giger ch 1-7

1. In assessing baseline color of skin, the abdomen can be expected to be: A Least pigmented. B Most pigmented. C Unreliable for examination. D Unrelated to other areas.

A

10. Nursing diagnoses offer a useful tool to assess culturally diverse patient needs. A True B False

A

11. On which of these factors does the North American Nursing Diagnosis Association (NANDA) focus the diagnoses? A The patient B The system C The provider D The ecosystem

A

11. Which of these factors are among those essential in communication assessment? Mark all that apply. A Dialect B Style C Volume D Touch E Context of speech F Kinesics

A

14. Jehovah's Witnesses are opposed to: A Blood transfusions. B Blood tests. C Medication. D Consumption of red meat.

A

15. Seventh -Day Adventists' practices include avoidance of: A Caffeine, alcohol, drugs, and tobacco. B Surgery on Sunday or Saturday after sundown. C Blood transfusions. D Tap water, undistilled.

A

17. The context of speech refers to the use of emotion when communicating. A True B False

A

17. When planning post -discharge outpatient educational sessions for a group of clients, the nurse should avoid Saturday sessions for patients who are: A Seventh Day Adventists B Muslims C Jehovah's Witnesses D American Indians

A

20. Because of the oral tradition of this cultural group, in providing discharge teaching, it would be inappropriate to provide written communication for which of the following cu l- ture groups? A Hmongs B Hispanic Americans C Japanese Americans D African Americans

A

21. M. Chang is a 20 - year - old Chinese American. She would like to go to college but has an aged, ill father at home. If M. Chang's cultural value orientation regarding relationships is collateral, she will be likely to: A Stay home and take care of her father. B Go ahead with college since she is young and her needs must come first. C Find a nurse to take care of her father so that she can go to college. D Ask her minister what she should do and then take her minister's advice.

A

3. An individual' s feelings of environmental control will affect beliefs about compliance with a medical regimen. Which of the following is most likely to be true? A A person with internal locus of control will be more likely to feel personal actions that can influence future health. B A person with external locus of control will be more likely to feel personal actions that can influence future health. C A person who believes in fate and change as an important determinant of nature has an internal locus of control. D A belief that the natural course of nature cannot be affected by individuals indicates belief in internal locus of control.

A

3. In planning discharge instruction, the nurse is aware that the client who is most likely to be compliant will demonstrate: A Future orientation. B Past orientation. C Present orientation. D Tempered orientation.

A

4. Seminole, Pima, and Papago Indians are known to have been highly susceptible to diabetes mellitus. A. True B False

A

4. The nurse in the outpatient medication clinic has a full appointment book. A Hispanic American client arrives at 12:30 PM for a 10 AM appointment, and a Native American client does not show up for the appointment. These culturally diverse clients are: A Members of cultural groups that have a different view of time. B Immature and irresponsible in health care matters. C Displaying passive -aggressive tendencies. D Acting out feelings of anger toward the system.

A

4. The nurse is admitting a 40 - year -old female patient newly emigrated from Mexico. The patient has hypertension. As this is the initial visit to the clinic, the best approach to assess what, if any, folk medicine the patient may have used is for the nurs e to ask: A "What have you been doing to treat your symptoms?" B "Have you been using any remedies that come from Mexico?" C "Would you like to keep wearing that garlic necklace while you are in the hospital?" D " Have you been using herbs to treat your illness?"

A

4. The principle that is most important to the provision of culturally competent care is the nurse's: A Awareness of personal stereotypes based on culture B Knowledge of specific behavior that is typical of persons in a given culture C Sensitivity to what the physician says about persons in the cultural group of t he patient. D Awareness of actions that can be expected of persons in a given culture.

A

4. When planning discharge care for a family with open boundaries, the nurse is aware that this family system: A Will use available support systems to meet its needs. B Is more prone to crisis, related to increased exposure to stressors. C Discourages family members from setting up channels. D Strives to maintain family stability by avoiding outside influences.

A

5. When providing care for clients of different cultural backgrounds, the nurse needs to be careful to avoid: A Stereotyping. B Socializing. C Enculturation. D Assimilation.

