Cultural - HESI

The nurse educator is providing in-service education to the nursing staff regarding transcultural nursing care; a staff member asks the nurse educator to provide an example of the concept of acculturation. The nurse educator should make which most appropriate response?

"A person who moves from China to the United States (U.S.) and learns about and adapts to the culture in the U.S."

The nurse develops a plan of care for a White American client. The nurse considers the practices and preferences of the culture when planning the care, knowing that which are characteristics associated with this ethnic group?

-Community social organizations are important. -Health often is viewed as an absence of disease or illness. -The client will appear stoic when expressing physical concerns. -Members usually rely primarily on the modern Western health care delivery system.

The nurse is caring for a Hispanic American client admitted with a diagnosis of diabetic ketoacidosis. Several family members are present. What examples of nonverbal communication would the nurse expect?

-Dramatic body language -Smiling and shaking hands -Avoiding any confrontations with staff -Using gestures or facial expressions to express emotion or pain

The nurse is caring for a non-English-speaking client and is attempting to integrate the client's cultural practices into Western medicine. What are some other aspects of culturally competent care the nurse can employ?

-Increasing client safety -Using spiritual practices -Reducing health disparities -Increasing client satisfaction -Preventing misunderstandings between the nurse and the client

The nurse is assessing the cultural beliefs of five clients requiring specimen collection for a diagnostic test. Which cultural assessments are correct?

-Insertion of a throat culture swab into the mouth of a Southeast Asian client may be perceived as threatening. -Hindus collecting a stool specimen for a hemoccult screening test need to use the left hand to place the stool onto the Hemoccult card. -Self-urine collection performed by a right-hand-dominant Muslim client may be collected incorrectly because only a Muslim's left hand can be used for dirty activities.

Which clients have a high risk of obesity and diabetes mellitus?

-Latino American man -Native American man -Hispanic American man -African American woman

The nurse is explaining a preoperative teaching plan to an English-speaking client. What are some other aspects of verbal communication?

-Timing -Volume -Voice tone -Ability to share thoughts and feelings

The nurse is admitting a client and knows that clients typically share information about herbal supplements or therapies only if they are specifically asked. What are some additional things the nurse needs to do when dealing with this topic with clients?

-Use open-ended questions. -Respond to clients with comments that invite an open-minded discussion. -Document the use of any herbal product(s) or dietary supplements in the client record. -Create an accepting and nonjudgmental attitude when assessing use of or interest in herbal products or dietary supplements.

What are 5 main categories of complementary and alternative medicine (CAM)?

1. whole medical systems, 2. mind-body medicine, 3. biologically based practices, 4. manipulative and body-based practices, 5. energy medicine.

The nurse is caring for a Native American client and notices that the client has been mostly silent. What is the best action for the nurse to take?

Accept it because this behavior is normal and makes the client feel comfortable.

A community health nurse has volunteered to assist in providing health care instructions to a Native American community group. The nurse plans instructions based on the common practices and rituals of this group, knowing that which are associated characteristics of this ethnic group?

Alcohol abuse is common. Vitamin D deficiency is a concern. Corn is an important component of the diet. This group is at increased risk for gallbladder disease.

When communicating with a client who speaks a different language, which best practice should the nurse implement?

Arrange for an interpreter to translate.

A kosher meal is delivered to a Jewish American client. Which action by the nurse is most appropriate in assisting the client with the meal?

Ask the client to prepare the meal for eating.

The nurse is planning care for a hospitalized male client who is an Orthodox Jew. Which action by the nurse is best for this client?

Assign a male unlicensed assistive personnel to help the client with his personal care.

What action should the nurse consider when counseling a client of the Amish tradition?

Avoid using scientific or medical jargon.

The nurse is planning the menu for a Chinese American client. Which foods should the nurse plan to include in the dietary plan?

Broccoli Green beans

The nurse notes that the client whose religion is Orthodox Judaism has received a cheeseburger with fries and skim milk as a beverage. Considering this finding, what is the best nursing action?

Call the dietary department and ask for a replacement meal tray.

The nurse is reviewing the plan of care with an Asian American client. The client frequently nods the head during the review. Based upon this behavior, what should be the nurse's next action?

Contact a qualified medical interpreter.

The nurse is providing discharge instructions to a Chinese American client regarding prescribed dietary modifications. During the teaching session, the client continuously turns away from the nurse. The nurse should implement which best action?

Continue with the instructions, verifying client understanding.

The nurse is providing discharge instructions to an Asian American client regarding prescribed dietary modifications. During the teaching session, the client continuously turns away from the nurse. Which nursing action is most appropriate?

Continue with the instructions, verifying client understanding.

The nurse is annoyed by a healthy Hispanic American client who had minor abdominal surgery 2 days ago. The client claims he cannot get out of bed by himself, and the nurse lectures the client and tells him to try to be tough. What type of cultural behavior is this called?

