Chapter 7

Which statement made by the client demonstrates hardiness when faced with a health issue? "My father was diagnosed with this illness as well." "What do I need to do to manage this illness?" "I know my faith will get me through this illness." "Can you explain what caused this illness?"

"What do I need to do to manage this illness?"

A client who recently immigrated from Eastern Europe comes to the clinic for an evaluation. During the assessment, the nurse notes that the client has adopted the local area's mannerisms and dress. The nurse interprets this as what? Acculturation Cultural identity Linguistic competence Cultural competence

Acculturation

The nurse educator is providing education to the nursing staff regarding culturally appropriate nursing care. A nursing student asks the nurse educator to describe the concept of acculturation. Which statement by the nurse is the appropriate response? "It involves adopting aspects of a different culture in when in a new environment." "It is integrating a set of values that belong to a group or culture." "It involves identifying with a group of individuals who have culturally specific beliefs and identifies." "It is a process of completely converting to another belief system."

"It involves adopting aspects of a different culture in when in a new environment."

For a client who belongs to an ethnic group that is known to have poor metabolism of psychotropic medications, the nurse should anticipate that the client may be at risk for which problem? Decreased therapeutic effect Paradoxical drug effects Adverse drug effects Increased drug resistance

Adverse drug effects

Which approach to care best reflects cultural competence? Always assign nurses of a specific ethnic background to clients with the same ethnic background. Learn all behaviors and values associated with people of specific ethnic backgrounds. Assess the culturally mediated beliefs of each client on an individual basis. Believe that people are more alike than they are different.

Assess the culturally mediated beliefs of each client on an individual basis.

Which represents the best brief definition of culture? Culture refers to a person's racial background. Culture refers to a person's religious beliefs. Culture is shared attitudes, customs, and beliefs. Culture is a society's social norms.

Culture is shared attitudes, customs, and beliefs.

An older adult client in the hospital has not had a bowel movement for 3 days and the nurse planned to give the client a stool softener this morning. The client declined the medication, however, stating that the client's spouse will be bringing the client a herbal medication later in the day that is often used by members of their ethnic group. Which reaction demonstrates cultural care accommodation/negotiation? Documenting the client's wishes and informing the client's care team what the client will be taking Teaching the client about the risks associated with nonstandard doses of herbal remedies Teaching the client about the benefits of the medication that was ordered for the client Ensuring that the herbs are sent to the hospital pharmacy for clearance before the client is allowed to take them

Documenting the client's wishes and informing the client's care team what the client will be taking

Personal space and distance is a cultural perspective that can impact nurse-client interactions. What is the best way for the nurse to interact physically with a client who has a different cultural perspective on space and distance than the client? Explain that physical contact is necessary and ask about the client's cultural personal space preferences. Realize that sitting close to the client is an indication of warmth and caring. Sit 3 to 6 feet away from the client in an attempt to not offend. Remember not to intrude into the personal space of the elderly.

Explain that physical contact is necessary and ask about the client's cultural personal space preferences.

Nurses cannot learn all the variations in culturally mediated beliefs. Which approach would be most helpful when caring for clients from other cultures? Explore the client's personal values and traditional care constructs for health and illness. Be respectful and nonjudgmental. Explain one's own cultural beliefs or the cultural expectations of the health care environment. Allow the client to practice his or her religious rituals.

Explore the client's personal values and traditional care constructs for health and illness.

When providing care for a cognitively impaired client who is strongly tied to the client's culture of origin, the nurse supports these expectations by doing what? Including family when discussing new medication treatment options Encouraging the family to consider enrolling the client in an adult day care center Being careful to discuss the client's condition only with the client's spouse Providing family members with information regarding appropriate long-term care facilities

Including family when discussing new medication treatment options

Why is understanding a client's cultural context important to a psychiatric mental health nurse? It influences perceptions of health and illness. It influences the adoption of traditional gender roles. It helps the care provider avoid offending the client. It helps the care provider choose treatment options.

It influences perceptions of health and illness.

