Nursing Fundamental LEC chapter 5: Cultural Diversity
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) Ethnocentrism B) Cultural diversity C) Stereotyping D) Cultural blindness
D) Cultural blindness Explanation: The nurse is demonstrating cultural blindness, which occurs when one ignores differences and proceeds as though they do not exist.
The use of one's culture as a cultural standard is known as: A) ethnocentrism. B) ritualism. C) culture. D) cultural relativity.
A) ethnocentrism.
When reviewing the chart of an older adult client, the nurse notes that the client identifies as Japanese. The nurse realizes the client is referring to which ancestral and cultural factor? A) race B) ethnocentrism C) values D) ethnicity
D) ethnicity Explanation: Ethnicity refers to a common bond of kinship with country of origin, for this client Japan. Race refers to biologic differences, for this client Asian. Ethnocentrism is the belief that one's personal heritage is superior to others. Values are beliefs and attitudes that are important to a person. The scenario does not provide details to determine if the client expresses ethnocentrism nor any personal values.
A client says to the nurse, "Why don't you wear a white cap like nurses do on the soap operas?" This is an ethnocentric statement based on the: A) nursing personality. B) past history. C) media. D) genetics.
C) media. Explanation: Ethnocentrism is a way of looking at the world through a personal lens that has been influenced by personality, genetics, family/relationships, and media. None of the remaining options play a role in the client's comment to the nurse.
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) "What type of food did your family prepare for you, and does it have special meaning?" B) "You can only eat the food that we serve you." C) "Do you understand that you are on a strict diet and any variation can cause you harm?" E) "I will need to get permission from your health care provider for you to eat the food your family brought in."
A) "What type of food did your family prepare for you, and does it have special meaning?"
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) Stereotyping B) Cultural conflict C) Cultural imposition D) Culture shock
C) Cultural imposition Explanation: The nurse has demonstrated cultural imposition by assuming that traditional pain relief measures are superior and the client should conform to the nurse's belief regarding pain control. This is not an example of cultural conflict because the nurse did not ridicule the request; it was simply dismissed. The nurse is not stereotyping, as no generalization is made about a group of people. The nurse is not demonstrating culture shock because the view of pain medications that the nurse expresses is consistent with the majority, Western culture.
While the nurse conducts a comprehensive cultural assessment on a client with metastatic colon cancer the client states, "The pain with this cancer is God's way of punishing me for all the drinking and bad things I did in the military. I lost so many friends in the war that I look forward to having a few beers with them after I die." The nurse will use questions to explore the client's statement. -----> Click to specify whether the nurse's question obtains information about health beliefs and practices or cultural sanctions/restrictions. 1) Have you experienced flashbacks to your military years? 2) Are you part of a faith community? 3) How much alcohol do you use daily? 4) How do you express emotions or feelings? 5) How do you control your pain?
1) cultural sanctions/restrictions. 2) cultural sanctions/restrictions. 3) health beliefs and practices 4)cultural sanctions/restrictions. 5) health beliefs and practices
A student nurse is not looking forward to clinical rotation on a geriatric unit, stating "How can I get them to move faster? They always seem so slow!" How should the instructor respond? A) "Be careful of the negative attitude in your approach. How fast an individual moves will depend on physical ability not necessarily age." B) "You will get to learn how to best plan your care utilizing the slower response from older clients." C) "Perhaps you should review the information in our textbook for some techniques you can use." D) "I will show you several different techniques which you can use while providing care to these older clients."
A) "Be careful of the negative attitude in your approach. How fast an individual moves will depend on physical ability not necessarily age." Explanation: Ageism is a form of negative stereotypical thinking about older adults. This can include thinking all older adults are physically and cognitively impaired, have lack of interest in sex, or are burdensome to families and society. The instructor should first help the student recognize the stereotypical attitude and then provide tips on how to best address this attitude and not how to change the client's actions.
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) "What type of food did your family prepare for you, and does it have special meaning?" B)"You can only eat the food that we serve you." C)"Do you understand that you are on a strict diet and any variation can cause you harm?" D)"I will need to get permission from your health care provider for you to eat the food your family brought in."
A) "What type of food did your family prepare for you, and does it have special meaning?"
