Engage Fundamentals (Psychosocial Concepts for Nursing Practice): Inclusion, Equity, and Diversity

A nurse is reviewing information about culture with a group of newly hired nurses. Which of the following statements by a newly hired nurse should the nurse identify as an understanding of culture?

"Inclusion means each client is treated in the same manner, regardless of their culture." The nurse should recognize that practicing inclusion means that diversity is recognized among clients and groups, rather than expecting everyone to act or be treated in the same manner. "Cultural preferences do not include beliefs about health promotion and disease treatment." The nurse should recognize that cultural values can impact what an individual or group believes about their health and what health care practices they're willing to include. "Not every individual has cultural preferences." The nurse should recognize that each individual has preferences and values that guide communication and behaviors. "Culture can include language and communication practices." Culture involves the integration of human behaviors, including communication, language, actions, beliefs, values, customs, and institutions of racial, religious, social, and ethnic groups.

A nurse in a community clinic sees clients experiencing health disparities within vulnerable populations. The nurse should consider which of the following clients as belonging to a vulnerable population? (Select all that apply.)

A white male who has no chronic illness is incorrect. White males who do not have a chronic illness are not considered a vulnerable population. An African American adolescent who is pregnant is correct. Examples of vulnerable populations include immigrants, the elderly, minority ethnic groups, poverty-stricken individuals, clients with chronic illnesses, and veterans. A low-income family is correct. Examples of vulnerable populations include immigrants, the elderly, minority ethnic groups, poverty-stricken individuals, clients with chronic illnesses, and veterans. A female who is Latina and has type 2 diabetes mellitus is correct. Examples of vulnerable populations include immigrants, the elderly, minority ethnic groups, poverty-stricken individuals, clients with chronic illnesses, and veterans. A middle class male who lives in a large city is incorrect. Middle class males who live in large cities are not considered a vulnerable population.

A nurse is caring for a client who was born in India but has lived in the U.S. for 30 years. The client speaks English and has family members at the bedside. Which of the following actions should the nurse take?

Assume that the client has special cultural practices that will need accommodation. There is no indication that the client has special cultural practices that will need accommodation. Obtain use of a certified medical interpreter at the beginning of providing care. There is no indication that a certified medical interpreter will be needed at the beginning of providing care. Ask the family to leave the room while the nurse is present. There is no indication that the family should be asked to leave the room while the nurse is present. Inquire about any special cultural beliefs or practices. The nurse should inquire about any special cultural beliefs or practices as part of assessment or data collection, which is the first step of the nursing process.

A nurse is reviewing a client's medical record for factors that could impact accessibility to health care services. For which of the following factors should the nurse monitor?

Cultural diversity Cultural diversity occurs within and among cultural groups and includes a multitude of factors impacting diversity such as age, sexual orientation, culture, ethnicity, and socioeconomic status. Health disparities Health disparities can negatively affect populations who experience obstacles to health, including their ability to access care. Health equity Health equity is attaining the highest level of health for all individuals. Cultural competence Cultural competence includes appreciating, accepting, and respecting all individuals' cultural influences, beliefs, customs, and values.

A nurse is planning care for a client who uses culturally based folk- care for medical treatments. Which of the following actions should the nurse take?

Encourage the client to stop the use of folk care treatments. Discouraging the use of folk care treatments is not culturally competent nursing. Coordinate folk care treatments with modern medical treatments. The nurse should consider a mixture of the client's folk care and professional care-cure practices. Educate the client that folk care treatments cannot be used within the facility. Discouraging the use of culturally-based folk care treatments is not culturally competent nursing. Avoid the use of modern medical treatments administered by the provider. The professional and culturally competent care-cure practices include using modern day and research-based health care provided by health care professionals.

A nurse is reviewing the medial record of an adolescent who is a lesbian. The nurse should identify that which of the following findings are likely caused by the client being marginalized by others? (Select all that apply.)

Having a large group of close friends is incorrect. Having a large group of close friends during adolescence is positive and is not an effect of being marginalized by peers. Difficulty with personal relationships lasting into adulthood can be an effect of marginalization. Being bullied at school is correct. Being bullied at school can be a common finding of individuals who are part of a marginalized group, which can include individuals of a specific sexual orientation. Depression is correct. Depression can be a common finding of individuals who are part of a marginalized group, which can include individuals of a specific sexual orientation. Using illicit drugs is correct. Use of illicit drugs can be a common finding of individuals who are part of a marginalized group, which can include individuals of a specific sexual orientation. Working an after-school job is incorrect. Working an after-school job can be common among adolescents, and is not the effect of being marginalized by peers. Difficulty maintaining employment lasting into adulthood can be an effect of marginalization.

A nurse helping to develop an in-service about cultural competence is reviewing a list of health beliefs provided by members of a local cultural group. The nurse should recognize that this list provides which of the following types of information?

Health disparity data Health disparities provide information about health outcomes compared across varying populations. Information about the health beliefs of a group does not provide health disparity data. Emic knowledge Emic knowledge provides information from the viewpoint of an individual within a cultural group. Etic knowledge Etic knowledge provides information from the viewpoint of an individual outside of a cultural group. Objective data Objective data is observed information; the nurse should recognize that subjective data is provided through the insight of an individual who is part of a cultural group.

A nurse is caring for a newly admitted client. Which of the following actions should the nurse take first?

Implement nursing interventions. Implementation is the fourth step of the nursing process. Plan nursing interventions. Planning is the third step of the nursing process. Perform a cultural health assessment. Assessment is the first step of the nursing process. Evaluate the care plan. Evaluation is the final step of the nursing process.

A nurse is conducting a cultural assessment. Which of the following factors are incorporated in Leininger's Sunrise Enabler? (Select all that apply.)

