Ch.5 culture

A nurse who usually works on the surgical unit is asked to float to the oncology unit because of staffing needs. Which statement by the nurse indicates the possibility of the nurse experiencing culture shock? "I am very stressed now because I do not understand how things work on this unit." "Can someone please give me an orientation to this unit?" "The way we do things on the surgical unit are so much better than the procedures of this unit." "I was expecting all the clients on the oncology unit to be depressed."

"I am very stressed now because I do not understand how things work on this unit." The nurse is experiencing culture shock because of the new environment. When the culture one has learned differs from the culture in one's environment, a person can become disoriented and stressed. The acute experience of not comprehending the culture of the current environment is called culture shock. Asking for an orientation to a new unit is proper procedure for a float nurse. The third statement indicates ethnocentrism, not culture shock. The fourth statement indicates stereotyping.

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 foods that use milk solids since those are not milk products." "If I drink milk, I should drink one large glass a day and none at any other time." "I can use kosher parve foods because they are prepared without milk."

"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." 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.

A client has been admitted to the unit for chest pain. A nurse told the family that they could not be with the client. The family became very upset, and now the client wants to leave. What is the most culturally appropriate response by the charge nurse? "Would you feel more comfortable with your family with you?" "If you leave, you will be asked to sign a form indicating that you are leaving against medical advice." "Sometimes family can cause stress, and we try to maintain a stress-free care environment." "Why do you think you need to leave?"

"Would you feel more comfortable with your family with you?" Some cultures are very family oriented; others may have members who are skeptical of modern health care. The request for the client's family to leave most likely frightened the client. Asking the client how to make the client more comfortable is the best option. Asking the client why the client wants to leave is judgmental, implying there is no real reason to leave. Citing the hospital's policy regarding clients who leave against medical advice is not culturally sensitive and does not address the client's concerns. Clearly in this client's case, having the family present reduces, not causes, stress, so the comment about maintaining a stress-free environment is not valid.

Which nursing intervention reflects practice according to Madeline Leininger's transcultural nursing theory? Contacting a chaplain for every client Providing the same care to each client who has had a myocardial infarction Planning dietary interventions according to physiological condition Incorporating the client's request for complementary treatment therapy

Incorporating the client's request for complementary treatment therapy Leininger's theory of transcultural nursing includes assessing a cultural nature, accepting each client as an individual, having knowledge of health problems that affect particular cultural groups, and planning of care within the client's health belief system to achieve the best health outcomes. Therefore, incorporating the client's request for complementary treatment therapy is an example of this theory. The others do not support this theory.

A nurse is assigned to care for a client who does not speak the same 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 gestures and symbols to communicate with the client Enlisting other healthcare providers to assist with communication Using reassuring body language and making eye contact to assess needs Avoiding going into the client's room until the interpreter arrives

Using reassuring body language and making eye contact to assess needs The nurse assigned to care for a client who does not speak the same 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. Tell the client that it is important to pay attention to the teaching and ask if the client would like an interpreter. Change positions to promote eye contact with the client, asking open-ended questions to ensure understanding. Continue with teaching and leave written instructions for the client to review.

Utilize a key informant and continue with the teaching, verifying the client's understanding through open-ended questions. 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 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? a. 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 b. salad containing iceberg lettuce, spinach, tuna fish, zucchini, squash, radishes, carrots, celery, red onion, and ranch dressing, an orange, saltine crackers, coffee with nondairy creamer c. grilled steak, baked potato with butter, corn-on-the-cob, coleslaw (cabbage, carrots, onions and dressing), s'mores (graham crackers, marshmallows, and chocolate bar), water

a.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 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).

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. indicating that the cultural groups should adapt to the Anglo-American culture maintaining direct eye contact during conversations with all cultural groups 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

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 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.

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. A Native American/First Nations man stares at the floor while talking with the nurse. Assumption: The client is embarrassed by the conversation. b. A Hasidic Jewish man listens intently to a male health care provider, making direct eye contact with him, but refuses to make eye contact with a female nursing student. Assumption: Jewish men consider women inferior to men. c. A Muslim-Arab woman refuses to make eye contact with her male nurse. Assumption: She is being modest. d. A Black man rolls his eyes when asked how he copes with stress in the workplace. Assumption: He may feel he has already answered this question and has become impatient.

c. A Muslim-Arab woman refuses to make eye contact with her male nurse. Assumption: She is being modest. 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.

