7 - Cultural Diversity in the Community

Question 1

Research has shown that Asian men tend to have a greater sensitivity than white Europeans to codeine, and they experience significantly weaker effects from the drug. Which of the following types of cultural variations is being demonstrated?

a. ) Biological variations
b. ) Personal space
c. ) Social organization
d. ) Perception of time

Answer 1

a.) Biological variations

Biological variations are the physical, biological, and physiological differences that exist between racial groups and distinguish one group from another. Personal space is the physical distance between two individuals during an interaction. Social organization refers to the way in which a cultural group structures itself around the family to carry out role functions. Perception of time is the duration or period between successive events, where some cultures assign greater or lesser emphasis to events that occur in the past, present, or future.

Question 2

A nurse will be using an interpreter during a client encounter. Which of the following considerations should be made by the nurse? (Select all that apply.)

a. ) It is appropriate to use family members as interpreters.
b. ) Written materials should be available in the client’s primary language.
c. ) Observe the interpreter’s gestures to assure client understanding.
d. ) The gender, age, and educational level of the interpreter should be evaluated.
e. ) The nurse should face the interpreter when speaking.

Answer 2

b.) Written materials should be available in the client’s primary language.

d.) The gender, age, and educational level of the interpreter should be evaluated.

Family members should be used with caution. The client’s gestures and nonverbal messages should be observed to assure understanding. Written materials should be available in the client’s primary language. The gender, age, educational level, socioeconomic status, religion, and dialect should all be considered when selecting the proper interpreter. The nurse should face the client during the dialogue, not the interpreter.

Question 3

A client comes into the clinic and tells the nurse he goes to an acupuncturist for pain. The nurse says he should take pain medication instead. Which of the following best describes the action taken by the nurse?

a. ) Cultural conflict
b. ) Cultural blindness
c. ) Cultural relativism
d. ) Cultural imposition

Answer 3

d.) Cultural imposition

This is an example of cultural imposition—the act of imposing one’s cultural beliefs, values, and practices on individuals from another culture.

Cultural conflict is a perceived threat that may arise from a misunderstanding of expectations when nurses are unable to respond appropriately to another individual’s cultural practice because of unfamiliarity with the practice.

Cultural blindness occurs when people state that everyone is treated the same, regardless of their cultural orientation.

Cultural relativism recognizes that clients have different approaches to health, and that each culture should be judged on its own merit and not on the nurse’s personal beliefs.

Question 4

Hispanics tend to believe that the needs of the family take priority over those of the individual. Which of the following types of cultural variations is being demonstrated?

a. ) Communication
b. ) Personal space
c. ) Social organization
d. ) Environmental control

Answer 4

c.) Social organization

Social organization refers to the way in which a cultural group structures itself around the family to carry out role functions. Communication is the means by which culture is shared (verbal and nonverbal). Personal space is the physical distance between two individuals during an interaction. Environmental control refers to the person’s relationship with nature and to plan and direct factors in the environment that affect them.

Question 5

In the Vietnamese culture, individuals may focus on wishes and memories of their ancestors and look to them to provide direction for current situations. Which of the following types of cultural variations is being demonstrated?

a. ) Communication
b. ) Personal space
c. ) Social organization
d. ) Perception of time

Answer 5

d.) Perception of time

Perception of time is the duration or period between successive events, where some cultures assign greater or lesser emphasis to events that occur in the past, present, or future. Communication is the means by which culture is shared (verbal and nonverbal). Personal space is the physical distance between two individuals during an interaction. Social organization refers to the way in which a cultural group structures itself around the family to carry out role functions.

Question 6

A nurse supports the use of traditional home remedies in conjunction with Western medicine to promote healthy behaviors. Which of the following is being demonstrated by the nurse?

a. ) Cultural accommodation
b. ) Cultural awareness
c. ) Cultural preservation
d. ) Cultural repatterning

Answer 6

c.) Cultural preservation

Cultural preservation refers to assistive, supportive, facilitative, or enabling nurse actions and decisions that help the clients of a particular culture to retain and preserve traditional values, so they can maintain, promote, and restore health. Cultural accommodation refers to assistive, supportive, facilitative, or enabling nurse actions and decisions that help clients of a particular culture accept nursing strategies or negotiate with nurses to achieve satisfying health care outcomes. Cultural awareness refers to the self-examination and in-depth exploration of one’s own biases, stereotypes, and prejudices as they influence behavior toward other cultural groups. Cultural repatterning refers to assistive, supportive, facilitative, or enabling nurse actions and decisions that help clients of a particular culture to change or modify a cultural practice for new or different health care patterns that are meaningful, satisfying, and beneficial.

