Culture and Spirituality Exam 105

A patient expresses the desire to learn how to meditate. What does the nurse need to do first? A. Answer the patient's questions B. Help the patient get into a comfortable position C. Select a teaching environment that is free from distractions D. Encourage the patient to meditate for 10 to 20 minutes 2 times a day

C. Select a teaching environment that is free from distractions A quiet environment without distractions enhances learning and is essential for meditation.

Which of the following questions would best assess a patient's level of connectedness? A. What gives your life meaning? B. Which aspects of your spirituality would you like to discuss right now? C. Who do you consider to be the most important person in your life at this time? D. How do you feel about the accomplishments you've made in your life so far?

C. Who do you consider to be the most important person in your life at this time? Connectedness refers to feelings about relationships with self, others, and God; this question asks about connectedness with others.

You are in the process of admitting an ethnically diverse patient. To plan culturally competent care, you will conduct a cultural assessment that includes: A. biocultural history. B. ethnohistory. C. negotiation. D. ethnocentrism.

C. negotiation

The nurse is admitting a patient to the hospital. The patient states that he is a very spiritual person but does not practice any specific religion. The nurse understands that these statements a. Are contradictory b. Indicate a strong religious affiliation c. Indicate a lack of faith d. Are reasonable

D These statements are reasonable and are not contradictory. Many people tend to use the terms spirituality and religion interchangeably. Although closely associated, these terms are not synonymous. Religious practices encompass spirituality, but spirituality does not need to include religious practice. When a person has the attitude of something to live for and look forward to, hope is present.

The patient is in the intensive care unit (ICU), which has strict posted visiting hours and limits the number of visitors to two per patient at any one time. The patient is asking to see his wife and two daughters. The nurse should a. Tell the patient that they will be allowed to visit at the appropriate time. b. Allow the wife and one daughter to enter the ICU, but not the other daughter. c. Allow the two daughters to visit, and let the wife visit when they leave. d. Allow the wife and daughters to visit at the patient's request.

D Use of support systems is important in any health care setting. When patients depend on family and friends for support, encourage them to visit the patient regularly. As long as no interference with active patient care is involved, there is no reason to limit visitation.

The family of a client who died of heart failure is making arrangements for a ritual bath to be given by a ritual burial society. Nurses are making arrangements for access and privacy. Which religions have this​ tradition? (Select all that apply.) a. Buddhism b. Lutheran Christianity c. Baptist Christianity d. Judaism e. Islam

D. Judaism E. Islam Rationale Both the Muslim and Jewish religions have a tradition of a ritual bath after death. That is not true of the Buddhist religion or the Baptist or Lutheran traditions within Christianity.

Nurses play an important role in reducing health disparities. One important mechanism to do this is to: A. discourage use of evidence-based practice guidelines B. insist that patient adhere to the Health People 2020 guidelines C. teach patient how to use the internet to find resources related to their health D. engage in active listening and establish relationships with patients and families

D. engage in active listening and establish relationships with patients and families

A nurse has developed a plan of care to meet the needs of a client with the nursing diagnosis of Spiritual Distress. What would be an expected outcome?

Identify factors in life that challenge spiritual beliefs.

A nurse caring for a client of the Jewish faith knows the importance of asking about any food preferences when discussing diet. This is important for which of the following reasons?

Religious practices and beliefs can directly influence a client's self-care practices.

A college foreign exchange student is living with a family in England and is confused about the daily Catholic prayers and rituals of the family. The student longs for the comfort of her fundamentalist Protestant practices and reports to the campus nurse for direction. The nurse recognizes the student is experiencing which type of spiritual distress?

Spiritual alienation

As a client comes into the admitting​ area, a nurse notices a jeweled cross on the client​'s necklace. The nurse​ comments, "Great ​look; I can see your religious beliefs are important to ​you," and starts with the spiritual assessment of the client. How would this approach be​ evaluated? a. Complimenting the client​'s appearance is helpful b. No time was taken to establish rapport with the client c. A focus on jewelry might appear materialistic d. It is efficient and effective to dive right into the interview

b. No time was taken to establish rapport with the client Rationale Starting with the spiritual assessment of the client leaves no time to establish rapport with the client. It is not about​ jewelry, compliments, or starting quickly.

