Chapter 11: Assessing Culture

A nursing instructor is teaching about cultural awareness and sensitivity in client care. The student demonstrates understanding of the above when making which of the following statements?

"Cultural awareness happens first when the nurse obtains culturally specific information from the client's health history."

The nurse is assessing a client in the emergency department who appears to be confused and unable to follow commands. When obtaining the client's social history, which of the following questions should the nurse ask first?

"Have you consumed any alcohol today?"

A nurse is assessing a Navajo client, who has presented to the health clinic with complaints of feeling endangered, confusion, bad dreams, and hallucinations. Which culture-bound syndrome should the nurse suspect in this client?

Ghost sickness

When caring for a client from a culturally different background, what is the goal for incorporating the client's health beliefs and practices into the nursing plan of care?

Improvement of the client's health outcomes

Which of the following statements is true about biologic variation?

Both genetics and environment produce biologic variation.

A client has religious or cultural restrictions on eating certain foods while in the hospital. The best action for the nurse to take is which of the following?

Consult a nutritionist/dietician to make culturally acceptable food choices.

A nurse reviews a client's chart. The nurse learns that the client has been eating only 25% of their meals and has lost 2 lb. (.9 kg.) since admission. The client practices Orthodox Judaism. What action(s) would a culturally competent nurse take? Select all that apply.

1. Ask the client about food preferences. 2. Allow family members to bring food to the client. 3. Allow the client to arrange times they would like to eat their meals.

Which statement by the nurse demonstrates a cultural bias?

"American healthcare is really so much better than that provided by any other country."

A nurse demonstrates cultural skill by which of the following?

Interpreting data accurately based on a client's culture

A nurse is assessing a client admitted with anorexia nervosa. The nurse expects which of the following signs and symptoms?

fear of obesity, restricted food intake

A new nurse asks her preceptor if the new baby she is caring for is breast- or bottle-feeding. The preceptor tells the new nurse that the mother is Hispanic and to give the baby a bottle because Hispanics do both until the mother's milk comes in. This is an example of:

stereotyping.

A nurse is caring for a client who is an immigrant and believes in the magicoreligious system. The nurse understands that the client believes which of the following affect(s) health?

supernatural forces

When performing a cultural assessment, an important point to remember would be

that definitions of family differ

A nursing instructor is teaching students about communication in different cultures. When discussing the meaning of hand gestures and body language in different cultures, the nurse realizes that further instruction is necessary when a student makes which statement?

"I can make a circle with my thumb and forefinger and people of all cultures know it means OK."

Which statement by the nurse demonstrates an understanding of the importance that a client's culture plays in the client's health and wellness?

"I need to understand the client's cultural background to best interpret the client's needs."

A nursing instructor is teaching nursing students about cultural competence. The instructor determines understanding when the students make which of the following statements?

"The nurse must be aware of the client's beliefs and values to provide high-quality care."

The nurse is conducting a cultural assessment with a client who recently immigrated to the United States. Which interview question is of most importance when addressing family history as it impacts the client's care?

"Who is primarily responsible for making family decisions since arriving in the United States?"

During a client interview, the nurse is focusing on cultural influences particularly when assessing: (Select all that apply.)

1. Health care beliefs and practices 2. Nutrition 3. High-risk behaviors

A nurse at a culturally diverse clinic is conducting an assessment of a new client. The nurse asks the client, "What does suffering and pain mean to you?" What is the rationale for asking this question? Select all that apply.

1. better understanding how the client's culture views pain 2. determining the client's ability to manage pain 3. knowing that pain varies among cultures

A nurse is conducting a cultural assessment. Which of the following should the nurse include in the assessment? Select all that apply.

1. values 2. affiliations 3. communication

What aspects of culture are relevant when conducting a health assessment on a foreign-born client admitted for surgery? Select all that apply.

1. whether there are any existing language barriers 2. nutritional or dietary considerations 3. alternative medicine practices

A nurse has a regular client who is an immigrant from China and who follows the traditional medical system of that culture. To improve the ability to understand and work with this client, the nurse researches this client's cultural view of health. Which of the following would the nurse most likely discover?

A focus on maintaining balance between yin and yang

A nurse wants to determine their own tendencies to stereotype. Which of the following mnemonics should the nurse use to assess their cultural competence and biases?

ASKED

A younger female nurse is assigned to an older Arab American client. The client tells the nurse that he is uncomfortable having her as his nurse. The client states that he is accustomed to same-gender nurses caring for him. How should the nurse respond?

Ask the charge nurse to assign the client to a male nurse.

A nurse is conducting a routine cultural assessment on a client of Asian descent for whom the dominant language is a second language. The client's spouse is of African descent. How should the nurse assess the client's cultural identity?

Ask the client what culture they identify with.

In preparing to assess a client from a different culture, a nurse is aware that one needs to assess both factors that affect the client's approach to providers and factors that affect the client's disease, illness, and health state. Which of the following is a factor the nurse should consider that primarily affects the client's approach to providers?

Body language

A client comes to the ED with lower abdominal pain. She is extremely emotional and moving wildly on the gurney. A nurse says to another nurse that the client is "way overdoing it." What action should the nurse take to best provide care for this client?

Conduct a cultural assessment to better understand the client's perception of pain and illness.

A nurse educator is leading a group of nurses in exercises aimed at improving cultural competence. Which of the following would the educator use to best describe an aspect of the term "culture"?

