Chapter 8: Cultural Care Considerations

An infant with a diagnosis of pyelonephritis is receiving care on the pediatric unit and the nurse's review of the child's electronic health record reveals that the infant has not received any of her scheduled immunizations. The mother informs the nurse that immunizations are absolutely against her cultural beliefs, and she does not want her child to receive immunizations. In this scenario, what do the mother's views on immunizations represent?

A cultural taboo

The yin/yang theory of harmony and illness is rooted in which paradigm of health and illness?

Holistic

The nurse is providing care for an older adult client who has a diagnosis of shingles. The nurse is aware that this health problem is attributable to the varicella zoster virus. This belief is an example of which paradigm explaining the cause of disease and illness?

Biomedical

A nurse is caring for a client who suffered a fall while on vacation. He is from another state and has no visitors except his spouse, who seems lonely without any friends or family nearby. The nurse invites the spouse to attend services with her at the nurse's church, which is a denomination different from the spouse's. This could be construed as which of the following?

Cultural imposition

A parent informs the nurse that immunizations are contrary to her religious beliefs, and she does not want her child to receive them. The nurse proceeds to inform the parent that the child will be in grave danger of illness all her life and will not be allowed to start school unless she is immunized. The nurse also informs the parent that she had all of her own children vaccinated with no adverse effects. The nurse's behavior is an example of what?

Cultural imposition

Which term refers to the tendency to impose one's cultural beliefs, values, and patterns of behavior on a person or people from a different culture?

Cultural imposition

Effective, individualized care that shows respect for the dignity, personal rights, preferences, beliefs, and practices of people receiving care while acknowledging the bias of the caregiver and preventing that bias from interfering with care. This is a definition of?

Culturally competent nursing care

The nurse is providing care to a client who implements some of the principles and practices of Ayurvedic medicine. What should the nurse include when planning this client's care? Select all that apply

Accommodating special dietary considerations Providing a safe and quiet place for performing yoga

The nurse working with a community of Native Americans notices that they no longer look at the floor when engaged in conversation but make direct eye contact with the speaker. The nurse interprets this as an example of which characteristic?

Acculturation

The nurse is caring for a client who is terminally ill and whose family has requested to hold a spiritual ceremony involving incense. What is the nurse's best intervention?

Arrange for the ceremony to occur unless absolutely prohibited.

It is important for the nurse to acknowledge cultural differences that may influence the delivery of health care. In order to do this, the nurse must do which of the following?

Confront the nurse's own bias and influence of his or her culture.

Of the following nurse theorists, which one is considered the founder of transcultural nursing?

Madeline Leininger

Which term refers to a folk healer in the Native American culture?

Medicine man

In which religious group is pork the only meat prohibited?

Seventh-Day Adventists

The nurse is assigned to care for a patient with a cultural background that is different than the nurse's. Prior to delivering care, what is important for the nurse to do?

The nurse should explore his/her own cultural beliefs.

The nurse is providing education to the patient about wound care and the patient changes the subject to talk about the weather. What does the nurse understand may be the cause of the abrupt change of subject?

The patient may not understand what is being explained by the nurse.

During an orientation class, the medical unit's nursing educator is presenting education on transcultural nursing to a group of new nursing graduates. What should the staff educator identify as the underlying focus of transcultural nursing?

The underlying focus of transcultural nursing is to provide culture-specific and culture-universal care.

Which specialty in nursing involves providing nursing care in the context of the client's culture?

Transcultural nursing

You work in a city hospital and care for patient populations that are culturally diverse. One aspect of being a skilled nurse in this diverse environment is cultural competence. What action would indicate a lack of cultural competence?

Using your own values and beliefs to influence your patient's

Many large cities have neighborhoods where the residents voluntarily group according to familial customs and traditions. What cultural principle is exhibited by these actions?

ethnicity

An affiliation with a certain racial or cultural group that provides a sense of identity is:

ethnicity.

A new acute care client, a 57-year-old male, does not speak English. His daughter insists on staying with her father around the clock. While the daughter's offer is appreciated, the nurse also contacts the unit manager to enlist the services of a male interpreter. The interpreter is preferable because the daughter

lacks medical knowledge.

