Culture Set 2, Culture Set 3, Culture Set 1
Which questions should the nurse include in a cultural assessment? Select all that apply.
"What do you do to promote good health?" "What religion do you belong to?" "Do have a particular name for this illness?"
The nurse is caring for a terminally ill client who immigrated from Mexico. Which nursing intervention regarding spiritual care is appropriate?
Ask the client if a spiritual leader is desired.
The nurse admits a Native American/First Nations client to the critical care unit to rule out a myocardial infarction (MI). The client has several family members in the waiting room. Which nursing action is most appropriate?
Ask the client their personal beliefs about family support during hospitalization.
The nurse admits a client to the critical care unit to rule out a myocardial infarction (MI). The client has several family members in the waiting room. Which nursing action is most appropriate?
Ask the client their personal beliefs about family support during hospitalization.
a patient identifies his culture and faith beliefs as Islam and is currently partaking in Ramadan, the nurse provides culturally competent care by?
Ask the patient what time he/she can drink/eat to help schedule medication times
which intervention demonstrates that the nurse understands the cultural implication of the parents' belief that their child has been hexed?
Asking the parents to describe the types of symptoms they expect to see in the child
A 5-year-old African child is adopted by an American couple and slowly adapts to American society. Which process is this known as?
Assimilation
While preparing a Hindu client for surgery, it becomes apparent that the client's view about spirituality is entirely different from the nurse's. What is the most appropriate action by the nurse?
Be respectful, open, and willing to discuss spiritual issues as appropriate
A nurse is providing care to a client who has limited understanding of the dominant language. Which strategy is best for the nurse to use to ensure that the client obtains the needed health information?
Enlist the services of a qualified language interpreter
A family consists of a man, his parents, his wife, and their two sons. This is an example of which kind of family?
Extended family
African American cultural factors
Family -Close and supportive extended-family relationships -Strong kinship ties with nonblood relatives from church or organizational and social groups -Family unity, loyalty, and cooperation are important. -Usually matriarchal Folk and Traditional Health Care -Varies extensively and may include spiritualists, herb doctors, root doctors, conjurers, skilled elder family members, voodoo, faith healing Values and Beliefs -Present oriented -Members of the African American clergy are highly respected -Frequently highly religious Nursing Considerations -Many African American families may still use various folk healing practices and home remedies for treating particular illnesses. -Special care may be necessary for the hair and skin. -Special consideration should be given to the sometimes extensive and frequently informal support networks of patients (e.g., religious and community group members who offer assistance in a time of need).
If you have a patient of Indian heritage who is Hindu, what religious practices would affect nursing care?
Family may bring in hot or cold food and drink from home to help remove toxins
The nurse caring for members of the Hispanic community recognizes which of the following situations as the best reflection of the culture's view of family caring?
Family members taking turns staying with the client at night
The community nurse should examine the following when completing a cultural assessment of a client or community: Select all that apply
Family roles, social networks, health beliefs and practices
Which question should the nurse ask when assessing the sociocultural aspects of a patient's family?
Family structure
The nurse is developing a postoperative plan of care for a 40-year-old Filipino man scheduled for an appendectomy. What is the primary nursing action to include in the client's plan of care?
For the first postoperative day, offer pain medication on a regular basis as prescribed.
How is culture learned by each new generation?
Formal and informal experiences
A nurse finds that an Asian patient has assimilated into the American culture. Which unique characteristics of the patient's culture may be altered in the process of assimilation? Select all that apply.
Language Values Customs
What is an important part of being present with a patient?
Listening
focused assessment
assessment conducted to assess a specific problem; focuses on pertinent history and body regions
When reviewing the chart of an older adult client, the nurse notes that the client identifies as Asian. The nurse realizes the client is referring to which ancestral and cultural factor?
ethnicity
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
The use of one's culture as a cultural standard is known as:
ethnocentrism
When a client states, "I only want a WHITE DOCTOR," the client is expressing cultural:
ethnocentrism
When a client states, "I only want a white doctor," the client is expressing cultural:
ethnocentrism
When a white client states, "I only want a white doctor," the client is expressing cultural:
ethnocentrism
When an American client states, "I only want an American doctor," the client is expressing:
ethnocentrism
When a client states, "I only want a white doctor," the client is expressing cultural:
ethnocentrism.
A nurse is admitting a client who is from another culture. Prior to caring for a client from another culture, the nurse should place primary importance on which action?
examining personal biases and prejudices
A female Jamaican immigrant has been late to her last two clinic visits, which in turn has to be rescheduled. The best action that the nurse could take to prevent the patient from being late to her next appointment is:
explore what has prevented her from being at the clinic in time for her appointment
A group of students is reviewing material related to the role of religion and spirituality in health care choices. The students demonstrate understanding when they identify which of the following as the most prominent ethical dilemma facing health care providers when it comes to religion?
failure to seek timely medical care
A nurse interviews a client and finds that the client's view on health care does not involve participation in comprehensive prenatal care. Which religious view would the client most likely adhere to?
faith assembly of Indiana
A nursing instructor is describing formal and informal channels of communication that occur within a community. The instructor determines that the teaching was successful when the students identify which of the following as an example of informal communication?
filers
A nurse is assessing a client and determines that the client belongs to a minority group. Based on the nurse's understanding about minority groups, the nurse would anticipate that the client would likely experience which effects? Select all that apply.
health disparities, less power
When considering cultural competence, there are discrete areas that the nurse must develop knowledge of to understand the health care needs of others. These discrete areas include understanding of: (Select all that apply.)
his or her own heritage. - the heritage of the nursing profession. - the heritage of the patient. - the heritage of the health care system.
A nurse educator is leading a group of nurses in exercises aimed at improving cultural competence. Which of the following would the educator use to best describe an aspect of the term "culture"?
it is shared through norms for behaviors, values, and beliefs
A nurse is participating in an educational exercise in which she is conducting a self-examination of her own biases. This activity addresses what construct of cultural competence?
cultural awareness
A group of students is reviewing material on cultural competence. The students demonstrate understanding of this concept when they identify which of the following as the starting point?
cultural desire
A nurse admits to a colleague, "I sometimes tend to avoid clients from other cultures because it's awkward and it's usually frustrating for me and for the client." This nurse is likely lacking in what construct of cultural competency?
cultural desire
The nurse attends a Native-American Alcoholic Anonymous support group and develops close relationships with three group members. The nurse is demonstrating which of the following?
cultural encounter
A 20-year-old housekeeper, born and educated in Iraq, wears her traditional clothing and head covering. A 50-year-old patient tells the nurse, "They are in America and should dress like we do." What is this statement an example of?
cultural imposition
A nurse is telling a new mother from Africa that she shouldn't carry her baby in a sling created from a large rectangular cloth. The African woman tells the nurse that everyone in Mozambique carries babies this way. The nurse believes that bassinets are safer for infants. What term best describes what the nurse is doing?
cultural imposition
The nurse is caring for the family of a client who has just died. The family requests that the client's arms not be crossed and that any of the clothing and dressings containing blood be left and be prepared for burial with the client. The nurse understands this family's request as indicative of their religious beliefs most likely associated with which religion?
judaism
The nurse and a Hispanic client are developing a transcultural nursing care plan related to hypertension. The nurse will include in the plan
nutritional information specifically for a Hispanic client.
To provide a high-quality spiritual assessment, the nurse understands that the focus must be on which of the following?
objectivity in assessment
When assessing a rural community, the nurse will most likely identify which of the following as lacking related to health care services?
obstetric care
A nurse has identified the goal of becoming more culturally sensitive and competent. What is the primary rationale for cultural sensitivity in health care settings?
obtain accurate assessment data
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
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:
cultural ritual
A nurse is caring for a 55-year-old man from Thailand. The client has bacterial pneumonia and a temperature of 104°F (40.0°C); yesterday his temperature was 102°F (38.9°C). The physician on call prescribes cool compresses for the client to help lower the fever. However, the client insists that the nurse bring him warm blankets because they will help him recover more quickly. The nurse recognizes that the client's request is an example of:
cultural ritual.
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:
cultural ritual.
Mr. Perez is a Mexican immigrant who migrated to the United States and lives in a Spanish-speaking community with other relatives. He is taken to the ER following a fall at work and is admitted to the hospital for observation. Which of the following is the nurse caring for Mr. Perez aware that he is at risk for?
cultural shock
The emergency department (ED) nurse is caring for a client injured in a motor vehicle collision (MVC). The client recently immigrated to the country. The nurse should implement interventions aimed at addressing which issue?
cultural shock
The emergency department (ED) nurse is caring for a client who recently immigrated from CHINA and was injured in a motor vehicle collision (MVC). The nurse should implement interventions aimed at addressing which issue?
cultural shock
The emergency department (ED) nurse is caring for a client who recently immigrated from China and was injured in a motor vehicle collision (MVC). The nurse should implement interventions aimed at addressing which issue?
cultural shock
A nurse walks by a patient's room and observes a Shaman performing a healing ritual for the patient. The nurse then remarks to a coworker that the ritual is a waste of time and disruptive to the other patients on the floor. This nurse is displaying the feelings associated with:
culture conflict
A nurse is caring for a 79-year-old Appalachian woman who was placed in a long-term care facility by her son, who is no longer able to care for her. She appears disoriented and reports being bothered by the "bright lights and constant activity." The nurse appropriately documents what condition in the chart?
culture shock
A nurse is caring for a 79-year-old client who is new to a long-term care facility. Previously, the client lived in a rural community in a household consisting of the client and an adult child. The child is no longer able to care for the client. The client appears disoriented and reports being bothered by the "bright lights and constant activity." The nurse appropriately documents what condition in the chart?
culture shock
The nurse identifies a collaborative problem related to spirituality. When planning the client's care, the nurse would direct interventions toward which of the following?
psychological or physiologic response of the body to stress
After teaching a group of students about the major world religions and their view of health and illness, the instructor determines that the teaching was successful when the students identify which statement as best reflective of Buddhism?
some holy days include fasting from dawn to dusk
The nurse is caring for a Hispanic client admitted with an upper respiratory infection. The client tells the nurse that they follow 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
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
During report for a 42-year-old Hispanic client who is 10 hours postoperative from an appendectomy, the day shift nurse states, "The client states the pain is 10 on a 0 (no pain) to 10 (severe pain) scale, but you know how those people exaggerate their pain." What would best describe the nurses's action?
stereotyping
A preconceived and untested belief about an individual or group of individuals is:
stereotyping.
A FEMALE ASIAN client is admitted to the emergency department with a fractured femur. What cultural factor might affect client care?
the client may NOT REPORT PAIN
A client of Chinese origin enters your office to be seen. You can assume
the client may be well acculturated to your dominant culture, so don't assume.
Which client admitted to the emergency department (ED) might require the nurse to include interventions aimed at addressing CULTURAL SHOCK in the plan of care?
the client who recently immigrated from Mexico who fell from a ladder
Which client admitted to the emergency department (ED) might require the nurse to include interventions aimed at addressing cultural shock in the plan of care?
the client who recently immigrated from Mexico who fell from a ladder
patient-centered assessment
tool for assessing patient complexity using the social determinants of health that often explain why patients with the same or similar health conditions differ in their ability to manage their health and in their outcomes
Encouraging clients to set up personal items and wear their own sleepwear is means of promoting which of the following?
Self-Identity.
Which factors contribute to the concept of a culture? Select all that apply.
beliefs about health practices, styles used for communication, language
Initial Assessment
comprehensive nursing assessment resulting in baseline data that enables the nurse to make a judgment about a patient's health status, ability to manage one's own health care, and need for nursing, and to plan individualized, holistic health care for the patient
Each culture has its own healers who usually:
cost less than traditional or biomedical providers.
A client believes that the illness is caused by an imbalance of yin and yang. The nurse states, "You can call it whatever you believe, but you have a metabolic disorder." What is this nurse demonstrating?
cultural blindness
A staff nurse meets with the charge nurse and is reporting that all the new nurses are leaving messes on the unit. The staff nurse states, "These youngsters think they can waltz in here and get our jobs." What is this nurse demonstrating?
cultural conflict
A client who immigrated from another coutnry informs the nurse of dietary requests. The nurse responds to the special dietary needs by stating, "You are now living here, and you should try to start eating those foods common to our diet." This inappropriate response is an example of:
cultural imposition.
The nursing researcher is studying so-called "unnatural illnesses." What cause of such illnesses would be included in the study?
Witchcraft
minimum data set
a standard established by health care institutions that specifies the information that must be collected from every patient
A 46-year old woman from Bosnia came to the U.S. 6 years ago. Although she did not celebrate Christmas when she lived in Bosnia, she celebrates Christmas with her family now. This woman has experienced assimilation into the culture of the U.S. because she:
adapted to and adopted the American culture
A nurse knows that the most important risk factor for assessing health related problems is what demographic information?
age
When an American client states, "I only want an American doctor," the client is expressing:
ethnocentrism.
nursing history
assessment of the patient by interview to identify the patient's health status, strengths, health problems, health risks, and need for nursing care
biocultural variations include: Select all that apply:
height, weight, general appearance, body proportions
Which reason below is a challenge of a multicultural healthcare work force?
high level of immigration in U.S
A Hindu client on hospice care tells his nurse that he is not afraid of death. He explains that this is because he believes he has lived a very good life and therefore his next life should be even better than this one, as all of his life actions will be carried into the next. The nurse recognizes this belief as which of the following?
karma
When describing a spiritual assessment to a group of students, which of the following would an instructor most likely include?
knowledge of the spiritual temperament of the community is helpful
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.
The nurse is preparing to lead a health promotion activity among a group of clients from different cultures. The nurse would expect that which client would require the least amount of personal space?
middle easterner
Which of the following best reflects nursing's view of clients as holistic beings?
mind, body, spirit
Which type of data would the nurse need to validate the information obtained during a spiritual assessment?
objective
The nurse is caring for a client whose language skills are very limited in the dominant language. Which nursing action is appropriate when communicating with the client?
obtaining a certified interpreter
A client refuses to allow any healthcare worker of Asian descent to provide care. This client is demonstrating what practice?
racism
Shared practices and rituals used to express one's faith can be called
religion
The nurse chooses to use a formal assessment technique when doing a spiritual assessment. Which of the following techniques would be most appropriate?
self-response assessment instrument
all of the following are dimensions of religions EXCEPT:
spiritual (experiential, ritualistic, consequential are aspects)
A patient's husband has asked that his wife be cared for exclusively by female nurses, a request that the patient herself agrees with. Knowing that the couple is of Middle Eastern origin, what action should the care team take in response to this request?
take reasonable measures to accommodate the request
When performing a cultural assessment, an important point to remember would be
that definitions of family differ
Your Arab American patient has just been admitted and you are asking them personal questions. They are not responding. What is most likely the reason that they are not cooperating?
there is no personal relationship with HCP
The biggest obstacle to the use of facilities and services within a community is the lack of what among its members?
transportation
A community health nurse assesses the economics of a community because income definitely has a direct relationship to the health of the residents.
true
emergency assessment
type of rapid focused assessment conducted when addressing a life-threatening or unstable situation
Which stereotypical ideas about older adult clients does the nurse associate with the concept of ageism? Select all that apply.
uninterested in intimacy physically impaired burdensome to family
The nurse experienced in working with different communities understands that the following groups are at higher risk for health problems and increased mortality: (Select all that apply.)
unmarried people. elderly. immigrant farm families
The nurse is caring for a Haitian client. Which health belief system does the nurse anticipate?
using faith healing
To help the nurse identify possible coping responses in clients, which of the following would be most important for the nurse to understand about spirituality?
varies in different situations
A nurse will be working in a clinic in South Asia for several weeks, where the majority of residents have darkly pigmented skin. The nurse should expect a higher-than-average incidence of what integumentary health problem?
vitiligo
The nursing researcher is studying so-called "unnatural illnesses." What cause of such illnesses would be included in the study?
witchcraft
The nurse is collecting data from an African-American client scheduled for surgery. Which questions would be most appropriate for the nurse to ask on initial assessment? Select all that apply.
"Do you ever experience chest pain?" "Do you have any difficulty breathing?" "Do you frequently have episodes of headache?"
The nurse is collecting data from an African-American client scheduled for surgery. Which questions would be most appropriate for the nurse to ask on initial assessment? Select all that apply.
"Do you ever experience chest pain?" - "Do you have any difficulty breathing?" - "Do you frequently have episodes of headache?"
When an older African American woman shares with the nurse that, "It's time to think about retiring," the nurse demonstrates an understanding of a culturally created issue that would be relevant to the client by asking:
"Do you have a pension income that will allow you to retire now?"
The nurse in an ambulatory care clinic is performing an admission assessment for an African-American client who is scheduled for a cataract removal with intraocular lens implantation. Which question would be appropriate for the nurse to ask the client on an initial assessment?
"Do you have any breathing or heart problems?"
A 62-year-old male patient has just been told he has a terminal illness. Which of the following statements supports a nursing diagnosis of spiritual distress related to diagnosis of terminal illness?
"I have nothing to live for now."
Which statement by the nurse who is caring for a practicing Muslim patient demonstrates cultural sensitivity?
"I will bring you a basin of water for your prayer time."
Which statement demonstrates the nurse's ability to communicate sincerely and respectfully with a culturally diverse client population?
"I'm always careful to apologize when I'm having difficulty understanding a client."
Which statement by the client assures the nurse that the client has made a positive adjustment to middle age?
"I've taken up gardening and plan to become a master gardener."
The unlicensed assistive personnel (UAP) is assigned to care for a client who is of Asian heritage. The UAP tells the nurse, "I think that my assignment needs to be changed. Every time I try to talk, the client turns away." Which statement is the most appropriate teaching response from the nurse?
"If the client turns away, continue with the discussion."
The nurse is teaching a black client about common health conditions. What statement by the client most directly address a health problem with an increased incidence in this population group?
"It is important to monitor my blood pressure."
Which statement demonstrates a lack of knowledge concerning the role eye contact plays in various cultures?
"It's so important to maintain eye contact with the client while providing discharge teaching."
The staff nurse overhears the charge nurse, who is of Italian heritage, talking to the unlicensed assistive personnel. Which statement made by the charge nurse is an example of ethnocentrism?
"Italians are best at everything."
The nurse is providing home care for a patient who traditionally drinks herbal tea to treat an illness. How should the nurse respond to a request for the herbal tea?
"Let me check with the doctor to make sure it is okay with your medicines."
The nurse is learning about the impact of different cultures on nursing. Which statements describe the benefits of culturally congruent care? Select all that apply.
- It will help the nurse interpret the needs of the patient who belongs to a different culture.- It will help the nurse identify the similarities and differences of various patients across different cultures.- It will help the nurse deliver the specific kind of health care that is expected from patients who belong to a different culture.
A nurse is developing a transcultural care plan for an Asian patient who identifies with both his native and American culture. Which nursing actions are required for providing culturally congruent care? Select all that apply.
- Obtain the patient's health beliefs.- Self-examine his or her own culture.- Assess cultural and biophysical factors that influence treatments.
The nurse is developing a transcultural care plan for an Asian patient who identifies with both his native and American culture. Which components would the nurse incorporate in order to provide culturally congruent care? Select all that apply.
- Obtaining knowledge of the patient's health beliefs - Self-examining his or her own culture - Being open and accepting of cultural differences
Which measures should the nurse adopt to ensure effective communication when caring for a non-English-speaking patient? Select all that apply.
- Understand cultural and language differences. - Avoid interpreting based on personal cultural beliefs. - Provide written information in the primary language.
The clinic nurse is obtaining demographic data from a client. The client states, "Why do you need to know what my ethnicity is?" How should the nurse respond?
"Collecting this information allows us to develop a personalized plan of care to meet your needs."
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 statement, made by a nurse caring for a client diagnosed with dementia and a history of falls best demonstrates the principle of beneficence?
"Current research refutes the use of restrains to keep my client safe from falls."
The nursing instructor is teaching a nursing student about the definition of diversity. Which teaching will the nursing instructor include?
"Diversity demonstrates differences among groups of people."
A registered nurse is admitting a patient of French heritage to the hospital. Which question asked by the nurse indicates that the nurse is stereotyping the patient?
"Do you bathe and use deodorant more than one time a week?"
A clinic nurse is performing an admission assessment on an African-American client scheduled for cataract removal with intraocular lens implantation. Which question should the nurse avoid asking on the initial assessment?
"Do you have any family problems?"
Which question is the most appropriate to learn about a patient's religious practices?
"Do you have any specific religious or spiritual practices or beliefs?"
What questions should be included in a spiritual assessment? Select all that apply.
"Do you need a private place to pray?" "What gives you meaning to your life?" "How does your spiritual practices help you to deal with pain?
When interviewing a Native American patient upon admission to the hospital, which culturally sensitive questions would the nurse ask? Select all that apply.
"Do you use any folk remedies?" "Do you have a family physician?" "Do you use a shaman?"
The nurse just attended a seminar on cultural diversity. Which statement by the nurse would require further education?
"Ethnicity and race are the same thing and are affected by cultural practice.
The nurse has just attended a seminar on concepts of cultural diversity. Which statement made by the nurse would require further education?
"Ethnicity and race are the same thing and are affected by cultural practice."
The nurse just attended a seminar on cultural diversity. Which statement by the nurse would require further education?
"Ethnicity and race are the same thing and are affected by cultural practice."
Which response to the federal funding of medical research would be compatible with the Utilitarian theory of ethics?
"Federal research funds should be used to impact most common forms of cancer."
A nurse is planning a program to address measures to reduce the leading cause of mortality in children age 1 to 14 years. Which of the following would the nurse include?
Accident prevention
Immigrants who begin to use technology while continuing to adhere to their traditional mode of dress are exhibiting what aspect of cultural identity?
Acculturation
A home health care nurse is making a first visit to an older African American woman living in an extended family situation. To help establish a trusting relationship, which action by the nurse is best?
Address the patient by "Ms." or "Mrs." and her last name.
The nurse is caring for an elderly patient undergoing dialysis. The patient's spouse died of a heart attack a week ago. Which statement made by the patient indicates spiritual distress?
"All my prayers and good deeds were in vain."
The nurse suspects that an adolescent patient from the inner city stereotypes other people. Which statement did the patient make that caused the nurse to come to this conclusion?
"All people who live in the suburbs drive big cars."
The nurse is assessing an Asian patient with arthritis. The patient asks the nurse about the benefits of alternative therapies for arthritis. Which response made by the nurse would demonstrate ethnocentrism?
"Alternative therapies are not as useful as current Western therapies."
A nurse is caring for a woman who has given birth to a healthy baby. The woman's husband and mother are in the room, and more family members are in the lobby. Which comment by the nurse demonstrates culturally competent care?
"Are there any ceremonies or other practices that are important to you at this time?"
The nurse is caring for a client of ASIAN descent and is post-operative 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?"
The nurse is caring for a client of Asian descent and is post-operative 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?"
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?"
The nurse is caring for a client of Asian descent and is post-operative 24 hours from an appendectomy. The client is hesitant to get out of bed. How should the nurse respond?
"Can you described what you are feeling when you try to move?"
The nurse is caring for a black client who is admitted for hypertension (HTN). The nurse notes that the client has not been eating the food provided, and family members have brought in homemade food. What would be the best response by the nurse?
"Can you tell me what foods you prefer to eat and what your family is bringing you?"
The nurse is caring for a client who is admitted for hypertension (HTN). The nurse notes that the client has not been eating the food provided, and family members have brought in homemade food. What would be the best response by the nurse?
"Can you tell me what foods you prefer to eat and what your family is bringing you?"
The nursing instructor is discussing the importance of spiritually assessing a patient in order to be able to provide holistic care. What suggestion can she give to the student who is not sure of the correct questions to ask?
" You may use the FICA spiritual assessment tool."
Which response to the federal funding of professionally assisted suicide would be compatible with the deontological theory of ethics?
"All life is sacred and require all measures to maintain it."
A client requests to be cared for by a nurse who is a member of his own culture. The nurse recognizes that which barrier exists in regards to this client's nursing care?
