Videbeck Chapter 7: Client's Response to Illness Q's, Chapter 7 Psych nursing, Mental Health: Chapter 7: Client's Response to Illness, Chapter 7, NU245- Chapter 7: Client's Response to Illness

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The nurse in an psychiatric inpatient facility encourages clients to attend daily prayer sessions. What is the most likely reason for the nurse's action? Choose the best answer.

Prayer helps in coping with stress.

feeling a connection to a higher power

The nurse is caring for a client recently admitted to the hospital with pneumonia. After speaking with the client, the nurse notes the client believes the source of the illness is not physiological. Which statement by the client may have led the nurse to think this?

"I have been ignoring my prayers."

Which scenario conveys the application of cultural competence in the provision of nursing care?

A new nurse asks a Hispanic colleague to explain how cultural beliefs might influence a Hispanic client's response to health care interventions.

In order to help preserve and maintain a client's cultural belief regarding the need for "hot foods," which action should the culturally competent nurse take?

Educate the staff to help them assist the client in selecting food choices from the client's menu that supports this belief

The nurse is assessing a client who recently immigrated to the United States. The client is experiencing a high level of stress and reports that nobody in the workplace is willing to work with or talk to the client. What is the most likely cause of stress in the client?

Low sense of belonging

"It involves adopting aspects of a different culture in when in a new environment."

The nurse caring for several clients on a surgical unit notes that one of the clients the nurse is caring for is Muslim. The nurse, without asking the client, decides to remove all pork from the client's meal tray prior to delivering it to the room. What best describes the nurse's action?

Stereotyping

The nurse educator is providing education to the nursing staff regarding culturally appropriate nursing care. A nursing student asks the nurse educator to describe the concept of acculturation. Which statement by the nurse is the appropriate response? "It involves adopting aspects of a different culture in when in a new environment." "It is integrating a set of values that belong to a group or culture." "It involves identifying with a group of individuals who have culturally specific beliefs and identifies." "It is a process of completely converting to another belief system."

"It involves adopting aspects of a different culture in when in a new environment."

Which statement made by the client demonstrates hardiness when faced with a health issue?

"What do I need to do to manage this illness?"

Which statement made by the client demonstrates hardiness when faced with a health issue? "My father was diagnosed with this illness as well." "What do I need to do to manage this illness?" "I know my faith will get me through this illness." "Can you explain what caused this illness?"

"What do I need to do to manage this illness?"

Physical Space or Distance: -In the United States and many other Western cultures, ___ to ___ feet is a comfortable distance. Latin Americans and people from the Middle East tend to ____ to one another than do people in Western cultures. People from ___ and ___ cultures are usually more comfortable with distances greater than __ to ___ feet.

-2 to 3 feet -Stand closer -Asian -Native American's -2 to 3 feet

Individual Factors: -___, ___, ___ -Effect on coping with illness -Expression of illness -Erikson's states of psychosocial development; each stage dependent on successful completion of previous one -Adult developmental tasks

-Age -Growth -Development

Self-Awareness Issues: -Limited personal experience can cause ___: -Saying the "___" -Doing something ___ or ____ -Frequently review for stereotypical biases: -Approach with a ___ caring attitude -Ask the client preferences and ___, ___, and health practice needs -Recognize any ___ feelings or ____ and discuss them with a colleague to dispel myths and misconceptions -Remember that a wide variety of factors influence the client's complex response to illness

-Anxiety -"Wrong thing" -Offensive -Disrespectful -Genuine -Spiritual -Religious -Negative -Stereotypes

Cultural Factors: -Culturally competent nursing care means being sensitive to issues related to culture, race, gender, sexual orientation, social class, economic situation, and other factors. -___ about causes of illness -Factors in cultural ___ 1. 2. 3. 4. 5. 6. -Socioeconomic status, social class

-Beliefs -Assessment 1. Communication 2. Physical space or distance 3. Social organization 4. Time orientation 5. Environmental control 6. Biologic variations

Nurse's Role in Working with Patient from Various Cultures: -Knowledge seeking about a patient's ___, ___, and health practices -___ as best source of information -General cultural knowledge to guide nurse in ___, decisions about what questions to ask -Preferences, health practices, beliefs -General knowledge not replacement for patient assessment -___ variations in individuals in culture

-Cultural values -Beliefs -Patient -Initial meeting -Wide

Cultural Patterns and Differences: -Knowledge of ___ cultural patterns as starting point when relating to people from different ___. -___ variations among people from any culture.

-Expected -Ethnic backgrounds -Wide

Individual Factors: -___, ___ factors -Physical health, health practices -Healthier= ___ -Response to drugs -Differences in ___ groups related to ___, efficacy -Slow metabolism = ___

-Genetics -Biological -Better coping with stress or illness -Ethnic -Metabolism -Need for lower doses

Self-Awareness Issues: -Maintain ___, caring ____ -Ask how nurse can promote or assist with ____, ___, ____ practices -Recognize own ___, possible ___ -Remember that patient's response to illness is ___, ___

-Genuine -Attitude -Spiritual -Religious -Health -Feelings -Prejudices -Complex -Unique

Individual Factors: -___: the belief that personal abilities and efforts affect the events in our lives. -Hardiness: -Three components: ___, ___, ___ -___: having healthy responses to stressful circumstances or risk situations -Resiliency is ___; can be stressful to one, but not to another. -___: involving using problem-solving abilities and believing that one can cope with adverse or novel situations. -___: the essence of a person's being and his/her beliefs about the meaning of life and the purpose for living.

-Self-efficacy -Commitment -Control -Challenge -Resilience -Subjective -Resourcefulness -Spirituality

Interpersonal Factors; -___: the feeling of being connected with or involvement in a social system or environment of which a person feels as integral part. -Feeling ___, and like he/she "___" -Social networks, social support -Perception of support system, ___ of support system -Family support

-Sense of belonging -Valued -"Fits" -Responsiveness

Hardiness has three components: 1. 2. 3.

1. Commitment 2. Control 3. Challenge

Low sense of belonging

The nurse in an psychiatric inpatient facility encourages clients to attend daily prayer sessions. What is the most likely reason for the nurse's action? Choose the best answer. Prayer helps in coping with stress. Prayer helps in curing illness. Prayer prevents the progression of the illness. Prayer helps in improving the effectiveness of therapy.

Prayer helps in coping with stress.

A nurse is teaching a class on culture in healthcare to a group of nursing students. Which scenario discussed by the nurse demonstrates the concept of acculturation?

A Japanese family emigrated to another country several years ago and have now adopted some aspects of that country's culture.

Which of the following is most influential in determining health beliefs and practices? A. Cultural factors B. Individual factors C. Interpersonal factors D. All of the above are equally influential

The nurse has been working with a client to develop self-efficacy. What client statement would most likely suggest to the nurse that self-efficacy is improving? A. "I have decided to apply for a promotion at work." B. "I don't come down with colds anymore when I'm under stress." C. "Situations that others find stressful don't really bother me." D. "I have a group of good friends I can rely on."

A. "I have decided to apply for a promotion at work." Self-efficacy is the belief that one's own actions and abilities impact the events in one's life. Clients with high self-efficacy are more likely to set goals and take actions to achieve those goals. A client who has set a goal of achieving a promotion at work and taken the action to apply for the promotion is demonstrating self-efficacy. The other statements, while positive, don't necessarily depict that trait. For instance, being unaffected physically or emotionally by stressful situations may be indicative of hardiness or resilience; neither statement represents the client taking action. Having a personal network to rely on is helpful, but its existence doesn't suggest self-efficacy unless the client is actively seeking its support in achieving personal goals.

Which component of hardiness encompasses the ability to make appropriate decisions in life activities? A. Control B. Change C. Commitment D. Challenge

A. Control Control is the ability to make appropriate decisions in life activities. Commitment is active involvement in life activities. Challenge is the ability to perceive change as beneficial rather than just stressful. Change is not a component of hardiness, according to Kobasa (1979).

