Cultural Diversity
A nurse is working in a clinic that serves a community with a high population of immigrants. Which nursing assessment is the priority?
Language assessment
Which nursing action displays linguistic competence?
Learning pertinent words and phrases in the client's language
Nurses are responsible for delivering culturally competent care for all clients. Culturally competent care does not account for:
client's height.
The nurse is caring for a client whose language skills are very limited in the dominant language, and an interpreter has been obtained. The interpreter appears to be telling the client more than the nurse is saying and possibly providing an opinion or medical advice. Which action is appropriate for the nurse to take?
Speak privately with the interpreter and instruct them to only provide language interpretation.
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
A student nurse is not looking forward to clinical rotation on a geriatric unit, stating "How can I get them to move faster? They always seem so slow!" How should the instructor respond?
"Be careful of the negative attitude in your approach. How fast an individual moves will depend on physical ability not necessarily age."
How is culture learned by each new generation?
Formal and informal experiences
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?
"Can you tell me what foods you prefer to eat and what your family is bringing you?"
The nurse has just attended a seminar on concepts of cultural diversity. Which statement made by the nurse would require further education?
"Culture cannot be influenced, and you are born with your culture."
The nurse just attended a seminar on cultural diversity. Which statement by the nurse would require further education?
"Ethnicity and race are the same thing and are affected by cultural practice."
Which nursing intervention reflects culturally appropriate care when addressing a client?
"Good morning, Mr. Smith. I am your nurse, John."
The nurse is teaching a Black client about common health conditions. Which statement by the client most directly addresses a health problem with an increased incidence in this population group?
"It is important to monitor my blood pressure."
A nurse is admitting a client to the unit. Which cultural question is most appropriate?
"What are your dietary needs and preferences?"
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?"
A nurse caring for clients of different cultures in a hospital setting attempts to make eye contact with clients when performing the initial assessment. What assumption might the nurse make based on common cultural practices?
A Muslim-Arab woman refuses to make eye contact with her male nurse. Assumption: She is being modest.
What is the priority assessment for the nurse when developing a plan of care for a client living in poverty?
Access to care
When talking with a client, the nurse notes that the client keeps backing up. What would be the most appropriate response?
Ask the client about personal space preferences.
The nurse is caring for a terminally ill client who immigrated from Mexico. Which nursing intervention regarding spiritual care is appropriate?
Ask the client if a spiritual leader is desired.
A client says to the nurse, "Why don't you wear a white cap like nurses do on the soap operas?" This is an ethnocentric statement based on the:
media.
A new resident in a long-term care facility who was having difficulty adapting to the routine has begun participating in activities on a daily basis. Which stage of culture shock is this resident displaying?
Beginning resolution
The home health nurse is conducting the health history interview with a client who does not speak the dominant language. What would be the best action made by the nurse?
Conduct the health history utilizing a telephonic interpreter (over-the-phone translation).
A client believes that the illness is caused by an imbalance of yin and yang. The nurse states, "You can call it whatever you believe, but you have a metabolic disorder." What is this nurse demonstrating?
Cultural blindness
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?
Cultural imposition
Which term describes the tendency to impose one's cultural beliefs, values, and patterns of behavior on a person from a different culture?
Cultural imposition
The nurse is caring for a client who does not speak the dominant language. In order to facilitate unencumbered communication with the client, the nurse will take which action(s)? Select all that apply.
Determine in which language the client communicates effectively. Review facility policy on communication with clients who do not speak the dominant language. Schedule a certified interpreter when collecting client health history.
The nurse is caring for a client who is postoperative 3 days from coronary artery bypass graft. The client has a prescription to ambulate. What is the best action by the nurse?
Discuss with the client the need for assistance during ambulation.
A nurse is caring for a postoperative client after knee arthroplasty. The nurse plans to help the client ambulate but is aware that the client may feel threatened by physical closeness because the client is from a culture that tends to prefer more personal space when interacting with others. Using the principles of culturally competent care, what would be the most appropriate nursing action?
