Chapter 16: Cultural Uniqueness, Sensitivity, and Competence My Nursing Test Banks

Chapter 16: Cultural Uniqueness, Sensitivity, and Competence

Test Bank

MULTIPLE CHOICE

1. The nurse who states, I believe in the uniqueness and value of human beings is basing care on the philosophy of

a.

civil liberties.

b.

individual worth.

c.

American heritage.

d.

the American Health Care System Code.

ANS: B

Belief in the uniqueness and value of each human being, regardless of differences that may be observed or perceived in that individual, is called the philosophy of individual worth. The other options do not identify this belief.

DIF: Cognitive Level: Comprehension REF: p. 197 OBJ: 5

TOP: Philosophy of individual worth KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity

2. A behavior to avoid when interacting with a person of a different culture is

a.

diversity.

b.

acculturation.

c.

stereotyping.

d.

behavior based on unbiased attitudes.

ANS: C

Stereotyping, which is making inaccurate generalizations about all members of a specific group without exception, is to be avoided. Stereotypes ignore individual differences.

DIF: Cognitive Level: Analysis REF: p. 193 OBJ: 1h

TOP: Stereotypes KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity

3. A new mother on the OB unit refuses to allow her newborn to wear disposable diapers. She insists on applying cloth diapers without safety pins, because this is how her culture applies diapers. During break, the nurse discusses the patients strange diapering technique compared with the excellent American method of diapering. Besides violating confidentiality, the nurse is displaying

a.

ethnocentrism.

b.

stereotyping.

c.

unusual behavior during break.

d.

lack of adherence to hospital policy on diapering.

ANS: A

Ethnocentrism is the belief that ones way of doing things is better than the ways of people of different cultures. Stereotyping is making false assumptions about others based on inaccurate generalizations. Discussing the patients diapering technique during break is unethical. It is unlikely that there is a policy on diapering.

DIF: Cognitive Level: Application REF: p. 193 OBJ: 1e

TOP: Ethnocentrism KEY: Nursing Process Step: Implementation

MSC: NCLEX: Safe, Effective Care Environment

4. The codes of ethics of practical/vocational nursing organizations include the expectation that nurses will

a.

attempt to educate individuals of diverse cultures in the American way.

b.

provide care regardless of race, creed, or cultural background.

c.

utilize stereotypes in selecting best nursing care practices.

d.

ignore cultural uniqueness and provide the same care to all patients.

ANS: B

Provision of care regardless of race, creed, or cultural background is found in the code of ethics. The other options are not part of the code.

DIF: Cognitive Level: Knowledge REF: p. 193 OBJ: 7

TOP: Code of ethics content KEY: Nursing Process Step: N/A

MSC: NCLEX: Safe, Effective Care Environment

5. Which statement about culture will help the nurse implement culturally competent care?

a.

Each culture measures other cultures using its own ways as the norm.

b.

Culture is primarily based on genetic inheritance.

c.

Stereotypes about cultures can be accepted as true.

d.

Cultural diversity is based entirely on race.

ANS: A

The worth of everything, within or outside the group, depends on whether it fits the world view of the cultural group. The other options are untrue statements.

DIF: Cognitive Level: Analysis REF: p. 193 OBJ: 7

TOP: Culture KEY: Nursing Process Step: Implementation

MSC: NCLEX: Safe, Effective Care Environment

6. Patient A, who has terminal cancer, and Patient B, who has a bladder infection, share a hospital room. Neither patient is a member of the majority culture of the area. Patient A is quiet and rarely acknowledges pain. Patient B cries and moans loudly much of the day. What understanding will help the nurse provide culturally sensitive care for both patients?

a.

The better educated the person, the less likely the person is to openly express pain.

b.

A mentally unstable person is more likely to be noisy about pain sensations.

c.

People respond to the sensation of pain in culturally determined ways.

d.

People who distrust health care workers tend to be silent about their pain.

ANS: C

Ones culture influences both the definition of pain and provides guidelines for approved ways of expressing response to the sensation of pain. The other options are not true statements.

