transcultural nursing midterm
hen the nurse uses informal or ad ho translators such as family members or untrained hospital staff, it potentially (select all that apply): A. Breaches patient confidentiality B. Ensures compliance with the Office of Minority Health C. Meets ethical standards D. Is intrusive of patient privacy rights
A. Breaches patient confidentiality D. Is intrusive of patient privacy rights
Which statement best describes Cross's concept of cultural blindness? A. Attitudes that are destructive of cultures B. Attitudes that involve bias and discrimination C. Levels of awareness and an effective response to diverse populations D. A belief in treating all groups the same without regard for differences
D. A belief in treating all groups the same without regard for differences
The nurse encounters multiple patients from culturally diverse groups who are living in poverty in the hospital's local community. The nurse desires to get involved in attempting to address this problem. The most effective initial approach by the nurse is to: A. Contact the local council members and other legislators to state some of the problem these patients are experiencing B. Study a foreign language to reduce the language barrier that exists between the nurse and at least one ethnic cultural group C. Join a nursing organization and advocate for the groups through collective action D. Attempt to establish a trusting relationship with each individual patient to identify his or her specific healthcare needs.
D. Attempt to establish a trusting relationship with each individual patient to identify his or her specific healthcare needs.
In a culturally competent work setting, the responsibility for Kim's success as a new nurse on the unit lies with: A. Human resources B. Kim C. The staff D. Kim, human resources, and the nursing staff
D. Kim, human resources, and the nursing staff
Military personnel who are exposed to the suicide of friends and colleagues are 10 times more likely to also experience: A. Anxiety and depression B. Bipolar disease C. Behavioral problems D. PTSD
D. PTSD
According to some researchers, minority group members can establish better relationships with members of the dominant group by (select all that apply): A. Building trust through honest dialogue B. Being vigilant in watching for any signs of prejudice or bias toward them C. Being willing to give others the benefit of the doubt D. Demanding equitable treatment for themselves and others E. Striving to understand how their behaviors are perceived
A. Building trust through honest dialogue C. Being willing to give others the benefit of the doubt E. Striving to understand how their behaviors are perceived
The interpreter arrives on the unit to see Mr. Nam, a Vietnamese patient. The nurse's initial action before beginning the interpreting session is to: A. Discuss the clinical situation and goals of the interview with the interpreter. B. Introduce the patient and interpreter. C. Provide a list of questions to ask the patient. D. Allow the interpreter an opportunity to determine how the interview should be conducted.
A. Discuss the clinical situation and goals of the interview with the interpreter.
The most frequent causes of physical trauma or injury during deployment are: A. Explosions from land mines, IEDs, or mortar fire B. Accidental injuries due to falls or equipment failure C. Motor vehicle accidents D. Helicopter crashes E. Burns and infections
A. Explosions from land mines, IEDs, or mortar fire
The nurse admits a patient who is homeless to the unit. When planning care for this patient, what attitude by the nurse is most realistic? A. Homelessness poses a serious barrier to healthcare access. B. There are many available healthcare services provided by governmental agencies for the Homeless. C. Quality care is provided to the homeless to the same extent it is provided to others. D. Persons who are homeless are aided by government subsidies like Medicaid.
A. Homelessness poses a serious barrier to healthcare access.
Having knowledge about Kim's cultural background is useful because (select all that apply): A. It enables the nurses to get to know Kim's cultural values and beliefs B. It provides cultural information as a resource for the nurses' future encounters with patients who share Kim's ethnicity. C. It assists in overcoming the language barrier. D. It helps prevent problems in miscommunication.
A. It enables the nurses to get to know Kim's cultural values and beliefs B. It provides cultural information as a resource for the nurses' future encounters with patients who share Kim's ethnicity. D. It helps prevent problems in miscommunication.
