Chapter 18 My Nursing Test Banks

 

Kozier & Erbs Fundamentals of Nursing, 9/E
Chapter 18

Question 1

Type: MCSA

A community health nurse is learning about the REACH initiative and has decided to implement community education on the following topics that relate to this approach. (Select those that apply):

1. Child and adult immunizations

2. Cardiovascular disease

3. Chronic lower respiratory disease

4. Stroke

5. Infant mortality

Correct Answer: 1,2,5

Rationale 1: REACH: Racial and Ethnic Approaches to Community Health is an initiative of the Centers for Disease Control and Prevention. Six core health areas that are the focus of this initiative include infant mortality, deficits in breast and cervical cancer screening and management, cardiovascular diseases, diabetes, HIV infections/AIDS, and child and adult immunizations. This initiative was congruent with the identification of the leading causes of death in the United States, which include chronic lower respiratory disease and stroke, along with heart disease, cancer, unintentional injuries, and diabetes.

Rationale 2: REACH: Racial and Ethnic Approaches to Community Health is an initiative of the Centers for Disease Control and Prevention. Six core health areas that are the focus of this initiative include infant mortality, deficits in breast and cervical cancer screening and management, cardiovascular diseases, diabetes, HIV infections/AIDS, and child and adult immunizations. This initiative was congruent with the identification of the leading causes of death in the United States, which include chronic lower respiratory disease and stroke, along with heart disease, cancer, unintentional injuries, and diabetes.

Rationale 3: REACH: Racial and Ethnic Approaches to Community Health is an initiative of the Centers for Disease Control and Prevention. Six core health areas that are the focus of this initiative include infant mortality, deficits in breast and cervical cancer screening and management, cardiovascular diseases, diabetes, HIV infections/AIDS, and child and adult immunizations. This initiative was congruent with the identification of the leading causes of death in the United States, which include chronic lower respiratory disease and stroke, along with heart disease, cancer, unintentional injuries, and diabetes.

Rationale 4: REACH: Racial and Ethnic Approaches to Community Health is an initiative of the Centers for Disease Control and Prevention. Six core health areas that are the focus of this initiative include infant mortality, deficits in breast and cervical cancer screening and management, cardiovascular diseases, diabetes, HIV infections/AIDS, and child and adult immunizations. This initiative was congruent with the identification of the leading causes of death in the United States, which include chronic lower respiratory disease and stroke, along with heart disease, cancer, unintentional injuries, and diabetes.

Rationale 5: REACH: Racial and Ethnic Approaches to Community Health is an initiative of the Centers for Disease Control and Prevention. Six core health areas that are the focus of this initiative include infant mortality, deficits in breast and cervical cancer screening and management, cardiovascular diseases, diabetes, HIV infections/AIDS, and child and adult immunizations. This initiative was congruent with the identification of the leading causes of death in the United States, which include chronic lower respiratory disease and stroke, along with heart disease, cancer, unintentional injuries, and diabetes.

Global Rationale: Page Reference: 318

Cognitive Level: Applying

Client Need: Health Promotion and Maintenance

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 03 Describe the role of federal agencies and initiatives regarding the provision of culturally responsive health care.

Question 2

Type: MCSA

A new graduate nurse is working in a busy emergency department of a hospital, situated in a culturally diverse area of the city. In striving to be culturally sensitive, the nurse will:

1. Try to learn about the attitudes toward health care and traditions of the different cultures in that area.

2. Understand and attend to the total context of the clients situation, using knowledge, attitudes, and skills.

3. Possess the underlying background knowledge that will provide these clients with the best possible health care.

4. Continuously strive to be culturally competent.

Correct Answer: 1

Rationale 1: Cultural sensitivity implies that nurses possess some basic knowledge of and constructive attitudes toward the health traditions observed among the diverse cultural groups found in the setting in which they are practicing.

Rationale 2: To understand and attend to the total context of the clients situation, using knowledge, attitudes, and skills is a general nursing expectation and does not address cultural sensitivity directly.

