Chapter 5: Cultural Diversity

The nurse is caring for a client who is admitted for hypertension (HTN). The nurse notes that the client has not been eating the food provided, and family members have brought in homemade food. What would be the best response by the nurse? "You should consider eating the food provided, which is healthier." "Do you understand the specific diet for your HTN?" "It is ok to eat what your family brought you, as long as we see what it is." "Can you tell me what foods you prefer to eat and what your family is bringing you?"

"Can you tell me what foods you prefer to eat and what your family is bringing you?" Explanation: The nurse should attempt to provide culturally sensitive food; however, the nurse should assess what foods the client wants to eat. The nurse should educate the client on food preferences that are also appropriate to the disease-specific dietary restrictions. Even though the diet may be healthier, the nurse should first assess the client's preferences. The nurse should verify the client's understanding of the diet but should avoid closed-ended questions such as asking if the client understands the specific diet for HTN. Chapter 5: Cultural Diversity - Page 93

The clinic nurse is obtaining demographic data from a client. The client states, "Why do you need to know what my ethnicity is?" How should the nurse respond? "Collecting this information allows us to develop a personalized plan of care to meet your needs." "We require the information for identification purposes." "Understanding your background will prevent us from doing anything to offend you." "Insurance companies requires us to ask all clients."

"Collecting this information allows us to develop a personalized plan of care to meet your needs." Explanation: Identifying and understanding the client's ethnicity will assist the nurse and healthcare team to develop and provide individualized culturally competent care. Ethnicity is not used for client identification. Insurance companies may request this data; however, it is not the priority reason for the nurse to collect the data. Chapter 5: Cultural Diversity - Page 91

Which nursing intervention reflects culturally appropriate care when addressing a client? "Good morning, Mr. Smith. I am your nurse, John." "You can sit in this chair, Sally." "Thank you for coming to the clinic today." "I see you are here because you have a sinus infection."

"Good morning, Mr. Smith. I am your nurse, John." Explanation: The nurse can demonstrate professionalism and culturally appropriate care by addressing clients by their last names and introducing oneself. The nurse should follow up thoroughly with requests, respect the client's privacy, and ask open-ended rather than direct questions until trust has been established. Chapter 5: Cultural Diversity - Page 92

The staff nurse overhears the charge nurse, who is of Italian heritage, talking to the unlicensed assistive personnel. Which statement made by the charge nurse is an example of ethnocentrism? "People who are Irish are usually alcoholics." "Asian people are bad drivers." "Italians are best at everything." "Hispanics are usually lazy."

"Italians are best at everything." Explanation: Ethnocentrism is the belief that one's cultural is better than other cultures. Therefore, the statement "Italians are the best at everything" demonstrates ethnocentrism. The other options are examples of stereotyping. Stereotyping is a fixed attitude about people who share common characteristics. Chapter 5: Cultural Diversity - Page 90-96

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

"The more curious the nurse is about the client's culture, the more the client will want to share." Explanation: 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 Chapter 5: Cultural Diversity - Page 81

A new client comes to the primary care clinic and asks for help treating head lice. The interview reveals that the client lives with nine other people in a one-bedroom apartment. Which statement by the client is nurse's priority concern? "We do not have running water." "I often worry about my future." "I am receiving government assistance." "We do not have air-conditioning."

"We do not have running water." Explanation: The priority in this 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 concern for one's future needs to be addressed, but the need for water is the first priority. That the client receives government assistance might serve as an indicator of the client's economic challenges but is not a priority nursing concern. The lack of air conditioning would be a concern in a heat wave, but not as much a priority as the lack of running water. Chapter 5: Cultural Diversity - Page 87

The unlicensed assistive personnel 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?" "You can only eat the food that we serve you." "Do you understand that you are on a strict diet and any variation can cause you harm?" "I will need to get permission from your health care provider for you to eat the food your family brought in."

