Mental Health Chapter 7 PrepU

Which scenario conveys the application of cultural competence in the provision of nursing care?

A new nurse asks a Hispanic colleague to explain how cultural beliefs might influence a Hispanic client's response to health care interventions.

Which stage of Erikson's psychosocial development includes building confidence in one's own abilities?

Industry versus inferiority

The nurse is caring for a client who was born and educated in southeast Asia. The client moved to the United States two years ago. The client wears Western clothing and eats fast food. Which answer describes what the client has modeled?

acculturation

Which would play a role in a person's cultural identity? Select all that apply.

-Health beliefs -Health practices -Values -Norms -Behavior

The nurse is caring for a pediatric client whose parent is at the bedside. The nurse wants to assess the parent's understanding of discharge instructions. Which question will best assess the parent's understanding of the discharge instructions?

"Can you show me how you will set up this nebulizer for your son?"

The nurse is caring for a client of Native American/First Nations heritage. The client tells the nurse, "I would like a shaman at my bedside to tell me if I will heal from this disease." Which response by the nurse best demonstrates cultural competence for this client?

"Do you have a way to contact your shaman?"

The nurse is caring for a client recently admitted to the hospital with pneumonia. After speaking with the client, the nurse notes the client believes the source of the illness is not physiological. Which statement by the client may have led the nurse to think this?

"I have been ignoring my prayers."

The nurse has been working with a client to develop self-efficacy. What client statement would most likely suggest to the nurse that self-efficacy is improving?

"I have decided to apply for a promotion at work."

During an interview, the nurse is assessing a client for traits that aid in the stress response. What client statement would the nurse recognize as most representative of hardiness?

"I perform my best when I am under pressure."

The nurse educator is providing education to the nursing staff regarding culturally appropriate nursing care. A nursing student asks the nurse educator to describe the concept of acculturation. Which statement by the nurse is the appropriate response?

"It involves adopting aspects of a different culture in when in a new environment."

Which statement made by the client demonstrates hardiness when faced with a health issue?

"What do I need to do to manage this illness?"

A nurse is preparing an educational program identifying the major barriers experienced by culturally diverse populations when accessing mental health services. Which information should the nurse include? (Select all that apply.)

-Client and health care provider do not share a common language -Health care beliefs are not shared by both client and health care provider -Group value systems are not mutually accepted

The nurse is teaching new parents about the developmental stages. When discussing trust vs. mistrust, which parenting skills should be included?Select all that apply.

-Feed the baby when hungry. -Use a car seat while travelling. -Change diapers when wet or soiled. -Keep the baby close.

The nurse is working in a local for-profit mental health clinic. After reviewing the demographic data of the clients seeking treatment at the clinic, the nurse finds that there is a low Hispanic population using the clinic, despite a high Hispanic population in the area. Which intervention(s) does the nurse perform to best serve this population? Select all that apply.

-Hire office staff members who speak Spanish. -Provide free bus vouchers for those needing to get to and from the clinic. -Eliminate demographic information on intake forms that would reveal immigration status. -Partner with the local community health center to provide screenings within the community.

The nurse is speaking to a group of high school students about health promotion. The nurse encourages the students to make friends and widen their social networks. What are the reasons the nurse might give this advice? Select all that apply.

-It helps to reduce stress. -It helps to diminish illnesses. -It has a positive influence on the ability to cope.

A nurse is conducting a developmental assessment of an older adult client who has come to the clinic for a check-up. During the assessment, the client states the following: "I retired 3 years ago, and I have been keeping busy ever since." "I am fairly inactive because my knees always ache." "I am looking forward to moving into an independent living program at the end of the year." "I have been keeping to myself lately." "My spouse died last year, and I am still having a hard time with being alone." Which statements would the nurse recognize as meeting developmental tasks for this age group? Select all that apply.

-Retirement and keeping busy -Transition to a different living siutation

A client has come to the mental health center for an initial visit. The nurse has little experience with the client's culture, having cared for only one other client with a similar background. When assessing the new client, which approaches would be best for the nurse to use to provide culturally competent care? Select all that apply.

-Use the new client as the primary source of information. -Demonstrate genuine interest in learning about the new client. -Ask the new client about personal beliefs and practices.

A nurse is teaching a class on culture in healthcare to a group of nursing students. Which scenario discussed by the nurse demonstrates the concept of acculturation?