Rationale 3: To possess the underlying background knowledge that will provide these clients with the best possible health care is a general nursing expectation and does not address cultural sensitivity directly.

Rationale 4: Cultural sensitivity implies that nurses possess some basic knowledge not competency of and constructive attitudes toward the health traditions observed among the diverse cultural groups found in the setting in which they are practicing.

Global Rationale: Page Reference: 316

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 06 Differentiate culturally influenced approaches to healing and treatment.

Question 3

Type: MCSA

A client is the child of an African American father and Asian American mother. The client has been exposed to cultural foods, traditions, and customs from both parents throughout life. This client exemplifies which of the following?

1. Diversity

2. Subculture

3. Biculture

4. Cultural sensitivity

Correct Answer: 3

Rationale 1: Diversity refers to the fact or state of being different.

Rationale 2: A subculture is usually composed of people who have a distinct identity yet are related to a larger cultural group.

Rationale 3: Biculture is used to describe a person who has dual patterns of identification and crosses two cultures, lifestyles, and sets of values.

Rationale 4: Nurses demonstrate cultural sensitivity when they possess some basic knowledge of and constructive attitudes toward the health traditions observed among the diverse cultural groups found in a setting in which they are practicing.

Global Rationale: Page Reference: 316

Cognitive Level: Understanding

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 01 Describe concepts related to culture such as race, ethnicity, and acculturation.

Question 4

Type: MCSA

A nurse is working with a home health client whose spouse was not born in the United States. During the home visit, the nurse realizes that the client has acquired the identity of her spouses culture and has adopted some of the health practices of that culture. The nurse understands this process as which of the following?

1. Acculturation

2. Assimilation

3. Diversity

4. Heritage consistency

Correct Answer: 2

Rationale 1: Acculturation occurs when people adapt to or borrow traits from another culture. Acculturation can also be defined as the changes of ones cultural patterns to those of the host society.

Rationale 2: Assimilation is the process by which an individual develops a new cultural identity. It encompasses various aspects such as behavior, marital, identification, and civic. The underlying assumption is that the person from a given cultural group loses his or her original cultural identity to acquire the new one.

Rationale 3: Diversity is the fact or state of being different.

Rationale 4: Heritage consistency relates to the observance of beliefs and practices of a persons traditional cultural system.

Global Rationale: Page Reference: 319

Cognitive Level: Understanding

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 01 Describe concepts related to culture such as race, ethnicity, and acculturation.

Question 5

Type: MCSA

Which of the following situations would illustrate cultural prejudice on the nurses part?

1. Making an assumption that all members of each culture are alike

2. Believing that all culture members will have the same beliefs

3. Bringing previous negative information and experiences into this situation

4. Taking general knowledge from literature and applying it to the situation

Correct Answer: 3

Rationale 1: Prejudice is a negative belief or preference that is generalized about a group, which leads to prejudgment. Prejudice occurs when the person making the judgment generalizes an experience of one individual from a culture to all members of that group. This option describe stereotypical behavior not necessarily a prejudice.

Rationale 2: This option describe stereotypical behavior not necessarily a prejudice.

Rationale 3: Prejudice is a negative belief or preference that is generalized about a group, which leads to prejudgment. Prejudice occurs when the person making the judgment generalizes an experience of one individual from a culture to all members of that group.

Rationale 4: This option describe stereotypical behavior not necessarily a prejudice.

Global Rationale: Page Reference: 317

Cognitive Level: Understanding

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 08 Create self-awareness of your own culture, beliefs, biases, and assumptions.

Question 6

Type: MCSA

A new graduate nurse is moving from a small rural college town to a metropolitan area to begin work in a county hospital. The nurse has had limited prior experience with the various cultural groups that are served by the hospital. This nurse is at greatest risk for which of the following?

1. Prejudice

2. Stereotyping

3. Discrimination

4. Culture shock

Correct Answer: 4

Rationale 1: Prejudice is a negative belief or preference that is generalized about a group and leads to prejudging.

Rationale 2: Stereotyping is assuming that all members of a culture or ethnic group are alike.

