culture and diversity
A female client, from a male-dominated culture, is being discharged after a lengthy hospitalization. Which action by the nurse prior to providing discharge instructions is appropriate? A. Ask the client when the best time for teaching would be. B. Make sure instructions are understood by the client. C. Ensure that the healthcare provider gives the instructions. D. Assess who the decision maker is in the family.
c
The nurse is working with a patient of a different culture. The nurse acknowledges the patient's culture and asks how it can be incorporated in the plan of care. Which model of cultural competence is the nurse using? LEARN model Spector's Heritage Chain Leininger's culture care diversity theory American Association of Colleges of Nursing (AACN)
LEARN model
Which statement by a nurse indicates an understanding of the concept of multiculturalism? "Multiculturalism describes a society in which many subcultures coexist." "Multiculturalism describes shared values, beliefs, attitudes, and customs in a community of people." "Multiculturalism describes the quality of being unlike or different." "Multiculturalism is the process of adapting to local customs."
"Multiculturalism describes a society in which many subcultures coexist."
The nurse is evaluating the plan of care for a female patient admitted for a hip replacement. The patient reports being of the Muslim faith. Which patient statement indicates the cultural goals were met? "Thank you for providing me with only female nurses." "I understand how to inject my medicine into my belly." "I will read more about the rehabilitation process in this booklet." "I watched the video about which exercises I need to do twice a day."
"Thank you for providing me with only female nurses."
Which statement by the nurse reflects that the nurse is practicing negative classism? "The patient will be back because he keeps losing jobs due to alcohol abuse." "I can provide the patient a list of resources that he can afford." "The patient needs to understand the complications of his disease." "It is essential for the patient to follow up with the healthcare provider after discharge."
"The patient will be back because he keeps losing jobs due to alcohol abuse."
The nurse is assessing the cultural needs of an adult male patient who believes in the hot-cold theory. Which response by the nurse indicates cultural humility? "Would you be willing to share information about it?" "Is this the practice of voodoo?" "That is ridiculous and we cannot agree with this theory." "What does this belief have to do with your health care?"
"Would you be willing to share information about it?"
The nurse is assessing a group of patients in a community center for risk factors for health problems. Which patient should the nurse determine to be at greatest risk for health problems? A patient with an eighth-grade education making minimum wage A patient who is part of the second generation of an immigrant family A patient with a family of four and a secure income A patient who is middle-aged and exercises four days a week
A patient with an eighth-grade education making minimum wage
The nurse is using the LEARN model of cultural competence when working with a patient of a different ethnicity. Which action by the nurse indicates an understanding of the "A" portion of this model? Acknowledges the patient's beliefs and works to incorporate these into the plan of care Asserts to the patient that the medical model is correct and the patient should follow the plan of care Affirms the patient's beliefs, but explains the rules of the hospital and asserts that the plan of care must be followed Accepts that the patient has differing beliefs, but emphasizes the importance of compliance
Acknowledges the patient's beliefs and works to incorporate these into the plan of care
The nurse is caring for a patient of the Jewish faith who is admitted with new onset of diabetes mellitus. The nurse asks about religious practices. Which information provided by the patient most impacts the plan of care? Adheres to a kosher diet Prays three times a day Does no work on the Sabbath Attends synagogue daily
Adheres to a kosher diet
An 82-year-old female patient informs the nurse that the surgeon has declined to perform replacement surgeries on people of their age. Which behavior is the surgeon demonstrating? Ageism Gender bias Classism Homophobia
Ageism
The nurse caring for a patient who is Vietnamese notices that the patient is losing weight. The patient does not eat much of the food found on the menu. Which intervention would be most appropriate for this patient? Allowing the family to bring in food the patient prefers within dietary restrictions Providing the patient three different food choices with each meal and snack Continuing to weigh the patient on a monthly basis and monitor for trends Monitoring serum albumin and total protein levels once a month
Allowing the family to bring in food the patient prefers within dietary restrictions
The nurse is presenting an in-service to staff nurses regarding the spiritual health of patients admitted to the unit. Which role of the nurse is appropriate regarding the spiritual health of patients? Assisting the patients in recalling past experiences in which they drew upon hope while in crisis Declining to discuss spirituality directly out of respect for differing beliefs Asking the patient's family for permission before disclosing the patient's prognosis Introducing patients to the chaplain, who can assist them in finding religious belief
Assisting the patients in recalling past experiences in which they drew upon hope while in crisis
The home health nurse is assigned to care for four patients. Which family should the nurse document as exhibiting enculturation? Child learning dances from grandparents Child playing with toys from home country Child maintaining the same religion as parents Child listening to stories from parents' upbringing
Child learning dances from grandparents
The nurse recognizes that certain ethnic groups or races may tend toward developing specific diseases. The nurse should assess an American Indian for which disease? Diabetes mellitus Chronic obstructive pulmonary disease (COPD) Cancer Hypertension
Diabetes mellitus
The nurse is planning care for four patients. Which action by the nurse indicates gender stereotyping? Giving an 8-year-old girl a doll to play Asking a 5-year-old boy which color bandage he would prefer Turning the television on for a 12-year-old boy Playing a board game with a 9-year-old girl
Giving an 8-year-old girl a doll to play
The nurse is caring for an older adult patient who wants to postpone elective surgery because the family will be gathering for Yom Kippur on that day. Which is an appropriate response from the nurse? Inform the surgeon and advocate for rescheduling the procedure. Insist that the patient keep the surgery date. Inform the patient that their surgery may have to be postponed indefinitely. Ask the patient whether their family will really mind if they don't join them for the holy day.