The nurse is assessing a client who recently immigrated to the United States. The client is experiencing a high level of stress and reports that nobody in the workplace is willing to work with or talk to the client. What is the most likely cause of stress in the client? Low hardiness Low self-efficacy Low resilience Low sense of belonging

Low sense of belonging

Racial bias is evident in mental health care treatment, as reflected by what? White clients are given access to better facilities within most mental health treatment centers. Nonwhite clients are institutionalized much more frequently than are whites. It is increasingly difficult to receive reimbursement for mental health services. Most nonwhite clients are grossly undermedicated when treated in inpatient facilities.

Nonwhite clients are institutionalized much more frequently than are whites.

The nurse in an psychiatric inpatient facility encourages clients to attend daily prayer sessions. What is the most likely reason for the nurse's action? Choose the best answer. Prayer helps in coping with stress. Prayer helps in curing illness. Prayer prevents the progression of the illness. Prayer helps in improving the effectiveness of therapy.

Prayer helps in coping with stress.

When interviewing a Native American client, the nurse avoids which behavior because it is deemed unacceptable by the client's culture? Sitting in the presence of an elder Prolonged eye contact Strict attention to time commitments Expression of emotion or affection

Prolonged eye contact

A Native American client discusses cultural beliefs with the nurse providing care. In order to recognize any negative feelings or stereotypes the nurse has, which should the nurse do to ensure culturally competent nursing care can be provided? Reflect on how the client's beliefs may have similarities and differences from the nurse's own culture. Research Native American health care beliefs. Provide the client with written information on traditional medical principles. Agree to disagree on medical practices and beliefs.

Reflect on how the client's beliefs may have similarities and differences from the nurse's own culture.

The nurse is assessing a client of Middle Eastern descent. The nurse finds that the client is standing at a distance of approximately 1.5 feet while speaking to the nurse. What should the nurse interpret from this behavior? The client is behaving in a manner that is culturally acceptable. The client is trying to invade the nurse's personal space. The client likes to be spoken to from a close distance. The client wants to develop a social relationship with the nurse.

The client is behaving in a manner that is culturally acceptable.

The nurse is performing a psychosocial assessment of a client. Which behavior would indicate that the client has a high self-efficacy? The client is extremely ambitious. The client has anxiety and depression. The client has an increased sense of self-doubt. The client does not believe that others would help the client if needed.

The client is extremely ambitious.

Which culture is comfortable with making direct eye contact? Western Native American Asian Chinese

Western

The nurse is caring for a client of Middle Eastern descent who has been newly diagnosed with type 2 diabetes. The client is insistent that the client's family provide all food. How should the nurse respond? By providing the client and the family with detailed instructions with the dietary requirements of the condition By explaning to the family that they must check with the staff before giving the client food and beverages By requesting a consultation with a dietitian By informing the client's health care provider of the client's reluctance to eat facility-prepared foods

By providing the client and the family with detailed instructions with the dietary requirements of the condition

Which statement about culture is true? Cultures are static. Cultural identity reflects what determines behavior. Culture is based solely on a common purpose. Acculturation eventually leads to the emergence of the dominant culture.

Cultural identity reflects what determines behavior.

A psychiatric-mental health nurse is working on developing cultural competence. Which would be most appropriate for the nurse to do? Research information about the cultures of the population being served after assessing the client. Recognize that one's own culture is the predominant way of addressing a client's health care needs. Assume that any individual of a racial or ethnic group is the same as another individual in that group. Demonstrate an appreciation of, and a genuine interest in, the individual and his or her cultural beliefs.

Demonstrate an appreciation of, and a genuine interest in, the individual and his or her cultural beliefs.