Rationale 3: Discrimination occurs when a person acts on prejudice and denies another person one or more of the fundamental rights.

Rationale 4: Culture shock is a disorder that occurs in response to transition from one cultural setting to another. A persons former behaviors are ineffective in such a setting, and basic cues for social behavior are absent.

Global Rationale: Page Reference: 315-327.

Cognitive Level: Understanding

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 08 Create self-awareness of your own culture, beliefs, biases, and assumptions.

Question 7

Type: MCSA

A client has requested that she have a special item present in her room and explains that it gives her a feeling of comfort and a sense of organization. This client is focusing on which component of heritage consistency?

1. Culture

2. Religion

3. Ethnicity

4. Socialization

Correct Answer: 2

Rationale 1: Culture is a learned behavior and depends on underlying societal traits including knowledge, beliefs, art, law, morals, and customs.

Rationale 2: Religion is one of the four overlapping components of heritage consistency. It may be defined by a system of beliefs, practices, and ethical values about divine or superhuman power and is closely related to ethnicity. Religion gives a person a frame of reference and a perspective with which to organize information.

Rationale 3: Ethnicity describes the traits and common religious customs and language of a group within the social system.

Rationale 4: Socialization is the process of being raised within a culture and acquiring the characteristics of that group.

Global Rationale: Page Reference: 317

Cognitive Level: Understanding

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 01 Describe concepts related to culture such as race, ethnicity, and acculturation.

Question 8

Type: MCSA

Before a client goes to surgery, he requests to have his spiritual leader present and pray over him. According to the HEALTH traditions model, which traditional methods is the client invoking?

1. Maintaining HEALTH

2. Protecting HEALTH

3. Restoring HEALTH

4. Changing HEALTH

Correct Answer: 3

Rationale 1: Methods of maintaining HEALTH include following a proper diet, wearing proper clothing, concentrating and using the mind, and practicing ones religion.

Rationale 2: Traditional methods of protecting HEALTH include wearing protective objects such as amulets, avoiding people who may cause trouble, and placing religious objects in the home.

Rationale 3: Traditional methods of restoring HEALTHphysical, mental, and spiritualinclude the use of herbal remedies, exorcism, and health rituals. This situation describes a healing ritual.

Rationale 4: Changing HEALTH is not one of the traditional methods in the HEALTH traditions model.

Global Rationale: Page Reference: 320

Cognitive Level: Understanding

Client Need: Health Promotion and Maintenance

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 04 Describe cultural models of care, such as cultural competency.

Question 9

Type: MCSA

A client makes the following statement: I must be paying for all the wrongs I did in my life, to have such a diagnosis as this. The nurse understands that this client views health from which of the following beliefs?

1. Magico-religious belief

2. Holistic health belief

3. Biomedical health belief

4. Folk medicine

Correct Answer: 1

Rationale 1: In the magico-religious health belief view, health and illness are controlled by supernatural forces. The client may believe that illness is the result of being bad or opposing Gods will.

Rationale 2: The holistic health belief holds that the forces of nature must be maintained in balance or harmony. Human life is one aspect of nature that must be in harmony with the rest of nature.

Rationale 3: Biomedical health belief, also scientific belief, is based on the belief that life and life processes are controlled by physical and biochemical processes that can be manipulated by humans.

Rationale 4: Folk medicine is defined as those beliefs and practices related to illness prevention and healing that derive from cultural traditions rather than from modern medicines scientific base.

Global Rationale: Page Reference: 321

Cognitive Level: Understanding

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 05 Describe health views from culturally diverse perspectives.

Question 10

Type: MCSA

A Chinese client is hospitalized with a fever of unknown origin and follows a very traditional, cultural view of illness. Which of the following foods will the client prefer?

1. Hot tea

2. Warm soup

3. Spicy meat

4. Cold liquids

Correct Answer: 4

Rationale 1: In this case, the fever would be considered a hot illness and the client is not likely to select this treatment.

Rationale 2: In this case, the fever would be considered a hot illness and the client is not likely to select this treatment.

