Wong's Ch. 2: Family, Social, Cultural, and Religious Influences on Child Health Promotion

A parent of a newborn is expressing concern about returning to work after taking time off under the Family and Medical Leave Act (FMLA). The nurse understands that the Act allows a new parent to take off from work for _____ weeks. (Record your answer as a whole number.) a. 6 b. 12 c. 18 d. 24

ANS: 12 The passage of the Family and Medical Leave Act (FMLA) in 1993 set the stage for a greater focus on the issues of contemporary families. FMLA allows eligible employees to take up to 12 weeks of unpaid leave each year to care for newborn or newly adopted children, parents, or spouses who have serious health conditions or to recover from their own serious health condition.

A parent of a 12-year-old child states to the nurse, My 12-year-old watches TV constantly while at homeis this OK? The nurse should recommend to the parent that television viewing should be limited to _____ hours a day? (Record your answer in a whole number.)

ANS: 2 Children may identify closely with people or characters portrayed in reading materials, movies, and television programs and commercials. Pediatric nurses can educate and support parents on the effects of mass media on their children by recommending that television viewing should be limited to 2 hours a day or less.

A nurse is admitting a child, in foster care, to the hospital. The nurse recognizes that foster parents care for the child _____ hours a day. (Record your answer as a whole number.) a. 12 b. 24 c. 36 d. 48

ANS: 24 The term foster care is defined as 24-hour substitute care for children outside of their own homes.

A nurse is assessing a familys structure. Which describes a family in which a mother, her children, and a stepfather live together? a. Blended b. Nuclear c. Binuclear d. Extended

ANS: A A blended family contains at least one step-parent, step-sibling, or half-sibling. The nuclear family consists of two parents and their children. No other relatives or nonrelatives are present in the household. In binuclear families, parents continue the parenting role while terminating the spousal unit. For example, when joint custody is assigned by the court, each parent has equal rights and responsibilities for the minor child or children. An extended family contains at least one parent, one or more children, and one or more members (related or unrelated) other than a parent or sibling.

A young child from Mexico is hospitalized for a serious illness. The father tells the nurse that the child is being punished by God for being bad. The nurse should recognize that this is a(n): a. health belief common in this culture. b. early indication of potential child abuse. c. misunderstanding of the familys common beliefs. d. belief common when fortune tellers have been used.

ANS: A A common health belief in the Mexican-American cultural group is that health is controlled by the environment, fate, and the will of God. The fathers comment has no relation to child abuse. The father would not misunderstand the familys beliefs. It is a cultural belief that health is controlled by the environment, fate, and the will of God. Mexicans may use the services of curandero (healers), not fortune tellers.

When minority groups immigrate to another country, a certain degree of cultural or ethnic blending occurs through the involuntary process of: a. acculturation. b. ethnocentrism. c. culture shock. d. cultural sensitivity.

ANS: A Acculturation is the gradual changes that are produced in a culture by the influence of another culture that cause one or both cultures to become more similar. The minority culture is forced to learn the majority culture to survive. Ethnocentrism is the belief that ones way of living and behaving is the best way. This includes the emotional attitude that the values, beliefs, and perceptions of ones ethnic group are superior to those of others. This would limit the blending. Culture shock is the helpless feeling and state of disorientation felt by an outsider attempting to adapt to a different culture group. This would limit the blending. Cultural sensitivity is an awareness of cultural similarities and differences. The nurse should develop the dynamics of cultural sensitivity to provide culturally competent care.

A 35-year-old client is currently on fertility treatments. When responding to a question from the client about multiple births, which statement by the nurse is accurate? a. Use of fertility treatments has been associated with an increase in multiple births. b. Your chance of having multiple births is at the same rate as all women of childbearing age. c. There is not enough evidence about the use of fertility treatments increasing the rate of multiple births. d. Because of your age and the fertility treatments, you have almost a 100% chance of a multiple birth.

