5Fundamentals of Nursing: The Art & Science of Person Centered Care, 10th Edition; Taylor, Lynn, Bartlett. Chapter 5 Culturally Respectful Care

A nurse is caring for patients of diverse cultures in a community health clinic . Which concepts will nurse incorporate to guide the plan of care. Select all that apply.

a. the U.S. has become less inclusive of same sex-couples

b. Cultural diversity is limited to people of varying cultures of races

c. cultural diversity is separate and distinct from health and illness.

d. people may be members of multiple cultural groups at one time

e. culture guides what is acceptable behavior for people in a specific group

f. cultural practices may evolve over time but mainly remain constant

d. people may be members of multiple cultural groups at one time

e. culture guides what is acceptable behavior for people in a specific group

f. cultural practices may evolve over time but mainly remain constant

A person may belong to multiple cultural, ethnic, and racial groups at one time. Culture guides what is acceptable behavior for people in a specific group. Cultural practices and beliefs may evolve over time mainly remaining as long as they satisfy a group's needs. The U.S. has become more inclusive of same sex couples. The definition of cultural diversity includes but is not limited to people of varying cultures, racial and ethnic origin, religion, language, psychical size, biological sex, sexual orientation, age, disability, socioeconomic status, occupational status, and geographic location. Cultural diversity, and integral component of health and illness,, includes culture, ethnicity, and race.

At the last staff meeting, the nurse manager discussed the organizational initiative to improve provision of culturally competent care. During rounds, which behaviors inconsistent with this goal require the manager to intervene. Select all the apply.

a. a staff nurse tells the AP that patients should not be given a choice, but should shower or bathe daily

b. A nurse asks the family of a patient who has died if they would like to wash their loved one's body.

c. A nurse tells another nurse that Jewish dietary restrictions are just a way for them to get special.

d. A catholic nurse insists that a patient diagnosed with terminal bladder cancer see the chaplain in residence.

e. a nurse obtains a translator to speak to the patient in their native language

f. a nurse refuses care for a married gay pt who is HIV positive because the nurse is against same-sex marriages,

a. a staff nurse tells the AP that patients should not be given a choice, but should shower or bathe daily

d. A catholic nurse insists that a patient diagnosed with terminal bladder cancer see the chaplain in residence.

Cultural imposition occurs when someone believes others should conform to their beliefs, such as whether or not to shower or bathe daily, when catholic nurse insists that a terminally ill patient see a chaplain. Cultural blindness occurs when a nurse treats all patients the same regardless of culture. Culture conflict occurs when a nurse judges a patient's dietary restrictions as a way to get their favorite foods. When a nurse refuses to respect an older adults ability to speak for themselves, or refuses to treat a patient based on their sexual orientation , stereotyping has occurred.

An Ambulatory nurse serving a large, culturally diverse population is planning a free blood pressure screening clinic. Based on the nurse's understanding of racial differences in health and illness, which groups will the nurse target for screening? Select all that apply.

a. Native American people

b. African American people

c. Alaska Native people

d. Asian people

e. White people

f. Hispanic people

b. African American people

c. Alaska Native people

b. African American people

c. Alaska Native people

All of these groups of people are more prone to developing HTN Alaska and native Americans are prone to heart disease, diabetes, cirrhosis, and fetal alcohol syndrome.

A nurse is using the Explanatory Model of Health and Illness (ESFTR) model to assess how a patient from another culture views their diagnosis of COPD. What interview question is most appropriate to assess the E aspect of this model?

a. How do you get your medications?

b. How does having COPD affect your lifestyle?

c. Are your concerned about the side effects of your medications?

d. Can you describe hoe you will take your medications?

b. How does having COPD affect your lifestyle?

The ESFT model, across cultural communication tool guides in understanding a patients explanatory model ( a pts concept of their illness) social and environmental factors and fears and concerns and also guides providers in contracting for therapeutic approaches.

"How does having COPD affect your lifestyle?" explores the explanatory model.