Ethnocentrism
A nurse's reflection of his practice reveals that he tends to see his own culture as the "gold standard" to which all other cultures should aspire. This nurse should create learning goals to address what phenomenon?
Ethnocentrism
A male nurse is assigned to the care of a gay male with alcoholism. This sexual orientation is inconsistent with the beliefs of the nurse. What actions, if any, can the nurse take to provide patient-centered care to this patient?
Examine his own feelings about alcoholism and homosexuality.
What action by a nurse would indicate an understanding that foreign-speaking patients experience a clash of more than one culture when admitted to a health care facility?
Explaining medical terms and verifying that the patient understands
White cultural factors
Family -Nuclear family is highly valued. - Elderly family members may live in a long-term care facility when they can no longer care for themselves. Folk and Traditional Health Care -Self-diagnosis of illnesses -Use of over-the-counter drugs (especially vitamins and analgesics) -Dieting (especially fad diets) -Extensive use of exercise and exercise facilities Values and Beliefs -Youth is valued over age -Cleanliness -Orderliness -Attractiveness -Individualism -Achievement -Punctuality Nursing Considerations -Careful assessment of client's use of over-the-counter medications (observe for signs and symptoms of toxic medication levels, especially fat-soluble vitamins) -Nutritional assessments of dietary habits
Muslim cultural factors
Family -The family forms the basic building block of Muslim society. The man is considered the head of the family. Folk and Traditional Health Care - Preventive health care strategies in Muslim experience include personal hygiene, dietary measures such as the restriction in eating specific ingredients (such as pork and its byproducts, and drinking alcohol), and the avoidance of addictive habits such as smoking tobacco or overconsumption of food. Values and Beliefs - Belief that there is no God but Allah and that Muhammad is his messenger.. - Belief that Allah will determine when they die; Nursing Considerations - Respect the modesty needs of both men and women: special clothing or draping may be necessary, assign health care providers of the same sex, avoid touching patients of the opposite sex, and limit eye contact. - Make accommodations for prayer needs. - Offer a halal diet free of alcohol and pork or pork products; make sure medications are alcohol- and pork-free.
A nurse is providing care to a medically compromised client with limited ability to speak the dominant language. To obtain information about the client's culture, who would be appropriate for the nurse to use as a key informant? Select all that apply.
Family, interpreters, client's religious contact, friends
The nurse is caring for a patient who does not speak English. She decides to use an interpreter to explain procedures and to answer questions that the patient may have. In performing the interview, what should the nurse do?
Direct questions to the patient.
The nurse is assessing a client's spirituality using the FICA Spiritual Assessment Tool. Which question would the nurse identify as indicating the client's faith and beliefs?
Do you consider yourself spiritual or religious?
The nurse educator is providing in-service education to the nursing staff regarding transcultural nursing care; a staff member asks the nurse educator to describe the concept of acculturation. The nurse educator should make which most appropriate response?
"It is a process of learning a different culture to adapt to a new or changing environment."
The nurse is teaching a black client about common health conditions. Which statement by the client most directly addresses a health problem with an increased incidence in this population group?
"It is important to monitor my blood pressure."
A nursing student is discussing cultural diversity issues in a clinical conference when the nursing instructor asks the student to describe ethnocentrism. Which statement, if made by the student, would indicate a lack of understanding of the concept of ethnocentrism?
"It is imposing one's beliefs on individuals from another culture."
After speaking to a patient with depression, the nurse observes that the patient is experiencing discrimination. Which statement made by the patient helped the nurse to arrive at this conclusion?
"My boss fired me when I admitted that I'm gay."
Which statement best exhibits a belief in a magico-religious health belief system?
"My child is so sick because God is punishing me."
When teaching a group of unlicensed assistive personnel (UAP) about race, which statement by a UAP REQUIRES INTERVENTION by the nurse?
"People with common physical features share the same culture."
When teaching a group of unlicensed assistive personnel (UAP) about race, which statement by a UAP requires intervention by the nurse?
"People with common physical features share the same culture."
Which statement exhibits an understanding of the meaning of culturally congruent nursing care?
"Providing culturally congruent nursing care offers care the client has confidence in."
When taking the Daily Spiritual Experiences Scale, a client says the word "God" in the scale is bothersome. Which response by the nurse would be most helpful in encouraging a client to complete the scale?
"Substitute whatever word you prefer that would represent the divine or holy."
A nurse is conducting an assessment of an American Indian woman who has come to the clinic complaining of persistent headaches. The patient tells the nurse that the medicines prescribed by the tribal healer have done "some good." What is the appropriate response of the nurse at this time?
"Tell me about these medicines and how often you are using them."
A nursing instructor is providing a session on cultural beliefs related to health. On completion of the session, the instructor asks a nursing student to describe the beliefs of many Appalachian clients in regard to health care providers (HCPs). Which is an appropriate response by the nursing student?
"The Appalachian client may prefer personal relationships with health care providers and a desire for frequent communication."
The nurse manager is giving a staff inservice on providing culturally sensitive education to clients. Which statements indicate to the nurse manager that the staff understands providing culturally sensitive education? Select all that apply.
"The population served will determine the culturally sensitive resources to use for teaching." "Assessment of a client's preferred learning approach is essential to facilitate the learning process." "It is important to have an accurate translator when the nurse and client do not speak the same language."
The nurse manager is giving a staff inservice on providing culturally sensitive education to clients. Which statements indicate to the nurse manager that the staff understands providing culturally sensitive education? Select all that apply.
"The population served will determine the culturally sensitive resources to use for teaching." - "Assessment of a client's preferred learning approach is essential to facilitate the learning process." - "It is important to have an accurate translator when the nurse and client do not speak the same language."
A pregnant patient from a nondominant culture explains that milk and dairy products cannot be consumed for 2 months during the pregnancy because of the need to fast for her religion. Which response should the nurse make after learning this information?
"There are other food sources where you can obtain the nutrients that are in milk.
A client believes in the use of herbal therapy and asks the nurse if he can continue to use a herbal tea therapy. What is the most culturally appropriate nursing response?
"There is no reason the tea cannot be used as long as the ingredients do not interfere with the medication."
The mother of a black newborn asks the nurse about the bluish-black areas she noticed around the infant's lower back and buttocks. What is the nurse's best response?
"These areas are normal and should disappear by early childhood."
A client is admitted to the hospital and the nurse is attempting to complete an admission assessment. The client reports that the spiritual healer will be coming in soon and is upset by the admission questions. What is the most appropriate response by the nurse?
"We can wait for your healer to come and then work together to answer these questions."
A nurse is admitting a client to the unit. Which cultural question is most appropriate?
"What are your dietary needs and preferences?"
A nursing student is critically examining her own social position. In this process, the student should prioritize what reflective question?
"What factors have contributed to my own social position?"
The nurse is assessing the diet and nutritional status of a client from a different culture. Which of the following questions would be appropriate for the nurse to ask? Select all that apply.
"What foods do you commonly eat?" & "Do you have any special routines for eating?" & "Are there any foods that you can't eat?" & "Do you have certain foods to keep you healthy?"
Which question would best assist a nurse in determining the health beliefs of a culturally diverse client who has a history of hypertension?
"What have you been doing to help control your high blood pressure?"
During the first prenatal visit for a 20-year-old Hispanic woman, the nurse assesses the patient's health beliefs and practices. Which questions are appropriate as part of this assessment? Select all that apply.
"What is the language that is usually spoken in your home?" "How do you define health and illness?" "Do you have specific beliefs or preferences concerning food or food preparation?" "Do you or the members of your family have certain beliefs and practices surrounding pregnancy and childbirth?"
The unlicensed assistive personnel (UAP) reports to the nurse that the client is refusing to eat the food on the meal tray. The nurse observes the client eating the food brought in by family members. How should the nurse respond?
"What type of food did your family prepare for you, and does it have special meaning?"
The unlicensed assistive personnel reports to the nurse that the client is refusing to eat the food on the meal tray. The nurse observes the client eating the food brought in by family members. How should the nurse respond?
"What type of food did your family prepare for you, and does it have special meaning?"
A Hispanic client has been hospitalized for 6 days for postoperative infection. The client's weight is decreasing each day, and the nutritional intake is declining. Which nutritional assessment question is most appropriate?
"What type of food do you eat at home?"
A client from a minority culture has been hospitalized for 6 days for postoperative infection. The client's weight is decreasing each day, and the nutritional intake is declining. Which nutritional assessment question is most appropriate?
"What type of food do you eat at home?"
The nurse is caring for a client 4 days after total hip arthroplasty and notes the client has lost weight. The unlicensed assistive personnel reports the client's food intake has decreased. Which question will the nurse ask the client to determine if cultural causes are responsible for the weight loss?
"What type of food do you like to eat at home?"
A nurse is interviewing a newly admitted patient. Which question would be considered culturally sensitive?
"What types of food do you eat for meals?"
An Asian woman comes to the clinic with a complaint of back pain. During the history, she tells the nurse that she usually uses acupuncture for her pain. What is the nurse's best response?
"When have you used acupuncture, and what effects did it have?"
A nurse is assessing a family and is establishing baselines for planning subsequent interventions. What question best facilitates this aspect of care?
"When we talk about 'health', what exactly does that mean to you?"
The nurse cares for clients in the emergency department. Which statement made by a health care professional is an indication of racism?
"White people are superior to Black people."
You are caring for an 8-year-old who is receiving an intramuscular injection. The patient says, "You hurt me all the time. What did I do wrong?" What is your best response?
"Why do you think you did anything wrong?"
A client is admitted to the health care facility with hypoglycemia. After the client is stable, the nurse discovers that the client has not had the prescribed medicines. The client believes that eating saffron will keep blood sugar under control. What is the most appropriate response by the nurse?
"Why don't you take the medicines, too, and benefit from both?"
A client with Asian heritage is admitted to the health care facility with hypoglycemia. After the client is stable, the nurse discovers that the client has not had the prescribed medicines. The client believes that eating saffron will keep his blood sugar under control. What is the most appropriate response by the nurse?
"Why don't you take the medicines, too, and benefit from both?"
Which statement demonstrates the nurse's understanding of the importance cultural symbolism has on nursing care?
"Will you explain to me what you mean when you say your heart hurts?"
Which assessment question demonstrates cultural sensitivity regarding a rural, African American client's understanding of a high-risk medical condition?
"Will you tell me what it means to be diagnosed with high blood pressure?"
You are caring for a 65-year-old man with severe heart disease who is awaiting a heart transplant. It is during the Christmas season and he must stay in the hospital until the surgery or his death. His wife and physician consistently reinforce the severity of the situation and that he must stay in the hospital for tests. You are working the p.m. shift and he breaks down crying saying he doesn't want this and just wants to go home. What do you say?
"You don't have to do this. What do you want to do?"
The nurse is caring for a client who practices Catholicism and was newly diagnosed with cancer. The client states, "God is punishing me for my past sins." How should the nurse respond?
"You sound upset, would like you to talk about it?"
A registered nurse is admitting a patient of French heritage to the hospital. Which question asked by the nurse indicates that the nurse is stereotyping the patient?
"do you bathe and use deodorant more than once a week?"
When a newly emigrated Asian male reports symptoms suggestive of possible depression, the nurse sensitive to cultural factors affecting this population would ask
"Are you satisfied with the work you've found here in the United States?"
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 his personal space preferences"
A nurse is caring for a female client of Hawaiian descent. Which interview question would be appropriate based on the cultural beliefs of Hawaiians?
"Do you use any medicinal plants or minerals?"
A nurse is caring for a female patient of Hawaiian descent. Which interview question would be appropriate based on the cultural beliefs of Hawaiians?
"Do you use any medicinal plants or minerals?"
The nurse is interviewing a client who is Native American/First Nations. What question would be best to ask this client?
"Do you use herbal or medicinal plants?"
A client admitted to the hospital asks the nurse whether it would be acceptable for the client to bring food from home to eat that better meets the client's cultural preferences. What is the nurse's best response?
"Food from home is fine as long as it does not violate hospital policy or contradict the prescribed diet."
Which nursing intervention reflects culturally appropriate care when addressing a client?
"Good morning, Mr. Smith. I am your nurse, John."
Which statement by the nurse is a culturally appropriate reaction to a client's perception of pain?
"If a client needs to yell in pain, that is his or her right."
Which statement demonstrates the nurse's ability to communicate sincerely and respectfully with a culturally diverse client population?
"I'm always careful to apologize when I'm having difficulty understanding a client".
Which client response best demonstrates successful coping with the age-related functional loses affecting quality of life being experienced by an African American client?
"I've been using a magnifying glass to read the wonderful novel I got as a gift."
The nursing instructor is providing a session on cultural beliefs related to health and illness. At the end of the session, the instructor asks a nursing student to describe the beliefs of some African Americans in regard to illness. Which statement would be the best response by the student?
"Illness is a disharmonious state that may be caused by demons and spirits."
A nurse is teaching a family from Guatemala about the importance of exercise to reduce body weight. The husband asks, "What exercise do we do?" Considering the time orientation of this family, which response by the nurse is most effective?
"Is there an exercise that you can do today for 30 minutes and make it part of your daily routine?"
A nurse has responded to a patient's request for hot water rather than ice water at the bedside. The nurse's colleague states, "They have all kinds of bizarre ideas about healing, like thinking that cold water will make you sick." How should the nurse best respond to this colleague's statement?
"It's different from what you or I might choose, but it's not right to characterize it as bizarre."
Which statement demonstrates a lack of knowledge concerning the role eye contact plays in various cultures?
"It's so important to maintain eye contact with the client while providing discharge teaching".
The staff nurse overhears the charge nurse talking to the unlicensed assistant personal (UAP). Which statement made by the charge nurse is an example of ethnocentrism?
"Italians are best at everything."
The staff nurse overhears the charge nurse talking to the unlicensed assistant personal (UAP). Which statement made by the charge nurse is an example of ethnocentrism?
"Italians are the best at everything"
Which terms are the basic elements of culture? Select all that apply.
- Shared- Learned- Symbolic- Integrated
Health problems of Hispanics
1) Diabetes 2) lactose intolerance
Health problems of Asians
1) HTN 2) liver cancer 3) lactose intolerance 4) Thalassemia (blood disorder)
Health problems of Whites
1) breast cancer 2) heart disease 3) HTN 4) diabetes 5) obesity
Identify three of the eight subtasks in relation to special consideration of adolescents
1. Develop relationships with peers 2. Accept a sex role 3. Accept ones physical appearance 4. Become emotionally independent from parents 5. Prepare for marriage and family life 6. Prepare for economic independence 7. Acquire and ideology and value system 8. Achieve and accept socially responsible behavior
Stages of Culture Shock
1. confusion 2. small victories 3. honeymoon 4. irritation and anger 5. resolution
The nurse is reviewing a client's Daily Spiritual Experiences Scale. Which score would the nurse interpret as indicating that the client has more daily spiritual experiences?
25
The nurse is taking a client history. With which client is direct eye contact appropriate?
32-year-old white woman
Which clients has a high risk of obesity and diabetes mellitus? Select all that apply.
40-year-old Latino American man - 45-year-old Native American man- 35-year-old Hispanic American man - 40-year-old African American woman
According to the Indian Heart Association, what percent of the Asian Indian culture account for the world's heart disease condition?
60%
Which clients has a high risk of obesity and diabetes mellitus?
A 40-year-old Latino American man, A 45-year-old Native American man, A 35-year-old Hispanic American man, A 40-year-old African American woman
Based on cultural factors, which client would be most likely to ask the following: "Why is there a male nurse in my wife's room?"
A 43-year-old Muslim male
A nurse is assessing the religious beliefs of a community. Which of the following would be a sign of a healthy community?
A Jewish synagogue and Christian church that partner together to operate a food pantry
Which patient demonstrates acculturation?
A Korean student in the U.S. who observes both Thanksgiving and traditional ancestral spirituality.
Which patient demonstrates acculturation?
A Korean student in the United States who observes both Thanksgiving and traditional ancestral spirituality
Which client should a nurse recognize has the highest risk to develop lead poisoning?
A Mexican-American child who is given azarcon and greta regularly for chronic upset stomach
Which definition of culture is most accurate?
A belief system that guides behavior
The nurse is performing a community health assessment. When performing data collection, the nurse should seek out what informants?
A combination of community leaders and "typical" residents
A Hispanic client is diagnosed with inoperable brain cancer. The client's wife insists that any discussion about treatment options be postponed until all local family members are present. The nurse correctly views this as:
A cultural tradition that relieves the ill family member of the burden of decision making
A Hispanic woman brings her school age child to the clinic for an intestinal ailment that has lasted for 5 days. Based on the client's culture, which of the following options would be most likely as a response when the family is asked about possible alternatives for treating the child's ailment?
A curandera
From a critical cultural perspective, culture refers to which of the following?
A dynamic process enacted between people and their families
Which of the following would be the best indication that a community's police department is inadequate?
A high rate of homicides
In order to provide culturally competent care, nurses must be alert to factors inhibiting sensitivity to diversity in the health care system, including cultural imposition. Which examples exemplify cultural imposition? Select all that apply.
A hospital nurse tells a nurse's aide that patients should not be given a choice whether or not to shower or bathe daily. & A Catholic nurse insists that a patient diagnosed with terminal bladder cancer see the chaplain in residence.
Several pregnant patients have recently been told that the obstetrics unit at their local rural hospital will be closing, effective in 1 month. This is the second obstetric unit in a rural facility that has closed within a 40-mile radius. What is the problem is the community facing?
A lack of accessibility to meet health care needs.
A community health nurse is providing care to a group of Hispanic people living in an area that is predominantly populated by white people. What are the Hispanic people in this community an example of?
A minority
cultural diversity
A mixture of different ethnic groups, ideologies,beliefs or traditions An integral component of both health and illness because of the cultural values and beliefs that we learn in our families and communities as well as the need for healthcare providers to understand physiologic characteristics common to certain populations
Which activity would be best supported by the Council on Nursing and Anthropology Association?
A multidisciplinary research project on the effects of culture on pain management plans.
When applying for certification as a transcultural nurse, which activity best supports the need to possess appropriate specialized knowledge?
A portfolio showing completion of educational classes that support culturally congruent nursing.
When providing culturally competent care to clients, a nurse understands that cultural competence involves which characteristics? Select all that apply.
A process that requires life-long learning & A commitment to promoting health equity & Knowledge of influences on the clients' beliefs & Awareness of one's own influences on responses
A Catholic priest baptizes a stillborn baby of a Catholic family. What type of practice is this considered?
A ritual
Pain is. Pick all that apply
A universally recognized phenomenon, Frequent and compelling reason to seek health care, Chronic pain is the least likely cause of disability
The nursing student is learning about the different types of families. What could be an example of a blended family?
A woman bringing her adopted son into a new family when she remarries
Health care organizations are expected to be culturally competent. Which service shows the ability to best manage the difference in cultural values and practices?
Ability to adapt special diets to meet client cultural dietary needs.
The Crux of Transcultural Mental Health Nursing is Communication and include skills: Select all that apply
Ability to understand and state an issue or problem as it is perceived from the client's perspective, Recognize resistance and defensiveness, Recognition that everyone makes interactive mistakes
The success of any public health intervention depends on various characteristics to be successful. Which are some of those necessary characteristics?
Acceptability, Accessibility, Availability
What is the priority assessment for the nurse when developing a plan of care for a client living in poverty?
Access to care
A nurse is planning a program to address measures to reduce the leading cause of mortality in children age 1 to 14 years. Which of the following topics would best address this cause of death?
Accident prevention
Which statement describes the difference between assimilation and acculturation?
Acculturation refers to distinct cultures exchanging features; assimilation involves the merging of cultures.
You are working with a patient who has undergone transgender transformation to become a male. Western cultural masculine attributes to emphasize include
Achievement, material success, and recognition.
Which factor is required in the delivery of culturally congruent care?
Acquiring specific knowledge, skills, and attitudes
Which of the following is required in the delivery of culturally congruent care?
Acquiring specific knowledge, skills, and attitudes
Cultural taboos
Activities or behaviors that are avoided or prohibited by a particular cultural group
A 46-year-old woman from Bosnia came to the United States 6 years ago. Although she did not celebrate Christmas when she lived in Bosnia, she celebrates Christmas with her family now. This woman has experienced assimilation into the culture of the United States because she took which action?
Adapted to and adopted the American culture
A 46-year-old woman from Bosnia came to the United States 6 years ago. Although she did not celebrate Christmas when she lived in Bosnia, she celebrates Christmas with her family now. This woman has experienced assimilation into the culture of the United States because she:
Adapted to and adopted the American culture.
After the death of a Native American man, the nurse opened a window to allow spirits to leave. This action is an example of which attribute of the concept of cultural competence?
Adapting interventions based on cultural practices (Tailoring)
While going through the process of acculturation a client will be:
Adapting to and adopting a new culture
Which behavior by the nurse demonstrates cultural blindness?
Administering antibiotics to a child whose parents do not believe in Western medicine
An example of a nurse imposing his/her own cultural beliefs on a client is evident in which of the following examples?
Administering less potent pain medication to an outpatient surgery client
Which of the following best represents the dominant values in American society on individual autonomy and self-determination
Advance directive
When striving for social justice, which intervention demonstrates an understanding of nursing responsibility?
Advocating for a free client for unemployed African emigrates.
When striving for social justice, which intervention demonstrates an understanding of nursing responsibility?
Advocating for a free clinic for unemployed African emigrants
A Muslim patient is scheduled for transplant surgery. The patient asks the nurse to postpone the operation for an hour so that the evening prayers can be completed before the operation. How should the nurse respond to such a request?
Agree to the patient's request and postpone surgery.
A community health nurse has volunteered to assist in providing health care instructions to a Native-American community group. The nurse plans instructions based on the common practices and rituals of this group, knowing that which are associated characteristics of this ethnic group? Select all that apply.
Alcohol abuse is common, Vitamin D deficiency is a concern, Corn is an important component of the diet, & This group is at increased risk for gallbladder disease.
Leininger (1991) identified three nursing decision and action modes to achieve culturally congruent care. These modes are "cultural care preservation or maintenance," "cultural care accommodation," and "cultural care repatterning." When assessing patients during the admission process, the nurse utilizes
All these action modes simultaneously
The nurse is caring for a critically ill infant. Which is the best intervention by the nurse to help the mother to bond with the dying infant?
Allow the mother to hold the infant and pray.
A nurse has to examine a patient and administer an intravenous medication that is not a life-saving drug. The patient is a devout Muslim. When the nurse goes to administer the medication she finds that the patient is getting ready for his namaz (prayers). The nurse understands that the patient prays at certain times, as specified in his culture. What should the nurse do in this scenario?
Allow the patient to pray and come back later to administer the medication
A nurse is caring for a patient who is a devout Muslim. The nurse enters the patient's room to administer a scheduled intravenous medication; however, the nurse finds the patient preparing for namaz (prayers). Which action by the nurse is acceptable?
Allow the patient to pray and come back later to administer the medication.
The incidence of infant mortality varies in the United States. What group has 1.4 times the number of infant deaths than Whites and is more likely to begin prenatal care in the third trimester?
American Indians
An older Chinese client experienced a stroke that left him with right-sided weakness and now refuses to participate in physical therapy until his son is present. The nurse should initially interpret this behavior as:
An illustration of cultural collectivism
The nurse is planning to assess a community. Which of the following activities would be most appropriate for the nurse to do when collecting objective data about a community?
Analyze census data.
This model provides a comprehensive and practical overview of key assessment areas and the foundation for culturally competent care.
Andrews/Boyle Transcultural Nursing Assessment Guide
The nurse has been caring for a patient who just died. The patient's daughter is crying uncontrollably, saying, "She was my best friend. I thought she would make it! I don't know what I am going to do." What is the nurse's best response? a. Express sympathy, and ask if she would like to talk with a chaplain. b. Give the daughter time to cry in her mother's room alone. c. Ask the daughter if her father is still living. d. Inquire if the daughter would like to pray.
