Chapter 5: Cultural Diversity

Which definition of culture is most accurate?

A belief system that guides behavior Explanation: 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. Culture is not simply a cluster of individuals with no commonality. Culture is not a grouping of people based on altruism. Members of a culture are not completely uniform.

When providing culturally competent care to clients, a nurse understands that cultural competence involves which characteristics? Select all that apply.

A process that requires life-long learning A commitment to promoting health equity Knowledge of influences on the clients' beliefs Awareness of one's own influences on responses Explanation: Cultural competency is an integral component of the knowledge and practice base of nursing and is continually improved through a life-long learning process and commitment to health equity. It requires a knowledge of the influences on clients' beliefs and self-awareness of one's own influences on clients' responses.Standards of practice for culturally competent nursing care continue to be refined and are driven by the principles of social justice and health equity, not fidelity, with the aim of reducing health disparities.

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

A ritual Explanation: Rituals are common and observable expressions of culture in hospitals, clinics, homes, schools, and work settings. A stigma is social disapproval. Cultural competence is care delivered with an awareness of aspects of a client's culture. A health disparity is a health difference between groups of people.

A nurse overhears another nurse make a statement that indicates racism. The nurse makes this determination based on which characteristic indicative of social value?

Skin color Explanation: Racism uses skin color, not size, language or dress, as the primary indicator of social value.

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 Explanation: The client believes in the hot/cold theory of disease, so the client needs to treat cold diseases with hot food and hot diseases with cold food. The most appropriate choice would be the soup, hot tea, and toast. The other options are all cold foods, which the client would not use to treat a cold disease such as an upper respiratory infection.

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. Explanation: As a component of cultural assessment, the nurse should seek to understand the cultural lens through which the client may understand health promotion. Health promotion is not a concept exclusive to Western cultures, though it may be considered differently among non-Western cultures. Even if health promotion is not a priority in a client's culture, the nurse should still address issues related to health promotion in a respectful and relevant manner. Health promotion is not directly linked to socioeconomic development levels.

A client believes that the 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 Explanation: The nurse is demonstrating cultural blindness, which occurs when one ignores differences and proceeds as though they do not exist.

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 Explanation: Cultural conflict occurs when people become aware of cultural differences (the younger nurses) and feel threatened (most likely by their younger age) and respond by ridiculing the beliefs or actions of others to make themselves feel more secure. Cultural assimilation occurs when one adapts to a new culture. Cultural blindness occurs when one ignores a cultural difference. Cultural diversity encompasses culture, race, ethnicity, religion, language, gender, socioeconomic status, and more.

Which term is most appropriate for describing a healthcare practitioner who is respectful of the healthcare traditions of other cultures?

Culturally sensitive Explanation: Culturally sensitive is defined as being respectful of other diverse cultures. Culturally impositive is the tendency for healthcare practitioners to impose their beliefs, practices, and values on people of other cultures. Culturally appropriate and culturally competent refer to the holistic care given by healthcare practitioners.

The nurse is assessing a client who is unresponsive. To obtain information about the client's culture, the nurse interviews a person who has native knowledge about the client's culture. Which technique is the nurse using?

Key informant Explanation: The key informant technique is a method in which the interviewer looks for, locates, and interviews people who have expert or native knowledge about a culture. A willingness to discuss this knowledge and rapport with the interviewer are critical. The optimal key informant about a client is the client, but medically or culturally compromised clients (i.e., those who are unable to function optimally in the culture) might not be able to fill the role. The explanatory model is similar to the ethnographic interview. Given that the client is the expert on the client's own multicultural identity, questions are posed by the nurse to understand the client's beliefs about the client's health, or the explanation for the client's condition. The ethnographic interview is a structured way to elicit the respondent's concepts and understandings. The nurse interviewer asks questions, the client answers, and the nurse interviewer asks for clarification of the client's responses, if needed. A variety of techniques are used in open-ended interviewing to elicit responses from the interviewee that are as free from influence by the interviewer's comments as possible. Open-ended questions require that the respondent use the respondent's own words to answer.

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 Explanation: Although all of the assessments are appropriate, the priority assessment is communication. If clients do not speak the dominant language, it may be necessary to obtain an interpretor to provide culturally appropriate care.

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." Explanation: When clients are forced to participate in care that conflicts with their values, feelings of guilt and abandonment are likely. These feelings may deepen and threaten the client's well-being. The other answer choices are not related to mandated change.

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

Witchcraft Explanation: "Unnatural illnesses" are thought to be punishments for failing to follow a 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.

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

ethnocentrism. Explanation: Viewing one's own culture as superior to all others is ethnocentrism. Cultural relativity is the belief that to understand a person, you must understand that person's cultural context. Cultural pervasiveness refers to how widespread the effects of a culture are. Racism is the belief that one's race is superior to others.

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. Explanation: Ethnocentrism is a way of looking at the world through a personal lens that has been influenced by personality, genetics, family/relationships, and media. None of the remaining options play a role in the client's comment to the nurse.