TCN PRACTICE QS

Which viewpoint, regarding birth control, would be supportive of the cultural beliefs of a Mormon woman?

Which viewpoint, regarding birth control, would be supportive of the cultural beliefs of a Mormon woman?

Each Mormon couple has a religious responsibility to parent a large family.

Which behavior would demonstrate appropriate family functioning?

A Black woman being supported during labor by her grandmother

For traditional cultural groups, including Blacks, Hispanics, Filipinos, Asians, and Aboriginal people, the family and social network (especially the grandmother or other maternal relatives) may be of primary importance in advising and supporting the pregnant woman. The remaining options do not describe characteristic correct cultural family roles during birth.

The nurse is completing the admission assessment for a 28-year-old college graduate who is labor with her first child. Which of the following would be the most appropriate question for the nurse to ask?

"Do you have anyone special who you would like to be with you during your child's birth?"

The nurse is aware that some practices among the various cultures are limited to just certain groups of individuals, and the nurse should include questions concerning these various practices in the assessment. In which areas has the reporting of pica been noted? (Select all that apply.)

Kenya

Saudi Arabia

Uganda

Pica—the craving for and ingestion of nonfood substances—is common in rural Southern United States among black females, as well as Kenya, Uganda, and Saudi Arabia.

Which of the following is essential to the birth of culturally congruent care for a pregnant woman?

A thorough cultural assessment

It is essential that the nurse do a thorough cultural assessment to ascertain how much the pregnant woman uses nontraditional support systems and/or Western health care during her pregnancy. Only after the assessment is completed can a trusting relationship be established. Without a thorough cultural assessment, the remaining options will be limited in their effectiveness.

Census data indicate that new immigrants with children tend to cluster in certain areas of the United States and Canada. Which of the following geographic areas are noted to have the higher populations of new immigrant children? (Select all that apply.)

Montreal

New Jersey

Vancouver

Virginia

Immigrants and their children can be found throughout the United States and Canada; however, they tend to cluster in certain geographic areas. New Jersey and Virginia are two locations in the United States, and Montreal and Vancouver are two in Canada. Oregon is not a prominent location.

Data collected from around the world have shown the variations in growth and development among the many cultures. It has shown the differences in the rate of growth, the timing of the growth, and how it compares when children reach adulthood. One factor appears to be consistent around the world. Which of the following is correct?

Adult head size is reached by age 5 years in all cultures.

Certain growth patterns appear across cultural boundaries. For example, adult head size is reached by the age of 5 years; however, there are some noted differences. Tooth eruption occurs earlier in Asian and Black infants than in Whites. Whites and Blacks are usually taller than Aboriginal people. Black children have longer legs in proportion to height than other groups.

Which intervention is appropriate for the treatment of a child for symptoms generally associated with the act of "casting the evil eye"?

Introducing fluids to the child every hour while awake

The evil eye, mal ojo, is an affliction feared throughout much of the world. The most serious threat to the infant with mal ojo is dehydration, the nurse encountering this problem in the community setting needs to assess the severity of the dehydration and plan for immediate fluid and electrolyte replacement. The remaining options identify interventions for symptoms not generally associated with mal ojo.

The nurse needs to be aware of the cultural differences in raising children to be able to recognize potential abuse or harm to the child. Which of the following represents a potential incident of abuse and should be further investigated to protect the child?

The young Hispanic girl who mentions that her uncle plays games with her at night in her room

Three characteristics have been identified to help define child maltreatment. Departure from one's culturally acceptable behavior is one of them. Some Middle Eastern and Mexican societies allow fondling of the genitals of infants and young children to soothe them or encourage them to sleep; however, fondling of older children or for sexual gratification of adults is outside the acceptable cultural behaviors. The young Hispanic child should be further assessed to ensure she is not being sexually abused by a family member. The other choices all represent acceptable cultural practices.

Which cultural value should be the basis for nutritional information given to the Hispanic mother of a newborn?

Fat babies are considered healthy because there is little understanding of the health risks involved.

Fat babies are considered healthy because there is little understanding of the health risks involved.

What assessment question demonstrates an understanding of the mostcommon prenatal concern reported by pregnant lesbian women?

"Do you feel you are receiving appropriate and effective prenatal care?"

The most common fear reported by lesbian mothers is the fear of unsafe and inadequate care from the practitioner once the mother's sexual orientation is revealed. While the remaining options reflect concerns, they are not reported as frequently as the correct option.

Which outcome demonstrates the successful implementation of culturally congruent care for a pregnant client whose culture holds holistic health beliefs?

The mother sipped on an herbal tea to maintain hydration during the labor.

In recent years, nurses and other health professionals have attempted to understand the client's lifestyle, value system, and health and illness behaviors so that effective interventions can be implemented to reduce risks in a manner that is culturally congruent with community, group, and individual values. Holistic health beliefs incorporate natural elements, such as herbal teas, in the plan of care. The remaining options are not holistic in their focus.

Which disorder is viewed as a biological variation that accounts for an increased incidence of both maternal and infant morbidity in Aboriginal people population?

Diabetes mellitus

An important biologic variation relative to pregnancy is diabetes mellitus. The incidence of non-insulin-dependent and gestational diabetes is much higher than normal among some Aboriginal people groups—a problem that increases maternal and infant morbidity. The remaining options are not disproportionally high in this population.

Which of the following would be an appropriate approach for the nurse to take to help encourage a hospitalized child to eat?

