Chapter 04 My Nursing Test Banks

Tabloski Gerontological Nursing, 3/e
Chapter 04

Question 1

Type: MCSA

The charge nurse is made aware that a 96-year-old patient does not want to be cared for by African Americans. What does this patients attitude exemplify?

1. Culture

2. Ethnicity

3. Life trajectory differences

4. Complexity of the Cultural Care triad

Correct Answer: 4

Rationale 1: Culture has many definitions and reflects racial, ethnic, religious, or social groups. This patients attitude demonstrates more than the patients culture.
Reference: Page 78

Rationale 2: Ethnicity pertains to a social group within the social system that claims to possess variable traits.
Reference: Page 78

Rationale 3: Life trajectory is the experiences of an individuals life and can differ among individuals.
Reference: Page 78

Rationale 4: The patients age would indicate that the patient was born during a time when racial bias was acceptable. Although the nurse may not possess the same racial bias, this circumstance illustrates the complexity of the Cultural Care triad, where the nurse, patient, and caregiver come from diverse backgrounds, ethnicities, and life experiences.
Reference: Page 78

Global Rationale:

Cognitive Level: Analyzing

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 2. Apply the Cultural Care triad to the complex interrelationships of the nurse, caregiver, and patient within community and institutional (home or residential) settings.

Question 2

Type: MCSA

The husband of a female patient of the Islamic culture asks that only a female doctor examine his wife. How should the nurse respond to the husband?

1. A female doctor will be provided.

2. The request is unreasonable and cannot be honored.

3. Both male and female doctors respect the patients privacy.

4. The patients body will be covered during any examinations.

Correct Answer: 1

Rationale 1: A common cultural conflict is misunderstanding a cultural practice of modesty and the need for gender-specific care. The nurse should recognize this as a legitimate request and make every attempt to honor the request.
Reference: Page 89

Rationale 2: Stating that the request is unreasonable shows insensitivity to the patients cultural need.
Reference: Page 89

Rationale 3: Although both male and female staff has professional and ethical responsibilities to respect a patients privacy, the nurse must still make efforts to meet the request of the patient.
Reference: Page 89

Rationale 4: The response of covering the patient shows insensitivity to the patients cultural need.
Reference: Page 89

Global Rationale:

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 3. Identify potential areas of conflict derived from the demographic, ethnocultural, and life trajectory variables of the people within the triad.

Question 3

Type: MCSA

The nurse learns that a patient of the Jewish faith does not eat certain types of foods and fasts on religious holidays. What should the nurse do to ensure that this patients needs are met?

1. Report the patients needs to the oncoming nurse.

2. Document the patients preferences on the assessment form.

3. Talk with the dietitian to obtain food preferences for the patients meals.

4. Explain to the patient that eating is needed to maintain nutritional status.

Correct Answer: 3

Rationale 1: The nurse needs to do more than report the patients needs to the oncoming nurse.
Reference: Page 88

Rationale 2: The nurse needs to do more than documenting the patients preferences on the assessment form.
Reference: Page 88

Rationale 3: Talking with the dietitian to obtain food preferences for the patients meals meets the patients needs.
Reference: Page 88

Rationale 4: Trying to convince the patient to not follow cultural or religious beliefs demonstrates cultural insensitivity on the part of the nurse.
Reference: Page 88

Global Rationale:

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 3. Identify potential areas of conflict derived from the demographic, ethnocultural, and life trajectory variables of the people within the triad.

Question 4

Type: MCSA

An infant of African origin is being cared for by parents who immigrated to the United States 6 months prior. The mother is using an herbal paste to treat the babys diaper rash. What should the nurse do to ensure cultural competence?

1. Instruct the mother to stop using the paste.

2. Ask the mother to explain the ingredients in the paste.

3. Provide the mother with another cream to use for the diaper rash.

4. Explain to the mother that herbal ingredients are harmful to the baby.

Correct Answer: 2

Rationale 1: Instructing the mother to stop using the paste demonstrates cultural insensitivity by the nurse and should not be done.
Reference: Page 88

Rationale 2: To recognize cultural practices, the nurse must acknowledge that use of folk and home remedies are part of caregiving practices. Asking the mother what ingredients are in the paste allows the nurse to best evaluate what the mother is using, and then a determination of the benefit or detriment to the infant can be made in a nonjudgmental manner.
Reference: Page 88

Rationale 3: Providing the mother with another cream to use for the diaper rash demonstrates cultural insensitivity by the nurse and should not be done.
Reference: Page 88

Rationale 4: Explaining to the mother that herbal ingredients are harmful to the baby demonstrates cultural insensitivity by the nurse and should not be done.
Reference: Page 88

Global Rationale:

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 4. Describe the value and process of heritage and life trajectory assessments of nurses, caregivers, and patients.

