Mod 24 Culture and Diversity
A non-English-speaking immigrant mother seeks care at a local outpatient clinic in an area where many immigrants have settled. The mother is accompanied by 15-year-old child who speaks English. How should the nurse address the language barrier? A. Ask the local immigrant service organization to provide an interpreter. B. Ask the child to act as translator. C. Conduct a physical assessment with no explanations. D. Use signs and gestures to communicate.
A A representative of a local organization will understand the culture and may even have specific helpful knowledge of the family's background. Federal law requires provision of an interpreter. Asking a family member to act as translator may create confidentiality issues. Signs and gestures are inadequate for clear communication. An interpreter should be available to explain the physical assessment. However, the client's privacy should be protected, so the interpreter may not be present in the examining room at all times.
The nurse is treating a male client from India who is recovering from surgery. The nurse is concerned that several of the client's family members are gathered in the hospital room throughout the day, and that the client's mother insists on caring for the client even when the nurse is present. Which intervention would indicate that nurse needs more teaching? A. Remind the family that the nurse is equipped to provide the client with safe, effective care. B. Teach the client and his family about safety issues such as crowding and self-medication. C. Explain to both the client and his family members the necessity of early mobility. D. Provide the client with nutritional counseling and incorporate preferred foods into their meal plan.
A Clients whose origins are from India tend to have strong family ties, so it is not uncommon for several family members to gather in the client's room, causing crowding. Because the mother typically will provide care for the client, this may be cause for concern for the nurse, because many from India believe in self-medication and herbal medicines, which may interfere with treatment. The nurse, therefore, should collaborate with the client and family to provide safe, effective care. The nurse should also explain to the client and his family members the necessity of early mobility and independence with activities of daily living, as well as help the client meet nutritional needs through meal accommodation, nutritional counseling, and incorporation of preferred foods in the meal plan.
The nurse is teaching a patient from another culture how to self-administer insulin injections. Which action could be misinterpreted as understanding of the directions given? A. Moving the head up and down B. Avoiding direct eye contact C. Bowing when entering the room D. Maintaining a 3-5 foot distance
A Moving the head up and down in one culture could be a sign of respect, whereas in Western culture it could be misinterpreted as a nod of understanding. Refraining from making eye contact is a sign of respect. Maintaining space is done in many cultures. Bowing when entering the room indicates respect.
Which is a core belief about health in non-Western cultures? A. Health is a state of harmony that encompasses mind, body, and spirit. B. Health is the strength to do anything you want. C. Health is the absence of disease. D. Health is an attribute of youth.
A Non-Western cultures view health as a harmonious state. Western society sees health as the absence of disease. Other views of health are more individual. Next Question
The nurse is observing a family with two children interacting. The nurse asks the father to pick a toy from the box and hand it to the son. The father picks a dump truck. Which concept is the nurse observing? A. Gender stereotyping B. Heterosexism C. Discrimination D. Classism
A The father is practicing gender stereotyping because he assumes that a dump truck is an appropriate toy for a boy. The father is not showing discrimination because they are not showing preference for one child over another. Classism is reflected when a person is treated differently based on their finances or class in society. Heterosexism is when a person views heterosexuality as the only correct sexual orientation.
The nurse is preparing a presentation on sexual orientation and discrimination in the healthcare setting. Which information should the nurse include? A. Provide the same care regardless of gender or orientation. B. Promote health insurance for same-gender couples. C. Ask the patient with which gender they identify. D. Provide gender-specific instructions for the patient.
A The nurse should include in the presentation that the nurse should provide equal care to all patients regardless of gender or sexual orientation. All patient teaching should be directed to the patient's needs, and should not be gender focused. The nurse could ask with which gender the patient identifies, but this does not address sexual orientation discrimination. Equality for health insurance does not interfere with patient care.
The nurse is working with a group of teenagers. Which group would be considered a subculture of teenagers? A. Goth B. Generation X C. Musicians D. Baby boomers
A The term subculture is sometimes used to label groups characterized by specific norms, beliefs, and values that coexist or even oppose those of the dominant culture. In a group of teenagers, a subculture would be those who practice goth. Baby boomers and people from generation X are older than teenagers. People who are musicians practice a hobby, not a subculture.
