Cultural and Spiritual Considerations Practice Questions

A nurse is assessing a woman whose religious beliefs do not allow blood transfusions. She has severe anemia, is very weak, and has altered mental status. What should the nurse do to provide culturally competent care to this woman? 1. Examine his or her feelings about the role of religious beliefs in making decisions about life. 2. Recognize that he or she cannot provide care to patients whose religious beliefs endanger their lives. 3. Try to convince the patient to have a blood transfusion to save her own life. 4. Determine whether the patient is competent to make her own decisions about health care.

1. Examine his or her feelings about the role of religious beliefs in making decisions about life.

A nurse is teaching a family from Guatemala about the importance of exercise to reduce body weight. The husband asks "What exercise should we do?" Considering the time orientation of this family, what is the most effective way for the nurse to respond? 1. "Research has shown that walking 30 minutes most days of the week is best." 2. "Is there any exercise that you can do today for 30 minutes and add it to your daily routine?" 3. "If you exercise 30 minutes most days of the week, you can lose weight by your next visit." 4. I have always found that resistance weight training each day for 30 minutes is effective."

2. "Is there any exercise that you can do today for 30 minutes and add it to your daily routine?"

A school nurse notices a boy with a bandage on his arm and black fluid under the edge of the bandage. She asks the teen what happened to his arm. He replies that his mother applied axle grease to a boil. What is the nurse's most appropriate response to this boy? 1. Tell the teen to remove the bandage and wash his arm. 2. Ask the teen what the boil looks like and feels like and if the axle grease is healing the boil. 3. Advise the teen to tell his mother to use antibiotic cream rather than axle grease. 4. Suggest that the teen see a health care provider because the axle grease will infect the boil.

2. Ask the teen what the boil looks like and feels like and if the axle grease is healing the boil.

An older man who is near death has been admitted to the hospital, and family members are at his bedside. Which question or statement should the nurse use during the admission assessment to address the spiritual needs of the patient and his family appropriately? 1. "What is your religion? I'll make the appropriate spiritual arrangements." 2. "Tell me what death means to people in your culture." 3. "Are there any special needs that you and your family request at this time?" 4. "I'll call the hospital priest so he can administer last rights."

3. "Are there any special needs that you and your family request at this time?"

A nurse is caring for a woman who has just been pronounced dead. Her adult children are in the room. Which statement by the nurse indicates culturally competent care? 1. "Which funeral home would you like notified of your mother's death?" 2. "We will be moving her to the morgue in about 30 minutes." 3. "Would you like some time alone with your mother for any specific ceremonies?" 4. "Here are some of her personal belongings that were in the drawer."

3. "Would you like some time alone with your mother for any specific ceremonies?"

__ refers to differences in gender, age, culture, race, ethnicity, religion, sexual orientation, physical or mental disabilities, and social and economic status. a. discrimination b. spirituality c. cultural sensitivity d. diversity

d. diversity Diversity refers to differences in gender, age, culture, race, ethnicity, religion, sexual orientation, physical or mental disabilities, and social and economic status. Discrimination is excluding a person based on gender, age, culture, race, religion, or sexual orientation. A review of spirituality definitions in health care literature provided several themes: relationship to God, a spiritual being, a higher being, or reality greater than the self; existential, not of the material world; meaning and purpose in life; and life force of the person or integrating aspect of the person. Religion may or may not be part of one's spirituality. Cultural sensitivity is being aware of and sensitive to another's culture.

The nurse is assessing a patient's spiritual beliefs and practices. Which questions should be considered part of the assessment? a. What type of spiritual/religious support do you desire? b. What is the name of your clergy, ministers, chaplains, pastor, rabbi? c. What does pain mean to you? d. What does dying mean to you? e. What are your educational goals? f. Do you use prayer in your life?

a, b, d, f Options A, B, D, and F are all questions related to spiritual assessment. Pain is part of physical and cultural assessment. Educational goals are not part of a nursing assessment.