A

6. Cultural behavior, or how one acts in certain situations, is: A Socially acquired. B Genetically acquired. C Stereotyping. D Institutional.

A

6. The nurse has determined that space and territoriality are very important to the client from a different culture. What is the best way for the nurse to enter the client's space in order to deliver nursing care? A Explain nursing care and procedures be fore beginning. B Avoid touching the client during care. C Keep the curtains pulled around the bed at all times. D Stand at least 8 feet from the bed during client -nurse discussions.

A

7. Jenny Jones is a 45 -year -old African American admitted to the psychiatric unit with paranoid schizophrenia. She is put on Risperdal (risperidone). Based on your knowledge, you realize that the drug is an antipsychotic. Because of Jenny's race, it is possible that she might develop which of the following disorders as a side effect of this drug? A Tardive dyskinesia B Echolalia C Dysphagia D Echopraxia

A

9. When the nurse is planning care for a client with a different cultural background, t he initial primary concern in delivering culturally competent care is for the nurse to: A Assess how cultural variables may affect the client's health -related actions. B Explain how the client can adapt to hospital routines. C Speak s lowly and clearly to ensure effective communication. D Allow the family to provide care during the hospital stay.

A

The nurse is preparing a healthy diet plan for Mrs . O. In doing so, she takes the time to include the Polish foods that Mrs. O. favors. This is an example of the nurse's demonstrating: A Cultural competence B Bicultural values. C Ethnocentrism.

A

16. In which of these cultural groups may touch be symbolic of "undoing" an evil spell or preventing harm or healing? Mark all that apply. A Mexican Americans B American Indians C Italian Americans D French Americans E Asian Americans

ABE

1. Communication approaches the nurse can use while providing culturally appropriate nursing care for a client with limited understanding of English include all of the following except : A Using a lot of hand gestures. B Asking questions that require a yes or no response. C Repeating the message with different words. D Speaking slowly and distinctly.

B

1. In providing discharge teaching to a patient with future -time orientation, the culturally competent nurse is aware the patient is likely to: A Rely on current status. B Take precautions related to a future goal. C Be focused on the future with little thought of present actions. D Be attentive to the nurse out of respect.

B

1. The nurse suspects that the client has nontraditional health beliefs and often uses nontraditional remedies to treat various illnesses. What is the best approach for obtaining this information from the client? A "What are your favorite foods?" B "Have you been taking any remedies that your family taught you to use?" C "Would you like to keep wearing that gold cross while you are in the hospital?" D "You haven't been eating any of those funny herbs your people use, have you?"

B

1. Which one of the following nursing actions is most likely to reduce a patient's anxiety and enhance the patient's personal security as it relates to the concept of personal space needs? A Touching the patient before and during procedures B Providing explanations when performing tasks C Making eye contact as much as possible D Reducing the need for the patient to make decisions

B

12. According to NANDA, deviations from the dominant culture are automatically and ethnocentrically considered: A Normal. B Abnormal. C Irrelevant. D Nonassessable.

B

12. Which of these factors associated with communication differs among cultural groups and is usually most closely linked to geographic location? A Volume B Dialect C Language style D Kinesics

B

13. Religious structures fall into two different groups; one of these is the church type. Which of these statements about the church type of religious structure is accurate? A People involved isolate themselves from the rest of society and create their own laws and values. B It is a broadly based religion that generally includes people by virtue of their membership i n society. C It places personal commitment and experience before family and community functions. D People involved often congregate in clan -like environments.

B

2. If people have a fatalistic attitude toward life, they are likely to seek medical attention: A More readily. B Less readily.

B

3. A nurse in an outpatient clinic is about to interview a culturally diverse client. Which sitting posture during an interview is most neutral and acceptable to people of most cultures? A Legs crossed, leaning slightly backward in chair with one arm ext ended on the desk B Feet on the floor and upper body leaning slightly forward toward client C One leg crossed and the upper body turned slightly away from client D Feet on the floor and arms crossed over chest

B

3. Susceptibility to disease is based on cultural heritage. A True B False

B

3. Transcultural nursing is viewed as a culturally competent practice field that is: A Nurse centered and research focused. B Client centered and research focused. C Spiritually centered and research focused. D Concerned with differences between but not within cultural groups.