In order to help preserve and maintain a client's cultural belief regarding the need for "hot foods," which action should the culturally competent nurse take? A. Educate the staff to help them assist the client in selecting food choices from the client's menu that supports this belief B. Assure the client that these needs will be considered by the staff C. Discuss the possibility of the family providing the appropriate foods D. Ask for a dietary consult with an understanding of the "hot and cold food" belief

A. Educate the staff to help them assist the client in selecting food choices from the client's menu that supports this belief In cultural care preservation/maintenance, the nurse assists the client in maintaining health practices that are derived from membership in a certain ethnic group. The nurse helps the client select and obtain foods congruent with these beliefs most effectively by educating staff. This is not necessarily possible or even advised if there are medically required food restrictions

Personal space and distance is a cultural perspective that can impact nurse-client interactions. What is the best way for the nurse to interact physically with a client who has a different cultural perspective on space and distance than the client? A. Explain that physical contact is necessary and ask about the client's cultural personal space preferences. B. Realize that sitting close to the client is an indication of warmth and caring. C. Sit 3 to 6 feet away from the client in an attempt to not offend. D. Remember not to intrude into the personal space of the elderly.

A. Explain that physical contact is necessary and ask about the client's cultural personal space preferences. When providing nursing care that involves physical contact, the nurse should know the client's cultural personal space preferences. Sitting close or too far away from the patient may be interpreted as offensive. Age is not necessarily a deciding factor in regard to a person's cultural practices.

The nurse is teaching new parents about the developmental stages. When discussing trust vs. mistrust, which parenting skills should be included? Select all that apply. A. Feed the baby when hungry. B. Use a car seat while traveling. C. Allow the infant play on his or her own. D. Change diapers when wet or soiled. E. Keep the baby close.

A. Feed the baby when hungry. B. Use a car seat while traveling. D. Change diapers when wet or soiled. E. Keep the baby close. According to the Erikson's stages of psychosocial development, the infant needs to develop basic trust that the parents will take care of him or her. This includes feeding and changing diapers when needed as well as keeping the infant safe. The nurse should not encourage the parents to let the baby play unattended.

Children of parents who abused alcohol and substances are able to develop self-esteem and self-efficacy by developing which characteristics? A. Resilience B. Hardiness C. Social skills D. Tolerance

A. Resilience Resilience is having healthy responses to stressful situations or risky environments. Hardiness is the ability to resist illness when under stress. Social skills are a type of coping strategy. Tolerance is the ability to deal with increasing levels of stress in an adaptive way.

Evaluating the cultural practices of others according to the nurse's own culture can be counteracted by the nurse's use of which practice? A. Self-assessment B. Self-disclosure C. Self-discipline D. Self-esteem

A. Self-assessment Ethnocentrism, or the tendency to believe that one's own way of thinking, believing, and behaving is superior to that of others, is counteracted by the nurse's use of self-analysis. The other answers are not applicable as a counteraction to ethnocentrism.

Which factor has the greatest impact on a person's ability to cope with illness? A. age B. occupation C. financial status D. gender

A. age A person's age seems to affect how he or she copes with illness. For instance, the age at onset of schizophrenia is a strong predictor of the prognosis of the disease. People with a younger age at onset have poorer outcomes, such as more negative signs (apathy, social isolation, and lack of volition) and less effective coping skills, than do people with a later age at onset. While the other options may exert some impact, the degree is not as profound as the affect of age.

The nurse is trying to effectively deal with the spiritual needs of a client. To best meet the client's need, what should the nurse do? A. clarify own spiritual values and beliefs before exploring clients' beliefs B. have the healthcare provider deal with spiritual needs C. ask the manager what to do D. have clergy come to see the client

A. clarify own spiritual values and beliefs before exploring clients' beliefs

When interviewing a Native American client, the nurse avoids which behavior because it is deemed unacceptable by the client's culture? Sitting in the presence of an elder Prolonged eye contact Strict attention to time commitments Expression of emotion or affection

Prolonged eye contact

32. Which of the following cultural phenomena that should be assessed by the nurse includes preference such as touch and eye contact? A) Communication B) Social organization C) Environmental control D) Biologic variations

Ans: A Feedback: Communication involves verbal and nonverbal communication. Social organization refers to family structure and organization, religious values and beliefs, ethnicity, and culture. Environmental control refers to a client's ability to control the surroundings or direct factors in the environment.

7. The nurse is preparing to administer PRN medication to a client of a Japanese descent who is anxious. The prescription reads, ìAlprazolam (Xanax) 0.25 to 1.0 mg PO PRN.î The best dose for the nurse to give initially is A) 0.25 mg. B) 0.5 mg. C) 0.75 mg. D) 1.0 mg

Ans: A Feedback: In general, nonwhites treated with Western dosing protocols have higher serum levels per dose and suffer more side effects. Persons of Asian descent often metabolize drugs more slowly, requiring lower doses to produce therapeutic effects.

Ask the client how the medicine bag can be respected while preparing for surgery.

Racial bias is evident in mental health care treatment, as reflected by what? White clients are given access to better facilities within most mental health treatment centers. Nonwhite clients are institutionalized much more frequently than are whites. It is increasingly difficult to receive reimbursement for mental health services. Most nonwhite clients are grossly undermedicated when treated in inpatient facilities.

Nonwhite clients are institutionalized much more frequently than are whites.

The nurse is caring for a client of Middle Eastern descent who has been newly diagnosed with type 2 diabetes. The client is insistent that the client's family provide all food. How should the nurse respond? By providing the client and the family with detailed instructions with the dietary requirements of the condition By explaning to the family that they must check with the staff before giving the client food and beverages By requesting a consultation with a dietitian By informing the client's health care provider of the client's reluctance to eat facility-prepared foods

By providing the client and the family with detailed instructions with the dietary requirements of the condition

A client who recently immigrated from Eastern Europe comes to the clinic for an evaluation. During the assessment, the nurse notes that the client has adopted the local area's mannerisms and dress. The nurse interprets this as what?

Acculturation

For a client who belongs to an ethnic group that is known to have poor metabolism of psychotropic medications, the nurse should anticipate that the client may be at risk for which problem?

Adverse drug effects

For a client who belongs to an ethnic group that is known to have poor metabolism of psychotropic medications, the nurse should anticipate that the client may be at risk for which problem? Decreased therapeutic effect Paradoxical drug effects Adverse drug effects Increased drug resistance

Adverse drug effects

The nurse is assessing a client who has come in for a routine check-up. What factors should the nurse assess that could directly impair the client's ability to cope with illness? Select all that apply.

Amount of sleep Nutritional status Existence of chronic illness Involvement in social activities

28. A client from which of the following cultural groups is likely to prefer closeness in personal space? A) Arab Americans B) Chinese C) Cubans D) African Americans

Ans: A Feedback: Arab Americans prefer closeness in personal space. Chinese keep respectful distance. Cubans have greatly varying preferences for personal space. African Americans respect privacy and use a respectful approach.

5. Which one of the following statements about the roles that biologic makeup plays in a client's emotional responses is most accurate? A) Biologic differences can affect a client's response to treatment with psychotropic drugs. B) Biologic differences do not affect a client's response to treatment with psychotropic drugs. C) Heredity and biologic factors are under voluntary control. D) Persons cannot change their health status and improve the ability to cope.

Ans: A Feedback: Biologic differences can affect a client's response to treatment with psychotropic drugs. Heredity and biologic factors are not under voluntary control. Persons can change their health status and improve their ability to cope.

4. Genetics have been shown to play which of the following roles in a person's mental and emotional health? A) Several mental disorders appear to run in families. B) Specific genes have been linked to certain mental disorders. C) Biologic factors can be modified to change the influence on emotional health. D) Psychiatric treatment is effective regardless of an individual's biologic influences.

Ans: A Feedback: Heredity and biologic factors are not under voluntary control. We cannot change these factors. Research has identified genetic links to several disorders. Although specific genetic links have not been identified for several mental disorders (e.g., bipolar disorder, major depression, and alcoholism), research has shown that these disorders tend to appear more frequently in families. Genetic makeup tremendously influences a person's response to illness and perhaps even to treatment.

3. Which one of the following statements is most accurate regarding the age at onset of a mental illness such as schizophrenia? A) Persons who are diagnosed at a younger age will more likely have a poorer outcome. B) Persons who are diagnosed at a younger age will more likely have a better outcome. C) Age at diagnosis is not related to outcomes. D) Younger clients have more experiences that will help them.

Ans: A Feedback: Persons who are diagnosed with schizophrenia at a younger age at onset have poorer outcomes, such as more negative signs and less effective coping skills, than do people with a later age at onset. A possible reason for this difference is that younger clients have not had experiences of successful independent living or the opportunity to work and be self-sufficient and have a less well-developed sense of personal identity than older clients.