Which nursing actions are appropriate when caring for a patient who participates in the Hindu religion? (Select all that apply.)

• Consider the patient to be open to new ideas in health care practices. • Anticipate many dietary restrictions, conforming to individual sect doctrine. • Accommodate certain rites to be practiced following death

A nurse is completing a spiritual assessment of a client using the FICA assessment tool. Which question would the nurse most likely ask first?

"Do you consider yourself a spiritual person?"

In caring for the patient's spiritual needs, the nurse understands that a. Establishing presence is part of the art of nursing b. Presence involves "doing for" the patient c. A caring presence involves listening to the patient's wishes only d. The nurse must use her expertise to make decisions for the patient

A Establishing presence is part of the art of nursing. Presence involves "being with" a patient versus "doing for" a patient. Demonstrate a caring presence by listening to the patient's concerns and willingly involving family in discussions about the patient's health. Show self-confidence when providing health instruction, and support patients as they make decisions about their health.

The nurse is admitting a patient who is a member of the Seventh Day Adventist religion. The physician has written an order for specific tests to be done the next day, which is Saturday. The nurse should a. Discuss the patient's beliefs about the Sabbath b. Order the tests without questioning c. Inform the physician that the tests cannot be performed d. Reorder the tests for Sunday

A It is essential to consider cultural differences and explore personal preferences when determining nursing interventions to enhance spiritual well-being. Some Seventh Day Adventists may not mind having tests on the Sabbath. Others might. Ordering the tests without questioning may lead to patient refusal later and to wasted resources as well as spiritual distress for the patient. Informing the physician that the tests cannot be performed is premature without speaking with the patient first. It is not in the realm of the nurse to reorder tests. Some tests may be critical and may need to be done on the Sabbath.

In assessing the spiritual health of her patients, the nurse understands that a. Spiritual beliefs change as patients grow and develop b. Spiritual health in older adults leads to peace and acceptance of others c. Older adults often express spirituality by focusing on themselves d. The basis of beliefs among older people is focused on one or two factors

A Spiritual beliefs change as patients grow and develop. Health spirituality in older adults leads to peace and acceptance of self. However, older adults often express their spirituality by turning to important relationships and giving of themselves to others. Beliefs among older people vary based on many factors, such as gender, past experience, religion, economic status, and ethnic background.

A complex concept that is unique to each individual; is dependent upon a person's culture, development, life experiences, beliefs, and ideas about life; and is a unifying theme in peoples' lives is called a. Spirituality b. Religion c. Self-transcendence d. Faith .

A Spirituality is a complex concept that is unique to each individual; is dependent upon a person's culture, development, life experiences, beliefs, and ideas about life; and is a unifying theme in peoples' lives. Religion refers to the system of organized beliefs and worship that a person practices to outwardly express spirituality. Self-transcendence is the belief that there is a force outside of and greater than the person. Faith allows people to have firm beliefs despite lack of physical evidence

When evaluating a patient's risk for spiritual crises, which of the following are part of the evaluation process? (Select all that apply.) a. Review the patient's self-perception regarding spiritual health b. Review the patient's view of his/her purpose in life c. Discuss with family and associates the patient's connectedness d. Ask whether the patient's expectations are being met e. Impress on the patient that spiritual health is permanent once obtained

A, B, C, D One critical thinking model for spiritual health evaluation lists the evaluation process as including a review of the patient's self-perception regarding spiritual health, the patient's view of his/her purpose in life, discussion with the family and close associates about the patient's connectedness, and determining whether the patient's expectations are being met. Attainment of spiritual health is a lifelong goal.

Spiritual distress has been identified in a patient who has been diagnosed with AIDS. Upon evaluating the following interventions, which are appropriate for the diagnosis of Spiritual distress? (Select all that apply.) a. Develop activities to heal body, mind, and spirit b. Assess for potential suicide c. Offer to pray with the patient d. Teach relaxation, guided imagery, and meditation e. Have patient avoid church attendance

A, C, D Interventions that are appropriate for the nursing diagnosis of Spiritual distress include (1) helping the patient develop/identify activities to heal body, mind, and spirit; (2) offering to pray with the patient; and (3) teaching relaxation, guided imagery, and medication. Assessing for potential suicide would be appropriate for the nursing diagnosis of Hopelessness. Attendance at church should be encouraged.