Question 5

Type: MCMA

A patient of the Latino culture is recovering from surgery and has not requested any pain medication. What should the nurse include when assessing this patient for pain?

Standard Text: Select all that apply.

1. Does pain indicate that death is near?

2. What is the patients cultural perspective towards pain?

3. Does the patient believe that pain is punishment for past behaviors?

4. What are the socially acceptable behaviors of pain in the patients culture?

5. Is experiencing pain an expected part of living within the patients culture?

Correct Answer: 2,3,4

Rationale 1: The nurse needs to understand the patients beliefs about pain. Death and dying is another category of beliefs and is not included within the category of pain.
Reference: Page 88

Rationale 2: The nurse needs to understand the patients beliefs about pain. One area to assess is the patients cultural perspective towards pain.
Reference: Page 88

Rationale 3: The nurse needs to understand the patients beliefs about pain. One area to assess is if the patient believes that pain is punishment for past behaviors.
Reference: Page 88

Rationale 4: The nurse needs to understand the patients beliefs about pain. One area to assess is the socially acceptable behaviors of pain within the patients culture.
Reference: Page 88

Rationale 5: The nurse needs to understand the patients beliefs about pain. Asking if pain is an expected part of living within the patients culture is not a part of the pain assessment.
Reference: Page 88

Global Rationale:

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 5. Create a plan of care for the older adult integrating Cultural Care.

Question 6

Type: MCSA

The family of a 95-year-old patient of the Chinese culture is planning on caring for the patient in the home. How can the nurse best meet the patients needs?

1. Discussing how other families have approached this problem

2. Explaining to the family that resources are available to help the patient

3. Exploring the resources the family has to meet the patients needs in its home

4. Insisting that the family reconsider its decision and look at other care options

Correct Answer: 3

Rationale 1: Comparing the family to other families of different cultural backgrounds does not recognize the cultural aspects of this patient and the family.
Reference: Page 89

Rationale 2: Expressing personal judgment of what is a burden to the family does not recognize the cultural aspects of this patient and the family.
Reference: Page 89

Rationale 3: Helping the family explore resources to meet the patients needs is the best method to respect the tradition of the cultural background of this patient and family.
Reference: Page 89

Rationale 4: Insisting the family break tradition and look at other care options does not recognize the cultural aspects of this patient and the family.
Reference: Page 89

Global Rationale:

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 3. Identify potential areas of conflict derived from the demographic, ethnocultural, and life trajectory variables of the people within the triad.

Question 7

Type: MCMA

An older patient is refusing a prescribed course of treatment because it goes against religious principles. The nurse realizes that religion plays what role within ethnocultural heritage?

Standard Text: Select all that apply.

1. Provides a system of practices

2. Provides a meaningful philosophy

3. Gives the patient a frame of reference

4. Conducive to spiritual harmony and health

5. Increases morbidity and mortality of older patients

Correct Answer: 1,2,3,4

Rationale 1: A component of a persons heritage is religion, which provides a system of practices.
Reference: Page 81

Rationale 2: A component of a persons heritage is religion, which provides a meaningful philosophy about health.
Reference: Page 81

Rationale 3: A component of a persons heritage is religion, which gives the patient a frame of reference.
Reference: Page 81

Rationale 4: A component of a persons heritage is religion, which is conducive to spiritual harmony and health.
Reference: Page 81

Rationale 5: Evidence shows that religion helps to decrease morbidity and mortality in older patients.
Reference: Page 81

Global Rationale:

Cognitive Level: Analyzing

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 3. Identify potential areas of conflict derived from the demographic, ethnocultural, and life trajectory variables of the people within the triad.

Question 8

Type: MCMA

The nurse is caring for an older patient who only speaks Spanish. To meet the national standards for culturally and linguistically appropriate services in healthcare, what will the nurse do?