"What type of food did your family prepare for you, and does it have special meaning?" Explanation: The culturally competent nurse should assess the type of food the client is eating and if the food has special meaning. Some cultures use food for healing and balance during times of illness. The client may have a restricted diet, but educating the client and family can allow the client to meet the cultural needs while still getting nutrition and meeting the dietary restrictions. The nurse does not need to ask permission from the health care provider regarding the food brought in from the family. Telling the client that he or she must only eat the food offered in the health care setting is not true or empathetic. Chapter 5: Cultural Diversity - Page 93

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

"What type of food do you eat at home?" Explanation: 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. Chapter 5: Cultural Diversity - Page 87

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

"What type of food do you like to eat at home?" Explanation: 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. Chapter 5: Cultural Diversity - Page 315

A nurse is interviewing a newly admitted patient. Which question is considered culturally sensitive? "Do you think you will be able to eat the food we have here?" "Do you understand that we can't prepare special meals?" "What types of food do you eat for meals?" "Why can't you just eat our food while you are here?"

"What types of food do you eat for meals?" Asking patients what types of foods they eat for meals is culturally sensitive. The other questions are culturally insensitive.

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? "Saffron does not have any effect on blood sugar level." "What would you think about taking the medicines, too, and benefitting from both?" "Yes, I agree that you should continue taking saffron for diabetes." "Let me inform the health care provider that you are not taking your medicines."

"What would you think about taking the medicines, too, and benefitting from both?" Explanation: 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. Chapter 5: Cultural Diversity - Page 93

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? "You sound upset. Would like you to talk about it?" "Why do you think God is punishing you?" "Would you like me to get someone from your church to visit you?" "You didn't get cancer as punishment."

"You sound upset. Would like you to talk about it?" Explanation: 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. Chapter 5: Cultural Diversity - Page 93

A nurse caring for culturally diverse patients in a health care provider's office is aware that patients of certain cultures are more prone to specific disease states than the general population. Which patients would the nurse screen for diabetes mellitus based on the patient's race? Select all that apply. A Native American patient An African-American patient An Alaska Native An Asian patient A White patient A Hispanic patient

A Native American patient An Alaska Native A White patient A Hispanic patient Native Americans, Alaska Natives, Hispanics, and Whites are more prone to developing diabetes mellitus. African Americans are prone to hypertension, stroke, sickle cell anemia, lactose intolerance, and keloids. Asians are prone to hypertension, liver cancer, thalassemia, and lactose intolerance.

In order to provide culturally competent care, nurses must be alert to factors inhibiting sensitivity to diversity in the health care system. Which nursing actions are examples of cultural imposition? Select all that apply. A hospital nurse tells a nurse's aide that patients should not be given a choice whether or not to shower or bathe daily. A nurse treats all patients the same whether or not they come from a different culture. A nurse tells another nurse that Jewish diet restrictions are just a way for them to get a special tray of their favorite foods. A Catholic nurse insists that a patient diagnosed with terminal bladder cancer see the chaplain in residence. A nurse directs interview questions to an older adult's daughter even though the patient is capable of answering them. A nurse refuses to care for a married gay man who is HIV positive because she is against same-sex marriage.

A hospital nurse tells a nurse's aide that patients should not be given a choice whether or not to shower or bathe daily. A Catholic nurse insists that a patient diagnosed with terminal bladder cancer see the chaplain in residence. . Cultural imposition occurs when a hospital nurse tells a nurse's aide that patients should not be given a choice whether or not to shower or bathe daily, and when a Catholic nurse insists that a patient diagnosed with terminal bladder cancer see the chaplain in residence. Cultural blindness occurs when a nurse treats all patients the same whether or not they come from a different culture. Culture conflict occurs when a nurse ridicules a patient by telling another nurse that Jewish diet restrictions are just a way for Jewish patients to get a special tray of their favorite foods. When a nurse refuses to respect an older adult's ability to speak for himself or herself, or if the nurse refuses to treat a patient based on that patient's sexual orientation, the nurse is engaging in stereotyping.

