Chapter 4Culturally Sensitive Care My Nursing Test Banks

Chapter 4Culturally Sensitive Care

MULTIPLE CHOICE

1.A client from a different culture is having difficulty adjusting to living in the United States. The nurse realizes this client is experiencing:

1.

an expected reaction.

2.

culture shock.

3.

remorse.

4.

guilt.

ANS: 2

Culture shock is alienation, disorientation, and uncertainty that can occur during the process of adjusting to a new cultural group. The client having difficulty adjusting to living in the United States is an example of culture shock. Difficulty adjusting to living in the United States is not an expected reaction, remorse, or guilt.

PTS: 1 DIF: Analyze REF: Culture

2.A client from the Japanese culture tells the nurse that she is a member of an organization for Japanese information technology professionals. The nurse realizes this client is describing:

1.

an ethnic group.

2.

cultural norms.

3.

a subculture.

4.

personal preferences.

ANS: 3

Subculture refers to the membership in a smaller group within a larger culture. Membership in a Japanese information technology professionals group is an example of a subculture. The Japanese information technology professionals group is not an example of an ethnic group, cultural norm, or personal preference.

PTS: 1 DIF: Analyze REF: Subculture

3.The nurse is providing care to a client from the Native American ethnic group. The nurse realizes that which of the following would be a health belief for this client?

1.

Illness is punishment from God.

2.

The body must be intact upon death.

3.

Hospitals are a place to die.

4.

Illness is a price to be paid from a past or future event.

ANS: 4

A heath belief of individuals within the Native American ethnic group is that illness is a price to be paid from a past or future event. Individuals within the African American ethnic group have a health belief that illness is a punishment from God. Individuals within the Chinese ethnic group have a health belief that the body must be intact upon death. Individuals from the Hispanic ethnic group have a health belief that hospitals are a place to die.

PTS:1DIF:Analyze

REF: Table 4-2 The Health Values/Beliefs and Customs/Practices of Cultures in the United States

4.While assessing a client from a different culture, the nurse passes over several sections because of previous experience with other clients from the same culture. Which of the following is this nurse demonstrating?

1.

Stereotyping

2.

Diversity

3.

Cultural sensitivity

4.

Time management

ANS: 1

Stereotyping is generalizing characteristics of a culture as being the same for everyone within that cultural group. The nurse should avoid stereotyping when conducting assessments with clients of different cultures. The nurse is not demonstrating diversity, cultural sensitivity, or time management.

PTS:1DIF:Analyze

REF: Values of Different Cultural Groups in the United States

5.The nurse, using an interpreter to communicate with a client from a different culture, is concerned that the clients body language does not match the content the interpreter provides. Which of the following communication issues does this situation describe?

1.

Stereotyping

2.

Intrinsic distortion

3.

Conflict

4.

Extrinsic distortion

ANS: 2

Intrinsic distortion occurs when information is passed from one person to another through an interpreter. Distortions can occur through vocal tones, eye contact, phrasing, and body language. Extrinsic distortion occurs when the interpreter is improperly prepared due to not being familiar with medical terminology or regional dialect issues. Stereotyping and conflict are not communication issues.

PTS: 1 DIF: Analyze REF: Transcultural Communication

6.An interpreter who will assist in communicating with a client from a different culture will not arrive for several hours. The client has many questions and the only person available to assist with translating is the clients adult daughter. Which of the following situations can occur with using this family member as an interpreter?

1.

The daughter may alter information to protect the client.

2.

The nurse will not have to wait for the interpreter to arrive.

3.

The clients care can begin sooner if the daughter is used to interpret.

4.

The client will understand everything that is occurring with his health.

ANS: 1

One issue with using a family member as an interpreter is that the family member may be protective of the client. The adult daughter may alter information to protect the client. Using the daughter as an interpreter would reduce the amount of time the nurse needs to wait to assess and plan care for the client, but the quality of the information may be compromised. Using the daughter as an interpreter does not guarantee that the client will understand everything that is occurring with his health.

PTS: 1 DIF: Analyze REF: Interpreters for Transcultural Communication

7.The nurse is frustrated with a client from a different culture who is not adhering to the prescribed medication regime. Which of the following should the nurse assess in this client?

