Question 1

The nurse made a follow-up appointment for a client at the clinic,but the client did not come.Two days later the client presented at the clinic explaining that a temporary job had come up and he could not come back until he had finished and been paid for that job.Which of the following actions should be taken by the nurse next?

Accepted Answer

Although health care systems are set up according to the expectation that clients can plan for the future,some clients focus on the present with little attention to the future.For the patient to receive care,the nurse should try to fit him in that day.Setting up an appointment would possibly be useless because the client may not attend the future appointment either.Poverty-stricken persons would be wise to accept employment when it becomes available.

Question 2

A nurse set up a clinic appointment for Friday of the following week.An Arab patient asked to come earlier in the week.As those days were heavily booked,the nurse left the appointment on Friday.The patient was a "no show." Which of the following best explains what happened?

Accepted Answer

The nurse should know the days of religious worship.Protestants usually worship on Sundays; Muslims' day of worship is from sunset Thursday to sunset on Friday; and Jews and Seventh-Day Adventists' holy day is from sunset on Friday to sunset on Saturday.The other responses do not address the recognition by the nurse of the significance of the days of worship that were indicated as a priority for the client when an appointment was requested for earlier in the week.

Question 3

A patient had wrapped a tummy band around her newborn's abdomen.What should the nurse say to the new mother?

Accepted Answer

Unless a particular action is harmful,the nurse should engage in culture care preservation and maintenance.Before acting,it is helpful to know why the mother is engaging in this behavior.If the mother responds,"I'm not sure; it's just always been done," the nurse can educate the mother on how to care for the cord.If the mother appears to believe the tummy band is very important,the nurse can cooperate with the behavior,because tummy bands will not hurt the baby.

Question 4

A woman who spoke English was an immigrant from the Middle East,attending the clinic for the first time with two female friends.When a male nurse attempted to get a health history,the woman refused to respond to his questions.Which of the following actions should be taken by the nurse?

Accepted Answer

He should ask a female nurse to talk with the client.Many culture groups have strong norms regarding appropriate gender behavior.Norms are the rules by which human behavior is governed and result from the cultural values held by the group.All societies have rules or norms that specify appropriate and inappropriate behavior.Individuals are rewarded or punished as they conform to,or deviate from,the established norms.Thus,this woman is likely to not deviate from these cultural norms and should be given the opportunity to speak with a female nurse.The other responses do not address the cultural needs regarding gender that this client needs to have addressed.

Question 5

Before interviewing an Hispanic family,what is the most important action for the nurse to take?

Accepted Answer

Regardless of the culture of the client family,it is crucial to establish rapport and gain trust and confidence before attempting to gather data.First impressions are important and the nurse should ensure a mutually respectful relationship is created.Thus,starting by providing compliments,greeting them with poor Spanish,or assuming that the male is the authority in the family may all lead to an unacceptable first impression of the nurse to the family.

Question 6

A nurse was responsible for setting up a health fair with free pizza being served during lunch.The nurse observed a few people who did not eat but just talked quietly during lunch.Which of the following actions should be taken by the nurse?

Accepted Answer

Many ethnic groups prefer certain foods as part of their cultural identity.The nurse should take this opportunity to learn foods preferred by the community.It cannot be assumed a supervisor would know preferred foods of the community.Making assumptions about the community or offering the leftovers to those who did not eat would not be culturally sensitive approaches for the nurse to take with this population.

Question 7

A nurse was explaining a problem to the client so the client could make an informed decision about alternative treatment approaches.The client responded,"The doctor will choose the best treatment.Do whatever the doctor says." Which of the following actions should be taken next by the nurse?

Accepted Answer

One of the three ways people are oriented is destiny,in which people must endure and accept whatever comes in a fatalistic,inevitable manner,as destiny cannot be changed.The other responses do not address the perspective of destiny that has been indicated by the client in the initial response.

Question 8

A nurse reviewed the treatment the surgeon recommended for a woman's breast lump.When the nurse asked the woman if she could be admitted to the hospital for immediate surgery,the husband thanked the nurse for her time and said they would get back in touch after they speak with other family members.Which of the following actions would be most appropriate for the nurse to take?

Accepted Answer

We typically focus on the individual as the central figure in decisions about the self.However,in other cultures female clients may seek assistance from other members of the family and allow male relatives to make decisions about important health-related matters.The husband has indicated by his response that collateral relationships are valued,thus decisions about the client may be interrelated with the influence of illness on the entire family or group.The other responses do not address the value of collateral relationships that the nurse must recognize and address.

Question 9

Which of the following statements best defines Leininger's term "culture universal"?

Accepted Answer

Culture universal is used by Leininger to refer to the commonalities of values,norms of behavior,and life patterns that are similarly held among cultures about human behavior and lifestyles and form the basis for formulating theories for developing cross-cultural laws of human behavior.

Question 10

A nurse became frustrated because after each interview question there was a long pause before the client responded.Which of the following actions should be taken by the nurse?

