Question 1

The nurse is caring for a client who just had abdominal surgery.The client's nonverbal cues indicate pain,but the client denies the need for the pain medication prescribed by the healthcare provider.The nurse recognizes that this client is from a culture that feels it is inappropriate to complain about pain.Which action by the nurse is appropriate?

Accepted Answer

The nurse should offer the pain medication again and emphasize that providing comfort is their most important responsibility. The nurse should also explain that effective pain management is important for the healing process and reassure the client that there is no shame in expressing pain or discomfort. It is important to respect cultural differences and beliefs, but ultimately the nurse's responsibility is to prioritize the client's physical and emotional wellbeing. Choosing options A and B involves going against the client's wishes and autonomy, which is unethical. Option D is not an appropriate or compassionate response.

Question 2

The nurse is reviewing the discharge instructions for administration of home medications with an older adult client.In considering the normal changes experienced with aging when developing a teaching plan for this client,what type of bias should the nurse be careful to avoid?

Accepted Answer

Ageism refers to stereotyping, discrimination, or prejudice against individuals based on their age, and it can lead to a bias in the nurse's teaching plan for the older adult client. The nurse should avoid assuming that older adults are less capable or less intelligent than younger adults, or that all older adults have the same needs or limitations. Instead, the nurse should use person-centered care and individualized teaching strategies to address the client's unique needs and preferences. Relativism, fundamentalism, and multiculturalism are not directly related to the issue of age bias in this scenario.

Question 3

The nurse is evaluating the following goal: Client will select low-fat foods from a list by the end of the month.The client,who has different beliefs about food,has not been able to achieve this goal.Which action by the nurse is appropriate?

Accepted Answer

The best choice is to modify the plan of care to be consistent with the client's beliefs regarding food. This goal may not be achievable for the client if it goes against their beliefs about food. It is important for the nurse to work with the client and find a goal that is achievable and aligns with the client's beliefs. Changing the goal or extending the time frame may not solve the problem if the underlying issue is the client's beliefs about food. Ensuring that the client understands the importance of the goal may also not be effective if the client does not believe in the goal. Modifying the plan of care is the best choice as it allows the nurse to work with the client's beliefs and preferences to establish a realistic and achievable goal.

Question 4

A general term used for a variety of conditions in which an individual is born with a reproductive or sexual anatomy that does not seem to fit the typical definitions of female or male is

Accepted Answer

Intersex is the general term used for a variety of conditions in which an individual is born with a reproductive or sexual anatomy that does not seem to fit the typical definitions of female or male. Homosexual refers to a person's sexual orientation towards individuals of the same sex, while transgender refers to a person whose gender identity does not match the sex they were assigned at birth. Genderqueer relates to non-binary gender identities that fall outside of the traditional male/female binary.

Question 5

The novice nurse working in an inner-city hospital that serves a diverse client population states,"I want to learn everything possible about all of the clients." Which response by the seasoned nurse is appropriate?

Accepted Answer

A) It is a priority for the nurse to develop an awareness of his or her own perceptions, prejudices, and stereotypes regarding the client populations that are served. Reading about culture and remaining nonjudgmental are strategies that can be incorporated after engaging in a self-awareness inventory. Although experience working with diverse clients will help, it will be more meaningful after engaging in a self-awareness inventory.
B) It is a priority for the nurse to develop an awareness of his or her own perceptions, prejudices, and stereotypes regarding the client populations that are served. Reading about culture and remaining nonjudgmental are strategies that can be incorporated after engaging in a self-awareness inventory. Although experience working with diverse clients will help, it will be more meaningful after engaging in a self-awareness inventory.
C) It is a priority for the nurse to develop an awareness of his or her own perceptions, prejudices, and stereotypes regarding the client populations that are served. Reading about culture and remaining nonjudgmental are strategies that can be incorporated after engaging in a self-awareness inventory. Although experience working with diverse clients will help, it will be more meaningful after engaging in a self-awareness inventory.
D) It is a priority for the nurse to develop an awareness of his or her own perceptions, prejudices, and stereotypes regarding the client populations that are served. Reading about culture and remaining nonjudgmental are strategies that can be incorporated after engaging in a self-awareness inventory. Although experience working with diverse clients will help, it will be more meaningful after engaging in a self-awareness inventory.