Rationale 3: In this case, the fever would be considered a hot illness and the client is not likely to select this treatment.

Rationale 4: The concept of yin and yang in the Chinese culture is an example of a holistic health belief. A Chinese client who has a yang illness, or a hot illness, may prefer a yin or cold treatment. In this case, the fever would be considered a hot illness and the client may prefer the opposite or yin treatment.

Global Rationale: Page Reference: 322

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 06 Differentiate culturally influenced approaches to healing and treatment.

Question 11

Type: MCSA

A community health nurse works with a variety of cultures providing health care services that include preventive care, acute treatment, and education. Of the following clients, which is most likely to use folk medicine?

1. The client who speaks little English and does not have a job

2. A family who has numerous relatives in a Spanish-American sector of the city

3. A female client whose culture is one of male dominance

4. A Chinese client who has a small, family run business in the area

Correct Answer: 1

Rationale 1: Folk medicine is defined as beliefs and practices that relate illness prevention and healing derived from cultural traditions rather than modern medicines scientific base. People who have limited access to scientific health care may turn to folk medicine or folk healing. Because folk healing is more culturally based, it may be more comfortable and less frightening for the client who is not fluent in the English language and has limited access to scientific health care.

Rationale 2: Even though any of these clients could utilize folk medicine, it is more likely to be used by one described in another option.

Rationale 3: Even though this client could utilize folk medicine, it is more likely to be used by one mentioned in another option.

Rationale 4: Even though this client could utilize folk medicine, it is more likely to be used by one mentioned in another option.

Global Rationale: Page Reference: 322

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 06 Differentiate culturally influenced approaches to healing and treatment.

Question 12

Type: MCSA

A female client is being discharged after a lengthy hospitalization. The family is from a male-dominated culture. Before discharge instructions are given, the nurse should:

1. Make sure instructions are understood by the client.

2. Arrange for teaching when the spouse is available.

3. Make sure that the physician gives the instructions.

4. Ask the client when the best time for teaching would be.

Correct Answer: 2

Rationale 1: Regardless of cultural considerations its always necessary to make sure that the instructions are understood.

Rationale 2: The nurse needs to identify who has the authority to make decisions in a clients family. If the decision maker is someone other than the client, as in this situation, the nurse needs to include that person in health care discussions. In this situation, we do not know if the nurse is male or female, so the best answer given with the information that is known is to arrange for teaching when the spouse is available.

Rationale 3: This will not address the cultural issue of male dominance.

Rationale 4: This will not address the issue of male dominance.

Global Rationale: Page Reference: 323

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 06 Differentiate culturally influenced approaches to healing and treatment.

Question 13

Type: MCSA

A newly immigrated client is constantly attended to by family members. This has presented a problem to the nursing staff and the delivery of nursing care. In order to address this issue in a culturally sensitive manner, the nurse:

1. explains to the client that he has to limit visitors.

2. Evaluate the benefits of family participation in the clients care.

3. Questions the family as to how they see their interaction with the client.

4. Have the physician limit the number of visitors the client can have.

Correct Answer: 2

Rationale 1: Telling the client he has to limit visitors or having the physician do this may be in conflict with cultural values and not be helpful to the client.

Rationale 2: Cultural family values may dictate the extent of the familys involvement in the hospitalized clients care. In some cultures, the entire community may want to visit and participate in the clients care. The nurse should evaluate the positive benefits of family participation in the clients care and modify visiting policies as appropriate.

Rationale 3: It would be more appropriate to question the client, not the family, about the positive benefits of the family interactions since the family is obviously supportive of their presence.

Rationale 4: This is a nursing issue and should be managed by the nurse.

Global Rationale: Page Reference: 322-323

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 06 Differentiate culturally influenced approaches to healing and treatment.

