Public Health Nursing: Ch. 8

While obtaining a health history from a patient who resides in a predominantly Hispanic community, the nurse notices that the patient continues to move closer to the nurse when asked a question. In which manner would the nurse react to demonstrate cultural competence?

Establish an appropriate spatial zone based on the patient's culture.

The public health nurse is reviewing epidemiological data within a Bosnian community and notices an increase in smoking and subsequent lung cancer rates over the past five years. Which plan of care formulated by the nurse can be used to modify high-risk behaviors while preserving the culture?

Socialize in smoke-free environments

of the public health department is The nurse manager providing a learning activity related to cultural competence and biases, Which statement made by a coworker would cause the nurse to examine his or her personal beliefs?

"I must emphasize following traditional medicine over the patient's holistic practices and beliefs."

Affecting 90 percent of adults entering health care institutions, which national health problem would the public health nurse associate with the inability to obtain, process, and understand basic health information?

Health literacy

The nurse implemented a program to decrease the incidence of type 2 diabetes mellitus in the American Indian population. The nurse worked with people to incorporate healthy food choices and exercise within their cultural practices. Which factor should the nurse examine to evaluate the effectiveness of this program?

Hemoglobin AlC levels of each community member

The nurse is developing programs to promote health care in marginalized populations. Which group should be included? Select all that apply. One, some, or all responses may be correct.

Homeless Drug abusers LGBTQ community

The nurse manager is reviewing the current organization to determine the level of cultural competence. Which finding would cause the nurse manager to recommend further training?

Lack of clinical documentation about sexual orientation

Which social determinant of health would the nurse identify that most significantly influences health belief systems, health practices, and health outcomes?

Language

Which patient situation would the public health nurse recognize negatively influences the ability to access care, share medical history with providers, complete forms, follow instructions, and engage in health promotion activities?

Limited health literacy

Which potential characteristic of a culturally diverse patient would the public health nurse address to increase his or her willingness to participate in a treatment plan? Select all that apply. One, some, or all responses may be correct.

Low health literacy Limited English proficiency Reception and processing of information Belief about the origin and treatment of disease

The nurse manager is evaluating the cultural competence of an employee using Orlandi's model. Which finding would indicate cultural competence in the affective domain?

Desire to change

The health care provider has requested a visiting nurse visit a 30-year-old patient with new onset type 1 diabetes mellitus. The nurse determines during the initial visit that the patient is a practicing Muslim. Which should the nurse outline in the plan of care before the next visit? Select all that apply. One, some, or all responses may be correct.

Determine food preferences and dislikes. Evaluate blood glucose control when fasting. Research Islamic dietary laws and restrictions.

Which factor would the public health nurse recognize that influences differences in how individuals within a cultural group receive, process, and distribute information? Select all that apply. One, some, or all responses may be correct.

Dialect and language spoken Geographic location in the current country Degree of assimilation in the country of residence Amount of interaction between the older and younger generations

Which method of communication would the public health nurse recognize is most often considered rude or disrespectful by numerous cultural groups?

Direct eye contact

Which characteristic would the public health nurse associate with culture? Select all that apply. One, some, or all responses may be correct.

Establishes what is considered to be a health problem Influences who provides treatment for health problems Determines how information is received, processed, and distributed Clarifies how symptoms and concerns of health situations are expressed

The nurse is performing an assessment of a community with Eastern European immigrants. Which social determinant of health would the nurse evaluate when developing programs for this demographic?

Middle school level of educational completion

Which biological variation would the public health nurse assess for when examining a patient of African American descent? Select all that apply. One, some, or all responses may be correct.

Mongolian spots Keloid formations Sickle cell anemia

Which quality is expected of the culturally competent public health nurse? Select all that apply. One, some, or all responses be correct. may

Awareness of social determinants of health Knowledge of specific questions to ask patients Avoidance of uncompromised patient-provider relationships Promotion of positive patient health beliefs, practices, and behaviors Respect for individuals with different values and beliefs

Which mode of intervention would the public health nurse implement by advocating, mediating, negotiating, and intervening between a patient's culture and the biomedical health system on behalf of the patient?

Cultural brokering

The nurse is assigned to a new community of Hispanic residents. The nurse has never worked with these residents, so the nurse researches the culture including norms, lifestyles, values, and religions by interviewing members within the community. Which action is the nurse performing through these actions?

