Cultural and Ethnic Considerations Ch. 6

Which term is defined as a set of learned values, beliefs, and customs passed from one generation to another?

a. Culture

b. Religion

c. Ethnicity

d. Subculture

a. Culture

Culture

Culture is a set of learned values, beliefs, customs, and practices taught and shared by a group and passed from one generation to another.

Religion

Religion is a system of worship beliefs and practices that falls within social, cultural, or ethnic norms.

Ethnicity

“Ethnicity” refers to a group of people who share a common sociocultural heritage that is based on shared traditions.

Subculture

A subculture shares many characteristics with the primary culture, but it has specific patterns of behavior and ideals that distinguish it from the main culture.

Which term is used to describe an awareness of one’s own cultural beliefs and practices in relation to those of others?

a. Stereotype

b. Cultural bias

c. Unconscious bias

d. Cultural competence

d. Cultural competence

Stereotype

A stereotype is an idea or image of a person or culture that is not easily changed.

Cultural bias

Cultural bias is one’s conviction that the beliefs and practices of their particular culture are the best.

Unconscious bias

Unconscious bias is an unintentional bias that occurs from one’s cultural stereotypes.

Cultural competence

Cultural competence is the awareness of one’s own cultural beliefs and practices and their relation to those of others, which may be different.

Which term describes a type of care that involves understanding variations in patients’ community or personal practices and integrating them into nursing care?

a. Urgent

b. Hospice

c. Transcultural

d. Alternative

c. Transcultural

Urgent

In urgent care, the patient receives treatment for serious health issues that need immediate attention.

Hospice

Hospice care focuses on the palliative treatment of a critically ill patient’s discomfort and symptoms while attending to their spiritual and emotional needs.

Transcultural

Understanding variations in patients’ cultural and subcultural practices and integrating this understanding into all aspects of nursing care describes transcultural nursing.

Alternative

Alternative or complementary care, such as acupuncture, aromatic therapy, and meditation, includes therapies used for patient care but is not a type of nursing.

Which population in the United States decreased as a percentage of the total population since 2000?

a. White

b. Asian

c. Black or African American

d. Hispanic

a. White

White

Between 2000 and 2010, the White population decreased.

Asian

Between 2000 and 2010, the population of Asians increased.

Black or African American

The Black or African American population increased from 2000 to 2010.

Hispanic

Between 2000 and 2010, the Hispanic population increased.

Which definition best describes the meaning of “gender identity”?

a. The attraction felt toward others

b. A person’s outward sexual appearance

c. The relationship between the clothing a person wears and their biological sex

d. The internal sense of self as being male, female, neither male nor female, or both male and female

d. The internal sense of self as being male, female, neither male nor female, or both male and female

The attraction felt toward others

Sexual orientation, not gender identity, refers to the attraction felt toward others.

A person’s outward sexual appearance

Gender identity is not defined as a person’s outward sexual appearance.

The relationship between the clothing a person wears and their biological sex

Gender identity is not defined by what type of clothing a person chooses to wear.

The internal sense of self as being male, female, neither male nor female, or both male and female

Gender identity is defined as the internal sense of self as being male, female, neither male nor female, or both male and female.

Which description characterizes how disabilities are commonly defined?

a. An irregular human condition that needs to be fixed

b. A description of what a person is capable of doing, rather than what the person cannot do

c. An impairment that makes it harder for a person to perform certain activities and interact with their surroundings

d. A consistent experience that unites people with mental and physical impairments

c. An impairment that makes it harder for a person to perform certain activities and interact with their surroundings

An irregular human condition that needs to be fixed

In disability culture, the disability is often seen as a human condition that does not need to be fixed, but instead needs to be accommodated.

A description of what a person is capable of doing, rather than what the person cannot do

Disabilities are largely defined by what the person cannot do that most people can do.

An impairment that makes it harder for a person to perform certain activities and interact with their surroundings

The Centers for Disease Control and Prevention (CDC) defines a disability as “any condition of the body or mind (impairment) that makes it more difficult for the person with the condition to do certain activities (activity limitation) and interact with the world around them (participation restrictions)” (CDC, 2020).

A consistent experience that unites people with mental and physical impairments

The experience of being disabled varies from person to person based on the disability.

Which characteristic is common among all cultures? Select all that apply. One, some, or all responses may be correct.

a. Culture is separate from communication patterns.

b. Culture is dynamic yet stabilized through traditions and customs.

c. Culture is learned from birth through language and socialization.

d. Culture is an adaptation to specific conditions in a specific location.

e. Culture is rarely sustained when people move to a new setting.

b. Culture is dynamic yet stabilized through traditions and customs.

c. Culture is learned from birth through language and socialization.

d. Culture is an adaptation to specific conditions in a specific location.