Standard Text: Select all that apply.

1. Offer language assistance services to the patient.

2. Post signs in the patients room written in Spanish.

3. Encourage the patients family members to serve as interpreters.

4. Explain the cost to employ an interpreter to help the patient with language needs.

5. Provide a written notice in the patients language informing of the right to receive language assistance services.

Correct Answer: 1,2,5

Rationale 1: To meet the national standards for culturally and linguistically appropriate services, the nurse needs to offer language assistance services to the patient.
Reference: Page 77

Rationale 2: To meet the national standards for culturally and linguistically appropriate services, the nurse needs to post signage in the patients native language.
Reference: Page 77

Rationale 3: Family should not be used to provide interpretive services except upon request by the patient.
Reference: Page 77

Rationale 4: Healthcare organizations must offer and provide language assistance services at no cost to each patient.
Reference: Page 77

Rationale 5: To meet the national standards for culturally and linguistically appropriate services, the nurse needs to provide the patient with a written notice in the patients language, informing the patient of the right to receive language assistance services.
Reference: Page 77

Global Rationale:

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 3. Identify potential areas of conflict derived from the demographic, ethnocultural, and life trajectory variables of the people within the triad.

Question 9

Type: MCMA

An older patient from an Asian background is refusing to eat. What are the consequences if the patient continues to avoid eating?

Standard Text: Select all that apply.

1. Hostility

2. Depression

3. Weight loss

4. Withdrawal

5. Dehydration

Correct Answer: 3,5

Rationale 1: Refusing to eat will not lead to the patient demonstrating hostility.
Reference: Page 89

Rationale 2: Refusing to eat will not lead to the patient demonstrating depression.
Reference: Page 89

Rationale 3: Refusing to eat will lead to the patient outcome of weight loss.
Reference: Page 89

Rationale 4: Refusing to eat will not lead to the patient demonstrating withdrawal.
Reference: Page 89

Rationale 5: Refusing to eat will lead to the patient outcome of dehydration.
Reference: Page 89

Global Rationale:

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 3. Identify potential areas of conflict derived from the demographic, ethnocultural, and life trajectory variables of the people within the triad.

Question 10

Type: MCMA

While conducting an assessment, the nurse learns that an older patient from a European country practices heritage consistency. What did the nurse assess in this patient?

Standard Text: Select all that apply.

1. The patients name has not been Americanized.

2. The patient attended social activities at the church.

3. The patient does not participate in any cultural events.

4. The patient has returned to the mother land several times.

5. The patient immigrated to the United States as a young adult.

Correct Answer: 1,2,4,5

Rationale 1: A factor that indicates heritage consistency is the patients name has not been Americanized.
Reference: Page 82

Rationale 2: A factor that indicates heritage consistency is attending social activities at the church.
Reference: Page 82

Rationale 3: A factor that indicates heritage consistency is participating in cultural events.
Reference: Page 82

Rationale 4: A factor that indicates heritage consistency is returning to the old country.
Reference: Page 82

Rationale 5: A factor that indicates heritage consistency is growing up as a child in the country of origin.
Reference: Page 82

Global Rationale:

Cognitive Level: Analyzing

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 4. Describe the value and process of heritage and life trajectory assessments of nurses, caregivers, and patients.

Question 11

Type: MCSA

The geriatric nurse caring for older Spanish-speaking patients is learning Spanish. Why is this important?

1. The nurse will be able to communicate better with the patients families.

2. It really does not matter because it is not important to learn the patients language.

3. Older people are moving south and learning Spanish will help the nurse in the future.

4. The elderly Hispanic population is the fastest growing elderly population in the United States.

Correct Answer: 4

Rationale 1: More than half of the growth in the total US population between 2000 and 2010 resulted from an increase in the Hispanic population. The nurse will be better able to communicate with the patients and not necessarily the families.
Reference: Page 79

Rationale 2: More than half of the growth in the total US population between 2000 and 2010 resulted from an increase in the Hispanic population. To provide culturally and linguistically appropriate services, healthcare organizations should implement strategies to support a diverse staff that represents the demographics of the service area.
Reference: Page 79

Rationale 3: More than half of the growth in the total US population between 2000 and 2010 resulted from an increase in the Hispanic population. There is no evidence to suggest that older people are moving south and learning Spanish will help the nurse in the future.
Reference: Page 79

Rationale 4: More than half of the growth in the total US population between 2000 and 2010 resulted from an increase in the Hispanic population. Knowing Spanish will help the nurse communicate with the Spanish-speaking patients.
Reference: Page 79

Global Rationale:

Cognitive Level: Analyzing

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 3. Identify potential areas of conflict derived from the demographic, ethnocultural, and life trajectory variables of the people within the triad.

