Culture Eqa
A client who has liver failure says, "I have complete trust in God and I am sure he will take care of my family even if I am not here." Which concept does this most exemplify?
Faith The client's trust that God will take care of his or her family exemplifies faith. An example of religion would be if the client carried out specific rituals or practices to cope. Connectedness involves finding comfort through one's relationship with oneself, other people, and or with a higher power. Transcendence is the belief in a greater force outside of the material world.
When caring for a client who adheres to a kosher diet, which important thing should the nurse make sure to exclude from the client's meals?
Pork and shellfish A client who adheres to a kosher diet will not eat pork and shellfish. Jehovah's Witnesses will not eat blood-containing food products. Some Buddhist and Hindu clients may be vegetarians and avoid all meat, fish, and poultry. Russian Orthodox clients will avoid animal and dairy products during Lent.
A client with a terminal illness is grateful for the care received in the hospital and has slowly started to come to terms with imminent death. The nurse recognizes that the client's behavior and attitude is most consistent with which cultural group?
Somalian Culture Terminally ill clients who belong to the Somalian culture may slowly accept their imminent death and have faith in God. Somalian clients will generally express their gratitude to the care received in the hospital. Clients who belong to the German and Ukrainian cultures may not accept their illness and may fight against the illness in them. Clients who belong to a more secular culture or are less identified by religious institutions may not accept their imminent death.
A nurse is assessing the grief response of a family member whose relative has died. What must the nurse consider first about the family to conduct an effective assessment?
Cultural background The degree of anguish experienced or expressed is most often set or imposed by the cultural background of the individual, so cultural background must be assessed before care is planned. Although personality traits do enter into the grief process, they are not as important in the developing awareness stage as is cultural background. Educational level has no relationship to the grieving process; nor does socioeconomic class.
A 15-year-old emancipated minor gave birth to a boy 36 hours ago and has requested a circumcision. What is the medical priority?
Obtaining an informed consent signed by the mother of the baby As an emancipated minor, the mother of the baby has the right to make the decision regarding the circumcision and is responsible for signing the informed consent. A nurse does not administer a lidocaine injection into the newborn penis; the physician does. Circumcision is a decision made by the parent(s), often for cultural or religious reasons. Education can be provided as needed, as the provider obtains a signed consent. Because the mother of the baby is an emancipated minor, the grandmother does not have the authority to sign the consent in this situation.
The American parents of an adopted Spanish preschooler inform the nurse that the child often stutters while speaking. Upon assessment, the nurse finds that there is no hearing impairment, brain injuries, or developmental disorders in the child. What does the nurse suspect is the cause for the stuttering?
The change in language exposure has caused stuttering. A change in language exposure may sometimes cause a child to stutter as the child takes time to master the new language. If the child is pressured to speak, there may be articulation problems. The child will be quiet and often speak less if the child is not comfortable with the new environment. If the environment is not a happy or positive one, the child will have other social and developmental issues along with speech problems.
The nurse is caring for a client who self-identifies as having a strong Hispanic heritage. According to transcultural nursing researchers, what should the nurse ask when assessing a woman with depression for the risk of self-harm who also identifies as having Hispanic ethnicity?
"How do you express yourself when you're angry?" Transcultural nursing researchers who have studied Hispanic women for the purpose of providing them better nursing care have learned from these women that their culture tends to limit how they can express anger acceptably, which has also shown to result in a higher risk of suicide. The nurse has initiated exploration of potential culture-based issues with this client by asking about her cultural heritage. Asking the client how she expresses anger is the next step the nurse should take to validate (or invalidate) any known cultural characteristics that influence this individual client that may be contributing to her depression. Although questions about seeing friends, having outside interests, or noticing depression are appropriate, they are not as culture-focused as limits on anger expression can be for many women of Hispanic ethnicity.
During an assessment which client statement may indicate to the nurse that the client is experiencing spiritual distress?
