culture and diversity
The nurse is preparing a presentation on social differences for colleagues. Which statement should the nurse include in the presentation? A. "Individuals with an external locus of control are more likely to take preventive healthcare measures than those with an internal locus of control." B. "Practices regarding proximity to others, body movements, and touch are similar across groups." C. "Subcultures can maintain heritage and identity through dress, foods eaten, and cultural festivities." D. "Clients from present-oriented cultures are generally receptive to preventive healthcare measures."
"Subcultures can maintain heritage and identity through dress, foods eaten, and cultural festivities." Rationale: Subcultures can maintain heritage and identity through dress, foods eaten, and cultural festivities. Practices regarding proximity to others, body movements, and touch differ among groups, such as when an individual's perception of personal space causes comfort or anxiety. Present-oriented cultures focus on the here and now, and individuals from these cultures may not be receptive to preventive healthcare measures. Those who follow an external locus of control are less likely to be engaged in preventive measures than those who follow an internal locus of control, because they do not see themselves as being in control of their health.
Which statement by the nurse indicates a need for cultural competence training? A. "Provide the client in room 3 a female nurse because she is Muslim." B. "The client in room 5 prefers hot beverages when ill." C. "Do not bother the client in room 2 during his prayers." D. "The client down the hall is on welfare. She will be back."
"The client down the hall is on welfare. She will be back." Rationale: The nurse stating the client on welfare will be back due to lack of income indicates insensitivity to someone with financial issues. Many cultures prefer hot beverages when ill. This is acknowledging the client's beliefs. The nurse is recognizing the client's religion when providing the client time to pray. The nurse understands the importance of same-sex healthcare providers in the Muslim faith.
The nurse is reviewing the medical records of a small urgent care clinic to identify clients who may be considered vulnerable. Which client should the nurse include as those who may be vulnerable? (Select all that apply.) A. A 17-year-old teenager enrolled in an afterschool boys' and girls' program B. A 42-year-old man with a psychiatric history who lives in his car in a nearby park C. An 82-year-old man living alone with no family nearby D. A 22-year-old woman who is crying and anxious due to fighting with her roommate E. A 32-year-old woman who lists the local shelter as her home address
A 42-year-old man with a psychiatric history who lives in his car in a nearby park An 82-year-old man living alone with no family nearby A 32-year-old woman who lists the local shelter as her home address Rationale: Vulnerable populations include older adults, children, people living in poverty, homeless people, and those who are in abusive relationships, are mentally ill, or chronically ill. An episode of anxiety or an altercation without a history of abuse is not considered evidence of belonging to a vulnerable population. A teenager in an afterschool program is not considered a member of a vulnerable population.
A non-English-speaking immigrant mother seeks care at a local outpatient clinic in an area where many immigrants have settled. The mother is accompanied by 15-year-old child who speaks English. How should the nurse address the language barrier? A. Ask the child to act as translator. B. Conduct a physical assessment with no explanations. C. Use signs and gestures to communicate. D. Ask the local immigrant service organization to provide an interpreter.
Ask the local immigrant service organization to provide an interpreter. Rationale: A representative of a local organization will understand the culture and may even have specific helpful knowledge of the family's background. Federal law requires provision of an interpreter. Asking a family member to act as translator may create confidentiality issues. Signs and gestures are inadequate for clear communication. An interpreter should be available to explain the physical assessment. However, the client's privacy should be protected, so the interpreter may not be present in the examining room at all times.
Which should the nurse include when caring for a client of a different culture? A. Enforce use of specialty practitioners. B. Enforce use of Western healthcare practices. C. Instruct client to take ordered medications. D. Be nonjudgmental in healthcare beliefs.
Be nonjudgmental in healthcare beliefs. Rationale: The nurse should be nonjudgmental in healthcare beliefs for all clients and include their beliefs into the plan of care. The nurse should never enforce Western health care or any healthcare practices on any client. The nurse should not enforce the use of specialty practitioners if the client does not believe in this practice. The nurse would instruct the client to take the medications prescribed, but this is unrelated to the client's culture.
