Question 1

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:

Accepted Answer

Correct:Hispanic patients may want the support and care of a savador,which is similar to that offered by a chiropractor.
Incorrect:a.A verbo would be consulted regarding herbs.
b.A spiritualist would be consulted to communicate with decreased family or friends.
d.Acupuncturists deliver treatment for many reasons,including pain relief,smoking cessation,and eating disorders.

Question 2

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:

Accepted Answer

Correct:Empacho is believed to be caused by lodged food particles,causing acute stomach/intestinal pain.
Incorrect:a.Mal ojo is due to "admiration" from a stranger resulting in diarrhea.
b.Susto is "fright disease" such as caused by a bicycle wreck or loud shouting.
c.Bilis follows a rage.

Question 3

Which statement is true regarding health care for minorities?

Accepted Answer

Correct:Most families with racially or ethnically diverse backgrounds have a lower socioeconomic status than is observed in the population at large.Dramatic changes in technology and specialization in the health care field have caused health care costs to skyrocket.Therefore,not everyone can afford health care services.
Incorrect:a.More minorities than general population members lack health insurance.
c.At 40%,Mexican Americans have one of the highest uninsured rates.
d.African Americans,Hispanics,and Native Americans have much higher rates of poverty than do non-Hispanic whites and Asians.The median family income of Asians is slightly higher than that of non-Hispanic whites; because their income is higher,Asians have better access to health care.

Question 4

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

Accepted Answer

Correct:In Asian culture,individuals tend to be present oriented and time is viewed as being more flexible than in the Western culture; being on time for appointments is not seen as a priority.
Incorrect:b.The people of the Asian culture usually have close,extended family ties,and emphasis is on family needs rather than individual needs; all members participate in health care decisions.
c.The Asian culture is present oriented.
d.The Asian culture is present oriented,and Asian individuals are often late for appointments because they are less concerned with planning ahead.

Question 5

The nurse is preparing a plan of care for an African-American 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?

Accepted Answer

Correct:In the African-American culture,women,especially "Granny," play a key role in health care decisions.
Incorrect:b.Males often make decisions in Asian cultures.
c.In the Asian culture,it is important for an individual to agree with those in authority and to appear compliant,even if there is no intention of complying with instructions or plan of care.
d.A low tone of voice is consistent with the American Indian culture,and touching another's hand is not common among Asians or American Indians.

Question 6

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:

Accepted Answer

Correct:In the Southeast Asian culture,touching a burning cigarette or piece of cotton to the skin,usually the abdomen,is done to compensate for "heat" lost through diarrhea.This type of burning is a common part of self-care.
Incorrect:a.Quieting a child by burning his or her skin is not a practice of Southeast Asian culture.
b.Using burns to bring out toxic wind from the body is not a practice of Southeast Asian culture.
d.Brushing the body with ruda to allow spirits to return is not a practice of Southeast Asian culture.

Question 7

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

Accepted Answer

Correct:Biologic variations include denser bones in African Americans.Biologic variations such as body build and structure,genetic variations,skin characteristics,susceptibility to disease,and nutritional variations exist among different cultures.Other common variations include skin color,eye shape,hair texture,and adipose tissue deposits.
Incorrect:a.The belief that exposure of a pregnant woman to an eclipse can result in cleft lip is an example of environmental control.
c.A grandmother who has a lot of say in health care decisions is an example of ways that social organization affects cultural beliefs.
d.Family feasts to celebrate and make decisions and Vietnamese immigrants gathering at an altar into which the names of ancestors have been carved are examples of ways that social organization affects cultural beliefs.

Question 8

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:

Accepted Answer

Correct:Stereotyping is associating certain behavior or competencies with an ethnic group without considering the individual.
Incorrect:a.Cultural humility is a lifelong commitment to reduce the power imbalances due to lack of cultural consideration.
c.Cultural assimilation is the cultural absorption of a minority group into the main cultural body.
d.Acculturation is the process of becoming adapted to a new or different culture.

Question 9

A nurse is seeking to become culturally competent in regards 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: African Americans, Asians, Hispanics, and American Indians?

Accepted Answer

Correct:Lactose intolerance is found in all four of the noted ethnicities.
Incorrect:a.Mongolian spots are found in African American,Asians,and Hispanics but not in American Indians.
b.Sickle cell anemia is found only in African Americans.
d.Thalassemia is common only to Asians.

Question 10

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:

Accepted Answer

Correct:Mal ojo is due to "admiration" from a stranger resulting in diarrhea.
Incorrect:b.Susto is "fright disease" such as caused by a bicycle wreck or loud shouting.
c.Bilis follows a rage.
d.Empacho is believed to be caused by lodged food particles.