"I deserve a better life than this. I don't understand why God decided to make me ill." Spiritual distress is a disturbance in a client's belief system which can cause a loss of faith and an inability to experience and integrate life's meaning and purpose. The client expressing anger at God for causing his or her illness is questioning his or her spirituality, which indicates he or she is in spiritual distress. The client searching for a divine existence, the client who expresses faith that God is with him or her, and the client who is grateful for his or her support system are showing signs of positive spiritual health.
A registered nurse is teaching a nursing student about the importance of values in nursing practice. Which information provided by the registered nurse is appropriate? Select all that apply.
"Values vary among clients and develop and change over time." "The values that an individual holds reflect cultural and social influences." "To discuss differences in opinions and values, the nurse should be clear about his or her own values." The nurse should know that values vary among people and develop and change over time. The nurse should know that the values an individual hold reflect cultural and social influences. The nurse should know that it is important to be clear about one's own values before discussing the differences of opinions and values. People consider strong values as facts rather than opinions. The nurse should never evaluate the client's values and beliefs in terms of his or her own values and beliefs.
The nurse is teaching the Hispanic parents of a preschool child about the prevention of lead poisoning. Which statement by the parents indicates a need for further teaching?
"We can use orange powders for diarrhea." Greta and azarcon (also known as alarcon, coral, luiga, maria luisa, and rueda), traditional Hispanic remedies taken for upset stomach, constipation, diarrhea, and vomiting, are also used for teething babies. Both are fine orange powders with a lead content as high as 90%. Further teaching is required if the family indicates that they will continue treating diarrhea with a home remedy. Food should not be stored in open cans, particularly those that have been imported. Cold water for consumption (drinking, cooking, and especially reconstitution of powdered infant formula) should be used; hot water dissolves lead more quickly than does cold water, yielding a higher level of lead. Frequent healthy snacks are encouraged because lead is absorbed better on an empty stomach.
Which theory proposes that older adults experience a shift from a materialistic to cosmic view of the world?
Gerotranscendence theory The gerotranscendence theory is a recent theory that proposes that the older adult experiences a shift in perspective with age. The person moves from a materialistic and national view of the world to a more cosmic and transcendent one. The activity theory considers the continuation of activities performed during middle age as necessary for successful aging. The continuity theory suggests that a person's personality remains stable and behavior becomes more predictable as people age. The disengagement theory states that aging individuals withdraw from customary roles and engage in more introspective, self-focused activities.
Which belief of a nurse may have a negative effect on health services for minority clients?
The mind, body, and spirit are distinct entities. Eastern tradition considers body-mind-spirit as a single entity; if the nurse refuses to accept and respect that a client of a different culture may believe this, then the quality of care can be affected. Children of multiracial, multicultural, and multiheritage marriages fall into more than one category, so the nurse should focus on culture rather than race. For the Chinese, disease is caused by fluctuations in opposing forces—the yin-yang energies. The nurse should not make assumptions about a client's race based on his or her appearance; the nurse should record the client's race as he or she self-identifies.
A nurse and a nutritionist are discussing the needs of a client who practices the Russian Orthodox faith. What should the nurse and the nutritionist consider when planning meals for this client?
The client does not eat meat on Wednesdays and Fridays. A client who is Russian Orthodox may refrain from eating meat on Wednesdays and Fridays, and the nurse and the nutritionist should consider this when developing a nutrition plan for the client. A client who is Jewish might avoid pork and shellfish as part of a kosher diet. A client who practices the Jehovah's Witness faith might avoid blood-containing food. A client who is Hindu might follow a strict vegetarian diet.
While talking with a 60-year-old client, the nurse learns that the client emigrated 15 years ago from China and likes to live independently away from the client's grown children. The client eats only Chinese foods at home. What should the nurse infer from these findings?
The client has undergone biculturalism. When different cultures encounter other cultures, they tend to adapt the cultural beliefs and psychology of each other's culture. The people of Chinese culture feel that their children are responsible for caring for them in old age. Therefore when Chinese people adapt some characteristics of American culture but prefer to eat only Chinese foods, it indicates that the client has undergone biculturalism. Assimilation is a cultural process by which a person can give up their original identity and develop a new cultural identity. In the process of acculturation, both the host culture and the original culture are changed as a result of reciprocal influences. In the process of enculturation, the person learns norms, values, and behaviors of their own culture, similar to socialization.
