Chapter 9 My Nursing Test Banks

 

Kneisl, Contemporary Psychiatric-Mental Health Nursing, 3/e Test Bank
Chapter 9

Question 1

Type: MCSA

In trying to understand other cultures, what should the nurse know about how cultural values influence health beliefs?

1. Cultural values will not matter if the nurse is from the dominant culture.

2. Cultural values may shape perceptions of health, disease, prevention, and treatment.

3. Cultural values will not shape perceptions of health, disease, prevention, and treatment.

4. Cultural values and other differences will negatively influence outcomes.

Correct Answer: 2

Rationale 1: The nurse must be aware that cultural values will shape perceptions of health, disease, prevention, and treatment. Acknowledging divergent values can be a significant first step toward improving ones cultural competence and sensitivity to differences, especially when the nurse is from the dominant culture. If nursing care is delivered with an acknowledgment of cultural differences, then outcomes will be enhanced.

Rationale 2: The nurse must be aware that cultural values will shape perceptions of health, disease, prevention, and treatment. Acknowledging divergent values can be a significant first step toward improving ones cultural competence and sensitivity to differences, especially when the nurse is from the dominant culture. If nursing care is delivered with an acknowledgment of cultural differences, then outcomes will be enhanced.

Rationale 3: The nurse must be aware that cultural values will shape perceptions of health, disease, prevention, and treatment. Acknowledging divergent values can be a significant first step toward improving ones cultural competence and sensitivity to differences, especially when the nurse is from the dominant culture. If nursing care is delivered with an acknowledgment of cultural differences, then outcomes will be enhanced.

Rationale 4: The nurse must be aware that cultural values will shape perceptions of health, disease, prevention, and treatment. Acknowledging divergent values can be a significant first step toward improving ones cultural competence and sensitivity to differences, especially when the nurse is from the dominant culture. If nursing care is delivered with an acknowledgment of cultural differences, then outcomes will be enhanced.

Global Rationale:

Cognitive Level: Applying

Client Need: Health Promotion and Maintenance

Client Need Sub:

Nursing/Integrated Concepts:

Learning Outcome: Explain what it means to be a culturally competent nurse.

Question 2

Type: MCSA

A new nurse is oriented to a position in a community health center that serves a diverse client population. The new nurse says, The first thing I need to do is learn everything possible about the cultures of all the clients. What is the best response staff can give the new nurse?

1. You need to first understand who you are.

2. This will come with time as you get to know clients and then encounter problems.

3. I will give you a great book that describes all of the critical factors.

4. You should always be nonjudgmental.

Correct Answer: 1

Rationale 1: It is a priority for the nurse to develop an awareness of his or her own perceptions, prejudices, and stereotypes regarding the particular cultural groups of interest. Reading about culture and remaining nonjudgmental are strategies that can be incorporated after engaging in a self-awareness inventory. Although experience working with diverse clients will help, it will be more meaningful after engaging in a self-awareness inventory.

Rationale 2: It is a priority for the nurse to develop an awareness of his or her own perceptions, prejudices, and stereotypes regarding the particular cultural groups of interest. Reading about culture and remaining nonjudgmental are strategies that can be incorporated after engaging in a self-awareness inventory. Although experience working with diverse clients will help, it will be more meaningful after engaging in a self-awareness inventory.

Rationale 3: It is a priority for the nurse to develop an awareness of his or her own perceptions, prejudices, and stereotypes regarding the particular cultural groups of interest. Reading about culture and remaining nonjudgmental are strategies that can be incorporated after engaging in a self-awareness inventory. Although experience working with diverse clients will help, it will be more meaningful after engaging in a self-awareness inventory.

Rationale 4: It is a priority for the nurse to develop an awareness of his or her own perceptions, prejudices, and stereotypes regarding the particular cultural groups of interest. Reading about culture and remaining nonjudgmental are strategies that can be incorporated after engaging in a self-awareness inventory. Although experience working with diverse clients will help, it will be more meaningful after engaging in a self-awareness inventory.

Global Rationale:

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: Explain what it means to be a culturally competent nurse.

Question 3

Type: MCSA

A nurse is admitting a client who is from Japan. What is the first step the nurse should take?

1. Ask all family members to stay with the client during the admission assessment.

2. Call for a Japanese interpreter.

3. Talk with the client to determine the clients level of fluency.

4. Follow the admission assessment paperwork carefully.

Correct Answer: 3

Rationale 1: The priority is for the nurse to determine the clients level of fluency in English and assess the degree to which another language is used as the primary language. If the assessment indicates the need for an interpreter, then the nurse should refer the client for services. Carefully following the assessment paperwork will not be helpful if the nurse and the client do not understand each other. It is unprofessional and inappropriate for family members to serve as interpreters.

Rationale 2: The priority is for the nurse to determine the clients level of fluency in English and assess the degree to which another language is used as the primary language. If the assessment indicates the need for an interpreter, then the nurse should refer the client for services. Carefully following the assessment paperwork will not be helpful if the nurse and the client do not understand each other. It is unprofessional and inappropriate for family members to serve as interpreters.

Rationale 3: The priority is for the nurse to determine the clients level of fluency in English and assess the degree to which another language is used as the primary language. If the assessment indicates the need for an interpreter, then the nurse should refer the client for services. Carefully following the assessment paperwork will not be helpful if the nurse and the client do not understand each other. It is unprofessional and inappropriate for family members to serve as interpreters.

