NU309 PrepU Chapter 2

The nurse is caring for a child from a different culture. Which statement(s) by the nurse demonstrates an understanding of how culture impacts a client? Select all that apply. A. "Culture can impact who a client chooses to see for health care needs." B. "Culture can impact the diet a client follows." C. "When a client moves to a different city, the client follows the cultural practices that are prevalent in the new city." D. "A client's cultural beliefs can impact spirituality and/or religion." E. "A client's cultural beliefs should be incorporated into the care a client receives.

A. "Culture can impact who a client chooses to see for health care needs." B. "Culture can impact the diet a client follows." D. "A client's cultural beliefs can impact spirituality and/or religion." E. "A client's cultural beliefs should be incorporated into the care a client receives. (Culture is a set of traditions and beliefs held by groups of people. Beliefs, diet, language, values, religion and spirituality are included in culture. Some cultures utilize folk healers to provide health care. The nurse should incorporate a client's beliefs as much as possible into care. When a client moves to a different location, the client tends to bring cultural beliefs and does not necessarily follow all the cultural practices of the new location.) Page 31

A couple had decided not to circumcise their newborn for nonreligious reasons. What is the appropriate response from the nurse? A. "OK, great. I will let the physician know." B. "What arrangements have you made outside the hospital?" C. "That's very unusual; tell me what has led you to this decision." D. "It's much better for the health of your newborn if you circumcise him."

A. "OK, great. I will let the physician know." (The nurse should remain as nonjudgmental as possible when speaking with a client. There are many reasons why a couple may decide to leave their newborn uncircumcised. Both health benefits and risks are associated with circumcision. The nurse should respect the couple's decision.) Page 31

During a well-child visit, the parent asks the nurse, "I want to make sure to keep my family's culture and traditions alive, so that my children have a good understanding of it. Is there anything we can do as a family?" The household is an extended family; the children's grandparents speak English as a second language. Which suggestion(s) would be appropriate for the nurse to provide? Select all that apply. A. "Pick a time during the week to talk with your children about your childhood experiences and traditions." B. "Try planning one night where the grandparents talk with the children in the native language." C. "Once or twice a month, have a family dinner that showcases specific foods of your culture." D. "Incorporate important cultural traditions during holiday and family celebrations, like birthdays." E. "Have your children read books by authors from all different cultures to open up their view."

A. "Pick a time during the week to talk with your children about your childhood experiences and traditions." B. "Try planning one night where the grandparents talk with the children in the native language." C. "Once or twice a month, have a family dinner that showcases specific foods of your culture." D. "Incorporate important cultural traditions during holiday and family celebrations, like birthdays." (To help preserve cultural heritage, it would be important for the parent to speak to the children about their childhood and traditions and values at specific times, such as bedtime or "talk time," so the children can appreciate how long these values have been revered by the family. The children should spend time with family members talking in the native language, eating culturally traditional foods, and celebrating cultural traditions. The children should also read books written by authors from the culture or that positively describe the culture.) Page 27

A nurse is conducting a class for the staff at the clinic about sexual orientation. The nurse determines that additional teaching is needed when the class makes which statement? A. "Sexual orientation is the same as gender identity." B. "Sexual orientation refers to a person's emotional attraction to another person." C. "Gay is used to refer to individuals with emotional attractions to people of the same sex." D. "The terms heterosexual and straight refer to the same sexual orientation."

A. "Sexual orientation is the same as gender identity." (Sexual orientation refers to a person's attraction to and sexual fulfillment with another person. Gender identity is the inner sense a person has of being male, female, or nonbinary, which may be the same as or different from the sex assigned at birth; everyone holds a gender identity. Gay is a term typically associated with male-identifying individuals who are sexually attracted to male partners. However, this term is sometimes used to refer to men and women who have same-sex partners. Heterosexual and straight are both terms used to refer to someone who finds sexual fulfillment with a member of the opposite sex.) Page 35-36

A nurse is uncomfortable caring for a pregnant client who is married to her female life partner. The best advice another nurse can give her would include which statement? A. "Spend some time self-reflecting why this family difference might be bothering you." B. "Maybe you should take another nursing course that focuses on cultural competencies; then you might have a better feeling caring for this family." C. "If you can just put on your happy face and focus on the baby rather than the parents, you will be able to care for all families." D. "Maybe it would be best if you don't care for this group of families and focus on caring for the classic husband and wife team."

