Question 1

A ritual differs from a custom in that a ritual is

Accepted Answer

Rituals are highly structured and prescribed patterns of behavior used by a cultural group to respond to or in anticipation of specific life events such as birth,death,illness,healing,marriage,worship,and other important events.Customs are frequent or common practices carried out by tradition and include communication patterns,family and kinship relations,work patterns,and dietary,religious,and health care practices.Options "b" and "d" do not differentiate a ritual from a custom.

Question 2

A patient from which cultural group is most likely to interpret your touching her arm as comforting and reassuring,as you intended?

Accepted Answer

Haitians perceive touch as comforting,sympathetic,and reassuring.For the Chinese and Japanese,touching is limited and open expression of emotions is unacceptable.In the Middle Eastern cultures,men and women do not shake hands or touch each other in any manner outside the immediate family or marital relationship.Touching and embracing on arrival and on departure are common among the same sex,but not between sexes; therefore,the interpretation of a nurse touching a Middle Eastern patient would depend on the gender of the nurse and the patient.

Question 3

The belief that no culture is either inferior or superior to another and that behavior must be assessed from the cultural context in which it occurs is referred to as

Accepted Answer

Culturally competent nursing care is provided by nurses who use cross-cultural nursing care models that consist of using an ethic of cultural relativism to provide nursing services.Cultural relativism is the belief that no culture is either inferior or superior to another,that behavior must be evaluated in relation to the cultural context in which it occurs,and that respect,equality,and justice are basic rights for all racial,ethnic,and cultural groups.Cultural diversity is the state of different combinations of cultural and subcultural minorities coexisting in a given location.Ethnocentrism is a condition that occurs when individuals or groups of people perceive their own cultural group and cultural values to be superior to all others and have disdain for the expression of any way of life but their own.Multiculturalism is the act of living and functioning in two or more subcultures within the primary culture.

Question 4

A 10-year-old girl who has recently arrived from El Salvador,states in broken English,"I don't fit in,and I don't know what I am supposed to do at school." You recognize that she is most likely experiencing

Accepted Answer

Culture shock is the disorientation and uncertainty that results from the expenditure of mental,emotional,and physical energy during the process of adjusting to a new cultural group.This can lead to frustration,anger,alienation,or depression.The appropriate term for what this young girl is experiencing is culture shock,not cultural rejection or cultural immersion.When she adjusts to a new cultural group,she may experience cultural bias from others,which makes the adjustment more difficult; her family is not the cause of her discomfort.

Question 5

Your patient,who is a Chinese American,is likely to indicate that he does not understand what you are saying by

Accepted Answer

Chinese Americans may smile when they do not understand what you are saying.They are hesitant to ask questions.They would not frown to indicate lack of understanding.Silence after a statement is used by a speaker who wishes the listener to consider the importance of what is said.

Question 6

The nurse is caring for a dying boy whose religion is Islam (Muslim).Which of the following is an important nursing consideration related to his impending death and religion?

Accepted Answer

Islam has specific practices related to death.The dead must be buried with the body intact.The nurse should contact someone from the person's mosque to assist.The family may be present.No baptism is performed at this time.

Question 7

A nurse is planning care for a patient with an ethnic background different from her own.Which of the following would be the most appropriate goal?

Accepted Answer

When possible,nursing care should facilitate integration of ethnic practices into the patient's health needs.Ethnic background is a vital part of an individual,and it would be inappropriate for a nurse to try to change it or the beliefs associated with it.Additionally,it would be very difficult to eliminate the influence ethnic background has on an individual's health needs.Ethnic practices need to be evaluated within the context of the health care setting to determine whether they are conflicting with health care goals and whether they are appropriate in the health care setting.

Question 8

The family and kinship patterns typical among Hispanic and Native American families include which characteristic?

Accepted Answer

Hispanic and Native American families are examples of collateral family kinship patterns.They are generally open in their expressions of friendships.Although the male is usually the head of the family responsible for activities outside the home,women also play a major role in decision making,particularly in relation to child rearing and caring.These families tend to socialize within their social family group.Their children are valued highly whether female or male.

Question 9

Your patient becomes agitated because you failed to touch her son as you complimented him.You recognize that her response is most likely related to her belief in

Accepted Answer

The evil eye belief is shared by many Mediterranean,African,and Spanish-speaking cultures.The evil eye is more often than not given unintentionally,for example,by complimenting a child unprotected by an amulet,gold cross,or other protective device or by not touching the child while offering a compliment.It is feared that a child will lose her good looks if complimented for her looks if she was unprotected by a device.It is also feared that such a child will develop symptoms such as headaches,restlessness,irritability,high fever,etc.,if the person complimenting the child was not touching the child at the time.Magico-religious perspective is one way people explain the causation of illness.Its basic premise is that the world is seen as an arena in which supernatural forces dominate.The fate of the world and those in it depends on the action of supernatural forces for good or evil.Witchcraft is believed to be the cause of illness because an individual has committed some offense and is being punished,or the illness results from acts of aggression by other individuals.In the yin-yang theory,health exists when all aspects of the person are in perfect balance because all organisms and objects in the universe consist of yin and yang energy forces.

Question 10

Your patient is a 72-year-old African American male.The patient is married,with three children and eight grandchildren.He is a retired lawyer from New York who is now living in Florida and has requested a health assessment.Together,the cultural influences just described make up which of the following?

Accepted Answer

Every individual has a combination of cultural influences,derived from membership in the primary culture as well as multiple subcultures,which creates a multicultural identity.This unique identity makes it critical for the nurse to assess each patient in context rather than simply as a normative member of a single culture,subculture,race,or ethnic or minority group.Cultural identity is the cultural orientation with which an individual self-identifies.Predominant cultural identity is the main cultural group with which one self-identifies.