Question 12

Type: MCMA

The nurse manager of a unit with older non-English-speaking patients notes that an unusually large number of conflicts occur between the younger nursing assistants and the patients. What should the manager identify as reasons for these conflicts?

Standard Text: Select all that apply.

1. Language

2. Education

3. Birth order

4. Decade of birth

5. Generation in the United States

Correct Answer: 1,2,4,5

Rationale 1: Changes in the past several decades have created cultural barriers that create misunderstandings between caregivers and patients. One source of conflict is language.
Reference: Page 85

Rationale 2: Changes in the past several decades have created cultural barriers that create misunderstandings between caregivers and patients. One source of conflict is education.
Reference: Page 85

Rationale 3: Changes in the past several decades have created cultural barriers that create misunderstandings between caregivers and patients. Birth order is not a source of conflict.
Reference: Page 85

Rationale 4: Changes in the past several decades have created cultural barriers that create misunderstandings between caregivers and patients. One source of conflict is decade of birth.
Reference: Page 85

Rationale 5: Changes in the past several decades have created cultural barriers that create misunderstandings between caregivers and patients. One source of conflict is generation in the United States.
Reference: Page 85

Global Rationale:

Cognitive Level: Analyzing

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 3. Identify potential areas of conflict derived from the demographic, ethnocultural, and life trajectory variables of the people within the triad.

Question 13

Type: MCSA

The nurse is preparing to admit an elderly patient who is deaf. What should the nurse do to ensure effective communication with the patient?

1. Use the hospital-approved interpreter program.

2. Use the patients family members to communicate with the patient.

3. Ask the patient to read assessment questions off of the computer screen.

4. Ask if anyone who is currently working could help communicate with the patient.

Correct Answer: 1

Rationale 1: Using the hospital-approved interpreter program is the intervention of choice when communicating with any patient who is deaf or has limited English proficiency.
Reference: Page 78

Rationale 2: Using family members can interfere with confidentiality and also does not ensure that the information is being communicated correctly.
Reference: Page 78

Rationale 3: Asking the patient to read assessment questions off of the computer screen does not ensure that the patient will understand the questions that are being asked.
Reference: Page 78

Rationale 4: Using other coworkers can interfere with confidentiality and also does not ensure that the information is being communicated correctly.
Reference: Page 78

Global Rationale:

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 1. Discuss the importance of the Transcultural Nursing Societys care standards and the culturally and linguistically appropriate services (CLAS) in healthcare.

Question 14

Type: MCSA

The nurse overhears a student nurse discussing the three areas of focus regarding Cultural Care nursing. Which statement by the student indicates a lack of understanding of Cultural Care nursing?

1. A nurse must apply the underlying background knowledge that must be possessed to provide a given patient with the best healthcare possible.

2. A nurse must understand and attend to the total context of the patients situation. It is a complex combination of knowledge, skills, and attitudes.

3. A nurse must understand the basic traditions of diverse cultural groups and be able to explain to patients how these traditions must be changed to fit into the plan of care.

4. A nurse must possess some basic knowledge of and constructive attitudes toward the health traditions observed among the diverse cultural groups found in the practice setting.

Correct Answer: 3

Rationale 1: This statement defines culturally appropriate care and does not indicate a lack of understanding of Cultural Care nursing.
Reference: Page 78

Rationale 2: This statement defines cultural competence and does not indicate a lack of understanding of Cultural Care nursing.
Reference: Page 78

Rationale 3: A nurse must have basic knowledge of diverse cultural groups, but in Cultural Care nursing the goal is to incorporate their traditions, not change them to meet the plan of care.
Reference: Page 78

Rationale 4: This statement defines cultural sensitivity and does not indicate a lack of understanding of Cultural Care nursing.
Reference: Page 78

Global Rationale:

Cognitive Level: Analyzing

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 2. Apply the Cultural Care triad to the complex interrelationships of the nurse, caregiver, and patient within community and institutional (home or residential) settings.

