139 Chapter 5 Questions

1. Despite the presence of a large number of older adult residents from Asian cultures, a long-term care facility has not integrated the medical concept of hot and cold into meal planning. The nurses at the facility should recognize this as an example of: A. cultural blindness. B. stereotyping. C. cultural assimilation. D. cultural imposition.

A Rationale: Cultural blindness is characterized by ignoring cultural differences or considerations and proceeding as if they do not exist. This phenomenon may underlie the failure to incorporate cultural considerations into dietary choices. Stereotyping assumes homogeneity of members of other cultures. Cultural assimilation involves the replacement of values with those of a dominant culture. Cultural imposition presumes that everyone should conform to a majority belief system. Question format: Multiple Choice Chapter 5: Culturally Respectful Care Cognitive Level: Understand Client Needs: Psychosocial Integrity Integrated Process: Culture and Spirituality Reference: p. 99

26. During the assessment of a client, the client reports using chamomile tea as a relaxant before bed to help with sleeping. The nurse ignores the client's statement and responds, "You will get some medication to help you sleep." From a cultural standpoint, which behavior is the nurse demonstrating? A. cultural blindness B. stereotyping C. acculturation D. cultural imposition

A Rationale: Cultural blindness occurs when one ignores differences and proceeds as though they do not exist. The nurse ignores the client's use of tea for sleep, stating that medication will be used. Stereotyping occurs when one assumes that all members of a culture, ethnic group, or race act alike. Acculturation occurs when a minority group lives within a dominant group and the members take on the values of the dominant culture, losing the cultural characteristics that once made them different. Cultural imposition is the belief that everyone else should conform to your own belief system. Question format: Multiple Choice Chapter 5: Culturally Respectful Care Cognitive Level: Understand Client Needs: Physiological Integrity: Basic Care and Comfort Integrated Process: Culture and Spirituality Reference: p. 99

5. A nurse walks by a client's room and observes a shaman performing a healing ritual. The nurse remarks to a coworker that the ritual is a waste of time and disruptive to the other clients on the floor. This nurse is displaying: A. cultural conflict. B. cultural blindness. C. stereotyping. D. culture shock.

A Rationale: Cultural conflict occurs when people become aware of cultural differences, feel threatened, and respond by ridiculing the beliefs and traditions of others to make themselves feel more secure about their own values. Cultural blindness occurs when one ignores differences and proceeds as though they do not exist. Stereotyping is the assumption that all members of a culture, ethnic group, or race act alike. Culture shock refers to the feelings a person experiences when placed in a different culture that is perceived as strange. Question format: Multiple Choice Chapter 5: Culturally Respectful Care Cognitive Level: Apply Client Needs: Psychosocial Integrity Integrated Process: Culture and Spirituality Reference: p. 99

17. The nurse is admitting a client to the medical-surgical unit. While conducting the client's assessment, the client speaks of naturalistic beliefs related to health care and the importance of the yin/yang theory. The client is diagnosed with cancer, a condition that is considered a "cold" illness in the culture and yin/yang beliefs. Which meal will the client most likely order for lunch? A. Chicken noodle soup with crackers, fruit crisp, and hot tea B. Turkey sandwich, small tossed salad, and iced tea C. Chef salad, bread, and water D. Fruit smoothie and granola bar

A Rationale: In some cultures, good health is thought to be achieved through the proper balance of yin (feminine, negative, dark, cold) and yang (masculine, positive, light, warm). Hot foods are eaten when a person has a "cold" illness, such as cancer, a headache, and stomach cramps. Based on this information, the client would likely select chicken noodle soup with crackers, fruit crisp, and hot tea, as these are hot foods. The other options are cold foods and would more likely be eaten when a client has a "hot" illness. Question format: Multiple Choice Chapter 5: Culturally Respectful Care Cognitive Level: Analyze Client Needs: Psychosocial Integrity Integrated Process: Nursing Process Reference: p. 107

32. A nurse manager is conducting an in-service education program for a group of staff nurses on developing cultural competence. The nurse manager determines that the educational program was successful based on which statement by the group? A. "It is important to see how any biases might impact our feelings about others." B. "Even if a treatment goes against the client's values, they have to have it." C. "Our personal beliefs and values have no effect on how we care for people." D. "Folk healers really can be a deterrent to a client's care."