Supporting the child's normal feeding customs as much as possible

Nurses should assess the influence of culture on eating habits, as a child's recovery might be enhanced by familiar foods. The nurse can foster an environment that closely simulates the home (perhaps use chopsticks instead of forks). Family members can be encouraged to visit during mealtime to encourage the child to eat. As the child's condition allows, food may be brought from home, and family can be encouraged to eat with the child, if appropriate.

Which intervention will have the greatest impact on providing culturally congruent nursing care to a Hispanic child whose parents speak only minimal English?

Assigning a nurse to the family who is able to communicate in the parents' dialect

Because ethnic minorities are underrepresented among health care professionals, parents and children often have different cultural backgrounds from their health care providers. So the greatest impact would occur when a nurse familiar with the parents' language is responsible for the communication between all involved parties. The physician's contact would be more limited than that of the nurse's. Providing a translator, while appropriate, can still allow for miscommunication especially in nursing areas. Written information needs to be supported by effectively communicated information.

All women who experience active birth go through the same basic experience; however, cultural differences may dictate that the way that experience is handled is different. For most US hospitals, the nurse is aware that which of the following may be a part of that experience? (Select all that apply.)

Fetal monitoring

Monitoring by an obstetrician

Hospital deliveries routinely involve a highly specialized group of nurses, obstetricians, perinatologists, and pediatricians who actively monitor the mother's physiologic status and the fetus status, deliver the infant, and provide postpartum and newborn care. Routine hospital care can also include inducing labor, providing anesthesia for labor and birth, and performing a cesarean section. Childbirth classes are conducted late in the pregnancy, not at the hospital during birth, and some clients may choose to birth their child with the assistance of a midwife, but this can occur at home.

Which question has particular importance when interviewing a young Amish couple when their infant is hospitalized with a cardiac problem?

"Is there anyone besides you who will be involved in making medical decisions for your child?"

In an extended family culture such as the Amish, a young Amish couple might turn to that community for assistance with decision making when a child is ill. The nurse should ask the parents if anyone else will be participating in the decision making that affects their child. Once that information is known, the nurse should include the person(s) identified by the parents in the child's plan of care. The Amish has no particular restrictions regarding medical procedures or the use of blood or blood products. Their culture, while preferring to meet their needs in a simple manner, does not generally require special accommodations or treatment.

The nurse must be careful not to stereotype individuals according to the perceived cultural influence but to conduct an accurate individual assessment to determine the situation of each individual. Which of the following are recognized as potential variables that can alter the way an individual follows the cultural norms? (Select all that apply.)

The length of time lived in a different country or culture

The beliefs of the individual

The potential of changing norms over time

It is essential for the nurse to remember that not all members of a cultural group behave in the same fashion. Individual differences, changing norms over time, the degree of acculturation, the length of time the family has lived in a country, and other factors account for variations from the stereotype. The age of marrying and starting own family or following family customs are recognized as factors.

Which outcome is a common result of unintended pregnancies?

Preterm labor

Unintended pregnancy can have numerous negative effects on the mother and the fetus, including a delay in prenatal care that can lead to preterm labor. The remaining options are not generally associated with either preterm labor or unintended pregnancies.

Which assessment question will best provide the nurse with an understanding of how birth is viewed by an African-based culture?

"Will you describe for me the care you would expect to receive if you were giving birth in your homeland?"

The different ways in which a particular society views this transitional period and manages birth are dependent in part on the culture's consensus about medical care. Assessing the client's perception of traditional care will allow the nurse insight into how much attention birth is given. Asking about folk healers and natural remedies makes certain assumptions about the expected care. The remaining options assess the client's concerns rather than her expectations of care.

A 23-year-old pregnant client is asking the nurse for information about giving birth in her home. How should the nurse respond?

Providing the client with information to include letting her know that there are times when a client is not able to birth at home but needs care in the hospital

A home birth is a viable option if the client has appropriate health care and assistance during the birthing. The client does need to be aware that there is the possibility that due to unforeseen complications or circumstances, she will not be able to birth at home, and she should be aware and prepared to come to the hospital if the need arises. The nurse should be willing to help her find the appropriate resources. It is the client's responsibility to check with her insurance. Providing the family with negative information would be inappropriate.

What intervention will best facilitate sleep for a 3-year-old black child who is hospitalized with bronchitis?

Making it possible for a parent to sleep in the child's bed

Co-sleeping is more acceptable and occurs most frequently among black families. It has been documented that children who co-sleep are more likely to wake at night or to have trouble falling asleep alone at bedtime. Arranging for the parent to share the child's bed will help assure proper sleep. The other interventions will not be particularly comforting to the black child.

Which situation is especially prevalent in culturally diverse children being raised in one-parent families and so should be assessed for?

Poverty-level existence

When a mother seems reluctant to breast-feed her ill infant, the culturally sensitive nurse asks:

"Are you afraid your baby will become nauseous and vomit?"

Asking the question directly will best identify the reason for the mother's hesitation to feed her infant. In many cultures, illness is viewed as a punishment for an evil act, while fasting (abstaining from solid food and sometimes liquids) is viewed as penance for evil.

Some cultures recognize the postpartum period as a time when the woman is more vulnerable than the pregnancy. The various symptoms of anxiety, crying, mood swings, and emotional instability are referred to as which of the following by Muslims?

"Jinn" possession

The traditional Muslim culture believes that "Jinn" possession includes possession by an evil spirit that has a negative power over the mind and the body. These same symptoms are associated with postpartum depression in the Western world; however, it is not a recognized disorder by the Middle East. The "Hot" state is common with those who follow the hot/cold theories, which is common in Chinese medicine.

Which activity is vital to the survival of cultural values and customs?

Providing the younger generations with opportunities to show cultural pride