Answer: a At crisis times, spiritual advisors or chaplains are the best resource with the expertise to address family members' needs. Leaving the daughter alone or inquiring about her father would not provide the emotional support needed. The nurse should avoid making suggestions to the daughter but instead should seek to identify needs from the daughter's cues.
The nurse, caring for a comatose Muslim client who is dying, realizes that from a cultural standpoint, the most therapeutic intervention is to:
Approach the family to identify and discuss any needs that exist
The wife of an Arabic patient in your hospital complains to the nurses that her husband is not receiving adequate pain control, but when the nurse asks him he rates his pain as a 2 on a scale of 0-10. The nurse understands that:
Arabic patients tend to act stoic in front of healthcare professionals
If you have a Chinese patient, what is an appropriate question to determine religious practices?
Are there any religious practices I need to know about to help care for you?
When communicating with a client who speaks a different language, which best practice should the nurse implement?
Arrange for an interpreter to translate.
A patient uses one-word answers and broken English phrases during an interview with the nurse. As a result, the nurse is unable to understand the patient's concerns. Which action should the nurse take?
Arrange for an intrepreter
When communicating with a client who speaks a different language, which best practice should the nurse implement?
Arrange for and interpreter to translate
A client who practices Catholicism is chronically ill and states that he feels disconnected from his support system, because he is unable to attend church services. What is the most appropriate action by the nurse?
Arrange for the chaplain to meet the client
Which intervention will best minimize the negative feelings an older newly immigrated Hispanic client has expressed regarding being admitted to an assisted living facility
Arranging for the client to share a room with another Hispanic client who also speaks Spanish
Which intervention will best minimize the negative feelings an older newly immigrated Hispanic client has expressed regarding being admitted to an assisted living facility?
Arranging for the client to share a room with another Hispanic client who also speaks Spanish.
Which nursing intervention demonstrates an understanding of the cultural preservation when caring for a Hispanic client?
Arranging for the client's diet to include the appropriate fever-fighting "cold" foods.
A male client refuses to allow the nurse to draw blood for a test because he believes blood is the body's life force and cannot be regenerated. It is likely that this client belongs to which ethnic group?
Asian
In comparing American culture with Asian cultures, which of the following statements is true?
Asian communication can be ambiguous. - face-saving communication promotes harmony
When caring for patients who are Jewish, how best can the nurse address their religious needs?
Ask about religious practices affecting care.
While assessing an older adult client's upper back, the nurse notes round, raised red spots along the client's back. The client's daughter says, "Oh, that is just cupping." What action should the nurse take?
Ask about the practice of cupping
A young Hispanic mother comes to the local clinic because her baby is sick. She speaks only Spanish and the nurse speaks only English. What should the nurse do?
Ask an interpreter for help
A nurse is conducting an ethnographic interview with a client. Which step would the nurse do first?
Ask an open-ended, general question
The husband of a patient in active labor asks the nurse to phone him when the baby is delivered because he needs to go to work. Which nursing response respects the husband's culture?
Ask if he knows that he can stay with his wife during labor.
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 his personal space preferences.
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.
The nurse is assessing an older adult of Asian decent who immigrated at the age of 3 years. The client speaks the dominant language and lives in a predominantly Asian neighborhood. Which action by the nurse is most appropriate?
Ask the client about special cultural beliefs or practices.
The nurse is assessing an older adult who immigrated at the age of 3 years. The client speaks the dominant language and lives in a neighborhood with many households from the country of origin. Which action by the nurse is most appropriate?
Ask the client about special cultural beliefs or practices.
A nurse is providing care to a client from a culture different from her own. The nurse is having difficulty relating to the client. What intervention by the nurse is most appropriate?
Ask the client how she wants to be treated based on her values and beliefs.
A kosher meal is delivered to a Jewish-American client . Which action by the nurse is most appropriate in assisting the client with the meal?
Ask the client to prepare the meal for eating.
While assessing an older Vietnamese client, the nurse notes several oval-shaped reddened areas on her back and arms. The client's daughter explains them to be the result of a traditional healing practice called "cupping." The nurse's immediate reaction should be to:
Ask the daughter to explain the practice in detail
The nurse asks a Chinese-American patient who was recently diagnosed with hypertension if he is limiting his sodium intake as directed. The patient does not make eye contact with the nurse but nods his head yes. Which action should the nurse take next?
Ask the patient how much salt he is consuming each day.
Which initial action should the nurse take to provide effective cultural care in a community setting?
Asses patients in their normal environment.
Which nursing action is required when it is determined that a client is self-administering ginseng for back pain?
Assess and document the client's blood pressure.
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.
The nurse is unable to confirm that a rash on a dark-skinned patient is due to an allergic reaction. Which action should the nurse take?
Assess the patient in direct sunlight.
An example of distributive justice related to health care includes:
Assessing an insurance cohort a $5 copay for generic medication prescriptions
An example of distributive justice related to health care includes:
Assessing an insurance cohort a $5.00 co-pay for generic medication prescriptions.
Which nursing intervention demonstrates one of the strengths of the transcultural nursing Theory of Culture Care Diversity and Universality?
Assessing for stress factors affecting a Haitian client as well as her immediate family.
When a culturally diverse client dies, the nurse best demonstrates cultural sensitivity when managing the care of the body by:
Assessing the family's expectations regarding how their loved one's body will be handled
When a culturally diverse client dies, the nurse best demonstrates cultural sensitivity when managing the care of the body by:
Assessing the family's expectations regarding how their loved ones body will be handled
When completing a transcultural assessment of communication, which assessment by the nurse is most appropriate?
Assessment of eye contact, personal space, and social taboos
Which component of transcultural nursing has been greatly supported through the research conducted by anthropologists?
Assessment of woman's ability to function successfully in her role within the family.
A nurse is planning care for a hospitalized male client who is an Orthodox Jew. Which action by the nurse is best for this client?
Assign a male unlicensed assistive personnel (UAP) to help the client with his personal care.
A 4-year-old African child is adopted by an American couple. This child slowly adapts to American society. What is this process known as?
Assimilation
You are caring for a 28-year-old married man diagnosed with leukemia. He is hospitalized on reverse isolation. It is his anniversary and his wife is planning to visit. What would be appropriate nursing care to promote spiritual health?
Assist him in planning a celebration of his anniversary.
Which intervention reflects an understanding of a common negative psychosocial outcome of increased longevity?
Assisting the client to identify social activities he or she is interested in attending.
Which action by the nurse demonstrates prejudicial behavior?
Assuming that all patients of Asian descent are materialistic
Stereotyping
Assuming that everyone in a particular group is the same.
A client from Malaysia is admitted to the health care facility with reports of cramping pain in the abdomen and loose stools. Where should the nurse be seated when interviewing the client?
At more than one arm's distance
The nurse is triaging a hysterical patient in the emergency room. The patient is crying, has uncontrollable spasms, and is trembling and shouting. It is important to identify the manifestation of illness in order to effectively treat a patient. The nurse identifies this as a culture-bound syndrome called
Ataque de nervios.
A patient states that he does not believe in the existence of God. This patient most likely is an:
Atheist
A pregnant patient from a nondominant culture wants to deliver the baby "the American way" with epidural pain management. How should the nurse describe this patient's statement about childbirth?
Attempting assimilation
Which is an example of cultural competence in nursing?
Attending a conference for cultural diversity
Which scenario is an example of cultural competence in nursing?
Attending a conference for cultural diversity
Which are examples of cultural competence? Select all that apply.
Attending a cultural diversity lecture series in the community & Making arrangement for an acupuncturist to come to the hospital and provide pain relief for the client & Having a one-on-one conversation with a Muslim client regarding prayer needs and practices & Performing a self-assessment of one's own personal biases
Checklist for culturally responsive health care services include. Pick all that apply:
Available, Accessible, Acceptable
What action should the nurse consider when counseling a client of the Amish tradition?
Avoid using scientific or medical jargon.
When counseling a female Amish client, what should the nurse do?
Avoid using scientific or medical jargon.
Which behavior by the nurse is stereotyping?
Avoiding older adult clients because their care is time consuming
To enhance their cultural awareness, nursing students need to make an in-depth self-examination of their own:
Background, recognizing her biases and prejudices.
To enhance cultural awareness, nursing students need to make an in-depth self-examination of which attributes?
Background, recognizing personal biases and prejudices
To enhance their cultural awareness, nursing students need to make an in-depth self-examination of their own:
Background, recognizing personal biases and prejudices.
Which food items should likely be avoided in the diet plan for a Muslim patient? Select all that apply.
Bacon. Marshmallows
How best can a nurse evaluate goal attainment for a patient with a culturally diverse background?
Base decisions on feedback from the patient and the nurse's professional judgment.
A nursing student demonstrates understanding of the different communities when classifying Mothers Against Drunk Driving (MADD) as which type of community?
Based on specific function
To overcome barriers that are perceived by older clients, nurses can assume which approach to interact effectively
Be sensitive to the life experiences and previous health care experiences
Cultural self-awareness
Become aware of the role of cultural influences in your own life
In making a correct nursing diagnosis regarding a rash on a patient, the nurse should complete which of the following tasks first?
Become familiar with the patients normal coloring to establish a baseline.
A new resident in a long-term care facility who was having difficulty adapting to the routine has begun participating in activities on a daily basis. Which stage of culture shock is this resident displaying?
Beginning resolution
A nurse can improve cultural awareness with which behavior?
Being sensitive to differences between the cultures of the nurse and patient
While assessing a client who does not speak English, the nurse is aware of nonverbal indications of anxiety that include which of the following?
Being uncooperative and withdrawn.
Ethnocentrism
Belief in the superiority of one's nation or ethnic group.
A nurse considers the culture of an Appalachian woman when counseling her about contraceptives. Which beliefs are consistent with this culture? Select all that apply.
Belief is in a divine existence rather than attending a particular church. & Isolation is an accepted way of life. & Feelings about losses or death may be fatalistic. & Independence and self-determination are valued.
One aspect of a culture is invisible, or less observable, to others. A nurse wanting to develop an awareness of the practices of different cultures within that community would have which of the following as an example of this component?
Believing in supernatural influences
Narrow mindedness and an obstinate or blind attachment to a particular opinion or viewpoint
Bigotry
The nurse correctly differentiates race from ethnicity by noting that race is based on which characteristics?
Biological
Indicators of child health status include: check all that apply:
Birth weight, Infant mortality, Immunization rates
Mongolian spots are a common finding in which of these groups? Mark all that apply.
Black Americans, Asian Americans, American Indians.
The nurse understands that which statement regarding herbal and health therapies is correct?
Black cohosh produces estrogen-like effects.
Which statement will be the basis for determining the target population for a community education program regarding hypertension?
Black females have a higher average systolic blood pressure than White females at every age.
A nurse is caring for a Japanese immigrant who is one day post-op. The patient refuses to take pain medication but is reluctant to get out of bed with physical therapy (PT). Which action by the nurse is best?
Bring the medicine; explain that it will make PT easier.
A nurse is planning the menu for a Chinese-American client. Which foods should the nurse plan to include in the dietary plan? Select all that apply.
Broccoli & green beans.
A nurse is planning the menu for a Chinese-American client. Which foods should the nurse plan to include in the dietary plan? Select all that apply.
Broccoli, Green beans
A client who does not speak the dominant language is admitted to the hospital. Which cultural intervention would be most appropriate by the nurse?
Call for an interpretor who is familiar with health care.
The nurse notes that the client whose religion is Orthodox Judaism has received a cheeseburger with fries and skim milk as a beverage. Considering this finding, what is the best nursing action?
Call the dietary department and ask for a replacement meal tray.
This model has five encompassing concepts that depict the process for developing cultural competence. The concepts are cultural awareness, cultural knowledge, cultural skill, cultural encounter, and cultural desire.
Campinha-Bacote Model of Cultural Competence in the Delivery of Healthcare Services
culturally congruent care
Care that fits people's valued life patterns and sets of meanings generated from the people themselves. Sometimes this differs from the professionals' perspective on care.
Which of the following statements accurately describe cultural factors that may influence healthcare? Select all that apply.
Certain racial and ethnic groups are more prone to developing specific diseases and conditions. Most mental health norms are based on research and observations made of white, middle-class people. In many cultures, the man is the dominant figure and generally makes decisions for all family members. When people move to the United States, they may speak their own language fluently but have difficulty speaking English.
What is the best method for the nurse to ensure that a Croatian patient's nutritional needs are met during hospitalization?
Check with the patient on admission to determine dietary limitations and preferences.
A cardiac care nurse works with a diverse client population. The nurse would assess a client from which cultural group for an increased effect of an antihypertensive medication?
Chinese
Two largest groups of mental health consumers include
Chronically mentally ill and aging population
The nurse observes a religious charm hanging from the wrist of a client being prepared for surgery. The nurse's best initial approach is to:
Clarify whether the charm may remain in place during the procedure
Which culture-specific health practice is likely to be seen in a patient of Latino descent?
Classification of treatments as hot or cold therapies
A nurse is conducting a cultural assessment of a client. Which person would the nurse identify as the expert?
Client
When assessing a client's spirituality, the client completes a Brief Religious Coping Questionnaire. When reviewing the completed questionnaire, the nurse identifies which of the following as indicating positive religious coping?
Client looks to god for support in a crisis
Various laws and legislation that is part of the american culture will not be acceptable to other cultures. What concept is demonstrated by the Patient Self-Determination Act of 1991?
Client's autonomy
Which nursing intervention demonstrates an understanding of the importance of managing assessment information in a culturally congruent manner?
Client's edema was documented as, "Client reports, 'My legs swell when I spend too much time standing.'"
The nurse is performing an admission assessment on a patient with a diagnosis of pancreatic cancer. The nurse asks the patient about religious preference. The patient states, "Leave me alone about religion. I don't want to talk about it with you!" What is the best intervention by the nurse?
Collaborate with the hospital clergy.
In developing a culturally sensitive care plan for a Hmong (Asain-American) psychiatric patient, which of the following would be inappropriate?
Communicating all instructions in written form.
The nurse is reviewing the FICA Spiritual Assessment Tool. Which of the following would the nurse assess when addressing the letter "C"?
Community
The parents of a blended family have a baby boy age six months who is due for immunizations. The clinic closest to their home has recently closed, and they feel intimidated by the prospect of going to the large, university hospital near their home. Which of the following factors is the primary influence on this aspect of the family's health?
Community health care structure
The nurse develops a plan of care for a White-American client. The nurse considers the practices and preferences of the culture when planning the care, knowing that which are characteristics associated with this ethnic group? Select all that apply.
Community social organizations are important, Health often is viewed as an absence of disease or illness, The client will appear stoic when expressing physical concerns, & Members usually rely primarily on the modern Western health care delivery system.
The nurse develops a plan of care for a White-American client. The nurse considers the practices and preferences of the culture when planning the care, knowing that which are characteristics associated with this ethnic group? Select all that apply.
Community social organizations are important. - Health often is viewed as an absence of disease or illness. - The client will appear stoic when expressing physical concerns. - Members usually rely primarily on the modern Western health care delivery system.
The nurse is aware that the foundations of making a culturally competent ethical decision s which?
Compassion
The home health nurse is conducting the health history interview with a client who does not speak the dominant language. What would be the best action made by the nurse?
Conduct the health history utilizing a telephonic interpreter (over-the-phone translation).
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
A nurse is caring for a 70-year-old client from a different culture whose breast cancer has metastasized. The nurse observes that the client tends to defer responsibility for decision making around treatment options to her eldest son. How should the nurse respond to this?
Confirm that the client wants her son to make decisions and follow those decisions accordingly
The nurse is caring for a married female patient from the Middle East who defers to her husband to answer all assessment questions. The nurse understands that it is common in this culture for the male to hold a dominant role in the relationship. What stage of cultural awareness does the nurse display?
Conscious competence
A nurse is assigned to care for a client who practices Orthodox Judaism. After reading the client's medical record, the nurse takes time to talk with the client about how to make his hospital stay more comfortable. The nurse admits to the client that she is not familiar with Orthodox Judaism but would like to learn more. The nurse is in which stage of cultural awareness?
Conscious incompetence
Which actions does the nurse take to become culturally competent? Select all that apply.
Consider patient's preferences when developing care plans & Overcome cultural prejudices, biases, and personal beliefs & Recognize personal attitudes toward patients from other cultures & Improve professional cross-cultural communication skills
Which actions does the nurse take to become culturally competent? Select all that apply.
Consider patient's preferences when developing care plans. Overcome cultural prejudices, biases, and personal beliefs. Recognize personal attitudes toward patients from other cultures. Improve professional cross-cultural communication skills.
Which precautions should the nurse take to prevent ethnocentrism while providing care to a patient? Select all that apply.
Consider the patient's preferences while planning care. Do not consider one's culture and practices as superior. Recognize the relevance of the patient's health practices. Obtain knowledge of current transcultural care practices.
The nurse uses the acronym CULTURE when working with a diverse population. What elements does the acronym stand for? (Select all that apply.)
Consider your own cultural biases. - Learn to use cultural assessment tools. - Treat patients with dignity and respect.
A nurse is providing discharge instructions to an Asian-American client regarding prescribed dietary modifications. During the teaching session, the client continuously turns away from the nurse. Which nursing action is most appropriate?
Continue with the instructions verifying client understanding.
The nurse is providing discharge instructions to a Chinese American client regarding prescribed dietary modifications. During the teaching session, the client continuously turns away from the nurse. The nurse should implement which best action?
Continue with the instructions, verifying client understanding.
A 54 year old Filipino male has been admitted to the hospital for surgery. Surgery went well, and the patient is no longer NPO. He practices a traditional Filipino diet and is requesting a meal. What medication needs to be considered when his wife brings him a meal containing a significant amount of garlic?
Coumadin
Which nursing intervention demonstrates an understanding of an emotion outcome observed in clients immigrating from violent cultural environments?
Counseling the client on anger management techniques.
On which maternal-child healthcare issue would the world health organization's (WHO) nursing and midwifery team be most useful as a resource?
Creating breastfeeding policies to be adopted by a third world health care system
On which maternal-child health care issue would the World Health Organization's (WHO) nursing and midwifery team be most useful as a resource?
Creating breastfeeding policies to be adopted by a third world healthcare system.
Is defined as a process, rather than an end point, in which the nurse continuously strives to work effectively within the cultural context of an individual, family, or community from a diverse cultural background.
Cultural Competence
A client is admitted with end stage pancreatic cancer and is experiencing extreme pain. The client asks the nurse if an acupuncturist can come to the hospital to help manage the pain. The nurse states, "You won't need acupuncture. We have pain medications." Which characteristic has the nurse displayed?
Cultural IMPOSITION
A client, origianlly from Asia, believes that her illness is caused by an imbalance of yin and yang. The nurse states, "You can call it whatever you believe, but you have a metabolic disorder." What is this nurse demonstrating?
Cultural blindness
The nurse is caring for the teenage child of immigrants from China. The teenager voices distress because after living in the country for several years, he no longer wants to participate in some of the Chinese religious rituals that are important to his parents. What is the teenager experiencing?
Cultural change
The nurse is providing care for a patient with hypertension who is of Latino origin. The nurse belongs to a culture that believes in consumption of hot juices and foods for hypertension. However, the nurse includes cold juices in the patient's diet plan. Which trait does the nurse demonstrate in this case?
Cultural competence
A staff nurse meets with the charge nurse and is reporting that all the new nurses are leaving messes on the unit. The staff nurse states, "These youngsters think they can waltz in here and get our jobs." What is this nurse demonstrating?
Cultural conflict
Which term describes the tendency to impose one's cultural beliefs, values, and patterns of behavior on a person from a different culture?
Cultural imposition
Which professional nursing actions does Madeleine Leininger suggest to promote patient-centered care? Select all that apply.
Cultural maintence. Cultural care repatterning. Cultural care accommodation
The nurse caring for several clients on a hospital unit notices that the white client makes eye contact with the staff, while an older adult client of Japanese descent does not make eye contact when speaking to the staff. What cultural concept explains this difference?
Cultural relativity
A nurse is providing care for clients of different cultures in a blended community clinic. Which characteristics of culture should the nurse consider when planning culturally competent care? Select all that apply.
Culture guides behavior into acceptable ways for people in a specific group. - Culture influences the way people of a group view themselves. - There are differences both within cultures and among cultures. -Subcultures exist within most cultures.
A nurse caring for clients in a culturally diverse neighborhood knows that culture affects the nurse's interactions with the client. Which are characteristics of culture? Select all that apply.
Culture guides what is acceptable behavior for people in a specific group. - Cultural practices and beliefs mainly remain constant as long as they satisfy a group's needs. - Culture influences the way people of a group view themselves, have expectations, and behave.
The emergency department nurse is caring for a client injured in a motor vehicle collision. The client recently immigrated to the country. The nurse should implement interventions aimed at addressing which issue?
Culture shock
Upon moving to another country, a college student is very confused by many local customs. The student is especially bothered by the custom of men and women eating in separate areas and it makes the student angry and resentful of the new culture. What are the feelings experienced by this student?
Culture shock
Refers to particular values, beliefs, and patterns of behavior that tend to be special or unique to a group and that do not tend to be shared with members of other cultures.
Culture-specific
Refers to the commonly shared values, norms of behavior, and life patterns that are similarly held among cultures about human behavior and lifestyle.
Culture-universal
which statement made by a nurse caring for a client diagnosed with dementia and a history of falls best demonstrates the principle of beneficence
Current research fegutes the use of restraints to keep my client safe from falls
Which statement, made by a nurse caring for a client diagnosed with dementia and a history of falls, best demonstrates the principle of beneficence?
Current research refutes the use of restraints to keep my client safe from falls
Which nursing evaluation demonstrates that an African American female client is being monitored for a specific culturally focused health risk?
Current systolic blood pressure has shown a 16-point decrease from baseline.
A young patient tells the nurse that it is taboo to date before the age of 18 years. How should the nurse interpret this patient's statement?
Dating before the age of 18 years is not permitted.
Which principle concerning death rituals is the primary basis for the nurse's role in the death and grieving process?
Death rituals are critical to an individual's grief process
When planning to teach an Islamic client, the nurse needs to be aware of which of the following?
Decision making tends to be generally consultative between spouses.
The nurse is documenting assessment data obtained from an older Hispanic client reporting pain possibly resulting from osteoarthritis. Which notation demonstrates that the nurse implemented culturally congruent assessing techniques?
Denies using any type of traditional folk remedies to manage the pain in right hand.
The nurse is documenting assessment data obtained from an older Hispanic client reporting pain possibly resulting from osteoarthritis. Which reaction demonstrates that the nurse implemented culturally congruent assessing techniques?
Denies using any type of traditional folk remedies to manage the pain the right hand
The nurse is caring for a patient who has emigrated from another country. The patient is in need of abdominal surgery but seems reluctant to sign the surgical permits. What is one tactic that the nurse should use?
Determine the family social hierarchy.
Which intervention demonstrates the nurse's application of the holistic health belief system when managing the care of a child newly diagnosed with asthma?
Determining whether any family member is a cigarette smoker.
The nurse is planning an educational program for an immigrant population. Which nursing action will enhance the effectiveness of the program?
Developing cross-cultural linguistic competencies
A nurse is assessing a client from India who complains of panic, sexual dysfunction, fatigue, weakness, and loss of appetite. Which culture-bound syndrome should the nurse suspect in this client?
Dhat
Which disorder is viewed as a biological variation that accounts for an increased incidence of both maternal and infant morbidity in Native American Indian population?
Diabetes mellitus
Which of the following diseases are African Americans at highest risk for? Select all that apply
Diabetes mellitus & Glaucoma
A nurse is developing a care plan for a Hispanic client who has diabetes. What cultural intervention is MOST appropriate?
Dietary counseling, as Hispanic diets are often high in carbohydrates
A nurse is developing a care plan for a Hispanic client who has diabetes. What cultural intervention is most appropriate?