A Japanese family emigrated to another country several years ago and have now adopted some aspects of that country's culture.

A client who recently immigrated from Eastern Europe comes to the clinic for an evaluation. During the assessment, the nurse notes that the client has adopted the local area's mannerisms and dress. The nurse interprets this as what?

Acculturation

For a client who belongs to an ethnic group that is known to have poor metabolism of psychotropic medications, the nurse should anticipate that the client may be at risk for which problem?

Adverse drug effects

A nurse is caring for a Native American client who has been admitted to the unit for new onset of diabetes mellitus. The client will not agree to any treatments until the local Shaman is present. Which action by the nurse is appropriate in this situation?

Arrange for the client's Shaman to come to the unit and meet with the client and health care providers.

The nurse who is preparing a Native American client for surgery notes that the client is wearing a medicine bag. What intervention should the nurse implement to best address the client's spiritual needs with respect to presurgical care needs?

Ask the client how the medicine bag can be respected while preparing for surgery.

Which approach to care best reflects cultural competence?

Assess the culturally mediated beliefs of each client on an individual basis.

A student nurse is preparing a presentation regarding different cultures. Which definition of culture is most accurate?

Belief system that guides behavior

Which component of hardiness encompasses the ability to make appropriate decisions in life activities?

Control

Which developmental task occurs in the middle adult growth area?

Creation of a comfortable home

Which statement about culture is true?

Cultural identity reflects what determines behavior.

Which represents the best brief definition of culture?

Culture is shared attitudes, customs, and beliefs.

A psychiatric-mental health nurse is working on developing cultural competence. Which would be most appropriate for the nurse to do?

Demonstrate an appreciation of, and a genuine interest in, the individual and his or her cultural beliefs.

An older adult client in the hospital has not had a bowel movement for 3 days and the nurse planned to give the client a stool softener this morning. The client declined the medication, however, stating that the client's spouse will be bringing the client a herbal medication later in the day that is often used by members of their ethnic group. Which reaction demonstrates cultural care accommodation/negotiation?

Documenting the client's wishes and informing the client's care team what the client will be taking

A nurse is aware that which of these represents a biochemical variation that may exist between clients of different racial backgrounds?

Drug metabolism

In order to help preserve and maintain a client's cultural belief regarding the need for "hot foods," which action should the culturally competent nurse take?

Educate the staff to help them assist the client in selecting food choices from the client's menu that supports this belief

Personal space and distance is a cultural perspective that can impact nurse-client interactions. What is the best way for the nurse to interact physically with a client who has a different cultural perspective on space and distance than the client?

Explain that physical contact is necessary and ask about the client's cultural personal space preferences.

Children learn cultural characteristics as they associate with others. Which entity has the most profound influence on the development of traditional values and practices?

Family

Which action is most effective in assisting the nurse to provide culturally competent care?

Identifying one's own biases and feelings about different cultural groups

A young adult client who has come to the clinic for evaluation reports feeling anxious lately. During the interview, the client states, "I feel like I still don't know what I should be doing with my life." The nurse interprets this statement as most suggestive of a problem with which developmental task?

Identity

The nurse is assessing a client and finds that the client has very low self-esteem. According to Erikson's stage of psychosocial development, this behavior may be an indication of failure in which stage?

Industry vs. inferiority (school age)

Why is understanding a client's cultural context important to a psychiatric mental health nurse?

It influences perceptions of health and illness.

The nurse is assessing a client who recently immigrated to the United States. The client is experiencing a high level of stress and reports that nobody in the workplace is willing to work with or talk to the client. What is the most likely cause of stress in the client?

Low sense of belonging

Which stage of psychosocial development involves establishing the next generation?

Middle adult

What is one way in which nurses can develop cultural self-awareness?

Objectively examine personal beliefs, values, and practices.

A client visits the clinic and tells the nurse about experiencing a great deal of stress on the job for the past 2 months. The nurse should instruct the client that two antecedents of the stress response are the person-environment relationship and which additional client factor?

Perception

The nurse is working in a mental health facility. The nurse ensures that all able-bodied clients in the facility participate in the group exercise program every morning. For which reasons would this intervention be beneficial for the clients with mental illness? Select all that apply.

Physical activity improves mood and lowers anxiety. Physical activity prevents medical conditions. Physical activity can foster a sense of well-being.

