Chapter 2 Family, Culture, and Complementary Therapies(FREE) My Nursing Test Banks

Olds Maternal-Newborn Nursing and Womens Health, 10e (Davidson)

Chapter 2 Family, Culture, and Complementary Therapies

1) A couple who came to the United States two years ago with their two children are seeing the nurse in the community clinic. The nurse knows their family is acculturating when the mother makes which statement?

1. The children are much less well-behaved than they used to be.

2. Our diet now includes hamburgers and French fries.

3. We celebrate the same holidays that we used to at home.

4. When the children leave the house, I worry about them.

Answer: 2

Explanation: 2. Inclusion of fast food in the diet is an indication of acculturation, because it shows a belief in the nutritional value of these foods and an acceptance of purchasing fast food as equivalent in value to home-cooked meals.

Page Ref: 22

Cognitive Level: Understanding

Client Need/Sub: Psychosocial Integrity: Cultural Awareness/Cultural Influences on Health

Standards: QSEN Competencies: I. B. 3. Provide patient-centered care with sensitivity and respect for the diversity of human experience. | AACN Essentials Competencies: VII. 7. Collaborate with other healthcare professionals and patients to provide spiritually and culturally appropriate health promotion and disease and injury prevention interventions. | NLN Competencies: Relationship-Centered Care: Appreciate the patient as a whole person, with his or her own life story and ideas about the meaning of health or illness. | Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 1 Compare the characteristics of different types of families.

MNL LO: 1.1.1 Relate the effect of culture and family to the childbearing experience.

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2) Which of the following best describes a nuclear family?

1. A family is composed of an unmarried woman who chooses to conceive or adopt without a life partner.

2. Children live in a household with both biologic parents and no other relatives or persons.

3. A couple shares household and childrearing responsibilities with parents, siblings, or other relatives.

4. The head of the household is widowed, divorced, abandoned, or separated or most often the mother remains unmarried.

Answer: 2

Explanation: 2. In the nuclear family, children live in a household with both biologic parents and no other relatives or persons.

Page Ref: 19

Cognitive Level: Understanding

Client Need/Sub: Health Promotion and Maintenance: Developmental Stages and Transitions

Standards: QSEN Competencies: I. A. 2. Describe how diverse cultural, ethnic, and social backgrounds function as sources of patient, family, and community values. | AACN Essentials Competencies: VII. 3. Assess health/illness beliefs, values, attitudes, and practices of individuals, families, groups, communities, and populations. | NLN Competencies: Relationship-Centered Care: The role of family, culture, and community in a persons development. | Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 1 Compare the characteristics of different types of families.

MNL LO: 1.1.1 Relate the effect of culture and family to the childbearing experience.

3) What is the term for when children alternate between two homes, spending varying amounts of time with each parent in a situation called co-parenting and usually involving joint custody?

1. Blended or reconstituted nuclear family

2. Extended kin network family

3. Binuclear family

4. Extended family

Answer: 3

Explanation: 3. A binuclear family is a postdivorce family in which the biologic children are members of two nuclear households, with parenting by both the father and the mother.

Page Ref: 20

Cognitive Level: Understanding

Client Need/Sub: Health Promotion and Maintenance: Developmental Stages and Transitions

Standards: QSEN Competencies: I. A. 2. Describe how diverse cultural, ethnic, and social backgrounds function as sources of patient, family, and community values. | AACN Essentials Competencies: VII. 3. Assess health/illness beliefs, values, attitudes, and practices of individuals, families, groups, communities, and populations. | NLN Competencies: Relationship-Centered Care: The role of family, culture, and community in a persons development. | Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 1 Compare the characteristics of different types of families.

MNL LO: 1.1.1 Relate the effect of culture and family to the childbearing experience.

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4) Duvalls eight stages in the family life cycle of a traditional nuclear family have been used as the foundation for contemporary models that describe the developmental processes and role expectations for different family types. Which of the following is an example of Stage IV of this family life cycle?

1. Families launching young adults (all children leave home)

2. Families with preschool-age children (oldest child is between 2.5 and 6 years of age)

3. Middle-aged parents (empty nest through retirement)

4. Families with schoolchildren (oldest child is between 6 and 13 years of age)

Answer: 4

Explanation: 4. Stage IV is families with schoolchildren (oldest child is between 6 and 13 years of age).

Page Ref: 21

Cognitive Level: Understanding

Client Need/Sub: Health Promotion and Maintenance: Developmental Stages and Transitions

Standards: QSEN Competencies: I. A. 2. Describe how diverse cultural, ethnic, and social backgrounds function as sources of patient, family, and community values. | AACN Essentials Competencies: VII. 3. Assess health/illness beliefs, values, attitudes, and practices of individuals, families, groups, communities, and populations. | NLN Competencies: Relationship-Centered Care: The role of family, culture, and community in a persons development. | Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 2 Identify the stages of a family life cycle.

MNL LO: 1.1.1 Relate the effect of culture and family to the childbearing experience.

5) A 7-year-old client tells the nurse that Grandpa, Mommy, Daddy, and my brother live at my house. The nurse identifies this as what type of family?

1. Binuclear

2. Extended

3. Gay or lesbian

4. Traditional

Answer: 2

Explanation: 2. An extended family consists of a couple who share the house with their parents, siblings, or other relatives.

Page Ref: 20

Cognitive Level: Understanding

Client Need/Sub: Health Promotion and Maintenance: Developmental Stages and Transitions

Standards: QSEN Competencies: I. A. 2. Describe how diverse cultural, ethnic, and social backgrounds function as sources of patient, family, and community values. | AACN Essentials Competencies: VII. 3. Assess health/illness beliefs, values, attitudes, and practices of individuals, families, groups, communities, and populations. | NLN Competencies: Relationship-Centered Care: The role of family, culture, and community in a persons development. | Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 1 Compare the characteristics of different types of families.