The Surgeon General used the data from the 2000 census classification system to identify disparities in mental health care along racial-ethnic lines. What is the secondary use of this data?
To determine when and how the health care needs of the ethnic populations are being met The census classification system categorized individuals according to racial and ethnic descriptions. In addition to identifying health disparities, recording these classifications helps to determine when and how the health care needs of ethnic populations are being met. Nurses should practice culturally relevant nursing in order to meet the needs of culturally diverse clients of a specific ethnic group; the census has nothing to do with this. Because each racial group contains multiple ethnic cultures, the census does not succeed in identifying all of them in the United States, and it doesn't include them all as options. Although the census helps identify health disparities, it does not attempt to examine and determine why they exist.
A nurse is performing health screenings of toddlers in a culturally diverse neighborhood. Which child should the nurse consider at risk for beta-thalassemia (Cooley anemia)?
Two-year-old child of Greek descent with a large abdomen Beta-Thalassemia is common in children who are black or of Mediterranean descent (Italian, Greek, Syrian); an enlarged abdomen may be the result of hepatomegaly or splenomegaly. Pale skin is expected in children of Irish descent; children with β-thalassemia may have bronze skin as a result of hemosiderosis if the excess iron is not chelated. Defective hemoglobin leads to damaged red blood cells and a decreased hematocrit. Asian descent is not a risk factor for β-thalassemia.
A nurse understands that the effects of different variables on a client's health beliefs and practices can help healthcare providers to plan and deliver individualized care. Which statement made by the client should the nurse consider as an influence of the client's intellectual background on his or her health beliefs?
"Don't include eggs in my diet because eggs contribute to excess body heat." If the client states that eggs should not be included in his or her diet because they cause excess body heat, this statement is an example of the influence of the client's intellectual background on his or her health beliefs. If the client states that seafood or ham should not be included in his or her diet because it is against his or her beliefs, this statement is an example of the influence of the client's cultural background on his or her health beliefs. If the client says that he or she does not smoke or drink because these drugs are a major sin, this statement is an example of spiritual factors influencing his or her health beliefs and practices. If the client says that he or she has stopped taking prescribed medications because he or she has recently lost their job, this statement is an example of the client's socioeconomic influence on his or her health beliefs and practices.
The registered nurse is preparing to perform a physical assessment of a client with darker skin who is suspected to have jaundice. Which statement by the nurse indicates effective technique?
"I will examine the sclera closest to the iris." The most important assessment for clients who are suspected to have jaundice is examining the sclera closest to the iris. Assessments of the conjunctiva, lips, tongue, nail beds, palms, and soles are effective for a client who is suspected to have cyanosis.
An African-American woman is diagnosed with primary hypertension. She asks, "Is hypertension a disease of African-American people?" What is the nurse's best response?
"The higher-risk population is composed of African-American men and women." African-Americans represent a higher-risk population than Caucasian-Americans for hypertension; the reason is unknown. African-American women are more frequently affected by hypertension than are Caucasian women. African-Americans of both sexes have a higher prevalence than Caucasian-Americans of both sexes. African-American women have a higher risk than African-American men.
One morning a client with the diagnosis of acute depression says, "God is punishing me for my past sins." What is the best response by the nurse?
"You sound very upset about this." The response focuses on the client's feelings rather than the statement, and it serves to open channels of communication. "Why do you think that?" asks the client to decide what is causing the feelings; most people are unable to explain why they feel as they do. "Do you believe that God is punishing you for your sins?" simply echoes the client's statement and does not reflect feelings or stimulate further communication. "If you feel this way, you should talk to your spiritual advisor" does nothing to stimulate further communication; in fact, it tells the client to talk about the feelings with someone else.