Question 6

A nurse is explaining the need to obtain laboratory tests on a client who has an infection and is of a cultural group different from the nurse's.During the interview,the client avoids eye contact and refrains from answering questions for long periods of time.Which does this behavior indicate to the nurse?

Accepted Answer

In some cultures, direct eye contact can be seen as a sign of disrespect or submission. The nurse should be aware of this cultural difference and not interpret the lack of eye contact as a sign of dishonesty or unwillingness to communicate. It is important for the nurse to remain respectful of the client's cultural norms and find alternative ways to build rapport and gather necessary information. Therefore, the nurse should choose option A.

Question 7

The nurse notices that a client,who is from another country,appears uncomfortable when the nurse asks to look at the client's abdominal incision from a recent surgery.Which nursing action is the most culturally competent?

Accepted Answer

A) The most culturally competent intervention is to explain to the client the reason for the intervention using lay terms. The nurse should close the client's curtain to maintain privacy for all clients; this is not necessarily just a culturally competent action. Asking the client why she is uncomfortable is confronting the client and is not culturally competent. Waiting until the next assessment time to observe the incision is inappropriate, as this can lead to missing important assessment findings regarding the state of the client's incision.
B) The most culturally competent intervention is to explain to the client the reason for the intervention using lay terms. The nurse should close the client's curtain to maintain privacy for all clients; this is not necessarily just a culturally competent action. Asking the client why she is uncomfortable is confronting the client and is not culturally competent. Waiting until the next assessment time to observe the incision is inappropriate, as this can lead to missing important assessment findings regarding the state of the client's incision.
C) The most culturally competent intervention is to explain to the client the reason for the intervention using lay terms. The nurse should close the client's curtain to maintain privacy for all clients; this is not necessarily just a culturally competent action. Asking the client why she is uncomfortable is confronting the client and is not culturally competent. Waiting until the next assessment time to observe the incision is inappropriate, as this can lead to missing important assessment findings regarding the state of the client's incision.
D) The most culturally competent intervention is to explain to the client the reason for the intervention using lay terms. The nurse should close the client's curtain to maintain privacy for all clients; this is not necessarily just a culturally competent action. Asking the client why she is uncomfortable is confronting the client and is not culturally competent. Waiting until the next assessment time to observe the incision is inappropriate, as this can lead to missing important assessment findings regarding the state of the client's incision.

Question 8

Which acculturation behavior will the nurse observe in a client who has emigrated from another country to the United States?

Accepted Answer

A)Individuals experience acculturation when they begin to adapt or borrow habits of the new culture. The client who attends church in the neighboring community to meet new people is displaying acculturation. The other behaviors are examples of a client who may feel comfortable only in the client's culture.
B)Individuals experience acculturation when they begin to adapt or borrow habits of the new culture. The client who attends church in the neighboring community to meet new people is displaying acculturation. The other behaviors are examples of a client who may feel comfortable only in the client's culture.
C)Individuals experience acculturation when they begin to adapt or borrow habits of the new culture. The client who attends church in the neighboring community to meet new people is displaying acculturation. The other behaviors are examples of a client who may feel comfortable only in the client's culture.
D)Individuals experience acculturation when they begin to adapt or borrow habits of the new culture. The client who attends church in the neighboring community to meet new people is displaying acculturation. The other behaviors are examples of a client who may feel comfortable only in the client's culture.

Question 9

The nurse places a client in a treatment room of the emergency department for treatment of abdominal pain and vaginal bleeding.The spouse,speaking for the client,asks that only a female provider examine his wife for the pelvic exam.The nurse recognizes that the client is from a culture that prohibits men from examining women.Which is the most culturally appropriate statement by the nurse?

Accepted Answer

The most culturally appropriate statement by the nurse is to honor the request of the client and their spouse. Option D states that every attempt will be made to honor the request, which shows respect for the client's culture and preferences. It is important for nurses to be culturally sensitive and respectful in their care of clients. Options A and B do not address the request and may come across as insensitive or dismissive. Option C is not appropriate as it does not take into consideration the client's cultural beliefs and may lead to distrust or noncompliance with care.

Question 10

The nurse is caring for a client from a different culture who had a myocardial infarction and is receiving atorvastatin (Lipitor).The nurse assesses the client's diet to be very high in fat.Which is the best plan by the nurse to improve the client's diet and reduce the risk that the client may need additional medications?