MNL LO: 1.1.1 Relate the effect of culture and family to the childbearing experience.

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6) A nurse is performing an assessment on a family with a father and mother who both work. What type of family does she record this family as being?

1. A traditional nuclear family

2. A dual-career/dual-earner family

3. An extended family

4. An extended kin family

Answer: 2

Explanation: 2. A dual-career/dual-earner family is characterized by both parents working, by choice or necessity.

Page Ref: 19

Cognitive Level: Understanding

Client Need/Sub: Health Promotion and Maintenance: Developmental Stages and Transitions

Standards: QSEN Competencies: I. A. 2. Describe how diverse cultural, ethnic, and social backgrounds function as sources of patient, family, and community values. | AACN Essentials Competencies: VII. 3. Assess health/illness beliefs, values, attitudes, and practices of individuals, families, groups, communities, and populations. | NLN Competencies: Relationship-Centered Care: The role of family, culture, and community in a persons development. | Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 1 Compare the characteristics of different types of families.

MNL LO: 1.1.1 Relate the effect of culture and family to the childbearing experience.

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7) Why is it important for the nurse to understand the type of family that a client comes from?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Select all that apply.

1. Family structure can influence finances.

2. Some families choose to conceive or adopt without a life partner.

3. The nurse can anticipate which problems a client will experience based on the type of family the client has.

4. Understanding if the clients family is nuclear or blended will help the nurse teach the client the appropriate information.

5. The values of the family will be predictable if the nurse knows what type of family the client is a part of.

Answer: 1, 2

Explanation: 1. Single-parent families often face difficulties because the sole parent may lack social and emotional support, need assistance with childrearing issues, and face financial strain.

2. In the single mother by choice family, the mother is typically older, college-educated, and financially stable and has contemplated pregnancy significantly prior to conceiving.

Page Ref: 20

Cognitive Level: Understanding

Client Need/Sub: Health Promotion and Maintenance: Developmental Stages and Transitions

Standards: QSEN Competencies: I. B. 3. Provide patient-centered care with sensitivity and respect for the diversity of human experience. | AACN Essentials Competencies: VII. 3. Assess health/illness beliefs, values, attitudes, and practices of individuals, families, groups, communities, and populations. | NLN Competencies: Relationship-Centered Care: Promote and accept the patients emotions; accept and respond to distress in patient and self; facilitate hope, trust, and faith | Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 1 Compare the characteristics of different types of families.

MNL LO: 1.1.1 Relate the effect of culture and family to the childbearing experience.

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8) The public health nurse is working with a student nurse. The student nurse asks which of the six groups of people they have seen today are considered to be families. How should the nurse respond?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Select all that apply.

1. The married heterosexual couple without children

2. The gay couple with two adopted children

3. The unmarried heterosexual couple with two biological children

4. The lesbian couple not living together that have no children

5. The married heterosexual couple with three children, living with grandparents

Answer: 1, 2, 3, 5

Explanation: 1. Families take many forms in todays society. The basis for people to be considered a family is a commitment to one another and the sharing of responsibilities, chores, and expenses. A couple without children is still a family.

2. Families take many forms in todays society. The basis for people to be considered a family is a commitment to one another and the sharing of responsibilities, chores, and expenses. Gay and lesbian families are those in which two or more people who share a same-sex orientation live together, or in which a gay or lesbian single parent rears a child.

3. Families take many forms in todays society. The basis for people to be considered a family is a commitment to one another and the sharing of responsibilities, chores, and expenses. A family may be formed without a legal marriage.

5. Families take many forms in todays society. The basis for people to be considered a family is a commitment to one another and the sharing of responsibilities, chores, and expenses. Extended family members, including parents or grandparents, will often live with their adult children or grandchildren, creating intergenerational families.

Page Ref: 20

Cognitive Level: Understanding

Client Need/Sub: Health Promotion and Maintenance: Developmental Stages and Transitions

Standards: QSEN Competencies: I. C. 5. Recognize personally held attitudes about working with patients from different ethnic, cultural and social backgrounds. | AACN Essentials Competencies: VII. 3. Assess health/illness beliefs, values, attitudes, and practices of individuals, families, groups, communities, and populations. | NLN Competencies: Relationship-Centered Care: Demonstrate self-awareness, self-care, self-growth, be open and nonjudgmental. | Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 1 Compare the characteristics of different types of families.

MNL LO: 1.1.1 Relate the effect of culture and family to the childbearing experience.

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9) In assessing a new family coming to the clinic, the nurse determines they are an extended kin family because the family exhibits what as characteristics of an extended kin network family?

Note: Credit will be given only if all correct and no incorrect choices are selected.

Select all that apply.

1. A sharing of a social support network

2. Each family establishes their own sources of goods and services

3. Elderly parents share housing

4. Children are members of two nuclear families

5. A sharing of goods and services

Answer: 1, 5

Explanation: 1. Extended kin family networks share a social support network.

5. Extended kin family networks share goods and services.

Page Ref: 20

Cognitive Level: Understanding

Client Need/Sub: Health Promotion and Maintenance: Developmental Stages and Transitions

Standards: QSEN Competencies: I. B. 1. Elicit patient values, preferences and expressed needs as part of clinical interview, implementation of care plan and evaluation of care. | AACN Essentials Competencies: VII. 3. Assess health/illness beliefs, values, attitudes, and practices of individuals, families, groups, communities, and populations. | NLN Competencies: Relationship-Centered Care: Demonstrate self-awareness, self-care, self-growth; be open and non-judgmental. | Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 1 Compare the characteristics of different types of families.