The nurse is reviewing the medical records of a small urgent care clinic to identify clients who may be considered vulnerable. Which client should the nurse include as those who may be vulnerable? (Select all that apply.) A. A 42-year-old man with a psychiatric history who lives in his car in a nearby park B. An 82-year-old man living alone with no family nearby C. A 32-year-old woman who lists the local shelter as her home address D. A 17-year-old teenager enrolled in an afterschool boys' and girls' program E. A 22-year-old woman who is crying and anxious due to fighting with her roommate
A, B, C Vulnerable populations include older adults, children, people living in poverty, homeless people, and those who are in abusive relationships, are mentally ill, or chronically ill. An episode of anxiety or an altercation without a history of abuse is not considered evidence of belonging to a vulnerable population. A teenager in an afterschool program is not considered a member of a vulnerable population.
*The nurse is to provide an assessment for a client of Asian descent. Which factor would the nurse need to understand related to the client's worldview? (Select all that apply.) A. Values B. Healthcare practices C. Educational level D. Language E. Healthcare beliefs
A, B, D, E Healthcare beliefs, language, and values are part of a culture's worldview and can influence a client's acceptance of and cooperation with the treatment plan. If the client does not speak the same language as the nurse and the healthcare provider, an interpreter will be required. Healthcare practices may differ from what the nurse plans and can include alternative practices that may interfere with the treatment plan. Although not part of the worldview or culture, the client's level of education will be considered when planning teaching for the client.
The nurse is preparing a presentation on health disparities in the United States. Which information is appropriate for the nurse to include? (Select all that apply.) A. African American women are at greater risk for heart disease than any other single population. Your answer is correct. B. Gay and lesbian individuals face greater discrimination in health care than transgender individuals. C. Muslim individuals are less likely to be engaged in seeking preventive health measures. Your answer is correct. D. Undocumented immigrants are more likely to have diseases such as HIV and tuberculosis than those with legal status. Your answer is correct. E. American Indians have a lower incidence of diabetes than any other race.
A, C, D Health disparities among certain populations are a concern in the United States. American Indians have a higher incidence of diabetes (33%) than any other race. Because Muslim individuals believe the status of their health is Allah's will, not in their control, they are less likely to take preventive health measures. African American women are at greater risk for heart disease than any other single population. Transgender individuals face greater discrimination in health care than do gay and lesbian individuals. Undocumented immigrants are more likely to have diseases such as HIV and tuberculosis than those with legal status.
*Which aspect of organizational governance should reflect adherence to cultural competence standards within a healthcare facility? (Select all that apply.) A. Organizational practice implementation B. Staff training C. Mission statement D. Policies and procedures E. Translation services
A, C, D Organizational mission, policies and procedures, and practice implementation should support cultural competence. Translation services and staff training are not parts of organizational governance.
The nurse is performing a cultural assessment on an adult client. Which information should the nurse include? (Select all that apply.) A. The client's region or country of origination B. Whether the client has insurance C. The language spoken at home D. The cultural or religious influences in decision making E. The kinds of food and drink the client prefers
A, C, D, E
*The nurse is providing care to a non-English-speaking client who is noncompliant with care. The client has expressed a desire to use traditional culturally based therapies. Which should the nurse identify as a potential cultural barrier in the client following the recommended care? (Select all that apply.)
A, C, D, E Barriers to care that are influenced by cultural differences may include lack of trust in the healthcare system or the provider, the belief that illness is not related to pathophysiology, the influence of family and community, and a cultural belief that discussing an illness can influence the disease process. Although a lack of insurance may influence the client's entry into care, it does not have cultural significance.
The nurse manager is planning a presentation for a group of nurses about culture and diversity. Which barrier to respecting a client's culture should the nurse manager include in the presentation? (Select all that apply.) A. Refusal of Western healthcare providers to believe in mind-body connection Your answer is correct. B. Incorporating the client's beliefs into the plan of care C. Refusing to allow family members to be involved in managing illness and disease Your answer is correct. D. Belief that illnesses are linked to scientific pathophysiology and not changes in energy Your answer is correct. E. Clients may not trust the current healthcare system and the providers
A, C, D, E Clients from other cultures may not trust the current healthcare system and providers because they believe in traditional healers. Current Western healthcare providers may not believe in the mind-body connection and turn to traditional science. Another barrier is refusing to allow the family to be involved in managing illness and disease. It is not a barrier when healthcare providers incorporate the client's beliefs into the plan of care.