B

4. The nurse is working with a culturally diverse patient population in a clinic. In order to deliver culturally competent care, it is essential for the nurse to: A Do a physical examination on each patient. B Do a cultural assessment on each patient. C Have "lived experience" with the culture of the patients served. D Observe each patient for his or her unique behavior.

B

5. Cultural groups vary greatly. Which of the following is false concerning these differences? A Environmental control refers to the ability of a group to plan activities that control nature. B Social organization refers to the differences that exist within the family unit in a culture. C Verbal communication differences exist among cultures, and nonverbal communication differences exist between cultures. D The personal space and its meaning vary from one culture to another.

B

5. Every society has what is called the dominant value orientation. Which of the following best describes the dominant value orientation of the majority culture in the United States? A Belief in ancestral knowledge and reverence for aged members of the society B Working hard and being self - supporting and financially independent C Living within a communal group and rejecting personal belongings D Moving away from other people and living in a cabin without heat, lights, or water

B

5. Keloids are more commonly seen in: A Asians B Blacks C American Indians D Europeans

B

6. A person is more likely to be compliant with a practice related to long -term health promotion if the individual is: A Past and present oriented. B Present and future oriented. C Past and future oriented.

B

6. One category of drugs thought to be metabolized differently by virtue of race is antihypertensives. You have a 28 - year -old African -American male patient who has just been diagnosed with hypertension. Based on your knowledge, you would expect which cate gory of antihypertensives to be the least efficacious for your patient because these types of drugs would have to be given at a higher dose? A Alpha- adrenergic receptor blocking agents B Beta -adrenergic receptor blocking agents C ACE inhibitors D Calcium channel blockers

B

7. Time takes on different meanings from one culture to another. To explore the relationship of time to nursing interventions, the nurse should: A Avoid using set times to do procedures, if possible. B Be flexible in attitudes and don't become emotionally upset when the client desires procedures to be done at "awkward times." C Encourage clients to set their own times when they would like the nurse to perform nursing care activities, regardless of the nurse's schedule. D. Disregard the usual adherence to time schedules for medications.

B

8. Mr. Cappelini is a 40 - year - old Italian man who just arrived in the United States. His English is limited, and the nurse does not speak Italian. Which intervention would be helpful in communicating with Mr. Cappelini? A The nurse tells him, "I have Italian friends, so I have a good idea what you mean." B The nurse responds, "Please explain that to me again." C Explain in Italian dialect, "I'ma not understandinga you."

B

8. Time takes on different meanings from one culture to another. To explore the relationship of time to nursing interventions, the nurse should: A. Avoid using set times to do procedures, if possible. B Be flexible in attitudes and not become emotionally upset when the client desires procedures to be done at "awkward times." C Encourage clients to set their own times when they would like the nurse to perform nursing care activities, regardless of the nurse's schedule. D Disregard the usual adherence to time schedules for medications.

B

8. Which of these zones of interpersonal space is usually permitted by family members and friends? A Intimate zone B Personal zone C Social zone D Public zone

B

the use of transcultural nursing knowledge is founded on the goal of a. increasing client compliance to the western medical model b. delivering culturally sensitive care that is free of inherent biases c. eliminating cultural differences. d. establishing system centered health policy

B

10. Succinylcholine (Anectine) is a muscle relaxant used during surgery. It is inactivated by hydrolysis by the enzyme pseudocholinesterase. Some individuals have the atypical form of the enzyme and may develop prolonged muscle paralysis and inability to breathe after this drug is administered. Which of the groups listed below has the greatest risk (in fact, it is said to be 1 out of 135)? A African Americans and Asians B American Indians and Hispanics C Jews and Alaskan Eskimos D Asians and Whites

C

10. When developing communication skills for cultural competence, the best practice for the nurse when talking with clients of another culture is to: A Speak loudly and slowly when communicating. B Always utilize an interpreter if a culturally appropriate interpreter is available. C Use simple words, avoid use of idioms and medical terms, and assess constantly for comprehension. D Always talk with the client and family together, since this will increase the chance that someone understands what is said.