Question 7

A nurse believes that the best treatment for illness is the use of Western medicine and alternative therapies should not be used for healing. Which of the following best describes what has happened?

a. ) Ethnocentrism
b. ) Cultural imposition
c. ) Racism
d. ) Stereotyping

Answer 7

a.) Ethnocentrism

Ethnocentrism is the belief that one’s own cultural group determines the standards by which another group’s behavior is judged. Cultural imposition is the act of imposing one’s cultural beliefs, values, and practices on individuals from another culture. Racism is a form of prejudice that occurs through the exercise of power by individuals and institutions against people who are judged to be inferior on the basis of intelligence, morals, beauty, inheritance, and self-worth. Stereotyping is ascribing certain beliefs and behaviors about a given racial and ethnic group to an individual without assessing for individual differences.

Question 8

A Mexican American mother insists on using special candles to help her daughter’s ear infection. The nurse asks the mother if she would also give her daughter antibiotics. Which of the following best describes the action of the nurse?

a. ) Cultural accommodation
b. ) Cultural repatterning
c. ) Culture brokering
d. ) Cultural awareness

Answer 8

a.) Cultural accommodation

This means that the nurse supports and facilitates the use of cultural practices with interventions from the biomedical health care system. Cultural accommodation refers to assistive, supportive, facilitative, or enabling nurse actions and decisions that help clients of a particular culture accept nursing strategies or negotiate with nurses to achieve satisfying health care outcomes.

Cultural repatterning refers to assistive, supportive, facilitative, or enabling nurse actions and decisions that help clients of a particular culture to change or modify a cultural practice for new or different health care patterns that are meaningful, satisfying, and beneficial.

Culture brokering is advocating, mediating, negotiating, and intervening between the client’s culture and the biomedical health care culture on behalf of clients.

Cultural awareness refers to the self-examination and in-depth exploration of one’s own biases, stereotypes, and prejudices as they influence behavior toward other cultural groups.

Question 9

A nurse advocates and intervenes between the health care system and the client’s cultural beliefs on behalf of the client. Which of the following best describes the nurse’s action?

a. ) Cultural accommodation
b. ) Culture brokering
c. ) Cultural preservation
d. ) Cultural repatterning

Answer 9

b.) Culture brokering

Culture brokering is advocating, mediating, negotiating, and intervening between the client’s culture and the biomedical health care culture on behalf of clients. Cultural accommodation refers to assistive, supportive, facilitative, or enabling nurse actions and decisions that help clients of a particular culture accept nursing strategies or negotiate with nurses to achieve satisfying health care outcomes. Cultural preservation refers to assistive, supportive, facilitative, or enabling nurse actions and decisions that help the clients of a particular culture to retain and preserve traditional values, so they can maintain, promote, and restore health. Cultural repatterning refers to assistive, supportive, facilitative, or enabling nurse actions and decisions that help clients of a particular culture to change or modify a cultural practice for new or different health care patterns that are meaningful, satisfying, and beneficial.

Question 10

The tendency to ignore all differences between cultures and to act as though the differences do not exist is defined as:

a. ) cultural conflict.
b. ) culture shock.
c. ) cultural blindness.
d. ) cultural imposition.

Answer 10

c.) cultural blindness.

Cultural blindness occurs when people state that everyone is treated the same, regardless of their cultural orientation. Cultural conflict is a perceived threat that may arise from a misunderstanding of expectations when nurses are unable to respond appropriately to another individual’s cultural practice because of unfamiliarity with the practice. Culture shock is the feeling of helplessness, discomfort, and disorientation experienced by an individual attempting to understand or effectively adapt to a cultural group whose beliefs and values are radically different from the individual’s culture. Cultural imposition is the act of imposing one’s cultural beliefs, values, and practices on individuals from another country.