A nurse is assigned to care for a client who does not speak the dominant language. An interpreter has been contacted and will be at the bedside shortly. Which action by the nurse would be most effective in reassuring the client until the interpreter arrives? Using gestures and symbols to communicate with the client Enlisting other healthcare providers to assist with communication Using reassuring body language and making eye contact to assess needs Avoiding going into the client's room until the interpreter arrives

A nurse is assigned to care for a client who does not speak the dominant language. An interpreter has been contacted and will be at the bedside shortly. Which action by the nurse would be most effective in reassuring the client until the interpreter arrives? Using gestures and symbols to communicate with the client Enlisting other healthcare providers to assist with communication Using reassuring body language and making eye contact to assess needs Avoiding going into the client's room until the interpreter arrives The nurse assigned to care for a client who does not speak the dominant language can reassure the client by using appropriate body language and anticipating needs until an interpreter arrives. Doing so is important because there may be a delay in the interpreter arriving. Gestures and symbols can be confusing, as can enlisting multiple people to communicate. Avoiding the client's room is not appropriate or in the best interest of the client. Chapter 5: Cultural Diversity - Page 86

2. A nurse caring for patients in a culturally diverse neighborhood knows that culture affects the nurses interactions with patients. Which of the following is a characteristic of culture? Select all that apply. A) Culture guides what is acceptable behavior for people in a specific group. B) Modeling behavior is the primary means of transmitting culture. C) Culture is generally not affected by the groups social and physical environment. D) Cultural practices and beliefs mainly remain constant as long as they satisfy a groups needs. E) Culture influences the way people of a group view themselves, have expectations, and behave. F) Because of individual influences, there are differences both within and among cultures.

A) Culture guides what is acceptable behavior for people in a specific group. D) Cultural practices and beliefs mainly remain constant as long as they satisfy a groups needs. E) Culture influences the way people of a group view themselves, have expectations, and behave. F) Because of individual influences, there are differences both within and among cultures.

21. A nurse is caring for an Appalachian patient following her hysterectomy. Which of the following Appalachian values and beliefs should be considered when planning nursing care for this patient? Select all that apply. A) Isolation is considered as a way of life. B) Dependence and self-determination are valued. C) Lifestyle is more revered than compliance with healthcare issues. D) They may be fatalistic about losses and deaths. E) There is a deep love, respect, and affection between people and the land. F) Death is seen as a part of life and not feared.

A) Isolation is considered as a way of life. B) Dependence and self-determination are valued. D) They may be fatalistic about losses and deaths.

3. Which of the following statements is true of cultural assimilation? A) Mutual cultural assimilation occurs when characteristics from two groups are traded. B) Cultural assimilation is the integration of a majority group with a minority group. C) Moving to a different culture may result in psychological discomfort. D) Cultural assimilation is identifying with a collective cultural group, primarily based on common heritage.

A) Mutual cultural assimilation occurs when characteristics from two groups are traded.

19. A nurse is caring for an African American in an acute care setting. Which one of the following might be a special nursing consideration for this patient? A) The patient might request a visit from a folk healer. B) The patient may be upset by drawing blood for a test. C) The patient may perceive illness as a punishment from God. D) The patient may expect the caregiver to deduce the problem by instinct.

A) The patient might request a visit from a folk healer.

14. Although all of the following are factors to consider when caring for patients with limited income, which one is the most important? A) basic human needs may go unmet B) limited access to reliable transportation C) decreased access to healthcare services D) risk for increased incidence of disease

A) basic human needs may go unmet

7. A nurse walks by a patients room and observes a Shaman performing a healing ritual for the patient. The nurse then remarks to a coworker that the ritual is a waste of time and disruptive to the other patients on the floor. This nurse is displaying the feelings associated with: A) culture conflict B) cultural blindness C) stereotyping D) cultural shock

A) culture conflict

9. A nurse is doing preoperative teaching for an African American man before he has abdominal surgery. What topic should be included in the teaching? A) the possibility of developing a keloid over the healed incision B) the increased risk of developing an infection in the incision C) his racial characteristics that will slow healing D) cultural influences on his response to surgery

A) the possibility of developing a keloid over the healed incision

A young Hispanic mother comes to the local clinic because her baby is sick. She speaks only Spanish and the nurse speaks only English. What is the appropriate nursing intervention? Use short words and talk more loudly. Ask an interpreter for help. Explain why care can't be provided. Provide instructions in writing.

