Deck 4: Cultural Considerations

Question 1

The nurse is caring for an older adult Native American client who is experiencing severe chest pain. The client is accompanied by a tribesman at the insistence of the client. The tribesman tells the nurse that their culture teaches acceptance of death as part of the natural cycle of life and that treatments must be stopped. The client's son insists that his father be treated, and states he feels the tribe's teachings are antiquated. Which action by the nurse is the most appropriate?

A) Call the social worker to plan a family meeting without the tribesman.
B) Interview the client and ascertain his wishes and beliefs.
C) Convene the hospital ethics committee.
D) Call the nursing supervisor.

Answer 1

Interview the client and ascertain his wishes and beliefs.

Question 2

The nurse is completing a self-assessment to determine cultural competence. Which behavior indicates cultural competence?

A) Obtaining a ham sandwich for a Jewish client admitted to the hospital unit after trays have been delivered.
B) Referring to the Asian client as an Oriental.
C) Permitting a Bedouin to sleep on the floor.
D) Advising a Catholic client that being taken to the chapel for noon Mass is impossible because lunch times have been assigned.

Answer 2

Permitting a Bedouin to sleep on the floor.

Question 3

The nurse is interviewing a client and wishes to determine health practices that are important to the client's beliefs. Which statement would be appropriate for the nurse to use to obtain this information?

A) "Do you use any nontraditional medicine?"
B) "Tell me what you do to try to improve your health."
C) "How many times have you been sick in your life?"
D) "Do you have medical insurance?"

Answer 3

"Tell me what you do to try to improve your health."

Question 4

When providing an in-service to new staff nurses, the nurse educator discusses expectations concerning the acceptance of client cultural beliefs. Which statement by a participant indicates the need for further teaching?

A) "The acceptance of different cultural values is needed to provide quality nursing care."
B) "Cultural values may dictate my client assignments on the nursing unit."
C) "My own cultural values are irrelevant to the acceptance of the values of others."
D) "My knowledge of the cultural values of others will increase in time."

Question 5

The charge nurse is making assignments for the next shift. Three of the staff members are female and one is male. Which client should be assigned to a female staff member?

A) The African American female.
B) The African American male.
C) The Arab American male.
D) The Arab American female.

Question 6

The nurse is caring for a client who insists on having food very hot and very cold at each meal. The nurse correctly recognizes this as a health belief in which cultural group?

A) Cuban Americans.
B) Jewish Americans.
C) Chinese Americans.
D) Native Americans.

Question 7

The nurse is studying matriarchal cultures and needs to complete a report on how this aspect affects health care within the culture. Which cultures will the nurse explore as being matriarchal?

A) Appalachian.
B) American Indian.
C) African American.
D) Italian.
E) Arab American.

Question 8

The nurse is admitting a client of the Muslim faith during the holy month of Ramadan. The client tells the nurse that he must fast during this time. Which response by the nurse is the most appropriate?

A) "What can we do to accommodate your needs during your stay here?"
B) "I will let your healthcare provider know that you need to be discharged."
C) "Fasting is harmful to your body."
D) "You must have food during times of illness."

Question 9

The nurse is preparing to perform an assessment of the client's social support and organization. Which question will provide the needed information?

A) "Where were you born?"
B) "What is the primary language spoken in your home?"
C) "Which political party are you associated with?"
D) "Do you have a religious affiliation linked with the cultural affiliation?"

Question 10

The nurse is interviewing a client and wishes to determine the roles of various members of an extended family living together in one household. Which statements would be helpful for the nurse to use to obtain this information?

A) "What language is spoken in your house?"
B) "Are all of your family members working?"
C) "Tell me about the responsibilities of family members in your home."
D) "Who makes the decisions for your family members?"
E) "Are you happy with your place in the family?"

Question 11

The nurse is collecting data concerning the client's chief complaint. The client reports having attempted to manage the illness using herbs. Which response by the nurse is most therapeutic?

A) "What herbs have been used to manage your condition?"
B) "Does your healthcare provider know about your herbal remedies?"
C) "Don't you realize your recovery may have been impeded by these herbal preparations?"
D) "When was the last dosage of the herbal remedies taken?"

Question 12

The nurse is setting up a meal tray and notes that the client refuses to look at the food and asks the nurse to take it away. The meal contains a chicken breast, green beans, fruit cocktail, and cottage cheese. Which response by the nurse is the most appropriate?

A) "I know you are not hungry so just let me know when you want your tray."
B) "The hospital food is horrible here."
C) "Is there a problem with the food being sent to you?"
D) "I will get you some juice and crackers from the unit kitchen."

Question 13

The nurse is admitting a client and asks to see all medications taken on a routine basis. The client offers a long list containing prescription medications and a variety of herbal preparations that are unfamiliar names to the nurse. Which action by the nurse would be appropriate at this time?

A) Write down all the names of the herbals and look them up later.
B) Tell the client that herbals are ineffective and to throw them away.
C) Inform the healthcare provider of the herbals.
D) Ask the client what they are taken for and how often.

Question 14

The nurse manager is discussing cultural considerations with a group of staff nurses. Which statements by the staff nurses indicate an appropriate understanding of cultural concepts?

A) "Culture can best be described as an awareness of belonging to a group in which certain characteristics differentiate the members of one group from another."
B) "A good description of culture is one that recognizes it's the socially transmitted beliefs, behaviors, values, customs, lifestyles, and ways of thinking of a specific population that guides an individual's worldview."
C) "Culture is the belief that one's own beliefs, way of life, values, and customs are superior to others."
D) "Culture is the identification of an individual or group by shared genetic heritage and biologic characteristics."
E) "Decisions made by an individual are largely influenced by culture."