The nurse is performing a cultural assessment on an adult client. Which information should the nurse include? (Select all that apply.) A. The client's region or country of origination B. Whether the client has insurance C. The language spoken at home D. The cultural or religious influences in decision making E. The kinds of food and drink the client prefers
A, C, D, E Subjective data would be gathered by asking questions about cultural beliefs. Objective data would be gathered through observation of the client and the interactions between significant family members who might be present. Discovering the region or country the client originates from and lives in would give clues about the client's culture. It is important to know what language is spoken at home and whether the client understands English so that communication can be effective. Insurance is not necessarily a question that would come up during a cultural assessment, although socioeconomic status may affect healthcare delivery.
*The home health nurse visits a multigenerational family to determine needs. The nurse observes the grandchildren listening to stories from the grandparents of the old country and traditions, and asking questions. Which concept is the nurse observing during this interaction? A. Acculturation B. Enculturation C. Assimilation D. Ageism
B Enculturation is a process in which children learn cultural characteristics from adults. Therefore, the grandchildren listening and asking questions about their culture indicates enculturation. Ageism is treating all older adults as if they are incompetent and unable to do for themselves. Acculturation is adopting the culture of the majority in which the person lives. Assimilation is the process of adapting to and integrating characteristics of the dominant culture as one's own culture.
*The nurse is working with a patient of a different culture. The nurse acknowledges the patient's culture and asks how it can be incorporated in the plan of care. Which model of cultural competence is the nurse using? A. Leininger's culture care diversity theory B. LEARN model C. Spector's Heritage Chain D. American Association of Colleges of Nursing (AACN)
B In the LEARN model from the Association of American Medical Colleges, the "A" stands for acknowledging and discussing the differences and similarities between the two cultural perceptions. Spector's model includes the cultural heritage of the patient and the healthcare provider and the diversity of the area in which patient and provider live and work. Leininger developed a theory with a unique emphasis on cultural care and the nurse and it does not have an acronym for acknowledge. The AACN advocates for cultural competence.
*The nurse is researching cultures and diversity in health care. Which cultural characteristic that affects health care should the nurse classify as an environmental control? A. Skin color B. Preventive medicine C. Personal boundaries D. Emphasis on the past
B Preventive medicine is an environmental control, because those who follow an internal locus of control will be motivated to eat healthy, exercise, and make use of other wellness measures. Skin color is a biological factor. Personal boundaries are space factors, and emphasis on the past is a time orientation.
The nurse makes a statement, "Chinese people drink only hot tea, so don't put coffee on their trays." The charge nurse identifies this remark is an example of which concept associated with culture? A. Prejudice B. Stereotyping C. Diversity
B Stereotyping is when a person assumes all members of a particular group have the same characteristics. This nurse is assuming all members of a group have the same eating habits. Ethnocentrism is the belief in the superiority of one's own culture and lifestyle. This nurse is making a generalization about a culture, not declaring the superiority of her own culture. Prejudice is a judgment about a person, place, or racial background that has no basis in knowledge. This nurse is making an assumption that all Chinese have the same traits. Diversity is a state of being different and occurs between and within cultural groups. It is not related to the statement this nurse made.
The nurse is evaluating the plan of care for a female patient admitted for a hip replacement. The patient reports being of the Muslim faith. Which patient statement indicates the cultural goals were met? A. "I will read more about the rehabilitation process in this booklet." B. "Thank you for providing me with only female nurses." C. "I understand how to inject my medicine into my belly." D. "I watched the video about which exercises I need to do twice a day."
B The nurse adhered to cultural sensitivity by assigning only female nurses to care for a female patient of the Muslim faith. The ability to administer injections, follow the rehab process, and understand how to do the exercises follows patient teaching needs.
