Deck 2: Care of the Family in a Culturally Diverse Society

Question 1

A nurse is performing an assessment on a family with a father and mother who both work. What type of family does she record this family as being?

A) A traditional nuclear family
B) A dual-career/dual-earner family
C) An extended family
D) An extended kin family

Answer 1

A dual-career/dual-earner family

Question 2

The nurse caring for several patients and their families knows that roles in each family are determined by:

A) Age.
B) Stressors.
C) Demographic trends.
D) Definition of family.
E) Ethnocentrism.

Answer 2

Age.
Stressors.
Demographic trends.

Question 3

The nurse in the community should use a family assessment tool to obtain what type of information?

A) How long the family has lived at its current address
B) What other health insurance the family has had in the past
C) How the family meets its nutritional needs and obtains food
D) What eye color the family desires in its unborn child

Answer 3

How the family meets its nutritional needs and obtains food

Question 4

In assessing a new family coming to the clinic, the nurse determines they are an extended kin family. Extended kin network family characteristics include:

A) A sharing of a social support network.
B) The sharing of goods and services.
C) Elderly parents share housing.
D) Children are members of two nuclear families.
E) Living in a Latino community.

Question 5

Why is it important for the nurse to understand the type of family that a client comes from? Standard Text:

A) Family structure can influence finances and the ability to purchase nutritious foods.
B) Many types of families exist, and it is important to address the persons who hold power within the family.
C) The nurse can anticipate which problems a client will experience based on the type of family the client has.
D) Understanding if the client's family is nuclear or blended will help the nurse teach the client the appropriate information.
E) The values of the family will be predictable if the nurse knows what type of family the client is a part of.

Question 6

When working with families entering the childbearing years, the nurse knows that teaching will be needed regarding the challenges of:

A) Meeting the emotional needs of a newborn.
B) Exploring the couple's feelings about role transition.
C) Accessing resources in the community.
D) Raising the infant in formal traditions of the grandparents.
E) Exploring ways of dealing with family conflict.

Question 7

The nurse is preparing a community presentation on family development. Which statement should the nurse include?

A) The youngest child determines the family's current stage.
B) A family does not experience overlapping of stages.
C) Family development ends when the youngest child leaves home.
D) The stages describe the family's progression over time.

Question 8

The nurse is performing a cultural assessment using the Transcultural Assessment Model. What aspect of communication should the nurse keep in mind when planning the assessment?

A) Personal space does not vary from one culture to another.
B) Cultural groups living in the United States are future-oriented.
C) Nonverbal communication is consistent across cultures.
D) The use of silence can differ among different groups.

Question 9

A couple who came to the United States two years ago with their two children are seeing the nurse in the community clinic. The nurse knows their family is acculturating when the mother makes which statement?

A) "The children are much less well-behaved than they used to be."
B) "Our diet now includes hamburgers and French fries."
C) "We celebrate the same holidays that we used to at home."
D) "When the children leave the house, I worry about them."

Question 10

The nurse is caring for a postpartal patient of Hmong descent who immigrated to the United States 5 years ago. The patient asks for the regular hospital menu because American food tastes best. The nurse assesses this response to be related to which of the following cultural concepts?

A) Acculturation
B) Ethnocentrism
C) Enculturation
D) Stereotyping

Question 11

The nurse is preparing to assess the development of a family new to the clinic. The nurse understands that the primary use of a family assessment tool is to:

A) Obtain a comprehensive medical history of family members.
B) Determine to which clinic the client should be referred.
C) Predict how a family will likely change with the addition of children.
D) Understand the physical, emotional, and spiritual needs of members.

Question 12

The pregnant patient reports to the nurse that she is eating dirt on a weekly basis and was told to do this by her grandmother to have a healthy pregnancy. How should the nurse respond?

A) "The soil might contain contaminants that could harm your baby."
B) "This practice is completely unhealthy and should be stopped."
C) "Your grandmother gave you bad advice. Stop at once."
D) "There is no problem with this practice. Feel free to continue."

Question 13

In assessing a family, the community nurse uses a family assessment tool, which provides an organized framework to collect data concerning:

A) Access to laundry, and grocery facilities.
B) Access to health care.
C) Sharing of religious beliefs and values.
D) Acculturation to traditional lifestyles.
E) Ability to include a new spouse into the family unit.

Question 14

In working with immigrants in an inner-city setting, the nurse recognizes that acculturation of immigrants often brings with it the benefit of:

A) Improved socioeconomic status.
B) Use of preventive care services.
C) Increased job-related stressors.
D) Increase in substance abuse over time.
E) More physician visits due to language barriers.