In order to help preserve and maintain a client's cultural belief regarding the need for "hot foods," which action should the culturally competent nurse take? Educate the staff to help them assist the client in selecting food choices from the client's menu that supports this belief Discuss the possibility of the family providing the appropriate foods Ask for a dietary consult with an understanding of the "hot and cold food" belief Assure the client that these needs will be considered by the staff

Educate the staff to help them assist the client in selecting food choices from the client's menu that supports this belief

Children learn cultural characteristics as they associate with others. Which entity has the most profound influence on the development of traditional values and practices? Community Church Family School

Family

The nurse is scheduled to begin a clinical rotation at an outpatient mental health clinic that is in a neighborhood with a large number of Asian residents. Since the nurse does not share this cultural background with the potential clients, which is the best way for the nurse to ensure cultural sensitivity in this setting? Reflect on, analyze, and foster awareness of the nurse's own culture Ask to be paired with a classmate who is of Asian descent Conduct research on various Asian subcultures that the nurse may encounter Expose himself or herself to as many different cultures as possible before the nurse's rotation begins

Reflect on, analyze, and foster awareness of the nurse's own culture

Children of parents who abused alcohol and substances are able to develop self-esteem and self-efficacy by developing which characteristics? Resilience Hardiness Social skills Tolerance

Resilience

Which characteristic would be most prevalent in an individual demonstrating low self-efficacy? Self-doubt Personal goals Self-motivation Stress management

Self-doubt

When conducting an assessment with a client from another country, what can a nurse do to ensure the client receives culturally sensitive care? After the focused assessment, decide if a cultural assessment is necessary. Show genuine interest in the client's culture and personal life experiences. Develop a plan of care after talking to the client's family. Develop a plan of care based on the nurse's own knowledge of a client's culture.

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

The nurse caring for several clients on a surgical unit notes that one of the clients the nurse is caring for is Muslim. The nurse, without asking the client, decides to remove all pork from the client's meal tray prior to delivering it to the room. What best describes the nurse's action? Stereotyping Racism Honoring rituals Transcultural nursing

Stereotyping

On assessment, the nurse finds that the client demonstrates low hardiness. Which can the nurse anticipate regarding the client based on this observation? Choose the best answer. The client has low self-esteem. The client is not spiritually inclined. The client has reduced sense of belonging. The client has difficulty in problem solving under stress.

The client has difficulty in problem solving under stress.

The nurse is assessing executives in the corporate sector. Which characteristic of the executives would indicate a higher hardiness? Choose the best answer. The executive has low stress and is less resistant to illnesses. The executive has high stress and is less resistant to illnesses. The executive has low stress and is more resistant to illnesses. The executive has high stress and is more resistant to illnesses.

The executive has high stress and is more resistant to illnesses.

All except which problem stem from attitudes in which the focus is on the nurse's beliefs and values rather than those of the client? Holding preconceived judgement about cultural groups Developing a general belief system about all people from the same culture Treating the client as a source of cultural information Viewing a specific client population from a stigmatized view

Treating the client as a source of cultural information

The client was born and educated in Japan. The client moved to the United States two years ago. The client wears Western clothing and eats fast food. Which answer describes what the client has modeled? cross culturalism ethnic mosaic acculturation inclusiveness

acculturation

The nurse is trying to effectively provide culturally competent care for a client. To best meet the client's needs, what should the nurse do? clarify own cultural values and beliefs before trying to meet the client's needs treat the client the same as with any other culture encountered ask neighbor's about known cultures acquire knowledge about the cultural group

acquire knowledge about the cultural group

An important part of cultural competence includes the capacity to communicate effectively and convey information that is easily understood. When providing care the nurse should know that cultural competence includes which example? dramatism linguistic competence negociation skills cultivation analysis

linguistic competence

When immigrants arrive from another country to live in the U.S. they bring their own culture. When providing care the nurse should know that an individual's culture includes what items? Select all that apply. values beliefs stressors feelings patterns of accepted behavior

values beliefs patterns of accepted behavior

Which component of hardiness encompasses the ability to make appropriate decisions in life activities? Control Commitment Challenge Change

Control

Which developmental task occurs in the middle adult growth area? Creation of a comfortable home Preparation for retirement Adjustment to health changes Maintenance of a maximal level of health

Creation of a comfortable home

A client visits the clinic and tells the nurse about experiencing a great deal of stress on the job for the past 2 months. The nurse should instruct the client that two antecedents of the stress response are the person-environment relationship and which additional client factor? Physiologic status Perception Ethnicity Personality

Perception

What is one way in which nurses can develop cultural self-awareness? Ask peers and colleagues about practicing cultural competence. Objectively examine personal beliefs, values, and practices. Realize nothing can be done to change one's values and beliefs. Assert to others that personal biases cannot be changed.

