug metabolism differences, lactose intolerance, and malaria-related conditions—such as sickle cell disease, thalassemia, glucose-6-phosphate dehydrogenase (G6PD) deficiency, and Duffy blood group—are considered biochemical variations. The malaria-related conditions would obviously occur in populations living in or originating from mosquito-infested locales such as the Mediterranean and Africa.

Which of the following best reflects nursing's view of clients as holistic beings? Mind, body, spirit Spiritual, egocentric, naive Id, ego, superego Physical, psychosocial, religious

Mind, body, spirit Explanation: Nursing has a long history of incorporating spirituality into client care. References to spirituality underlie a primary idea in nursing, that clients are viewed as holistic beings in body, mind, and spirit. Id, ego, and superego are concepts associated with psychoanalytic theory. A holistic view is more than physical, psychosocial, and religious or spiritual, egocentric, and naà¯ve.

The nurse is assessing a client and notices that when being asked questions, the client does not make eye contact. The nurse should include what in the plan of care? Fear of authority Uncomfortable answering questions. Minimal eye contact due to culture History of abuse

Minimal eye contact due to culture Explanation: Some cultures make minimal eye contact out of respect. There is no indication the client is fearful of authority, uncomfortable answering questions or has been abused.

After completing an admission assessment the client asks if the room door can be closed so that the client can have silence when reading the Bible. What does this indicate to the nurse about the client's spirituality? The client reads the Bible instead of praying The client has limited reading material Reading the Bible provides comfort to the client Noise interrupts the client's ability to concentrate when reading

Reading the Bible provides comfort to the client Explanation: The client is using the time in the hospital to read scripture to gain focus and relieve stress. There is no evidence that the client has limited reading material or reads the Bible instead of praying. There is also no indication that the client needs absolute silence when reading.

When assessing the client, the nurse finds that verbal responses are minimal, with little eye contact and he states he does not "get out much." Which nursing diagnosis would be most appropriate? Social interaction, impaired Social isolation Depression Spiritual distress

Social interaction, impaired Explanation: With impaired social interaction, there is little engagement with other, poor eye contact and minimal communication. Social isolation occurs when the client experiences loneliness; can be hostile and uncommunicative. The client expresses concern with meaning of life and death with spiritual distress. Depression is a medical diagnosis.

The nurse is assessing a client's ability to employ coping mechanisms when given a diagnosis of cancer. What type of assessment would be beneficial for the nurse to use? Physical assessment Spiritual assessment Cultural assessment Mini-Mental status assessment

Spiritual assessment

Matters of the human soul are referred to as what? Values and beliefs Spirituality Culture Ethnicity

Spirituality Explanation: Spirituality, in the most fundamental sense, pertains to matters of the human soul, be it a state of mind, a state of being in the world, a journey of self-discovery, or a place outside the five senses. Culture can be defined as a shared, learned, and symbolic system of values, beliefs, and attitudes that shapes and influences the way people see and behave in the world. Ethnicity is one's self-defined race. Values and beliefs are those things that a person or culture sees as having worth.

A nurse should conduct an assessment of a client's Risk for Complications after gathering data related to the client's spirituality. When planning the client's care, the nurse should be aware that complications are primarily due to the effect of spirituality on what phenomenon? Pain Worry Emotional lability Stress

Stress Explanation: The RC related to spirituality is due to the psychologic or physiologic responses of the body under stress. Stress induced by states such as spiritual distress will create a cascade of events within the body that produce physiological responses and are influenced by the size and duration of the stressor, as well as by the client's ability to respond to that stressor. Pain, worry, and volatile emotions are possible, but the deleterious effects of spiritual distress are known to result from stress.

The nurse reviews data collected while completing a spiritual assessment with a client. Which data should the nurse focus as the primary source of information for this assessment? Subjective Secondary sources Objective Medical record

Subjective

A nurse's colleague states, "I think Mrs. Nguyen in room 412 is a Buddhist, so she'll definitely be a vegetarian." The nurse should understand what principle of religion and spirituality when planning clients' care? The beliefs of members of a particular religion are not necessarily homogeneous. Nurses should avoid planning care on the basis of religion. Decisions around a religious client's care should be deferred to the clergy of that religion. Clients who claim to be spiritual generally oppose meat consumption.

The beliefs of members of a particular religion are not necessarily homogeneous. Explanation: When conducting any type of review of the denominations or faiths in a particular community, be aware that a client's spiritual dimension is subjective and may vary greatly among persons, even persons of the same denomination or faith. Clergy should not be granted ultimate authority over a person's care, unless that is the client's explicit desire. Spirituality and vegetarianism are not synonymous.