C

11. Mr. Johansen, born in Sweden, is fair -skinned, blond, and blue -eyed and has little body hair. Mr. Stavros, born in Greece, is olive - skinned, has dark brown hair and eyes, and has thick, dark body hair. This is an example of: A.Environmental control o f culture. B.Social organization of a culture. C.Biological variations in racial groups. D.Variation in space orientation of a culture.

C

16. To provide a culturally appropriate diet that is high in protein for someone of the Seventh Day Adventist religion, the nurse should select: A Seafood and eggs. B Meat and beans C Peanut butter and whole wheat bread D Pasta and tomato sauce

C

18. A Cambodian family immigrated to the United States and has been living in Denver for over 5 years. During a family assessment, the mother expressed concern about their children, ages 10, 13, and 16, stating, "The children act so differently now. They are less respectful to us and want to eat only American food and go to rock concerts. It's hard to believe they are our children." The children are demonstrating: A Cultural relativism. B Ethnocentrism. C Biculturalism. D Acculturation.

C

2. The major purpose of culturally congruent nursing care is to enable the nurse to: A Be aware of his or her own cultural beliefs and values. B Change his o r her beliefs to meet the patient's needs. C Provide care in a culturally sensitive manner. D Refrain from making judgments when patients are wrong

C

2. The nurse assesses a client and determines that the patient has future -time orientation. With this information the client is more likely to: A Have little motivation for developing goals. B Have difficulty adhering to schedules. C Return for follow -up visits. D Live for the present.

C

2. To determine if a client with a limited English vocabulary understands the pre - operative teaching related to coughing and deep breathing, the nurse should ask the client to: A Verbalize what was learned regarding coughing and deep breathing. B Verba lize to an interpreter how to cough and breathe deeply. C Demonstrate how to cough and breathe deeply postoperatively.

C

2. When making patient care assignments that include a female Islamic patient, the nurse knows: A Sex of the nurse is not pertinent. B Sex of the patient is not pertinent. C The nurse needs to arrange for care by someone of the same sex. D Only family members can give care.

C

22. According to the 2000 census, the largest ethnic minority group residing in the United States today is: A Asian Americans B Black Americans C Hispanic Americans D American Indians

C

3. To avoid cultural conflicts with a client, the nurse should: A Assure him that he is receiving quality health care. B Provide the client with information about the dominant culture. C Ask the client about his expectations about nursing care and procedures. D Thoroughly explain necessary nursing interventions that might cause the client embarrassment.

C

3. While planning discharge teaching, the nurse knows the client with which of the following family backgrounds is most likely to hold to traditional values? A Chinese B Indian C Amish D African American

C

4. Belief that one's culture is superior to all others is called: A Discrimination. B Stereotyping. C Ethnocentrism. D Racism.

C

5. The nurse is teaching an American Indian client about the importance of taking a prescription medication at the time ordered. Whic h of the following shows the greatest understanding of the implications of social versus clock time? A A person who is social time oriented is likely to take medication on time. B A person who is social time oriented is more likely to have a clock. C A person who is clock oriented is more likely to be attentive to the times that medication is ordered. D A person who is clock oriented is more likely to be past time oriented.

C

6. The nurse responding to patients from diverse cultures with interpersonal awareness, knowledge, skill, and sensitivity is known as having: A Enculturation. B Culture care preservation. C Cultural competence. D Culture care accommodation.

C

6. When planning nursing care for a client with a different cultural background, the nurse should: A Identify how cultural variables affect the health problem. B Try to explain how the client can adapt to hospital routines. C Speak slowly and clearly to ensure effective communication. D Allow the family to provide care during the hospital stay.

