Ch. 5: Cultural Diversity Quiz

A nurse is caring for a female patient of Hawaiian descent. Which interview question would be appropriate based on the cultural beliefs of Hawaiians?

"Do you use any medicinal plants or minerals?" The native Hawaiian culture has a strong belief in medicinal plants and minerals to help with health and wellness. The culture does not have an issue with individuals of opposite gender caring for a client. The culture does not have a belief regarding hot and cold foods and the balance of these types of food for overall health. The culture does not have a belief regarding using fad diets to lose weight

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." People are often born into an ethnic group, or ethnicity develops by immersion in a community. People of the same ethnicity often speak similar dialects and share similar values. Ethnicity and race are terms used interchangeably; however, they are not the same thing. Race refers specifically to physical characteristics.

A nurse is admitting a client to the unit. Which cultural question is most appropriate?

"What are your dietary needs and preferences?" By asking about dietary needs and preferences, the nurse can have insight into religious and cultural dietary practice. Asking about "normal" foods assumes that a cultural dietary request is abnormal. The other options will produce limited insight and imply that a cultural dietary need is a restriction or hindrance.

A family recently emigrated from Haiti to the United States. The mother reports that her teenage daughter is showing signs of fear, has vague reports of stomach pain, and feels humiliated by her peers because of her culture. What is the priority assessment for the nurse?

Assess for culture shock. The client is experiencing symptoms associated with culture shock. Culture shock occurs when a person is immersed in a different culture that is perceived as strange. The person may feel foolish, fearful, incompetent, or humiliated, and these feelings can lead to frustration and anxiety. Cultural assimilation is when one begins to assume some characteristics of a culture outside of one's own. Cultural blindness occurs when cultural differences are ignored. Cultural imposition occurs when one pushes his or her beliefs onto another person.

A Malaysian client is admitted to the health care facility with complaints of cramping pain in the abdomen and loose stools. Where should the nurse be seated when interviewing the client?

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.

Which of the following is an example of cultural competence in nursing?

Attending a conference for cultural diversity Cultural competence can be shown by actively learning about culture through attending a conference. Assessing the rate at which an illness leads to death does not develop cultural competence. One's own church is a familiar culture, and attending it does not breed cultural expansion or competence. The provider should never assume that beliefs or values are shared.

A nurse is conducting a cultural assessment of a client. Which person would the nurse identify as the expert?

Client When gathering cultural information, the interviewee is the expert. Other family members may provide information about the culture, but the client is the expert. The nurse and health care provider are responsible for obtaining information related to the culture.

An Asian client believes that her 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 The nurse is demonstrating cultural blindness, which occurs when one ignores differences and proceeds as though they do not exist.

Which of the following is the tendency to impose one's cultural beliefs, values, and patterns of behavior on a person or people from a different culture?

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 of another group. Cultural taboos are activities or behaviors that are avoided, forbidden, or prohibited by a particular cultural group.

A client is admitted with end stage pancreatic cancer and is experiencing extreme pain. The client asks the nurse if 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 The nurse has demonstrated cultural imposition by assuming that traditional pain relief measures are superior and the patient should conform to the nurse's belief regarding pain control. This is not an example of cultural conflict because the nurse did not ridicule the request; it was simply dismissed.

The client is an Alaskan Inuit woman recently admitted to the hospital with a ruptured ovarian cyst. She has expressed that it is very important that her husband be present to receive all medical information. Using the concepts of culturally competent care, which is the best response?

Document the client's request in the nursing care plan. A culturally sensitive nurse is one who respects a client's requests while ensuring that their requests reflect safe medical practice. This client's request does not interfere with client safety. Thus, her request should be respected and communicated through documentation to other health care personnel.

When describing the concept of ethnicity, which statement would be most appropriate to use?

Ethnicity allows people to define themselves and others to define them. Ethnicity is a cluster of ways for people to define themselves and be defined by others. It involves the selection of certain shared cultural characteristics, such as symbols of a common group origin, history, or descent. Ethnicity is not culture. Ethnic identity is distinguished from culture in that ethnic identity is self-conscious about select symbolic elements that are taken as the emblem of group social identity. Ethnicity or ethnic identity refers to a self-conscious, past-oriented form of identity based on a notion of shared cultural (and perhaps ancestral) heritage, as well as current position within the larger society.

A nurse is working in an inner city clinic with a heavy population of Hispanic migrant workers. Which nursing assessment is the priority?

Language assessment While all of the assessments are appropriate, the priority assessment is communication. If the client speaks Spanish, it may be necessary to obtain a translator to provide culturally appropriate care.

Which of the following nursing actions displays linguistic competence?

Learning pertinent words and phrases in the client's language Linguistic competence is best displayed by learning pertinent words or phrases in the client's language. Speaking loudly and repeating English words do not solve the communication barrier or show an effective response to a linguistic need. Asking the client's family to translate is discouraged because it is often unreliable and leads to confusion for the client and the nurse.

An Asian client is admitted to the unit. What cultural assessment might the nurse anticipate?

Nonverbal expressions of pain While every client is unique, it is important to have a basic understanding of cultural tendencies. In the Asian culture, complaining is uncommon. As a result, Asian clients may not report pain and the nurse must be careful to observe for nonverbal signs of discomfort. The other answer selections are not typical cultural considerations within the Asian culture.

A nurse is providing care to a client who is from a different culture. Which aspect about culture would be most important for the nurse to integrate into the client's care?