Cultural imposition

The nurse is collecting data from an African American client scheduled for surgery. Which questions would be most appropriate for the nurse to ask on initial assessment?

Do you ever experience chest pain? Do you have any difficulty breathing? Do you frequently have episodes of headache

The nurse in an ambulatory care clinic is performing an admission assessment for an African American client who is scheduled for a cataract removal with intraocular lens implantation. Which question would be appropriate for the nurse to ask the client on an initial assessment?

Do you have any breathing or heart problems? In the African American culture, asking personal questions on an initial contact or meeting is considered intrusive.

A clinic nurse is performing an admission assessment on an African American client scheduled for cataract removal with intraocular lens implantation. Which question should the nurse avoid asking on the initial assessment?

Do you have any family problems?

The nurse caring for an Orthodox Jewish client plans a diet that adheres to the practices of the client's faith. When planning care, the nurse recognizes that which principles are consistent with dietary kosher laws?

Eating fish with scales and fins is allowed. Unleavened bread is eaten during Passover week. Meat from animals that are vegetable eaters is allowed. Meat is allowed if the food animal is ritually slaughtered.

Which is the best nursing intervention regarding complementary and alternative medicine?

Educating the client about therapies that he or she is using or is interested in using

An antihypertensive medication has been prescribed for a client with hypertension. The client tells the clinic nurse that he would like to take an herbal substance to help lower his blood pressure. The nurse should take which action?

Encourage the client to discuss the use of an herbal substance with the health care provider (HCP).

A critically ill Hispanic client tells the nurse through an interpreter that she is Roman Catholic and firmly believes in the rituals and traditions of the Catholic faith. Based on the client's statements, which actions by the nurse demonstrate cultural sensitivity and spiritual support?

Ensures that a close relative stays with the client Makes a referral for a Catholic priest to visit the client Offers to provide a means for praying the rosary if the client wishes

The nurse is developing a postoperative plan of care for a 40-year-old Filipino man scheduled for an appendectomy. What is the primary nursing action to include in the client's plan of care?

For the first postoperative day, offer pain medication on a regular basis as prescribed. Filipinos view pain as part of living an honorable life. The client may appear stoic and be tolerant of a high degree of pain.

The nurse is caring for a slightly intoxicated newly admitted Native American client with gallbladder disease. Based on the client's diagnosis, what dietary issue could be causing this client's problem?

Fried bread and mutton prepared in lard

A home care nurse is assigned to visit a Hispanic American client to perform an admission assessment. On the initial meeting with the client, the nurse should plan to incorporate which social custom?

Greet the client with a handshake.

The nurse is preparing a plan of care for a client, and is asking the client about religious preferences. The nurse considers the client's religious preferences as being characteristic of a Jehovah's Witness if which client statement is made?

I cannot have any food containing or prepared with blood.

The nurse in a health care clinic is preparing to conduct a nutritional session with a group of culturally diverse pregnant women. At the first session the nurse will be meeting with each client individually. The nurse prepares a list of items to be included in the session and lists which item as the priority?

Identify the food preferences and methods of food preparation for each client.

The unlicensed assistive personnel (UAP) is assigned to care for a client who is of Asian heritage. The UAP tells the nurse, "I think that my assignment needs to be changed. Every time I try to talk, the client turns away." Which statement is the most appropriate teaching response from the nurse?

If the client turns away, continue with the discussion.

The nursing instructor is providing a session on cultural beliefs related to health and illness. At the end of the session, the instructor asks a nursing student to describe the beliefs of some African Americans in regard to illness. Which statement would be the best response by the student?

Illness is a disharmonious state that may be caused by demons and spirits.

The nurse educator asks a student to list the 5 main categories of complementary and alternative medicine (CAM), developed by the National Center for Complementary and Alternative Medicine. Which statement, if made by the nursing student, indicates a need for further teaching regarding CAM categories?

Magnetic therapy and massage therapy are a focus of CAM. Magnetic therapy and massage therapy are therapies within specific categories of CAM.

The nurse is providing care to a Puerto Rican-American client who is terminally ill. Numerous family members are present most of the time, and many of the family members are very emotional. What is the most appropriate nursing action for this client?

Make the necessary arrangements so that family members can visit.

The nurse is caring for a Chinese client who is in labor. The client is exhibiting facial grimacing and appears to be in pain. When the nurse offers the client an analgesic, the client refuses. The nurse should take which initial action?

Offer an analgesic again. In the Chinese culture, it is considered impolite to accept something when it is first offered.

The nurse at a health care clinic is preparing to examine a Hispanic child who was brought to the clinic by the mother. During assessment of the child, the nurse should avoid which action?

Overly admiring the child. Hispanic clients may believe in mal ojo "evil eye".

The nurse is implementing the complementary therapy of therapeutic touch when caring for clients. The nurse should implement which action when performing therapeutic touch?

