Transcultural ch. 3, 5, 6

The nurse is completing the admission assessment for a 28-year-old college graduate who is labor with her first child. Which of the following would be the most appropriate question for the nurse to ask?

"Do you have anyone special who you would like to be with you during your child's birth?"

Which question would best assist a nurse in determining the health beliefs of a culturally diverse client who has a history of hypertension? a. "Can you identify stressors in your life that may have contributed to high blood pressure?" b. "Have you been taking your antihypertension medications as it was prescribed?" c. "Do your ethnic foods you eat tend to be salty?" d. "What have you been doing to help control your high blood pressure?"

"What have you been doing to help control your high blood pressure?"

Which viewpoint, regarding birth control, would be supportive of the cultural beliefs of a Mormon woman?

Each Mormon couple has a religious responsibility to parent a large family.

Which outcome demonstrates the successful implementation of culturally congruent care for a pregnant client whose culture holds holistic health beliefs?

The mother sipped on an herbal tea to maintain hydration during the labor. In recent years, nurses and other health professionals have attempted to understand the client's lifestyle, value system, and health and illness behaviors so that effective interventions can be implemented to reduce risks in a manner that is culturally congruent with community, group, and individual values. Holistic health beliefs incorporate natural elements, such as herbal teas, in the plan of care. The remaining options are not holistic in their focus.

Which outcome is a common result of unintended pregnancies? a. Preterm labor b. Uterine hemorrhage c. Skeletal deformities d. Cardiac malformations

a. Preterm labor Unintended pregnancy can have numerous negative effects on the mother and the fetus, including a delay in prenatal care that can lead to preterm labor. The remaining options are not generally associated with either preterm labor or unintended pregnancies

Which intervention is essential to the delivery of culturally congruent care for a pregnant woman? a. A thorough cultural assessment. b. A therapeutic nurse-client relationship. c. Nursing staff who are culturally sensitive. d. Identification of the woman's health belief system

a. A thorough cultural assessment. It is essential that the nurse do a thorough cultural assessment to ascertain how much the pregnant woman uses nontraditional support systems and/or Western health care during her pregnancy. Only after the assessment is completed can a trusting relationship be established. Without a thorough cultural assessment, the remaining options will be limited in their effectiveness.

Which pregnant woman would be most accepting of her baby's father being viewed as an observer during the birth process? a. An American giving birth for the first time. b. An Asian whose first delivery required surgical intervention. c. A Hispanic whose first birth was attended to by a midwife. d. A Swede whose has experienced two previous stillbirths.

a. An American giving birth for the first time.

Which nursing intervention demonstrates an understanding of the cultural preservation when caring for a Hispanic client? a. Arranging for the client's diet to include the appropriate fever-fighting "cold" foods. b. Encouraging the client's family to learn to administer the medication as prescribed. c. Offering to have a sleeping chair moved into the room so the client's daughter can stay the night. d. Providing all educational material in the client's preferred language.

a. Arranging for the client's diet to include the appropriate fever-fighting "cold" foods.

The nurse is assessing a 5-month-old American Indian infant whose culture includes the use of a cradleboard. Which physical complication should the nurse be alert to regarding this child? a. Hip dysplasia b. Anterior skull flattening c. Abduction of the knees d. Hyperflexion of the ankles

a. Hip dysplasia

Which situation is especially prevalent in culturally diverse children being raised in one-parent families and so should be assessed for? a. Poverty level existence b. Childhood diabetes c. Gang membership d. Depression

a. Poverty level existence

Which is the primary criticism for using standardized printed history form when assessing the culturally diverse client population? a. Western medicine's signs and symptoms are not always recognized as such by other cultures b. People of another culture are not comfortable sharing personal information in such an impersonal manner c. Many cultures rely heavily upon pictures to communicate information rather than written words d. Being asked to fill out a form may be looked upon as an insult by cultures that are people focused.

a. Western medicine's signs and symptoms are not always recognized as such by other cultures

Which assessment question demonstrates an understanding of the most common prenatal concern reported by pregnant lesbian women? a. "Were you and your partner tested for possible HIV/AIDS?" b. "Do you feel you are receiving appropriate and effective prenatal care?" c. "Will you be prepared to manage the stressors of being a lesbian mother?" d. "Are you experiencing any financial problems related to paying for prenatal care?"

b. "Do you feel you are receiving appropriate and effective prenatal care?" The most common fear reported by lesbian mothers is the fear of unsafe and inadequate care from the practitioner once the mother's sexual orientation is revealed. While the remaining options reflect concerns, they are not reported as frequently as the correct option.