Not all members of the same culture act and think alike. Culture is shared unequally by its members; that is, not all members of the same culture act and think alike. Culture is also dynamic and changes as people come into contact with new beliefs and ideas. Some learning of culture is purposeful and some is absorbed without awareness. Much of culture is implicit, a combination of habit and assumptions about the world, such that habits are enacted without reflection in the daily course of living. This makes culture difficult for members to describe.

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 The charge nurse is clearly exhibiting ageism, which is a form of stereotyping. Cultural assimilation is when one begins to assume some characteristics of a culture outside of one's own. Cultural blindness occurs when cultural differences are ignored. Cultural imposition occurs when one pushes his beliefs onto another person.

A new client comes to the primary care clinic and asks for help treating head lice. The nurse assesses that the client lives in low-income housing, and nine other people live with her in a one-bedroom apartment. Which of the following is a primary nursing concern?

The client does not have running water. The priority in this poverty situation is the lack of running water. The already challenging task of eradicating head lice in a crowded living space is worsened by the lack of running water. The feelings of hopelessness need to be addressed, but the need for water is the first priority.

The nurse is caring for a client who speaks a language other than English and is using an interpreter to communicate. What would be the best way to choose an interpreter for this client?

The interpreter should understand the health care system. Obviously, nurses cannot become fluent in all languages, but certain strategies for fostering effective cross-cultural communication are necessary when providing care for clients who are not fluent in English. Cultural needs should be considered when choosing an interpreter; however, it is also important to use an interpreter who understands the health care system. In choosing an interpreter, the nurse should not select one who speaks in a loud voice, conducts the conversation quickly, or always makes direct eye contact. Direct eye contact is regarded differently among cultures.

You are a nursing researcher studying so-called "unnatural illnesses." What cause of such illnesses would be included in your study?

Witchcraft "Unnatural illnesses" are thought to be punishments for failing to follow God's rules, resulting in evil forces or witchcraft causing physical or mental health problems. "Natural illnesses" are thought to be caused by dangerous agents such as cold air or impurities in the air, water, or food.

A student nurse is preparing a presentation regarding different cultures. Which definition of culture is most accurate?

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.

When a client states, "I only want an American doctor," the client is expressing cultural:

ethnocentrism. Viewing one's own culture as the only correct standard by which to view people of other cultures is ethnocentrism.

Persistent gaps between the health status of minorities and non-minorities are defined as:

health disparities "Despite continued advances in health care and technology, racial and ethnic minorities continue to have higher rates of disease, disability and premature death than non-minorities."

A nurse is working with a culturally diverse group of clients. The nurse understands that cultural norms:

require an individualized approach by the nurse. Knowing a cultural norm does not enable one to predict a person's response. Generalizing about cultural norms in contemporary societies is inappropriate because people belong to more than one subcultural group and are influenced uniquely by multiple and diverse groups. Exceptions to cultural norms always exist. Therefore the nurse needs to approach each person as an individual.

A preconceived and untested belief about an individual or group of individuals is:

stereotyping. Stereotypes are exaggerated descriptors of character or behavior that are commonly reiterated in mass media, idiomatic expressions, and folklore.

A nurse is providing care to a client who has limited understanding of the English language. Which person would the nurse be legally required to use to facilitate communication?

trained language interpreter Hospitals are required to provide trained language interpreters for "the client who does not speak or understand the predominant language of the community" (The Joint Commission, 2014). Furthermore, hospitals that receive Medicare or Medicaid reimbursement are subject to Title VI of the Civil Rights Act, which prohibits recipients of federal funds from discriminating or denying benefits on the basis of race, color, or national origin. According to the The National Standards for Culturally and Linguistically Appropriate Services, hospitals that fail to provide trained interpreters for people who speak limited English or no English, or for deaf people who use sign language, are in violation of the law. In addition, obtaining trained interpreters rather than bilingual members of the client's family or friends, however well-intentioned or convenient the latter might be, is important because interpretation of behavior goes beyond translation of words. Much medical vocabulary and terminology is difficult to translate into other languages.

Which of the following examples related to eye contact are expected based on cultural variables? (Select all that apply.)

• An American male looks directly into the eyes of another while speaking. • An Asian male is considered aggressive when looking directly at another. • A Hispanic male looks down while speaking to his grandmother. • An Arabic male averts his eyes while speaking to a group. Eye contact is the most culturally variable form of communication. The American culture emphasizes eye contact while speaking. An Asian male is considered impolite or aggressive when maintaining eye contact. Hispanics may look down in deference to age or authority. A Hasidic Jewish male may avoid all eye contact with women. Averting the eyes is common in the Asian culture. While all individuals are unique, these are cultural commonalities.

A nurse interviews a client to determine his health beliefs and behaviors. The nurse uses this information for which aspect of care? Select all that apply.

• conducting an assessment • developing client outcomes • providing client education An understanding of the client's health beliefs and behaviors is essential to create client-centered communication (not nurse-centered communication), complete an assessment, and plan and implement care and education.

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 most likely experience which effect? Select all that apply

• health disparities • less power The term minority refers to a group of people within a society whose members have different ethnic, racial, national, religious, sexual, political, linguistic, or other characteristics from most of society. Being of a minority group often results in having less power and being disadvantaged, including health disparities in a society. Greater advantages, improved access to care, and economic privileges are not associated with minorities.

A nurse is attempting to gain insight into a client's cultural beliefs and attitudes. Which method would the nurse most likely use? Select all that apply.

• open-ended interviewing • ethnographic interview • key informants • use of the client's language Methods to gain the client's perspective include open-ended interviewing (a variant of which is the ethnographic interview); the use of key informants; observation over time; and use of the client's language.