A. "Spend some time self-reflecting why this family difference might be bothering you." (There are some major barriers for health care providers when caring for individuals who are different from them. One of these barriers is the potential for personal bias. This barrier can only be addressed through self-reflection, trying to understand why these differences might be bothersome, and setting those feelings aside while taking care of clients. A cultural nursing course might be beneficial, but it will not help in the meantime. Pretending to be okay with the family differences will not deal with the problem. Ignoring feelings by working only with traditional family units will not solve the problem in the long term.) Page 28

The nurse is mentoring a group of graduate nurses on potential positions available at the health care facility. A male nurse expresses interest in working in pediatric care. A colleague states, "Children relate better to women—they are used to their mothers and want nurses like them." When reviewing the response with the colleague, which response is accurate? A. "We must avoid that type of comment as it presents a stereotype." B. "We cannot say those types of statements as they are taboo." C. "I am sad you discouraged the nurse from that department. That is harassment." D. "You exhibited bullying by not supporting the interest in pediatrics."

A. "We must avoid that type of comment as it presents a stereotype." (The nurse is most correct to identify that the comment was stereotyping. Stereotyping means expecting a person to act in a characteristic way without regard to his or her individual traits. It is generally derogatory in nature. The statement did not identify an uncomfortable topic or taboo. The statement does not constitute either harassment or bullying.) Page 26

A female client who practices Orthodox Judaism is about to give birth, and the male spouse has been sitting in the waiting room all day. Which response from the nurse is appropriate? A. "Your wife is about to give birth. Do you want to go into the room now?" B. "You are needed back in the room. Your wife is about to give birth." C. "I see you waiting here. Do you want to talk about it?" D. "How can I help you feel comfortable so you can be with your wife."

A. "Your wife is about to give birth. Do you want to go into the room now?" (It is common among practitioners of the Orthodox Jewish religion for men to wait outside the birthing room and pray. Praying is how the male spouse supports the birthing process. The best response is to ensure that the spouse knows he is permitted to enter the room, and for the nurse to ask what his preferences are. Saying that the spouse is needed pressures him to go against religious practices. Asking if the spouse would like to talk about it or how to help the client feel comfortable presents that the spouse is unable to be present or that something is wrong.) Page 24

A nurse is working with a culturally diverse patient population. Which strategy would the nurse most likely use to assist in recognizing cultural influences on pain perception? Select all that apply. A. Appreciate that the meaning of pain varies among cultures. B. Appreciate that not all people communicate or express their level of pain in the same way. C. Recognize that communication of pain may not even be acceptable within a culture. D. Assume that everyone who is in pain will behave like they are in pain. E. Develop an awareness of personal values and beliefs. F. Use an assessment tool (e.g., rating scale from 0 to 10) to assist in measuring the pain. G. Remember that if someone is in enough pain, he or she will inform others.

A. Appreciate that the meaning of pain varies among cultures. B. Appreciate that not all people communicate or express their level of pain in the same way. C. Recognize that communication of pain may not even be acceptable within a culture. E. Develop an awareness of personal values and beliefs. F. Use an assessment tool (e.g., rating scale from 0 to 10) to assist in measuring the pain. (Strategies to help recognize cultural influences on pain perception are to appreciate that the meaning of pain varies among cultures; appreciate that not all people communicate their level of pain the same way; recognize that communication of pain may not even be acceptable in a culture; develop an awareness of personal beliefs and your responses; and use an assessment tool to measure the degree of pain. The nurse should never assume that everyone will act like they are in pain, nor should he or she think that all people in pain will inform the nurse.) Page 35

The nurse is providing an educational program for the staff working at a homeless shelter. The program is focused on the impact of homelessness on children. What information should be included in the presentation? Select all that apply. A. Homeless children are at an increased risk for sexual abuse. B. A short period of uncertain housing is not detrimental as long as the family are able to remain available. C. Homeless children are at risk for developing chronic health problems. D. Acute health conditions are increased in homeless children. E. Having space in a shelter will neutralize the health risks to the homeless child.

A. Homeless children are at an increased risk for sexual abuse. C. Homeless children are at risk for developing chronic health problems. D. Acute health conditions are increased in homeless children. (Homelessness is a psychological and physiological stressor on the family unit. Children who are homeless are at an increase risk for both acute and chronic health concerns. Even when homeless families have beds in shelter settings these children and their parents are still at an elevated risk for health problems. Incidence of sexual abuse is increased in homeless children. Although the family unit may remain together, this does not minimize the overall risk of homelessness.) Page 35

A nurse is working to develop cultural competence. Which aspect would the nurse need to incorporate as the foundation for this concept? A. Respect B. Knowledge C. Empathy D. Technical skill

A. Respect (Cultural competence, or respecting cultural differences, allows the nurse to plan culturally competent care and to integrate cultural elements into care.) Page 28

What could be the consequence of a nurse assigning a client to a staff member who is of the same culture as the client? A. Stereotyping B. Ensuring better care and understanding C. Helping in assessing client's cultural heritage D. Helping build nurse-client relationship

