Cultural Chapter 31

The nurse is assessing a depressed client's spirituality. Which question should the nurse ask when determining meaning and purpose for a client? 1. "How does your illness affect your life goals?" 2. "How do you feel about yourself right now?" 3. "What are your thoughts about forgiving others?" 4. "What brings you joy and peace in your life?"

1 1 "How does your illness affect your life goals" is a question the nurse should ask to determine meaning and purpose in a client's life. 2 The question "How do you feel about yourself right now" determines interconnections, a client's self-concept, self-esteem, and sense of self. It does not assess meaning and purpose. 3 Asking, "What are your thoughts about forgiving others" is determining relationships, the client's ability to connect with other and to engage in the forgiveness of others. It does not assess meaning and purpose in a client's life. 4 The question, "What brings you joy and peace in your life" determines inner strengths, a client's ability to manifest joy and faith. It does not address meaning and purpose.

A Native American client with depression wants to talk to a shaman. Which nursing intervention is most appropriate? 1. Try to locate a shaman who will agree to come to the mental health unit. 2. Explain to the client that "voodoo" medicine will not heal the depression. 3. Ask the client to explain what the shaman can do that the psychiatrist cannot. 4. Inform the client that refusing treatment is a client's right.

1 1 The most appropriate nursing intervention should be to try to locate a shaman that will agree to come to the mental health unit. 2 Telling the client that the shaman is "voodoo" is disrespectful of the client's cultural and spiritual beliefs. 3 While the nurse can ask the client to explain what the shaman can do that the psychiatrist cannot, it is not the most appropriate intervention. The nurse should incorporate client's cultural and spiritual beliefs whenever possible. 4 Informing the client that refusing treatment is a client's right is too premature. The client is not refusing treatment at this time but is asking for a shaman.

The nurse is caring for a client at risk for spiritual distress and impaired religiosity. Which action should the nurse take? 1. Assess for substance use/abuse. 2. Monitor the client for biological variations. 3. Evaluate the client's paralanguage. 4. Plan for territoriality needs.

1 1 The nurse should assess for substance use/abuse when caring for spiritual and religious needs. When at risk for spiritual distress or impaired religiosity, clients may turn to use of various substances, which can affect the ability to deal with problems in a positive spiritual or religious manner. 2 When the nurse is monitoring for biological variations, the nurse is assessing for biological differences among people in various racial groups, not caring for spiritual distress and impaired religiosity. Body structure, skin color, physiological responses to medication and susceptibility to disease are some examples of biological variations. 3 While paralanguage is important for the cultural phenomenon of communication, it is not related to impaired religiosity and spiritual distress. Examples of paralanguage include voice quality, intonation, rhythm, and speed of the spoken word.

The nurse is using an interpreter for a client with an anxiety disorder who does not speak the nurse's language. Which technique should the nurse use? 1. Maintain eye contact with the client. 2. Involve a family member for sensitive subjects. 3. Talk separately with the interpreter at length. 4. Use medical terms throughout the conversation.

1 1 The nurse should maintain eye contact with the client rather than with the interpreter. 2 Whenever possible, use a certified interpreter with a background in healthcare, not relatives or children. Relatives or children may not be objective or may have difficulty relaying information about sensitive topics. 3 The nurse should avoid talking separately with the interpreter at length; the client may feel left out and distrustful. 4 The nurse should avoid using medical jargon or colloquialisms that the interpreter or client may not understand.

The nurse is incorporating "hot" and "cold" cultural beliefs about food into the plan of care for a client with a mental health illness. The nurse is most likely caring for which client? 1. An African American 2. A Latino American 3. A Native American 4. An Alaska Native

2 1 An African American does not follow the "hot" and "cold" dietary practices. 2 The nurse would most likely be caring for the Latino American. Latino Americans follow the "hot" and cold" dietary practices. 3 While a Native American would be prone to lactose intolerance, most Native Americans do not follow the "hot" and "cold" dietary practices. 4 An Alaska Native would not follow the "hot" and "cold" dietary practices for an illness.

Which population group should the mental health nurse most closely assess for thoughts of suicide? 1. African-American males 2. Alaska Native young adults 3. Asian American youth 4. White females

2 1 While African-American men and boys, in the face of racism, have been found more likely to suppress emotional distress, which may result in less likelihood of seeking treatment for mood disorders, they are not the highest risk for suicide. 2 American Indian and Alaska Native (AI/AN) young adults have the highest rates of suicide in the United States, at nearly 3 to 10 times prevalence compared with other racial and ethnic groups. 3 While Asian Americans and Hispanic or Latino youth are less likely to access mental health-care than white individuals, they are not the highest risk for suicide. 4 White females are not the highest risk for suicide.

The nurse is caring for a mental health client's spiritual needs. Which factors should the nurse assess as spiritual needs? (Select all that apply.) 1. Experience 2. Hope 3. Forgiveness 4. Love 5. Doctrine

2, 3, 4 1 The experiential dimension is one of the seven dimensions of all religious traditions. It is not a spiritual need. 2 One of the five types of spiritual needs is hope. 3 Forgiveness is a spiritual need of all clients. 4 One of the five types of spiritual needs associated with all human beings is love. 5 One of the seven dimensions of all religious traditions is the doctrinal dimension. It is not a spiritual need.

