Chapter 5 - Cultural diversity

While completing a health history interview for a female client who practices Islam, the nurse motes that the client's spouse answers all the questions. The nurse recognizes that behavior may be due to what? a- the client is too sick to answer the questions b- the spouse does not trust the client to answer the questions c- the spouse may be the dominant member of the family d- the client does not want to answer the questions

In some cultures, the male may be the dominant member of the family. The dominant member of the family will often speak for the client. The culturally competent nurse should understand that the cultural practices of the client and incorporate into the client's care. The client is not too ill to answer nor unable to answer. The spouse is responsible for answering therefore the duty and responsibility lies with the spouse to answer the questions.

A male nurse is preparing to take the vital signs of a female client. Which ethnic group would consider this improper? a- white b- black c- native american/first nations d- Arab Muslim

d- Arab Muslim The Islamic religion does not allow the use of health care professionals of the opposite gender unless it is impossible to locate one of the same gender. Native american, first nations, whites, and blacks do not necessarily share this sentiment.

A parent informs the nurse that immunizations are against her cultural and religious beliefs and she does not want her 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 she had all her children vaccinated. What is the nurse's behavior an example of? a- cultural imposition b- cultural blindness c- cultural conflict d- stereotyping

a- 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 transitions of others to make themselves feel more secure in their own values.

Upon moving to China, a North American college student is experiencing many new feelings that the student associates with placement in a different culture. What are the feelings experienced by this student? a- culture shock b- cultural assimilation c- ethnocentrism d- sterotyping

a- culture shock The student is experiencing culture shock, whch is defined as the feelings a person experiences when placed in a different culture. Stereotyping is the assumption that all members of a culture, subculture, or ethnic group act alike. Ethnocentrism is the belief that one's ideas, beliefs, and practices are the best, are superior, or are most preferred to those of others. Cultural assimilation occurs when members of a minority group live within a dominant group and lose the cultural characteristics that make them different.

A nursing student is providing care to a postoperative client of Asian descent. The student reports to the primary nurse that the client is "eating food from home". What is the nurse's best response? a- food from home is fine as long as it does not violate hospital policy or contradict the prescribed diet b- food from home has too much fat and salt and should be avoided c- the client will need to adjust to the food that is provided d- tell the client to stop eating food from home immediately

a- food from home is fine as long as it does not violate hospital policy or contradict the prescribed diet. Accommodate the cultural dietary practices of clients as much as possible. Dietary departmetns in many hopsitals and long-term care facilities can provide meals that are consistent with special dietary practices. Families may be encouraged to bring food from home for patients with particular preferences when this practice does not violate policy.

The delivery of culturally competent nursing practice incorporates the concept of: a- planning and implementing care in a way that is sensitive to the needs of individuals, families, and groups from diverse cultural populations b- ethnocentrism into the delivery of care c- challenging the beliefs and values of clients from diverse cultures d- recognizing that the health care system is void of culture, and that cultural imposition must occur

a- planning and implementing care in a way that is sensitive to the needs of individuals, families, and groups from diverse cultural populations. Providing culturally competent nursing care means that care is planned and implemented in a way that is sensitive to the needs of individuals, families, and groups from diverse cultural populations within society. To provide culturally competent care, the nurse must be aware that the health care system itself is a culture and that cultural imposition and ethnocentrism must be avoided. A nurse is sensitive to other cultures and their beliefs and not challenging them.

In addressing health promotion for a client who is a member of another culture, the nurse should be guided by which principle? a- the client may have a very different understanding of health promotion b- the nurse should avoid performing health promotion education if this is not a priority in the client's culture d- health promotion is a concept that is largely exclusive to Western cultures

a- the client may have a very different understanding of health promotion. As a component of cultural assessment, the nurse should seek to understand the health promotion. Health promotion is not a concept exclusive to Western cultures, through 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 caring for a client who speaks a different language than herself and is using an interpreter to communicate. What would be the best way to choose an interpreter for this client? a- the interpreter should understand the health care system b- the interpreter should always make direct eye contact c- the interpreter should speak in a loud voice d- the interpreter should conduct the conversation quickly to avoid misinterpretation

a- the interpreter should understand the health care system. Obviously, nurses cannot become fluent in all languages, but certain strategies for fostering

An older adult client who only speaks Cantonese 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 to the client? a- a trusted friend b- a hospital translator c- a Cantonese-speaking hospital employee d- a family member

b- 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 a friend, family member, or hospital employee

A nurse is caring for a postoperative client of Asian descent after know arthroplasty. The nurse plans to help the client ambulate, but is aware that the client may feel threatened due to physical closeness. What would be the most appropriate nursing action? a- ambulate the client without answering the client's questions b- explain the purpose and need for assistance during ambulation c- let the client ambulate slowly on his or her own when stable d- instruct family members to ambulate the client

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 answering the client's question is non therapeutic, as the nurse would be performing a procedure without giving adequate explanation.

