nursing 222 chapter 5

ethnicity

sense of identification that a cultural group collectively has; sharing of common and unique cultural and social believes and behavior patterns

culture conflict

situation that occurs when people become aware of cultural differences, feel threatened, and respond by ridiculing the beliefs and traditions of others to make themselves feel more secure about their own values

A nurse is admitting a client to the unit. Which cultural question is most appropriate? a. "Will you be making requests for special food based on your religion?" b. "Will you be able to eat the normal food provided?" c. "What are your dietary needs and preferences?" d. "Do you have food restrictions?"

c. "What are your dietary needs and preferences?"

personal space

external environment surrounding a person that is regarded as being part of that person

subculture

group of people with different interests or goals than the primary culture

A nurse is working in a clinic that serves a community with a high population of immigrants. Which nursing assessment is the priority? a. Language assessment b. Blood sugar assessment c. Spiritual assessment d. Blood pressure assessment

a. Language assessment

culture

The sum total of the knowledge, attitudes, and habitual behavior patterns shared and transmitted by the members of a society.

The nurse works in an urban hospital and cares for a diverse population of clients. Which action(s) by the nurse demonstrates the delivery of culturally sensitive care to clients? Select all that apply. a. asking the client questions regarding health care beliefs related to the client's culture b. maintaining direct eye contact during conversations with all cultural groups c. indicating that the cultural groups should adapt to the Anglo-American culture d. allowing the client to keep a religious necklace on until going into the operating room e. integrating the client's cultural practices when assisting with the creation of the plan of care

a, c, d

A client has been admitted to the unit for chest pain. A nurse told the family that they could not be with the client. The family became very upset, and now the client wants to leave. What is the most culturally appropriate response by the charge nurse? a. "Would you feel more comfortable with your family with you?" b. "Why do you think you need to leave?" c. "If you leave, you will be asked to sign a form indicating that you are leaving against medical advice." d. "Sometimes family can cause stress, and we try to maintain a stress-free care environment."

a. "Would you feel more comfortable with your family with you?"

A nurse convinces a client who is a Jehovah's Witness that receiving blood products is more important than the legalistic components of religion. What client reaction may be expected following this mandated change? a. The client states, "I feel like I abandoned my religion." b. The client states, "Why isn't blood administration forced on all who need that treatment?" c. The client states, "I can't get over my feelings of legalism as a Jehovah's Witness." d. The client states, "I am glad that nurse told me what to do."

a. The client states, "I feel like I abandoned my religion."

A nurse is conducting a cultural assessment of a client. Which person would the nurse identify as the expert? a. Client b. Health care provider c. Nurse d. Older family member

a. client

The use of one's culture as a cultural standard is known as: a. ethnocentrism. b. cultural relativity. c. culture. d. ritualism.

a. ethnocentrism

The nurse just attended a seminar on cultural diversity. Which statement by the nurse would require further education? a. "People of the same ethnicity share many of the same cultural and social beliefs." b. "Ethnicity and race are the same thing and are affected by cultural practice." c. "Ethnicity begins at birth or through adoption of characteristics." d. "Ethnicity can often determine dialect and political interests."

b. "Ethnicity and race are the same thing and are affected by cultural practice."

The nurse is taking a client history. With which client is direct eye contact appropriate? a. 44-year-old woman of Asian descent b. 32-year-old white woman c. 60-year-old woman of Arab descent d. 55-year-old Native American/First Nations woman

b. 32-year-old white woman

When completing a transcultural assessment of communication, which assessment by the nurse is most appropriate? a. Assessment of religious beliefs and prayer schedules b. Assessment of income level to determine poverty status c. Assessment of eye contact, personal space, and social taboos d. Assessment of racial identification and cultural affiliation

c. Assessment of eye contact, personal space, and social taboos

A staff nurse meets with the charge nurse and is reporting that all the new nurses are leaving messes on the unit. The staff nurse states, "These youngsters think they can waltz in here and get our jobs." What is this nurse demonstrating? a. Cultural blindness b. Cultural diversity c. Cultural conflict d. Cultural assimilation

c. Cultural conflict

cultural diversity

coexistence of different ethnic, biological sex, racial, and socioeconomic groups within one social unit

The community health nurse is developing a workshop for a group of Native American/First Nation clients. Which topic should the nurse teach? a. Heart-healthy diets b. Preventing diabetes c. Signs of stroke d. Alcohol use disorder

d. Alcohol use disorder

While performing the initial assessment of an infant, the nurse notes a soiled string of yarn around the infant's neck. Which response from the nurse would facilitate culturally competent care? a. "I see the sacred string is dirty. In your culture, is it okay that I clean it?" b. "I noticed a ritual string on your child. Is this a cultural practice to protect the child's health?" c. "I noticed the string around your child's neck. Why do you include this practice in your child's health care?" d. "I see you have a string tied to your child's neck. Can you explain why you do this?"

d. "I see you have a string tied to your child's neck. Can you explain why you do this?"

