class 5 - chapter 5: culturally respectful care

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."

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?

"Can you describe what you are feeling when you try to move?"

A nurse overhears another nurse make a statement that indicates racism. The nurse makes this determination based on which characteristic indicative of social value?

Skin color

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

A client is experiencing culture shock. Which findings would the nurse likely assess? Select all that apply.

correct answer: disorientation, stress your answer: disorientation, stress, increased activity, weakness

The nurse has just attended a seminar on concepts of cultural diversity. Which statement made by the nurse would require further education?

"Culture cannot be influenced, and you are born with your culture."

Which nursing intervention reflects culturally appropriate care when addressing a client?

"Good morning, Mr. Smith. I am your nurse, John."

A nurse is admitting a client to the unit. Which cultural question is most appropriate?

"What are your dietary needs and preferences?"

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?

"What would you think about taking the medicines, too, and benefitting from both?"

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 kosher parve foods because they are prepared without milk."

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?"

What is the priority assessment for the nurse when developing a plan of care for a client living in poverty?

Access to care

When talking with a client, the nurse notes that the client keeps backing up. What would be the most appropriate response?

Ask the client about personal space preferences.

A nurse is providing care to a client from a culture different from the nurse's own. The nurse is having difficulty relating to the client. What intervention by the nurse is most appropriate?

Ask the client how the client wants to be treated based on the client's values and beliefs.

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?

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

Which behavior by the nurse is stereotyping?

Avoiding older adult clients because their care is time consuming

A nurse is conducting a cultural assessment of a client. Which person would the nurse identify as the expert?

Client

A nurse interviews a client to determine the client's health beliefs and behaviors. The nurse uses this information for which aspects of care? Select all that apply.

Conducting an assessment Developing client outcomes Providing client education

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

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?

Discuss with the client the need for assistance during ambulation.

A client tells the nurse that the only thing that helps the client sleep is a glass of warm milk. The nurse caring for the client insists that this cultural practice is a myth and tries to convince the client that reading a book would be better. What is the nurse demonstrating?

Ethnocentrism

How is culture learned by each new generation?

Formal and informal experiences

While the nurse conducts a comprehensive cultural assessment on a client with metastatic colon cancer the client states, "The pain with this cancer is God's way of punishing me for all the drinking and bad things I did in the military. I lost so many friends in the war that I look forward to having a few beers with them after I die." The nurse will use questions to explore the client's statement. Click to specify whether the nurse's question obtains information about health beliefs and practices or cultural sanctions/restrictions.

Health Beliefs/Practices: How much alcohol do you use daily? How do you control your pain? Cultural Sanctions/Restrictions: Have you experienced flashbacks to your military years? Are you part of a faith community? How do you express emotions or feelings?

The nurse is caring for a client from another culture who is diagnosed with lung cancer. Which nursing action best demonstrates culturally sensitive care?

Incorporating the client's need for daily prayer into the nursing care plan.

Which nursing intervention reflects practice according to Madeline Leininger's transcultural nursing theory?

Incorporating the client's request for complementary treatment therapy

An unlicensed assistive personnel (UAP) has made a disparaging comment about a client from another culture, stating that the client's hygiene practices are "oddComplet". 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

A nurse is working in a clinic that serves a community with a high population of immigrants. Which nursing assessment is the priority?

Language assessment

The nurse is caring for a client who perceives time differently. What action should the nurse take for this client?

Maintain flexibility when the client requests interventions at specific times.

A White client has requested that they not receive any care from Black nurses. This client is demonstrating what practice?

Racism

Which behaviors demonstrated by the client would the nurse consider reflections of the client's pride in ethnicity? Select all that apply.

Requesting native cuisine Listening to folk music and dance Asking to wear unique clothing

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?

Stereotyping

The nurse caring for several clients on a surgical unit notes that one of the clients has a surname associated with Arabic ancestry. The nurse 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

The younger nurses on a unit, who seem to adapt easily to the new technology presented, are perceived as threatening by two nurses who have worked on the unit for years. The older nurses begin to ridicule the younger nurses, saying, "You might be able to work a computer, but we know how to provide real care." How should the charge nurse respond?

The charge nurse should discuss the concept of cultural conflict and help both parties see their respective value to the unit.

In addressing health promotion for a client who is a member of another culture, the nurse should be guided by which principle?

The client may have a very different understanding of health promotion.

A nurse convinces a client who is a Jehovah's Witness that receiving blood products is more important than the legalistic components of religion. What client reaction may be expected following this mandated change?