Rationale 4: The priority is for the nurse to determine the clients level of fluency in English and assess the degree to which another language is used as the primary language. If the assessment indicates the need for an interpreter, then the nurse should refer the client for services. Carefully following the assessment paperwork will not be helpful if the nurse and the client do not understand each other. It is unprofessional and inappropriate for family members to serve as interpreters.

Global Rationale:

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: Explain what it means to be a culturally competent nurse.

Question 4

Type: MCSA

A nurse is working with a student on the acute care psychiatric unit. The student asks the nurse why it is important to assess clients values when there are many other more important issues to attend. Which of the following replies should the nurse emphasize?

1. Health behaviors are strongly influenced by personal values.

2. Values form the scientific rationale for health behaviors.

3. Values regarding health are common across many cultures.

4. Ensure that clients values are congruent with nurses values.

Correct Answer: 1

Rationale 1: Personal values are shaped by culture. Perceptions of health, disease, prevention, and treatment may vary among different cultural groups. Acknowledging divergent values can be a significant first step toward improving ones cultural competence and sensitivity to differences. Health behaviors are multi-determined actions. The clients values do not have to be congruent with the nurses values. Health values vary across cultures.

Rationale 2: Personal values are shaped by culture. Perceptions of health, disease, prevention, and treatment may vary among different cultural groups. Acknowledging divergent values can be a significant first step toward improving ones cultural competence and sensitivity to differences. Health behaviors are multi-determined actions. The clients values do not have to be congruent with the nurses values. Health values vary across cultures.

Rationale 3: Personal values are shaped by culture. Perceptions of health, disease, prevention, and treatment may vary among different cultural groups. Acknowledging divergent values can be a significant first step toward improving ones cultural competence and sensitivity to differences. Health behaviors are multi-determined actions. The clients values do not have to be congruent with the nurses values. Health values vary across cultures.

Rationale 4: Personal values are shaped by culture. Perceptions of health, disease, prevention, and treatment may vary among different cultural groups. Acknowledging divergent values can be a significant first step toward improving ones cultural competence and sensitivity to differences. Health behaviors are multi-determined actions. The clients values do not have to be congruent with the nurses values. Health values vary across cultures.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: Explain what it means to be a culturally competent nurse.

Question 5

Type: MCSA

A nurse is asked to consult with the local domestic violence shelter. The shelter employees state that women of Hispanic descent do not use the services offered. An employee states, You know with all that Hispanic machismo you can bet that those women are probably being abused. The nurse recognizes that:

1. The agency should place flyers in the local schools.

2. The agency should advertise their services in the local newspaper.

3. The agency needs help to promote culturally competent values, policy, structures, and practices.

4. The agency should add a Spanish greeting on the agencys phone message.

Correct Answer: 3

Rationale 1: Agencies that acknowledge, accept, and work with cultural differences may be viewed as culturally competent, whereas those agencies that ignore culture when delivering services are viewed as culturally blind. There may be an increased risk of conflict in health care services when providers lack cultural sensitivity. Strategies to increase advertising and add a Spanish phone message should be targeted at the specific Hispanic cultural group as a part of a larger strategy.

Rationale 2: Agencies that acknowledge, accept, and work with cultural differences may be viewed as culturally competent, whereas those agencies that ignore culture when delivering services are viewed as culturally blind. There may be an increased risk of conflict in health care services when providers lack cultural sensitivity. Strategies to increase advertising and add a Spanish phone message should be targeted at the specific Hispanic cultural group as a part of a larger strategy.

Rationale 3: Agencies that acknowledge, accept, and work with cultural differences may be viewed as culturally competent, whereas those agencies that ignore culture when delivering services are viewed as culturally blind. There may be an increased risk of conflict in health care services when providers lack cultural sensitivity. Strategies to increase advertising and add a Spanish phone message should be targeted at the specific Hispanic cultural group as a part of a larger strategy.

Rationale 4: Agencies that acknowledge, accept, and work with cultural differences may be viewed as culturally competent, whereas those agencies that ignore culture when delivering services are viewed as culturally blind. There may be an increased risk of conflict in health care services when providers lack cultural sensitivity. Strategies to increase advertising and add a Spanish phone message should be targeted at the specific Hispanic cultural group as a part of a larger strategy.

Global Rationale:

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: Explain what it means to be a culturally competent nurse.

Question 6

Type: MCSA

Serving as a nurse advocate for culturally diverse clients means that the nurse:

1. Helps them make substantive changes in their health behavior.

2. Supports and defends their right to their medical beliefs and values.

3. Makes a decision about which beliefs are wrong and need radical adjustments.

4. Explains western medical concepts so they can better adapt.

Correct Answer: 2

Rationale 1: The nurse-as-culture-broker serves as a bridge between the client and the providers in the health care system by intervening to facilitate the acquisition of effective heath care. Providing explanations about western medical concepts or imposing the nurses values are not a form of advocacy.

Rationale 2: The nurse-as-culture-broker serves as a bridge between the client and the providers in the health care system by intervening to facilitate the acquisition of effective heath care. Providing explanations about western medical concepts or imposing the nurses values are not a form of advocacy.

