Ignatavicius: Medical-Surgical Nursing, 6th Edition

Chapter 4: Cultural Aspects of Health and Illness est !an" M#$ I%$E CH&ICE 1. The nurse is caring for a client of another culture. Which of the following would be the priority intervention of the nurse that would demonstrate an understanding of the need for cultural competence? a Avoid assuming that members of the same culture all share the same beliefs and . values. b Develop an understanding of your own cultural heritage, feelings, and . experiences. c ecome bilingual to communicate effectively with the population of clients . served. d Develop an understanding of the religious beliefs of clients served by the nurse. . A!"# ecoming culturally competent first re$uires you to examine your feelings and experiences regarding diversity, starting with an understanding of your own heritage. %eneral assumptions about cultural groups are similar to stereotyping and should be avoided. &t is difficult to become fluent in many languages, because the area in which the nurse wor's may serve many different populations. After examining your own views, you(ll need to learn more about specific cultural differences so that you can develop an appreciation for the values and beliefs of clients and co)wor'ers. D&*# 0 1# T03# 6"+# +ognitive ,evel# Application -.*# !/A for Application and above ,earning 0utcome 2 +lient !eeds +ategory# 3sychosocial &ntegrity 4+ultural Diversity5 &ntegrated 3rocess# +aring

7. The nurse is developing a teaching plan on cultural sensitivity for his colleagues who are caring for clients from other cultures. What intervention might a client of another culture interpret as culturally insensitive? a The nurse ma'es sure that the Arab female client is covered during assessment. . b The nurse avoids ma'ing direct eye contact with the male American &ndian client. . c The nurse does not encourage the 1apanese)American client to express feelings . openly. d The nurse hugs an .gyptian)American female client who has received bad news. .

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A!"# D The nurse should avoid physical touch with clients of cultures other than his or her own because touch by strangers may be unacceptable, even in stressful situations. &t is always acceptable practice to ma'e sure that clients are completely covered when providing care and carrying out assessment. Although eye contact in American culture is a positive communication techni$ue, it is viewed as disrespectful in other cultures. &f a client is from another culture, it is good practice to research how he or she might respond to a specific intervention before implementation. D&*# 0 1# T03# 6"+# +ognitive ,evel# Application -.*# !/A for Application and above ,earning 0utcome 2 +lient !eeds +ategory# 3sychosocial &ntegrity 4+ultural Diversity5 &ntegrated 3rocess# +aring

2. A 6exican)American client is insistent that her family members stay with her in her hospital room while she is recovering from surgery. What will be the priority action of the nurse? a .xplain the policy of the hospital regarding visitors. . b As' the "panish)spea'ing chaplain to assist in explaining why this is . unacceptable. c Arrange for additional cots to accommodate family members( overnight stay. . d !otify the physician of the client(s anxiety and suggest a prescription. . A!"# + &f a client as's that family members stay, the nurse should facilitate this process by ma'ing arrangements and notifying administration. Although it is important for visitors to understand hospital policies, it is possible that the administration will be willing to change policies, within reason, to meet client needs. &t is always acceptable to arrange for interpreters if there is difficulty communicating with a multicultural client in her or his language. ;owever, in this case, the chaplain does not have to explain why it is unacceptable, because the re$uest is within reason. The physician can be notified that the client is upset, but if allowing the family to stay decreases the client(s anxiety, then antianxiety medication is usually not necessary. D&*# 0 1# T03# 6"+# +ognitive ,evel# Application -.*# !/A for Application and above ,earning 0utcomes 7, < +lient !eeds +ategory# 3sychosocial &ntegrity 4+ultural Diversity5 &ntegrated 3rocess# +aring

<. A nurse is caring for a lesbian client. What is a priority assessment $uestion for this client? a =When did you last have a complete physical examination?>

.lsevier items and derived items 8 7919, 799:, 7997 by "aunders, an imprint of .lsevier &nc.

Test an' . b =;ow much alcohol do you consume?> . c =Do you smo'e?> . d =Do you use recreational drugs?> .