Question 14

Type: MCSA

The best way for the nurse to show cultural sensitivity when addressing the personal questions required of the nursing history is to:

1. Break the assessment into shorter intervals and discuss general topics first.

2. Thoroughly explain the reason for asking many questions before beginning the assessment.

3. Pick a time when the family is present and can help with the admission assessment questions.

4. Wait until the nurse-client relationship has been established.

Correct Answer: 1

Rationale 1: Clients may be offended when the nurse immediately asks personal questions. In some cultures, courtesies should be established before business or personal topics are discussed. Discussing general topics can convey that the nurse is interested and has time for the client. This enables the nurse to develop a rapport with the client before progressing to discussion that is more personal.

Rationale 2: Even if the explanation is given, clients from some cultures may still find questions of a personal nature offensive so early in the nurse-client association.

Rationale 3: The sensitive issue is not necessarily one of language or communication barriers.

Rationale 4: Waiting to complete the assessment is not a good idea as there is certain, initial information that needs to be collected from the client.

Global Rationale: Page Reference: 323-324

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 06 Differentiate culturally influenced approaches to healing and treatment.
10 Plan a culturally responsive nursing care plan.

Question 15

Type: MCSA

A non-English speaking client is needs to have an emergency surgical procedure. The hospital has an interpreter available. When the interpreter arrives to explain the procedure and help with the consent form, the nurse provides the best support when:

1. Asking the interpreter to use words the client is familiar with for the best understanding.

2. Requesting that the interpreter translate as closely as possible, the same words used by the professional staff.

3. Suggesting that the questions be directed to the interpreter, so nothing is omitted.

4. Addressing the questions to the clients family.

Correct Answer: 2

Rationale 1: The objective of the professional interpreter is for the complete transfer of the thought behind the utterance in one language into an utterance in a second language (California Healthcare Interpreters Association, 2002).

Rationale 2: An interpreter is an individual who mediates spoken or signed communication between people using different languages without adding, omitting, or distorting meaning or editorializing. The objective of the professional interpreter is for the complete transfer of the thought behind the utterance in one language into an utterance in a second language (California Healthcare Interpreters Association, 2002).

Rationale 3: The questions should be addressed to the client, not the interpreter.

Rationale 4: The questions should be addressed to the client, not the family unless the client is incapable of answering.

Global Rationale: Page Reference: 323-324

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 07 Describe ways culture influences communication patterns and how to provide linguistically appropriate care.

Question 16

Type: MCSA

During the admission interview, the cultural diverse client averts her eyes and refrains from answering questions for long periods of time. The nurse culturally sensitive nurse will:

1. Come back at a different time, when the client is feeling more communicative.

2. Have another nurse finish the interview, since there is something uncomfortable the client senses.

3. Understand that this may be completely appropriate and take cues accordingly.

4. Leave the room and come back after having learned more about this particular culture.

Correct Answer: 3

Rationale 1: The nursing interview is the nurses responsibility and should not be postponed for what the nurse perceives as the clients reluctance to communicate.

Rationale 2: The nurse is responsibility for the admission interview and it should not be avoided for reasons of discomfort.

Rationale 3: Nonverbal communication includes silence, touch, eye movement, facial expressions, and body posture. Some cultures are quite comfortable with long periods of silence. Many people value silence and view it as essential to understanding a persons needs or use silence to preserve privacy. Before assigning meaning to nonverbal behavior, the nurse must consider the possibility that the behavior may have a different meaning for the client and family.

Rationale 4: The admission history can not be postponed in order for the nurse to improve his/her cultural awareness.

Global Rationale: Page Reference: 324

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 06 Differentiate culturally influenced approaches to healing and treatment.
10 Plan a culturally responsive nursing care plan.

Question 17

Type: MCSA

The school nurse is conducting head lice screenings. Before checking the head of an Asian child, the nurse first:

1. Ask permission.

2. Make sure the child understands the reason for the contact.

3. Put gloves on.

4. Ask the child to wait until last, to avoid embarrassing the child.

Correct Answer: 1

Rationale 1: In some Asian cultures, only certain elders are permitted to touch the head of others, and children are never patted on the head. Nurses should, therefore, touch a clients head only with permission.

Rationale 2: The nurse should explain the reason for the touching to all children.

Rationale 3: Nurses should always wear gloves for this type of screening process.