The culturally competent nurse recognizes that the consequences of misunderstandings between the nurse and linguistically diverse patients are most likely to result in (select all that apply): A. Misdiagnosis B. Suboptimal pain management C. Reduction in the cost of care D. Poor patient satisfaction E. Enhanced treatment of chronic care
A. Misdiagnosis B. Suboptimal pain management D. Poor patient satisfaction
The nurses on a medical-surgical unit are offered an opportunity to take a night course in Spanish for healthcare personnel. One nurse refuses to take the course because she believes that this action by the nurses would discourage Spanish-speaking patients from appreciating the importance of learning and speaking English. This way of thinking is based on: A. Myths about language diversity B. Evidence-based practice C. Cultural sensitivity D. Linguistic diversity
A. Myths about language diversity
When delivering cross-linguistic nursing (CLN), to ensure evidence-based practice, the nurse reviews the literature on cultural competency and finds which of the following statements is accurate about language differences between nurses and their patients? Language differences between patients and nurses often: A. Perpetuate discrimination and compromise care B. Impact doctors and nurses equally C. Impact doctors more than nurses D. Enhance nurse-patient interactions
A. Perpetuate discrimination and compromise care
A health assessment that takes into consideration major healthcare concerns that veterans experience should include screening for: A. Physical and sexual trauma, TBI, depression, PTSD B. Loss of hearing and/or vision, insomnia, amputations, paralysis C. Chemical or toxic exposures and infectious diseases D. Respiratory diseases, loss of limbs, TBI, heart disease E. Gunshot wounds, infections, STDs, toxic syndrome
A. Physical and sexual trauma, TBI, depression, PTSD
To ensure the cultural acclimation of newly hired nurses from culturally diverse backgrounds, nurse administrators and human resource personnel can assist by (select all that apply): A. Providing staff development opportunities that promote cultural sharing B. Orienting culturally diverse nurses to the culture of the unit and the institution C. Setting a deadline by which new staff must complete their orientation D. Assigning a mentor to work specifically with a new nurse
A. Providing staff development opportunities that promote cultural sharing B. Orienting culturally diverse nurses to the culture of the unit and the institution D. Assigning a mentor to work specifically with a new nurse
Research indicates that _____is/are the most significant factors in determining healthcare outcomes. A. Race and ethnicity B. Socioeconomic status C. Language skills D. Religious beliefs
A. Race and ethnicity B. Socioeconomic status
Cultural competency skills needed when initially establishing attempting to establish a rapport with veterans should include: A. Reflective listening and use of the Pearls model B. Learning about the veteran's religious and/or spiritual background C. Determining the patient's views on time and space D. Considering the patient's cultural norms
A. Reflective listening and use of the Pearls model
When a patient asks to have someone other than a culturally diverse coworker care for them, culturally competent nurses can respond by: A. Speaking supportively about the professional competence of the nurse B. Agreeing to take the assignment on behalf of the nurse C. Insisting that the patient will have to accept the hospital's policy on nondiscrimination D. Refusing to care for the patient
A. Speaking supportively about the professional competence of the nurse
The nurse is planning the discharge of a patient who is unemployed. The nurse realizes that it is important to include what strategies in the patient's discharge planning (select all that apply): A. Teach the patient preventive health measures. B. Identify community resources. C. Provide any medical information in the patient's own language. D. Determine the patient's ability to pay for prescriptions.
A. Teach the patient preventive health measures. B. Identify community resources. C. Provide any medical information in the patient's own language. D. Determine the patient's ability to pay for prescriptions.
What statement by the nurse is true regarding the intersection of cultural differences, language barriers, lack of health insurance, and poverty? A. The combination of these factors compounds the problem of access for the poor. B. There are no differences between those with language barriers and those without in their impact on healthcare access. C. Cultural differences have little impact on healthcare access. D. All persons who lack private healthcare insurance are eligible for Medicare or Medicaid.
A. The combination of these factors compounds the problem of access for the poor.
A culturally competent nurse recognizes that cultural group members who have a collectivist perspective value: A. The needs of the group or team over that of the individual B. The needs of the individual C. Needs based on the circumstances D. The demands of the team leader
A. The needs of the group or team over that of the individual
The nurse discovers that a newly admitted patient is unable to speak or understand English. In taking a patient-centered approach to care, what is an appropriate goal of care? Please select all that apply. A. The patient will understand the diagnosis and treatment plan in his own language. B. The patient will learn some English to communicate with the staff. C. The patient's family will be included in the care planning as the patient desires. D. The patient's children will be utilized to translate to minimize the need for a medical translator.