19. Which of the following situations would most likely provide social support to a client? A) A friend who will share his or her perspective on an issue B) The transportation service that provides access to daily rehabilitation services C) Fellow teammates participating in a community softball league D) The teacher assisting a client to obtain a GED

Ans: A Feedback: Social support is emotional sustenance that comes from friends, family members, and even health-care providers who help a person when a problem arises. It is different from social contact, which does not always provide emotional support. An example of social contact is the friendly talk that goes on at parties.

33. Which of the following questions best encourages the client to disclose information the nurse must assess to provide culturally competent care? A) ìHow do you want me to help you?î B) ìDo you want me to contact your preacher?î C) ìWhat special dietary preferences do you have?î D) ìWhich family members do you want to receive calls from?î

Ans: A Feedback: To provide culturally competent care, the nurse must find out as much as possible about a client's cultural values, beliefs, and health practices. Often, the client is the best source for that information, so the nurse must ask the client what is important to him or her. An open and objective approach to the client is essential. Clients will be more likely to share personal and cultural information if the nurse is genuinely interested in knowing and does not appear skeptical or judgmental. Assuming the client wants a preacher or has dietary preferences is assuming the client's values. Asking about preferred family members does little to assess the nature of family relationships

Ability to perceive change as beneficial rather than just stressful:

Challenge

8. A client's prognosis is said to be good due to a high degree of self-efficacy. Which of the following is evidence of a high degree of self-efficacy? A) The client is self-motivated and asks for help when needed. B) The client is able to resist illness when under stress. C) The client responds well in stressful situations. D) The client uses good problem-solving abilities.

Ans: A Feedback: People with high self-efficacy set personal goals, are self-motivated, cope effectively with stress, and request support from others when needed. Hardiness is the ability to resist illness when under stress. Resilience is defined as having healthy responses to stressful circumstances or risky situations. Resourcefulness involves using problem- solving abilities and believing that one can cope with adverse or novel situations.

20. A holistic plan of recovery would be especially important to a client from which of the following cultural groups? A) American Indian B) African American C) Mexican American D) Arab American

Ans: A Feedback: The American Indians' concept of health is holistic and wellness oriented. African Americans and Mexican Americans value feelings of well-being, ability to fulfill role expectations, and being free of pain or excess stress. Arab Americans view health as a gift of God manifested by eating well, meeting social obligations, being in a good mood, and having no stressors or pain.

14. Which of the following statements about spirituality are true? Select all that apply. A) Many clients with mental disorders have disturbing religious delusions. B) Religious activities have been shown to be linked with better health and a sense of well-being. C) Spirituality only involves religion. D) Hope and faith are two critical factors in psychiatric and physical rehabilitation. E) Spirituality may include a relationship with the environment.

Ans: A, B, D, E Feedback: Many clients with mental disorders have disturbing religious delusions. Religious activities have been shown to be linked with better health and a sense of well-being. Spirituality involves the essence of a person's being and his or her beliefs about the meaning of life and the purpose for living. It may include belief in God or a higher power, the practice of religion, cultural beliefs and practices, and a relationship with the environment. Hope and faith are two critical factors in psychiatric and physical rehabilitation.

13. Which of the following personal characteristics influence a client's response to stressors? Select all that apply. A) Self-efficacy B) Sense of belonging C) Spirituality D) Hardiness E) Resilience F) Resourcefulness

Ans: A, C, D, E, F Feedback: Personal characteristics that influence a client's response to stressors include self- efficacy, spirituality, hardiness, resilience, and resourcefulness. Sense of belonging is an interpersonal factor that can influence a client's response to stressors.

24. Several family members arrive to visit an African American client. The nurse can best meet this client's need for socialization by providing the client and family which of the following? A) Individual visits to provide the client with a calm environment B) Group gatherings and open conversation C) Inclusion of ritualistic health practices with the family present D) A spiritual healer to remove the illness and protect the family

Ans: B Feedback: During illness, families are often a support system for the sick person. Families often feel comfortable demonstrating public affection such as hugging and touching one another. Conversation among family and friends may be animated and loud. Spiritual rituals are more prevalent in Native American cultures.

35. How might the nurse best provide culturally competent care? A) Behave as appropriate for the nurse's culture. B) Find out as much as possible about a client's cultural values, beliefs, and health practices. C) Know what to expect from many cultural groups. D) Validate knowledge about culture through continuing education.

Ans: B Feedback: Each client is an individual; the nurse can never assume that any individual client will fit the general preferences of his or her culture.

15. Individuals who grow up in ìat-riskî environments but are able to become productive, successful citizens are believed to possess which of the following characteristics? A) Hardiness B) Resilience C) Social skills D) Tolerance

Ans: B Feedback: Resilience is having healthy responses to stressful situations or risky environments. Hardiness is the ability to resist illness when under stress. Social skills are a type of coping strategy. Tolerance is the ability to deal with increasing levels of stress in an adaptive way.

21. A nurse and a client of Chinese heritage are collaborating on treatment goals. The nurse would document which of the following as the client's priority goal? A) The client will be free of pain and excess stress. B) The client will express a feeling of balance and harmony. C) The client will be free of physical symptoms of illness. D) The client will express gratefulness to God for recovery

Ans: B Feedback: Chinese and many other Asian cultures view health as a balance of body, mind, and spirit. Pain-free is a major focus of African American culture. Russians and Latino cultures focus largely on physical aspects of health. Arab cultures view health as a gift of God.

25. A Filipino client meets the nurse for the first time. The client simply smiles at the nurse when introduced. The nurse interprets this behavior as A) a display of being shy and introverted. B) a typical greeting for a Filipino client. C) constricted verbal skills associated with the client's illness. D) a sign that the client may be suspicious of the nurse.

Ans: B Feedback: Smiles rather than handshakes are a common form of greeting in Pilipino culture. Filipino clients consider direct eye contact impolite, so there is little direct eye contact with authority figures such as nurses and physicians.

16. Which of the following factors would be the most influential in determining a client's response to a particular stressor? A) The client's experience with stress B) The client's perception of the stressor C) Duration of the stressor D) Severity of the stressor

Ans: B Feedback: The client will respond to the stressor based on his or her appraisal (perception) of the stressor. Resilience is related to positive outlook. The client's experience with stress, the duration of the stressor, and the severity of the stressor would not be the most influential in determining a client's response to a stressor.

34. The nurse is making a cultural assessment of a client. The most important data about a client's cultural beliefs are A) objective data about the culture. B) subjective data from the client. C) subjective data from the family. D) subjective data from society

Ans: B Feedback: The client's perception and description of cultural beliefs and values are most important.

Active involvement in life activities:

Commitment

10. It is recorded in the client's chart that the family is resilient. The nurse concludes which of the following characteristics about the family life of this client? Select all that apply. A) Family members are independent of one another. B) Family members spend time together. C) Family members engage in recreational activities together. D) Family members share the same personal goals. E) Family members allow individual members to develop unique daily routines.

Ans: B, C Feedback: Factors that are present in resilient families include positive outlook, spirituality, family member accord, flexibility, family communication, and support networks. Resilient families also spend time together, share recreational activities, and participate in family rituals and routines together. Personal goal setting reflects self-efficacy.

6. Which of the following individual factors can a person modify to improve mental and emotional health? Select all that apply. A) Serotonin deficiency B) Lack of exercise C) Poor nutrition D) Type I diabetes E) Sleeplessness

Ans: B, C, E Feedback: Personal health practices, such as exercise, poor nutritional status, lack of sleep, or a chronic physical illness, can influence the client's response to illness. Unlike genetic factors, how a person lives and takes care of himself or herself can alter many of these factors. For this reason, nurses must assess the client's physical health even when the client is seeking help for mental health problems. Serotonin deficiency and type I diabetes are not under voluntary control.

12. Which of the following statements about hope and symptoms of mental illness are true? Select all that apply. A) Hope is not realistic and therefore is not related to mental well-being. B) Persons having more hope experienced fewer actual symptoms. C) Hope is a cause of mental illness. D) There is not a significant relationship between hopelessness and increased symptoms. E) A possible way to help clients manage and decrease symptoms would be to support the development of hope.