Which nursing assessment questions assess the faith, belief, fellowship, and community aspect of a client's spirituality? Select all that apply.
1. "What gives meaning to your life?" 2. "What is your source of power, hope, and belief during difficult times?" 3. "In what way do your beliefs help or strengthen you for coping with illness?" A nurse can assess the faith, belief, fellowship, and community aspect of a client's spirituality by asking a client what gives meaning to his or her life, about his or her source of power, hope, or belief during difficult times, and about how his or her beliefs help or strengthen him or her for coping with illness. When a nurse asks the client in what way illness affects his or her capability to express what is essential in life, it helps in assessing the vocation aspect of spirituality. When a nurse asks the client how he or she feels about the changes that have been caused by the illness, it helps in assessing the life and self-responsibility aspect of spirituality.
A client says, "None of the medications will work on me because I am away from my holy land." What course of action should the nurse take to comply with teamwork and collaboration competency according to the Quality and Safety Education for Nurses (QSEN)?
Approach the agency chaplain to discuss the spiritual needs of the client According to Quality and Safety Education for Nurses (QSEN) competency, the nurse complies with teamwork and collaboration competency to function effectively within the nursing and interprofessional teams. In the given scenario, the nurse should collaborate with the agency chaplain to discuss the client's spiritual needs. The nurse complies with the patient-centered care competency by providing care to the client with respect to his or her diversity, values, and beliefs. The nurse complies with the evidence-based practice competency by conducting thorough research on the effect of emotional distress on the client's health. The nurse complies with the quality improvement competency by using the flow chart data to provide the best possible care and monitor the outcome of care processes.
For which families should the nurse include information related to safe sleeping habits as a priority during a scheduled health maintenance visit for a toddler-age child? Select all that apply.
Asian, African, and Hispanic Americans Asian American, African American, and Hispanic American families are more likely to co-sleep with their toddler-age children; therefore, it is essential for the nurse to teach information that enhances safety with this practice for these families. Irish American and Caucasian American clients are less likely to engage in co-sleeping with their children.
A nurse is caring for a client who believes that surgery contaminates the soul unless proper cleansing rituals are performed. Which nursing activity adheres to the Quality and Safety Education for Nurses (QSEN) competency patient-centered care?
Coordinating with appropriate spiritual practitioners to help perform the cleansing ritual before the client's surgery Patient-centered care requires the nurse to understand that the client is the source of control when providing care. The nurse should therefore observe and respect any of the client's values, needs, and preferences when delivering health care. The nurse in the given situation complies with the client's wishes by coordinating with appropriate spiritual practitioners to help perform the cleansing ritual before the surgery. Quality improvement requires the nurse to use data for monitoring the outcomes of care processes. The nurse adheres to this competency by evaluating the effects of complying with the requests of clients regarding their psychological health. In order to adhere to the QSEN competency called safety, the nurse should minimize the risk of harm by improving his or her professional performance. The nurse improves his or her communication skills in order to reduce the risk of harming the client emotionally. Evidence-based practice requires nurses to integrate best professional practices with the client's preferences when delivering health care. The nurse complies with this competency by conducting research about the ritualistic practices of the client's community to formulate a care plan.
According to the Centers for Disease Control and Prevention, compared to Caucasians, the syphilis rates among Hispanics are two times higher in 2011. What may be the reason for this?
Difference in the status of health literacy One cause of the higher rates of syphilis among Hispanic clients could be a lack of health literacy. Presence of equitable health care support would reduce, not cause a health disparity, as would availability of health care facilities. There is no known genetic predisposition to syphilis among any racial/ethnic group.
Why is it important for a nurse in the prenatal clinic to provide nutritional counseling to all newly pregnant women?
Different cultural groups favor different essential nutrients. The nurse should become informed regarding the cultural eating patterns of clients so that foods containing the essential nutrients that are part of these dietary patterns may be included in the diet. Fluid retention is only one component of weight gain; growth of the fetus, placenta, breasts, and uterus also contributes to weight gain. The need for calories and nutrients increases during pregnancy. Pregnancy diets are not specific; they are composed of the essential nutrients.