Question 15

Type: MCSA

Which assessment finding indicates that an older patient is practicing heritage consistency?

1. A patient who changed his name so that it is Americanized

2. A patient who does not maintain regular contact with extended family

3. A patient who resides in an ethnic neighborhood different from her own ethnic background

4. A patient who attended parochial school with a religious philosophy similar to the familys background

Correct Answer: 4

Rationale 1: Changing the name to Americanize it is not an example of heritage consistency.
Reference: Page 82

Rationale 2: Not maintaining regular contact with extended family members is not an example of heritage consistency.
Reference: Page 82

Rationale 3: Residing in an ethnic neighborhood that is different from the patients ethnic background is not an example of heritage consistency.
Reference: Page 82

Rationale 4: Attending parochial school with a religious philosophy similar to the familys background is an example of heritage consistency.
Reference: Page 82

Global Rationale:

Cognitive Level: Analyzing

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 4. Describe the value and process of heritage and life trajectory assessments of nurses, caregivers, and patients.

Question 16

Type: MCSA

Which statement made by a nursing assistant indicates that education regarding culturally competent care is needed?

1. I will always address all patients by their last name.

2. I will ask my patients how they would like for me to address them.

3. I will respect my patients need for privacy when they wish to pray.

4. I will allow my patients to spend time with their families and not interrupt them when its their scheduled time for a shower.

Correct Answer: 1

Rationale 1: It is appropriate to address patients by their last names until they give permission to use another name.
Reference: Page 89

Rationale 2: It is important to ask patients how they would like to be addressed.
Reference: Page 89

Rationale 3: It is important to respect the patients ethnocultural values, beliefs, and practices.
Reference: Page 89

Rationale 4: It is important to show respect for the patients support people and family.
Reference: Page 89

Global Rationale:

Cognitive Level: Analyzing

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 3. Identify potential areas of conflict derived from the demographic, ethnocultural, and life trajectory variables of the people within the triad.

Question 17

Type: MCMA

The nurse is preparing to perform a cultural assessment on a patient recently admitted to a long-term care facility. Which questions will the nurse use to assess the patients communication pattern?

Standard Text: Select all that apply.

1. Does the patient speak or defer to a family member?

2. What nonverbal communication behaviors are exhibited?

3. How does the patient avoid using nonverbal communication?

4. How does the patient react to the nurses movement towards them?

5. What is the patients proximity to other people and objects within the environment?

Correct Answer: 1,2,4,5

Rationale 1: It is important to learn about the patients communication patterns by asking the question, Does the patient speak or defer to a family member?
Reference: Page 88

Rationale 2: It is important to learn about the patients communication patterns by asking the question, What nonverbal communication behaviors are exhibited?
Reference: Page 88

Rationale 3: It is important to learn about the patients communication patterns by asking the question, What nonverbal communication behaviors are exhibited? and not How does the patient avoid using nonverbal communication?
Reference: Page 88

Rationale 4: It is important to learn about the patients communication patterns by asking the question, How does the patient react to the nurses movement towards them?
Reference: Page 88

Rationale 5: It is important to learn about the patients communication patterns by asking the question, What is the patients proximity to other people and objects within the environment?
Reference: Page 88

Global Rationale:

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 5. Create a plan of care for the older adult integrating Cultural Care.

Question 18

Type: MCMA

The staff development instructor is preparing a presentation on the Cultural Care triad. What information should the instructor include in this presentation?

Standard Text: Select all that apply.

1. The triad consists of the nurse, patient, and direct caregiver.

2. Based on recent statistics, there is a demographic parity in this triad.

3. Based on recent statistics, there is demographic disparity in this triad.

4. The number of patients over the age of 100 is the lowest that it has ever been.

5. The registered nurse is a white female between the ages of 40 and 55, married with no children.

Correct Answer: 1,3

Rationale 1: The Cultural Care triad does consist of the nurse, caregiver, and patient.
Reference: Page 79

Rationale 2: There is no demographic parity or equal distribution of a given entity within this triad.
Reference: Page 79

Rationale 3: There is demographic disparity or variations below given percentages of the total population within this triad.
Reference: Page 79

Rationale 4: The number of patients over the age of 100 is the highest that it has ever been.
Reference: Page 79

Rationale 5: The nurse in general is a white non-Hispanic female between the ages of 40 and 59, is married, and has children.
Reference: Page 79

Global Rationale:

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 2. Apply the Cultural Care triad to the complex interrelationships of the nurse, caregiver, and patient within community and institutional (home or residential) settings.