The nurse is using the LEARN model of cultural competence when working with a patient of a different ethnicity. Which action by the nurse indicates an understanding of the "A" portion of this model? A. Affirms the patient's beliefs, but explains the rules of the hospital and asserts that the plan of care must be followed B. Acknowledges the patient's beliefs and works to incorporate these into the plan of care C. Accepts that the patient has differing beliefs, but emphasizes the importance of compliance D. Asserts to the patient that the medical model is correct and the patient should follow the plan of care
B The nurse should acknowledge and discuss the differences and similarities between the perceptions of the patient and that of the healthcare team. Assert, affirm, and accept are not steps in the LEARN model.
The nurse caring for a patient who is Vietnamese notices that the patient is losing weight. The patient does not eat much of the food found on the menu. Which intervention would be most appropriate for this patient? A. Continuing to weigh the patient on a monthly basis and monitor for trends B. Allowing the family to bring in food the patient prefers within dietary restrictions C. Providing the patient three different food choices with each meal and snack D. Monitoring serum albumin and total protein levels once a month
B The patient is Vietnamese and may not like the typical foods of the American diet. Therefore, the nurse should encourage the family to bring in foods that the patient likes within any current dietary restrictions. The nurse should not just provide the patient three choices for meals and a snack. This is usually done in a long-term care facility anyway, and this would not solve the problem of not liking American food. If the patient is losing weight, the nurse would monitor the weight and serum albumin/total protein levels more frequently than once a month.
Which aspects of culture should the nurse consider when assessing a client? (Select all that apply.) A. A client's culture is determined by race. B. Beliefs are a part of culture. C. Culture is defined by nonphysical traits. D. Values are a part of culture. E. Customs are part of the culture of a client.
B, C, D, E The culture that encompasses a client's way of life is based on nonphysical traits. The values and beliefs a client holds are part of culture and can influence health care. Customs can influence a client's attitude toward health. Race refers to physical and genetic heritage and is directly related to such physical traits as skin color, but it is not related to a client's culture.
The nurse is assessing a client of a different culture who has different religious beliefs than that of the nurse. Which statement or question by the nurse demonstrates cultural competence when assessing the client? (Select all that apply.) A. "I cannot continue with this assessment if you are not willing to be compliant with my plan of care." B. "Would you prefer to be examined by a nurse who is of your sex?" Your answer is correct. C. "May I ask what your partner might think about this plan of care?" Your answer is correct. D. "Are there certain times of the day that you need privacy for prayer or meditation?" Your answer is correct. E. "How do you feel about taking medications or blood products if they are prescribed?"
B, C, D, E The nurse can show knowledge of a client's culture by asking appropriate questions that are not demeaning or rude. Asking about family support opens the conversation so the client feels comfortable speaking about family objections. Religious or cultural beliefs may require a female client to be examined by female nurse, or they may necessitate that the nurse plan care around the client's daily spiritual practices. Asking how the client feels about taking medications opens the conversation to what cultural or religious beliefs might interfere with the medical care of the client. Refusing to work a plan of care around a client's cultural beliefs is unethical and not beneficial to the client.
Which action by the nurse illustrates the concept of cultural humility? A. The nurse provides an example of one's authoritative stance when teaching a patient which diet is best for their diagnosis. B. The nurse discusses one's cultural superiority over the patient's culture. C. The nurse expresses sensitivity to the differences between the patient's culture and one's own. D. The nurse explains to a patient that their religious beliefs lack scientific validity when discussing the diagnosis.
C Cultural humility is displayed when a nurse recognizes that their personal cultural values are not superior to the cultural values of another person. The nurse is not demonstrating cultural humility when they are claiming cultural superiority over another person. Taking an authoritative stance to influence a patient against dietary choices does not reflect cultural humility. Abusing the power of the nurse's position against the patient's religion is not using cultural humility. Cultural humility is demonstrated when the nurse is sensitive to the differences in their patient's culture, even though the nurse's personal values are not the same as the patient's.
Which statement by a nurse indicates an understanding of the concept of multiculturalism? A. "Multiculturalism is the process of adapting to local customs." B. "Multiculturalism describes shared values, beliefs, attitudes, and customs in a community of people." C. "Multiculturalism describes a society in which many subcultures coexist." D. "Multiculturalism describes the quality of being unlike or different."