DIF: Cognitive Level: Analysis REF: p. 199 OBJ: 7

TOP: Pain expression KEY: Nursing Process Step: Implementation

MSC: NCLEX: Safe, Effective Care Environment

7. Mrs. Lee tells the nurse who asks why she ate so little of the food on her tray that her condition requires hot foods, so she ate only the hot foods on the tray. The nurse notices that several items the patient left on the tray were served hot, and several of the foods the patient ate were served cold. The nurse should

a.

tell the dietary department to make sure Mrs. Lees foods are hot when served.

b.

check Mrs. Lees menu choices and change choices from cold entrees to hot entrees.

c.

tell Mrs. Lee that no hospital food service serves entrees as hot as she may fix at home.

d.

ask Mrs. Lee to make a list of foods she believes would help her condition.

ANS: D

For this patient, hot and cold do not refer to the temperature at which food is served, but rather to culturally determined properties of the food. Asking for a list of foods Mrs. Lee believes would help her condition is the most helpful action for the nurse to take. The other options do not demonstrate understanding the culturally diverse meanings of hot and cold.

DIF: Cognitive Level: Application REF: p. 204, Box 16-5|p. 208, Box 16-9

OBJ: 7 TOP: Health practices

KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity

8. A Native American patient keeps a small bunch of feathers on the over-the-bed table. They are in the way whenever the nurse serves a tray or sets up equipment for a treatment. A culturally competent action would be to

a.

throw them away while the patient is sleeping.

b.

move them to a place where they wont be in the way.

c.

leave them where the patient wishes to place them.

d.

ask why there are a bunch of feathers in a hospital room.

ANS: C

Individuals of some cultures believe that amulets and charms are helpful in preventing or curing illness. It is likely that the small bunch of feathers serves this purpose. Leaving them where placed is the culturally sensitive thing to do. The nurse might also respectfully ask about the feathers to gather data about the patients health beliefs and practices. The other options are not culturally competent behaviors.

DIF: Cognitive Level: Application REF: p. 204, Box 16-5

OBJ: 7 TOP: Culturally competent care

KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity

9. A student nurse asks, Does ethnocentrism have any negative consequences? The most accurate reply is based on the understanding that

a.

discrimination is the basis for ethnocentrism and prejudice.

b.

ethnocentrism may give rise to prejudice, which may result in discrimination.

c.

prejudice has no relationship to ethnocentrism and discrimination.

d.

ethnocentrism has only positive consequences associated with ethnic pride.

ANS: B

When ethnocentrism, the belief that ones culture is superior to other cultures, leads to intolerance of another culture, prejudice results. Discrimination results when rights and privileges are withheld from the other culture. The other options do not accurately explain the relationship.

DIF: Cognitive Level: Comprehension REF: p. 193 OBJ: 1e

TOP: Ethnocentrism KEY: Nursing Process Step: Implementation

MSC: NCLEX: N/A

10. During a discussion on cultural diversity, a nurse asks for an example of an ethnic group. The most accurate response would be

a.

Caucasians.

b.

Spanish-speaking.

c.

Irish-Americans.

d.

homosexuals.

ANS: C

Ethnic groups are composed of people who are members of the same race, religion, or nation and speak the same language. Irish-Americans are an example of an ethnic group. Caucasian is a racial group. Spanish-speaking refers only to shared language, but the individuals might be from Mexico, Spain, or the West Indies, each of which is ethnically different. Homosexuals do not comprise an ethnic group.

DIF: Cognitive Level: Comprehension REF: p. 197 OBJ: 7b

TOP: Ethnicity KEY: Nursing Process Step: N/A MSC: NCLEX: N/A

11. Which statement by a nurse is an example of nonjudgmental thinking?

a.

Hispanic-American patients live at the poverty level and dont have a chance.

b.

Asian-American patients are unreadable. Nurses dont know what theyre feeling.

c.

Native-American patients could benefit from a lesson in assimilation.

d.

