Chapter 05: Cultural Diversity

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

1. Requesting native cuisine 2. Listening to folk music and dance 3. Asking to wear unique clothing

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 student nurse is not looking forward to clinical rotation on a geriatric unit, stating "How can I get them to move faster? They always seem so slow!" How should the instructor respond?

"Be careful of the negative attitude in your approach. How fast an individual moves will depend on physical ability not necessarily age."

Which behavior by the nurse is stereotyping?

Avoiding older adult clients because their care is time consuming

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

Access to care

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

Ask an open-ended, general question

A family recently immigrated to a new country. The parent reports that the teenager is showing signs of fear, has vague reports of stomach pain, and feels humiliated by peers because of their culture. What is the priority assessment for the nurse?

Culture shock

The nurse is caring for a client who is postoperative 3 days from coronary artery bypass graft. 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.

The nurse is caring for a client whose language skills are very limited in the dominant language, and an interpreter has been obtained. The interpreter appears to be telling the client more than the nurse is saying and possibly providing an opinion or medical advice. Which action is appropriate for the nurse to take?

Speak privately with the interpreter and instruct them to only provide language interpretation.

The labor and delivery nurse is getting report from the previous shift regarding a client with Asian heritage. The departing nurse states that the client did not ask for pain medication because "Asian people can handle pain." The nurse receiving report understands that this an example of what?

Stereotyping

A family has immigrated and settled in a neighborhood that primarily speaks their native language. The nurse caring for this family recognizes that which family member will likely require the greatest amount of time to learn the dominant language?

The 45-year-old mother in the family who does not work outside the home

A nurse is assigned to care for a client who does not speak the dominant language. An interpreter has been contacted and will be at the bedside shortly. Which action by the nurse would be most effective in reassuring the client until the interpreter arrives?

Using reassuring body language and making eye contact to assess needs

The emergency department nurse is caring for a client injured in a motor vehicle collision. The client recently immigrated to the country. The nurse should implement interventions aimed at addressing which issue?

Culture shock

A nurse is working in a clinic that serves a community with a high population of immigrants. Which nursing assessment is the priority?

Language assessment

Which nursing action displays linguistic competence?

Learning pertinent words and phrases in the client's language

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

"What are your dietary needs and preferences?"

Which scenario is an example of cultural competence in nursing?

Attending a conference for cultural diversity

The spouse of a client asks the nurse whether the spouse may bring in a cream from home to apply to the client's skin. The spouse says, "Whenever anyone gets sick, we always use this cream." The nurse interprets this as:

ritual.

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

ethnocentrism.

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.

The nurse is caring for a client admitted with an upper respiratory infection. The client tells the nurse about following the holistic belief of hot/cold. Which food items should the nurse provide to the client based on this information?

Soup, hot tea, and toast

The nurse obtains a health history interview on a client with lung cancer. The client states, "I became too focused at work; I did not have time to rest. I usually work 8 hours per day but, for the past few months, I have been spending at least 12 hours per day at the office. That is probably the reason why I was diagnosed with cancer. Maybe when I try to go back to my usual schedule, the cancer will go away. I did not want to be here but my wife is insistent. I do not think medications work. My brother-in-law died of cancer. He took a lot of medicines and prayed really hard, but he died just the same."

The nurse determines that the client believes in the hollistic magico religious cause of illness as manifested by believing one can be cured of cancer by limiting work hours and commenting in the lack of confidence in prayer

The nurse is providing discharge teaching for a client who is from a different culture. The nurse notes that the client will look away from the nurse and does not maintain eye contact. What would be the most appropriate action by the nurse, with regard to culturally competent care?

Utilize a key informant and continue with the teaching, verifying the client's understanding through open-ended questions.

Nurses are responsible for delivering culturally competent care for all clients. Culturally competent care does not account for:

client's height.

A client who practices Islam dies at the hospital surrounded by family members. Which action by the nurse demonstrates cultural sensitivity related to the client's death?

consulting the family member prior to performing post-mortem care

A client who immigrated from another country informs the nurse of dietary requests. The nurse responds to the special dietary needs by stating, "You are now living here, and you should try to start eating those foods common to our diet." This inappropriate response is an example of:

cultural imposition.

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."

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."

The client is admitted to the hospital with a ruptured ovarian cyst. The client has expressed that it is very important that the spouse 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 client's spouse has asked that the client be cared for exclusively by female nurses. How should the nurse incorporate this request into the care plan?

Document the request and make all reasonable efforts to honor it

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

1. Conducting an assessment 2. Developing client outcomes 3. Providing client education

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.

1. Family 2. Friends 3. Interpreters 4. Client's religious contact

Which factors contribute to the concept of a culture? Select all that apply.

1. Language 2. Art and music 3. Items and clothing worn 4. Beliefs about health practices 5. Styles used for communication

Nurses are socialized into the:

healthcare culture.

A client says to the nurse, "Why don't you wear a white cap like nurses do on the soap operas?" This is an ethnocentric statement based on the:

media.

The nurse is teaching a Black client about common health conditions. Which statement by the client most directly addresses a health problem with an increased incidence in this population group?

"It is important to monitor my blood pressure."

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."

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

"What would you think about taking the medicines, too, and benefitting from both?"

The nurse is educating a client of Chinese descent regarding the reduction and elimination of lactose in the diet. Which statement(s) made by the client indicates that the education was effective? Select all that apply.

1. "When I drink coffee or tea, I should use a non-dairy creamer instead of milk or cream." 2. "I should replace 2% milk with lactose-free milk." 3. "I can use kosher parve foods because they are prepared without milk."

Which disorders might a nurse screen for in a black client, based on race? Select all that apply.

1. Keloid formations 2. Lactase deficiency 3. Sickle cell anemia

What are characteristics of nurses that make them a subculture? Select all that apply.

1. Uniforms worn based on place of employment 2. Language or medical terminology used to communicate 3. Legal authorization to provide health care to others

The nurse works in an urban hospital and cares for a diverse population of clients. Which action(s) by the nurse demonstrates the delivery of culturally sensitive care to clients? Select all that apply.

1. asking the client questions regarding health care beliefs related to the client's culture 2. allowing the client to keep a religious necklace on until going into the operating room 3. integrating the client's cultural practices when assisting with the creation of the plan of care

A nurse is assigned the care of a client who speaks a nondominant language. The nurse does not understand the client's language. Which agency resource is best for the nurse to use in this case?

A professional interpreter.

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 personal space preferences.

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

Ask the client how the client wants to be treated based on the client's values and beliefs.

A client is admitted with end-stage pancreatic cancer and is experiencing extreme pain. The client asks the nurse whether 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

Upon moving to another country, a college student is very confused by many local customs. He is especially bothered by the custom of men and women eating in separate areas and it makes him angry and resentful of the new culture. What are the feelings experienced by this student?

Culture shock

Which is a cultural norm of the health care system?

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