Accepted Answer

A)Every culture has culture-specific diets; the nurse must include the individual in the family who does the meal preparation if a different diet is to be successful. Asking the client about having a nurse from the same culture speak to him is racist and implies that the nurse cannot understand the dietary needs of a client from another culture. At this point, a consult by dietary services is premature. Providing information is a good idea, but the nurse must also teach the client.
B)Every culture has culture-specific diets; the nurse must include the individual in the family who does the meal preparation if a different diet is to be successful. Asking the client about having a nurse from the same culture speak to him is racist and implies that the nurse cannot understand the dietary needs of a client from another culture. At this point, a consult by dietary services is premature. Providing information is a good idea, but the nurse must also teach the client.
C)Every culture has culture-specific diets; the nurse must include the individual in the family who does the meal preparation if a different diet is to be successful. Asking the client about having a nurse from the same culture speak to him is racist and implies that the nurse cannot understand the dietary needs of a client from another culture. At this point, a consult by dietary services is premature. Providing information is a good idea, but the nurse must also teach the client.
D)Every culture has culture-specific diets; the nurse must include the individual in the family who does the meal preparation if a different diet is to be successful. Asking the client about having a nurse from the same culture speak to him is racist and implies that the nurse cannot understand the dietary needs of a client from another culture. At this point, a consult by dietary services is premature. Providing information is a good idea, but the nurse must also teach the client.

Question 11

The clinic nurse is caring for an infant during a routine wellness exam.The parents and infant immigrated to the United States 6 months ago.The mother explains that she believes that an herbal remedy is the best way to treat the infant's colic.Which action by the nurse is appropriate?

Accepted Answer

The nurse should ask the mother what the ingredients are in the herbal remedy to ensure that the infant is not being exposed to any potential harmful substances. This also allows the nurse to educate the mother on any potential adverse effects of the remedy or interactions with any medications the infant may be taking. Providing an alternate remedy or telling the mother not to use the remedy without further assessment and education may not effectively address the mother's concerns or provide safe and appropriate care for the infant.

Question 12

A nurse is interviewing a client at a clinic near a shelter for the homeless.Understanding the lack of resources this client has available,which should the nurse assess during the intake phase of the health history? Select all that apply.

Accepted Answer

The nurse should assess social support available, access to medication, access to nutritious meals, and any personal resources that the client may have available, as these factors are likely to impact the client's overall health status and ability to manage their health condition. The number of times married is not relevant to the current clinical situation and may not provide useful information.

Question 13

During a sexual history,the client states,"I have always felt like a man trapped in a woman's body." The nurse should recognize that the client may identify as what?

Accepted Answer

The client's statement may indicate that they identify as transgender, meaning that their gender identity does not match the sex they were assigned at birth. The other answer choices are not necessarily related to the client's statement about feeling like a man trapped in a woman's body.

Question 14

A nurse is working at a healthcare clinic serving the needs of an inner-city population that is predominantly made up of minority people groups.A neighbor says the nurse must be brave because most of "those" people have guns and are in gangs.Which response by the nurse is appropriate?

Accepted Answer

This response addresses the neighbor's stereotype and offers an opportunity to talk about the reality of working in a healthcare clinic serving a diverse population. It also allows the nurse to educate the neighbor about the community and combat discrimination.

Question 15

A novice nurse is working in a busy emergency department of a hospital situated in a culturally diverse area of the city.Which should the nurse do when providing culturally competent care?

Accepted Answer

Acquiring the underlying background knowledge necessary to provide culturally competent care is essential in a culturally diverse healthcare setting. This includes gaining knowledge about the beliefs, values, and traditions of different cultural groups to ensure that healthcare is delivered in a sensitive, respectful, and appropriate manner. Treating everyone the same may lead to cultural misunderstandings and poor healthcare outcomes. Assumptions that working in this emergency department will be the same as in other care contexts may lead to insensitive and inappropriate care. Basing the standard of care on the needs and attitudes of the dominant cultural group in the area may undermine the care of other cultural groups.

Question 16

A nurse working in an assisted living facility is preparing an educational program regarding ageism for the colleagues on the unit.Which statements reflect ageism? Select all that apply.

Accepted Answer

Ageism refers to negative attitudes and beliefs about older adults that can lead to discrimination and mistreatment. Statements B, C, and E reflect ageism because they reflect negative stereotypes and assumptions about older adults, such as laziness, sickness, and inability to recover from illness. Statement A may not necessarily reflect ageism, depending on the context and the client's situation. Statement D is a reflection of respect and addressing clients in a professional manner, so it does not reflect ageism.