A nurse is demonstrating ethnocentrism. Which statement would reflect this concept? a. "Anybody on welfare is just lazy." b. "Irish people are all heavy drinkers." c. "Asians are always the smartest in the class." d. "My Russian heritage is superior to all others."

d. "My Russian heritage is superior to all others."

The nurse admits a client to the critical care unit to rule out a myocardial infarction. The client has several family members in the waiting room. Which nursing action is most appropriate? a. Explain to the family that too many visitors will tire the client. b. Allow all the visitors into the room. c. Insist that only one family member can be in the room at a time. d. Assess the client's beliefs about family support during hospitalization.

d. Assess the client's beliefs about family support during hospitalization.

Which scenario is an example of cultural competence in nursing? a. Assuming the provider and the client share beliefs and values b. Assessing the rate at which an illness causes death in a culture c. Attending one's own church d. Attending a conference for cultural diversity

d. Attending a conference for cultural diversity

Nurses are responsible for delivering culturally competent care for all clients. Culturally competent care does not account for: a. developmental level. b. available technology. c. individual values. d. client's height.

d. client's height.

The emergency department nurse is caring for a client injured in a motor vehicle collision. The client recently immigrated to the country. The nurse should implement interventions aimed at addressing which issue? a. Generalization b. Ethnocentrism c. Ageism d. Culture shock

d. culture shock

A nurse overhears another nurse make a statement that indicates racism. The nurse makes this determination based on which characteristic indicative of social value? a. Dress b. Size c. Language d. Skin color

d. skin color

cultural assimilation

process that occurs when a minority group, living as part of a dominant group within a culture, loses the cultural characteristics that made it different

cultural imposition

tendency of some to impose their beliefs, practices, and values on another culture because they believe that their ideas are superior to those of another person or group

linguistic competence

the ability of caregivers and organizations to understand and effectively respond to the linguistic needs of patients and their families in a health care encounter

cultural blindness

the process of ignoring differences in people and proceeding as though the differences do not exist

culture shock

those feelings, usually negative, a person experiences when placed in a different culture

The nurse is caring for a client who is postoperative 24 hours from an appendectomy. The client is hesitant to get out of bed. How should the nurse respond? a. "Can you describe what you are feeling when you try to move?" b. "Would like to wait until your family arrives to get out of bed?" c. "I will come back later and help you get up." d. "You need to get up and walk to prevent complications."

a. "Can you describe what you are feeling when you try to move?"

When talking with a client, the nurse notes that the client keeps backing up. What would be the most appropriate response? a. Back away from the client. b. Ask the client about personal space preferences. c. Move closer to the client. d. Ask the client why he or she is backing away.

b. Ask the client about personal space preferences.

A nurse is providing care to a client who is from a different culture. Which aspect about culture would be most important for the nurse to integrate into the client's care? a. Individuals can easily describe their culture. b. Culture is relatively static and unchanging. c. Not all members of the same culture act and think alike. d. Individuals learn culture in a purposeful manner.

c. Not all members of the same culture act and think alike.

The nurse is using an interpreter to communicate with a client who speaks a different language. What would be the best way to choose an interpreter for this client? a. The interpreter should speak in a loud voice. b. The interpreter should always make direct eye contact. c. The interpreter should understand the health care system. d. The interpreter should conduct the conversation quickly to avoid misinterpretation.

c. The interpreter should understand the health care system.

cultural competence

care delivered with an awareness of the aspects of the patient's culture

stereotyping

assigning characteristics to a group of people without considering specific individuality

Nurses are socialized into the: a. nursing specialties. b. healthcare culture. c. caring paradigm. d. diagnostic process.

b. healthcare culture.

