Deck 8: Cultural Considerations for Psychiatric Mental Health Nursing

Question 1

A nurse wants to engage a translator for a severely anxious 21-year-old male who immigrated to Canada 2 years ago. Of the four translators below who are available and fluent in the patient's language, which one should the nurse call?

A) A 65-year-old female professional translator
B) A 24-year-old male professional translator
C) A member of the patient's family
D) The patient's best friend

Answer 1

A 24-year-old male professional translator

Question 2

To provide culturally competent care, the nurse should do which of the following?

A) Accurately interpret the thinking of individual patients
B) Predict how a patient may perceive treatment interventions
C) Formulate interventions to reduce the patient's ethnocentrism
D) Identify strategies that fit within the cultural context of the patient

Answer 2

Identify strategies that fit within the cultural context of the patient

Question 3

A group activity on an inpatient psychiatric unit is scheduled to begin at 1000 hours. A patient, who was recently discharged from the Canadian Navy, arrives at 0945 hours. Which analysis best explains this behaviour?

A) The patient wants to lead the group and give directions to others.
B) The patient wants to secure a chair that will be close to the group leader.
C) The military culture values timeliness. The patient does not want to be late.
D) The behaviour indicates feelings of self-importance that the patient wants others to appreciate.

Answer 3

The military culture values timeliness. The patient does not want to be late.

Question 4

A nurse prepares to teach important medication information to a patient of Middle Eastern descent. How should the nurse manage the teaching environment?

A) Stand very close to the patient while teaching.
B) Maintain direct eye contact with the patient while teaching.
C) Maintain a neutral emotional tone during the teaching session.
D) Sit 4 feet or more from the patient during the teaching session.

Question 5

The sibling of an Asian Canadian patient tells the nurse, "My sister needs help for pain. She cries from the hurt." Which understanding by the nurse will contribute to culturally competent care for this patient?

A) People of Asian descent often express emotional distress with physical symptoms.
B) People of Asian descent will probably respond best to a therapist who is impersonal.
C) People of Asian descent will require prolonged treatment to stabilize these symptoms.
D) People of Asian descent should be given direct information about the diagnosis and prognosis.

Question 6

Which term refers to the sharing of common traits, customs, and race?

A) World view
B) Ethnicity
C) Ethnocentrism
D) Culture

Question 7

A patient diagnosed with depression tells the nurse, "There's nothing you can do. This is a punishment. The only thing I can do is see a healer." A religious world view perspective would indicate which of the following?

A) The patient has delusions of persecution.
B) The patient has likely been misdiagnosed with depression.
C) The patient may believe the distress is the result of a curse or spell.
D) The patient feels hopeless and helpless related to an unidentified cause.

Question 8

The nurse would increase the distance of personal space when interacting with a patient who is of which of the following origins?

A) Middle Eastern
B) Asian
C) Southern European
D) Latin American

Question 9

Which world view is predominant in Western culture?

A) Holistic
B) Biomedical
C) Religious
D) Natural laws

Question 10

When caring for a patient of Western culture, the nurse is aware that the personal space of this patient is which of the following?

A) up to 0.5 m
B) 0.5 to 1.0 m
C) 1.0 to 1.5 m
D) 1.5 to 2.0 m

Question 11

A patient in the emergency department shows a variety of psychiatric symptoms, including restlessness and anxiety. The patient says, "I feel sad because evil spirits have overtaken my all of me-they think for me and they do things I would not normally do." Which world view is most applicable to this individual?

A) Religious
B) Holistic
C) Scientific
D) Biomedical

Question 12

A First Nations patient describes a difficult childhood and dropping out of high school. The patient used many recreational substances as a teenager to escape feelings of isolation but stopped 13 years ago. The patient now says, "I feel stupid. I've never had a good job. There is nothing that I am good enough at doing to be able to work." Which nursing diagnosis applies?

A) Risk for other-directed violence
B) Chronic low self-esteem
C) Deficient knowledge
D) Social isolation

Question 13

Which communication techniques would be most effective for a nurse to use during an assessment interview with an adult Indigenous patient?

A) Open and friendly; ask direct questions; touch the patient's arm or hand occasionally for reassurance.
B) Frequent nonverbal behaviours, such as gestures and smiles; make an unemotional face to express negatives.
C) Soft voice; break eye contact occasionally; general leads and reflective techniques.
D) Stern voice; unbroken eye contact; minimal gestures; direct questions.

Question 14

An experienced psychiatric nurse plans to begin a new job in a community-based medication clinic. The clinic sees culturally diverse patients. Which action should the nurse take first to prepare for this position?

A) Investigate cultural differences in patients' responses to psychotropic medications.
B) Contact the clinical nurse specialist for guidelines regarding cultural competence.
C) Examine the literature on various health beliefs of members of diverse cultures.
D) Complete an online continuing education offering about psychopharmacology.

Question 15

The nurse knows that the blueprint for guiding actions that impact care, health, and well-being is which of the following?

A) World view
B) Ethnicity
C) Ethnocentrism
D) Culture

Question 16

Which intervention best demonstrates that a nurse correctly understands the cultural needs of a hospitalized Asian Canadian patient diagnosed with a mental illness?

A) Encouraging the family to attend community support groups
B) Involving the patient's family to assist with activities of daily living
C) Providing educational pamphlets to explain the patient's mental illness
D) Restricting homemade herbal remedies the family brings to the hospital

Question 17

A patient of Asian descent has a diagnosis of depression. A colleague tells the nurse, "This patient often looks down and is reluctant to share feelings. However, I've observed the patient spontaneously interacting with other black patients." Select the nurse's best response.

