Chap 7-Client's Response to Illness

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

Acculturation

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

"I have been ignoring my prayers."

The nurse is caring for a Native American client. After asking the client some questions, the nurse determines that the client closely follows the Native American culture. Which request would be consistent with this culture?

"I would like to use herbs and participate in a pipe ceremony to aid in healing."

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

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

The nurse is meeting an African American client for the first time. Which nonverbal behavior is appropriate in this situation? Select all that apply.

-Greet the client with a handshake -Maintain eye contact with the client

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

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

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

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

A nurse is reading a journal article about spirituality, religion, and mental health. Which information would the nurse likely find? Select all that apply.

-Spirituality develops over time. -Spirituality involves self-transcendence and transcendence beyond the self. -Spirituality can be expressed through adherence to a particular religion. -Religious beliefs often influence approaches to mental health.

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

A new nurse has a client who speaks Spanish; the nurse has asked a Hispanic colleague to tell the new nurse about the culture, ideas for care, and how cultural beliefs might influence the client's response to health care interventions.

The nurse working in the psychiatric unit observes that the African American clients experience more side effects from psychotropic drugs compared to the White clients. This is most likely for which reason?

African Americans metabolize psychotropic drugs more slowly.

The nurse should anticipate that an individual's culture will have the most significant influence on which situation?

An Arab American has begun grieving because her husband of several decades has just died.

Which is the primary religion of Cambodians?

Buddhism

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

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

Which approach to care best reflects cultural competence?

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

The nurse correctly differentiates race from ethnicity by noting that race is based on which characteristics?

Biological

On meeting a client for the first time, the nurse pats the client on the shoulder. The client expresses discomfort with the nurse's behavior. To which culture does the client most likely belong?

Chinese

A nurse is assessing a client who immigrated from Russia. During the psychosocial assessment, the client describes himself as "sick." Which sign or symptom is most likely causing the client to feel this way?

Constipation.

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

Control

Which statement about culture is true?

Cultural identity reflects what determines behavior.

Which represents the best brief definition of culture?

Culture is a shared structure for living.

A culturally competent nurse can identify that some cultural and ethnic groups feel that mental illness is caused by what?

Disruption of harmony

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

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

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

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

Nurses cannot learn all the variations in culturally mediated beliefs. Which approach would be most helpful when caring for clients from other cultures?

Explore the client's personal constructs for health and illness.

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

Family

The nurse is providing care for a recent immigrant from India. When the client identifies as a member of the culture's lowest caste, what concern should the nurse address first with the client?

How the client feels about seeking medical and psychiatric care

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

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

When providing care for a cognitively impaired client who is strongly tied to the client's culture of origin, the nurse supports these expectations by doing what?

Including family when discussing new medication treatment options

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

Industry versus inferiority

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

Industry vs. inferiority (school age)

The nurse is caring for a client who immigrated from Cambodia. What might the client perceive as the cause of the client's mental illness?

Khmer Rouge brutalities

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

Know the client's cultural personal space preferences.

As a culture, what do African Americans believe is the cause of mental illness?

Lack of spiritual balance

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

Low sense of belonging

Which stage of psychosocial development involves establishing the next generation?

Middle adult

Racial bias is evident in mental health care treatment, as reflected by what?

Nonwhite clients are institutionalized much more frequently than are whites.

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

Objectively examine personal beliefs, values, and practices.

A female nurse enters the room of a male Cambodian client who is about to undergo a procedure. When the nurse tries to apply cardiac monitoring leads to the client's chest, the client recoils and makes a disapproving facial expression. Which explains the client's reaction to the nurse's actions?

Politeness is highly valued in the Cambodian culture

When interviewing a Native American client, the nurse avoids which behavior because it is deemed unacceptable by the client's culture?

Prolonged eye contact

A Haitian American client has a history of not keeping follow-up appointments for necessary lab work. What intervention should the nurse implement to help the client keep the appointments?

Provide an explanation about the importance of keeping the appointment

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

Resilience

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

Self-analysis

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

Self-doubt

When conducting an assessment with a client from another country, what can a nurse do to ensure the client receives culturally sensitive care?

Show genuine interest in the client's culture and personal life experiences.

In which culture is touch uncommon and loudness considered disrespectful?

South Asian women

A nurse receives feedback from a colleague that the nurse tends to maintain direct eye contact while speaking to clients. Which client may interpret this nonverbal communication as disrespectful?

South Asians

When a nurse tells a coworker that an Asian client probably did not want any pain medication because "Asian women typically are stoic," the nurse is expressing a belief known as

Stereotype

The nurse caring for several clients on a surgical unit notes that one of the clients the nurse is caring for is Muslim. The nurse decides to remove all pork from the client's meal tray prior to delivering it to the room. What best describes the nurse's action?

Stereotyping

While working on the unit, a nurse overhears another nurse colleague talking with several staff members about a client who is of Asian descent. During the conversation, the nurse says, "Asians are always so intelligent." The observing nurse interprets this statement as what?

Stereotyping

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

Striving to achieve the ability to work within the cultural context of an individual or community from a diverse cultural or ethnic background

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

The client has difficulty in problem solving under stress.

The nurse is assessing a client of Middle Eastern descent. The nurse finds that the client is standing at a distance of approximately 1.5 feet while speaking to the nurse. What should the nurse interpret from this behavior?

The client is behaving in a manner that is culturally acceptable.

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

The client is extremely ambitious.

Which is the primary treatment sought in the Arab American culture?

Western medicine

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

Treating the client as a source of cultural information

Which factor has the greatest impact on a person's ability to cope with illness? All of the following impair a person's ability to cope except:

age.

When an Arabic client newly diagnosed with type 2 diabetes is insistent that the client's family provide all food, the nurse initially

provides the client and the client's family with detailed instructions with the dietary requirements of the condition.

In which culture is autonomy utilized in making health care decisions?

western cultures