intro to nursing - culture (week 4 ch 9)
A patient with mouth cancer is advised to undergo radiation therapy. However, the patient refuses to do so. The health care provider gives the patient and family other treatment options. Which step of the LEARN mnemonic is the health care provider performing? Listen Explain Negotiate Recommend
Recommend The "Recommend" step involves making suggestions to the patient and/or the family members when appropriate. Negotiating involves arriving at a mutually agreeable, culturally oriented, and patient-centered plan
While measuring the vital signs of a Muslim patient, the nurse observes that the patient is anxious. Which statement by the nurse indicates a good understanding of transcultural nursing? "I know modesty is very important for you, but you'll have to adjust this time." "I know modesty is very important for you, but it should not interrupt the assessment." "I know modesty is very important for you. However, we have to adhere to hospital rules." "I know modesty is very important for you. Is there any way I can make you comfortable?"
"I know modesty is very important for you. Is there any way I can make you comfortable?" Muslim patients often highly value modesty and may be uncomfortable with certain procedures, particularly if the health care worker is of the opposite sex. Therefore the nurse should make the patient comfortable by showing an attitude of helpfulness and asking what can be done to make the patient more comfortable. The nurse should demonstrate flexibility and should not instruct the patient to adjust because it may violate the patient's core values. The nurse should provide a culturally congruent assessment to the patient. The nurse should not force the patient to adhere to the hospital rules; instead, the nurse should provide patient-centered care.
*The registered nurse is evaluating the student nurse for the teach-back technique. Which statement made by the student nurse indicates the need for further teaching? Select all that apply. One, some, or all responses may be correct. "I should avoid using models during the teaching process." "I should use charts to facilitate patient understanding." "I should ask the patient whether he or she understood the teaching." "I should let the patient ask questions during the course of teaching." "I should teach the patient again after finishing the first round of teaching."
"I should avoid using models during the teaching process." "I should ask the patient whether he or she understood the teaching." The nurse should not ask whether the patient has understood but should instead check the patient's extent of learning or verify understanding by asking the patient specific questions about the teaching.
The nurse is carrying out an assessment of a patient with pain in the abdomen. Which question by the nurse is open-ended? "Is the pain here?" "Is the pain very severe or mild?" "What do you think of your problem?" "How many days have you had this pain?"
"What do you think of your problem?" Open-ended questions allow the patient to express feelings or to elaborate more on the situation. Open-ended questions do not limit the patient's response to either "yes" or "no" or a short answer. In this scenario, asking what the patient thinks about the problem is an open-ended question. Asking about the location, severity, or duration of the pain are closed-ended questions.
To enhance cultural awareness, which should the nursing students include in their self-examination? Motivation, culture, and commitment to caring Social, cultural, and biophysical factors Engagement in cross-cultural interactions Background, personal biases, and prejudices
Background, personal biases, and prejudices Cultural awareness involves an in-depth self-examination of one's own background, recognizing biases and prejudices and assumptions about other people. Assessing one's own motivation, culture, and commitment to caring will not enhance cultural awareness of patients. Assessing one's own social, cultural, and biophysical factors will not assist the nurse in cultural awareness. Engagement in cross-cultural interactions will assist the nurse in a cultural encounter but will not promote cultural awareness.
The nurse is explaining the concept of being culturally competent to another nurse. Which is a component of cultural competence? Select all that apply. One, some, or all responses may be correct. Cultural awareness Cultural knowledge Cultural skills Cultural encounters Cultural desire Cultural difference
Cultural awareness Cultural knowledge Cultural skills Cultural encounters Cultural desire Cultural competence consists of five components: cultural awareness, cultural knowledge, cultural skills, cultural encounters, and cultural desire. Cultural awareness refers to an in-depth self-examination of one's beliefs to help recognize biases, prejudices, and assumptions. Cultural knowledge involves obtaining adequate information about cultural groups. Cultural skills allow a person to assess social, cultural, and biophysical factors that affect treatment and care of patients. Cultural encounters involve engaging in cross-cultural interactions that provide information about other cultures. Cultural desire refers to the motivation and commitment to build on cultural similarities. Cultural difference is not a component of cultural competence.
