Ch 5 - Culture Diversity

When teaching a group of unlicensed assistive personnel (UAP) about race, which statement by a UAP REQUIRES INTERVENTION by the nurse?

"People with common physical features share the same culture."

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."

Which statement by the nurse is a culturally appropriate reaction to a client's perception of pain?

"If a client needs to yell in pain, that is his or her right."

What is the priority assessment for the nurse when developing a plan of care for a client living in poverty?

Access to care

A male client refuses to allow the nurse to draw blood for a test because he believes blood is the body's life force and cannot be regenerated. It is likely that this client belongs to which ethnic group?

Asian

A nurse is planning meals for clients in a long-term care facility. Which cultural practice should the nurse take into consideration when choosing foods for these clients?

In the Asian and Hispanic culture, diseases and foods are classified as hot or cold, and a proper balance between them promotes wellness.

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

Which statement best conveys the relationship between race and ethnicity?

RACE denotes PHYSICAL characteristics while ETHNICITY is rooted in a common HERITAGE.

The charge nurse overhears two new graduate nurses talking in the break-room. One graduate nurse states, "I hate getting reports from the older nurses; they are just too slow." The charge nurse understands that the nurse is demonstrating what?

ageism

What factor threatens to increase the number of people who are living at poverty level?

feminization of poverty

A nurse is performing nutritional assessments of new residents of a long-term care facility. Which resident would the nurse assess as being at greater risk for having lactose intolerance?

black male

Which area is typically included in a cultural assessment?

food preferences

Nursing students are socialized into the:

health care culture.

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.

health disparities less power

A client with Asian heritage is admitted to the unit. What cultural assessment might the nurse anticipate?

Nonverbal expressions of pain

A nurse is assigned the care of a client who speaks only Arabic. The nurse does not know the language. What action is appropriate for the nurse in this case?

Request a professional interpreter.

The staff nurse overhears the charge nurse talking to the unlicensed assistant personal (UAP). Which statement made by the charge nurse is an example of ethnocentrism?

"Italians are the best at everything"

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 his personal space preferences"

The nurse is caring for a client of ASIAN descent and is post-operative 24 hours from an appendectomy. The client is hesitant to get out of bed. How should the nurse respond?

"Can you describe what you are feeling when you try to move?"

Which behavior by the nurse demonstrates cultural blindness?

Administering antibiotics to a child whose parents do not believe in Western medicine

Which nursing action displays linguistic competence?

Learning pertinent words and phrases in the client's language

A client reports to the primary health care facility for routine physical examination after cardiac rehabilitation following myocardial infarction. Keeping in mind that the client is Latino, how should the nurse conduct the interview?

The nurse should avoid using medical terminology.

The nurse is caring for a client who is terminally ill and recently immigrated to the country. The nurse understands that in order to provide quality end-of-life care for the client, what would be the PRIORITY action by the nurse?

Understand the client's personal and cultural views regarding death and dying.

A community health nurse is providing care to a group of Hispanic people living in an area that is heavily populated by white people. What are the Hispanic people in this community an example of?

a minority

A Catholic priest baptizes a stillborn baby of a Catholic family. What type of practice is this considered?

a ritual

A nurse is conducting an ethnographic interview with a client. Which step would the nurse do first?

asks an open-ended, general question

A FEMALE ASIAN client is admitted to the emergency department with a fractured femur. What cultural factor might affect client care?

the client may NOT REPORT PAIN

The nurse is caring for a Haitian client. Which health belief system does the nurse anticipate?

using faith healing

When a client states, "I only want a WHITE DOCTOR," the client is expressing cultural:

ethnocentrism

The nurse is caring for a black 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 clinic nurse is obtaining demographic data from a client. The client states, "Why do you need to know what my ethnicity is?" How should the nurse respond?

"Collecting this information allows us to develop a personalized plan of care to meet your needs."

Which questions should the nurse include in a cultural assessment? Select all that apply.

"What do you do to promote good health?" "What religion do you belong to?" "Do have a particular name for this illness?"