A female client is a practicing Muslim and is admitted to the unit for observation. What cultural characteristic might the nurse expect? a- possible use of medicinal herbs b- limited eye contact with the opposite sex c- isolation, which is an accepted way of life d- excessive interaction with health care providers

b- limited eye contact with the opposite sex. While all clients are unique, in the Muslim culture, females usually limit eye contact with the opposite sex due to modesty concerns. It is rare within the culture to use herbs as a treatment option. Isolation is not common in the Muslim culture, as family is seen as the basic building block of the Muslim society. Excessive interaction is not anticipated, as the man is considered the head of the household and speaker for the family unit.

A client of Arab descent has been admitted to the health care facility with varicose veins. What should the nurse avoid while conducting the interview of the client? a- asking about the client's medical history b- maintaining eye contact c- giving a light handshake d- asking about the client's personal life

b- maintaining eye contact. while interviewing a client of Arab descent, the nurse should avoid maintaining eye contact is sexually suggestive; if the nurse does so during the interview, it may give the worng messgae to the client. However, the nurse may give a light handshake or ask about the client's personal life and medical history during the interview.

A nurse is assigned the care of a client who speaks only Arabic. The nurse does not know the language. What action is appropriate for the nurse in this case? a- communicate with the client non-verbally b- request a professional interpreter c- refuse to that charge of the client d- ask another nurse to take care of the client

b- request a professional interpreter. In a situation in which the nurse is assigned care of a client who speaks a language the nurse does not speak, the nurse should request a professional interpreter. However, the nurse should not refuse to take charge of the client because the nurse cannot refuse duty. Non-verbal communication with the client through gestures would not give complete information, and therefore it is not appropriate for this situation. The nurse may receive help from another nurse who is appropriately bilingual.

A client is admitted to the hospital and the nurse is attempting to complete an admission assessment. The client reports that her spiritual healer will be coming in soon and is upset by the admission questions. What is the most appropriate response by the nurse? a- we can wait for your healer, but they can't do anything to provide care in a traditional care environment b- we can wait for your healer to come and then work together to answer these questions c- these questions are important and must be answered now d- when your spiritual healer gets here, please have her complete this admission information

b- we can wait for your healer to come and then work together to answer these questions. In some cultures, a client may associate admission questions with incompetence because they are used to a traditional healer, who is often well acquainted with the client's care needs. As long as the client is stable, it is acceptable to wait until the clietn is more comfortable to complete the admission questionnaire. By saying that the nurse and the healer can work together, it shows acceptance outside of the realm of traditional medicine. It is inappropriate for the healer to complete the admission assessment. It is also inappropriate to say the healer cannot "do anything" in the traditional care environment.

Based on cultural factors, which client would be most likely to ask the following: "Why is there a male nurse in my wife's room"? a- a 43 year old white male b- a 43 year old native american/first nations male c- a 43 year old Muslim male d- a 43 year old black male

c- a 43 year old Muslim male. Modesty is very important in the Muslim culture. Care providers should be of the same sex when possible, and the nurse should avoid touching clients of the opposite sex.

A client from Malaysia is admitted to the health care facility with reports of cramping pain in the abdomen an loose stools. Where should the nurse be seated when interviewing the client? a- behind the client b- in one corner of the room c- at more than one arm's distance d- alongside the client

c- at more than one arm's distance. While interviewing the Malaysian client, the nurse should sit at a distance of more than one arm's length from the client. The nurse should not sit alongside the client, as he may feel uncomfortable. If the nurse sits at the back of the client, the nurse may not be able to observe the client's body language. If the nurse sits in a corner of the room, communication may not be effective.

A client who immigrated from Pakistan informs the nurse of his 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 out diet." This inappropriate response is an example of: a- cultural assimilation b- cultural blindness c- cultural imposition d- cultural diversity

c- cultural imposition. The nurse's response is an example of cultural imposition, which is defined as the belief that everyone should conform to the makority belief system. Cultural blindness is teh result of ignoring differences and proceeding 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, disailities, 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.

Health care facilities that sponsor health-promotion activities only in affluent areas are considered: a- culturally affluent b- culturally sensitive c- culturally blind d- culturally different

c- culturally blind. Another way of thinking about ethnocentrism in nursing is that it can reflect an individual's, a group's, or an agency's cultural blindness. It can also reflect a lack of capacity to reach out effectively to minorities or culturally stigmatized groups.