A nurse understands the importance of an accurate spiritual assessment when caring for clients. The experienced nurse would consider which of the following findings as abnormal? The client mentions the belief that prayer reduces stress. The client reports regular attendance at a local mosque, church, or another meeting place. The client describes feeling disconnected from God, nature, family, or peers. The client discusses participating in religious groups and spiritual practices that provide comfort.

The client describes feeling disconnected from God, nature, family, or peers.

The nurse is setting an outcome with the client experiencing spiritual distress. Which goal would be appropriate? The client will express meaning and purpose in life. The client will initiate interaction with others. The client will express feelings of connectedness with others. The client will attend a community event every week.

The client will express meaning and purpose in life.

An elderly client is touring the United States and has a heart attack. When admitting this client to the coronary care unit, what would be important to note in the family history? The decision makers for the family Reliability of information source Chronic childhood illnesses Quality of family relationships

The decision makers for the family

The nurse is caring for a first-time mother and newborn in the postpartum unit. The nurse overhears the new mother ask family members to prepare the nursery and purchase clothing for the baby. What would the culturally sensitive nurse suspect? The new mother is young, and the pregnancy was unexpected and the baby is unwanted. The new mother may believe buying infant clothing before the delivery is bad luck. The mother is from a lower socioeconomic level and is not able to buy what is needed for the baby. The new mother and requires education about how to prepare for the new baby.

The new mother may believe buying infant clothing before the delivery is bad luck.

What must occur before a client will be willing to teach the nurse about her culture? The nurse needs to establish a value-based partnership The nurse needs to establish rapport and trust The client's family must allow it The nurse needs to hide her biases

The nurse needs to establish rapport and trust Explanation: If the nurse has established rapport and trust, clients will be willing to teach about their cultures.

The nurse prepares to complete a spiritual assessment with a client. What should the nurse keep in mind when completing this assessment? It gives the nurse an opportunity to speak freely about personal spiritual beliefs and practices The reason is to better understand the client's spiritual perspective related to health It offers the nurse a chance to subjectively discuss the client's spiritual beliefs The reason is for the nurse to share personal views in relation to what the client believes

The reason is to better understand the client's spiritual perspective related to health Explanation: The reason for a spiritual assessment is to better understand the client and the client's spiritual perspective related to health. The nurse must be objective during the assessment. It does not matter what the nurse's views are concerning the client's spiritual beliefs. The nurse does not need to share personal spiritual views with the client.

Spirituality can best be described as necessary for healing. another way of expressing a connection to a church. a part of community identification. a source of inner strength.

a source of inner strength. Explanation: Spirituality, in the most fundamental sense, pertains to matters of the human soul, be it a state of mind, a state of being in the world, a journey of self-discovery, or a place outside the five senses. Having faith in God and participating in organized religious life are important to people of diverse cultures and ethnicities and are often seen as a source of inner strength and spirituality.

A nursing instructor is teaching the importance of religion and spirituality to clients. The instructor identifies which of the following as the first step in promoting the spiritual aspect of holistic care? take a training class to increase knowledge reflect on one's own spiritual dimension consult a supervisor read the Bible

reflect on one's own spiritual dimension Explanation: Nurses aware of their own spirituality are more comfortable discussing potential spiritual needs with clients. Introspective reflections on one's own beliefs and biases about the relationship between spirituality and health can be undertaken through writing in journals, meditation, or discussions with interested people.

Shared practices and rituals used to express one's faith can be called spirituality. religion. denomination. philosophy.

religion. Explanation: Religion is defined as the rituals, practices, and experiences shared within a group that involve a search for the sacred.

The most effective way for a nurse to learn about an ethnic group within the community in which he/she practices is study transcultural nursing texts and articles about the group. do a community survey of the areas where the ethnic group lives. spend time with a variety of individuals of that ethnic group. interview the traditional healers within the group.

spend time with a variety of individuals of that ethnic group. Explanation: Repeated face-to-face encounters help to refine or modify the nurse's knowledge of the culture. The nurse must seek out many such encounters with the desire to understand more about the culture.

When performing a cultural assessment, an important point to remember would be that the cultural/ethnic background is evident in the client's appearance that definitions of family differ to use first names of those you are speaking to that alternative therapies are reasons for seeking care

that definitions of family differ