Deck 10: Cultural Competency and Social Issues in Nursing and Health Care

Question 1

A Hispanic patient is visited by several family members and the nurse witnessed one visitor who pinches a piece of skin at the waist. The nurse asks the purpose and learns the "provider" is listening for a snap from the abdominal region, which is then repeated several times. The patient most likely suffers from:

A) mal ojo.
B) susto.
C) bilis.
D) empacho.

Answer 1

empacho.

Question 2

A nurse is submitting a grant application to improve access to health care and mortality for minority groups. The grant focuses on the six causes of death that are identified as priorities for minorities, which include:

A) chronic obstructive pulmonary disease.
B) malnutrition.
C) cirrhosis of the liver.
D) cancer.

Answer 2

cancer.

Question 3

While completing a nursing degree in Virginia, a student who is interested in teaching in Laredo, Texas, enrolls in Spanish classes for 4 years, knowing that a high number of Mexican-Americans live there. This nursing student values:

A) cultural competence.
B) ethnocentrism.
C) prejudice.
D) stereotyping.

Answer 3

cultural competence.

Question 4

A Southeast Asian woman brings her baby into the clinic because the baby is lethargic. The nurse determines that the baby has had diarrhea and vomiting for several days, resulting in dehydration. Physical examination reveals small, round burns on the abdomen. These burns probably are the result of cigarettes or burning cotton used to:

A) try to quiet the child and is considered child abuse.
B) bring out toxic wind from the body.
C) balance heat loss from the body.
D) brush the body with ruda to allow spirits to return.

Question 5

Which statement is true regarding health care for minorities?

A) Federal legislation that provides free health insurance for minorities has resulted in fewer minorities than members of the general population who lack health insurance.
B) Higher costs of health care coupled with lower wages for minorities have prevented most minorities from seeking health care.
C) Because many Mexican Americans are highly skilled workers with comparable wages, they have the lowest uninsured rate.
D) Asians, because of their quiet demeanor and unwillingness to challenge the health care system, have the highest rate of uninsured people.

Question 6

When planning health care, the nurse should be mindful that members of the Asian culture tend to:

A) miss appointments because they are present oriented and time is viewed as flexible.
B) look to their ancestors for guidance.
C) plan ahead and be future oriented.
D) arrive early because they have no concept of time.

Question 7

A nurse performing a history and physical on a newly admitted Hispanic patient learns the patient has just used the services of a savador to:

A) determine which herbs would best reduce hot flashes in a menopausal woman.
B) communicate with a family member who recently died.
C) receive treatments to reduce lower back pain.
D) receive acupuncture to stop smoking.

Question 8

A nurse is preparing to teach a class related to risk factors for cancer to a diverse ethnic group attending a health fair. The nurse should be aware:

A) that Hispanic women overestimate the prevalence of cancer and strictly following breast self-examination guidelines.
B) of the importance of risk factors such as smoking and alcohol consumption that increase esophageal cancer when speaking with black.
C) that American-Indian women have a higher rate of ovarian cancer than the general population.
D) that cancer as well as heart disease and stroke are lower in ethnic groups.

Question 9

A nurse caring for a Hispanic child admitted with diarrhea notices the child is wearing red yarn around the wrist. The nurse compliments the child's "jewelry," knowing it is believed to prevent:

A) mal ojo.
B) susto.
C) bilis.
D) empacho.

Question 10

An Asian teenager is admitted with an eating disorder which she contributes to by not meeting the academic expectations of her parents. The nurse is overheard saying, "That isn't the reason; all Asians are really smart." This nurse is demonstrating:

A) cultural humility.
B) stereotyping.
C) cultural assimilation.
D) acculturation.

Question 11

The nurse is preparing a plan of care for an black patient who has had a change of bowel habits from being constipated and having only two firm stools weekly to having three or more loose stools daily. Which comment is related to cultural variation for health information?

A) The individual states, "I will need to discuss health care options with my grandmother."
B) The eldest male member of the family will make all health care decisions.
C) The patient has high respect for the nurse and nods approvingly, although she has no intention of complying with instructions or plan of care.
D) The individual speaks very quietly and gently reaches to hold the nurse's hand for support.

