Potter and Perry Chapter 9 Culture & Ethnicity

A 6 m/o child from Guatemala was adopted by an American family in Indiana. The child's socialization into the American midwestern culture is best described as:

1. Assimilation

2. Acculturation

3. Biculturalism

4. Enculturation

4: Socialization into one's primary culture as a child is known as enculturation.

A 46 y/o woman from Bosnia came to the US 6 years ago. Although she didn't celebrate Christmas when she lived in Bosnia, she celebrates Christmas with her family now. This woman has experienced assimilation into the culture of the US b/c she:

1. Chose to be bicultural.

2. Adapted to and adopted the American culture.

3. Had an extremely negative experience with the American culture.

4. Gave up part of her ethnic identity in favor of the American culture.

2: Assimilation results when an individual gradually adopts and incorporates the characteristics of the dominant culture.

To enhance their cultural awareness, nursing students need to make an in-depth self-examination of their own:

1. Motivation and commitment to caring.

2. Social, cultural, and biophysical factors.

3. Engagement in cross-cultural interactions.

4. Background, recognizing her biases and prejudices.

4: Cultural awareness is an in-depth self-examination of one's own background, recognizing biases and prejudices and assumptions about other people.

Which of the following is required in the delivery of culturally congruent care?

1. Learning about vast cultures

2. Motivation and commitment to caring

3. Influencing treatment and care of patients

4. Acquiring specific knowledge, skills, and attitudes

4: Specific knowledge, skills, and attitudes are required in the delivery of culturally congruent care.

A registered nurse is admitting a patient of French heritage to the hospital. Which question asked by the nurse indicates that the nurse is stereotyping the patient?

1. "What are your dietary preferences?"

2. "What time do you typically go to bed?"

3. "Do you bathe and use deodorant more than one time a week?"

4. "Do you have any health issues that we should know about?"

3: Nurses need to avoid stereotypes or unwarranted generalizations about any particular group that prevents further assessment of the individual's unique characteristics.

When action is taken on one's prejudices:

1. Discrimination occurs.

2. Delivery of culturally congruent care is ensured.

3. Effective intercultural communication develops.

4. Sufficient comparative knowledge of diverse groups is obtained.

1: Prejudices associate negative permanent characteristics with people who are different from the valued group. When a person acts on these prejudices, discrimination occurs.

A nursing student is doing a community health rotation in an inner-city public health department. The student investigates sociodemographic and health data of the people served by the health department, and detects disparities in health outcomes between the rich and poor. This is an example of a(n):

1. Illness attributed to natural and biological forces.

2. Creation of the student's interpretation and descriptions of the data.

3. Influence of socioeconomic factors in morbidity and mortality.

4. Combination of naturalistic, religious, and supernatural modalities.

3: Health disparity populations are populations that have a significant increased incidence or prevalence of disease or that have increased morbidity, mortality, or survival rates compared to the health status of the general population.

Culture strongly influences pain expression and need for pain medication. However, cultural pain is:

1. Not expressed verbally or physically.

2. Expressed only to others from a similar culture.

3. Usually more intense than physical pain.

4. Suffered by a patient whose valued way of life is disregarded by practitioners.

4: Patients suffer cultural pain when health care providers disregard values or cultural beliefs.

Which of the following best represents the dominant values in American society on individual autonomy and self-determination?

1. Physician orders

2. Advance directive

3. Durable power of attorney

4. Court-appointed guardian

2: Informed consent and advance directives protect the right of the individual to know and make decisions ensuring continuity of individual autonomy and self-determination.

The nurse at an outpatient clinic asks a patient who is Chinese American with newly diagnosed hypertension if he is limiting his sodium intake as directed. The patient does not make eye contact with the nurse but nods his head. What should the nurse do next?

1. Ask the patient how much salt he is consuming each day

2. Discuss the health implications of sodium and hypertension

3. Remind the patient that many foods such as soy sauce contain "hidden" sodium

4. Suggest some low-sodium dietary alternatives

1: In an Asian culture spoken messages often have little to do with their meanings. It is important for the nurse to clarify how much salt the patient is consuming in his diet.

A female Jamaican immigrant has been late to her last two clinic visits, which in turn had to be rescheduled. The best action that the nurse could take to prevent the patient from being late to her next appt. is:

1. Give her a copy of the city bus schedule.

2. Call her the day before her appt. as a reminder to be on time.

3. Explore what has prevented her from being at the clinic in time for her appt.

4. Refer her to a clinic that is closer to her home.

3: Present-time orientation is in conflict with the dominant organizational norm in health care that emphasizes punctuality and adherence to appointments. Nurses need to expect conflicts and make adjustments when caring for ethnic groups.

