Taylor Fundamentals of Nursing Chapter 5- Cultural Diversity

A community health nurse is providing care to a group of Hispanic people living in an area that is predominantly populated by white people. What are the Hispanic people in this community an example of?

A majority

A subculture

A minority

A subgroup

A minority

The term minority refers to a group of people whose physical and cultural characteristics differ from the majority of people in a society. Subcultures are relatively large groups of people who are members of an even larger cultural group but who have certain ethnic, occupational, or physical characteristics that are not common to that larger group. A subgroup is a division of a group that is in some way distinguished from the larger group. A majority is most of the people in a large group.

Which behaviors demonstrated by the client would the nurse consider reflections of the client's pride in ethnicity? Select all that apply.

Requesting assistance when transferring from bed to chair

Listening to folk music and dance

Requesting native cuisine

Asking to wear unique clothing

Crying when given a diagnosis of cancer

Requesting native cuisine

Listening to folk music and dance

Asking to wear unique clothing

Pride in one's ethnicity is demonstrated by valuing certain physical characteristics, giving children ethnic names, wearing unique items of clothing, appreciating folk music and dance, and eating native dishes. Feeling emotional when given a concerning diagnosis and asking for assistance do not reflect pride in ethnicity.

In addressing health promotion for a client who is a member of another culture, the nurse should be guided by which principle?

The client may have a very different understanding of health promotion.

The nurse should avoid performing health promotion education if this is not a priority in the client's culture.

Health promotion is a concept that is largely exclusive to Western cultures.

A culture's conceptualization of health promotion is a result of that culture's level of socioeconomic development.

The client may have a very different understanding of health promotion.

As a component of cultural assessment, the nurse should seek to understand the cultural lens through which the client may understand health promotion. Health promotion is not a concept exclusive to Western cultures, though it may be considered differently among non-Western cultures. Even if health promotion is not a priority in a client's culture, the nurse should still address issues related to health promotion in a respectful and relevant manner. Health promotion is not directly linked to socioeconomic development levels.

Which behavior by the nurse is stereotyping?

Explaining to others that Western medicine is always superior

Avoiding older adult clients because their care is time consuming

Openly ridiculing the practice of acupuncture

Grouping care assignments to allow ample time to care for complex clients

Avoiding older adult clients because their care is time consuming

Avoiding older adult clients because their care is time consuming is stereotyping. This is a mistaken belief and an overgeneralization. Some older adult clients are very healthy.

-Ridiculing acupuncture is cultural conflict.

-Assuming that Western medicine is superior is ethnocentrism.

-Grouping care assignments to allow ample time to provide care is an appropriate strategy in time management.

A family has immigrated and settled in a neighborhood that primarily speaks their native language. The nurse caring for this family recognizes that which family member will likely require the greatest amount of time to learn the dominant language?

The 18-year-old daughter in the family who works at a restaurant in a neighboring town

The 45-year-old mother in the family who does not work outside the home

The 12-year-old son in the family who attends public school

The 58-year-old father in the family who works in a nearby factory

The 45-year-old mother in the family who does not work outside the home

The 45-year-old mother will have the greatest challenge in learning the dominant language due to not working outside the home and living in a community that speaks the native language. Children usually assimilate more rapidly and learn the language of the dominant culture quickly because they leave home each day to go to school, making new friends in the dominant culture. Wage earners also tend to learn a new language more quickly through the work setting. Language acquisition is tied to necessity and assimilation, rather than to the degree of difficulty.

A nurse is working with a culturally diverse group of clients. The nurse understands that cultural norms:

require an individualized approach by the nurse.

can be generalized to anyone of that culture.

are fairly consistent across cultural groups.

allow nurses to predict a client's response.

require an individualized approach by the nurse.

Knowing a cultural norm does not enable one to predict a person's response. Generalizing about cultural norms in contemporary societies is inappropriate because people belong to more than one subcultural group and are influenced uniquely by multiple and diverse groups. Exceptions to cultural norms always exist. Therefore the nurse needs to approach each person as an individual.

The nurse is caring for a client who perceives time differently. What action should the nurse take for this client?

Set all interventions to be done at specific times.

Perform interventions at random times during shift.

Have the client set all times for the interventions.

Maintain flexibility when the client requests interventions at specific times.

Maintain flexibility when the client requests interventions at specific times.

People view time differently. Social time can reflect attitudes regarding punctuality that vary among cultures. The nurse should maintain a flexible attitude and adapt the time of interventions to the client's needs and requests.