A Rationale: It is important to become aware of the role of cultural influences in one's own life, objectively examining one's own beliefs, values, practices, and family experiences. An increasing sensitivity to the importance of these factors also leads to an increased sensitivity to cultural influences in others' lives. Being aware of biases can help identify how they affect one's feelings about others and nursing care of others. Clients should not be forced to participate in care that conflicts with their values. If a client is forced to accept such care, resulting feelings of guilt and alienation from a religious or cultural group are likely to threaten that client's well-being. Folk medicine practitioners can work closely with professional health practitioners in the interest of the client and family. Such efforts promote mutual understanding, respect, and cooperation. Question format: Multiple Choice Chapter 5: Culturally Respectful Care Cognitive Level: Apply Client Needs: Safe, Effective Care Environment: Management of Care Integrated Process: Culture and Spirituality Reference: p. 109

2. Which statement is true of cultural assimilation? A. Mutual cultural assimilation occurs when characteristics from two cultures are traded. B. Cultural assimilation is the integration of a majority group into a minority group. C. Cultural assimilation is the psychological discomfort one experiences on moving to a different culture. D. Cultural assimilation is identifying with a collective cultural group, primarily based on common heritage.

A Rationale: Mutual cultural assimilation occurs with the trading of characteristics from both groups. Cultural assimilation, in general, occurs as a minority group integrates into a majority group. Culture shock is the psychological discomfort that can result from moving into a different cultural group. Ethnicity means the collective cultural group one identifies with, primarily based on common heritage. Question format: Multiple Choice Chapter 5: Culturally Respectful Care Cognitive Level: Understand Client Needs: Psychosocial Integrity Integrated Process: Nursing Process Reference: p. 98

33. A group of clinic nurses are engaged in a staff meeting discussion about culture to improve culturally respectful care being given to the clients. Which statement by one of the nurses indicates the need for further clarification and education? A. "All cultures are basically the same, even though the beliefs may be different." B. "Although cultural practices evolve over time, they remain relatively constant." C. "Language is the key, because it is the primary way that culture is transmitted." D. "What is acceptable behavior is shaped by a person's culture."

A Rationale: Not all cultures are the same. Because a culture is made up of people, there are differences both within cultures and among cultures. Culture helps shape what is acceptable behavior for people in a specific group, and language is the primary means of transmitting culture. Cultural practices and beliefs may evolve over time, but they mainly remain constant as long as they satisfy a group's needs. Question format: Multiple Choice Chapter 5: Culturally Respectful Care Cognitive Level: Apply Client Needs: Psychosocial Integrity Integrated Process: Culture and Spirituality Reference: p. 98

8. Which factor is the most important to consider when caring for clients with limited income? A. Basic human needs going unmet B. Limited access to reliable transportation C. Decreased access to healthcare services D. Risk for increased incidence of disease

A Rationale: Poverty prevents many people from consistently meeting their basic human needs. Limited means of transportation, decreased access to healthcare services, and an increased incidence of disease are also influenced by limited income, but meeting one's basic human needs is the most important factor. Question format: Multiple Choice Chapter 5: Culturally Respectful Care Cognitive Level: Analyze Client Needs: Health Promotion and Maintenance Integrated Process: Culture and Spirituality Reference: p. 103

31. When providing culturally respectful care to a client from a different cultural background, which question is appropriate to begin a pain assessment? A. "Can you tell me what you think might be causing your pain?" B. "Do you have any tingling that comes with the pain?" C. "Have you tried anything to help stop the pain?" D. "Is there something you are not telling me about the pain?"

