Chapter 6: Cultural and Ethnic Considerations

2. What is a fixed concept of how all members of an ethnic group act or think? a. Variations within a cultural group b. Identical practices c. Holistic nursing d. Ethnic stereotypes

ANS: D Ethnic stereotypes are fixed concepts of how all members of an ethnic group act or think. PTS: 1 DIF: Cognitive Level: Knowledge REF: Page 95 OBJ: 4 TOP: Culture KEY: Nursing Process Step: N/A

43. A nation, community, or broad group of people who establish particular aims, beliefs, or standards of living and conduct is known as a _____________.

ANS: society A society is a nation, community, or broad group of people who establish particular aims, beliefs, or standards of living and conduct. PTS: 1 DIF: Cognitive Level: Knowledge REF: Page 94 OBJ: 4 TOP: Society KEY: Nursing Process Step: N/A

12. What is the term for a group of people who share biologic physical characteristics? a. Race b. Culture c. Religion d. Social organization

ANS: A A race is a group of people who share biologic physical characteristics. PTS: 1 DIF: Cognitive Level: Knowledge REF: Page 96 OBJ: 4 TOP: Race KEY: Nursing Process Step: N/A

35. The nurse is caring for a postpartum patient who requests to dry and bury the umbilical cord near an object or in a place that symbolizes what the parents want for the child's future. Which cultural beliefs does the nurse recognize this patient adhering to? a. American Indian b. African American c. Chinese American d. Mexican American

ANS: A After delivery, American Indians practice taking the umbilical cord from the newborn, drying and burying it near an object or place that symbolizes what the parents want for the child's future. PTS: 1 DIF: Cognitive Level: Comprehension REF: Page 112 Table 6-4 OBJ: 4 TOP: Health belief systems KEY: Nursing Process Step: N/A

16. A nurse is caring for a female neonate born to observant Orthodox Jewish parents. What book does the nurse know will be used when naming this neonate? a. Bible b. Koran c. Holy Torah d. Book of Mormon

ANS: C For observant Jews, female babies are usually named during a reading of the Holy Torah. PTS: 1 DIF: Cognitive Level: Knowledge REF: Page 103 Box 6-4 OBJ: 2 | 4 TOP: Religious practices KEY: Nursing Process Step: N/A

41. Following the death of a Presbyterian infant, the nurse should help arrange for __________.

ANS: baptism Presbyterians believe in infant baptism. PTS: 1 DIF: Cognitive Level: Application REF: Page 104 Box 6-4 OBJ: 4 TOP: Infant baptism KEY: Nursing Process Step: Implementation

11. What is the term for a generalization about a form of behavior, an individual, or a group? a. Dialect b. Religion c. Ethnicity d. Stereotype

ANS: D A stereotype is a generalization about a form of behavior, an individual, or a group. PTS: 1 DIF: Cognitive Level: Knowledge REF: Page 95 OBJ: 4 TOP: Stereotype KEY: Nursing Process Step: N/A

7. What is a set of learned values, beliefs, customs, and practices shared by a group? a. Race b. Ethnicity c. Culture d. Religion

ANS: C Culture is a set of learned values, beliefs, customs, and practices shared by a group. PTS: 1 DIF: Cognitive Level: Knowledge REF: Page 94 OBJ: 4 TOP: Culture KEY: Nursing Process Step: N/A

4. What is the term for when members of a particular ethnic group believe that their beliefs and practices are the best? a. Prejudice b. Separatism c. Ethnocentrism d. Bias

ANS: C When members of a particular ethnic group believe that their practices and beliefs are the best, it is referred to as ethnocentrism. PTS: 1 DIF: Cognitive Level: Knowledge REF: Page 95 OBJ: 4 TOP: Culture KEY: Nursing Process Step: N/A

31. The nurse is caring for a Chinese American patient. How should this nurse demonstrate cultural awareness? a. Maintain eye contact with the patient b. Hold the patient's hand while conversing c. Touch the patient's arm when speaking to the patient d. Sit side-to-side when speaking with the patient