C

7. According to Giger and Davidhizar, which of these zones of interpersonal space is the preferred distance between people other than French Americans and African Americans in the United States? A 0 to 18 inches B 18 inches to 3 feet C 3 to 6 feet D Greater than 12 feet

C

7. Which of the following interventions is helpful in communicating with a client who speaks a language other than yours? A Reassure the client that you have friends of his ethnic or racial background. B Speak to the client using his ethnic dialect. C Ask the client for clarification if you don't understand what he is saying. D At the initial meeting, address the client by his first name.

C

9. Betty Chang, a 60 - year - old Chinese patient, is admitted to your unit. She is placed on all of the drugs below. However, based on your cultural knowledge, you would need to pay particular attention to Betty because of which drugs? A Dyazide (hydrochlor othiazide/triamterene) B Glucophage (metformin) C Propanolol (Inderal) D Atacand (candesartan)

C

1. A nurse is caring for four terminal patients with diverse cultural backgrounds. Which of the following clients should the nurse anticipate will wish to engage in end -of - life procedures, such as making a will, a living will, and funeral arrangements? A A single Native American who had worked as a forest ranger B A female immigrant from China who is an acupuncturist C A refugee laborer from a war -torn Western African country D A fourth- generation New England male who is an accountant

D

15. Which of these cultural groups may not commonly use touch to convey emotions? A Italian Americans B African Americans C Mexican Americans D American Indians

D

19. In assessing a patient's religious or spiritual practice, the best approach for the nurse to use is to ask: A " What dietary restrictions are imposed by your religious and spiritual beliefs?" B "Would you accept blood transfusions if your condition required blood therapy?" C "Please tell me whether your religion allows you to eat meat daily." D " How can I help you in meeting any religious or spiritual needs you may have?"

D

2. A 23-year -old Jehovah' s Witness is scheduled for an appendectomy. The client has expressed concern related to receiving blood during the surgery. The best response of the nurse is: A "Your surgeon is very competent and will do only what is necessary to save your life." B "You don't have to worry about contamination of the blood supply because it is always tested." C "I will have the hospital chaplain interpret the Bible for you to show you there is no religious objection to blood transfusions." D " Transfusions are not routine for this procedure; however, I will call and alert your surgeon of your beliefs and wishes."

D

2. A newborn with which of these skin colors would rarely have Mongolian spots? A Yellow B Red C Brown D White

D

5. Culture is best defined as the: A Worldview and traditions transmitted by a group from generation to generation. B Classification of people according to shared biological characteristics. C Religious or racial characteristics of a group that set it apart from the larger soci e- ty of which it is a part. D Assumption of attitudes, values, and beliefs held by a particular cultural group that have been passed down from one generation to the next.

D

7. When providing care to clients with diverse cultural backgrounds, it is imperative for the nurse to recognize that: A Cultural considerations must be put aside when the client enters the health care system. B Current health standards should determine the acceptability of cultural practices. C Clients with the same cultural background will respond similarly to stressful situations. D Generalizations about the behavior of a particular ethnic group may be inaccurate.

D

8. Angiotensin - converting enzyme inhibitors such as captopril (Capoten) tend to be less effective as single therapy for which of the racial/ethnic groups listed below? A Whites B Hispanics C Asians D African Americans

D

8. Dr. T.W. is frequently bothered when patients arrive at the clinic late for appointments. He is so irritated by this behavior that he often finds it hard to provide appropriate care to these individuals. What should Dr. T.W. do first in trying to overcome his difficulty? A Identify the meaning of health to the patient B Allow the patients to arrive late and build this into his schedule C Understand that these cultural practices are helpful to the patient D Examine his own culturally based values, beliefs, attitudes, and practices

D

9. Which of the following is an appropriate guideline for overcoming language barriers? A Ask often if the person understands. B Avoid nouns and conjunctions. C Talk slightly louder than normal. D Use gestures with the words.

D

5. Which of these cultural phenomena are among those considered essential and are evidenced among all cultural groups? Mark all that apply. A Communication B Space C Social organization D Time E Environmental control F Biological variations

F

13. Speaking loudly usually denotes anger. A True B False

FALSE

14. Silence as a method of communication usually indicates nothing. A True B .False

FALSE