Which culturally related perspective on illness/disease is based on a belief in achieving health by attaining a state of harmony in the body?

naturalistic or holistic

A Nigerian client visits a general practice clinic with nondescript abdominal pain. The nurse references Nigerian cultural information to successfully complete the assessment, taking into account cultural differences which can affect treatment. Which areas of treatment can be impacted by cultural differences? Select all that apply.

pain management hygiene practices

American Indian/Alaska Native, African American, Asian, Native Hawaiian/Other Pacific Islander, and Caucasian are designations for which groups in the United States?

population groups

Physical characteristics, such as hair color, eye color, eye shape, skin color, and bone structure, are associated with differences in:

race.

The nurse is caring for a Native American client who states that he uses an indigenous healer. The nurse seeks clarification by asking whether the client is referring to a(n)

shaman.

A nurse is taking a history. The client has limited English proficiency. When communicating with this client the nurse should:

speak slowly (not loudly), use simple words and short sentences, and avoid jargon.

Transculturally, touch can be interpreted in different ways depending on the cultural understanding of the client. Regardless of culture, clients are more at ease with physical contact from a nurse if the nurse:

states the purpose and procedure for touching.

A nurse who views a client as likely to be argumentative solely because she is Hispanic is guilty of:

stereotyping.

A nursing student learns that a client has been immersed since birth in her Croatian culture. The client's parents speak to her in Croatian even though they all speak fluent English. They also belong to a Croatian organization in their neighborhood. This is an example of what?

A basic characteristic of ethnic cultures

How can a nurse improve his or her transcultural sensitivity and demonstrate culturally competent nursing care?

All of the responses are correct.

Personal space and distance are culturally dependent and can impact nurse-client interactions significantly. What is the best way for the nurse to interact with a client who has a different cultural perspective on space and distance?

Allow the client to adopt a position that is comfortable for them.

A nurse would expect that a woman from which of the following cultures would want only a female physician to examine her

Arab

The nurse should anticipate making an appointment with a female physician in the medical practice for a female patient of which culture?

Arab

An emergency department nurse is preparing to inspect and palpate the head and scalp of an older adult who experienced a fall. A member of which group would most likely consider this examination as a violation of norms?

Asian

When performing a physical assessment, the nurse should be aware that in which culture would it be impolite to touch the patient's head?

Asian

Which of the following are important considerations when providing culturally competent care in a community clinic?

Asking about cultural beliefs related to health, illness, treatments, and dietary practices.

The nurse is caring for a client who expresses the belief that her illness (cellulitis) is a result of bacteria that has caused an infection. To which of the following views of disease/illness does this client allude?

Biomedical and/or scientific

Three major paradigms are used to explain the causes of disease and illness. Which three of the following are the paradigms? Choose all three.

Biomedical or scientific view Naturalistic or holistic perspective Magico-religious view

The nurse is admitting a client who is a recent immigrant from China and who has a diagnosis of adenocarcinoma. During the client's admission assessment, the client speaks of her beliefs related to health care and indirectly references the yin/yang theory. Based on her cancer diagnosis and her yin/yang beliefs, which meal will the client most likely order for lunch?

Chicken noodle soup with crackers, fruit crisp, and hot tea

The nurse listens to a client explain that she is receiving manipulations from a health care provider. The nurse documents in the client's chart that the client is using which therapy?

Chiropractic

The nurse is caring for a client who is a recent immigrant. Which of the following variables should the nurse prioritize when performing an assessment of the client's cultural beliefs?

Client's communication style

Despite the presence of a large cohort of elderly residents of Asian heritage, a long-term care facility has not integrated the Asian concepts of hot and cold into meal planning. Which of the following should the nurses at the facility recognize this as an example of?

Cultural blindness

The nurse observes that a coworker is unable to understand that an intelligent person would engage the services of a medicine man. The nurse's coworker has strong ethnocentric tendencies and an inability to recognize others' values, beliefs, and practices. The nurse understands that the coworker's behavior is an example of which attitude?

Cultural blindness

Which of the following terms refers to Leininger's description of the person's inability to recognize his or her own values, beliefs, and practices and those of others?

Cultural blindness

A nurse is caring for an elderly woman who predominantly identifies with an East Asian culture. How can the nurse best demonstrate an awareness of culturally congruent care?

Establish effective communication.

Giger and Davidhizar created an assessment model to guide nurses in exploring cultural phenomena that might affect nursing care. When using this model in the care of a client who has had a transurethral prostate resection (TUPR), what area of care would be influenced most directly?

Explaining the rationale for continuous bladder irrigation (CBI)

The nurse is performing a cultural nursing assessment of a newly admitted client. What should the nurse include in the assessment? Select all that apply.