1.

Hearing

2.

Vision

3.

Orientation

4.

Literacy

ANS: 4

If a client whose dominant language is not English appears to be nonadherent to the prescribed health care regime, the nurse should assess if the client understands the written instructions. The client could be illiterate. The nurse does not need to assess the clients hearing, vision, or orientation.

PTS:1DIF:Apply

REF:Language and Literacy Barriers in Transcultural Communication

8.An elderly clients daughter tells the nurse that she has done all that she can do to help her mother, and she needs to return home to care for her own family. The nurse realizes this client is a member of which type of family structure?

1.

Linear

2.

Collateral

3.

Individualistic

4.

Encapsulated

ANS: 3

The individualistic family focuses on the nuclear family, self-responsibility, and accountability. There is less respect for authority, and elders do not have the higher position of respect. The client is a member of this type of family. Linear families have a nuclear family with extended hereditary persons within the extended family. Collateral families include additional lateral group members as part of the group. Encapsulated is not a type of family structure.

PTS: 1 DIF: Analyze REF: Family Role in Culture

9.The nurse is planning care for a client from a different culture. Which of the following should the nurse use when planning care for this client?

1.

Plan care using the same approaches as any other client.

2.

Communicate to the client that culture cannot be taken into consideration with care.

3.

Accept cultural practices that could be negative for the client.

4.

Preserve the cultural beliefs and practices of the client.

ANS: 4

When developing a plan of care for a client from a different culture, the nurse should preserve the cultural beliefs and practices of the client, adapt the plan of care to address the clients beliefs and practices and communicate to the client that the nurse is taking his culture into consideration, and repattern cultural beliefs and practices that could be negative to the client. The nurse should not plan care using the same approaches she uses with any other client.

PTS: 1 DIF: Apply REF: Planning and Implementation

10.The nurse is providing care to a client from a different culture. Which of the following behaviors should the nurse demonstrate while providing this care?

1.

Objectivity

2.

Subjectivity

3.

Bias

4.

Judgmental attitude

ANS: 1

When delivering culturally competent nursing care, the nurse must be objective, unbiased, and nonjudgmental. The nurse should not be subjective, biased, or use a judgmental attitude.

PTS: 1 DIF: Apply REF: Planning and Implementation

11.When the nurse is evaluating care for cultural considerations, which of the following should be done first?

1.

Examine the plan of care.

2.

Evaluate the outcomes of care.

3.

Make revisions.

4.

Review the goals and objectives set for the client.

ANS: 4

When evaluating care for cultural considerations, the nurse should review the goals and objectives that have been set for the client, examine the plan of care and interventions with the goals for care, evaluate the outcomes of care with how the clients cultural background has been taken into consideration and reevaluate the care, and make revisions to continue to enhance the outcomes.

PTS: 1 DIF: Apply REF: Evaluation

12.A female client of the Middle Eastern culture is admitted to a care area with both male and female nurses. Which of the following should be done to respect this clients cultural practices?

1.

Assign only female nurses to care for the client.

2.

Assign only male nurses to care for the client.

3.

Assign either male or female nurses to care for the client.

4.

Explain to the client that male nurses are more competent to provide care.

ANS: 1

When taking the practices of the Middle Eastern culture into consideration for client care, the client should be assigned only female nurses. Male health care providers are not permitted to touch female clients. Explaining to the client that male nurses are more competent to provide care is not a true statement and would not support the clients cultural needs.

PTS:1DIF:Apply

REF: Table 4-2 The Health Values/Beliefs and Customs/Practices of Cultures in the United States

13.The nurse is caring for a client from the white American cultural group. Which of the following cultural considerations should the nurse ensure when providing care to this client?

1.

There is minimal tolerance for delays so provide pain medication in a timely manner.

2.

Submission to those in authority is a characteristic of this culture group.

3.

Prayer is emphasized for prevention and treatment of health problems.

4.

Illnesses are treated with hot or cold foods.

ANS: 1

White Americans have different backgrounds in regard to their cultures and subcultures. In general, white Americans do not tolerate delays in health care. Submission to those in authority is a characteristic of the Asian American cultural group. Prayer for the prevention and treatment of health problems is a characteristic of the African American cultural group. Using hot or cold foods to treat illnesses is a characteristic of the Hispanic cultural group.