A Rationale: Regardless of the cultural background of the client, the nurse needs to assess each client individually to provide culturally respectful care. Asking open-ended questions, such as what the client thinks might be causing the pain, provides an opportunity to obtain specific information from the client about their beliefs related to health care. Questions about tingling and trying anything to stop the pain are closed-ended questions that would not provide additional information other than a yes or no answer. Asking the client if there is something they are not telling the nurse is challenging and may be viewed as accusatory, blocking any further communication. Question format: Multiple Choice Chapter 5: Culturally Respectful Care Cognitive Level: Apply Client Needs: Physiological Integrity: Basic Care and Comfort Integrated Process: Nursing Process Reference: p. 109

27. A nurse is reviewing the health history of an African American client who has come to the clinic for an evaluation. Based on the nurse's understanding of physiologic variations in racial and ethnic groups, the nurse is alert for the possibility of which condition? A. hypertension B. spinal muscle atrophy C. cirrhosis D. cystic fibrosis

A Rationale: Studies have shown that certain racial and ethnic groups are more prone to certain diseases and conditions. For example, African American clients are at higher risk for hypertension as well as stroke, sickle cell anemia, lactose intolerance and keloids, among others. Spinal muscle atrophy and cystic fibrosis have been linked to Eastern European Jewish clients. Cirrhosis of the liver and diabetes has been linked to Native American clients. Question format: Multiple Choice Chapter 5: Culturally Respectful Care Cognitive Level: Understand Client Needs: Health Promotion and Maintenance Integrated Process: Nursing Process Reference: p. 100

29. A nurse is using the ESFT model to address health disparities for a group of clients at the clinic. When gathering information from the clients, which question will the nurse to ask first to identify potential threats to adherence? A. "What do you think may be the cause of your problem?" B. "How do you usually get any medicines that you might need?" C. "Do you have enough money to afford paying for your medicines?" D. "How quickly are you usually able to get your medicines?"

A Rationale: The ESFT model (Explanatory model of health and illness, Social and environmental factors, Fears and concerns, Therapeutic contracting) is a crosscultural communication tool that helps health care professionals strengthen communication and identify potential threats to treatment adherence. Asking about the client's thoughts about the cause of the problem addresses the "E" section of the model and forms the basis for subsequent questions related to social and environmental factors, such as how the client usually gets the medicines, if the client is able to afford the medicines, and how quickly the client can get the medicines. Question format: Multiple Choice Chapter 5: Culturally Respectful Care Cognitive Level: Analyze Client Needs: Psychosocial Integrity Integrated Process: Nursing Process Reference: p. 106

35. A nurse is talking with a coworker about the diversity of cultures in the client population being admitted to their unit. During the conversation, the coworker becomes defensive about personal beliefs and values that are different. The coworker becomes condescending and begins to ridicule the values of the different client populations, stating, "Their beliefs and values are really out there. They make absolutely no sense. No way would I ever believe them." The nurse interprets the coworker's behavior and statements as reflective of which concept? A. culture conflict B. cultural imposition C. cultural blindness D. culture shock

A Rationale: The coworker's behavior and statements reflect culture conflict, when people become aware of cultural differences, feel threatened, and respond by ridiculing the beliefs and traditions of others to make themselves feel more secure about their own value. Cultural imposition is the belief that everyone else should conform to one's own belief system, and cultural blindness occurs when one ignores differences and proceeds as though they do not exist. A person may experience culture shock when placed in a different culture one perceives as strange. Culture shock may result in psychological discomfort or disturbances, because the patterns of behavior a person found acceptable and effective in their own culture may not be adequate or even acceptable in the new culture. Question format: Multiple Choice Chapter 5: Culturally Respectful Care Cognitive Level: Understand Client Needs: Safe, Effective Care Environment: Management of Care Integrated Process: Culture and Spirituality Reference: p. 99

28. An older adult client is brought to the emergency department via ambulance due to a fall. The client does not speak the area's dominant language. Shortly after the client arrives, several family members and a neighbor who called the ambulance arrive, all of whom speak the area's dominant language. When attempting to gather information about what happened, which action by the nurse is appropriate? A. Arrange for an interpreter to be present to translate. B. Have the neighbor who called the ambulance explain what happened. C. Ask the client to explain as best as possible what occurred. D. Enlist the aid of a family member to answer the nurse's questions.