Kinship and social factors is correct. Leininger's Sunrise Enabler consists of the following basic elements that work together to influence the client as a whole person: technological factors; religious, spiritual, and philosophical factors; kinship and social factors; cultural values, beliefs, and lifeways; biological factors; political and legal factors; economic factors, and education factors. Biological factors is correct. Leininger's Sunrise Enabler consists of the following basic elements that work together to influence the client as a whole person: technological factors; religious, spiritual, and philosophical factors; kinship and social factors; cultural values, beliefs, and lifeways; biological factors; political and legal factors; economic factors, and education factors. Health disparity factors is incorrect. Leininger's Sunrise Enabler consists of the following basic elements that work together to influence the client as a whole person: technological factors; religious, spiritual, and philosophical factors; kinship and social factors; cultural values, beliefs, and lifeways; biological factors; political and legal factors; economic factors, and education factors. Economic factors is correct. Leininger's Sunrise Enabler consists of the following basic elements that work together to influence the client as a whole person: technological factors; religious, spiritual, and philosophical factors; kinship and social factors; cultural values, beliefs, and lifeways; biological factors; political and legal factors; economic factors, and education factors. Political and legal factors is correct. Leininger's Sunrise Enabler consists of the following basic elements that work together to influence the client as a whole person: technological factors; religious, spiritual, and philosophical factors; kinship and social factors; cultural values, beliefs, and lifeways; biological factors; political and legal factors; economic factors, and education factors.

A nurse is caring for a client who is from a different culture. To provide the best possible client care, which of the following actions should the nurse take first?

Obtain a cultural health assessment. Obtaining a cultural health assessment on clients assists nurses in planning and providing culturally competent nursing care; however, this is not the first action the nurse should take. Develop cultural competence. The nurse should develop cultural competence, including positive and open communication, to provide the best client care possible. However, this is not the first action the nurse should take. Conduct a self-assessment. This is the first action the nurse should take. Conducting a self-assessment allows the nurse to identify self-bias and to understand their own cultural views, assumptions, and values. Recognizing ones own cultural views facilitates equal treatment of all clients and decreases the risk for creating healthcare disparities. Create an individualized plan of care. While it is important to create an individualized plan of care for each client, this is not the first action the nurse should take.

A nurse is planning care for a client who is a veteran. Which of the following information should the nurse consider?

The client is at an increased risk for poor health outcomes. A veteran is considered a member of a vulnerable population. Vulnerable individuals have an increased risk for poor health outcomes resulting from barriers to social, economic, and environmental resources, including limitations due to illness or disability. The client will require a social services consult. The nurse should investigate the need for a social services consult because the client is part of a vulnerable population and at greater risk for poor health outcomes resulting from barriers to social, economic, and environmental resources. The client is guaranteed veterans health benefits. Not all veterans are guaranteed to have veterans health benefits. The nurse should assist the client as needed to determine eligibility. The client will not be affected by socioeconomic factors. The client is a veteran, which is considered to be a vulnerable population, and is at higher risk for poor health outcomes resulting from barriers to social, economic, and environmental resources.

A nurse is talking with a group of clients in a community setting. Which of the following statements by the nurse describes how culture affects a client's definition of health and illness?

"Health and illness can be defined differently by individual clients." Culture impacts how individual clients live their lives and how they perceive and receive health care. In addition, health and illness are viewed and defined differently by each client a nurse encounters. "Health and illness are similarly defined for all clients." Culture impacts how individual clients live their lives and how they perceive and receive health care. In addition, health and illness are viewed and defined differently by each client a nurse encounters. "Health is similarly defined for all clients, but illness can be viewed differently." Culture impacts how individual clients live their lives and how they perceive and receive health care. In addition, health and illness are viewed and defined differently by each client a nurse encounters. "Health and illness only need to be defined if a client has a chronic health condition." Culture impacts how individual clients live their lives and how they perceive and receive health care. In addition, health and illness are viewed and defined differently by each client a nurse encounters.

A nurse is interviewing a client who states that they are transgender, although they have a biological sex of male listed in their records. Which of the following information should the nurse plan to incorporate when assisting with the client's plan of care?

The client will prefer to have caregivers who are female. The nurse should not make assumptions about the client's preferences for care. The nurse should offer the client an opportunity to express their own preferences, if any exist. The client has changed the way they view sexuality. The nurse should recognize that the client's identity as transgender does not dictate their sexual beliefs or preferences. The client will not want to be addressed by the use of pronouns such as "him" or "her." The nurse should not make assumptions about how the client will want to be addressed, but should ask the client what their preference is. The client associates their identity to something different from their sex assigned at birth. A client who identifies as transgender has an identity that differs from their sex assigned at birth.

A nurse is reviewing information to enhance their own cultural awareness. The nurse should identify the need to examine which of the following?

The nursing process While it is important to understand the nursing process, it will not help to enhance cultural awareness when caring for clients. Self-bias The nurse should identify that by examining their own self-bias, they increase awareness of their own cultural and health beliefs, which can enhance cultural awareness when caring for clients. Health disparities While it is important to understand health disparities, it alone will not help enhance cultural awareness when caring for clients. Cultural diversity While it is important to understand cultural diversity, it alone will not help enhance cultural awareness when caring for clients.

A nurse is caring for a client who speaks a different language than the nurse. Which of the following actions should the nurse take?

Use a certified medical interpreter. The nurse should use a certified medical interpreter for communication purposes within the medical field when the client speaks a different language than the nurse. Use a family member as an interpreter. The nurse should avoid the use of the client's family members or significant other as the source of interpretation because this can be a violation of the client's right to confidentiality. Repeat important words so the client recognizes their importance. There is no need to repeat important words if the client cannot understand them. Talk slowly so that each word is heard clearly. Speaking slowly will not assist with the client's understanding.