-It is not realistic to have the client set all the times for the interventions or to have the interventions at a specific time or interventions at random times during the shift.

A nurse is admitting a client to the unit. Which cultural question is most appropriate?

"Will you be able to eat the normal food provided?"

"Do you have food restrictions?"

"What are your dietary needs and preferences?"

"Will you be making requests for special food based on your religion?"

"What are your dietary needs and preferences?"

By asking about dietary needs and preferences, the nurse can gain insight into religious and cultural dietary practices. Asking about "normal" foods assumes that a cultural dietary request is abnormal. The other options will produce limited insight and imply that a cultural dietary need is a restriction or hindrance.

The public health nurse is preparing a presentation about disparities in health care in the community and is prioritizing the importance of culturally safe care. What key concept(s) will the nurse include? Select all that apply.

Pointing out groups within the community that possess less power

Ethnic identities within subcultures in the community

Major differences in beliefs within a particular culture

Information regarding minorities within the community

History of the concepts of "culture" and "ethnicity" in the nursing profession

Identifying groups that are disadvantaged within the community

Information regarding minorities within the community

Identifying groups that are disadvantaged within the community

Pointing out groups within the community that possess less power

Major differences in beliefs within a particular culture

Ethnic identities within subcultures in the community

The term minority refers to a group of people within a society whose members have different ethnic, racial, national, religious, sexual, political, linguistic, or other characteristics from the majority of that society. Racial and ethnic minorities continue to have higher rates of disease, disability, and premature death than nonminorities; therefore, these are key points that the nurse should present. This would include identifying those who are disadvantaged and lack power in the community. The reality of differences within cultures and in subcultures are relevant, since cultures are not homogeneous units. For the purposes of planning care, it is not necessary to provide an overview of the history of concepts within the profession.

Nurses are socialized into the:

diagnostic process.

nursing specialties.

healthcare culture.

caring paradigm.

healthcare culture.

Culture enables people of similar cultural heritage to understand the meanings of each other's words as part of the particular context, to read each other's nonverbal behavior fairly accurately, and to communicate through symbols. All of these characteristics apply to health care, so health care can be considered a culture into which one can be socialized. The other answers pertain to the career, practice, or intellectual aspects of nursing but not as much to the social aspect of nursing.

A client is admitted with end-stage pancreatic cancer and is experiencing extreme pain. The client asks the nurse whether an acupuncturist can come to the hospital to help manage the pain. The nurse states, "You won't need acupuncture. We have pain medications." Which characteristic has the nurse displayed?

Culture shock

Cultural conflict

Cultural imposition

Stereotyping

Cultural imposition

The nurse has demonstrated cultural imposition by assuming that traditional pain relief measures are superior and the client should conform to the nurse's belief regarding pain control. This is not an example of cultural conflict because the nurse did not ridicule the request; it was simply dismissed. The nurse is not stereotyping, as no generalization is made about a group of people. The nurse is not demonstrating culture shock because the view of pain medications that the nurse expresses is consistent with the majority, Western culture.

Which client admitted to the emergency department might require the nurse to include interventions aimed at addressing culture shock in the plan of care?

A client who recently immigrated and fell from a ladder

A client whose parents were immigrants and is admitted with flu-like symptoms

A client who is bilingual and has a history of asthma

A client who immigrated 25 years ago reporting chest pain

A client who recently immigrated and fell from a ladder

Culture shock is bewilderment over behavior that is culturally strange to a person who has recently entered that culture from a different culture. Individuals who are exposed to a different culture for the first time can be at risk for culture shock. The client who recently immigrated is experiencing a different culture for the first time and is at risk for culture shock. The clients in the other options have been in the new culture longer and are less likely to experience culture shock.

The nurse is caring for a client who is postoperative 24 hours from an appendectomy. The client is hesitant to get out of bed. How should the nurse respond?

"You need to get up and walk to prevent complications."

"Would like to wait until your family arrives to get out of bed?"

"Can you describe what you are feeling when you try to move?"

"I will come back later and help you get up."

"Can you describe what you are feeling when you try to move?"

The client who is hesitant to move and get out of bed may be expecting pain. Some clients, however, my control their emotions and expressions of physical discomfort in front of strangers. Telling the client to get up and walk to prevent complications is important, but the nurse needs to assess why the client is hesitating to get up. Leaving the client or waiting for the family does not address the reason why the client is hesitant to get up.