The nurse is educating a client of Chinese descent regarding the reduction and elimination of lactose in the diet. Which statement(s) made by the client indicates that the education was effective? Select all that apply. A) "When I drink coffee or tea, I should use a non-dairy creamer instead of milk or cream." B) "I should replace 2% milk with lactose-free milk." C) "I can use foods that use milk solids since those are not milk products." D) "If I drink milk, I should drink one large glass a day and none at any other time." E) "I can use kosher parve foods because they are prepared without milk."
A) "When I drink coffee or tea, I should use a non-dairy creamer instead of milk or cream." B) "I should replace 2% milk with lactose-free milk." E) "I can use kosher parve foods because they are prepared without milk." Explanation: The nurse determines that the client understands and can apply the education provided when the client states the intention to substitute milk for non-dairy coffee creamer, substitute milk for a lactose-free milk product, and use kosher parve (kosher neutral) products, which are not made with milk products. The statement about drinking a large glass of milk once daily instead of several times a day indicates the client requires further education, because the client should avoid milk or only drink small amounts. Dry milk solids contain milk and should be avoided; examples include some bread, cereals, puddings, gravy mixes, caramels, or chocolate.
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) "If you leave, you will be asked to sign a form indicating that you are leaving against medical advice." C) "Sometimes family can cause stress, and we try to maintain a stress-free care environment." D) "Why do you think you need to leave?"
A) "Would you feel more comfortable with your family with you?"
A nurse is conducting an ethnographic interview with a client. Which step would the nurse do first? A) Ask an open-ended, general question B) Request clarification of a key term C) Identify clues to what may be important D) Document the client's view of self
A) Ask an open-ended, general question Explanation: An ethnographic interview begins with an open-ended, general question. Then, based on the client's response, the nurse selects some key terms and asks for clarification, repeating the exact words and phrases that the client used. The terms are clues to what is important to the client, so the nurse asks the client to talk more about them. Finally, the nurse documents the information on the client's view of self or of the issue discussed.
When talking with a client, the nurse notes that the client keeps backing up. What would be the most appropriate response? A) Ask the client about personal space preferences. B) Back away from the client. C) Ask the client why he or she is backing away. D) Move closer to the client.
A) Ask the client about personal space preferences. Explanation: It is most appropriate to ask the client what is preferred in regard to personal space. If the nurse needs to invade the client's personal space to do an examination or take vital signs, it is important to discuss the matter. It is not appropriate to back away without assessing preference. It may make the client feel judged if the nurse asks why he or she is backing away. Moving closer to the client just perpetuates the problem.
When completing a transcultural assessment of communication, which assessment by the nurse is most appropriate? A) Assessment of eye contact, personal space, and social taboos B) Assessment of religious beliefs and prayer schedules C) Assessment of racial identification and cultural affiliation D) Assessment of income level to determine poverty status
A) Assessment of eye contact, personal space, and social taboos Explanation: Components of the transcultural assessment of communication are the cultural values associated with communication—eye contact, personal space, and social taboos. Religious assessment, racial identification, and income levels are not part of the transcultural assessment of communication.
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 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) Culture shock B) Cultural assimilation C) Cultural imposition D) Cultural blindness
A) Culture shock Explanation: The client is experiencing symptoms associated with culture shock. Culture shock occurs when a person is immersed in a different culture that is perceived as strange. The person may feel foolish, fearful, incompetent, or humiliated, and these feelings can lead to frustration and anxiety. Cultural assimilation is when one begins to assume some characteristics of a culture outside of one's own. Cultural blindness occurs when cultural differences are ignored. Cultural imposition occurs when one pushes his or her beliefs onto another person.
A nurse is providing care to a medically compromised client with limited ability to speak the dominant language. To obtain information about the client's culture, who would be appropriate for the nurse to use as a key informant? Select all that apply. A) Family B) Friends C) Interpreters D) Staff E) Client's religious contact
A) Family B) Friends C) Interpreters E) Client's religious contact
When providing care to a client, the nurse refers to the client's ethnic group. Which aspects would the nurse include as pertaining to this concept? Select all that apply. A) Language B) Religious beliefs C) Shared beliefs of origin D) Skin color E) Eye shape
A) Language B) Religious beliefs C) Shared beliefs of origin Explanation: Although the terms race and ethnic group sometimes refer to the same people, race takes biologic characteristics as the markers of separate social status, and ethnic group takes social characteristics (such as language, religious tenets, shared beliefs of origin) as markers of cultural identity.