A Rationale: To avoid misinterpretation of questions by the client and answers by the nurse, it is important to use an interpreter who understands the health care system. Sometimes a family member or friend can translate for the nurse, but such a person may be protective and not the most reliable means of transferring information, thus, guidelines discourage using family members or friends as translators. Question format: Multiple Choice Chapter 5: Culturally Respectful Care Cognitive Level: Apply Client Needs: Safe, Effective Care Environment: Management of Care Integrated Process: Communication and Documentation Reference: p. 101

34. A nurse is researching the cultural groups in the community and finds that there is a large population of Hispanic American immigrants in the community. Further research reveals that this group is primarily English-speaking. In addition, the nurse notes that many of the other cultural groups have adopted some of the foods from the Hispanic American community. The nurse identifies this as which situation? A. mutual cultural assimilation B. culture shock C. ethnicity D. stereotyping

A Rationale: When a minority group lives within a dominant group, many members may lose the cultural characteristics that once made them different, and they may take on the values of the dominant culture. This process is called cultural assimilation. Mutual cultural assimilation also occurs, with both groups taking on some characteristics of the other, as described in the scenario. Culture shock occurs when a person is placed in a different culture they perceive as strange. Ethnicity is a sense of identification with a collective cultural group, largely based on the group members' common heritage. When one assumes that all members of a culture, ethnic group, or race act alike, stereotyping is at work. Question format: Multiple Choice Chapter 5: Culturally Respectful Care Cognitive Level: Understand Client Needs: Psychosocial Integrity Integrated Process: Culture and Spirituality Reference: p. 98

30. A client who has recently immigrated here from Eastern Europe comes to the clinic accompanied by the client's adult child, the child's spouse and their young child. When obtaining the health history, the nurse will attempt to obtain the majority of information from which person? A. client B. client's adult child C. adult child's young child D. adult child's spouse

A Rationale: When caring for clients from a different culture, it is important for the nurse to first ask how the client wants to be treated based on their values and beliefs. An effective way to identify specific factors that influence a client's behavior is to perform a cultural assessment. The primary informant should be the client, if possible. If the client is not able to respond to the questions, a family member or a friend can be consulted. Question format: Multiple Choice Chapter 5: Culturally Respectful Care Cognitive Level: Understand Client Needs: Health Promotion and Maintenance Integrated Process: Nursing Process Reference: p. 107

16. 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? A. Know 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 ft (0.90 to 1.80 m) away from the client in an attempt to not offend. D. Remember not to intrude into the personal space of the older adult.

A Rationale: When providing nursing care that involves physical contact, the nurse should know the client's cultural preferences relating to personal space. Sitting close to, or too far away from, the client may be interpreted as offensive. Age is not necessarily a deciding factor in regards to a person's cultural practices. Question format: Multiple Choice Chapter 5: Culturally Respectful Care Cognitive Level: Apply Client Needs: Psychosocial Integrity Integrated Process: Culture and Spirituality Reference: p. 102

24. A nurse is part of a community group tasked with developing health care programs and services to address culture and cultural diversity. The community reflects trends that have occurred overall in the country over the past several decades. Which program(s) and service(s) will the group need to address? Select all that apply. A. increase in programs for the growing older adult population B. increase in programs to address greater awareness of multiracial identities C. Increase in number of services available in suburban areas due to increased growth D. reduction in services to address smaller numbers of Hispanic Americans E. focus on programs to address the increasing number of nuclear families F. combined services to address the lesser numbers of generations living under the same roof