Question 17

A nurse is working with a number of clients at a free clinic.Which client population is at the highest risk for low levels of healthcare?

Accepted Answer

Undocumented immigrants often face significant barriers to accessing healthcare, including lack of insurance, fear of deportation or discrimination, language barriers, and limited access to transportation. This population is at a higher risk for low levels of healthcare due to these barriers. Other populations may also face similar challenges, but in general, undocumented immigrants face the highest risk.

Question 18

The client is admitted to the hospital following a miscarriage,and she is septic.The healthcare provider orders antibiotics,which the client refuses,stating,"I don't deserve them.I lost my baby because I had sex outside of marriage." Which is the appropriate response by the nurse?

Accepted Answer

The client's personal beliefs and feelings are important, but in this situation, her refusal of antibiotics could result in serious harm to her health. It is important for the nurse to prioritize the client's physical well-being and educate her about the necessity of taking the medication to treat the infection, regardless of any personal beliefs or feelings of self-blame.

Question 19

Which treatment program would be most appropriate for homeless clients whose type 1 diabetes requires daily insulin injections?

Accepted Answer

A) The outpatient clinic would provide the care the client requires in the most cost-effective manner. There is no indication for inpatient or partial hospitalization at this time. Because the client is homeless, home health care would not be the best option in this situation.
B) The outpatient clinic would provide the care the client requires in the most cost-effective manner. There is no indication for inpatient or partial hospitalization at this time. Because the client is homeless, home health care would not be the best option in this situation.
C) The outpatient clinic would provide the care the client requires in the most cost-effective manner. There is no indication for inpatient or partial hospitalization at this time. Because the client is homeless, home health care would not be the best option in this situation.
D) The outpatient clinic would provide the care the client requires in the most cost-effective manner. There is no indication for inpatient or partial hospitalization at this time. Because the client is homeless, home health care would not be the best option in this situation.

Question 20

A female client,from a male-dominated culture,is being discharged after a lengthy hospitalization.Which action by the nurse prior to providing discharge instructions is appropriate?

Accepted Answer

A)The nurse needs to identify who has the "authority" to make decisions in a client's family. If the decision maker is someone other than the client, the nurse needs to include that individual in healthcare discussions. Nurses need an awareness of cultural variations of gender because they will be caring for diverse client needs. What might be considered sexism by one culture may not be in another. Regardless of who is present during the teaching, it is always necessary to make sure that the instructions are understood, but it is difficult to do that before instructions are given. Asking the client when the best time for teaching would be does not address the need for the decision maker of the family to be present. The nurse should not simply leave giving instructions to the healthcare provider.
B)The nurse needs to identify who has the "authority" to make decisions in a client's family. If the decision maker is someone other than the client, the nurse needs to include that individual in healthcare discussions. Nurses need an awareness of cultural variations of gender because they will be caring for diverse client needs. What might be considered sexism by one culture may not be in another. Regardless of who is present during the teaching, it is always necessary to make sure that the instructions are understood, but it is difficult to do that before instructions are given. Asking the client when the best time for teaching would be does not address the need for the decision maker of the family to be present. The nurse should not simply leave giving instructions to the healthcare provider.
C)The nurse needs to identify who has the "authority" to make decisions in a client's family. If the decision maker is someone other than the client, the nurse needs to include that individual in healthcare discussions. Nurses need an awareness of cultural variations of gender because they will be caring for diverse client needs. What might be considered sexism by one culture may not be in another. Regardless of who is present during the teaching, it is always necessary to make sure that the instructions are understood, but it is difficult to do that before instructions are given. Asking the client when the best time for teaching would be does not address the need for the decision maker of the family to be present. The nurse should not simply leave giving instructions to the healthcare provider.
D)The nurse needs to identify who has the "authority" to make decisions in a client's family. If the decision maker is someone other than the client, the nurse needs to include that individual in healthcare discussions. Nurses need an awareness of cultural variations of gender because they will be caring for diverse client needs. What might be considered sexism by one culture may not be in another. Regardless of who is present during the teaching, it is always necessary to make sure that the instructions are understood, but it is difficult to do that before instructions are given. Asking the client when the best time for teaching would be does not address the need for the decision maker of the family to be present. The nurse should not simply leave giving instructions to the healthcare provider.

Quiz 24: Culture and Diversity