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A!"# A ecause there is a higher incidence of at)ris' behavior in this population, it is important that the nurse find out about health care screening practices. The other $uestions could be as'ed at a later date if additional teaching is needed. D&*# 0 1# T03# 6"+# +ognitive ,evel# Application -.*# !/A for Application and above ,earning 0utcomes ?, @ +lient !eeds +ategory# 3sychosocial &ntegrity 4+ultural Diversity5 &ntegrated 3rocess# +aring

?. The nurse is providing discharge instructions regarding medications to an older adult client who has expressed concerns about paying the hospital bills. What will the nurse emphasiAe based on best cultural practice? a The client should be prepared to show the nurse how he fills his daily pill planner . at his next appointment. b The client should 'eep a daily diary of side effects being experienced from his . medication, as well how he is coping. c The client must adhere to his medication regimen, unless the cost becomes . prohibitive. d The client should as' his pharmacist for the generic version of his medication to . 'eep costs at a minimum. A!"# D 0lder adults may be less li'ely to follow the prescribed therapy because of drug costs when compared with younger adults. D&*# 0 1# T03# 6"+# +ognitive ,evel# Application -.*# !/A for Application and above ,earning 0utcomes :, B +lient !eeds +ategory# 3sychosocial &ntegrity 4+oping 6echanisms5 &ntegrated 3rocess# +aring

:. The nurse is preparing a class on cultural competence for members of her community. Which definition of cultural competence is most accurate, according to the C.". Department of ;ealth and ;uman "ervices? a The ability of health care providers and organiAations to understand and respond . effectively to the cultural and linguistic needs that clients bring to the health care

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Test an' setting b The commitment made by a health care organiAation to provide $uality care to all . clients, regardless of race, religion, national origin, or economic status c The recognition of a body of learned beliefs, traditions, and guides for behavior . that are shared among members of a particular group d The setting aside of a health care professionalDs own cultural beliefs to embrace or . adopt those of a different cultural group

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A!"# A &n 7999, the C.". Department of ;ealth and ;uman "ervices 4D;;"5 developed a widely recogniAed definition of cultural competence as =the ability of health care providers and organiAations to understand and respond effectively to the cultural and linguistic needs that clients bring to the health care setting.> D&*# 0 1# T03# 6"+# +ognitive ,evel# +omprehension -.*# p. 7B ,earning 0utcome 2 +lient !eeds +ategory# 3sychosocial &ntegrity 4+ultural Diversity5 &ntegrated 3rocess# +aring

E. What can health care institutions do to assist in meeting the cultural goals of Healthy People 2010? a .nsure accurate recording of a clientDs race and/or ethnicity in the medical record. . b ;ire physicians and nurses from culturally diverse bac'grounds. . c 3rovide magaAines written in more than one language in waiting areas of clinics. . d Translate human immune deficiency virus 4;&F5 and ac$uired immune . deficiency syndrome 4A&D"5 prevention guidelines into multiple literacy and language forms. A!"# D A goal of Healthy People 2010 is to eliminate the disparities of health status experienced by racial and ethnic minorities in the areas of cancer screening and management, cardiovascular disease, diabetes, and ;&F)A&D". 0nly the action of translating ;&F prevention guidelines into multiple literacy and language forms would assist in meeting this goal. The other actions only demonstrate sensitivity to cultural differences. D&*# +ognitive ,evel# +omprehension -.*# p. 7B 0 1# ,earning 0utcome 1 T03# +lient !eeds +ategory# ;ealth 3romotion and 6aintenance 43rinciples of Teaching/,earning5 6"+# &ntegrated 3rocess# +aring

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Test an' B. The nurse is interacting for the first time with a new home health client. What information obtained by observation is considered part of cultural assessment? a The client as's the nurse how to obtain assistance with his utility bills. . b The client(s wife reports that the children are having difficulty in school. . c The client tells the nurse that he or she would li'e to move into public housing. . d The client(s wife corrects the husbandDs response to $uestions about his parents. .