Ans: B, E Feedback: Persons having more hope experienced fewer actual symptoms. A significant relationship between hopelessness and increased symptoms was also demonstrated. This may indicate that one of the ways to help clients manage and decrease symptoms is having a wellness plan that includes a positive future outlook and support for the development of hope.

1. The nurse is assessing the anxiety level of a young school-age child. The nurse encourages the child to express feelings through the use of toys in a play situation. The purpose for this approach to assessment is largely related to which of the following? A) The child has cognitive impairment and has limited vocabulary skills. B) The child has not been intellectually stimulated and can only express self through play. C) Children may not have developed the language to fully describe their feelings. D) Children will not express themselves openly unless instructed to do so by parents.

Ans: C Feedback: A client's age can influence how he or she expresses illness. A young child may lack the understanding and ability to describe his or her feelings, which may make management of the disorder more challenging. Nurses must be aware of the child's level of language and work to understand the experience as he or she describes it.

26. Females from which of the following cultures are most likely to be expected to move in with husband's family? A) African Americans B) Mexican Americans C) South Asians D) Haitians

Ans: C Feedback: African Americans are more likely to have a nuclear family. Mexican Americans mostly live in nuclear families. South Asians expect the daughters to move in with the husband's family. Haitians may have an extended or a nuclear family.

18. A client reports feeling like he belongs among his peers with whom he shares a group home. The nurse incorporates this sense of belonging when formulating discharge plans because the nurse understands which of the following? A) Living with a peer group often increases anxiety. B) Peers may alienate the client from daily living activities. C) The client will likely feel needed by his peers. D) Peer groups often do too much for each other causing dependency.

Ans: C Feedback: An increased sense of belonging is associated with decreased levels of anxiety. Persons with a sense of belonging are less alienated and isolated, have a sense of purpose, believe they are needed by others, and feel productive socially.

23. A nurse is working with a Middle-Eastern client being treated for major depression. The client is expressing feelings of guilt for not being able to ìsnap out of it.î A therapeutic response by the nurse would be, A) ìYou have to keep trying to feel better.î B) ìWhat do you think could have caused your depression?î C) ìClinical depression is not something you have brought on yourself.î D) ìIt will take several weeks for your medicine to start to help you feel better.î

Ans: C Feedback: Arab Americans believe mental illness is something the person can control. Educating about the etiology reduces the guilt associated with having an illness. Suggesting the client keep trying or caused the depression in some way implies that the client is responsible for the illness. Informing about medication ignores the client's feelings of guilt.

29. Direct eye contact is preferred by which of the following cultures? A) Native Americans B) Cambodians C) Russians D) Chinese

Ans: C Feedback: Of these cultures, only Russians prefer direct eye contact. Native Americans communicate respect by avoiding eye contact. For Cambodians, eye contact is acceptable, but ìpoliteî women lower their eyes. For Chinese, eye contact is avoided with authority figures.

30. Beliefs about the causes of pain and illness vary among cultures. In the United States (Western culture), pain and illness are generally attributed to A) economic class. B) psychological influences. C) physiologic causes. D) sociocultural factors.

Ans: C Feedback: Usually, Americans believe that pain and illness arise from physical causes. Two prevalent types of beliefs about what causes illness in non-Western cultures are natural and unnatural or personal. Unnatural or personal beliefs attribute the causes of illness to the active, purposeful intervention of an outside agent, spirit, or supernatural force or deity. The natural view is rooted in a belief that natural conditions or forces, such as cold, heat, wind, or dampness, are responsible for illness.

27. Culture has the most influence on a person's health beliefs and practices. African Americans believe that the cause of mental illness occurs because of which of the following? A) Lack of harmony of emotions B) Supernatural causes C) Heredity D) Lack of spiritual balance

Ans: D Feedback: African Americans believe that mental illness is caused by lack of spiritual balance. Chinese believe that mental illness is caused by lack of harmony of emotions. Haitians believe that mental illness is caused by supernatural causes. Cubans believe that mental illness is hereditary.

2. A nurse is teaching decision-making skills to a client with dependent personality disorder. According to Erikson, the likely cause of the client developing dependent personality is failure to meet the critical task of which developmental stage? A) Trust B) Autonomy C) Initiative D) Industry

Ans: D Feedback: Failure to complete the critical task results in a negative outcome for that stage of development and impedes completion of future tasks. Tasks of trust versus mistrust include viewing the world as safe and reliable and viewing relationships as nurturing, stable, and dependable. In autonomy versus shame and doubt, children achieve a sense of control and free will. In initiative versus guilt, the child begins to develop a conscience, and learns to manage conflict and anxiety. Industry versus inferiority involves school-age children building confidence in their own abilities and taking pleasure in accomplishments.

9. A client is actively involved in community service activities. The benefit of involvement in meaningful daily activities will most directly contribute to which of the following attributes? A) Self-efficacy B) Resilience C) Resourcefulness D) Hardiness

Ans: D Feedback: Hardiness is the ability to resist illness when under stress. Hardiness has three components: commitmentóactive involvement in life activities; controlóability to make appropriate decisions in life activities; and challengeóability to perceive change as beneficial rather than just stressful. Self-efficacy is a belief that personal abilities and efforts affect the events in our lives. Resilience is defined as having healthy responses to stressful circumstances or risky situations. Resourcefulness involves using problem- solving abilities and believing that one can cope with adverse or novel situations.

11. Spirituality is especially important in helping people cope primarily for which of the following reasons? A) Spirituality helps people set personal goals. B) Spirituality gives people meaningful daily activities in which to participate. C) Spirituality provides a reliable support network. D) Spirituality guides beliefs about the meaning of life events.

Ans: D Feedback: Spirituality involves the essence of a person's being and his or her beliefs about the meaning of life and the purpose for living. Spirituality is a genuine help to many adults with mental illness, serving as a primary coping device and a source of meaning and coherence in their lives. It may also help to provide a social network, but it serves primarily as a belief system. Personal goal setting is a demonstration of self-efficacy. Hardiness is enhanced through commitment to meaningful daily activities.

22. The nurse is preparing to conduct an admission assessment interview with a Mexican American client. During the interview, the nurse should respect the client's culture through which behavior? A) Greet the client with a hug, B) Encourage direct eye contact during questioning C) Prohibiting the next of kin to remain present D) Introduce self with a handshake

Ans: D Feedback: With Mexican Americans touch by strangers is not appreciated, but a handshake is polite and welcomed. Nonverbal communication generally avoids direct eye contact with authority figures. Socially, contact with families comes first.

31. The nurse considers cultural variations pertaining to a client's nonverbal communication. Which of the following is the primary rationale for considering alternative meanings of nonverbal communication? A) The nurse must become expert at interpreting the client's gestures. B) Nonverbal signs indicative of certain mental illnesses transcend cultural differences. C) Mental illnesses impair a client's ability to express nonverbal messages. D) Nonverbal messages have different meanings in various cultures.

Ans: D Feedback: The nurse should be aware that nonverbal communication has different meanings in various cultures. These differences are important to note because many people make inferences about a person's behavior. The nurse can never know all culturally relevant messages. All communication is culturally relative. Persons with mental illness are fully capable of nonverbal expression.

17. The client says to the nurse, ìI know I can learn to cope with my family situation. By getting help here at the clinic, I'll be able to deal with them more effectively, and I won't be so stressed out all the time.î This client is demonstrating a high level of A)Hardiness B)resilience C)sense of belonging D)self-efficacy

Ans:D Feedback: Self-efficacy is a belief that personal abilities and efforts affect the events in our lives. A person who believes that his or her behavior makes a difference is more likely to take action. Persons with high self-efficacy are self-motivated, get needed support, and cope effectively. Hardiness is the ability to resist illness when under stress. Resilience is defined as having healthy responses to stressful circumstances or risky situations. Sense of belonging is the client's place in the group, family, etc.

Arrange for the client's Shaman to come to the unit and meet with the client and health care providers.

The nurse who is preparing a Native American client for surgery notes that the client is wearing a medicine bag. What intervention should the nurse implement to best address the client's spiritual needs with respect to presurgical care needs? Remove the medicine bag and give it to a family member for safe keeping. Ask the client to provide information about his or her personal spiritual belief system. Ask the client how the medicine bag can be respected while preparing for surgery. Explain to the client that the medicine bag must be removed in order to minimize the risk of infection during the surgical procedure.

