Question 1

A nurse is designing a form for lesbian, gay, bisexual, and transgender (LGBT) patients. Which design should the nurse use?

Accepted Answer

Include LGBT-inclusive language on forms and assessments to facilitate disclosure, knowing that disclosure is a choice impacted by many factors. For example, provide options such as "partnered" under relationship status. For parents, use parent/guardian, instead of mother/father. Use neutral and inclusive language when talking with patients (e.g., partner or significant other), listening and reflecting patient's choice. Remember that some LGBT patients are also legally married.

Question 2

A nurse works at a hospital that uses equity-focused quality improvement. Which strategy is the hospital using?

Accepted Answer

Organizations can implement equity-focused quality improvement by recognizing disparities and committing to reducing them. Staff diversity is a priority for equity-focused quality improvement, not staff satisfaction. While the family is important, the focus is on the patients. Organizations should start by implementing a change on a small scale (pilot testing), learning from each test, and refining the intervention through performance improvement cycles (e.g., plan, do, study, and act).

Question 3

A nurse is providing care to a patient from a different culture. Which action by the nurse indicates cultural competence?

Accepted Answer

Cultural competence refers to a developmental process that evolves over time that impacts ability to effectively function in the multicultural context. Communicates effectively and speaking a different language indicates linguistic competence. Visiting a foreign country does not indicate cultural competence.

Question 4

A nurse is using the RESPECT mnemonic to establish rapport, the "R" in RESPECT. Which actions should the nurse take? (Select all that apply.)

Accepted Answer

The "R" in RESPECT stands for rapport and includes the following behaviors: connect on a social level; seek the patient's point of view; and consciously attempt to suspend judgment. The "S" stands for support and includes the behavior of helping the patient overcome barriers. The "P" stands for partnership and includes the following behaviors: be flexible with regard to issues of control and stress that you will be working together to address medical problems. The "C" stands for cultural competence and includes the behavior of knowing your limitations in addressing medical issues across cultures.

Question 5

Which action indicates the nurse is meeting a primary goal of cultural competent care for patients?

Accepted Answer

Although cultural competence and patient-centered care both aim to improve health care quality, their focus is slightly different. The primary aim of cultural competence care is to reduce health disparities and increase health equity and fairness by concentrating on people of color and other marginalized groups, like transgender patients. Patient-centered care, rather than cultural competence care, provides individualized care and restores an emphasis on personal relationships; it aims to elevate quality for all patients.

Question 6

A nurse is caring for an immigrant with low income. Which information should the nurse consider when planning care for this patient?

Accepted Answer

Populations with health disparities (immigrant with low income) have a significantly increased incidence of disease or increased morbidity and mortality when compared with the general population. Although Americans' health overall has improved during the past few decades, the health of members of marginalized groups has actually declined.

Question 7

A nurse is assessing population groups for the risk of suicide requiring medical attention. Which group should the nurse monitor $\bold{most}$ closely?

Accepted Answer

Gay, lesbian, and bisexual young people have a significantly increased risk for depression, anxiety, suicide attempts, and substance use disorders, being 4 times as likely as their straight peers to make suicide attempts that require medical attention. Caucasian youth, Asian Americans, and African-Americans are not as likely to attempt suicide resulting in medical attention.

Question 8

A nurse is beginning to use patient-centered care and cultural competence to improve nursing care. Which step should the nurse take $\bold{first}$?

Accepted Answer

Becoming more aware of your biases and attitudes about human behavior is the first step in providing patient-centered care, leading to culturally competent care. It is helpful to think about cultural competence as a lifelong process of learning about others and also about yourself. Learning about the world view, developing cultural skills, and understanding organizational forces are not the first steps.

Question 9

A nurse is performing a cultural assessment using the ETHNIC mnemonic for communication. Which area will the nurse assess for the "H"?

Accepted Answer

The "H" in ETHNIC stands for healers: Has the patient sought advice from alternative health practitioners? While health, history, and homeland are important, they are not components of "H."

Question 10

A nurse is assessing the health care disparities among population groups. Which area is the nurse monitoring?

Accepted Answer

While health disparities are the differences among populations in the incidence, prevalence, and outcomes of health conditions, diseases and related complications, health care disparities are differences among populations in the availability, accessibility, and quality of health care services (e.g. screening, diagnostic, treatment, management, and rehabilitation) aimed at prevention, treatment, and management of diseases and their complications.

Question 11

A nurse is providing care to a culturally diverse population. Which action indicates the nurse is successful in the role of providing culturally congruent care?