A. Stereotyping (A nurse who thinks stereotypically may assign a client to a staff member who is of the same culture as the client because the nurse assumes that all people of that culture are alike. The nurse also may believe that clients with the same skin color have similar social situations. Because stereotypes are preconceived ideas unsupported by facts, they may not be real or accurate. They can be dangerous because they are dehumanizing and interfere with accepting others as unique individuals. Assigning a client to a staff member who is of the same culture as the client will not help in ensuring better care and understanding; assessing the client's cultural heritage; or building nurse-client relationships.) Page 26

A nursing student asks the instructor why nurses focus on assessing sociocultural aspects of clients. Which response from the nurse is most accurate? A. Such assessment can reveal why people take certain preventive or treatment measures related to their health. B. This assessment is necessary to pinpoint genetic risks in people. C. Assessment of sociocultural components makes nurses better equipped to work in diverse settings. D. Nurses should strive to understand all dimensions of the client, even those that seem less important.

A. Such assessment can reveal why people take certain preventive or treatment measures related to their health. (Assessing sociocultural status, ethnicity, and cultural beliefs of families and clients can reveal why people take the type of preventive health measures that they do or seek a particular type of care for illness. While the other answers might be partially correct, they do not represent the best answer for this question.) Page 24

After reading a journal article about culture and cultural diversity, a nurse demonstrates understanding of the information when the nurse identifies which situation as an example of cultural assimilation? A. an American living in France celebrating French National Day B. an Indian national living in America celebrating India's Independence Day C. an American celebrating the 4th of July with his grandparents D. a Mexican celebrating Anniversary of the Battle of Puebla in Puebla, Mexico, with his children

A. an American living in France celebrating French National Day (Cultural assimilation is the process of taking on a culture that is different from one's original culture. The best example of this is an American celebrating a national French holiday when residing in France.) Page 27-28

While taking a health history, the nurse finds out that the pregnant woman of Japanese descent comes from a culture that does not eat meat. Which foods will indicate sufficient protein intake? Select all that apply. A. beans and rice eaten every day B. stir-fried carrots and beans regularly C. egg drop soup 2 to 3 times per week D. dried fruit for dessert E. apples as a snack daily

A. beans and rice eaten every day B. stir-fried carrots and beans regularly C. egg drop soup 2 to 3 times per week (A typical Japanese diet, for example, includes many vegetables such as bean sprouts, broccoli, mushrooms, water chestnuts, and alfalfa. Adequate protein is ingested, however, by mixing sources of incomplete protein such as beans and rice. Neither dried fruit nor apples will not meet protein needs.) Page 34

The nurse is reviewing the medical record of a female client. The history reveals that the client believes that her gender identity and sex match. The nurse would identify the client's gender identity by which term? A. cisgender B. heterosexual C. tansgender D. homosexual

A. cisgender (Cisgender is the term to denote when an individual feels their gender and their sex match. Transgender refers to an individual who feels their gender and their sex do not match. Heterosexual and homosexual are terms that relate to sexual orientation, not gender identity.) Page 37-38

When treating a client from Puerto Rico, a doctor comments to the nurse, "I don't understand why he's lived in this country for 4 years and hasn't learned to speak English yet? What's wrong with him?" This is an example of: A. cultural destructiveness. B. cultural blindness. C. cultural awareness. D. prejudice.

A. cultural destructiveness. (Cultural destructiveness is the belief that everyone should follow the same cultural pattern. Someone who is culturally destructive would see differences as obstacles. This physician's annoyance with the language barrier is an example of cultural destructiveness.) Page 28

As part of the nurse's prenatal checklist when working with an expectant mother, the nurse mentions the potentially harmful effects of the mother drinking alcohol during pregnancy. Both the mother-to-be and her spouse look offended and say, "We are Sikhs! Alcohol is prohibited in our religion." The nurse responds, "I apologize—I am afraid I do not know much about your religion, although I would like to learn more. Are there any resources you could refer me to?" Which behavior is the nurse exhibiting? A. cultural humility B. prejudice C. cultural awareness D. ethnocentrism

A. cultural humility (Cultural humility is a lifelong process of self-reflection and self-critique that begins not with an assessment of a client's beliefs, but rather an assessment of one's own. The nurse exhibits cultural humility in this scenario by being willing to learn more about another culture. The nurse does not exhibit cultural awareness, as the nurse was not already aware that Sikhs do not drink alcohol. However, the nurse is also not exhibiting prejudice, which is a preconceived judgment of a group of people, nor ethnocentrism, which is believing that one's own culture is superior to all others.) Page 28

A clinical nurse specialist is conducting a review class for a group of nurses about cultural competence and cultural diversity. Which term reflects the view of the world and set of traditions of a specific social group passed down through generations? A. culture B. race C. values D. ethnicity

A. culture (Culture consists of the world view and group of traditions shared by a social group and passed down through generations.) Page 28

