Coursepoint Fundamentals PrepU: Chp5 - Culturally Respectful Care

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.

- "When I drink coffee or tea, I should use a non-dairy creamer instead of milk or cream." - "I should replace 2% milk with lactose-free milk." - "I can use kosher parve foods because they are prepared without milk." Explanation: The nurse determines that the client understands and can apply the education provided when the client states the intention to substitute milk for non-dairy coffee creamer, substitute milk for a lactose-free milk product, and use kosher parve (kosher neutral) products, which are not made with milk products. The statement about drinking a large glass of milk once daily instead of several times a day indicates the client requires further education, because the client should avoid milk or only drink small amounts. Dry milk solids contain milk and should be avoided; examples include some bread, cereals, puddings, gravy mixes, caramels, or chocolate.

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

32-year-old white woman Explanation: White Westerners generally make and maintain eye contact throughout communication. Although it may be natural for whites to look directly at a person while speaking, that is not always true of people from other cultures. It may offend clients of Asian descent or Native Americans/First Nations clients, who are likely to believe that lingering eye contact is an invasion of privacy or a sign of disrespect. Clients with Arab heritage may misinterpret direct eye contact as sexually suggestive.

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.

A family recently immigrated to a new country. The parent reports that the adolescent 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 Explanation: 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.

The nurse is caring for two clients with the same ethnic background but who appear to live out cultural practices in different ways. When understanding the needs of these clients and providing culturally safe care, the nurse should follow which principle?

Ethnicity and culture are not synonymous Explanation: 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 as symbols of a common group origin, history, identity, or descent. Ethnicity and culture are both valid and important concepts, though they do not mean the same thing. The two concepts are not mutually exclusive.

Classification of illness can occur with cultural practice. What is an example of an unnatural illness?

Evil forces caused a client to develop schizophrenia. Explanation: In some groups, illnesses are classified as natural and unnatural. Natural illnesses are caused by dangerous agents, such as cold air or impurities in the air or water. Unnatural illnesses are punishments for failing to follow a god's rules, resulting in evil forces, or witchcraft causing physical or mental health problems.

A 45-year-old client who is hospitalized for the first time in the client's life is experiencing culture shock, not understanding what is going on with the client's body or in the hospital. Place the stages of culture shock listed below in the order in which the client will most likely experience them.

Honeymoon Disenchantment Beginning resolution Effective function Explanation: Culture shock is a stress syndrome that normally progresses through a series of recognizable stages (honeymoon, disenchantment, beginning resolution, and effective function) to its resolution.

Which statement best conveys the relationship between race and ethnicity?

Race denotes physical characteristics, while ethnicity is rooted in a common heritage. Explanation: The term "race" is usually used in reference to particular physical characteristics, while ethnicity is an identification with a cultural group that is often based on a common heritage. Because it is rooted in objective physical traits, race is usually considered to be somewhat independent of culture.

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.

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

client's height. Explanation: In partnership with the person, family, and others; the nurse develops an individualized plan considering the person's characteristics or situation including but not limited to: values, beliefs, spiritual and health practices, preferences, choices, developmental level, coping style, culture, environment, and available technology. A physical characteristic such as one's height does not contribute to cultural competence.

The community health nurse is assessing a home-bound client. The client expresses their own past-oriented ancestral heritage and family rituals. The nurse recognizes that the client is expressing:

ethnic identity. Explanation: 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 and current position in larger society. Assimilation refers to new customs and attitudes that are acquired through contact and communication among persons of a particular culture and subculture refers to a group of people within a culture who have ideas and beliefs that are different from the rest of that society. Ethnocentrism is the practice of seeing one's own culture as the highest standard.

Nurses are socialized into the:

healthcare culture. Explanation: Culture enables people of similar cultural heritage to understand the meanings of each other's words as part of the particular context, to read each other's nonverbal behavior fairly accurately, and to communicate through symbols. All of these characteristics apply to health care, so health care can be considered a culture into which one can be socialized. The other answers pertain to the career, practice, or intellectual aspects of nursing but not as much to the social aspect of nursing.

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

Access to care Explanation: Poverty has long been a barrier to adequate health care. If clients cannot access health care, it does not matter if they have affordable housing, health insurance, or financial assistance. It is not possible to create a plan of care with client involvement without adequate support and access to care.