*The nurse, while caring for a patient of a different cultural background, learns about the patient's cultural practices that affect health. The nurse uses these facts to plan the patient's care. Which component of Campinha-Bacote's model of cultural competency is reflected in this scenario? Cultural skill Cultural desire Cultural encounter Cultural knowledge
Cultural encounter Cultural encounter involves the cross-cultural interactions between the nurse and the patient that provide opportunities to learn about other cultures and develop effective intercultural communication. Cultural knowledge is the knowledge of diverse groups, including the values, health beliefs, care practices, world views, and bicultural ecologies commonly found within each group.
Which statement is true regarding culturally congruent care? Culturally congruent care has predetermined criteria from which patterns of life and the system of meaning are generated. Culturally congruent care bridges gaps to provide supportive care for patients from certain cultures. In culturally congruent care, transcultural nursing enables health care providers to deliver uniform services irrespective of health beliefs. Culturally congruent care sometimes diverges from the values of the professional health care system.
Culturally congruent care sometimes diverges from the values of the professional health care system. Transcultural nursing provides culturally congruent care, or care that fits a person's life patterns, values, and the system of meaning.
he nurse attends to an Asian male patient at a clinic who is joined by his family. The nurse finds that the patient speaks a different language and determines that he needs an interpreter. A male interpreter is appointed, as preferred by the patient. How should nurses communicate with this patient? Select all that apply. One, some, or all responses may be correct. Direct the questions to the interpreter. Introduce themselves to the patient. Introduce the interpreter to the patient before introducing themselves. Observe the patient's nonverbal and verbal behaviors. Request the interpreter to ask the patient for feedback and clarification.
Introduce themselves to the patient. Observe the patient's nonverbal and verbal behaviors. Request the interpreter to ask the patient for feedback and clarification. Even if the interpreter is present, the nurses should introduce themselves to the patient. Observing the patient's nonverbal and verbal behaviors helps in communication. Requesting that the interpreter ask the patient for feedback at regular intervals helps assess the clinical and cultural data in detail. As a rule, nurses should direct questions to the patient. As the primary caregivers, the nurses should first introduce themselves and then the interpreter.
The nurse is caring for a Muslim patient who is recovering from a motor vehicle accident. The patient is observing Ramadan, the ninth lunar month, in which Muslims fast during daylight for 28 days. The nurse understands that a good diet is important for the patient's wounds to heal. What should the nurse do when planning the patient's diet? Select all that apply. One, some, or all responses may be correct. Reschedule meals. Ask the patient's closest kin to ask him not to fast. Start enteral tube feedings if the patient refuses to take food orally. Respect the cultural beliefs and assure the patient that medical needs will be taken care of. Try to convince the patient not to fast because it will affect recovery.
Reschedule meals. Respect the cultural beliefs and assure the patient that medical needs will be taken care of. The nurse should understand the patient's cultural and spiritual beliefs and deliver health care accordingly. Muslims fast during Ramadan. Therefore the nurse should not assume that the patient will take regular meals during Ramadan. Likewise, the treatment and medication regimen should be rescheduled according to the cultural needs of the patient. The nurse should respect the patient's culture and assure the patient that the hospital staff will provide optimal care. Asking the patient's family to ask the patient not to fast would be emotionally disturbing. Starting enteral tube feedings is also not ethical because that would be against the patient's will. Trying to convince the patient not to fast may indicate that the nurse disrespects the patient's personal beliefs.
The registered nurse is teaching a patient of a different cultural background the procedure to self-administer insulin. After teaching, the nurse asks the patient to self-administer insulin. Which type of technique does the nurse use in this situation? Teach-back Health literacy Cultural encounter Linguistic competence
Teach-back The teach-back technique is an ongoing process of asking patients for feedback by demonstration. In this instance, the patient is being asked to self-administer insulin in front of the registered nurse. Health literacy is the ability to obtain and understand health information. Cultural encounter is an intervention that involves a nurse directly interacting with patients from culturally diverse backgrounds. Linguistic competence is the ability of the nurse to communicate effectively and convey information in a manner that is easily understood by the patient.
