Deck 8: Culture, Ethnicity, and Spirituality

Question 1

The nurse determines which patient is at the greatest risk for a spiritual crisis?

A) A patient, whose religion opposes the use of blood products, has a severely bleeding ulcer
B) A single parent who must decide to terminate life support for a terminally ill child
C) A newlywed whose spouse has died in an automobile accident caused by a drunk driver
D) A patient who denies the need for spiritual support when given the diagnosis of terminal cancer

Answer 1

A patient, whose religion opposes the use of blood products, has a severely bleeding ulcer

Question 2

The nurse is addressing the possibility that a family of newly emigrated Hispanics may experience cultural shock.Which statements are truisms concerning this cultural adaptation issue? Select all that apply.

A) Most primitive cultures embrace the lifestyle of the industrialized ones.
B) It may take generations for family members to become acculturated.
C) The most resistant to adaptation are children and young adults.
D) Typical responses include fear and distrust of strangers.
E) Family members are at high risk for anxiety disorder.

Answer 2

It may take generations for family members to become acculturated.
Family members are at high risk for anxiety disorder.

Question 3

An Asian-American patient diagnosed with depression explains to the nurse that eating two specific foods will restore the balance of hot and cold and she will be cured.The nurse should:

A) Explain that foods cannot cure mental disorders.
B) Arrange for the patient to talk with the dietitian.
C) Change the subject to focus on medication compliance.
D) Accept that cultural beliefs about illness die slowly.

Answer 3

Arrange for the patient to talk with the dietitian.

Question 4

The nurse believes that a patient is exhibiting internal locus of control related to spiritual development.Which patient statement supports this conclusion?

A) "Praying gives me tremendous comfort."
B) "I pray because my church says that prayer is the way to God"
C) "I will ask that my fellow church members pray for me to get better."
D) "My mother prayed daily and she was such a good and kind person."

Question 5

An Asian-American patient is referred to the mental health clinic.He has many somatic complaints for which no physical basis has been found.The patient tells the nurse that he does not believe this clinic can help him.Based on knowledge of the beliefs common to this culture,what can the nurse hypothesize about the patient?

A) Because of the cultural stigma attached to mental illness, he may be expressing psychological distress via somatic symptoms.
B) Acculturation has occurred because feelings of hopelessness are alien to his native culture.
C) Suicide is not a present danger because suicidal impulses are rarely associated with feelings of helplessness among Asian-American patients.
D) The patient has rejected both family care and traditional healing methods in favor of health care practices of the new culture.

Question 6

The nurse plans to use pamphlets to teach a newly immigrated Vietnamese patient about diabetes mellitus.Before initiating this education,the priority information for the nurse to obtain is the patient's:

A) Ability to read and understand English
B) Readiness and ability to learn this material
C) Previous knowledge and interest in the subject
D) Willingness to participate and follow instructions

Question 7

Which communication behavior would be considered uncharacteristic for a patient from a high-context culture?

A) Little direct eye contact
B) Use of global messages
C) Use of nonverbal symbolization
D) Arguing points with the physician

Question 8

To include a cultural focus in patient care planning,which belief about faith will the nurse incorporate? Faith is a:

A) Belief of body and mind
B) Manner of expressing spirituality
C) Use of spiritual resources without empiric proof
D) Search for the sacred, transcendent, or universal

Question 9

A patient confides to the nurse that she feels guilty about the poor relationship she had with her mother-in-law,who is now deceased.The patient tells the nurse that she is sure God will punish her for this and that she needs to confess her sins to someone.Which of the following is the best response by the nurse?

A) "Would you like to speak to the chaplain when he comes later today? In the meantime, we could talk about your relationship with your mother-in-law."
B) "It sounds as if you need to talk about this. Let's sit down in a private area. I'd like to know more about your relationship with your mother-in-law."
C) "We all have trouble with our in-laws occasionally. God doesn't punish us for that."
D) "What's done is done. We need to focus on your positive qualities."

Question 10

A patient's cultural background is identified as being sociologically low context.Which nursing interventions would be appropriate for such a patient? Select all that apply.

A) Asking the patient to contribute suggestions to include in the care plan
B) Providing the patient with privacy during visits with their religious leaders
C) Instructing the patient on how to select foods within their prescribed diet plan
D) Waiting to provide medication education until family members are visiting
E) Facilitating the family in assuming responsibility for the patient's physical needs

Question 11

A patient diagnosed with paranoid schizophrenia is describing religiously-based delusions that other patients find offensive.Which nursing intervention will the nurse implement to provide a therapeutic milieu?

