Cultural Awareness Chapter 9

Which statement made by a new graduate nurse about the teachback technique requires intervention and further instruction by the nurse's preceptor?

"After teaching a patient how to use an inhaler, I need to use the Teach Back technique to test my patient's understanding."

During an encounter with an elderly patient, the nurse recognizes that a thorough cultural assessment is necessary because the patient has recently come to the United States from Russia and has never been hospitalized before. The nurse wants to discuss cultural similarities between herself and the patient. Which step of the LEARN mnemonic is this?

Acknowledge

A new nurse is caring for a hospitalized obese patient who is homeless. This is the first time the patient has been admitted to the hospital, and the patient is scheduled for surgery. Which of the following is a universal skill that will help the nurse work effectively with this patient?

The nurse asks the patient, "Tell me about the main problems you have had with your health from not having a home."

A nurse has worked in a home health agency for a number of years. She goes to visit a patient who has diabetes and who lives in a public housing facility. This is the first time the nurse has cared for the patient. The patient has four other family members who live with her in the one-bedroom apartment. Which of the following, based on Campinha-Bacote's (2002) model of cultural competency, is an example of cultural awareness?

The nurse silently reflects about how her biases regarding poverty can influence how she assesses the patient.

Which of the following are examples of problems with the health care system that contribute to health disparities? (Select all that apply.)

A health care provider assumes that the patient missed two appointments because the patient does not care about his or her health and does not inquire about the reasons for missed visits. A community hospital lacks an adequate staff of social workers who are able to ensure patients' access to resources they need to take care of their health. A hospital discharges a patient without ensuring that the patient has a primary care provider and has made a follow-up appointment. A nurse uses a family member as an interpreter to explain the patient's medications. The hospital conducts quality improvement without stratifying data by race, ethnicity, language, socioeconomic status, sexual orientation, and other axes of social group identities.

Which of the following changes can help create a more inclusive environment for lesbian, gay, bisexual, and transgender (LGBT) patients? (Select all that apply.)

Explicitly including sexual orientation and gender identity into nondiscrimination policies Displaying art that reflects LGBT community Modifying health care forms to provide opportunities for gender identity and sexual orientation disclosure Ensuring access to unisex or single-stall bathrooms

A nurse is preparing to perform a cultural assessment of a patient. Which of the following questions is an example of a contrast question?

How different is this problem from the one you had previously?

When you care for a patient who does not speak English, it is necessary to call on a professional interpreter. Which of the following are proper principles for working with interpreters? (Select all that apply.)

If you feel an interpretation is not correct, stop and address the situation directly with the interpreter. Pace a conversation so there is time for the patient's response to be interpreted. Ask the patient for feedback and clarification at regular intervals

Which of the following are considered social determinants of health? (Select all that apply.)

Lack of primary health care providers in a zip code Poor-quality public school education that prevents a person from developing adequate reading skills Lack of affordable health insurance Employment opportunities that do not provide paid vacation or sick leave Neighborhood safety that prevents a person from walking around the block or socializing with neighbors outside of his or her home

In the United States, there has never been a president of Asian or Hispanic culture. This is an example of

Marginalization

How can a nurse work on developing cultural awareness? (Select all that apply.)

Reflect on his or her past learning about health, illness, race, gender, and sexual orientation Develop greater self-knowledge about personal biases Recognize consciously the multiple factors that influence his or her own world view Engage in an in-depth self-examination of his or her own background

A patient is admitted through the emergency department (ED) after a serious car accident. The nurse assesses the patient and quickly learns that he speaks little English. Spanish is his primary language. The nurse speaks some Spanish. Which interventions would be appropriate at this time? (Select all that apply.)

The nurse requests a professional interpreter The nurse determines the interpreter's qualifications and makes sure that the interpreter can speak the patient's dialect. The nurse uses short sentences to explain the treatments provided in the ED. The nurse directs questions to the patient by looking at the patient instead of at the interpreter.