Deck 7: Social, Cultural, and Spiritual Context of Psychiatric Nursing Care

Question 1

Which factor is most likely to delay a member of a minority group from seeking needed medical care? (Select all that apply.)

A) Access to medical insurance
B) Ability to speak English as a second language
C) Availability of primary physicians for referrals
D) Amount of support provided by ethnic community
E) Familiarity of the community where care is being offered

Answer 1

Access to medical insurance
Ability to speak English as a second language
Availability of primary physicians for referrals

Question 2

A nurse assessing sociocultural risk factors for a 34-year-old female,single,poorly educated immigrant with three young children and who receives support from social services,should be most concerned about the effects of:

A) age.
B) gender.
C) immigration.
D) disadvantagement.

Answer 2

disadvantagement.

Question 3

Sociocultural risk factors are identified by assessing which patient characteristic?

A) Belief system
B) Daily health habits
C) Stress management habits
D) Restfulness of the home environment

Answer 3

Belief system

Question 4

Two patients,an African-American agnostic man and a Caucasian Baptist woman,are both diagnosed with schizophrenia,paranoid type.Both patients are 42 years old and live at the poverty level.The age of onset for the illness was 21 years in the male patient and 41 years in the female patient.What sociocultural factor accounts for the male patient's less favorable prognosis?

A) His religious belief system
B) Caucasian Americans are more amenable to treatment.
C) Males living in poverty receive less social support than women living in poverty.
D) He had an earlier onset of illness that has resulted in his longer course of illness.

Question 5

One task of an administrator of a culturally sensitive mental health system would be to:

A) eliminate all staff bias related to cultural diversity.
B) hire significant numbers of minority health care providers.
C) incorporate the values of culture competency into all levels of care.
D) keep access to care open for the dominant ethnic, social, and religious groups.

Question 6

An elderly Hispanic woman has become depressed after the death of her husband.The nurse would anticipate that this patient is most likely to:

A) be less able to adapt than before.
B) recover and return to her preillness state.
C) believe the death is a punishment for past acts.
D) suffer recurrences of depression because of cultural strain.

Question 7

Which intervention will the nurse consider to be a central responsibility when planning for culturally competent treatment?

A) Learn what the illness means to the patient and how the patient's beliefs can help mediate the stressors.
B) Learn as much as possible regarding the beliefs of both the patient and the patient's extended family.
C) Ask the patient about beliefs in a formal organized religion and daily or weekly religious practices that can be factored into treatment.
D) Tell the patient that it will be important to examine together the belief systems of both the nurse and patient to be sure that they are congruent.

Question 8

With regard to sociocultural risk factors,nursing care should be based on the premise that:

A) risk for individual development of a psychiatric disorder usually remains constant over time.
B) all members of ethnic groups have the same risk for developing a psychiatric disorder.
C) risk factors interact constantly, so different factors become important at different times.
D) sociocultural risk factors affect assessment and nursing care planning more than implementation of care.

Question 9

Which statement will be most important for planning future community mental health services?

A) The population over age 65 years will continue to increase.
B) Many more people will move out of rural and into urban areas.
C) The U.S. population will increase drastically by the year 2050.
D) The U.S. population will become more diverse with regard to race and ethnicity.

Question 10

A nurse working in a mental health center would determine which patient to be the best candidate for a spirituality-based 12-step intervention program?

A) A patient who has generalized anxiety disorder
B) A patient who has an addiction to alcohol
C) A patient with a personality disorder
D) A patient who has agoraphobia

Question 11

Which of these statements by a nurse suggests that the nurse will display cultural sensitivity when interviewing a patient from a different culture?

A) "The patient's cultural background is very different from my own."
B) "I think introducing ethnic humor is an effective way of establishing rapport."
C) "I have to remember to document the patient's ethnic origin and religion in the record."
D) "Before the interview I will take a few minutes to review actions that might offend a patient of this culture."

Question 12

A student nurse asks an instructor,"Since most of the patients on the unit are female,does that mean that women experience more mental illness than men?" The instructor replies:

A) "That's a very astute observation. You're right."
B) "The prevalence is relatively the same for men and women."
C) "As a matter of fact, mental illness is more prevalent among men."
D) "I'm sure that you will be able to find that information in your textbook."

Question 13

During a team conference about a patient,the patient's spouse states,"My spouse is Irish,so I should have expected a drinking problem." This statement is an example of:

A) racism.
B) intolerance.
C) stereotyping.
D) discrimination.

Question 14

A 32-year-old Caucasian female college graduate who weighs 150 pounds is heavily sedated by the amount of lorazepam (Ativan) prescribed for anxiety reduction.A Hispanic male heavy laborer who is the same age and weight as the female patient has taken the same dose of Ativan and states that his anxiety is barely under control.What factor most likely accounts for this difference?

A) The male is Hispanic, whereas the female is Caucasian.
B) Social stratification and poverty make treatment more difficult.
C) Men more often underrate the efficacy of antianxiety medication.
D) The female gastrointestinal system more readily absorbs benzodiazepines.

Question 15

A culturally competent nurse possesses which characteristics? (Select all that apply.)

A) Flexibility
B) An unbiased nature
C) Sensitivity to diversity
D) Willingness to learn
E) Mastery of nursing skills

Question 16

A nurse working with individuals from ethnic minority groups recognizes which as a factor that affects mental health care?

A) They often delay seeking help until problems become intense or chronic.
B) They characteristically do not engage in early termination from care.
C) They tend to dislike using community support systems.
D) They tend to avoid using family support systems.

Question 17

Asian patients prescribed psychiatric medications:

A) exhibit better response to antidepressants and phenothiazine than do African-American patients.
B) have less tendency to abuse alcohol with their medications than do white patients.
C) have extrapyramidal side effects at lower dosage levels than do other ethnic groups.
D) experience fewer side effects when taking anticholinergic medications than do white patients taking the same dosage.

Question 18

When conducting an admission interview,a mental health nurse asks a patient a series of questions related to personal beliefs.When the patient asks why these questions are being asked,how should the nurse respond?

A) "These questions are routine and are a mandatory part of the admission process."
B) "The prime reason is that these questions help the staff to identify any specific health care practices that would conflict with your religious beliefs."
C) "Mental health can be affected by personal belief systems, so it is important that your treatment plan be developed to be compatible with your beliefs."
D) "These questions are asked of every patient and are confidential, but if you are not comfortable answering them I will simply note that in your chart."