The nurse manager is planning a presentation for a group of nurses about culture and diversity. Which barrier to respecting a client's culture should the nurse manager include in the presentation? (Select all that apply.) A. Belief that illnesses are linked to scientific pathophysiology and not changes in energy B. Incorporating the client's beliefs into the plan of care C. Refusing to allow family members to be involved in managing illness and disease D. Refusal of Western healthcare providers to believe in minddash-body connection E. Clients may not trust the current healthcare system and the providers
Belief that illnesses are linked to scientific pathophysiology and not changes in energy Refusing to allow family members to be involved in managing illness and disease Refusal of Western healthcare providers to believe in minddash-body connection Clients may not trust the current healthcare system and the providers Rationale: Clients from other cultures may not trust the current healthcare system and providers because they believe in traditional healers. Current Western healthcare providers may not believe in the minddash-body connection and turn to traditional science. Another barrier is refusing to allow the family to be involved in managing illness and disease. It is not a barrier when healthcare providers incorporate the client's beliefs into the plan of care.
The nurse belongs to a Christian denomination that considers homosexuality sinful. However, while working with a lesbian client, the nurse maintains an open, interpersonal rapport with the client while providing consistent, effective care. Which term best describes the nurse's behavior? A. Enculturation B. Assimilation C. Stereotyping D. Cultural humility
Cultural humility Rationale: The nurse is practicing cultural humility, which is the realization that a client needs care, not judgment. Assimilation is the process of adapting to and integrating characteristics of the dominant culture as one's own. Stereotyping is an overgeneralization of group characteristics that reinforces societal biases and distorts individual characteristics. Enculturation, or cultural transmission, is exemplified by a process that children use to learn cultural characteristics from adults.
Which aspects of culture should the nurse consider when assessing a client? (Select all that apply.) A. Customs are part of the culture of a client. B. Culture is defined by nonphysical traits. C. A client's culture is determined by race. D. Beliefs are a part of culture. E. Values are a part of culture.
Customs are part of the culture of a client. Culture is defined by nonphysical traits. Beliefs are a part of culture. Values are a part of culture. Rationale: The culture that encompasses a client's way of life is based on nonphysical traits. The values and beliefs a client holds are part of culture and can influence health care. Customs can influence a client's attitude toward health. Race refers to physical and genetic heritage and is directly related to such physical traits as skin color, but it is not related to a client's culture.
The preceptor is monitoring a graduate nurse's assessment of a male client who recently immigrated to the United States from China. Which assessment activity by the graduate nurse indicates the need for follow-up regarding culturally competent care? A. Discourage use of acupuncture or cupping for pain relief. B. Inquire if the client speaks any English. C. Ask the client about food preferences or food preparation needs. D. Determine if the client has any daily spiritual practices.
Discourage use of acupuncture or cupping for pain relief. Rationale: The provision of culturally competent care begins with incorporating culture into the initial nursing assessment. It is appropriate for the nurse to ask the client about his proficiency with English to ensure that they communicate effectively about treatment. The nurse should inquire about religious or cultural practices at specific times of day or during the week and plan care accordingly. The nurse should also ask about (not discourage) use of traditional healing practices such as herbal supplements or minddash-body practices (e.g., cupping, acupuncture). Administering culturally competent care also involves inquiring about cultural practices related to food preparation and preferences.
Which is a core belief about health in non-Western cultures? A. Health is the absence of disease. B. Health is the strength to do anything you want. C. Health is an attribute of youth. D. Health is a state of harmony that encompasses mind, body, and spirit.
Health is a state of harmony that encompasses mind, body, and spirit. Rationale: Non-Western cultures view health as a harmonious state. Western society sees health as the absence of disease. Other views of health are more individual.
The nurse is to provide an assessment for a client of Asian descent. Which factor would the nurse need to understand related to the client's worldview? (Select all that apply.) A. Educational level B. Healthcare beliefs C. Healthcare practices D. Language E. Values
Healthcare beliefs Healthcare practices Language Values Rationale: Healthcare beliefs, language, and values are part of a culture's worldview and can influence a client's acceptance of and cooperation with the treatment plan. If the client does not speak the same language as the nurse and the healthcare provider, an interpreter will be required. Healthcare practices may differ from what the nurse plans and can include alternative practices that may interfere with the treatment plan. Although not part of the worldview or culture, the client's level of education will be considered when planning teaching for the client.