Rationale 3: The nurse-as-culture-broker serves as a bridge between the client and the providers in the health care system by intervening to facilitate the acquisition of effective heath care. Providing explanations about western medical concepts or imposing the nurses values are not a form of advocacy.

Rationale 4: The nurse-as-culture-broker serves as a bridge between the client and the providers in the health care system by intervening to facilitate the acquisition of effective heath care. Providing explanations about western medical concepts or imposing the nurses values are not a form of advocacy.

Global Rationale:

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: Describe the role of the psychiatricmental health nurse as culture broker.

Question 7

Type: MCSA

A nurse is working at a health care clinic serving the needs of the homosexual community. A neighbor says the nurse must be brave because most of those people have AIDS. What would be the nurses best response?

1. Its okay because Im not intimate with any of the clients.

2. Thats an unfortunate stereotype. Can we talk about the reality?

3. Its very difficult for me when you discriminate like that.

4. Hey, its a job like any other job. All jobs have problems.

Correct Answer: 2

Rationale 1: It is the nurses role to promote the act of bridging, linking, or mediating between groups of people from different cultural systems to reduce conflict or produce change. Calling the neighbors comment discriminatory may increase conflict. Rationalizing or failing to confront the neighbors perceptions does not promote cultural brokering.

Rationale 2: It is the nurses role to promote the act of bridging, linking, or mediating between groups of people from different cultural systems to reduce conflict or produce change. Calling the neighbors comment discriminatory may increase conflict. Rationalizing or failing to confront the neighbors perceptions does not promote cultural brokering.

Rationale 3: It is the nurses role to promote the act of bridging, linking, or mediating between groups of people from different cultural systems to reduce conflict or produce change. Calling the neighbors comment discriminatory may increase conflict. Rationalizing or failing to confront the neighbors perceptions does not promote cultural brokering.

Rationale 4: It is the nurses role to promote the act of bridging, linking, or mediating between groups of people from different cultural systems to reduce conflict or produce change. Calling the neighbors comment discriminatory may increase conflict. Rationalizing or failing to confront the neighbors perceptions does not promote cultural brokering.

Global Rationale:

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: Describe the role of the psychiatricmental health nurse as culture broker.

Question 8

Type: MCSA

When assessing a client from a culture different from that of the nurse, which of the following is an effective approach to meet the goal of cultural sensitivity?

1. Ask the client how he or she is alienated from his or her primary cultural group.

2. Determine what aspects of the clients life should be preserved as they are.

3. Explain to the client that values must be adjusted to reach a healthy state.

4. Teach the client how to assimilate into the dominant culture.

Correct Answer: 2

Rationale 1: Cultural sensitivity is the process of increasing professional effectiveness through understanding, respecting, and appreciating the importance of cultural factors in the delivery of health services. Asking the client how he or she is alienated, teaching the client to assimilate, and explaining that the clients values have to be changed are ethnocentric strategies and not supportive.

Rationale 2: Cultural sensitivity is the process of increasing professional effectiveness through understanding, respecting, and appreciating the importance of cultural factors in the delivery of health services. Asking the client how he or she is alienated, teaching the client to assimilate, and explaining that the clients values have to be changed are ethnocentric strategies and not supportive.

Rationale 3: Cultural sensitivity is the process of increasing professional effectiveness through understanding, respecting, and appreciating the importance of cultural factors in the delivery of health services. Asking the client how he or she is alienated, teaching the client to assimilate, and explaining that the clients values have to be changed are ethnocentric strategies and not supportive.

Rationale 4: Cultural sensitivity is the process of increasing professional effectiveness through understanding, respecting, and appreciating the importance of cultural factors in the delivery of health services. Asking the client how he or she is alienated, teaching the client to assimilate, and explaining that the clients values have to be changed are ethnocentric strategies and not supportive.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: Describe the role of the psychiatricmental health nurse as culture broker.

Question 9

Type: MCSA

The nurse is caring for a client from a different cultural background. The client has difficulty expressing beliefs about the treatment plan to the physician. Which nursing action would be most appropriate for this client?

1. The nurse should act as the cultural broker to bridge the gap between the client and the physician.

2. The nurse should encourage the client to speak up when the physician is present.

3. The nurse should encourage the client to accept the plan of care as ordered.

4. The nurse should encourage the client to discuss concerns with the clients spouse so that the spouse can tell the physician.

Correct Answer: 1

Rationale 1: A conflict may arise when there are differences in values, beliefs, or behaviors between a client and provider concerning the appropriateness and feasibility of a treatment plan. The nurse can facilitate bridging this gap between the client and the physician. Encouraging the client to speak up, accept the plan of care, or have a spouse act on the clients behalf are strategies that do not address the clients needs.

Rationale 2: A conflict may arise when there are differences in values, beliefs, or behaviors between a client and provider concerning the appropriateness and feasibility of a treatment plan. The nurse can facilitate bridging this gap between the client and the physician. Encouraging the client to speak up, accept the plan of care, or have a spouse act on the clients behalf are strategies that do not address the clients needs.

Rationale 3: A conflict may arise when there are differences in values, beliefs, or behaviors between a client and provider concerning the appropriateness and feasibility of a treatment plan. The nurse can facilitate bridging this gap between the client and the physician. Encouraging the client to speak up, accept the plan of care, or have a spouse act on the clients behalf are strategies that do not address the clients needs.