The nurse cares for a pregnant woman who is lactose intolerant. What food item will the nurse recommend to ensure the client's calcium needs are met? A. dark green vegetables B. cranberry juice C. Greek yogurt D. kidney beans

A. dark green vegetables (When counseling during pregnancy, the nurse should not advise a woman who is lactose intolerant to drink milk or to eat products such as cheese or Greek yogurt. She can obtain adequate calcium through supplements or other foods high in calcium such as dark green vegetables. Other products such as seafood, orange juice (not cranberry), and legumes contain or can be fortified with calcium as well. Kidney beans are a good source of protein.) Page 34

A nurse doing an admission assessment on a new Chinese American client notices that the client will not make eye contact. The most likely reason for this is that it: A. is a sign of respect. B. is a sign of disrespect. C. implies the client is not interested. D. implies the client wants to avoid the nurse.

A. is a sign of respect. (Whether people look at one another when talking is culturally determined. Chinese Americans, for example, may not make eye contact during a conversation. This social custom shows respect for the position of the health care provider and is a compliment and not an avoidance issue.) Page 30

A laboring client, 2 cm dilated and 50% effaced, is screaming in pain. The nurse caring for this client recognizes this woman's response to pain should be documented using which label? A. low pain threshold B. high pain tolerance C. lack of pain control D. inappropriate response to pain

A. low pain threshold (A person's response to pain is both individually and culturally determined. The pain threshold is the point at which the individual reports a stimulus is painful. Pain tolerance is the point at which an individual withdraws from a stimulus. Lack of pain control and inappropriate response to pain reflects the nurse's individual bias.) Page 35

A female-to-male (FTM) transgender individual who has undergone breast surgery wants to become a parent. During the teaching session, which instruction is essential for the client to understand to achieve the goal of pregnancy? A. stopping current testosterone hormone therapy B. discussing how to deal with leakage of milk from nipples C. feeling confident in selecting a supportive health care provider D. discussing safety concerns if victimization occurs during pregnancy

A. stopping current testosterone hormone therapy (To sustain a successful pregnancy, it is essential to stop testosterone hormone therapy to carry the pregnancy. The cessation of testosterone and the changes that occur with pregnancy can cause huge shifts in an individual's mental well-being and can lead to increased gender dysphoria. FTM transgender individuals may also find it difficult to obtain an understanding health care provider, one whom they can trust and who can care for the specific needs related to pregnancy, gender dysphoria, and lactation. Though important, this ultimately does not achieve the goal of pregnancy. Breast surgery involves removal of the breasts as part of the transitioning; therefore, there will be no leakage of milk with pregnancy. Transgender women face victimization at twice the rate that cisgender women do; however, there is no indication that this is a problem in this scenario.) Page 38

A nurse is teaching the parents about administering medication to their child. The medication should be administered every 6 hours. Assessment reveals that the family does not have a strict time orientation. When teaching the parents about administering the medication, which statement by the nurse would be appropriate to promote the best outcome? A. "You must give the medicine at 6 am, 12 noon, 6 pm, and 12 midnight." B. "It is important that you give the medicine 4 times per day." C. "Just make sure your child gets the medicine once per day." D. "It is okay if you miss some doses during the day."

B. "It is important that you give the medicine 4 times per day." (Although giving the medication at 6-hour intervals is important, people who do not have strict time orientation may have difficulty following a strict medical regimen. If they are told, for example, to give a child a medication at 6 am, 12 noon, 6 pm, and 12 midnight daily, the nurse may need to stress that the medication must be administered four times a day, not necessarily at the specific times. The key is to ensure that the child gets the correct doses. Telling the parents that one dose/day or missing a dose is okay would be inappropriate because it would not allow the medication to be effective.) Page 30

A woman in active labor begins to recite a lullaby to "call the baby outside." Which action by the nurse caring for this woman is most appropriate at this time? A. Administer IV pain medication. B. Allow the client to perform a ritual. C. Ask the woman the importance of this lullaby to her culture. D. Ask the family to join in with the singing of this lullaby.

B. Allow the client to perform a ritual. (The nurse can acknowledge and celebrate a client's culture without stereotyping by such actions as ensuring that the client has the opportunity to perform her cultural traditions during labor, such as reciting a lullaby to "call her child outside." There is no indication that pain medication is needed at this time. When one respects the culture, quizzing about the purpose or importance of reciting this lullaby is inappropriate.) Page 26

A woman is in the second stage of labor, 8-cm dilated and 90% effaced. She keeps very quiet without expressing any outward signs of pain. Which intervention by the nurse would be most appropriate in this situation? A. Administer pain medication without asking the woman. B. Allow the woman to labor according to her cultural beliefs. C. Monitor the woman to attempt to predict when it is time to push. D. Review the nursing goal to minimize the amount of pain with birth.