Cultural immersion

Which mode of intervention would the public health nurse implement by supporting and facilitating the use of scientifically supported cultural practices of a patient's culture along with the biomedical health care system?

Cultural preservation

Which mode of intervention would the public health nurse implement by helping patients to reorder, change, or modify their cultural practices when the cultural practices are harmful to them?

Cultural repatterning

How would the public health nurse interpret excessive drinking in an American Indian/Alaskan Native patient?

Disharmony between individual and spirit world

Patients from which cultural group would the public health nurse expect to be comfortable with less space?

Hispanic

In addition to culture, race, and ethnicity, which factor would the culturally competent public health nurse recognize that influences human behavior and health, and results in health disparities in the United States? Select all that apply. One, some, or all responses may be correct.

Income Education Cross-cultural experiences

Which potential outcome would the public health nurse expect when reviewing the results of non-culturally competent health care? Select all that apply. One, some, or all responses may be correct.

Increased barriers to accessing care Obstacles in gathering assessment data Ineffective communication between patient and nurse Increased gap in racial and health disparities between minority and majority populations

Which primary goal would the public health nurse work toward to balance cost and quality when practicing culturally competent nursing?

Outcome effectiveness

The nurse is caring for an older patient of Asian descent with a diagnosis of breast cancer. The patient asks how to manage the disease and the side effects when using a holistic approach. Which information provided by the nurse infers the use of cultural imposition?

Use of antiemetics and opioid analgesics

The nurse is scheduled to provide blood pressure checks in a predominantly African American neighborhood. Which statement made by the nurse would be categorized as stereotyping?

"I can check their blood pressure every month, and they won't change due to their diets."

The nurse is preparing to obtain a health history from a patient, including a cultural assessment. Which question posed by the nurse allows the nurse to examine the impact of culture and tradition on the patient? Select all that apply. One, some, or all responses may be correct.

"What do you rely upon when going through a difficult time?" "Who within your family takes care of things when you are ill?" "In which way do you include your religious practices into daily life?" "Is it difficult to incorporate cultural tradition with Western practices?"

An overweight Hispanic patient being treated for hypertension and pre-diabetes is in for a follow-up appointment to ascertain effectiveness of treatment. Upon review of assessment compared with the last visit, the nurse determines which question is necessary to connect cultural elements to noncompliance of treatment? Select all that apply. One, some, or all responses may be correct.

"What foods do you generally prefer to eat?" "How many family members live in your home?" "Do you and your family engage in any religious celebrations?" "How do you feel about your health status and the treatment the health care provider has chosen?"

Which racial difference would the public health nurse recognize affects assessment and treatment plans? Select all be correct. that apply. One, some, or all responses may

Laboratory findings Enzymatic differences Susceptibility to disease

Which cultural group would the nurse identify as being at high risk of malnutrition due to cultural food preferences?

American Indian/Alaskan Natives

The nurse is preparing to discharge a patient of Orthodox Jewish descent when the patient states they cannot leave the hospital yet because it is during Shabbat. Which action would the nurse take to demonstrate cultural relativism?

Allow the patient to remain in the hospital through the end of Shabbat and then proceed with discharge teaching.

According to transcultural nursing theorists, in which action would the public health nurse engage to ensure culturally competent, positive outcomes for all patients? Select all that be correct. apply. One, some, or all responses may be correct.

Acquire skills. Obtain knowledge. Commit to change. Develop proficient attitude.

A patient who speaks little English is having difficulty navigating the health care system to receive treatment and asks the public health nurse for help. The nurse makes multiple phone calls to ensure the patient receives the treatment needed. Which concept is the nurse utilizing?

Advocacy

Which cultural group would the public health nurse associate with decreased efficacy of psychotropic, immunosuppressant, cardiovascular, antiretroviral, and anti-hypertensive medications?

African American

Which primary cultural element would the public health nurse derive information from to accurately assess a patient's health needs? Select all that apply. One, some, or all responses may be correct.

Communication Personal space Perception of time Biological variations Environmental control

Which mode of intervention would the public health nurse implement by assisting, supporting, facilitating, or enabling patients in their use of cultural practices to achieve satisfying health care outcomes when those practices are not harmful to the patients?