Rationale 4: A conflict may arise when there are differences in values, beliefs, or behaviors between a client and provider concerning the appropriateness and feasibility of a treatment plan. The nurse can facilitate bridging this gap between the client and the physician. Encouraging the client to speak up, accept the plan of care, or have a spouse act on the clients behalf are strategies that do not address the clients needs.

Global Rationale:

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: Describe the role of the psychiatricmental health nurse as culture broker.

Question 10

Type: MCSA

A mental health client is admitted to the psychiatric unit one month after abdominal surgery. During the initial assessment, the nurse asks the client about pain. In order to provide culturally competent care, the nurse should not:

1. Acknowledge that each client holds various beliefs about pain.

2. Abstain from stereotyping a clients pain responses based on the persons culture.

3. Assume that all clients will verbally express their pain and ask for medication.

4. Respect the clients right to react to pain in whatever manner desired.

Correct Answer: 3

Rationale 1: The nurse should not assume that all clients will verbalize pain and ask for medications. The nurse will provide culturally competent care by acknowledging differences in pain expression, accepting the manner in which clients will express pain, and abstaining from stereotyping a clients pain responses based on the persons culture.

Rationale 2: The nurse should not assume that all clients will verbalize pain and ask for medications. The nurse will provide culturally competent care by acknowledging differences in pain expression, accepting the manner in which clients will express pain, and abstaining from stereotyping a clients pain responses based on the persons culture.

Rationale 3: The nurse should not assume that all clients will verbalize pain and ask for medications. The nurse will provide culturally competent care by acknowledging differences in pain expression, accepting the manner in which clients will express pain, and abstaining from stereotyping a clients pain responses based on the persons culture.

Rationale 4: The nurse should not assume that all clients will verbalize pain and ask for medications. The nurse will provide culturally competent care by acknowledging differences in pain expression, accepting the manner in which clients will express pain, and abstaining from stereotyping a clients pain responses based on the persons culture.

Global Rationale:

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: Describe the role of the psychiatricmental health nurse as culture broker.

Question 11

Type: MCSA

The nurse makes certain that a client who is Catholic is able to attend Mass on Sunday. The nurse has determined the clients religious practices from the assessment. This is an example of:

1. Ethnocentrism.

2. Cultural blindness.

3. Culturally competent care.

4. Differential treatment based on spiritual beliefs.

Correct Answer: 3

Rationale 1: The nurse has increased competence through the skilled use of the nursing assessment to deliver care that is culturally appropriate. The care provided has been individualized based on the clients assessment. Clients would receive care based on their own spiritual needs. Ethnocentrism is the belief that ones own cultural values are superior and preferable to any other cultural group. Cultural blindness would occur if the nurse did not consider the clients individual differences in the plan of care.

Rationale 2: The nurse has increased competence through the skilled use of the nursing assessment to deliver care that is culturally appropriate. The care provided has been individualized based on the clients assessment. Clients would receive care based on their own spiritual needs. Ethnocentrism is the belief that ones own cultural values are superior and preferable to any other cultural group. Cultural blindness would occur if the nurse did not consider the clients individual differences in the plan of care.

Rationale 3: The nurse has increased competence through the skilled use of the nursing assessment to deliver care that is culturally appropriate. The care provided has been individualized based on the clients assessment. Clients would receive care based on their own spiritual needs. Ethnocentrism is the belief that ones own cultural values are superior and preferable to any other cultural group. Cultural blindness would occur if the nurse did not consider the clients individual differences in the plan of care.

Rationale 4: The nurse has increased competence through the skilled use of the nursing assessment to deliver care that is culturally appropriate. The care provided has been individualized based on the clients assessment. Clients would receive care based on their own spiritual needs. Ethnocentrism is the belief that ones own cultural values are superior and preferable to any other cultural group. Cultural blindness would occur if the nurse did not consider the clients individual differences in the plan of care.

Global Rationale:

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: Incorporate the strategies discussed here in your work with specific cultural groups.

Question 12

Type: MCSA

A nurse interviews a Chinese client who has been given a diagnosis of schizophrenia. The family is present during the interview. Which cultural values should the nurse consider as she prepares to interact with the client and family?

1. Talking circles

2. Medicine men

3. Fatalism

4. Kinship solidarity

Correct Answer: 4

Rationale 1: The nurse should be aware that kinship solidarity might be a prominent cultural value among Asians. Kinship solidarity refers to the belief that an individual is subservient to the family or kinship-based group. Thus, separation from family members may be stressful. Talking circles and medicine men are part of Native American cultural beliefs. Fatalism is the belief held by some Hispanic groups that individuals could not control their own health.

Rationale 2: The nurse should be aware that kinship solidarity might be a prominent cultural value among Asians. Kinship solidarity refers to the belief that an individual is subservient to the family or kinship-based group. Thus, separation from family members may be stressful. Talking circles and medicine men are part of Native American cultural beliefs. Fatalism is the belief held by some Hispanic groups that individuals could not control their own health.

Rationale 3: The nurse should be aware that kinship solidarity might be a prominent cultural value among Asians. Kinship solidarity refers to the belief that an individual is subservient to the family or kinship-based group. Thus, separation from family members may be stressful. Talking circles and medicine men are part of Native American cultural beliefs. Fatalism is the belief held by some Hispanic groups that individuals could not control their own health.