A nurse is caring for a client with bacterial pneumonia and a temperature of 104°F (40.0°C). Yesterday, the client's temperature was 102°F (38.9°C). The health care provider on call prescribes cool compresses for the client to help lower the fever. The client insists that the nurse bring warm blankets because they will help the client to recover more quickly. The nurse recognizes that the client's request is an example of: cultural ritual. cultural competence. cultural stereotyping. ethnocentrism.

cultural ritual. Clients and families often express rituals, or practices habitually repeated in certain contexts, during times of stress, such as during an acute hospitalization. Keeping the body covered and warm is a home remedy used by many cultures to help heal the body. As in this example, cultural rituals may conflict with Western medical beliefs. Cultural competence is an approach to health care in which one is aware of one's one cultural beliefs and biases and understands the effects that a client's culture has on the client's health care. Stereotyping involves applying a preconceived and untested generalization to a whole group of people. Ethnocentrism is the belief that one's culture is superior to another.

A student nurse is not looking forward to clinical rotation on a geriatric unit, stating "How can I get them to move faster? They always seem so slow!" How should the instructor respond? "Be careful of the negative attitude in your approach. How fast an individual moves will depend on physical ability not necessarily age." "You will get to learn how to best plan your care utilizing the slower response from older clients." "Perhaps you should review the information in our textbook for some techniques you can use." "I will show you several different techniques which you can use while providing care to these older clients."

"Be careful of the negative attitude in your approach. How fast an individual moves will depend on physical ability not necessarily age." Ageism is a form of negative stereotypical thinking about older adults. This can include thinking all older adults are physically and cognitively impaired, have lack of interest in sex, or are burdensome to families and society. The instructor should first help the student recognize the stereotypical attitude and then provide tips on how to best address this attitude and not how to change the client's actions.

The nurse is caring for a client who is postoperative 24 hours from an appendectomy. The client is hesitant to get out of bed. How should the nurse respond? "You need to get up and walk to prevent complications." "Can you describe what you are feeling when you try to move?" "I will come back later and help you get up." "Would like to wait until your family arrives to get out of bed?"

"Can you describe what you are feeling when you try to move?" The client who is hesitant to move and get out of bed may be expecting pain. Some clients, however, my control their emotions and expressions of physical discomfort in front of strangers. Telling the client to get up and walk to prevent complications is important, but the nurse needs to assess why the client is hesitating to get up. Leaving the client or waiting for the family does not address the reason why the client is hesitant to get up.

The nurse is caring for a client who is admitted for hypertension (HTN). The nurse notes that the client has not been eating the food provided, and family members have brought in homemade food. What would be the best response by the nurse? "You should consider eating the food provided, which is healthier." "Do you understand the specific diet for your HTN?" "Can you tell me what foods you prefer to eat and what your family is bringing you?" "It is ok to eat what your family brought you, as long as we see what it is."

"Can you tell me what foods you prefer to eat and what your family is bringing you?" The nurse should attempt to provide culturally sensitive food; however, the nurse should assess what foods the client wants to eat. The nurse should educate the client on food preferences that are also appropriate to the disease-specific dietary restrictions. Even though the diet may be healthier, the nurse should first assess the client's preferences. The nurse should verify the client's understanding of the diet but should avoid closed-ended questions such as asking if the client understands the specific diet for HTN.

A nurse is demonstrating ethnocentrism. Which statement would reflect this concept? "Irish people are all heavy drinkers." "Asians are always the smartest in the class." "My Russian heritage is superior to all others." "Anybody on welfare is just lazy."

"My Russian heritage is superior to all others." Ethnocentrism is viewing one's own culture as the only correct standard by which to view people of other cultures. Stereotypes are preconceived and untested beliefs about people. They are exaggerated descriptors of character or behavior that are commonly reiterated in mass media, idiomatic expressions, and folklore. They may be demeaning ("People on welfare are lazy, just living off handouts"; "Irish people are all heavy drinkers") or idealizing ("Asians are always the smartest in the class"; "Nurses are patient people"). Either way, they mislead and deny the individuality of the person.

What is the priority assessment for the nurse when developing a plan of care for a client living in poverty? Access to care Access to health insurance Access to affordable housing Access to financial assistance

Access to care 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.

The nurse is assessing an older adult who immigrated at the age of 3 years. The client speaks the same language as the nurse and lives in a neighborhood with many households from the country of origin. Which action by the nurse is most appropriate? Contact a traditional healer as part of culturally competent care of the client. Avoid direct eye contact with the client when speaking. Ask the client about special cultural beliefs or practices. Contact the client's oldest son to assist with health care decision making.