Dietary counseling, as Hispanic diets are often high in carbohydrates
When action is taken on one's prejudices:
Discrimination occurs.
The nurse is caring for a client of Asian descent. The client is ostoperative 3 days from coronary artery bypass graft (CABG). 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.
The nurse is caring for a client who is postoperative 3 days from coronary artery bypass graft (CABG). 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.
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.
Which nursing action supports a 2020 National Health Goal that addresses cultural diversity?
Discussing breastfeeding with a pregnant patient who is Hispanic
Recent world events are a good reminder that nurses everywhere should be aware of what is going on in other areas of the world due to which reason?
Disease can spread quickly today with all the world traveling
transcultural nursing
Distinct discipline developed by Leininger that focuses on the comparative study of cultures to understand similarities and differences among groups of people
Refers to differences in race, ethnicity, national origin, religion, age, gender, sexual orientation, ability or disability, social and economic status or class, education, and related attributes of groups of people in society.
Diversity
A 72 year old, Filipino male patient is brought into the emergency room by his son. His son tells the nurse that he is experiencing severe abdominal pain. The father seems stoic and is not showing outward signs of pain. How would you asses the patient's pain?
Do a full abdominal assessment of the patient and assess vital signs
When a child from a remote part of Africa dies as a result of a chronic illness, the nurse notes that while the parents appear saddened, they do not express the degree of grief typically expressed by American parents. Which question asked by the nurse best demonstrates an understanding of this particular cultural response?
Do children often die in your native country?
Mandating change
Do not force patients to participate in care that conflicts with their values
When interviewing a Native American patient on admission to the hospital emergency department, which questions are appropriate for the nurse to ask? (Select all that apply.)
Do you use any folk remedies? - Do you have a family physician? - Do you use a Shaman?
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?
Document the client's request in the nursing care plan.
The client is an Inuit woman recently admitted to the hospital with a ruptured ovarian cyst. She has expressed that it is very important that her husband be present to receive all medical information. Using the concepts of culturally competent care, which is the best response?
Document the client's request in the nursing care plan.
The nurse who is attempting to practice in a culturally sensitive manner must first realize that recognition of the visible signs of a client's culture:
Does not ensure understanding of the underlying cultural beliefs
The nurse is caring for a Hispanic-American client admitted with a diagnosis of diabetic ketoacidosis. Several family members are present. Which behavior, if displayed by the family members, would the nurse interpret as characteristic of this cultural group?
Dramatic body language
The nurse is caring for a Hispanic-American client admitted with a diagnosis of diabetic ketoacidosis. Several family members are present. Which behavior, if displayed by the family members, would the nurse interpret as characteristic of this cultural group?
Dramatic body language.
The nurse caring for an Orthodox Jewish client plans a diet that adheres to the practices of the client's faith. The nurse recognizes that which principles are consistent with dietary kosher laws? Select all that apply.
Eating fish with scales and fins is allowed, Unleavened bread is eaten during Passover week, Meat from animals who are vegetable eaters is allowed, & Meat is allowed if the food animal is ritually slaughtered.
The nurse caring for an Orthodox Jewish client plans a diet that adheres to the practices of the client's faith. The nurse recognizes that which principles are consistent with dietary kosher laws? Select all that apply.
Eating fish with scales and fins is allowed. -Unleavened bread is eaten during Passover week. - Meat from animals who are vegetable eaters is allowed. - Meat is allowed if the food animal is ritually slaughtered.
Which intervention is an example of health promotion with a focus on social justice?
Educating a Hispanic client to the social service programs he or she is qualified for
Which intervention is an example of health promotion with a focus on social justice?
Educating a Hispanic client to the social service programs he or she is qualified for.
Which intervention is directed toward minimizing cause of children's deaths worldwide?
Educating parents on the importance of vaccinations and immunizations
Which intervention is directed towards minimizing the primary cause of children's deaths worldwide?
Educating parents on the importance of vaccinations and immunizations.
The role of the nurse regarding complementary and alternative medicine should include which action?
Educating the client about therapies that he or she is using or is interested in using
The role of the nurse regarding complementary and alternative medicine should include which action?
Educating the client about therapies that he or she is using or is interested in using.
Cultural competent nursing care
Effective, individualized care that demonstrates respect for the dignity, personal rights, preferences, beliefs and practices of the person receiving care while acknowledging any biases Sensitive to the needs of individuals, families and groups from diverse populations within society
When reviewing the demographics of various communities, the nurse would identify a community with a large percentage of which age as most likely to have health-related concerns?
Elderly
A male Hispanic client describes the fact that he mixed hot and cold foods, causing them to lump together and "get stuck in his intestines," causing diarrhea and abdominal pain. The nurse would document this as which of the following?
Empacho
An antihypertensive medication has been prescribed for a client with hypertension. The client tells the clinic nurse that they would like to take an herbal substance to help lower their blood pressure. The nurse should take which action?
Encourage the client to discuss the use of an herbal substance with the health care provider.
A Hispanic patient tells an African American nurse, "You are African American and can't possibly understand how a person like me feels." What is an appropriate response by the nurse at this time?
Encourage the patient to describe what he means by his statement.
Which intervention will best assist the nurse in understanding the culturally diverse client's perception and description of his or her current illness?
Encouraging the client to describe his or her illness in terms of his or her cultural metaphors.
A 2-month-old child from Guatemala was adopted by an American family in Indiana. Which term best describes the child's socialization into the American Midwestern culture?
Enculturation
The nurse observes that a 2-year-old American child slowly grows into the American society that the child lives in. What is this process of socialization into one's primary culture known as?
Enculturation
A 6-month-old child from Guatemala was adopted by an American family in Indiana. The child's socialization into the American midwestern culture is best described as:
Enculturation.
Which activity will best minimize the risk of allowing discrimination and prejudicial behaviors to impact personal nursing practice?
Engaging in regular reflective, cultural self-assessments.
A nurse is assessing patients with different cultural backgrounds. Which actions would the nurse perform to obtain a systematic cultural assessment? Select all that apply.
Establish trusting relations with the patient. Obtain information with open-ended questions. Gather area demographic information from census data.
Which intervention demonstrates an attempt to meet a goal related to the health issues in Africa identified by the Millennium Development project?
Establishing a series of rural prenatal clinics
Which intervention demonstrates an attempt to meet a goal related to the health issues in Africa as identified by the Millennium Development project?
Establishment of a series of rural prenatal clinics.
A nurse is gathering information about the history of the community in which she works. Which of the following should she include in this study?
Ethnic groups who settled in the area, based on information from the local library
When a home-bound client expresses her past-oriented ancestral heritage and family rituals, the nurse recognizes that the client is expressing:
Ethnic identity
A powerful determinant of one's identity is
Ethnicity
When describing the concept of ethnicity, which statement would be most appropriate to use?
Ethnicity allows people to define themselves and others to define them.
Which statement is correct in regard to the older clients health status?
Ethnicity and income level affect the older adults health status
Which statement best serves as a guide for nurses seeking to learn more about ethnicity?
Ethnicity is based on cultural similarities and differences in a society.
When asked to describe the differences between ethnicity and race, what should the student nurse explain?
Ethnicity refers to a shared identity, whereas race is limited to biological attributes.
Can be described as the universal tendency for any culture to see it's own values and practices as natural and correct.
Ethnocentrism
In performing a cultural assessment, knowledge of a patient's country of origin and its history and ecological contexts is known as
Ethnohistory
Violence due to a form of hatred in the workplace
Ethnoviolence
Classification of illness can occur with cultural practice. What is an example of an unnatural illness?
Evil forces caused a client to develop schizophrenia.
A nurse is assessing a woman whose religious beliefs do not allow blood transfusions. She has severe anemia, is very weak, and has altered mental status. What behavior by the nurse is needed to provide effective care to this woman?
Examine his or her own feelings about the importance of religious beliefs in making decisions about life
Because touching the head has specific meaning in the Vietnamese culture, before measuring the head circumference of a child, the nurse should:
Explain the procedure and ask permission of the parent.
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. What would be the most appropriate nursing action?
Explain the purpose and need for assistance during ambulation.
A nurse is caring for a postoperative client of Asian descent after knee arthroplasty. The nurse plans to help the client ambulate, but is aware that the client may feel threatened due to physical closeness. What would be the most appropriate nursing action?
Explain the purpose and need for assistance during ambulation.
A female Jamaican immigrant has been late to her last two clinic visits, which in turn had to be rescheduled. The best action that the nurse could take to prevent the patient from being late to her next appointment is
Explore what has prevented her from being at the clinic in time for her appointment.
A Jamaican immigrant has been late to the last two clinic visits, which in turn had to be rescheduled. Which nursing action is most appropriate to help prevent the patient from being late to the next appointment?
Explore what has prevented the patient from being at the clinic in time for the appointment.
What is spirituality?
Expressing meaningful aspects of self
The reaction to the research conducted in Sierra Leone by their government demonstrates the need to respond appropriately to achieve the desired results. Which was a major fault of this study?
Failed to adequately respond to the major problem
Which behavioral characteristic of a patient indicates hopelessness?
Failing to follow medical recommendations
An African-American woman collapses at the funeral of her mother and later states that she could hear everything people were saying to her but, for a brief period, she could not move. The nurse interprets this as which of the following?
Falling out
religion is defines as being born out of each persons unique life experience and his or her personal effort to find purpose and meaning in life
False, that is spirituality not religion.
According to Purnell Model for Cultural Competence, what initially indoctrinates an individual to cultural norms?
Family
Hispanic cultural factors
Family - Familial role is important. - Compadrazgo: special bond between a child's parents and the child's grandparents - Family is the primary unit of society. Folk and Traditional Health Care -Curanderas(os): folk healers who base treatments on humoral pathology—basic functions of the body are controlled by four body fluids or "humors": - Blood—hot and wet -Yellow bile—hot and dry - Black bile—cold and dry -Phlegm—cold and wet -The secret of good health is to balance hot and cold within the body Values and Beliefs -Respect is given according to age (older) and sex (male). - Roman Catholic Church may be very influential. Nursing Considerations - It may be difficult to convince an asymptomatic patient that he or she is ill. - Special diet considerations are necessary if the patient believes in the hot/cold theory of treating illnesses. -Diet counseling may be necessary at times, because the usual diet of many members is high in starch.
Asian cultural factors
Family -welfare of family is valued above the person -extended families common -person's ancestors are respected -sharing among family members is expected Folk and Traditional Health Care - Theoretical basis is in Taoism, which seeks a balance in all things - proper balance of yin (feminine, negative, dark, cold) and yang (masculine, positive, light, warm) -diseases and foods are classified as hot or cold and a proper balance between them will promote wellness Values and Beliefs - strong sense of self-respect and self-control - high respect for age - respect for authority - respect for hard work Nursing Considerations - may be upset by drawing of blood for lab tests - may refuse surgery - seldom complain - dietary considerations if the pt is on a salt-restricted diet as many Asian foods have high salt content
A nursing care assistant fails to report in a timely manner a request for pain medication from an African-American male client who is recovering from a stab wound. The nurse's initial action is to evaluate the care assistant's:
Feelings regarding this particular client
What are the three factors that the Asian American population believe affect your health status? Select all that apply
Fire & Water & Wind
What is the most critical factor in the very first assessment by the nurse?
First impressions
Providing culturally congruent care means providing care that
Fits the patient's valued life patterns and set of meanings.
When a nurse is discussing a medication home regimen with an Alaskan Eskimo patient, the nurse might expect which of the following?
Focused on present events.
When caring for the patient who believes there is a relationship between outcomes and internal feelings of control, the patient can be expected to do which of the following?
Follow directions given for healthcare.
Which area is typically included in a cultural assessment?
Food preferences
An Asian American client is experiencing a fever. The nurse recognizes that the client is likely to self-treat the disorder, using which method?
Foods considered to be yin.
What is the initial step in preparing for a career in international nursing with Asian populations?
Gaining practical experience with the culture through volunteer work among Asian emigrants
What is the initial step in preparing for a career in international nursing with Asian populations?
Gaining practical experience with the culture through volunteer work among Asian emigrates.
When performing a spiritual assessment, what may help the nurse to identify related nursing diagnoses, needed interventions, and improve patient care?
Gaining relevant information about the patient's spirituality.
While studying about various cultures, the student nurse is aware that a subculture is based on which characteristics?
Gender, Age, Profession, Hobbies, Sexual preference
What are barriers to high quality healthcare for children?
Geography, Racism, Poverty
A nurse is assessing a Navajo client, who has presented to the health clinic with complaints of feeling endangered, confusion, bad dreams, and hallucinations. Which culture-bound syndrome should the nurse suspect in this client?
Ghost sickness
This model includes six cultural phenomena that are used as a framework for patient assessment and to provide culturally competent care to clients. The six cultural phenomena are communication, time, space, social organization, environmental control, and biological variations.
Giger and Davidhizar Transcultural Assessment Model
The nurse recognizes that which of the following are signs of a healthy local government? Select all that apply.
Government leaders are accessible to the community. A high percentage of the community members are registered to vote. Open community meetings are regularly held. There is an atmosphere of tolerance among different groups
A home care nurse is assigned to visit a Hispanic-American client to perform an admission assessment. On the initial meeting with the client, the nurse should plan to incorporate which social custom?
Greet the client with a handshake.
The home care nurse is assigned to visit a Mexican-American client to perform an admission assessment. On initially meeting the client, what should the nurse do?
Greet the client with a handshake.
A nurse is assigned to collect data from a Hispanic-American client during the hospital admission. The nurse should plan to use which communication patterns? Select all that apply.
Greet the client with a handshake. - Smile through the admission process. - Use affirmative nods during the conversations with the client.
A nurse is assigned to collect data from a Hispanic-American client during the hospital admission. The nurse should plan to use which communication patterns? Select all that apply.
Greet the client with a handshake. - Smile through the admission process.- Use affirmative nods during the conversations with the client.
A nurse is assigned to collect data from a Hispanic-American client during the hospital admission. The nurse should plan to use which communication patterns? Select all that apply.
Greet the client with a handshake., Smile through the admission process. , Use affirmative nods during the conversations with the client.
Negative Attitudes and Behaviors in Multicultural Workplace include: Pick all that apply
Hatred, discrimination, ethnoviolence
Which question demonstrates the nurse's appropriate understanding of the value the African American culture places on formal health care for a skin rash?
Have you been putting any lotions or creams on your rash?"
Which characteristic is the basis for success in effectively functioning as a nurse in an international setting?
Having strong communication skills that relate to the establishment of an effective nurse-client relationship
Which characteristic is the basis for success in effectively functioning as a nurse in an international setting?
Having strong communication skills that relate to the establishment of an effective nurse-client relationship.
The nurse assumes that an Asian patient with bruises on the back is experiencing abuse. However, the patient does not look scared and speaks to the nurse confidently. Which further assessment should help the nurse best understand the patient's condition?
Health care practices
The nurse assumes that an Asian patient with bruises on the back is experiencing abuse. However, the patient does not look scared and speaks to the nurse confidently. Which further assessment should help the nurse to best understand the patient's condition?
Health care practices
What is the yin/yang theory of health?
Health exists when all aspects of the person are in perfect balance.
When assessing a community, the nurse is reviewing statistics related to adult mortality in clients who are 65 years of age and older. The nurse would assess the community for health programs to address which of the following as the major cause of death in this age group?
Heart disease
Which of the following diseases are Arabic individuals predisposed to? Select all that apply
Hepatitis, tuberculosis, sickle cell anemia
Which theory has been expanded in an attempt to study the degree to which a person's lifestyle reflects his or her traditional heritage?
Heritage consistency
Socioeconomic Factors Influencing Mental Health Include Which of the Following?
High rates of depression, Immigration, Poverty
The nurse is concerned with the rising unemployment rate of the community in which she lives. How will the nurse be affected by this problem?
High unemployment rates are associated with higher morbidity and mortality rates.
The risk for peripheral artery disease is increased in African Americans due to which of the following factors? Select all that apply
Higher incidences of diabetes & Higher incidence of hypertension
A nurse is gathering health information about a community that is economically unstable. Which of the following should she expect to find?
Higher morbidity and morality
Which of the following religions from Asian Indian race practice cremation? Select all that apply
Hinduism & Jainism & Buddhism & Sikhism
How do you best provide spiritual care to an infant?
Hold and rock the infant.
A patient is diagnosed with end-stage renal disease. The patient tells the nurse, "I know I am going to be all right, and I will be healthy again. I believe in God, and He will make things right. My spouse and I are yet to tour the world." What kind of spiritual belief does this patient exhibit?
Hope
The nurse is caring for a patient receiving chemotherapy for cancer. The patient does not complain despite the challenges faced. The patient is looking forward to a positive outcome. What term should the nurse use to define this attitude?
Hope
Which of the following questions is/are appropriate to ask during a transcultural assessment? (Select all that apply.)
How do you act when you are angry? & What is your role in your extended family? & When communicating with friends, how close do you stand?
Which situation is especially prevalent in culturally diverse children being raised in one-parent families and so should be assessed for?
How is your husband adjusting to the fact that you are working outside your home
Which assessment question will best help the nurse determine how much a Japanese American client's view of health and illness is influenced by his ethnic culture?
How long has your family lived in America?"
You are caring for a client who is Navajo and in the end stages of life. The client passes and the client's family insists that no one can handle or cleanse the body except for the chosen family members and the preparation must be done as soon as possible. As a nurse who understands cultural compliance, what should your response be?
I just need to do documentation and obtain a death certificate from your healthcare provider
A nurse is preparing to conduct a community assessment. Upon completing the assessment, which of the following should the nurse expect as the primary outcome?
Identification of health-related concerns in the community
Which actions does the transcultural nurse take to improve culturally congruent care? Select all that apply.
Identifies cultures that are frequently neglected or may be misunderstood. Understands the culture-specific health practices of patients in their care. Studies patient-related cultural care symbols and their possible meanings. Uses the "emic" perspective to understand transcultural health concerns
What does cluster analysis do?
Identifies patterns and points to specific problems
Primary prevention and cultural competence in the community includes:
Identify high risk behaviors, Identify family context, Identify social support, Identify cultural needs and norms
while completing a family and social history on a patient it is important that the nurse does what?
Identify key decision makers
The nurse in a health care clinic is preparing to conduct a nutritional session with a group of culturally diverse pregnant women. At the first session the nurse will be meeting with each client individually. The nurse prepares a list of items to be included in the session and lists which item as the priority?
Identify the food preferences and methods of food preparation for each client.
Which intervention is most culturally congruent when supporting an African American client attempting to determine the feasibility of entering an assisted living care facility?
Identifying facilities in the area that are close to the town's African American neighborhoods.
Race
Identity with a group of people who share a biological ancestor Based on physical characteristics such as skin pigmentation, body stature, facial features and hair texture. Because of the significant blending of physical characteristics through the centuries, race has become harder to define
Compare the following statements. Which are considered predominant in non-Western cultures? (Select all that apply.)
Illness is an imbalance between humans and nature. Diagnoses are described as holistic. Treatment of disease can be magico-religious based.
Foster (1976) identified two distinct categories of healers cross-culturally. Of the following characteristics, which are congruent with the healing practices of naturalistic practitioners? (Select all that apply.)
Illness is impersonal and is due to biological forces. Illness is caused by alterations in the body equilibrium. Healing modalities include herbs, massage, and surgery.
The nurse is beginning an assessment with a pregnant patient from a non-English-speaking culture. The interpreter is having difficulty understanding what the patient is trying to say and the patient is becoming frustrated. Which nursing diagnosis would be the most appropriate for this situation?
Impaired verbal communication
A nurse is preparing an in-service program for a group of fellow nurses about spirituality and religion. When describing the effects of religion and spirituality, which of the following would the nurse include? Select all that apply.
Improved client sense of well-being & Enhanced coping with end-of-life issues & Increased adherence to medical regimens
A nurse is relying heavily on gestures and simplified language during the assessment of a client from another culture who speaks minimal English. During the lengthy assessment, the nurse asks the client if she is "okay" by making a circle with his thumb and forefinger. The nurse should be aware of which of the following?
In some cultures, this gesture is offensive.
A nurse is planning meals for clients in a long-term care facility. Which cultural practice should the nurse take into consideration when choosing foods for these clients?
In the Asian and Hispanic culture, diseases and foods are classified as hot or cold, and a proper balance between them promotes wellness.
Which of the following factors has the greatest impact on health care available to non-Hispanic white minority groups in the United Sates?
Inappropriately high poverty rates
Which nursing intervention reflects culturally appropriate care when caring for a female Latino client?
Include the client's spouse in decision-making, if the client desires.
Which phrases about culture are accurate? Select all that apply.
Includes laws, morals, and customs. Involves one's unconscious thoughts. Visible to people outside the culture
The nurse recognizes that ethnicity differs from race in that ethnicity:
Includes more than biological identification
Madeline Leininger's transcultural nursing theory
Incorporating the client's request for complementary treatment therapy
Which nursing intervention reflects practice according to Madeline Leininger's transcultural nursing theory?
Incorporating the client's request for complementary treatment therapy
Why practice Culturally competent Health Care? Pick all that apply
Increase Patient Satisfaction, Increase Patient Compliance, Sense of Security in Healthcare Received
There are eight factors that affect Transcultural Nursing. List two of these factors.
Increase in the migration of people Rise in multicultural identities Increased Use of health care technology Cultural conflicts, clashes, and violence Increase in the number of people traveling for work Increase in legal suits r/t cultural conflict, ignorance Rise in feminism and gender issues Increased demand for comm. and cult. based hc svc
A nurse has just learned that a community recreation league for youth has just been eliminated due to lack of funding. Which of the following results should the nurse suspect?
Increased gang activity
Eliminating disparities in the health status of people from diverse racial, ethnic, and cultural backgrounds has become one of the two most important priorities of Healthy People 2020 because populations with health disparities have
Increased incidence of disease
Which three factors have influenced pregnancy and childbirth over the last three decades in western society?
Increased number in the workforce, Explosion of information available on the internet, Advances in reproductive technology
A nurse has just learned that a community course on water safety in a beachfront town has recently been eliminated due to a lack of funding. Which of the following results should the nurse expect?
Increased sports injuries
The nurse recognizes that changes in demographics have an influence on health care delivery. One of the expectations in the United States by the year 2020 is:
Increases in the Hispanic and Latino populations
It is best for nurses to have a broad understanding of cultural influences on health care because of
Increasing global diversity.
A White-American client maintains eye contact with the nurse during a conversation regarding the preoperative teaching plan. What is the best interpretation of the client's behavior?
Indicating trustworthiness
A White-American client maintains eye contact with the nurse during a conversation regarding the preoperative teaching plan. What is the best interpretation of the client's behavior?
Indicating trustworthiness.
Nurses caring for patients in health care facilities need to provide culturally competent care to an increasingly diverse population. Which statements accurately describe a characteristic of cultural diversity that exists in the United States? Select all that apply.
Individuals may be members of multiple cultural groups at one time &Culture guides what is acceptable behavior for people in a specific group. & Cultural practices may evolve over time but mainly remain constant.
A nursing student is doing a community health rotation in an inner-city public health department. The student investigates sociodemographic and health data of the people served by the health department and detects disparities in health outcomes between the rich and poor. Which phrase best describes this disparity?
Influence of socioeconomic factors in morbidity and mortality
A nursing student is doing a community health rotation in an inner-city public health department. The student investigates sociodemographic and health data of the people served by the health department and detects disparities in health outcomes between the rich and poor. This is an example of a(n):
Influence of socioeconomic factors in morbidity and mortality.
A nursing student is doing a community health rotation in an inner-city public health department. The student investigates sociodemographic and health data of the people served by the health department, and detects disparities in health outcomes between the rich and poor. This is an example of a(n):
Influence of socioeconomic factors in morbidity and mortality.
A nurse is assessing the cultural beliefs of five clients requiring specimen collection for a diagnostic test. Which cultural assessments are correct? Select all that apply.