Which is required in the delivery of culturally congruent care? Learning about a variety of cultures Being motivated and committed to caring Influencing treatment and care of patients Acquiring specific knowledge, skills, and attitudes
Acquiring specific knowledge, skills, and attitudes Acquiring specific knowledge, skills, and attitudes is required in the delivery of culturally congruent care. Learning about a variety of cultures will not help the nurse deliver culturally congruent care to a specific patient. Being motivated and committed to caring and influencing treatment and care of patients are important to the nurse's care of every patient and family, not necessarily required for delivery of culturally congruent care.
The nurse at an outpatient clinic asks a Chinese American patient with newly diagnosed hypertension if he is limiting sodium intake as directed. The patient nods his head but does not make eye contact with the nurse. Which action would the nurse take next? Ask the patient how much salt he is consuming each day. Discuss the health implications of sodium and hypertension. Remind the patient that many foods such as soy sauce contain hidden sodium. Suggest some low-sodium dietary alternatives
Ask the patient how much salt he is consuming each day. In Asian cultures, spoken messages often have little to do with their meanings. The nurse should clarify how much salt the patient is consuming in his diet. Discussing the health implications of sodium and hypertension, reminding the patient which foods contain hidden sodium, and suggesting low-sodium dietary alternatives will not assist the nurse in knowing whether the Chinese American patient is limiting his sodium intake.
Which statement describes cultural skill according to Campinha-Bacote's model of cultural competency? Examining oneself in-depth and recognizing the bias Providing opportunities to learn about different cultures Assessing social, cultural, and biophysical factors before initiating the treatment Obtaining the knowledge about values, health beliefs, and care practices of various cultures
Assessing social, cultural, and biophysical factors before initiating the treatment Campinha-Bacote's model suggests that nurses see themselves as becoming rather than being culturally competent because cultural competency is developmental. Cultural skill is better explained by the ability to assess social, cultural, and biophysical factors that influence patient treatment and care. Cultural awareness involves an in-depth self-examination of one's own background, recognizing biases, prejudices, and assumptions about other people. Cultural encounters provide cross-cultural interactions that create opportunities to learn about other cultures and develop effective intercultural communication. Cultural knowledge helps the nurse obtain sufficient comparative knowledge of the values, health beliefs, care practices, world views, and bicultural ecology commonly found within each group.
An Arab woman is admitted to the hospital. A male nurse is assigned to examine this patient. The patient is uncomfortable and expresses displeasure at being assigned a male nurse. What should the nurse manager do? Ask the male nurse to go ahead with the examination. Assign a female nurse to carry out the examination. Remain in the room when the male nurse is examining the patient. Explain to the patient that the hospital is short on staff and that she has to cooperate
Assign a female nurse to carry out the examination. Arab women are generally reluctant to have men examine them. The head nurse should respect the patient's wishes and culture and assign a female nurse to her. The head nurse should not ask the male nurse to proceed because this would violate the patient's wishes. The mere presence of a female nurse during an examination by a male nurse would not make the patient comfortable. Telling the patient the hospital is short-staffed may not be true and should not be used as an excuse to disobey the patient's wishes.
What measure does the nurse outline for providing culturally competent care? Less diversity among health care providers Better communication between health care providers and patients In-depth self-examination of one's own background to recognize biases Treating all patients uniformly regardless of cultural and racial associations
Better communication between health care providers and patients To provide culturally competent care, the communication between the patient and health care provider should be effective. In-depth self-examination helps in developing cultural awareness.
The nurse is incorporating the patient's religious dietary preferences into the care plan. Which step of the LEARN mnemonic is the nurse applying? Explain Negotiate Recommend Acknowledge
Negotiate The nurse is applying the negotiation step by incorporating aspects of the patient's culture into the patient-centered plan. During the explanation step, the nurse explains his or her perceptions of the patient's problem. During the recommendation step, the nurse recommends care while involving the patient. During the acknowledgment step, the nurse acknowledges and discusses cultural differences and similarities between the nurse and the patient.