Explain the purpose and need for assistance during ambulation.
Which nursing intervention reflects practice according to Madeline Leininger's transcultural nursing theory?
Incorporating the client's request for complementary treatment therapy
A nurse is part of an orientation team for a group of newly hired nurses. The nurse is to prepare a presentation for the group about different cultural groups common to the facility. As part of the presentation, the nurse is planning to describe how culture is communicated to provide a foundation for culturally competent care. Which methods of communication would the nurse include? Select all that apply.
Language Behavior Symbols
While caring for a client from a culture different from the nurse's, the nurse inadvertently offends the client. What is the best action by the nurse?
Learn from the mistake and do not repeat it.
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
A nurse is working with a local community group to address health disparities in the area. Which concepts would be important for the group to address when planning to correct health disparities? Select all that apply.
Minority Disadvantaged Less powerful
A nurse is attempting to gain insight into a client's cultural beliefs and attitudes. Which methods would the nurse likely use? Select all that apply.
Open-ended interviewing Ethnographic interviewing Key informants Use of the client's language
A nurse is conducting a seminar for a group of nurses about the cultural competency in nursing. When describing culture, which terms would be appropriate for the nurse to use? Select all that apply.
Pervasive Holistic Recognizable Ritualistic
The younger nurses on a unit, who seem to adapt easily to the new technology presented, are perceived as threatening by two nurses who have worked on the unit for years. The older nurses begin to ridicule the younger nurses, saying, "You might be able to work a computer, but we know how to provide real care." How should the charge nurse respond?
The charge nurse should discuss the concept of cultural conflict and help both parties see their respective value to the unit.
In addressing health promotion for a client who is a member of another culture, the nurse should be guided by which principle?
The client may have a very different understanding of health promotion.
The nurse works in an urban hospital and cares for a diverse population of clients. Which action(s) by the nurse demonstrates the delivery of culturally sensitive care to clients? Select all that apply.
asking the client questions regarding health care beliefs related to the client's culture allowing the client to keep a religious necklace on until going into the operating room integrating the client's cultural practices when assisting with the creation of the plan of care
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
A client who immigrated from another country informs the nurse of dietary requests. The nurse responds to the special dietary needs by stating, "You are now living here, and you should try to start eating those foods common to our diet." This inappropriate response is an example of:
cultural imposition.
A nurse is working with a culturally diverse group of clients. The nurse understands that cultural norms:
require an individualized approach by the nurse.
The nurse is educating a client of Chinese descent regarding the reduction and elimination of lactose in the diet. Which statement(s) made by the client indicates that the education was effective? Select all that apply.
"When I drink coffee or tea, I should use a non-dairy creamer instead of milk or cream." "I should replace 2% milk with lactose-free milk." "I can use kosher parve foods because they are prepared without milk."
The nurse is caring for a client who perceives time differently. What action should the nurse take for this client?
Maintain flexibility when the client requests interventions at specific times.
The nurse is caring for a client from another culture who is diagnosed with lung cancer. Which nursing action best demonstrates culturally sensitive care?
Incorporating the client's need for daily prayer into the nursing care plan.
The client, visiting from a foreign country, arrived at the facility seeking medical assistance following an accident. The client has limited proficiency in the dominant language. An onsite certified interpreter is unavailable. To assist in interpretation, what is an appropriate nursing intervention?
Use a contracted video interpretation service.
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.
When a home-bound client expresses the client's past-oriented ancestral heritage and family rituals, the nurse recognizes that the client is expressing:
ethnic identity.
When reviewing the chart of an older adult client, the nurse notes that the client identifies as Japanese. The nurse realizes the client is referring to which ancestral and cultural factor?
ethnicity
When an American client states, "I only want an American doctor," the client is expressing:
ethnocentrism.
Nurses are socialized into the:
healthcare culture.