Which question has particular importance when interviewing a young Amish couple when their infant is hospitalized with a cardiac problem? a. "Will you need any special accommodation while here with your child?" b. "Is there anyone besides you who will be involved in making medical decisions for your child?" c. "Are you prepared to allow your child to receive blood or blood products if that becomes necessary?" d. "Does your culture allow for invasive medical procedures in treating your child's cardiac condition?"

b. "Is there anyone besides you who will be involved in making medical decisions for your child?" In an extended family culture such as the Amish, a young Amish couple might turn to that community for assistance with decision making when a child is ill. The nurse should ask the parents if anyone else will be participating in the decision making that affects their child. Once that information is known, the nurse should include the person(s) identified by the parents in the child's plan of care. The Amish has no particular restrictions regarding medical procedures or the use of blood or blood products. Their culture, while preferring to meet their needs in a simple manner, does not generally require special accommodations or treatment.

Which additional assessment should be conducted when monitoring a darkly pigmented person for cyanosis? a. Observing the client's gait and posture b. Asking the client to provide the location and date of his or her birth. c. Asking the client to "squeeze my hand" and determine muscle strength. d. Observing the client's urinary output for 12 hours.

b. Asking the client to provide the location and date of his or her birth. Poor cyanosis leads to lack of oxygen in brain and change in LOC, may not be able to answer this question

Which nursing action is required when it is determined that a client is self-administering ginseng for back pain? a. Asking the client to close his or her eyes and touch his or her nose with a finger b. Assessing and documenting the client's blood pressure c. Informing the client that herbal therapy can cause serious side effects d. Questioning the client to determine the daily dosage of the medication

b. Assessing and documenting the client's blood pressure

Which cultural value should be the basis for nutritional information given to the Hispanic mother of a newborn? a. Milk is used to supplement breast milk without recognizing the potential of triggering a milk allergy. b. Fat babies are considered healthy because there is little understanding of the health risks involved. c. Hispanic families believe in early introduction of solid foods without realizing the risk of infant choking. d. There is a high risk for the development of gastritis in Hispanic child who were formula fed as infants.

b. Fat babies are considered healthy because there is little understanding of the health risks involved.

Which intervention associated with culturally directed infant attachment practices will best support autonomy in a 3-year-old child? a. Rocking the child to sleep. b. Giving the child finger foods for lunch. c. Taking the child for walks in the park. d. Reading to the child as part of the bedtime ritual.

b. Giving the child finger foods for lunch.

What intervention will best facilitate sleep for a 3-year-old African American who is hospitalized with bronchitis? a. Offering the child a high carbohydrate bedtime snack. b. Making it possible for a parent to sleep in the child's bed. c. Playing the television on a low volume until the child falls asleep. d. Encouraging the parents to bring the child's favorite toy to the hospital.

b. Making it possible for a parent to sleep in the child's bed. Co-sleeping is more acceptable and occurs most frequently among black families. It has been documented that children who co-sleep are more likely to wake at night or to have trouble falling asleep alone at bedtime. Arranging for the parent to share the child's bed will help assure proper sleep. The other interventions will not be particularly comforting to the black child.

