Question 1

An 82-year-old Asian American patient tells the nurse that she has lived in the United States for 50 years. The patient speaks English but lives in a predominantly Asian neighborhood. The nurse will need to

Accepted Answer

Further assessment of the patient's health care preferences is needed before making further plans for culturally appropriate care. The other responses indicate stereotyping of the patient based on ethnicity and would not be appropriate initial actions.

Question 2

When doing an admission assessment for a patient, the nurse notices that the patient pauses before answering questions about the health history. The most appropriate action by the nurse is to

Accepted Answer

Patients from some cultures take time to consider a question carefully before answering. The nurse will show respect for the patient and help to develop a trusting relationship by allowing the patient time to give a thoughtful answer. Asking the patient why the answers are taking so much time, stopping the assessment, and handing the patient a form indicate that the nurse does not have time for the patient.

Question 3

When performing a cultural assessment with a patient of a different culture, the nurse's first action should be to

Accepted Answer

An early step in performing a cultural assessment is to determine whether the patient feels an affiliation with any cultural group. The other actions may be appropriate if the patient does identify with a particular culture.

Question 4

A new RN graduate is assessing a newly admitted non-English-speaking Chinese patient. The charge nurse should intervene if the new RN's first action is to

Accepted Answer

Many people of Asian ethnicity believe that touching a person's head is disrespectful; the RN should ask permission before touching the patient's head. The other actions are appropriate.

Question 5

To determine a patient's cultural practices regarding communication and eye contact, the nurse should

Accepted Answer

Observation of the patient's interactions with visitors will provide the most useful information. Asking about the meaning of silence will not be helpful in assessing the patient's cultural values regarding eye contact. Avoiding eye contact may not be appropriate for interactions with some patients. The nurse should attempt to adapt communication to the patient's communication style.

Question 6

If an interpreter is not available when a patient speaks a language different from the nurse's language, it is appropriate for the nurse to

Accepted Answer

The use of gestures will enable some information to be communicated to the patient. The other actions will not improve communication with the patient.

Question 7

The best example of culturally appropriate nursing care when caring for a newly admitted patient is

Accepted Answer

Many cultures consider it disrespectful to touch a patient without asking permission, so asking a patient for permission is culturally appropriate. The other actions may be appropriate for some patients but are not appropriate across all cultural groups or for all individual patients.

Question 8

When planning health care for a community with a large number of recent immigrants from Asia, the most important intervention for the nurse to include is

Accepted Answer

Tuberculosis (TB) is endemic in many parts of Asia, and the incidence of TB is much higher in immigrants from Asia than in the general US population. Teaching about contraceptive use, colonoscopy, and testing for pregnancy may also be appropriate for some patients but is not generally indicated for all members of this community.

Question 9

While talking with the nursing supervisor, a staff nurse expresses frustration that a Native American patient always has several family members at the bedside. The most appropriate action by the nursing supervisor is to

Accepted Answer

The first step in providing culturally competent care is to understand one's own beliefs and values related to health and health care. Asking the nurse about personal beliefs will help to achieve this step. Reminding the nurse that this cultural practice is important to the family and patient will not decrease the nurse's frustration. The remaining responses (suggest that nurse ask family members to leave the room, and have the nurse explain to family that too many visitors will tire the patient) are not culturally appropriate for this patient.

Question 10

A Hispanic patient complains of abdominal cramping caused by empacho. The nurse's first action should be to

Accepted Answer

Further assessment of the patient's cultural beliefs is appropriate before implementing any interventions for a culture-bound syndrome such as empacho. Although medication, a visit by a curandero(a), or massage may be helpful, more information about the patient's beliefs is needed to determine which intervention(s) will be most helpful.

Question 11

When planning care for a hospitalized patient who uses culturally based treatments, the most appropriate action by the nurse is to

Accepted Answer

Many culturally based therapies can be accommodated along with the use of Western treatments and medications. The nurse should attempt to use both traditional folk treatments and the ordered Western therapies as much as possible. Some culturally based treatments can be effective in treating "Western" diseases. Not all folk remedies interfere with Western therapies. It may be appropriate for the patient to continue some culturally based treatments while he or she is hospitalized.

Question 12

A family member of an elderly Hispanic patient admitted to the hospital tells the nurse that the patient has traditional beliefs about health and illness. The best action by the nurse is to

Accepted Answer

Because the patient has traditional health care beliefs, it is appropriate for the nurse to ask whether the patient would like a visit by a curandero(a). There is no cultural reason for the nurse to avoid asking the patient questions, and questions may be necessary to obtain necessary health information. The patient (rather than the daughter) should be consulted about personal cultural beliefs. The hospital routines for meals, care, and visits should be adapted to the patient's preferences rather than expecting the patient to adapt to the hospital schedule.

Quiz 3: Culturally Competent Care