The younger nurses on a unit, who seem to adapt easily to the new technology presented, are perceived as threatening by two nurses who have worked on the unit for years. The older nurses begin to ridicule the younger nurses, saying, "You might be able to work a computer, but we know how to provide real care." How should the charge nurse respond? a. The charge nurse should recognize that this is cultural imposition and the younger nurses are forcing new technology on the older nurses. b. The charge nurse should understand that this is stereotyping in the form of racism and intervene immediately. c. The charge nurse should discuss the concept of cultural conflict and help both parties see their respective value to the unit. d. The charge nurse should demonstrate cultural blindness and pretend that the issue does not exist.

c. The charge nurse should discuss the concept of cultural conflict and help both parties see their respective value to the unit

The nursing researcher is studying so-called "unnatural illnesses." What cause of such illnesses would be included in the study? a. Food b. Impurities in water c. Witchcraft d. Cold air

c. witchcraft

What is the priority assessment for the nurse when developing a plan of care for a client living in poverty? a. Access to care b. Access to affordable housing c. Access to financial assistance d. Access to health insurance

a. Access to care

A nurse caring for clients of different cultures in a hospital setting attempts to make eye contact with clients when performing the initial assessment. What assumption might the nurse make based on common cultural practices? a. A Black man rolls his eyes when asked how he copes with stress in the workplace. Assumption: He may feel he has already answered this question and has become impatient. b. A Native American/First Nations man stares at the floor while talking with the nurse. Assumption: The client is embarrassed by the conversation. c. A Muslim-Arab woman refuses to make eye contact with her male nurse. Assumption: She is being modest. d. A Hasidic Jewish man listens intently to a male physician, making direct eye contact with him, but refuses to make eye contact with a female nursing student. Assumption: Jewish men consider women inferior to men.

c. A Muslim-Arab woman refuses to make eye contact with her male nurse. Assumption: She is being modest.

Ethnocentrism

belief that one's own ideas, beliefs, and practices are best, superior, or most preferred to those of others; using one's cultural norms as the standard to evaluate others' beliefs

race

division of human beings based on distinct physical characteristics

The nurse is teaching a family, who has recently learned a family member has a lactase deficiency, how to make healthier dietary choices to ensure the family member obtains enough calcium in their diet. The nurse determines the teaching was successful when they choose which menu as the best choice? a. fried hamburger patty with lettuce, onion slices, tomato, mayonnaise, ketchup, whole wheat bun, french fries, low-fat yogurt, diet soda b. grilled steak, baked potato with butter, corn-on-the-cob, coleslaw (cabbage, carrots, onions and dressing), s'mores (graham crackers, marshmallows, and chocolate bar), water c. salad containing iceberg lettuce, spinach, tuna fish, zucchini, squash, radishes, carrots, celery, red onion, and ranch dressing, an orange, saltine crackers, coffee with nondairy creamer d. baked salmon patty, steamed spinach, sweet potato, salad with romaine lettuce, hard-boiled egg slices, carrots, celery, cucumber, and vinegar vinaigrette dressing, apple slices, ice tea

d. baked salmon patty, steamed spinach, sweet potato, salad with romaine lettuce, hard-boiled egg slices, carrots, celery, cucumber, and vinegar vinaigrette dressing, apple slices, ice tea

Cultural respect

enables nurses to deliever services that are respectful of and responsibe to the health beliefs, practices, and cultural and linguistic needs of diverse patients.

The nurse is caring for a client who is admitted for hypertension (HTN). The nurse notes that the client has not been eating the food provided, and family members have brought in homemade food. What would be the best response by the nurse? a. "Can you tell me what foods you prefer to eat and what your family is bringing you?" b. "It is ok to eat what your family brought you, as long as we see what it is." c. "You should consider eating the food provided, which is healthier." d. "Do you understand the specific diet for your HTN?"

a. "Can you tell me what foods you prefer to eat and what your family is bringing you?"

The clinic nurse is obtaining demographic data from a client. The client states, "Why do you need to know what my ethnicity is?" How should the nurse respond? a. "Collecting this information allows us to develop a personalized plan of care to meet your needs." b. "Insurance companies requires us to ask all clients." c. "We require the information for identification purposes." d. "Understanding your background will prevent us from doing anything to offend you."

a. "Collecting this information allows us to develop a personalized plan of care to meet your needs."

The nurse is teaching a Black client about common health conditions. Which statement by the client most directly addresses a health problem with an increased incidence in this population group? a. "Increasing dairy will improve my bones." b. "I need to watch the amount of high-density lipids I eat." c. "Getting a mammogram in my thirties is important." d. "It is important to monitor my blood pressure."

d. "It is important to monitor my blood pressure."