A nursing student is taking postoperative vital signs in the postanesthesia care unit. She knows that some ethnic groups are more prone to genetic disorders. Which of the following patients is most at risk for developing malignant hypertension?

1. Ashkenazi Jew

2. Chinese American

3. African American

4. Filipino

3: Certain genetic disorders are linked with specific ethnic groups such as malignant hypertension among African Americans.

A community health nurse is making a healthy baby visit to a new mother who recently emigrated to the United States from Ghana. When discussing contraceptives with the new mom, the mother states that she won't have to worry about getting pregnant for the time being. The nurse understands that the mom most likely made this statement because:

1. She won't resume sexual relations until her baby is weaned.

2. She is taking the medroxyprogesterone (Depo-Provera) shot.

3. Her husband was recently deployed to Afghanistan.

4. She has access to free condoms from the clinic.

1: In some African cultures such as in Ghana and Sierra Leone some women will not resume sexual relations with their husbands until the baby is weaned.

During their clinical post-conference meeting, several nursing students were discussing their patients with their instructor. One student from a middle-class family shared that her patient was homeless. This is an example of caring for a patient from a different:

1. Ethnicity.

2. Culture.

3. Heritage.

4. Religion.

2: Culture is the context in which groups of people interpret and define their experiences relevant to life transitions. This includes events such as birth, illness, and dying. It is the system of meanings by which people make sense of their experiences.

When interviewing a Native American patient on admission to the hospital emergency department, which questions are appropriate for the nurse to ask? (Select all that apply.)

1. Do you use any folk remedies?

2. Do you have a family physician?

3. Do you use a Shaman?

4. Does your family have a history of alcohol abuse?

1, 2, 3: Obtain information about folk remedies and cultural healers that the patient uses. Assessment data yield information about the patient's beliefs about the illness and the meaning of the signs and symptoms.

The Collins family includes a mother, Jean; stepfather, Adam; two teenage biological daughters of the mother, Lisa and Laura; and a biological daughter of the father, 25-year-old Stacey. Stacey just moved home following the loss of her job in another city. The family is converting a study into Stacey's bedroom and is in the process of distributing household chores. When you talk to members of the family, they all think that their family can adjust to lifestyle changes. This is an example of family:

1 Diversity.
2 Durability.
3 Resiliency.
4 Configuration.

C. Resiliency is the ability of the family to cope with the unexpected. In this scenario the family used resources to provide some short-term solutions for the adult child's return home.

The most common reason grandparents are called on to raise their grandchildren is because of:

1. Single parenthood

2. Legal intervention

3. Dual-income families

4. Increased divorce rate

B. Legal Intervention: This new parenting responsibility is caused by a number of societal factors: the increase in the divorce rate, dual-income families, and single parenthood. But most often it is a consequence of legal intervention when parents are unfit or renounce their parental obligations.

A family's access to adequate health care, opportunity for education, sound nutrition, and decreased stress is affected by:

1. Development.

2. Family function.

3. Family structure.

4. Economic stability.

D. Economic Stability: the ability of families to meet health care, education, and basic needs is often affected by the economic resources of the family.

David Singer is a single parent of a 3-year-old boy, Kevin. Kevin has well-managed asthma and misses day care infrequently. David is in school studying to be an information technology professional. His income and time are limited, and he admits to going to fast-food restaurants frequently for dinner. However, he and his son spend a lot of time together. David receives state-supported health care for his son, but he does not have health insurance or a personal physician. He has his son enrolled in a government-assisted day care program. Which of the following are risks to this family's level of health? (Select all that apply.)

1. Economic status

2. Chronic illness

3. Underinsured

4. Government assisted daycare

1. Economic Status

3. Underinsured

economic status is stretched. He has multiple resources for his son, but he is not insured. Thus, as a result, there is a potential that David does not follow through with personal health promotion activities. Although asthma is a chronic illness, this is well managed, and there is adequate health care for his son.

The Cleric family, which includes a mother, stepfather, two teenage biological daughters of the mother, and a biological daughter of the father is an example of a(n):

1. Nuclear family

2. Blended family

3. Extended family

4. Alternative family

B. Blended families result when two people who have children from a previous marriage/relationship marry.

Which of the following are possible outcomes with clear family communication? (Select all that apply.)

1. Family goals

2. Increased socialization

3. Decision making

4. Methods of discipline

5. Improved education

6. Impaired coping

1. Family goals

3. Decision making

4. Methods of Discipline

Communication among family members is an example of family:

A. Attributes
B. Function
C. Structure
D. Development

B. Function: Communication is a component of family functioning, whether that be setting goals, coping, or establishing discipline. Family functioning is what the family does, and communication is an important component of function.

Which of the following contribute to family hardiness? (Select all that apply.)