B. Allow the woman to labor according to her cultural beliefs. (The way people respond to pain is an example of a trait that is heavily influenced by culture. Some women and children scream with pain; others remain stoic and quiet. Both are "proper" responses, just culturally different. The best nursing intervention is to allow the woman to labor the way that is best for her. Administering pain medication without permission is unacceptable nursing practice. The nurse will have to assess the woman frequently, especially noting if any blood is coming from the vagina and performing frequent vaginal exams to know when it is time to push. "A close watch" could mean just looking into the room frequently. In some cultures, being stoic is expected behavior, so minimizing the pain may not be the goal of the woman.) Page 28

The nurse is scheduled to work in a clinic in a neighborhood with many diverse cultures. Which action(s) by the nurse demonstrate cultural competence? Select all that apply. A. The nurse provides instructions to the mother only. B. The nurse asks the child or family about the use of folk remedies. C. The nurse learns about the demographic of the neighborhood. D. The nurse researches folk healers in the area. E. The nurse speaks to the father regarding health care decisions.

B. The nurse asks the child or family about the use of folk remedies. C. The nurse learns about the demographic of the neighborhood. D. The nurse researches folk healers in the area. (Cultural competence is the ability to apply knowledge about a child's culture so that health care interventions can be adapted to meet the needs of the child. It is crucial that the nurse remembers that diversity exists within cultures and this is as important as the diversity between cultures. Every child is a unique individual with his or her own beliefs, values, and history. Nurses need to avoid stereotyping, which can lead to misconceptions. The nurse should know about local culture-based health practices and how they may affect children, as well as the demographics of the local population. The nurse should inquire about client preferences, beliefs and values.) Page 28

A client asks a nurse how to preserve cultural heritage for the client's American-born children. What suggestion(s) might the nurse offer? Select all that apply. A. Serve ethnic food occasionally, and make these meals family-only events. B. Read books with children written by authors that promote your culture. C. Encourage children to investigate their friends' cultures. D. Talk to children about your childhood, traditions, and values. E. Celebrate holidays in your traditional manner.

B. Read books with children written by authors that promote your culture. D. Talk to children about your childhood, traditions, and values. E. Celebrate holidays in your traditional manner. (Preserving individual heritage when living in another culture calls for creative planning. Some common suggestions include: (1) Plan an "ethnic night" once a week when only ethnic food is served. Encourage children to invite friends for the meal and discuss the traditions behind the various foods. (2) If a foreign language is part of your traditions, reserve one night a week when family members speak only the native language so they will value two languages. (3) Choose books for children that are written by authors from your culture authors that promote your culture. Read them together as a family. (4) Monitor television for programs that focus positively on your culture. Watch them with your children. (5) As bedtime stories or "talk time," talk to your children about your childhood and traditions and values so they can appreciate how long these values have been revered by your family. (6) Celebrate holidays in your traditional manner. Including cultural influences in holiday celebrations adds a rich ingredient and feeling of security to these occasions. Learning about another friend's culture does not promote an understanding of their own culture.) Page 27

An Islamic woman is in active labor and informs the nurse that she is fasting during the day since it is Ramadan. What would the nurse assess for in this woman related to her cultural ritual? A. Fasting will be able to continue since laboring women are not allowed to eat at this time. B. Respect this woman's faith, but also assess for dehydration and hypoglycemia. C. Ask the family to bring in traditional foods during the evening hours so the woman can receive some nourishment. D. Call the health care provider for a prescription for IV fluids to keep her hydrated as she labors.

B. Respect this woman's faith, but also assess for dehydration and hypoglycemia. (Knowing which religion a family practices can help the nurse locate the correct religious support person if one is needed. It helps in planning care if the nurse knows a woman wants a time set aside daily for private prayer or if she intends to fast, such as during Ramadan. The nurse should respect the woman's faith; however, the nurse should also assess hydration status and for hypoglycemia since she is fasting yet working hard to give birth to the infant. Most women in labor can drink fluids throughout the labor process. Asking the family to supply foods may be appropriate but also may be inappropriate if the woman is the one that cooks for the family. Hydration in the form of IV fluids may be considered inappropriate since the culture is for fasting from fluids and food.) Page 31

A nurse is assigned four clients for care. The clients are from various cultures. The nurse says, "I don't think people have any differences. I think we are all alike, and so I plan to treat all of my clients equally and with respect." Which response by the charge nurse is appropriate? A. The charge nurse agrees and states that respect is important. B. The charge nurse disagrees stating cultural blindness has occurred. C. The charge nurse agrees stating the nurse is being culturally sensitive. D. The charge nurse disagrees stating equality is not always achievable.