Question 11

A nurse is working with a population that exhibits a large amount of diversity. The nurse recognizes that skin color of individuals within this population is an example of:

a. ) multiculturalism.
b. ) ethnicity.
c. ) race.
d. ) culture.

Answer 11

c.) race.

Race is primarily a social classification that relies on physical markers. Multiculturalism is the blending of diverse cultures. Ethnicity is the shared feeling of peoplehood among a group of individuals and relates to cultural factors, such as nationality, geographic region, culture, ancestry, language, beliefs, and traditions. Culture is a set of beliefs, values, and assumptions about life that are widely held among a group of people and transmitted intergenerationally.

Question 12

A client shares with the nurse that her grandparents immigrated to the United States from Germany. Which of the following best describes what she has disclosed?

a. ) Multiculturalism
b. ) Ethnicity
c. ) Race
d. ) Culture

Answer 12

b.) Ethnicity

Ethnicity represents the identifying characteristics of culture, such as race, religion, or natural origin. Multiculturalism is the blending of diverse cultures. Race is primarily a social classification that relies on physical markers. Culture is a set of beliefs, values, and assumptions about life that are widely held among a group of people and transmitted intergenerationally.

Question 13

A nurse is observing behaviors that may be defined by culture. Which of the following is the nurse most likely to observe?

a. ) Speaking a dialect of a language in a local region
b. ) Standing when an older adult gets on the bus to give him a seat
c. ) Immigrating to the United States and seeking work
d. ) An organizational structure of a cultural group

Answer 13

b.) Standing when an older adult gets on the bus to give him a seat

Culture is a set of beliefs, values, and assumptions about life that are widely held among a group of people and is transmitted intergenerationally. Behaviors may be culturally determined, as illustrated in the correct response. This behavior is based on the value of respect of elderly people. Speaking a particular dialect in a local area would not fit the definition of culture. An organizational structure of a group is not an observable behavior. Immigrating to the United States does not demonstrate culture.

Question 14

A nurse is unable to provide culturally competent care to a population within the community. Which of the following is an effect of this type of care?

a. ) Enhanced communication
b. ) Increased cost of health care
c. ) Achievement of health indicators
d. ) Improvement in client compliance

Answer 14

b.) Increased cost of health care

Care that is not culturally competent may increase health care costs and decrease positive client outcomes. Communication is inhibited through care that is not culturally competent. It is not possible to achieve health indicators if culturally competent care is not given. Client compliance decreases if culturally competent care is not provided.

Question 15

A nurse wants to obtain information on the alternative methods of health care her 45-year- old female client uses. Who would be the best person to ask about this?

a. ) The husband of the client
b. ) A community leader of the ethnic group
c. ) The client herself
d. ) The religious leader of the ethnic group

Answer 15

c.) The client herself

Clients provide a rich source of information about their own cultures. The client would be the preferred person to collect this information instead of the husband, community leader, or religious leader.

Question 16

Which of the following statements about race is true?

a. ) In the United States, children of biracial parents are usually assigned the race of the father.
b. ) Ethnicity and race are synonymous terms.
c. ) Individuals may be of the same race but of different cultures.
d. ) No social significance is usually placed on race.

Answer 16

c.) Individuals may be of the same race but of different cultures.

It is often a misconception that persons of the same race have the same culture. For example, African Americans may have been born in Africa, the Caribbean, North America, or elsewhere and have very different cultures. In the United States, children of biracial parents are usually assigned the race of the mother. Ethnicity is a contrasting term to race. Race is a characteristic that allows for some groups to be separated, treated as superior, and given access to power and other valued resources, while others are treated as inferior and have limited access to power and resources.