Accepted Answer

The goal of transcultural nursing is to provide culturally congruent care, or care that fits the person's life patterns, values, and system of meaning. Patterns and meanings are generated from people themselves, rather than from predetermined criteria. Discovering patients' cultural values, beliefs, and practices as they relate to nursing and health care requires you to assume the role of learner (not become the leader) and to partner with your patients and their families to determine what is needed to provide meaningful and beneficial nursing care. Culturally congruent care is sometimes different from the values and meanings of the professional health care system.

Question 12

A nurse is teaching patients about health care information. Which patient will the nurse assess closely for health literacy?

Accepted Answer

About 9 out of 10 people in the United States experience challenges in using health care information. Patients who are especially vulnerable are the elderly (age 65+), immigrants, persons with low incomes, persons who do not have a high-school diploma or GED, and persons with chronic mental and/or physical health conditions. A 35-year-old patient and patients with high-school and college education are not identified in the vulnerable populations.

Question 13

A nurse is assessing a patient's ethnohistory. Which question should the nurse ask?

Accepted Answer

An ethnohistory question is the following: How different is your life here from back home? Caring beliefs and practice questions include the following: Which caregivers do you seek when you are sick and How different is what we do from what your family does when you are sick? The language and communication is the following: What language do you speak at home?

Question 14

A nurse is using Campinha-Bacote's model of cultural competency. Which areas will the nurse focus on to become competent? (Select all that apply.)

Accepted Answer

Campinha-Bacote's model of cultural competency has five interrelated components: cultural awareness; cultural knowledge; cultural skills; cultural encounters; and cultural desire. Cultural transition is not a component of this model.

Question 15

The nurse is caring for a Chinese patient using the Teach-Back technique. Which action by the nurse indicates successful implementation of this technique?

Accepted Answer

The Teach-Back technique asks open-ended questions, like what will you tell your spouse about changing the dressing, to verify a patient's understanding. When using the Teach-Back technique do not ask a patient, "Do you understand?" or "Do you have any questions?" Does this make sense and do you think you can do this at home are closed-ended questions. Would you tell me if you don't understand something so we can go over it is not verifying a patient's understanding about the teaching.

Question 16

The nurse learns about cultural issues involved in the patient's health care belief system and enables patients and families to achieve meaningful and supportive care. Which concept is the nurse demonstrating?

Accepted Answer

The nurse is demonstrating culturally congruent care. Culturally congruent care, or care that fits a person's life patterns, values, and system of meaning, provides meaningful and beneficial nursing care. Marginalized groups are populations left out or excluded. Health care disparities are differences among populations in the availability, accessibility, and quality of health care services (e.g. screening, diagnostic, treatment, management, and rehabilitation) aimed at prevention, treatment, and management of diseases and their complications. Transcultural nursing is a comparative study of cultures in order to understand their similarities (culture that is universal) and the differences among them (culture that is specific to particular groups).

Question 17

The nurse is caring for a patient of Hispanic descent who speaks no English. The nurse is working with an interpreter. Which action should the nurse take?

Accepted Answer

Direct your questions to the patient. Look at the patient, instead of looking at the interpreter. Pace your speech by using short sentences, but do not break your sentences. Observe the patient's nonverbal and verbal behaviors.

Question 18

A nurse is working at a health fair screening people for liver cancer. Which population group should the nurse monitor $\bold{most}$ closely for liver cancer?

Accepted Answer

While Asian Americans generally have lower cancer rates than the non-Hispanic Caucasian population, they also have the highest incidence rates of liver cancer for both sexes compared with Hispanic, non-Hispanic Caucasians, or non-Hispanic African-Americans.

Question 19

A nurse is assessing the patient's meaning of illness. Which area of focus by the nurse is $\bold{priority}$?

Accepted Answer

To provide culturally congruent care, you need to understand the difference between disease and illness. Illness is the way that individuals and families react to disease, whereas disease is a malfunctioning of biological or psychological processes. The way a patient interacts to family/social interactions is communication processes and family dynamics.

Question 20

A nurse is using core measures to reduce health disparities. Which group should the nurse focus on to cause the $\bold{most}$ improvement in core measures?

Accepted Answer

To improve results, the nurse should focus on the highest disparity. Poor people received worse care than high-income people for about 60% of core measures. American Indians and Alaska Natives received worse care than Caucasians for about 30% of core measures.

Quiz 9: Cultural Awareness

A nurse is designing a form for lesbian, gay, bisexual, and transgender (LGBT) patients. Which design should the nurse use?

A nurse works at a hospital that uses equity-focused quality improvement. Which strategy is the hospital using?

A nurse is providing care to a patient from a different culture. Which action by the nurse indicates cultural competence?

A nurse is using the RESPECT mnemonic to establish rapport, the "R" in RESPECT. Which actions should the nurse take? (Select all that apply.)