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A!"# D The interaction among family members can give important clues to culture and cultural influence. &n many cultures, the husband is the authority of the household and wives do not express opinions or $uestion the validity of the husbandDs statements. D&*# 0 1# T03# 6"+# +ognitive ,evel# Application -.*# !/A for Application and above ,earning 0utcome < +lient !eeds +ategory# 3sychosocial &ntegrity 4*amily Dynamics5 &ntegrated 3rocess# +aring

@. The client states, =& cannot receive blood transfusions, because it is against my beliefs. & am concerned about having this surgery.> What is the nurse(s best response? a =Gou should allow the health care professionals to do whatever is needed to save . your life.> b =&f you are worried about contamination, the blood supply in this country is the . safest in the world.> c =There really is nothing unacceptable about blood transfusion.> . d =There are good alternatives to transfusions if you should lose an excessive . amount of blood.> A!"# D The clientDs rights and wishes should be respected while providing accurate information for reassurance. &n this case, stating that there are alternatives to transfusions is the best response. The health care provider should not attempt to persuade the client to go against his or her wishes or religious beliefs. .ven though the blood supply is safe, the nurse should realiAe while wor'ing with the client that this is not the issue. The nurse should also not try to change the client(s views or practices. D&*# +ognitive ,evel# Application -.*# !/A for Application and above 0 1# ,earning 0utcome < T03# +lient !eeds +ategory# 3sychosocial &ntegrity 4-eligious and "piritual &nfluences on ;ealth5 6"+# &ntegrated 3rocess# +aring

.lsevier items and derived items 8 7919, 799:, 7997 by "aunders, an imprint of .lsevier &nc.

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19. Which of the following methods of cultural assessment will provide long)term understanding of a particular culture? a &nterviewing a client . b 0bservation of a group . c 3articipation in the community . d Fisitation of a group of clients . A!"# + 3articipating in a community that has a large number of members from a particular culture provides insight into the particular cultural group as a whole, rather than from an individual point of view. The nurse can learn about issues such as the buying and social habits of the group and its political views. D&*# 0 1# T03# 6"+# +ognitive ,evel# +omprehension -.*# p. 7B ,earning 0utcome < +lient !eeds +ategory# 3sychosocial &ntegrity 4+ultural Diversity5 &ntegrated 3rocess# +aring

11. The client expresses distress over missing religious services while in the hospital. What is the nurse(s best action? a Tell the client that he or she shouldn(t worry about it right now. . b As' the client(s spouse or family member to pray with the client. . c As' the hospital(s professional chaplain to tal' to the client and help you manage . the client(s distress. d .ncourage the client to reschedule procedures for another day. . A!"# + When the client is experiencing spiritual distress, it is best for the nurse to collaborate with the professional chaplain in managing the client(s religious concerns. The client(s family may also help ease spiritual distress, but it is hard to plan for this without 'nowing the family extremely well. D&*# +ognitive ,evel# Application -.*# !/A for Application and above 0 1# ,earning 0utcome E T03# +lient !eeds +ategory# 3sychosocial &ntegrity 4-eligious and "piritual &nfluences on ;ealth5 6"+# &ntegrated 3rocess# +aring

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M#$ I%$E 'ES%&NSE 1. Which of these factors are included as part of 3urcell(s domains for assessing cultural groups or persons? (Select all that apply.) a !utrition and communication . b *amily roles and organiAation . c !ursing wor' force . d iofeedbac' . e Death rituals and spirituality . f Alternative and complementary therapies . g ;ealth care practices and practitioners . h Acupuncture and acupressure . A!"# A, , +, *, %, ; The following are part of 3urcell(s domains for assessing cultural groups or persons# H !utrition H +ommunication H *amily roles and organiAation H Wor' force issues H iocultural ecology H ;igh)ris' behaviors H 0verview 4such as heritage5 H 3regnancy and childbirth practices H Death rituals H "pirituality H ;ealth care practices H ;ealth care practitioners D&*# 0 1# T03# 6"+# +ognitive ,evel# +omprehension -.*# p. 7@ ,earning 0utcome < +lient !eeds +ategory# 3sychosocial &ntegrity 4+ultural Diversity5 &ntegrated 3rocess# +aring

.lsevier items and derived items 8 7919, 799:, 7997 by "aunders, an imprint of .lsevier &nc.