A) "Black patients depend on the church for support. Have you consulted the patient's pastor?"
B) "Encourage the patient to talk in a group setting. It will be less intimidating than one-to-one interaction."
C) "Don't take it personally. Black patients often have a resentful attitude that takes a long time to overcome."
D) "The patient may have difficulty communicating in English. Have you considered using a cultural broker?"

Question 18

An Indigenous patient sadly describes a difficult childhood. The patient abused alcohol as a teenager but stopped 10 years ago. The patient now says, "I feel stupid and good for nothing. I don't help my people." How should the treatment team focus planning for this patient?

A) Psychopharmacological and somatic therapies should be central techniques.
B) Apply a psychoanalytic approach, focused on childhood trauma.
C) Depression and alcohol abuse should be treated concurrently.
D) Use a holistic approach, including mind, body, and spirit.

Question 19

A patient who speaks limited English has gotten upset with the nurse when she gestured with her foot towards the washroom as her hands were full and wanted to help the patient find the washroom. What should the nurse do?

A) Contact a translator.
B) Apologize for upsetting the patient and ask what happened that upset the patient.
C) Explain to the patient that you were pointing to the washroom with your foot.
D) Research the patients' cultural background to assess what it was that may have been misinterpreted.

Question 20

A psychoeducational session will discuss medication management for a culturally diverse group of patients. Group participants are predominantly members of minority cultures. Of the four staff nurses below, which nurse should lead this group?

A) Very young registered nurse
B) Older, mature registered nurse
C) Newly licensed registered nurse
D) A registered nurse who is very thin

Question 21

A Vietnamese patient's family reports that the patient has wind illness. Which menu selection will be most helpful for this patient?

A) Iced tea
B) Ice cream
C) Warm broth
D) Gelatin dessert

Question 22

A patient who has been hospitalized for 3 days with a serious mental illness says, "I've got to get out of here and back to my job. I get 60 to 80 messages a day, and I'm getting behind on my email correspondence." What is this patient's perspective about health and illness?

A) Fateful, magical
B) Eastern, holistic
C) Western, biomedical
D) Harmonious, religious

Question 23

The nurse administers medications to a culturally diverse group of patients on a psychiatric unit. What expectation should the nurse have about pharmacokinetics?

A) Patients of different cultural groups may metabolize medications at different rates.
B) Metabolism of psychotropic medication is consistent among various cultural groups.
C) Differences in hepatic enzymes will influence the rate of elimination of psychotropic medications.
D) It is important to provide patients with oral and written literature about their psychotropic medications.

Question 24

A nurse cares for a first-generation Canadian whose family emigrated from Germany. Which world view about the source of knowledge would this patient likely have?

A) Knowledge is acquired through use of affective or feeling senses.
B) Science is the foundation of knowledge and proves something exists.
C) Knowledge develops by striving for transcendence of the mind and body.
D) Knowledge evolves from an individual's relationship with a supreme being.

Question 25

When completing an admission assessment on a patient with a diagnosis of depression, the nurse discovers that the patient is taking an herb that is believed to treat depression in their culture but is contraindicated with the pharmacological treatment the patient is receiving. What is the nurses' initial action?

A) Respect the cultural need for the herb and alter the medication treatment.
B) Provide information to the patient as to why the herb is contraindicated.
C) Inform the patient that she or he will not be able to take this herb while in hospital.
D) Do not address this with the patient but report it to the health care provider in charge of care.

Question 26

A nurse prepares to assess a newly hospitalized patient who moved to Canada 6 months ago from Somalia. The nurse should first determine which of the following?

A) If the patient's immunizations are current
B) The patient's religious preferences
C) The patient's specific ethnic group
D) Whether a translator is needed

Question 27

The nurse should be particularly alert to somatization of psychological distress among patients whose cultural beliefs include which of the following?

A) Mental illness reflects badly on the family.
B) Mental illness shows moral weakness.
C) Intergenerational conflict is common.
D) The mind and body are merged.
E) Food choices influence one's health.

Question 28

Which questions should the nurse ask to determine an individual's world view?

A) What is more important: the needs of an individual or the needs of a community?
B) How would you describe an ideal relationship between individuals?
C) How long have you lived at your present residence?
D) Of what importance are possessions in your life?
E) Do you speak any foreign languages?

Question 29

Why is the study of culture so important for psychiatric nurses in Canada?

A) Psychiatric nurses often practice in other countries.
B) Psychiatric nurses must advocate for the traditions of the Western culture.
C) Cultural competence helps protect patients from prejudice and discrimination.
D) Patients should receive information about their illness and treatment in terms they understand.
E) Psychiatric nurses often interface with patients and their significant others over a long period of time.

Question 30

A Mexican Canadian patient puts a picture of the Virgin Mary on the bedside table. What is the nurse's best action?

A) Move the picture so it is beside a window.
B) Send the picture to the business office safe.
C) Leave the picture where the patient placed it.
D) Send the picture home with the patient's family.

Question 31

A nurse begins work in an agency that provides care to members of a minority ethnic population. The nurse will be better able to demonstrate cultural competence after doing which of the following?

A) Identifying culture-bound issues
B) Implementing scientifically proven interventions
C) Correcting inferior health practices of the population
D) Exploring commonly held beliefs and values of the population