A, B, C Rationale: Analysis of the 2010 U.S. census data reveals sweeping changes over the last 20 years. The U.S. population is bigger, older, and less inclined toward marriage and traditional families than in 1990. Other trends reveal that the United States includes more Hispanic and Asian individuals, as well as is more embracing of several generations living under one roof, more inclusive of same-sex couples, more aware of multiracial identities, more suburban, and less rural. Therefore, services and programs need to address these changes. Question format: Multiple Select Chapter 5: Culturally Respectful Care Cognitive Level: Apply Client Needs: Psychosocial Integrity Integrated Process: Culture and Spirituality Reference: p. 96

19. What is the term that describes the inability of a person to recognize one's own values, beliefs, and practices as well as those of others, because of strong ethnocentric tendencies? A. Acculturation B. Cultural blindness C. Cultural imposition D. Stereotyping

B Rationale: Cultural blindness occurs when one ignores differences and proceeds as though they do not exist, resulting in bias and stereotyping. Acculturation is the process by which members of a culture adapt or learn how to take on the behaviors of another group. Cultural imposition is the tendency to impose one's cultural beliefs, values, and patterns of behavior on a person from a different culture. Stereotyping is when one assumes that all members of a culture, ethnic group, or race act alike. Question format: Multiple Choice Chapter 5: Culturally Respectful Care Cognitive Level: Apply Client Needs: Psychosocial Integrity Integrated Process: Culture and Spirituality Reference: p. 99

3. An immigrant lives with relatives in a community with many households from the country of origin. The client is taken to the emergency department following a fall at work and is admitted to the hospital for observation. The nurse is aware that this client is at risk for: A. cultural assimilation. B. culture shock. C. cultural imposition. D. cultural blindness.

B Rationale: Culture shock refers to the feelings a person experiences when placed in a different culture perceived as strange. Culture shock may result in psychological discomfort or disturbances, as the patterns of behavior a person found acceptable and effective in the native culture may not be adequate or even acceptable in the new one. The person may then feel foolish, fearful, incompetent, inadequate, or humiliated. Cultural assimilation is the process in which a minority group or culture comes to resemble those of a dominant group. Cultural imposition is the tendency of a person or group to impose their values and patterns of behavior onto other persons. Cultural blindness is the phenomenon in which a person follows the cultural tradition and values without judging that it is either good or bad. Question format: Multiple Choice Chapter 5: Culturally Respectful Care Cognitive Level: Apply Client Needs: Psychosocial Integrity Integrated Process: Culture and Spirituality Reference: p. 98

21. A nurse is performing a health history on a client who identifies as Native American/First Nations. Based on familial history and racial disparities, for which health issue should the nurse prepare to monitor in this client? A. autoimmune disorders B. heart disease C. Alzheimer disease D. lung cancer

B Rationale: Heart disease, diabetes, malignant neoplasm, and unintentional injuries are the leading causes of death among Native American/First Nations populations resulting in a decreased lifespan. Autoimmune disorders, dementia-related disorders, and lung cancer are not primary disorders the nurse should monitor for in this client. Question format: Multiple Choice Chapter 5: Culturally Respectful Care Cognitive Level: Understand Client Needs: Health Promotion and Maintenance Integrated Process: Nursing Process Reference: p. 100

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

B Rationale: Nurses can develop cultural self-awareness by becoming aware of the role of cultural influences in their own lives, objectively examining their own beliefs, values, and practices, and identifying and reflecting on personal biases. Thinking to oneself or asserting to others that one's values and beliefs or biases cannot be changed would not help a person become more culturally self-aware. Asking peers and colleagues about practicing cultural competence might help one develop cultural competence but would not help one develop cultural self-awareness. Question format: Multiple Choice Chapter 5: Culturally Respectful Care Cognitive Level: Understand Client Needs: Psychosocial Integrity Integrated Process: Nursing Process Reference: p. 109

12. A client is operated on for gallstones. On the postoperative night, the nurse finds that the client is not sleeping and is tossing and turning. When asked about analgesics, the client denies having pain. Which nursing action is most appropriate? A. Believing that the client has no pain B. Assessing for nonverbal expressions of pain C. Inspecting the incision site for any abnormality D. Asking the client if the client is feeling hungry