Which nursing action displays linguistic competence? A) Learning pertinent words and phrases in the client's language B) Speaking loudly to a client who does not speak the dominant language C) Repeating statements to a client who speaks only a language different from the nurse D) Asking a family member to interpret for a client who does not speak the dominant language
A) Learning pertinent words and phrases in the client's language
Which nursing action displays linguistic competence? A) Learning pertinent words and phrases in the client's language B) Speaking loudly to a client who does not speak the dominant language C) Repeating statements to a client who speaks only a language different from the nurse D) Asking a family member to interpret for a client who does not speak the dominant language
A) Learning pertinent words and phrases in the client's language Explanation: Linguistic competence is best displayed by learning pertinent words or phrases in the client's language. Speaking loudly and repeating words do not solve the communication barrier or show an effective response to a linguistic need. Asking the client's family to interpret is discouraged because it is often unreliable and leads to confusion for the client and the nurse.
A nurse is assessing a client and determines that the client belongs to a minority group. Based on the nurse's understanding about minority groups, the nurse would anticipate that the client would likely experience which effects? Select all that apply. A) Less power B) Health disparities C) Greater advantages D) Improved access to care E) Increased economic privileges
A) Less power B) Health disparities Explanation: The term minority refers to a group of people within a society whose members have different ethnic, racial, national, religious, sexual, political, linguistic, or other characteristics from most of society. Being of a minority group often results in having less power and being disadvantaged, including health disparities in a society. Greater advantages, improved access to care, and economic privileges are not associated with minorities.
A nurse is attempting to gain insight into a client's cultural beliefs and attitudes. Which methods would the nurse likely use? Select all that apply. A) Open-ended interviewing B) Ethnographic interviewing C) Key informants D) Short-term observation E) Use of the client's language
A) Open-ended interviewing B) Ethnographic interviewing C) Key informants E) Use of the client's language Explanation: Methods to gain the client's perspective include open-ended interviewing (a variant of which is the ethnographic interview); the use of key informants; observation over time (not short-term); and use of the client's language.
Which stereotypical ideas about older adult clients does the nurse associate with the concept of ageism? Select all that apply. A) Physically impaired B) Cognitively enhanced C) Burdensome to family D) Financially independent E) Uninterested in intimacy
A) Physically impaired C) Burdensome to family E) Uninterested in intimacy
Which behaviors demonstrated by the client would the nurse consider reflections of the client's pride in ethnicity? Select all that apply. A) Requesting native cuisine B) Listening to folk music and dance C) Asking to wear unique clothing D) Crying when given a diagnosis of cancer E) Requesting assistance when transferring from bed to chair
A) Requesting native cuisine B) Listening to folk music and dance C) Asking to wear unique clothing Explanation: Pride in one's ethnicity is demonstrated by valuing certain physical characteristics, giving children ethnic names, wearing unique items of clothing, appreciating folk music and dance, and eating native dishes. Feeling emotional when given a concerning diagnosis and asking for assistance do not reflect pride in ethnicity.
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) Soup, hot tea, and toast B) Turkey sandwich, milk, and gelatin C) Chicken salad, water, and a frozen fruit juice bar D) Fruit salad, apple juice, and pudding
A) Soup, hot tea, and toast Explanation: The client believes in the hot/cold theory of disease, so the client needs to treat cold diseases with hot food and hot diseases with cold food. The most appropriate choice would be the soup, hot tea, and toast. The other options are all cold foods, which the client would not use to treat a cold disease such as an upper respiratory infection.
A newly hired young nurse overheard the charge nurse talking with an older nurse on the unit. The charge nurse said, "All these young nurses think they can come in late and leave early." What cultural factor can the new nurse assess from this conversation? A) Stereotyping B) Cultural blindness C) Cultural conflict D) Cultural imposition
A) Stereotyping Explanation: The charge nurse is clearly exhibiting ageism, which is a form of stereotyping. Cultural assimilation is when one begins to assume some characteristics of a culture outside of one's own. Cultural blindness occurs when cultural differences are ignored. Cultural imposition occurs when one pushes one's cultural beliefs onto another person.
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 discuss the concept of cultural conflict and help both parties see their respective value to the unit. B)The charge nurse should demonstrate cultural blindness and pretend that the issue does not exist. C)The charge nurse should understand that this is stereotyping in the form of racism and intervene immediately. D)The charge nurse should recognize that this is cultural imposition and the younger nurses are forcing new technology on the older nurses.