A community health nurse is providing care to a group of Hispanic people living in an area that is predominantly populated by white people. What are the Hispanic people in this community an example of? a. A subgroup b. A majority c. A subculture d. A minority

d. a minority

A client is completing a health history form and asks the nurse, "Why does this ask for my ethnicity instead of my race?" What is the appropriate nursing response? a. "Ethnicity is a social category that is being used to replace racial categories." b. "Race is based on physical characteristics, and ethnicity is specific to where you live." c. "Ethnicity is a sense of identity with a collective cultural group." d. "Race and ethnicity are the same thing."

a. "Ethnicity is a social category that is being used to replace racial categories."

When providing culturally competent care to clients, a nurse understands that cultural competence involves which characteristics? Select all that apply. a. A commitment to promoting health equity b. A process that requires life-long learning c. Awareness of one's own influences on responses d. Knowledge of influences on the clients' beliefs e. Guidance by the principles of fidelity

a. A commitment to promoting health equity b. A process that requires life-long learning c. Awareness of one's own influences on responses d. Knowledge of influences on the clients' beliefs

A nurse is providing care to a client from a culture different from the nurse's own. The nurse is having difficulty relating to the client. What intervention by the nurse is most appropriate? a. Ask the client how the client wants to be treated based on the client's values and beliefs. b. Ask another nurse to take over the client's care. c. Consult the Office of Minority Health Resource Center to help in the provision of care. d. Look up the client's culture online and try to figure out methods to relate.

a. Ask the client how the client wants to be treated based on the client's values and beliefs

Which behavior by the nurse is stereotyping? a. Avoiding older adult clients because their care is time consuming b. Openly ridiculing the practice of acupuncture c. Explaining to others that Western medicine is always superior d. Grouping care assignments to allow ample time to care for complex clients

a. Avoiding older adult clients because their care is time consuming

A client believes that the illness is caused by an imbalance of yin and yang. The nurse states, "You can call it whatever you believe, but you have a metabolic disorder." What is this nurse demonstrating? a. Cultural blindness b. Stereotyping c. Ethnocentrism d. Cultural diversity

a. Cultural blindness

How is culture learned by each new generation? a. Formal and informal experiences b. Involvement in religious activities c. Belonging to a subculture d. Ethnic heritage

a. Formal and informal experiences

The nurse is caring for a client who perceives time differently. What action should the nurse take for this client? a. Maintain flexibility when the client requests interventions at specific times. b. Perform interventions at random times during shift. c. Have the client set all times for the interventions. d. Set all interventions to be done at specific times.

a. Maintain flexibility when the client requests interventions at specific times.

The nurse is assessing an infant of Asian descent and notes dark blue spots on the infant's lower back. What action should the nurse take next? a. Press lightly on the pigmented area and observe the infant's reaction. b. Document and report the findings to authorities. c. Ask the parents to leave the room and conduct a thorough assessment. d. Contact the health care provider.

a. Press lightly on the pigmented area and observe the infant's reaction.

The nurse is providing discharge teaching for a client who is from a different culture. The nurse notes that the client will look away from the nurse and does not maintain eye contact. What would be the most appropriate action by the nurse, with regard to culturally competent care? a. Utilize a key informant and continue with the teaching, verifying the client's understanding through open-ended questions. b. Change positions to promote eye contact with the client, asking open-ended questions to ensure understanding. c. Continue with teaching and leave written instructions for the client to review. d. Tell the client that it is important to pay attention to the teaching and ask if the client would like an interpreter.

a. Utilize a key informant and continue with the teaching, verifying the client's understanding through open-ended questions.

A parent informs the nurse that immunizations are against the parent's cultural and religious beliefs and the parent does not want the child to receive immunizations. The nurse proceeds to inform the parent that the child will be consistently ill and will not be allowed to start school unless immunized. The nurse also informs the parent that the nurse had all of the nurse's own children vaccinated. The nurse's behavior an example of: a. cultural imposition. b. cultural blindness. c. cultural conflict. d. stereotyping.

a. cultural imposition.

A nurse interviews a client to determine the client's health beliefs and behaviors. The nurse uses this information for which aspects of care? a. Providing nurse-centered communication b. Conducting an assessment c. Developing client outcomes d. Providing client education e. Complementing interventions

b,c,d

The nurse has just attended a seminar on concepts of cultural diversity. Which statement made by the nurse would require further education? a. "Culture can be seen in attitudes and institutions of certain populations." b. "Culture cannot be influenced, and you are born with your culture." c. "Culture helps to define identity within specific groups of people." d. "Language is the primary way that people share their culture."

b. "Culture cannot be influenced, and you are born with your culture."