Question 15

The nurse is caring for a family in the community with a 2-month-old infant who is breastfed. The father helps by changing diapers and dressing and bathing the baby. The mother will return to work when the baby is 3 months old, and a child care provider has been arranged. Although the mother occasionally feels fatigued, the couple has resumed having sexual relations, although not as frequently as before the pregnancy. Which family model best describes this family?

A) Model of the Childbearing Family
B) Model Incorporating the Unattached Young Adult
C) Model of the Nuclear Family
D) Model Incorporating Divorce and Remarriage

Question 16

The nurse teaching a group of students about trends that have affected the contemporary family includes:

A) An increase in the median age at the time of marriage.
B) A higher percentage of marriages ending in divorce.
C) A decline in childless families.
D) Traditional nuclear families remaining the norm.
E) An increased acceptance of single women having children.

Question 17

The public health nurse is working with a student nurse. The student nurse asks which of the six groups of people they have seen today are considered to be families. The nurse responds:

A) "The married heterosexual couple without children."
B) "The gay couple with two adopted children."
C) "The unmarried heterosexual couple with two biological children."
D) "The lesbian couple not living together that have no children."
E) "The married heterosexual couple with three children, living with grandparents."

Question 18

A nurse is comparing several different families' developmental stages, using Duvall's eight-stage family life cycle. Which person serves as a marker for a family's developmental stage in this theory?

A) The youngest child
B) The mother
C) The oldest child
D) The father

Question 19

In learning about Duvall's life-cycle stages ascribed to traditional families, the nursing student recognizes that developmental tasks of each stage include:

A) Adjusting to new roles as mother and father.
B) Working out authority and socialization roles with the school.
C) Becoming a single parent with custodial responsibilities.
D) Becoming a couple and dating.
E) Adjusting to the loss of a spouse.

Question 20

A 7-year-old patient tells you that "Grandpa, Mommy, Daddy, and my brother live at my house." The nurse identifies this family type as:

A) Binuclear.
B) Extended.
C) Gay or lesbian.
D) Traditional.

Question 21

The nurse is working with a woman newly enrolled in an English-as-a-second-language class. The nurse wants to teach the woman about the importance of hand washing before meals. The best way to assimilate the nurse's cultural values about hygienic nutrition is to:

A) Have the nurse model proper hand washing before examining the woman.
B) Provide written materials in English about hygiene and diet for the patient to take home.
C) Have the woman repeat her interpretation of the information that was taught.
D) Schedule a medical interpreter to accompany the patient to her next visit.

Question 22

A nurse is working in a clinic where people from several cultures are seen. As a first step toward the goal of personal cultural competence, the nurse will:

A) Enhance cultural skills.
B) Gain cultural awareness.
C) Seek cultural encounters.
D) Acquire cultural knowledge.

Question 23

During the assessment phase of a family, the community nurse recognizes that culture influences childrearing and childbearing in the:

A) Beliefs about the importance of children.
B) Beliefs and attitudes about pregnancy.
C) Norms regarding infant feeding.
D) Acculturation is important in rearing children.
E) Time orientation to the future is very important.

Question 24

When planning care of childbearing families, the nurse encounters different spiritual and religious beliefs and practices. Which spiritual practice could impact the nurse's care of the childbearing family?

A) A strong belief in reincarnation, and thus refusal of an autopsy
B) The desire to light candles at home during a naming ceremony
C) Request by the family to speak to a Roman Catholic priest
D) Refusing consent for a blood transfusion by a Jehovah's Witness

Question 25

The nurse manager in a hospital with a large immigrant population is planning an in-service. Aware of how ethnocentrism affects nursing care, the nurse manager includes the statement, "The belief that one's own values and beliefs are the only or the best values:

A) "Means that newcomers to the United States should adopt the norms and values of the country."
B) "Can create barriers to communication through misunderstanding."
C) "Leads to an expectation that all clients will exhibit pain the same way."
D) "Improves the quality of care provided to culturally diverse patient bases."

Question 26

During the assessment, the nurse notices that an African American baby has a darker, slightly bluish-hued patch about 5 cm 7 cm on the buttocks and lower back. What is the nurse's next action?

A) Call the Department of Social Services (DSS) to report this sign of abuse.
B) Confer with the physician about the possibility of a bleeding tendency.
C) Ask the mother about the cause of the bruise.
D) Chart the presence of a Mongolian spot.

