Chapter 15. Culture & Ethnicity My Nursing Test Banks

Chapter 15. Culture & Ethnicity

Multiple Choice

Identify the choice that best completes the statement or answers the question.

____ 1. North American healthcare culture typically reflects which culture?

1)

Asian

2)

European American

3)

Latino

4)

African American

ANS: 2

Although the demographics are changing in this recent decade with increasing Hispanic and Asian inhabitants, North American healthcare culture typically reflects the dominant (European American) culture because most healthcare providers belong to that culture.

PTS: 1 DIF: Easy REF: p. 317

KEY:Nursing process: N/A | Client need: PSI | Cognitive level: Recall

____ 2. A 26-year-old man of Mexican heritage is admitted for observation after sustaining injuries in a motor vehicle accident. When assessing this patient, the nurse must consider that he may possess which view of pain?

1)

A belief in taboos against narcotic use to relieve pain

2)

Expectation of immediate treatment for relief of pain

3)

Endurance of pain longer and report it less frequently than some patients do

4)

Use of herbal teas, heat application, and prayers to manage his pain

ANS: 3

In general, patients of Mexican heritage may endure pain longer and report it less frequently than some. Patients of Japanese heritage may have taboos against narcotic use to relieve pain. Patients of Puerto Rican heritage may use herbal teas, heat application, and prayers to manage pain. Remember that all of these are archetypes and are not necessarily true for all members of a cultural group.

PTS:1DIFifficultREF:p. 329

KEY: Nursing process: Assessment | Client need: PHSI | Cognitive level: Application

____ 3. The nurse is caring for a 42-year-old Chinese American patient who underwent emergency coronary artery bypass graft surgery. He is self-employed and has no health insurance. Each day members of his family spend hours at his bedside. Which is the most important factor for the nurse to focus on when planning the patients discharge?

1)

Ethnic background

2)

Family support

3)

Employment status

4)

Healthcare coverage

ANS: 2

The nurse should focus on the patients strengths and resources for health restoration and self-care. In this case, that is the patients family. His family can be a great support for him when he is discharged (e.g., preparing healthy meals, helping him manage exercise and treatment regimens). Although the patients ethnic background is very important to his care, discharge planning should revolve around his available resources. Insurance should not be the focus at this time, although at some point the nurse has probably obtained data about these topics.

PTS:1DIF:ModerateREF:pp. 320, 326

KEY: Nursing process: Planning | Client need: PSI | Cognitive level: Application

____ 4. A patient who came from Central America is admitted with diabetes mellitus. The nurse is collecting biographical information. Which information provided by the patient represents his ethnicity?

1)

Latino

2)

Catholic

3)

White

4)

Teacher

ANS: 1

Ethnicity refers to groups whose members share a common cultural heritage. This patient came from a Spanish-speaking country in Central America; therefore, his ethnicity is considered Latino. Catholic is his religion, white is his race, and teacher is his occupation.

PTS:1DIF:ModerateREF:p. 318

KEY: Nursing process: Assessment | Client need: PSI | Cognitive level: Application

____ 5. A patient who moved to the United States from Italy comes to the clinic for medical care. The patient has been in this country for several years and has adopted some elements of her new country. Yet she still retains some customs from her homeland. This patient is experiencing

1)

Assimilation

2)

Socialization

3)

Acculturation

4)

Immigration

ANS: 3

This patient is experiencing acculturation; she has accepted both her own and the new culture and has incorporated elements of both into her life. Socialization is the process of learning to become a member of a society or group. Cultural assimilation occurs when the new member gradually learns and takes on, to a great extent, the dominant cultures values, beliefs, and behaviors. Immigration is the act of moving to a new country.

PTS:1DIF:ModerateREF:p. 319

KEY: Nursing process: N/A | Client need: PSI | Cognitive level: Analysis

____ 6. Which of the following is considered a practice (as opposed to a belief or value)?

1)

Always drinking water after exercise

2)

Thinking often about cleanliness

3)

Emphasis on success

4)

Maintaining youth

ANS: 1

A practice is a set of behaviors that one follows, such as always drinking water after exercise. Preoccupation with cleanliness, emphasis on success, and maintaining youth are examples of values that are dominant in United States culture.

PTS:1DIF:EasyREF:p. 320

KEY: Nursing process: N/A | Client need: PSI | Cognitive level: Comprehension

____ 7. The nurse is caring for a patient who emigrated from Puerto Rico. She can best care for this patient by learning about the

1)

Practices of the patients ethnic group

2)

Patients individual cultural beliefs

3)

Values of her own culture

4)

Spanish-speaking community

ANS: 2

The nurse cares for this patient by becoming familiar with the patients individual cultural and ethnic beliefs and values. It is helpful to become familiar with the patients ethnic group and the Spanish-speaking community; however, the nurse should not assume that the individual holds the same values, beliefs, and practices as his ethnic group or community. The nurse should explore her own culture but not assume that the patient holds those same beliefs and practices.

