Fundamentals of Nursing Chapter 13

16. Which question should the nurse use to begin an ethnographic interview with a newly admitted adult client from Egypt? A) "How have you been feeling during the past week" B) "Why are you here?" C) "What is making you feel pain?" D) "Can you describe your family?"

Ans: A Feedback: An ethnographic interview begins with an open-ended, general question.

1. A student nurse is preparing a presentation regarding different cultures. Which definition of culture is most accurate? A) Belief system that guides behavior B) Altruistic grouping C) Cluster of individuals D) Complete uniformity of members

Ans: A Feedback: 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.

5. Within a culture, the world becomes predictable and coherent for its inhabitants. This predictability has been defined as: A) habituation. B) normalization. C) stereotypical. D) desensitization.

Ans: A Feedback: Culture is habituated; it reflects a usual way of doing things that people learn through socialization as they may mature and become deeply involved in different subcultures. Cultural habituation is advantageous.

15. The parent of a Black newborn asks the nurse about the bluish-black areas the parent noticed around the newborn's lower back and buttocks. What is the nurse's best response? A) "These areas are normal and should disappear by early childhood." B) "It will be best if you have these areas treated with laser surgery." C) "These spots will normally fade in about 2 weeks." D) "This discoloration occurs in some infants and is usually permanent."

Ans: A Feedback: These types of discolored areas are referred to as Mongolian spots. The discolorations are clusters of melanocytes and appear as bluish-black areas typically found on a Black infant's lower back and buttocks, as well as East Indian and Asian infants. They are normal, occur in 80% to 90% of these populations, and typically disappear by early childhood.

26. The nurse caring for several clients on a surgical unit notes that one of the clients practices Islam. The nurse decides to remove all pork from the client's meal tray prior to delivering it to the room. What best describes the nurse's action? A) Stereotyping B) Racism C) Honoring rituals D) Transcultural nursing

Ans: A Feedback: While the nurse was trying to be thoughtful (as with transcultural nursing), the action would be considered stereotyping since the nurse assumed this ritual was part of the client's practices. Racism involves negative thoughts or feelings toward a specific group of people.

22. The nurse correctly differentiates race from ethnicity by noting that race is based on which characteristics? A) Biological B) Social C) Spiritual D) Religious

Ans: A Feedback: The biological characteristics of race are based on either physical appearance or place of origin.

28. A nurse has just been hired at a healthcare facility that performs abortions. Based on the nurse's religious beliefs, the nurse strongly feels that abortion is unacceptable. This situation will prevent the nurse from being able to practice: A) transcultural nursing. B) safe and effective care. C) efficient care. D) holistic care.

Ans: A Feedback: Transcultural nursing refers to the nurse being able to understand the culture(s) of clients, and the ability to recognize one's own ethnocentrism and the ethnocentrism of the biomedical healthcare system. The nurse's strong religious beliefs in regards to abortion will prevent transcultural nursing from occurring.

6. When an American client states, "I only want an American doctor," the client is expressing cultural: A) ethnocentrism. B) relativity. C) pervasiveness. D) superiority.

Ans: A Feedback: Viewing one's own culture as the only correct standard by which to view people of other cultures is ethnocentrism.

24. What are characteristics of nurses that make them a subculture within their countries of practice? Select all that apply. A) Uniforms worn based on place of employment B) Language or medical terminology used to communicate C) Legal authorization to provide healthcare to others D) View of work as a reward; shared work ethic E) Sensitivity to the importance of time

Ans: A, B, C Feedback: The dominant culture of nurses is the middle-class group. Work ethic and importance of time are values of this group. Dress, terminology, and legal authority belong to the nursing subculture.

21. The public health nurse is preparing a presentation about disparities in healthcare in the community. What key concepts will the nurse include? Select all that apply. A) Information regarding minorities within the community B) Identifying groups that are disadvantaged within the community C) Pointing out groups within the community that possess less power D) Differences in beliefs within a particular culture E) Ethnic identities within subcultures in the community

Ans: A, B, C Feedback: 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 the majority of that society. Racial and ethnic minorities continue to have higher rates of disease, disability, and premature death than nonminorities; therefore, these are key points that the nurse should present.