ANS: A Because women in their thirties are almost 2.5 times as likely as women in their twenties to have higher-order plural births, increased childbearing among older women and the expanded use of fertility drugs have been associated with an increase in the multiple-birth ratio. The rate of having a multiple birth for this client is not the same for all women of childbearing age. There are data indicating that fertility treatments increase the rate of multiple births, but fertility treatments do not have a 100% rate of multiple births.

Currently, the fastest-growing segment of the homeless population in the United States consists of: a. families. b. runaway adolescents. c. migrant farm workers. d. individuals with mental disorders.

ANS: A Homeless individuals lack resources and community ties necessary to provide for their own adequate shelter. One of the most pressing problems in the United States is the rapidly growing number of homeless families, which currently account for 50% of the nations homeless. Runaway (or throwaway) adolescents are often victims of physical and social abuse. Although it is a significant issue, this is not the fastest-growing segment of the homeless population. Migrant farm workers form one of the most severely disadvantaged groups in the United States. They have a mobile existence, which is detrimental for children. They do not constitute the fastest-growing segment of the homeless population. Individuals with mental disorders may be homeless. They do not constitute the fastest-growing segment of the homeless population.

The nurse is teaching a group of new parents about the experience of role transition. Which statement by a parent would indicate a correct understanding of the teaching? a. My marital relationship can have a positive or negative effect on the role transition. b. If an infant has special care needs, the parents sense of confidence in their new role is strengthened. c. Young parents can adjust to the new role easier than older parents. d. A parents previous experience with children makes the role transition more difficult.

ANS: A If parents are supportive of each other, they can serve as positive influences on establishing satisfying parental roles. When marital tensions alter caregiving routines and interfere with the enjoyment of the infant, then the marital relationship has a negative effect. Infants with special care needs can be a significant source of added stress. Older parents are usually more able to cope with the greater financial responsibilities, changes in sleeping habits, and reduced time for each other and other children. Parents who have previous experience with parenting appear more relaxed, have less conflict in disciplinary relationships, and are more aware of normal growth and development.

In which cultural group is good health considered to be a balance between yin and yang? a. Asians b. Australian aborigines c. Native Americans d. African-Americans

ANS: A In Chinese health beliefs, the forces termed yin and yang must be kept in balance to maintain health. The belief in this balance is not consistent with Australian aborigines, Native Americans, or African-Americans.

The father of a hospitalized child tells the nurse, He cant have meat. We are Buddhist and vegetarians. The nurses best intervention is to: a. order the child a meatless tray. b. ask a Buddhist priest to visit. c. explain that hospital patients are exempt from dietary rules. d. help the parent understand that meat provides protein needed for healing.

ANS: A It is essential for the nurse to respect the religious practices of the child and family. The nurse should arrange a dietary consult to ensure that nutritionally complete vegetarian meals are prepared by the hospital kitchen. It is not necessary to ask a Buddhist priest to visit. The nurse should be able to arrange for a vegetarian tray. The nurse should not encourage the child and parent to go against their religious beliefs. Nutritionally complete, acceptable vegetarian meals should be provided.

A 3-year-old girl was adopted immediately after birth. The parents have just asked the nurse how they should tell the child that she is adopted. Which guidelines concerning adoption should the nurse use in planning a response? a. Telling the child is an important aspect of their parental responsibilities. b. The best time to tell the child is between ages 7 and 10 years. c. It is not necessary to tell the child who was adopted so young. d. It is best to wait until the child asks about it.

ANS: A It is important for the parents not to withhold information about the adoption from the child. It is an essential component of the childs identity. There is no recommended best time to tell children. It is believed that children should be told young enough so they do not remember a time when they did not know. It should be done before the children enter school to keep third parties from telling the children before the parents have had the opportunity.

When assessing a family, the nurse determines that the parents exert little or no control over their children. This style of parenting is called: a. permissive. b. dictatorial. c. democratic. d. authoritarian.