Culture is separate from communication patterns.

Culture includes communication, methods of economic and physical survival, transportation systems, family systems, social customs and mores, and religious systems.

Culture is dynamic yet stabilized through traditions and customs.

Culture is dynamic and ever-changing while also being stabilized through language, traditions, and norms or customs.

Culture is learned from birth through language and socialization.

Language and socialization are common to all cultures, as is the fact that culture is learned from birth onward.

Culture is an adaptation to specific conditions in a specific location.

Culture is often influenced by local conditions, such as the availability of natural resources.

Culture is rarely sustained when people move to a new setting.

Cultural adaptations to one setting may be sustained when people move to a new setting.

When caring for a female patient who has chosen to have an abortion, which action demonstrates cultural competence when the nurse has personal beliefs against having an abortion?

a. Asking the patient for the reason for the abortion

b. Submitting a letter of resignation and change employers

c. Examining personal feelings by performing a self-assessment

d. Transferring to another unit where abortion procedures are not performe

c. Examining personal feelings by performing a self-assessment

Asking the patient for the reason for the abortion

While the reason for the abortion may be relevant, the nurse is not demonstrating cultural competence by determining the reason.

Submitting a letter of resignation and change employers

Changing employers is not a solution because the nurse still may encounter women who have had or who plan to have an abortion. Self-assessment assists the nurse to determine how personal beliefs and practices may affect the ability to care for those from other cultures or with different beliefs.

Examining personal feelings by performing a self-assessment

Understanding one’s own personal beliefs enables a person to respond with openness, understanding, and acceptance of cultural differences. The understanding of one’s own culture can be achieved via self-assessment.

Transferring to another unit where abortion procedures are not performed

Transferring to another department is not a solution because the nurse still may encounter women who have had or who plan to have an abortion. Through self-assessment, the nurse can identify how personal beliefs and practices influence the ability to care for those from other cultures or with different beliefs.

Which question would the nurse ask during the assessment of a diabetic patient of unclear gender from another country? Select all that apply. One, some, or all responses may be correct.

a. “What language do you speak?”

b. “How well do you understand English?”

c. “Do you use any folk medicines or treatments?”

d. “What are your dietary practices?”

e. “What are your sexual practices?”

f. “What are your preferred pronouns?”

a. “What language do you speak?”

b. “How well do you understand English?”

c. “Do you use any folk medicines or treatments?”

d. “What are your dietary practices?”

f. “What are your preferred pronouns?”

What language do you speak?”

Information about the language the patient speaks is important to provide effective communication.

“How well do you understand English?”

Information about the patient’s understanding of English is important to provide effective communication.

“Do you use any folk medicines or treatments?”

Information about use of folk medicines is necessary to develop a plan of care to meet the patient’s needs.

“What are your dietary practices?”

Information about dietary practices that could interfere with treatment is necessary to develop a plan of care to meet the patient’s needs.

“What are your sexual practices?”

The nurse should perform an assessment to obtain necessary information without engaging in irrelevant questions about sexual health and sexual matters out of personal curiosity.

“What are your preferred pronouns?”

If the patient’s gender identity is unclear, the nurse should clarify by asking if they have preferred pronouns.

Which behavior might a nurse encounter while questioning an older patient from a different culture experiencing disturbed cognitive function?

a. The patient’s child translates their responses.

b. The patient believes that the nurse is not trustworthy.

c. The patient responds to questions with cultural sensitivity.

d. The patient decides to discontinue the use of home remedies.

b. The patient believes that the nurse is not trustworthy.

The patient’s child translates their responses.

Adults may be reluctant to answer questions about personal health if responses are translated by their children or grandchildren.

The patient believes that the nurse is not trustworthy.

Some older adults are less tolerant of other cultures because of early life experiences, which raises the possibility of misunderstandings and distrust of a caregiver from a different cultural group.

The patient responds to questions with cultural sensitivity.

Older people experiencing disturbed cognitive function sometimes speak without cultural sensitivity and make hurtful comments.

The patient decides to discontinue the use of home remedies.

Older adults may value home remedies and cultural practices and sometimes resist the caregivers’ attempts to change their practices.

Which statement best describes race?

a. A group of people who share biological and physical characteristics

b. A group of people who have an internal experience that is part of their identity

c. A group of people who share a common social and cultural heritage based on shared traditions

d. A group of people who have barriers to health care and tend to have poorer outcomes

a. A group of people who share biological and physical characteristics

A group of people who share biological and physical characteristics

“Race” refers to a group of people who share similar biological and physical characteristics.