PTS: 1 DIF: Moderate REF: p. 320

KEY: Nursing process: Planning | Client need: PSI | Cognitive level: Application

____ 8. The nurse is teaching a clinic patient about hypertension. Which statement by the patient suggests that he is present oriented?

1)

I know I need to lose weight; Ill have to begin an exercise program right away.

2)

If I change my diet and begin exercising, maybe I can control my blood pressure without medications.

3)

I know I need to give up foods that contain a lot of salt, but with teenagers in the house it is very difficult.

4)

I will reduce the amount of calories, salt, and fat that I eat; I certainly do not want to have a stroke.

ANS: 3

Knowing an action is needed but giving reasons for not beginning it just now shows a focus on the present. The patient knows that he should reduce his sodium intake, but his present situation is preventing him from doing so. Therefore, he is disregarding the impact consuming sodium might have on his future. The other responses are future oriented because they indicate that the patient is planning lifestyle changes that will affect his future.

PTS:1DIFifficultREF:pp. 321, 326

KEY: Nursing process: Assessment | Client need: PHSI | Cognitive level: Analysis

____ 9. A patient of Japanese heritage avoids asking for narcotics for pain relief. The nurse writes a nursing diagnosis of Pain related to reluctance to take medication secondary to cultural beliefs. If the cultural archetype is true for this particular patient, this probably means that the patient views pain as

1)

A punishment for immoral behavior

2)

A part of life

3)

Best treated with herbal teas and prayer

4)

A virtue and a matter of family honor

ANS: 4

Patients of Japanese heritage may view pain as a virtue and a matter of family honor. They may be more accepting of pain medications if the nurse reassures them that pain control enhances healing. Patients of Mexican heritage may view pain as punishment for immoral behavior. Those of Navajo Indian heritage commonly view pain as a part of life, whereas those of Puerto Rican heritage may feel that pain is best treated with herbal teas and prayer. Keep in mind that these are all archetypes and do not necessarily apply to all members of a cultural group.

PTS:1DIF:ModerateREF:pp. 320-321, 326

KEY: Nursing process: Diagnosis | Client need: PSI | Cognitive level: Comprehension

____ 10. The nurse is developing a plan of care for a patient of Aleut descent who sustained a hip fracture. Which intervention by the nurse recognizes the patients indigenous healthcare system and should be included in the plan of care?

1)

Asking the family to bring in medals and amulets

2)

Scheduling a visit from the shaman

3)

Providing the patient with her favorite herbal tea

4)

Requesting that the physician consult the patients acupuncturist

ANS: 2

For the patient of Aleut descent, contacting the shaman and scheduling a visit with the patient might be helpful in recovery. Patients of Hispanic descent might benefit from herbal tea and medals and amulets brought in by the family. However, it is important to check with the physician before administering any herbal preparations that might interfere with prescribed medications. Asians and Pacific Islanders might benefit from a visit by the acupuncturist.

PTS:1DIFifficultREF:pp. 323, 325

KEY: Nursing process: Planning | Client need: PSI | Cognitive level: Application

____ 11. A client incorporates alternative healthcare into her regular health practices. For which alternative therapy should the patient visit a formally trained practitioner?

1)

Use of herbs and roots

2)

Application of oils and poultices

3)

Burning of dried plants

4)

Acupuncture

ANS: 4

Acupuncture requires a formally trained practitioner. Use of herbs and roots, the application of oils and poultices, and the burning of dried plants do not require formally trained practitioners. Patients should be advised to inform their traditional primary healthcare provider when using various herbal remedies, as they can interfere with other prescribed medication and cause untoward side effects.

PTS:1DIF:ModerateREF:pp. 325-326

KEY: Nursing process: Interventions | Client need: SECE | Cognitive level: Recall

____ 12. An elderly patient tells the charge nurse that she wants another nurse to take care of her. When the charge nurse questions the patient, she states I dont want a man taking care of me. Which cultural barrier is this patient exhibiting?

1)

Ethnocentrism

2)

Racism

3)

Sexism

4)

Chauvinism

ANS: 3

This patient is exhibiting sexism; she is objecting to the nurse merely because of his sex. Although we tend to think of sexism in a negative light, this woman may merely be reflecting a cultural attitude. The patient is in no position to actually discriminate against the nurse, in terms of employment, and so on. Therefore, her preferences should be respected. Ethnocentrism occurs when a person is positively biased toward their own culture. Racism is a form of prejudice and discrimination based on race. Chauvinism occurs when a person assumes that he is superior.

PTS:1DIF:EasyREF:p. 328

KEY: Nursing process: Assessment | Client need: PSI | Cognitive level: Application

____ 13. A patient who had surgery 8 hours ago has not voided. The nurse notifies the physician for an order to insert an indwelling urinary catheter. Which of the following statements should the nurse use to describe the procedure to the patient?

1)

I need to put a Foley in you because you havent voided since your surgical procedure.

2)

I need to insert a tube into your bladder to drain the urine because you havent urinated since surgery.

3)

I need to catheterize you because you havent urinated since having your surgery.

4)

I need to place a catheter in your bladder because you havent voided since surgery.