C Multiculturalism refers to many cultures and subcultures existing together. Therefore, this statement indicates the nurse understands the concept. Culture describes shared values and customs. Diversity describes the quality of being unlike or different. Assimilation is the process of adapting to local customs.
The nurse is caring for an older adult patient who wants to postpone elective surgery because the family will be gathering for Yom Kippur on that day. Which is an appropriate response from the nurse? A. Ask the patient whether their family will really mind if they don't join them for the holy day. B. Insist that the patient keep the surgery date. C. Inform the surgeon and advocate for rescheduling the procedure. D. Inform the patient that their surgery may have to be postponed indefinitely.
C Respecting the patient's religious beliefs and practices is an important element in culturally competent nursing care. The nurse should not pressure patients about religious beliefs while informing them of medical concerns.
The nurse obtains an interpreter to facilitate dietary teaching for a patient who does not speak English. How should the nurse evaluate the effectiveness of this teaching session? A. Providing written information in English with pictures B. Asking the family if the patient understood C. Using the interpreter to verbalize understanding D. Having the patient make menu choices
C The best way for the nurse to evaluate the effectiveness of this teaching session is to utilize the interpreter's services to determine what the patient understands. The patient may not be able to read the menu choices if they are in English. The nurse would not ask the family because they may confuse what information is being asked. Providing written information in English with pictures is an intervention and does not evaluate the patient's understanding.
*The nurse recognizes that certain ethnic groups or races may tend toward developing specific diseases. The nurse should assess an American Indian for which disease? A. Cancer B. Chronic obstructive pulmonary disease (COPD) C. Diabetes mellitus D. Hypertension
C The nurse should assess for diabetes mellitus in the American Indian patient because this ethnic group has a 33% higher risk for this disease. Chronic obstructive pulmonary disease (COPD) occurs most often in smokers. Cancer is the result of genetics and carcinogens. Hypertension occurs more often in African Americans.
Which statement by the nurse indicates a need for cultural competence training? A. "Provide the client in room 3 a female nurse because she is Muslim." B. "The client in room 5 prefers hot beverages when ill." C. "The client down the hall is on welfare. She will be back." D. "Do not bother the client in room 2 during his prayers."
C The nurse stating the client on welfare will be back due to lack of income indicates insensitivity to someone with financial issues. Many cultures prefer hot beverages when ill. This is acknowledging the client's beliefs. The nurse is recognizing the client's religion when providing the client time to pray. The nurse understands the importance of same-sex healthcare providers in the Muslim faith.
The nurse is preparing to provide discharge instructions for a patient who immigrated from another country and speaks little English. Which nursing intervention would be most appropriate to help this patient? A. Using the patient's family to interpret directions B. Providing directions in a booklet with pictures C. Utilizing the hospital's interpreter services D. Speaking slowly and loudly when providing directions
C When the nurse does not speak the same language as the patient, the most appropriate way for the nurse to handle the situation is to provide an interpreter. This maintains patient privacy and provides information in a language the patient understands. Providing pamphlets with pictures can supplement teaching, but it should not be the main information provided. The nurse would not be able to assess the patient's understanding. Using a family member as an interpreter can violate patient privacy. Speaking loudly and clearly does not alleviate language barriers. Additional Learning
The nurse wants to provide culturally competent care to a client who lives on a long-term care unit. Which activity is appropriate for the nurse to implement? (Select all that apply.) A. Teaching the client about the U.S. healthcare system B. Memorizing which foods members of each culture eat to restore health C. Asking the client and his family how the illness affects them D. Asking the client where he thinks illness originates E. Seeking to understand one's own culture, its beliefs, and its assumptions
C, D, E To provide culturally competent care, the nurse must first understand her own culture, its beliefs, and its assumptions. To assist in evaluating a client's culture, the nurse should ask certain questions to understand the client's beliefs. Asking where the client thinks his illness comes from will help the nurse understand illness from the client's perspective. Not all members of a culture eat the same thing. Memorizing stereotypes will not help the nurse to provide culturally competent care. Teaching the client about the U.S. healthcare system does not help the nurse in providing culturally competent care.