A group of people who have an internal experience that is part of their identity

Gender identity refers to the internal sense of self as being male, female, neither male nor female, or both male and female. Gender identity is an internal experience that is part of that person’s identity.

A group of people who share a common social and cultural heritage based on shared traditions

“Ethnicity” refers to a group of people who share a common social and cultural heritage based on shared traditions, national origin, and physical and biological characteristics.

A group of people who have barriers to health care and tend to have poorer outcomes

People with disabilities have barriers to health care and tend to have poorer outcomes. A disability is defined by the Centers for Disease Control and Prevention (CDC) as “any condition of the body or mind that makes it more difficult for the person with the condition to do certain activities and interact with the world around them.”

Which term describes a nurse who addresses questions to the companion of a patient who uses a wheelchair?

a. Ableism

b. Transcultural nursing

c. Cultural bias

d. People-first language

a. Ableism

Ableism

Ableism, which is discrimination and prejudice toward people with disabilities, occurs in health care when conversation and health questions are directed at a person other than the patient who happens to have a disability.

Transcultural nursing

Transcultural nursing is integrating an understanding of variations in cultural and subcultural practices into nursing care.

Cultural bias

Cultural bias is a conviction that the beliefs and practices of one’s own particular culture are best.

People-first language

People-first language is illustrated by the nurse’s stating, “a person with blindness” instead of “a blind person.”

Which concept is illustrated if the nurse assumes that a patient is a heavy drinker and poorly educated because of their culture?

a. Stereotyping

b. Ethnocentrism

c. Cultural sensitivity

d. Cultural competence

a. Stereotyping

Stereotyping

It is important to understand that not everyone in a cultural, racial, or ethnic group has identical beliefs and practices and that each person should be treated in an individual, holistic manner. In this case, the nurse would be stereotyping, or making assumptions that those characteristics will be present because the patient is of a certain culture.

Ethnocentrism

When one believes that the practices of one’s own culture are best, it is called ethnocentrism.

Cultural sensitivity

Being culturally sensitive means being accepting and having an awareness of the beliefs and practices of other cultures.

Cultural competence

Cultural competence is the awareness of one’s own cultural beliefs and practices and their relation to those of others, which may be different.

For which reason might a patient stay silent after a nurse has spoken?

a. The patient is embarrassed by what the nurse has said.

b. The patient is angry about what the nurse has said.

c. The patient is considering what the nurse has said.

d. The patient disapproves of what the nurse has said.

c. The patient is considering what the nurse has said.

The patient is embarrassed by what the nurse has said.

Silence is not a sign of embarrassment, but the silence does allow the listener to reflect on what has been said before replying.

The patient is angry about what the nurse has said.

In general, some cultures value silence, whereas Western cultures find it uncomfortable. Silence is not usually a sign of anger.

The patient is considering what the nurse has said.

In general, some cultures value silence, whereas Western cultures find it uncomfortable. Silence allows time for the listener to consider what the speaker has said before continuing.

The patient disapproves of what the nurse has said.

Silence is not usually a sign of disapproval but is used to let the listener reflect on what has been said before replying.

Which statement about culturally sensitive communication is accurate?

a. Touch is universally reassuring in most cultures.

b. Silence can mean different things to different cultures.

c. The language patterns in a country are usually similar.

d. The nurse should address patients informally to help them feel comfortable.

b. Silence can mean different things to different cultures.

Touch is universally reassuring in most cultures.

Culturally sensitive communication includes determining the patient’s preferences for touch. The meanings and practices of touch may vary widely.

Silence can mean different things to different cultures.

Culturally sensitive communication includes attending to the patient’s use of silence. Silence can indicate a lack of understanding, stubbornness, apprehension, discomfort, agreement, disagreement, respect, or disdain.

The language patterns in a country are usually similar.

Regional accents or expressions within one country may complicate communication.

The nurse should address patients informally to help them feel comfortable.

Culturally sensitive communication includes asking all patients how they like to be addressed. If in doubt, the nurse would address them formally.

Which statement about perceptions of personal space in the United States is accurate?

a. Closer contact is reserved for coworkers.

b. Closer contact is reserved for casual acquaintances.

c. Closer contact is reserved for more intimate relationships.

d. Closer contact is more common than in many other countries.

d. Closer contact is more common than in many other countries.

Closer contact is reserved for coworkers.