A. The patient will understand the diagnosis and treatment plan in his own language. C. The patient's family will be included in the care planning as the patient desires.
The culturally competent nurse uses Kleinman's Explanatory Model during a cultural assessment. This model was selected because the nurse wants the patient to focus on A. The patient's perceptions about his illness B. The patient's allegiance to his family C. The patient's concerns about his spiritual beliefs D. The patient's concerns about the hospital staff
A. The patient's perceptions about his illness
According to the stages of intercultural competence, a person who believes that their way of doing something is the only way may be viewed as being at what stage of competence? A. Unconscious incompetence B. Conscious incompetence C. Conscious competence D. Unconscious competence
A. Unconscious incompetence
When using any of the cultural assessment tools, the culturally competent nurse employs a particular type of listening technique that requires the nurse to A. Question the patient's comments B. Restate and clarify C. Discuss the situation from the nurse's point of view D. Offer advice based on the nurse's medical knowledge
B. Restate and clarify
Active listening is a strategy used by culturally competent nurses. This means that during communication, the culturally competent nurse: A. Allows the speaker to speak without ever interrupting B. Seeks clarification to ensure accuracy C. Uses nonverbal communication for emphasis D. Actively engages the speaker by sharing stories
B. Seeks clarification to ensure accuracy
servicemen and women who are contemplating suicide are less likely to reach out for help due to: A. Fear of being demoted or released from the military B. Stigma and military culture C. Upsetting family and friends D. Ambivalence about taking their life
B. Stigma and military culture
When language diversity is first suspected, the initial response by the nurse should be to: A. Provide an interpreter. B. Notify the physician of this concern. C. Determine the patient's primary language and his or her ability to speak and read it. D. Conduct a full cultural assessment.
C. Determine the patient's primary language and his or her ability to speak and read it.
The nurse who suspects a patient is experiencing symptoms of PTSD attempts to prevent an exacerbation by: A. Encouraging frequent visitors and patient activities as a distraction B. Minimizing stimuli by limiting harsh noises and maintaining a quiet environment C. Assisting the patient with ADLs D. Monitoring the patient carefully and reporting the behavior to a physician E. Providing analgesics to promote comfort and minimize pain
B. Minimizing stimuli by limiting harsh noises and maintaining a quiet environment
What nursing measures provide the best strategy for the nurse to obtain critical information from the patient when caring for veterans who are depressed or withdrawn? A. A physical assessment tool to determine injury or disease B. A communication tool for facilitating nurse-patient interaction C. A cultural assessment tool to explore race, ethnicity, religion, and culture D. A nursing health history E. Obtain a partner to assist with care
B. A communication tool for facilitating nurse-patient interaction
When culturally competent nurses are working with diverse colleagues, the first step in the process is to: A. Determine the new colleague's level of communication. B. Explore their own attitudes, beliefs, and behavior. C. Share cultural knowledge about their own cultural background. D. Explore cultural differences that exist between themselves and the new staff member.
B. Explore their own attitudes, beliefs, and behavior.
Which of these factors represents the most military-specific cause of PTSD? A. Military culture B. Exposure to combat C. Lower status and rank D. Sexual trauma
B. Exposure to combat
The nurse admits Mr. Smith, a member of the Cherokee Tribe, to the unit. When preparing to conduct the initial nursing interview and assessment, the nurse considers that Mr. Smith's cultural heritage suggests that his language is most likely to be: A. Low context B. High context C. Nonverbal D. Mid Context
B. High context
the nurse complains to his charge nurse that one of his patients is threatening and intimidating because of his loud and forceful tone of voice. The culturally competent charge nurse recognizes that this behavior most likely reflects this patient's: A. Cultural beliefs B. Linguistic style C. Language context D. Cultural language
B. Linguistic style
A female patient who is unable to speak English is discovered by the nurse crying alone in her room. What initial action by the nurse is most appropriate? A. The nurse goes to contact the family before entering the room. B. The nurse approaches the patient smiling and offers the patient tissues. C. The nurse contacts an interpreter. D. The nurse speaks in English and tells the patient that everything will be all right.