A) Engaging the delusional patient in prayer in order to redirect the problematic behavior
B) Explaining to the delusional patient that such talk is offensive to some of the milieu and will not be allowed
C) Asking for the pastoral counselor to visit the unit and talk with both the delusional patient as well as the rest of the milieu
D) Removing the delusional patient from the milieu when staff is unable to successfully refocus the conversation to a non-religious topic

Question 12

A culturally diverse patient refuses to participate in a group because of the presence of a person who "can put spells on." The nurse recognizes a priority need to explore this patient's:

A) Economic status
B) Home environment
C) Health-illness beliefs
D) Educational background

Question 13

A nurse is planning to incorporate a culturally sensitive focus in her nursing care.Which of these underlying principles concerning cultural heritage will be included?

A) A group is formed from among individuals who share similar ancestral origins.
B) A condition of belonging to a group is that all members share a unique heritage.
C) Learned patterns of behavior and thinking are shared by members of a cultural group.
D) The classification of humans into cultural groups is generally based on physical characteristics.

Question 14

A nurse works in a mental health clinic serving many Southeast Asian individuals.Which statements by the nurse would validate a striving toward cultural competence? Select all that apply.

A) "It's a challenge to plan treatment that is culturally congruent."
B) "My dream is to be accepted by the Southeast Asian patients I care for."
C) "There is so much to learn about the Southeast Asians and their problems."
D) "Psychiatric care tends to be similar for those of Southeast Asian cultures."
E) "I always try to be sensitive to the uniqueness of my culturally diverse patients."

Question 15

Assessment of interpersonal relationships of Asian and Asian-American patients is dependent on the nurse's understanding that the culture of these patients is identified as high context and will therefore value:

A) Privacy; family is not routinely included in health discussions
B) Their right to make independent decisions about their care
C) Sharing their opinions and wishes with healthcare team
D) Their role and place in their family structure

Question 16

The nurse identifies a patient as being in spiritual distress.Which patient statement supports this nursing diagnosis?

A) "I've never felt so alone before in my entire life."
B) "I don't know if I could get through this without faith in God."
C) "I've always relied on my faith in God but now I feel I've been abandoned."
D) "Why do bad things happen to good people? I've always been a good person."

Question 17

When working with a patient newly emigrated from Asia who has been assessed as having xenophobia,the nurse could anticipate making the assessment that the individual:

A) Resists sharing food with others
B) Would be reluctant to ride an elevator
C) Is unlikely to talk with nonfamily members
D) Fears the consequences of going out of doors

Question 18

A novice nurse has identified impaired verbal communication for an older Asian patient who recently immigrated to the United States based on the patient's reluctance to maintain eye contact and engage in a conversation with staff.In order to assure that the diagnosis is appropriate,the nurse manage asks:

A) "Have you asked the patient why communication is difficult for them?"
B) "Could you be misdiagnosing common shyness for a communication issue?"
C) "Have you noticed the patient communicating differently with family when they visit?"
D) "Do you think the patient's cultural traditions have a part to play in their communication behaviors?"

Question 19

As a nurse assesses culture factors with patients,the subculture that poses the greatest risk to a patient's mental health is:

A) Poverty
B) Female gender
C) Advanced age
D) Cultural ethnicity

Question 20

A patient is dealing with the loss of a spouse.Which response shows an understanding of the role spirituality plays in the management of grief?

A) "He's in a better place; my faith tells me that is true."
B) "I find that my faith is stronger now that I'm alone."
C) "I'm told that a sense of spiritual connection will help me go on with life."
D) "My faith helps me deal and gives me renewed hope; I rely on it to help me heal."

Question 21

A patient experiencing depression over the loss of a loved one shares that,"I'm not a religious person but I need something to help me cope with this." The nurse shows an understanding to the need for an outlet for the expression of emotions when (select all that apply):

A) Asking, "Does dancing make you feel good?"
B) Encouraging the patient to talk about the feelings
C) Offering to arrange for a consult with the music therapist
D) Asking, "Can you think of ways to express your emotions in a healthy way?"
E) Suggesting the patient draw a picture of what it feels like to experience such a loss

Question 22

Guidelines for communicating with a patient whose ability to speak and understand English is questionable include (select all that apply):

A) Use interpreters whenever possible.
B) Allow sufficient time for patient to formulate response.
C) Recruit a family member as an interpreter whenever possible.
D) Use nonverbal communication whenever it is considered appropriate.
E) Maintain eye contract if such interaction is accepted by the patient's culture.