Objectively examine personal beliefs, values, and practices.

A client visits the clinic and tells the nurse about experiencing a great deal of stress on the job for the past 2 months. The nurse should instruct the client that two antecedents of the stress response are the person-environment relationship and which additional client factor? Physiologic status Perception Ethnicity Personality`

Perception

A female nurse is conducting a family assessment of a Hispanic client. When the nurse asks questions about family problems, the nurse notices that the client is reluctant to answer. A possible cause for this behavior is that some members of the Hispanic culture believe what? Personal matters are considered to be family problems. Information should not be shared with females. Females are cultural leaders to be revered and not burdened with personal matters. Imbalances in yin and yang result in problems and this information is not to be shared with those outside the culture.

Personal matters are considered to be family problems.

The nurse is working in a mental health facility. The nurse ensures that all able-bodied clients in the facility participate in the group exercise program every morning. For which reasons would this intervention be beneficial for the clients with mental illness? Select all that apply. Physical activity improves mood and lowers anxiety. Physical activity increases the efficacy of the psychotropic drugs. Physical activity prevents medical conditions. Physical activity can foster a sense of well-being. Physical activity decreases the need for psychotherapy.

Physical activity improves mood and lowers anxiety. Physical activity prevents medical conditions. Physical activity can foster a sense of well-being.

Which stage of psychosocial development involves establishing the next generation? Adolescence Young adult Middle adult Maturity

Middle adult

The nurse who is preparing a Native American client for surgery notes that the client is wearing a medicine bag. What intervention should the nurse implement to best address the client's spiritual needs with respect to presurgical care needs? Remove the medicine bag and give it to a family member for safe keeping. Ask the client to provide information about his or her personal spiritual belief system. Ask the client how the medicine bag can be respected while preparing for surgery. Explain to the client that the medicine bag must be removed in order to minimize the risk of infection during the surgical procedure.

Ask the client how the medicine bag can be respected while preparing for surgery.

Which would play a role in a person's cultural identity? Select all that apply. Health beliefs Health practices Values Norms Behavior

Health beliefs Health practices Values Norms Behavior

Which stage of Erikson's psychosocial development includes building confidence in one's own abilities? Industry versus inferiority Initiative versus shame and doubt Identity versus role confusion Generativity versus stagnation

Industry versus inferiority

The nurse is performing a psychosocial assessment of a 30-year-old client who has recently moved back home. What developmental stressors may be noted in this client? Select all that apply. Stress related to health changes Stress related to career growth Stress related to moving out of parental home Stress related to the inability to look after self Stress related to reversing roles with parents

Stress related to career growth Stress related to moving out of parental home

The mental health nurse is interviewing a client of Asian descent regarding the client's health care practices. The nurse understands that cultural competence is important in the care of this client. Cultural competence in health care can be best described as what? The ability to understand and effectively interact with individuals or members of a community from diverse cultural or ethnic backgrounds Knowing the characteristics of each individual cultural group in America A combination of a person's beliefs about cultural values and knowledge about his or her own culture The client's ability to tell the health care provider about his or her cultural beliefs and practices

The ability to understand and effectively interact with individuals or members of a community from diverse cultural or ethnic backgrounds

The nurse is trying to effectively deal with the spiritual needs of a client. To best meet the client's need, what should the nurse do? have clergy come to see the client clarify own spiritual values and beliefs before exploring clients' beliefs ask the manager what to do have the healthcare provider deal with spiritual needs

clarify own spiritual values and beliefs before exploring clients' beliefs

The nurse educator is discussing spirituality for nurses in a mental health class. The nurse educator asks a student nurse, "Which of the following is most consistent with spirituality?" The student nurse identifies which description? closely intertwined with beliefs about health and mental illness living according to one's beliefs participation in common ways of worshiping feeling a connection to a higher power

feeling a connection to a higher power