A 62-year-old male patient has just been told he has a terminal illness. Which of the following statements supports a nursing diagnosis of spiritual distress related to diagnosis of terminal illness? A. "I have nothing to live for now." B. "What will happen to my wife when I die?" C. "How much longer do I have to live?" D. "I need to go to church and pray for a miracle."

A. "I have nothing to live for now." Patients with spiritual distress verbalize lack of hope and meaning.

A patient who is hospitalized with heart failure states that she sees her illness as an opportunity and a challenge. Despite her illness, she is still able to see that life is worth living. This is an example of: A. Hope. B. Faith. C. Values. D. Connectedness.

A. Hope Hope refers to an energizing source that is oriented to future goals and outcomes. Faith allows people to have firm beliefs despite lack of physical evidence; in this situation the patient is energized by the future and has hope that it will be positive despite her heart failure.

A nurse is caring for a patient who refuses to eat until after the sun sets. Which religion does this patient most likely practice? A. Islam B. Sikhism C. Hinduism D. Catholicism

A. Islam Patients who practice Islam do not eat until after the sun goes down during the month of Ramadan.

Which of the following nursing interventions support(s) a healing relationship with a patient? (Select all that apply): A. Praying with the patient B. Giving pain medications before a painful procedure C. Telling a patient that it is time to take a bath before family arrive to visit D. Making the patient's bed following hospital protocol E. Helping a patient see positive aspects related to a chronic illness

A. Praying with the patient E. Helping a patient see positive aspects related to a chronic illness Praying with patients and mobilizing the patient's hope create a healing relationship

A Hispanic patient complains of abdominal cramping caused by empacho. Which action should the nurse take first? a. Ask the patient what treatments are likely to help. b. Massage the patient's abdomen until the pain is gone. c. Administer prescribed medications to decrease the cramping. d. Offer to contact a curandero(a) to make a visit to the patient.

ANS: A Further assessment of the patient's cultural beliefs is appropriate before implementing any interventions for a culture-bound syndrome such as empacho. Although medication, a visit by a curandero(a), or massage may be helpful, more information about the patient's beliefs is needed to determine which intervention(s) will be most helpful.

The nurse is performing an admission assessment for a non-English speaking patient who is from China. Which actions could the nurse take to enhance communication (select all that apply)? a. Use an electronic translation application. b. Use a telephone-based medical interpreter. c. Wait until an agency interpreter is available. d. Ask the patient's teenage daughter to interpret. e. Use exaggerated gestures to convey information.

ANS: A, B, C Electronic translation applications, telephone-based interpreters, and agency interpreters are all appropriate to use to communicate with non-English-speaking patients. When no interpreter is available, family members may be considered, but some information that will be needed in an admission assessment may be misunderstood or not shared if a child is used as the interpreter. Gestures are appropriate to use, but exaggeration of the gestures is not needed.

The nurse is caring for a Native American patient who has traditional beliefs about health and illness. Which action by nurse is most appropriate? a. Avoid asking questions unless the patient initiates the conversation. b. Ask the patient whether it is important that cultural healers are contacted. c. Explain the usual hospital routines for meal times, care, and family visits. d. Obtain further information about the patient's cultural beliefs from a family member.

ANS: B Because the patient has traditional health care beliefs, it is appropriate for the nurse to ask whether the patient would like a visit by a shaman or other cultural healer. There is no cultural reason for the nurse to avoid asking the patient questions because they are necessary to obtain health information. The patient (rather than the family) should be consulted about personal cultural beliefs. The hospital routines for meals, care, and visits should be adapted to the patient's preferences rather than expecting the patient to adapt to the hospital schedule.

The nurse plans care for a hospitalized patient who uses culturally based treatments. Which action by the nurse is best? a. Encourage the use of diagnostic procedures. b. Coordinate the use of folk treatments with ordered medical therapies. c. Ask the patient to discontinue the cultural treatments during hospitalization. d. Teach the patient that folk remedies will interfere with orders by the health care provider.

