Question 1

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

Accepted Answer

A spiritual crisis may occur when religious or spiritual beliefs conflict with a necessary procedure or a treatment protocol,such as permitting a blood transfusion.Although the remaining options all present with a serious emotional situation,there is no evidence to support that the patient's beliefs are being challenged.

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.

Accepted Answer

Many immigrants experience culture shock,a sudden or violent disturbance of emotions that involves a sense of anxiety,fear,and distrust.Children and young adults usually adapt to their new surroundings more quickly.It takes approximately three generations or longer for members of a minority group to integrate into the dominant cultural environment.

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:

Accepted Answer

Culturally determined beliefs about health and illness should be respected.If there are no contraindications to the patient eating the foods mentioned,the nurse should facilitate obtaining them.Attempt to explain the flaw in the patient's belief is an attempt to negate culturally determined beliefs.Changing the subject does not address patient concerns.Assuming that the belief is inflexible suggests the patient's beliefs have no merit.

Question 4

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

Accepted Answer

During development,one's sense of faith,meaning moral values,and judgment moves from an external locus of control to an internal locus of control.An example of such internal control is the expressed feeling of comfort derived from prayer.The remaining options reflect external locus of control since each is an expression of how beliefs about prayer are provided by others; church doctrine and the faith of others.

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?

Accepted Answer

The following facts are known about beliefs commonly held by members of this culture: there is a stigma attached to mental illness; mental illness is often described in somatic terms; members of this culture come into treatment late and often have feelings of hopelessness upon entry into the system; families tend to care for their members with mental illness; and traditional healing has usually been tried and failed before the patient attempts to access the mental health system.

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:

Accepted Answer

Pamphlets are useful only if the patient can read and understand the language in which the material is written.The other options are secondary to this priority concern.

Question 7

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

Accepted Answer

Arguing to get a point across is more characteristic of the communication of a person from a low-context culture.A person from a high-context culture would not be expected to dispute a person with authority.The person from a high-context culture would be expected to use global communication and nonverbal symbolization but to make little direct eye contact.

Question 8

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

Accepted Answer

Faith is the ability to draw on spiritual resources without having physical and empiric proof.Body and mind refer to psychosomatic concepts.A manner of expressing spirituality refers to religion.A search for the sacred,transcendent,or universal refers to spirituality.

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?

Accepted Answer

The patient has identified a specific spiritual problem that a chaplain would be equipped to handle,so a referral is appropriate.The nurse,in the meantime,is equipped to discuss relationship issues.Offering to talk about the relationship without addressing the patient's expressed spiritual needs is not therapeutic.Suggesting that the patient's relationship issues are not uncommon minimizes the patient's feelings.Attempting to refocus the patient dismisses the patient's needs.

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.

Accepted Answer

Behaviors and communication styles of cultural societies referred to as low context (individualistic)are those in which people care for themselves.Low-context societies emphasize thinking and values that are centered on the individual: autonomy,individual initiative,the right to privacy,and emotional independence.Facilitating family in assuming responsibility for the patient's physical and educational needs is not compatible with the characteristic needs of the low-context society.

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?

Accepted Answer

Occasionally,individuals with serious mental disorders experience delusions that are spiritual or religious in nature.Certified pastoral counselors are skilled with regard to counseling patients and consulting with staff about these problems,and they assist the health care team in ways that address the particular concerns of individual patients.Challenging or debating the truth of a person's delusions is not therapeutic,and spiritual delusions are no exception.Engaging in spiritual or religious practice with individuals on a psychiatric unit is also inappropriate.Removing the patient from the milieu is seldom therapeutic and done only to maximize milieu safety.

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:

Accepted Answer

Culture influences beliefs about health and illness,including causes of illness.What the nurse might label as delusional might be a culturally determined belief about illness causation.The other assessments do not relate to the situation as directly.

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?

Accepted Answer

Cultural heritage is learned patterns of behavior and thinking shared by a particular group that is transmitted over time to other members.Ancestral origins,a similar heritage,and physical characteristics may be shared traits but alone do not constitute cultural heritage.

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.

Accepted Answer

Culturally competent health care requires the development of interpersonal skills,communication skills,and awareness and sensitivity to the uniqueness of individuals.It is also an ongoing process,because each new encounter presents the opportunity to gain additional knowledge and skills.Psychiatric care should be tailored to the individual and not to cultural stereotypes.

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:

Accepted Answer

Asian and Asian-American patients have been socialized into high-context cultures in which there is collective identity,group decision making,emotional dependence,deference to those of higher status and age,and use of indirect language to communicate.The remaining options are characteristic of low-context cultures.

Question 16

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

Accepted Answer

Spiritual distress is a nursing diagnosis that is defined as a disruption in the value and belief systems that pervades the person's state of being and that transcends the physical and psychosocial self.Feeling abandoned when one has always relied on faith is an indication of spiritual distress.Feeling alone and questioning why something has occurred is not necessarily spirit based,and not an indication of spiritual distress.Questioning one's ability to manage an emotion without one's faith is a testimony to the faith,not an expression of despair.

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:

Accepted Answer

Xenophobia is defined as a morbid fear of strangers.The xenophobic individual would not necessarily resist sharing food (fear of germs),riding in elevators (fear of closed spaces),or going out of doors (fear of open spaces).

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:

Accepted Answer

Misunderstanding occurs when the nurse fails to take into account culture-specific interaction patterns.Silence,infrequent eye contact,shame,fear,and language barriers all affect a patient's ability to interact.In light of the patient's cultural diversity,the other options are less likely to be pertinent.

Question 19

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

Accepted Answer

Many people in poverty suffer discrimination and stigma which places them at risk for depression and other anxiety-related illnesses.The other subcultures do not present with the same or greater degree of risk.

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?

Accepted Answer

Spirituality allows one to cope with these feelings by providing a sense of hope and meaning to experiences that would otherwise be crippling.Spirituality is often a key component in the healing process,and it is an integral part of the patient's treatment plan.The remaining options do not as directly deal with the patient's personal loss and the progression to healing.

Quiz 8: Culture, Ethnicity, and Spirituality