Family structure Cultural beliefs Health practices Values

The nurse is caring for a client who states that his religion prohibits him from eating meat. The nurse inquires whether the client practices

Hinduism.

For which religious group is all meat prohibited?

Hindus

A patient who is Asian practices the yin/yang theory of harmony and illness. What paradigm of health and illness is this practice rooted in?

Holistic

In a small, rural hospital the nurse is caring for a client who speaks a language other than English. The nurse needs to use an interpreter to communicate but the hospital does not have access to an interpreter who speaks the client's language. When choosing another individual to interpret for this client, what characteristic should the nurse prioritize?

Interpreter should ideally be fluent in several dialects of the client's language.

The nurse is helping a client choose her menu options for the following day. The nurse reads out the option of ham with scalloped potatoes and the client states that her religion does not allow this. Which of the following is most likely the client's religion?

Islam

The nurse is caring for a client admitted with "fever of unknown origin." The client, who is aware that he has a fever, requests "yin" foods to combat the fever. The nurse is aware that the client is speaking of the yin/yang theory, which has to do with balance, harmony, energy, hot, and cold. Because the physician has ordered "diet as desired," the nurse encourages which of the following menu items

Jello salad

The nurse is conducting a community education class on cultural diversity. The nurse explains that cultural sensitivity includes which of the following?

Knowledge of cultural preferences

When providing care for a client who belongs to a Hispanic culture, which of the following may be considered inappropriate in a health care setting?

Males participating in health care activities.

Clients from which of the following religious groups would be most likely to shun the use of caffeine-containing beverages?

Mormonism

Most nurses have been taught to maintain direct eye contact when communicating with clients. However, some cultural groups do not usually value direct eye contact when communicating with the nurse. Which cultural group would most likely consider the direct eye contact impolite?

Native American/First Nation

After several weeks of working with a client who has human immunodeficiency virus (HIV), the nurse has become more aware of the role of health disparities. Which of the following variables are known to underlie health disparities? Select all that apply.

Poverty Isolated geographic location Overdependence on publicly funded facilities

Computed tomography of a 72-year-old woman reveals lung cancer with metastasis to the liver. The client's son has been adamant that any "bad news" be withheld from his mother in order to protect her from stress, stating that this is a priority in his culture. How should the nurse and the other members of the care team best respond?

Speak with the son to explore his rationale and attempt to reach a consensus.

A nurse is planning the care of a 48-year-old woman who has just received a diagnosis of breast cancer. The client has been explicit about her desire to integrate a variety of complementary therapies into her treatment regimen. What is the nurse's primary responsibility around the use of complementary therapies?

To assess the client's use of complementary therapies in order to promote safety

The nurse is preparing a discharge teaching session with an Asian client to evaluate the client's ability to change a dressing. The client speaks and understands minimal English. What would be the best way to promote understanding during the teaching session?

Use an interpreter during the teaching session.

A client who is a native of New South Wales has been admitted to the hospital unit for three weeks with bacterial meningitis. The client is finally healthy enough to be discharged and much client education time and effort is spent discussing the disease process and its future prevention. What cultural concept is important to keep in mind during teaching?

appreciate client's beliefs about the cause of illness

Anglo-Americans typically hold the cultural belief that someone maintaining eye-to-eye contact is usually trustworthy. Other cultures may hold different beliefs about maintaining eye contact. A nurse who believes a client may be offended by direct eye contact should:

ask the client if the action is offensive

A new client is admitted to the unit and initial assessment will include four areas: physical appearance, body structure, mobility, and behavior. What type of assessment will the nurse perform?

biocultural

Which culturally related perspective on illness/disease is based on a cause-and-effect philosophy of human body functions?

biomedical or scientific

A new client is admitted to the unit, and the nurse's initial assessment will include a systematic appraisal of the client's cultural characteristics, health practices, and beliefs. What type of assessment will the nurse perform to gather this information?

cultural

The inability of a person to recognize his or her own values, beliefs, and practices and those of others because of strong ethnocentric tendencies is termed

cultural blindness.

A nurse has engaged a translator to help in communicating with a Vietnamese client. When asking questions of the client and obtaining answers, the nurse should:

look at the client while asking questions and carefully listen to the client's response.

Which culturally related perspective on illness/disease involves a belief in supernatural forces or a higher power?

magico-religious

Some members of this cultural group may consider it impolite to touch a person's head.

Asian American