The nurse is assessing a client of a different culture who has different religious beliefs than that of the nurse. Which statement or question by the nurse demonstrates cultural competence when assessing the client? (Select all that apply.) A. "I cannot continue with this assessment if you are not willing to be compliant with my plan of care." B. "How do you feel about taking medications or blood products if they are prescribed?" C. "Would you prefer to be examined by a nurse who is of your sex?" D. "May I ask what your partner might think about this plan of care?" E. "Are there certain times of the day that you need privacy for prayer or meditation?"
How do you feel about taking medications or blood products if they are prescribed?" "Would you prefer to be examined by a nurse who is of your sex?" "May I ask what your partner might think about this plan of care?" "Are there certain times of the day that you need privacy for prayer or meditation?" Rationale: The nurse can show knowledge of a client's culture by asking appropriate questions that are not demeaning or rude. Asking about family support opens the conversation so the client feels comfortable speaking about family objections. Religious or cultural beliefs may require a female client to be examined by female nurse, or they may necessitate that the nurse plan care around the client's daily spiritual practices. Asking how the client feels about taking medications opens the conversation to what cultural or religious beliefs might interfere with the medical care of the client. Refusing to work a plan of care around a client's cultural beliefs is unethical and not beneficial to the client.
Which aspect of organizational governance should reflect adherence to cultural competence standards within a healthcare facility? (Select all that apply.) A. Organizational practice implementation B. Policies and procedures C. Mission statement D. Translation services E. Staff training
Organizational practice implementation Policies and procedures Mission statement Rationale: Organizational mission, policies and procedures, and practice implementation should support cultural competence. Translation services and staff training are not parts of organizational governance
The nurse is researching cultures and diversity in health care. Which cultural characteristic that affects health care should the nurse classify as an environmental control? A. Personal boundaries B. Preventive medicine C. Emphasis on the past D. Skin color
Preventive medicine Rationale: Preventive medicine is an environmental control, because those who follow an internal locus of control will be motivated to eat healthy, exercise, and make use of other wellness measures. Skin color is a biological factor. Personal boundaries are space factors, and emphasis on the past is a time orientation.
The nurse is treating a male client from India who is recovering from surgery. The nurse is concerned that several of the client's family members are gathered in the hospital room throughout the day, and that the client's mother insists on caring for the client even when the nurse is present. Which intervention would indicate that nurse needs more teaching? A. Explain to both the client and his family members the necessity of early mobility. B. Provide the client with nutritional counseling and incorporate preferred foods into their meal plan. C. Remind the family that the nurse is equipped to provide the client with safe, effective care. D. Teach the client and his family about safety issues such as crowding and self-medication.
Remind the family that the nurse is equipped to provide the client with safe, effective care. Rationale: Clients whose origins are from India tend to have strong family ties, so it is not uncommon for several family members to gather in the client's room, causing crowding. Because the mother typically will provide care for the client, this may be cause for concern for the nurse, because many from India believe in self-medication and herbal medicines, which may interfere with treatment. The nurse, therefore, should collaborate with the client and family to provide safe, effective care. The nurse should also explain to the client and his family members the necessity of early mobility and independence with activities of daily living, as well as help the client meet nutritional needs through meal accommodation, nutritional counseling, and incorporation of preferred foods in the meal plan.
The nurse wants to provide culturally competent care to a client who lives on a long-term care unit. Which activity is appropriate for the nurse to implement? (Select all that apply.) A. Memorizing which foods members of each culture eat to restore health B. Seeking to understand one's own culture, its beliefs, and its assumptions C. Teaching the client about the U.S. healthcare system D. Asking the client and his family how the illness affects them E. Asking the client where he thinks illness originates
Seeking to understand one's own culture, its beliefs, and its assumptions Asking the client and his family how the illness affects them Asking the client where he thinks illness originates Rationale: To provide culturally competent care, the nurse must first understand her own culture, its beliefs, and its assumptions. To assist in evaluating a client's culture, the nurse should ask certain questions to understand the client's beliefs. Asking where the client thinks his illness comes from will help the nurse understand illness from the client's perspective. Not all members of a culture eat the same thing. Memorizing stereotypes will not help the nurse to provide culturally competent care. Teaching the client about the U.S. healthcare system does not help the nurse in providing culturally competent care.