Cultural diversity accounts for some African-Americans thinking illness is caused by a curse.

ANS: D

The correct statement makes no value judgments regarding whether this is good or bad. The other options make judgments.

DIF: Cognitive Level: Application REF: p. 198 OBJ: 5

TOP: Nonjudgmental thinking KEY: Nursing Process Step: N/A

MSC: NCLEX: N/A

12. Which statement regarding cultural diversity can be used as a basis for caregiving?

a.

Silence should always be interpreted as an indication of the patients dissatisfaction with care.

b.

Rules regarding the appropriate amount of eye contact vary among cultures.

c.

Personal space requirements are similar for all cultures.

d.

The germ theory of illness is universally accepted.

ANS: B

The amount of eye contact that is desirable varies among cultures. The nurse should be aware of cultural norms for eye contact for culturally diverse groups. The other options are not true statements.

DIF: Cognitive Level: Analysis REF: p. 203 OBJ: 7

TOP: Eye contact KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity

13. Which statement by a nurse demonstrates cultural competence?

a.

Without knowledge of cultural diversity, misunderstandings arise between patient and nurse.

b.

Nurses who assume care for persons of different cultures need to assume those beliefs as their own in order to give good care.

c.

Women of most cultures have adopted assertive communication.

d.

Traditional healing practices should not be combined with Western medicine to treat a patient.

ANS: A

Failure to develop cultural sensitivity to patients of diverse cultural backgrounds may create misunderstandings between nurse and patient. Data may be misinterpreted. Implementation of plans and patient compliance with plans may be sabotaged if the nurse does not understand the culture of the patient. The statement, Nurses who assume care for persons of different cultures need to assume those beliefs as their own in order to give good care is unnecessary and impractical. It is not true that women of most cultures have adopted assertive communication. Traditional healing practices and Western medicine may be used in combination with good results.

DIF: Cognitive Level: Application REF: p. 193|p. 200

OBJ: 7 TOP: Cultural competence

KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity

14. How would a culturally competent care plan differ from a standard care plan?

a.

It would contain adaptations that recognize the patients cultural preferences.

b.

It would follow the legal mandates for providing care regardless of culture.

c.

It would provide information about nonjudgmental behaviors to use.

d.

It would focus on the nurses values, assumptions, and health beliefs.

ANS: A

Culturally competent care involves continuous attempts by staff to use knowledge and skills to effectively provide care for patients of different cultures. Adapting standard care to meet the specific cultural preferences of the patient is part of a culturally competent care plan. The other options would not be contained in a culturally competent plan of care.

DIF: Cognitive Level: Analysis REF: p. 207 OBJ: 7

TOP: Culturally competent care KEY: Nursing Process Step: Implementation

MSC: NCLEX: Safe, Effective Care Environment

15. Which of the following is an example of the process of socialization?

a.

The student nurse assesses the needs of a patient who is a member of another culture.

b.

The student nurse learns how to think and act like a nurse.

c.

The student nurse uses cultural bias when evaluating the beliefs of a diverse culture.

d.

The student nurse demonstrates ethnocentrism related to health-illness beliefs.

ANS: B

Socialization is the process by which a person of one culture learns how to function within another culture. The other options are not examples of the socialization process, but rather are merely statements that incorporate terms relating to culture.

DIF: Cognitive Level: Application REF: p. 193 OBJ: 6

TOP: Socialization KEY: Nursing Process Step: N/A

MSC: NCLEX: N/A

16. Which statement by a health care worker can the nurse identify as a stereotype?

a.

People over 65 are poor drivers.

b.

Assimilation requires adopting part of the dominant culture.

c.

All individuals have common basic daily needs.

d.

Most people perceive themselves as members of the middle class.

ANS: A

A stereotype is a false assumption about all members of a specific group. Saying people over 65 are poor drivers is an inaccurate generalization about a specific group of people. The other options do not fit the definition of a stereotype.