A) The charge nurse should discuss the concept of cultural conflict and help both parties see their respective value to the unit.
The nurse is caring for several clients of different cultures. Which client situation would the nurse recognize as the client with highest risk of culture shock? A) The client from Ethiopia states, "All these machines attached to me scare me and I need to get them off." B) The client from Mexico states, " I am having difficulty reading these pamphlets you gave me." C)The client from France states, "I miss my family back home." D) The client from England states, "I do not understand what all these new medications are for."
A) The client from Ethiopia states, "All these machines attached to me scare me and I need to get them off."
In addressing health promotion for a client who is a member of another culture, the nurse should be guided by which principle? A) The client may have a very different understanding of health promotion. B) Health promotion is a concept that is largely exclusive to Western cultures. C) A culture's conceptualization of health promotion is a result of that culture's level of socioeconomic development. D) The nurse should avoid performing health promotion education if this is not a priority in the client's culture.
A) The client may have a very different understanding of health promotion. Explanation: As a component of cultural assessment, the nurse should seek to understand the cultural lens through which the client may understand health promotion. Health promotion is not a concept exclusive to Western cultures, though it may be considered differently among non-Western cultures. Even if health promotion is not a priority in a client's culture, the nurse should still address issues related to health promotion in a respectful and relevant manner. Health promotion is not directly linked to socioeconomic development levels.
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, "I am glad that nurse told me what to do." C) The client states, "I can't get over my feelings of legalism as a Jehovah's Witness." D) The client states, "Why isn't blood administration forced on all who need that treatment?"
A) The client states, "I feel like I abandoned my religion." Explanation: When clients are forced to participate in care that conflicts with their values, feelings of guilt and abandonment are likely. These feelings may deepen and threaten the client's well-being. The other answer choices are not related to mandated change.
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) 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 B) fried hamburger patty with lettuce, onion slices, tomato, mayonnaise, ketchup, whole wheat bun, french fries, low-fat yogurt, diet soda 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) 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
A) 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
The nurse is preparing the discharge plan for a new mother and her newborn son. Which new teaching should the nurse ensure is included after noting the family is Jewish? A) care following the scheduled circumcision B) proper breastfeeding techniques C) when to schedule the next follow-up appointment D)the proper sleeping position for the newborn
A) care following the scheduled circumcision
A client who practices Islam dies at the hospital surrounded by family members. Which action by the nurse demonstrates cultural sensitivity related to the client's death? A) consulting the family member prior to performing post-mortem care B) informing the family members they may say their goodbyes so that care can be provided C) having the family members consult with the funeral home for transport D) allowing the family to remain present when the nurse washes the client prior to shrouding
A) consulting the family member prior to performing post-mortem care Explanation: Only family members may touch or wash the body of a deceased individual who practiced the Islamic faith, so the nurse should ask for permission prior to providing post-mortem care. The family may choose to remain, but the nurse will not be allowed to wash the body. It will be the nurse's responsibility to arrange for transport to the funeral home after care is rendered by the family.
A nurse is caring for a client with bacterial pneumonia and a temperature of 104°F (40.0°C). Yesterday, the client's temperature was 102°F (38.9°C). The health care provider on call prescribes cool compresses for the client to help lower the fever. The client insists that the nurse bring warm blankets because they will help the client to recover more quickly. The nurse recognizes that the client's request is an example of: A) cultural ritual. B) cultural competence. C) cultural stereotyping. D) ethnocentrism.
A) cultural ritual. Explanation: Clients and families often express rituals, or practices habitually repeated in certain contexts, during times of stress, such as during an acute hospitalization. Keeping the body covered and warm is a home remedy used by many cultures to help heal the body. As in this example, cultural rituals may conflict with Western medical beliefs. Cultural competence is an approach to health care in which one is aware of one's one cultural beliefs and biases and understands the effects that a client's culture has on the client's health care. Stereotyping involves applying a preconceived and untested generalization to a whole group of people. Ethnocentrism is the belief that one's culture is superior to another.