ANS: B Many culturally based therapies can be accommodated along with the use of Western treatments and medications. The nurse should attempt to use both traditional folk treatments and the ordered Western therapies as much as possible. Some culturally based treatments can be effective in treating "Western" diseases. Not all folk remedies interfere with Western therapies. It may be appropriate for the patient to continue some culturally based treatments while he or she is hospitalized.

The nurse is caring for an Asian patient who is being admitted to the hospital. Which action would be most appropriate for the nurse to take when interviewing this patient? a. Avoid eye contact with the patient. b. Observe the patient's use of eye contact. c. Look directly at the patient when interacting. d. Ask a family member about the patient's cultural beliefs.

ANS: B Observation of the patient's use of eye contact will be most useful in determining the best way to communicate effectively with the patient. Looking directly at the patient or avoiding eye contact may be appropriate, depending on the patient's individual cultural beliefs. The nurse should assess the patient, rather than asking family members about the patient's beliefs.

When doing an admission assessment for a patient, the nurse notices that the patient pauses before answering questions about the health history. Which action by the nurse is most appropriate? a. Interview a family member instead. b. Wait for the patient to answer the questions. c. Remind the patient that you have other patients who need care. d. Give the patient an assessment form listing the questions and a pen.

ANS: B Patients from some cultures take time to consider a question carefully before answering. The nurse will show respect for the patient and help develop a trusting relationship by allowing the patient time to give a thoughtful answer. Asking the patient why the answers are taking so much time, stopping the assessment, and handing the patient a form indicate that the nurse does not have time for the patient.

Which strategy should be a priority when the nurse is planning care for a diabetic patient who is uninsured? a. Obtain less expensive medications. b. Follow evidence-based practice guidelines. c. Assist with dietary changes as the first action. d. Teach about the impact of exercise on diabetes.

ANS: B The use of standardized evidence-based guidelines will reduce the incidence of health care disparities among various socioeconomic groups. The other strategies may also be appropriate, but the priority concern should be that the patient receives care that meets the accepted standard.

The nurse plans health care for a community with a large number of recent immigrants from Vietnam. Which intervention is the most important for the nurse to implement? a. Hepatitis testing b. Tuberculosis screening c. Contraceptive teaching d. Colonoscopy information

ANS: B Tuberculosis (TB) is endemic in many parts of Asia, and the incidence of TB is much higher in immigrants from Vietnam than in the general U.S. population. Teaching about contraceptive use, colonoscopy, and testing for hepatitis may also be appropriate for some patients but is not generally indicated for all members of this community.

The nurse performs a cultural assessment with a patient from a different culture. Which action by the nurse should be taken first? a. Request an interpreter before interviewing the patient. b. Wait until a family member is available to help with the assessment. c. Ask the patient about any affiliation with a particular cultural group. d. Tell the patient what the nurse already knows about the patient's culture.

ANS: C An early step in performing a cultural assessment is to determine whether the patient feels an affiliation with any cultural group. The other actions may be appropriate if the patient does identify with a particular culture.

The nurse working in a clinic in a primarily African American community notes a higher incidence of uncontrolled hypertension in the patients. To correct this health disparity, which action should the nurse take first? a. Initiate a regular home-visit program by nurses working at the clinic. b. Schedule teaching sessions about low-salt diets at community events. c. Assess the perceptions of community members about the care at the clinic. d. Obtain low-cost antihypertensive drugs using funding from government grants.

ANS: C Before other actions are taken, additional assessment data are needed to determine the reason for the disparity. The other actions also may be appropriate, but additional assessment is needed before the next action is selected.

An older Asian American patient tells the nurse that she has lived in the United States for 50 years. The patient speaks English and lives in a predominantly Asian neighborhood. Which action by the nurse is most appropriate? a. Include a shaman when planning the patient's care. b. Avoid direct eye contact with the patient during care. c. Ask the patient about any special cultural beliefs or practices. d. Involve the patient's oldest son to assist with health care decisions.

ANS: C Further assessment of the patient's health care preferences is needed before making further plans for culturally appropriate care. The other responses indicate stereotyping of the patient based on ethnicity and would not be appropriate initial actions.

The nurse is caring for a newly admitted patient. Which intervention is the best example of a culturally appropriate nursing intervention? a. Insist family members provide most of the patient's personal care. b. Maintain a personal space of at least 2 feet when assessing the patient. c. Ask permission before touching a patient during the physical assessment. d. Consider the patient's ethnicity as the most important factor in planning care.