Ask the client how the medicine bag can be respected while preparing for surgery.

Which approach to care best reflects cultural competence?

Assess the culturally mediated beliefs of each client on an individual basis.

Which approach to care best reflects cultural competence? Always assign nurses of a specific ethnic background to clients with the same ethnic background. Learn all behaviors and values associated with people of specific ethnic backgrounds. Assess the culturally mediated beliefs of each client on an individual basis. Believe that people are more alike than they are different.

Assess the culturally mediated beliefs of each client on an individual basis.

A nurse in a multicultural community knows that to give a client meaningful spiritual care within the health care context it must be what?

Congruent with the client's beliefs

A handshake is considered an acceptable greeting for anyone in which of the following cultures? (Select all that apply) A. Filipino B. Haitian C. Mexican American D. Native American E. South Asian F. White European American

B C and F

Which of the following assessments indicates positive growth and development for a 30-year-old adult? A. Is dissatisfied with body image B. Enjoys social activities with three of four close friends C. Frequently changes jobs to "find the right one" D. Plans to move from parental home in near future

Which of the following client statements would indicate self-efficacy? A. "I like to get several opinions before deciding a course of action." B. "I know if I can learn to relax, I will feel better." C. "I'm never sure if I'm making the right decision." D. "No matter who hard I try to relax, something always comes up."

Which of the following states the naturalistic view of what causes illness? A. Illness is a natural part of life and therefore unavoidable. B. Illness is caused by cold, heat, wind, and dampness. C. Only natural agents are effective in treating illness. D. Outside agents, such as evil spirits, upset the body's natural balance.

The nurse who is preparing a Native American client for surgery notes that the client is wearing a medicine bag. What intervention should the nurse implement to best address the client's spiritual needs with respect to presurgical care needs? A. Ask the client to provide information about his or her personal spiritual belief system. B. Ask the client how the medicine bag can be respected while preparing for surgery. C. Explain to the client that the medicine bag must be removed in order to minimize the risk of infection during the surgical procedure. D. Remove the medicine bag and give it to a family member for safe keeping.

B. Ask the client how the medicine bag can be respected while preparing for surgery. Nurses who are unsure of a person's social or cultural preferences need to ask the client directly during the initial encounter about preferred terms of address and ways the nurse can help support the client's spiritual, religious, or health practices. None of the remaining options demonstrates respect and interest in the client's spiritual needs related to the medicine bag.

A client has come to the mental health center for an initial visit. The nurse has little experience with the client's culture, having cared for only one other client with a similar background. When assessing the new client, which approaches would be best for the nurse to use to provide culturally competent care? Select all that apply. A. Speak to the client in an informal manner because that is the tone the previous client preferred. B. Ask the new client about personal beliefs and practices. C. Assume the new client follows beliefs similar to those of the previous client. D. Demonstrate genuine interest in learning about the new client. E. Use the new client as the primary source of information.

B. Ask the new client about personal beliefs and practices. D. Demonstrate genuine interest in learning about the new client. E. Use the new client as the primary source of information. To provide culturally competent care, the nurse must find out as much as possible about a client's cultural values, beliefs, and health practices. Typically, the client is the best source for that information, so the nurse must ask the client what is important to him or her. Doing so—and demonstrating genuine interest in the process—shows respect for the client as an individual and increases the likelihood that the client will share the necessary information. At the initial meeting, the nurse must be alert for the client's preferences for greeting, eye contact, and physical distance. Based on the client's behavior, the nurse can decide what approach is best. Variation among members of any cultural group is wide, and the nurse must remain alert for these individual differences. The nurse should never assume that a client follows certain practices or favors certain types of interaction (such as informality in discussions with the nurse) merely because someone else from the same culture did so.

A student nurse is preparing a presentation regarding different cultures. Which definition of culture is most accurate?

Belief system that guides behavior

Direct eye contact may be considered disrespectful in which of the following cultures? A. African American B. Arab Americans C. Chinese D. Russian E. South Asian F. Vietnamese

C E and F

Which of the following statements would cause concern for achievement of developmental tasks of a 55-year-old woman? A. "I feel like I'm taking care of my parents now." B. "I really enjoy just sitting around visiting with friends." C. "My children need me now just as much as when they were small." D. "When I retire, I want a smaller house to take care of."

The nurse is caring for a client of Native American/First Nations heritage. The client tells the nurse, "I would like a shaman at my bedside to tell me if I will heal from this disease." Which response by the nurse best demonstrates cultural competence for this client? A. "The disease you have can be treated, and you will recover." B. "Can you tell me why you want a shaman?" C. "Do you have a way to contact your shaman?" D. "The outcome of the disease you have cannot be predicted by anyone."

C. "Do you have a way to contact your shaman?" Many members of Native American/First Nations cultures believe in shaman, or medicine men. These healers are believed to be psychic and rely on herbal medicines, healing ceremonies, and feasts to heal diseases or illnesses. The other answer choices are dismissive to the client's culture and preferences and demonstrate a lack of cultural competence.

The nurse educator is providing education to the nursing staff regarding culturally appropriate nursing care. A nursing student asks the nurse educator to describe the concept of acculturation. Which statement by the nurse is the appropriate response? A. "It involves identifying with a group of individuals who have culturally specific beliefs and identifies." B. "It is a process of completely converting to another belief system." C. "It involves adopting aspects of a different culture in when in a new environment." D. "It is integrating a set of values that belong to a group or culture."

C. "It involves adopting aspects of a different culture in when in a new environment." Acculturation is the process of adopting some aspects of the dominant culture. Religious conversion is completely converting to another belief system. Cultural identity is a set of cultural beliefs and values with which one looks for standards of behavior.

Ability to make appropriate decisions in life activities:

Control

Which component of hardiness encompasses the ability to make appropriate decisions in life activities?

Control

C. Acculturation The client is exhibiting acculturation, the socialization process by which minority groups learn and adopt selective aspects of the dominant culture. Cultural identity refers to the set of cultural beliefs with which one looks for standards of behavior. Linguistic competence is the capacity to communicate effectively and convey information that is easily understood by diverse audiences. Cultural competence is a set of skills that respect and respond to the health beliefs, practices, and cultural and linguistic needs of diverse clients to bring about positive health care outcomes.

The nurse is reviewing notes taken during an initial interview with a client who reports high levels of stress related to employment. The notes include the following: - The client is married and has 2 adult children who "visit a few times each year." - The client reports sleeping 5-6 hours each night but waking frequently with thoughts of work. - The client has a gym membership but reports "I'm usually so exhausted after work that I just go home and watch TV." - The client reports, "I don't usually have time for lunch at work, but I sometimes grab something from the vending machine." Based on these notes, which factors would the nurse identify as negatively influencing the client's ability to cope with stress? Select all that apply. A. Lack of social support B. Poor family support C. Activity level D. Sleep pattern E. Nutritional choices

C. Activity level D. Sleep pattern E. Nutritional choices Physical health can influence how a person responds to psychosocial stress or illness. The healthier a person is, the better he or she can cope. The notes suggest poor nutrition, inadequate sleep, and a lack of exercise, all of which can negatively impact coping abilities. There is no information in the notes that suggests poor family support. Similarly, since there is no mention of friends or colleagues in the notes, there is no evidence on which to judge the level of social support. The nurse or health care provider might decide to explore each factor at a subsequent visit, but there is currently no basis to identify either as a negative influence.

Which statement about culture is true? A. Acculturation eventually leads to the emergence of the dominant culture. B. Culture is based solely on a common purpose. C. Cultural identity reflects what determines behavior. D. Cultures are static.

C. Cultural identity reflects what determines behavior. Cultures are dynamic and continually changing. Everyone has a cultural identity or set of cultural beliefs with which one looks for standards of behavior. Culture is not only a way of life for people who identify or associate with one another on the basis of some common purpose, need, or similarity of background, but also the totality of learned, socially transmitted beliefs, values, and behaviors that emerge from its members' interpersonal transactions. With acculturation, minority groups learn and adopt selective aspects of the dominant culture, but eventually a new minority culture evolves that is different from the native culture and also different from the dominant culture.

A psychiatric-mental health nurse is working on developing cultural competence. Which would be most appropriate for the nurse to do? A. Research information about the cultures of the population being served after assessing the client. B. Recognize that one's own culture is the predominant way of addressing a client's health care needs. C. Demonstrate an appreciation of, and a genuine interest in, the individual and his or her cultural beliefs. D. Assume that any individual of a racial or ethnic group is the same as another individual in that group.