The nursing instructor is leading a class discussion concerning the challenges of providing optimal care to any client who speaks a different language. The instructor determines the session is successful when the students correctly choose which as an appropriate reason(s) to always request a certified interpreter? Select all that apply. A) avoid a civil rights violation B) to avoid breaking confidentiality C) potential for modifying information D) misunderstanding of medical terminology E) a requirement of insurance companies
A)avoid a civil rights violation B)to avoid breaking confidentiality C) potential for modifying information D) misunderstanding of medical terminology
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 subculture B) A subgroup C) A minority D) A majority
C) A minority
A new resident in a long-term care facility who was having difficulty adapting to the routine has begun participating in activities on a daily basis. Which stage of culture shock is this resident displaying? A) Honeymoon B) Disenchantment C) Beginning resolution D) Effective functioning
C) Beginning resolution
The nurse has just attended a seminar on concepts of cultural diversity. Which statement made by the nurse would require further education? A) "Culture helps to define identity within specific groups of people." B) "Culture cannot be influenced, and you are born with your culture." C) "Language is the primary way that people share their culture." D) "Culture can be seen in attitudes and institutions of certain populations."
B) "Culture cannot be influenced, and you are born with your culture. Explanation: Culture is learned through life experiences from one generation to the next. Culture helping to define identity, language being the primary way that people share their culture, and culture being seen in attitudes of certain populations are correct options; these are all components that define culture.
The nurse has just attended a seminar on concepts of cultural diversity. Which statement made by the nurse would require further education? A) "Culture helps to define identity within specific groups of people." B) "Culture cannot be influenced, and you are born with your culture." C) "Language is the primary way that people share their culture." D) "Culture can be seen in attitudes and institutions of certain populations."
B) "Culture cannot be influenced, and you are born with your culture."
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) "I need to watch the amount of high-density lipids I eat." B) "It is important to monitor my blood pressure." C) "Getting a mammogram in my thirties is important." D) "Increasing dairy will improve my bones."
B) "It is important to monitor my blood pressure." Explanation: Monitoring the blood pressure is important for identifying the risk for hypertension and stroke, which are common health conditions among the Black population. The other statements are correct for preventing diabetes, breast cancer, and osteoporosis, but these diseases are not disproportionately common health conditions for the population.
The nurse is collecting the health history of a client and notes the client is apprehensive in answering questions. The client states, "My spiritual healer will be here soon." What is the best response by the nurse? A) "I will leave the questionnaire here. Please fill it out when your spiritual healer arrives." B) "We can wait until your spiritual healer arrives and work together to answer these questions." C) "I can wait until your spiritual healer arrives, but you are the only one who can answer these questions." D) "These questions need to be answered so we can provide you with the best care."
B) "We can wait until your spiritual healer arrives and work together to answer these questions."
A nurse is admitting a client to the unit. Which cultural question is most appropriate? A) "Will you be able to eat the normal food provided?" B) "What are your dietary needs and preferences?" C) "Do you have food restrictions?" D) "Will you be making requests for special food based on your religion?"
B) "What are your dietary needs and preferences?" Explanation: By asking about dietary needs and preferences, the nurse can gain insight into religious and cultural dietary practices. Asking about "normal" foods assumes that a cultural dietary request is abnormal. The other options will produce limited insight and imply that a cultural dietary need is a restriction or hindrance.
The nurse is caring for a terminally ill client who immigrated from Mexico. Which nursing intervention regarding spiritual care is appropriate? A) Inquire if the client desires the Sacrament of the Sick. B) Ask the client if a spiritual leader is desired. C) Do nothing unless the client requests spiritual assistance. D) Call a Roman Catholic priest to visit the client.
B) Ask the client if a spiritual leader is desired.
The client is admitted to the hospital with a ruptured ovarian cyst. The client has expressed that it is very important that the spouse be present to receive all medical information. Using the concepts of culturally competent care, which is the best response? A) Explain to the client that the client is required to make all decisions related to the client's own health care. B) Document the client's request in the nursing care plan. C) Bring the client's spouse into the hallway to discuss surgical options for the client. D) Explain to the client that it is not a good idea to have the spouse in the room when discussing such a private matter.
B) Document the client's request in the nursing care plan.
A nurse is caring for a postoperative client after knee arthroplasty. The nurse plans to help the client ambulate but is aware that the client may feel threatened by physical closeness because the client is from a culture that tends to prefer more personal space when interacting with others. Using the principles of culturally competent care, what would be the most appropriate nursing action? A) Let the client ambulate slowly on his or her own when stable. B) Explain the purpose and need for assistance during ambulation. C) Instruct family members to assist in ambulating the client. D) Ambulate the client explaining it is an expected outcome of their treatment.