ANS: C Many cultures consider it disrespectful to touch a patient without asking permission, so asking a patient for permission is always culturally appropriate. The other actions may be appropriate for some patients but are not appropriate across all cultural groups or for all individual patients. Ethnicity may not be the most important factor in planning care, especially if the patient has urgent physiologic problems.

A female staff nurse is assessing a male patient of Arab descent who is admitted with complaints of severe headaches. It is most important for the charge nurse to intervene if the nurse takes which action? a. The nurse explains the 0 to 10 intensity pain scale. b. The nurse asks the patient when the headaches started. c. The nurse sits down at the bedside and closes the privacy curtain. d. The nurse calls for a male nurse to bring a hospital gown to the room.

ANS: C Many males of Arab ethnicity do not believe it is appropriate to be alone with any female except for their spouse. The other actions are appropriate.

A staff nurse expresses frustration that a Native American patient always has several family members at the bedside. Which action by the charge nurse is most appropriate? a. Remind the nurse that family support is important to this family and patient. b. Have the nurse explain to the family that too many visitors will tire the patient. c. Suggest that the nurse ask family members to leave the room during patient care. d. Ask about the nurse's personal beliefs about family support during hospitalization.

ANS: D The first step in providing culturally competent care is to understand one's own beliefs and values related to health and health care. Asking the nurse about personal beliefs will help achieve this step. Reminding the nurse that this cultural practice is important to the family and patient will not decrease the nurse's frustration. The remaining responses (suggest that the nurse ask family members to leave the room, and have the nurse explain to family that too many visitors will tire the patient) are not culturally appropriate for this patient.

The nurse cares for a patient who speaks a different language. If an interpreter is not available, which action by the nurse is most appropriate? a. Talk slowly so that each word is clearly heard. b. Speak loudly in close proximity to the patient's ears. c. Repeat important words so that the patient recognizes their significance. d. Use simple gestures to demonstrate meaning while talking to the patient. ANS: D The use of gestures will enable some information to be communicated to the patient. The other actions will not improve communication with the patient.

ANS: D The use of gestures will enable some information to be communicated to the patient. The other actions will not improve communication with the patient.

The nurse educator is providing in-service education to the nursing staff regarding transcultural nursing care; a staff member asks the nurse educator to describe the concept of acculturation. The nurse educator should make which most appropriate response? 1. "It is a process of learning a different culture to adapt a new or changing environment." 2. "It is a subjective perspective of the person's heritage and a sense of belonging to a group." 3. "It is a group of individuals in a society who are culturally distinct and have a unique identity." 4. "It is a group that shares some of the characteristics of the larger population group of which it is a part."

Answer: 1. Rationale: Acculturation is a process of learning a different culture to adapt to a new or changing environment. Option 2 describes ethnic identity. Option 3 describes an ethnic group. Option 4 describes a subculture. Test-Taking Strategy: Note the strategic words most appropriate. Focus on the subject, acculturation. Think about the definition of acculturation to help direct you to the correct option.

The nurse is caring for a patient who claims that he does not believe in God, nor does he believe in an "ultimate reality." The nurse realizes that this patient a. Is devoid of spirituality b. Is an atheist/agnostic c. Finds no meaning through relationships with others d. Believes that what he does is meaningless

B Some individuals do not believe in the existence of God (atheist) or believe that there is no known ultimate reality (agnostic). This does not mean that spirituality is not an important concept for the atheist or the agnostic. Atheists search for meaning in life through their work and their relationships with others. Agnostics discover meaning in what they do or how they live because they find no ultimate meaning for the way things are. They believe that people bring meaning to what they do.

Which of the following statement about religion and spirituality is true? a. Religion is a unifying theme in people's lives b. Spirituality is unique to the individual c. Spirituality encompasses religion d. Religion and spirituality are synonymous

B Spirituality is a complex concept that is unique to each individual. Religion refers to the system of organized beliefs and worship that a person practices to outwardly express spirituality. People from different religions view spirituality differently. Although closely associated, spirituality and religion are not synonymous. Religious practices encompass spirituality, but spirituality does not need to include religious practice.