ANS: A Permissive parents avoid imposing their own standards of conduct and allow their children to regulate their own activity as much as possible. The parents exert little or no control over their childrens actions. Dictatorial or authoritarian parents attempt to control their childrens behavior and attitudes through unquestioned mandates. They establish rules and regulations or standards of conduct that they expect to be followed rigidly and unquestioningly. Democratic parents combine permissive and dictatorial styles. They direct their childrens behavior and attitudes by emphasizing the reasons for rules and negatively reinforcing deviations. They respect the childs individual nature.

Nicole and Kelly, age 5 years, are identical twins. Their parents tell the nurse that the girls always want to be together. The nurses suggestions should be based on which statement? a. Some twins thrive best when they are constantly together. b. Individuation cannot occur if twins are together too much. c. Separating twins at an early age helps them develop mentally. d. When twins are constantly together, pathologic bonding occurs.

ANS: A Twins work out a relationship that is reasonably satisfactory to both. They develop a remarkable capacity for cooperative play and considerable loyalty and generosity toward each other. Parents should foster individual differences and allow the children to follow their natural inclinations. Individuation does occur. In twinship, one member of the pair is more dominant, outgoing, and assertive than the other. Early separation may produce unnecessary stresses for the children. There is no evidence that pathologic bonding occurs when twins are constantly together.

A nurse is caring for an African-American child recently admitted to the hospital. The nurse should be aware of which broad cultural characteristics for this child when planning care? (Select all that apply.) a. Silence may indicate a lack of trust. b. Maintaining constant eye contact may be viewed as aggressive. c. Self-care and folk medicine do not play a role in healthcare. d. Illness may be seen as the will of God. e. No importance is attached to nonverbal behavior.

ANS: A, B, D A nurse should be aware of the African-American broad cultural characteristics, which include: initial eye contact to show respect; maintaining eye contact can be viewed as aggressive, silence may indicate a lack of trust, and illness may be seen as the will of God. Self-care and folk medicine are prevalent in this culture, and importance is placed on nonverbal behavior.

Divorced parents of a preschool child are asking whether their child will display any feelings or behaviors related to the effect of the divorce. The nurse is correct when explaining that the parents should be prepared for which type of behaviors? (Select all that apply.) a. Displaying fears of abandonment b. Verbalizing that he or she is the reason for the divorce c. Displaying fear regarding the future d. Ability to disengage from the divorce proceedings e. Engaging in fantasy to understand the divorce

ANS: A, B, E A child 3 to 5 years of age (preschool) may display fears of abandonment, verbalize feelings that he or she is the reason for the divorce, and engage in fantasy to understand the divorce. They would not be displaying fear regarding the future until school age, and the ability to disengage from the divorce proceedings would be characteristic of an adolescent.

Children are taught the values of their culture through observation and feedback, relative to their own behavior. In teaching a class on cultural competence, the nurse should be aware that which factor(s) may be culturally determined? (Select all that apply.) a. Degree of competition b. Racial variation c. Determination of status d. Social roles e. Geographic boundaries

ANS: A, C, D Degree of competition, determination of status, and social roles are all factors that are determined by the assumptions, beliefs, and practices of the members of the culture. In cultures that value individual resourcefulness, competition would be acceptable. Status is culturally determined and varies according to each culture. Some will ascribe higher status to age or socioeconomic status. Social roles also are influenced by the culture. Race and culture are two distinct attributes. The racial grouping describes transmissible traits, whereas the culture is determined by the pattern of assumptions, beliefs, and practices that unconsciously frames or guides the outlook and decisions of a group of people. Cultural development may be limited by geographic boundaries. It is not the boundaries that are culturally determined.

Which term best describes a group of people who share a set of values, beliefs, practices, social relationships, law, politics, economics, and norms of behavior? a. Race b. Culture c. Ethnicity d. Social group

ANS: B Culture is a pattern of assumptions, beliefs, and practices that unconsciously frames or guides the outlook and decisions of a group of people. A culture is composed of individuals who share a set of values, beliefs, and practices that serve as a frame of reference for individual perceptions and judgments. Race is defined as a division of mankind possessing traits that are transmissible by descent and are sufficient to characterize it as a distinct human type. Ethnicity is an affiliation of a set of persons who share a unique cultural, social, and linguistic heritage. A social group consists of systems of roles carried out in groups. Examples of primary social groups include the family and peer groups.