Rationale 4: The nurse should be aware that kinship solidarity might be a prominent cultural value among Asians. Kinship solidarity refers to the belief that an individual is subservient to the family or kinship-based group. Thus, separation from family members may be stressful. Talking circles and medicine men are part of Native American cultural beliefs. Fatalism is the belief held by some Hispanic groups that individuals could not control their own health.

Global Rationale:

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: Incorporate the strategies discussed here in your work with specific cultural groups.

Question 13

Type: MCSA

The nurse is taking the history of a psychiatric client who is of Puerto Rican descent. Which assessment question would evaluate for the presence of fatalism?

1. When was your last hospitalization?

2. How do you manage your health?

3. Who accompanied you to the hospital?

4. Are you experiencing problems getting to the doctor?

Correct Answer: 2

Rationale 1: Fatalism is the belief that an individual cannot control ones health. Asking who accompanied the client to the hospital assesses support systems. Asking about the last hospitalization assesses health history. Asking if the client experiences any problems getting to the doctor addresses barriers to accessing health care.

Rationale 2: Fatalism is the belief that an individual cannot control ones health. Asking who accompanied the client to the hospital assesses support systems. Asking about the last hospitalization assesses health history. Asking if the client experiences any problems getting to the doctor addresses barriers to accessing health care.

Rationale 3: Fatalism is the belief that an individual cannot control ones health. Asking who accompanied the client to the hospital assesses support systems. Asking about the last hospitalization assesses health history. Asking if the client experiences any problems getting to the doctor addresses barriers to accessing health care.

Rationale 4: Fatalism is the belief that an individual cannot control ones health. Asking who accompanied the client to the hospital assesses support systems. Asking about the last hospitalization assesses health history. Asking if the client experiences any problems getting to the doctor addresses barriers to accessing health care.

Global Rationale:

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: Incorporate the strategies discussed here in your work with specific cultural groups.

Question 14

Type: MCSA

Which of the following nurses exhibits cultural sensitivity?

1. The nurse who learns a second language and attends cultural events to increase his or her awareness.

2. The nurse who feels comfortable allowing the Muslim client to pray only once during the day.

3. The nurse who develops a knitting group for clients.

4. The nurse who develops a teaching group titled Antioxidants for Life.

Correct Answer: 1

Rationale 1: The nurse who attends cultural events and is learning a second language is working at increasing his or her awareness and openness to other cultures. The nurse who is only comfortable letting the Muslim client pray once per day is exhibiting cultural blindness. The nurses who develop the knitting group and the nutrition group are providing care that can be generalized to all clients.

Rationale 2: The nurse who attends cultural events and is learning a second language is working at increasing his or her awareness and openness to other cultures. The nurse who is only comfortable letting the Muslim client pray once per day is exhibiting cultural blindness. The nurses who develop the knitting group and the nutrition group are providing care that can be generalized to all clients.

Rationale 3: The nurse who attends cultural events and is learning a second language is working at increasing his or her awareness and openness to other cultures. The nurse who is only comfortable letting the Muslim client pray once per day is exhibiting cultural blindness. The nurses who develop the knitting group and the nutrition group are providing care that can be generalized to all clients.

Rationale 4: The nurse who attends cultural events and is learning a second language is working at increasing his or her awareness and openness to other cultures. The nurse who is only comfortable letting the Muslim client pray once per day is exhibiting cultural blindness. The nurses who develop the knitting group and the nutrition group are providing care that can be generalized to all clients.

Global Rationale:

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: Incorporate the strategies discussed here in your work with specific cultural groups.

Question 15

Type: MCSA

A nurse is meeting with a Cuban family in which the wife abuses alcohol. During the family assessment meeting, the nurse observes that the husband speaks for the wife and other family members when the nurse is directing questions towards them. The husband says, I am responsible for my family. What cultural values should the nurse consider when planning care for this client?

1. Health care decisions will involve the entire family.

2. Health care decisions may be made by the husband.

3. Health care decisions may have to be made when the clients husband is not present.

4. Health care decisions will involve the wife only.

Correct Answer: 2

Rationale 1: In some Hispanic families, health care decisions may involve the head of the household who decides what is best for the family. If decisions are made without the husbands knowledge and input, it is doubtful that they will succeed.

Rationale 2: In some Hispanic families, health care decisions may involve the head of the household who decides what is best for the family. If decisions are made without the husbands knowledge and input, it is doubtful that they will succeed.

Rationale 3: In some Hispanic families, health care decisions may involve the head of the household who decides what is best for the family. If decisions are made without the husbands knowledge and input, it is doubtful that they will succeed.

Rationale 4: In some Hispanic families, health care decisions may involve the head of the household who decides what is best for the family. If decisions are made without the husbands knowledge and input, it is doubtful that they will succeed.

Global Rationale:

Cognitive Level: Applying

Client Need: Health Promotion and Maintenance

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: Learning Outcome 09-3: [

Question 16

Type: MCSA

In the aftermath of Hurricane Katrina, many individuals presented with signs and symptoms of post-traumatic stress disorder. Of what type of risk factor is this an example?

1. Ethnicity

2. Socioeconomic status

3. Social environment

4. Gender

Correct Answer: 3

Rationale 1: Higher levels of stress associated with particular events in ones social environment may be associated with increased rates of mental disorder. Individuals of varying ethnicity, both genders, and all socioeconomic statuses were all affected by the hurricane.

