Mental Health Ch. 5

According to the Western scientific view of health, illness is the result of pathogens. energy blockage. spirit invasion. soul loss

pathogens.

The psychiatric nurse planning and implementing care for culturally diverse clients should understand holistic theory. systems theory. adaptation theory. political power theory.

holistic theory.

The question that would give data of least value to the assessment of family dynamics is "What changes have occurred recently at work?" "Are your wife and children conforming to your expectations?" "Are you experiencing stress associated with conforming to family expectations?" "Do you expect others to shun or avoid you because you are seeing a therapist?"

"Do you expect others to shun or avoid you because you are seeing a therapist?" The question about others' reaction to seeking help from a psychotherapist will not provide data about family dynamics.

A peer asks you to help him differentiate between culture and ethnicity for clarification. Which statement by the peer would acknowledge that you had appropriately helped him clarify the difference between the two terms? "So, ethnicity refers to having the same life goals whereas culture refers to race." "So, ethnicity refers to norms within a culture, and culture refers to shared likes and dislikes." "So, ethnicity refers to shared history and heritage, whereas culture refers to sharing the same beliefs and values." "So, ethnicity refers to race, and culture refers to having the same worldview."

"So, ethnicity refers to shared history and heritage, whereas culture refers to sharing the same beliefs and values." Ethnicity is sharing a common history and heritage. Culture comprises the shared beliefs, values, and practices that guide a group's members in patterned ways of thinking and acting. The other options are all incorrect definitions of ethnicity and culture.

The nurse assesses the wellness beliefs and values of a client from another culture best when asking "What do you think is making you ill?" "When did you first feel ill?" "How can I help you get better?" "Did you do something to cause the illness?"

"What do you think is making you ill?"

Which assessment question would produce data that would help a nurse understand healing options acceptable to a client of a different culture? "Is there someone in your community who usually cures your illness?" "What usually helps people who have the same type of illness you have?" "What questions would you like to ask about your condition?" "What sorts of stress are you presently experiencing?"

"What usually helps people who have the same type of illness you have?" Asking about typical treatment seeks information about the "usual" cultural treatment of the disorder experienced by the client.

You are working on the psychiatric unit and assisting with the care for Mr. Tran, a refugee from Darfur, who came to the United States 1 year ago. Although Mr. Tran understands and speaks some very limited English, he is much more comfortable conversing in his native language. Mike, the nurse working directly with Mr. Tran, says to you, "I am so frustrated trying to communicate with Mr. Tran! He insists on speaking his language instead of English. I think if people want to live here, they ought to have to speak our language and act like we do!" Which of the following responses you could make promotes culturally competent care? (select all that apply): "You are right that Mr. Tran needs to speak English, but all patients do have a right to an interpreter, so you need to comply." "I agree that it is frustrating trying to communicate with Mr. Tran. Maybe we could see if his family members can help convince him to try speaking English." "Mr. Tran will have to learn to speak English eventually to live and work successfully in this country. Just try to be patient and encourage him to try speaking English." "What you are saying is actually considered cultural imposition, which is imposing our own culture onto someone from a different culture." "Mr. Tran's ability to speak and understand English is very limited. He needs to have an interpreter to make sure he can make his needs and feelings known."

3,4 Cultural imposition is imposing our own cultural norms onto those from another cultural group. By obtaining an interpreter for Mr. Tran, the nurse is promoting culturally competent care, ensuring the patient can communicate his feelings and needs thoroughly to the staff. Patients do have a right to an interpreter, but stating that Mike is right is not promoting culturally competent care and is instead confirming his opinion. Asking family members to convince the patient to speak English is not promoting culturally competent care and also undermines the trust between nurse and patient. Instead of encouraging the patient to speak English an interpreter should be obtained for the patient.

Which statement best explains the term "worldview"? Beliefs and values held by people of a given culture about what is good, right, and normal. Ideas derived from the major health care system of the culture about what causes illness. Cultural norms about how, when, and to whom illness symptoms may be displayed. Valuing one's beliefs and customs over those of another group.

Beliefs and values held by people of a given culture about what is good, right, and normal. A worldview is a system of thinking about how the world works and how people should behave in the world and toward each other. It is from this view that people develop beliefs, values, and the practices that guide their lives.

Which source of healing might be most satisfactory to a client who believes his illness is caused by spiritual forces? Acupuncture Dietary change Cleansings Herbal medicine

Cleansings

In the Eastern tradition, disease is believed to be caused by fluctuations in opposing forces. outside influences. members' disobedience. adoption of Western beliefs.

In the Eastern tradition, disease is believed to be caused by fluctuations in opposing forces, the yin-yang energies.

Data concerning client age, sex, education, and income should be the focus of an assessment in order to best understand cultural issues related to health practices. power and control. psychological stability. assimilation and conformity.

power and control.

Ms. Wong, aged 52 years, comes to the emergency room with severe anxiety. She was raised in China but immigrated to the United States at age 40 years. She was recently fired from her job because of a major error in the accounting department that she managed. Ms. Wong's aged parents live with her. Ms. Wong states, "I am a failure." Which of the following statements may accurately assess the basis for Ms. Wong's anxiety and feelings of failure? Ms. Wong may feel that she has let herself down since she did not achieve her personal goals in the workplace. Ms. Wong may feel that she has shamed the family by being fired and may no longer be able to provide for them. Ms. Wong may feel personally inadequate since she failed in her quest for independence and self-reliance. Ms. Wong may be feeling anxiety because in her family's traditions her failure may result in a changed fate.