In discussing spiritual well-being, the nurse identifies that the vertical dimension involves a. The positive relationships and connections people have with others b. The transcendent relationship between a person and God c. Confidence in something for which there is no proof d. Providing an attitude of something to live for and look forward to

B The concept of spiritual well-being is often described as having two dimensions. The vertical dimension supports the transcendent relationship between a person and God or some other higher power. The horizontal dimension describes positive relationships and connections people have with others. Faith provides confidence in something for which there is no proof. When a person has the attitude of something to live for and look forward to, hope is present.

The nurse and the patient have the same religious affiliation. Because of this, the nurse a. Can assume that they have the same spiritual beliefs b. Should not impose her personal values on the patient c. Must use an assessment tool to assess the patient's beliefs d. Can skip the spiritual belief assessment

B The nurse can use an assessment tool or direct an assessment with questions based on principles of spirituality, but it is important not to impose personal value systems on the patient. This is particularly true when the patient's values and beliefs are similar to those of the nurse because it then becomes very easy to make false assumptions. It is important to conduct the spiritual belief assessment; conducting an assessment is therapeutic because it expresses a level of caring and support.

The patient is having a difficult time dealing with his AIDS diagnosis. He states, "It's not fair. I'm totally isolated from my family because of this. Even my father hates me for this. He won't even speak to me." The nurse needs to a. Assure the patient that his father will accept his situation soon. b. Use therapeutic communication to establish trust and caring. c. Point out that the patient has no control and that he has to face the consequences. d. Tell the patient, "If your father can't get over it, forget it. You have to move on."

B The nurse needs to use therapeutic communication to establish trust and a caring presence because providing spiritual care requires caring, compassion, and respect. The nurse should not offer false hope. The nurse should help the patient maintain feelings of control. The nurse should encourage renewing relationships if possible and establishing connections with self, significant others, and God.

The nurse is caring for a patient who is terminally ill with very little time left to live. The patient states, "I always believed that there was life after death. Now, I'm not so sure. Do you think there is?" The nurse states, "I believe there is." The nurse has attempted to a. Strengthen the patient's religion b. Provide hope c. support the patient's agnostic beliefs d. Support the horizontal dimension of spiritual well-being

B When a person has the attitude of something to look forward to, hope is present. Religion refers to the system of organized beliefs and worship that a person practices to outwardly express spirituality. This is not evident here. Agnostics believe that there is no known ultimate reality. This would indicate a lack of belief in life after death. The horizontal dimension of spiritual well-being describes positive relationships and connections people have with others. In this case, the patient is more concerned with the vertical dimension, which supports the transcendent relationship with God or some other higher power.

Which of the following statements made by an older adult whose husband recently died most indicates the need for follow-up by the nurse? A. "I planted a tree at church in my husband's honor." B. "I have been unable to talk with my children lately." C. "My friends think that I need to go to a grief support group." D. "I believe that someday I'll meet my husband in heaven."

B. "I have been unable to talk with my children lately." Feelings of connectedness are important for the older adult; this statement indicates that this woman is having difficulty staying connected with her children, who are potentially an important resource for the woman.

An emergency department nurse is caring for a patient who was severely injured in a car accident. The patient's family is in the waiting room. They are crying softly. The nurse sits down next to the family, takes the mother's hand, and says, "I can only imagine how you're feeling. What can I do to help you feel more at peace right now? " In this example the nurse is demonstrating: A. Prayer. B. Presence. C. Coaching. D. Instilling hope.

B. Presence The nurse demonstrates presence in this situation by establishing a therapeutic relationship and being with the mother during a particularly stressful time.

Which of the following would be the most appropriate outcome for a patient who has a nursing diagnosis of spiritual distress related to loneliness? A. Encourage the patient to meditate 2 to 3 times a week. B. The patient will set up a time to speak to a close friend in 1 week. C. Encourage the patient to phone his brother and set up a time to go out for dinner. D. The patient will experience greater connections with family members in 2 months.

B. The patient will set up a time to speak to a close friend in 1 week. This outcome addresses the patient's nursing diagnosis. The statement "The patient will set up a time to speak to a close friend in 1 week" as well as encouraging the patient to set up a time to go to dinner with his brother are both nursing interventions. The statement "The patient will experience greater connections with family members in 2 months" is a goal.