Rationale 2: Higher levels of stress associated with particular events in ones social environment may be associated with increased rates of mental disorder. Individuals of varying ethnicity, both genders, and all socioeconomic statuses were all affected by the hurricane.

Rationale 3: Higher levels of stress associated with particular events in ones social environment may be associated with increased rates of mental disorder. Individuals of varying ethnicity, both genders, and all socioeconomic statuses were all affected by the hurricane.

Rationale 4: Higher levels of stress associated with particular events in ones social environment may be associated with increased rates of mental disorder. Individuals of varying ethnicity, both genders, and all socioeconomic statuses were all affected by the hurricane.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: Identify the risk factors associated with mental disorders that affect the experience, expression, reporting, and evaluation of mental disorders among culturally diverse groups.

Question 17

Type: MCSA

A 40-year-old client was brought to the emergency room after a motor vehicle accident. The client had been drinking alcohol and the clients blood alcohol level was 0.12 g/dl. The client reports a family history of alcoholism and tells the nurse, It is hopeless; I am a drunk just like the rest of my family. The nurse knows that the clients risk for alcohol abuse:

1. Will determine the clients response to treatment.

2. Can be modified through abstinence and behavior change.

3. Is high based on the clients age.

4. Is low based on the clients alcohol level.

Correct Answer: 2

Rationale 1: Evidence points to a genetic vulnerability for developing alcoholism, but the use of alcohol is a risk factor susceptible to change. It is not possible to determine the clients response to treatment. The clients age and blood alcohol level do not have an impact on the risk for alcohol use.

Rationale 2: Evidence points to a genetic vulnerability for developing alcoholism, but the use of alcohol is a risk factor susceptible to change. It is not possible to determine the clients response to treatment. The clients age and blood alcohol level do not have an impact on the risk for alcohol use.

Rationale 3: Evidence points to a genetic vulnerability for developing alcoholism, but the use of alcohol is a risk factor susceptible to change. It is not possible to determine the clients response to treatment. The clients age and blood alcohol level do not have an impact on the risk for alcohol use.

Rationale 4: Evidence points to a genetic vulnerability for developing alcoholism, but the use of alcohol is a risk factor susceptible to change. It is not possible to determine the clients response to treatment. The clients age and blood alcohol level do not have an impact on the risk for alcohol use.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: Identify the risk factors associated with mental disorders that affect the experience, expression, reporting, and evaluation of mental disorders among culturally diverse groups.

Question 18

Type: MCSA

A 19-year-old Native American client is admitted with a diagnosis of major depression with suicidal ideation. What assessment is made?

1. The client is at high risk for suicide.

2. The client will benefit from a talking circle.

3. The client will need a single room.

4. The client will need a medicine man.

Correct Answer: 1

Rationale 1: Native American youth have an increased risk for suicide when compared to other cultural groups. There is nothing to suggest that the client will need a single room. Assuming that the client will need a medicine man or benefit from a talking circle relies on stereotyped generalizations about Native American clients.

Rationale 2: Native American youth have an increased risk for suicide when compared to other cultural groups. There is nothing to suggest that the client will need a single room. Assuming that the client will need a medicine man or benefit from a talking circle relies on stereotyped generalizations about Native American clients.

Rationale 3: Native American youth have an increased risk for suicide when compared to other cultural groups. There is nothing to suggest that the client will need a single room. Assuming that the client will need a medicine man or benefit from a talking circle relies on stereotyped generalizations about Native American clients.

Rationale 4: Native American youth have an increased risk for suicide when compared to other cultural groups. There is nothing to suggest that the client will need a single room. Assuming that the client will need a medicine man or benefit from a talking circle relies on stereotyped generalizations about Native American clients.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: Identify the risk factors associated with mental disorders that affect the experience, expression, reporting, and evaluation of mental disorders among culturally diverse groups.

Question 19

Type: MCSA

A client with a history of alcohol dependence is discharged with nutritional recommendations to increase the intake of vitamin B foods and thiamine. The client states, I cant eat this stuff. This food isnt fit for real people. Which factor does the nurse recognize was not incorporated into the plan of care?

1. Age

2. Social environment

3. Marital status

4. Lifestyle habits

Correct Answer: 4

Rationale 1: Dietary practices are lifestyle habits that will influence the clients ability to adhere to the treatment plan. Marital status or social environment may or may not influence if the client adheres to the dietary recommendations. Age should not influence the clients ability to adhere to the dietary recommendations.

Rationale 2: Dietary practices are lifestyle habits that will influence the clients ability to adhere to the treatment plan. Marital status or social environment may or may not influence if the client adheres to the dietary recommendations. Age should not influence the clients ability to adhere to the dietary recommendations.

Rationale 3: Dietary practices are lifestyle habits that will influence the clients ability to adhere to the treatment plan. Marital status or social environment may or may not influence if the client adheres to the dietary recommendations. Age should not influence the clients ability to adhere to the dietary recommendations.

Rationale 4: Dietary practices are lifestyle habits that will influence the clients ability to adhere to the treatment plan. Marital status or social environment may or may not influence if the client adheres to the dietary recommendations. Age should not influence the clients ability to adhere to the dietary recommendations.

Global Rationale:

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: Identify the risk factors associated with mental disorders that affect the experience, expression, reporting, and evaluation of mental disorders among culturally diverse groups.

