Question 1

A nurse is caring for an Arab American patient in the hospital.The patient has many visitors who seem to be tiring the patient.What action by the nurse is best?

Accepted Answer

In Arab American Muslim culture,visiting the sick is a cultural value and expectation.Although the visits may be tiring,they may also be important to the patient.The nurse can suggest shorter visits so the patient can have both the visitors and more rest.Limiting the number of visitors would violate this cultural norm as would limiting visits to family only.Checking in at the front desk serves no useful purpose.

Question 2

When attempting to provide culturally sensitive care according to the explanatory model,the nurse asks the patient:

Accepted Answer

The gerontologic nurse uses this model to explore the meaning of the health problem from the patient's perspective.

Question 3

While caring for an older Korean patient,the nurse notes that the patient answers questions regarding health history when asked but is otherwise silent and does not maintain eye contact.Being culturally sensitive,the nurse recognizes that the patient's actions are most likely a(n):

Accepted Answer

Asian cultures generally view eye contact as rude and are often passive in their care.The patient may or may not have further questions.It is not a sign of discomfort or dissatisfaction.

Question 4

A geriatric nurse practitioner working with a tribe of Native Americans makes the decision to acculturate in an attempt to provide culturally appropriate care.The nurse does this best by:

Accepted Answer

Acculturation is a process that occurs when a member of one cultural group adopts the values,beliefs,expectations,and behaviors of another group,usually in an attempt to become recognized as a member of the group.The other actions might be helpful in acculturating.

Question 5

The culturally sensitive nurse will recognize that an older adult patient with a high-context ethnic background will appreciate:

Accepted Answer

The interactional patterns of high-context (universalism)patients refer to the characteristics of relationships and behaviors toward others.When a person from a high-context culture interacts with the nurse,a more personal relationship is expected.This is not related to television shows,teaching materials,or appointment cancellations.

Question 6

The nurse in an assisted living facility is preparing to admit an older adult patient who speaks very little English.The nurse decides that it is most important that an interpreter be present when the patient:

Accepted Answer

The more complex the decision making,the more important it is to have an interpreter present.Although all situations would benefit from an interpreter,the most important time is when the patient is signing official documents that have legal implications.

Question 7

A Hispanic patient explains that the Hispanic culture believes that dietary management would be just as effective in managing her problems as medication,so the patient's prescription has not been filled.Which action by the nurse illustrates cultural accommodation?

Accepted Answer

Cultural care accommodation or negotiation refers to those assistive,supportive,facilitative,or enabling creative professional actions and decisions that help people of a designated culture adapt to or negotiate with others for a beneficial or satisfying health outcome.The nurse can ask the patient to share more about beliefs,offer a consultation with a nutritionist,or research the beliefs,but these actions do not show accommodation.

Question 8

In an attempt to be sensitive to varying cultural responses to touch,before shaking a patient's hand,the nurse will:

Accepted Answer

The best way to show respect and implement the appropriate response is to follow the lead of the patient by waiting for the patient to extend a hand.

Question 9

The nurse in an assisted living facility is practicing a form of cultural bias called ethnocentrism when:

Accepted Answer

Ethnocentrism is a belief that one's own cultural group is superior to that of another's.In nursing we have a unique culture and expect our patients to adapt to us rather than attempting to adapt to the culture of the patient.Confiscating items used in healing rituals shows ethnocentrism and disrespect to the resident.Limiting activities in a group room,encouraging people to attend church services of their religion,and letting prospective Jewish residents know that the facility does not have a kosher kitchen are not examples of ethnocentrism.

Question 10

A postmenopausal black woman who has been experiencing uterine bleeding tells the nurse,"I expect I'll need a total hysterectomy because when my sister had this problem that's what she had done." The nurse recognizes that this woman belongs to a cultural subgroup whose health care beliefs are most influenced by the:

Accepted Answer

The patient shows a tendency to identify with the biomedical model,which views the body as a functioning machine.When a part gives out or is functioning abnormally,traditional Western medical treatment is sought and expected.The magico-religious models believe that health is a reward from a higher power.The balance/harmony models state that illness is the result of a state of imbalance in body energies.Personal experience influences all of these models.

Question 11

The student learns that which of the following is the best definition of culture?

Accepted Answer

A culture is a set of shared and learned beliefs,behaviors,and expectations among a group of people.The individuals in different cultures may or may not look similar.Group beliefs about what is right or wrong are known as values.Cultural members may come from many different parts of the world.