MNL LO: 1.1.1 Relate the effect of culture and family to the childbearing experience.

10) The transcultural nursing theory was developed in 1961 by Dr. Madeleine Leininger. Its foundation is in which of the following?

1. The framework categorizes a familys progression over time

2. The family life cycle of a traditional nuclear family

3. Anthropology and nursing

4. Holistic health beliefs

Answer: 3

Explanation: 3. Transcultural nursing theory is rooted in the caring that embraces the beliefs and practices of individuals or groups of similar or different cultures.

Page Ref: 21

Cognitive Level: Remembering

Client Need/Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention

Standards: QSEN Competencies: I. B. 2. Describe how diverse cultural, ethnic, and social backgrounds function as sources of patient, family, and community values. | AACN Essentials Competencies: VII. 3. Assess health/illness beliefs, values, attitudes, and practices of individuals, families, groups, communities, and populations. | NLN Competencies: Relationship-Centered Care: The role of family, culture, and community in a persons development. | Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 3 Identify prevalent cultural norms related to childbearing and childrearing.

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MNL LO: 1.1.1 Relate the effect of culture and family to the childbearing experience.

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11) The nurse is preparing a community presentation on family development. Which statement should the nurse include?

1. The youngest child determines the familys current stage.

2. A family does not experience overlapping of stages.

3. Family development ends when the youngest child leaves home.

4. The stages describe the familys progression over time.

Answer: 4

Explanation: 4. Family development stages describe the changes and adaptations that a family goes through over time as children are added to the family.

Page Ref: 20

Cognitive Level: Understanding

Client Need/Sub: Health Promotion and Maintenance: Developmental Stages and Transitions

Standards: QSEN Competencies: I. A. 2. Describe how diverse cultural, ethnic, and social backgrounds function as sources of patient, family, and community values. | AACN Essentials Competencies: VII. 3. Assess health/illness beliefs, values, attitudes, and practices of individuals, families, groups, communities, and populations. | NLN Competencies: Relationship-Centered Care: The role of family, culture, and community in a persons development | Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 2 Identify the stages of a family life cycle.

MNL LO: 1.1.1 Relate the effect of culture and family to the childbearing experience.

12) In learning about Duvalls life-cycle stages ascribed to traditional families, the nursing student recognizes that developmental tasks of each stage include which of the following?

Note: Credit will be given only if all correct and no incorrect choices are selected.

Select all that apply.

1. Adjusting to new roles as mother and father

2. Working out authority and socialization roles with the school

3. Becoming a single parent with custodial responsibilities

4. Becoming a couple and dating

5. Adjusting to the loss of a spouse

Answer: 1, 2, 5

Explanation: 1. Adjusting to new roles as mother and father occurs in Stage II, which describes childbearing families with infants.

2. Working out authority and socialization roles with schools occurs in Stage IV, which describes families with school-age children.

5. Stage VIII includes adjusting to the loss of a spouse.

Page Ref: 20, 21

Cognitive Level: Understanding

Client Need/Sub: Health Promotion and Maintenance: Developmental Stages and Transitions

Standards: QSEN Competencies: I. A. 2. Describe how diverse cultural, ethnic, and social backgrounds function as sources of patient, family, and community values. | AACN Essentials Competencies: VII. 3. Assess health/illness beliefs, values, attitudes, and practices of individuals, families, groups, communities, and populations. | NLN Competencies: Relationship-Centered Care: The

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role of family, culture, and community in a persons development | Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 2 Identify the stages of a family life cycle.

MNL LO: 1.1.1 Relate the effect of culture and family to the childbearing experience.

13) The nurse is planning a community education program on the role of complementary and alternative therapies during pregnancy. Which statement about alternative and complementary therapies should the nurse include?

1. They bring about cures for illnesses and diseases.

2. They are invasive but effective for achieving health.

3. They emphasize prevention and wellness.

4. They prevent pregnancy complications.

Answer: 3

Explanation: 3. Complementary and alternative therapies have many benefits during pregnancy. They emphasize prevention and wellness, aiming for holistic health rather than cure or treatment.

Page Ref: 29

Cognitive Level: Understanding

Client Need/Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention

Standards: QSEN Competencies: II. A. 2. Describe scopes of practice and roles of health care team members. | AACN Essentials Competencies: VII. 3. Assess health/illness beliefs, values, attitudes, and practices of individuals, families, groups, communities, and populations. | NLN Competencies: Teamwork: Contribution of other individuals and groups in helping patient/family achieve health goals | Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 7 Differentiate between complementary and alternative therapies.

MNL LO: 1.1.2 Explore the role of the nurse in maternity care delivery.

14) The nurse is preparing to assess the development of a family new to the clinic. The nurse understands that which of the following is the primary use of a family assessment tool?

1. Obtain a comprehensive medical history of family members.

2. Determine to which clinic the client should be referred.

3. Predict how a family will likely change with the addition of children.

4. Understand the physical, emotional, and spiritual needs of members.

Answer: 4

Explanation: 4. Understanding the physical, emotional, and spiritual needs of members is the main reason for using a family assessment tool.

Page Ref: 21

Cognitive Level: Understanding

Client Need/Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention

Standards: QSEN Competencies: I. B. 10. Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management. | AACN Essentials Competencies: IV. 1. Demonstrate skills in using patient care technologies, information systems, and communication devices that support safe nursing practice. | NLN Competencies: Quality and Safety: Carefully maintain and use electronic and/or written health records. | Nursing/Integrated Concepts: Nu

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rsing Process: Assessment

Learning Outcome: 1 Compare the characteristics of different types of families.