DIF: Cognitive Level: Application REF: p. 193 OBJ: 1h

TOP: Stereotypes KEY: Nursing Process Step: N/A MSC: NCLEX: N/A

17. Culver suggests that regardless of ones specific environment, two essential environmental needs are evident for each person. The nurse can correctly identify these needs as

a.

diversion and recreation.

b.

emotional and spiritual support.

c.

body alignment and activity.

d.

oxygen and safety.

ANS: D

The most essential component of the environment is oxygen; the next most important need is safety. After these environmental needs have been met, the individual can focus on altering the environment to accommodate comfort and personal taste. The other options are not identified as needs relating to the environment.

DIF: Cognitive Level: Comprehension REF: p. 196 OBJ: 4

TOP: Basic daily needs KEY: Nursing Process Step: N/A

MSC: NCLEX: N/A

18. A patient tells the nurse that she is accustomed to adhering to a strict schedule for meals and sleep. The nurse reports that the patient

a.

follows clock time.

b.

lives on linear time.

c.

is obsessive-compulsive.

d.

will complain if medications and treatments are not performed on time.

ANS: A

People who follow clock time eat, sleep, work, and engage in recreational activities at definite times each day. People who live on linear time eat when they are hungry and sleep when tired, without regard to the clock. The assessment that the patient is obsessive-compulsive cannot be made with the provided information. The report that the patient will complain if medications and treatments are not performed on time cannot be concluded from the information provided.

DIF: Cognitive Level: Application REF: p. 199 OBJ: 6

TOP: Concept of time

KEY: Nursing Process Step: Assessment (Data Collection)

MSC: NCLEX: Physiological Integrity

19. When collecting data, which question provides the best understanding of the patients culturally determined food patterns and assists with developing a culturally competent care plan?

a.

What effect will hospitalization have on your family?

b.

What religious practices are important in your life?

c.

Do you use food to maintain health or treat illness?

d.

Describe the role of children in your family.

ANS: C

Although each of the questions is appropriate to ask in order to increase understanding of cultural diversity, only one relates to food patterns.

DIF: Cognitive Level: Application REF: p. 199 OBJ: 7

TOP: Culturally competent care

KEY: Nursing Process Step: Assessment (Data Collection)

MSC: NCLEX: Physiological Integrity

20. Data collection suggests that a patients health beliefs are personalistic. Which statement by the patient would the nurse determine as consistent with personalistic health beliefs?

a.

Please call my physician for me so I can discuss my symptoms.

b.

I would like to wear the amulet thats in my bedside stand.

c.

X-rays will find the cause of my back pain.

d.

I hope the doctor will recommend surgery.

ANS: B

Personalistic health beliefs suggest that illness is caused by magical powers and is cured by rituals. Wearing amulets offers protection from illness and may sometimes be considered curative. The other statements are consistent with beliefs in biomedicine.

DIF: Cognitive Level: Analysis REF: p. 203 OBJ: 7

TOP: Personalistic health belief system

KEY: Nursing Process Step: Assessment (Data Collection)

MSC: NCLEX: Physiological Integrity

21. Recently a community has experienced an influx of individuals from Afghanistan. What action should the nurse suggest to modify the agency environment to better accommodate these culturally diverse patients?

a.

Provide handouts and patient teaching materials in appropriate languages.

b.

Hold meetings in the community to explain the Afghan culture.

c.

Provide reference guides about Far Eastern cultures to all nursing staff.

d.

Utilize the cookbook method of learning to accommodate this immigrant group.

ANS: A

Providing information in the language of the culturally diverse group indicates that the agency is interested in serving individuals in the group. Ensuring understanding may also foster compliance by the individual. The other options would not help to accommodate the individuals from this group.

DIF: Cognitive Level: Application REF: p. 206, Box 16-6

OBJ: 7 TOP: Cultural competence

KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity

22. The nurse sets a goal to avoid stereotyping culturally diverse patients. Which of the following measures will help the nurse attain this goal?

a.

Automatically apply all information known about a culture to patients of that cultural group.

b.

Assume that all individuals from Southeast Asia practice Buddhism.

c.