While assessing an older adult client's upper back, the nurse notes round, raised red spots along the client's back. The client's daughter says, "Oh, that is just cupping." What action should the nurse take?

Ask about the practice of cupping. Explanation: Complementary and alternative medicine are therapies that are used in addition to, or instead of, conventional medical treatment. Some cultures have specific health practices. The culturally competent nurse understands to assess different cultural practices before making conclusions or assumptions. The nurse should ask the client's adult daughter to explain the practice. The other options do not assess what cupping is and require further information before implementing.

A nurse is caring for a postoperative client after knee arthroplasty. The nurse plans to help the client ambulate but is aware that the client may feel threatened by physical closeness because the client is from a culture that tends to prefer more personal space when interacting with others. Using the principles of culturally competent care, what would be the most appropriate nursing action?

Explain the purpose and need for assistance during ambulation. Explanation: The nurse should explain the purpose of ambulation and the need for assistance while ambulating to the client. This would relieve the client's anxiety associated with physical closeness. However, the client won't be able to ambulate without assistance. Even though the nurse can instruct a family member to ambulate the client, this is not an appropriate action. Ambulating the client without recognizing the cultural difference is nontherapeutic, as the nurse would be not be performing culturally competent care by not acknowledging cultural practice.

A nurse is assessing a client's culture. Which aspect would be the easiest for the nurse to recognize?

Material Explanation: The easiest level of culture to recognize is material — in artwork, drama, tools, clothes, food, buildings, and rituals. Values and beliefs are harder to recognize. Sometimes they can be accessed by asking about items of material 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." Explanation: Culture is learned through life experiences from one generation to the next. Culture helping to define identity, language being the primary way that people share their culture, and culture being seen in attitudes of certain populations are correct options; these are all components that define culture.

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." Explanation: Monitoring the blood pressure is important for identifying the risk for hypertension and stroke, which are common health conditions among the Black population. The other statements are correct for preventing diabetes, breast cancer, and osteoporosis, but these diseases are not disproportionately common health conditions for the population.

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

"What are your dietary needs and preferences?" Explanation: By asking about dietary needs and preferences, the nurse can gain insight into religious and cultural dietary practices. 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 nurse is working to develop cultural competence. Which activities would be appropriate for the nurse to engage in when exploring the nurse's own cultural awareness? Select all that apply.

- Critical reflection - Feedback from colleagues - Self-assessment Explanation: Cultural awareness, critical reflection, feedback from colleagues and self-assessment are appropriate ways to explore one's own culture, biases and perspectives. Nurses need to exert effort in exploring their own cultures because culture tends to be invisible to the person. Journal article research and client interviews would be helpful in learning about the culture of others.

The nurse is caring for a client who does not speak the dominant language. In order to facilitate unencumbered communication with the client, the nurse will take which action(s)? Select all that apply.

- Determine in which language the client communicates effectively. - Review facility policy on communication with clients who do not speak the dominant language. - Schedule a certified interpreter when collecting client health history. Explanation: All clients have the right to unencumbered communication with a health care provider. Using children as interpreters or requiring clients to provide their own interpreters is a civil rights violation. In addition, the use of untrained interpreters, volunteers, or family is considered inappropriate because it undermines confidentiality and privacy. It also violates family roles and boundaries. The best form of communication with a client who does not speak or has limited ability in the dominant language is through a certified interpreter. A certified interpreter is a translator who is certified by a professional organization through rigorous testing based on appropriate and consistent criteria.

When providing care to a client, the nurse refers to the client's ethnic group. Which aspects would the nurse include as pertaining to this concept? Select all that apply.

- Language - Religious beliefs - Shared beliefs of origin Explanation: Although the terms race and ethnic group sometimes refer to the same people, race takes biologic characteristics as the markers of separate social status, and ethnic group takes social characteristics (such as language, religious tenets, shared beliefs of origin) as markers of cultural identity.

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.

- Less power - Health disparities Explanation: 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.

Which nursing actions are appropriate when collecting a health history for a client whose primary language differs from the dominant language? Select all that apply.

- Use the facility telephonic interpreting system. - Have a bilingual nurse assist with the health history. - Request assistance from a certified interpreter. Explanation: When caring for a client whose primary language differs from that of the nurse, the nurse should first use a certified interpreter. If a certified interpreter is unavailable, the nurse should then use the telephonic interpreting system or a bilingual staff member. The nurse should never use children to interpret. The nurse should speak in short sentences, using simple terminology.