Accepted Answer

Wide cultural variation exists when interpreting silence.Some individuals find silence uncomfortable,whereas others use silence to show understanding and respect.Because the nurse is uncomfortable,action should be taken.The only way to know the meaning of the silence is to ask.

Question 11

A nurse felt very good about an Asian man who had responded positively to the instructions given to him.Later,the nurse heard him tell his wife that there was no way he could implement the suggestions.Which of the following best describes the problem that the client is experiencing?

Accepted Answer

Asian clients may provide the nurse with the anss they think the nurse wants to hear.This behavior is consistent with their cultural value for harmonious relationships with others.The other responses do not recognize this cultural variation among this population that the nurse should recognize.

Question 12

A nurse carefully explained that the medication had to be taken three times a day,with each meal.The patient came to the clinic with symptoms of medication overdose.How should the nurse respond?

Accepted Answer

It is not helpful to confront the patient or accuse someone of noncompliance.A review of the prescription may have been helpful,but because the patient had an overdose,one might assume the medication is being taken more than three times a day.The nurse has engaged in cultural imposition-that is,assuming the patient's beliefs,values,and patterns of behavior are identical to hers.Not everyone eats exactly three times a day.The family may eat more or less than three times a day.

Question 13

Which of the following statements best describes how the population of the United States is changing?

Accepted Answer

The number of immigrants and refugees in the United States is projected to continue to increase.The U.S.has grown largely through immigration.The growth will not occur because of changes in death rate,birth rate,or life span.

Question 14

A baby was dehydrated because of diarrhea.The mother explained that she had finally gone to a folk healer who told her to give the baby herbal tea,which did seem to be helping a bit,but the baby still seemed ill.Which of the following statements would be the most appropriate reply by the nurse?

Accepted Answer

Rejecting the folk healer's advice may cause the mother not to trust Western medicine.If possible,the nurse should build on what the mother is doing.It is usually helpful to include any behaviors that may be helpful or neutral in effect.In this case,the mother is encouraging fluid,which is crucial,and tea is boiled,so the water is clearly safe.Just adding salt and sugar is risky because of the need for careful measurement.Nothing in the example suggests the nurse recognizes what kind of tea is being given.It is easier to give the mother fluids with the appropriate electrolytes while supporting at least some aspect of the healer's advice.It must be remembered that most indigenous healing practices are innocuous.

Question 15

In a client's culture it is exceedingly rude to ask any questions about income or wealth.Which of the following actions should be taken by the nurse to draw conclusions about the client's socioeconomic status (SES)?

Accepted Answer

SES may be determined by examining income,occupation,and educational level.If that is not possible,age,gender,possessions,location of residence,religion,and race may also be considered.

Question 16

When one woman asked her friend to stay while a painful procedure was done,it was explained that only one immediate family member could be in the room.The woman asked the nurse,"How do you define family?" Which of the following would be the best response by the nurse?

Accepted Answer

Families are changing from the norm of husband,wife,and children to single parents,blended,extended,committed,or cohabitation with domestic partners.Consequently,rather than debate the definition of family,it is more practical and comprehensive to ask the client whom he or she considers to be family.

Question 17

At a military base,a family from Qatar,a Muslim Arabic country,came in to the prenatal clinic because the wife believed she was pregnant.Which of the following providers would be the most appropriate choice for this client?

Accepted Answer

During pregnancy,many female clients will prefer female health care providers and may refuse to be examined by a man.People from Arab Muslim countries feel even more strongly about males touching a female.

Question 18

A client,accompanied by her son,spoke only Spanish while the nurse did not.Which of the following actions should be taken by the nurse to best meet the client's need?

Accepted Answer

Asking the son would violate confidentiality,and gender issues may also arise.The only safe approach is to obtain a Spanish interpreter who is knowledgeable about medical terminology and procedures,as well as comfortable with cultural beliefs and health prac-
tices.It is important to have an interpreter rather than trying to make gestures and pantomine so that the communication between the nurse and client is clear and accurate.

Question 19

A woman stood very close to the nurse and asked a question about her husband's condition.The nurse took a step back and shared the requested information.No other questions were asked.Was this a successful interaction?

Accepted Answer

Sense of spatial distance is significant because culturally appropriate distance zones vary widely.Many cultures stand closer for important conversations,whereas the nurse stepped back because being so close made the nurse uncomfortable.

Question 20

When a nurse visited a client's home,it was apparent that the client had not begun to implement the needed exercise program.Rather,the client had been doing drawings about his illness experience.Which of the following actions would be most appropriate for the nurse to take next?

Accepted Answer

The dominant cultural value is action oriented,so the client would be expected to have begun to exercise.Dominant cultural values include an emphasis on productivity and being busy.However,some persons are not action oriented but being oriented,with a focus on expression of impulses and desires.

Quiz 13: Cultural Diversity and Community Health Nursing