Deck 4: Cultural, Spiritual, and Environmental Influences on the Child

Question 1

The nurse is admitting a 15-year-old girl of Asian descent for abdominal pain lasting 3 days. The accompanying parent reports that the patient is exhibiting intense pain, vomiting, and diarrhea. The nurse notes that the patient places her pain level at 3 on a scale of 0 to 10. Which conclusion does the nurse draw regarding the discrepancy in the level of pain?

A)The patient's response may be related to cultural expectations.
B)The patient is angry that the parent insisted on seeking medical treatment.
C)The parent's fear of serious illness is causing an exaggeration of symptoms.
D)The parent wants to make sure the daughter gets immediate medical care.

Answer 1

The patient's response may be related to cultural expectations.

Question 2

The nurse works in a neighborhood pediatric clinic that serves a multicultural population. The nurse uses the Giger and Davidhizar transcultural assessment model. Which of the six aspects is most helpful when performing pediatric assessments?

A)Acceptance of social organizations of which the patient and family are members
B)Awareness of personal space between the individuals who are communicating
C)Recognition of communication and how thoughts and feelings are expressed
D)Knowledge of biological variations, such as appropriate weight and development

Answer 2

Knowledge of biological variations, such as appropriate weight and development

Question 3

The nurse is providing care for a pediatric patient whose family culture is Hispanic. Which action is best when the nurse notices the patient is eating poorly at meals and rejecting snacks?

A)Ask the family members to share the types of foods preferred by the patient.
B)Encourage the family to prepare and bring favorite foods to the patient.
C)Offer the patient a variety of healthy and nutritious foods every 2 hours.
D)Contact the health-care provider and ask that dietary supplements be ordered.

Answer 3

Encourage the family to prepare and bring favorite foods to the patient.

Question 4

Identify one or more choices that best complete the statement or answer the question.
The nurse in a pediatric clinic is concerned about health-care disparities among the patient population. Which patient or family comment indicates the presence of health disparities related to culture? Select all that apply.

A)"I didn't bring my child sooner because I have a limited income."
B)"I tried all the remedies my mother used, but he just got sicker."
C)"My mother does not speak English and will need an interpreter."
D)"I felt certain that you would see my child who is now an adolescent."
E)"We took a bus and transferred twice to get our sick child here."

Question 5

The nurse is preparing to provide care to a child from a culture that is unfamiliar to the nurse. Which action by the nurse is most effective in providing culturally competent care?

A)Researching the culture on the Internet
B)Recognizing that each person and family is unique
C)Seeking advice from a coworker from the same culture
D)Determining which family member is the decision maker

Question 6

Identify one or more choices that best complete the statement or answer the question.
The nurse is conducting a health assessment on a 10-year-old boy from an Asian culture who has bruises on his arms and back. The bruises appear similar in size and shape. The nurse is familiar with Asian culture but should evaluate the patient by asking which questions? Select all that apply.

A)"Have you fallen or injured yourself recently?"
B)"How often do you feel hungry?"
C)"What does your family do to heal illness?"
D)"Are you playing any sports in school?"
E)"Has anyone hit you or otherwise hurt you?"

Question 7

The nurse is completing the admission process for a pediatric patient by obtaining information related to the patient's culture. Which area of assessment is most important if the patient is an infant?

A)The religious beliefs of the patient's family
B)The family's perception of the current health status
C)The patient's food preferences
D)The typical daily schedule followed by family and patient

Question 8

Identify one or more choices that best complete the statement or answer the question.
The nurse is aware that pediatric patients and their families have cultural needs and influences during periods of hospitalization. Which cultural elements does the nurse specifically provide for the hospitalized patient? Select all that apply.

A)Follow the schedules for meals and sleep times observed at home.
B)Encourage visitations and play times with the patient's siblings.
C)Provide a private and suitable place for caregiver hygiene and meals.
D)Set scheduled times for parents to have uninterrupted access to the patient.
E)Promote staff acceptance to parenteral input to the patient's plan of care.

Question 9

During orientation, the new nurse on a pediatric unit is informed that Leininger's cultural care theory is implemented because of a large multicultural population at the facility. Which aspect of Leininger's theory best defines the theory's impact on nursing care?

A)Transcultural nursing occurs when the nurse incorporates the patient's culture into the care provided.
B)The theory considers the complexity and interrelatedness of an individual within an environment and the community to which he or she belongs.
C)The theory helps explain how practices handed down from generations can impact an individual's health today.
D)Leininger's theory has been able to capture and articulate how culture affects health.

Question 10

A child who is 10 years of age is brought to the clinic with symptoms of a serious lower respiratory infection. The attending adult self-identifies as a grandparent. The child states the grandparent is the only family of the patient. Which is the most important information for the nurse to acquire prior to treatment?