Question 20

Type: MCSA

Clients who experience sexual assault often experience increased rates of mental disorder. Which risk factor would apply to a client who was sexually assaulted?

1. Physical environment

2. Social environment

3. Social class

4. Ethnicity

Correct Answer: 2

Rationale 1: Higher levels of stress associated with particular events in ones social environment are associated with an increased chance or probability of mental disorder. A traumatic event, such as sexual assault, may produce adverse mental health consequences. Ethnicity, the physical environment, and social class are risk factors not associated with sexual assault.

Rationale 2: Higher levels of stress associated with particular events in ones social environment are associated with an increased chance or probability of mental disorder. A traumatic event, such as sexual assault, may produce adverse mental health consequences. Ethnicity, the physical environment, and social class are risk factors not associated with sexual assault.

Rationale 3: Higher levels of stress associated with particular events in ones social environment are associated with an increased chance or probability of mental disorder. A traumatic event, such as sexual assault, may produce adverse mental health consequences. Ethnicity, the physical environment, and social class are risk factors not associated with sexual assault.

Rationale 4: Higher levels of stress associated with particular events in ones social environment are associated with an increased chance or probability of mental disorder. A traumatic event, such as sexual assault, may produce adverse mental health consequences. Ethnicity, the physical environment, and social class are risk factors not associated with sexual assault.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: Identify the risk factors associated with mental disorders that affect the experience, expression, reporting, and evaluation of mental disorders among culturally diverse groups.

Question 21

Type: MCSA

The nurse educator knows that one strategy to integrate cultural diversity in nursing is to:

1. Retain students from one cultural background.

2. Work within monocultural frameworks.

3. Recruit and mentor nursing students from diverse cultures.

4. Attract students from other disciplines to nursing.

Correct Answer: 3

Rationale 1: Schools of nursing need to integrate content that emphasizes cultural diversity. Educators need to work within multicultural and multidisciplinary frameworks to tackle issues in the real world. Yet, recruitment and retention of students from diverse cultures continue to be problems in schools of nursing. Nursing faculty can recruit and mentor students from diverse cultures to serve as clinicians, managers, faculty, and leaders who can then serve as role models for other students. One way to attract and educate a diverse student group is to practice diversity in faculty recruitment.

Rationale 2: Schools of nursing need to integrate content that emphasizes cultural diversity. Educators need to work within multicultural and multidisciplinary frameworks to tackle issues in the real world. Yet, recruitment and retention of students from diverse cultures continue to be problems in schools of nursing. Nursing faculty can recruit and mentor students from diverse cultures to serve as clinicians, managers, faculty, and leaders who can then serve as role models for other students. One way to attract and educate a diverse student group is to practice diversity in faculty recruitment.

Rationale 3: Schools of nursing need to integrate content that emphasizes cultural diversity. Educators need to work within multicultural and multidisciplinary frameworks to tackle issues in the real world. Yet, recruitment and retention of students from diverse cultures continue to be problems in schools of nursing. Nursing faculty can recruit and mentor students from diverse cultures to serve as clinicians, managers, faculty, and leaders who can then serve as role models for other students. One way to attract and educate a diverse student group is to practice diversity in faculty recruitment.

Rationale 4: Schools of nursing need to integrate content that emphasizes cultural diversity. Educators need to work within multicultural and multidisciplinary frameworks to tackle issues in the real world. Yet, recruitment and retention of students from diverse cultures continue to be problems in schools of nursing. Nursing faculty can recruit and mentor students from diverse cultures to serve as clinicians, managers, faculty, and leaders who can then serve as role models for other students. One way to attract and educate a diverse student group is to practice diversity in faculty recruitment.

Global Rationale:

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: Apply personal strategies for developing, knowledge, motivation, and skills that can improve your intercultural competence.

Question 22

Type: MCSA

When focusing on developing new theories in nursing, what is most important for nurses to know?

1. Recognize that most theories cannot be modified.

2. Research helps with behavioral observation in multicultural groups.

3. Most people with mental disorders never seek professional treatment.

4. Acknowledge vulnerability of the mental health community.

Correct Answer: 2

Rationale 1: Nursing research may define what knowledge is meaningful for a particular multicultural group. Through research, nurses can become informed regarding which interventions might be useful in specific community-based programs. Research may contribute to the development of more inclusive theories to account for behaviors observed in multicultural groups.

Rationale 2: Nursing research may define what knowledge is meaningful for a particular multicultural group. Through research, nurses can become informed regarding which interventions might be useful in specific community-based programs. Research may contribute to the development of more inclusive theories to account for behaviors observed in multicultural groups.

Rationale 3: Nursing research may define what knowledge is meaningful for a particular multicultural group. Through research, nurses can become informed regarding which interventions might be useful in specific community-based programs. Research may contribute to the development of more inclusive theories to account for behaviors observed in multicultural groups.

Rationale 4: Nursing research may define what knowledge is meaningful for a particular multicultural group. Through research, nurses can become informed regarding which interventions might be useful in specific community-based programs. Research may contribute to the development of more inclusive theories to account for behaviors observed in multicultural groups.

Global Rationale:

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: Apply personal strategies for developing, knowledge, motivation, and skills that can improve your intercultural competence.