Question 15

The nurse is preparing an educational program for the staff on cultural considerations. The nurse includes the following definition: "The adoption and incorporation of characteristics, customs, and values of the dominant culture by those new to that culture." Which term is the nurse referring to?

A) Ethnicity.
B) Assimilation.
C) Ethnocentrism.
D) Culture.

Question 16

A seasoned nurse notes that a novice nurse voices frustration and a lack of appreciation for clients with differing health care beliefs and practices. Which action will best assist the seasoned nurse to improve the novice nurse's practice?

A) Advising the novice to reduce displays of frustration and lack of appreciation for the values of others.
B) Encouraging the novice to look closely at own cultural practices and beliefs.
C) Recommending a written reprimand for the novice nurse.
D) Requiring the novice nurse to meet with a counselor concerning ethnic biases.

Question 17

The nurse is assigned to provide care to a Muslim client who is diagnosed with diabetes. When planning the care for the shift, which factor may have the greatest impact on the care?

A) The client has a strong respect for the elders in the family.
B) Pork in the diet is forbidden.
C) The client may practice religious fasting.
D) Lamb and chicken are the main sources of protein.

Question 18

The female nurse is examining a Vietnamese male and notes that he will not make eye contact with her during the assessment. The client appears very uncomfortable and is sweating and flushed. Which action by the nurse would be appropriate in this situation?

A) Obtain a blood sugar reading.
B) Ask the client if he would like a male to perform the examination.
C) Assure the client that the exam will be over quickly.
D) Continue with the examination.

Question 19

The nurse manager is preparing for an accreditation visit and wants to assure that the unit is delivering culturally appropriate health care. Which action would demonstrate this approach by the nurse manager?

A) Insisting the staff teaches clients English during their hospitalization.
B) Examining the process used to admit clients.
C) Providing written materials in languages spoken most commonly by clients admitted to the unit.
D) Limiting education and training to the bedside nurses.

Question 20

Which questions will the nurse plan to ask when assessing a client's ethnicity, which may impact their healthcare needs?

A) "What is your religious preference?"
B) "Are there any foods or dietary practices that will impact your care?"
C) "Which ethnic group do you identify yourself as belonging to?"
D) "Does your mother practice the same religion as you?"
E) "What political party do you belong to?"

Question 21

While working in an ambulatory care clinic, a Hispanic client who speaks limited English seeks care. When preparing to provide the discharge instructions to the client, which is a responsibility of the nurse?

A) Providing the client with an English-to-Spanish translation dictionary.
B) Providing instructions written in English along with the contact number for a translator.
C) Providing resources to provide information the client will understand.
D) Providing a translator fluent in the client's primary language.

Question 22

The nurse educator is discussing culture and ethnicity with a group of student nurses. Which student statements indicate appropriate understanding of the material presented?

A) "The gene pool in the United States has become less diverse over the past decade."
B) "I have found it easiest to classify individuals with cultural groups by assessing their skin tones and facial features."
C) "When identifying individuals of the same race, they will have shared genetic heritage, biologic and physiologic characteristics."
D) "Ethnic groups share common values over generations."
E) "An individual may self-identify with an ethnic group that is different from the ethnic group of their birth or race."

Question 23

The nurse is discharging a Chinese American client the hospital. The nurse notes the client is nodding in agreement in response to the nurse's statements during discharge teaching. After completing the exchange of information, which is the priority action by the nurse?

A) Documenting the client's understanding of the discharge instructions.
B) Asking the client if she understood the information being relayed.
C) Asking the client questions to assess understanding of the information provided.
D) Requesting that the client sign the discharge paperwork.

Question 24

The nurse is caring for a Vietnamese client. When providing care, the nurse should include which action?

A) Maintaining direct eye contact.
B) Providing greater than the usual amount of personal space.
C) Using periods of silence to indicate positive emotion.
D) Engaging in a casual discussion about feelings.

Question 25

When planning care to manage osteoporosis in an African American client, which must be taken into consideration?

A) The daily dietary intake contains bread at every meal.
B) Snacks often replace meals beginning in adolescence.
C) Lactose intolerance may be a factor.
D) Pork is not allowed in the diet.

Question 26

The nurse caring for a Navajo client notes a lack of verbal communication when attempting to interact with the client. Which inference can be made about this behavior?

A) The client likely does not understand the nurse's attempts to engage her.
B) The client is demonstrating disapproval with the nurse through the use of silence.
C) The client is uneasy speaking with the nurse without the male head of her household.
D) The client is illustrating agreement with the nurse's actions by using silence.

Question 27

The nurse is providing postoperative care to a Chinese American client. Which traditional Chinese cultural concepts may impact the nurse-client interaction?

A) The client may dislike being touched by strangers.
B) Health is associated with being overweight.
C) There is a strong belief in the use of herbs to manage illness.
D) Ceremonies are an important part in the recognition of illness and disease.

Question 28

A Filipino American client is discussing concerns related to osteoporosis with the nurse educator. Which concept related to cultural nutrition may pose problems for this client's plan of care and will need to be incorporated into the information provided?

A) Potential for lactose intolerance.
B) Pork is a primary source of protein.
C) Heavy use of salt and vinegar.
D) Chicken is a primary source of protein.

Question 29

The nurse must order a meal tray for a Jewish client who is off the unit for testing and will require insulin administration immediately upon returning to the unit. Which dietary selection is the most appropriate for this client?

A) BLT sandwich, potato salad, fruit wedge, and unsweetened tea.
B) Roast beef sandwich, potato chips, and 2% milk.
C) Egg salad sandwich, side salad, applesauce, and diet soda.
D) Pork tenderloin sandwich, fruit cup, and milk.