B. The charge nurse disagrees stating cultural blindness has occurred. (The charge nurse is correct to disagree with the nurse's statement. People commit cultural blindness when they do not see or believe there are cultural differences among people. Cultural destructiveness can occur by making everyone fit the same cultural pattern, and excluding those who don't fit. Equality is strived for with cultural sensitivity in understanding and accepting different cultural values, attitudes, and behaviors. Agreeing with the nurse's statement does not represent cultural competence.) Page 28

A school-aged child with immigrant parents expresses concern to the school nurse about feeling embarrassed over the parents' limited ability to speak the dominant language, noting that classmates are sometimes cruel. After counseling the child, the nurse identifies that which evaluation reflects a positive outcome for this child? A. The child does not directly confront the teasing classmates about the parents' heritage, and instead talks with a teacher. B. The child sees their differences but no longer feels isolated because of the family's differences. C. The child finds a voice and confronts the children who have been making fun of the parents' heritage. D. The child tries to blend in with the peer group and tries to avert attention from the parents' culture.

B. The child sees their differences but no longer feels isolated because of the family's differences. (When a child states that they no longer feel socially isolated because of the family's differences, this is an example of an expected outcome that has been resolved positively. Not directly confronting teasing friends usually does not make the child feel positive. Finding a voice and confronting classmates who make fun of their background is not the ideal way for the child to deal with this situation. Blending in with peers can be beneficial, but not if the child is trying to avert attention from the parents' culture.) Page 26

During an interview with a client, the nurse asks the client about their sexual orientation. The client tells the nurse, "I am queer." The nurse interprets this statement as indicating which situation? A. The client is strictly bisexual. B. The client is not exclusively heterosexual. C. The client's gender identity differs from their sex assigned at birth. D. The client does not identify as being solely male or female.

B. The client is not exclusively heterosexual. (Queer is an adjective used by some people to indicate that their sexual orientation is not exclusively heterosexual. Sometimes, for those who identify as queer, the terms "lesbian," "gay," and "bisexual" are perceived to be too limiting and/or fraught with cultural connotations they feel do not apply to them. People are bisexual if they achieve sexual satisfaction from both same-sex and heterosexual relationships. Transgender is an umbrella term for people whose gender identity and/or gender expression differs from what is typically associated with the sex they were assigned at birth. Nonbinary is a gender identity term that refers to a person who does not identify as being solely male or solely female.) Page 35-36

While interviewing a client, a nurse assesses the client's reaction to health care and determines that the reaction reflects the client's preferred ways of acting based on traditions. Which term would the nurse use to document this information? A. culture B. cultural values C. ethnicity D. race

B. cultural values (Culture is a view of the world and a set of traditions that a specific social group uses and transmits to the next generation. Cultural values are preferred ways of acting based on those traditions. Ethnicity refers to the cultural group into which a person was born, although the term is sometimes used in a narrower context to mean only race. Race refers to a category of people who share a socially recognized physical characteristic. The term is rarely used today as the research on the human genome shows no basic differences in structure among people.) Page 27

Native Americans who are wearing their tribal dress are demonstrating their native dance to a community group. This is an example of: A. acculturation. B. ethnicity. C. race. D. ethnocentrism.

B. ethnicity. (Ethnicity is the bond or kinship that people feel with their country of birth or place of ancestral origin. Race refers to biologic differences in physical features, such as skin color and eye shape. Ethnocentrism is the belief that one's ethnic heritage is the "correct" one and superior to others. Acculturation involves the process of adapting to or taking on the behaviors of another group.) Page 26 & 28

A nurse is discussing calcium with a client who is lactose intolerant. Which foods will the nurse include when selecting the client's dinner? A. baked potato with butter and sour cream B. green leafy salad C. hot dog and bun D. fruit and yogurt parfait

B. green leafy salad (The nurse should counsel this client to consider what the food choices contain in order to decide if milk or milk products are present. Milk products should not be recommended to a client who has an intolerance to lactose. A green leafy salad is high in calcium and contains no milk or milk products, so it is the best choice. Sour cream and yogurt both contain milk products. Processed meats, such as deli meat and hot dogs, also contain dairy as well as some breads and buns.) Page 27 & 34

A group of women having sex with women (WSW) are attending a free medical care health fair in their community. When caring for this population, the nurse will assess for which potential health condition? Select all that apply. A. human immunodeficiency virus (HIV) B. human papillomavirus (HPV) C. herpes simplex virus type 2 (HSV-2) D. endometrial cancer E. cervical polyps

B. human papillomavirus (HPV) C. herpes simplex virus type 2 (HSV-2) (There is a belief that women who have sex with women (WSW) are at much lower risk for contracting sexually transmitted infections. Although there may be a lower incidence of HIV in this population, there is still the risk for contracting human papillomavirus (HPV) and herpes simplex virus type 2 (HSV-2) because these are transmitted via skin-to-skin contact. WSW are not at any higher risk for development of endometrial cancer and cervical polyps.) Page 36