Inform the surgeon and advocate for rescheduling the procedure.
The nurse is teaching a patient from another culture how to self-administer insulin injections. Which action could be misinterpreted as understanding of the directions given? Moving the head up and down Avoiding direct eye contact Maintaining a 3-5 foot distance Bowing when entering the room
Moving the head up and down
The nurse is preparing a presentation on sexual orientation and discrimination in the healthcare setting. Which information should the nurse include? Provide the same care regardless of gender or orientation. Provide gender-specific instructions for the patient. Ask the patient with which gender they identify. Promote health insurance for same-gender couples.
Provide the same care regardless of gender or orientation.
The nurse is working with a patient who speaks limited English and is prescribed a sodium-restricted diet. Which intervention should the nurse perform to ensure the patient and family adhere to the dietary restrictions? Providing information in the patient's language about foods to avoid Admonishing the wife for bringing in the patient's favorite home-cooked foods Having the family member who speaks some English interpret for the patient Documenting that the patient is noncompliant if the family brings in food from home
Providing information in the patient's language about foods to avoid
The nurse observes the patient in prayer with family members. Which cultural characteristic should the nurse recognize is occurring? Social organization Personal space Time orientation Environmental control
Social organization
The nurse is researching teenage behaviors as related to those who are goth, techies, and artsy. Which term describes what is the nurse is studying? Subculture Ageism Enculturation Assimilation
Subculture
Which action by the nurse illustrates the concept of cultural humility? The nurse expresses sensitivity to the differences between the patient's culture and one's own. The nurse discusses one's cultural superiority over the patient's culture. The nurse provides an example of one's authoritative stance when teaching a patient which diet is best for their diagnosis. The nurse explains to a patient that their religious beliefs lack scientific validity when discussing the diagnosis.
The nurse expresses sensitivity to the differences between the patient's culture and one's own.
A patient of Vietnamese descent is admitted to the hospital. The patient is on a regular diet and tells the nurse their wife wants to bring in foods that are cooked according to their culture. Which is the nurse's best response? You are not on any dietary restrictions, so this should be acceptable." "It is against the facility's policy to allow family members to bring in food." "I will need to check with the healthcare provider because this may not be possible." "Why would you want to bring in food from home when we provide your meals?"
You are not on any dietary restrictions, so this should be acceptable."
The nurse is reviewing the medical record of an assigned patient and notes the patient identifies as transgender. Which statement best describes this patient's gender identity? Transgender individuals do not identify with the gender assigned to their body. Transgender individuals are born with anatomic characteristics that do not seem to fit the typical definitions of female or male. Transgender individuals demonstrate preferences toward one gender group over another. Transgender individuals have negative feelings or behaviors toward gays or lesbians.
Transgender individuals do not identify with the gender assigned to their body.