Question 19

Type: MCSA

Which statement that a nurse makes about ethnocultural heritage would need to be corrected?

1. A person can only value characteristics that are heritage consistent.

2. Heritage consistency describes the degree to which a persons lifestyle reflects his or her respective tribal culture.

3. Ethnicity pertains to a social group within the social system that claims to possess variable traits such as a common religion or language.

4. Culture is the thoughts, communications, actions, beliefs, values, and institutions of racial, ethnic, religious, or social groups.

Correct Answer: 1

Rationale 1: A person can value characteristics that are both heritage consistent (traditional) and heritage inconsistent (modern). These values exist on a continuum.
Reference: Page 81

Rationale 2: Heritage consistency does describe the degree to which a persons lifestyle reflects his or her tribal culture.
Reference: Page 81

Rationale 3: Ethnicity does pertain to a social group within the social system that claims to possess variable traits such as a common religion or language.
Reference: Page 81

Rationale 4: Culture can be defined as the thoughts, communications, actions, beliefs, values, and institutions of racial, ethnic, religious, or social groups.
Reference: Page 81

Global Rationale:

Cognitive Level: Analyzing

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 3. Identify potential areas of conflict derived from the demographic, ethnocultural, and life trajectory variables of the people within the triad.

Question 20

Type: MCSA

The nurse is completing a heritage assessment with an older patient from a non-English-speaking culture. Which question would not be a part of this assessment?

1. Where was your mother born?

2. Did you live in an extended family?

3. Where did your father go to school?

4. Do you belong to a religious institution?

Correct Answer: 3

Rationale 1: The question Where was your mother born? is a question asked when completing a heritage assessment.
Reference: Page 86

Rationale 2: The question Did you live in an extended family? is a question asked when completing a heritage assessment.
Reference: Page 86

Rationale 3: The question Where did your father go to school? is not a question asked when completing a heritage assessment.
Reference: Page 86

Rationale 4: The question Do you belong to a religious institution? is a question asked when completing a heritage assessment.
Reference: Page 86

Global Rationale:

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 4. Describe the value and process of heritage and life trajectory assessments of nurses, caregivers, and patients.

Question 21

Type: MCMA

The nurse is conducting a heritage assessment with an older patient and wants to understand the patients beliefs on expectations for healthcare. Which categories of belief will the nurse assess in the patient?

Standard Text: Select all that apply.

1. Space

2. Manners

3. Employment

4. Independence

5. Death and dying

Correct Answer: 1,2,4,5

Rationale 1: One category of belief is that of space. The nurse needs to understand if the patient needs space for privacy for prayer or other personal activities.
Reference: Page 88

Rationale 2: One category of belief is that of manners. The nurse needs to understand what the patient expects in regards to gender-specific care, modesty, and touch.
Reference: Page 88

Rationale 3: Employment is not a category of belief when assessing the older patients beliefs on expectations for healthcare.
Reference: Page 88

Rationale 4: One category of belief is that of independence. The nurse needs to understand what the patient expects in regards to activity and living arrangements.
Reference: Page 88

Rationale 5: One category of belief is that of death and dying. The nurse needs to understand the patients perspectives regarding death, life-sustaining treatments, and funeral rituals.
Reference: Page 88

Global Rationale:

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 4. Describe the value and process of heritage and life trajectory assessments of nurses, caregivers, and patients.

Question 22

Type: MCMA

The geriatric nurse wants to improve the ability to provide Cultural Care to older patients. What steps will the nurse need to perform to improve cultural competency?

Standard Text: Select all that apply.