A nurse is providing care to a client from a culture different from her own. The nurse is having difficulty relating to the client. What intervention by the nurse is most appropriate?

Ask the client how she wants to be treated based on her values and beliefs.

Which behavior by the nurse is stereotyping?

Avoiding older adult clients because their care is time consuming

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 the client in a one-bedroom apartment. Which consideration is the priority nursing concern?

The client does not have running water.

A nurse is caring for a Native American/First Nations woman who is receiving chemotherapy for breast cancer. Which nursing action is the best example of providing culturally sensitive care?

The nurse uses a low tone of voice when explaining the care plan to the client.

Which is a cultural norm of the health care system?

There is the use of a systematic approach and problem-solving methodology.

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 client with Asian heritage is admitted to the health care facility with hypoglycemia. After the client is stable, the nurse discovers that the client has not had the prescribed medicines. The client believes that eating saffron will keep his blood sugar under control. What is the most appropriate response by the nurse?

"Why don't you take the medicines, too, and benefit from both?"

A nurse is presenting an in-service program to a group of nurses about culture and cultural diversity. When describing culture, which characteristics would the nurse include? Select all that apply.

Culture has recognizable patterns. Culture is dynamic.

The nursing researcher is studying so-called "unnatural illnesses." What cause of such illnesses would be included in the study?

witchcraft

Which scenario is an example of cultural competence in nursing?

Attending a conference for cultural diversity

Which behaviors demonstrated by the client would the nurse consider as reflection of the client's pride in ethnicity? Select all that apply.

requesting native cuisine listening to folk music and dance asking to wear person unique clothing

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

require an individualized approach by the nurse.

Which client admitted to the emergency department (ED) might require the nurse to include interventions aimed at addressing CULTURAL SHOCK in the plan of care?

the client who recently immigrated from Mexico who fell from a ladder

Which stereotypical ideas about older adult clients does the nurse associate with the concept of ageism? Select all that apply.

uninterested in intimacy physically impaired burdensome to family

The nurse is teaching about sources of calcium for a client newly diagnosed with lactose intolerance. The client would require further teaching if which food is chosen?

yogurt

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 term describes the tendency to impose one's cultural beliefs, values, and patterns of behavior on a person from a different culture?

Cultural imposition

A client of Arab descent has been admitted to the health care facility with varicose veins. What should the nurse avoid while conducting the interview of the client?

Maintaining eye contact

The nurse is reviewing the diets for a group of assigned patients. The nurse notes that a client requires an alternate meal choice if pork is being served. What cultural group would require an alternative meal choice?

Muslim

The nurse is caring for a client of ASIAN descent. The client is postoperative 3 days from CABG. The client has a prescription to ambulate. What is the best action by the nurse?

Obtain a prescription for physical therapy consult to ambulate the client.

A nurse has recently completed a seminar on cultural diversity. Which statement regarding development of cultural knowledge indicates a need for additional teaching?

"The more curious the nurse is about the client's culture, the more the client will want to share."

The nurse is collecting the health history of a client and notes the client is apprehensive in answering questions. The client states, "My spiritual healer will be here soon." What is the best response by the nurse?

"We can wait until your spiritual healer arrives and work together to answer these questions."

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 (UAP) 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 Hispanic client has been hospitalized for 6 days for postoperative infection. The client's weight is decreasing each day, and the nutritional intake is declining. Which nutritional assessment question is most appropriate?

"What type of food do you eat at home?"

The nurse is caring for a client who practices Catholicism and was newly diagnosed with cancer. The client states, "God is punishing me for my past sins." How should the nurse respond?

"You sound upset, would like you to talk about it?"

The nurse is assessing an older adult of Asian decent who immigrated at the age of 3 years. The client speaks the dominant language and lives in a predominantly Asian neighborhood. Which action by the nurse is most appropriate?

Ask the client about special cultural beliefs or practices.

When completing a transcultural assessment of communication, which assessment by the nurse is most appropriate?

Assessment of eye contact, personal space, and social taboos

A Muslim client is admitted to the hospital. What cultural considerations might the nurse include in the plan of care? Select all that apply.