ANS: D Chinese Americans view maintaining eye contact as ill-mannered and disrespectful. They are uncomfortable when face-to-face, and prefer to sit side-to-side or at a right angle to carry on conversation. Touching is not usual during conversation; it is regarded as disrespectful or impolite. PTS: 1 DIF: Cognitive Level: Application REF: Page 111 Table 6-4 OBJ: 4 | 5 TOP: Health belief systems KEY: Nursing Process Step: N/A

13. What is the term for a group of people who share a common social and cultural heritage based on shared traditions, national origin, and physical and biologic characteristics? a. Race b. Culture c. Religion d. Ethnicity

ANS: D Ethnicity refers to a group of people who share a common social and cultural heritage based on shared traditions, national origin, and physical and biologic characteristics. PTS: 1 DIF: Cognitive Level: Knowledge REF: Page 96 OBJ: 4 TOP: Ethnicity KEY: Nursing Process Step: N/A

17. A nurse is caring for an Orthodox Jewish woman immediately after she has given birth. What can the nurse expect regarding the spouse's participation in his wife's care? a. He will share a bed with the patient. b. He will ask to bathe with the patient. c. He will touch the patient frequently. d. He will avoid physical contact with the patient.

ANS: D For observant Jews, a woman is considered to be in a ritual state of impurity whenever blood is coming from her uterus, such as during menstrual periods and after the birth of a child. During this time, her husband will not have physical contact with her. When this time is completed, she will bathe herself in a pool called a mikvah. Nurses need to be aware of this practice and be sensitive to the husband and wife because the husband will not touch his wife. PTS: 1 DIF: Cognitive Level: Comprehension REF: Page 103 Box 6-4 OBJ: 4 | 5 TOP: Religious practices KEY: Nursing Process Step: N/A

45. A generalization about a form of behavior, an individual, or a group is known as a _________________.

ANS: stereotype A stereotype is a generalization about a form of behavior, an individual, or a group. PTS: 1 DIF: Cognitive Level: Knowledge REF: Page 95 OBJ: 4 TOP: Stereotype KEY: Nursing Process Step: N/A

44. A set of learned values, beliefs, customs, and practices that are shared by a group and are passed from one generation to another is known as ________________.

ANS: culture Culture is a set of learned values, beliefs, customs, and practices that are shared by a group and are passed from one generation to another. PTS: 1 DIF: Cognitive Level: Knowledge REF: Page 94 OBJ: 4 TOP: Culture KEY: Nursing Process Step: N/A

42. While caring for a Mexican American family in the home, the home health nurse recognizes that the family may also consult the _____________ for health advice.

ANS: curandero, folk healer curandero folk healer The curandero or folk healer is an important figure in the health care of MexicanAmericans. PTS: 1 DIF: Cognitive Level: Application REF: Page 107 Figure 6-2 OBJ: 4 TOP: Mexican Americans KEY: Nursing Process Step: Implementation

40. The cultural characteristic of unwillingness to leave a current activity—which may result in late or missed appointments—is called ____________.

ANS: elasticity Elasticity is the ethnic characteristic of being late or missing an appointment altogether because of involvement in a current activity. PTS: 1 DIF: Cognitive Level: Knowledge REF: Page 100 OBJ: 4 TOP: Elasticity KEY: Nursing Process Step: N/A

39. The nurse should not maintain eye contact with a Korean patient because many Asians believe prolonged eye contact is _____________.