Insertion of a throat culture swab into the mouth of a Southeast Asian client may be perceived as threatening. - Hindus collecting a stool specimen for a Hemoccult screening test need to use the left hand to place the stool onto the Hemoccult card. - Self-urine collection performed by a right hand-dominant - Muslim client may be collected incorrectly because only a Muslim's left hand can be used for dirty activities.
A nurse is assessing the cultural beliefs of five clients requiring specimen collection for a diagnostic test. Which cultural assessments are correct? Select all that apply.
Insertion of a throat culture swab into the mouth of a Southeast Asian client may be perceived as threatening. - Hindus collecting a stool specimen for a Hemoccult screening test need to use the left hand to place the stool onto the Hemoccult card. - Self-urine collection performed by a right hand-dominant Muslim client may be collected incorrectly because only a Muslim's left hand can be used for dirty activities.
emic worldview
Insider or native perspective
You have a male patient who is a follower of Islam. How would this affect your care?
Integrate prayer times around care.
culture
Integrated patterns of human behavior that include the language, thoughts, communications, actions, customs, beliefs, values, and institutions of racial, ethnic, religious, or social groups
An Asian-American client will accept hygiene care from only family members. The cultural origin of this behavior is most likely:
Interdependency
A nurse is teaching an Appalachian patient who says, "Whatever will be, will be." The nurse understands that which of the following is most accurate about this scenario?
Internal feelings of control are related to compliance.
Which nursing diagnosis is most appropriate for a young Middle Eastern immigrant who expresses concern for the safety of his family members who were unable to relocate with him out of a war zone?
Interrupted Family Processes
During an assessment of a patient, the nurse finds that the patient speaks a different language and that an interpreter is needed. Which technique would the nurse use to communicate with this patient? Select all that apply.
Introduce herself to the patient. Observe the patients' nonverbal and verbal behaviors. Ask the interpreter to ask the patient for feedback and clarification.
A nurse is caring for an Appalachian patient following her hysterectomy. Which of the following Appalachian values and beliefs should be considered when planning nursing care for this patient? Select all that apply.
Isolation is considered as a way of life. Dependence and self-determination are valued. They may be fatalistic about losses and deaths.
Which teaching statement best exemplifies cultural competence in relation to time for the American culture?
It is important to arrive within 20 minutes of your scheduled appointment time.
Which teaching statement best exemplifies cultural competence in relation to time for the American culture?
It is important to be on time for your health care appointment.
A nurse is conducting an interview of a Portuguese patient with the assistance of an interpreter. The nurse speaks to the interpreter directly and maintains eye contact. The interpreter then translates the information for the patient. Which statement describes the communication pattern being used by the nurse?
It is inappropriate as the nurse is not speaking to the patient directly.
When addressing the issue of organ donation, which culture belief is the basis for the Amish family's traditional viewpoint?
It is preferable that an intact body be buried
A nurse is working with a client who has received a terminal diagnosis. To help the nurse identify the client's possible coping responses, which of the following would be most important for the nurse to understand about spirituality?
It varies in different situations.
The nurse is explaining to the patient that the physician wrote an order to administer a blood transfusion for severe anemia. The patients emphatically refuses the blood transfusion. What religious practice should the nurse inquire about?
Jehovah's Witness
. A nurse educator is reviewing the unit's resources about religious groups and their views about blood and blood products, organ donation, and autopsy. A member of which group is most likely to refuse a blood transfusion?
Jehovah's witnesses
The nurse is caring for a Chinese patient who is reluctant to answer questions about her health background. The nurse asks the patient if she would like her husband present when health questions are asked. The nurse does this knowing that the Chinese culture is a collectivistic and patrilineal culture. What does this mean?
Kinship is limited to the side of the father.
Cultural competence by nursing in geriatrics includes. Pick all that apply:
Knowledge of population specific health-related cultural values, beliefs, and behaviors, Disease incidence, prevalence or mortality rates, Skills in working with culturally diverse populations
A nurse is explaining the concept of being culturally competent to another nurse. Which terms are components of cultural competence? Select all that apply.
Knowledge, Attitudes, Beliefs, Skills, Encounters
A nurse is working in an inner city clinic with a heavy population of Hispanic migrant workers. Which nursing assessment is the priority?
LANGUAGE assessment
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
A nurse is working in an inner city clinic with a heavy population of Hispanic migrant workers. Which nursing assessment is the priority?
Language assessment
A patient is admitted to the hospital. Which characteristics would help the nurse identify the ethnicity of the patient? Select all that apply.
Language. Geographical space
The nurse is developing a plan of care for a hospitalized Asian-American client. The nurse should include which measures in the client's plan of care? Select all that apply.
Limit eye contact, Clarify responses to questions, & Maintain physical space with the client.
The nurse is developing a plan of care for a hospitalized Asian-American client. The nurse should include which measures in the client's plan of care? Select all that apply.
Limit eye contact. - Clarify responses to questions. - Maintain physical space with the client.
The nurse is conducting an assessment of a rural community. Which of the following community assessment findings is most characteristic of rural communities?
Limited access to specialized health care
A young couple who have been married less than a year are having difficulty with adjusting to parenting. What is a contributing factor to this level of maladjustment?
Limited time in learning to be a marital partner
A group of nurses are trying to establish a small medical clinic in an impoverished, rural community. The nurses realize this project will require the input and participation from the others to help making it successful and enable them to provide quality health care. To whom should the nurses look to for possible partnership in this venture to help make it successful?
Local churches, The local government, The national government, The local schools, The local radio stations
What cultural considerations might the nurse expect of those living in poverty?
Low levels of self-respect and feelings of worthlessness are common. • Living conditions are often crowded, with several families living together. • Family structures are often unstable and abusive. • Large numbers in the culture need government assistance.
From culture to culture time often takes on different meanings. In exploring the relationship of time to nursing interventions, the nurse should:
Maintain a flexible attitude when the client requests procedures to be done at specific times
A patient is scheduled for a chemotherapy treatment and asks the nurse to pray. What is the best intervention by a nurse who is not accustomed to praying?
Maintain a respectful silence and allow the patient to lead all the prayers.
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 client of Arab descent has been admitted to the health care facility with varicose veins. What should the nurse avoid while conducting the interview of the client?
Maintaining eye contact
As the international nursing community grows, there are specific goals in mind to be accomplished by the nurses as they travel to different regions to assist with healthcare, especially in areas where healthcare is not as readily available as it is in other areas. Which is considered a goal to be achieved by the Global Health team?
Maintaining sustainability
The nurse is providing care to a Puerto Rican-American client who is terminally ill. Numerous family members are present most of the time, and many of the family members are very emotional. What is the most appropriate nursing action for this client?
Make the necessary arrangements so family members can visit.
Within the 45-64 years of age group, a nurse knows that the most common cause of mortality is from what source?
Malignant neoplasms
A nurse provides care to a vast culturally diverse population. How can the nurse best address the need to provide cultural congruent nursing care?
Master the skills required to perform an effective cultural assessment.
Which statement(s) reflect/s the practice of transcultural nursing? (Select all that apply.)
May be considered a general and specialty practice area & Challenges traditional ethnocentric nursing practice & Aims to identify individual patient care preferences
A nurse doing discharge teachings with a Navajo diabetic patient should recognize the patient may experience which of the following?
May have trouble with keeping appointments.
A patient from a nondominant culture is in the second stage of labor and is not demonstrating any manifestations of pain. What should the nurse do to support this patient?
Measure the pain level with a pain rating scale
Traditional Western medicine, in contrast to alternative therapy, uses:
Medication administration
A Buddhist patient has end-stage pancreatic cancer. In what spiritual practice would this patient most likely engage?
Meditating on the meaning of life
Sickle cell disease and other hemoglobinopathies such as thalassemia are often found in persons originating from which geographical regions?
Mediterranean and Africa.
A nurse is providing care to a client and has enlisted the help of a trained interpreter to assist in communicating with the client. Which action would the nurse do first?
Meet with the interpreter alone before a combined meeting with the client.
You are taking care of a 32 year old Mexican man who has suffered severe trauma to his right arm but has refused pain killers and states that his pain is zero. Which of the following are important to remember when taking care of Mexican male patients? Select all that apply
Mexican men commonly tolerate pain until it becomes extreme & Mexican Americans tend to perceive pain as a necessary part of life & Enduring pain is often viewed as a sign of strength & Many hope the pain will just go away
A nurse is planning care that is grounded in the fact that clients are holistic beings. Which of the following lists of components constitute the view of clients as holistic beings?
Mind, body, spirit
Which MDG is the basis for advocating for the use of condoms in the third world countries?
Minimizing the spread of HIV
Which MDG is the basis for advocating for the use of condoms in third world counties?
Minimizing the spread of HIV.
In western society, during pregnancy who at the focus of care during pregnancy and childbirth
Mother and fetus
The nurse is reviewing the diets for a group of assigned patients. The nurse notes that a client requires an alternate meal choice if pork is being served. What cultural group would require an alternative meal choice?
Muslim
3. Which of the following statements is true of cultural assimilation?
Mutual cultural assimilation occurs when characteristics from two groups are traded.
A nurse caring for culturally diverse patients in a physician's office is aware that patients of certain cultures are more prone to specific disease states than the general population.which patients would the nurse screen for diabetes mellitus based on the patient's race? Select all that apply.
Native Americans, Hispanics, and Whites (African Americans are prone to hypertension, stroke, sickle cell anemia, lactose intolerance, and keloids & Asians and Pacific Islanders are prone to hypertension, liver cancer, thalassemia, and lactose intolerance.)
All of the following are considered universal attributes that we have in common with other members of the human race EXCEPT:
Need for formal education
A nurse is caring for a middle-aged Hindu Asian patient following an incidence of high blood pressure. After reviewing the patient data, the nurse concludes that the patient's health care practices and health care needs are not congruent. Which action by the nurse should provide culturally congruent care? Select all that apply.
Negotiate for a change in his cultural practices. Preserve the patient's values relevant to maintaining his health. Modify the patient's lifestyle to develop a beneficial health care pattern.
A client with Asian heritage is admitted to the unit. What cultural assessment might the nurse anticipate?
Nonverbal expressions of pain
A nurse is providing care to a client who is from a different culture. Which aspect about culture would be most important for the nurse to integrate into the client's care?
Not all members of the same culture act and think alike.
The nurse recognizes that the family of a deceased Buddhist client will:
Not move the body until it is cold
A mother brought a child in to the Emergency Department stating that she thinks her child's appendix has ruptured. Before any diagnostic tests can be done, the father comes in and says, "I don't want anything done, we will take the child to our church where prayer will heal him." What is an appropriate action by the nurse at this time?
Notify the ethics committee immediately.
Which of the following nursing interventions shows the greatest degree of culturally competent nursing care for a Muslim female client?
Notifying staff that the client's bath will be done by her sister
Which nursing intervention best shows compliance with offering linguistically appropriate services for a culturally diverse population?
Notifying the client that he or she is entitled to language translation services.
A family that consists of two homosexual parents and three children living in the same house is an example of which type of family?
Nuclear
What is the nurse legal obligated to do if findings clearly differentiate from the previous assessments?
Nurses are responsible for alerting the appropriate health care professional whenever assessment data differ significantly from the patient's baseline, indicating a potentially serious problem
What knowledge will best assist a nurse in providing nonprejudicial care that is sensitive to the beliefs and practices of a culturally diverse client population?
Nurses will not consciously question the bias of their own thinking and so must make a concerted effort to do so regularly.
After teaching a group of students about spirituality and religion, the instructor determines that the students need additional teaching when they state which of the following?
Nursing has only recently begun to incorporate spirituality into client care
After teaching a group of students about spirituality and religion, the instructor determines that the students need additional teaching when a student states which of the following?
Nursing has only recently begun to incorporate spirituality into client care.
After teaching a group of students about spirituality and religion, the instructor determines that the students need additional teaching when they state which of the following?
Nursing has only recently begun to incorporate spirituality into client care.
When performing an assessment of a patient, the nurse observes that the patient begins to cry when asked if she has a religious preference. What part of the care plan would the nurse document this assessment finding?
Objective data
What is one way in which nurses can develop cultural self-awareness?
Objectively examine own beliefs, values, and practices.
An instructor is emphasizing the need for nurses to be culturally sensitive and competent for which reason?
Obtain accurate assessment data
Which advice from an experienced nurse will help a new graduate nurse enhance cultural competency?
Obtain sufficient knowledge about a patient's cultures and beliefs.
A nurse is assessing an Asian male patient in a day care center. The nurse is developing a transcultural care plan for the patient who identifies both with his native as well as American culture. Which components would the nurse incorporate in order to provide culturally congruent care? Select all that apply.
Obtaining knowledge of the patient's health beliefs & Self-examining his or her own culture & Being open and accepting of cultural differences
The nurse is caring for a Chinese client who is in labor. The client is exhibiting facial grimacing and appears to be in pain. When the nurse offers the client an analgesic, the client refuses. The nurse should take which initial action?
Offer an analgesic again.
A Navajo man is hospitalized with a kidney stone in obvious distress, but is trying to conceal it. When asked to rate his pain, he tells you "It's nothing I can't handle". You have orders to give 4 mg of morphine stat. What do you do?
Offer pain medications and explain it will provide healing
Which intervention demonstrates that a nurse requires additional education regarding the support of a client's spiritual health?
Offering to add the client to the nurse's prayer list
The nurse plans to use an interpreter when teaching a Spanish-speaking client about diabetes mellitus. The best interpreter for the nurse to select is which of the following?
One who translates not only the words but the nonverbal messages too.
Because of the influence of various religions upon individuals, what one group may deem as appropriate; another group will absolutely forbid it. Which may be considered ethical and permitted by one cultural group while another group would consider it unacceptable?
Organ donation, Autonomy in decision making
Which of the components described below represent the Filipino culture? Select all that apply.
Orientation to the past is evident in their respect for elders. The family, rather than the individual, is the unit. Sharing is common since interdependence is important.
The city police department has had to make significant budget cutbacks and have been forced to decrease their workforce. The nurse has seen in increase in injuries caused by violent crimes in the emergency department. What would be a priority nursing diagnosis for this issue?
Other-Directed Violence related to insufficient police protection
etic worldview
Outsider's perspective
A nurse at a health care clinic is preparing to examine a Hispanic child who was brought to the clinic by the mother. During assessment of the child, the nurse should avoid which action?
Overly admiring the child
A nurse is caring for a patient from Taiwan who constantly requests pain medication. What should the nurse consider when assessing the patient's pain?
Pain is what the patient says it is.
The nurse is preparing to assess a pregnant patient who is a member of a non-English-speaking culture. Which areas should the nurse assess to address cultural diversity? (Select all that apply.)
Pain, Time, Touch, Communication
An example of a culture where a male relative will regularly decline to observe the birth process is:
Pakistani
As a novice nurse caring for a patient from a different culture, what may you find confusing or upsetting?
Patient's nonverbal communication
Which is a form of nonverbal communication? Select all that apply.
Patting the back, Crying, Smiling, Crossed arms
How can a nurse determine if the members of a community are involved in the government and political structures?
Percentage of registered voters that actually vote
Which stereotypical ideas about older adult clients does the nurse associate with the concept of ageism?
Physically impaired, Burdensome to family, Uninterested in intimacy
A nurse is assessing an Asian client and observes several reddened and bruised areas on the skin. Further assessment reveals that the client was using cupping to treat back pain. The nurse understands this as which of the following?
Placing heated glass jars on the skin that are allowed to cool
The nurse plans to do dietary teaching with an African-American client. The nurse focuses the plan based on which foods that are characteristically consumed by individuals of this culture? Select all that apply.
Pork, Fried Foods, & greens
The nurse plans to do dietary teaching with an African-American client. The nurse focuses the plan based on which foods that are characteristically consumed by individuals of this culture? Select all that apply
Pork, greens, fried foods
The nurse is implementing the complementary therapy of therapeutic touch when caring for clients. The nurse should implement which action when performing therapeutic touch?
Position hands 2 to 4 inches from the body.
Which reaction on the part of the nurse is reflective of the "surface adjustment stage" of cultural adaption?
Possessing a basic understanding of what is expected.
A Native American/First Nations client comes to a new clinic. The client has been to multiple clinics. The client uses peyote as part of his religion. Past care providers have dismissed the client's concerns as being imaginary. What is the priority nursing diagnosis?
Powerlessness related to the inability to make heath care providers understand his symptoms
A Native American/First Nations client comes to a new clinic. The client has been to multiple clinics. The client uses peyote as part of the client's religion. Past care providers have dismissed the client's health concerns as being imaginary. What is the priority nursing diagnosis?
Powerlessness related to the inability to make heathcare providers understand the client's symptoms
The nurse identifies low-risk therapies to a client and should include which therapies in the discussion? Select all that apply.
Prayer, Touch, Massage, Relaxation
The nurse identifies low-risk therapies to a client and should include which therapies in the discussion?
Prayer, touch, massage, & relaxation.
Which patient data will the nurse consider while preparing a care plan for a Jehovah's Witness patient?
Preferences
Is an adverse judgment or opinion formed beforehand or without knowledge or examination of the facts.
Prejudice
An emergency department nurse is caring for a patient who was severely injured in a car accident. The patient's family is in the waiting room. They are crying softly. The nurse sits down next to the family, takes the mother's hand, and says, "I can only imagine how you're feeling. What can I do to help you feel more at peace right now?" In this example the nurse is demonstrating:
Presence
It is determined that an older, widowed client is a member of a familistic culture. Which intervention is best directed toward communicating effectively with the client?
Presenting information related to possible treatment modalities to the entire family.
cultural competence
Process in which the health care professional continually strives to achieve the ability and availability to work effectively with individuals, families, and communities
acculturation
Process of adapting to and adopting a new culture
Culture care restructuring or repatterining
Professional actions and decisions that help patients reorder, change, or modify their lifestyles toward new, different or more beneficial health care patterns
Cultural care accommodation
Professional actions and decisions that nurses make on behalf of those in their care to help people of a designated culture achieve a beneficial or satisfying health outcome
When providing nutritional education for a Mexican-American patient with newly diagnosed hypertension, the nurse notes that the patient is nodding "yes" to everything that is being said. With a better understanding of cultural interdependence, a nurse should immediately
Prompt the patient further to elicit additional questions or concerns.
During a family assessment, a teenage girl alludes to the fact that her grandfather used to touch her in a sexual manner. What is the nurse's primary responsibility when learning this information?
Promptly report the allegations to authorities.
The nurse is conducting an admission assessment on an African-American client scheduled for a hernia repair. Which assessment data are of least priority during the initial assessment?
Psychosocial assessment data
The nurse is conducting an admission assessment on an African-American client scheduled for a hernia repair. Which assessment data are of least priority during the initial assessment?
Psychosocial assessment data.
This model is an organizing framework of 12 domains as well as the primary and secondary characteristics of culture, which determine the beliefs, values, and practices of an individual's cultural heritage.
Purnell Model for Cultural Competence
To promote sound clinical reasoning, your nursing assessments should be
Purposeful, Prioritized, Complete, Systematic, Factual and accurate, Relevant, Recorded in a standard manner
Which statement best conveys the relationship between race and ethnicity?
RACE denotes PHYSICAL characteristics while ETHNICITY is rooted in a common HERITAGE.
Which statement best conveys the relationship between race and ethnicity?
Race denotes physical characteristics while ethnicity is rooted in a common heritage.
Which statement best conveys the relationship between race and ethnicity?
Race denotes physical characteristics, while ethnicity is rooted in a common heritage.
A black client refuses to allow any health care worker of Asian descent to provide care. This client is demonstrating what practice?
Racism
Implies that superior or inferior traits and behaviors are determined by race
Racism
What is the best way to provide spiritual care to a 2-year-old patient?
Read a childhood story about good vs evil.
Which action by the nurse is essential to providing culturally congruent care?
Recognize one's own personal cultural heritage, patterns, and biases.
What is the most important aspect of providing spiritual care in nursing practice?
Recognize situations and patient behaviors indicating a spiritual need.
What response is most appropriate for the nurse if a patient prefers to seek acupuncture for pain relief before taking prescribed medication?
Recognize that alternative forms of treatment can be effective.
If a patient's primary language differs from that of the health care professionals providing care, which action is most appropriate for the nurse to take?
Recognize that continuous affirmative answers by the patient require verification of understanding.
In addition to understanding the culture of the client, what other actions are required to provide culturally competent nursing care? Select all that apply.
Recognizing one's own culture and biases & Recognizing the culture of the healthcare system
The nurse is providing diabetic diet teaching to a Hispanic man and his wife. When the nurse is discussing foods that are acceptable, the wife continues to interrupt with statements like, "Oh, he doesn't eat that," or, "All he eats is rice and beans." What should the nurse do?
Refer the patient and his wife to a dietitian familiar with Spanish food choices.
The ambulatory care nurse is discussing preoperative procedures with a Japanese American client who is scheduled for surgery the following week. During the discussion, the client continually smiles and nods the head. How should the nurse interpret this nonverbal behavior?
Reflecting a cultural value.
Following a surgical procedure, an older Chinese woman refuses to perform the range of motion and breathing exercises requested, in addition is hesitant to complete her hygienic care and grooming. The nurse recognizes that this is most likely related to:
Reliance upon family members to assist with care
A patient asks the nurse if there are church services in the hospital because the patient attends mass every Sunday. The nurse realizes that this patient is demonstrating:
Religion
Which statement, made by a nurse caring for a culturally diverse population, regarding spiritual assessments, demonstrates the need for future education?
Religion is a private matter and difficult to assess
When a Navajo Indian client dies, it is important for the nurse to recognize that the family will be:
Reluctant to touch the body because of a belief in evil spirits
Despite significant improvements in the overall health status of the U.S. population over the past few decades, disparities among ethnic and racial minorities have
Remained a serious challenge locally and nationally.
A geriatric client is observed smoking a cigarette and lowering the oxygen nasal prongs away from the nostrils. Which is the priority action of the nurse?
Remind the client to avoid smoking during oxygen therapy
A patient states, "My religion does not permit me to bathe today." What would be the most appropriate nursing action?
Request a clarification of the patient's beliefs and adapt a plan for bathing accordingly.
A nurse is assigned the care of a client who speaks only Arabic. The nurse does not know the language. What action is appropriate for the nurse in this case?
Request a professional interpreter.
A nurse is providing care to a Hispanic client who is terminally ill. Numerous family members are present most of the time, and many of the family members are very emotional. What is the appropriate action?
Request permission to move the client to a private room and allow the family members to visit.
The nurse is interviewing a female Hispanic client who is scheduled for a cardiovascular education program. The client states, "I can't eat and I don't sleep because my daughter left to return to Mexico. I am sad and nervous. I need rest." The nurse suspects that she is suffering from susto. Which action by the nurse would be best?
Reschedule the education program
You have a patient who has been diagnosed with terminal brain cancer. You notice the family bringing in Catholic medallions and icons to put around the patient as they are dying. What would be the nurse's reaction? Select all that apply
Respect the family's beliefs and do not disturb the icons and medallions & Assess the family's religious needs on admit determining the need for clergy
An older Chinese woman is admitted to the hospital after a hip fracture. The nurse encourages the patient to walk about the room; however, the patient refuses to walk without her son. Which action by the nurse is culturally congruent?
Respect the patient's wish and ask her to walk when her son is present.
While preparing a client for surgery, a nurse discovers that the client's view about spirituality is entirely different from hers. What is the most appropriate action by the nurse?
Respect the privacy of his spiritual beliefs and rituals
Which intervention demonstrates integrative nursing care?
Respecting a client's wish to have his or her minister accompany him or her to the operating room.
The nurse overhears a colleague state, "All people from that client's country are rude." What is the appropriate nursing response?
Respond by saying, "Stereotypes keep us from accepting others as unique individuals."
In teaching a patient with present time orientation, the nurse should consider which of the following?
Result in the patient's attending to other events that are happening rather than focusing on times medication should be taken.