A nurse who usually works on the surgical unit is asked to float to the oncology unit because of staffing needs. Which statement by the nurse indicates the possibility of the nurse experiencing culture shock?

"I am very stressed now because I do not understand how things work on this unit."

"Can someone please give me an orientation to this unit?"

"The way we do things on the surgical unit are so much better than the procedures of this unit."

"I was expecting all the clients on the oncology unit to be depressed."

"I am very stressed now because I do not understand how things work on this unit."

The nurse is experiencing culture shock because of the new environment. When the culture one has learned differs from the culture in one's environment, a person can become disoriented and stressed. The acute experience of not comprehending the culture of the current environment is called culture shock. Asking for an orientation to a new unit is proper procedure for a float nurse. The third statement indicates ethnocentrism, not culture shock. The fourth statement indicates stereotyping.

The clinic nurse is obtaining demographic data from a client. The client states, "Why do you need to know what my ethnicity is?" How should the nurse respond?

"Collecting this information allows us to develop a personalized plan of care to meet your needs."

"Understanding your background will prevent us from doing anything to offend you."

"We require the information for identification purposes."

"Insurance companies requires us to ask all clients."

"Collecting this information allows us to develop a personalized plan of care to meet your needs."

Identifying and understanding the client's ethnicity will assist the nurse and healthcare team to develop and provide individualized culturally competent care. Ethnicity is not used for client identification. Insurance companies may request this data; however, it is not the priority reason for the nurse to collect the data.

Which is a cultural norm of the health care system?

There are rigid procedures attending birth and death.

The omnipotence of technology is yet to be recognized.

There is a tolerance of tardiness, disorderliness, and disorganization.

There is the use of a systematic approach and problem-solving methodology.

There is the use of a systematic approach and problem-solving methodology.

Cultural norms of the health care system include the use of a systematic approach and problem-solving methodology; the omnipotence of technology; the dislike of tardiness, disorderliness, and disorganization; and the use of certain procedures attending birth and death.

Which population group should the nurse routinely screen for heart disease?

Asian

Black

Hispanic

White

White

Whites (Caucasians) have a high incidence of heart disease and should be screened based on race and age parameters.

A nurse is assessing a client and determines that the client belongs to a minority group. Based on the nurse's understanding about minority groups, the nurse would anticipate that the client would likely experience which effects? Select all that apply.

Greater advantages

Less power

Improved access to care

Health disparities

Increased economic privileges

Less power

Health disparities

The term minority refers to a group of people within a society whose members have different ethnic, racial, national, religious, sexual, political, linguistic, or other characteristics from most of society. Being of a minority group often results in having less power and being disadvantaged, including health disparities in a society. Greater advantages, improved access to care, and economic privileges are not associated with minorities.

A nurse is caring for a postoperative client after knee arthroplasty. The nurse plans to help the client ambulate but is aware that the client may feel threatened by physical closeness because the client is from a culture that tends to prefer more personal space when interacting with others. Using the principles of culturally competent care, what would be the most appropriate nursing action?

Instruct family members to assist in ambulating the client.

Let the client ambulate slowly on his or her own when stable.

Ambulate the client explaining it is an expected outcome of their treatment.

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Explain the purpose and need for assistance during ambulation.

Explain the purpose and need for assistance during ambulation.

The nurse should explain the purpose of ambulation and the need for assistance while ambulating to the client. This would relieve the client's anxiety associated with physical closeness. However, the client won't be able to ambulate without assistance. Even though the nurse can instruct a family member to ambulate the client, this is not an appropriate action. Ambulating the client without recognizing the cultural difference is nontherapeutic, as the nurse would be not be performing culturally competent care by not acknowledging cultural practice.

The nurse is caring for a client who is terminally ill and recently immigrated to the country. The nurse understands that in order to provide quality end-of-life care for the client, what would be the priority action by the nurse?

Make every effort to involve the client and the client's family with the end-of-life care.

Understand the client's personal and cultural views regarding death and dying.

Arrange for end-of-life care to be provided by personnel familiar with the client's culture.

Share the client's concerns regarding the dying process with the interdisciplinary care team.

Understand the client's personal and cultural views regarding death and dying.

Differences in beliefs, values, and traditional health care practices are relevant when planning end-of-life care. It is the nurse's responsibility to become familiar with the client's personal and cultural views. The other actions seek the views of others such as the client's family, those who are familiar with the client's culture, and the interdisciplinary team. Those actions do not address the client's personal and cultural views.