ANS: impolite rude Many Asians avoid eye contact, believing it to be impolite or rude. PTS: 1 DIF: Cognitive Level: Comprehension REF: Page 111 Table 6-4 OBJ: 2 | 4 TOP: Asians KEY: Nursing Process Step: Implementation

20. A nurse is preparing to discuss birth control options for a Roman Catholic patient. What is the most appropriate method for the nurse to discuss with this patient? a. Abstinence b. Vasectomy c. Tubal ligation d. Oral contraceptives

ANS: A Birth control for Roman Catholics is prohibited except for abstinence or natural family planning. Referral to a priest for questions about this can be of great help. Nurses can teach the techniques of natural family planning if they are familiar with them; otherwise, this should be referred to the physician or to a support group of the Church that instructs couples in this method of birth control. Sterilization is prohibited unless there is an overriding medical reason. PTS: 1 DIF: Cognitive Level: Application REF: Page 104 Box 6-4 OBJ: 3 | 5 | 7 TOP: Religious practices KEY: Nursing Process Step: N/A

23. Which statement about the biomedical health belief system is true? a. Life processes can be manipulated by human beings by mechanical interventions. b. Life processes cannot be manipulated by human beings by mechanical interventions. c. Disease has a nonspecific cause, onset, course, and treatment. d. Disease is only caused by failure of body parts and chemical imbalances.

ANS: A Characteristic of the biomedical health belief system include the beliefs that life is regulated by biomedical and physical processes. Life processes can be manipulated by human beings by mechanical interventions. Health is the absence of disease or signs and symptoms of disease. Disease is an alteration of the structure and function of the body. Disease has a specific cause, onset, course, and treatment. It is caused by trauma, pathogens, chemical imbalances, or failure of body parts. Treatment focuses on the use of physical and chemical treatments. PTS: 1 DIF: Cognitive Level: Comprehension REF: Page 106 Table 6-2 OBJ: 4 TOP: Health belief systems KEY: Nursing Process Step: N/A

14. A nurse is caring for a neonate born to observant Orthodox Jewish parents. Who can the nurse anticipate will name the neonate? a. Father b. Mother c. Grandfather d. Grandmother

ANS: A For observant Jews, babies are named by the father. PTS: 1 DIF: Cognitive Level: Knowledge REF: Page 103 Box 6-4 OBJ: 2 | 3 TOP: Religious practices KEY: Nursing Process Step: N/A

29. A patient requests a consultation between the physician and a religious leader known as an Imam. What is this patient's cultural belief? a. Muslim b. African American c. Chinese American d. Mexican American

ANS: A Muslims may wish to have their doctor consult with an Imam, a religious leader. PTS: 1 DIF: Cognitive Level: Comprehension REF: Page 112 Table 6-4 OBJ: 4 TOP: Health belief systems KEY: Nursing Process Step: N/A

27. The nurse is caring for a patient who fasts during daylight hours during Ramadan. The nurse recognizes that the patient is adhering to the cultural beliefs of which culture? a. Muslims b. African Americans c. Chinese Americans d. Mexican Americans

ANS: A Muslims practice fasting during daylight hours during Ramadan. PTS: 1 DIF: Cognitive Level: Knowledge REF: Pages 101-102 Box 6-4 OBJ: 4 | 5 TOP: Health belief systems KEY: Nursing Process Step: N/A

25. Which health belief system includes a belief of a supernatural force exerting influence to cause health or illness? a. Folk b. Holistic c. Biomedical d. Alternative/complementary

ANS: A The folk health belief system is commonly referred to as "third-world" beliefs and practices. It is often called strange by nurses and other health professionals who are unfamiliar with folk medicine beliefs. PTS: 1 DIF: Cognitive Level: Knowledge REF: Page 106 Table 6-2 OBJ: 4 TOP: Health belief systems KEY: Nursing Process Step: N/A

24. Which health belief system is commonly referred to as "third-world" beliefs and practices? a. Folk health belief system b. Holistic health belief system c. Biomedical health belief system d. Alternative/complementary belief system

ANS: A The folk health belief system is commonly referred to as "third-world" beliefs and practices. It is often called strange or weird by nurses and other health professionals who are unfamiliar with folk medicine beliefs. PTS: 1 DIF: Cognitive Level: Knowledge REF: Page 106 Table 6-2 OBJ: 4 TOP: Health belief systems KEY: Nursing Process Step: N/A