In the United States, closer contact is not reserved for work colleagues. People working together are often given a larger amount of personal space than what is common in many other countries.

Closer contact is reserved for casual acquaintances.

In the United States, people are often more comfortable when given a larger amount of personal space than what is common in many other countries. Closer contact is reserved for more intimate relationships.

Closer contact is reserved for more intimate relationships.

People in the United States tend to be more comfortable when they are given a larger amount of personal space than what is common in many other countries. People in intimate relationships tend to have closer personal contact.

Closer contact is more common than in many other countries.

Closer personal contact is more common in other countries than in the United States.

Which action would a nurse who is working in a clinic serving a low-income community take when observing that many patients are consistently late?

a. Review the importance of being on time with the affected individuals.

b. Post a sign in the waiting room reminding people to be on time, using the most commonly spoken languages.

c. Change appointment times to accommodate local bus schedules.

d. Implement a new policy charging a fee for late or missed appointments.

c. Change appointment times to accommodate local bus schedules.

Review the importance of being on time with the affected individuals.

Patients in low-income communities may be dependent on local public transportation to get to and from appointments. Reminding them of the importance of being on time will not affect this.

Post a sign in the waiting room reminding people to be on time, using the most commonly spoken languages.

Hanging signs in the waiting room reminding people to be on time, even if they are in the language most commonly used in the community, will not address lateness or missed appointments if these issues are due to problems with local public transportation.

Change appointment times to accommodate local bus schedules.

People in low-income communities frequently rely on public transportation to get to and from medical appointments. Arranging the schedule so it coincides with the arrival of local buses or trains can help promote timeliness.

Implement a new policy charging a fee for late or missed appointments.

People in low-income communities could not afford to pay an extra fee for being late. This may discourage people from seeking medical care.

Which statement explains why several older women in a patient’s family are making decisions about the patient’s health care?

a. The patient is from a matriarchal culture.

b. The patient is from a patriarchal culture.

c. The patient is from a nuclear family.

d. The patient is from an extended family.

a. The patient is from a matriarchal culture.

The patient is from a matriarchal culture.

In a matriarchal culture, the women usually make the decisions about health care.

The patient is from a patriarchal culture.

In a patriarchal culture, the oldest man in the family is often consulted on decision making.

The patient is from a nuclear family.

In a nuclear family, there would not be several older women involved with the patient’s care.

The patient is from an extended family.

Extended families can be either matriarchal (where women make decisions) or patriarchal (where men make decisions), depending on the family’s culture.

Which health belief system refers to patients who use herbs, foods, and a native healer to address common physical ailments?

a. Folk

b. Biomedical

c. Alternative

d. Complementary

a. Folk

Folk

Folk medicine often includes herbs, foods, rituals, and spiritual practices. It may also include native healers who incorporate religious practices and magic.

Biomedical

In a biomedical health belief system, treatment focuses on the use of physical and chemical interventions.

Alternative

Acupuncture, aromatic therapy, meditation, therapeutic touch, and a variety of other techniques are examples of alternative therapies.

Complementary

A complementary belief system uses nonmedical forms of therapy, such as acupuncture, aromatic therapy, meditation, and therapeutic touch.

Which assessment practice would the nurse use to ensure that care is sensitive to the needs of individual patients?

a. Take the perspective of the patient

b. Assume that the patient's beliefs are different

c. Assess the individual on their own terms

d. Adhere to bicultural practices

c. Assess the individual on their own terms

Take the perspective of the patient

The nurse would not take the perspective of the patient to ensure that care is sensitive to the needs of individual patients. Rather, the nurse must be aware of and open to the wide range of such beliefs to ensure that the care provided is sensitive to the needs of individual patients.

Assume that the patient's beliefs are different

The nurse would not assume that the patient’s beliefs are different. The nurse should not make assumptions about patients based on appearance, language, ethnic origin, names, or religious practices. Nurses are better able to understand each individual by assessing them on their own terms.

Assess the individual on their own terms

To ensure that the care provided is sensitive to the needs of individual patients, the nurse would assess the individual and family on their own terms. This helps the nurse understand each person.

Adhere to bicultural practices

The nurse would not adhere to bicultural or biracial practices to ensure that care is sensitive to the needs of individual patients. Rather, the nurse must be aware of and open to the wide range of such beliefs to ensure that the care provided is sensitive to the needs of individual patients.

Which biological variation among cultures is the most important for health care practice?

a. Height variations

b. History of diseases

c. Skin color varieties

d. Hair color differences

b. History of diseases

Height variations

Biological variations contributing to differences in height do not play a role in health care practice.