Rationale 4: Asking the child to wait until last to avoid embarrassment is not appropriate and does not address the cultural issue.

Global Rationale: Page Reference: 324

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 06 Differentiate culturally influenced approaches to healing and treatment.

Question 18

Type: MCSA

In order to show appropriate sensitivity to the client, the nurse will:

1. Explain the procedure, then wait for permission to continue.

2. Explain to the client what will occur during the assessment.

3. Ask the client to stay quiet since the nurse will be listening to the heart.

4. Take the baseline vital signs, then determine if cardiac auscultation is necessary.

Correct Answer: 1

Rationale 1: Cardiac assessment requires that the nurse move into the clients intimate space. Before beginning this, the nurse should explain the procedure and then await permission to continue.

Rationale 2: Explaining the assessment only while performing the procedure and not before is likely to cause the anxiety and so negatively affect the assessment values.

Rationale 3: This option is not addressing the sensitivity issues appropriate for this scenario.

Rationale 4: This option is not addressing the sensitivity issues appropriate for this scenario.

Global Rationale: Page Reference: 323-324

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 06 Differentiate culturally influenced approaches to healing and treatment.

Question 19

Type: MCSA

When a nurse is teaching a client from a culture that is present oriented, about a dressing change that should be preformed twice a day, the nurse best addresses the cultural issue by:

1. Allowing the client to select the times the dressing will be changed.

2. instructing the client to change the dressing after breakfast and before going to bed

3. At 10 AM and 4 PM

4. Whenever the client chooses, as long as it gets done twice daily

Correct Answer: 2

Rationale 1: This option does not assure the dressing changes will occur as prescribed.

Rationale 2: For clients who are present oriented, it is important to avoid fixed schedules. The nurse can offer a time range for activities and treatments, such as in the morning or after breakfast, and in the evening or before going to bed. This would fit better with the client who isnt focused on times of the day, such as 10 AM and 4 PM, but will provide for a dressing change twice daily.

Rationale 3: This option is not likely to be followed by a client who is present oriented.

Rationale 4: This option does not comply with the intended order for the dressing changes.

Global Rationale: Page Reference: 326

Cognitive Level: Applying

Client Need: Health Promotion and Maintenance

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 06 Differentiate culturally influenced approaches to healing and treatment.

Question 20

Type: MCSA

Which of the following food items would be appropriate to serve a Jewish client who observes kosher customs, assuming all have been properly inspected and prepared?

1. Hamburger, fruit, and milk

2. Fish, vegetables, and hot tea

3. Ham, baked potato, and fresh fruit

4. Cream soup, sausage, and toast

Correct Answer: 2

Rationale 1: The eating of milk products and meat products at the same meal is prohibited.

Rationale 2: This menu is in accordance with the kosher tradition since there is no pork being served and dairy and meat are not served together.

Rationale 3: Orthodox Judaism and Islam prohibit the ingestion of pork or pork products (ham and sausage).

Rationale 4: The eating of milk products and meat products at the same meal is prohibited.

Global Rationale: Page Reference: 326-327

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 06 Differentiate culturally influenced approaches to healing and treatment.

Question 21

Type: MCSA

A community health nurse is exploring the concept of heritage consistency among clients the nurse works with. Which of the following examples are indicative of heritage consistency?

1. A client frequently visits the old neighborhood in the United States.

2. A client was raised by a single parent.

3. The clients childhood development occurred in an immigrant neighborhood.

4. The client participates in religious festivals and cultural events.

Correct Answer: 3

Rationale 1:

Rationale 2:

Rationale 3:

Rationale 4:

Global Rationale: Page Reference: 328

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 04 Describe cultural models of care, such as cultural competency.

Question 22

Type: MCSA

The nurse is working in a clinic setting and is meeting a new client for the first time. In order to convey cultural sensitivity, the nurse should introduce herself in the following way:

1. Im Jane, and Ill be your nurse today.

2. Im Dr. Smiths nurse, Jane.

3. Im Jane Brown, and Im a nurse here at the clinic.

4. Im glad to meet you. You can call me Jane.

Correct Answer: 3

Rationale 1: The appropriate introduction should include introducing themselves by full name, then explaining their role. This helps establish a relationship and provides an opportunity for clients, others, and nurses to learn the pronunciation of one anothers names and their roles. This option does not fulfill these requirements.