32. The nurse is caring for a Mexican American patient. What nursing intervention would best demonstrate cultural sensitivity? a. Encouraging consultation of male members of the family regarding health care decisions b. Discouraging consultation of male members of the family regarding health care decisions c. Insisting on providing all personal care required by the patient d. Asking only female family members about health care decisions

ANS: A When caring for Mexican Americans, families may expect to help care for the patient. Male family members usually are consulted before health care decisions are made. PTS: 1 DIF: Cognitive Level: Application REF: Page 112 Table 6-4 OBJ: 4 | 5 | 7 TOP: Health belief systems KEY: Nursing Process Step: N/A

34. The nurse is caring for a Mexican American patient who is in labor. How can this nurse best demonstrate cultural sensitivity? a. Encouraging female family members to be present for the delivery b. Encouraging the patient's spouse to be present for the delivery c. Asking the patient's spouse to see his baby before cutting the umbilical cord d. Asking the patient's spouse to hold the neonate before bathing the neonate

ANS: A When caring for Mexican Americans, it is considered inappropriate for the husband to be present during birth. The father is not expected to see his wife or baby until both are cleaned and dressed. PTS: 1 DIF: Cognitive Level: Application REF: Page 112 Table 6-4 OBJ: 4 TOP: Health belief systems KEY: Nursing Process Step: N/A

36. What are some characteristics that cultures have in common? (Select all that apply.) a. Economic practices b. Survival modes c. Transportation systems d. Language e. Family systems

ANS: A, B, C, E Language may differ within cultures; the rest are shared characteristics. PTS: 1 DIF: Cognitive Level: Comprehension REF: Page 95 Box 6-1 OBJ: 1 | 4 TOP: Common traits KEY: Nursing Process Step: N/A

37. What should the culturally sensitive nurse do for a Muslim woman being treated in the hospital? (Select all that apply.) a. Assign only female staff to care for her. b. Keep her head and extremities covered as much as possible. c. Arrange for family to bring specially prepared pork dishes. d. Let her make decisions relative to her care. e. Allow privacy for prayer.

ANS: A, B, E Muslim women are not accustomed to making decisions, leaving it to the head of the house or the family as a whole. Muslims do not eat pork. PTS: 1 DIF: Cognitive Level: Application REF: Page 102 Box 6-4 OBJ: 4 | 5 TOP: Muslims KEY: Nursing Process Step: Implementation

38. A nurse working in a long-term care facility is admitting an 85-year-old resident of Hispanic descent diagnosed with Alzheimer disease. What should this nurse take into consideration when caring for the resident? (Select all that apply.) a. Cultural background has an important role in determining the resident's status b. The resident will be culturally sensitive to caregivers c. Home remedies may have value even if harmful d. The resident will have a strong sense of trust for health care workers e. Communication should involve gesturing whenever possible

ANS: A, C Cultural background has an impact on family dynamics and plays an important role in determining the role and the status of the older person. Some older adults are less tolerant of other cultures as a result of influences or experiences early in their lives, which raises the possibility of misunderstandings and distrust when the caregiver is of a cultural group different than that of the older person. Communication should suit the individual needs of the resident and does not necessarily involve gesturing. PTS: 1 DIF: Cognitive Level: Application REF: Page 96 OBJ: 6 TOP: Older Adult KEY: Nursing Process Step: Implementation

1. Culture varies from patient to patient. Why is it important that the nurse understand and accept each person as an individual? a. To develop a plan of care b. To provide holistic care c. To identify differences d. To support each patient

ANS: B Accepting each person as an individual is the first step in providing holistic care. PTS: 1 DIF: Cognitive Level: Comprehension REF: Page 95 OBJ: 2 TOP: Culture KEY: Nursing Process Step: N/A

3. All nurses should work to provide culturally appropriate nursing care. What is the integration of cultural knowledge into all aspects of care? a. Cultural competence b. Transcultural nursing c. Nursing process d. Team nursing