The unlicensed assistive personnel reports to the nurse that the client is refusing to eat the food on the meal tray. The nurse observes the client eating the food brought in by family members. How should the nurse respond? a. Do you understand that you are on a strict diet and any variation can cause you harm?" b. "What type of food did your family prepare for you, and does it have special meaning?" c. "You can only eat the food that we serve you." d. "I will need to get permission from your health care provider for you to eat the food your family brought in."

b. "What type of food did your family prepare for you, and does it have special meaning?"

A client is admitted to the health care facility with hypoglycemia. After the client is stable, the nurse discovers that the client has not taken the prescribed medicines. The client believes that eating saffron will keep blood sugar under control. What is the most appropriate response by the nurse? a. "Let me inform the health care provider that you are not taking your medicines." b. "What would you think about taking the medicines, too, and benefitting from both?" c. "Saffron does not have any effect on blood sugar level." d. "Yes, I agree that you should continue taking saffron for diabetes."

b. "What would you think about taking the medicines, too, and benefitting from both?"

The nurse is caring for a terminally ill client who immigrated from Mexico. Which nursing intervention regarding spiritual care is appropriate? a. Do nothing unless the client requests spiritual assistance. b. Ask the client if a spiritual leader is desired. c. Inquire if the client desires the Sacrament of the Sick. d. Call a Roman Catholic priest to visit the client.

b. Ask the client if a spiritual leader is desired.

A client is admitted with end-stage pancreatic cancer and is experiencing extreme pain. The client asks the nurse whether an acupuncturist can come to the hospital to help manage the pain. The nurse states, "You won't need acupuncture. We have pain medications." Which characteristic has the nurse displayed? a Cultural conflict b. Cultural imposition c. Culture shock d. Stereotyping

b. Cultural imposition

A family recently immigrated to a new country. The parent reports that the teenager is showing signs of fear, has vague reports of stomach pain, and feels humiliated by peers because of their culture. What is the priority assessment for the nurse? a. Cultural assimilation b. Culture shock c. Cultural imposition d. Cultural blindness

b. Culture shock

The nurse is caring for a client who does not speak the dominant language. In order to facilitate unencumbered communication with the client, the nurse will take which action(s)? Select all that apply. a. Ask the client's child, who speaks the dominant language, to explain treatment options to the client. b. Review facility policy on communication with clients who do not speak the dominant language. c. Request that the client's spouse carries out language interpretation at discharge. d. Determine in which language the client communicates effectively. e. Schedule a certified interpreter when collecting client health history.

b. Review facility policy on communication with clients who do not speak the dominant language. d. Determine in which language the client communicates effectively. e. Schedule a certified interpreter when collecting client health history.

The nurse is caring for a client admitted with an upper respiratory infection. The client tells the nurse about following the holistic belief of hot/cold. Which food items should the nurse provide to the client based on this information? a. Chicken salad, water, and a frozen fruit juice bar b. Soup, hot tea, and toast c. Fruit salad, apple juice, and pudding d. Turkey sandwich, milk, and gelatin

b. Soup, hot tea, and toast

The home health nurse is conducting the health history interview with a client who does not speak the dominant language. What would be the best action made by the nurse? a. Write out all questions using appropriate medical terms. b. Use simple words with simple actions. c. Conduct the health history utilizing a telephonic interpreter (over-the-phone translation). d. If the client does not answer, repeat the question again using a louder tone.

c. Conduct the health history utilizing a telephonic interpreter (over-the-phone translation).

Which nursing intervention reflects practice according to Madeline Leininger's transcultural nursing theory? a. Providing the same care to each client who has had a myocardial infarction b. Planning dietary interventions according to physiological condition c. Incorporating the client's request for complementary treatment therapy d. Contacting a chaplain for every client

c. Incorporating the client's request for complementary treatment therapy

While caring for a client from a culture different from the nurse's, the nurse inadvertently offends the client. What is the best action by the nurse? a. Ask the client why the client is so mad. b. Examine the interaction and focus on the majority culture. c. Learn from the mistake and do not repeat it. d. Recognize that there is a cultural bias that led to the mistake.

c. Learn from the mistake and do not repeat it.

A client who immigrated from another country informs the nurse of dietary requests. The nurse responds to the special dietary needs by stating, "You are now living here, and you should try to start eating those foods common to our diet." This inappropriate response is an example of: a. cultural blindness. b. cultural assimilation. c. cultural imposition. d. cultural diversity.

c. cultural imposition

transcultural nursing

xc providing nursing care that is planned and implemented in a way that is sensitive to the needs of individuals, families, and groups representing the diverse cultural populations within our society