The client states, "I feel like I abandoned my religion."

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 hollistic biomedical cause of illness as manifested by believing one can be cured of cancer by limiting work hours

Which is a cultural norm of the health care system?

There is the use of a systematic approach and problem-solving methodology.

The client, visiting from a foreign country, arrived at the facility seeking medical assistance following an accident. The client has limited proficiency in the dominant language. An onsite certified interpreter is unavailable. To assist in interpretation, what is an appropriate nursing intervention?

Use a contracted video interpretation service.

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.

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

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?

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

Nurses are responsible for delivering culturally competent care for all clients. Culturally competent care does not account for:

client's height.

Which examples are considered acceptable cultural norms in health care? Select all that apply.

correct answer: your answer: Defining diabetes mellitus as a metabolic disorder characterized by elevated blood sugar, Encouraging adult women to conduct self-breast exams once a month, Documenting pain with every client assessment, Following a specific regimen for cardiac rehab your answer: Encouraging adult women to conduct self-breast exams once a month, Documenting pain with every client assessment

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?

correct answer: "I am very stressed now because I do not understand how things work on this unit." your answer: "I was expecting all the clients on the oncology unit to be depressed."

While performing the initial assessment of an infant, the nurse notes a soiled string of yarn around the infant's neck. Which response from the nurse would facilitate culturally competent care?

correct answer: "I see you have a string tied to your child's neck. Can you explain why you do this?" your answer: "I noticed a ritual string on your child. Is this a cultural practice to protect the child's health?"

The nurse is caring for a client who does not speak the dominant language. In order to facilitate unencumbered communication with the client, the nurse will take which action(s)? Select all that apply.

correct answer: Determine in which language the client communicates effectively, Review facility policy on communication with clients who do not speak the dominant language, and Schedule a certified interpreter when collecting client health history. your answer: Determine in which language the client communicates effectively, Review facility policy on communication with clients who do not speak the dominant language, Schedule a certified interpreter when collecting client health history, and Ask the client's child, who speaks the dominant language, to explain treatment options to the client.

The client is admitted to the hospital with a ruptured ovarian cyst. The client has expressed that it is very important that the spouse be present to receive all medical information. Using the concepts of culturally competent care, which is the best response?

correct answer: Document the client's request in the nursing care plan. your answer: Explain to the client that the client is required to make all decisions related to the client's own health care.

A client's spouse has asked that the client be cared for exclusively by female nurses. How should the nurse incorporate this request into the care plan?

correct answer: Document the request and make all reasonable efforts to honor it your answer: Assess the couple's rationale for making the request

The public health nurse is preparing a presentation about disparities in health care in the community and is prioritizing the importance of culturally safe care. What key concept(s) will the nurse include? Select all that apply.

correct answer: Information regarding minorities within the community, Identifying groups that are disadvantaged within the community, Pointing out groups within the community that possess less power, Major differences in beliefs within a particular culture, Ethnic identities within subcultures in the community your answer: Information regarding minorities within the community, Identifying groups that are disadvantaged within the community, Pointing out groups within the community that possess less power

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:

correct answer: cultural ritual your answer: cultural competence

A nurse is caring for a postoperative client after knee arthroplasty. The nurse plans to help the client ambulate but is aware that the client may feel threatened by physical closeness because the client is from a culture that tends to prefer more personal space when interacting with others. Using the principles of culturally competent care, what would be the most appropriate nursing action?

correct answer: explain the purpose and need for assistance during ambulation your answer: instruct family members to assist in ambulating the client

A nurse is working with a local community group to address health disparities in the area. Which concepts would be important for the group to address when planning to correct health disparities? Select all that apply.

correct answer: minority, disadvantage, and less powerful your answer: minority, disadvantaged, less powerful and ethnicity

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:

cultural imposition

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:

ethnic identity.

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?

ethnicity

Nurses are socialized into the:

healthcare culture.

A client says to the nurse, "Why don't you wear a white cap like nurses do on the soap operas?" This is an ethnocentric statement based on the:

media.

A 35-year-old client was admitted to the hospital following an automobile accident with a fractured leg. Which action should the nurse prioritize after learning this client's family is of Italian descent?

monitor hemoglobin and hematocrit for possible anemia

The spouse of a client asks the nurse whether the spouse may bring in a cream from home to apply to the client's skin. The spouse says, "Whenever anyone gets sick, we always use this cream." The nurse interprets this as:

ritual.