Question 12

A nurse is admitting a Mexican-American child, and the mother comments that the child was exposed to mal ojo. The nurse should expect to find which symptom associated with this exposure?

A) Fever
B) Nervous tension
C) Bruising
D) Somnolence

Question 13

A cultural phenomenon that is based on biologic variation would include:

A) belief that exposure of a pregnant woman to an eclipse can result in cleft lip.
B) denser bones in blacks result in less morbidity associated with osteoporosis.
C) the grandmother who determines that her grandchild has scoliosis and should seek treatment, then informs the parents of her decision.
D) a family that participates in feasts prepared to celebrate and make decisions.

Question 14

A nurse is given a referral to make a home visit to a Russian immigrant. The nurse knows very little about the health beliefs of this ethnic group. To research this group, she can use an Internet search engine and enter the term "Russian cultures" or "Russian health beliefs." To obtain more generalized information, she could also search under:

A) federally recognized minorities.
B) marginalized populations.
C) Asian/Pacific Islander cultures.
D) Latino cultures.

Question 15

A priority action for the nurse who works with culturally diverse clients is completion of a:

A) sign language course.
B) cultural self-assessment.
C) cultural client assessment.
D) continuing education course on how to speak Spanish.

Question 16

A nurse is seeking to become culturally competent in regard to obtaining information during health history and when performing physical diagnosis. The nurse is aware that which biologic variation is found in all of the following ethnicities: blacks, Asians, Hispanics, and American Indians?

A) Mongolian spots
B) Sickle cell anemia
C) Lactose intolerance
D) Thalassemia

Question 17

A nurse is caring for a recent Asian immigrant client and is overheard making the following comment, "These rituals you believe in are false. You live in America now and must believe in realistic health practices, like Americans do." The nurse is exhibiting:

A) stereotyping.
B) ethnocentrism.
C) cultural accommodation.
D) empathy.

Question 18

A nurse is preparing discharge teaching for an Asian-American woman with a fractured hip. The nurse reviews the client's diet history while hospitalized and is concerned that the patient refused milk and yogurt, placing her at risk for osteoporosis. What cultural variation is the nurse overlooking? Asian Americans:

A) have denser bones than other ethnic groups.
B) consume diets rich in pork bone and shells, reducing the risk of osteoporosis.
C) would participate in the practice of burning to compensate for this injury.
D) would consult a curandero for dietary consultation.

Question 19

A Mexican-American patient is attacked and beaten. This patient is at risk for "fright disease," which is known as:

A) susto.
B) empacho.
C) bilis.
D) mal ojo.

Question 20

A nurse plans to move to an area that is rich in immigrants from several countries and is concerned about respecting others' cultural beliefs. The nurse's first step to ensure cultural competence and sensitivity is to:

A) enroll in a nursing theories course to increase knowledge about transcultural practices.
B) become immersed in nursing literature about culturally diverse clients.
C) participate in continuing education that focuses on health assessment variations among cultural groups.
D) conduct a cultural self-assessment.

Question 21

Six cultural phenomena that vary among cultural groups are known to affect health care. The influence of the consequences of these phenomena can be seen in which of the following? (select all that apply)

A) Asians and American Indians tend to be nonadherent with medications because they believe that the environment has no control over their fate.
B) Some cancers such as stomach cancer occur less frequently among blacks.
C) Blacks and American Indians often resist direct eye contact.
D) Mexican Americans are more likely to stand close and touch health care providers.
E) Whites are often late for health care appointments.

Question 22

On the scale from 1 to 10, with 1 being no prejudice and 10 being extreme prejudice, the placement of hate on the continuum would be at number _____.

Question 23

Although communication varies among members of different cultures, the greatest obstacle to providing multicultural care is differences in _____.

Question 24

A nurse involved in researching the leading causes of death for minorities considers the federally defined minority groups, which include: (select all that apply)

A) Blacks
B) Russians
C) Hispanics
D) Asians or Pacific Islanders
E) Scandinavians