C. Demonstrate an appreciation of, and a genuine interest in, the individual and his or her cultural beliefs. Cultural competence requires that a nurse demonstrates a willingness and ability to draw on community-based values, traditions, and customs and that the nurse values clients' cultural beliefs. The nurse needs to demonstrate a genuine interest in, and respect for, the individual and his or her beliefs. The nurse should learn about the client's country of origin and culture before assessing the client. Cultural competence requires the nurse to adjust or recognize his or her own culture in order to understand the client's culture. It also requires the nurse to understand and appreciate the cultural differences and similarities within, among, and between groups. Nurses need to avoid assuming that all individuals of a racial or ethnic group are the same.

The nurse educator is discussing spirituality for nurses in a mental health class. The nurse educator asks a student nurse, "Which of the following is most consistent with spirituality?" The student nurse identifies which description? A. living according to one's beliefs B. participation in common ways of worshiping C. feeling a connection to a higher power D. closely intertwined with beliefs about health and mental illness

C. feeling a connection to a higher power Spirituality develops over time and is a dynamic, conscious process characterized by two movements of transcendence; either deep within the self or beyond the self. Self-transcendence involves self-reflection and living according to one's values in establishing meaning to events and a purpose to life. Closely intertwined with beliefs about health and mental illness, living according to one's beliefs, and participation in common ways of worshipping are not things that are most consistent with spirituality.

The nurse is preparing to provide discharge instructions to a client. The nurse wants to know the client's ability to read, write, and understand the instructions provided. What is the nurse assessing? A. medical knowledge B. intellectual ability C. health literacy D. demographic data

C. health literacy Health literacy is the ability to use reading, writing, verbal, and numerical skills in the context of health. Someone with low health literacy will not be able to understand the materials provided and will need additional support in understanding. The nurse is not assessing the client's intellect, demographic data, or medical knowledge.

Which component of hardiness encompasses the ability to make appropriate decisions in life activities? Control Commitment Challenge Change

Control

Which developmental task occurs in the middle adult growth area?

Creation of a comfortable home

Which developmental task occurs in the middle adult growth area? Creation of a comfortable home Preparation for retirement Adjustment to health changes Maintenance of a maximal level of health

Creation of a comfortable home

Which statement about culture is true?

Cultural identity reflects what determines behavior.

Which statement about culture is true? Cultures are static. Cultural identity reflects what determines behavior. Culture is based solely on a common purpose. Acculturation eventually leads to the emergence of the dominant culture.

Cultural identity reflects what determines behavior.

___: nursing care means being sensitive to issues related to culture, race, gender, sexual orientation, social class, economic situation, and other factors.

Culturally competent

Which represents the best brief definition of culture? Culture refers to a person's racial background. Culture refers to a person's religious beliefs. Culture is shared attitudes, customs, and beliefs. Culture is a society's social norms.

Culture is shared attitudes, customs, and beliefs.

A nurse is caring for a Native American client who has been admitted to the unit for new onset of diabetes mellitus. The client will not agree to any treatments until the local Shaman is present. Which action by the nurse is appropriate in this situation? A. Explain to the client that confidentiality policies do not allow for a meeting with the client's Shaman. B. Explain that the Shaman is not a health care provider and cannot be included in treatment discussions. C. Discuss with the client the right to refuse any medication or treatment. D. Arrange for the client's Shaman to come to the unit and meet with the client and health care providers.

D. Arrange for the client's Shaman to come to the unit and meet with the client and health care providers. By including the Shaman in treatment discussions, the client will be assured that religious beliefs are important to the healthcare team. The client does have the right to refuse any treatment. However, the nurse should make every effort to resolve the issue so the client can be treated. The Shaman and family can be included in treatment discussions if the client agrees to include them. HIPAA regulations are not violated if the client gives permission for the Shaman to be present for a treatment meeting.

A nurse in a multicultural community knows that to give a client meaningful spiritual care within the health care context it must be what? A. Congruent with the client's societal standards B. Congruent with cultural mores C. Congruent with the client's family's wishes D. Congruent with the client's beliefs

D. Congruent with the client's beliefs To be meaningful, spiritual care within the health care context must be congruent with the client's spiritual beliefs. Just as with social and cultural assessments, making assumptions or generalizations about a client's spiritual needs based on ethnic or religious affiliation is almost certain to be an oversimplification. Spiritual care designed to meet anything other than the client's beliefs and needs is not meaningful for the client.

Which characteristic would be most prevalent in an individual demonstrating low self-efficacy? A. Self-motivation B. Stress management C. Personal goals D. Self-doubt

D. Self-doubt Self-efficacy is a belief that personal abilities and efforts affect the events in our lives. A person who believes that his or her behavior makes a difference is more likely to take action. People with low self-efficacy have low aspirations, experience much self-doubt, and may be plagued by anxiety and depression. People with high self-efficacy set personal goals, are self-motivated, cope effectively with stress, and request support from others when needed.

The nurse is caring for a client who, because of cultural beliefs, attributes their anxiety to a supernatural cause. When developing a plan of care for this client, which information would be most important for the nurse to keep in mind? A. The client has accepted the anxiety as a permanent, untreatable condition. B. The client will be eager to seek pharmaceutical therapy for the anxiety. C. The client will be deeply ashamed of experiencing anxiety. D. The client will have difficulty seeing the relationship between their health practices and anxiety.

D. The client will have difficulty seeing the relationship between their health practices and anxiety. Clients with unnatural or personal beliefs regarding illness attribute their conditions to the intentional actions of external agents or supernatural forces. These clients don't necessarily see their conditions as permanent. However, because they believe the source to be external, they may be more likely to seek traditional cultural remedies that focus on an outside factor instead of medication or interventions focused on their own health practices. While some cultures may stigmatize mental health issues, potentially causing deep shame or guilt among clients from those backgrounds, the nurse should not automatically assume that is the case.

A psychiatric-mental health nurse is working on developing cultural competence. Which would be most appropriate for the nurse to do?

Demonstrate an appreciation of, and a genuine interest in, the individual and his or her cultural beliefs.

A psychiatric-mental health nurse is working on developing cultural competence. Which would be most appropriate for the nurse to do? Research information about the cultures of the population being served after assessing the client. Recognize that one's own culture is the predominant way of addressing a client's health care needs. Assume that any individual of a racial or ethnic group is the same as another individual in that group. Demonstrate an appreciation of, and a genuine interest in, the individual and his or her cultural beliefs.

Demonstrate an appreciation of, and a genuine interest in, the individual and his or her cultural beliefs.

Documenting the client's wishes and informing the client's care team what the client will be taking

An older adult client in the hospital has not had a bowel movement for 3 days and the nurse planned to give the client a stool softener this morning. The client declined the medication, however, stating that the client's spouse will be bringing the client a herbal medication later in the day that is often used by members of their ethnic group. Which reaction demonstrates cultural care accommodation/negotiation? Documenting the client's wishes and informing the client's care team what the client will be taking Teaching the client about the risks associated with nonstandard doses of herbal remedies Teaching the client about the benefits of the medication that was ordered for the client Ensuring that the herbs are sent to the hospital pharmacy for clearance before the client is allowed to take them

Documenting the client's wishes and informing the client's care team what the client will be taking

In order to help preserve and maintain a client's cultural belief regarding the need for "hot foods," which action should the culturally competent nurse take? Educate the staff to help them assist the client in selecting food choices from the client's menu that supports this belief Discuss the possibility of the family providing the appropriate foods Ask for a dietary consult with an understanding of the "hot and cold food" belief Assure the client that these needs will be considered by the staff

Educate the staff to help them assist the client in selecting food choices from the client's menu that supports this belief

___: refers to a client's ability to control the surrounding or direct favors in the environment.

Environmental Control

Explain that physical contact is necessary and ask about the client's cultural personal space preferences.

Personal space and distance is a cultural perspective that can impact nurse-client interactions. What is the best way for the nurse to interact physically with a client who has a different cultural perspective on space and distance than the client? Explain that physical contact is necessary and ask about the client's cultural personal space preferences. Realize that sitting close to the client is an indication of warmth and caring. Sit 3 to 6 feet away from the client in an attempt to not offend. Remember not to intrude into the personal space of the elderly.