What standards or guidelines exist to help eliminate racial and ethnic health disparities and to improve the health of all people who live in the United States? a. Each ethnic group has its own written standards for competent cultural care. b. The U.S. Office of Minority Health published standards to ensure culturally appropriate health care services. c. The American Society of Cultural Competence has guidelines containing the health beliefs and practices of major cultural groups. d. There are no standards or guidelines for giving competent cultural care.

b. The U.S. Office of Minority Health published standards to ensure culturally appropriate health care services. There are 14 standards that provide for culturally and linguistically appropriate services (CLAS). Option A is incorrect. There are guidelines and standards. Option D is not a legitimate group.

An Asian woman comes to the clinic with a complaint of back pain. During the history, she tells the nurse that she usually uses acupuncture for her pain. What is the nurses best response? a. When have you used acupuncture, and what effects did it have? b. Acupuncture is good for some problems, but for major illnesses its best to use medications. c. Why did you use acupuncture? d. I have heard that many Asian people use acupuncture.

ANS: A Feedback A Asking about the use and effectiveness of acupuncture acknowledges the patients choice of treatment and allows the nurse to gather more data about its effectiveness for this patient. B Asking Why did you use acupuncture? is a nontherapeutic response and questions the patients reason for her health care decisions. C Asking Why did you use acupuncture? is a nontherapeutic response and questions the patients reason for her health care decisions. D Commenting that, I have heard that many Asian people use acupuncture is an example of stereotyping.

A nurse can improve cultural awareness with which behavior? a. Being sensitive to differences between the cultures of the nurse and patient b. Making generalizations about various ethnic and cultural groups c. Learning everything about the various cultural groups in the nurses city d. Taking a foreign language class

ANS: A Feedback A Being sensitive to differences between the cultures of the nurse and patient. This allows the nurse to be open and to collect data about each unique patient. B Making generalizations about various ethnic and cultural groups leads to stereotyping. C Learning everything about the various cultural groups in the nurses city provides useful information about a specific city, but does not necessarily improve cultural awareness of cultures in other cities. D Learning a foreign language may help a nurse learn information about one culture, but does not improve cultural awareness of other cultures.

After the death of a Native American man, the nurse opened a window to allow spirits to leave. This action is an example of which attribute of the concept of cultural competence? a. Adapting interventions based on cultural practices (Tailoring) b. Gaining information about cultural differences (Knowledge) c. Considering the effects of anothers values and experiences (Understanding) d. Showing appreciation for cultural differences (Respect)

ANS: A Feedback A The nurse changed (adapted) the usual procedure after death by opening the window, which was a practice of this Native American family. B Gaining information is the first step, but is insufficient to adapt an intervention as described in this example. C Understanding develops after knowledge, but does not involve taking action. D Respect is the step before Adaptation, when nurses comprehend the cultural differences, but do not adapt nursing care.

Which question is most effective in assessing a patients personal beliefs about health and illness? a. What or who do you believe controls your health? b. Do you see your health care provider annually? c. Do you have specific beliefs about health and illness? d. Who makes the health decisions in your family?

ANS: A Feedback A What or who do you believe controls your health? is a broad question that allows the patient to describe his or her beliefs. B Asking if the patient visits his or her health care provider annually assumes the patient has a health care provider, and it is a closed-ended question that yields little data. C Do you have specific beliefs about health and illness? will yield a yes or no answer, but does not provide information needed. D Who makes the health decisions in your family? does not provide information about the beliefs of the patient

A nurse is caring for a woman who has given birth to a healthy baby. The womans husband and mother are in the room, and more family members are in the lobby. Which comment by the nurse demonstrates culturally competent care? a. We need to take your baby to the nursery now for a physical examination. b. Are there any ceremonies or other practices that are important to you at this time? c. We can only allow immediate family in the room with you at this time. d. Because breastfeeding is the best way to feed your baby, well bring your baby to you when she is hungry.

ANS: B Feedback A Although a physical examination is important, it is not necessary for culturally competent care and can be performed at another time. B Asking about ceremonies or other practices collects data about culturally-based behaviors of this patient and family surrounding childbirth. C Limiting visitors based on an arbitrary or subjective definition of immediate family may interfere with culturally competent care. D Breastfeeding is a choice the mother makes, not the nurse.