ANS: 2

I need to insert a tube into your bladder . . . best describes the procedure for the patient because the explanation is in terms most patients will understand. The other options contain medical jargon that could confuse the patient.

PTS:1DIF:ModerateREF:p. 328

KEY: Nursing process: Interventions | Client need: PHSI | Cognitive level: Application

____ 14. A Hispanic patient is frustrated because the healthcare team does not understand the importance of hot and cold therapies. Which nursing diagnosis is most appropriate for this patient?

1)

Powerlessness

2)

Impaired Verbal Communication

3)

Spiritual Distress

4)

Risk for Noncompliance

ANS: 1

Powerlessness is the best nursing diagnosis for the patient who is unable to make healthcare personnel understand the importance of his cultural beliefs. Impaired Verbal Communication can be used for patients who do not speak or understand the healthcare personnels language. Spiritual Distress might occur because a treatment is not in agreement with the patients religious beliefs. Risk for Noncompliance can be identified when a patient fails to follow a health-promoting or therapeutic plan the healthcare provider believes they agreed to.

PTS:1DIF:ModerateREF:p. 330

KEY: Nursing process: Diagnosis | Client need: PSI | Cognitive level: Analysis

____ 15. A patient of Scandinavian heritage is admitted for observation after sustaining injuries in a motor vehicle accident. The nurse expects that he may endure pain stoically, without grimacing or vocalizing. The nurses thinking is an example of a/an

1)

Archetype

2)

Bias

3)

Prejudice

4)

Stereotype

ANS: 1

An archetype is an example of a person or thingsomething that is recurrentand it has its basis in facts. Therefore, it becomes a symbol for remembering some of the culture specifics and is usually not negative. A bias is the tendency to see only one side of an issue, a lack of impartiality. Prejudice refers to negative attitudes toward other people that are based on faulty and rigid stereotypes about race, gender, sexual orientation, and so on. A cultural stereotype is the unsubstantiated belief that all people of a certain racial or ethnic group are alike in certain respects. Similar to biases, a stereotype may be positive or negative.

PTS:1DIF:ModerateREF:pp. 320-321

KEY: Nursing process: Assessment | Client need: PHSI | Cognitive level: Application

____ 16. A patient reports experiencing gas, abdominal bloating, and diarrhea after consuming milk or cheese. Lactose intolerance might immediately be suspected if the patient is of which heritage?

1)

African American

2)

Mexican American

3)

European American

4)

Arab American

ANS: 1

Lactose intolerance, caused by a deficiency of the enzyme lactase, is more commonly seen in African Americans than in the other cultural groups listed. Of course, one would assume lactose as the cause of the patients symptoms, but it would be important to rule it out.

PTS:1DIF:ModerateREF:ESG, Chapter 15, Supplemental Materials, Disease Risks for Each of the Major Cultural Groups of the United States

KEY: Nursing process: Assessment | Client need: PHSI | Cognitive level: Application

Multiple Response

Identify one or more choices that best complete the statement or answer the question.

____ 1. Which statement(s) about culture is/are true? Choose all that apply.

1)

Culture exists on both material and nonmaterial levels.

2)

Culture mainly influences food choices and special holidays.

3)

Cultural customs change over time at different rates.

4)

Culture is learned through life experiences shared by other cultural members.

ANS: 1, 3, 4

Culture is learned through life experiences that are shared by other members of the culture, such as family members, those sharing similar religious beliefs, and people of similar cultural heritage in the same community. Culture exists at many levels that are both material and nonmaterial. Cultural customs, beliefs, attitudes, and practices are not static but change over time at different rates, depending on current events, other significant people, and social influences. Culture is all encompassing and affects everything its members think and do; it is not limited to food and holidays. Although those are visible manifestations of a culture, dietary practices and cultural calendars are not the essence of true and meaningful culture.

PTS:1DIF:EasyREF:pp. 317-318

KEY: Nursing process: N/A | Client need: PSI | Cognitive level: Comprehension

____ 2. The nurse is caring for a patient of Japanese heritage who refuses pain medication despite the nurses explaining its importance in the healing process. Which intervention(s) by the nurse is/are appropriate for this patient? Select all that apply.

1)

Assess the patients pain levels at less frequent intervals.

2)

Document in the patients record that the patient does not want to take opioids.

3)

Utilize nonpharmacological measures to help control the patients pain.

4)

Notify the primary care provider of the patients noncompliance.

ANS: 2, 3

Patients of Japanese heritage commonly avoid opioid use; however, they sometimes reconsider after healthcare personnel explain that they improve the healing process. When the patient continues to refuse pain medications despite explanation, the nurse should respect the patients wishes and utilize nonpharmacological measures to control pain. The nurse should document that the patient wishes to avoid opioid use in the nurses notes. The nurse should continue to assess pain levels in this patient at the same frequency as before. She should recognize and respect his cultural beliefs and not label him as noncompliant. Note that the same intervention would be appropriate for any patient in this situation, not just a Japanese patient.

PTS: 1 DIF: Moderate REF: p. 329

KEY: Nursing process: Interventions | Client need: PHSI | Cognitive level: Application

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