B Rationale: The nurse should be aware that some clients tend to control their emotions and expressions of physical discomfort. Keeping this in mind, the nurse should assess the client for nonverbal expressions of pain. The nurse should not believe the client has no pain based solely on the client's statement because after surgery pain is likely to occur. The nurse may need to inspect the incision site, but it is not the priority action. Asking the client about hunger irrelevant to the client's pain level. Question format: Multiple Choice Chapter 5: Culturally Respectful Care Cognitive Level: Apply Client Needs: Psychosocial Integrity Integrated Process: Culture and Spirituality Reference: p. 100

22. A nurse in a large metropolitan city has been working in a health clinic that has primarily served Middle Eastern clients for several years. The nurse is well-respected and effective in providing care to this population. Given this information, what can be inferred about the nurse? A. The nurse's knowledge and skills provide expected care for clients in this demographic. B. The nurse is knowledgeable about Middle Eastern culture and respects and values providing culturally competent care. C. The nurse is attempting to overcompensate for cultural blindness and ethnocentrism within the community. D. This employment has allowed the nurse to demonstrate ethnic identity and cultural bias to a specific group of people.

B Rationale: The nurse who recognizes and respects cultural diversity has cultural sensitivity, avoids cultural imposition, blindness, and ethnocentrism, and provides nursing care that accepts the significance of cultural factors in health and illness. Ethnic identity refers to the client's self-recognition of ethnicity and would not be something the nurse can "demonstrate." Question format: Multiple Choice Chapter 5: Culturally Respectful Care Cognitive Level: Apply Client Needs: Psychosocial Integrity Integrated Process: Culture and Spirituality Reference: p. 99

9. A nurse is providing care for a client who recently immigrated from another country. The nurse says, "You have to get up and walk whether you want to or not." This statement is an example of: A. culture shock. B. stereotyping. C. cultural imposition. D. cultural competence.

C Rationale: Cultural imposition is the tendency for health care personnel to impose their beliefs, practices, and values on people of other cultures because they believe their ideas are superior. When health care professionals assume they have the right to make decisions for clients, the clients often respond by becoming passive, angry, or resistant to treatment. Culture shock is an experience a person may have when one moves to a cultural environment which is different from one's own. A stereotype is an over-generalized belief about a particular category of people. Cultural competence is the ability to interact effectively with people of different cultures. Question format: Multiple Choice Chapter 5: Culturally Respectful Care Cognitive Level: Apply Client Needs: Psychosocial Integrity Integrated Process: Nursing Process Reference: p. 105

7. An older adult client from a minority culture refuses to eat at the nursing home, stating, "I just do not like the food here." What factor should the staff assess for this problem? A. The client does not like to eat with other residents of the home. B. The client is using this as a means of going home. C. The food served may not be culturally appropriate. D. The food served may violate religious beliefs.

C Rationale: Residents in long-term care settings often do not have much choice of foods. As a result, they may not be able to select cultural food preferences. When assessing the cause of decreased appetite in clients, the nurse should determine whether the problem may be related to culture and diet. There is no indication in the scenario that the client is not eating based on not liking to eat with other residents, a religious belief, or wanting to go home. Question format: Multiple Choice Chapter 5: Culturally Respectful Care Cognitive Level: Apply Client Needs: Psychosocial Integrity Integrated Process: Culture and Spirituality Reference: p. 103

13. A nurse engages in professional rituals as a means to standardize practice and ensure efficiency. In doing so, the nurse integrates understanding of: A. a preconceived and untested belief about people. B. viewing one's own culture as the only correct standard. C. common and observable expressions of culture. D. a belief system held to varying degrees as absolute truth.