Ask the client about special cultural beliefs or practices. Asking the client his or her beliefs exemplifies that the nurse recognizes the importance of respecting differences rather than imposing standards. The nurse cannot assume the client's beliefs based on cultural appearance, so contacting a tribal healer, avoiding making eye contact, or asking the client's son is not appropriate. Once asked, if the client believes cultural support is significant to health and recovery, then the nurse should respect the client's beliefs or practices.

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? Allow all the visitors into the room. Explain to the family that too many visitors will tire the client. Insist that only one family member can be in the room at a time. Assess the client's beliefs about family support during hospitalization.

Assess the client's beliefs about family support during hospitalization. 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.

A nurse is conducting a cultural assessment of a client. Which person would the nurse identify as the expert? Older family member Client Nurse Health care provider

Client

The home health nurse is conducting the health history interview with a client who speaks a different language. What would be the best action made by the nurse? Use simple words with simple actions. Write out all questions using appropriate medical terms. Conduct the health history utilizing a telephonic interpreter (over-the-phone translation). If the client does not answer, repeat the question again using a louder tone.

Conduct the health history utilizing a telephonic interpreter (over-the-phone translation). When speaking with a client who speaks a different language, the nurse should use a trained or certified interpreter. If an on-site interpreter is unavailable, the nurse should other methods including bilingual staff, volunteers, webcam, or telephonic interpreting. The nurse should maintain a moderate, low tone in voice and avoid shouting or talking loudly. The nurse should avoid using medical terms. Because the client may not be able to read the same language as the nurse, it is not appropriate to write out all questions using appropriate medical terminology. When asking questions, the nurse should discuss one topic at a time and avoid conjunctions.

A client believes that the illness is caused by an imbalance of yin and yang. The nurse states, "You can call it whatever you believe, but you have a metabolic disorder." What is this nurse demonstrating? Ethnocentrism Cultural diversity Stereotyping Cultural blindness

Cultural blindness The nurse is demonstrating cultural blindness, which occurs when one ignores differences and proceeds as though they do not exist.

The nurse is caring for a client who does not speak the same language. 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 same language. Schedule a certified interpreter when collecting client health history. Request that the client's spouse carries out language interpretation at discharge. Ask the client's child, who speaks the same language as the nurse, to explain treatment options to the client.

Determine in which language the client communicates effectively. Review facility policy on communication with clients who do not speak the same language. Schedule a certified interpreter when collecting client health history. 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 same language as health care staff 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.

A nurse is providing care to a client who has limited understanding of the language the nurse speaks. Which strategy is best for the nurse to use to ensure that the client obtains the needed health information? Ask a bilingual family member to translate Enlist the services of a qualified language interpreter Ask another nurse who speaks the client's language to interpret Use a laboratory aide who is from the same country as the client

Enlist the services of a qualified language interpreter Hospitals are required to provide qualified language interpreters for the client who does not speak or understand the same language of hospital staff. Obtaining qualified interpreters rather than bilingual members of the client's family or friends, however well-intentioned or convenient the latter might be, is important because interpretation of behavior goes beyond translation of words. Much medical vocabulary and terminology is difficult to translate into other languages, and another nurse who speaks the language or a laboratory aide from the same country as the client would not be trained to interpret.

How is culture learned by each new generation? Ethnic heritage Involvement in religious activities Formal and informal experiences Belonging to a subculture

Formal and informal experiences Culture is a shared system of beliefs, values, and behavioral expectations that provide social structure for daily living. Culture includes the beliefs, habits, likes, dislikes, customs, rituals, and ethnic heritage that are learned through formal and informal experiences within one's family and within the cultural group to which one belongs. Involvement in religious experiences can be part of the culture learned through formal and informal experiences.

An unlicensed assistive personnel (UAP) has made a disparaging comment about a client from another culture, stating that the client's hygiene practices are "oddly completed". 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 Complete an incident report describing the UAP's racist behavior Document the fact that the UAP must not be assigned care of this client Report the statement to the client in the interests of transparency and accountability

Initiate a dialogue with the UAP about the potential harms of ethnocentrism

A nurse is part of an orientation team for a group of newly hired nurses. The nurse is to prepare a presentation for the group about different cultural groups common to the facility. As part of the presentation, the nurse is planning to describe how culture is communicated to provide a foundation for culturally competent care. Which methods of communication would the nurse include? Select all that apply. Language Behavior Symbols Implicit beliefs Lifeways

Language Behavior Symbols Culture is communicated through language, behavior, and symbols. Implicit beliefs and lifeways are components of culture.