Explain that physical contact is necessary and ask about the client's cultural personal space preferences.

Nurses cannot learn all the variations in culturally mediated beliefs. Which approach would be most helpful when caring for clients from other cultures? Explore the client's personal values and traditional care constructs for health and illness. Be respectful and nonjudgmental. Explain one's own cultural beliefs or the cultural expectations of the health care environment. Allow the client to practice his or her religious rituals.

Explore the client's personal values and traditional care constructs for health and illness.

Question #1: Is the following statement true or false? Cultural factors include hardiness and resilience.

False: Cultural factors include the patient's beliefs about health and illness. Hardiness and resilience are individual factors.

Children learn cultural characteristics as they associate with others. Which entity has the most profound influence on the development of traditional values and practices?

Family

Children learn cultural characteristics as they associate with others. Which entity has the most profound influence on the development of traditional values and practices? Community Church Family School

Family

Is the ability to resist illness when under stress.

Hardiness

Which would play a role in a person's cultural identity? Select all that apply. Health beliefs Health practices Values Norms Behavior

Health beliefs Health practices Values Norms Behavior

When providing care for a cognitively impaired client who is strongly tied to the client's culture of origin, the nurse supports these expectations by doing what? Including family when discussing new medication treatment options Encouraging the family to consider enrolling the client in an adult day care center Being careful to discuss the client's condition only with the client's spouse Providing family members with information regarding appropriate long-term care facilities

Including family when discussing new medication treatment options

Which stage of Erikson's psychosocial development includes building confidence in one's own abilities?

Industry versus inferiority

Which stage of Erikson's psychosocial development includes building confidence in one's own abilities? Industry versus inferiority Initiative versus shame and doubt Identity versus role confusion Generativity versus stagnation

Industry versus inferiority

The nurse is assessing a client and finds that the client has very low self-esteem. According to Erikson's stage of psychosocial development, this behavior may be an indication of failure in which stage?

Industry vs. inferiority (school age)

The nurse is speaking to a group of high school students about health promotion. The nurse encourages the students to make friends and widen their social networks. What are the reasons the nurse might give this advice? Select all that apply.

It helps to reduce stress. It helps to diminish illnesses. It has a positive influence on the ability to cope.

Why is understanding a client's cultural context important to a psychiatric mental health nurse?

It influences perceptions of health and illness.

Why is understanding a client's cultural context important to a psychiatric mental health nurse? It influences perceptions of health and illness. It influences the adoption of traditional gender roles. It helps the care provider avoid offending the client. It helps the care provider choose treatment options.

It influences perceptions of health and illness.

Which stage of psychosocial development involves establishing the next generation?

Middle adult

Which stage of psychosocial development involves establishing the next generation? Adolescence Young adult Middle adult Maturity

Middle adult

What is one way in which nurses can develop cultural self-awareness? Ask peers and colleagues about practicing cultural competence. Objectively examine personal beliefs, values, and practices. Realize nothing can be done to change one's values and beliefs. Assert to others that personal biases cannot be changed.

Objectively examine personal beliefs, values, and practices.

A client visits the clinic and tells the nurse about experiencing a great deal of stress on the job for the past 2 months. The nurse should instruct the client that two antecedents of the stress response are the person-environment relationship and which additional client factor?

Perception

A female nurse is conducting a family assessment of a Hispanic client. When the nurse asks questions about family problems, the nurse notices that the client is reluctant to answer. A possible cause for this behavior is that some members of the Hispanic culture believe what? Personal matters are considered to be family problems. Information should not be shared with females. Females are cultural leaders to be revered and not burdened with personal matters. Imbalances in yin and yang result in problems and this information is not to be shared with those outside the culture.

Personal matters are considered to be family problems.

Physical activity improves mood and lowers anxiety. Physical activity prevents medical conditions. Physical activity can foster a sense of well-being.

The nurse is working in a mental health facility. The nurse ensures that all able-bodied clients in the facility participate in the group exercise program every morning. For which reasons would this intervention be beneficial for the clients with mental illness? Select all that apply. Physical activity improves mood and lowers anxiety. Physical activity increases the efficacy of the psychotropic drugs. Physical activity prevents medical conditions. Physical activity can foster a sense of well-being. Physical activity decreases the need for psychotherapy.

Physical activity improves mood and lowers anxiety. Physical activity prevents medical conditions. Physical activity can foster a sense of well-being.

The delivery of culturally competent nursing care requires the incorporation of which concept?

Planning and implementing care that is sensitive to the needs of clients from diverse cultures.

Reflect on how the client's beliefs may have similarities and differences from the nurse's own culture.

A Native American client discusses cultural beliefs with the nurse providing care. In order to recognize any negative feelings or stereotypes the nurse has, which should the nurse do to ensure culturally competent nursing care can be provided? Reflect on how the client's beliefs may have similarities and differences from the nurse's own culture. Research Native American health care beliefs. Provide the client with written information on traditional medical principles. Agree to disagree on medical practices and beliefs.

Reflect on how the client's beliefs may have similarities and differences from the nurse's own culture.

Reflect on, analyze, and foster awareness of the nurse's own culture

The nurse is scheduled to begin a clinical rotation at an outpatient mental health clinic that is in a neighborhood with a large number of Asian residents. Since the nurse does not share this cultural background with the potential clients, which is the best way for the nurse to ensure cultural sensitivity in this setting? Reflect on, analyze, and foster awareness of the nurse's own culture Ask to be paired with a classmate who is of Asian descent Conduct research on various Asian subcultures that the nurse may encounter Expose himself or herself to as many different cultures as possible before the nurse's rotation begins

Reflect on, analyze, and foster awareness of the nurse's own culture

Children of parents who abused alcohol and substances are able to develop self-esteem and self-efficacy by developing which characteristics?

Resilience

Children of parents who abused alcohol and substances are able to develop self-esteem and self-efficacy by developing which characteristics? Resilience Hardiness Social skills Tolerance

Resilience

Is defined as having healthy response to stressful circumstances or risky situations.

Resilience

Involves using problem-solving abilities and believing that one can cope with adverse or novel situations.

Resourcefulness

Evaluating the cultural practices of others according to the nurse's own culture can be counteracted by the nurse's use of which practice?

Self-assessment

Which characteristic would be most prevalent in an individual demonstrating low self-efficacy?

Self-doubt

Which characteristic would be most prevalent in an individual demonstrating low self-efficacy? Self-doubt Personal goals Self-motivation Stress management

Self-doubt

Is a belief that personal abilities and efforts affect the evens in our lives.

Self-efficacy

Is the feeling of connectedness with or involvement in a social system or environment of which a person feels an integral part.

Sense of belonging

When conducting an assessment with a client from another country, what can a nurse do to ensure the client receives culturally sensitive care?

Show genuine interest in the client's culture and personal life experiences.

When conducting an assessment with a client from another country, what can a nurse do to ensure the client receives culturally sensitive care? After the focused assessment, decide if a cultural assessment is necessary. Show genuine interest in the client's culture and personal life experiences. Develop a plan of care after talking to the client's family. Develop a plan of care based on the nurse's own knowledge of a client's culture.

Show genuine interest in the client's culture and personal life experiences.

Refers to family structures and organization, religious values and beliefs, ethnicity, and culture, al of which affect a person's role and, therefore, his or her health and illness behavior.

Social organizations

Is emotional sustenance that comes from friends, family members, and even health-care providers who help a person when a problem arises. It is different from social contact, which does not always provide emotional support.

Social support

___: refers to one's income, education, and occupation. It strongly influences a person's health, including whether or not the person has insurance and adequate access to health care or can afford prescribed treatment.

Socioeconomic status

Involves the essence of a person's being and his or her beliefs about the meaning of life and the purpose for living.

Spirituality

Stereotyping

The nurse is performing a psychosocial assessment of a 30-year-old client who has recently moved back home. What developmental stressors may be noted in this client? Select all that apply. Stress related to health changes Stress related to career growth Stress related to moving out of parental home Stress related to the inability to look after self Stress related to reversing roles with parents

Stress related to career growth Stress related to moving out of parental home

The mental health nurse is interviewing a client of Asian descent regarding the client's health care practices. The nurse understands that cultural competence is important in the care of this client. Cultural competence in health care can be best described as what? The ability to understand and effectively interact with individuals or members of a community from diverse cultural or ethnic backgrounds Knowing the characteristics of each individual cultural group in America A combination of a person's beliefs about cultural values and knowledge about his or her own culture The client's ability to tell the health care provider about his or her cultural beliefs and practices

The ability to understand and effectively interact with individuals or members of a community from diverse cultural or ethnic backgrounds

The mental health nurse is interviewing a client of a different cultural background regarding the client's health care practices. The nurse understands that cultural competence is important in the care of this client. Cultural competence in health care can be best described as what?