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. Explanation: The dominant culture in Western societies emphasizes eye contact while speaking, but many other cultures regard this behavior in different ways. For example, direct eye contact may be considered impolite or aggressive by many Asians, Native Americans/First Nations, Indochinese, Arabs, and Appalachians; these groups of people tend to avert their eyes while speaking. Hispanics may look downward in deference to age, gender, social position, economic status, or authority. Muslim-Arab women often indicate modesty by avoiding eye contact with men, and Hasidic Jewish men may avoid direct eye contact with women. The only option above that has the correct assumption is the option regarding a Muslim-Arab woman refusing to make eye contact with her male nurse due to modesty. The nurse must be aware of the cultural meaning of eye contact in relationship to the health care situation.

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. Explanation: It is most appropriate to ask the client what is preferred in regard to personal space. If the nurse needs to invade the client's personal space to do an examination or take vital signs, it is important to discuss the matter. It is not appropriate to back away without assessing preference. It may make the client feel judged if the nurse asks why he or she is backing away. Moving closer to the client just perpetuates the problem.

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. Explanation: The best way to provide culturally appropriate care is to ask the client what the client values and believes and how the client would like to be treated. Asking another nurse to take over care will not help identify the cultural care needs. Researching the client's culture online and consulting the Minority Health Resource Center may be helpful as a learning experience later, but they do not help immediately in the provision of care. Also, remember that information about any culture is general and must be individualized.

The nurse admits a client to the critical care unit to rule out a myocardial infarction. The client has several family members in the waiting room. Which nursing action is most appropriate?

Assess the client's beliefs about family support during hospitalization. Explanation: Asking the client about the client's beliefs exemplifies that the nurse recognizes the importance of respecting differences rather than imposing standards. If the client believes family support is significant to health and recovery, the nurse should respect the client's beliefs and allow the visitors into the room.

Which scenario is an example of cultural competence in nursing?

Attending a conference for cultural diversity Explanation: 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.

Which behavior by the nurse is stereotyping?

Avoiding older adult clients because their care is time consuming Explanation: Avoiding older adult clients because their care is time consuming is stereotyping. This is a mistaken belief and an overgeneralization. Some older adult clients are very healthy. Ridiculing acupuncture is cultural conflict. Assuming that Western medicine is superior is ethnocentrism. Grouping care assignments to allow ample time to provide care is an appropriate strategy in time management.

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 Explanation: The student is experiencing culture shock, which is defined as the feelings a person experiences when placed in a different culture. Stereotyping is the assumption that all members of a culture, subculture, or ethnic group act alike. Ethnocentrism is the belief that one's ideas, beliefs, and practices are the best, are superior, or are most preferred to those of others. Cultural assimilation occurs when members of a minority group live within a dominant group and lose the cultural characteristics that make them different.

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. Explanation: For members of some cultures, providing care and performing nursing interventions can intrude into personal space. The nurse should discuss with the client the need for assistance during ambulation and prepare the client for potential closeness. The client may ambulate independently, but the nurse should still assist. Having the family or physical therapy ambulate the client does not address the issue related to culture and nursing interventions.

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. Explanation: A culturally sensitive nurse is one who respects a client's requests while ensuring that the requests reflect safe medical practice. This client's request does not interfere with client safety. Thus, the request should be respected and communicated through documentation to other healthcare personnel. Telling the client that the client must make all health care decisions does not address the client's request. There is no need to move to the hallway to discuss the client's care with the client's spouse, and this would likely be offensive.

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 Explanation: Although cultural assessment in a tactful and respectful manner is likely appropriate in this situation, the care team's guiding principle and obligation should be to accommodate and respect the couple's request. It would be inappropriate for the care team to attempt to convince the couple to change their minds or assume that it is a personal preference. The nurse would not teach the couple that male nurses on the unit are empathetic, as having female nurses is the client's preference.

Which area is typically included in a cultural assessment?

Food preferences Explanation: Dietary tolerance is associated with both cultural food preferences and biologic variation. A client's marital status and employment status are aspects of demographic information recorded in the client's health record but would not be pertinent, in and of themselves, to a cultural assessment. Ethics would not be typically covered in a cultural assessment, although one's religious affiliation might be.

The nurse is caring for a client from another culture who is diagnosed with lung cancer. Which nursing action best demonstrates culturally sensitive care?