The nurse is caring for a client who perceives time differently. What action should the nurse take for this client? Set all interventions to be done at specific times. Maintain flexibility when the client requests interventions at specific times. Have the client set all times for the interventions. Perform interventions at random times during shift.

Maintain flexibility when the client requests interventions at specific times. People view time differently. Social time can reflect attitudes regarding punctuality that vary among cultures. The nurse should maintain a flexible attitude and adapt the time of interventions to the client's needs and requests. It is not realistic to have the client set all the times for the interventions or to have the interventions at a specific time or interventions at random times during the shift.

Which statement best conveys the relationship between race and ethnicity? Race denotes physical characteristics, while ethnicity is rooted in a common heritage. Race and ethnicity can be considered to be synonymous in the context of health care. Race and ethnicity are both culturally determined concepts. Race is based on an individual's cultural history and is independent of ethnicity.

Race denotes physical characteristics, while ethnicity is rooted in a common heritage. 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.

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 Turkey sandwich, milk, and gelatin Chicken salad, water, and a frozen fruit juice bar Fruit salad, apple juice, and pudding

Soup, hot tea, and toast 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? Culture shock Stereotyping Ageism Ethnocentrism

Stereotyping

Which is a cultural norm of the health care system? There is the use of a systematic approach and problem-solving methodology. There is a tolerance of tardiness, disorderliness, and disorganization. There are rigid procedures attending birth and death. The omnipotence of technology is yet to be recognized.

There is the use of a systematic approach and problem-solving methodology. Cultural norms of the health care system include the use of a systematic approach and problem-solving methodology; the omnipotence of technology; the dislike of tardiness, disorderliness, and disorganization; and the use of certain procedures attending birth and death.

The nurse is preparing the discharge plan for a new mother and her newborn son. Which new teaching should the nurse ensure is included after noting the family is Jewish? care following the scheduled circumcision proper breastfeeding techniques when to schedule the next follow-up appointment the proper sleeping position for the newborn

care following the scheduled circumcision Orthodox Judaism and some members of non-orthodox Jewish denominations consider circumcision as a sacred ritual which is performed on the 8th day of the infant's life. Clients of other faiths may request the circumcision be completed before the newborn is discharged home from the hospital and some will choose not to circumcise their newborn. The other choices should be part of every client's discharge teaching.

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: ethnocentrism. assimilation. a subculture. ethnic identity.

ethnic identity.

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: ethnocentrism. assimilation. a subculture. ethnic identity.

ethnic identity. 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: nursing specialties. healthcare culture. caring paradigm. diagnostic process.

healthcare culture. 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.

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 Cultural assimilation Cultural blindness Cultural diversity

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.

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 Stereotyping Ethnocentrism Cultural assimilation

Culture shock

A nurse is providing care to a client who is from a different culture. Which aspect about culture would be most important for the nurse to integrate into the client's care? Not all members of the same culture act and think alike. Culture is relatively static and unchanging. Individuals learn culture in a purposeful manner. Individuals can easily describe their culture.

Not all members of the same culture act and think alike. Culture is shared unequally by its members; that is, not all members of the same culture act and think alike. Culture is also dynamic and changes as people come into contact with new beliefs and ideas. Some learning of culture is purposeful and some is absorbed without awareness. Much of culture is implicit, a combination of habit and assumptions about the world, such that habits are enacted without reflection in the daily course of living. This makes culture difficult for members to describe.

Upon admission, the client noted practicing Orthodox Judaism. Upon receiving the meal tray, the client states, "I cannot eat this. Please remove the tray." Which item on the tray is the client referring to because of kosher dietary laws? 'a tossed salad with tomatoes, lettuce, and cucumbers a fruit salad with oranges, pineapples, and grapes a baked pork chop with gravy a roll with butter

a baked pork chop with gravy The kosher dietary laws indicate that any animal which chews its cud is allowed in the diet. Pork products are prohibited, as pigs do not chew their cud. The nurse should remove the entire tray and obtain another tray that meets the required kosher laws for the client. Vegetables, fruits, and bread made without lard are allowed items.