B) Explain the purpose and need for assistance during ambulation. Explanation: The nurse should explain the purpose of ambulation and the need for assistance while ambulating to the client. This would relieve the client's anxiety associated with physical closeness. However, the client won't be able to ambulate without assistance. Even though the nurse can instruct a family member to ambulate the client, this is not an appropriate action. Ambulating the client without recognizing the cultural difference is nontherapeutic, as the nurse would be not be performing culturally competent care by not acknowledging cultural practice.
A nurse is researching information about the different cultures of the population served by the facility. Which aspects of culture would be important for the nurse to keep in mind when learning about them? Select all that apply. A) Characteristics apply more to an individual than a group. B) Language is a means for communicating culture. C) Culture is something a child is born with. D) Culture includes explicit beliefs and attitudes. E) Culture facilitates self-worth and self-esteem.
B) Language is a means for communicating culture E)Culture facilitates self-worth and self-esteem.
The nurse is caring for a client who perceives time differently. What action should the nurse take for this client? A) Set all interventions to be done at specific times. B) Maintain flexibility when the client requests interventions at specific times. C) Have the client set all times for the interventions. D) Perform interventions at random times during shift.
B) Maintain flexibility when the client requests interventions at specific times. Explanation: People view time differently. Social time can reflect attitudes regarding punctuality that vary among cultures. The nurse should maintain a flexible attitude and adapt the time of interventions to the client's needs and requests. It is not realistic to have the client set all the times for the interventions or to have the interventions at a specific time or interventions at random times during the shift.
A client has recently immigrated and is exhibiting symptoms of culture shock. The client reports feeling unaccepted in the new culture. The client states, "I can't do anything right here." What is the priority nursing diagnosis? A) Powerlessness related to the loss of familiar cultural practice B) Situational low self-esteem related to culture shock and feelings of fear and incompetence C) Spiritual distress related to low self-esteem D) Social isolation related to culture shock and feelings of low self-worth
B) Situational low self-esteem related to culture shock and feelings of fear and incompetence
A client is seeking care at the local clinic. The nurse is completing a cultural assessment. Which scenario would demonstrate cultural assimilation? A) The client does not speak the dominant language and requires an interpreter. B) The client's child learned the dominant language as a second language. C) The client and child cook traditional foods for the family. D) The client enjoys watching television programs from the home country.
B) The client's child learned the dominant language as a second language. Explanation: The child is demonstrating an example of cultural assimilation by taking on the language of the dominant culture. When a minority group lives within a dominant group, its members may adapt some of their cultural practices that once made them different. This process is referred to as cultural assimilation. Watching television from the home country, cooking traditional foods, and speaking only the original language demonstrate the original culture and an attempt to bring the minority culture into the dominant culture.
A client from a minority culture has been hospitalized for 6 days for postoperative infection. The client's weight is decreasing each day, and the nutritional intake is declining. Which nutritional assessment question is most appropriate? A) "Why aren't you eating your food?" B) "Are you aware that you are losing weight?" C) "What type of food do you eat at home?" D) "Don't you like what is on your food tray?"
C) "What type of food do you eat at home?" Explanation: Cultural food preferences often put the client at risk for inadequate nutrition. By exploring what foods the client eats at home, the nurse can assess the client's cultural dietary preferences and work to incorporate these foods into the meal plan. The other choices are judgmental and indicate that the client should eat what is presented regardless of cultural preference.
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 Native American/First Nations man stares at the floor while talking with the nurse. Assumption: The client is embarrassed by the conversation. B) 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. D) 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.
C) A Muslim-Arab woman refuses to make eye contact with her male nurse. Assumption: She is being modest.
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) Use simple words with simple actions. B) Write out all questions using appropriate medical terms. 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)
The nurse is caring for a client who is postoperative 3 days from coronary artery bypass graft. The client has a prescription to ambulate. What is the best action by the nurse? A) Allow the client to slowly ambulate independently. B) Instruct the family to assist the client with ambulation. C) Discuss with the client the need for assistance during ambulation. D) Obtain a prescription for physical therapy consult to ambulate the client.
C) Discuss with the client the need for assistance during ambulation. Explanation: For members of some cultures, providing care and performing nursing interventions can intrude into personal space. The nurse should discuss with the client the need for assistance during ambulation and prepare the client for potential closeness. The client may ambulate independently, but the nurse should still assist. Having the family or physical therapy ambulate the client does not address the issue related to culture and nursing interventions.
