Dukek Chapter 10: Cultural and Religious Influences on Food and Nutrition

The nurse prepares to assess the nutritional status of a client who recently immigrated from Jordan. Which question should the nurse use to understand the client's dietary preferences?

"Are there any foods you will not eat?" To assess the degree of dietary acculturation the nurse should ask if there are any specific foods that the client will not eat. Asking about enjoying American food will not help understand the client's dietary preferences. The time of day the main meal is eaten and missing food from the native country also do not help understand the client's dietary preferences.

A client uses canned and frozen vegetables when preparing soup or stews at home. What should the nurse respond to this client?

"Check the amount of sodium in the canned items before adding salt to the dish" Canned items contain more sodium. The nurse should remind the client to check the sodium content of the items being used before adding salt. Canned and frozen items are not necessarily less expensive. Not all canned items are nutritionally better. The ideal meal is prepared from scratch. Some use canned or frozen items to increase the volume of the meal or for convenience.

A nurse is preparing to participate in an outreach program on nutrition in a predominantly Asian American community. To provide beneficial information, the nurse should keep in mind aspects of dietary acculturation. Which of the following statements by the nurse would be most constructive in altering behavior in this population?

"lets talk about serving size when choosing foods" Portion control is a better option than advising people to eliminate an important native food from their diet.

In preparing community education on nutrition, the nurse should include that in the United States, what percentages of food spending was spent on eating out?

43% Data from 2012 show that 43.1% of food spending was on food away from home (FAFH), which has risen steadily from 25.9% in 1970.

What percentage of the food budget does the average American spend on food away from home?

43% On average, Americans spend 43% of their food budget on food away from home.

"Soul food" is a term referring to the blended culture that resulted in traditional food and cooking techniques of southern African Americans. Which of the following statements are CORRECT regarding soul food? Select all that apply.

African Americans have the lowest fruit and vegetable intake among U.S. racial/ethnic groups. Soul food tends to be high in fat, cholesterol, and sodium. Meats in soul food are often breaded and fried. African Americans have the lowest fruit and vegetable intake among U.S. racial/ethnic groups. Soul food makes use of foods that are high in fat, cholesterol, and sodium and low in calcium, fiber, and potassium. A variety of beef and pork cuts are used, often breaded and fried. Food habits tend to reflect socioeconomic status, geographic location, and work schedule.

Which of the following groups has the HIGHEST life expectancy of all ethnic groups in the United States?

Asian American women Asian American women have the highest life expectancy of all ethnic groups in the United States.

A nurse is learning more about food beliefs associated with various religions. Which of the following religions has a moral code that focuses on making thoughtful decisions about food?

Buddhism The Buddhist code of morality is set forth in the Five Moral Precepts, which are to not (1) kill or harm living things; (2) steal; (3) engage in sexual misconduct; (4) lie; and (5) consume intoxicants, such as alcohol, tobacco, or mind-altering drugs. Believing that thoughtful food decisions can contribute to spiritual enlightenment, a Buddhist asks himself these questions.

The nurse is working with a family that traditionally uses soy sauce and rice when preparing food. The nurse is most likely working with a family from which of the following cultures?

Chinese Traditional Chinese foods and the effect of acculturation are highlighted in Table 10.6. Grains are the foundation of the traditional diet—predominately rice in southern China and wheat, in the form of noodles, dumplings, pancakes, and steamed bread, in northern China. Sodium intake is generally assumed to be high because of traditional food preservation methods (salting and drying) and condiments (e.g., soy sauce).

Sour cream, vinegar, dill, and black pepper are examples of seasonings commonly used by which of the following cultures?

German Examples of seasonings used by German cultures are sour cream, vinegar, dill, mustard, and black pepper.

Black beans and pinto beans are commonly used in which culture?

Latin America culture Types of legumes used in Latin American culture include black beans and pinto beans.

The nurse recognizes that food habits would be LEAST affected by which of the possible influences listed?

a documentary on the television Culture has an unconscious effect on food choices. This is influence by availability and cost. Religion tends to have a greater impact on food habits than does nationality or culture.

