Question 1

The nurse in the emergency department finds a woman collapsed on the floor and crying loudly.The woman's husband was in a car accident and is being attended to by the medical staff.Which statement by the nurse best demonstrates acting in a culturally competent manner?

Accepted Answer

The nurse is demonstrating cultural competence and using cross-cultural therapeutic health care skills by offering to allow the client to express herself.The nurse is imposing personal beliefs on expected behavior in the other options.

Question 2

A Navajo Native American is traveling across the country and becomes ill.He visits a hospital emergency department and appears very uncomfortable in the surroundings.The nurse knows that traditional Navajo Native Americans typically receive health care in:

Accepted Answer

Many traditional Native Americans receive health care in their homes,community settings,or social places.The emergency department setting would be very uncomfortable for this client.

Question 3

Culture includes common beliefs and practices in areas such as religion,economics,diet,health,and:

Accepted Answer

In addition to shared beliefs and practices in religion,economics,diet,and health,a person's cultural integration consists of patterns of communication,politics,art,and kinship.The other three options are not part of a person's culture.

Question 4

It is important for the nurse to be familiar with the religious practices of clients cared for most often in a particular region because attitudes toward health and illness,death and burial,food,and procreation have a strong impact on a client's beliefs and practices.The nurse knows that the religion practiced most often around the world is:

Accepted Answer

More than 2 billion individuals throughout the world are practicing Christians.Although these religions are seen in large numbers worldwide,it is important for the nurse to be familiar with the religions most frequently seen in the client populations with whom he works within his own area.

Question 5

Which client communication problem can the nurse most easily correct?

Accepted Answer

The nurse can easily correct communication problems caused by cultural differences in a number of ways,including learning what cultural beliefs and practices are important to the client and being accepting of those beliefs.Communication problems due to age and gender differences and altered cognition cannot be corrected by the nurse.

Question 6

A nurse preparing to interview a client in the client's room begins to move newspapers off a chair to sit down.The client requests that the nurse sit in another chair and leave the newspapers where they were.The client is demonstrating:

Accepted Answer

Territoriality is the need to gain control over an area of space and claim it for oneself,as it helps to provide a sense of identity,security,autonomy,and control over the environment.Personal space is the distance maintained between people.Manipulation and paranoia are not demonstrated in this case.

Question 7

Refugees frequently experience depression,anxiety,and stress-related disorders caused by their particular circumstances.Therefore,in addition to a cultural assessment,what is important for the nurse to assess? (Select all that apply. )

Accepted Answer

A refugee is a person who flees from his or her home or country,usually because of war or persecution in the homeland.The refugee has experienced trauma not only in his life experiences,but also in the process of fleeing from home.Therefore,a more accurate assessment can be performed if these questions are answered.The type of medical insurance obtained is of little concern to this person at this time.

Question 8

The nurse is caring for a 20-year-old woman from Puerto Rico.The client speaks English,but she is accompanied by her mother,who does not.The client has a history of mental illness,and through the interpreter,the nurse learns that the mother,who has traditional Puerto Rican cultural beliefs,believes that the client's mental illness is caused by:

Accepted Answer

It is a common traditional Puerto Rican cultural belief that mental illness is caused by witchcraft,magic,or evil spells,as opposed to more traditional Western medicine,which believes that stress and chemical imbalances play a role in mental illness.A trance is considered a state of consciousness in some cultures.

Question 9

A Hmong man from Laos is a client at an outpatient mental health clinic and is being seen for his diagnosis of bipolar disorder.The importance of lithium testing was stressed in his discharge plans;however,it is discovered that he has had his lithium level checked only once,rather than the three scheduled times.What is the nurse's best action?

Accepted Answer

In the Hmong culture,it is believed that loss of blood leads to decreased body strength,which can cause the soul to leave the body,resulting in death.If the nurse did not discuss why the client was not getting his blood levels tested and gave him additional instructions as listed in the other options,the nurse would not understand and would not be able to incorporate the client's cultural beliefs into the plan of care.The nurse and the client can now make revisions that will be acceptable while meeting the needs of the client.

Question 10

A client seen in the mental health clinic feels her depression is the result of being "punished" due to becoming pregnant as an adolescent and giving the infant up for adoption against her family's wishes.This view of her depression is considered:

Accepted Answer

Naturalistic illnesses are caused by impersonal factors without regard for the individual.Forces that exist outside the individual cause mental illness.Personalistic illnesses are seen as aggression or punishment directed toward a specific person.