A. Family meetings

B. Establishing family roles

C. Willingness to change in time of stress

D. Passive orientations to life

E. Positive perceptions of self

A. Family meetings

B. Establishing family roles

C. Willingness to change in time of stress

Which of the following demonstrate family resiliency? (Select all that apply.)

1. Resuming full-time work when spouse loses job

2. Arguing ways to deal with problems among siblings

3. Developing hobbies when children leave home

4. Placing blame on family members

1. Resuming full-time work when spouse loses job

3. Developing hobbies when children leave home

Family resiliency is the ability to cope with expected and unexpected stressors. Resiliency helps to evaluate healthy responses when individuals and families are experiencing stressful events

Diane is a hospice nurse who is caring for the Robinson family. This family is providing end-of-life care for their grandmother, who has terminal breast cancer. When Diane visits the home 3 times a week, she focuses on symptom management for the grandmother and assists the family with coping skills. Diane's approach is an example of which of the following?

1. Family as context

2. Family as patient

3. Family as system

4. Family as structure

B. Family as patient: When the family as patient is the approach, family processes and relationships (e.g., parenting or family caregiving) are the primary focuses of nursing care.

When nurses view the family as context, their primary focus is on the:

1. The family within a system

2. The family process and relationships

3. The interactions between family members

4. The health and development of an individual family member

D. Health needs of an individual member: When you view the family as context, the primary focus is on the health and development of an individual member existing within a specific environment (i.e., the patient's family). Although the focus is on the individual's health status, assess how much the family provides the individual's basic needs.

Which of the following are included in a family function assessment? (Select all that apply.)

1. Cultural practices

2. Decision making

3. Rituals and celebrations

4. Neighborhood crime data

5. Family status of influenza vaccinations

1. Cultural practice

2. Decision making

3. Rituals and Celebrations

cultural practices help identify culturally related health practices, diets, and religious practices. Decision making provides information as to how the family copes and meets challenges related to changes in family life or dynamics. Rituals and celebrations address how a family celebrates accomplishments and how they deal with challenges. Neighborhood crime data are relevant for community assessment, but they do not give sufficient information about family function.

Karen Johnson is a single mother of a school-age daughter. Linda Brown is also a single mother of two teenage daughters. Karen and Linda are active professionals, have busy social lives, and date occasionally. Three years ago they decided to share a house and housing costs, living expenses, and child care responsibilities. The children consider one another as their family. This family form is considered a(n):

:1. Diverse family relationship.

2. Blended family relationship

3. Extended family relationship

4. Alternative family relationship.

D. Alternative Family relationship: This relationship includes multiadult households, "skip-generation" families, communal groups with children, "nonfamilies," cohabitating partners, and homosexual couples.

During a visit to a family clinic the nurse teaches the mother about immunizations, car seat use, and home safety for an infant and toddler. Which type of nursing interventions are these?

a. Health promotion activities
b. Acute care activities
c. Restorative care activities
d. Growth and development care activities

A. Health promotional activities: Health promotion activities focus on interventions designed to maintain the physical, social, emotional, and spiritual health of the family unit. They can include information about specific health behaviors, family coping techniques, and growth and development.

Which best defines family caregiving? (Select all that apply.)

A. Developing a nurturing family to raise children.
B. Providing physical and emotional care for a family member.
C. Establishing a safe physical environment for family.
D. Monitoring for side effects of illness and treatments.
E. Providing an environment conductive to spirituality

B. Providing physical and emotional care for a family member

C. Establishing a safe physical environment for a family

D. Monitoring for side effects of illness and treatments

Family caregiving involves the routine provision of services and personal care activities for a family member by spouses, siblings, or parents. Caregiving activities include finding resources, personal care (bathing, feeding, or grooming), monitoring for complications or side effects of illness and treatments, providing instrumental activities of daily living (shopping or housekeeping), and the ongoing emotional support and decision making that is necessary.

When a nurse completes the nursing data on a client, to complete the admission and develop a plan of care, the nurse will need to:

A. Test the family unit's ability to cope.

B. Evaluate communication patterns.

C. Identify family unit form and attitudes.

D. Gather health data from all family members.

C

A patient comes from a close-knit family.

The patient's family functions as context.

You will need to evaluate:

A. Attainment of patient needs.

B. Family attainment of developmental tasks.

C. Individual family members caring about

one another.

D. Family satisfaction with its new level of

functioning.

D

You are caring for a patient. Visitors at the bedside include the patient's life partner, widowed father, brother, and niece. The nurse acknowledges that current trends in American families include

A. Couples without children.

B. More singles choosing to live alone.

C. A very different look from 15 years ago.

D. A mother, father, and more than one child.

C