Chapter 07: DIVERSITY Flashcards
Which of the following practices applies to nursing care for clients with a foreign cultural background?
a.
Altering nonverbal behaviour to reflect the cultural norms the client is used to
b.
Keeping all behaviours culturally neutral to avoid misinterpretation
c.
Relying on friendly gestures to communicate a caring attitude
d.
Avoiding showing prejudice by using the same behaviour with all clients
A
Cultural competence in community health nurses (CHNs) includes the adoption of culturally congruent behaviours. CHNs need to make sure their nonverbal communication techniques take into consideration the client’s use of eye contact, facial expressions, body language, touch, and space.
A CHN often used to sit with his legs crossed at the knees when collecting a client’s history. However, he stopped doing this around his Iranian clients after being told that they were offended because this posture exposed the sole of his foot. In changing his behaviour, which culture-related response did the CHN exhibit? a. Cultural sensitivity b. Cultural awareness c. Cultural knowledge d. Cultural skill
D
Cultural skill refers to the effective integration of cultural awareness and cultural knowledge to obtain relevant cultural data and meet the needs of culturally diverse clients. The CHN’s use of cultural skill ensures that nonverbal communication techniques take into consideration the client’s use of eye contact, facial expressions, body language, touch, and space.
A CHN states, “The best way to treat clients from other countries is to care for them the same way we would want to be cared for ourselves. After all, we are all human beings with the same expectations and needs.” Which culture-related response does this statement exemplify? a. Cultural awareness b. Cultural blindness c. Cultural knowledge d. Cultural preservation
B
Cultural blindness is a denial of diversity and the inability to recognize the uniqueness of individual clients. An example is CHNs who, attempting to be culturally unbiased, treat all clients in the same manner by conducting their nursing assessments using the same questions, do not actively listen to the responses, and fail to modify their questioning to gain an understanding of client culture and client uniqueness.
A CHN rearranges the room and moves the bed of a bedridden Muslim client so that the client is facing toward Mecca for his daily prayers. What does the CHN’s culture-related response exemplify? a. Cultural skill b. Cultural awareness c. Cultural brokering d. Cultural imposition
A
Cultural skill refers to the effective integration of cultural awareness and cultural knowledge to obtain relevant cultural data and meet the needs of clients from diverse cultural backgrounds. For this client, daily prayers in the tradition of Islam are important, possibly more important from the client’s perspective than medical treatment.
Which one of the following is an example of “overt racism”?
a.
Using traditional food and traditional dress
b.
Restricting the burning of sweet grass
c.
Participating in hate crimes
d.
Making job positions available only to persons who are Canadian-born
C
Overt racism is an open demonstration by attitudes, actions, policies, and practices of a feeling of superiority over individuals or groups with the intent of harming or damaging. Hate crimes, for example, are considered to be one example of overt racism.
A health care provider states, “I’m not going to change the way I practise medicine regardless of where the client is from, because research shows that Western medicine is the best.” Which of the following behaviours does this statement exemplify? a. Ethnocentrism b. Prejudice c. Racism d. Stereotyping
A
Ethnocentrism, a type of cultural prejudice at the cultural population level, is the belief that one’s own cultural group determines the standards of behaviour by which all other groups are to be judged. CHNs who assume that their way of providing nursing care is the only right way are ethnocentric.
A health care worker tells the CHN, “It does no good to try to teach those Aboriginal clients about nutrition because they will just eat whatever they want to, no matter how much we teach them.” Which of the following behaviours does this statement exemplify? a. Cultural imposition b. Ethnocentrism c. Racism d. Stereotyping
D
Stereotyping occurs when generalizations are applied to an individual without exploring individual values, beliefs, and behaviours. In this instance, the health care worker makes the assumption that all Aboriginal people are not educable. The health care worker is also guilty of making assumptions about noncompliance among other Aboriginal people she has known; this noncompliance may have had to do with their inability to buy nutritious foods, which tend to be more expensive.
Migrant workers tend to have high occupational mobility, are often poor, and have limited formal education. They may seek health care only when they are ill and unable to work. What does the CHN need to do whenever she has a chance to interact with migrant workers?
a.
Advocate for emergency health care.
b.