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 husband has asked that his wife be cared for exclusively by female nurses. Knowing that the couple is originally from the Middle East, what action should the care team take in response to this request? a- teach the couple that the male nurses on the unit are empathetic, trustworthy, and competent b- assess the couples's rationale for making the request c- take reasonable measures to accommodate the request d- determine whether the request is rooted in culture or whether it is a personal preference

c- take reasonable measures to accommodate the request. While cultural assessment in a tactful and respectful manner is likely appropriate in this situation, the care team's guiding principle and obligation in this situation is to accommodate and respect the couple's request. It would be inappropriate for the care team to attempt to convenience the couple to change their minds or assume that it is a personal preference. The nurse would not teach the couple that male nurses on the unit are empathetic as this is the client's cultural preference.

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? a- the nurse should ask the supervisor for a different assignment b- the nurse should communicate with the client non-verbally c- the nurse should request the help of a professional interpreter d- the nurse should get a language dictionary and translate

c- the nurse should request the help of a professional interpreter. The nurse should request the help of a professional interpreter to communicate effectively with client who does not speak the same language as the nurse. Trying to use a language dictionary to help communicate may be troublesome and time-consuming. The nurse cannot shun nursing responsibilities by asking for a different assignment. Asking the client to communicate non-verbally may lead to a break in communication or misinterpretations.

A nursing student is preparing a presentation regarding different cultures. Which definition of culture is most accurate? a- complete uniformity of members b- cluster of individuals c- altruistic grouping d- belief system that guides behavior

d- belief system that guides behavior. Culture is a belief system that the members of the culture hold, to varying degrees, consciously or unconsciously, as absolute truth. That belief system guides everyday behavior and makes it routine.

A nurse who provides care in a large, inner-city hospital is aware of the large influence of culture on health. The nurse recognizes that culture is best understood as a shared system that encompasses: a- dress, relationships, and diet b- knowledge, skills, and norms c- health behaviors, roles, and priorities d- beliefs, values, and practices

d- beliefs, values, and practices. Culture is defined in many ways, but at the broadest level, it can be understood to be a shared system of beliefs, values, and behavioral expectations that provide social structure for daily living. These beliefs, values, and expectations frequently direct other aspects of an individual's life (thinking, behavior, dress, and diet) but these are not the central components of the concept of culture. Health behaviors are also influenced by the beliefs, values, and behavioral expectations of the client's culture. Knowledge, skills, and norms are influenced by a profession and not a culture.

Which term describes the tendency to impose one's cultural beliefs, values, and patterns of behavior on a person or people from a different culture? a- cultural taboos b- cultural blindness c- acculturation d- cultural imposition

d- cultural imposition Cultural imposition is the tendency to impose one's cultural beliefs, values, and patterns of behavior on a person or people 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 that are avoided, forbidden, or prohibited by a particular cultural group.

How is culture learned by each new generation? a- ethnic heritage b- involvement in religious activities c- belonging to a subculture d- formal and informal experiences

d- formal and informal experiences. Culture is a shared system of beliefs, values, and behavioral expectations that provide social structure for daily living. Culture includes the beliefs, habits, likes, dislikes, customs, and rituals learned through formal and informal experiences within one's family and within the cultural group to which one belongs.

Which statement best conveys the relationship between race and ethnicity? a- race and ethnicity can be considered to be synonymous in the context of health care b- race is based on an individual's cultural history and is independent of ethnicity c- race and ethnicity are both culturally determined concepts d- race denotes physical characteristics while ethnicity is rooted in a common heritage

d- race denotes physical characteristics while ethnicity is rooted in a common heritage. The term "race" is usually used in reference to particular physical characteristics, while ethnicity is an identification with a cultural group that is often based on a common heritage. Because it is rooted in objective physical traits, race is usually considered to be somewhat independent of culture.

Culture shock is best defined as: a- expectations learned over a period of time b- a recognizable and predictable pattern of human behavior c- using one's own culture as the correct standard for comparison d- the acute experience of not understanding the culture in which one is situated

d- the acute experience of not understanding the culture in which one is situated. Culture shock occurs when a person is immersed in an environment different from teh one they are accustomed to, resulting in rapid disorientation and distress

A client with Asian heritage is admitted to the health care facility with hypoglycemia. After the client is stable, the nurse discovers that the client has not had the prescribed medicines. The client believes that eating saffron will keep his 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- let me inform the physician that you are not taking saffron for diabetes c- yes, i agree that you should continue taking saffron for diabetes d- why don't you take the medicines, too, and benefit from both?

d- why don't you take the medicines, too, and benefit from both? Although the nurse may disagree with the client's beliefs concerning the casue 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. Agreeing with the client may encourage him and indicate low faith in the present treatment. It is inappropriate to call the doctor and complain about the client.