Parents of a firstborn child are asking whether it is normal for their child to be extremely competitive. The nurse should respond to the parents that studies about the ordinal position of children suggest that firstborn children tend to: a. be praised less often. b. be more achievement oriented. c. be more popular with the peer group. d. identify with peer group more than parents.

ANS: B Firstborn children, like only children, tend to be more achievement-oriented. Being praised less often, being more popular with the peer group, and identifying with peer groups more than parents are characteristics of later-born children.

When discussing discipline with the mother of a 4-year-old child, the nurse should include which instruction? a. Children as young as 4 years old rarely need to be punished. b. Parental control should be consistent. c. Withdrawal of love and approval is effective at this age. d. One should expect rules to be followed rigidly and unquestioningly.

ANS: B For effective discipline, parents must be consistent and must follow through with agreed-on actions. Realistic goals should be set for this age group. Parents should structure the environment to prevent unnecessary difficulties. Requests for behavior change should be phrased in a positive manner to provide direction for the child. Withdrawal of love and approval is never appropriate or effective. Discipline strategies should be appropriate to the childs age, temperament, and severity of the misbehavior. Following rules rigidly and unquestioningly is beyond the developmental capabilities of a 4-year-old.

A Hispanic toddler has pneumonia. The nurse notices that the parent consistently feeds the child only the broth that comes on the clear liquid tray. Food items, such as Jell-O, Popsicle, and juices are left. Which statement would best explain this? a. Parent is trying to feed child only what child likes most. b. Parent is trying to restore normal balance through appropriate hot remedies. c. Hispanics believe the evil eye enters when a person gets cold. d. Hispanics believe an innate energy, called chi, is strengthened by eating soup.

ANS: B In several groups, including Filipino, Chinese, Arabic, and Hispanic cultures, hot and cold describe certain properties completely unrelated to temperature. Respiratory conditions such as pneumonia are cold conditions and are treated with hot foods. The parent may be trying to feed the child only what the child likes most, but it is unlikely that a toddler would consistently prefer the broth to Jell-O, Popsicle, and juice. The evil eye applies to a state of imbalance of health, not curative actions. Chinese individuals believe in chi as an innate energy.

Which is considered characteristic of children who are the youngest in their family? a. More dependent than firstborn children b. More outgoing than firstborn children c. Identify more with parents than with peers d. Are subject to greater parental expectations

ANS: B Later-born children are obliged to interact with older siblings from birth and seem to be more outgoing and make friends more easily than firstborns. Being more dependent, identifying more with parents than peers, and being subject to greater parental expectations are characteristics of firstborn children and only children.

A parent of a school-age child is going through a divorce. The parent tells the school nurse the child has not been doing well in school and sometimes has trouble sleeping. The nurse should recognize this as which implication? a. Indication of maladjustment b. Common reaction to divorce c. Lack of adequate parenting d. Unusual response that indicates need for referral

ANS: B Parental divorce affects school-age children in many ways. In addition to difficulties in school, they often have profound sadness, depression, fear, insecurity, frequent crying, loss of appetite, and sleep disorders. This is not an indication of maladjustment, suggestive of lack of adequate parent, or an unusual response that indicates need for referral in school-age children after parental divorce.

The nurse discovers welts on the back of a Vietnamese child during a home health visit. The childs mother says she has rubbed the edge of a coin on her childs oiled skin. What explanation should the nurse recognize about this? a. Child abuse b. Cultural practice to rid the body of disease c. Cultural practice to treat enuresis or temper tantrums d. Child discipline measure common in the Vietnamese culture

ANS: B Rubbing the edge of a coin on a childs oiled skin is descriptive of coining. The welts are created by repeatedly rubbing a coin on the childs oiled skin. The mother is attempting to rid the childs body of disease. The mother was engaged in an attempt to heal the child. This is not child abuse or discipline.