A)How to reach one of the patient's parents
B)Which other family members live with the patient
C)If the grandparent has legal custody of the patient
D)What caused the grandparent to seek medical care

Question 11

Identify one or more choices that best complete the statement or answer the question.
The charge nurse on a pediatric unit is aware that the nurses do not demonstrate culturally competent care. Which actions does the charge nurse implement to help the nurses develop this competency? Select all that apply.

A)Arrange for classes to learn about culturally competent care.
B)Identify the cultural groups most frequently served by the facility.
C)Share the reasons why nurses need to be culturally competent.
D)Teach nurses that their own cultures and beliefs are to be eliminated.
E)Provide cultural assessment tools for the unit nurses to use.

Question 12

Identify one or more choices that best complete the statement or answer the question.
A 17-year-old pediatric patient is admitted for a fractured femur. The patient exhibits signs of being withdrawn and emotional throughout the day. During reassessment by the nurse, which approaches will reveal spiritual distress? Select all that apply.

A)Asking the patient about pain level using a scale of 0 to 10
B)Inquiring about the meaning of the fracture and hospitalization to the patient
C)Observing for and explaining the meaning of swelling and erythema of the leg
D)Performing an assessment of the patient's behaviors using the FICA scale
E)Discussing the patient's previous methods of handling distress with the parents

Question 13

Identify one or more choices that best complete the statement or answer the question.
As the director of nursing (DON), who is responsible for planning the needs of a pediatric unit for the next several years, the DON focuses on the changing demographics for the pediatric population. Based on Federal statistics, which needs does the DON prioritize for culturally sensitive care? Select all that apply.

A)Suggest for increased availability of educational literature in Chinese.
B)Plan to acquire more interpreters to serve the French population.
C)Determine whether local changes reflect national demographic changes.
D)Identify the probable increase in Hispanic children requiring care.
E)Obtain literature that is presented in both English and Spanish.

Question 14

Identify one or more choices that best complete the statement or answer the question.
The new nurse on the pediatric unit asks not to be assigned a child whose family is from the Middle East. Which personal questions does the nurse manager suggest the nurse contemplate as a method to develop self-awareness related to cultural differences? Select all that apply.

A)What have been my experiences with those of different cultures?
B)Is my unacceptance related to political differences between countries?
C)Am I attempting to not reject the culture of my family and my upbringing?
D)Are there conflicting values between the patient/family and myself?
E)Why do I feel so guilty and ashamed for not accepting a different culture?

Question 15

Identify one or more choices that best complete the statement or answer the question.
The nurse provides care in a pediatric health-care facility with a culturally diverse patient population. In which manner will the nurse promote effective and culturally considerate communication with patients? Select all that apply.

A)Communicate in a language understood by the patient and family.
B)Identify the person responsible for making the patient's medical decisions.
C)Utilize opportunities to learn about interacting with diverse cultures.
D)Identify patient's/family's perception about the cause of physical illness.
E)Learn about and practice culturally correct nonverbal communication.
F)None of above

Question 16

The nurse is providing care for a child of a family who are migrant workers. According to Dr. Madeleine Leininger's cultural care theory, which component of the theory is key for providing culturally competent nursing care?

A)Gaining the trust of patients/families of the culture
B)Capturing and articulating how culture impacts health
C)Understanding the environment created by migration
D)Learning the culture practices embraced by the patient/family

Question 17

The nurse is considering taking classes to learn another language besides English. Which factor has the greatest impact on the nurse deciding which language to study?

A)The current cultural makeup of the area around the facility.
B)The availability of foreign language classes within travel distance.
C)The languages that are currently covered by professional interpreters.
D)The 2020 projected ethnicity breakdown in the United States.

Question 18

Identify one or more choices that best complete the statement or answer the question.
The nurse is making a home visit for a patient and family who are from a different culture than the nurse. Which assessment findings during the visit cause the nurse concern? Select all that apply.

A)The family home currently houses three generations of the family.
B)The household income is supplemented by government programs.
C)The interior of the home exhibits a lack of physical updates.
D)The children are accompanied by an adult to a playground.
E)The family lives 5 miles from a pediatric health-care facility.

Question 19

The nurse is attempting to collect information from the parents of a critically ill child brought to the emergency department. The parents are from a different country, and English is their second language. The child's father suddenly shouts, "I cannot talk with you, care for my child now!" Which response by the nurse is correct?

A)"I will get an interpreter to help us understand each other."
B)"This information is important for providing care for your child."
C)"Getting angry will just complicate things; you need to calm down."
D)"I know that you are frustrated, but getting this information is important."

Question 20

A nurse is caring for an infant from a different culture than her own. The mother allows the infant to continue to cry without assessing for a cause of the distress. The nurse is disturbed about this parenting. Which is the best action for the nurse to take initially?

A)Ask the mother to share what she believes about infant crying.
B)Teach the mother that infants cry for a reason that needs to be identified.
C)Consult with the child-life specialist about the appropriateness of mother's behavior.
D)Become a role model by demonstrating proper care of the infant to the mother.