( HA Ch 5) PrepU - Cultural and Spiritual Assessment
The nurse is working with a client on how to manage his hypertension. The client states that he is taking herbs recommended from within his community. How should the nurse best respond? a) "Let's talk with your physician to see how we an incorporate these into your plan of care. b) "Medications should not be mixed. You will need to chose how you will be treated." c) "Herbal remedies have not been tested. They should never be used." d) "Unless you FDA approved herbal treatment, we cannot be sure if the contents are safe.
a) "Let's talk with your physician to see how we an incorporate these into your plan of care. Some cultures use spiritualist, herbalist or traditional healers. It is important to try to incorporate cultural beliefs into care. All other responses do no take cultural beliefs into consideration.
Stereotyping is defined as a) expecting all members of a cultural group to hold the same beliefs and behave in the same way. b) the belief that one's cultural values are superior to all others. c) a worldview that each of us forms values and beliefs based on our own culture. d) a culture-bound syndrome found in many cultural groups.
a) expecting all members of a cultural group to hold the same beliefs and behave in the same way. Many people are aware of other cultures and their different beliefs, values, and accepted behaviors but do not recognize the considerable variation that can exist within any cultural group. Not recognizing this variation tends to lead to stereotyping all members of a particular culture, expecting group members to hold the same beliefs and behave in the same way.
A client comes to the ED with lower abdominal pain. She is extremely emotional and moving wildly on the gurney. A nurse says to another nurse that the client is "way overdoing it." What action should the nurse take to best provide care for this client? a) Conduct a cultural assessment to better understand the client's perception of pain and illness. b) Tell the physician the client is not hurting as much as she lets on c) Talk to the client's family to find out if this is the normal behavior for this client d) Move the client so she will not bother other clients in the department
a) onduct a cultural assessment to better understand the client's perception of pain and illness. Some cultures encourage sick clients to be pampered and express pain freely. Whatever the situation, nurses must display a nonjudgmental attitude, provide facts, and use a culturally specific approach when administering prescribed treatments. They must never interpret the client's inactivity and dependence as apathy, depression, or "being difficult" without first conducting a cultural assessment and gaining insight into the client's medical diagnosis and behavior. It is not appropriate for the nurse to tell the physician that the client is not in as much pain as she is letting on, to move the client away from other clients in the department, or to talk to the client's family to find out if this is the normal behavior for this client.
A nurse admits a client to the hospital that is African American. The nurse recognizes that this client is at increased risk for what conditions due to ethnicity or culture? Select all that apply a) Gallbladder disease b) Cerebrovascular accident c) Peripheral artery disease d) Asthma e) Skin cancer f) Osteoporosis
b) Cerebrovascular accident c) Peripheral artery disease d) Asthma African Americans are at high risk for all diseases of the cardiovascular system, such as hypertension, heart attacks, stroke, and peripheral artery disease. African Americans have the highest prevalence rate of asthma and are more likely to die from the disease than members of other U.S. racial or ethnic groups. Gallbladder disease and cancer vary by ethnic group in the US. Native Americans and Mexican Americans have higher rates of disease and cancer. Osteoporosis is more prevalent in small framed people such as Asians. Fair skinned people, especially those with light eyes and freckles, are at highest risk for developing skin cancers, although all people who are exposed to high levels of intense sunlight are at risk.
A nurse is participating in an educational exercise in which she is conducting a self-examination of her own biases. This activity addresses what construct of cultural competence? a) Cultural desire b) Cultural awareness c) Cultural skill d) Cultural knowledge
b) Cultural awareness Cultural awareness is the process of conducting a self-examination of one's own biases toward other cultures and the in-depth exploration of one's cultural professional background. Self-examination of biases is not central to cultural desire, knowledge, or skill.
The nurse plans time to sit with a client to help address the client's spiritual needs. Why is this important? a) Clients feel more comfortable talking with nurses b) Nurses have the most time to address a client's spiritual needs c) Clients are holistic beings consisting of body, mind, and spirit d) Nurses are easier to talk to than spiritual advisors or chaplains
c) Clients are holistic beings consisting of body, mind, and spirit Attending to spiritual needs has been a part of the nursing profession since the beginning with Florence Nightingale. The most important reason for nurses to address spiritual needs is because nurses see clients as holistic beings consisting of body, mind, and spirit. The reason nurses address spiritual needs is not because clients feel more comfortable talking with nurses or are easier to talk with than spiritual advisors or chaplains. Nurses do not necessarily have the most time to address a client's spiritual needs.