Incorporating the client's need for daily prayer into the nursing care plan. Explanation: Nurses should be culturally competent and sensitive to provide care that respects (not just not offends) and incorporates the client's culture. Incorporating the client's culture creates an individual plan of care and not a treatment plan for all clients with the same diagnosis. The nurse should not use unmodified standardized care plans that do not account for cultural differences. Explaining the biomedical culture to the client does not ensure culturally sensitive care. The nurse should attempt to understand the client's culture, not have the client understand the culture of the health care system.

An unlicensed assistive personnel (UAP) has made a disparaging comment about a client from another culture, stating that the client's hygiene practices are "oddComplet". When questioned by the nurse, it becomes clear that this characterization stems from differences between the client's culture and the UAP's culture. What is the nurse's best response?

Initiate a dialogue with the UAP about the potential harms of ethnocentrism Explanation: Viewing one's own culture as the point of reference to all others is ethnocentrism. The UAP's statement provides a teachable moment for the nurse and would not be considered egregious to the extent that an incident report, documentation or removal from care is necessary.

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." Explanation: Stereotypes are preconceived ideas usually unsupported by facts. They tend to be neither real nor accurate. They can be dangerous because they interfere with accepting others as unique individuals. The nurse can professionally educate the colleague about the harm involved in stereotyping individuals. Ignoring the comment or reporting the colleague to the nurse manager would result in a missed opportunity to educate the colleague on stereotyping. Agreeing would only strengthen this harmful practice.

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.

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 Explanation: Stereotyping is a fixed attitude about people who share common characteristics. Clients with Asian heritage often do not express pain or emotions. Therefore, the misconception is they do not feel pain. Culture shock is bewilderment over behavior that is culturally atypical for the client. Ethnocentrism is the belief that one's culture is better than other cultures. Ageism is a negative belief that older adults are physically and cognitively impaired.

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 Explanation: 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 one's cultural beliefs onto another person.

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

The client's child learned the dominant language as a second language. Explanation: The child is demonstrating an example of cultural assimilation by taking on the language of the dominant culture. When a minority group lives within a dominant group, its members may adapt some of their cultural practices that once made them different. This process is referred to as cultural assimilation. Watching television from the home country, cooking traditional foods, and speaking only the original language demonstrate the original culture and an attempt to bring the minority culture into the dominant culture.

The nurse is using an interpreter to communicate with a client who speaks a different language. What would be the best way to choose an interpreter for this client?

The interpreter should understand the health care system. Explanation: 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 the dominant language. 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.

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 Explanation: The nurse assigned to care for a client who does not speak the dominant language can reassure the client by using appropriate body language and anticipating needs until an interpreter arrives. Doing so is important because there may be a delay in the interpreter arriving. Gestures and symbols can be confusing, as can enlisting multiple people to communicate. Avoiding the client's room is not appropriate or in the best interest of the client.

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. Explanation: Eye contact is a culturally variable nonverbal behavior. In some cultures, direct eye contact when speaking with others may be considered impolite or aggressive and clients may avert their eyes during the conversation. Therefore, utilizing a key informant or interpreter will help with interpreting nonverbal behavior and ensure teaching is completely translated and understood. Telling the client that it is important to listen implies that the client is not paying attention to the teaching. Changing positions to maintain eye contact is not culturally competent care and may make the client uncomfortable. Leaving the instructions for the client to review is not appropriate, as the nurse should finish the teaching and use teach-back to evaluate the learning.

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.

asking the client questions regarding health care beliefs related to the client's culture allowing the client to keep a religious necklace on until going into the operating room integrating the client's cultural practices when assisting with the creation of the plan of care Explanation: There are many ways in which nurses should deliver culturally sensitive care, but the priority is to understand the difference in culture and ethnicity and integrate these beliefs into the care delivery system. Asking questions related to culture is important since not all cultural groups follow a general belief practice. This should be considered whenever the plan of care is being developed. Allowing a client to wear a religious necklace until going into the operating room and keeping it in a safe place to be returned after a procedure is a demonstration of cultural sensitivity. Implying that a cultural group should adapt to the Anglo-American way is not culturally sensitive. Not all cultural groups respond to direct eye contact and the nurse should be aware of how this may be perceived.