27. While studying about various cultures, the student nurse is aware that a subculture is based on which characteristic? Select all that apply. A) Gender B) Age C) Profession D) Hobbies E) Sexual preference

Ans: A, B, C, D, E Feedback: A subculture is based on any common interest or identity; therefore, all of these options are examples of subcultures.

8. Healthcare facilities that sponsor health-promotion activities only in affluent areas are considered: A) culturally sensitive. B) culturally blind. C) culturally affluent. D) culturally different.

Ans: B Feedback: Another way of thinking about ethnocentrism in nursing is that it can reflect an individual's, a group's, or an agency's cultural blindness. It can also reflect a lack of capacity to reach out effectively to minorities or culturally stigmatized groups.

23. A Black client refuses to allow any healthcare worker of Asian descent to provide care. This client is demonstrating what practice? A) Ethnocentrism B) Racism C) Stereotyping D) Ethnic identification

Ans: B Feedback: Racism usually involves negative thoughts or actions against another individual based on skin color or ethnicity. Stereotyping does not always involve negative thoughts against others. Ethnocentrism and ethnic identification are beliefs that are within a person and not necessarily directed toward others.

17. The newly employed nurse working in a healthcare provider's office seeks advice on the job responsibilities and how best to implement these responsibilities. Who is the key informant for this nurse? A) The healthcare provider B) The nurse who has been working in the office for 8 years C) The office manager who has been employed by this provider for 14 years D) The unlicensed assistive personnel who has worked in the office for 22 years

Ans: B Feedback: While the healthcare provider will convey expectations of the nurse's role, the nurse presently working will be the key informant for the newly employed nurse. The key informant is the person who has an especially rich base of cultural knowledge, is reflective, willing to share one's views, and is able to articulate one's culture; in this case, the responsibilities of a nurse in this setting. The office manager and unlicensed assistive personnel, while employed in this office longer, will have different roles in this office culture than will the nurse.

3. Nursing students are socialized into the: A) nursing specialties. B) healthcare culture. C) caring paradigm. D) diagnostic process.

Ans: B Feedback: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.

11. A nurse in the hospital is caring for a client who identifies as Native American/First Nations. Which statement should best guide the nurse's care? A) There is no concept of a nuclear family. B) There is likely to be deep mistrust for the healthcare providers. C) There may be a role for a tribal medicine man in the client's care. D) The client is likely to expect immediate results of treatment.

Ans: C Feedback: In many Native American/First Nations cultures, there is a role for a medicine man in the treatment of illness. There is no reason to believe that the concept of a nuclear family does not exist, that there will be mistrust for the healthcare providers or that quick results are expected.

18. The nurse is caring for the adolescent child of immigrants from China. The adolescent voices distress because after living in the United States for several years, the client no longer wants to participate in some of the Chinese religious rituals that are important to the parents. What is the client experiencing? A) Culture shock B) Cultural ethnocentrism C) Cultural change D) Cultural relativity

Ans: C Feedback: The adolescent is experiencing cultural change. This often occurs when a person changes upon coming into contact with new beliefs and ideas. Culture shock is a stress response that involves being unable to comprehend the culture that one is immersed in. Viewing one's own culture as the only correct standard by which to view people of other cultures is ethnocentrism. Cultural relativity refers to an understanding that cultures relate differently to the same given situations.

14. Which area is typically included in a cultural assessment? A) Marital status B) Employment status C) Food preferences D) Ethics

Ans: C Feedback: Dietary tolerance is associated with both cultural food preferences and biologic variation.

20. The nurse is caring for two clients from an Hispanic background. The nurse notices some differences between the two in the religious practices and the slang used for communicating. What is most likely the etiology of these differences? A) Cultural norms B) Cultural relativity C) Ethnicity D) Ethnocentrism

Ans: C Feedback: Ethnicity or ethnic identity refers to the differences among a group who share the same cultural and/or ancestral heritage. Cultural norms are the actions that are expected by others within the culture. Cultural relativity refers to the differences between cultures in the meaning of various behaviors. Ethnocentrism is the belief that one's own practices are the only correct practices.