Rationale 2: The appropriate introduction should include introducing themselves by full name, then explaining their role. This helps establish a relationship and provides an opportunity for clients, others, and nurses to learn the pronunciation of one anothers names and their roles. This option does not fulfill these requirements.

Rationale 3: Ways for nurses to be culturally sensitive and to convey sensitivity to clients include introducing themselves by full name, then explaining their role. This helps establish a relationship and provides an opportunity for clients, others, and nurses to learn the pronunciation of one anothers names and their roles.

Rationale 4: The appropriate introduction should include introducing themselves by full name, then explaining their role. This helps establish a relationship and provides an opportunity for clients, others, and nurses to learn the pronunciation of one anothers names and their roles. This option does not fulfill these requirements.

Global Rationale: Page Reference: 327-328

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 07 Describe ways culture influences communication patterns and how to provide linguistically appropriate care.

Question 23

Type: MCSA

A home health client participates in cultural health practices that the nurse feels may be detrimental to his health. In order to remain attentive to cultural sensitivity and provide appropriate cultural nursing care, the nurse should:

1. Explain the right and wrong of the clients treatment and try to persuade him to follow the scientific perspective.

2. Have the clients physician explain the care to the client in a firm but gentle manner.

3. Validate the clients practices and understand that for this client, it may be beneficial to continue with his preferences.

4. Try to negotiate with the client by exploring his views and then provide relevant scientific information.

Correct Answer: 4

Rationale 1: Right and wrong terms should be avoided in culturally sensitive areas and where differing views are present.

Rationale 2: The nurse, not the physician, is the caregiver in this situation, so it is the nurses responsibility to teach and see that the plan of care is carried out.

Rationale 3: If the clients views can lead to harmful behavior or outcomes, then an attempt is made to shift the clients perspectives to the scientific view.

Rationale 4: Negotiation acknowledges that the nurse-client relationship is reciprocal and that different views exist of health, illness, and treatment. During the negotiation process, the clients views are explored and acknowledged, then relevant scientific information is provided.

Global Rationale: Page Reference: 327-328

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 10 Plan a culturally responsive nursing care plan.

Question 24

Type: MCSA

The nurse is evaluating the following goal: Client will select low-fat foods from a list by the end of the month. The client, who is from a different culture, has not been able to achieve this goal. The nurse should:

1. Consider whether the clients belief system has been an influencing factor.

2. Extend the time frame and give the client a longer period to achieve the goal.

3. Make sure that the client understands the importance of the goal.

4. Select a different goal.

Correct Answer: 1

Rationale 1: If the outcomes are not achieved for a client from a different culture, the nurse should be especially careful to consider whether the clients belief system has been adequately included as an influencing factor.

Rationale 2: Extending the time frame may not be as helpful as looking at the cultural practicesincluding dietary onesof the client.

Rationale 3: Checking how the client understands the importance of the goal may not be as helpful as looking at the cultural practicesincluding dietary onesof the client.

Rationale 4: Selecting a different goal may not be as helpful as looking at the cultural practicesincluding dietary onesof the client.

Global Rationale: Page Reference: 327-328

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 10 Plan a culturally responsive nursing care plan.

Question 25

Type: MCSA

A nurse educator uses Madeleine Leiningers model and describes a formal area of study and practice focused on comparative human-care differences and similarities of the beliefs, values, and patterned lifeways of cultures to provide culturally congruent, meaningful, and beneficial health care to people. This is a definition of:

1. Transcultural nursing

2. Cultural competence

3. Cultural Knowledge

4. Competent nursing

Correct Answer: 1

Rationale 1: Transcultural nursing focuses on providing care within the differences and similarities of the beliefs, values, and patterns of cultures

Rationale 2: cultural competence is a life-long process in which the nurse continuously strives to achieve the ability and availability to effectively work within the cultural context of a client (individual, family, community).