1. Become aware of patients life trajectories.

2. Become aware of individual ethnocultural heritage.

3. Assume that all people of the same culture have similar beliefs.

4. Recognize adaptations patients made to live in the North American culture.

5. Focus on the patients ethnocultural heritage as the strongest link in the triad.

Correct Answer: 1,2,4

Rationale 1: One step to develop cultural competency is becoming aware of patients life trajectories. This will support mutual respect between the patient, caregiver, and nurse.
Reference: Page 90

Rationale 2: One step to develop cultural competency is becoming aware of individual ethnocultural heritage. Only by knowing ones own culture can a person be ready to learn about anothers culture.
Reference: Page 90

Rationale 3: Assuming that all people of the same culture have similar beliefs does not support the development of cultural competency.
Reference: Page 90

Rationale 4: One step to develop cultural competency is recognizing adaptations patients made to live in the North American culture. This step helps the nurse identify the patients and caregivers preferences in health practices, diet, and hygiene.
Reference: Page 90

Rationale 5: There are three parts to the triad: patient, caregiver, and nurse. It is important for the nurse to be aware of all three parts to develop cultural competency.
Reference: Page 90

Global Rationale:

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 4. Describe the value and process of heritage and life trajectory assessments of nurses, caregivers, and patients.

Question 23

Type: MCSA

The nurse has identified the diagnosis of Risk for Impaired Verbal Communication for a patient with limited English skills. Which intervention would be appropriate for this diagnosis?

1. Asking a family member to act as an interpreter

2. Writing questions on a clip board for the patient to read

3. Using an interpreter when communicating with the patient

4. Speaking loudly and slowly when attempting to communicate with the patient

Correct Answer: 3

Rationale 1: Family members should not be used as interpreters.
Reference: Page 92

Rationale 2: Writing questions does not help improve communication with the patient.
Reference: Page 92

Rationale 3: Using a competent interpreter is the most appropriate intervention.
Reference: Page 92

Rationale 4: Speaking loudly and slowly does not help improve communication with the patient.
Reference: Page 92

Global Rationale:

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 5. Create a plan of care for the older adult integrating Cultural Care.

Question 24

Type: MCMA

A student nurse is preparing a presentation to explain the steps in developing cultural competency. What questions should the student ask to become more aware of personal ethnocultural heritage?

Standard Text: Select all that apply.

1. Do you value stoic behavior?

2. Where were your parents and grandparents born?

3. What are examples of your ethnocultural life trajectories?

4. What do you see as seminal cultural events of your lifetime?

5. Which life experience stands out as an event in your heritage?

Correct Answer: 1,2,3,4

Rationale 1: One question to ask when becoming aware of personal ethnocultural heritage is Do you value stoic behavior?
Reference: Page 90

Rationale 2: One question to ask when becoming aware of personal ethnocultural heritage is Where were your parents and grandparents born?
Reference: Page 90

Rationale 3: One question to ask when becoming aware of personal ethnocultural heritage is What are examples of your ethnocultural life trajectories?
Reference: Page 90

Rationale 4: One question to ask when becoming aware of personal ethnocultural heritage is What do you see as seminal cultural events of your lifetime?
Reference: Page 90

Rationale 5: One question that is not asked when becoming aware of personal ethnocultural heritage is Which life experience stands out as an event in your heritage? since there must be a cumulative effort to learn from each experience.
Reference: Page 90

Global Rationale:

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 4. Describe the value and process of heritage and life trajectory assessments of nurses, caregivers, and patients.

Question 25

Type: MCSA

The nurse has provided a presentation on Cultural Care to a group of nursing assistants. Which statement indicates that additional instruction is needed by the nurse?

1. Cultural Care describes nursing care as culturally aware.

2. Cultural Care describes nursing care as culturally sensitive.

3. Cultural Care describes nursing care as culturally competent.

4. Cultural Care describes nursing care as culturally appropriate.

Correct Answer: 1

Rationale 1: Cultural Care is defined as nursing care that is culturally competent, culturally appropriate, and culturally sensitive. Being culturally aware is not a part of the definition of Cultural Care.
Reference: Page 76

Rationale 2: Cultural Care is defined as nursing care that is culturally competent, culturally appropriate, and culturally sensitive.
Reference: Page 76

Rationale 3: Cultural Care is defined as nursing care that is culturally competent, culturally appropriate, and culturally sensitive.
Reference: Page 76

Rationale 4: Cultural Care is defined as nursing care that is culturally competent, culturally appropriate, and culturally sensitive.
Reference: Page 76

Global Rationale:

Cognitive Level: Analyzing

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 4. Describe the value and process of heritage and life trajectory assessments of nurses, caregivers, and patients.

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