A male nurse is assigned to the care of a gay male with alcoholism. This sexual orientation is inconsistent with the beliefs of the nurse. What actions, if any, can the nurse take to provide patient-centered care to this patient? a. No action is necessary at this time. b. Examine his own feelings about alcoholism and homosexuality. c. Determine the patients degree of risk for contracting the human immunodeficiency virus. d. Discuss homosexuality and alcoholism with the patient.

ANS: B Feedback A Not acting will not facilitate patient-centered care. The nurse needs to reflect on his feelings about this patient. B Examining ones own feelings about alcoholism and gay men specifically and identifying ones own beliefs and values generally is part of the process for developing cultural competence, which should allow one to recognize the uniqueness of patients and to demonstrate respect for individuals. C Determining the patients degree of risk for contracting the human immunodeficiency virus is based on an assumption that because the patient is gay, he has or will have the human immunodeficiency virus. D A discussion with the patient may help the nurse understand him, but will not necessarily provide insight into the nurses beliefs and feelings.

What are the characteristics of ones culture? a. Color of skin and hair b. System of beliefs and practices c. Food preferences d. Language and religion

ANS: B Feedback A Skin and hair color are examples of racial characteristics based on genetics. B System of beliefs and practices is part of the definition of culture. C Food preferences are an example of ethnicity. D Language and religion are examples of ethnicity.

During the first prenatal visit for a 20-year-old Hispanic woman, the nurse assesses the patients health beliefs and practices. Which questions are appropriate as part of this assessment? Select all that apply. a. You are Hispanic, do you need me to find an interpreter? b. What is the language that is usually spoken in your home? c. How do you define health and illness? d. Which Catholic church do you attend? e. Do you have specific beliefs or preferences concerning food or food preparation? f. Do you or the members of your family have certain beliefs and practices surrounding pregnancy and childbirth?

ANS: B, C, E, F Correct: What is the language that is usually spoken in your home? How do you define health and illness? Do you have specific beliefs or preferences concerning food or food preparation? Do you or the members of your family have certain beliefs and practices surrounding pregnancy and childbirth? These four questions support culturally sensitive nursing care. Incorrect: You are Hispanic, do you need me to find an interpreter? assumes that all Hispanic persons speak Spanish only and is an example of stereotyping. Which Catholic church do you attend? assumes that all Hispanics are Catholics and is an example of stereotyping.

Which of the components described below represent the Filipino culture? Select all that apply. a. Tagalog and Cebuano are the primary dialects spoken. b. Orientation to the past is evident in their respect for elders. c. The family, rather than the individual, is the unit. d. Most Filipinos are Catholic. e. Filipinos like to eat rice with most meals. f. Sharing is common since interdependence is important.

ANS: B, C, F Correct: Respect for elders is an example of values and beliefs, a part of culture. Value of family represents beliefs and customs of culture. Interdependence is a value of Filipinos. Incorrect: Language, religion, and food preferences are part of ethnicity, rather than culture.

The nurse is reviewing concepts related to one's heritage and beliefs. The belief in a divine or superhuman power or powers to be obeyed and worshipped as the creator(s) and ruler(s) of the universe is known as: a. culture b. religion c. ethnicity d. spirituality

b. religion Religion is defined as an organized system of beliefs concerning the cause, nature, and purpose of the universe, especially belief in or the worship of God or gods. Culture is the thoughts, communications, actions, customs, beliefs, values, and institutions of racial, ethnic, religious, or social groups. Ethnicity pertains to a social group within the social system that claims to possess variable traits, such as a common geographic origin, religion, or race. Spirituality is born out of each person's unique life experience and his or her personal effort to find purpose and meaning in life.

A nurse is conducting an assessment of an American Indian woman who has come to the clinic complaining of persistent headaches. The patient tells the nurse that the medicines prescribed by the tribal healer have done some good. What is the appropriate response of the nurse at this time? a. I advise you to stop taking those medicines from the tribal healer. b. Perhaps you should increase the frequency of the healers medicines. c. Tell me about these medicines and how often you are using them. d. Could your headaches be caused by the healers medicines?