Rationale 3: Cultural Knowledge reflects the presences of a sound educational foundation concerning the various worldviews of different cultures.

Rationale 4: Transcultural nursing is a component of competent nursing.

Global Rationale: Page Reference: 319

Cognitive Level: Understanding

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 04 Describe cultural models of care, such as cultural competency.

Question 26

Type: MCMA

A community health nurse uses The Heritage Assessment Interview tool when exploring the concept of heritage consistency among clients the nurse works with. Which of the following examples are indicative of heritage consistency?

Standard Text: Select all that apply.

1. A client frequently visits his old country neighborhood he grew up in.

2. A client is raised by a single parent.

3. The clients education occurred at a religious school.

4. The client participates in religious festivals and cultural events.

5. The client has been the first of his family to earn a college degree.

Correct Answer: 1,3,4

Rationale 1: The tool is designed to enhance the process in order to determine if clients are identifying with their traditional cultural heritage (heritage consistent) such as visiting an ethic neighborhood

Rationale 2: The tool is not designed to assess such non-culturally oriented events.

Rationale 3: The tool is designed to enhance the process in order to determine if clients are identifying with their traditional cultural heritage (heritage consistent) such as attending a religiously affiliated school.

Rationale 4: The tool is designed to enhance the process in order to determine if clients are identifying with their traditional cultural heritage (heritage consistent) such as attending and participating in such events.

Rationale 5: The tool is not designed to assess such non-culturally oriented events.

Global Rationale: Page Reference: 328-329

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 09 Identify methods of cultural assessment.

Question 27

Type: MCMA

The nurse shows attention to providing culturally responsive care to a minority client and her family when:

Standard Text: Select all that apply.

1. personally reflecting on feelings related to the clients nationality.

2. making an effort to direct all assessment questions initially to the client.

3. involving the family with the clients permission.

4. assessing the clients interest in alternative healing methods.

5. educating the client and family when appropriate.

Correct Answer: 1,3,4,5

Rationale 1: Culturally Responsive Care that involves family appropriately includes self reflection to identify your personal assumptions, biases, attitudes, prejudices, and stereotypes.

Rationale 2: Determine the cultural expectations related to the hierarchy of the family.

Rationale 3: Culturally Responsive Care that involves family appropriately includes explaining in detail the clients condition and the treatment plan with the family if the client is willing for the nurse to do so.

Rationale 4: Culturally Responsive Care that involves family appropriately includes asking about the clients use of cultural or alternative approaches to healing.

Rationale 5: Culturally Responsive Care that involves family appropriately includes explaining in detail the clients condition and treatment plan with family if the client is willing for the nurse to do so.

Global Rationale: Page Reference: 327-328

Cognitive Level: Applying

Client Need: Health Promotion and Maintenance

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 09 Identify methods of cultural assessment.

Question 28

Type: MCMA

The nurse shows an understanding of the term culture when responding:

Standard Text: Select all that apply.

1. Culture involves groups who share biological markers.

2. Cultures seldom have diversity within them.

3. Male nurses are an example of a culture.

4. A culture is primarily exhibited through shared thoughts, actions and beliefs.

5. A culture shapes its members view of the world.

Correct Answer: 4,5

Rationale 1: Race has been a term used to refer to groupings of people according to common origin or background and associated with perceived biological markers.

Rationale 2: Diversity occurs not only between cultural groups but also within cultural groups.

Rationale 3: A subculture is usually composed of people who have a distinct identity and yet are related to a larger cultural group.

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

Rationale 5: Macro- and micro-cultures combine to shape the individuals world-view and influence interaction with the others.

Global Rationale: Page Reference: 316

Cognitive Level: Applying

Client Need: Health Promotion and Maintenance

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 04 Describe cultural models of care, such as cultural competency.

Kozier & Erbs Fundamentals of Nursing, 9/E Test Bank

Copyright 2012 by Pearson Education, Inc.

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