A nurse cares for a client who practices Hinduism. The nurse understands that Hindus believe illness is caused by which type of behavior?
Result of past and current life actions
The nurse consults with a nutritionist regarding the dietary preferences of an Asian-American client. Which food should be included in the dietary plan?
Rice
The nurse consults with a nutritionist regarding the dietary preferences of an Asian-American client. Which food should be included in the dietary plan?
Rice.
When considering the various cultural aspects associated with death rituals, which of the following should guide a nurse's practice?
Rituals for burial and bereavement are likely to reflect original cultural practices
When considering the various cultural aspects associated with death rituals, which of the following should guide a nurse's practice?
Rituals for burial and bereavement are likely to reflect original cultural practices.
A common factor among many of the major denominations in the united states and Canada is their willingness to be involved with providing healthcare, especially to those who need it the most. What denomination is recognized for being one of the major contributors to healthcare?
Roman Catholic
Which notion best demonstrates that the nurse is respectful of a client's spiritual and religious beliefs?
Rosary beads were sent to the diagnostic lab attached to the client's hospital gown
The client in a rehabilitation unit is having a difficult time adjusting to the scheduled activities on the unit, as well as being dependent on others for meals and medications. Which word best describes what the client is experiencing?
SHOCK
A nurse must perform a nonformal spiritual assessment of a client. Which tool would be most appropriate for the nurse to use?
SPIRIT assessment tool
When evaluating a community's education, which of the following would the nurse use to identify the effectiveness of the community's school system?
Scores on standardized tests
During the assessment of a Caucasian client with wax accumulation in the ear, the nurse observes that the earwax is wet. The nurse recognizes that this is related to what physiologic variation among racial groups?
Secretions produced by apocrine glands are based on genetic traits.
What intervention should be initiated first by a nurse assigned to care for a culturally diverse patient admitted with significant body odor?
Seek information to determine the underlying cause of the body odor.
The nurse is caring for a member of the Jewish faith who needs to undergo a critical procedure on Saturday. The patient is refusing the procedure because it is scheduled to be done on the Sabbath. The nurse impresses on the patient the urgency of the procedure, stating that delaying the procedure would put his life at risk. The patient continues to refuse. What should the nurse do?
Seek permission from the patient to contact the patient's rabbi.
Which is an example of multilateral health care aid?
Sending the hospital ship HOPE to Japan to provide post-earthquake health care.
A nurse is assessing a community's environmental protection. The nurse should address which of the following?
Sewage treatment facilities
A nurse is assessing a client who recently immigrated to the United States from Kenya. When the nurse asks the client her reason for coming to the health clinic, the client responds by saying, "bad blood." The nurse recognizes that the client is most likely referring to which of the following?
Sexually transmitted infection
ethnicity
Shared identity related to social and cultural heritage such as values, language, geographical space, and racial characteristics.
The nurse is assessing culture. What are the basic elements of culture? Select all that apply.
Shared, Learned, Symbolic, Integrated
A community health nurse is making a healthy baby visit to a new mother who recently emigrated to the United States from Ghana. When discussing contraceptives with the new mom, the mother states that she won't have to worry about getting pregnant for the time being. The nurse understands that the mom most likely made this statement because:
She won't resume sexual relations until her baby is weaned.
Regarding a client who is an Orthodox Jew and maintains a Kosher diet, the nurse will make sure that the client's menu does not include:
Shellfish
When performing a cultural assessment on a client from another country, what can a nurse do to ensure the client receives culturally sensitive care?
Show genuine interest in the client's culture and personal life experiences.
The nurse calls the dietary department to obtain a dinner meal for a White-American client who was admitted to the hospital at 4:00 PM. The health care provider prescribed a diet "as tolerated." Considering the practices and preferences of the White-American culture, which food should the nurse request for the meal?
Sirloin steak & potatoes.
The nurse calls the dietary department to obtain a dinner meal for a White-American client who was admitted to the hospital at 4:00 PM. The health care provider prescribed a diet "as tolerated." Considering the practices and preferences of the White-American culture, which food should the nurse request for the meal?
Sirloin steak and potatoes
A client has recently immigrated and is exhibiting symptoms of culture shock. The client reports feeling unaccepted in the new culture. The client states, "I can't do anything right here." What is the priority nursing diagnosis?
Situational low self-esteem related to culture shock and feelings of fear and incompetence
A nurse is determining the adequacy of long-term care services in a community. Which of the following are long-term care services that should be offered in a community? Select all that apply.
Skilled nursing care facilities. Rehabilitation centers. Assisted-living centers
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
Which strategy would most help an English-speaking nurse to communicate with a patient for whom English is a second language?
Slow down when speaking to articulate more clearly.
The nurse is conducting a health history of the patient who presents to the urgent care with complaints of shortness of breath. The nurse asks, "Who lives with you?" Which type of assessment is the nurse conducting?
Social assessment
To appropriately plan and implement care in the aging population, the nurse must assess
Social, cultural and family contexts
During the patient assessment, the client shares that the family attends church nearly every Sunday. Which function of the family does this represent?
Socialization
enculturation
Socialization into one's primary culture as a child
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 Catholic patient with diabetes receives the following items on his meal tray on the Friday before Easter. For which of the foods does the nurse offer to substitute?
Spaghetti with meat sauce
A Hispanic single parent is having difficulty finding employment due to a lack of a car and speaking primarily Spanish. Which factor is a barrier to health care?
Spanish as primary language
The nurse is caring for a client whose language skills are very limited in the dominant language, and an interpreter has been obtained. The interpreter appears to be telling the client more than the nurse is saying and possibly providing an opinion or medical advice. Which action is appropriate for the nurse to take?
Speak privately with the interpreter and instruct them to only provide language interpretation.
The nurse is caring for a 45-year-old woman who is a breast cancer survivor. What activity associated with her cancer experience will promote this patient's spiritual well-being?
Speaking about her cancer experience to increase breast cancer awareness
Which precautions does the nurse take while interacting with a patient from a different culture? Select all that apply.
Speaks with the patient in a slower speech pattern. Refrains from speaking loudly when with the patient. Asks questions and seeks feedback from the patient. Does not incorporate humor, jargon, and slang phrases
There are cultural context of health and illness differences in comparing Western versus non-Western cultures. The nurse is aware that in Western culture the overall treatment is:
Specialty-specific
The nurse is assessing a patient's ability to employ coping mechanisms when given a diagnosis of cancer. What type of assessment would be beneficial for the nurse to use?
Spiritual assessment
What is transcendence?
Spiritual growth over time
Within transcultural nursing, sensitivity to social organization is the recognition of the client's:
Status and expected role in the family
A newly hired young nurse overheard the charge nurse talking with an older nurse on the unit. The charge nurse said, "All these young nurses think they can come in late and leave early." What cultural factor can the new nurse assess from this conversation?
Stereotyping
Which nursing action acts as a barrier to the patient-nurse relationship?
Stereotyping
What spiritual practices would you incorporate in your care for an American Indian patient from a reservation?
Storytelling
Preparing for a career in global public health nursing requires more than just learning the basic nursing skills. Which can the nurse also do to prepare for a career in global public health and international nursing?
Studying the history of the area traveling to, Understanding community development theory, Understanding re-patterning
The school nurse is in the talking to a group of students about sexually transmitted diseases. One of the students says, "I know that most of the 10th grade has already had sex. There's drinking and parties, and this is where a lot of it happens." What type of data is the nurse collecting?
Subjective
Culture strongly influences pain expression and need for pain medication. However, cultural pain is:
Suffered by a patient whose valued way of life is disregarded by practitioners.
An older client is seen in the clinic for a physical examination. Laboratory studies reveal that the hemoglobin and hematocrit levels are low, indicating the need for further diagnostic studies and a blood transfusion. The client is a Jehovah's Witness and refuses to have a blood transfusion. The nurse should take which most appropriate action?
Support the client's decision not to receive a blood transfusion.
Which intervention is in accordance with the program priorities of the international committee of the Red Cross (ICRC)?
Supporting refugee camps in countries experiencing civil war
Which intervention is in accordance with the stated goal of the International Committee of the Red Cross (ICRC)?
Supporting refugee camps in countries experiencing civil wars.
Which factors are biological variations that should be assessed by the nurse when conducting a transcultural assessment? (Select all that apply.)
Susceptibility to illness & Body frame and structure & Existence of genetic disease
What are the characteristics of one's culture?
System of beliefs and practices
The nurse is examining a Hispanic-American child who was brought to the clinic by the mother. Which are appropriate nursing actions? Select all that apply.
Taking the child's temperature, Asking questions about the child, Obtaining an interpreter if necessary
The nurse is examining a Hispanic-American child who was brought to the clinic by the mother. Which are appropriate nursing actions? Select all that apply.
Taking the child's temperature. & Asking questions about the child. &Obtaining an interpreter if necessary.
The nurse is examining a Hispanic-American child who was brought to the clinic by the mother. Which are appropriate nursing actions? Select all that apply.
Taking the child's temperature. - Asking questions about the child. - Obtaining an interpreter if necessary.
A nurse who seeks to work as an international nurse can apply for positions with the World Health Organization (WHO). Which position is the nurse most likely to fill with WHO?
Technical advisor
ethnocentrism
Tendency to hold one's own way of life as superior to that of others
Which statement by the nurse demonstrates ethnocentrism?
That client needs to learn that pain is best managed with traditional medications like morphine."
The nurse is caring for a patient who claims to be an agnostic. What should the nurse understand about the patient's spiritual belief?
That existence of a God is not known
A family has immigrated and settled in a neighborhood that primarily speaks their native language. The nurse caring for this family recognizes that which family member will likely require the greatest amount of time to learn the dominant language?
The 45-year-old mother in the family who does not work outside the home
A family has moved from Spain to a primarily Spanish-speaking neighborhood near a large metropolitan area. The nurse caring for this family recognizes that which family member will likely require the greatest amount of time to learn the dominant language?
The 45-year-old mother in the family who does not work outside the home
A nurse caring for the Arab community observes a client crying. The woman was recently informed that her radiation treatments may affect her ability to become pregnant. The nurse recognizes that the client is most likely reacting to a cultural attitude regarding:
The Arab view that infertility is grounds for divorce
A blood glucose screening is most appropriate for which ethnic client?
The Hispanic male
The nurse is preparing a plan of care for a client who is a Jehovah's Witness. The client has been told that surgery is necessary. The nurse considers the client's religious preferences in developing the plan of care and should document which information?
The administration of blood and blood products is not allowed.
The primary problem with using English-speaking children of immigrant families as interpreters is that:
The adults may resent their dependence upon the child
The eudaimonistic model of health emphasizes:
The biopsychosocial and spiritual wellness of the person.
The nurse approaches the subject of organ donation with a terminally ill Buddhist client based on the understanding that:
The body holds no specific value to the Buddhist after death
The nurse approaches the subject of organ donation with a terminally ill Buddhist client based on the understanding that:
The body holds not a specific value to the Buddhist after death
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.
The younger nurses 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.
A new client comes to the primary care clinic and asks for help treating head lice. The nurse assesses that the client lives in low-income housing, and nine other people live with the client in a one-bedroom apartment. Which consideration is the priority nursing concern?
The client does not have running water.
The nurse is caring for several clients of different cultures. Which client situation would the nurse recognize as the client with highest risk of culture shock?
The client from Ethiopia states, "All these machines attached to me scare me and I need to get them off.".
A nurse is assisting in developing a postoperative plan of care for a Filipino-American client scheduled for surgery. The nurse should consider which factors when addressing pain? Select all that apply.
The client has a high tolerance to pain & Pain medication needs to be offered on a regular basis as prescribed.
A nurse is assisting in developing a postoperative plan of care for a Filipino-American client scheduled for surgery. The nurse should consider which factors when addressing pain? Select all that apply.
The client has a high tolerance to pain. -Pain medication needs to be offered on a regular basis as prescribed.
Which statement, made by a nurse caring for a client diagnosis with an aggressive form of cancer, best demonstrates the principle of veracity?
The client is aware of the risks of taking the experimental chemotherapy medication
A Native-American man comes to the clinic for a physical examination. When asked about his mental status, the client acknowledges that he has had visions of his deceased brother and speaks to him when he needs counsel. Which best describes the nurse's assessment of this client behavior?
The client is demonstrating behavior that may be regarded as normal within his culture.
The nurse is bathing a hospitalized Native-American client and notes that the client avoids eye contact during the procedure. The nurse should make which interpretation concerning the client's behavior?
The client is displaying behavior that is a common cultural action.
The nurse is assessing a client for pain and suspects that the client's culture may be affecting the pain response. What nonverbal assessment would the nurse expect?
The client is holding pressure on the abdomen when speaking.
The nurse is assessing a client for pain and suspects that the client's culture may be affecting the pain response. What nonverbal indicator of pain would the nurse expect to observe?
The client is holding pressure on the abdomen when speaking.
. A clinic nurse is conducting a comprehensive assessment of a 70-year-old male client of Native American ethnicity. The nurse observes that the client rarely makes eye contact and holds his head low during the assessment. How should the nurse best interpret this practice?
The client may be showing the nurse respect.
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.
The nurse is reviewing the plan of care with an Asian-American client. The client frequently nods the head during the review. The nurse should interpret this behavior as which indication?
The client may not necessarily agree with the plan.
A female Asian client is admitted to the emergency department with a fractured femur. What cultural factor might affect client care?
The client may not report pain.
The home health nurse is conducting a health history interview with a client that immigrated from Mexico 3 months ago. What action observed by the nurse would indicate that the client is adapting to the majority culture?
The client reads books in the language of the new country.
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."
A client is seeking care at the local clinic. The nurse is completing a cultural assessment. Which scenario would demonstrate cultural assimilation?
The client's child learned the dominant lanuguage as a second language.
A Hispanic woman is seeking care at the local clinic. The nurse is completing a cultural assessment. Which scenario would demonstrate cultural assimilation?
The client's daughter, who is with her, learned the dominant language as her second language.
A Hispanic woman is seeking care at the local clinic. The nurse is completing a cultural assessment. Which scenario would demonstrate cultural assimilation?
The client's daughter, who is with her, learned the dominant lanuguage as her second language.
When conducting a client's spiritual assessment, the nurse should observe the actions of the client as well as note the client's answers. which would be an indication of the client's possible spiritual and religious beliefs?
The client's visitors who are not family members - The type of reading material the client brought to the unit - The practice of any specific rituals used throughout the day when possible - The client is quiet and reserved and has no visitors
Which is the basis to support the need for transcultural nursing in a health care setting that serves a multicultural metropolitan community?
The diversity seen in the values, beliefs, behaviors, as well as physical and mental characteristics of the client population.
Which statement is true relative to caring for a Hindu patient who is dying?
The family will place a drop of water on the patient's lips.
An older adult woman of Chinese ancestry refuses to eat at the nursing home, stating, "I'm just not hungry." What factors should the staff assess for this problem?
The food served may not be culturally appropriate.
What is the basis for assessing the economic status of a culturally diverse client population as a factor affecting the delivery of individualized health care services?
The general health of the members of the lower socioeconomic classes is poor.
A nurse experienced in doing community assessments realizes that the following is true regarding education?
The higher the community's education level, the healthier the community.
While evaluating the health history, the nurse determines that the patient subscribes to the hot/cold theory of health. Which of the following will most likely describe this patient's view of wellness?
The humors must be balanced.
A home health nurse is visiting a 60-year-old patient. During the initial visit, the patient's husband answers all of the questions. What would the nurse assess based on this behavior?
The husband is the dominant member of the family.
Which is the primary outcome of the indiscriminate use of the emergency department by the uninsured members of the community?
The ill postpone treatment that results in the lack of early treatment interventions
Which is the primary outcome of the indiscriminative use of the emergency department by the uninsured members of a community?
The ill postpone treatment that results in the lack of early treatment interventions.
Which outcome of a free market economy has the greatest negative impact on the delivery of health care services?
The inability of the working poor to process adequate health insurance.
Which consideration is the basis for the selection of an interpreter for an older client who has a limited ability to speak and understand English?
The interpreter should ideally be of similar age and of the same gender as the client.
The nurse is caring for a client who speaks a differnt language than herself and is using an interpreter to communicate. What would be the best way to choose an interpreter for this client?
The interpreter should understand the health care system.
The nurse is using an interpreter to communicate with a client who speaks a different language. What would be the best way to choose an interpreter for this client?
The interpreter should understand the health care system.
Which cultural fact will be the basic force to manage when assessing a perimenopausal woman of a non-American culture?
The larger the number of females in the client's extended family, the more menopausal symptoms she will report.
A nurse is working with a Native American child. When the nurse advises the mother to return her child to the clinic in 2 weeks, the woman is vague about her ability to do so. The nurse is annoyed at the mother's apparent lack of concern about her child. What information does the nurse manager share with this nurse?
The nurse and the mother have different time orientations.
The nurse needs to be aware of how the nurse's cultural beliefs may dictate that a certain action is wrong but the culture of the client may believe that particular actions are acceptable, When these disagreements present an ethical dilemma, the nurse must make a decision as to how to proceed. Which must the nurse keep in mind when making the decision of how to proceed?
The nurse has certain standards to maintain
The nurse includes pork in the diet of a patient of Middle Eastern descent. The patient is offended and informs the nurse that the pork will not be eaten. Which statement explains the nurse's behavior?
The nurse has failed to plan culturally congruent care
A Muslim patient refuses to eat the pork that was served on his dinner tray. Which statement offers an explanation for this?
The nurse has failed to plan culturally congruent care.
A patient tells the nurse, "I don't want any Western medicines because they contain too many chemicals. I prefer folk medicine because it has no side effects." The nurse informs the patient that all folk medicine is harmful because it contains poisonous herbs. Which statement describes the nurse's behavior?
The nurse lacks cultural competence.
A patient tells the nurse, "I don't want any Western medicines because they contain too many chemicals. I prefer folk medicine because it has no side effects."The nurse informs the patient that all folk medicine is harmful because it contains poisonous herbs. Which statement describes the nurse's behavior?
The nurse lacks cultural competence.
Transcultural nursing is a specialty and formal area of practice. Which statements apply Dr. Madeleine Leininger's theory of Culture Care Diversity and Universality to nursing practice? Select all that apply.
The nurse objectively assesses personal beliefs prior to the provision of culturally competent care. - The nurse consults clergy for assistance in the provision of care. - The nurse carefully assesses the decision maker in the care environment. - The nurse will accommodate cultural dietary preferences as much as possible.
A nurse in a large metropolitan city enjoys working in a health clinic that primarily serves Hispanic patients. What does this statement imply about the nurse?
The nurse respects and values providing culturally competent care.
The nurse is preparing to provide preoperative teaching to a Spanish-speaking client and the client's family. Which nursing action would be most effective for teaching the client?
The nurse secures the assistance of a professional interpreter to communicate with the client
The nurse is preparing to provide preoperative teaching to a Spanish-speaking client and the client's family. Which nursing action would be most effective for teaching the client?
The nurse secures the assistance of a professional interpreter to communicate with the client.
A client reports to the primary health care facility for routine physical examination after cardiac rehabilitation following myocardial infarction. Keeping in mind that the client is Latino, how should the nurse conduct the interview?
The nurse should avoid using medical terminology.
Family members have brought food to the room of a woman who delivered a baby boy earlier that day. The nurse is invited to eat the food and participate in the celebration of the birth. Which action should the nurse take?
The nurse should eat food of personal liking and rejoice in the family's celebration.
A nurse is caring for a Native American/First Nations woman who is receiving chemotherapy for breast cancer. Which nursing action is the best example of providing culturally sensitive care?
The nurse uses a low tone of voice when explaining the care plan to the client.
Which statement serves as a basis for preparing to engage in international nursing regarding one's acceptance by the local population of the host country?
The nurse will be accepted as a visitor and treated as such.
A nurse is preparing to travel to Southeast Asia to work at a local health care clinic in a small town. As the nurse prepares to go, which will be important for the nurse to remember while working in this other culture?
The nurse will be collaborating with peers
Which example below best characterizes a patient's race?
The patient and his family have blonde hair and fair skin.
An elderly woman has been admitted to the hospital for the treatment of an acute illness and has received only one visitor in the several days since admission. The student nurse asks the patient about her relationship to this individual and the patient states, "In reality, she's my best friend but I consider her to be my family, even though I have a daughter somewhere." What foundational belief of family nursing should most influence the student's interactions with the patient?
The patient can define who is and who is not part of her family.
A patient of Islamic faith is being educated on a new diagnosis of diabetes mellitus. The patient asks no questions during or after the session. What does the nurse understand may be the reason for the patient not asking questions?
The patient considers asking questions of the nurse a sign of mistrust in her abilities.
ANA Standards of Practice: Standard 1 Assessment
The registered nurse collects comprehensive data pertinent to the patient's health or the situation.
The nurse is caring for a patient who follows the Hindu religion and holds karma responsible for the illness. What is karma?
The result of past behaviors
Which of the following is true regarding language barriers and health care?
There are laws addressing language barriers and health care.
Which is a cultural norm of the health care system?
There is the use of a systematic approach and problem-solving methodology.
A nurse in the hospital is caring for a Native American/First Nations male. Which statement should best guide the nurse's care?
There may be a role for a tribal medicine man in the client's care.
A nurse is working with a 22-year-old woman of Asian ethnicity who has been diagnosed with bipolar disorder. When planning culturally appropriate care, the nurse should consider which of the following?
There may be shame associated with having a psychiatric disorder.
A nurse is caring for a Navajo client who is hospitalized due to pneumonia. Based on their culture, which of the following is believed to be the cause of the illness?
They have a spiritual imbalance
A nurse is planning to instruct the Hispanic-American client about nutrition and dietary restrictions. When developing the plan for the instructions, the nurse should include which information for this ethnic group? Select all that apply.
They have difficulty adhering to a prescribed diet. - They view food as a primary form of socialization. - They enjoy food that is rich in color, flavor, and texture.
A nurse is planning to instruct the Hispanic-American client about nutrition and dietary restrictions. When developing the plan for the instructions, the nurse should include which information for this ethnic group? Select all that apply.
They have difficulty adhering to a prescribed diet. - They view food as a primary form of socialization. -They enjoy food that is rich in color, flavor, and texture.
The nurse is planning to instruct a Hispanic-American client about nutrition and dietary restrictions. What factors should the nurse keep in mind when developing this client's plan of care? Select all that apply.
They view food as a primary form of socialization & Any occasion is seen as a time to celebrate with food.
The nurse is planning to instruct a Hispanic-American client about nutrition and dietary restrictions. What factors should the nurse keep in mind when developing this client's plan of care? Select all that apply.
They view food as a primary form of socialization. - Any occasion is seen as a time to celebrate with food.
The new nurse is caring for a client of Asian descent. What should the nurse expect when caring for this client?
This client will require the nurse to keep an arm's length distance.
A 40-year-old nurse is taking a health history from a 20-year-old Hispanic man and notes that he looks down at the floor when he answers questions. What should the nurse understand about this behavior?
This is culturally appropriate behavior.
A pregnant patient from a nondominant culture arrives 2 hours late for a scheduled sonogram. What does this patient's behavior indicate to the nurse?
Time orientation may be different for the patient's culture.
Why would a nurse apply generalizations while assessing a patient?
To anticipate certain patient behaviors
assimilation
To become absorbed into another culture and adopt its characteristics
In working with a Japanese woman, a nurse assesses the environment and high-risk behaviors associated with this client's cultural group. Why is it important for the nurse to take these factors into account?
To find clues to the current health status of an individual
The nurse is caring for an Eastern Orthodox client. During Lent, the nurse should offer the client which dietary choice?
Tossed green salad
The nurse is caring for an Eastern Orthodox client. During Lent, the nurse should offer the client which dietary choice?
Tossed green salad.
Enables us to view view our profession from a cultural perspective.
Transcultural Nursing
The nurse is admitting a bed-bound patient who is a practicing Muslim. Acting as an advocate for the patient and demonstrating cultural sensitivity, what arrangements should the nurse make?