The nurse recognizes that one of the healthy eating aspects of the Asian American diet that should be encouraged is which of the following?

a variety of vegetables are used extensively A variety of vegetables are used extensively in traditional Chinese foods. Dairy products are limited due to the common occurrence of lactose intolerance, thus limiting calcium intake. Soy sauce is high in sodium and should be limited as well as the use of animal fats.

All of the following are best choices for sauces when eating Italian food EXCEPT for which of the following?

alfredo Sauces used in Italian cooking that are better choices for a healthy nutritional plan include red clam, marinara, wine, cacciatore, fra diavolo, and marsala. Alfredo sauce is a high-fat sauce.

The nurse is helping a client make healthier options when eating at an Italian food restaurant. The nurse should encourage the client to avoid which of the following foods?

alfredo sauce with pasta Best choices when ordering at an Italian restaurant include garden salad, vinegar and oil dressing, vegetables for a side dish instead of pasta, and Italian ice or fruit. Alfredo sauce would indicate a higher fat content.

The nurse educator is discussing culture and body image in a nutrition class. The nurse educator correctly states that In which of the listed cultures is being thin be associated with beauty?

american In the United States, thinness, particularly in women, is equated with beauty and status. Africans, Mexicans, American Indians, and Caribbean Islanders consider overweight to be a sign of health, beauty, and prosperity.

Which of the following statements regarding convenience foods is CORRECT?

are likely higher in sodium that "from scratch" items With planning and label reading, convenience foods can be part of a healthy diet. The more convenient the meal is, the greater the impact all around on time, budget, and nutritional value. Frozen complete or nearly complete meals or boxed "helper" type entrées earn their designation as "convenient" but cost more than "from-scratch" items, lack that "homemade" taste, tend to be high in sodium, and the 1- to 2-cup portion sizes listed on the label may leave many people hungry.

The nurse notes that a client is an Eastern Orthodox Christian. Which dietary action should be taken to support this client's religious beliefs?

ask if there are any foods required on feast day Because Eastern Orthodox Christians observe numerous feast days throughout the year, the nurse should ask if there are any foods required to be eaten on a feast day. Eastern Orthodox Christians do not restrict bacon or caffeinated beverages. Water before and after meals is a Seventh-Day Adventists practice.

The nurse is concerned that a client of Japanese descent only drinks green tea for breakfast. What should the nurse do first to improve this client's nutrition for the first meal of the day?

ask what foods are preferred to eat for breakfast The client may not follow or consume a "typical" American diet and the only menu selection available for breakfast may be the green tea. The nurse needs to first assess what the client typically consumes for breakfast. This is the best action to perform first. The dietitian may need to be contacted to help with meal choices. If the client's menu selections continue to be less than nutritionally sound, the health care provider might need to be contacted to discuss the use of nutritional supplements. The nurse should not haphazardly select menu items that the client does not want or does not eat.

A 68-year-old Asian American client who was recently diagnosed with type II diabetes has come to the clinic for a class on nutrition and diabetes. Which of the following nursing actions demonstrates respect for the client's culture?

asking the client what food she enjoys eating For effective cross-cultural nutrition counseling, the nurse should establish rapport and show respect for cultural differences. Being attuned to cultural and individual variations will increase acceptance of the message.

The nurse understands that all of the following actions regarding food are influenced by culture EXCEPT:

available food in the region Among the characteristics defined by culture is what food is considered edible, the role of food, how food is prepared, the symbolic use of food, and when and how food is eaten.

The nurse is working with a Hispanic client who wants to retain as much of a culturally traditional diet possible while adopting a healthier eating pattern. Which of the following traditional Hispanic foods should the nurse recommend?

avocado Avocados are commonly eaten in the traditional Hispanic diet. If the client wants to continue to eat a Hispanic diet but wants to adopt a healthier eating pattern, avocados offer significant health benefits. The other answer options provide a significant source of saturated fat and should be minimally incorporated into a healthy eating pattern

Which of the following statements would explain why immigrant children assume foodways of a new culture sooner than their parents do?

children learn from other children at school Children tend to accept new ways quickly as they learn from other children at school.