MNL LO: 1.1.1 Relate the effect of culture and family to the childbearing experience.

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15) The nurse in the community should use a family assessment tool to obtain what type of information?

1. How long the family has lived at its current address

2. What other health insurance the family has had in the past

3. How the family meets its nutritional needs and obtains food

4. What eye color the family desires in its unborn child

Answer: 3

Explanation: 3. A family assessment is a collection of data about the familys type and structure, current level of functioning, support system, sociocultural background, environment, and needs.

Page Ref: 21

Cognitive Level: Understanding

Client Need/Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention

Standards: QSEN Competencies: VI. A. 2. Identify essential information that must be available in a common database to support patient care. | AACN Essentials Competencies: IV. 7. Recognize the role of information technology in improving patient care outcomes and creating a safe care environment. | NLN Competencies: Quality and Safety: Carefully maintain and use electronic and/or written health records. | Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 1 Compare the characteristics of different types of families.

MNL LO: 1.1.1 Relate the effect of culture and family to the childbearing experience.

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16) In assessing a family, the community nurse uses a family assessment tool, which provides an organized framework to collect data concerning which of the following?

Note: Credit will be given only if all correct and no incorrect choices are selected.

Select all that apply.

1. Access to laundry and grocery facilities

2. Access to health care

3. Sharing of religious beliefs and values

4. Acculturation to traditional lifestyles

5. Ability to include a new spouse into the family unit

Answer: 1, 2, 3

Explanation: 1. Access to laundry, grocery, and recreational facilities is a means of meeting the physical, emotional, and spiritual needs of members, which is part of the family assessment tool.

2. Access to health care is a means of meeting the physical, emotional, and spiritual needs of members, which is part of the family assessment tool.

3. Sharing of religious beliefs and values is a means of meeting the physical, emotional, and spiritual needs of members, which is part of the family assessment tool.

Page Ref: 21

Cognitive Level: Understanding

Client Need/Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention

Standards: QSEN Competencies: VI. B. 1. Seek education about how information is managed in care settings before providing care. | AACN Essentials Competencies: IV. 1. Demonstrate skills in using patient care technologies, information systems, and communication devices that support safe nursing care. | NLN Competencies: Quality and Safety: Carefully maintain and use electronic and/or written health records. | Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 1 Compare the characteristics of different types of families.

MNL LO: 1.1.1 Relate the effect of culture and family to the childbearing experience.

17) The nurse is assessing a client who reports seeing an acupuncturist on a weekly basis to treat back pain. The nurse understands that acupuncture is an example of what?

1. A risky practice without evidence of efficacy

2. A folk remedy

3. A complementary therapy

4. An alternative therapy

Answer: 3

Explanation: 3. Acupuncture is a therapy that is used in conjunction with conventional medical treatment, and therefore is an example of a complementary therapy.

Page Ref: 28

Cognitive Level: Understanding

Client Need/Sub: Physiological Integrity: Basic Care and Comfort

Standards: QSEN Competencies: II. A. 2. Describe scopes of practice and roles of health care team members. | AACN Essentials Competencies: IX. 17. Develop a beginning understanding of complementary and alternative modalities and their role in health care. | NLN Competencies: Teamwork: Contribution of other individuals and groups in helping patient/family achieve health goals. |

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Nursing/Integrated Concepts: Nursing Process: Diagnosis

Learning Outcome: 7 Differentiate between complementary and alternative therapies.

MNL LO: 1.1.2 Explore the role of the nurse in maternity care delivery.

18) In caring for pregnant clients, the nurse realizes that information on conventional, complementary, and alternative medicine is best obtained by which of the following means?

1. Obtained at the medical office if the physician feels it is appropriate

2. Obtained from family and friends who have already experienced a situation

3. Readily obtainable on the Internet

4. Passed on by word of mouth

Answer: 3

Explanation: 3. The dramatic increase in complementary and alternative therapies that began in the final decade of the 20th century is partially due to the advent of the Internet.

Page Ref: 28

Cognitive Level: Understanding

Client Need/Sub: Safe and Effective Care Environment: Management of Care

Standards: QSEN Competencies: II. B. 7. Clarify roles and accountabilities under conditions of potential overlap in team member functioning. | AACN Essentials Competencies: IX. 17. Develop a beginning understanding of complementary and alternative modalities and their role in health care. | NLN Competencies: Quality and Safety: Communicate effectively with different individuals (team members, other care providers, patients, families, etc.) so as to minimize risks associated with handoffs among providers and across transitions in care. | Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 7 Differentiate between complementary and alternative therapies.

MNL LO: 1.1.2 Explore the role of the nurse in maternity care delivery.

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19) In working with immigrants in an inner-city setting, the nurse recognizes that acculturation of immigrants often brings with it which of the following benefits?

Note: Credit will be given only if all correct and no incorrect choices are selected.

Select all that apply.

1. Improved socioeconomic status

2. Use of preventive care services

3. Better nutrition

4. Increase in substance abuse over time

5. More physician visits due to language barriers

Answer: 1, 2, 3

Explanation: 1. Improvement of socioeconomic status is a benefit of acculturation in the United States.

2. Acculturation of immigrants increases the likelihood that the family members will use preventive health services.

3. Improved socioeconomic status leads to better nutrition and access to health care.

Page Ref: 22

Cognitive Level: Understanding

Client Need/Sub: Health Promotion and Maintenance: Management of Care

Standards: QSEN Competencies: I. B. 3. Provide patient-centered care with sensitivity and respect for the diversity of human experience. | AACN Essentials Competencies: VII. 7. Collaborate with other healthcare professionals and patients to provide spiritually and culturally appropriate health promotion and disease and injury prevention interventions. | NLN Competencies: Relationship-Centered Care: Appreciate the patient as a whole person, with his or her own life story and ideas about the meaning of health or illness. | Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 3 Identify prevalent cultural norms related to childbearing and childrearing.