History of diseases

Especially important to health care practice is a family history of diseases that are common within the ethnic group. Some diseases, such as diabetes, asthma, or heart disease, tend to be more prevalent among certain cultural groups.

Skin color varieties

Differences in skin color may be an obvious feature among different groups; however, this characteristic does not play a major role in health care practice.

Hair color differences

While hair color is an obvious feature, family history of diseases that are common within the ethnic group is more important for health care practice.

Which action would the nurse take for a female patient who wishes to be cared for by a female nurse due to cultural reasons?

a. Assigning her a female nurse

b. Referring her to the nurse manager

c. Informing her that special requests cannot always be accommodated

d. Providing reassurance that male nurses will be respectful and professional

a. Assigning her a female nurse

Assigning her a female nurse

People of some cultures prefer nursing care from people of the same gender. A culturally sensitive nurse would honor that request by assigning female nurses to care for the patient.

Referring her to the nurse manager

There is no need to refer her to the nurse manager if the nurses are able to accommodate their request.

Informing her that special requests cannot always be accommodated

Providing culturally sensitive nursing care to this patient includes accommodating this request as much as possible.

Providing reassurance that male nurses will be respectful and professional

While male nurses are respectful and professional, this type of reassurance does not change the patient’s cultural practices.

Which consideration applies if the nurse lives in an area where the culture is very different from the nurse’s own?

a. It is not necessary for nurses to be aware of the community in which they practice.

b. It is the nurse’s responsibility to learn as much as possible about the people and the culture.

c. It is the patient's responsibility to communicate aspects of their culture to the nurse.

d. It is the responsibility of local outreach programs to promote cultural awareness to health care workers.

b. It is the nurse’s responsibility to learn as much as possible about the people and the culture.

It is not necessary for nurses to be aware of the community in which they practice.

Culture has a strong influence on patients, colleagues, and nurses. Therefore, nurses should be aware of the community in which they work.

It is the nurse’s responsibility to learn as much as possible about the people and the culture.

If the nurse resides in an area that is populated heavily by a culture that is unlike their own, it is the nurse’s responsibility to learn as much as possible about the people and the culture.

It is the patient's responsibility to communicate aspects of their culture to the nurse.

Patients, colleagues, and nurses are influenced by culture. It is therefore essential that nurses are aware of the community where they work.

It is the responsibility of local outreach programs to promote cultural awareness to health care workers.

Cultural influences impact patients, colleagues, and nurses, so nurses should be aware of the community where they work.

Which community is being referred to when the term “American Indian” is used?

a. Native tribes residing within the continental United States

b. Native tribes residing within all of North America

c. Indigenous peoples of North and South America

d. Indigenous people of Canada

a. Native tribes residing within the continental United States

Native tribes residing within the continental United States

When the term “American Indian” is used, it is intended to refer to tribes residing within the continental United States. The nurse should respect how a person wishes to be identified.

Native tribes residing within all of North America

The term “American Indian” refers to tribes residing within the continental United States.

Indigenous peoples of North and South America

When using the term “American Indian,” it is meant to refer to the tribes living within the continental United States.

Indigenous people of Canada

When the term “American Indian” is used, it is intended to refer to tribes residing within the continental United States. Preferred terms used in the United States may be offensive to indigenous people in Canada.

Which strategy would the nurse adopt to ensure effective communication while interacting with a pediatric patient’s parents who are unable to read or write?

a. Providing instructional material supported by illustrations

c. Suggesting that a spiritual advisor visit with the family

d. Maintaining eye contact while giving instructions to the parents

e. Seeking assistance from other family members when communicating

a. Providing instructional material supported by illustrations

Providing instructional material supported by illustrations

The nurse would provide illustrated materials to the parents to help them understand the instructions and avoid misinterpretation.

Suggesting that a spiritual advisor visit with the family

Suggesting that a spiritual advisor visit with the family will not address the communication issue.

Maintaining eye contact while giving instructions to the parents

Maintaining eye contact is part of effective communication but will not enhance understanding of care instructions with parents who are unable to read or write.

Seeking assistance from other family members when communicating

Seeking assistance from family members may result in a bias or a violation of privacy and confidentiality.

Which action would the nurse take with a child who smiles and frequently nods their head during patient teaching?

a. Performing a baseline hearing assessment for the child

b. Avoiding silence so the child does not feel the need to speak

c. Using validation techniques such as asking questions

d. Documenting the child’s behavior, and reporting it to the health care provider

c. Using validation techniques such as asking questions

Performing a baseline hearing assessment for the child

A baseline hearing assessment is not required for the child because the patient responds by nodding and smiling, implying that the child does not have a hearing impairment.