Question 23

Type: MCSA

The nurse who wants to actively and effectively work with culturally diverse clients will:

1. Seek out homeless people.

2. Avoid global mental health issues.

3. Seek out practicing nurses of a particular cultural background and read transcendental awareness journals.

Correct Answer: 3

Rationale 1: Nursing competencies must include the ability to actively and effectively work with culturally diverse clients. Look for opportunities for meaningful dialogue and relationship building across cultures. You may seek out practicing nurses of a particular cultural background to serve as resource consultants. You may mentor nurse colleagues from other cultures who work in your setting. You may read transcultural journals (e.g.,Journal of Transcultural Nursing, Journal of Cultural Diversity, etc.) to familiarize yourself with critical culture-based issues and opportunities, and develop and expand your psychiatricmental health nursing practice by continuing to familiarize yourself with global mental health issues.

Rationale 2: Nursing competencies must include the ability to actively and effectively work with culturally diverse clients. Look for opportunities for meaningful dialogue and relationship building across cultures. You may seek out practicing nurses of a particular cultural background to serve as resource consultants. You may mentor nurse colleagues from other cultures who work in your setting. You may read transcultural journals (e.g.,Journal of Transcultural Nursing, Journal of Cultural Diversity, etc.) to familiarize yourself with critical culture-based issues and opportunities, and develop and expand your psychiatricmental health nursing practice by continuing to familiarize yourself with global mental health issues.

Rationale 3: Nursing competencies must include the ability to actively and effectively work with culturally diverse clients. Look for opportunities for meaningful dialogue and relationship building across cultures. You may seek out practicing nurses of a particular cultural background to serve as resource consultants. You may mentor nurse colleagues from other cultures who work in your setting. You may read transcultural journals (e.g.,Journal of Transcultural Nursing, Journal of Cultural Diversity, etc.) to familiarize yourself with critical culture-based issues and opportunities, and develop and expand your psychiatricmental health nursing practice by continuing to familiarize yourself with global mental health issues.

Global Rationale:

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: Apply personal strategies for developing, knowledge, motivation, and skills that can improve your intercultural competence.

Question 24

Type: MCSA

The nurse advocating for culturally diverse issues knows that cultural competence and sensitivity is based on:

1. Uniformity training.

2. Life experiences.

3. Client assessment.

4. New knowledge.

Correct Answer: 4

Rationale 1: Nurses need to make a conscious decision to acknowledge and value the diversity in others. Developing cultural competence and sensitivity needed for comprehensive care is based on new knowledge, personal self-assessment, supervised practice, mentoring experiences, experience in culturally diverse clinical practice settings, participation in discussions, and diversity training.

Rationale 2: Nurses need to make a conscious decision to acknowledge and value the diversity in others. Developing cultural competence and sensitivity needed for comprehensive care is based on new knowledge, personal self-assessment, supervised practice, mentoring experiences, experience in culturally diverse clinical practice settings, participation in discussions, and diversity training.

Rationale 3: Nurses need to make a conscious decision to acknowledge and value the diversity in others. Developing cultural competence and sensitivity needed for comprehensive care is based on new knowledge, personal self-assessment, supervised practice, mentoring experiences, experience in culturally diverse clinical practice settings, participation in discussions, and diversity training.

Rationale 4: Nurses need to make a conscious decision to acknowledge and value the diversity in others. Developing cultural competence and sensitivity needed for comprehensive care is based on new knowledge, personal self-assessment, supervised practice, mentoring experiences, experience in culturally diverse clinical practice settings, participation in discussions, and diversity training.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: Apply personal strategies for developing, knowledge, motivation, and skills that can improve your intercultural competence.

Question 25

Type: MCSA

The nursing student knows that in order to avoid conflict with cultural diverse populations:

1. Open discussion is necessary to actively address suspicions and distortions.

2. Exclude the offending party so communication flows better.

3. Take into account most minorities are working people.

4. Become a certified transcultural nurse.

Correct Answer: 1

Rationale 1: Make every attempt to openly discuss cultural conflicts in order to actively address suspicions and distortions. Avoiding conflict may result in chronic strained communication, insensitivity, and exclusion that thwart culturally competent care. Recognize the importance of fostering transcultural communication with other health care providers, and take into account the presence of a multicultural workforce.

Rationale 2: Make every attempt to openly discuss cultural conflicts in order to actively address suspicions and distortions. Avoiding conflict may result in chronic strained communication, insensitivity, and exclusion that thwart culturally competent care. Recognize the importance of fostering transcultural communication with other health care providers, and take into account the presence of a multicultural workforce.

Rationale 3: Make every attempt to openly discuss cultural conflicts in order to actively address suspicions and distortions. Avoiding conflict may result in chronic strained communication, insensitivity, and exclusion that thwart culturally competent care. Recognize the importance of fostering transcultural communication with other health care providers, and take into account the presence of a multicultural workforce.

Rationale 4: Make every attempt to openly discuss cultural conflicts in order to actively address suspicions and distortions. Avoiding conflict may result in chronic strained communication, insensitivity, and exclusion that thwart culturally competent care. Recognize the importance of fostering transcultural communication with other health care providers, and take into account the presence of a multicultural workforce.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: Apply personal strategies for developing, knowledge, motivation, and skills that can improve your intercultural competence.

Kneisl, Contemporary Psychiatric-Mental Health Nursing, 3/e Test Bank

Copyright 2012 by Pearson Education, Inc.

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