Transfer the patient to a room that faces east.
A nurse is teaching a novice nurse how to provide culturally competent care to patients in a culturally diverse community health clinic. Although all of the following are important to providing culturally competent nursing care, which one is most basic?
Treating each patient at the clinic as an individual
Collectivism beliefs need to maintain group harmony above interests of individuals.
True
In individualism importance is placed on inputs, rights, and rewards. Emphasize autonomy, competitiveness, achievement, and self sufficiency.
True
The components of community include social structure, political structure, and religious structure
True
To determine the sources of strength for a patient, the nurse could ask, "In what ways do they help?"
True
Ethical Dilemma
Two or more clear moral principles apply but support mutually inconsistent courses of action
Blood groups are said to differentiate people in different racial groups. You have a 29 year old American Indian client admitted to your unit with diabetes. Based on what you know about American Indians, you might expect the patients blood type to be which of the following?
Type O
Research has been used to show where changes needed to be made and how to better meet the needs of various cultures within the health care realm. For cultures where family ties are extremely close and very important for social events, how has moving to the United States affected some of the traditions of Pakistani women?
Unable to feed "Ghutti" to the newborn at the hospital
A Navajo patient is receiving dialysis for kidney failure. The nurse overhears him talking about his peyote use which he thinks will heal his spirit and therefore is kidneys. What do you do?
Understand the Navajo holistic belief system and allow him to continue
The nurse is caring for a client who is terminally ill and recently immigrated to the country. The nurse understands that in order to provide quality end-of-life care for the client, what would be the PRIORITY action by the nurse?
Understand the client's personal and cultural views regarding death and dying.
The nurse is caring for a client who is terminally ill and recently immigrated to the country. The nurse understands that in order to provide quality end-of-life care for the client, what would be the priority action by the nurse?
Understand the client's personal and cultural views regarding death and dying.
Which nursing behaviors indicate culturally competent care?
Understanding that there is diversity even among people of the same cultural group
When assessing an Asian client, the best way to obtain information is to:
Use an interesting approach to get information.
The nurse develops a plan of care for a Native-American client. The nurse identifies which practices and preferences as characteristic of this ethnic group? Select all that apply.
Use of religion Avoiding eye contact Use of spiritual practices Use of healing practices
The nurse develops a plan of care for a Native-American client. The nurse identifies which practices and preferences as characteristic of this ethnic group? Select all that apply.
Use of religion, Avoiding eye contact, Use of spiritual practices, & Use of healing practices.
A client was recently admitted to the intensive care unit following an acute gastroesophageal bleed. His native language is Spanish, and he use of the dominant language is limited. When speaking with the client, it is important that the nurse remembers to do what? Select all that apply.
Use simple sentences. Use interpretive services when communicating client instructions for discharge. Rephrase a question if the client's response does not match the original inquiry.
Which nursing actions are appropriate when collecting a health history for a client whose primary language differs from the dominant language? Select all that apply.
Use the facility telephonic interpreting system. Have a bilingual nurse assist with the health history. Request assistance from a certified interpreter.
The nurse is caring for a Native American who has had recent surgery. In the patient's culture, it is a sign of weakness to complain of pain. In the nurse's culture, people who are having pain ask for pain medicine. The nurse has assumed that the patient has not been having pain and does not need medication because he has not complained of pain. What is the nurse doing?
Utilizing cultural imposition by not asking the patient about his pain
For a client who is a Buddhist and maintains a traditional diet, the nurse will make sure that a sufficient quantity of which of the following is included in the menu?
Vegetables
The nurse is planning the menu for an Asian-American client in collaboration with the hospital dietitian. The meal plan is designed to incorporate which food as a usual component of an Asian diet?
Vegetables
The nurse is planning the menu for an Asian-American client in collaboration with the hospital dietitian. The meal plan is designed to incorporate which food as a usual component of an Asian diet?
Vegetables.
What common and alternative medicines are used among Asian Indians? Select all that apply
Vegetarian diet, Herbal supplements, Ayurveda
The nurse is planning to instruct the Hispanic-American client about nutrition and dietary restrictions. When developing the plan, the nurse is aware that which is a characteristic of this ethnic group?
Views food as a primary form of socialization
An Arab woman arrives in the emergency department reporting vaginal bleeding. It is determined that the client is 5 months pregnant with her second child and has had no prenatal care. The nurse realizes that the most likely reason for this lack of health care is that the client:
Views pregnancy as a normal life event
Which behavior supports the nurse's evaluation that an older client is successfully engaged in "active aging"?
Volunteering at the local elementary school as a classroom helper
Which behavior supports the nurse's evaluation that an older client is successfully engaged in "active aging"?
Volunteering at the local elementary school as a classroom helper.
The nurse on the elective surgery floor receives a report that describes the client's abdominal wound dressing as having a moderate amount of yellowish and bloody drainage on it and a very foul smell. In planning for a dressing change, it is most important for the nurse to perform which action?
Wash her hands before and after the dressing change.
Which is the primary criticism for using standardized printed history forms when assessing the culturally diverse client population?
Western medicine's signs and symptoms are not always recognized as such by other cultures.
The nurse is conducting a spiritual needs assessment in an effort to create a nursing care plan for a client. The nurse recognizes that which questions will assist the nurse in understanding this client's religion?
What do you believe your punishment will be if you do something wrong?
Which of the following would be most appropriate for the nurse to ask when beginning to assess a client's spirituality?
What gives you hope or peace?
A 65 year old Filipino man diagnosed with Type 2 Diabetes Mellitus is being discharged home. The nurse provided discharge instructions regarding ways to best manage his blood glucose level. After providing education which statement made by the patient indicates that teaching was successful?
When I am shopping for groceries, I will make sure to buy foods that are high in protein, omega fat, complex carbs, and fiber
Which nursing intervention demonstrates an understanding of the full scope on culturally sensitive nursing care?
When planning a teenaged focused educational program on sexuality, both homosexual and heterosexual lifestyle choices are discussed
The nurse is conducting a spiritual needs assessment with a newly admitted client to the unit. Which question would be the appropriate approach to determine this client's culture?
When you need strength or hope, who or what do you turn to?
Your patient is a 25-year old female of Mexican descent. She was recently diagnosed with Type II Diabetes Mellitus and is preparing for discharge. You are preparing to provide education about proper diet. She writes out a list of her favorite foods. Which food would you explain to her is best to avoid?
White Rice
In which of the following populations should the nurse carefully assess the patient's use of over-the-counter medications?
White middle class
A hospice nurse recognizes that the client is closer to death and prepares to follow through on the care plan that was already developed. As this has already been discussed with the family, the nurse is prepared to take the appropriate steps to support the family during this difficult time. What is that most appropriate question for the nurse to ask?
Who would you like me to call when it appears death is imminent?
The nurse educator asks a student to list the five categories of complementary and alternative medicine (CAM), developed by the National Center for Complementary and Alternative Medicine. Which statement, if made by the nursing student, would indicate an understanding of the five categories of CAM?
Whole medical systems, mind-body medicine, biologically based practices, manipulative and body-based practices, and energy medicine
A nurse is assessing a community's formal and informal means of communication. Which of the following are examples of informal means of communication? Select all that apply.
Word of mouth. Newsletters. Bulletin board notices. Fliers distributed door-to-door
list three complementary and alternative practices for pain.
Yoga, Acupuncture, Imagery
Social justice related to healthcare is best demonstrated when:
a client reporting chest pain is seen immediately by an emergency room physician
A community health nurse is providing care to a group of Hispanic people living in an area that is heavily populated by white people. What are the Hispanic people in this community an example of?
a minority
Spirituality is defined as:
a personal effort to find meaning and purpose in life.
A Catholic priest baptizes a stillborn baby of a Catholic family. What type of practice is this considered?
a ritual
What is the priority assessment for the nurse when developing a plan of care for a client living in poverty?
access to care
Which of the following is required in the delivery of culturally congruent care?
acquiring specific knowledge, skills, and attitudes
validation
act of confirming or verifying
ethical distress
acting in a manner that is contrary to personal and professional values When the nurse knows the right thing to do but either personal or institutional factors make it difficult to follow the correct course of action
Which of the following best represents the dominant values in American society on individual autonomy and self-determination?
advance directive
primary source
an account of an event created by someone who took part in or witnessed the event
time-lapsed assessment
an assessment that is scheduled to compare a patient's current status to baseline data obtained earlier
biculturalism
an individual identifies equally with two or more cultures
Variable that can negatively influence an interview
anxiety, pain, language, previous negative experiences, unrealistic expectations
A nurse is validating assessment findings with a client, and the client proceeds to describe some of the psychological and spiritual components that she believes underlie her disease process. This understanding of the cause of illness is most closely associated with which of the following?
asian cultures
The nurse at an outpatient clinic asks a patient who is Chinese American with newly diagnosed hypertension if he is limiting his sodium intake as directed. The patient does not make eye contact with the nurse but nods his head. What should the nurse do next?
ask the patient how much salt he is consuming each day
Which behaviors demonstrated by the client would the nurse consider as reflection of the client's pride in ethnicity?
asking to wear person unique clothing, requesting native cuisine, listening to folk music and dance
A nurse is conducting an ethnographic interview with a client. Which step would the nurse do first?
asks an open-ended, general question
What does the entire nursing process rest upon?
assessment and ongoing assessment
When providing culturally competent care to clients, a nurse understands that cultural competence involves which characteristics? Select all that apply.
awareness of one's own influences on responses knowledge of influences on the clients' beliefs a commitment to promoting health equity
A nurse is performing nutritional assessments of new residents of a long-term care facility. Which resident would the nurse assess as being at greater risk for having lactose intolerance?
black male
Which stereotypical ideas about older adult clients does the nurse associate with the concept of ageism? Select all that apply.
burdensome to family, physically impaired, uninterested in intimacy
the 4 C's of a cultural assessment
call, cause, cope, concern
A nurse who provides care in a busy, inner-city clinic performs physical examinations on clients of various cultures. In a client from which group would the nurse expect to find the greatest amount of body odor from perspiration?
caucasian
2. What meal would be appropriate for an Islamic and Arabic individual who is low in iron?
chicken, spinach salad, and juice
A father, mother, grandmother, and three school-aged children have immigrated to the United States from Thailand. Which member(s) of the family are likely to learn to speak English more rapidly?
children
The nurse is preparing a client for cancer chemotherapy treatment. While talking with the client, she says, "miracles do happen and I'm praying for one." The nurse interprets this statement as suggesting which religious preference?
christianity
A nurse is conducting a cultural assessment of a client. Which person would the nurse identify as the expert?
client
Nurses are responsible for delivering culturally competent care for all clients. Culturally competent care does not account for:
client's height.
Observation
conscious and deliberate use of the five senses to gather data
A nurse is providing care for a Cambodian patient. The nurse says, "You have to get up and walk whether you want to or not." What is this statement an example of?
cultural imposition
During their clinical post-conference meeting, several nursing students were discussing their patients with their instructor. One student from a middle-class family shared that her patient was homeless. This is an example of caring for a patient from a different:
culture
The emergency department nurse is caring for a client injured in a motor vehicle collision. The client recently immigrated to the country. The nurse should implement interventions aimed at addressing which issue?
culture shock
A nurse is assessing a community of Native Americans. One important piece of health-related information that the nurse should obtain is the incidence of
diabetes mellitus.
When action is taken on one's prejudices:
discrimination occurs
A nurse is assessing an African-American client who has a longstanding diagnosis of hypertension. The nurse should be aware that the client may experience a greater-than average effect of what medication?
diuretic
A nurse is assessing a client of East Asian descent. Which biological variation would the nurse expect?
dry cerumen in the client's ears
which intervention is an example of health promotion with a focus on social justice
educating a Hispanic client to the social service programs he or she is qualified for
A 6-month old child from Guatemala was adopted by an American family in Indiana. The child's socialization into the American midwestern culture is best described as
enculturation
When a home-bound client expresses her past-oriented ancestral heritage and family rituals, the nurse recognizes that the client is expressing:
ethnic identity
When a home-bound client expresses the client's past-oriented ancestral heritage and family rituals, the nurse recognizes that the client is expressing:
ethnic identity.
The nurse is caring for two clients with the same ethnic background. The nurse notices some differences between the two in the religious practices and the slang used for communicating. What is most likely the etiology of these differences?
ethnicity
What factor threatens to increase the number of people who are living at poverty level?
feminization of poverty
Which area is typically included in a cultural assessment?
food preferences
How is culture learned by each new generation?
formal and informal experiences
18. Which of the following are considered cultural norms of the healthcare system? Select all that apply.
frequent use of jargon and documentation. professional deference to pecking order. use of a problem-solving methodology. use of certain procedures for birth and death
reasons for using complementary and alternative practices for pain include: Pick all that apply:
frustration with conventional medicine - desire to take less medication and decrease health costs - expectations of wellness rather than just the absence of symptoms
The nurse bases foundational knowledge for a spiritual assessment of religion on which defining characteristic?
group orientation
Nursing students are socialized into the:
health care culture.
A nurse is assessing a client and determines that the client belongs to a minority group. Based on the nurse's understanding about minority groups, the nurse would anticipate that the client would likely experience which effects?
health disparities
Persistent gaps between the health status of minorities and non-minorities are defined as:
health disparities
A nurse is assessing a client and determines that the client belongs to a minority group. Based on the nurse's understanding about minority groups, the nurse would anticipate that the client would likely experience which effects? Select all that apply.
health disparities less power
Persistent gaps between the health status of minorities and non-minorities are defined as:
health disparities.
Nurses are socialized into the:
healthcare culture.
A client tells the nurse that the intravenous line must be placed in his right hand. Based on the nurse's understanding of the major religions, the nurse identifies this request as reflecting which of the following?
hinduism
which of the following are negatives to completing the health history form for a patient that is culturally divers: Pick all that apply
history forms are usually in English, literacy issues, varying cultural interpretations of symptoms or diseases
Spirituality is a human experience that (Select all that apply.)
includes a supreme being. seeks to transcend self
A nursing student is doing a community health rotation in an inner-city public health department. The student investigates sociodemographic and health data of the people served by the health department, and detects disparities in health outcomes between the rich and the poor. This is an example of a(n):
influence of socioeconomic factors in morbidity and mortality
Data
information
subjective data
information perceived only by the affected person
objective data
information that is seen, heard, felt, or smelled by an observer; signs
A nurse assesses a client's spirituality and religious practices. During the assessment, the nurse notes that the client is very quiet and rarely asks any questions of the health care workers. The nurse interprets this as being associated with which religion?
islam
While interviewing a hospitalized client, he states, "The holy days of Ramadan are coming soon. I am not to have any food or drink from sunrise to sunset during this time." Further assessment reveals that the client's request is associated with which religion?
islam
A nurse educator could be considered culturally as a(an):
key informant.
A nurse is working in a clinic with a high population of overseas workers. Which nursing assessment is the priority?
language assessment
A nurse is assessing a client and determines that the client belongs to a minority group. Based on the nurse's understanding about minority groups, the nurse would anticipate that the client would likely experience which effects?
less power & health disparities
The nurse is caring for a client who perceives time differently. What action should the nurse take for this client?
maintain flexibility in the schedule
Risk factors for mental disorders
may be specific to an ethnic group.
A nurse is attempting to gain insight into a client's cultural beliefs and attitudes. Which methods would the nurse likely use? Select all that apply.
open-ended interviewing ethnographic interview key informants
What symptom is greatly influenced by a person's cultural heritage?
pain
Review of Systems (ROS)
physical examination of all body systems in a systematic manner as part of the nursing assessment
interview
planned communication for a specific purpose (e.g., data collection)
A nurse is modifying an Asian client's diet to accommodate the concept of hot and cold. The nurse demonstrates an understanding of this concept when identifying which of the following as a cold condition?
pneumonia
A client refuses to allow any health care worker of Asian descent to provide care. This client is demonstrating what practice?
racism
Which behaviors demonstrated by the client would the nurse consider as reflection of the client's pride in ethnicity? Select all that apply.
requesting native cuisine listening to folk music and dance asking to wear person unique clothing
A nurse is working with a culturally diverse group of clients. The nurse understands that cultural norms:
require an individualized approach by the nurse.
nursing assessments focus on the patients________ to health problems
response
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
The wife of a client asks the nurse if she could bring in a cream from home to apply to her husband's skin. She says, "Whenever anyone gets sick we always use this cream." The nurse interprets this as:
ritual
The wife of a client asks the nurse if she could bring in a cream from home to apply to her husband's skin. She says, "Whenever anyone gets sick we always use this cream." The nurse interprets this as:
ritual.
while preparing medications for a patient from a diverse background the nurse must be aware of: Pick all that apply
side effects, adverse reactions, toxicity
cue
significant information that is helpful in making decisions
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
What characteristic is used to describe racial categories?
skin color
A newly hired young nurse overheard the charge nurse talking with an older nurse on the unit. The charge nurse said, "All these young nurses think they can come in late and leave early." What cultural factor can the new nurse assess from this conversation?
stereotyping
A nurse states, "Hispanic people have no clue about primary prevention of illness." The nurse is demonstrating which of the following?
stereotyping
A nurse states, "That woman is 78 years old—too old to learn how to change a dressing." What is the nurse demonstrating?
stereotyping
A preconceived and untested belief about an individual or group of individuals is:
stereotyping
The nurse assesses a client's spiritual dimension, documenting the primary source of information at which location?
subjective data
Culture strongly influences pain expression and need for pain medication. However, cultural pain is:
suffered by a patient whose valued way of life is disregarded by practitioners
Physical Assessment
systematic examination of the patient for objective data to better define the patient's condition and to help the nurse in planning care, usually performed in a head-to-toe format; a collection of objective data about changes in the patient's body systems
cultural blindness
tendency to ignore cultural differences and to proceed as if they did not exist The tendency to judge others based on ones own culture
On the basis of median age:
the Asian population tends to be younger.
social justice related to health care is best demonstrated when:
the ER at a local hospital will provide care for all clients regardless of ability to pay
Acculturation
the adoption of the behavior patterns of the surrounding culture
Before determining whether cultural practices are helpful, harmful, or neutral, nurses must first understand:
the logic of the traditional belief systems.
What should a nurse do if there is any data discrepancy or conflict?
the nurse must investigate further, gathering focused information to support, confirm, or negate the suspicions.
A nurse is doing preoperative teaching for an African American man before he has abdominal surgery. What topic should be included in the teaching?
the possibility of developing a keloid over the healed incision
When providing care that is respectful of a client's health belief system, the nurse bases interventions on the understanding that:
there are three major health belief worldviews that help explain illness.
The nurse is teaching about sources of calcium for a client newly diagnosed with lactose intolerance. The client would require further teaching if which food is chosen?
yogurt
List 2 of the five cultural issues/factors that influence health promotion and health maintenance in communities
• Involve local community elders• Involve family, churches, community work sites• Health messages must be congruent with cultural beliefs• Language barriers and cultural beliefs• Sensitivity is essential to meeting health needs within diverse cultures
Using Roy's adaptation model, the nurse identifies that the goal of nursing care is to assist the client to achieve what? Select all that apply.
• Optimal mental health • Physical health • Role function • Interdependence
List two biological factors that influence nursing care of pregnant women of various cultures
• Sickle Cell Gene is most commonly found in African Americans - Diabetes mellitus is most commonly found in Native Americans (MOST COMMON) Pima Indians of Arizona-diabetes mellitus and gestational diabetes is on the rise and is much higher in the Native American groups - Pregnant American Indians and Alaskan Native women with type 2 diabetes are at an increased risk of having babies born with birth defects
List 2 ways in which Cultural Origins can cause conflict in healthcare workforce.
• cultural perspectives on family obligations • cultural perspectives on hygiene • perspectives on cross cultural communication • perspective on touch • perspective on etiquette • perspective on clothing/accessories • perspective on time orientation • perspective on interpersonal relationships • perspective on gender and sexual orientation • perspective on moral and religious beliefs
Which statement, made by a nurse caring for a client diagnosed with an aggressive form of cancer best demonstrates the principle of veracity?
"The client is aware of the risks of taking the experimental chemotherapy medication."
A nurse has recently completed a seminar on cultural diversity. Which statement regarding development of cultural knowledge indicates a need for additional teaching?
"The more curious the nurse is about the client's culture, the more the client will want to share."
The nurse is collecting the health history of a client and notes the client is apprehensive in answering questions. The client states, "My spiritual healer will be here soon." What is the best response by the nurse?
"We can wait until your spiritual healer arrives and work together to answer these questions."
The nurse is setting an outcome with the patient experiencing spiritual distress. Which goal would be appropriate?
The patient will express meaning and purpose in life.
What outcome should the nurse prioritize when addressing a patient's social, cultural, and spiritual issues?
The patient will express meaning and purpose in life.
The nurse is visiting a patient from a nondominant culture that was recently discharged from the hospital for complications of pregnancy. Which outcome of care would be appropriate for this patient?
The patient will understand signs of the complication developing again.
The nursing instructor is discussing holistic health care with her nursing students. The instructor talks about the different factors the nurse must consider when creating a holistic plan of care. What are these factors? (Mark all that apply.)
The patient's developmental life stage & The patient's emotional context & The patient's physiologic health condition
When applying Mechanic's model of illness behavior, which assessment question best supports the nurse's attempt to determine the client's motivation for seeking health care?
"Has your ability to go to work been affected by the pain in your shoulder?"
Which question asked during the assessment process of an American Indian client is directed by currently accurate information regarding that culture's risk for a specific disease?
"Have you ever been told you have a problem with drinking too much alcohol?"
Which assessment question demonstrates an understanding of the impact that changing female roles have on a culturally diverse family?
"How is your husband adjusting to the fact you are working outside your home?"
Which question reflects an understanding regarding a middle-aged married woman's emotional willingness to undergo elective surgery?
"How many people depend on you for help on a daily basis?"
Which assessment question will provide the nurse with information regarding a Hispanic client's ability to be financially secure after retirement?
"How many years did you attend a formal school?"
The nurse is caring for a Catholic patient who is going to surgery tomorrow. The patient states that she is afraid and asks the nurse to pray with her, although the nurse is not religious. What is the most appropriate response by the nurse?
"I am uncomfortable praying. May I call the chaplain for you?"
The nurse teaches a pregnant patient from a nondominant culture that the health care provider wants the patient to rest for several hours every afternoon. Which patient statement indicates that teaching has been effective?
"I need to lie down after lunch and not get up until it's time to prepare dinner."
Which statement by a patient best illustrates reflection on a spiritual need?
"I need to think a little more about how I feel about undergoing this treatment."
When planning to assess a client's spirituality and religious practices, the nurse also includes assessment of complementary and alternative medical practices based on the understanding that approximately how many Americans use these types of practices?
33%
A nurse caring for clients of different cultures in a hospital setting attempts to make eye contact with clients when performing the initial assessment. What assumption might the nurse make based on common cultural practices?
A Muslim-Arab woman refuses to make eye contact with her male nurse. Assumption: She is being modest.
Social justice related to health care is best demonstrated when:
A client reporting chest pain is seen immediately by an emergency room physician.
Which client admitted to the emergency department might require the nurse to include interventions aimed at addressing culture shock in the plan of care?
A client who recently immigrated and fell from a ladder
When providing culturally competent care to clients, a nurse understands that cultural competence involves which characteristics? Select all that apply.
A process that requires life-long learning. A commitment to promoting health equity. Knowledge of influences on the clients' beliefs. Awareness of one's own influences on responses
A nurse is assigned the care of a client who speaks a nondominant language. The nurse does not understand the client's language. Which agency resource is best for the nurse to use in this case?
A professional interpreter.
when striving for social justice, which intervention demonstrates an understanding of nursing responsibility.
Advocating for a free clinic for unemployed African immigrants
The use of midwives has played a significant part in helping to improve infant and maternal complications and death, especially in countries where there is a high rate of both complications. Which us a recognized role of a midwife in helping to improve the healthcare services around the world?