C Rationale: Rituals are common and observable expressions of culture, and this is equally true of professional rituals within the nursing and health care culture. A preconceived and untested belief about people is called a stereotype. Viewing one's own culture as the only correct standard is ethnocentrism. A belief system held to varying degrees as absolute truth is referred to as culture. Question format: Multiple Choice Chapter 5: Culturally Respectful Care Cognitive Level: Apply Client Needs: Safe, Effective Care Environment: Management of Care Integrated Process: Nursing Process Reference: p. 107

4. A client tells the nurse that a neighbor, who is a young housekeeper from another country, wears the traditional clothing and head covering of the neighbor's native country. The client says of people like the neighbor, "They are in our country and should dress like we do." What is this statement an example of? A. Cultural assimilation B. Cultural blindness C. Cultural conflict D. Cultural imposition

D Rationale: A variety of factors may affect sensitivity to other cultures, especially when those from another culture are perceived as holding beliefs that differ from the majority belief system. Cultural imposition is the belief that everyone should conform to the majority belief system. Cultural conflict involves criticism or ridicule of another's culture to make one feel better about one's own culture. Cultural blindness involves not acknowledging differences in culture and acting as if they do not exist. Cultural assimilation involves members of a minority culture adopting aspects of the majority culture in which they live. Question format: Multiple Choice Chapter 5: Culturally Respectful Care Cognitive Level: Apply Client Needs: Psychosocial Integrity Integrated Process: Nursing Process Reference: p. 99

20. A family consisting of two parents, one grandparent and three school-age children have immigrated to the United States. The nurse needs to provide medication education to the grandparent, who does not speak the dominant language. Which strategy is best for the nurse to use to convey health information to the grandparent? A. Ask a family member who speaks the dominant language to interpret the information. B. Ask someone in the office who speaks the same language to interpret when giving information. C. Use hand gestures and drawings or videos to explain the information. D. Engage the services of a trained interpreter.

D Rationale: Engaging the services of a trained interpreter is the best way to convey health information to clients who have difficulty understanding and speaking the dominant language. Relying on family members to interpret could result in medical terms being mistranslated or misunderstood. Asking someone in the office to translate does not ensure client privacy and confidentiality, Hand gestures may have different connotations across cultures and can easily be misinterpreted. Question format: Multiple Choice Chapter 5: Culturally Respectful Care Cognitive Level: Apply Client Needs: Safe, Effective Care Environment: Management of Care Integrated Process: Communication and Documentation Reference: p. 101

15. A nurse is caring for an older adult. How does the nurse demonstrate awareness of culturally competent care? A. Maintaining eye contact at all times B. Trying to speak louder than usual C. Using touch when communicating D. Establishing effective communication

D Rationale: Establishment of an environment of culturally competent care and respect begins with effective communication, which occurs not only through words, but also through body language and other cues, such as voice, tone, and loudness. Maintaining eye contact at all times is inappropriate because not all cultures are comfortable with eye contact. Speaking louder is an incorrect answer because the issue is a communication problem, not a hearing problem. Not all cultures are comfortable with touch, so this could block communication. Question format: Multiple Choice Chapter 5: Culturally Respectful Care Cognitive Level: Apply Client Needs: Psychosocial Integrity Integrated Process: Culture and Spirituality Reference: p. 101

6. A nurse is caring for a client who constantly requests pain medication. What should the nurse consider when assessing the client's pain? A. Most people react to pain in the same way. B. Pain in adults is less intense than pain in children. C. The client has a low pain tolerance. D. Pain is what the client says it is.

D Rationale: Pain is what the client says it is, and nursing care should always be individualized. The nurse respects the client's right to respond to pain in whatever manner is culturally and individually appropriate and never stereotypes a client's perceptions or responses to pain. Pain tolerance is subjective, again, the client's pain is what he or she says it is. Question format: Multiple Choice Chapter 5: Culturally Respectful Care Cognitive Level: Apply Client Needs: Physiological Integrity: Basic Care and Comfort Integrated Process: Nursing Process Reference: p. 100

23. A labor and delivery nurse cares for a client who recently immigrant from Japan and is in labor. During shift report, which statement by the nurse will another nurse challenge? A. "The client has requested to wait to receive pain medication." B. "The client does not want family in the labor room." C. "The client is a recent immigrant to this country." D. "The client is stoic and will not complain at all."