A nurse's personal reflection reveals that the nurse tends to see their own culture as the "gold standard" to which all other cultures should aspire. This nurse should create learning goals to address what phenomenon? a) Acculturation b) Unconscious incompetence c) Ethnocentrism d) Stereotyping
c) Ethnocentrism The perception that one's worldview is the only acceptable truth and that one's beliefs, values, and sanctioned behaviors are superior to all others is called ethnocentrism. Unconscious incompetence involves being unaware that one lacks cultural knowledge and unaware that cultural differences exist. Acculturation involves the modification of cultural values to align with those of the predominant culture. Stereotyping is expecting all members of a particular culture to hold the same beliefs and behave in the same way.
The nurse plans to use the FICA spiritual history tool when assessing a client's spiritual needs. What will the nurse include in this assessment? Select all that apply. a) Address in care b) Sources of hope c) Importance d) Community e) Faith and belief
c) Importance d) Community a) Address in care e) Faith and belief When using the FICA spiritual history tool, the nurse will assess importance, community, address in care, and faith and belief. Sources of hope is a part of the HOPE assessment tool.
After teaching a group of students about spirituality and religion, the instructor determines that the students need additional teaching when a student states which of the following? a) Spirituality and religion are important factors that can affect health decisions and outcomes. b) There has been a tremendous growth in the understanding of spirituality in the past 20 years. c) Nursing has only recently begun to incorporate spirituality into client care. d) Religion and spirituality are separate and distinct, but interrelated concepts.
c) Nursing has only recently begun to incorporate spirituality into client care. Nursing has a history of incorporating spirituality into client care, as evidenced by the writings of Florence Nightingale denoting an inner strength. Spirituality and religion are important factors that can affect health decisions and outcomes. They are separate and distinct concepts that are interrelated. Spirituality has undergone tremendous growth in its conceptual understanding during the past 20 years.
The path one pursues in the search for life's meaning and purpose. a) Denomination b) Philosophy c) Spirituality d) Religion
c) Spirituality Spirituality is defined as a search for meaning and purpose in life; it seeks to understand life's ultimate questions in relation to the sacred.
Matters of the human soul are referred to as what? a) Culture b) Values and beliefs c) Spirituality d) Ethnicity
c) Spirituality Spirituality, in the most fundamental sense, pertains to matters of the human soul, be it a state of mind, a state of being in the world, a journey of self-discovery, or a place outside the five senses. Culture can be defined as a shared, learned, and symbolic system of values, beliefs, and attitudes that shapes and influences the way people see and behave in the world. Ethnicity is one's self-defined race. Values and beliefs are those things that a person or culture sees as having worth.
The nurse reviews data collected while completing a spiritual assessment with a client. Which data should the nurse focus as the primary source of information for this assessment? a) Medical record b) Objective c) Subjective d) Secondary sources
c) Subjective Subjective data will be the primary source of information during a spiritual assessment with objective data used to validate the information. The medical record and secondary sources are not the primary sources of information for a spiritual assessment.
You are caring for a 70-year-old Serbian woman who is in the United States visiting her family. What must occur before this patient is willing to teach you about her culture? a) You need to hide your biases b) You need to establish a value-based partnership c) You need to establish rapport and trust d) The patient's family must allow it
c) You need to establish rapport and trust If you have established rapport and trust, patients will be willing to teach you.
A nurse is completing a comprehensive assessment of a client who has been referred to the clinic. Which of the following would be most appropriate for the nurse to ask when beginning to assess the client's spirituality? a) "Would you like to speak to a chaplain?" b) "What religion are you?" c) "Do you believe in God?" d) "What gives you hope or peace?"
d) "What gives you hope or peace?" When beginning a spiritual assessment, the nurse needs to initiate the interaction by opening up a general dialogue about global concepts such as hope, peace, comfort, strength, love, and connection. The most useful techniques typically have general introductory questions, which then lead to more focused questions such as beliefs, formalized religion, and eventually questions about the client's desires related to accessing resources such as a chaplain or spiritual leader.