The nurse is providing care to a bilingual preschool-age child. Which should the nurse take into consideration regarding the child's language development? Select all that apply.
Disabilities will manifest in both languages. Milestones are reached at the same stage for both languages. When planning care for a bilingual preschool-age child, the nurse should consider that language disabilities will manifest in both languages and that milestones for both languages will be reached during the same time frame. There is no evidence that the language spoken in the home will be less developed. A bilingual child will be able to read in both languages. Bilingual children should not act as medical interpreters for their family members.
The parents of an autistic child begin family therapy with a nurse therapist. The father states that the family members wish to share their religious beliefs with the therapist. What should the nurse do?
Encourage family discussion of their religion in the sessions. If religious beliefs are a family concern, the nurse should allow discussion of the family's thoughts and feelings on the subject; the discussion should be encouraged, not limited. The role of the nurse is to facilitate and listen, not to participate in a mutual discussion about religious beliefs. The religious leader is not part of the family unit and should be invited only if this is requested by the family.
What rules of impression management should the nurse follow when caring for an Asian client? Select all that apply.
Greet the client and family in their language. Observe the distance maintained by the client. Clarify whether the client wants someone from the family to be present. While caring for a client, the nurse should observe and maintain the distance displayed by the client. In Asian cultures, touching someone is considered disrespectful or unethical. Before examining the client, the nurse should clarify whether the client wants someone from the family to be present. The nurse should greet the client and family in his or her language, if possible. When relatives visit the client, ask for introductions and the visitors' relationships to the client. The nurse should avoid talking to the client in the presence of relatives and friends. In such cases, the nurse should tell them to wait in the waiting room, then talk to the client in private.
Which nursing interventions can help a terminally ill client cope with feelings related to death? Select all that apply.
Helping the client to find meaning and purpose in life by listening to his or her concerns Allowing time for religious readings, spiritual visitations, or attendance at religious services Encouraging the client to pray if he or she wishes by facilitating privacy and a proper environment Feelings of connectedness are important for the client who is terminally ill; therefore, the nurse should promote connectedness by helping the client find meaning and purpose in life by listening to his or her concerns. Prayer and devotion can help the client cope with feelings related to death, so the nurse should allow time for religious readings, spiritual visitations, or attendance at religious services. The nurse can also encourage the client to pray if he or she wishes by facilitating privacy and a proper environment. To help the client to cope with the pain, the nurse should provide medications and therapies for pain management. To help the client manage other aspects of the illness, the nurse can educate the client about complementary medicine.
A client dies during surgery, and the family members ask that the hospital not conduct autopsy examinations. Which religion might the nurse expect this family to practice?
Islam This family is likely to be Muslim; Islam does not allow autopsies. Hinduism, Buddhism, and Christianity allow such postmortem examinations when required.
The nurse is advised to join a community health center that mainly caters to Latino clients. Which skills should the nurse develop to help reduce health disparities? Select all that apply.
Learning to speak basic medical Spanish Learning about the health literacy rate of the community Incorporating the health beliefs of the community in any nursing care plans Learning about and respecting unique beliefs and values prevalent among the group In order to provide effective health care service to the ethnic group, the nurse should learn to speak basic medical Spanish. This promotes communication and develops trust between the nurse and the clients. Learning about the clients' health literacy can help the nurse identify areas of opportunity for client education and health promotion. Incorporation of beliefs and values in plans of care can make the care more effective. The nurse should learn about the unique values and beliefs of the ethnic group and respect them to deliver equitable health care. Updating the clinical supplies at the health care facility is a basic responsibility of the nurse, but it will not help reduce health disparity.
A client has a "prayer cloth" pinned to the hospital gown. The cloth is soiled from being touched frequently. What should the nurse do when changing the client's gown?