MNL LO: 1.1.1 Relate the effect of culture and family to the childbearing experience.

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20) The nurse is caring for a postpartal client of Hmong descent who immigrated to the United States 5 years ago. The client asks for the regular hospital menu because American food tastes best. The nurse assesses this response to be related to which of the following cultural concepts?

1. Acculturation

2. Ethnocentrism

3. Enculturation

4. Stereotyping

Answer: 1

Explanation: 1. Acculturation (assimilation) is the correct assessment because the client adapted to a new cultural norm in terms of food choices.

Page Ref: 28

Cognitive Level: Understanding

Client Need/Sub: Health Promotion and Maintenance: Management of Care

Standards: QSEN Competencies: I. B. 3. Provide patient-centered care with sensitivity and respect for the diversity of human experience. | AACN Essentials Competencies: VII. 7. Collaborate with other healthcare professionals and patients to provide spiritually and culturally appropriate health promotion and disease and injury prevention interventions. | NLN Competencies: Relationship-Centered Care: Appreciate the patient as a whole person, with his or her own life story and ideas about the meaning of health or illness. | Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 3 Identify prevalent cultural norms related to childbearing and childrearing.

MNL LO: 1.1.1 Relate the effect of culture and family to the childbearing experience.

21) The nurse is teaching a community education class on complementary and alternative therapies. To assess learning, the nurse asks, In traditional Chinese medicine, what is the invisible flow of energy in the body that maintains health and ensures physiologic functioning? Which answer indicates that teaching was successful?

1. Meridians

2. Chi

3. Yin

4. Yang

Answer: 2

Explanation: 2. Chi is the energy that flows through the body along meridians, or pathways, to maintain health.

Page Ref: 29

Cognitive Level: Remembering

Client Need/Sub: Physiological Integrity: Basic Care and Comfort

Standards: QSEN Competencies: I. A. 2. Describe how diverse cultural, ethnic, and social backgrounds function as sources of patient, family, and community values. | AACN Essentials Competencies: VII. 3. Assess health/illness beliefs, values, attitudes, and practices of individuals, families, groups, communities, and populations. | NLN Competencies: Relationship-Centered Care: The role of family, culture, and community in a persons development. | Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 7 Differentiate between complementary and alternative therapies.

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MNL LO: 1.1.2 Explore the role of the nurse in maternity care delivery.

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22) The nurse is admitting a client in labor who states that she is a naturopath. The nurse understands that this client believes which of the following?

1. An initial worsening of symptoms after treatment means the correct remedy has been used.

2. There are five elements that take form in the body.

3. Her pregnancy is a kapha condition.

4. Naturopathy is a form of medicine that utilizes the healing forces of nature.

Answer: 4

Explanation: 4. This is the correct answer. Naturopathy is more precisely defined as a healing system that combines safe and effective traditional means of preventing and treating human disease with the most current advances in modern medicine.

Page Ref: 29

Cognitive Level: Remembering

Client Need/Sub: Health Promotion and Maintenance: Ante/Intra/Postpartum and Newborn Care

Standards: QSEN Competencies: I. C. 4. Seek learning opportunities with patients who represent all aspects of human diversity. | AACN Essentials Competencies: VII. 3. Assess health/illness beliefs, values, attitudes, and practices of individuals, families, groups, communities, and populations. | NLN Competencies: Relationship-Centered Care: Respect the patients dignity, uniqueness, integrity, and self-determination, and his or her own power and self-healing processes. | Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 7 Differentiate between complementary and alternative therapies.

MNL LO: 1.1.2 Explore the role of the nurse in maternity care delivery.

23) The nurse is counseling a pregnant woman who intends to see a naturopathic physician. The nurse tells the woman that she can expect education on which of the following?

Note: Credit will be given only if all correct and no incorrect choices are selected.

Select all that apply.

1. Clinical nutrition

2. Botanical medicine

3. Lifestyle modification

4. Use of like to cure like

5. The role of yin and yang

Answer: 1, 2, 3

Explanation: 1. Naturopathic physicians teach their clients about clinical nutrition.

2. The use of botanical medicine is a part of naturopathy.

3. Lifestyle modification is a part of naturopathy.

Page Ref: 29

Cognitive Level: Understanding

Client Need/Sub: Health Promotion and Maintenance: Ante/Intra/Postpartum and Newborn Care

Standards: QSEN Competencies: I. C. 4. Seek learning opportunities with patients who represent all aspects of human diversity. | AACN Essentials Competencies: VII. 3. Assess health/illness beliefs, values, attitudes, and practices of individuals, families, groups, communities, and populations. | NLN Competencies: Relationship-Centered Care: Respect the patients dignity, uniqueness, integrity, and self-determination, and his or her own power and self-healing processes. | Nursing/InteConc: Nursing Pr

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ocess: Assessment

Learning Outcome: 8 Summarize the benefits and risks of complementary and alternative therapies.

MNL LO: 1.1.2 Explore the role of the nurse in maternity care delivery.

24) During the assessment phase of a family, the community nurse recognizes that culture influences childrearing and childbearing in which of the following ways?

Note: Credit will be given only if all correct and no incorrect choices are selected.

Select all that apply.

1. Beliefs about the importance of children

2. Beliefs and attitudes about pregnancy

3. Norms regarding infant feeding

4. Acculturation is important in rearing children

5. Time orientation to the future is very important

Answer: 1, 2, 3

Explanation: 1. Culture influences beliefs about the importance of children.

