Question 1

If an interpreter is not available when a patient speaks a language different from the nurse's language, it is appropriate for the nurse to

Accepted Answer

The use of gestures will enable some information to be communicated to the patient. The other actions will not improve communication with the patient.

Question 2

While talking with the nursing supervisor, a staff nurse expresses frustration that a Native American patient always has several family members at the bedside. The most appropriate action by the nursing supervisor is to

Accepted Answer

The first step in providing culturally competent care is to understand one's own beliefs and values related to health and health care. Asking the nurse about personal beliefs will help to achieve this step. Reminding the nurse that this cultural practice is important to the family and patient will not decrease the nurse's frustration. The remaining responses (suggest that the nurse ask family members to leave the room, and have the nurse explain to family that too many visitors will tire the patient) are not culturally appropriate for this patient.

Question 3

The nurse obtains information about all these areas during the health interview for a new patient. Which area will be the focus of patient teaching?

Accepted Answer

Behaviors are strongly linked to many health care problems. The patient's carbohydrate intake is a behavior that the patient can change. The other information will be useful as the nurse develops an individualized plan for improving the patient's health, but will not be the focus of patient education.

Question 4

A family member of an elderly Hispanic patient admitted to the hospital tells the nurse that the patient has traditional beliefs about health and illness. The best action by the nurse is to

Accepted Answer

Because the patient has traditional health care beliefs, it is appropriate for the nurse to ask whether the patient would like a visit by a curandero(a) or other cultural healers. There is no cultural reason for the nurse to avoid asking the patient questions, and questions may be necessary to obtain necessary health information. The patient (rather than the daughter) should be consulted about personal cultural beliefs. The hospital routines for meals, care, and visits should be adapted to the patient's preferences rather than expecting the patient to adapt to the hospital schedule.

Question 5

When performing a cultural assessment with a patient of a different culture, the nurse's first action should be to

Accepted Answer

An early step in performing a cultural assessment is to determine whether the patient feels an affiliation with any cultural group. The other actions may be appropriate if the patient does identify with a particular culture.

Question 6

A new RN graduate is assessing a newly admitted non-English-speaking Chinese patient who complains of severe headaches. The charge nurse should intervene if the new RN's first action is to

Accepted Answer

Many people of Asian ethnicity believe that touching a person's head is disrespectful; the RN should ask permission before touching the patient's head. The other actions are appropriate.

Question 7

The best example of culturally appropriate nursing care when caring for a newly admitted patient is

Accepted Answer

Many cultures consider it disrespectful to touch a patient without asking permission, so asking a patient for permission is always culturally appropriate. The other actions may be appropriate for some patients but are not appropriate across all cultural groups or for all individual patients.

Question 8

When caring for a patient who is Native American, the best initial action by the nurse is to

Accepted Answer

Observation of the patient's use of eye contact will be most useful in determining the best way to communicate effectively with the patient. Looking directly at the patient or avoiding eye contact may be appropriate, depending on the patient's individual cultural beliefs. The nurse should assess the patient, rather than asking family members about the patient's beliefs.

Question 9

When doing an admission assessment for a patient, the nurse notices that the patient pauses before solve questions about the health history. The most appropriate action by the nurse is to

Accepted Answer

Patients from some cultures take time to consider a question carefully before answering. The nurse will show respect for the patient and help develop a trusting relationship by allowing the patient time to give a thoughtful answer. Asking the patient why the answers are taking so much time, stopping the assessment, and handing the patient a form indicate that the nurse does not have time for the patient.

Question 10

An 82-year-old Asian American patient tells the nurse that she has lived in the United States for 50 years. The patient speaks English but lives in a predominantly Asian neighborhood. The nurse will need to

Accepted Answer

Further assessment of the patient's health care preferences is needed before making further plans for culturally appropriate care. The other responses indicate stereotyping of the patient, based on ethnicity, and would not be appropriate initial actions.

Question 11

When planning care for a hospitalized patient who uses culturally based treatments, the most appropriate action by the nurse is to

Accepted Answer

Many culturally based therapies can be accommodated along with the use of Western treatments and medications. The nurse should attempt to use both traditional folk treatments and the ordered Western therapies as much as possible. Some culturally based treatments can be effective in treating "Western" diseases. Not all folk remedies interfere with Western therapies. It may be appropriate for the patient to continue some culturally based treatments while he or she is hospitalized.

Question 12

When planning health care for a community with a large number of recent immigrants from China, the most important intervention for the nurse to include is

Accepted Answer

Tuberculosis (TB) is endemic in many parts of Asia, and the incidence of TB is much higher in immigrants from China than in the general U.S. population. Teaching about contraceptive use, colonoscopy, and testing for pregnancy also may be appropriate for some patients but is not generally indicated for all members of this community.

Question 13

When developing strategies to decrease health care disparities, the nurse working in a clinic located in a neighborhood with many Vietnamese individuals will include

Accepted Answer

Health care disparities are due to stereotyping, biases, and prejudice of health care providers; the nurse can decrease these through staff education. The other strategies also may be addressed by the nurse but will not impact health disparities.

Question 14

Which of these strategies should be a priority when the nurse is planning care for a hypertensive patient who is uninsured?

Accepted Answer

The use of standardized evidence-based guidelines will reduce the incidence of health care disparities among various socioeconomic groups. The other strategies also may be appropriate, but the priority concern should be that the patient receives care that meets the accepted standard.

Question 15

The nurse working in a clinic in a primarily African American community notes a higher incidence of uncontrolled hypertension in clinic patients than the national average. To correct this health disparity, which action should the nurse take first?

Accepted Answer

Before other actions are taken, additional assessment data are needed to determine the reason for the disparity. The other actions also may be appropriate, but additional assessment is needed before the next action is selected.

Question 16

A Hispanic patient complains of abdominal cramping caused by empacho. The nurse's first action should be to

Accepted Answer

Further assessment of the patient's cultural beliefs is appropriate before implementing any interventions for a culture-bound syndrome such as empacho. Although medication, a visit by a curandero(a), or massage may be helpful, more information about the patient's beliefs is needed to determine which intervention(s) will be most helpful.

Question 17

Which information will the nurse need to collect when assessing the health status of a community?

Accepted Answer

Health status is the aggregate of all health measures for individuals in a community and includes data such as life expectancy, birth and death rates, and mortality from various diseases. Although income, traffic patterns, and occupations are factors that impact a community's health status, they are not health measures.

Quiz 2: Health Disparities and Culturally Competent Care