An 82-year-old female patient informs the nurse that the surgeon has declined to perform replacement surgeries on people of their age. Which behavior is the surgeon demonstrating? A. Gender bias B. Homophobia C. Classism D. Ageism
D Ageism is discrimination against older adults. Gender bias is demonstrating preferences toward one gender group over another. Classism involves oppressive practices based on socioeconomic status. Homophobia involves negative feelings or behaviors toward gays or lesbians.
The nurse is assessing the cultural needs of an adult male patient who believes in the hot-cold theory. Which response by the nurse indicates cultural humility? A. "What does this belief have to do with your health care?" B. "Is this the practice of voodoo?" C. "That is ridiculous and we cannot agree with this theory." D. "Would you be willing to share information about it?"
D Asking the patient about their belief ensures that the nurse understands it and incorporates the Heritage Chain model into practice (see the image below). The nurse would not be judgmental or enforce beliefs onto the patient, and using words such as "ridiculous" is unacceptable and shows no cultural knowledge. Asking the patient if the practice of the hot-cold theory is voodoo would indicate that the nurse does not have a cultural knowledge or understanding and would not make the patient feel comfortable. Asking this patient about what their belief has to do with their health care would indicate that the nurse does not have an interest in incorporating the patient's cultural beliefs into a healthcare plan and would be inappropriate.
The nurse is caring for a non-English-speaking patient. Which intervention should the nurse avoid? A. Addressing questions to the patient, not the patient's family members B. Using verbal and nonverbal cues when addressing the patient C. Providing teaching sheets in the patient's language D. Using family members as the first line of interpretation
D Effective communication with interpreter services includes using nonverbal and verbal communication. It includes eye contact; speaking in simple, not complex terms; and providing the patient with teaching sheets in their language. Family members should not be used as interpreters for confidentiality reasons. Questions should be addressed to the patient.
Which statement by the nurse reflects that the nurse is practicing negative classism? A. "The patient needs to understand the complications of his disease." B. "I can provide the patient a list of resources that he can afford." C. "It is essential for the patient to follow up with the healthcare provider after discharge." D. "The patient will be back because he keeps losing jobs due to alcohol abuse."
D Negative classism is when a person treats another person differently due to financial reasons. When the nurse states that the patient will be back because they have no job and abuses alcohol, this reflects negativity related to finances and alcohol abuse. The remaining statements reflect the nurse's attempts to help the patient meet needs without prejudice.
The nurse is assessing a group of patients in a community center for risk factors for health problems. Which patient should the nurse determine to be at greatest risk for health problems? A. A patient who is part of the second generation of an immigrant family B. A patient who is middle-aged and exercises four days a week C. A patient with a family of four and a secure income D. A patient with an eighth-grade education making minimum wage
D Patients with lower educational levels and incomes are at higher risk for health issues. Therefore, the patient with an eighth-grade education who makes minimum wage is at highest risk. The patient who is part of the second generation of an immigrant family, the patient from a family of four with a secure income, and a patient who is middle-aged and exercises four days a week are at minimal risk for health issues.
*The nurse observes the patient in prayer with family members. Which cultural characteristic should the nurse recognize is occurring? A. Time orientation B. Personal space C. Environmental control D. Social organization
D Religious beliefs are part of what may identify the social organization of the culture of a family unit. Although the family members might be close to each other, focus is not on personal space, which refers to the comfortable or appropriate distance for interaction with other people. Time orientation differs among cultures, with some putting more value on the past and present; Anglo-American culture places more emphasis on the future. However, the focus during this patient's prayer is not on time. The family is displaying social organization and not controlling the environment around them.
*The nurse is presenting an in-service to staff nurses regarding the spiritual health of patients admitted to the unit. Which role of the nurse is appropriate regarding the spiritual health of patients? A. Declining to discuss spirituality directly out of respect for differing beliefs B. Asking the patient's family for permission before disclosing the patient's prognosis C. Introducing patients to the chaplain, who can assist them in finding religious belief D. Assisting the patients in recalling past experiences in which they drew upon hope while in crisis
D Spiritual health is the state of wellness encompassing personal fulfillment as well as the fulfillment of life with others. The nurse can support the patient's spirituality by assisting the patient to recall times when they experienced hope. Spirituality is not the same as religious beliefs. The nurse can assist the patient in developing spirituality without involving religious practices. The patient should be the focus of care and information. It is important to include the family and any source of support, but the focus is the patient. The role of the nurse is to support the patient's experience of spirituality, not promote religious belief. The chaplain can provide support to the patient in the development of personal spiritual development.