The nurse makes a statement, "Chinese people drink only hot tea, so don't put coffee on their trays." The charge nurse identifies this remark is an example of which concept associated with culture? A. Prejudice B. Ethnocentrism C. Diversity D. Stereotyping
Stereotyping Rationale: Stereotyping is when a person assumes all members of a particular group have the same characteristics. This nurse is assuming all members of a group have the same eating habits. Ethnocentrism is the belief in the superiority of one's own culture and lifestyle. This nurse is making a generalization about a culture, not declaring the superiority of her own culture. Prejudice is a judgment about a person, place, or racial background that has no basis in knowledge. This nurse is making an assumption that all Chinese have the same traits. Diversity is a state of being different and occurs between and within cultural groups. It is not related to the statement this nurse made.
The nurse is providing care to a nondash-English-speaking client who is noncompliant with care. The client has expressed a desire to use traditional culturally based therapies. Which should the nurse identify as a potential cultural barrier in the client following the recommended care? (Select all that apply.) A. The belief that illness is not related to pathophysiology B. The lack of insurance to cover the necessary medication and related supplies C. Cultural belief that discussing the disease can influence the disease process D. Lack of trust in the healthcare system and providers E. The importance of the beliefs and cultural practices of the client's family and community
The belief that illness is not related to pathophysiology Cultural belief that discussing the disease can influence the disease process Lack of trust in the healthcare system and providers The importance of the beliefs and cultural practices of the client's family and community Rationale: Barriers to care that are influenced by cultural differences may include lack of trust in the healthcare system or the provider, the belief that illness is not related to pathophysiology, the influence of family and community, and a cultural belief that discussing an illness can influence the disease process. Although a lack of insurance may influence the client's entry into care, it does not have cultural significance.
The nurse is performing a cultural assessment on an adult client. Which information should the nurse include? (Select all that apply.) A. The client's region or country of origination B. The language spoken at home C. The cultural or religious influences in decision making D. Whether the client has insurance E. The kinds of food and drink the client prefers
The client's region or country of origination The language spoken at home The cultural or religious influences in decision making The kinds of food and drink the client prefers Rationale: Subjective data would be gathered by asking questions about cultural beliefs. Objective data would be gathered through observation of the client and the interactions between significant family members who might be present. Discovering the region or country the client originates from and lives in would give clues about the client's culture. It is important to know what language is spoken at home and whether the client understands English so that communication can be effective. Insurance is not necessarily a question that would come up during a cultural assessment, although socioeconomic status may affect healthcare delivery.
The nurse is preparing a presentation on health disparities in the United States. Which information is appropriate for the nurse to include? (Select all that apply.) A. Gay and lesbian individuals face greater discrimination in health care than transgender individuals. B. Undocumented immigrants are more likely to have diseases such as HIV and tuberculosis than those with legal status. C. African American women are at greater risk for heart disease than any other single population. D. Muslim individuals are less likely to be engaged in seeking preventive health measures. E. American Indians have a lower incidence of diabetes than any other race.
Undocumented immigrants are more likely to have diseases such as HIV and tuberculosis than those with legal status. African American women are at greater risk for heart disease than any other single population. Muslim individuals are less likely to be engaged in seeking preventive health measures. Rationale: Health disparities among certain populations are a concern in the United States. American Indians have a higher incidence of diabetes (33%) than any other race. Because Muslim individuals believe the status of their health is Allah's will, not in their control, they are less likely to take preventive health measures. African American women are at greater risk for heart disease than any other single population. Transgender individuals face greater discrimination in health care than do gay and lesbian individuals. Undocumented immigrants are more likely to have diseases such as HIV and tuberculosis than those with legal status.