Ask an interpreter for help. The nurse should ask an interpreter for help. Many facilities have a qualified interpreter who understands the health care system and can reliably provide assistance. Using short words, talking loudly, and providing instructions in writing will not help the nurse communicate with this patient. Explaining why care can't be provided is not an acceptable choice because the nurse is required to provide care; also, since the patient doesn't speak English, she won't understand what the nurse is saying.

8. Which of the following statements accurately describe cultural factors that may influence healthcare? Select all that apply. A) Nurses and patients generally agree upon the health practices that are being instituted. B) Certain racial and ethnic groups are more prone to developing specific diseases and conditions. C) Although pain affects people differently, most people react to pain in the same manner. D) Most mental health norms are based on research and observations made of white, middle-class people. E) In many cultures, the man is the dominant figure and generally makes decisions for all family members. F) When people move to the United States, they may speak their own language fluently but have difficulty speaking English.

B) Certain racial and ethnic groups are more prone to developing specific diseases and conditions. D) Most mental health norms are based on research and observations made of white, middle-class people. E) In many cultures, the man is the dominant figure and generally makes decisions for all family members. F) When people move to the United States, they may speak their own language fluently but have difficulty speaking English.

22. What is one way in which nurses can develop cultural self-awareness? A) Ask peers and colleagues about practicing cultural competence. B) Objectively examine own beliefs, values, and practices. C) Realize nothing can be done to change ones values and beliefs. D) Assert to others that personal biases cannot be changed.

B) Objectively examine own beliefs, values, and practices.

16. A nurse in a large metropolitan city enjoys working in a health clinic that primarily serves Hispanic patients. What does this statement imply about the nurse? A) The nurses knowledge and skills are not adequate to care for patients with acute illnesses. B) The nurse respects and values providing culturally competent care. C) The nurse is attempting to overcome cultural blindness. D) This employment makes the nurse feel superior to a minority group of people.

B) The nurse respects and values providing culturally competent care.

12. A 40-year-old nurse is taking a health history from a 20-year-old Hispanic man and notes that he looks down at the floor when he answers questions. What should the nurse understand about this behavior? A) The patient is embarrassed by the questions. B) This is culturally appropriate behavior. C) The patient dislikes the nurse. D) The patient does not understand what is being asked.

B) This is culturally appropriate behavior.

4. Mr. Perez is a Mexican immigrant who migrated to the United States and lives in a Spanish-speaking community with other relatives. He is taken to the ER following a fall at work and is admitted to the hospital for observation. Which of the following is the nurse caring for Mr. Perez aware that he is at risk for? A) cultural assimilation B) cultural shock C) cultural imposition D) cultural blindness

B) cultural shock

18. Which of the following are considered cultural norms of the healthcare system? Select all that apply. A) inability to define health and illness B) frequent use of jargon and documentation C) professional deference to pecking order D) use of a problem-solving methodology E) belief in the fallibility of technology F) use of certain procedures for birth and death

B) frequent use of jargon and documentation C) professional deference to pecking order D) use of a problem-solving methodology F) use of certain procedures for birth and death

5. What characteristic is used to describe racial categories? A) language B) skin color C) music preferences D) food likes and dislikes

B) skin color

15. The nurse is providing home care for a patient who traditionally drinks herbal tea to treat an illness. How should the nurse respond to a request for the herbal tea? A) We do not allow our patients to drink herbal tea. B) Why in the world would you want to drink that stuff? C) Let me check with the doctor to make sure it is okay with your medicines. D) I have to fill out a lot of forms that you will have to sign before I can do that.

C) Let me check with the doctor to make sure it is okay with your medicines.

13. An older adult woman of Chinese ancestry refuses to eat at the nursing home, stating, Im just not hungry. What factors should the staff assess for this problem? A) The woman does not like to eat with other residents of the home. B) The woman is using this as a means of going home. C) The food served may not be culturally appropriate. D) The food served may violate religious beliefs.