Assign care providers of the same sex. Avoid touching clients of the opposite sex. Make accommodations for the prayer needs of the client.

A client from Malaysia is admitted to the health care facility with reports 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

A nurse is developing a care plan for a Hispanic client who has diabetes. What cultural intervention is MOST appropriate?

Dietary counseling, as Hispanic diets are often high in carbohydrates

The nurse is caring for a client of Asian descent. The client is postoperative 3 days from coronary artery bypass graft (CABG). 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.

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.

A nurse is caring for a postoperative client of Asian descent after knee arthroplasty. The nurse plans to help the client ambulate, but is aware that the client may feel threatened due to physical closeness. What would be the most appropriate nursing action?

Explain the purpose and need for assistance during ambulation.

A nurse is providing care to a medically compromised client with limited ability to speak the dominant language. To obtain information about the client's culture, who would be appropriate for the nurse to use as a key informant? Select all that apply.

Family, interpreters, client's religious contact, friends

Which teaching statement best exemplifies cultural competence in relation to time for the American culture?

It is important to arrive within 20 minutes of your scheduled appointment time.

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.

A Native American/First Nations client comes to a new clinic. The client has been to multiple clinics. The client uses peyote as part of his religion. Past care providers have dismissed the client's concerns as being imaginary. What is the priority nursing diagnosis?

Powerlessness related to the inability to make heath care providers understand his symptoms

The nurse overhears a colleague state, "All people from that client's country are rude." What is the appropriate nursing response?

Respond by saying, "Stereotypes keep us from accepting others as unique individuals."

The client in a rehabilitation unit is having a difficult time adjusting to the scheduled activities on the unit, as well as being dependent on others for meals and medications. Which word best describes what the client is experiencing?

SHOCK

A client has recently immigrated and is exhibiting symptoms of culture shock. The client reports feeling unaccepted in the new culture. The client states, "I can't do anything right here." What is the priority nursing diagnosis?

Situational low self-esteem related to culture shock and feelings of fear and incompetence

A Hispanic single parent is having difficulty finding employment due to a lack of a car and speaking primarily Spanish. Which factor is a barrier to health care?

Spanish as primary language

A nurse in the hospital is caring for a Native American/First Nations male. Which statement should best guide the nurse's care?

There may be a role for a tribal medicine man in the client's care.

The new nurse is caring for a client of Asian descent. What should the nurse expect when caring for this client?

This client will require the nurse to keep an arm's length distance.

The younger nurses 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.

A nurse convinces a client who is a Jehovah's Witness that receiving blood products is more important than the legalistic components of religion. What client reaction may be expected following this mandated change?

The client states, "I feel like I abandoned my religion."

A Hispanic woman is seeking care at the local clinic. The nurse is completing a cultural assessment. Which scenario would demonstrate cultural assimilation?

The client's daughter, who is with her, learned the dominant language as her second language.

A staff nurse meets with the charge nurse and is reporting that all the new nurses are leaving messes on the unit. The staff nurse states, "These youngsters think they can waltz in here and get our jobs." What is this nurse demonstrating?

cultural conflict

The emergency department (ED) nurse is caring for a client who recently immigrated from CHINA and was injured in a motor vehicle collision (MVC). The nurse should implement interventions aimed at addressing which issue?

cultural shock

A nurse is caring for a 79-year-old Appalachian woman who was placed in a long-term care facility by her son, who is no longer able to care for her. She appears disoriented and reports being bothered by the "bright lights and constant activity." The nurse appropriately documents what condition in the chart?

culture shock

A nurse is caring for a female client 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 nurse is interviewing a client who is Native American/First Nations. What question would be best to ask this client?

"Do you use herbal or medicinal plants?"

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).

When a home-bound client expresses her past-oriented ancestral heritage and family rituals, the nurse recognizes that the client is expressing:

ethnic identity

Based on cultural factors, which client would be most likely to ask the following: "Why is there a male nurse in my wife's room?"

A 43-year-old Muslim male

The nurse is taking a client history. With which client is direct eye contact appropriate?

32-year-old white woman

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.

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

A client originally from Asia 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