ANS: B All nurses should provide transcultural nursing, which is the integration of cultural knowledge into all aspects of care. PTS: 1 DIF: Cognitive Level: Knowledge REF: Pages 95-96 OBJ: 1 | 2 TOP: Culture KEY: Nursing Process Step: N/A

18. A nurse is caring for an Orthodox Jewish patient. What is the most appropriate dietary requirement for the nurse to implement? a. Mixing of milk and meat at a meal b. Use of separate cooking utensils for meat and milk products c. Use of one set of cooking utensils for meat and milk products d. Consumption of food not slaughtered in accordance with Jewish law

ANS: B For observant Jews, Kosher dietary laws include the following: no mixing of milk and meat at a meal; no consumption of food or any derivative thereof from animals not slaughtered in accordance with Jewish law; use of separate cooking utensils for meat and milk products; if a patient requires milk and meat products for a meal, the dairy foods should be served first, followed later by the meat. PTS: 1 DIF: Cognitive Level: Application REF: Page 103 Box 6-4 OBJ: 4 TOP: Religious practices KEY: Nursing Process Step: N/A

5. What is the term used to describe cultures in which women make decisions about health care and provide the care and discipline to the children? a. Biologic b. Matriarchal c. Cultural d. Patriarchal

ANS: B In a matriarchal society, women make the decisions about health care. In patriarchal society, the men make decisions about health care. There is no such thing as biologic or cultural cultures. PTS: 1 DIF: Cognitive Level: Knowledge REF: Page 100 OBJ: 4 TOP: Culture KEY: Nursing Process Step: N/A

10. The father of an American Indian has just died. What should the nurse do immediately after death? a. Provide privacy so that the family may touch and kiss the deceased goodbye b. Ask about providing help with the death ceremony c. Carefully wrap the deceased's clothing for the family to take home d. Mention the deceased by name frequently

ANS: B In the American Indian culture it is taboo to touch the deceased or any of the belongings of the deceased. After death, the name of the deceased is not spoken. PTS: 1 DIF: Cognitive Level: Application REF: Page 112 Table 6-4 OBJ: 1 | 4 | 6 TOP: American Indian KEY: Nursing Process Step: Implementation

15. A nurse is caring for a male neonate born to observant Orthodox Jewish parents. Who will the nurse anticipate will circumcise the neonate? a. A bishop b. A mohel c. His father d. His physician

ANS: B Male children are named 8 days after birth, when ritual circumcision is done. A mohel performs the circumcision. PTS: 1 DIF: Cognitive Level: Knowledge REF: Page 103 Box 6-4 OBJ: 2 | 4 TOP: Religious practices KEY: Nursing Process Step: N/A

6. What basic philosophy in the United States is relevant to health care? a. Folk remedies b. Biomedical therapy c. Holistic therapy d. Spiritual intervention

ANS: B Most people in the United States believe biomedical therapy is the best way to treat disease. PTS: 1 DIF: Cognitive Level: Comprehension REF: Page 106 Table 6-2 OBJ: 4 TOP: Culture KEY: Nursing Process Step: N/A

19. The nurse is preparing an Orthodox Jewish patient's tray during Passover. What intervention is appropriate for this patient? a. Avoid fish dishes b. Encourage time for prayer c. Offer the patient leavened products d. Encourage the use of loud music in celebration

ANS: B Orthodox Jews say prayers over the bread and wine before meals. Time and a quiet environment should be provided for this. During Passover, no leavened products are eaten. PTS: 1 DIF: Cognitive Level: Application REF: Page 103 Box 6-4 OBJ: 4 TOP: Religious practices KEY: Nursing Process Step: N/A

9. The nurse from New York City is caring for a patient from Atlanta, Georgia. What difference between the nurse and patient may cause them to experience difficulty in communicating? a. Race b. Subculture c. Ethnic group d. Culture