When interviewing a client of a different culture, which parameters should the nurse consider? (Select all that apply.) 1. Insurability 2. Space 3. Biological variations 4. Time 5. Communication

2, 3, 4, 5 1 Insurability is not one of the six characteristic phenomena to assess. 2 Space is one of the six characteristic phenomena to assess for culture. 3 When interviewing a client of a different culture, the nurse should assess biological variations, one of the six characteristic phenomena. 4 Time is one of the six characteristic phenomena to assess when interviewing a client of a different culture. 5 When interviewing a client of a different culture, the nurse should assess communication which is one of the six characteristic phenomena.

The nurse is considering the effects a prescribed psychiatric medication may have on a dark-skinned client. Which characteristic is the nurse evaluating? 1. Culture 2. Ethnicity 3. Race 4. Assimilation

3 1 Culture describes a particular society's entire way of living, encompassing shared patterns of belief, feeling, and knowledge that guide people's conduct and are passed down from generation to generation. It does not focus on the color of a client's skin and reactions to medications. 2 Ethnicity relates to groups of people who identify with each other because of a shared social and cultural heritage passed on to each successive generation (Giger, 2017). It does not relate to the skin color of clients and reactions to medications. 3 Some scientists argue the benefit of understanding racial differences in evaluating response to treatments such as medications. Race may be understood as a more biological term, describing a group of people who share similar inherited characteristics such as skin color, facial features, and blood groups. 4 Assimilate is incorporating practices and values of the majority culture. It does not relate to the effects of medication based upon a client's skin color.

The nurse is caring for a client with posttraumatic stress disorder who is of a different culture. Which action should the nurse take to promote environmental control for this client? 1. Give time options when appropriate 2. Teach good nutrition habits, incorporating the client's preferences 3. Support the client in participating in cultural and spiritual rituals 4. Observe for the use of touch among family members

3 1 Giving time options when appropriate is an intervention for the cultural variable time, not environmental control. 2 Teaching good nutrition habits and incorporating the client's preferences are interventions for the cultural variable biological variations, which includes nutritional preferences and deficiencies. 3 Supporting the client in cultural and spiritual rituals is an intervention for the cultural variable environmental control, the degree to which individuals perceive that they have control over their environments and includes cultural beliefs and spiritual practices. 4 Observing the use of touch among family members is an intervention for the cultural variable social organization, not environmental control.

A nurse is providing culturally competent care based on Bennett's Model of Intercultural Sensitivity. Which nursing behavior indicates integration? 1. Accepts clients of different cultures 2. Develops a desire to be informed about different cultures 3. Easily incorporates a variety of cultural viewpoints into care 4. Demonstrates empathy for cultural differences

3 1 In this model, competence begins to develop as an individual achieves acceptance that there are cultural differences. This is acceptance, not integration. 2 A desire to be informed occurs in acceptance, not integration. 3 Easily incorporating a variety of cultural viewpoints into care is integration. The ultimate goal in Bennett's model is integration, in which an individual is able to value a variety of cultural viewpoints and fluidly integrate them into his or her own worldview. 4 Demonstrating empathy is adaptation, not integration. As the individual becomes more culturally competent, he or she accomplishes adaptation, which incorporates empathy and the ability to communicate effectively across cultural differences.

Which question should the nurse ask to determine social organization for a client of color? 1. "What do you do to keep well?" 2. "How do you and your family express grief?" 3. "Are there any routines you need to follow?" 4. "Who makes the decisions in your household?"

4 1 "What do you do to keep well" is a question to assess environmental control, not social organization. 2 Environmental control, not social organization, can be assessed by asking, "How do you and your family express grief?" 3 "Are there any routines you need to follow" is an assessment question for time, not social organization. 4 "Who makes the decisions in your household" is a question to assess social organization.

The client and nurse are discussing religion and spirituality. Which statement from the client indicates religion? 1. "I believe in a higher power." 2. "At times I want to feel a sense of transcendence." 3. "At times I am overwhelmed by a sacred gratefulness." 4. "I worship in a mosque."

4 1 Belief in a higher power is spirituality, not religion. Religion is a set of beliefs, values, rites, and rituals adopted by a group of people. 2 Spirituality may be considered a quest for the transcendent that might lead to staunch belief or nonbelief. It is not religion. 3 Spirituality is distinguished by its connection to that which is considered sacred. It does not represent religion, an organized form of worship. 4 Worshipping in a mosque indicates religion. It is a type of religion, a set of beliefs, values, rites, and rituals adopted by a group of people.

The nurse is caring for an anxious client. Which information should the nurse share with the client about spiritual and religious needs? (Select all that apply.) 1. Forgiveness is the greatest spiritual need. 2. Love increases the hormone cortisol. 3. Inability to participate in faith rituals can result in spiritual distress. 4. Hope helps strengthen the immune system. 5. Journaling can be helpful for spiritual healing.

4, 5 1 Love is the greatest spiritual need, not forgiveness. 2 Love decreases (not increases) production of the stress hormone cortisol but increases the production of oxytocin, the "feel good" hormone and decreases inflammation. 3 Risk for impaired religiosity (not spiritual distress) is the inability to participate in rituals of a particular faith tradition. A susceptibility to the impaired ability to experience and integrate meaning and purpose in life through connectedness within self, literature, or a power greater than the client is risk for spiritual distress. 4 Hope helps strengthen the immune system, promotes healing, facilitates coping, and enhances quality of life. 5 Journaling can assist in spiritual healing by clarifying beliefs and values and in recognizing and resolving feelings about current life situations.

______ exists within each individual, regardless of belief system, and serves as a force for interconnectedness between the self and others, the environment, and a higher power.

Spirituality Spirituality exists within each individual, regardless of belief system, and serves as a force for interconnectedness between the self and others, the environment, and a higher power. Spirituality is the human quality that gives meaning and sense of purpose to an individual's existence.