The ability to understand and effectively interact with individuals or members of a community from diverse cultural or ethnic backgrounds

On assessment, the nurse finds that the client demonstrates low hardiness. Which can the nurse anticipate regarding the client based on this observation? Choose the best answer.

The client has difficulty in problem solving under stress.

On assessment, the nurse finds that the client demonstrates low hardiness. Which can the nurse anticipate regarding the client based on this observation? Choose the best answer. The client has low self-esteem. The client is not spiritually inclined. The client has reduced sense of belonging. The client has difficulty in problem solving under stress.

The client has difficulty in problem solving under stress.

The nurse is assessing a client of Middle Eastern descent. The nurse finds that the client is standing at a distance of approximately 1.5 feet while speaking to the nurse. What should the nurse interpret from this behavior? The client is behaving in a manner that is culturally acceptable. The client is trying to invade the nurse's personal space. The client likes to be spoken to from a close distance. The client wants to develop a social relationship with the nurse.

The client is behaving in a manner that is culturally acceptable.

The nurse is performing a psychosocial assessment of a client. Which behavior would indicate that the client has a high self-efficacy?

The client is extremely ambitious.

The nurse is performing a psychosocial assessment of a client. Which behavior would indicate that the client has a high self-efficacy? The client is extremely ambitious. The client has anxiety and depression. The client has an increased sense of self-doubt. The client does not believe that others would help the client if needed.

The client is extremely ambitious.

The nurse is assessing executives in the corporate sector. Which characteristic of the executives would indicate a higher hardiness? Choose the best answer.

The executive has high stress and is more resistant to illnesses.

The nurse is assessing executives in the corporate sector. Which characteristic of the executives would indicate a higher hardiness? Choose the best answer. The executive has low stress and is less resistant to illnesses. The executive has high stress and is less resistant to illnesses. The executive has low stress and is more resistant to illnesses. The executive has high stress and is more resistant to illnesses.

The executive has high stress and is more resistant to illnesses.

___: or whether one views time as precise of approximate, differs among cultures.

Time orientation

All except which problem stem from attitudes in which the focus is on the nurse's beliefs and values rather than those of the client?

Treating the client as a source of cultural information

All except which problem stem from attitudes in which the focus is on the nurse's beliefs and values rather than those of the client? Holding preconceived judgement about cultural groups Developing a general belief system about all people from the same culture Treating the client as a source of cultural information Viewing a specific client population from a stigmatized view

Treating the client as a source of cultural information

Which culture is comfortable with making direct eye contact? Western Native American Asian Chinese

Western

self-efficacy

a belief that personal abilities and efforts affect the events in our lives

spirituality

a client's beliefs about life, health, illness, death, and one's relationship to the universe involves the essence of a person's being and his or her beliefs about the meaning of life and the purpose for living

race

a division of humankind possessing traits that are transmitted by descent and sufficient to identify it as a distinct human type

Which is most influential in determining health beliefs and practices? a. Cultural factors b. Individual factors c. Interpersonal factors d. All the above are equally influential.

a. cultural factors

The client was born and educated in Japan. The client moved to the United States two years ago. The client wears Western clothing and eats fast food. Which answer describes what the client has modeled? cross culturalism ethnic mosaic acculturation inclusiveness

acculturation

The nurse is caring for a client who was born and educated in southeast Asia. The client moved to the United States two years ago. The client wears Western clothing and eats fast food. Which answer describes what the client has modeled?

acculturation

The nurse is trying to effectively provide culturally competent care for a client. To best meet the client's needs, what should the nurse do? clarify own cultural values and beliefs before trying to meet the client's needs treat the client the same as with any other culture encountered ask neighbor's about known cultures acquire knowledge about the cultural group

acquire knowledge about the cultural group

Which factor has the greatest impact on a person's ability to cope with illness? All of the following impair a person's ability to cope except:

age.

culture

all the socially learned behaviors, values, beliefs, and customs, transmitted down to each generation, as well as a population's ways of thinking that guide its members' views of themselves and the world

Which client statement would indicate self-efficacy? a. "I like to get several opinions before deciding a course of action." b. "I know if I can learn to relax, I will feel better." c. "I'm never sure if I'm making the right decision." d. "No matter how hard I try to relax, something always comes up."

b. "I know if I can learn to relax, I will feel better."

Which assessment indicates positive growth and development for a 30-year-old adult? a. Is dissatisfied with body image b. Enjoys social activities with three or four close friends c. Frequently changes jobs to "find the right one" d. Plans to move from parental home in near future

b. enjoys social activities with three or four close friends

Which states the naturalistic view of what causes illness? a. Illness is a natural part of life and therefore unavoidable. b. Illness is caused by cold, heat, wind, and dampness. c. Only natural agents are effective in treating illness. d. Outside agents, such as evil spirits, upset the body's natural balance.

b. illness is caused by cold, heat, wind, and dampness

culturally competent

being sensitive to issues related to culture, race, gender, sexual orientation, social class, economic situation, and other factors

Which statement would cause concern for achievement of developmental tasks of a 55-year-old woman? a. "I feel like I'm taking care of my parents now." b. "I really enjoy just sitting around visiting with friends." c. "My children need me now just as much as when they were young." d. "When I retire, I want a smaller house to take care of."

c. "My children need me now just as much as when they were young."

The nurse is trying to effectively deal with the spiritual needs of a client. To best meet the client's need, what should the nurse do?

clarify own spiritual values and beliefs before exploring clients' beliefs

The nurse is trying to effectively deal with the spiritual needs of a client. To best meet the client's need, what should the nurse do? have clergy come to see the client clarify own spiritual values and beliefs before exploring clients' beliefs ask the manager what to do have the healthcare provider deal with spiritual needs

clarify own spiritual values and beliefs before exploring clients' beliefs

ethnicity

concept of people identifying with one another based on a shared heritage

resilience

defined as having healthy responses to stressful circumstances or risky situations

social support

emotional sustenance that comes from friends, family members, and even health care providers who help a person when a problem arises

The nurse educator is discussing spirituality for nurses in a mental health class. The nurse educator asks a student nurse, "Which of the following is most consistent with spirituality?" The student nurse identifies which description? closely intertwined with beliefs about health and mental illness living according to one's beliefs participation in common ways of worshiping feeling a connection to a higher power

feeling a connection to a higher power

social network

groups of people whom one knows and with whom one feels connected

resourcefulness

involves using problem-solving abilities and believing that one can cope with adverse or novel situations

An important part of cultural competence includes the capacity to communicate effectively and convey information that is easily understood. When providing care the nurse should know that cultural competence includes which example?

linguistic competence

environmental control

refers to a client's ability to control the surroundings or direct factors in the environment

social organization

refers to family structure and organization, religious values and beliefs, ethnicity, and culture, all of which affect a person's role and, therefore, his or her health and illness behavior

socioeconomic status

refers to one's income, education, and occupation

hardiness

the ability to resist illness when under stress

sense of belonging

the feeling of connectedness with involvement in a social system or environment of which a person feels an integral part

When immigrants arrive from another country to live in the U.S. they bring their own culture. When providing care the nurse should know that an individual's culture includes what items?

values beliefs patterns of accepted behavior

When immigrants arrive from another country to live in the U.S. they bring their own culture. When providing care the nurse should know that an individual's culture includes what items? Select all that apply. values beliefs stressors feelings patterns of accepted behavior

values beliefs patterns of accepted behavior

The nurse manager is discussing cultural competence at a staff meeting and asks "What are essential behaviors to demonstrate cultural competence?" The staff nurse identifies which behaviors? Select all that apply.

Videbeck Chapter 7: Client's Response to Illness Q's, Chapter 7 Psych nursing, Mental Health: Chapter 7: Client's Response to Illness, Chapter 7, NU245- Chapter 7: Client's Response to Illness

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