"How do you get your medications?" refers to social and environmental factor

"Are you concerned about the side effects of your medications?" addresses fears and concerns

"Can you describe how you will take your medications?" involves therapeutic contracting.

A nurse tells a patient, "tonight's menu selection is pork. I understand many people in your culture do not eat pork; may I order something else for you?" When the patient states they no longer observe this dietary practice, the nurse understands that the patient has experienced what transition?

a. Cultural assimilation

b. Cultural imposition

c. Culture shock

d. Ethnocentrism

a. Cultural assimilation

Assimilation occurs when minority groups living withing a dominant group lose the cultural characteristics that make them different.

Cultural imposition occurs when one person believes that everyone should conform to their own belief system

Cultural shock occurs when a person is placed in a different culture perceived as strange

Ethnocentrism is the belief , and practices of one's own cultural group are best, superior or most preferred to those of others.

The charge nurse overhears a nurse state, ""The patient is 78 years old - too old to learn how to change a dressing" How should the charge nurse respond.

a. "Please don't impose your view of the patient's culture on them."

b. I wish you would try to demonstrate more cultural sensitivity."

c. "Try to be open to your patient's culture, to make the biggest impact"

d. "Grouping all older adults as having trouble learning is a form of stereotyping."

d. Stereotyping is assuming that all members of a group are alike. This is not an example of cultural competence nor is the nurse imposing her culture on the patient. The information in this scenario does not suggest the nurse is not open to her patient's culture.

A young Hispanic mother comes to the local clinic because her baby is sick. She speaks only Spanish, and the nurse speaks only English. Which action should the nurse take next?

a. Use short words and speak loudly

b. Obtain a medical interpreter

c. Explain why care cannot be provided

d. Provide instructions in writing

b. Requesting an interpreter reflects best practice. Qualified interpreters, available in many facilities or via video or phone, have knowledge of health care and can provide assistance. Using short words, talking loudly, and providing instructions in writing will not aid communication. Explaining why care cannot be provided will not meet the patient's health needs; the nurse is required to provide care. Since the patient doesn't speak English, this will not be understood.

A nurse is interviewing a newly admitted patient from another culture. What question best displays cultural sensitivity?

a. "Do you think you'll be able to eat the food we have here?"

b. "You do understand that we can't prepare special meals?"

c. "What types of food do you typically prepare for meals?"

d. "Could you make an exception on what food you eat while you are here?"

c. Asking patients what types of foods they eat for meals is culturally sensitive. The other questions are culturally insensitive.

A nurse tells a new mother from Africa that she should not carry her infant in a sling because bassinets are safer. The charge nurse suggests the nurse is displaying which behavior?

a. Cultural imposition

b. Clustering

c. Cultural competency

d. Stereotyping

a. The nurse is trying to impose her belief that bassinets are preferable to baby slings on the African mother—in spite of the fact that African women have safely carried babies in these slings for years.

A community organization includes provision of culturally competent care in their mission. Which action has the organization set as a priority?

a. Learning the predominant language of the community

b. Obtaining significant information about the community

c. Treating each patient at the clinic as an individual

d. Recognizing the importance of the patient's family

c. In all aspects of nursing, patients should be treated as individuals; this remains true when providing culturally competent care. Additional ways to provide culturally competent care include learning the predominant language in the community, researching the patient's culture, and recognizing the influence of family on the patient's life.

A surgeon will not attempt a life-saving repair of a ruptured aneurysm unless the patient agrees to receive blood transfusions. Although receiving blood products is against the patient's religious beliefs, the surgeon ordered four units of packed red blood cells. What action will the nurse take first?

a. Administer the blood transfusion

b. Call the patient's family and ask them to reason with the patient

c. Discuss obtaining a court order to save the patient's life

d. Maintain the patient's comfort and support their decision

d. The nurse does not force patients to participate in care that conflicts with their values. Imposing such care may engender feelings of guilt and alienation from a religious or cultural group and create a threat to the patient's well-being.