Question 11

The best way to overcome ethnocentrism is to

Accepted Answer

Ethnocentrism is a condition that occurs when individuals or groups of people perceive their own cultural values,beliefs,norms,and customs to be superior to all others,and have disdain for the expression and expresser of any way of life but their own.To overcome ethnocentrism,the nurse first must be willing and able to confront his own cultural biases and stereotyping,and examine the impact they will have on the patient.It is necessary to maintain an objective and nonjudgmental view of the values,beliefs,and practices of others.It is not necessary to develop language skills in the patient's primary language to avoid ethnocentrism.Option "c" is one aspect of developing cultural competence.Option "d" is not a method for overcoming ethnocentrism.

Question 12

Families with a linear family and kinship pattern are usually patriarchal and emphasize the goals of

Accepted Answer

When the family has a linear pattern,it usually consists of the nuclear family in addition to hereditary,linearly extended family members (i.e.,grandparents,aunts,uncles,and cousins).The welfare,continuity,and goals of the hereditary family take precedence over those of the individual family member.The linear family is usually patriarchal,places a strong emphasis on the enculturation of children,and greatly respects elder family members.The goals of the family take precedence over the individual members.

Question 13

Approaches for overcoming language barriers include

Accepted Answer

Special approaches for overcoming language barriers include: 1)using a culturally sensitive interpreter with fluency in health care terminology; 2)speaking slowly and distinctly in a normal tone; 3)using gestures or pictures to illustrate meaning; 4)avoiding clichés,jargon,and value-laden terms; 5)speaking to the patient,rather than to the interpreter; and 6)obtaining feedback to confirm accurate understanding.

Question 14

A nursing student is describing the Chinese American philosophy of yin and yang in a post-conference.The student describes how foods are classified using this belief system.Which of the following statements correctly describes the yin and yang food correlation?

Accepted Answer

In the Chinese American culture,foods are classified as hot or cold and are transformed into yin and yang energy when metabolized by the body.Yang foods are hot; yin foods are cold.Hot foods are eaten when a cold illness is present.Cold foods are eaten when a hot illness is present.

Question 15

As you conduct a physical examination on your patient.You are alert for genetic traits and disorders to which African Americans are most subject,which include

Accepted Answer

African Americans are most subject to the genetic disorders of hypertension,diabetes mellitus,and glaucoma.American Indians have the ethnic-specific disorders of asthma,cirrhosis,and nasopharyngeal cancer.Gaucher's disease,hypercholesterolemia,and stomach cancer are seen predominately in Ashkenazi Jews.Lactase deficiency,osteoporosis,and peptic ulcer disease are genetic traits or disorders seen in Koreans.

Question 16

Patients from which group are most likely to avoid asking for pain medication because of their cultural belief that pain should be stoically endured?

Accepted Answer

Filipinos tend to be stoic,and believe that pain is God's will and that He will give them the strength to bear it.Thus,they are likely to avoid asking for pain medication.The Chinese,Vietnamese,and Puerto Ricans do not have such beliefs about pain and would probably ask for pain medication.

Question 17

A patient's refusal to be cared for by a female health professional should be considered to be related to his cultural values and beliefs,particularly if he belongs to which cultural group?

Accepted Answer

In Arab or Middle Eastern groups,male patients may refuse to have female health professionals care for them.Likewise,male health professionals are prohibited from touching or examining female patients.The cultural groups in options "a," "c",and "d" do not have health customs and practices similar to the Arabs.

Question 18

Which of the following statements is true concerning folk remedies?

Accepted Answer

Folk remedies should be used to reinforce treatment plans whenever they are compatible.This will assist in establishing a caring environment.Depending on the remedy,it may not be incompatible with modern regimens.In options "c" and "d," circumstances vary with the remedy.

Question 19

Cultures have unique value orientations,which provide order and give direction to individuals,in these five areas

Accepted Answer

All cultures have a fundamental set of values and concurrent value orientations,that is,patterned principles that provide order and give direction to individuals' thoughts and behaviors related to the solution of commonly occurring human problems.Cultures have their own unique value orientations in five areas: time (time orientation),human nature (innate human nature),activity (purpose of existence),relational (relationships with others),and people-to-nature (relationship to nature).There are three major ways in which people can perceive time: past,present,or future.The innate human nature of people may be perceived as good,evil,or a combination.In examining the purpose of existence,three major views are held by people from various cultures: 1)being orientation: a human being's value resides in their inherent existence and spontaneity; 2)becoming-in-being orientation: inner control,meditation,and detachment are emphasized as ways to achieve self-realization; and 3)doing orientation: active striving and accomplishment are paramount.
Relationships with others may be categorized in three ways: 1)linear: those that exist by virtue of heredity or kinship ties; 2)collateral: group goals and family orientation are all important; and 3)individual: focus on personal autonomy and independence; individual goals dominate.Relationship with nature includes three perceptions: 1)mastery: human beings dominate nature and have control over their environment; 2)harmony: human beings live in harmony with nature and must maintain that balance; and 3)destiny: human beings are subjugated to nature in a fatalistic manner.

Question 20

The bidirectional translation process is one method of determining the cultural meaning that a patient attaches to his symptoms.It involves

Accepted Answer

This process involves collecting the patient's symptom statements and analyzing them in the context of meanings and patterns of thought that are shared by other members of the patient's culture.Listen to the patient's symptoms,reflect on the meaning the patient seems to attach to the symptoms,restate the inferred meaning,and allow the patient time to determine if the reflected inferred-meaning statement accurately reflects the patient's own reality.Then restate and restructure the inferred meaning until the patient validates its accuracy.The bidirectional translation process does not involve what is stated in options "a," "c," or "d."

Quiz 5: Cultural Assessment