A nurse is taking a history on a low-income Hispanic toddler. The parent tells the nurse that occasional diarrhea is treated with azogue, a mercury compound commonly used in the parents native Mexico. What should the nurse recognize about this remedy? a. It is harmless. b. It is dangerous. c. It has a scientific basis. d. It has importance in certain religious practices.

ANS: B The ingestion of mercury is extremely dangerous for children. Solutions containing mercury are not harmless. The nurse should work with folk healers or respected members of the culture to teach the family of the dangers of mercury ingestion. No scientific basis exists for the use of mercury to treat diarrhea.

A nurse is working in a clinic that serves a culturally diverse population of children. The nurse should plan care, understanding that which complementary and alternative practices may be used by families of this diverse population? (Select all that apply.) a. Seeking another doctors opinion b. Seeking advice from a curandero or curandera c. Using acupuncture or acupressure as a therapy d. Consulting an herbalist e. Consulting a kahuna

ANS: B, C, D, E The curandero (male) or curandera (female) of the Mexican-American community is believed to have healing powers that are a gift from God. The Asian family may consult an herbalist, knowledgeable in medicines, or perhaps a specialized practitioner of Asian therapies, including acupuncture (insertion of needles) or acupressure (application of pressure). Native Hawaiians consult kahunas and practice hooponopono to heal family imbalance or disputes. The nurse may encounter use of these practices. Consulting another doctor would not be a complementary or alternative practice expected in a culturally diverse population.

A nurse is conducting a teaching session on the use of time-out as a discipline measure to parents of toddlers. Which are correct strategies the nurse should include in the teaching session? (Select all that apply.) a. Time-out as a discipline measure cannot be used when in a public place. b. A rule for the length of time-out is 1 minute per year. c. When the child misbehaves, one warning should be given. d. The area for time-out can be in the family room where the child can see the television. e. When the child is quiet for the specified time, he or she can leave the room.

ANS: B, C, E A rule for the length of time-out is 1 minute per year of age; use a kitchen timer with an audible bell to record the time rather than a watch. When the child misbehaves, one warning should be given. When the child is quiet for the duration of the time, he or she can then leave the room. Time-out can be used in public places and the parents should be consistent on the use of time-out. Implement time-out in a public place by selecting a suitable area or explain to children that time-out will be spent immediately on returning home. The time-out should not be spent in an area from which the child can view the television. Select an area for time-out that is safe, convenient, and unstimulating but where the child can be monitored, such as the bathroom, hallway, or laundry room.

A nurse is planning care for a Spanish-speaking child and family. The nurse speaks limited Spanish. Which interventions should the nurse plan when caring for this child and family? (Select all that apply.) a. Ask a visitor to interpret. b. Use a language-line telephone interpreter if a hospital interpreter is not available. c. Use written cards with common phrases in the Spanish language. d. Ask the family to provide an interpreter. e. When using a hospital interpreter, speak to the family not the interpreter.

ANS: B, C, E If a live interpreter is not available, the nurse should use a language line telephone interpreter. The nurse should use cards with common greetings, phrases, and names of body parts in the familys language. When using a hospital interpreter, the nurse should speak directly to the family and allow the interpreter to translate. Visitors or other family members should not be used as interpreters because of the risk of misinterpretation of medical terms.

Dunst, Trivette, and Deal identified the qualities of strong families that help them function effectively. Which qualities are included? (Select all that apply.) a. Ability to stay connected without spending time together b. Clear set of family values, rules, and beliefs c. Adoption of one coping strategy that always promotes positive functioning in dealing with life events d. Sense of commitment toward growth of individual family members as opposed to that of the family unit e. Ability to engage in problem-solving activities f. Sense of balance between the use of internal and external family resources

ANS: B, E, F A clear set of family rules, values, and beliefs that establishes expectations about acceptable and desired behavior is one of the qualities of strong families that help them function effectively. Strong families also are able to engage in problem-solving activities and to find a balance between internal and external forces. Strong families have a sense of congruence among family members regarding the value and importance of assigning time and energy to meet needs. Strong families also use varied coping strategies. The sense of commitment is toward the growth and well-being of individual family members, as well as the family unit.

