Deck 13: Cultural Diversity and Community Health Nursing

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?

A)Explain that patients are seen by appointment only, and set up another appointment for the client
B)Reinforce the need to plan ahead before arranging another appointment
C)Stress that health is the number one priority, and try to fit the client in sometime the same day
D)Understand that some clients are present oriented, and fit the client in so care can be given

Answer 1

Understand that some clients are present oriented, and fit the client in so care can be given

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?

A)A lot of people do family errands such as shopping on Fridays, Saturdays, and Sundays.
B)It was inconvenient for the client so he did not come.
C)A Muslim's holy day is from sunset Thursday to sunset Friday.
D)Patients do not like being told what to do.

Answer 2

A Muslim's holy day is from sunset Thursday to sunset Friday.

Question 3

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

A)"Can you explain to me the purpose of wrapping a band around the baby's tummy?"
B)"In the hospital, we prefer to expose the umbilical cord to air so it's easier to put medication on it as it dries up."
C)"Let me put some medication on the baby's cord, and then I'll put the tummy band back."
D)"Please remove that band; it is not helpful as the umbilical cord needs to be kept clean and dry."

Answer 3

"Can you explain to me the purpose of wrapping a band around the baby's tummy?"

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?

A)Ask a female nurse to talk with the client
B)Ensure that the client has privacy, with the two female friends waiting outside before trying again
C)Explain that the woman cannot see a physician until the nurse obtains a health history and does an initial examination
D)Stress that the clinic is free and she does not have to pay extra to see both the nurse and the physician

Question 5

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

A)Compliment each member on some visible asset
B)Establish rapport, and gain trust and confidence
C)Greet them in Spanish even if badly spoken and accented
D)Recognize the male as the authority figure in 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?

A)Assume it was a religious fast day, and not worry about it
B)Discuss with the supervisor what are traditional foods in that neighborhood
C)Offer to let those who did not eat take the leftover pizza home for a meal later in the day
D)Talk to the group, and ask what foods might have been more acceptable

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?

A)Ask if the client would like to discuss the choices with her family
B)Explain that the client has to decide, and wait for the client's decision
C)Explain that physicians cannot decide; perhaps the client could just flip a coin?
D)Nothing; simply accept that some fatalistic-oriented clients literally do not know how to choose
E)Suggest that the client discuss the situation with her ancestors and wait for guidance

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?

A)Ask if there was some reason the woman could not be immediately admitted for treatment
B)Explain to the woman why postponing the surgery was dangerous
C)Point out it that it's the woman's decision, and stress that she should go to the hospital immediately
D)Recognize that the husband and other family members may need to have input into this decision

Question 9

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

A)The preference to be cared for by someone from their own cultural group for maximum ease and comfort
B)The commonalities of values, norms, and life patterns that are held in all cultures
C)The particular values, beliefs, and patterning of behavior that is universal within a particular culture
D)The health care roles, norms, and behaviors that are involved when illness or injury occurs

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?

A)Accept the hesitation before receiving an ans
B)Ask the client what silence after a question means
C)Copy the client's behavior; insert a pause before asking the next question
D)Recognize that the client was distracted, and reschedule the home visit

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?

A)Polite response may not equal agreement.
B)Men do not take instruction from women.
C)His culture may value harmonious relationships over expressing disagreement.
D)The nurse told him what to do but did not ask if he could do it.

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?

A)"Can you explain what you believe happened to make you so ill now?"
B)"Can you tell me when in the day you and your family eat?"
C)"Please review with me when I taught you to take your medication."
D)"Why did you take more medication than we suggested?"

Question 13

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

A)Growth will occur because of a decrease in the death rate.
B)Growth will occur because of ongoing immigration.
C)Growth will occur because of an increase in the birth rate.
D)Growth will occur because of lengthening of the normal 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?

A)"Folk healers cannot cure such problems; let me give you appropriate fluids for your baby."
B)"Let's go back to feeding the baby formula, and see how the baby does."
C)"You continue to give the baby herbal tea, but let's put some sugar and salt in the tea."
D)"Your healer is correct; fluids are crucial for your baby. Let me give you some special fluids for you to give the baby."

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)?

A)Ask about the client's education or employment position
B)Ask his or her religious leader to share such information with the nurse
C)Let the financial office deal with the problem
D)Refer the issue to the social worker who has better sources of information

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?

A)"A person's husband, wife, or children"
B)"Anyone related to you by law or by blood ties"
C)"Someone who lives with you and has ties of commitment"
D)"Whoever you tell us is your 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?

A)A male obstetrician, expert in high-risk pregnancies
B)The female nurse midwife
C)The male obstetrician with a female nurse always in the room with the wife
D)Whichever provider was on duty until the pregnancy was confirmed

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?

A)Ask the woman if it's OK if the son translates for her
B)Call until she finds a Spanish interpreter employed by the agency
C)Let the son translate because he's obviously informed about the problem
D)Use gestures and pantomime to make oneself clear

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?

A)No, because the nurse should not ans any questions about a client, even if the wife is the one asking
B)No, because the woman and the nurse had different perceptions of personal space
C)Obviously yes, because the woman sought information, received it, and had no further questions
D)Yes, because the nurse was knowledgeable and able to respond appropriately

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?