Avoiding silence so the child does not feel the need to speak

During the process of decision making, the nurse would provide some periods of silence to allow the patient time to articulate their thoughts.

Using validation techniques such as asking questions

Gestures such as nodding and smiling may indicate that the patient is pretending only to please the nurse. Nurses often misinterpret these gestures and assume that the patient is understanding the instructions. The nurse needs to verify that the patient understands. Validating the child’s understanding will help determine whether the nurse’s teaching has been effective.

Documenting the child’s behavior, and reporting it to the health care provider

Documenting the child’s behavior will not address the behavior or facilitate the necessary teaching.

Which practice may hinder communication?

a. Talking slowly and precisely

b. Addressing the patient formally

c. Speaking quietly so the listener understands better

d. Having many family members accompany a patient

d. Having many family members accompany a patient

Talking slowly and precisely

Some cultural or regional groups speak very rapidly, which adds to the difficulty of understanding.

Addressing the patient formally

While every person has their own preference as to how they would like to be addressed, defaulting to a formal address is better than being inappropriately informal.

Speaking quietly so the listener understands better

Sometimes a person speaks more loudly to emphasize a point out of the mistaken belief that this helps the listener understand better. This practice often has the opposite effect of the one desired.

Having many family members accompany a patient

Large groups of family members tend to make communication difficult. They sometimes all try to assist by answering at once.

Which fact would the nurse consider when a young child from a patriarchal culture requires surgery?

a. The nurse would ensure that the surgery is scheduled as soon as possible.

b. Surgery would not be scheduled until the oldest male in the family is consulted.

c. The mother has the right to make the decision regarding the scheduling of surgery.

d. The primary care provider will decide when the surgery is to be scheduled.

b. Surgery would not be scheduled until the oldest male in the family is consulted.

The nurse would ensure that the surgery is scheduled as soon as possible.

The surgery would not be scheduled as soon as possible. Instead, the nurse would wait until the patriarch can be reached.

Surgery would not be scheduled until the oldest male in the family is consulted.

The structure of the patient’s family is an important consideration in the health care setting. A patriarchal family will sometimes delay any decisions regarding health care for one of the family members until the oldest male in the family is consulted. Therefore, the surgery should not be scheduled until the patriarch can be reached.

The mother has the right to make the decision regarding the scheduling of surgery.

In a patriarchal family, the oldest male member will make the decision; in a matriarchal family, the oldest female member may make the decision.

The primary care provider will decide when the surgery is to be scheduled.

The primary care provider has the authority to decide whether surgery is indicated, but not necessarily the exact time the surgery will be performed.

Which action would the nurse take when caring for a patient scheduled for surgery who is using chemical therapies?

a. Notifying the patient's health care provider

b. Noting the health practices in the patient’s record

c. Recognizing the patient’s right to participate in alternative therapies

d. Advising the patient that the facility will not be able to provide information on chemical therapies

a. Notifying the patient's health care provider

Notifying the patient's health care provider

Chemical interventions may include herbs that may be contraindicated before surgery and will need to be discontinued beforehand. The health care provider must be informed to address any contraindications.

Noting the health practices in the patient’s record

Noting the health practices in the patient’s record is appropriate but is not the most appropriate measure to be taken.

Recognizing the patient’s right to participate in alternative therapies

Recognizing the patient’s right to participate in alternative therapies is appropriate but is not the most appropriate measure to be taken.

Advising the patient that the facility will not be able to provide information on chemical therapies

Informing the patient that the facility will not be able to provide information during the patient’s stay is not appropriate.

Which accommodation would the nurse sometimes make due to a patient’s cultural background?

a. Adopting the patient’s cultural practice

b. Adapting how an assessment is performed

c. Ignoring the guidelines of the Health Insurance Portability and Accountability Act (HIPAA)

d. Allowing hospital policies to disregard the patient’s practices

b. Adapting how an assessment is performed

Adopting the patient’s cultural practice

A nurse would not need to adopt the patient’s cultural practice because of a patient’s cultural background.

Adapting how an assessment is performed

Because of a patient’s cultural background, the nurse sometimes must modify how an assessment is performed, how care is provided, or the usual routines of the institution in response to the patient’s needs. The process would still take place under the guidelines of the Health Insurance Portability and Accountability Act (HIPAA).

Ignoring the guidelines of the Health Insurance Portability and Accountability Act (HIPAA)

Although modifications to an assessment may be made because of a patient’s cultural background, they would still adhere to HIPAA guidelines.