Maria, a Spanish-speaking 5-year-old girl, has started kindergarten in an English-speaking school. Crying most of the time, she appears helpless and unable to function in this new situation. Which description best explains Marias behavior? a. Lacks adequate culture for attending school b. Lacks the maturity needed in school c. Is experiencing culture shock d. Is experiencing minority group discrimination

ANS: C Culture shock is the helpless feeling and state of disorientation felt by an outsider attempting to adapt to a different culture group. Her inability to speak English inhibits her ability to interact. This would explain Marias inability to function in this new situation. There is no evidence to support that Maria lacks adequate culture or maturity needed in school, or that she is experiencing minority group discrimination.

Which family theory explains how families react to stressful events and suggests factors that promote adaptation to these events? a. Interactional theory b. Developmental systems theory c. Family stress theory d. Duvalls developmental theory

ANS: C Family stress theory explains the reaction of families to stressful events. In addition, the theory helps suggest factors that promote adaptation to the stress. Stressors, both positive and negative, are cumulative and affect the family. Adaptation requires a change in family structure or interaction. Interactional theory is not a family theory. Interactions are the basis of general systems theory. Developmental systems theory is an outgrowth of Duvalls theory. The family is described as a small group, a semiclosed system of personalities that interact with the larger cultural system. Changes do not occur in one part of the family without changes in others. Duvalls developmental theory describes eight developmental tasks of the family throughout its life span.

The belief that health is a state of harmony with nature and the universe is common in which culture? a. Japanese b. African-American c. Native American d. Hispanic-American

ANS: C Many cultures ascribe attributes of health to natural forces. Many individuals of the Native-American culture view health as a state of harmony with nature and the universe. This belief is not consistent with the Japanese, African-American, or Hispanic-American cultural groups.

Which is a frequent health problem of migrant children and adolescents in the United States? a. Suicide b. Diabetes c. Tuberculosis d. Cardiovascular disease

ANS: C The rate of tuberculosis among migrant families is high. A high-risk factor for the children of migrant families is the migration of the families from areas that have high prevalence of tuberculosis; significant health issues, suicide, diabetes, and cardiovascular disease are not more prevalent in this population.

Research is being done on the development of assets in children. A community that is supportive of children has which external assets? (Select all that apply.) a. Unstructured environments to allow for freedom of choice b. Social competencies to make positive choices c. Empowerment to feel safe and secure d. Positive values to direct choice e. Boundaries to set expectations and actions

ANS: C, E Young people need to feel valued by their community and able to contribute to others. They need to feel safe and secure. They also need boundaries to help set expectations and actions. To develop appropriately, children need boundaries and expectations. With these, they will learn what is expected of them and what behaviors are acceptable to the community. Social competencies to make positive choices and boundaries to set expectations and actions are internal assets that, when developed, help the child make positive choices.

Which is the term for a family in which the paternal grandmother, the parents, and two minor children live together? a. Blended b. Nuclear c. Binuclear d. Extended

ANS: D An extended family contains at least one parent, one or more children, and one or more members (related or unrelated) other than a parent or sibling. A blended family contains at least one step-parent, step-sibling, or half-sibling. The nuclear family consists of two parents and their children. No other relatives or nonrelatives are present in the household. In binuclear families, parents continue the parenting role while terminating the spousal unit. For example, when joint custody is assigned by the court, each parent has equal rights and responsibilities for the minor child or children.

A nurse is selecting a family theory to assess a patients family dynamics. Which family theory best describes a series of tasks for the family throughout its life span? a. Interactional theory b. Developmental systems theory c. Structural-functional theory d. Duvalls developmental theory

ANS: D Duvalls developmental theory describes eight developmental tasks of the family throughout its life span. Interactional theory and structural-functional theory are not family theories. Developmental systems theory is an outgrowth of Duvalls theory. The family is described as a small group, a semiclosed system of personalities that interact with the larger cultural system. Changes do not occur in one part of the family without changes in others.