Which action indicates the nurse is meeting a primary goal of cultural competent care for patients?

A nurse is caring for an immigrant with low income. Which information should the nurse consider when planning care for this patient?

A nurse is assessing population groups for the risk of suicide requiring medical attention. Which group should the nurse monitor $\bold{most}$ closely?

A nurse is beginning to use patient-centered care and cultural competence to improve nursing care. Which step should the nurse take $\bold{first}$ ?

A nurse is performing a cultural assessment using the ETHNIC mnemonic for communication. Which area will the nurse assess for the "H"?

A nurse is assessing the health care disparities among population groups. Which area is the nurse monitoring?

A nurse is providing care to a culturally diverse population. Which action indicates the nurse is successful in the role of providing culturally congruent care?

A nurse is teaching patients about health care information. Which patient will the nurse assess closely for health literacy?

A nurse is assessing a patient's ethnohistory. Which question should the nurse ask?

A nurse is using Campinha-Bacote's model of cultural competency. Which areas will the nurse focus on to become competent? (Select all that apply.)

The nurse is caring for a Chinese patient using the Teach-Back technique. Which action by the nurse indicates successful implementation of this technique?

The nurse learns about cultural issues involved in the patient's health care belief system and enables patients and families to achieve meaningful and supportive care. Which concept is the nurse demonstrating?

The nurse is caring for a patient of Hispanic descent who speaks no English. The nurse is working with an interpreter. Which action should the nurse take?

A nurse is working at a health fair screening people for liver cancer. Which population group should the nurse monitor $\bold{most}$ closely for liver cancer?

A nurse is assessing the patient's meaning of illness. Which area of focus by the nurse is $\bold{priority}$ ?

A nurse is using core measures to reduce health disparities. Which group should the nurse focus on to cause the $\bold{most}$ improvement in core measures?

Quiz 9: Cultural Awareness

A nurse is designing a form for lesbian, gay, bisexual, and transgender (LGBT) patients. Which design should the nurse use?

A nurse works at a hospital that uses equity-focused quality improvement. Which strategy is the hospital using?

A nurse is providing care to a patient from a different culture. Which action by the nurse indicates cultural competence?

A nurse is using the RESPECT mnemonic to establish rapport, the "R" in RESPECT. Which actions should the nurse take? (Select all that apply.)

Which action indicates the nurse is meeting a primary goal of cultural competent care for patients?

A nurse is caring for an immigrant with low income. Which information should the nurse consider when planning care for this patient?

A nurse is assessing population groups for the risk of suicide requiring medical attention. Which group should the nurse monitor most\bold{most}most closely?

A nurse is beginning to use patient-centered care and cultural competence to improve nursing care. Which step should the nurse take first\bold{first}first ?

A nurse is performing a cultural assessment using the ETHNIC mnemonic for communication. Which area will the nurse assess for the "H"?

A nurse is assessing the health care disparities among population groups. Which area is the nurse monitoring?

A nurse is providing care to a culturally diverse population. Which action indicates the nurse is successful in the role of providing culturally congruent care?

A nurse is teaching patients about health care information. Which patient will the nurse assess closely for health literacy?

A nurse is assessing a patient's ethnohistory. Which question should the nurse ask?

A nurse is using Campinha-Bacote's model of cultural competency. Which areas will the nurse focus on to become competent? (Select all that apply.)

The nurse is caring for a Chinese patient using the Teach-Back technique. Which action by the nurse indicates successful implementation of this technique?

The nurse learns about cultural issues involved in the patient's health care belief system and enables patients and families to achieve meaningful and supportive care. Which concept is the nurse demonstrating?

The nurse is caring for a patient of Hispanic descent who speaks no English. The nurse is working with an interpreter. Which action should the nurse take?

A nurse is working at a health fair screening people for liver cancer. Which population group should the nurse monitor most\bold{most}most closely for liver cancer?

A nurse is assessing the patient's meaning of illness. Which area of focus by the nurse is priority\bold{priority}priority ?

A nurse is using core measures to reduce health disparities. Which group should the nurse focus on to cause the most\bold{most}most improvement in core measures?

A nurse is assessing population groups for the risk of suicide requiring medical attention. Which group should the nurse monitor $\bold{most}$ closely?

A nurse is beginning to use patient-centered care and cultural competence to improve nursing care. Which step should the nurse take $\bold{first}$ ?

A nurse is working at a health fair screening people for liver cancer. Which population group should the nurse monitor $\bold{most}$ closely for liver cancer?

A nurse is assessing the patient's meaning of illness. Which area of focus by the nurse is $\bold{priority}$ ?

A nurse is using core measures to reduce health disparities. Which group should the nurse focus on to cause the $\bold{most}$ improvement in core measures?