2. Culture influences attitudes about pregnancy and the right vs. the obligation of women to bear children.

3. Culture influences infant feeding norms and practices.

Page Ref: 24, 25

Cognitive Level: Applying

Client Need/Sub: Health Promotion and Maintenance: Developmental Stages and Transitions

Standards: QSEN Competencies: I. C. 1. Value seeing health care situations through patients eyes. | AACN Essentials Competencies: VII. 3. Assess health/illness beliefs, values, attitudes, and practices of individuals, families, groups, communities, and populations. | NLN Competencies: Relationship-Centered Care: Affirm and value diversity. | Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 3 Identify prevalent cultural norms related to childbearing and childrearing.

MNL LO: 1.1.1 Relate the effect of culture and family to the childbearing experience.

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25) The nurse is teaching a class to the community on mind-based therapies. A class participant gives an example of a friend with leukemia who was taught by her complementary therapist to concentrate on making antibodies that will fight and kill the cancer cells in the bloodstream. How would the nurse identify this technique?

1. Guided imagery

2. Qigong

3. Biofeedback

4. Homeopathy

Answer: 1

Explanation: 1. Guided imagery is a state of intense, focused concentration used to create compelling mental images and is useful in imagining a desired effect.

Page Ref: 30

Cognitive Level: Understanding

Client Need/Sub: Physiological Integrity: Physiological Adaptation

Standards: QSEN Competencies: I. A. 6. Describe strategies to empower patients or families in all aspects of the health care process. | AACN Essentials Competencies: IX. 3. Implement holistic, patient-centered care that reflects an understanding of human growth and development, pathophysiology, pharmacology, medical management, and nursing management across the health-illness continuum, across lifespan and in all healthcare settings. | NLN Competencies: Relationship-Centered Care: Respect the patients dignity, uniqueness, integrity, and self-determination and his or her own power and self-healing process. | Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 8 Summarize the benefits and risks of complementary and alternative therapies.

MNL LO: 1.1.2 Explore the role of the nurse in maternity care delivery.

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26) The nurse in a rural clinic is talking with some clients about biofeedback. The nurse explains to the clients that biofeedback is which of the following?

1. An alternative therapy

2. A state of great mental and physical relaxation in which one is susceptible to suggestion

3. A method used to help individuals learn to control their physiologic responses based on the concept that the mind controls the body

4. A complementary therapy in which one goes into a relaxed state and focuses on positive scenes

Answer: 3

Explanation: 3. Biofeedback is a method to learn control of physiological responses based on the concept that the mind controls the body.

Page Ref: 30

Cognitive Level: Understanding

Client Need/Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention

Standards: QSEN Competencies: I. B. 1. Elicit patient values, preferences, and expressed needs as part of clinical interview, implementation of care plan and evaluation of care. | AACN Essentials Competencies: IX. 17. Develop a beginning understanding of complementary and alternative modalities and their role in health care. | NLN Competencies: Relationship-Centered Care: Appreciate the patient as a whole person, with his or her own life story and ideas about the meaning of health or illness. | Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 8 Summarize the benefits and risks of complementary and alternative therapies.

MNL LO: 1.1.2 Explore the role of the nurse in maternity care delivery.

27) The nurse is admitting a Mexican woman scheduled for a cholecystectomy. The nurse uses a cultural assessment tool during the admission. Which question would be most important for the nurse to ask?

1. What other treatments have you used for your abdominal pain?

2. In what country were you were born?

3. When you talk to family members, how close do you stand?

4. How would you describe your role within your family?

Answer: 1

Explanation: 1. Knowing what other treatments the client has used for pain is most important because some traditional or folk remedies include the use of herbs, which can have medication interactions.

Page Ref: 31

Cognitive Level: Understanding

Client Need/Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention

Standards: QSEN Competencies: I. B. 1. Elicit patient values, preferences, and expressed needs as part of clinical interview, implementation of care plan and evaluation of care. | AACN Essentials Competencies: VII. 3. Assess health/illness beliefs, values, attitudes, and practices of individuals, families, groups and communities, and populations. | NLN Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 4 Summarize the importance of cultural competency in providing nursing care.

MNL LO: 1.1.2 Explore the role of the nurse in maternity care delivery.

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28) The nurse works in a facility that cares for clients from a broad range of racial, ethnic, cultural, and religious backgrounds. Which statement should the nurse include in a presentation to recently hired nurses on the client population of the facility?

1. Our clients come from a broad range of backgrounds, but we have a good interpreter service.

2. Many of our clients come from backgrounds different from your own, but it doesnt cause problems for the nurses.

3. Because most of the doctors are bilingual, we dont have to deal with the differences in cultural backgrounds of our clients.

4. Understanding the common values and health practices of our diverse clients will facilitate better care and health outcomes.

Answer: 4

Explanation: 4. Because of the implications for care based on cultural background, it is important for nurses to understand the backgrounds of the client population that accesses the facility. Without cultural awareness, caregivers tend to project their own cultural responses onto foreign-born clients; clients from different socioeconomic, religious, or educational groups; or clients from different regions of the country.

Page Ref: 25

Cognitive Level: Applying

Client Need/Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention

Standards: QSEN Competencies: I. B. 1. Elicit patient values, preferences, and expressed needs as part of clinical interview, implementation of care plan and evaluation of care. | AACN Essentials Competencies: VII. 3. Assess health/illness beliefs, values, attitudes, and practices of individuals, families, groups, communities, and populations | NLN Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 4 Summarize the importance of cultural competency in providing nursing care.