Cultural accommodation

The nurse is reviewing rates of tuberculosis (TB) in an immigrant population before a meeting. Which factor should the nurse explain as contributing to an increase in the number of TB cases? Select all that apply. One, some, or all responses be correct. may

Inability to afford adequate health care Employment in unsafe working conditions Failure to properly screen immigrants upon entry

Which type of implicit cultural communication would the public health nurse associate with a public information sign stating, "Thank You For Not Smoking"?

Indirectness

The public health nurse has noticed an increase in type 2 diabetes mellitus in lower socioeconomic ethnic groups. Which step would the nurse take to determine contributing factors?

Interview patients about the types of foods included in the diet.

Abstaining from which component listed in the Five Moral Precepts would the public health nurse recognize conflicts with eating meat? Select all that apply. One, some, or all responses may be correct.

Intoxicants Harming living things

The nurse is caring for a patient who presents to the outpatient clinic for a sports physical. While giving the health history, the patient reports being homosexual. Which step can the nurse take to ensure there is no discrimination or prejudice against the patient?

Involve the patient in the health care discussion to ensure the patient's voice is heard.

Associated with cultures valuing harmony with the environment, which belief would the public health nurse recognize that may affect a patient's adherence to a cancer treatment protocol? Select all that apply. One, some, or all responses may be correct.

Nothing will change. Medicine cannot cure cancer. Cancer is in disharmony with nature.

Which time-oriented focus, displayed by looking to their ancestors for guidance in current health situations, would the public health nurse observe in members of Vietnamese culture?

Past orientation

Which result would the public health nurse expect when the nurse's cultural system differs from a patient's cultural system?

Patient and nurse interactions may result in different understandings of health and health promotion.

Which action would the public health nurse ensure occurs when working with a patient who prefers family decision making over individual choice? Select all that apply. One, some, or all responses may be correct.

Patient needs are considered. Nurse advocates for the patient. Nurse clarifies the patient's wishes.

Which principle guides the public health nurse in delivering culturally competent nursing care?

Patient self-empowerment strategies

The nurse is preparing to administer immunizations to members of an Asian community. Which action by the nurse would require the nurse to examine his or her cultural competence?

Patting the child on the head for not crying

The home health nurse is developing a dietary plan for a patient who follows the Buddhist religion. Which should the nurse include in the plan?

Plant-based protein sources

Which intervention would the nurse include in the plan of care when it is determined that a new patient has limited health literacy?

Present instructions in simple terms and ask the patient to repeat the instructions in the patient's own words.

Which characteristic would the public health nurse recognize differentiates race from culture and ethnicity?

Race is defined as biological variations within population groups based on physical markers derived from genetic ancestry.

When working with immigrant populations, which step would the public health nurse take first to increase authenticity, accuracy, and approachability?

Recognizing the values, beliefs, and practices of the nurse's own culture

After responding with a smile and a nod to instructions to take an antibiotic for an infection, an Asian patient returns a week later having failed to take the medications. Which action would the public health nurse take first?

Repeat the medication instructions.

The nurse noticed an increase in pregnancy-induced hypertension in women within a Hispanic community. Which action should the nurse perform before developing prenatal classes for this population?

Research health beliefs.

Which action would the public health nurse take to effectively communicate trust with his or her patients? Select all that apply. One, some, or all responses may be correct.

Respecting all information the patient shares Providing data to facilitate good health care choices Promoting the patient as owner of his or her health care

Before planning health promotion programs for a group of new immigrants in the community, which step should be taken to ensure cultural competence is demonstrated? Select all that apply. One, some, or all responses may be correct.

Review personal beliefs and biases. Arrange for interpreters to attend program. Explore health practices and any special therapies. Research dietary and cultural practices and beliefs. Determine current needs of both individuals and families.

Which title would the public health nurse recognize belongs to an alternative healer within the Hispanic cultural group?

Santero priest

Which standard would the public health nurse identify as being among the Standards of Practice for Culturally Competent Nursing as described by the American Academy of Nursing Expert Panel? Select all that apply. One, some, or all responses may be correct.

Social Justice Critical Reflection Multicultural Workforce Advocacy and Empowerment

After observing a patient consistently late for health care appointments, which cultural variation would the public health nurse discuss first with the patient?

Time perception

Which explicit cultural behavior would the public health nurse observe to identify other persons from the same culture? Select all that apply. One, some, or all responses may be correct.

Verbal communication Interpersonal distance Public displays of affection