C) The food served may not be culturally appropriate.

20. In which of the following populations should the nurse carefully assess the patients use of over-the counter medications? A) African American B) Hispanic C) White middle class D) Asian

C) White middle class

17. A nurse is providing care for a Cambodian patient. The nurse says, You have to get up and walk whether you want to or not. What is this statement an example of? A) culture shock B) stereotyping C) cultural imposition D) cultural competence

C) cultural imposition

How is culture learned by each new generation? A) ethnic heritage B) involvement in religious activities C) formal and informal experiences D) belonging to a subculture

C) formal and informal experiences

The nurse practitioner sees patients in a community clinic that is located in a predominately White neighborhood. After performing assessments on the majority of the patients visiting the clinic, the nurse notes that many of the minority groups living within the neighborhood have lost the cultural characteristics that made them different. What is the term for this process? Cultural assimilation Cultural imposition Culture shock Ethnocentrism

Cultural assimilation When minority groups live within a dominant group, many members lose the cultural characteristics that once made them different in a process called assimilation. Cultural imposition occurs when one person believes that everyone should conform to his or her own belief system. Culture shock occurs when a person is placed in a different culture perceived as strange, and ethnocentrism is the belief that the ideas, beliefs, and practices of one's own cultural group are best, superior, or most preferred to those of other groups.

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 Cultural assimilation Cultural blindness Cultural diversity

Cultural conflict Explanation: Cultural conflict occurs when people become aware of cultural differences (the younger nurses) and feel threatened (most likely by their younger age) and respond by ridiculing the beliefs or actions of others to make themselves feel more secure. Cultural assimilation occurs when one adapts to a new culture. Cultural blindness occurs when one ignores a cultural difference. Cultural diversity encompasses culture, race, ethnicity, religion, language, gender, socioeconomic status, and more. Chapter 5: Cultural Diversity - Page 83

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? Stereotyping Cultural conflict Cultural imposition Culture shock

Cultural imposition Explanation: 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. Chapter 5: Cultural Diversity - Page 83

A nurse is telling a new mother from Africa that she shouldn't carry her baby in a sling created from a large rectangular cloth. The African woman tells the nurse that everyone in Mozambique carries babies this way. The nurse believes that bassinets are safer for infants. This nurse is displaying what cultural bias? Cultural imposition Clustering Cultural competency Stereotyping

Cultural imposition The nurse is trying to impose her belief that bassinets are preferable to baby slings on the African mother—in spite of the fact that African women have safely carried babies in these slings for years.

The emergency department nurse is caring for a client injured in a motor vehicle collision. The client recently immigrated to the country. The nurse should implement interventions aimed at addressing which issue? Culture shock Ethnocentrism Generalization Ageism

Culture shock Explanation: Culture shock is bewilderment over behavior that is culturally atypical for the client. The client who recently immigrated from another country would experience culture shock over being in a new culture, including a new culture of health care in the new country of residence. Ethnocentrism is the belief that one's culture is better than other cultures. Generalization is the belief that a person shares cultural characteristics with others from a similar background. Ageism is a negative belief that older adults are physically and cognitively impaired. Chapter 5: Cultural Diversity - Page 96

10. A nurse is caring for a patient from Taiwan who constantly requests pain medication. What should the nurse consider when assessing the patients pain? A) Most people react to pain in the same way. B) Pain in adults in less intense than pain in children. C) The patient is a constant complainer. D) Pain is what the patient says it is.

D) Pain is what the patient says it is.

23. A home health nurse is visiting a 60-year-old patient. During the initial visit, the patients husband answers all of the questions. What would the nurse assess based on this behavior? A) The patient does not want the nurse to visit. B) The husband does not trust his wife to answer questions. C) The patient is not able to answer the questions. D) The husband is the dominant member of the family.

D) The husband is the dominant member of the family.