Which outcome demonstrates the successful implementation of culturally congruent care for a pregnant client whose culture holds holistic health beliefs? a. The infant's father cut the umbilical cord. b. The mother sipped on an herbal tea to maintain hydration during the labor. c. Labor pain was successfully managed with nonpharmacologic interventions. d. Family members remained with the mother and infant during the entire hospitalization.

b. The mother sipped on an herbal tea to maintain hydration during the labor. In recent years, nurses and other health professionals have attempted to understand the client's lifestyle, value system, and health and illness behaviors so that effective interventions can be implemented to reduce risks in a manner that is culturally congruent with community, group, and individual values. Holistic health beliefs incorporate natural elements, such as herbal teas, in the plan of care. The remaining options are not holistic in their focus.

When a mother seems reluctant to breastfeed her ill infant, the culturally sensitive nurse asks: a. "Can I help by providing you with privacy?" b. "Will you be willing to give your infant some formula?" c. "Are you afraid your baby will become nauseous and vomit?" d. "Is there some reason you aren't willing to nurse your baby?"

c. "Are you afraid your baby will become nauseous and vomit?" Asking the question directly will best identify the reason for the mother's hesitation to feed her infant. In many cultures, illness is viewed as a punishment for an evil act, while fasting (abstaining from solid food and sometimes liquids) is viewed as penance for evil.

Which assessment question will best provide the nurse with an understanding of how childbirth is viewed by an African-based culture? a. "Does your culture utilize folk healers and natural remedies to manage labor?" b. "Can you share with me the concerns you have about your pregnancy and labor?" c. "Will you describe for me the care you would expect to receive if you were giving birth in your homeland?" d. "Are you comfortable with the type of prenatal and labor care provided to all pregnant women who give birth at this hospital?"

c. "Will you describe for me the care you would expect to receive if you were giving birth in your homeland?" The different ways in which a particular society views this transitional period and manages birth are dependent in part on the culture's consensus about medical care. Assessing the client's perception of traditional care will allow the nurse insight into how much attention birth is given. Asking about folk healers and natural remedies makes certain assumptions about the expected care. The remaining options assess the client's concerns rather than her expectations of care.

Which nursing action is required when it is determined that a client is self-administering ginseng for back pain? a. Question the client to determine the daily dosage of the medication. b. Inform the client that herbal therapy can cause serious side effects. c. Assess and document the client's blood pressure. d. Ask the client to close his or her eyes and touch his or her nose with a finger.

c. Assess and document the client's blood pressure.

Which intervention will have the greatest impact on providing culturally congruent nursing care to a Hispanic child whose parents speak only minimal English? a. Requesting that the child's physician be fluent in the parents' dialect. b. Providing the services of a translator who is familiar with the Spanish language. c. Assigning a nurse to the family who is able to communicate in the parents' dialect. d. Assuring that all information is provided in the written form using the parents' dialect.

c. Assigning a nurse to the family who is able to communicate in the parents' dialect. Because ethnic minorities are underrepresented among health care professionals, parents and children often have different cultural backgrounds from their health care providers. So the greatest impact would occur when a nurse familiar with the parents' language is responsible for the communication between all involved parties. The physician's contact would be more limited than that of the nurse's. Providing a translator, while appropriate, can still allow for miscommunication especially in nursing areas. Written information needs to be supported by effectively communicated information.

Which nursing intervention demonstrates an understanding of the importance of managing assessment information in a culturally congruent manner? a. When the client described "creaky joints," enrolling in the "Arthritis Support Group" was recommended. b. Client's request for, "recipes I can use with my sugar" was met with a booklet entitled, "Cooking for the Diabetic." c. Client's edema was documented as, "Client reports, 'My legs swell when I spend too much time standing.'" d. Client was educated on the concept of paranoia when reporting belief in the "evil eye."

c. Client's edema was documented as, "Client reports, 'My legs swell when I spend too much time standing.'"