Question 27

The charge nurse is reviewing the care plans written by the unit's staff nurses. The charge nurse recognizes that the nursing diagnosis most likely to be construed as culturally biased and possibly offensive is:

A) Fear related to separation from support system during hospitalization.
B) Spiritual Distress related to discrepancy between beliefs and prescribed treatment.
C) Interrupted Family Processes related to a shift in family roles secondary to demands of illness.
D) Noncompliance related to impaired verbal communication secondary to recent immigration from non-English-speaking area.

Question 28

When teaching a culturally diverse group of childbearing families about hospital birthing options, the culturally competent nurse:

A) Understands that the families have the same values as the nurse.
B) Teaches the families how childbearing takes place in the United States.
C) Insists that the clients answer questions instead of their husbands.
D) Incorporates the specific beliefs of the cultural groups that are attending the class.

Question 29

The nurse will assess numerous health practices during patient pregnancies. Some practices include the:

A) Prevalence of home remedies.
B) Importance of indigenous healers.
C) Influence of professional healthcare workers.
D) Addition of food to the formula at 2 weeks of age.
E) Wife's deferral to the spouse for decision making.

Question 30

Which questions are appropriate for the nurse to ask during a cultural assessment of a patient new to the clinic?

A) What genetic and other biological differences affect caregiving?
B) Which family member must be consulted for decisions about care?
C) What type of health provider is the most appropriate?
D) Does the patient have beliefs or traditions that might impact the care plan?
E) Are communications patterns established?

Question 31

The nurse is admitting a Mexican woman scheduled for a cholecystectomy. The nurse uses a cultural assessment tool during the admission. Which would be most important for the nurse to ask?

A) "What other treatments have you used for your abdominal pain?"
B) "In what country were you were born?"
C) "When you talk to family members, how close do you stand?"
D) "How would you describe your role within your family?"

Question 32

The nurse works in a facility that cares for patients from a broad range of racial, ethnic, cultural, and religious backgrounds. Which statement should the nurse include in a presentation to recently hired nurses on the patient population of the facility?

A) "Our patients come from a broad range of backgrounds, but we have a good interpreter service."
B) "Many of our patients come from backgrounds different from your own, but it doesn't cause problems for the nurses."
C) "Because most of the doctors are bilingual, we don't have to deal with the differences in cultural backgrounds of our patients."
D) "Understanding the common values and health practices of our diverse patients will facilitate better care and health outcomes."

Question 33

A woman of Korean descent has just given birth to a son. Her partner wishes to give her sips of hot broth from a thermos he brought from home. The patient has refused the nurse's offer of ice chips or other cold drinks. The nurse should:

A) Explain to the client that she can have the broth if she will also drink cold water or juice.
B) Encourage the partner to feed the client sips of broth and ask whether the patient would like you to bring her some warm water to drink as well.
C) Explain to the couple that food cannot be brought from home, but that the nurse will make hot broth for the client.
D) Encourage the client to have the broth, but explain that it must be boiled first in the kitchen.

Question 34

A laboring patient of Chinese descent has been very quiet during labor, and has made no noise during contractions during the past 4 hours. The nurse understands that this indicates that the client:

A) Believes pain should be endured and not expressed.
B) Is not in the active phase of labor yet.
C) Will not need pain medication during her hospitalization.
D) Has been abused by her husband, and is afraid to verbalize fear.

Question 35

A home health nurse has set up a home visit with a Korean couple to follow up on their jaundiced 4-day-old baby, who was discharged home yesterday. Considering family power structure, what family members might the nurse expect to see in the home?

A) Just the parents
B) The grandmother
C) The grandfather and parents
D) The godparents

Question 36

The labor and delivery nurse is caring for a laboring patient who has asked for a priest to visit her during labor. The patient's mother died during childbirth, and although there are no complications during her pregnancy, the patient is fearful of her own death during labor. What is the best response by the nurse?

A) "Nothing is going to happen to you. We'll take very good care of you during your birth."
B) "Would you like to have an epidural so that you won't feel the pain of the contractions?"
C) "The priest won't be able to prevent complications, and might get in the way of your providers."
D) "Would you like me to contact your parish or our hospital chaplain to come see you?"

Question 37

The nurse is working with a patient whose religious beliefs differ from those of the general population. The best nursing intervention to use to meet the specific spiritual needs of this family is to:

A) Ask how important the patient's religious and spiritual beliefs are when making decisions about health care.
B) Show respect while allowing time and privacy for religious rituals.
C) Ask for the patient's opinion on what caused the illness.
D) Identify healthcare practices forbidden by religious or spiritual beliefs.