Position hands 2 to 4 inches (5 to 10 cm) from the body.

The nurse is conducting an admission assessment on an African American client scheduled for a hernia repair. Which assessment data are of least importance during the initial assessment?

Psychosocial assessment data

The ambulatory care nurse is discussing preoperative procedures with a Japanese American client who is scheduled for surgery the following week. During the discussion, the client continually smiles and nods the head. How should the nurse interpret this nonverbal behavior?

Reflecting a cultural value

The nurse is caring for a newly admitted pregnant Hispanic client who refuses to eat her hot supper. What is the next best action by the nurse?

Replace her supper with cold foods. Many Asian and Hispanic cultures subscribe to the hot and cold theory of illness and view pregnancy as a hot state.

The nurse is providing care to a Hispanic client who is terminally ill. Numerous family members are present most of the time, and many of the family members are very emotional. What is the appropriate action?

Request permission to move the client to a private room and allow the family members to visit.

The nurse consults with a nutritionist regarding the dietary preferences of an Asian American client. Which food should be included in the dietary plan?

Rice

The nurse calls the dietary department to obtain a dinner meal for a White American client who was admitted to the hospital at 4:00 p.m. The health care provider prescribed a diet "as tolerated." Considering the practices and preferences of the White American culture, which food should the nurse request for the meal?

Sirloin steak and potatoes

An older client is seen in the clinic for a physical examination. Laboratory studies reveal that the hemoglobin and hematocrit levels are low, indicating the need for further diagnostic studies and a blood transfusion. The client is a Jehovah's Witness and refuses to have a blood transfusion. The nurse should take which most appropriate action?

Support the client's decision not to receive a blood transfusion.

Which meal tray should the nurse deliver to a client of Orthodox Judaism faith who follows a kosher diet?

Sweet and sour chicken with rice and vegetables, mixed fruit, juice. dairy-meat combination is unacceptable. Only fish that have scales and fins are allowed. meats that are allowed include animals that are vegetable eaters, cloven hoofed, and ritually slaughtered.

The nurse is examining a Hispanic American child who was brought to the clinic by the mother. Which are appropriate nursing actions?

Taking the child's vital signs Asking questions about the child Obtaining an interpreter if necessary

When counseling a female Amish client regarding gallbladder disease, what action should the nurse take?

Tell the client that at some point the gallbladder may need to be removed.

The nurse is caring for an Appalachian client. The nurse makes sure to have frequent contact with the client and to initiate many different conversations. What is the best reason why the nurse uses this approach?

The Appalachian client may prefer personal relationships with health care providers and a desire for frequent communication.

The nurse is creating a postoperative plan of care for a Filipino American client scheduled for surgery. The nurse should consider which factors when addressing pain?

The client has a high tolerance to pain. Pain medication needs to be offered on a regular basis as prescribed.

A Native American man comes to the clinic for a physical examination. When asked about mental status, the client acknowledges having visions of his deceased brother and speaks to him when he needs counsel. Which best describes the nurse's assessment of this client's behavior?

The client is demonstrating behavior that may be regarded as normal within his culture.

The nurse is preparing to provide preoperative teaching to a Spanish-speaking client and the client's family. Which nursing action would be most effective for teaching the client?

The nurse secures the assistance of a professional interpreter to communicate with the client.

The nurse manager is giving a staff in-service on providing culturally sensitive education to clients. Which statements indicate to the nurse manager that the staff understands providing culturally sensitive education?

The population served will determine the culturally sensitive resources to use for teaching. Assessment of a client's preferred learning approach is essential to facilitate the learning process. It is important to have an accurate translator when the nurse and client do not speak the same language.

The nurse is planning to instruct a Hispanic American client about nutrition and dietary restrictions. What factors should the nurse keep in mind when developing this client's plan of care?

They view food as a primary form of socialization. Any occasion is seen as a time to celebrate with food.

The nurse is caring for an Eastern Orthodox client. During Lent, the nurse should offer the client which dietary choice?

Tossed green salad. During Lent all animal products, including dairy products, are forbidden in the Eastern Orthodox religion.

The prenatal clinic nurse is performing an assessment on a culturally diverse client. Besides conversational style, what are some of the most important cultural and communication considerations the nurse must be aware of?

Touch Eye contact Personal space Time orientation

The home care nurse is assigned to visit a Mexican American client to perform an admission assessment. On initially meeting the client, which actions would be considered culturally appropriate?

Touch the client. Greet the client with a handshake. Smile during the admission assessment. Use affirmative nods during conversations.

The nurse is assigned to care for a Hispanic American client. The nurse should plan to use which communication technique that is appropriate for this culture?

Touch when having a conversation

The nurse is planning the menu for an Asian American client in collaboration with the hospital dietitian. The meal plan is designed to incorporate which food as a usual component of an Asian diet?

Vegetables