Question 1

The nurse is beginning her assessment on a 35-year-old woman.The patient appears to be of Asian descent.As part of the nurse's cultural assessment,what question is most appropriate for the nurse to ask pertaining to race prior to documenting the patient's race?

Accepted Answer

Although we commonly think of race as being based on biological characteristics,many,including the U.S.Census Bureau,believe that race is socially rather than biologically determined.For a culturally sensitive nurse,it is therefore most appropriate to ask the patient what race she identifies with and what name she prefers to use for it.We must avoid using our own assumptions and categories as the basis for determining race as this can lead to bias and even worse,a lack of providing proper patient centered focused care.

Question 2

Which statement is most reflective of Madeleine Leininger's theory of cultural care?

Accepted Answer

Although Madeleine Leininger does not use the specific term "cultural competence," her theory fits with that concept.The goal of her theory is to guide research that will assist nurses to provide culturally congruent care using her three modes of nursing care actions and decisions.The Purnell model for cultural competence stresses teamwork in providing culturally sensitive and competent care and the Purnell model identifies several levels of consciousness in achieving cultural competence.The Campinha-Bacote model identifies the mnemonic ASKED (awareness,skills,knowledge,encounters,and desire).

Question 3

As a nursing student and nurse,you will encounter many patients from diverse cultures.When caring for a culturally diverse patient,what initial question can you ask your patient that will best assist you to improve your cultural competency?

Accepted Answer

If there were only one intervention or question the nurse could use to improve cultural competence,it should be to routinely ask patients what matters most to them in their illness and treatment.No matter how busy the nurse is,she can find time to do this.From that point,she can use this information to incorporate cultural needs and preferences into the patient's plan of care.Each of the other questions can be asked of the patient; however,the first question that will elicit the most information is to ask the patient what matters most to him.The other three questions can follow in assisting to formulate the plan of care.

Question 4

The nurse is caring for a patient who emigrated from Puerto Rico.She can best care for this patient by learning about the:

Accepted Answer

The nurse cares for this patient by becoming familiar with the patient's individual cultural and ethnic beliefs and values.It is helpful to become familiar with the patient's ethnic group and the Spanish-speaking community; however,the nurse should not assume that the individual holds the same values,beliefs,and practices as his ethnic group or community.The nurse should explore her own culture but not assume that the patient holds those same beliefs and practices.

Question 5

Which of the following statements about race and ethnicity is/are true? Select all that apply.

Accepted Answer

Race refers to the grouping of individuals who share similar biological characteristics,such as blood type,skin color,and so forth.A person can be biracial; however,multicultural describes groups rather than individuals.Ethnicity refers to groups whose members share a common and social heritage that is transmitted to the next generation.

Question 6

A client incorporates alternative healthcare into her regular health practices.For which alternative therapy should the patient visit a formally trained practitioner?

Accepted Answer

Acupuncture requires a formally trained practitioner.Use of herbs and roots,the application of oils and poultices,and the burning of dried plants do not require formally trained practitioners.Patients should be advised to inform their traditional primary healthcare provider when using various herbal remedies,as they can interfere with other prescribed medication and cause untoward side effects.

Question 7

At a clinical post conference,a nursing student states,"I had a Chinese patient today and while I understand some of her cultural practices,she needs to understand that she is in the United States now and should follow our practices because we use scientific evidence." Which cultural barrier is the student demonstrating?

Accepted Answer

Ethnocentrism is the tendency to think that your own group (cultural,professional,ethnic,or social)is superior to others and to view behaviors and beliefs that differ greatly from your own as somehow wrong,strange,or unenlightened.The tendency to ethnocentrism exists in all groups,not just in the dominant culture.Stereotyping is a widely held belief that all people from a certain racial or ethnic group are alike in certain respects.Racism is a form of prejudice and discrimination based on the belief that a race is the principal determining factor of human traits and capabilities and that racial difference produce an inherent superiority or inferiority.