Ms. Wong may feel that she has shamed the family by being fired and may no longer be able to provide for them. Eastern tradition, such as in China, where Ms. Wong is from, sees the family as the basis for one's identity, and family interdependence as the norm. The views expressed in options a and c demonstrate Western tradition where self-reliance, individuality, and autonomy are highly valued. In the Eastern view one is born into an unchangeable fate.

Which of the following best explains the concept of cultural competence? Nurses have enough knowledge about different cultures to be assured they are delivering culturally sensitive care. Nurses are able to educate their patients from other cultures appropriately about the cultural norms of the United States. Nurses adjust their own practices to meet their patients' cultural preferences, beliefs, and practices. Nurses must take continuing education classes on culture in the process of becoming culturally competent.

Nurses adjust their own practices to meet their patients' cultural preferences, beliefs, and practices. Cultural competence means that nurses adjust and conform to their patients' cultural needs, beliefs, practices, and preferences rather than their own. This option does not describe cultural competence. Although nurses are continually learning regarding culture, it is a career-long process. The goal is not to educate patients about our own culture but rather to adjust to their cultural preferences. Although nurses may take continuing education regarding culture, this does not describe the term cultural competence. The other options do not describe cultural competence.

Which healing practice is least used in the Western health system of healing practices? Antibiotic medication Surgery Targeted cellular destruction Restoring lost balance or harmony

Restoring lost balance or harmony

Josefina Juarez, aged 36 years, comes to the mental health clinic where you work after being referred by her primary care provider. Josefina came to live in the United States from Brazil 5 years ago. She is now a single mother to 6 children, ages 2 to 15, following the death of her husband last year. During the initial intake assessment, Josefina tells you her problem is that she has headaches and backaches "almost every day" and "can't sleep at night." She shakes her head no and looks away when asked about anxiety or depression and states she does not know why she was referred to the mental health clinic. You recognize that Josefina may be exhibiting: regression. somatization. enculturation. assimilation.

Somatization is described as experiencing and expressing emotional or psychological distress as physical symptoms. Regression is a defense mechanism meaning to begin to function at a lower or previous level of functioning. Enculturation refers to how cultural beliefs, practices, and norms are communicated to its members. Assimilation refers to a situation in which immigrants adapt to and absorb the practices and beliefs of a new culture until these customs are more natural than the ones they learned in their homeland.

Which idea held by the nurse would best promote the provision of culturally competent care? Western biomedicine is one of several established healing systems. Some individuals will profit from use of both Western and folk healing practices. Use of cultural translators will provide valuable information into health-seeking behaviors. Need for spiritual healing is a concept that crosses cultural boundaries.

Western biomedicine is one of several established healing systems. A nurse who holds this belief would be likely be open to a variety of established interventions. In truth, nurses cannot apply a standard model of assessment, diagnosis, and intervention to all clients with equal confidence. This leads to culturally irrelevant interventions.

The psychiatric mental health nurse working with depressed clients of the Eastern culture must realize that a useful outcome criterion might be if client reports increased somatic expressions of distress. disruption of energy balance. appeasement of the spirits. increased anxiety.

appeasement of the spirits.

People who have an indigenous worldview see themselves as spiritual and believe that they are linked with all other living things. focus on the articulation of individual needs and ideas. view the self as an extension of cosmic energy that is repeatedly reborn. are concerned with being part of a harmonious community.

are concerned with being part of a harmonious community. Clients with an indigenous worldview are interested in connectedness and being in harmony with others. They have little interest in personal goals and autonomy.

When members of a group are introduced to the culture's worldview, beliefs, values, and practices, it is called acculturation. ethnocentrism. enculturation. cultural encounters.

c Members of a group are introduced to the culture's worldview, beliefs, values, and practices in a process called enculturation. Ethnocentrism is the universal tendency of humans to think that their way of thinking and behaving is the only correct and natural way. Acculturation is learning the beliefs, values, and practices of a new cultural setting, which sometimes takes several generations. Cultural encounters occur when members of varying cultures meet and interact.

The Eastern world view can be identified by the belief that one's identity is found in individuality. holds responsibility to family as central. time waits for no one. disease is a lack of harmony with the environment.

holds responsibility to family as central. The Eastern traditional world view is sociocentric. Individuals experience their selfhood and their lives as part of an interdependent web of relationships and expectations.

Deviation from cultural expectations is considered by members of the cultural group as a demonstration of hostility. lack of self-will. variation from tradition. illness.

illness.

When assessing and planning treatment for a client who has recently arrived in the United States from China, the nurse should be alert to the possibility that the client's explanatory model for his illness reflects supernatural causes. negative forces. inheritance. imbalance.

imbalance.

Exclusive use of Western psychological theories by nurses making client assessments will result in a high level of care for all clients. standardization of nomenclature for psychiatric disorders. inadequate assessment of clients of diverse cultures. greater ease in selecting appropriate treatment interventions.

inadequate assessment of clients of diverse cultures.

Clients of another culture are at greatest risk for misdiagnosis of a psychiatric problem because of biased assessment tools. insensitive practitioners. insensitive interviewing techniques. lack of the availability of cultural translators.

insensitive interviewing techniques. Inaccurate information or insufficient information may be obtained if the interviewer is not culturally sensitive. Only when assessment data are accurate can effective treatment be planned.

A client reporting gastric pain, tells the nurse, "I think my symptoms started when a neighbor cast a spell on me." The assessment the nurse can make is that the client has a major mental illness. is expressing a culture-bound illness. requires hospitalization to protect the neighbor. will probably not respond to Western medical treatment.

is expressing a culture-bound illness.