Based on a colleague's feedback, a nurse learns that she is aware of cultural differences in a general way but does not know what the specific differences are or how to communicate with a person of a specific culture. This nurse exhibits which of the following? a) Unconscious incompetence b) Conscious competence c) Unconscious competence d) Conscious incompetence
d) Conscious incompetence Conscious incompetence occurs when one is aware that one lacks knowledge about another culture; the individual is aware that cultural differences exist, but he or she does not know what they are or how to communicate effectively with clients from different cultures. Unconscious incompetence occurs when one is not aware that one lacks cultural knowledge and is not aware that cultural differences exist. Conscious competence involves consciously learning about the client's culture and providing culturally relevant interventions; the person is aware of differences and is able to have effective transcultural interactions. Unconscious competence involves the ability to automatically provide culturally congruent care to clients from a different culture. The person has much experience with a variety of cultural groups and has an intuitive grasp of how to communicate effectively in transcultural encounters.
A new graduate nurse from a small community college is going to work in an urban setting. She embraces the thought of working in a more diverse setting and wants to learn about different cultures. What behavior is this nurse exhibiting? a) Conscious incompetence b) Cultural knowledge c) Cultural skill d) Cultural desire
d) Cultural desire Cultural desire is the motivation to engage in intercultural encounters and acquire cultural competence. The starting point of cultural competence is cultural desire.
Sickle cell disease and other hemoglobinopathies such as thalassemia are often found in persons originating from which geographical regions? a) Central and South America. b) Northern and Central Europe. c) Australia and New Zealand. d) Mediterranean and Africa.
d) Mediterranean and Africa. Drug metabolism differences, lactose intolerance, and malaria-related conditions—such as sickle cell disease, thalassemia, glucose-6-phosphate dehydrogenase (G6PD) deficiency, and Duffy blood group—are considered biochemical variations. The malaria-related conditions would obviously occur in populations living in or originating from mosquito-infested locales such as the Mediterranean and Africa.
A nurse is planning care that is grounded in the fact that clients are holistic beings. Which of the following components constitute the view of clients as holistic beings? a) Id, ego, superego b) Spiritual identity, egocentric nature, naïve identity c) Physical identity, psychosocial identity, religious identity d) Mind, body, spirit
d) Mind, body, spirit Nursing has a long history of incorporating spirituality into client care. References to spirituality underlie a primary idea in nursing, that clients are viewed as holistic beings in body, mind, and spirit. Id, ego, and superego are concepts associated with psychoanalytic theory. A holistic view is more than physical, psychosocial, and religious aspects or spiritual, egocentric, and naïve components.
During the assessment of a Caucasian client with wax accumulation in the ear, the nurse observes that the ear wax is wet. The nurse recognizes this is related to what physiological variation among racial groups? a) Amount of chloride excreted by the functioning glands differs by racial groups b) Eccrine glands are more prevalent in the ears of Caucasians c) Caucasians acclimatized to the tropics have lower salt-chloride levels d) Secretions produced by apocrine glands are based on genetic traits
d) Secretions produced by apocrine glands are based on genetic traits Ear-wax produced by apocrine glands in the external ear varies between dry and wet wax, based on genetic trait. Ninety-seven percent of Caucasians have wet ear-wax. The apocrine glands opening into the hair follicles in the external auditory canal vary a lot in the number of functioning glands. Eccrine glands distributed over the entire body produce sweat secretions based on environmental and individual adaptation. The amount of chloride excreted by sweat glands differs by ethnic or racial group and the environment. The sweat of Caucasians acclimatized to the tropics has lower salt-chloride concentration than of non-acclimatized Caucasians.
The nurse is assessing a patient's ability to employ coping mechanisms when given a diagnosis of cancer. What type of assessment would be beneficial for the nurse to use? a) Physical assessment b) Cultural assessment c) Mini-Mental status assessment d) Spiritual assessment
d) Spiritual assessment Thoughts about spirituality and religion may vary immensely from one patient to the next. During a spiritual assessment, the health care professional should keep an objective perspective with the goal of meeting the patient where she or he is. Knowing how spirituality can vary will help the nurse to identify possible coping responses; otherwise, these resources might have gone unnoticed.
The nurse is setting an outcome with the patient experiencing spiritual distress. Which goal would be appropriate? a) The patient will attend a community event every week. b) The patient will initiate interaction with others. c) The patient will express feelings of connectedness with others. d) The patient will express meaning and purpose in life.
d) The patient will express meaning and purpose in life. An outcome appropriate for the patient experiencing spiritual distress would be for the patient to express meaning and purpose in life. The other options would be appropriate for the patient experiencing social isolation.