MNL LO: 1.1.1 Relate the effect of culture and family to the childbearing experience.

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29) The nurse manager in a hospital with a large immigrant population is planning an in-service. Aware of how ethnocentrism affects nursing care, the nurse manager asks, The belief that ones own values and beliefs are the only or the best values has which of the following results?

1. It implies newcomers to the United States should adopt the norms and values of the country.

2. It can create barriers to communication through misunderstanding.

3. It leads to an expectation that all clients will exhibit pain the same way.

4. It improves the quality of care provided to culturally diverse client bases.

Answer: 2

Explanation: 2. When the nurse assumes that a client has the same values and beliefs as the nurse, misunderstanding will frequently occur, which in turn can negatively impact nurse-client communication. Ethnocentrism is the conviction that the values and beliefs of ones own cultural group are the best or only acceptable ones.

Page Ref: 25

Cognitive Level: Understanding

Client Need/Sub: Psychosocial Integrity: Cultural Awareness/Cultural Influences on Health

Standards: QSEN Competencies: I. C. 1. Value seeing health care situation through patients eyes. | AACN Essentials Competencies: VII. 3. Assess health/illness beliefs, values, attitudes, and practices of individuals, families, groups, communities, and populations. | NLN Competencies: Relationship-Centered Care: Appreciate the patient as a whole person, with his or her own life story and ideas about the meaning of health or illness. | Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 4 Summarize the importance of cultural competency in providing nursing care.

MNL LO: 1.1.1 Relate the effect of culture and family to the childbearing experience.

30) The client reports using an alternative therapy that involves the manipulation of soft tissues. This therapy has reduced the clients stress, diminished pain, and increased circulation. Which therapy has this client most likely received?

1. Guided imagery

2. Homeopathy

3. Massage therapy

4. Reflexology

Answer: 3

Explanation: 3. Massage therapy involves the manipulation of soft tissues.

Page Ref: 30

Cognitive Level: Understanding

Client Need/Sub: Physiological Integrity: Basic Care and Comfort

Standards: QSEN Competencies: I. B. 2. Communicate patient values, preferences, and expressed needs to other members of the health care team. | AACN Essentials Competencies: IX. 17. Develop a beginning understanding of complementary and alternative modalities and their role in health care. | NLN Competencies: Relationship-centered Care: Appreciate the patient as a whole person, with his or her own life story and ideas about the meaning of health or illness | Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 8 Summarize the benefits and risks of complementary and alternative therapies.

MNL LO: 1.1.2 Explore the role of the nurse in maternity care delivery.

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31) The client in the first trimester of pregnancy tells the nurse she regularly sees a massage therapist to help with pain in her shoulders and neck. The nurse tells her that massage has which of the following added advantages?

Note: Credit will be given only if all correct and no incorrect choices are selected.

Select all that apply.

1. Increasing circulation

2. Reducing anxiety

3. Promoting a sense of well-being

4. Eliminating energy blockages

5. Allowing coordination of breathing and moving

Answer: 1, 2, 3

Explanation: 1. Massage therapy has been shown to increase circulation.

2. Massage therapy has been shown to reduce anxiety.

3. Massage therapy has been shown to promote a sense of well-being.

Page Ref: 30

Cognitive Level: Understanding

Client Need/Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention

Standards: QSEN Competencies: I. B. 3. Provide patient-centered care with sensitivity and respect for the diversity of human experience. | AACN Essentials Competencies: VII. 3. Assess health/illness beliefs, values, attitudes, and practices of individuals, families, groups, communities, and populations. | NLN Competencies: Relationship-Centered Care: Be open to others ideas; show humility, mutual trust, empathy, support and a capacity for grace. | Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 8 Summarize the benefits and risks of complementary and alternative therapies.

MNL LO: 1.1.2 Explore the role of the nurse in maternity care delivery.

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Copyright 2016 Pearson Education, Inc.

32) A nurse is working in a clinic where clients from several cultures are seen. As a first step toward the goal of personal cultural competence, the nurse will do which of the following?

1. Enhance cultural skills.

2. Gain cultural awareness.

3. Seek cultural encounters.

4. Acquire cultural knowledge.

Answer: 2

Explanation: 2. One begins to gain cultural competence by gaining cultural awareness or by gaining an effective and cognitive self-awareness of personal worldview biases, beliefs, etc.

Page Ref: 25

Cognitive Level: Understanding

Client Need/Sub: Psychosocial Integrity: Cultural Awareness/Cultural Influences on Health

Standards: QSEN Competencies: I. B. 1. Elicit patient values, preferences, and expressed needs as part of clinical interview, implementation of care plan and evaluation of care. | AACN Essentials Competencies: VI. 2. Use inter-and intraprofessional communication and collaborative skills to deliver evidence-based, patient-centered care. | NLN Competencies: Relationship-centered Care: Communicate information effectively: listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 4 Summarize the importance of cultural competency in providing nursing care.

MNL LO: 1.1.1 Relate the effect of culture and family to the childbearing experience.

33) When teaching a culturally diverse group of childbearing families about hospital birthing options, the culturally competent nurse does which of the following?

1. Understands that the families have the same values as the nurse

2. Teaches the families how childbearing takes place in the United States

3. Insists that the clients answer questions instead of their husbands

4. Incorporates the specific beliefs of the cultural groups that are attending the class

Answer: 4

Explanation: 4. Providing culturally competent care involves recognizing the importance of the childbearing familys value system, acknowledging that differences occur among people, and respecting and responding to ethnic diversity in a way that leads to mutually desirable outcomes.

