Chapter 13

Which is considered the most important factor in determining socioeconomic status (SES)?

Education level Rationale: SES is a composite of the economic status of a family or unrelated individuals based on income, wealth, occupation, educational attainment, and power. Educational attainment is the single most important factor.

Which elements make up an individual's socioeconomic status (SES)? Select all that apply.

Wealth Income Occupation Education level Rationale: SES is a composite of the economic status of a family or unrelated individuals based on income, wealth, occupation, educational attainment, and power. Health is not included in the conceptualization of SES.

Which statement by the nurse indicates the need for further education on solutions to healthcare problems among culturally diverse populations?

"Care should be focused on physical health in order to solve problems." Rationale: In addressing healthcare problems among culturally diverse populations, the nurse should provide care for the whole person: mental, physical, emotional, social, spiritual, and environmental aspects. The other statements reflect understanding of solving healthcare problems in culturally diverse populations. The nurse should collaborate with community resources to reach healthcare goals. The nurse should establish caring relationships with the communities, families, and individuals in the population. Nursing care should reflect community priorities and needs.

Which statement is best when working to overcome a language barrier without an interpreter?

"Do not take your medicine with food." Rationale: When communicating with a patient for whom there is a language barrier, the nurse should avoid use of contractions and should speak in simple sentences. The nurse should use simple words, such as "pain" instead of "discomfort." The nurse should discuss one topic at a time, for example asking "Does your head hurt?" and then asking "Does your stomach hurt?" The nurse should say nouns repeatedly instead of using pronouns. For example, the nurse should say "Put the cream on your rash in the morning."

The nurse educator is assessing student knowledge of values and norms as related to culture. Which statement made by a student indicates a need for further education on this topic?

"Values are the rules by which groups govern human behavior." Rationale:Norms are the rules by which human behavior is governed; norms result from cultural values held by a group. The other statements are correct. Values and norms are learned in childhood. All societies have rules or norms that specify appropriate and inappropriate behaviors. Values are a universal feature of all cultures, although the types and expressions of values differ widely.

Which describes ethnocentrism?

Believing one's own way of life is the best or most desirable Rationale: Ethnocentrism is a person's tendencies to view his or her own way of life as the most desirable, acceptable, or best and to act in a superior manner toward individuals from another culture. Transcultural nursing acknowledges the philosophical and theoretical similarities between nursing and anthropology. Cultural imposition is a person's tendency to impose his or her own beliefs, values, and patterns of behavior on individuals from another culture. Culture universal refers to the commonalities of values, norms of behavior, and life patterns that are similarly held among cultures about human behavior and lifestyles.

During an assessment, the new patient describes living with a spouse and the spouse's daughter from a previous marriage. How will the nurse document this family structure in the patient's record?

Blended Rationale: A blended family is one in which there is a husband, wife, and children from previous relationships. A nuclear family has a husband, wife, and child or children. An extended family includes the nuclear family plus other blood relatives. A nuclear dyad is a husband and wife alone, either childless or with no children living at home.

A nurse is performing a needs assessment to implement a health promotion program in communities with high poverty rates. What is the largest portion of this population that the nurse identifies as most in need of a health promotion program?

Children Rationale: Poverty among children in the United States has risen in all racial and ethnic groups and in all geographic settings. According to the U.S. Census Bureau, the poverty rate for children in 2012 was 21.8% higher than for any other age group. Children in poverty are at a high risk for lack of adequate nutrition and brain development. Approximately 10.5% of adult men and 14% of the adult female population lives in poverty. Poverty rates for older adults are lower, largely because of improvements in Social Security and the Supplemental Security Income program.

Which constellation in which people live together in society includes an unmarried man and woman sharing a household with or without children?

Cohabitation Rationale: Cohabitation involves an unmarried man and woman sharing a household with or without children. A blended family is one in which there is a husband, wife, and children from previous relationships. An extended family includes the nuclear family plus other blood relatives. A communal living situation includes a group of men and women with or without children.

A patient's socioeconomic status is based on what factors? Select all that apply.

Income Occupation Education level Rationale: Socioeconomic status is a composite of the economic status of an individual or family based on factors such as occupation, income, and education level. Culture and language are not factors on which a patient's socioeconomic status is based.

Which is a characteristic of culture?

Learned from birth through socialization Rationale: Culture is learned from birth through the processes of language acquisition and socialization. Culture does not stay the same. It is dynamic, meaning it changes over time and in response to environment and other factors. Culture is shared by members of the same cultural group. Culture adapts to specific conditions related to environmental and technical factors and also to availability of natural resources.

A nurse practitioner is providing care to a newly arrived refugee with diabetes. What financial assistance is available for the patient to continue with treatment?

Medical assistance Rationale: The financial assistance that is available to the newly arrived refugee diagnosed with diabetes is medical assistance. Medical assistance is available during the first 18 months in the United States. The newly arrived refugee is ineligible for Medicaid or state assistance. The patient may choose to privately pay at any time or after medical assistance has expired.

How does socioeconomic status (SES) affect the accessibility and use of healthcare services?

SES often dictates the patient's ability to purchase insurance or pay providers for care. Rationale: Patients with low socioeconomic status sometimes cannot afford to purchase private insurance and may not be able to pay for healthcare services out of pocket. Socioeconomic status does not affect whether or not a patient wants services; the patient may want services but may be unable to pay for them or vice versa. Socioeconomic status does not cause providers to make patients wait longer to receive healthcare services because all patients should be treated equally, regardless of status. Socioeconomic status does not require some patients to pay more money for their time and services because healthcare services should cost the same amount for all patients.

Which guidelines should the nurse follow when attempting to overcome language barriers when an interpreter is not available? Select all that apply.

Trying a third language Speaking with simple words Discussing one topic at a time Rationale: When communicating with a patient for whom there is a language barrier, the nurse should try a third language if possible. Many Indo-Chinese people speak French. Europeans often know three or four languages. The nurse should try Latin words or phrases. The nurse should use simple words, such as "pain" instead of "discomfort." The nurse should discuss one topic at a time, for example asking "Does your head hurt?" and then asking "Does your stomach hurt?" The nurse should be polite and formal. The nurse should avoid use of contractions and should speak in simple sentences.

Which describes transcultural nursing?

Understanding similarities between nursing and anthropology Rationale: Transcultural nursing acknowledges the philosophical and theoretical similarities between nursing and anthropology. Ethnocentrism is a person's tendencies to view his or her own way of life as the most desirable, acceptable, or best and to act in a superior manner toward individuals from another culture. Cultural imposition is a person's tendency to impose his or her own beliefs, values, and patterns of behavior on individuals from another culture. Culture universal refers to the commonalities of values, norms of behavior, and life patterns that are similarly held among cultures about human behavior and lifestyles.