A)Express admiration for his artistic ability, and do not schedule future visits because the patient is noncompliant
B)Point out the negative consequences that will ensue if the client does not begin exercising
C)Review with the client why exercise is so crucial to his recovery
D)Suggest drawing might be more forceful after exercising

Question 21

Which of the following actions was taken by the federal government to help improve health disparities among minorities?

A)Created scholarships and traineeships only for minority applicants
B)Created the National Center on Minority Health and Health Disparities
C)Established grants that funded only minority health projects
D)Legislated funds to create new colleges for preparing health professionals in minority neighborhoods

Question 22

Which of the following helps to balance the fact that poverty is typically a major factor in certain groups having poorer health?

A)A strong community health center in the neighborhood
B)Intact families where fathers are married to children's mothers
C)Strong family and community support for healthy behaviors
D)The large number of programs available to be of assistance in fighting poverty

Question 23

After being given negative news about a health problem,the client,with tears running down her face,asks,"Why did this happen to me?" Which of the following is the most appropriate response by the nurse?

A)"Could someone have cursed you?"
B)"Do you feel your life is out of balance?"
C)"God has a plan for each of us even if we do not understand it."
D)"Why do you think it might have happened?"

Question 24

A nurse is caring for a client from a different culture.Which of the following actions would be the most helpful for the nurse to take?

A)Ask to have a nurse from that culture assigned to the patient even if the nurse must be obtained from a different clinical area
B)Be aware of cultural similarities and differences between the nurse and the client
C)Explain that the patient must follow the rules of the hospital while a patient
D)Verbalize the nurse's own discomfort, and ask for assistance with surmounting the cultural differences

Question 25

A nurse is called by a friend who complains of symptoms of a cold.Which of the following responses would be the most appropriate by the nurse?

A)Ask the friend what she usually does for a cold and suggest that be done
B)Tell her to go to the urgent care center for assistance
C)Suggest that she make an appointment to see her health care provider
D)Point out to her that nurses are unable to treat patients

Question 26

A woman comes to the clinic,and the nurse believes that she is speaking French.She seems to understand English.A provider will need to complete a physical examination to confirm the health problem.Which of the following actions should be taken by the nurse?

A)Ask the client if she prefers a male or female provider
B)Ask a female provider to assume care
C)Ask the physician provider to see her immediately
D)Ask the secretary in the office who speaks French to assist in collecting a health history from the client

Question 27

Which of the following best describes the challenges when providing care to someone from a minority group? (Select all that apply.)

A)Communication, both words and gestures, may be unfamiliar.
B)Few members of the minority group are nurses themselves.
C)Immigrants will soon adapt to the mainstream culture, but in the meantime many are clinging to "the old ways."
D)So few patients are minority group members that it is difficult to remember how they prefer to receive care.
E)The nurse may have to confront personal values and beliefs.

Question 28

An unidentified patient was injured in a hit-and-run accident and was conscious.When asked how he felt,the patient looked very confused and responded in a language the nurse did not recognize.Which of the following actions should the nurse take next?

A)Look closely at the person, try to determine the patient's ethnic background, and then seek someone fluent in his language
B)Report the language barrier to administration, and let them handle the problem
C)Tell the unit supervisor so various translators can be brought to the floor until the language is recognized and communication can be established
D)Use gestures and pantomime until the nurse is able to determine what language the patient is speaking

Question 29

A nurse made a home visit for prenatal care and teaching for an Asian woman.The nurse noted the woman was having a hot lunch of foods the nurse did not recognize.When the nurse suggested some appropriate cold protein foods be added to the meal,the woman looked horrified and distrusting.Which of the following best describes what has happened in this situation?

A)The interference with eating seemed incredibly intrusive and inappropriate.
B)The nurse was giving advice when advice had not been sought.
C)The nurse had suggested foods unknown to the woman.
D)The yin and yang theory requires only hot food be eaten when female yin energy is dominant.

Question 30

Crying,a clinic patient explained that she knew she had this breast lump because she had spread nasty gossip about her neighbor.Which of the following actions by the nurse would likely be the most successful?

A)Explain the causes of a breast lump and the usual treatments
B)Refer the woman for an immediate biopsy to determine the status of the lump
C)Suggest that she has to repent and as much as possible undo her sin, but also make an appointment for a biopsy
D)Suggest that she has to repent, apologize to her neighbor, and pray for forgiveness

Question 31

The clinic was seeing a great number of Hmong immigrants from the mountainous regions of the Far East.If the nurse could not obtain a translator,which of the following would be the next best action?

A)Require each patient to bring a family member fluent in English
B)Start teaching Hmong patients English on each clinic visit
C)Suggest Hmong patients might be more comfortable seeking care elsewhere
D)Try to make flash cards with common phrases used during clinic visits

Question 32

Which of the following are the most important factors in reducing disparities in health outcomes between different cultural groups? (Select all that apply.)

A)A strong family structure
B)Access to a health care provider
C)Access to transportation
D)Health care insurance
E)Having ongoing employment
F)Owning one's own home

Question 33

A nurse was assigned to create and implement a community education program with the goal of preventing diabetes among the Hispanic population.As the nurse did not speak Spanish and was just beginning to be comfortable with the neighborhood Hispanic culture,which of the following would be the best approach for the nurse to take?

A)Be sure to use appropriate images in the handouts.
B)Copy literature and procedures found successful in other Hispanic communities.
C)Tell the supervisor the nurse is not competent for this task.
D)Try to find Hispanic volunteers who may be able to do the actual teaching.