B. The nurse approaches the patient smiling and offers the patient tissues.
According to research, what problems are most often encountered by patients who live in poverty? (Select all that apply.) A. Bilingualism B. Too little time for sharing information with providers C. ER overuse D. Mistrust of healthcare providers
B. Too little time for sharing information with providers C. ER overuse D. Mistrust of healthcare providers
Which statement is true about women and the military? A. Women account for about 2% of active-duty enlisted personnel. B. Women's roles in the military are limited to nurses, cooks, and secretaries. C. All roles, positions, and ranks are now open to women. D. Women have never been and are unlikely to be injured or killed in combat.
C. All roles, positions, and ranks are now open to women.
The nurse who works in a busy urban area has frequent encounters with patients from multicultural populations. When working with members of ethnically diverse groups, the nurse understands that the poorest patients are most likely to be found among: A. Asian immigrants B. Pacific Islanders C. Blacks and Hispanics D. Ethnic Whites
C. Blacks and Hispanics
The primary cross-cultural barrier in this case scenario is a problem due to: A. Kim's lack of experience in the United States B. Kim's educational preparation in nursing C. Challenges in communication D. Differences in worldview
C. Challenges in communication
The culturally competent nurse is working with a colleague who adopts a traditional interpersonal style. The nurse recognizes that persons practicing this style are more likely to: A. Be willing to abandon their cultural values B. Find it difficult to relinquish their beliefs and attitudes C. Fail to recognize or acknowledge their cultural identity D. Take pride in their own culture while being comfortable interacting with members of another
C. Fail to recognize or acknowledge their cultural identity
Which of these statements represents the strongest predictor of suicidal ideation? A. Pain and sexual trauma B. Romantic conflict C. Feelings of social isolation D. Employment dissatisfaction
C. Feelings of social isolation
The ETHNIC Model affords the nurse an opportunity to learn about the patient's A. Genetic predispositions to diseases B. Socio Economic problems C. Health beliefs, practices, preferences, and expectations D. Racial background
C. Health beliefs, practices, preferences, and expectations
When the nurse plans cross-linguistic care for her newly admitted patient, she is most concerned by patient behaviors that suggest differences in: A. Linguistic style B. Language context C. Literacy D. Cultural attitudes
C. Literacy
Research shows a positive relationship among income, completed education, net worth, and A. Language abilities B. Cultural attitudes C. Private health insurance D. Religious values
C. Private health insurance
Headaches, tinnitus, insomnia, and memory losses are symptoms that are usually associated with in veterans. A. Sexual trauma B. PTSD C. TBI D. CVA E. TIA
C. TBI
When discussing a patient's eligibility for indigent programs based on U.S. government definitions of poverty, what statement by the nurse demonstrates a good understanding of poverty Thresholds? A. Thresholds vary based on individual states' determinations. B. Thresholds are based on the income of the person designated head of household. C. Thresholds are consistent throughout the nation and are based on family size and age of its D. Thresholds are determined by townships and /or municipalities.
C. Thresholds are consistent throughout the nation and are based on family size and age of its
A patient explains to the nurse that she delayed coming to the ER after experiencing a severe burn because she did not have any money to pay for the visit. What statement by the culturally Is a competent nurse the most appropriate? A. Patients who are unable to pay are guaranteed emergency services by the Civil Rights Act of 1963. B. Patients are provided services through the Patients' Bill of Rights. C. Patients are protected by the Equal Opportunities Amendment. D. Patients are guaranteed services by the Emergency Medical Treatment Act.