*The nurse is preparing a presentation on social differences for colleagues. Which statement should the nurse include in the presentation? A. "Individuals with an external locus of control are more likely to take preventive healthcare measures than those with an internal locus of control." B. "Clients from present-oriented cultures are generally receptive to preventive healthcare measures." C. "Practices regarding proximity to others, body movements, and touch are similar across groups." D. "Subcultures can maintain heritage and identity through dress, foods eaten, and cultural festivities."
D Subcultures can maintain heritage and identity through dress, foods eaten, and cultural festivities. Practices regarding proximity to others, body movements, and touch differ among groups, such as when an individual's perception of personal space causes comfort or anxiety. Present-oriented cultures focus on the here and now, and individuals from these cultures may not be receptive to preventive healthcare measures. Those who follow an external locus of control are less likely to be engaged in preventive measures than those who follow an internal locus of control, because they do not see themselves as being in control of their health.
The nurse is caring for a patient of the Jewish faith who is admitted with new onset of diabetes mellitus. The nurse asks about religious practices. Which information provided by the patient most impacts the plan of care? A. Attends synagogue daily B. Does no work on the Sabbath C. Prays three times a day D. Adheres to a kosher diet
D The key to diabetes control is following a diabetic diet and counting carbohydrates. This may be more difficult when a patient is following a kosher diet. Prayer and attending synagogue should not impact blood glucose control. The patient should be able to follow the diabetic diet on the Sabbath.
Which should the nurse include when caring for a client of a different culture? A. Enforce use of Western healthcare practices. B. Enforce use of specialty practitioners. C. Instruct client to take ordered medications. D. Be nonjudgmental in healthcare beliefs.
D The nurse should be nonjudgmental in healthcare beliefs for all clients and include their beliefs into the plan of care. The nurse should never enforce Western health care or any healthcare practices on any client. The nurse should not enforce the use of specialty practitioners if the client does not believe in this practice. The nurse would instruct the client to take the medications prescribed, but this is unrelated to the client's culture.
The preceptor is monitoring a graduate nurse's assessment of a male client who recently immigrated to the United States from China. Which assessment activity by the graduate nurse indicates the need for follow-up regarding culturally competent care? A. Determine if the client has any daily spiritual practices. B. Inquire if the client speaks any English. C. Ask the client about food preferences or food preparation needs. D. Discourage use of acupuncture or cupping for pain relief.
D The provision of culturally competent care begins with incorporating culture into the initial nursing assessment. It is appropriate for the nurse to ask the client about his proficiency with English to ensure that they communicate effectively about treatment. The nurse should inquire about religious or cultural practices at specific times of day or during the week and plan care accordingly. The nurse should also ask about (not discourage) use of traditional healing practices such as herbal supplements or mind-body practices (e.g., cupping, acupuncture). Administering culturally competent care also involves inquiring about cultural practices related to food preparation and preferences. Next Question
The nurse is reviewing the medical record of an assigned patient and notes the patient identifies as transgender. Which statement best describes this patient's gender identity? A. Transgender individuals have negative feelings or behaviors toward gays or lesbians. B. Transgender individuals are born with anatomic characteristics that do not seem to fit the typical definitions of female or male. C. Transgender individuals demonstrate preferences toward one gender group over another. D. Transgender individuals do not identify with the gender assigned to their body.
D Transgender individuals, of any anatomic gender, do not identify with the gender assigned to their body. Intersex refers to individuals born with anatomic characteristics that do not seem to fit the typical definitions of female or male. Sexists demonstrate preferences toward one gender group over another. Homophobes have negative feelings or behaviors toward gays or lesbians.
Which action by the nurse indicates using verbal communication when interacting with a patient from another culture? A. Providing a video B. Providing pamphlets C. Providing a hands-on demonstration D. Using an interpreter
D Use of an interpreter is an example of using verbal communication to communicate with patients from other cultures. Pamphlets are written communication. A video is visual communication. Hands-on demonstration is tactile communication.