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

D) children

6. A 20-year-old housekeeper, born and educated in Iraq, wears her traditional clothing and head covering. A 50-year-old patient tells the nurse, They are in America and should dress like we do. What is this statement an example of? A) cultural assimilation B) cultural blindness C) cultural conflict D) cultural imposition

D) cultural imposition

A nurse is using the ESFT model to understand a patient's conception of a diagnosis of chronic obstructive pulmonary disease (COPD). Which interview question would be MOST appropriate to assess the E aspect of this model—Explanatory model of health and illness? How do you get your medications? How does having COPD affect your lifestyle? Are you concerned about the side effects of your medications? Can you describe how you will take your medications?

How does having COPD affect your lifestyle? The ESFT model guides providers in understanding a patient's explanatory model (a patient's conception of her or his illness), social and environmental factors, and fears and concerns, and also guides providers in contracting for therapeutic approaches. Asking the questions: "How does having COPD affect your lifestyle?" explores the explanatory model, "How do you get your medications?" refers to the social and environmental factor, "Are you concerned about the side effects of your medications?" addresses fears and concerns, and "Can you describe how you will take your medications?" involves therapeutic contracting.

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

Incorporating the client's need for daily prayer into the nursing care plan. Explanation: 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. Chapter 5: Cultural Diversity - Page 89

A nurse is researching information about the different cultures of the population served by the facility. Which aspects of culture would be important for the nurse to keep in mind when learning about them? Select all that apply. Characteristics apply more to an individual than a group. Language is a means for communicating culture. Culture is something a child is born with. Culture includes explicit beliefs and attitudes. Culture facilitates self-worth and self-esteem.

Language is a means for communicating culture. Culture facilitates self-worth and self-esteem. Cultural characteristics pertain more to groups than to individuals. It is communicated through language, behavior and symbols, and is learned and transmitted in the family and other social organizations. It includes implicit versus explicit beliefs, attitudes, values, customs, norms, taboos, arts, and lifeways. It is accepted by a community of individuals and facilitates self-work and self-esteem. Chapter 5: Cultural Diversity - Page 81

A nurse is assessing a client and determines that the client belongs to a minority group. Based on the nurse's understanding about minority groups, the nurse would anticipate that the client would likely experience which effects? Select all that apply. Less power Health disparities Greater advantages Improved access to care Increased economic privileges

Less power Health disparities 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 most of society. Being of a minority group often results in having less power and being disadvantaged, including health disparities in a society. Greater advantages, improved access to care, and economic privileges are not associated with minorities. Chapter 5: Cultural Diversity - Page 88

A nurse is providing care to a client who is from a different culture. Which aspect about culture would be most important for the nurse to integrate into the client's care? Not all members of the same culture act and think alike. Culture is relatively static and unchanging. Individuals learn culture in a purposeful manner. Individuals can easily describe their culture.

Not all members of the same culture act and think alike. Explanation: Culture is shared unequally by its members; that is, not all members of the same culture act and think alike. Culture is also dynamic and changes as people come into contact with new beliefs and ideas. Some learning of culture is purposeful and some is absorbed without awareness. Much of culture is implicit, a combination of habit and assumptions about the world, such that habits are enacted without reflection in the daily course of living. This makes culture difficult for members to describe. Chapter 5: Cultural Diversity - Page 81-83

A nurse is caring for patients of diverse cultures in a community health care facility. Which characteristics of cultural diversity that exist in the United States should the nurse consider when planning culturally competent care? Select all that apply. The United States has become less inclusive of same-sex couples. Cultural diversity is limited to people of varying cultures and races. Cultural diversity is separate and distinct from health and illness. People may be members of multiple cultural groups at one time. Culture guides what is acceptable behavior for people in a specific group. Cultural practices may evolve over time but mainly remain constant.

