unit 2

Just as it is important for each nurse to determine and reflect on his or her own cultural assessment, it is also important for each organization to be aware of its own transcultural position. Which would indicate an organization is meeting the standards for cultural competence?

The organization that has a defined set of principles written down and followed by each staff member

The nurse is aware that various factors have been identified as influencing an individual's behavior in preventing disease. Which clients represent those factors? (Select all that apply.)

The petite grandmother who says, "Every time that commercial comes on, I feel like they are talking about me." The 25-year-old female who presents and tells the nurse, "The last time I felt like this, I had a bladder infection." The boyfriend with a mole whose girlfriend keeps telling him, "That looks just like my uncle's and he had cancer."

The nurse is aware that some clients will not recognize the seriousness of their illness. Which statement by the client might reflect that they are not perceiving the seriousness of the symptoms that are being seen?

"I hope I can get some more sleep tonight. I always feel so tired."

Which statement demonstrates the nurse's ability to communicate sincerely and respectfully with a culturally diverse client population?

"I'm always careful to apologize when I'm having difficulty understanding a client."

Which question asked during the assessment process of an Aboriginal people client is directed by currently accurate information regarding that culture's risk for a specific disease?

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

Which statement best exhibits a belief in a magico-religious health belief system?

"My child is so sick because God is punishing me."

Which question would best assist a nurse in determining the health beliefs of a culturally diverse client who has a history of hypertension?

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

Which statement demonstrates the nurse's understanding of the importance cultural symbolism has on nursing care?

"Will you explain to me what you mean when you say your heart hurts?"

In spite of cultural diversity and the outward differences among the world's population, research has shown that any two individuals share approximately what percentage of their DNA sequence?

99.9%

The nurse should be aware many clients are reluctant to disclose they are using alternative methods. Which clients should the nurse be aware may be using alternative methods? (Select all that apply.)

A 24-year-old Aboriginal People female who appears in good condition but has lost 20 pounds since her last visit 1 year ago A 28-year-old Asian male who has not seen a physician in 5 years A 53-year-old Hispanic female who is returning for her first postoperative visit A 78-year-old White male who is upset his doctor appointment is the same time as his exercise class A 32-year-old Black female who is 22 weeks' pregnant and this is her first prenatal visit since finding out she was pregnant

Many challenges still exist in adequately providing proper health care to many of the world's population; however, the 21st century is providing new choices and changes that were not previously available. The nurse must be aware and prepared to deal with these changes and be able to communicate effectively to be able to provide the best health care the individual requires and desires. Which clients may represent a cultural challenge for which the nurse should be prepared? (Select all that apply.)

A 30-year-old Somalian mother who is seeking asylum in the United States A 24-year-old Black female traveling to Mexico for cancer treatment A 65-year-old Canadian gentleman traveling to the United States for knee replacement surgery

Health care organizations are expected to be culturally competent. Which service shows the ability to best manage the difference in cultural values and practices?

Ability to adapt special diets to meet client cultural dietary needs

Health disparities are a great concern to those who provide health care services. The Health Resources and Services Administration has identified certain populations that are at greater risk for disparities. Which have been identified as an at-risk group? (Select all that apply.)

An individual who lives in a remote location The fourth infant of a mother in her 30s An elderly gentleman who just moved into his new assisted-living apartment

Which nursing activity shows an understanding of the process of culturally competent nursing practice?

Attending two in-service programs yearly on attaining cultural competency

Which statement will be the basis for determining the target population for a community education program regarding hypertension?

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

A rural clinic provides health care to a community of mainly Aboriginal Peoples. The nursing staff is concerned that the needs of the local community are not being adequately met. They are aware that research has confirmed which is a potential obstacle?

Clients from various ethnic backgrounds are less likely to visit the clinic on a routine basis.

The nurse is managing the care of a child newly diagnosed with asthma. Which intervention demonstrates the nurse's application of the holistic health belief system?

Determining whether any family member is a cigarette smoker

Which nursing intervention best demonstrates a culturally sensitive approach to a client's belief in the effectiveness of folk healers?

Discussing interventions the healer would like incorporated into the client's care plan.

Which intervention will best assist the nurse in understanding the culturally diverse client's perception and description of his or her current illness?

Encouraging the client to describe his or her illness in terms of his or her cultural metaphors

Which activity will best minimize the risk of allowing discrimination and prejudicial behaviors to impact personal nursing practice?

Engaging in regular reflective, cultural self-assessments

Not only is the nurse responsible for implementing cultural competence but the organization by which the nurse is employed also has certain responsibilities to ensure cultural competence to provide the best possible health care to the local community. Which is recognized as helping to achieve the goal of achieving organizational cultural competence?

Establishing methods of accountability to ensure the goals and mission are being met

The nurse is aware that even though various aspects of each culture are different, there are a few which are very similar. What initially indoctrinates an individual to cultural norms?

Family

Research has confirmed that some diseases are more common among certain ethnic groups than others. Which ethnic groups are recognized for carrying the sickle cell trait? (Select all that apply.)

Middle Eastern Caribbean Mediterranean

Pain is a common reason that sends clients to seek health care. It is also one of the more challenging to treat and manage. Research has shown that which are often associated with incidences of severe pain? (Select all that apply.)

Lower education levels Medicaid insurance Chronic disease

A nurse provides care to a vast culturally diverse population. How can the nurse best address the need to provide cultural congruent nursing care?

Master the skills required to perform an effective cultural assessment

Which nursing intervention best shows compliance with offering linguistically appropriate services for a culturally diverse population?

Notifying the client that he or she is entitled to language translation services

What knowledge will best assist a nurse in providing nonprejudicial care that is sensitive to the beliefs and practices of a culturally diverse client population?

Nurses will not consciously question the bias of their own thinking and so must make a concerted effort to do so regularly.

It is determined that an older, widowed client is a member of a familistic culture. Which intervention is best directed toward communicating effectively with the client?

Presenting information related to possible treatment modalities to the entire family

Which intervention demonstrates integrative nursing care?

Respecting a client's wish to have his or her minister accompany him or her to the operating room

Which nursing activity has priority when providing culturally congruent care?

Self-reflection concerning beliefs associated with the client's culture

The nurse is performing basic assessments of a variety of clients in the clinic. The nurse is aware that a blood glucose screening is mostappropriate for which ethnic client?

The Hispanic male

A 27-year-old new client, who is hearing impaired, has presented to the clinic for a routine visit. Speaking mainly with sign language, the client explains that he is changing physicians because a staff member at the last clinic was constantly trying to talk him into getting cochlear implants, which he does not want. The nurse should be aware that which may be happening?

The client does not see himself as disabled, but simply a member of a certain subcultural group.

Which nursing intervention demonstrates an understanding of the importance of managing assessment information in a culturally congruent manner?

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

Which scenario would the nurse recognize as denial by a family member?

The father who insists the child is just stubborn and misbehaving like he was as a child

Which is the primary criticism for using standardized printed history forms when assessing the culturally diverse client population?

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