It is shared through norms for behaviors, values, and beliefs.

The nurse is caring for a client who is from another country, and states to the charge nurse, "I just don't know if the client really understands what I am saying, and I am not understanding the client either, even though he speaks English." What stage of cultural awareness is the nurse experiencing?

Conscious incompetence

When the nurse asks a client of African origin for the reason for coming to the health clinic, the client responds by saying, "Bad blood." The nurse recognizes that the client is most likely referring to which of the following?

Sexually transmitted infection

A nurse is performing a focused assessment on a newly admitted client. The client recently emigrated from Central America. The client is talking about the evil eye in a partial use of the dominant language. What is the best response of the nurse?

Obtain a translator.

A new graduate nurse from a small community college is going to work in an urban setting. She embraces the thought of working in a more diverse setting and wants to learn about different cultures. What behavior is this nurse exhibiting?

Cultural desire

The nurse knows that she will be caring for a client from Southern Korea who has been visiting with a family member. The nurse obtains some information about the Korean culture so that she will be able to meet the clients needs. What is the nurse demonstrating?

Cultural knowledge

A new graduate nurse, attending a hospital orientation, is asked to explain the goals of a cultural assessment. What would be the graduate nurse's best answer?

Developing and implementing a culturally congruent plan of care

A nurse is assessing a client from India who complains of panic, sexual dysfunction, fatigue, weakness, and loss of appetite. Which culture-bound syndrome should the nurse suspect in this client?

Dhat

A client requests to be cared for by a nurse who is a member of his own culture. The nurse recognizes that which barrier exists in regards to this client's nursing care?

Ethnocentrism

A nurse recognizes that the belief that one's worldview is the only acceptable truth and that one's beliefs, values, and sanctioned behaviors are superior to all others is called what?

Ethnocentrism

Sickle cell disease and other hemoglobinopathies such as thalassemia are often found in persons originating from which geographical regions?

Mediterranean and Africa.

The nurse is assessing a client and notices that when being asked questions, the client does not make eye contact. The nurse should include what in the plan of care?

Minimal eye contact due to culture

Which of the following statements is true of cultural groups and magico-religious beliefs in their health belief systems?

No culture is without an element of magico-religious beliefs.

As a novice nurse caring for a client from a different culture, what may the nurse find confusing or upsetting?

Patient's nonverbal communication

The nurse reviews the nursing notes (above) as well as the cultural assessment notes which indicate that the parents value high weights in infants. The nurse should do which of the following?

Provide education related to infant formula consumption and overfeeding.

A nurse provides care for a client who experiences anxiety, gastrointestinal complaints, and a fear of being poisoned or killed. The nurse recognizes this as which culture-bound syndrome?

Rootwork

When performing a cultural assessment on a client from another country, what can a nurse do to ensure the client receives culturally sensitive care?

Show genuine interest in the client's culture and personal life experiences.

A nurse is documenting assessment findings on a client of Hispanic descent who participates in traditional cultural practices such as folk healers and hot/cold balance. How should the nurse document these subjective findings?

The client states, "I usually see a folk healer when I am sick."

Suzie is a 16-year-old daughter in the Hanes family. She is the youngest of five children. She has had a series of illnesses and does not seem to be regaining her strength. She likes school but is falling behind a bit. Her mother is very attentive to her needs but does not seem overly concerned with the continuing pattern of illness. Which of the following is most likely a Hanes family belief?

The family values taking sick roles and caregiver roles.

Which of the following statements is true of sickle cell disease and other hemoglobinopathies?

They are associated with high-malaria environments.

A male nurse is caring for an elderly woman who has become withdrawn and somewhat confused since the nurse has come on duty. When the nurse goes into the room to bathe the client, she refuses to allow it. The best explanation for her actions would be which of the following?

cultural differences

The nurse spends a day off in a part of a non-English speaking community in order to learn more about the culture to improve interactions when providing client care. What cultural activity is this nurse demonstrating?

desire

Stereotyping is defined as

expecting all members of a cultural group to hold the same beliefs and behave in the same way.

A client of Native American/First Nations (Navajo) heritage is admitted to the hospital with dizziness, hallucinations, and loss of consciousness. The client is now awake, alert, and oriented. The nurse interviews the client and the client states he has been preoccupied with the death of someone close to him. The client's father states this reaction is common in his culture. Which of the following culture-bound syndromes is this client experiencing?

ghost sickness

Care that considers the client's body, mind, and spirit is which type of nursing care?

holistic care

The nurse and a client are developing a transcultural nursing care plan related to hypertension. The nurse will include in the plan

nutritional information specifically for the client's culture.

A new nurse is caring for a group of clients. A charge nurse intervenes when observing which of the following actions by the new nurse?

performing an admission assessment using the client's son as an interpreter

A client has been admitted to a medical floor with a diagnosis of pneumonia. Upon admission, the client is talkative and friendly to the nurse. When the nurse approaches the bed to listen to the client's lung sounds, the client becomes quiet and starts to pull away. The nurse understands that this reaction is most likely related to the client's perception of what?

space

The most effective way for a nurse to learn about an ethnic group within the community in which he/she practices is

spend time with a variety of individuals of that ethnic group.

A client returns to the floor following a colon resection. The client appears to be in excruciating pain but denies it when questioned by the nurse. The client's facial expressions and gestures indicate that the opposite is true. This is an example of which of the following?

the cultural and individual differences in pain response