People may be members of multiple cultural groups at one time. Culture guides what is acceptable behavior for people in a specific group. Cultural practices may evolve over time but mainly remain constant. A person may be a member of multiple cultural, ethnic, and racial groups at one time. Culture guides what is acceptable behavior for people in a specific group. Cultural practices and beliefs may evolve over time, but they mainly remain constant as long as they satisfy a group's needs. The United States has become more (not less) inclusive of same-sex couples. The definition of cultural diversity includes, but is not limited to, people of varying cultures, racial and ethnic origin, religion, language, physical size, biological sex, sexual orientation, age, disability, socioeconomic status, occupational status, and geographic location. Cultural diversity, including culture, ethnicity, and race, is an integral component of both health and illness.

The nurse overhears a colleague state, "All people from that client's country are rude." What is the appropriate nursing response? Say nothing and ignore the comment. Agree and state, "Yes, I've noticed the same thing." Report the colleague to the nurse manager. Respond by saying, "Stereotypes keep us from accepting others as unique individuals."

Respond by saying, "Stereotypes keep us from accepting others as unique individuals." Explanation: Stereotypes are preconceived ideas usually unsupported by facts. They tend to be neither real nor accurate. They can be dangerous because they interfere with accepting others as unique individuals. The nurse can professionally educate the colleague about the harm involved in stereotyping individuals. Ignoring the comment or reporting the colleague to the nurse manager would result in a missed opportunity to educate the colleague on stereotyping. Agreeing would only strengthen this harmful practice. Chapter 5: Cultural Diversity - Page 83

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? Stereotyping Cultural blindness Cultural conflict Cultural imposition

Stereotyping Explanation: 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. Chapter 5: Cultural Diversity - Page 83

A nurse states, "That patient is 78 years old—too old to learn how to change a dressing." What is the nurse demonstrating? Cultural imposition Clustering Cultural competency Stereotyping

Stereotyping Stereotyping is assuming that all members of a group are alike. This is not an example of cultural competence nor is the nurse imposing her culture on the patient. Clustering is not an applicable concept.

A family has immigrated and settled in a neighborhood that primarily speaks their native language. The nurse caring for this family recognizes that which family member will likely require the greatest amount of time to learn the dominant language? The 45-year-old mother in the family who does not work outside the home The 58-year-old father in the family who works in a nearby factory The 12-year-old son in the family who attends public school The 18-year-old daughter in the family who works at a restaurant in a neighboring town

The 45-year-old mother in the family who does not work outside the home Explanation: The 45-year-old mother will have the greatest challenge in learning the dominant language due to not working outside the home and living in a community that speaks the native language. Children usually assimilate more rapidly and learn the language of the dominant culture quickly because they leave home each day to go to school, making new friends in the dominant culture. Wage earners also tend to learn a new language more quickly through the work setting. Language acquisition is tied to necessity and assimilation, rather than to the degree of difficulty. Chapter 5: Cultural Diversity - Page 83

A client is seeking care at the local clinic. The nurse is completing a cultural assessment. Which scenario would demonstrate cultural assimilation? The client does not speak the dominant language and requires an interpreter. The client's child learned the dominant language as a second language. The client and child cook traditional foods for the family. The client enjoys watching television programs from the home country.

The client's child learned the dominant language as a second language. Explanation: The child is demonstrating an example of cultural assimilation by taking on the language of the dominant culture. When a minority group lives within a dominant group, its members may adapt some of their cultural practices that once made them different. This process is referred to as cultural assimilation. Watching television from the home country, cooking traditional foods, and speaking only the original language demonstrate the original culture and an attempt to bring the minority culture into the dominant culture. Chapter 5: Cultural Diversity - Page 83

Which is a cultural norm of the health care system? There is the use of a systematic approach and problem-solving methodology. There is a tolerance of tardiness, disorderliness, and disorganization. There are rigid procedures attending birth and death. The omnipotence of technology is yet to be recognized.

There is the use of a systematic approach and problem-solving methodology. Explanation: Cultural norms of the health care system include the use of a systematic approach and problem-solving methodology; the omnipotence of technology; the dislike of tardiness, disorderliness, and disorganization; and the use of certain procedures attending birth and death.