Question 12

A director of nursing works in a hospital that serves many Jehovah's Witness patients.What action by the nurse would best facilitate culturally appropriate health care?

Accepted Answer

Jehovah's Witnesses generally are opposed to receiving all blood products.A bloodless surgery program would be a culturally competent way to improve the health care of this population.

Question 13

A student nurse expresses frustration to the faculty member regarding an ethnic older adult who appears to be noncompliant.The student states,"Why can't the patient just do what we teach her to do?" What response by the nurse is best?

Accepted Answer

Culture is a blueprint for responding to individuals,family,and the community.Persons from strong cultural backgrounds cannot just change their behavior when instructed to do so.The nurse explains this to the student.Stating that the nurse understands the frustration is helpful but does not give the student any information that could help him or her work with this patient.Stating that people from a certain culture are never compliant is biased and prejudicial."Getting through" to the patient implies ethnocentrism and bias.

Question 14

The nurse uses the LEARN model when providing care.What event best demonstrates that this model has been successful?

Accepted Answer

The LEARN model includes listening to the patient,explaining your own perspectives,acknowledging the similarities and differences in both viewpoints,recommending a plan of action,and negotiating a final plan.If the patient and nurse have come to an agreement on a plan of action,this model has been successful.

Question 15

The nurse is caring for an older adult patient in need of hospitalization.The nurse is aware this patient is a member of an ethnic group that holds a collectivist perspective on community.The nurse best addresses the patient's medical needs by:

Accepted Answer

People with a collectivist perspective derive their identity from affiliation with and participation in a social group such as a family or clan.The needs of the group are more important than those of the individual,and decisions are made with consideration of the effect on the whole.Health care decisions may be made by a group (such as the tribal elders)or a group leader (such as the oldest son).The other options may or may not be needed depending on the specifics of the patient's case.

Question 16

The nurse is most effectively using the concept of future time orientation when:

Accepted Answer

In the concept of future orientation,people accept the idea that what is done now affects future health.This means that health screenings will help detect a problem today for potentially better health at a later time,days,weeks,or years ahead;it means that prevention may be worth pursuing.The other actions do not show a future orientation.

Question 17

A new nurse is caring for a patient from Appalachia.The patient seems guarded and secretive,which frustrates the new nurse.What advice from the mentor is most appropriate?

Accepted Answer

Patients from the Appalachian culture are typically wary and guarded around strangers and view the hospital as a place to go and die.The nurse explains this to the new nurse.Changing assignments will not help the new nurse become culturally competent.The new nurse could ask the patient if there has been some offense,but this is probably not the case."Why" questions put people on the defensive and are not considered examples of therapeutic communication.

Question 18

A older Asian patient receiving physical therapy after hip surgery has developed a low-grade fever.The patient explains that the fever will lessen if the treatment includes the principles of yin/yang.The nurse expects to support the patient by:

Accepted Answer

The yin/yang theory proposes that health is a result of balance within the body.A principle of this theory is that an illness is either hot or cold and must be treated by elements of the opposite state in order to put the system back into balance.It is not related to shaman visits,meditation,or amulets.

Question 19

An incapacitated older adult with dementia is brought to the emergency department by a rescue squad after falling and breaking an arm.When the patient's children arrive,they are adamantly against the patient having any medical care and insist that prayer will heal the broken arm.What action by the nurse is most appropriate?

Accepted Answer

This family may be Christian Scientists,who do not believe in medical care.Health crises are thought to be errors of the mind that can be altered by prayer.The nurse should check the facility policies for treating vulnerable adults and possibly notify social work,who can assist with ensuring adequate treatment occurs as allowed by policy.Allowing the family to pray with the patient is a caring action,but this complex situation requires more intervention.Calling security or the police will antagonize the family even more and demonstrates an adversarial relationship.

Question 20

A patient from a culture that differs from that of the nurse is hospitalized and near death.What action by the nurse best demonstrates cultural care preservation?

Accepted Answer

Cultural care preservation refers to those assistive,supportive,facilitative,or enabling professional actions and decisions that help people of a particular culture to retain and maintain their well-being,to recover from illness,or to face handicaps or death.Allowing the patient to have healing artifacts important in his or her culture nearby best demonstrates this concept.The other actions are caring but do not demonstrate this principle.

Quiz 5: Cultural Influences