Which action by the nurse indicates using verbal communication when interacting with a patient from another culture? Using an interpreter Providing pamphlets Providing a video Providing a hands-on demonstration
Using an interpreter
The nurse is caring for a non-English-speaking patient. Which intervention should the nurse avoid? Using family members as the first line of interpretation Providing teaching sheets in the patient's language Using verbal and nonverbal cues when addressing the patient Addressing questions to the patient, not the patient's family members
Using family members as the first line of interpretation
The nurse obtains an interpreter to facilitate dietary teaching for a patient who does not speak English. How should the nurse evaluate the effectiveness of this teaching session? Using the interpreter to verbalize understanding Having the patient make menu choices Asking the family if the patient understood Providing written information in English with pictures
Using the interpreter to verbalize understanding
The nurse is preparing to provide discharge instructions for a patient who immigrated from another country and speaks little English. Which nursing intervention would be most appropriate to help this patient? Utilizing the hospital's interpreter services Providing directions in a booklet with pictures Using the patient's family to interpret directions Speaking slowly and loudly when providing directions
Utilizing the hospital's interpreter services
A nurse is working with a number of clients at a free clinic. Which client population is at the highest risk for low levels of healthcare? A. Undocumented immigrants Your answer is correct. B. Teenagers C. Men who have sex with women D. Men who have protected sex with men
a
The clinic nurse is caring for an infant during a routine wellness exam. The parents and infant immigrated to the United States 6 months ago. The mother explains that she believes that an herbal remedy is the best way to treat the infant's colic. Which action by the nurse is appropriate? A. Ask the mother what the ingredients are in the remedy. Your answer is correct. B. Tell the mother not to use the remedy because there is no way to know what the ingredients' scientific effect may be. C. Explain how herbal ingredients may be harmful to the infant. D. Give the mother an alternate remedy for colic.
a
The novice nurse working in an inner-city hospital that serves a diverse client population states, "I want to learn everything possible about all of the clients." Which response by the seasoned nurse is appropriate? A. "This will come with time as you get to know clients and then encounter problems." B. "I will give you a great book that describes all of the critical factors." C. "You should always be nonjudgmental." D. "You need to first understand who you are."
a
The nurse notices that a client, who is from another country, appears uncomfortable when the nurse asks to look at the client's abdominal incision from a recent surgery. Which nursing action is the most culturally competent? A. Explain the reason for the intervention using lay terms. Your answer is correct. B. Close the client's curtain to maintain privacy. C. Ask the client to explain why she is uncomfortable. D. Wait until the next assessment time to observe the incision.
a
A nurse working in an assisted living facility is preparing an educational program regarding ageism for the colleagues on the unit. Which statements reflect ageism? Select all that apply. A. "The elderly are less likely to recover from illness." Your answer is correct. B. "If the client is competent to make decisions, I should not go to other members of the family for care decisions." C. "All elderly people are sickly." Your answer is correct. D. "Addressing an elderly client as 'Honey' or 'Sweetie' is disrespectful." E. "The elderly are just lazy, and that is why they need help with activities of daily living." Your answer is correct.
a c e
The nurse is caring for a client from a different culture who had a myocardial infarction and is receiving atorvastatin (Lipitor). The nurse assesses the client's diet to be very high in fat. Which is the best plan by the nurse to improve the client's diet and reduce the risk that the client may need additional medications? A. Give the client information specific to his culture related to low-fat diets. B. With the client's permission, discuss the dietary requirements with whoever prepares meals for the family. Your answer is correct. C. Consult a dietitian to teach the client about low-fat diets. D. Ask the client if he would rather have another nurse who is from the same culture speak to him about his dietary needs.\
b
Which acculturation behavior will the nurse observe in a client who has emigrated from another country to the United States? A. The client lives in a neighborhood that is populated predominantly with people from the client's country. B. The client attends church in the neighboring community to meet new people. Your answer is correct. C. The client buys all needed products from the local store owned by people from the client's country. D. The client speaks his native language only.
b
A general term used for a variety of conditions in which an individual is born with a reproductive or sexual anatomy that does not seem to fit the typical definitions of female or male is A. genderqueer. B. intersex. Your answer is correct. C. transgender. D. homosexual.
b
The client is admitted to the hospital following a miscarriage, and she is septic. The healthcare provider orders antibiotics, which the client refuses, stating, "I don't deserve them. I lost my baby because I had sex outside of marriage." Which is the appropriate response by the nurse? A. "I'll notify your healthcare provider about your decision." B. "You have a serious infection and really need the medication." Your answer is correct. C. "Do you think you should be punished because you had a miscarriage?" D. "I think you need to do what is best for you."
b
The nurse caring for an adult client from another country notices that the client consults with her mother on all healthcare decisions. What action by the nurse is the most culturally competent? A. Ask the client why the parent is being consulted for every decision. B. Accept the behavior of the client and family member. Your answer is correct. C. Ask the client's mother to leave the room to provide the client with more privacy. D. Confront the client's mother to state the importance of the client making her own decisions.