A nurse encourages both partners in a lesbian family to come into the examining room with the newborn during a well-baby check. What type of nursing is the nurse practicing? A. community nursing B. transcultural nursing C. ethnic nursing D. stereotyping nursing

B. transcultural nursing (Transcultural nursing is care guided by cultural aspects and respects individual differences. Community nursing is nursing care that takes place for a group of people in a specific area. Ethnicity refers to the cultural group into which a person was born. Stereotyping means expecting a person to act in a characteristic way without regard to his or her individual traits.) Page 27

A Native American who has just delivered her first child asks the nurse if she might have the placenta to take home. The nurse tells a co-worker that she thought it was the most bizarre request she has ever heard. This is an example of which type of behavior by the nurse? A. assimilation B. acculturation C. ethnocentrism D. discrimination

C. ethnocentrism (Ethnocentrism is the belief that one's own culture is superior to all others. Assimilation means that people have adopted the values of the dominant culture. Acculturation refers to the loss of ethnic traditions when a person gives up his or her native country's traditions for another's. Discrimination is the act of treating people differently based on their physical or cultural traits.) Page 28

The nurse is preparing to teach a class on cultural differences to a group of clients from the community. Which principle of culture will the nurse consider while planning the class information? A. Individuals are born with an understanding of their specific culture. B. Culture is always centered around religious activities and beliefs. C. Each generation learns about culture from family and the community. D. Culture is determined by one's own morals and personal beliefs.

C. Each generation learns about culture from family and the community. (Culture is a shared, not individual, system of beliefs, values, and behavioral expectations that provide social structure for daily living. Culture includes the beliefs, habits, likes and dislikes, and customs and rituals learned from family and the community through a process called enculturation. Individuals are not born with a sense or awareness of culture. Some cultures are heavily centered on religious practices and customs, however, all are not.) Page 27

Which concept characterizes transcultural nursing? A. Performing health-related activities and restoring wellness B. Acknowledging that clients with the same skin have similar social situations C. Planning care compatible with the client's health belief system D. Influencing culture by specific conditions related to an environment

C. Planning care compatible with the client's health belief system (Planning care compatible with the client's health belief system is a characteristic of transcultural nursing. Acknowledging that clients with the same skin color have similar social situations leads to stereotyping. Stereotyping can be dangerous because it is dehumanizing and also interferes in accepting others as unique individuals. Culture is influenced by specific conditions related to environment. Performing health-related activities and restoring wellness is an important aspect of nursing and does not only pertain to transcultural nursing.) Page 27 & 31

During shift hand-off, one nurse tells another nurse, "The client in room 1 has a different approach to treatment than I am used to seeing in clients. The client taught me a valuable lesson about assuming that all cultures react the same." The nurse is demonstrating which characteristic? A. cultural destructiveness B. cultural blindness C. cultural sensitivity D. cultural competence

C. cultural sensitivity (Cultural sensitivity is understanding and accepting different cultural values, attitudes, and behaviors. Cultural destructiveness is making everyone fit the same cultural pattern and excluding those who do not fit. People commit cultural blindness when they do not see or believe there are cultural differences among people. Cultural competence is the capacity to work effectively with people, integrating elements of their culture—vocabulary, values, attitudes, rules, and norms.) Page 28

A lesbian woman is in labor, and she has just arrived with her partner to the labor and delivery unit. The nurse who is up next for an assignment refuses to take care of this couple because to do so conflicts with her religious beliefs. This an example of: A. ethnocentrism. B. cultural blindness. C. discrimination. D. prejudice.

C. discrimination. (Discrimination is an actual act in which a person or a group of people are treated differently because of a physical or cultural trait.) Page 36-37

A 19-year-old pregnant adolescent who experienced a rape has arrive in the hospital in active labor with no prenatal care. It is priority for the nurse to assess the client for which potential adverse health concern? A. gestational diabetes B. preeclampsia C. sexually transmitted infections D. alcohol or drug withdrawal symptoms

C. sexually transmitted infections (Any pregnant female who presents without any prenatal care may be at increased risk for adverse health conditions, which may include sexually transmitted infections (STIs). STI risk is higher for victims of rape. It is rare for a younger client to develop gestational diabetes or preeclampsia. There is no indication that the client has an alcohol or substance use disorder.) Page 36

The nurse educator has completed a presentation on caring for babies born to mothers with a substance use disorder. Which statement by a participant would indicate the need for further education? A. "Babies born to mothers with a substance use disorder tend to be small for gestational age." B. "When a pregnant woman suffers from a substance use disorder, the child may suffer from withdrawal symptoms when born." C. "Mothers with a substance use disorder are at a higher risk for having a child with physical abnormalities." D. "Babies born to a mother with a substance use disorder don't have any difficulty eating."