The nurse is seeing a South Asian client who has hypertension. The nurse is counseling the client about modifying eating habits to decrease the risk of heart disease. Which of the following foods should the nurse recommend the client minimize or eliminate from the diet?

clarified butter A South Asian belief is that ghee (clarified butter) is soothing and gives strength, which may make it hard for some South Asian people to accept that ghee is not good for health, despite its high fat and calorie content.

Which of the following statements is correct about the Chinese yin and yang health beliefs?

cold foods are eaten to balance hot foods Yin represents female, cold, and darkness; yang represents male, hot, and light. Digested foods turn into air that is either yin or yang. Diseases caused by yin forces are treated with yang foods, and diseases caused by yang forces are treated with yin foods.

In the United States, lifestyle changes have had a dramatic impact on daily food preparation. Meals are often prepared using which of the following?

convenience foods According to an online Harris poll conducted in 2010, 75% of people who prepare meals at home either very often or occasionally use pre-prepared and/or frozen ingredients and use kitchen appliances such as microwave ovens and toaster ovens to speed both cooking and clean up.

The nurse instructs a client on tips to ensure adequate nutrition when eating in a restaurant. Which meal selection indicates that additional teaching is required?

crispy clam strips with coleslaw The client should be encouraged to select foods that are prepared as baked, braised, broiled, cooked in its own juice, grilled, lightly sautéed, poached, roasted, or steamed. The meal selection with the highest fat content is the crispy clam strips. The term "crispy" implies that fat was used in the preparation of the meal.

The nurse recognizes that developing a nutritional plan for a client must include which of the following?

cultural beliefs Food is more than just providing nutrients. Food and eating also have personal, social, and cultural meanings. Some cultures have certain foods that are strictly prohibited and must be incorporated into the plan to be successful.

A client of Latino descent who arrived 2 hours late for a scheduled diagnostic test is upset because the test needs to be rescheduled. What should the nurse suspect as the reason for the client's delay?

cultural difference in the interpretation of time "Being on time" and "not wasting time" is an American value. Personal interaction is more important than time management is a traditional value about time. Since the client is from a different culture, this is the most realistic reason for the client's delay in arriving for the test. It is unlikely that the client did not want to have the test or forgot the time for the test. The client would not have the ability to know if the test is no longer needed because of a change in health status.

The time of day that a meal is eaten would be influenced most by which of the following?

culture When and how food is eaten is influenced by food customs of the culture.

Food habits are one of the last behaviors people change when assimilating to a new country. The evolution that occurs as immigrants implement eating patterns and food selections of the host country is referred to as which of the following?

dietary acculturation Dietary acculturation is the process that occurs as members of a minority group adopt the eating patterns and food choices of the host country.

A Chinese client who is concerned about developing hypertension asks the nurse what to avoid when eating out. Which of the following foods should the nurse recommend the client avoid at restaurants?

egg rolls Egg rolls are deep fried, high in saturated fat and sodium unlike the foods in the alternate answer options. The nurse should sugges the client avoid this food at restaurants.

The nurse participates on the planning of a community health fair. When discussing the choices for the food booths, what should the nurse suggest that takes the different community members' religious practices into consideration?

eliminate pork or pork containing meal choices Since the different religions represented in the community are not specified, the wisest decision would be to eliminate pork or meals containing pork since individuals who follow Orthodox Judaism, Islam, Hinduism, and Buddhism all have a restriction or prohibition of that food item. There is no religious reason to restrict milk-based beverages or limiting beverages. There is no religious reason to use fresh fruit and vegetables in menu items.

The nurse is seeing a client wants to be able to eat out at a Mexican restaurant while adhering to a healthy eating pattern. Which of the following selections would be best for this client when eating out?

fajitas with pico de gallo sauce Sauces to choose at Mexican restaurant are salsa, mole, picante, enchilada, and pico de gallo. Fajitas are a best choice that have lots of vegetables and are stir-fried. Chile relleno and flautas are deep fried. Hard shell tacos and sour cream have high fat content.

The Buddhist code of morality is given in the Five Moral Precepts. In regard to food, which of the following statements is correct?

food selections may be a factor in spiritual enlightenment Buddhists believe that thoughtful food decisions can contribute to spiritual enlightenment and will ask themselves a series of questions to assess the necessity and input of the food.