7. 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: A) nursing personality. B) past history. C) media. D) genetics.

Ans: C Feedback: Ethnocentrism is a way of looking at the world through a personal lens that has been influenced by personality, genetics, family/relationships, and media.

10. A Catholic priest baptizes a stillborn baby of a Catholic family. What type of practice is this considered? A) Necessary B) Expected C) A ritual D) A birth rite

Ans: C Feedback: Rituals are common and observable expressions of culture in hospitals, clinics, homes, schools, and work settings

2. The client in a rehabilitation unit is having a difficult time adjusting to the scheduled activities on the unit, as well as being dependent on others for meals and medications. Which word best describes what the client is experiencing? A) Anxiety B) Disparity C) Resolution D) Shock

Ans: D Feedback: The acute experience of not comprehending the culture in which one is situated is called culture shock. This is often experienced by a client who suddenly finds himself in the subculture of a hospital or healthcare agency

12. When a home-bound client expresses past-oriented ancestral heritage and family rituals, the nurse recognizes that the client is expressing: A) race. B) assimilation. C) subculture. D) ethnic identity.

Ans: D Feedback: Ethnicity or ethnic identity referGs RtoADseElfS-cMoOnRscEio.uCsO, Mpast-oriented form of identity based on a notion of shared cultural (and perhaps ancestral) heritage, and current position in larger society. Race is based on biologic characteristics; assimilation refers to new customs and attitudes that are acquired through contact and communication among persons of a particular culture; subculture refers to a group of people within a culture who have ideas and beliefs that are different from the rest of that society.

25. The nurse working on a medical unit always performs hand hygiene between contact with each client. In addition to being understood as an infection control measure, this practice can be understood as: A) a custom. B) an obsession. C) a coping strategy. D) a ritual.

Ans: D Feedback: Handwashing is one of the many nursing rituals practiced by nurses. Rituals are common, observable expressions of a culture. This goes beyond custom but does not mean that it is an obsession. Hand hygiene is unlikely to be a coping strategy for a nurse.

4. A nurse educator could be considered culturally as a(an): A) referral source. B) respondent. C) expert. D) key informant.

Ans: D Feedback: People who know certain aspects of their culture better than others are called key informants.

19. A client tells the nurse that the only thing that helps him or her sleep is a glass of warm milk. The nurse caring for the client insists that this practice is a myth and tries to convince the client that reading a book will help make the client sleepy. What is the nurse demonstrating? A) Cultural pervasiveness B) Cultural superiority C) Stereotyping D) Ethnocentrism

Ans: D Feedback: Sometimes healthcare providers assume they know better than their clients what will help them. This is a form of ethnocentrism. Pervasiveness refers to learning a set of behaviors within a cultureG. RSAteDrEeoStMypOiRngE.reCfeOrMs to preconceived and untested beliefs about people.

13. When a labor and delivery nurse tells a coworker that an Asian client probably did not want any pain medication because "Asian women typically are stoic," the nurse is expressing a belief known as what? A) Stigma B) Ethnic slur C) Bias D) Stereotype

Ans: D Feedback: Stereotypes are preconceived and untested beliefs about people. Ethnic slur refers to a statement made about another according to their ethnicity; stigma refers to social disapproval; bias refers to an inability to view someone or something without being objective.

9. The nurse caring for several clients on a hospital unit notices that the American client makes eye contact with the staff, while an older adult client of Japanese descent does not make eye contact when speaking to the staff. What cultural concept explains this difference? A) Cultural dissonance B) Cultural negativity C) Cultural relativity D) Cultural neutrality

Feedback: Cultural relativity refers to the concept that cultures relate differently to the same situations, such as the meaning of eye contact. Many Americans view eye contact as demonstrating engagement in a conversation, whereas many elderly Japanese view avoidance of eye contact with a "superior" (the nurse in this scenario) as a sign of respect.