b
A nurse is interviewing a client at a clinic near a shelter for the homeless. Understanding the lack of resources this client has available, which should the nurse assess during the intake phase of the health history? Select all that apply. A. Number of times married B. Access to nutritious meals Your answer is correct. C. Any personal resources Your answer is correct. D. Access to medication Your answer is correct. E. Social support available
b c d e
A novice nurse is working in a busy emergency department of a hospital situated in a culturally diverse area of the city. Which should the nurse do when providing culturally competent care? A. Assume that working in this emergency department will be the same as in other care contexts the nurse has encountered. B. Treat everyone who comes to the emergency department seeking care as having the same needs. C. Acquire the underlying background knowledge necessary that will provide these clients with the best possible healthcare. Your answer is correct. D. Base the standard of care on the needs and attitudes of the dominant cultural group in the area.
c
A nurse is explaining the need to obtain laboratory tests on a client who has an infection and is of a cultural group different from the nurse's. During the interview, the client avoids eye contact and refrains from answering questions for long periods of time. Which does this behavior indicate to the nurse? A. The nurse should come back at a different time when the client is feeling more communicative. B. The nurse should have another nurse finish the interview who might be more culturally aware of this group's customs. C. In this client's culture, direct eye contact may show disrespect. Your answer is correct. D. Leave the room and come back after having learned more about this particular culture.
c
A nurse is working at a healthcare clinic serving the needs of an inner-city population that is predominantly made up of minority people groups. A neighbor says the nurse must be brave because most of "those" people have guns and are in gangs. Which response by the nurse is appropriate? A. "Hey, it's a job like any other job. All jobs have problems." B. "It's very difficult for me when you discriminate like that." C. "That's an unfortunate stereotype. Can we talk about the reality?" Your answer is correct. D. "It's okay because I'm not a gang member, so I will be okay."
c
During a sexual history, the client states, "I have always felt like a man trapped in a woman's body." The nurse should recognize that the client may identify as what? A. Homosexual B. Heterosexual C. Transgender Your answer is correct. D. Bisexual
c
The nurse is caring for a client who just had abdominal surgery. The client's nonverbal cues indicate pain, but the client denies the need for the pain medication prescribed by the healthcare provider. The nurse recognizes that this client is from a culture that feels it is inappropriate to complain about pain. Which action by the nurse is appropriate? A. Allow the client to suffer in silence. B. Consult with the healthcare provider about providing pain medication without the client's knowledge. C. Offer the pain medication to the client again, stating that providing comfort is the nurse's most important responsibility. Your answer is correct. D. Seek out a family member to convince the client to take the medication.
c
The nurse is evaluating the following goal: Client will select low-fat foods from a list by the end of the month. The client, who has different beliefs about food, has not been able to achieve this goal. Which action by the nurse is appropriate? A. Extend the time frame and give the client a longer period to achieve the goal. B. Make sure that the client understands the importance of the goal. C. Modify the plan of care to be consistent with the client's beliefs regarding food. Your answer is correct. D. Select a different goal.
c
The nurse places a client in a treatment room of the emergency department for treatment of abdominal pain and vaginal bleeding. The spouse, speaking for the client, asks that only a female provider examine his wife for the pelvic exam. The nurse recognizes that the client is from a culture that prohibits men from examining women. Which is the most culturally appropriate statement by the nurse? A. "The male and female providers both respect privacy." B. "Your spouse will be covered with a sheet, so it will not matter whether the examiner is male or female." C. "Every attempt will be made to honor your request." Your answer is correct. D. "The request is unreasonable and cannot be honored."
c
Which treatment program would be most appropriate for homeless clients whose type 1 diabetes requires daily insulin injections? A. Inpatient hospital-based care B. Home healthcare C. Outpatient clinic Your answer is correct. D. Partial hospitalization programs
c
A female client, from a male-dominated culture, is being discharged after a lengthy hospitalization. Which action by the nurse prior to providing discharge instructions is appropriate? A. Ask the client when the best time for teaching would be. B. Make sure instructions are understood by the client. C. Ensure that the healthcare provider gives the instructions. D. Assess who the decision maker is in the family.
d
The novice nurse working in an inner-city hospital that serves a diverse client population states, "I want to learn everything possible about all of the clients." Which response by the seasoned nurse is appropriate? A. "This will come with time as you get to know clients and then encounter problems." B. "I will give you a great book that describes all of the critical factors." C. "You should always be nonjudgmental." D. "You need to first understand who you are."
d
The home health nurse visits a multigenerational family to determine needs. The nurse observes the grandchildren listening to stories from the grandparents of the old country and traditions, and asking questions. Which concept is the nurse observing during this interaction? Enculturation Ageism Acculturation Assimilation
enculturation