Which area is typically included in a cultural assessment? A) Marital status B) Employment status C) Food preferences D) Ethics
C) Food preferences Explanation: Dietary tolerance is associated with both cultural food preferences and biologic variation. A client's marital status and employment status are aspects of demographic information recorded in the client's health record but would not be pertinent, in and of themselves, to a cultural assessment. Ethics would not be typically covered in a cultural assessment, although one's religious affiliation might be.
How is culture learned by each new generation? A) Ethnic heritage B) Involvement in religious activities C) Formal and informal experiences D) Belonging to a subculture
C) Formal and informal experiences Explanation: Culture is a shared system of beliefs, values, and behavioral expectations that provide social structure for daily living. Culture includes the beliefs, habits, likes, dislikes, customs, rituals, and ethnic heritage that are learned through formal and informal experiences within one's family and within the cultural group to which one belongs. Involvement in religious experiences can be part of the culture learned through formal and informal experiences.
The nurse is caring for a client from another culture who is diagnosed with lung cancer. Which nursing action best demonstrates culturally sensitive care? A) Explaining the biomedical culture to the client. B) Implementing a standardized care plan for the client with lung cancer after explaining the procedure in the client's native language. C) Incorporating the client's need for daily prayer into the nursing care plan. D) Treating all clients the same based on the diagnosis to demonstrate unbiased care.
C) Incorporating the client's need for daily prayer into the nursing care plan.
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 conduct the conversation quickly to avoid misinterpretation. C) The interpreter should understand the health care system. D) The interpreter should always make direct eye contact.
C) The interpreter should understand the health care system. Explanation: Obviously, nurses cannot become fluent in all languages, but certain strategies for fostering effective cross-cultural communication are necessary when providing care for clients who are not fluent in the dominant language. Cultural needs should be considered when choosing an interpreter; however, it is also important to use an interpreter who understands the health care system. In choosing an interpreter, the nurse should not select one who speaks in a loud voice, conducts the conversation quickly, or always makes direct eye contact. Direct eye contact is regarded differently among cultures.
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) Allow all the visitors into the room. B) Explain to the family that too many visitors will tire the client. 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. Explanation: Asking the client about the client's beliefs exemplifies that the nurse recognizes the importance of respecting differences rather than imposing standards. If the client believes family support is significant to health and recovery, the nurse should respect the client's beliefs and allow the visitors into the room.
Which nursing intervention reflects practice according to Madeline Leininger's transcultural nursing theory? A) Contacting a chaplain for every client B) Providing the same care to each client who has had a myocardial infarction C) Planning dietary interventions according to physiological condition D) Incorporating the client's request for complementary treatment therapy
D) Incorporating the client's request for complementary treatment therapy Explanation: Leininger's theory of transcultural nursing includes assessing a cultural nature, accepting each client as an individual, having knowledge of health problems that affect particular cultural groups, and planning of care within the client's health belief system to achieve the best health outcomes. Therefore, incorporating the client's request for complementary treatment therapy is an example of this theory. The others do not support this theory.
When a home-bound client expresses the client's past-oriented ancestral heritage and family rituals, the nurse recognizes that the client is expressing: A) race B) assimilation C) subculture D) ethnic identity
D) ethnic identity
A woman has moved from the east coast to the west coast. She is a single parent of four children who is having difficulty finding employment due to a lack of a car and primarily speaking an uncommon language for the area. Which factor is a barrier to health care? A) cultural differences B) multiple children C) female gender D) primary language other than the dominant one
D) primary language other than the dominant one Explanation: The client speaking a language that is uncommon for the area as one's primary language is a barrier to health care. Being from a different culture, female, or the parent of multiple children does not create a barrier to care.
A nurse is working with a culturally diverse group of clients. The nurse understands that cultural norms: A) allow nurses to predict a client's response. B) can be generalized to anyone of that culture. C) are fairly consistent across cultural groups. D) require an individualized approach by the nurse.
D) require an individualized approach by the nurse. Explanation: Knowing a cultural norm does not enable one to predict a person's response. Generalizing about cultural norms in contemporary societies is inappropriate because people belong to more than one subcultural group and are influenced uniquely by multiple and diverse groups. Exceptions to cultural norms always exist. Therefore the nurse needs to approach each person as an individual.