Question 11

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:

Accepted Answer

Correct:A cultural self-assessment allows the nurse to identify attitudes about individuals from different cultures.
Incorrect:a.To gain maximum benefit,the nurse must first identify his own attitudes before enrolling in a nursing theories course.
b.To gain maximum benefit,the nurse must first identify his own attitudes before immersing himself in nursing literature about culturally diverse clients.
c.To gain maximum benefit,the nurse must first identify his own attitudes before participating in continuing education that focuses on health assessment variations among cultural groups.

Question 12

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:

Accepted Answer

Correct:Marginalized populations include recently arrived immigrants.Their lives and health care needs often are kept secret and are understood only by them.
Incorrect:a.Russian immigrants are not federally recognized minorities.
c.A search for Asian/Pacific Islander cultures would not provide any information on Russian Immigrants.
d.A search for Latino cultures would not provide any information on Russian immigrants.

Question 13

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:

Accepted Answer

Correct:Cancer is identified as a leading cause of excessive death among minority group members.The six leading causes are cancer,cardiovascular disease and stroke,chemical dependency,diabetes,homicides/accidents,and infant mortality.
Incorrect:a.Chronic obstructive pulmonary disease is not identified as one of the six leading causes of death among minority groups.
b.Malnutrition is not identified as one of the six leading causes of death among minority groups.
c.Cirrhosis of the liver is not identified as one of the six leading causes of death among minority groups.

Question 14

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?

Accepted Answer

Correct:The child has what is referred to as mal ojo or "evil eye," which can lead to diarrhea,fever,and even death.
Incorrect:b.A child said to have fits of rage or bilis would experience nervous tension and fatigue.
c.Bruising is associated with cupping,a common practice among Southeast Asians.
d.Somnolence is not a symptom of mal ojo.

Question 15

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:

Accepted Answer

Correct:Ethnocentrism is the belief that one's own ethnic group,culture,or nation is best.
Incorrect:a.Stereotyping is defined as assigning certain beliefs and behaviors to groups without recognizing individuality.
c.Cultural accommodation involves making adjustments or adaptations to the beliefs of others.
d.Empathy is mentally identifying with a person's situation or character.

Question 16

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:

Accepted Answer

Correct:Cultural competence is the responsibility of all nurses to become knowledgeable about the values,beliefs,and health care practices of the culturally diverse groups that are dominant in the nurse's particular practice area.
Incorrect:b.Ethnocentrism is the belief that one's own ethnic group,culture,or nation is best.
c.Prejudice is a preconceived,deeply held,usually negative judgment that has been formed about other groups.
d.Stereotyping is assigning particular beliefs and behaviors to specific groups without recognition of individuality.

Question 17

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

Accepted Answer

Correct:Pork bones and shells are rich in calcium,reducing the risk of osteoporosis.
Incorrect:
a.African Americans have denser bones than other ethnic groups.
c.Although Southeast Asians participate in burning,it is used to compensate for heat loss such as with diarrhea.
d.Hispanic clients consult with curanderos,whereas Asian clients would seek an acupuncturist or bone setter.

Question 18

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:

Accepted Answer

Correct:African-American men have a higher risk for esophageal cancer than the general population so teaching risk factors is needed.
Incorrect:a.Hispanic women tend to underestimate the power of prevention and prevalence of cancer and have fewer screenings performed.
c.American women have a higher prevalence of diabetes than the general public and lower incidence of cancer than the general public.
d.Heart disease and stroke are leading cause of death in minorities with cancer being the second leading cause.

Question 19

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

Accepted Answer

Correct:Susto is an emotion-based illness common among Mexicans.An unexpected fall,a barking dog,or a car accident could cause susto.Symptoms include colic,diarrhea,high temperature,and vomiting.
Incorrect:b.Empacho,a disease that can affect children or adults,is caused by food particles that become lodged in the intestinal tract,causing sharp pains.
c.Bilis is a disease that is brought on by anger.It primarily affects adults and commonly occurs a day or two after a fit of rage.
d.Mal ojo is associated with "evil eye," which causes fever,diarrhea,and restlessness.

Question 20

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

Accepted Answer

Correct:The first step to becoming a culturally sensitive and competent health care provider is to conduct a cultural self-assessment.Through identification of health-related attitudes,values,beliefs,and practices,the nurse can better understand the cultural aspects of health care from the client's perspective.
Incorrect:a.A sign language course is not a priority because interpreters are usually available.
c.The nurse should always perform a cultural self-assessment first,before performing the patient's cultural assessment.
d.Taking a Spanish class is not a priority action and would be helpful only with patients who speak Spanish; the nurse may encounter many other patients with different language needs.

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