Allowing hospital policies to disregard the patient’s practices

The patient and family or support system are unlikely to accept any of the health teaching or treatments the nurse attempts to provide if their own beliefs are not recognized. A mutually acceptable alliance with the patient is imperative. Equally important is a mutual respect between the patient and the nurse.

Which term would be appropriate to add to the nursing problem list for a patient who speaks little English and does not understand their disease process?

a. Insufficient knowledge

b. Noncooperation

c. Communication

d. Hopelessness

c. Communication

Insufficient knowledge

Caution would be utilized when using certain nursing diagnoses to patient problem statements such as insufficient knowledge and noncooperation. These are difficult to tailor to particular patients.

Noncooperation

Caution would be utilized when using certain nursing diagnoses to patient problem statements, such as noncooperation, because these are difficult to tailor to particular patients.

Communication

Whether the nurse and the patient can understand each other must be determined. When patients do not understand something, they may nod yes, giving the impression that they understand. The nurse must not assume that the family or the patient understands the information.

Hopelessness

There is no indication of hopelessness.

Which action would the nurse perform after the baptism of a newborn in the absence of a priest?

a. Arranging for a prayer with the patient’s family and friends

b. Documenting the baptism in the nurse’s notes

c. Reading the Bible to the mother and the newborn baby

d. Checking the prescriptions required for the newborn baby

b. Documenting the baptism in the nurse’s notes

Arranging for a prayer with the patient’s family and friends

The nurse is not expected to arrange a prayer.

Documenting the baptism in the nurse’s notes

The nurse would chart the baptism in the nurse’s notes for documentation.

Reading the Bible to the mother and the newborn baby

The nurse is not expected to read the Bible.

Checking the prescriptions required for the newborn baby

The nurse need not check the newborn’s prescriptions.

Which technique would a nurse use when instructing a patient with limited English skills who is reluctant to use an interpreter?

a. Explaining the instructions in detail

b. Giving brief, simple instructions

c. Seeking assistance from family members

d. Maintaining eye contact during teaching

b. Giving brief, simple instructions

Explaining the instructions in detail

The nurse would not explain the guidelines in detail because the patient may not grasp the meaning of the instructions. The nurse would explain the information to the patient by using simple, brief sentences to help the patient understand the intended message.

Giving brief, simple instructions

The nurse would explain the information to the patient by using brief, simple, sentences to help the patient understand the intended message.

Seeking assistance from family members

Seeking assistance from family members may lead to inaccurate communication or a violation of privacy and confidentiality.

Maintaining eye contact during teaching

Maintenance of eye contact during communication may be considered ill-mannered and disrespectful and will not improve the communication.

Which nursing action will promote a healthier intake for an African American patient with a diet high in fat who has developed severe hypertension and cardiovascular disease?

a. Supporting the patient in his or her dietary habits

b. Suggesting baking and broiling instead of frying

c. Telling the patient to stop eating meat and become a vegetarian

d. Arranging a visit with another patient who had a heart attack because of eating high-fat foods

b. Suggesting baking and broiling instead of frying

An important health consideration is the effect of culturally determined dietary considerations. Many traditional foods are high in saturated fats, sodium, and sugar. If these foods are eaten regularly, they may affect the health of the individual and his or her family members. When assessing the patient, it is important to include questions to determine whether the patient consumes a cultural diet or a more general diet. The patient should be taught to alter the diet to accommodate health needs. Baking and broiling are much healthier methods of preparing food. Supporting the patient's unhealthy dietary choices or telling the patient to become a vegetarian are inappropriate. Factors other than food may have contributed to the patient's heart attack, so arranging a visit is also inappropriate.

In which community would a patient with ovarian cancer refuse to sign the informed consent for care and request that the nurse wait for the patient's spouse to arrive before getting the signature?

a. Muslim American community

b. Mexican American community

c. African American community

d American Indian community,

a. Muslim American community

People in Muslim American communities typically practice patriarchy. According to this system, the male member of the family makes decisions on health care and medication. In this community, the patient's spouse signs the informed consent form. Consent from the male individuals in the family is not a practice in the Mexican American, African American, or American Indian communities. Women belonging to these communities usually make their own health care decisions and generally sign their informed consent form.

The nurse will express which concern for a Hispanic patient who does not speak English?

a. Inability to adhere to the care routine of the hospital staff

b. Inability to understand the verbal remarks of the care staff

c. Lack of knowledge regarding medical and nursing diagnoses

d. Inability to cope with the hospital stay without his wife at his bedside

b. Inability to understand the verbal remarks of the care staff

It is of concern when the patient and the care staff are unable to understand each other's verbal remarks.