Question 8

Vulnerable populations are those most likely to develop health problems and experience poorer outcomes because of limited access to care and a wide variety of other stressors.Therefore,when caring for a patient from a vulnerable group,it is most important for the nurse to focus on:

Accepted Answer

Vulnerable populations are groups who are more likely to develop health problems and experience poorer outcomes because of limited access to care.Examples of vulnerable populations include the homeless,the poor,children,the elderly,and some ethnic and minority groups.When caring for patients from vulnerable groups,it is most important that the focus be on the patient's strengths and resources and not exclusively on the difficulties and risks.Working with family members is important in developing a plan of care,as is contacting a social worker if the situation warrants; however,the focus is first on the patient.

Question 9

Which statement(s)about culture is/are true? Select all that apply.

Accepted Answer

Culture is learned through life experiences that are shared by other members of the culture,such as family members,those sharing similar religious beliefs,and people of similar cultural heritage in the same community.Culture exists at many levels,both material and nonmaterial.Cultural customs,beliefs,attitudes,and practices are not static but change over time at different rates,depending on current events,other significant people,and social influences.Culture is all encompassing and affects everything its members think and do.It is not limited to food and holidays,although those are visible manifestations of a culture,dietary practices and cultural calendars are not the essence of true and meaningful culture.

Question 10

The nurse is teaching a clinic patient about hypertension.Which statement by the patient suggests that he is present-oriented?

Accepted Answer

Knowing an action is needed,but giving reasons for not beginning it "just now" shows a focus on the present.The patient knows that he should reduce his sodium intake,but his present situation is preventing him from doing so.Therefore,he is disregarding the impact consuming sodium might have on his future.The other responses are future-oriented because they indicate that the patient is planning lifestyle changes that will affect his future.

Question 11

The nurse is developing a plan of care for a patient of Aleut descent who sustained a hip fracture.Which intervention by the nurse recognizes the patient's indigenous healthcare system and should be included in the plan of care?

Accepted Answer

For the patient of Aleut descent,contacting the shaman and scheduling a visit with the patient might be helpful in recovery.Patients of Hispanic descent might benefit from herbal tea,medals,and amulets brought in by the family.However,it is important to check with the physician before administering any herbal preparations that might interfere with prescribed medications.Asians and Pacific Islanders might benefit from a visit by the acupuncturist.

Question 12

A patient who had surgery 8 hours ago has not voided.The physician has prescribed that an indwelling urinary catheter be inserted.Which of the following statements should the nurse use to describe the procedure to the patient? "I need to:

Accepted Answer

"I need to insert a tube into your bladder ..." best describes the procedure for the patient because the explanation is in terms most patients will understand.The other options contain medical jargon that could confuse the patient.

Question 13

Which of the following is considered a "practice" (as opposed to a belief or value)?

Accepted Answer

A practice is a set of behaviors that one follows,such as always drinking water after exercise.Being preoccupied with cleanliness,placing an emphasis on success,and maintaining youth are examples of values that are dominant in U.S.culture.

Question 14

The nursing student tells her instructor,"My patient is Jewish and when I tried to teach her about her antihypertensive medication she said,'I'd rather eat chicken soup than take those medications.'" What is the most appropriate response by the instructor?

Accepted Answer

It is not uncommon for any group,including those of the Jewish faith,to practice folk medicine and use folklore remedies.Chicken soup is a folk medicine,although it certainly may have some health value unrelated to hypertension.Folk medicine is defined as the belief and practice that the members of a group follow when they are ill as opposed to more conventional (biomedical or professional)standards.In this item,the most appropriate response by the instructor is to ask the student to talk to her patient about using both,as neither will interfere with the other and the patient most likely needs the antihypertensive medications.Asking the student to complete some research may be appropriate at another time,but this response will not assist the student in working with her patient.A patient can make his or her own choices and decisions but it is more appropriate to talk to the patient,provide some teaching,and gain insight before just "throwing in the towel."

Question 15

An elderly patient tells the charge nurse that she wants another nurse to take care of her.When the charge nurse questions the patient,she states,"I don't want a man taking care of me." Which cultural barrier is this patient exhibiting?