Nurses are responsible for delivering culturally competent care for all clients. Culturally competent care does not account for: individual values. developmental level. client's height. available technology.

client's height. 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.

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: stereotyping. cultural blindness. cultural imposition. cultural conflict.

cultural imposition.

A Native American/First Nations client comes to a new clinic. The client has been to multiple clinics. The client uses peyote as part of the client's religion. Past care providers have dismissed the client's health concerns as being imaginary. What nursing concern should the nurse identify for this client's care plan? social isolation related to living in a tribal unit that is decreasing in size unproductive management of therapeutic regimen related to mistrust of traditional health care personnel powerlessness related to the inability to make health care providers understand the client's symptoms situational low self-esteem related to the repeated use of peyote

powerlessness related to the inability to make health care providers understand the client's symptoms Peyote is a hallucinogenic drug that is legal when used as part of religious ritual. Use of the drug does not warrant dismissing the client's health concerns. The nurse should identify the nursing concern as powerlessness, because the client feels as though no one will listen. The other nursing concerns are not related to the given situation.

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. cultural blindness. cultural diversity. cultural assimilation.

cultural imposition. 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 has just attended a seminar on concepts of cultural diversity. Which statement made by the nurse would require further education? "Culture helps to define identity within specific groups of people." "Culture cannot be influenced, and you are born with your culture." "Language is the primary way that people share their culture." "Culture can be seen in attitudes and institutions of certain populations."

"Culture cannot be influenced, and you are born with your culture." 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 just attended a seminar on cultural diversity. Which statement by the nurse would require further education? "Ethnicity begins at birth or through adoption of characteristics." "People of the same ethnicity share many of the same cultural and social beliefs." "Ethnicity can often determine dialect and political interests." "Ethnicity and race are the same thing and are affected by cultural practice."

"Ethnicity and race are the same thing and are affected by cultural practice." People are often born into an ethnic group, or ethnicity develops by immersion in a community. People of the same ethnicity often speak similar dialects and share similar values. Ethnicity and race are terms used interchangeably; however, they are not the same thing. Race refers specifically to physical characteristics.

A nurse is admitting a client to the unit. Which cultural question is most appropriate? Will you be able to eat the normal food provided?" "What are your dietary needs and preferences?" "Do you have food restrictions?" "Will you be making requests for special food based on your religion?"

"What are your dietary needs and preferences?" 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.

The unlicensed assistive personnel reports to the nurse that the client is refusing to eat the food on the meal tray. The nurse observes the client eating the food brought in by family members. How should the nurse respond? "What type of food did your family prepare for you, and does it have special meaning?" "You can only eat the food that we serve you." "Do you understand that you are on a strict diet and any variation can cause you harm?" "I will need to get permission from your health care provider for you to eat the food your family brought in."

"What type of food did your family prepare for you, and does it have special meaning?" The culturally competent nurse should assess the type of food the client is eating and if the food has special meaning. Some cultures use food for healing and balance during times of illness. The client may have a restricted diet, but educating the client and family can allow the client to meet the cultural needs while still getting nutrition and meeting the dietary restrictions. The nurse does not need to ask permission from the health care provider regarding the food brought in from the family. Telling the client that he or she must only eat the food offered in the health care setting is not true or empathetic.

A client is admitted to the health care facility with hypoglycemia. After the client is stable, the nurse discovers that the client has not taken the prescribed medicines. The client believes that eating saffron will keep blood sugar under control. What is the most appropriate response by the nurse? "Saffron does not have any effect on blood sugar level." "What would you think about taking the medicines, too, and benefitting from both?" "Yes, I agree that you should continue taking saffron for diabetes." "Let me inform the health care provider that you are not taking your medicines."

"What would you think about taking the medicines, too, and benefitting from both?" Although the nurse may disagree with the client's beliefs concerning the cause of health or illness, respect for these beliefs helps the nurse to achieve health care goals. Asking the client to consider the benefits of medicine is appropriate because the nurse, without disrespecting the client's beliefs, persuades the client to have medicines also. Stating that saffron does not have any effect on blood sugar level is inappropriate, as it disregards the client's beliefs. Agreeing with the client may encourage him or her and indicate low faith in the present treatment. It is inappropriate to call the health care provider and report on the client.

In addressing health promotion for a client who is a member of another culture, the nurse should be guided by which principle? 1 The client may have a very different understanding of health promotion. 2 Health promotion is a concept that is largely exclusive to Western cultures. 3 A culture's conceptualization of health promotion is a result of that culture's level of socioeconomic development. 4 The nurse should avoid performing health promotion education if this is not a priority in the client's culture.