Question 17

A nurse implements nursing interventions considering the uniqueness of the person’s culture. Which of the following best describes this action?

a. ) Cultural diversity
b. ) Cultural knowledge
c. ) Cultural competence
d. ) Cultural awareness

Answer 17

c.) Cultural competence

Providing care based on the uniqueness of the client’s cultural norms and values is one of the three guiding principles of culturally competent nursing care. Cultural diversity refers to the degrees of variation represented among populations based on lifestyle, ethnicity, race, interest, across place, and place of origin across time. Cultural knowledge refers to the process of searching for and obtaining a sound educational understanding about culturally diverse groups. Cultural awareness refers to the self-examination and in-depth exploration of one’s own biases, stereotypes, and prejudices as they influence behavior toward other cultural groups.

Question 18

The nurse labels a patient an alcoholic because of his ethnicity. Which of the following best describes this action by the nurse?

a. ) Stereotyping
b. ) Prejudice
c. ) Racism
d. ) Ethnocentrism

Answer 18

a.) Stereotyping

Stereotyping is ascribing certain beliefs and behaviors about a given racial and ethnic group to an individual without assessing for individual differences. Prejudice is the emotional manifestation of deeply held beliefs about a group. Racism is a form of prejudice that occurs through the exercise of power by individuals and institutions against people who are judged to be inferior in, for example, intelligence, morals, beauty, and self-worth. Ethnocentrism is the belief that one’s own cultural group determines the standards by which another group’s behavior is judged.

Question 19

A nurse is working with an immigrant population. Which of the following should be the first action taken by the nurse?

a. ) Be aware of one’s own culture
b. ) Become familiar with traditional practices of the immigrants
c. ) Try to see things from the immigrant’s viewpoint
d. ) Learn to speak the language of the immigrant population

Answer 19

a.) Be aware of one’s own culture

Cultural competence is one of the core attributes of public health nurses. Nurses come from a variety of cultural backgrounds and have their own cultural traditions. Nurses also bring their biomedical beliefs and values to the practice environment that may differ from the client’s own beliefs and values. Because nurses recognize their own culture, they are better able to understand that there are differences among cultures. Being aware of one’s own culture should be done before completing the other tasks of increasing familiarity with traditional practices, trying to see things from the other’s point of view, or learning to speak the language.

Question 20

A nurse demonstrates cultural desire to provide culturally competent care. Which of the following actions would be taken by the nurse?

a. ) Relying on a textbook for information about an ethnic group
b. ) Bringing a translator to the local community clinic
c. ) Taking Spanish classes in the evening at a local college
d. ) Judging others using his or her own cultural values

Answer 20

c.) Taking Spanish classes in the evening at a local college

Cultural desire refers to the nurse’s intrinsic motivation to want to engage in the elements necessary to provide culturally competent care. The activity that suits the definition of cultural desire is one that a nurse would want to do instead of being directed to do so, referring to the intrinsic motivation of the nurse. Relying on a textbook for information, bringing a translator, and judging others do not demonstrate the definition of cultural desire as they are not demonstrating the intrinsic motivation of the nurse.

Question 21

A 35-year-old man from Russia comes to the United States seeking asylum because of religious persecution in his native country. Which of the following best describes this type of immigrant?

a. ) Legal immigrant
b. ) Lawful permanent resident
c. ) Refugee
d. ) Unauthorized immigrant

Answer 21

c.) Refugee

Refugees are people who seek protection in the United States because of fear of persecution in their homeland. Legal immigrants are people who are not citizens but are legally allowed to live and work in United States, usually because they fulfill labor demands or have family ties. Lawful permanent resident is another name for legal immigrants. Unauthorized immigrants may have crossed a border into the United States illegally, or their legal permission to stay in the United States may have expired.

Question 22

A nurse has experienced a cultural encounter. Which of the following best describes what has happened?

a. ) Sharing significant assessment findings with members of a racial minority
b. ) Visiting the native land of the clients served at a community health center
c. ) Telephoning the priest at a Hispanic church to discuss the health issues of a client
d. ) Learning about traditional healing practices from an American Indian client

Answer 22

d.) Learning about traditional healing practices from an American Indian client

Cultural encounter refers to the process that permits nurses to seek opportunities to directly engage in cross-cultural interactions with clients of diverse cultures to modify existing beliefs about a specific cultural group and possibly avoid stereotyping. Learning about traditional healing practices is an example of a direct cultural encounter. This occurs when a nurse engages in cross-cultural interactions. Sharing significant assessment findings demonstrates the nurse sharing information, not an engagement with the population. When visiting a native land, there may not be interaction with any other culture. Telephoning a priest at a Hispanic church does not demonstrate an interaction, but rather the nurse calling the priest to accomplish a nursing task.