D. Patients are guaranteed services by the Emergency Medical Treatment Act.
According to the literature, which of the following represents a high-risk period for reattempts of suicide by persons who are hospitalized? A. One day after the initial attempt at suicide B. Three months after the initial attempt C. One year after hospitalization D. The period immediately following discharge
D. The period immediately following discharge
The majority of veterans alive today are those who served in: A. World War I B. World War Il C. Korean War D. Vietnam War E. Persian Gulf
D. Vietnam War
Failure to report sexual trauma in the military is largely due to: A. Fear of reprisals or promises of benefits for silence B. Military culture, like loyalty to the group C. Fear of not being believed D. Lack of consequences for the perpetrator E. All of the above
E. All of the above
Which of these constitute social barriers to reintegration or transition to civilian life after deployment or service in the military? A. Unemployment and homelessness B. Depression, alcoholism, and drug abuse C. PTSD D. Feelings of isolation and alienation E. All of the above
E. All of the above
what percentage of Americans speak a language other than English at home? a. 1 in 5 b. 1 in 10 c. 1 in 15 d. 1 in 20
a. 1 in 5
when using Purnell's 12 domains to perform a cultural assessment, the culturally competent nurse understands that te term bicultural ecology refers to a. physical, biological, and physiological variations, such as skin color b. differences in geographic location c. attitudes toward preserving the environment d. ones country of origin
a. physical, biological, and physiological variations, such as skin color
which statement best illustrates what the nurse should consider when reflecting upon the patients context? a. social-political, historical, and structural situations impacting the patient b. fold and traditional health beliefs and attitudes c. preferences for Western vs. Eastern traditions d. employment and economic status of the patient
a. social-political, historical, and structural situations impacting the patient
when performing a cultural assessment, the nurse utilizes Giger and Davidhizar's Transcultural Assessment Model. when assessing the construct of space, the nurse considers the patients a. visual depth perception b. the patients comfort level regarding social distance c. the adequacy of the patients prior reception d. the patients sense of physiologic balance
b. the patients comfort level regarding social distance
which statements best describe nurses use terms like cultural humility, cultural awareness, cultural sensitivity, and cultural competency? a. the words all have the same meaning b. the words convey different meanings and are after a court of confusion c. each term conveys some aspect of being culturally competent
b. the words convey different meanings and are after a court of confusion c. each term conveys some aspect of being culturally competent
according to a report by the NIH and CDC, health disparities are a result of a. genetic predispositions b. wide variations in healthcare access c. cultural diversity among various groups d. racial and ethnic characteristics
b. wide variations in healthcare access
the culturally competent nurse recognizes that the most appropriate time for performing a cultural assessment is a. when obtaining a health history b. after the nurse has met with the patient and the family c. during each patient-nurse encounter d. during the physical examination
c. during each patient-nurse encounter
a nurse selects a cultural assessment model when performing a nursing history of a newly admitted recent immigrant from Cambodia. the primary reason for selecting the model is to a. determine the nurses ability to provide culturally competent care b. assess the patients ability to communicate in English c. gain cultural knowledge about factors that may influence the patients healthcare decision-making d. determine the patients readiness to utilize Western medicine
c. gain cultural knowledge about factors that may influence the patients healthcare decision-making
which statement below best describes a culturally competent nurse? a. having the motivation to provide quality care to assigned patients b. having the desire to partner or collaborate with the patient c. having the attitude, knowledge, and skills necessary to provide quality care to culturally diverse patients and groups d. having the knowledge of multiple languages to address various
c. having the attitude, knowledge, and skills necessary to provide quality care to culturally diverse patients and groups
the model that allows the nurse to express an understanding of how the patient feels without necessarily conveying agreement is called a. the sunrise model b. PEARLS c. validation d. the ESFT model
c. validation
in Leininger's Sunrise Model, "generic or folk systems" refers to a. Western medicine b. systems of medicine that are antiquated and no longer useful c. health practices of the elderly d. traditional healthcare practices and belief systems used as alternatives to Western medicine
d. traditional healthcare practices and belief systems used as alternatives to Western medicine