The nurse observes that the families who do not show up for scheduled clinic appointments are usually from minority cultural groups. The best explanation for this is that these families often differ from the dominant culture because they: a. lack education. b. avoid health care. c. are more forgetful. d. view time differently.

ANS: D Each cultural group has different conceptions of time and waiting. The dominant culture in the United States has a fairly rigid view of time. Other cultures may be late or miss activities because other issues take precedence over the appointment. Education is not the issue. It is the concept of time in the cultural group. It is not done to avoid health care. The family usually believes that the appointment can be made for a later time. The family does not forget the time, but other issues take priority.

Which term best describes the emotional attitude that ones own ethnic group is superior to others? a. Culture b. Ethnicity c. Superiority d. Ethnocentrism

ANS: D Ethnocentrism is the belief that ones way of living and behaving is the best way. This includes the emotional attitude that the values, beliefs, and perceptions of ones ethnic group are superior to those of others. Culture is a pattern of assumptions, beliefs, and practices that unconsciously frames or guides the outlook and decisions of a group of people. A culture is composed of individuals who share a set of values, beliefs, and practices that serves as a frame of reference for individual perception and judgments. Ethnicity is an affiliation of a set of persons who share a unique cultural, social, and linguistic heritage. Superiority is the state or quality of being superior; it does not include ethnicity.

The Vietnamese mother of a child being seen in the clinic avoids eye contact with the nurse. The best explanation for this, considering cultural differences, is that the parent: a. feels responsible for her childs illness. b. feels inferior to the nurse. c. is embarrassed to seek health care. d. is showing respect for the nurse.

ANS: D In some ethnic groups, eye contact is avoided. In the Vietnamese culture, an individual may not look directly into the nurses eyes as a sign of respect. The nurse providing culturally competent care would recognize that feeling responsible for the illness, feeling inferior, or embarrassment are not reasons for the mother to avoid eye contact with the nurse.

A mother brings 6-month-old Eric to the clinic for a well-baby checkup. She comments, I want to go back to work, but I dont want Eric to suffer because Ill have less time with him. The nurses most appropriate answer would be which statement? a. Im sure hell be fine if you get a good babysitter. b. You will need to stay home until Eric starts school. c. You should go back to work so Eric will get used to being with others. d. Lets talk about the child-care options that will be best for Eric.

ANS: D Lets talk about the child-care options that will be best for Eric is an open-ended statement that will assist the mother in exploring her concerns about what is best for both her and Eric. Im sure hell be fine if you get a good babysitter, You will need to stay home until Eric starts school, and You should go back to work so Eric will get used to being with others are directive statements. They do not address the effect of her working on Eric.

Which is most characteristic of the physical punishment of children, such as spanking? a. Psychological impact is usually minimal. b. Children rarely become accustomed to spanking. c. Childrens development of reasoning increases. d. Misbehavior is likely to occur when parents are not present.

ANS: D Through the use of physical punishment, children learn what they should not do. When parents are not around, it is more likely that children will misbehave because they have not learned to behave well for their own sake, but rather out of fear of punishment. Spanking can cause severe physical and psychological injury and interfere with effective parent-child interaction. Children do become accustomed to spanking, requiring more severe corporal punishment each time. The use of corporal punishment may interfere with the childs development of moral reasoning.

Poverty has serious implications for children and families. Social and cultural deprivation, including limited employment opportunities, inferior educational opportunities, inferior or no access to health care, and a lack of public services, is referred to as the _______________ type of poverty.

ANS: invisible Social and cultural deprivation, including limited employment opportunities, inferior educational opportunities, inferior or no access to health care, and a lack of public services is the definition of invisible poverty. Visible poverty is the lack of money or material resources, including insufficient clothing, poor sanitation, and deteriorating housing.