ANS: B Subcultures have characteristic patterns that distinguish them from the rest of the culture. PTS: 1 DIF: Cognitive Level: Comprehension REF: Page 94 OBJ: 2 TOP: Subculture KEY: Nursing Process Step: N/A

26. Which health belief system focuses on restoring balance with physical, social, and metaphysical worlds? a. Folk health belief system b. Holistic health belief system c. Biomedical health belief system d. Alternative/complementary belief system

ANS: B The treatment based on the holistic health belief system is designed to restore balance with physical, social, and metaphysical worlds. PTS: 1 DIF: Cognitive Level: Knowledge REF: Page 106 Table 6-2 OBJ: 4 TOP: Health belief systems KEY: Nursing Process Step: N/A

33. The nurse is caring for an African American patient. Who would the nurse expect to be the primary decision maker in the patient's family? a. Men b. Women c. Clergy d. Grandparents

ANS: B When caring for African Americans, women are primarily the decision makers in the family and are frequently the head of the household. PTS: 1 DIF: Cognitive Level: Comprehension REF: Page 112 Table 6-4 OBJ: 1 | 4 TOP: Health belief systems KEY: Nursing Process Step: N/A

8. A nurse is American-born and works in a large hospital with patients from many cultures. What must this nurse develop to provide the best care? a. Another language b. Assessment skills c. Cultural competence d. Care planning ability

ANS: C To provide care to patients from different cultures, the nurse must develop cultural competence. PTS: 1 DIF: Cognitive Level: Comprehension REF: Page 95 OBJ: 3 TOP: Culture KEY: Nursing Process Step: N/A

30. The nurse is delivering a meal tray to a female Muslim patient. What intervention is most appropriate for this patient? a. Offering her a ham and cheese sandwich b. Providing her with a male nurse c. Providing her with a female nurse d. Offering her bacon and eggs

ANS: C When caring for Muslims, same-sex health care providers should be used if at all possible. Ham and bacon are not appropriate items to offer a Muslim patient, since they do not consume pork products. PTS: 1 DIF: Cognitive Level: Application REF: Page 112 Table 6-4 OBJ: 4 TOP: Health belief systems KEY: Nursing Process Step: N/A

22. A nurse is caring for a patient who is a Latter-Day Saint. The nurse is aware members of this faith may wear sacred undergarments. What intervention is appropriate for the nurse caring for this patient? a. Instruct the patient to remove the undergarments b. Allow the patient to wear the undergarments only at night c. Allow the patient to wear the undergarments only during the day d. Remove the undergarments in emergency situations only

ANS: D For observant Latter-Day Saints, a sacred undergarment may be worn at all times and should be removed only in emergency situations. PTS: 1 DIF: Cognitive Level: Application REF: Page 101 Box 6-4 OBJ: 4 | 5 TOP: Religious practices KEY: Nursing Process Step: N/A

21. A nurse is preparing a meal tray for a patient who is a Latter-Day Saint. What beverage should the nurse prepare? a. Tea with all meals b. Coffee each morning c. Cola beverages d. Fruit juice

ANS: D For observant Latter-Day Saints, beverages with caffeine such as cola, coffee, and tea; alcohol; and other substances are considered injurious. PTS: 1 DIF: Cognitive Level: Application REF: Pages 101-102 Box 6-4 OBJ: 4 | 7 TOP: Religious practices KEY: Nursing Process Step: N/A

28. The nurse is caring for a Muslim patient. What dietary selection should the nurse serve to this patient? a. Bacon, eggs, and toast b. Pork fried rice c. Ham and cheese sandwich d. Chicken and rice

ANS: D Muslims practice avoidance of foods that include pork products. Bacon, pork, and ham are all pork products. Only the chicken and rice meal does not include a pork product. PTS: 1 DIF: Cognitive Level: Application REF: Pages 101-102 Box 6-4 OBJ: 1 | 2 | 4 TOP: Health belief systems KEY: Nursing Process Step: N/A