Which viewpoint, regarding birth control, would be supportive of the cultural beliefs of a Mormon woman? a. Mormons love children and strive for large families. b. The Mormon family avoids birth control until a son is born. c. Birth control is viewed as a sin by the Mormon's religious teachings. d. Each Mormon couple has a religious responsibility to parent a large family

d. Each Mormon couple has a religious responsibility to parent a large family

Which disorder is viewed as a biological variation that accounts for an increased incidence of both maternal and infant morbidity in Native American Indian population? a. Aortic stenosis b. Spina bifida c. Diabetes mellitus d. Multiple sclerosis

c. Diabetes mellitus An important biologic variation relative to pregnancy is diabetes mellitus. The incidence of non-insulin-dependent and gestational diabetes is much higher than normal among some Aboriginal people groups—a problem that increases maternal and infant morbidity. The remaining options are not disproportionally high in this population.

Which intervention is appropriate for the treatment of a child for symptoms generally associated with the act of "casting the evil eye"? a. Feeding the child bananas and rice cereal. b. Monitoring the child's apical heart rate hourly. c. Introducing fluids to the child every hour while awake. d. Frequent suctioning of the child's upper respiratory tract.

c. Introducing fluids to the child every hour while awake.

Which activity is evidence that the woman who is giving up her infant for adoption has received appropriate, specialized postnatal care? a. The infant is discussed only when the biological mother initiates the conversation. b. The biological mother is involved in the infant's care only when she requests to be. c. The biological mother is discharged with several mementos of her baby's birth. d. The infant's health care issues are discussed with the adoptive mother

c. The biological mother is discharged with several mementos of her baby's birth.

What is the basis for assessing the economic status of a culturally diverse client population as a factor affecting the delivery of individualized health care services? a. Health care facilities are required to provide free or cost reduced health care services to the economically distressed. b. The lower economically classes have different health care expectations than the more economically advantaged. c. The general health of the members of the lower socioeconomic classes is poor. d. Federal health care programs will be engaged to help meet his or her health care needs.

c. The general health of the members of the lower socioeconomic classes is poor.

Which question asked during the assessment process of an American Indian client is directed by currently accurate information regarding that culture's risk for a specific disease? a. "Have you ever been tested for diabetes mellitus?" b. "Do you have a family history of breast cancer?" c. "When was the last time you were tested for tuberculosis?" d. "Have you ever been told you have a problem with drinking too much alcohol?"

d. "Have you ever been told you have a problem with drinking too much alcohol?"

Which behavior would demonstrate appropriate family functioning? a. The father of an Italian woman being present during the delivery. b. An American woman being coached through labor by her sister. c. The husband of an Arabic woman cutting the infant's umbilical cord. d. An African American woman being supported during labor by her grandmother

d. An African American woman being supported during labor by her grandmother For traditional cultural groups, including Blacks, Hispanics, Filipinos, Asians, and Aboriginal people, the family and social network (especially the grandmother or other maternal relatives) may be of primary importance in advising and supporting the pregnant woman. The remaining options do not describe characteristic correct cultural family roles during birth.

Which intervention will have the greatest impact on providing culturally congruent nursing care to a child whose parents speak only a minimal amount of the dominant language? a. Providing the services of a translator who is familiar with the parents' native language b. Assuring that all information is provided in the written form using the parents' dialect c. Requesting that the child's health care provider be fluent in the parent's dialect d. Assigning a nurse to the family who is able to communicate int he parents' dialect

d. Assigning a nurse to the family who is able to communicate int he parents' dialect

Which statement will be the basis for determining the target population for a community education program regarding hypertension? a. The Jewish ethnic culture rarely experiences hypertension. b. Asian cultures have a biological risk factor for hypertension. c. After age 65, Black males experience on average a 10-point higher systolic pressure than White males of that same age. d. Black females have a higher average systolic blood pressure than White females at every age.

d. Black females have a higher average systolic blood pressure than White females at every age.

Which activity is vital to the survival of cultural values and customs? a. Having affluent members of the culture support poorer members. b. Electing representatives of the culture to governmental positions. c. Sponsoring cultural events to be attended by the general population. d. Providing the younger generations with opportunities to show cultural pride.

d. Providing the younger generations with opportunities to show cultural pride.

A blood glucose screening is most appropriate for which ethnic client? a. The Black male b. The White female c. The Muslim female d. The Hispanic male

d. The Hispanic male