D. "Babies born to a mother with a substance use disorder don't have any difficulty eating." (Babies born to mothers with a substance use disorder tend to be small for gestational age. They may also suffer from withdrawal symptoms and are at a higher risk for both physical and mental abnormalities. They may also suffer from problems eating, such as a decreased ability to suck. Some of the problems of the baby may not be immediately apparent, because these problems can also encompass cognitive and skill-attainment delays.) Page 36

While reviewing a woman's compliance with prenatal care, a nurse notes that which comment made by the woman may be a result of poverty rather than a cultural difference? A. "I just don't understand why I have to give up alcohol when I am pregnant." B. "In my culture, many women crave pica foods throughout the pregnancy." C. "I can't rest in the afternoon since I work all day, and then I have to pick my children up from day care." D. "I wish I could afford fresh fruits for vitamin C because I just don't remember to take those prenatal vitamins."

D. "I wish I could afford fresh fruits for vitamin C because I just don't remember to take those prenatal vitamins." (Many characteristic responses described as cultural limitations are actually the consequences of poverty (e.g., parents seeking medical care for their children late in the course of an illness or a woman not taking prenatal vitamins during pregnancy). Solving these problems may be a question of locating adequate financial resources and may not be related to cultural differences. Reducing alcohol intake may be an addiction problem. Many women work when they are pregnant and cannot take an afternoon rest. Working may or may not be due to poverty, so the nurse will have to ask additional questions before concluding the woman lives in poverty.) Page 25

When a pregnant client explains to the nurse that strawberries cause birthmarks, what is the nurse's best response? A. "That is ridiculous. Strawberries do not cause birthmarks." B. "Strawberries are high in folic acid and are great food for you and your baby." C. "You should eat at least 3 to 5 servings of fruit a day. Strawberries are a great way to get a serving in." D. "Wow, that's very interesting. Where did you learn that?"

D. "Wow, that's very interesting. Where did you learn that?" (Cultural influences can have a large impact on diet, and many clients choose to avoid certain foods at certain times. The most therapeutic response would be to have the client elaborate on this belief so the nurse may gain a better understanding of the client and her conceptions.) Page 34

A pregnant woman arrives in the L & D unit following premature rupture of membranes along with her spouse, who insists on being present and demands only female nurses assess his wife. When obtaining history and assessment data, the spouse provides all the answers. What is the best approach for the nurse to handle this situation? A. Call security and then inform the spouse that staff members need to speak with the woman alone. B. Evaluate whether it is essential to stand up to the spouse or pacify him. C. Educate the spouse about his expected role in the birthing process. D. Act as an advocate for the woman who has a male-dominant partner.

D. Act as an advocate for the woman who has a male-dominant partner. (In many cultures, the man is the dominant figure. In a strongly male-dominant culture, if approval for hospital admission or therapy is needed, the man would prefer to give this approval. Since the woman is a nondominant member of the family, the nurse may have to act as an advocate for her with a more dominant partner. Security would be viewed as a threat and not appropriate at this time. To gain information from the woman, the nurse may need to confront the spouse about his role in the birthing process. It is not appropriate to educate the spouse because this is a long-standing family environment, and this is not the time to try to change the family culture toward females.) Page 31

The mother of an infant is staying on the unit. The pediatric nurse notes that the infant has not received the recommended vaccinations for his age, so the nurse provides information on immunizations to the mother. The mother informs the nurse that immunizations are against her cultural and religious beliefs, and she does not want her child to receive immunizations. In this scenario, what do immunizations represent? A. acculturation B. cultural blindness C. a cultural imposition D. a cultural taboo

D. a cultural taboo (Immunizations in this scenario are a cultural taboo. Cultural taboos are defined as activities or behaviors that are avoided, forbidden, or prohibited by a particular cultural group. Cultural imposition is defined as the tendency to impose one's cultural beliefs, values, and patterns of behavior on a person from a different culture. Acculturation is the process by which members of a cultural group adapt to or learn how to take on the behaviors of another group. Cultural blindness is the inability of people to recognize their own values, beliefs, and practices and those of others because of strong ethnocentric tendencies.) Page 28

During labor, the nurse performs frequent cervical assessments. This would be considered the use of what type of space? A. public space B. business space C. conversational space D. intimate space

D. intimate space (Intimate space is the space closely surrounding a person. Physical examinations are conducted in this very tight space because palpation and auscultation are parts of the examination. Conversational space is usually 18 inches (46 cm) to 4 feet (1.2 m) away. Beyond 4 feet is business space. Public space is any distance beyond business space such as shouting across a parking lot.) Page 30