A nurse is teaching a novice nurse how to provide care for patients in a culturally diverse community health clinic. Although all these actions are recommended, which one is MOST basic to providing culturally competent care? Learning the predominant language of the community Obtaining significant information about the community Treating each patient at the clinic as an individual Recognizing the importance of the patient's family

Treating each patient at the clinic as an individual In all aspects of nursing, it is important to treat each patient as an individual. This is also true in providing culturally competent care. This basic objective can be accomplished by learning the predominant language in the community, researching the patient's culture, and recognizing the influence of family on the patient's life.

An adolescent informs the nurse at the clinic, "I do not know what is happening to me, my skin is turning very white in spots all over my hands." The nurse assesses hypopigmented areas on the hands and documents the finding. Following evaluation by the health care provider, what education will the nurse provide to the client? Using a pigmented cream will help to even the skin tones. The hypopigmented areas will be confined to the present location. There may be a slight stinging sensation when washing the hands. This is due to sun exposure, so your pigmented areas should be covered in sunscreen.

Using a pigmented cream will help to even the skin tones. Explanation: The adolescent is experiencing hypopigmentation, which is called vitiligo and can affect clients of any ethnic group. Vitiligo may be embarrassing for the person affected. A pigmented cream can be used to cover the area and make the skin tones more evenly blended. There are no physical symptoms such as stinging, and the disorder is not caused by sun exposure. The condition may affect different areas of the body and is not necessarily confined to the present area. Chapter 5: Cultural Diversity - Page 707

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? Utilize a key informant and continue with the teaching, verifying the client's understanding through open-ended questions. Tell the client that it is important to pay attention to the teaching and ask if the client would like an interpreter. Change positions to promote eye contact with the client, asking open-ended questions to ensure understanding. Continue with teaching and leave written instructions for the client to review.

Utilize a key informant and continue with the teaching, verifying the client's understanding through open-ended questions. Explanation: 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. Chapter 5: Cultural Diversity - Page 86

The nurse is preparing the discharge plan for a new mother and her newborn son. Which new teaching should the nurse ensure is included after noting the family is Jewish? care following the scheduled circumcision proper breastfeeding techniques when to schedule the next follow-up appointment the proper sleeping position for the newborn

care following the scheduled circumcision Explanation: Orthodox Judaism and some members of non-orthodox Jewish denominations consider circumcision as a sacred ritual which is performed on the 8th day of the infant's life. Clients of other faiths may request the circumcision be completed before the newborn is discharged home from the hospital and some will choose not to circumcise their newborn. The other choices should be part of every client's discharge teaching. Chapter 5: Cultural Diversity - Page 88

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

client's height. Explanation: 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. Chapter 5: Cultural Diversity - Page 85

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: stereotyping. cultural blindness. cultural imposition. cultural conflict.

cultural imposition. Explanation: 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. Chapter 5: Cultural Diversity - Page 83

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: cultural ritual. cultural competence. cultural stereotyping. ethnocentrism.

cultural ritual. Explanation: 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. Chapter 5: Cultural Diversity - Page 91

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

ethnocentrism. Explanation: 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. Chapter 5: Cultural Diversity - Page 90

Nurses are socialized into the: nursing specialties. healthcare culture. caring paradigm. diagnostic process.

healthcare culture. Explanation: Culture enables people of similar cultural heritage to understand the meanings of each other's words as part of the particular context, to read each other's nonverbal behavior fairly accurately, and to communicate through symbols. All of these characteristics apply to health care, so health care can be considered a culture into which one can be socialized. The other answers pertain to the career, practice, or intellectual aspects of nursing but not as much to the social aspect of nursing. Chapter 5: Cultural Diversity - Page 81

A woman has moved from the east coast to the west coast. She is a single parent of four children who is having difficulty finding employment due to a lack of a car and primarily speaking an uncommon language for the area. Which factor is a barrier to health care? cultural differences multiple children female gender primary language other than the dominant one

primary language other than the dominant one Explanation: The client speaking a language that is uncommon for the area as one's primary language is a barrier to health care. Being from a different culture, female, or the parent of multiple children does not create a barrier to care. Chapter 5: Cultural Diversity - Page 85