1.the client may have a very different understanding of health promotion. 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.

Which scenario is an example of cultural competence in nursing? Assessing the rate at which an illness causes death in a culture Attending a conference for cultural diversity Attending one's own church Assuming the provider and the client share beliefs and values

Attending a conference for cultural diversity 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.

When completing a transcultural assessment of communication, which assessment by the nurse is most appropriate? Assessment of eye contact, personal space, and social taboos Assessment of religious beliefs and prayer schedules Assessment of racial identification and cultural affiliation Assessment of income level to determine poverty status

Assessment of eye contact, personal space, and social taboos Components of the transcultural assessment of communication are the cultural values associated with communication—eye contact, personal space, and social taboos. Religious assessment, racial identification, and income levels are not part of the transcultural assessment of communication.

Which behavior by the nurse is stereotyping? Avoiding older adult clients because their care is time consuming Openly ridiculing the practice of acupuncture Explaining to others that Western medicine is always superior Grouping care assignments to allow ample time to care for complex clients

Avoiding older adult clients because their care is time consuming 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.

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 Cultural assimilation Cultural imposition Cultural blindness

Culture shock 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 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? Allow the client to slowly ambulate independently. Instruct the family to assist the client with ambulation. Discuss with the client the need for assistance during ambulation. Obtain a prescription for physical therapy consult to ambulate the client.

Discuss with the client the need for assistance during ambulation. 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.

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? race ethnocentrism values ethnicity

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.

The emergency department nurse is caring for a client injured in a motor vehicle collision. The client recently immigrated to the country. The nurse should implement interventions aimed at addressing which issue? Culture shock Ethnocentrism Generalization Ageism

Ethnocentrism Culture shock is bewilderment over behavior that is culturally atypical for the client. The client who recently immigrated from another country would experience culture shock over being in a new culture, including a new culture of health care in the new country of residence. Ethnocentrism is the belief that one's culture is better than other cultures. Generalization is the belief that a person shares cultural characteristics with others from a similar background. Ageism is a negative belief that older adults are physically and cognitively impaired.

Which area is typically included in a cultural assessment? Marital status Employment status Food preferences Ethics

Food preferences 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.

Which factors contribute to the concept of a culture? Select all that apply. Language Art and music Items and clothing worn Type of disease contracted Beliefs about health practices Styles used for communication

Language Art and music Items and clothing worn Beliefs about health practices Styles used for communication Culture includes, but is not limited to, language, communication style, traditions, religion, art, music, dress, health beliefs, and health practices. The type of disease contracted is influenced by physiological status, not 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 speak in a loud voice. The interpreter should conduct the conversation quickly to avoid misinterpretation. The interpreter should understand the health care system. The interpreter should always make direct eye contact.

The interpreter should understand the health care system. 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 same language as the nurse. 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.

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 ....( answer) a Holistic cause of illness as manifested by: b. believing one can be cured of cancer by limiting work one can be cured of cancer by limiting work hours

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.

An adolescent informs the nurse at the clinic, "I do not know what is happening to me, my skin is turning very white in spots all over my hands." The nurse assesses hypopigmented areas on the hands and documents the finding. Following evaluation by the health care provider, what education will the nurse provide to the client? Using a pigmented cream will help to even the skin tones. The hypopigmented areas will be confined to the present location. There may be a slight stinging sensation when washing the hands. This is due to sun exposure, so your pigmented areas should be covered in sunscreen.

Using a pigmented cream will help to even the skin tones. The adolescent is experiencing hypopigmentation, which is called vitiligo and can affect clients of any ethnic group. Vitiligo may be embarrassing for the person affected. A pigmented cream can be used to cover the area and make the skin tones more evenly blended. There are no physical symptoms such as stinging, and the disorder is not caused by sun exposure. The condition may affect different areas of the body and is not necessarily confined to the present area.

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: an ethnocentric practice. a symbol. a coping strategy. a ritual.

a ritual. Handwashing is one of the many nursing rituals practiced by nurses. Rituals are common, observable expressions of a culture. Hand hygiene is unlikely to be a coping strategy for a nurse, which is a practice for dealing with a stressor. Ethnocentrism is the practice of basing all other cultures on one's own, which is not evident with hand hygiene. Hand hygiene is practical, rather than symbolic.