The nurse is discussing core foods in a nutrition class. The nurse is correct when he defines core foods as which of the following?

food that is included in the diet on a daily basis Core foods provide a significant source of calories and are regularly included in the diet, usually on a daily basis.

The nurse is discussing all aspects of food related to culture. The nurse is using an inclusive term that refers to all the eating habits and culinary practices of a people, region, or historical period is known as which of the following?

food way The term "foodway" refers to all aspects of food including what is edible, the role of certain foods in the diet, how food is prepared, the use of foods, the number and timing of daily meals, how food is eaten, and health beliefs related to food.

The nurse educator is helping students understand secondary foods. Which of the following best describes this concept?

foods that are widespread in the diet but are not eaten consistently Secondary foods are widely consumed, but not on a daily basis such as vegetables, legumes, nuts, fish, eggs, and meats. Secondary foods used by a culture vary with availability. For instance, the types of legumes used in Chinese culture include mung beans and soybeans, whereas those used in Latin American culture include black beans and pinto beans.

When working with a client who practices Judaism, the nurse recognizes which of the following CORRECTLY represents the practice of kosher dietary laws?

having meat and dairy at separate meals Dairy products cannot be eaten with meat. Pork is prohibited, and only fish with fins and scales are allowed.

The nurse is sharing information about the prevalence of health conditions in various cultures. The nurse correctly states that the leading cause of death among African Americans is which of the following?

heart disease African Americans are more likely to have high blood pressure and less likely to have it under control resulting in a higher rate of heart disease in this cultural population.

Which of the following is a CORRECT description of the traditional Hispanic diet?

high in protein The traditional Hispanic diet is generally a low-fat, high-fiber diet that is rich in complex carbohydrates and vegetable proteins.

A Roman Catholic client has informed the nurse that the priest is coming to give him Communion in about 30 minutes. The lunch trays are being passed out on the unit. Which of the following actions would be appropriate for the nurse at this time?

hold the client's lunch tray until after the client has received communion Roman Catholics avoid food and beverages for 1 hour before Communion is taken.

The nurse recognizes which of the following foods is not likely to be a core food in a culturally traditional diet?

honey Complex carbohydrates include cereal grains, starchy tubers, and starchy vegetables.

Soy sauce is a traditional seasoning in Asian cultures. Which of the following diagnoses would signal a need to modify the use of soy sauce?

hypertension Sodium intake is assumed to be high is Asian American culture because of the traditional food preservation methods of salting and drying and the use of soy sauce as a condiment.

The nurse is seeing a client who is first generation Asian American. The nurse might expect to see which of the following negative changes to the client's traditional diet as a result of dietary acculturation?

increase in intake of saturated fat The effects of acculturation on the traditional Asian American diet is a fat intake increase as fast-food intake has increased

Individualism is not well-regarded in some other cultures, in which the welfare of the group is valued over that of the individual. What nursing intervention would improve communication with a client who values group welfare over individualism?

involve the family in the patients healthcare decisions Each culture has its own point of view on life, health, and illness, and the meaning of each in society. In many cultures, group welfare is valued over individualism. Decisions may be made by the group instead of the individual. To be effective in teaching and communication with a member of such a culture, the nurse would involve the family in planning and emphasize the good of the entire family rather than the benefits for the individual.

Kosher dietary laws are followed by which of the following religions?

jewish Orthodox Jews follow kosher dietary laws regardless of their national origin.

The nurse is seeing a client who recently immigrated to the United States. The nurse should not expect to see which of the following as part of the changes in food choices that will occur for this client during the process of acculturation?

new foods replace all traditional foods Interrelated changes in food choices that occur as part of acculturation include new foods being added to the diet, some traditional foods being replaced by new foods, and some traditional foods being rejected.

The nurse is working with a client who consumes a traditional southern African American diet. The nurse should expect th client may have experienced which of the following effects that are changes to soul food that result from acculturation?

packaged and luncheon meats are used more often More packaged and luncheon meats are consumed rather than a variety of meats. Substitution of commercially made bread replaces homemade breads and grains, and the intake of fatty meats is high.