Refer to textbook information about cultural groups to predict individual behavior.

d.

Gather information about how the patient believes illness can best be treated.

ANS: D

The treatments generally used by a patient will correspond to beliefs about illness causation and may reveal the expectation to combine Eastern and Western treatments. Automatically applying all information known about a culture to patients of that group, assuming that all individuals from Southeast Asia practice Buddhism, and referring to textbook information to predict individual behavior do not take into account the individual differences of patients from the same cultural groups.

DIF: Cognitive Level: Comprehension REF: p. 193 OBJ: 7

TOP: Stereotypes KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity

23. A nursing instructor is working with a Native-American student nurse. When the student is late for the first clinical day, the instructor states, Im not surprised shes late; Native-American students are always late. The instructors statement is an example of

a.

prejudice.

b.

stereotyping.

c.

ethnocentrism.

d.

discrimination.

ANS: B

Stereotyping is an assumption used to describe all members of a specific group without exception. It is an expectation that all individuals in a group will act exactly the same in a situation just because they are members of that group. Stereotyping ignores the individual differences that occur within every cultural group.

DIF: Cognitive Level: Comprehension REF: p. 193 OBJ: 1h

TOP: Stereotypes KEY: Nursing Process Step: N/A MSC: NCLEX: N/A

24. A patient who utilizes the biomedical health belief system would be most likely to respond to interventions by a/an

a.

diviner.

b.

shaman.

c.

herbalist.

d.

physician.

ANS: D

A physician cures disease based on the biomedical health belief system. The other options refer to persons who cure disease based on the personalistic health belief system.

DIF: Cognitive Level: Comprehension REF: p. 203, Box 16-2

OBJ: 7c TOP: Health belief systems KEY: Nursing Process Step: N/A

MSC: NCLEX: N/A

COMPLETION

1. The process of giving up parts of ones own culture and adopting parts of the culture of the dominant group is called ____________________.

ANS:

assimilation

The process of giving up parts of ones own culture and adopting parts of the culture of the dominant group is called assimilation.

DIF: Cognitive Level: Knowledge REF: p. 194 OBJ: 1

TOP: Assimilation KEY: Nursing Process Step: N/A MSC: NCLEX: N/A

MULTIPLE RESPONSE

1. Which statements about emotions and their expression can provide a basis for providing care to culturally diverse patients? (Select all that apply.)

a.

In some cultural groups, people do not display emotions openly in public.

b.

Emotions are universal, but cues to those emotions vary.

c.

Culture provides guidelines for approved ways of responding to pain.

d.

Silence has various culturally determined meanings.

ANS: A, B, C, D

Each of the statements is correct and should be considered when planning care for patients of the majority culture and for culturally diverse patients.

DIF: Cognitive Level: Analysis REF: p. 199 OBJ: 7

TOP: Cultural competence KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity

2. Mrs. X is a patient from South Korea. She has never experienced Western medical care. She is hospitalized with hepatitis C. Which measures will lead to successful negotiation of a treatment plan with this culturally diverse patient? (Select all that apply.)

a.

Encourage the patient to explain her views about the cause of illness.

b.

Explain the biomedical point of view of the health problem.

c.

Support beliefs and practices the patient sees as helpful and that do no harm.

d.

Realize that it is impossible to prevent a patients use of harmful health practices.

ANS: A, B, C

Encouraging the patient to explain her views about the cause of illness is necessary to understand her health beliefs. Explaining the biomedical point of view of the health problem allows the patient to compare her belief system with the biomedical explanation and to find common ground. It also helps the patient understand the rationale for treatment. This is part of the process of negotiating treatment plans with the patient. Many alternative healing practices are known to be beneficial (acupuncture), and others may do no harm if used (diet based on hot and cold principles). The nurse is participating in preserving helpful beliefs and practices. The nurse can participate in repatterning by counseling against harmful practices and supporting alternatives offered in the care plan.

DIF: Cognitive Level: Application REF: p. 207 OBJ: 7d

TOP: Negotiating treatment plans KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity

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