Advocating that proper maternity care is available to all populations
Being cared for by a nurse of the opposite gender would be an especially important issue for women from which of the following cultures?
Afghan
A nursing student is taking postoperative vital signs in the PACU. She knows that some ethnic groups are more prone to genetic disorders. Which of the following patients is most at risk for developing malignant hypertension?
African American
A nursing student is taking postoperative vital signs in the postanesthesia care unit. She knows that some ethnic groups are more prone to genetic disorders. Which of the following patients is most at risk for developing malignant hypertension?
African American
A nurse that has the knowledge of the biocultural history of clients and aware that individuals with a greater potential for and incidence of hypertension are:
African Americans
When reviewing cultural differences that relate to the incidence and prevalence of disease among various cultural groups, the nurse would expect to see the highest prevalence of asthma in which group?
African Americans
Which of the following factors contribute to the low participation rate of African Americans in hospice programs? Select all that apply
African Americans are more likely to be mistrustful of the medical system & African Americans tend to believe God alone determines life or death
Mongolian spots are common which of the following: Pick all that apply
African, Asian, Latin
A nurse is caring for a Hispanic male who has tattoos all over his body. The nurse tells her coworker, "I guarantee you this patient is a drug dealer." This statement can be described as which term or phrase?
Discrimination
The nurse is caring for a client of Asian descent. The client is postoperative 3 days from coronary artery bypass graft (CABG). 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.
Which nursing intervention best demonstrates a culturally sensitive approach to a client's belief in the effectiveness of folk healers?
Discussing interventions the healer would like incorporated into the client's care plan.
Which intervention demonstrates the implementation of the culturally congruent LEARN mnemonic when assessing an Asian client who reports a skin rash on both hands?
Discussing possible folk remedies that can be used along with the prescribed antibiotic lotion.
A nurse is assessing the cultural beliefs of five clients requiring specimen collection for a diagnostic test. Which cultural assessments are correct? Select all that apply.
Insertion of a throat culture swab into the mouth of a Southeast Asian client may be perceived as threatening. - Hindus collecting a stool specimen for a Hemoccult screening test need to use the left hand to place the stool onto the Hemoccult card. -Self-urine collection performed by a right hand-dominant Muslim client may be collected incorrectly because only a Muslim's left hand can be used for dirty activities.
The nurse realizes that the primary goal of a cultural assessment is to:
Provide care that is in concert with the client's cultural expectations
A nurse is caring for a 50-year-old Hindu Asian male patient who is hospitalized following an incidence of high blood pressure. After reviewing the patients' data, the nurse plans a diet that takes into consideration his culture. Which actions are required when developing a diet plan? Select all that apply.
Provide culturally sensitive teaching brochures. & Refer the patient to a dietitian who is familiar with his food choices & Develop a diet plan that includes the patients' cultural diet preferences.
A nurse is caring for a Hindu Asian patient who is hospitalized following an incidence of high blood pressure. Which actions are required when developing a diet plan for this patient? Select all that apply.
Provide culturally sensitive teaching brochures. Refer the patient to a dietitian who is familiar with the patient's food choices. Develop a diet plan that includes the patients' cultural diet preferences.
A Japanese patient is admitted to the hospital after a fall. The patient doesn't understand English. Which action can the nurse take to promote communication? Select all that apply.
Provide language assistance to the patient. Ask a nurse who speaks Japanese to assist.
Which action by a health care facility would demonstrate a commitment to providing culturally competent care?
Providing continuing education events focused on delivery of linguistic services
A nurse is providing nutritional counseling to culturally diverse patients with dietary restrictions. Which statement accurately describes a dietary concern based on a specific culture?
The Asian diet is often high in salt due to cooking with soy sauce.
A nurse is demonstrating ethnocentrism. Which statement would reflect this concept?
"My Russian heritage is superior to all others."
After speaking to a patient with depression, the nurse observes that the patient is experiencing discrimination. Which patient statement helped the nurse arrive at this conclusion?
"My boss fired me when I admitted that I'm gay."
Which of the following would be most appropriate for the nurse to ask when beginning to assess a client's spirituality?
"What gives you hope or peace?"
The nurse is caring for a 16-year-old boy receiving chemotherapy for testicular cancer. He says that his parents are religious and left a cross next to his bed for "good luck." What is the most appropriate response by the nurse?
"What helps you get through tough times?"
Which question is most effective in assessing a patient's personal beliefs about health and illness?
"What or who do you believe controls your health?"
A nurse is caring for a middle-aged Hindu Asian patient following an incidence of high blood pressure. The nurse understands the ethnicity of the patient and asks questions for cultural assessment. Which questions point out bicultural ecology and health risks? Select all that apply.
"What other problems do you have?" "How do you treat this problem at home?" "How has the problem affected you and your family?"
A nurse recognizes the need to assess a client's spirituality after the client has been admitted from the emergency department to the medical unit. How should the nurse best initiate this assessment?
"Would you describe yourself as being a religious or spiritual type of person?"
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?"
An Appalachian male 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 the client wants to leave. What is the most appropriate cultural response by the charge nurse?
"Would you feel more comfortable with your family with you?"
The nurse is caring for a woman who has just been pronounced dead. Her adult children are in the room. Which statement by the nurse indicates culturally competent care?
"Would you like time alone with your mother for any specific ceremonies?"
The nurse is caring for a client who practices Catholicism and was newly diagnosed with cancer. The client states, "God is punishing me for my past sins." How should the nurse respond?
"You sound upset. Would like you to talk about it?"
Which questions would the nurse include in an assessment using the Transcultural Assessment Model? Select all that apply.
- "What is your role in the family unit?"- "What illnesses or diseases are common in your family?" - "When you communicate with coworkers and others, how close do you stand?" - "If you have something important to discuss with your family, how do you approach them?"
When assessing African Americans for pain, the nurse should consider which of the following? Select all that apply
African Americans are more likely to under report their pain level & African Americans often use alternative pain management before seeking medical treatment & African Americans often deny or refuse pain medications
An older man who is near death has been admitted to the hospital, and family members are at his bedside. During the admission assessment the nurse uses which question or statement to appropriately address spiritual needs?
Are there any special needs or rituals that you and your family request at this time?
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.
When faced with a scenario where it is believed that a client from another cultural background is using herbal remedies along with the prescribed medication to treat her arthritis. The nurse's first action should be to:
Ask the client to identify what herbal remedies are being used along with the prescribed medications
While performing the initial assessment of an infant, the nurse notes a soiled string of yarn around the infant's neck. What action should the nurse take?
Ask the parent the purpose of the string and if it can be placed elsewhere on the infant's body.
The nurse at an outpatient clinic asks a patient who is Chinese American with newly diagnosed hypertension if he is limiting his sodium intake as directed. The patient does not make eye contact with the nurse but nods his head. What should the nurse do next?
Ask the patient how much salt he is consuming each day
During an assessment, a pregnant patient tells the nurse that "white foods" are not consumed in the patient's culture. What should the nurse do first after learning this information?
Ask the patient to define "white foods."
A patient tells the nurse that her religion prohibits her from eating food prepared outside of a special kitchen. What is the nurse's appropriate action to meet this patient's needs?
Ask the patient to describe the requirements for the special kitchen.
A school nurse notices a boy with a bandage on his arm and black fluid under the edge of the bandage. She asks the teen what happened to his arm. He replies that his mother applied axle grease to a boil. What is the nurse's most appropriate response to this boy?
Ask the teen what the boil looks like, what it feels like, and if the axle grease is helping it get better
Which nursing intervention demonstrates an avoidance of one of the cited criticisms of current transcultural nursing theories?
Asking the Jewish client whether he or she will need a kosher diet menu.
Which additional assessment should be conducted when monitoring a darkly pigmented person for cyanosis?
Asking the client to provide the location and date of his or her birth.
Which action by the nurse demonstrates unbiased and culturally sensitive care to a patient?
Asking the dietitian to remove pork from the diet of a Muslim patient
Culturally competent care would encourage which action by a patient's family?
Asking the family's spiritual advisor to visit the patient
A Muslim client is admitted to the hospital. What cultural considerations might the nurse include in the plan of care? Select all that apply.
Assign care providers of the same sex. Avoid touching clients of the opposite sex. Make accommodations for the prayer needs of the client.
Which nursing activity shows an understanding of the process of culturally competent nursing practice?
Attending two in-service programs yearly on attaining cultural competency.
A nurse is assessing a client's culture. Which aspect would be the easiest for the nurse to recognize?
Attitudes
Which statements are true regarding attitudes: Check all that apply
Attitudes are learned not inherited. Attitudes are formed of cultures around the age of 10. Attitudes can be changed Answer: A, B, D
Culture conflict
Becoming aware of cultural differences, feel threatened and respond by ridiculing the beliefs and traditions of others to make themselves feel more secure about their own values
The nurse is caring for a patient of Asian descent who speaks very little English. The nurse is especially concerned and attempts to develop a trusting relationship with the patient. She does this knowing that
Cultural assessment is intrusive in contrast to other types of interviews.
A family has recently immigrated. All members are quickly learning the language and the children are all in public school. Both parents are working and adapting to the new culture. What is this family demonstrating?
Cultural assimilation
The nurse practitioner sees patients in a community clinic that is located in a predominately White neighborhood. After performing assessments on the majority of the patients visiting the clinic, the nurse notes that many of the minority groups living within the neighborhood have lost the cultural characteristics that made them different. What is the term for this process?
Cultural assimilation
A nurse is participating in an educational exercise in which she is conducting a self-examination of her own biases. This activity addresses what construct of cultural competence?
Cultural awareness
Which assessment data influence patient-centered care?
Cultural beliefs
A nurse develops a nursing diagnosis for a patient. Which factor can cause a culturally insensitive diagnosis?
Cultural bias
A client believes that the illness is caused by an imbalance of yin and yang. The nurse states, "You can call it whatever you believe, but you have a metabolic disorder." What is this nurse demonstrating?
Cultural blindness
A client originally from Asia believes that her illness is caused by an imbalance of yin and yang. The nurse states, "You can call it whatever you believe, but you have a metabolic disorder." What is this nurse demonstrating?
Cultural blindness
A new graduate nurse from a small community college is going to work in an urban setting. She embraces the thought of working in a more diverse setting and wants to learn about different cultures. What behavior is this nurse exhibiting?
Cultural desire
A client is admitted with end stage pancreatic cancer and is experiencing extreme pain. The client asks the nurse if an acupuncturist can come to the hospital to help manage the pain. The nurse states, "You won't need acupuncture. We have pain medications." Which characteristic has the nurse displayed?
Cultural imposition
A client is admitted with end-stage pancreatic cancer and is experiencing extreme pain. The client asks the nurse whether an acupuncturist can come to the hospital to help manage the pain. The nurse states, "You won't need acupuncture. We have pain medications." Which characteristic has the nurse displayed?
Cultural imposition
Care that includes the nurse learning about cultural issues involved in the patient's health care belief system and enable patients and families to achieve meaningful and supportive care is known as
Culturally competent care, reflects the ability of a nurse to bridge cultural gaps in caring and enables patients and families to achieve meaningful and supportive caring
Which term is most appropriate for describing a healthcare practitioner who is respectful of the healthcare traditions of other cultures?
Culturally sensitive
According to the Office of Minority Health (OMH), the thoughts, communications, actions, customs, beliefs, values, and institutions of racial, ethnic, religious, or social groups are known as
Culture
During their clinical post-conference meeting, several nursing students were discussing their patients with their instructor. One student from a middle-class family shared that her patient was homeless. This is an example of caring for a patient from a different:
Culture
2. A nurse caring for patients in a culturally diverse neighborhood knows that culture affects the nurse's interactions with patients. Which of the following is a characteristic of culture? Select all that apply.
Culture guides what is acceptable behavior for people in a specific group. Cultural practices and beliefs mainly remain constant as long as they satisfy a group's needs. Culture influences the way people of a group view themselves, have expectations, and behave. Because of individual influences, there are differences both within and among cultures.
A nurse is presenting an in-service program to a group of nurses about culture and cultural diversity. When describing culture, which characteristics would the nurse include? Select all that apply.
Culture has recognizable patterns. Culture is dynamic.
A family recently emigrated from Haiti. The mother reports that her teenage daughter is showing signs of fear, has vague reports of stomach pain, and feels humiliated by her peers because of her culture. What is the priority assessment for the nurse?
Culture shock
A family recently immigrated to a new country. The parent reports that the teenager is showing signs of fear, has vague reports of stomach pain, and feels humiliated by peers because of their culture. What is the priority assessment for the nurse?
Culture shock
A nurse is caring for a Muslim patient who is recovering from a motor vehicle accident. The nurse understands that a high-protein diet is important for the patient's wounds to heal; however, the patient is following Ramadan. When constructing a diet plan for this patient, which factors should the nurse consider? Select all that apply.
Reschedule meals. Respect the cultural beliefs and assure the patient that medical needs will be taken care of.
A nurse assigned to the neonatal intensive care unit (NICU) has spent most of a day working with a critically ill infant, with the mother standing by. The infant experiences a cardiac arrest and does not survive. The mother spends an hour crying and holding the baby, saying good-bye. Which spiritual care intervention(s) is/are most appropriate for the nurse to implement? (Select all that apply.)
If desired, briefly hold the baby to say good-bye after the mother leaves. & Call the family spiritual adviser or the chaplain. &Ask the mother if you could call a family member or friend to be with her.
The nurse recognizes the following as an appropriate strategy for communicating with clients who are not fluent in English?
Incorporating hand gestures and pictures
According to Haviland, which structural elements help strengthen a patient's culture? Select all that apply.
Infrastructure, Social structure, Superstructure
Which disorders might a nurse screen for in a black man, based on his culture? Select all that apply.
Lactase deficiency, Sickle cell anemia, Keloid formations
The nurse is completing an assessment of an Asian-American client. Recognizing that there are commonly seen problems in individuals from this background, the nurse observes for particular signs and symptoms of:
Lactose intolerance
A community health nurse has volunteered to assist in providing health care instruction to a Native American community group. The nurse plans instruction based on the common practices and rituals of this group, knowing that which are characteristics associated with this ethnic group? Select all that apply.
Lactose intolerance is common, Vitamin D deficiency is a concern, Corn is an important component of the diet, & Fried bread and mutton are prepared in lard.
A community health nurse has volunteered to assist in providing health care instruction to a Native American community group. The nurse plans instruction based on the common practices and rituals of this group, knowing that which are characteristics associated with this ethnic group? Select all that apply.
Lactose intolerance is common., Vitamin D deficiency is a concern., Corn is an important component of the diet., Fried bread and mutton are prepared in lard.
Which assessment finding is a symbolic aspect of culture for a patient?
Language
A nurse is part of an orientation team for a group of newly hired nurses. The nurse is to prepare a presentation for the group about different cultural groups common to the facility. As part of the presentation, the nurse is planning to describe how culture is communicated to provide a foundation for culturally competent care. Which methods of communication would the nurse include? Select all that apply.
Language, Behavior, symbols
What cultural considerations might the nurse expect of those living in poverty? Select all that apply.
Large numbers in the culture need government assistance. & Living conditions are often crowded, with several families living together. & Low levels of self-respect and feelings of worthlessness are common. & Family structures are often unstable and abusive.
cultural knowledge
Learn about the belief system and practices of people in your community and of patients in the area in which you work
Which nursing action displays linguistic competence?
Learning pertinent words and phrases in the client's language
A pregnant patient from nondominant culture arrives for a prenatal examination is escorted to an examination room. When asked to remove clothing and wear an examination gown, the patient hesitates. What should the nurse do to ensure cultural sensitivity in preparation for the examination?
Leave the room
The nurse is preparing to administer prescribed medication to a client who is Native American/First Nations. The nurse enters the room and observes a shaman performing a healing ritual for the client. What action would be the most appropriate by the nurse?
Leave the room and return when the shaman is finished.
This model is based on the concept of cultural care and shows three major nursing modalities that guide nursing judgments and activities to provide culturally congruent care.
Leininger's Sunrise Model
A nurse is assessing a client and determines that the client belongs to a minority group. Based on the nurse's understanding about minority groups, the nurse would anticipate that the client would likely experience which effects? Select all that apply.
Less power - Health disparities
Participating in the community allows the nurse to be accepted as a member of it. This method of data collection allows the nurse to participate in the daily life of the community, obtain information about the structures and influences of the community, and also do which of the following?
Make observations.
A student nurse understands that avoiding offensive body language is important when working with people from unfamiliar cultures, but does not know what this means. Which suggestion by the nursing faculty member is best?
Mirror the patient's body language
The nurse is caring for a client of ASIAN descent. The client is postoperative 3 days from CABG. The client has a prescription to ambulate. What is the best action by the nurse?
Obtain a prescription for physical therapy consult to ambulate the client.
A nurse at a health care clinic is preparing to examine a Hispanic child who was brought to the clinic by the mother. During assessment of the child, the nurse should avoid which action?
Overly admiring the child.
A client refuses to allow any healthcare worker of Asian descent to provide care. This client is demonstrating what practice?
Racism
Can be defined as an attitude or action that disadvantages individuals or groups on the basis of their different culture, ethnicity, religion, language, etc.
Racism
Which statement, made by a nurse caring for a culturally diverse population, regarding spiritual assessments demonstrates the need for further education?
Religion is a private matter and difficult to assess.
How do people who participate in organized religion differ from nonreligious people?
Religious people express their spirituality through faith traditions.
During a spiritual assessment, the nurse asks if a patient's faith is helpful to them. The nurse is assessing the patient's:
Religious practices
An older Asian client who lives alone has begun to have difficulties cooking and maintaining a safe environment in the apartment she rents. Which intervention will have the most impact on the client's ability to maintain independence?
Requesting a social consult to help identify sources who can fund part-time in-home assistance.
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 most important aspect of providing culturally competent care is exhibited through what action by the nurse?
Seeking to understand individual patient customs, beliefs, and values
Which nursing activity has priority when providing culturally congruent care?
Self-reflection concerning beliefs associated with the client's culture.
The nurse chooses to use a formal assessment technique when doing a client's spiritual assessment. Which of the following techniques would be most appropriate?
Self-response assessment instrument
Which is an example of multilateral healthcare aid?
Sending the hospital ship HOPE to japan to provide post earthquake health care
Which action by an individual best demonstrates enculturation?
Sharing cultural expectations with younger family members
Which response is most appropriate when a client describes the alternative medicine therapy he has been using to treat his "stomach problems"?
Sharing that, "Most alternate medicine therapies hadn't been researched for either safety or effectiveness."
Which action taken by a nurse would reflect application of an appropriate generalization in a patient care setting?
Sharing with unlicensed assistive personnel that typically Muslim patients do not eat pork
Which meal tray should the nurse deliver to a client of Orthodox Judaism faith who follows a kosher diet?
Sweet and sour chicken with rice and vegetables, mixed fruit, juice
Which meal tray should the nurse deliver to a client of Orthodox Judaism faith who follows a kosher diet?
Sweet and sour chicken with rice and vegetables, mixed fruit, juice.
What aspect of culture is a full-time employed granddaughter of an elderly Asian female exhibiting if she asks the social worker to place her grandmother in an extended-care facility against the wishes of her parents?
System change
The nurse observes that an elderly Hispanic patient frequently nods his head and consistently says, "OK. I understand," while learning about the medication schedule. Which conclusion would the nurse make regarding the patient's behavior?
The patient may not have comprehended what was taught
A nurse is caring for an African American in an acute care setting. Which one of the following might be a special nursing consideration for this patient?
The patient might request a visit from a folk healer.
The nurse who is caring for a patient with an external locus of control can anticipate which of the following?
The patient will be more likely to be fatalistic about nature and illness.
The nurse is setting an outcome with the patient experiencing social isolation. Which goal would be appropriate?
The patient will express meaning and purpose in life.
When analyzing the assessment data on the admissions of a client with limited English skills, the nurse notices the client has answered yes or nodded the head indicating yes to all questions. The nurse interprets this as indicating which of the following?
The nurse should get an interpreter to assist with the assessment.
A client who speaks only Japanese has been admitted to the health care facility reporting chest pain. Since the assigned nurse does not know the client's language, what would be the most appropriate solution in this case?
The nurse should request the help of a professional interpreter.
The nurse is explaining the need for long-term calcium therapy to a patient. The patient tells the nurse, "I feel good now so I don't think I need to continue the therapy." How should the nurse interpret this statement?
The patient exhibits present-time orientation.
The nurse is assessing a patient with an Asian background. The nurse notices that the patient has assimilated into mainstream American culture. Which behaviors by the patient led to this conclusion? Select all that apply.
The patient has U.S. citizenship. The patient speaks fluent English. The patient has adopted Christianity
When planning care for the patient who is a Jehovah's Witness and may need blood in an upcoming surgery, the nurse should be aware of which of the following?
The patient may accept autologous blood through induced hemodilution.
Cultural imposition
Using one's own values and customs as an absolute guide in interpreting behaviors. Impose ones cultural beliefs, values and patterns of behavior on a person or people of a different culture
After assessing a community, the nurse plans programs to address the community's government. Which of the following would be most appropriate?
Using open forum community meetings
The nurse is providing discharge teaching for a client who is from a different culture. The nurse notes that the client will look away from the nurse and does not maintain eye contact. What would be the most appropriate action by the nurse, with regard to culturally competent care?
Utilize a key informant and continue with the teaching, verifying the client's understanding through open-ended questions.
The nurse educator asks a student to list the five categories of complementary and alternative medicine (CAM), developed by the National Center for Complementary and Alternative Medicine. Which statement, if made by the nursing student, would indicate an understanding of the five categories of CAM?
Whole medical systems, mind-body medicine, biologically based practices, manipulative and body-based practices, and energy medicine.
Which assessment question will best provide the nurse with an understanding of how childbirth is viewed by and African based culture?
Will you describe for me the care you would expect to receive if you were giving birth in your homeland
Which assessment question demonstrates cultural sensitivity regarding a rural, African American clients understanding of a high risk medical condition
Will you tell me what it means to be diagnosed with high blood pressure
A Muslim teenager is in the hospital for surgical repair of a severe fracture in the leg during the month of Ramadan, which the client says he would like to observe during his stay. Which of the following interventions should the nurse be prepared for in caring for this client?
Withhold all food and drink between sunrise and sunset
A group of nurses are working with a group of refugees who have recently relocated to the area. The nurses are concerned by some of the unsafe and unhealthy cultural practices and are trying to create an educational program that will help teach the young mothers a safer way to care for their children. Which will be important for the nurses to remember as they create this program?
Working to maintain the core values and beliefs while finding ways to Incorporated new methods that will be safer and healthier for the refugees
When caring for a patient of a different culture, it is important for the nurse to understand that
Working within the established family hierarchy produces better outcomes.
The charge nurse overhears two new graduate nurses talking in the break-room. One graduate nurse states, "I hate getting reports from the older nurses; they are just too slow." The charge nurse understands that the nurse is demonstrating what?
ageism
The community health nurse is developing a workshop for a group of Native American/First Nation clients. Which topic should the nurse teach?
alcohol use disorder
database
all the pertinent patient information that enables a comprehensive and effective plan of care to be designed and implemented
To enhance their cultural awareness, nursing students need to make an in-depth self-examination of their own:
background, recognizing her bias and prejudices
Although all of the following are factors to consider when caring for patients with limited income, which one is the most important?
basic human needs may go unmet
A nursing student is preparing a presentation regarding different cultures. Which definition of culture is most accurate?
belief system that guides behavior
Based on a colleague's feedback, a nurse learns that she is aware of cultural differences in a general way but does not know what the specific differences are or how to communicate with a person of a specific culture. This nurse exhibits which of the following?
conscious incompetence
The nurse is caring for a surgical patient who speaks only Mandarin Chinese. The nurse will (Select all that apply.)
consider the body structure of the patient for rehabilitation needs. & use the translation services of the institution for communication of the care plan. & explore the cultural practices for foods, eye contact, and body space for care provision.