The nurse is teaching a family, who has recently learned a family member has a lactase deficiency, how to make healthier dietary choices to ensure the family member obtains enough calcium in their diet. The nurse determines the teaching was successful when they choose which menu as the best choice?

baked salmon patty, steamed spinach, sweet potato, salad with romaine lettuce, hard-boiled egg slices, carrots, celery, cucumber, and vinegar vinaigrette dressing, apple slices, ice tea Explanation: The best choice is the salmon, spinach, sweet potato, salad, apple, and ice tea. The client will need to include other sources of calcium since milk and milk products are no longer advisable. This will include green leafy vegetables, dates, prunes, canned sardines and salmon with bones, egg yolks, whole grains, dried peas and beans, and calcium supplements. The other menu choices all include milk or milk products in some form (mayonnaise, yogurt, ranch dressing, butter, marshmallows, and chocolate bar).

A parent informs the nurse that immunizations are against the parent's cultural and religious beliefs and the parent does not want the child to receive immunizations. The nurse proceeds to inform the parent that the child will be consistently ill and will not be allowed to start school unless immunized. The nurse also informs the parent that the nurse had all of the nurse's own children vaccinated. The nurse's behavior an example of:

cultural imposition. Explanation: The nurse's behavior is an example of cultural imposition, defined as the tendency to impose one's cultural beliefs, practices, and values on a person from a different culture. Stereotyping is when one assumes that all members of a culture, ethnic group, or race act alike. Cultural blindness occurs when one ignores differences and proceeds as though they do not exist. Cultural conflict occurs when people become aware of cultural differences, feel threatened, and respond by ridiculing the beliefs and traditions of others to make themselves feel more secure in their own values.

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 Explanation: Only family members may touch or wash the body of a deceased individual who practiced the Islamic faith, so the nurse should ask for permission prior to providing post-mortem care. The family may choose to remain, but the nurse will not be allowed to wash the body. It will be the nurse's responsibility to arrange for transport to the funeral home after care is rendered by the family.

When reviewing the chart of an older adult client, the nurse notes that the client identifies as Japanese. The nurse realizes the client is referring to which ancestral and cultural factor?

ethnicity Explanation: Ethnicity refers to a common bond of kinship with country of origin, for this client Japan. Race refers to biologic differences, for this client Asian. Ethnocentrism is the belief that one's personal heritage is superior to others. Values are beliefs and attitudes that are important to a person. The scenario does not provide details to determine if the client expresses ethnocentrism nor any personal values.

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. Explanation: The nurse's response is an example of cultural imposition, which is defined as the belief that everyone should conform to the majority belief system. Cultural blindness is the result of ignoring differences and proceeding as though they do not exist. In this situation, the nurse did not ignore the request but inappropriately responded to it. Cultural diversity is defined as a diverse group in society, with varying racial classifications and national origins, religious affiliations, languages, physical sizes, genders, sexual orientations, ages, disabilities, socioeconomic statuses, occupational statuses, and geographic locations. Cultural assimilation occurs when members of a minority group live within a dominant group and lose the cultural characteristics that make them different.

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 __________ cause of illness as manifested by __________.

holistic believing one can be cured of cancer by limiting work hours Explanation: The holistic perspective presupposes that health is achieved when an individual is in harmony or in balance with the internal/external environment; illness is caused by any imbalance or disharmony. Believing that the cancer will be cured if the client cuts back on work hours is a means of restoring balance and harmony; thus, supports the holistic perspective of health. The biomedical perspective relies on empirical findings to explain health and illness. Believing in the effectiveness of medications supports the biomedical model. This perspective does not apply because the client is skeptical about relying on medications to cure the cancer. The client states, "I do not think medications work" and comments about how the brother-in-law took "a lot of medicines" and still died. The belief that supernatural forces influence health and illness supports the magico-religious perspective. Exhibiting confidence in the power of prayer to alleviate and/or cure illnesses falls under the magico-religious belief. The client comments that the brother-in-law died even though the brother-in-law prayed "really hard," which leads the nurse to believe the client does not hold the belief that prayer will cure the illness.

A woman has moved from the east coast to the west coast. She is a single parent of four children who is having difficulty finding employment due to a lack of a car and primarily speaking an uncommon language for the area. Which factor is a barrier to health care?

primary language other than the dominant one Explanation: The client speaking a language that is uncommon for the area as one's primary language is a barrier to health care. Being from a different culture, female, or the parent of multiple children does not create a barrier to care.

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

require an individualized approach by the nurse. Explanation: 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.