The registered nurse prepares a mutually agreeable, culturally oriented patient-centered plan. Which step of the LEARN communication technique is the nurse using? Perception Negotiation Recommend Acknowledge
Negotiation "Negotiation" is the fifth step of the communication technique, which involves preparing a culturally oriented and patient-centered plan by mutual agreement with the patient. "Recommend" is the nurse recommending decisions that patient can make.
The nurse finds that a patient has not understood the health education provided on personal hygiene. How does the nurse ensure that the patient understands the teachings? The nurse provides reading material on personal hygiene. The nurse clarifies the information and requests a teach-back. The nurse provides a video demonstration of personal hygiene. The nurse requests that a family member help the patient understand.
The nurse clarifies the information and requests a teach-back. If the patient does not understand instructions, the nurse should clarify the information and request that the patient teach back the instructions. This approach helps the nurse ascertain whether the patient has understood the teachings or not. Providing reading material and a video demonstration on personal hygiene to the patient reinforces the teaching but does not necessarily ensure that the patient has understood. Requesting that a family member help the patient understand will not help the nurse to assess the patient's understanding.
What action does the nurse perform upon admission to create an accepting environment for the transgender patient? Calling the patient by his or her birth name Using pronouns that match the patient's birth sex Showing the patient where the restroom for his or her birth sex is Including changing the "mother/father" option to "parent/guardian" on the assessment form
Including changing the "mother/father" option to "parent/guardian" on the assessment form
The nurse is assessing an Asian patient in a day care center. The nurse is developing a transcultural care plan for the patient who identifies both with his native culture and the American culture. Which component should the nurse incorporate to provide culturally congruent care? Select all that apply. One, some, or all responses may be correct. Ignoring biophysical differences of patients from different cultures Obtaining knowledge of the patient's health beliefs Self-examining the nurse's own culture Working in another country to learn new nursing practices Being open and accepting of cultural differences
Obtaining knowledge of the patient's health beliefs Self-examining the nurse's own culture Being open and accepting of cultural differences It is not necessary to work within another country to learn new practices, but it is helpful to engage with others from different cultures.
Which type of cultural competency recognizes biases, prejudices, and assumptions about other people? Cultural skills Cultural desire Cultural awareness Cultural knowledge
Cultural awareness Cultural awareness refers to recognizing biases, prejudices, and assumptions about other people. Cultural skills assess social, cultural, and biophysical factors that influence patient treatment and care. Cultural desire describes the motivation to learn from others, accept the role as a learner, and be open to and accepting of cultural differences. Cultural knowledge includes sufficient comparative knowledge of diverse groups, including values, health beliefs, care practices, and world views.
As per the Culturally and Linguistically Appropriate Standards (CLAS), what point is covered under communication and language assistance? Select all that apply. One, some, or all responses may be correct. Communicate the organization's progress. Offer language assistance to individuals at a low cost. Provide easy-to-understand print and multimedia materials. Ensure the competence of individuals providing language assistance. Inform patients of language assistance services verbally and in writing. Offer language assistance to individuals who have limited English proficiency.
Provide easy-to-understand print and multimedia materials. Ensure the competence of individuals providing language assistance. Inform patients of language assistance services verbally and in writing. Offer language assistance to individuals who have limited English proficiency.
The registered nurse is admitting a patient of French heritage to the hospital. Which question asked by the nurse indicates that the nurse is stereotyping the patient? "What are your dietary preferences?" "What time do you typically go to bed?" "Do you bathe and use deodorant more than 1 time a week?" "Do you have any health issues that we should know about?"
"Do you bathe and use deodorant more than 1 time a week?" Nurses need to avoid stereotypes or unwarranted generalizations about any particular group that prevents further assessment of the individual's unique characteristics. Asking about dietary preferences, preferred bed time, and health issues is important in the nurse's assessment of every patient.