Question 23

A city council discusses how former city laws promoted segregation in the community years ago. Which of the following was being demonstrated when segregation occurred?

a. ) Prejudice
b. ) Cultural imposition
c. ) Racism
d. ) Stereotyping

Answer 23

c.) Racism

Racism is a form of prejudice that occurs through the exercise of power by individuals and institutions against people who are judged to be inferior in, for example, intelligence, morals, beauty, and self-worth. Prejudice is the emotional manifestation of deeply held beliefs about a group. Cultural imposition is the act of imposing one’s cultural beliefs, values, and practices on individuals from another country. Stereotyping is ascribing certain beliefs and behaviors about a given racial and ethnic group to an individual without assessing for individual differences.

Question 24

Which statement about the nursing workforce is true?

a. ) The nursing workforce is overwhelmingly white.
b. ) The number of minority nurses meets the needs of the country’s demographics.
c. ) The nursing workforce is becoming increasingly diverse with increasing minorities.
d. ) Refugees make up a large part of the nursing workforce in some areas.

Answer 24

a.) The nursing workforce is overwhelmingly white.

The nursing workforce is 83% white. Because of the large percentage of white nurses this does not meet the needs of the country’s demographics. Unauthorized immigrants and refugees do not make up a part of the nursing workforce.

Question 25

A nurse states that the client has exhibited an explicit cultural behavior. Which of the following has the nurse most likely observed?

a. ) Verbal communication
b. ) Body language
c. ) Use of titles
d. ) Perception of health and illness

Answer 25

a.) Verbal communication

Explicit behaviors are straightforward and do not leave room for misinterpretation of what the person wants to communicate, such as when using verbal communication. Implicit behaviors are less exact and may be difficult to interpret, including body language, use of titles, and perception of health and illness.

Question 26

A nurse resigns from a position in a hospital to accept a job in a community setting. After starting the new job, the nurse feels helpless and confused, wondering if this was the right career choice. Which of the following terms best describes how the nurse is feeling?

a. ) Cultural conflict
b. ) Cultural relativism
c. ) Culture shock
d. ) Culture brokering

Answer 26

c.) Culture shock

Culture shock can happen to individuals within their own culture when they are having experiences such as starting a new job or career. Culture shock is brought on by anxiety from losing familiar signs and symbols of social interaction. Feelings associated with culture shock are helplessness, discomfort, and disorientation.

Cultural conflict is a perceived threat that may arise from a misunderstanding of expectations when nurses are unable to respond appropriately to another individual’s cultural practice because of unfamiliarity with the practice.

Cultural relativism recognizes that clients have different approaches to health, and that each culture should be judged on its own merit and not on the nurse’s personal beliefs.

Culture brokering is advocating, mediating, negotiating, and intervening between the client’s culture and the biomedical health care culture on behalf of clients.

Question 27

Asians may perceive illness as disharmony with other forces and that medicine is only able to relieve the symptoms rather than cure the disease. They may look to naturalistic solutions and acupuncture to resolve or cure health problems. Which of the following types of cultural variations is being demonstrated?

a. ) Communication
b. ) Personal space
c. ) Social organization
d. ) Environmental control

Answer 27

d.) Environmental control

Environmental control refers to the ability of individuals to control nature and to influence factors in the environment that affect them. Communication is the means by which culture is shared (verbal and nonverbal). Personal space is the physical distance between two individuals during an interaction. Social organization refers to the way in which a cultural group structures itself around the family to carry out role functions.

Question 28

The Refugee Act of 1980 had what effect on refugees who were immigrating into the United States?

a. ) Allowed specific provisions for refugees from Southern and Eastern Europe
b. ) Provided a uniform procedure for refugees to be admitted into the United States
c. ) Permitted refugees to set up communities in or around major metropolitan areas
d. ) Allowed refugees access to “green cards” that would allow them to work in the United States

Answer 28

b.) Provided a uniform procedure for refugees to be admitted into the United States

The Refugee Act of 1980 provided a uniform procedure for refugees to be admitted into the United States. Refugees were immediately eligible to receive Temporary Assistance for Needy Families, Supplemental Security Income, and Medicaid. This procedure was in effect for all refugees not just those from specific countries. It did not provide “green card” access or permit development of specific communities for refugees.