The nurse educator is preparing material for a nutrition class. The nurse educator correctly includes that foods that are reserved for special occasions or eaten sporadically are referred to as which of the following?

peripheral foods Peripheral foods or occasional foods are foods that are infrequently consumed. They may be foods that are reserved for special occasion, not readily available, or not generally well tolerated.

Which of the following foods would NOT be acceptable to serve a client who practices dietary restrictions of lacto-ovo-vegetarianism?

poultry Lacto-ovo-vegetarians do not consume meat but do include eggs and dairy products in their diets.

During a home visit the nurse notes that a family of Hispanic descent who immigrated to the United States a few years ago is in the process of acculturation. What did the nurse observe to come to this conclusion?

prepared frozen pizza for lunch Dietary acculturation occurs when eating patterns of immigrants change to resemble those of the host country. A study found that dietary acculturation in Mexican Americans leads to some negative effects, such as higher intakes of pizza. Generally, food habits are one of the last behaviors people change through acculturation. Usually, first-generation Americans adhere more closely to cultural food patterns and have at least one native meal daily. For many ethnic groups who move to the United States, breakfast and lunch are most likely to be composed of convenient American foods, whereas traditional foods are retained for the major dinner meal, which has greater emotional significance. During this home visit, the family was eating an American convenience food for lunch but the traditional food items were being prepared for the dinner meal.

The nurse is seeing a client who is Hispanic but has lived in the United States for 25 years. As a result of acculturation, the client's eating pattern has likely increased in which of the following foods?

processed Studies on Mexico-born Americans show that the intake of fiber, fruit, legumes, and vegetables decreases with duration of residence in the United States. There is a higher likelihood of consumption of process foods with length of residence in the U.S.

Adherents of Jainism, a branch of Hinduism, practice complete vegetarianism and avoid certain other foods such as:

root vegetables Devout Jains are complete vegetarians and may avoid blood-colored foods and root vegetables.

When providing nutritional education to a client from the Asian American culture, the nurse should keep in mind the that traditional method of food preparation is which of the following?

stir-fried Traditional methods of preparation in Asian cultures include stir-fried.

Stereotyping must be avoided in assessing clients from different cultures. Within any dominant cultural group, individuals exist with distinctive characteristics that affect food intake and nutritional level. The group of such individuals is identified as a:

subgroup Subgroups within a culture display a unique range of cultural characteristics that affect food intake and nutritional status.

The nurse received a report that a client being admitted to the unit has not had dinner while in the emergency department. The client is identified as a member of the Church of Jesus Christ of Latter-Day Saints (Mormon). What item would the nurse NOT include on a food tray for this client?

tea Mormons do not use coffee, tea, alcohol, or tobacco. Followers are encouraged to limit meats and consume mostly grains.

While performing a nutritional assessment on an American Indian client, the nurse notes that the client looks down when answering questions. The best interpretation of the client's behavior by the nurse is that:

the client is displaying respect for authority In many cultures, traditional values consider straightforwardness to be rude or too personal. It may be appropriate to avoid eye contact.

Although each culture has it owns customs, there is a common element that all share. Which of the following is common between cultures?

to use food as a way to socialize Each culture has food customs and bestows symbolism on certain foods. Each culture also determines which foods are used in celebrations.

The Chinese incorporate few dairy products into the diet. A good source of calcium would be what traditional food?

tofu Calcium is provided by tofu, small fish with edible bones, and soups made with bones that have been partially dissolved by vinegar in making stock.

The nurse recognizes what type of bread would be served during Passover for a client who is Jewish?

unleavened bread Only unleavened bread is eaten during the celebration of Passover.

Most Hindus avoid foods that are believed to inhibit physical and spiritual development. Foods that are considered to enhance spiritual purity include which of the following?

yogurt Foods that are considered to enhance spiritual purity include dairy products such as milk, yogurt, and ghee (clarified butter). When prepared together, pure foods can improve the purity of unpure foods. Some foods are innately polluted and can never be pure, such as beef or alcohol. Seafood is restricted. Most Hindus are vegetarians.