In identifying patients at the greatest risk for health disparities, the nurse would note that: A. patients who live in urban areas have readily available access to health care services. B. cultural differences exist in the ability of patients to communicate with their health care provider. C. a patient receiving care from a health care provider of a different culture would have decreased quality of care. D. men are more likely than women to have their cardiovascular disease symptoms ignored by their health care provider.

B. cultural differences exist in the ability of patients to communicate with their health care provider.

Which of the following is the first step in developing cultural competence? A. create opportunities to interact with a variety of cultural groups B. examine the nurse's own cultural background, values, and beliefs about health care C. learn a multitude of fold medicines and herbal substances that different cultures use for self care D. learn assessment skills for different cultural groups, including cultural beliefs and practices and physical assessment

B. examine the nurse's own cultural background, values, and beliefs about health care

Which of the following client statements most clearly suggests the potential of a nursing diagnosis of Spiritual Anxiety?

"Now that I'm nearing the end, I'm worried that God won't think I lived a good enough life."

The nurse works in a clinic located in a community with many Hispanics. Which strategy, if implemented by the nurse, would decrease health care disparities for the Hispanic patients? a. Improve public transportation to the clinic. b. Update equipment and supplies at the clinic. c. Obtain low-cost medications for clinic patients. d. Teach clinic staff about Hispanic health beliefs.

ANS: D Health care disparities are due to stereotyping, biases, and prejudice of health care providers. The nurse can decrease these through staff education. The other strategies also may be addressed by the nurse but will not directly impact health disparities.

Forcing one's own cultural beliefs and practices on another person is an example of: A. stereotyping B. ethnocentrism C. cultural relativity D. cultural imposition

B. ethnocentrism

The nurse creates a referral to pastoral care when he/she realizes that the patient is in need of a. Psychiatric care b. Return to religious affiliation c. Spiritual care d. Transfer to the psychiatric unit

C Spiritual care helps people identify meaning and purpose in life, look beyond the present, and maintain personal relationships, as well as a relationship with a higher being or life force. The patient may need psychiatric care and may be transferred to the psychiatric unit, but referral to pastoral care will not provide that. Return to a religious affiliation may follow a return to spiritual health.

When caring for a terminally ill patient, the nurse should focus on the fact that a. Spiritual care is possibly the least important nursing intervention. b. Spiritual needs often need to be sacrificed for physical care priorities. c. The nurse's relationship with the patient allows for an understanding of patient priorities. d. Members of the church or synagogue play no part in the patient's plan of care.

C The nurse's relationship with the patient allows the nurse to understand the patient's priorities. Spiritual priorities do not need to be sacrificed for physical care priorities. When a patient is terminally ill, spiritual care is possibly the most important nursing intervention. If the patient participates in a formal religion, involve in the plan of care members of the clergy or members of the church, temple, mosque, or synagogue.

A Catholic patient with diabetes receives the following items on his meal tray on the Friday before Easter. For which of the foods does the nurse offer to substitute? A. Apple sauce B. Cheese and crackers C. Spaghetti with meat sauce D. Tossed salad with ranch dressing

C. Spaghetti with meat sauce Most Catholics do not eat meat on Good Friday.

A client expresses confidence in his traditional healer to relieve symptoms of an illness. What is the client demonstrating?

Faith

Today you are caring for Mary Snow, who is preparing to undergo a left mastectomy. As you perform your physical assessment, she informs you that she is unable to accept blood products as treatment due to her religion. You interpret this as a belief of which of the following religions?

Jehovah's Witness

A client tells a nurse that he does not think he can have the recommended heart surgery because transfusions are against his religion. What is the best response of the nurse in this situation?

Obtain all the information needed for the client to make an informed decision.

A nurse is caring for a terminally ill client who believes that death and reincarnation are the ultimate gifts from God to mankind. What would be most appropriate to integrate into this client's plan of care when providing spiritual support?

Provide support that builds on the client's faith

Campinha-Bacote's model of culturally competent care encourages health care providers to:

Seek cultural encounters, obtain cultural knowledge, develop skills to conduct culturally sensitive assessments, and develop self-awareness