D Rationale: Stereotypes are preconceived and untested beliefs about people. Acting on a stereotype, such as "The client is stoic and will not complain," could result in the nurse's failure to assess pain and institute measures to alleviate pain. Statements that describe the client's request to wait to receive pain medication, not wanting family in the labor room, and being a recent immigrant to this country are conveying information, not stereotypes. Question format: Multiple Choice Chapter 5: Culturally Respectful Care Cognitive Level: Apply Client Needs: Psychosocial Integrity Integrated Process: Culture and Spirituality Reference: p. 99

14. A client new to a rehabilitation unit is having a difficult time adjusting to the scheduled activities on the unit, as well as being dependent on others for meals and medications. Which word best describes what the client is experiencing? A. Anxiety B. Disparity C. Resolution D. Culture shock

D Rationale: The acute experience of not comprehending or having trouble adjusting to an unfamiliar culture one has recently entered is called culture shock. This is often experienced by a client who is introduced to the subculture of a hospital or healthcare agency. There is no evidence in this case that the client is experiencing anxiety, just difficulty adjusting. Disparity refers to a difference between two different groups of people, often due to unfairness or injustice. Resolution refers to a problem being resolved or to one's determination to accomplish a certain goal. Question format: Multiple Choice Chapter 5: Culturally Respectful Care Cognitive Level: Apply Client Needs: Psychosocial Integrity Integrated Process: Culture and Spirituality Reference: p. 98

11. A home health nurse is visiting a client who is 60 years of age. During the initial visit, the client's spouse answers all of the questions. What would the nurse assess based on this behavior? A. The client does not want the nurse to visit. B. The spouse does not trust the client to answer questions. C. The client is not able to answer the questions. D. The spouse is the dominant member of the family.

D Rationale: To provide culturally competent care, the nurse must take into consideration the role of the family member who makes most decisions. To disregard this fact or to proceed with nursing care that is not approved by this person can result in conflict or disregard for what is being taught. Based on the information provided, it is more likely in this case that spouse is the decision maker and is involved in the care of the client than that the client does not want the nurse to visit, the spouse does not want the client to respond, or the client is unable to answer the questions. Question format: Multiple Choice Chapter 5: Culturally Respectful Care Cognitive Level: Apply Client Needs: Psychosocial Integrity Integrated Process: Culture and Spirituality Reference: p. 112

25. When providing culturally competent care to a client, which aspect of care is most important for the nurse to keep in mind? A. The client is an individual and must be treated as such. B. Different situations may cause the client to act differently based on culture. C. The client is likely a member of multiple cultural groups. D. The client must be viewed as a representative of a cultural group.

A Rationale: Although each client may be a member of multiple cultural, ethnic, and racial groups at one time and different cultural values may guide a client in different situations based on what is most important to that client at the time, it is imperative that the nurse view any client foremost as an individual, not as a representative of a cultural group. Question format: Multiple Choice Chapter 5: Culturally Respectful Care Cognitive Level: Analyze Client Needs: Psychosocial Integrity Integrated Process: Culture and Spirituality Reference: p. 96

18. The focal point of nursing is the nurse-client interaction. What must nurses consider about themselves when assessing clients from other cultures? A. Their own health disparities B. Their own health history C. Their own educational level D. Their own cultural orientation

D Rationale: Because the nurse-client interaction is the focal point of nursing, nurses should consider their own cultural orientation when conducting assessments of clients from other cultures. Nurses do not need to assess their own health disparities, health history, or educational level when assessing clients from other cultures. Question format: Multiple Choice Chapter 5: Culturally Respectful Care Cognitive Level: Apply Client Needs: Physiological Integrity: Physiological Adaptation Integrated Process: Culture and Spirituality Reference: p. 108