PTS:1DIF:Apply

REF: Values of Different Cultural Groups in the United States

MULTIPLE RESPONSE

1.The nurse is planning care for a client from a non-English-speaking culture. Which of the following cultural factors will influence the clients responses to the nurse? (Select all that apply.)

1.

How a person acts

2.

Communication pattern

3.

Socioeconomic background

4.

Thinking process

5.

Interpretation of others characteristics

6.

Family structure

ANS: 1, 2, 4, 5

The culture of an individual influences how a person acts, communicates, thinks, and interprets another persons characteristics. Socioeconomic background and family structure may or may not be influenced by a persons culture.

PTS: 1 DIF: Analyze REF: Culture

2.The nurse is assessing a Hispanic client. Which of the following disorders should the nurse include while conducting this assessment? (Select all that apply.)

1.

Phenylketonuria

2.

Chronic liver disease

3.

Diabetes mellitus

4.

Sickle cell anemia

5.

Hypertension

6.

Peptic ulcer disease

ANS: 3, 5

Diabetes mellitus and hypertension are disorders seen in the Hispanic ethnic group. Phenylketonuria is a disorder seen in the Irish ethnic group. Chronic liver disease is a disorder seen in the Native American ethnic group. Sickle-cell anemia is a disorder seen in the African American ethnic group. Peptic ulcer disease is a disorder seen in the Korean ethnic group.

PTS:1DIF:Apply

REF:Table 4-1 Diseases and Disorders of Specific Ethnic Groups

3.The nurse is assessing a client who immigrated to the United States 10 years ago. Which of the following should the nurse assess to ensure this client maintains the highest level of health? (Select all that apply.)

1.

Smoking behavior

2.

Alcohol intake

3.

Substance use

4.

Language comprehension

5.

Obesity

6.

Employment status

ANS: 1, 2, 3, 5

Acculturation into the United States has undesirable effects on the health of immigrants because of lifestyle changes, including smoking, alcohol intake, drug use, unhealthy diets, and obesity. The nurse should assess the clients smoking, alcohol, substance use, and weight to ensure the client maintains the highest level of health. Language comprehension and employment status would not be criteria to ensure the client maintains the highest level of health.

PTS:1DIF:ApplyREF:Immigrant Population

4.When planning and providing care to a client of a different culture, the nurse utilizes techniques to enhance communication and implement appropriate and effective interactions. The nurse is utilizing the concepts of culturally competent care that are included in which of the following regulatory bodies expectations? (Select all that apply.)

1.

American Nurses Association Core Competencies

2.

International Council of Nurses Code of Nursing

3.

National Patient Safety Goals

4.

Joint Commission standards

5.

American Academy of Nursing Professional Responsibilities

6.

American Nurses Association 1991 Position Statement

ANS: 3, 4, 5, 6

The concept of culturally competent nursing care is emphasized in the American Nurses Association position statement of 1991, the American Academy of Nursings professional responsibilities, the Joint Commission standards, and the National Patient Safety Goals. The American Nurses Association Core Competencies and the International Council of Nurses Code of Nursing do not address culturally competent care.

PTS: 1 DIF: Analyze REF: Culturally Competent Nursing Care

5.The nurse is identifying nursing diagnoses appropriate for a client from a different culture. Which of the following diagnoses would cause a potential cultural bias if used? (Select all that apply.)

1.

Verbal communication: Impaired

2.

Noncompliance

3.

Disturbed thought processes

4.

Sedentary lifestyle

5.

Knowledge deficit

6.

Powerlessness

ANS: 1, 2, 3, 5, 6

There are six (6) nursing diagnoses that can be troublesome for persons from different cultural backgrounds. These diagnoses are: 1) Verbal communication: Impaired, 2) Noncompliance, 3) Social Interaction: Impaired, 4) Disturbed thought processes, 5) Knowledge deficit, and 6) Powerlessness. Sedentary lifestyle is not a diagnosis that would be troublesome for a person from a different cultural background.

PTS:1DIF:AnalyzeREF:Nursing Diagnoses

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