Page Ref: 33

Cognitive Level: Understanding

Client Need/Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention

Standards: QSEN Competencies: I. B. 3. Provide patient-centered care with sensitivity and respect for the diversity of human experience. | AACN Essentials Competencies: VI. 2. Use inter-and intraprofessional communication and collaborative skills to deliver evidence-based, patient-centered care. | NLN Competencies: Relationship-centered Care: Communicate information effectively: listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 4 Summarize the importance of cultural competency in providing nursing care.

MNL LO: 1.1.1 Relate the effect of culture and family to the childbearing experience.

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Copyright 2016 Pearson Education, Inc.

34) Which questions are appropriate for the nurse to ask during a cultural assessment of a client who is new to the clinic?

Note: Credit will be given only if all correct and no incorrect choices are selected.

Select all that apply.

1. What genetic and other biological differences affect caregiving?

2. Which family member must be consulted for decisions about care?

3. What type of health provider is the most appropriate?

4. Does the client have beliefs or traditions that might impact the care plan?

5. Are communications patterns established?

Answer: 2, 3, 4

Explanation: 2. It is important the nurse recognize cultural differences in regard to which family member must be consulted for decisions about care.

3. Some cultures do not allow a person of the opposite gender to touch the client. Cultural sensitivity will recognize and allow for this.

4. The nurse must be aware of traditions and beliefs that might impact the care plan.

Page Ref: 25, 26

Cognitive Level: Applying

Client Need/Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention

Standards: QSEN Competencies: I. B. 1. Elicit patient values, preferences, and expressed needs as part of clinical interview, implementation of care plan and evaluation of care. | AACN Essentials Competencies: VI. 2. Use inter-and intraprofessional communication and collaborative skills to deliver evidence-based, patient-centered care. | NLN Competencies: Relationship-centered Care: Communicate information effectively: listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 4 Summarize the importance of cultural competency in providing nursing care.

MNL LO: 1.1.1 Relate the effect of culture and family to the childbearing experience.

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Copyright 2016 Pearson Education, Inc.

35) The nurse is working with a client whose religious beliefs differ from those of the general population. What is the best nursing intervention to use to meet the specific spiritual needs of this family?

1. Ask how important the clients religious and spiritual beliefs are when making decisions about health care.

2. Show respect while allowing time and privacy for religious rituals.

3. Ask for the clients opinion on what caused the illness.

4. Identify healthcare practices forbidden by religious or spiritual beliefs.

Answer: 2

Explanation: 2. Providing spiritually sensitive care involves determining the current spiritual and religious beliefs and practices that will affect the mother and baby, accommodating these practices where possible, and examining ones own spiritual or religious beliefs to be more aware and able to provide nonjudgmental care.

Page Ref: 33

Cognitive Level: Understanding

Client Need/Sub: Psychosocial Integrity: Religious and Spiritual Influences on Health

Standards: QSEN Competencies: I. C. 2. Respect and encourage individual expression of patient values, preferences, and expressed need. | AACN Essentials Competencies: VIII. 1. Demonstrate the professional standards of moral, ethical, and legal conduct. | NLN Competencies: Relationship-Centered Care: Appreciate the patient as a whole person with his or her own life story and ideas about the meaning of health or illness. | Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 6 Identify key considerations in providing spiritually sensitive care.

MNL LO: 1.1.1 Relate the effect of culture and family to the childbearing experience.

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Copyright 2016 Pearson Education, Inc.

36) The labor and delivery nurse is caring for a laboring client who has asked for a priest to visit her during labor. The clients mother died during childbirth, and although there are no complications during her pregnancy, the client is fearful of her own death during labor. What is the best response by the nurse?

1. Nothing is going to happen to you. Well take very good care of you during your birth.

2. Would you like to have an epidural so that you wont feel the pain of the contractions?

3. The priest wont be able to prevent complications, and might get in the way of your providers.

4. Would you like me to contact your parish or our hospital chaplain to come see you?

Answer: 4

Explanation: 4. Providing spiritually sensitive care involves determining the current spiritual and religious beliefs and practices that will affect the mother and baby and accommodating these practices where possible.

Page Ref: 33

Cognitive Level: Applying

Client Need/Sub: Psychosocial Integrity: Religious and Spiritual Influences on Health

Standards: QSEN Competencies: I. C. 2. Respect and encourage individual expression of patient values, preferences, and expressed need. | AACN Essentials Competencies: VIII. 1. Demonstrate the professional standards of moral, ethical, and legal conduct. | NLN Competencies: Relationship-Centered Care: Appreciate the patient as a whole person with his or her own life story and ideas about the meaning of health or illness. | Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 6 Identify key considerations in providing spiritually sensitive care.

MNL LO: 1.1.1 Relate the effect of culture and family to the childbearing experience.

37) The client reports relief from headaches when she rubs the temples on each side of the head. The nurse understands that this is a form of which of the following?

1. Acupressure

2. Acupuncture

3. Reflexology

4. Hydrotherapy

Answer: 1

Explanation: 1. Acupressure uses pressure from the fingers and thumbs to stimulate pressure points to relieve symptoms.

Page Ref: 29

Cognitive Level: Understanding

Client Need/Sub: Physiological Integrity: Basic Care and Comfort

Standards: QSEN Competencies: I. A. 2. Describe strategies to empower patients or families in all aspects of the health care process. | AACN Essentials Competencies: IX. 17. Develop a beginning understanding of complementary and alternative modalities and their role in health care. | NLN Competencies: Relationship-Centered Care: Appreciate the patient as a whole person, with his or her own life story and ideas about the meaning of health and illness. | Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 8 Summarize the benefits and risks of complementary and alternative therapies.

MNL LO: 1.1.2 Explore the role of the nurse in maternity care delivery.

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