Question 11

What is the usual approach to care for individuals who practice folk medicine?

Accepted Answer

Folk medicine is highly personalized;the descriptors fragmented,impersonal,and disjointed more often are associated with the Western medicine approach to health care.

Question 12

A traditional Arab female client is brought to the emergency department by her husband.She complains of feeling very anxious and short of breath and has chest pain.What would likely be a hindrance to the care of this client?

Accepted Answer

In some traditional Arab cultures,a woman will not make eye contact with any man except her husband and may not be touched by another man.Having only male staff in the emergency department on this shift would block necessary care.Arrangements would have to be made to have a female staff member come to the emergency department to assist in client care.The other options should not cause a problem.

Question 13

A client is continually late for his appointment at the mental health clinic.What is a likely reason for his lack of punctuality?

Accepted Answer

Mental dysfunction can lead to incorrect perception of time,causing the client to be continually late.In addition,some cultures do not see schedules and specific appointment times as important,causing the client to be continually late in the eyes of the caregiver.Environmental control refers to an individual's need to control his or her perception of the environment.Comfort zones are highly culture based,meaning that individual interpretation of personal space varies among cultures.Territorial needs provide a sense of identity and security for some clients.

Question 14

A male client is visiting his family in the United States and experiences what his family describes as a "breakdown." His family takes him to a stress treatment center at a local mental health clinic.The client is a follower of traditional folk medicine practices and is agitated when he learns that he must see a licensed psychiatrist.Which care providers is this client most likely accustomed to? (Select all that apply. )

Accepted Answer

Individuals who practice folk medicine for care typically do not see licensed health care providers,such as nurse practitioners and physicians.Folk medicine beliefs regarding the causes of disorders and treatments are different from Western medicine beliefs.

Question 15

What is the social orientation among most middle-class American families?

Accepted Answer

The nuclear family is the social orientation of family that is seen most frequently in this group.The extended family is seen as the social orientation for cultures such as some Alaskan,traditional Chinese,and Mexican cultures.Friends and significant others are not identified as a social orientation of family.

Question 16

A 45-year-old married man comes to the community mental health center after he is suspended from his job for fighting.Upon talking to him,the nurse discovers he and his wife recently moved to the United States and his wife needs to work to pay bills.He is angry and embarrassed that he cannot be the sole provider for his family.His behavior may be the result of:

Accepted Answer

Traditional roles for men and women are in conflict with societal expectations of Western society in this situation.Men tend to demonstrate more violent and abusive behaviors as mental health problems with this conflict.Cultural stereotyping is imposed by someone outside the culture,and religious and territoriality conflicts do not apply to this circumstance.

Question 17

Disease is defined as:

Accepted Answer

Disease differs from illness in that disease is an abnormal physical function,whereas illness refers to social,emotional,and intellectual dysfunction.Illness is affected by culture,but disease is not.

Question 18

The metabolism of psychotropic medications is most likely to be affected by:

Accepted Answer

Ethnicity is a determining factor in a person's genetic makeup.Religious and cultural practices could play a role in the metabolism of medications as a result of food or alternative treatment interactions with medications,but the metabolism is more closely related to the genetic makeup.Values have little to do with the metabolism of medications.

Question 19

An older Asian female with a diagnosis of depression is cared for by her granddaughter.Her granddaughter is very attentive to the client's needs,attends every therapy session,and is active in the planning and implementing of the treatment plan.The granddaughter's valuing of her grandmother is most likely due to her:

Accepted Answer

Cultural beliefs develop over many generations and are a learned set of values,beliefs,and behaviors.Asian cultures commonly value their elderly family members.Ethnicity and religion do not explain the granddaughter's behavior in that ethnicity describes customs and socialization patterns,and religion refers to an organized form of worship.Stereotyping is a preconceived belief about another cultural group,so it does not apply to this situation.

Question 20

Which areas comprise the DSM-IV-TR cultural assessment tool for clients? (Select all that apply. )

Accepted Answer

The six categories of cultural identity of the client,cultural explanation of the illness,cultural factors relating to psychosocial environment,cultural factors relating to level of functioning,cultural elements of the relationship between client and care provider,and overall cultural assessment constitute the cultural assessment tool,which allows mental health care providers to learn how clients perceive their world and how they cope,according to their culture.Previous mental illness would be found in the history section of a client's assessment.

Quiz 4: Sociocultural Issues