The nurse in an psychiatric inpatient facility encourages clients to attend daily prayer sessions. What is the most likely reason for the nurse's action? Choose the best answer.

Prayer helps in coping with stress.

A Native American client discusses cultural beliefs with the nurse providing care. In order to recognize any negative feelings or stereotypes the nurse has, which should the nurse do to ensure culturally competent nursing care can be provided?

Reflect on how the client's beliefs may have similarities and differences from the nurse's own culture.

The nurse is scheduled to begin a clinical rotation at an outpatient mental health clinic that is in a neighborhood with a large number of Asian residents. Since the nurse does not share this cultural background with the potential clients, which is the best way for the nurse to ensure cultural sensitivity in this setting?

Reflect on, analyze, and foster awareness of the nurse's own culture

Children of parents who abused alcohol and substances are able to develop self-esteem and self-efficacy by developing which characteristics?

Resilience

Evaluating the cultural practices of others according to the nurse's own culture can be counteracted by the nurse's use of which practice?

Self-assessment

Which characteristic would be most prevalent in an individual demonstrating low self-efficacy?

Self-doubt

When conducting an assessment with 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 caring for several clients on a surgical unit notes that one of the clients the nurse is caring for is Muslim. The nurse, without asking the client, decides to remove all pork from the client's meal tray prior to delivering it to the room. What best describes the nurse's action?

Stereotyping

The mental health nurse is interviewing a client of a different cultural background regarding the client's health care practices. The nurse understands that cultural competence is important in the care of this client. Cultural competence in health care can be best described as what?

The ability to understand and effectively interact with individuals or members of a community from diverse cultural or ethnic backgrounds

The nurse at a mental health clinic is performing the initial assessment of a client who emigrated from Mexico several years ago. The client, who seems reluctant to speak, is accompanied by their more talkative adult child. The nurse has never cared for someone of Mexican descent. Which individual should the nurse regard as the best source of information for providing competent care for the client?

The client

On assessment, the nurse finds that the client demonstrates low hardiness. Which can the nurse anticipate regarding the client based on this observation? Choose the best answer.

The client has difficulty in problem solving under stress.

The nurse is performing a psychosocial assessment of a client. Which behavior would indicate that the client has a high self-efficacy?

The client is extremely ambitious.

The nurse is caring for a client who, because of cultural beliefs, attributes their anxiety to a supernatural cause. When developing a plan of care for this client, which information would be most important for the nurse to keep in mind?

The client will have difficulty seeing the relationship between their health practices and anxiety.

The nurse is assessing executives in the corporate sector. Which characteristic of the executives would indicate a higher hardiness? Choose the best answer.

The executive has high stress and is more resistant to illnesses.

On assessment, the nurse finds that a client has low self-esteem. Which intervention implies the nurse is facilitating improvement of the client's self-efficacy with the use of social modeling?

The nurse encourages the client to observe other people with high self-efficacy.

All except which problem stem from attitudes in which the focus is on the nurse's beliefs and values rather than those of the client?

Treating the client as a source of cultural information

Which factor has the greatest impact on a person's ability to cope with illness?

age

The nurse is trying to effectively deal with the spiritual needs of a client. To best meet the client's need, what should the nurse do?

clarify own spiritual values and beliefs before exploring clients' beliefs

A nurse is caring for a client of a different ethnic and cultural background. What can the nurse do to promote cultural competence? Select all that apply.

demonstrate genuine interest and respect for the client tailor interventions to the client do not assume that all individuals of a racial/ethnic group are the same learn about the client's country of origin before assessing them

The nurse is caring for a young adult client of African descent who has symptoms of mental distress. Which barrier to mental health wellness does the nurse recognize that the client is most at risk for?

double stigma

The nurse educator is discussing spirituality for nurses in a mental health class. The nurse educator asks a student nurse, "Which of the following is most consistent with spirituality?" The student nurse identifies which description?

feeling a connection to a higher power

An important part of cultural competence includes the capacity to communicate effectively and convey information that is easily understood. When providing care the nurse should know that cultural competence includes which example?

linguistic competence

When immigrants arrive from another country to live in the U.S. they bring their own culture. When providing care the nurse should know that an individual's culture includes what items? Select all that apply.

values beliefs patterns of accepted behavior