Pin the prayer cloth to the clean gown. The prayer cloth has religious significance for the client and should be preserved as is. Making a new prayer cloth disregards what the prayer cloth means to the client. The prayer cloth is the property of the client and should not be discarded. Washing the prayer cloth with a detergent disregards what the prayer cloth means to the client; this never should be done without the client's permission.
What does a public health nurse expect to encounter when working with families raised in a culture of poverty?
Powerlessness relative to changing their situation Powerlessness is a characteristic feeling among people in the culture of poverty, which tends to erode their hope for change. People in the culture of poverty usually require immediate gratification because they do not have enough faith in the future to delay gratification. Pessimism, not optimism, about changing a lifestyle is more common in these families. There is not sufficient evidence to indicate that poor people feel shame for their situation or that they are inadequate parents.
Alternative therapy measures have become increasingly accepted within the past decade, especially in the relief of pain. Which methods qualify as alternative therapies for pain? Select all that apply.
Prayer 2 Hypnosis 4 Aromatherapy 5 Guided imagery Prayer is an alternative therapy that may relax the client and provide strength, solace, or acceptance. The relief of pain through hypnosis is based on suggestion; also, it focuses attention away from the pain. Some clients learn to hypnotize themselves. Aromatherapy can help relax and distract the individual and thus increase tolerance for pain, as well as relieve pain. Guided imagery can help relax and distract the individual and thus increase tolerance for pain, as well as relieve pain. Analgesics, both opioid and nonopioid, long have been part of the standard medical regimen for pain relief, so they are not considered an alternative therapy.
Test-Taking Tip: Make certain that the answer you select is reasonable and obtainable under ordinary circumstances and that the action can be carried out in the given situation.
Test-Taking Tip: Make certain that the answer you select is reasonable and obtainable under ordinary circumstances and that the action can be carried out in the given situation.
A nurse notices that a client is in spiritual distress. Which nursing action establishes the nurse as a caregiver?
The nurse provides therapeutic treatment to the client A nurse serves as a caregiver by meeting all the health care requirements of the client by providing measures that restore a client's emotional, spiritual, and social well-being. In the given scenario, the nurse provides therapeutic treatment to the client as a caregiver. As an educator, the nurse teaches the client about the signs of spiritual distress. As a client's advocate, the nurse communicates the wishes of the client to family members. The nurse follows the principle of accountability by collaborating with the agency chaplain to pursue the best treatment plan.
An elderly adult suffered an injury after falling down in the washroom. The primary healthcare provider performed a surgical procedure on the client and orders a blood transfusion. A family member of the client mentions that blood transfusions are not permitted in their community. What should the nurse do in order to handle the situation?
The nurse should inform the primary healthcare provider and not give blood to the client. The client or the client's family member has the right to refuse treatment and the nurse should value their beliefs and traditions. Therefore, the nurse should inform the primary healthcare provider and not perform the blood transfusion. The nurse should not wait for a court's order or explain or convince the family member to change his or her mind. The nurse should not proceed with the treatment because this may cause severe legal implications.
The nurse is overseeing a nursing student who is conducting an assessment of a client who does not speak English. No interpreter is available. Which action requires further teaching?
Using medical terminology Nurses should follow certain guidelines when interpreter is not available while assessing a client who does not understand English. Rather than using medical terminology, the nursing student should use simple, more well-known words, like "pain" instead of "discomfort." The nursing student's other actions are appropriate. Proceeding in an unhurried manner; speaking in a low, moderate voice; and pantomiming words and simple actions while verbalizing them promote effective communication.
Which statement regarding breast cancer stage and mortality is correct?
Which statement regarding breast cancer stage and mortality is correct? African American and Puerto Rican women have the highest risk for triple negative breast cancer. Caucasian women older, not younger than 40 years old are at a greater risk than other racial/ethnic groups. Breast cancer death rates are highest in African American, Hawaiian, Puerto Rican, and Samoan women. Non-Hispanic white women are more likely to present with an earlier-stage breast cancer than are American Indians/Alaskan Native, Asian Indian/Pakistani, black, Filipino, Hawaiian, Mexican,Puerto Rican, and Samoan women.