Accepted Answer

This patient is exhibiting sexism; she is objecting to the nurse merely because of his sex.Although we tend to think of sexism in a negative light,this woman may merely be reflecting a cultural attitude.The patient is in no position to actually discriminate against the nurse,in terms of employment,and so on.Therefore,her preferences should be respected.Ethnocentrism occurs when a person is positively biased toward her own culture.Racism is a form of prejudice and discrimination based on race.Chauvinism occurs when a person assumes that he is superior.

Question 16

A 26-year-old man of Mexican heritage is admitted for observation after sustaining injuries in a motor vehicle accident.When assessing this patient,the nurse must consider that he may possess which view of pain? He may:

Accepted Answer

In general,patients of Mexican heritage may endure pain longer and report it less frequently than will some other patients.Patients of Japanese heritage may have taboos against narcotic use to relieve pain.Patients of Puerto Rican heritage may use herbal teas,heat application,and prayers to manage pain.Remember that all of these are archetypes,and are not necessarily true for all members of a cultural group.

Question 17

Which statement(s)is/are most true about the concept of acculturation? Select all that apply.

Accepted Answer

Immigrants or new members of a group or country assume the characteristics of that culture through a learning process called acculturation.A person who is acculturated accepts both his own and the new culture,adopting elements of each.Acculturation is the outgrowth of the minority group's need to survive and flourish in the new culture.Many experts theorize that it takes years,perhaps three generations,for an immigrant group to become acculturated.Assimilation occurs when the new members gradually learn and take on the essential values,beliefs,and behavior of the dominant culture.

Question 18

A patient of Japanese heritage avoids asking for narcotics for pain relief.The nurse writes a nursing diagnosis of Pain related to reluctance to take medication secondary to cultural beliefs.If the cultural archetype is true for this particular patient,this probably means that the patient views pain as:

Accepted Answer

Patients of Japanese heritage may view pain as a virtue and a matter of family honor.They may be more accepting of pain medications if the nurse reassures them that pain control enhances healing.Patients of Mexican heritage may view pain as punishment for immoral behavior.Those of Navajo Indian heritage commonly view pain as a part of life,whereas those of Puerto Rican heritage may feel that pain is best treated with herbal teas and prayer.Keep in mind that these are all archetypes and do not necessarily apply to all members of a cultural group.

Question 19

The nurse is caring for a patient of Japanese heritage who refuses opioid pain medication despite the nurse's explaining its importance in the healing process.Which intervention(s)by the nurse is/are appropriate for this patient? Select all that apply.

Accepted Answer

Patients of Japanese heritage commonly avoid opioid use; however,they sometimes reconsider after healthcare personnel explain that they improve the healing process.When the patient continues to refuse pain medications despite explanation,the nurse should respect the patient's wishes and employ nonpharmacological measures to control pain.The nurse should document that the patient wishes to avoid opioid use in the nurses' notes.The nurse should continue to assess pain levels in this patient at the same frequency as before.She should recognize and respect his cultural beliefs and not label him as noncompliant.Note that the same intervention would be appropriate for any patient in this situation,not just a Japanese patient.It would be necessary to contact the primary provider only if these measure are ineffective and the patient experiences severe pain.

Question 20

A Spanish-speaking patient in the hospital is getting ready surgery and needs to sign the surgical consent form.Existing regulations determine the healthcare organization's responsibility for obtaining informed consent from this patient.The healthcare organization is required to do which of the following?

Accepted Answer

There are times when a nurse may use gestures,pictures,and family members in communicating with a patient.This is usually the case for some assessment issues such as assessing and locating pain.However,if and when there is a consent issue,the hospital or healthcare organization must ensure adequate resources to comply with informed consent requirements.At times,a translator is used,but this person usually only translates or restates information and does not necessarily explain the meaning of information.An interpreter is usually used for explaining the meaning of information,but there are requirements for licensing and approval.Each answer is too specific.The best answer is to ensure adequate resources that will comply with informed consent requirements.

Quiz 15: Culture Ethnicity