Question 29

A visitor from Japan comes to the United States for a 2-week vacation. Which of the following best describes this person?

a. ) Nonimmigrant
b. ) Refugee
c. ) Legal immigrant
d. ) Lawful permanent resident

Answer 29

a.) Nonimmigrant

A nonimmigrant is admitted for a limited duration for a specific purpose. Refugees are people who seek protection in the United States because of fear of persecution in their homeland. Legal immigrants are people who are not citizens but are legally allowed to live and work in United States, usually because they fulfill labor demands or have family ties. Lawful permanent resident is another name for legal immigrants.

Question 30

To meet a client’s needs, it is sometimes necessary to integrate into the client’s care a culturally relevant practice that lacks scientific utility. Which of the following best describes this action?

a. ) Cultural accommodation
b. ) Cultural awareness
c. ) Cultural preservation
d. ) Cultural repatterning

Answer 30

a.) Cultural accommodation

Cultural accommodation refers to assistive, supportive, facilitative, or enabling nurse actions and decisions that help people of a particular culture to accept nursing strategies, or to negotiate with nurses to achieve satisfying health care outcomes. Cultural awareness refers to the self-examination and in-depth exploration of one’s own biases, stereotypes, and prejudices as they influence behavior toward other cultural groups. Cultural preservation refers to assistive, supportive, facilitative, or enabling nurse actions and decisions that help the clients of a particular culture to retain and preserve traditional values so they can maintain, promote, and restore health. Cultural repatterning refers to assistive, supportive, facilitative, or enabling nurse actions and decisions that help clients of a particular culture to change or modify a cultural practice for new or different health care patterns that are meaningful, satisfying, and beneficial.

Question 31

A nurse is striving to be culturally competent. Which of the following actions would most likely be taken by the nurse?

a. ) Respect individuals from different cultures and value diversity
b. ) Immerse themselves in different cultures
c. ) Design care for special ethnic groups
d. ) Give explicit instructions to avoid client decision making

Answer 31

a.) Respect individuals from different cultures and value diversity

Nurses who strive to be culturally competent respect individuals from different cultures and value diversity. Immersing oneself in a different culture, designing care for special ethnic groups, and giving explicit instructions so the client does not have to make a decision does not demonstrate cultural competence.

Question 32

A large portion of foreign-born residents of the United States:

a. ) work in service-producing and blue-collar sectors.
b. ) reside in rural areas.
c. ) have a high school education.
d. ) are refugees and nonimmigrants.

Answer 32

a.) work in service-producing and blue-collar sectors.

Two-thirds of the foreign-born population lives in or around major metropolitan areas and works in mainly service-producing and blue-collar sectors. They are also more likely to be poorer. The majority of foreign born are legal immigrants (85%). More than 54% of the foreign-born adults in the labor force have completed high school, which would not be considered a large portion.

Question 33

A nurse is planning a refugee outreach clinic at the neighborhood health center. Which of the following considerations should be made by the nurse in order to provide culturally competent care? (Select all that apply.)

a. ) Their own background, beliefs, and knowledge may be significantly different from those of the people receiving care.
b. ) Language barriers may interfere with efforts to provide assistance.
c. ) Certain risk factors may be present for a given population.
d. ) Certain groups may use nontraditional healing practices.
e. ) Introduction of the American culture will be an important part of the encounter.

Answer 33

a.) Their own background, beliefs, and knowledge may be significantly different from those of the people receiving care.

b.) Language barriers may interfere with efforts to provide assistance.

c.) Certain risk factors may be present for a given population.

d.) Certain groups may use nontraditional healing practices.

When working with immigrants, it is important to be aware of one’s own beliefs while realizing that language barriers may exist, that different populations experience different risk factors and illnesses, and that nontraditional healing practices may be used. It would not be appropriate to impose the American culture into the encounter.