Inability to adhere to the care routine of the hospital staff and inability to cope without his wife at his bedside have nothing to do with this situation; the problem identified is the language barrier. It is not necessarily true that the patient has lack of knowledge regarding medical and nursing diagnoses, and this concern should be considered carefully.

p. 103

The nurse calls the priest for a dying patient from the Catholic faith. Which action would the nurse request of the priest to address the priority need of the patient at this time?

a. Performing the "anointing of the sick" sacrament

b. Praying with the patient and the family

c. Reading the Bible with the patient and the family

d. Singing songs of comfort to the patient and the family

a. Performing the "anointing of the sick" sacrament

The nurse calls a priest to perform the "anointing of the sick" sacrament. The priest applies holy oil to the patient's forehead and hands. The nurse does not call the priest to pray, read the Bible, or sing songs with the patient and the family in this situation because the patient is dying, and the "anointing of the sick" sacrament is of highest priority.

pp. 99,108

Which term is defined as a set of learned values, beliefs, customs, and practices taught, shared by a group, and passed from one generation to another?

a. Culture

b. Religion

c. Ethnicity

d. Subculture

a. Culture

Culture is a set of learned values, beliefs, customs, and practices taught, shared by a group, and passed from one generation to another. Religion is a preference that falls within social, cultural, or ethnic norms. Ethnicity refers to a group of people who share a common sociocultural heritage that is based on shared traditions. A subculture shares many characteristics with the primary culture, but it has specific patterns of behavior and ideals that distinguish it from the main culture.

р. 98

Which strategy does the nurse employ when examining a Chinese American patient with

a. Assign a nurse of the same gender.

b. Maintain prominent eye contact.

c. Try to speak in the patient's language.

d. Ask questions multiple times

a. Assign a nurse of the same gender.

During assessment, some patients may find it difficult to share information regarding their illness, especially if they have sexually transmitted diseases, like syphilis. In such conditions, patients feel shy and embarrassed; they tend to avoid or omit information when speaking to a nurse of the opposite sex. To make the patient feel comfortable, it is important to assign a nurse of the same gender. The patient may become aggressive if the nurse asks questions repeatedly; the nurse would maintain silence after asking questions, allowing the patient to think before answering. The nurse would avoid sustained eye contact; Asian communities treat this as an impolite sign. The nurse would use an interpreter rather than attempt speaking the patient's language. This aids effective communication and the ability to provide information about the illness to the patient.

pp. 110-113

Which dietary precaution would the nurse adopt while assisting in the care of a patient from the Muslim community?

a. Giving permissible meat

b. Providing pork on all Islamic holidays

c. Supplying pork only on a Monday.

d. Providing milk only on a Friday

a. Giving permissible meat

While caring for patients, the nurse should consider any dietary restrictions based on the patients' religious practices. Islamic communities prefer to eat permissible (halal) meat. Consuming pork is against Islamic religious beliefs; the nurse should not provide pork to this patient. In the Islamic culture, there is no restriction on intake of dairy products, such as milk; the nurse can give milk to the patient on all days.

pp. 110-113

During a patient interaction, the nurse notices that the Mexican patient is silent after being instructed that they need an ultrasound scan. Which conclusion does the nurse draw about the patient from the patient's behavior?

a. The patient is thinking about the test.

b. The patient is not agreeing to take the test.

c The patient is showing respect to the nurse.

d. The patient is not comfortable talking with the nurse.

b. The patient is not agreeing to take the test.

In Mexican communities, silence is a sign of disagreement; the patient's silence shows that the patient is unwilling to take the test. In Indian, American, Chinese, and Japanese communities, silence is an indication of active listening and that the patient is thinking about the test. Silence in Asian communities indicates a sign of respect toward older persons and medical professionals. Silence does not indicate that the patient is scared or uncomfortable interacting with the nurse. Avoiding eye contact indicates that the patient is uncomfortable interacting with the nurse.

р. 104

A female Muslim patient has been assigned to a male nurse and the patient is very upset. The nurse understands that the patient is upset because of which situation related to this patient's religious beliefs?

a. Her husband is not present.

b. Her nursing care provider is not a female.

c. Her mother is not present for all procedures.

d. Her primary health care provider is not present.

b. Her nursing care provider is not a female.

For modesty, Muslim women prefer to be cared for by female staff, a preference that should be respected. The other options are not involved with a female Muslim patient's religious beliefs.

pg.109