ANS: C Feedback A Advising the patient to stop taking any nonprescription medicines is inappropriate until the nurse knows the details about all medicines used by the patient. B Telling the patient to increase the frequency of the healers medicines is inappropriate until the nurse knows details about the medicines. C Asking the patient about the nature of these medicines and how often the patient uses them allows the nurse to collect data about the medicines and their uses, to learn more about the practices used by this patient to improve her health, and to check for potential drug interaction before prescribing other medications or treatment. D Suggesting the patients headaches are caused by the healers medicines is inappropriate until the nurse knows details about the medicines.

Which nursing behaviors indicate culturally competent care? a. Recognizing that there are different definitions of health and illness b. Complying with the stated plan of treatment despite the patients differing opinion c. Understanding that there is diversity even among people of the same cultural group d. Helping patients of different cultures adopt the beliefs and behaviors of the dominant culture

ANS: C Feedback A Recognizing that there are many different definitions of health and illness is not sufficient for culturally competent care. B Complying with the stated plan of treatment despite the patients differing opinion is not a culturally competent behavior. The patient needs to understand, support, and participate in the plan of care. C Understanding that there is diversity even among people of the same cultural group prevents assumptions and stereotypes that inhibit culturally competent care. D Helping patients of different cultures adopt the beliefs and behaviors of the dominant culture is an example of the opposite of cultural competence; it assumes that all persons should adopt certain beliefs and behaviors.

Which example below best characterizes a patients race? a. The language spoken in the patients home is Tagalog. b. The patients family follows a kosher diet. c. The patient and his family have blonde hair and fair skin. d. The patients grandparents came to the United States from Germany.

ANS: C Feedback A The language spoken at home refers to ethnicity. B A kosher diet refers to ethnicity. C Blonde hair and fair skin indicate genetics and race. D Although the patient and grandparents may share the same race, that the grandparents came to the United States from Germany does not relate to race.

Which question is the most appropriate to learn about a patients religious practices? a. How often do you go to church? b. Where is your church located? c. Do you mind telling me about your religion? d. Do you have any specific religious or spiritual practices or beliefs?

ANS: D Feedback A Asking the patient about his or her church makes the assumption that the patient worships in a church, which may not be correct. B Asking the patient about the location of his or her church makes the assumption that the patient worships in a church, which may not be correct. C The question is not an efficient way to learn about religious or spiritual practices. D Do you have any specific religious or spiritual practices or beliefs? is a broad, open-ended question that allows the patient to describe his or her religious beliefs. The question makes no reference to any particular faith.

A patient tells the nurse that her religion prohibits her from eating food prepared outside of a special kitchen. What is the nurses appropriate action to meet this patients needs? a. Call the dietary department to cancel the patients meal tray. b. Tell the patient that her diet must be carefully monitored and prepared at the hospital. c. Tell the patient that because of her illness, a few changes to her religious requirements will be necessary. d. Ask the patient to describe the requirements for the special kitchen.

ANS: D Feedback A Cancelling the patients food tray does not meet the patients needs. B Telling the patient that her diet must be carefully monitored and prepared at the hospital is inappropriate because it does not consider the ethnicity of the patient and is not culturally competent care. C Asking the patient to change her religious requirements does not respect her ethnicity and is not culturally competent care. D Asking the patient to describe the requirements for the special kitchen allows the nurse to collect more data about the needs of the patient.

A Hispanic patient tells an African American nurse, You are African American and cant possibly understand how a person like me feels. What is an appropriate response by the nurse at this time? a. Find a nurse who is not African American to interview the patient. b. Ask the patient, Why do you think that, since we just met? c. Note that the patient is very defensive about being racially different. d. Encourage the patient to describe what he means by his statement.

ANS: D Feedback A Finding a nurse who is not African American to interview the patient is neither necessary nor practical. B Asking the patient Why do you think that, since we just met? sounds defensive and may not facilitate further communication. C Making an assumption that the patient is very defensive about being racially different is not based on any data. D By encouraging the patient to describe what he means by his statement, the nurse is demonstrating cultural awareness and sensitivity by gathering more data about the unique beliefs and value systems of this patient.