Teach prevention and health maintenance.
c.
Ensure funding is available for adequate nutrition.
d.
Contact the Workplace Safety and Insurance Board (WSIB).
B
CHNs work with clients from diverse cultural backgrounds, and one example is migrant workers. Because migrant workers are highly mobile and tend to seek health care only when they are ill and unable to work, whenever a CHN interacts with these clients, it is important to teach them about disease prevention, health maintenance, health protection, and health promotion activities before the clients move on.
A family from Mexico presents to the public health department. None of the family members speak English, and no one at the health department speaks Spanish. Which of the following will be the most appropriate action on the part of the CHN?
a.
Attempting communication using an English–Spanish phrase book
b.
Calling the local hospital and arranging a referral
c.
Emphatically stating, “No hablo Español” (I don’t speak Spanish) and repeating as necessary
d.
Finding an interpreter to translate
D
Communication with the client or family is required for a cultural assessment. When CHNs do not speak or understand the client’s language, they need to obtain an interpreter.
A 40-year-old Bosnian Muslim woman who does not speak English presents to a community health centre in obvious pain and requests a female health care provider. She indicates through gestures that the pain originates in either the pelvic or the genital region. Assuming several people are available to interpret, which of the following persons would be the most appropriate choice of interpreter? a. A female who does not know the client b. A female from the client’s community c. A male who is certified as a medical interpreter d. The client’s 20-year-old daughter
A
Although it is important to use an experienced medical interpreter, in many cultures, it is considered inappropriate to have a male interpreter for a female client. This client has specifically requested a female health care provider; therefore, one might anticipate that the client will prefer a female interpreter as well. In spite of a male interpreter’s certification and ability, he cannot be effective if the client is withholding information that she feels is not right to discuss in front of a man. This client may also consider it inappropriate to have her daughter interpret private matters (especially of a sexual nature or if they involve infidelity). Additionally, the CHN should not use an interpreter from the same community as the client, in order to avoid breach of confidentiality.
At a local hospital, postpartum care policy requires that nurses observe the mother to assess her ability to care for the new baby and to promote bonding. A new immigrant mother says that, in her country, all infant care is provided by family members so that the mother can rest and recover. In her home country, it is believed that if the mother does not recover sufficiently, she will be unable to provide the best care. Which of the following actions will the culturally competent nurse take?
a.
Allow family members to provide care to the baby and assess the mother’s knowledge of child care through discussion.
b.
Explain the importance of bonding and how all good mothers gladly assume these responsibilities.
c.
Explain that the process of postpartum recovery does not require this much rest, but does require that she provide infant care.
d.
Explain that the mother must abide by hospital policy because documentation of this ability is required for discharge.
A
Culturally competent nursing care is individualized for each client, reflecting the client’s beliefs and values, and is provided with sensitivity.
The CHN who wishes to develop cultural competence can improve cultural awareness by doing which one of the following?
a.
Completing a survey of all the ethnic groups in the CHN’s community
b.
Considering how the CHN’s personal beliefs and decisions are reflective of his or her culture
c.
Inviting a family from another cultural background to participate in an event with the CHN
d.
Studying the beliefs and traditions of persons coming from other cultures
B
Cultural awareness is self-examination and in-depth exploration of one’s own beliefs and values as they influence behaviour.
The incidence of type 2 diabetes among Aboriginal peoples (First Nations, Inuit, and Métis) is three to five times higher than in the general population. When teaching a nutrition class to a group of students, of which a large percentage is Aboriginal, the CHN incorporates into the presentation such foods as bannock and other healthy dishes familiar to Aboriginal students. Which level of prevention does this culturally sensitive action represent? a. Primary prevention b. Secondary prevention c. Tertiary prevention d. Both primary and secondary prevention
A
Primary prevention involves such activities as health teaching to prevent a problem from occurring.
A nurse practitioner (NP) has just found out that her immigrant client is not taking the penicillin prescribed because his illness is “hot” and he feels that penicillin, a “hot” medicine, will not provide balance. If the NP changes the penicillin to a different but equally effective antibiotic, which cultural attribute will the NP be demonstrating? a. Cultural awareness b. Cultural brokering c. Cultural knowledge d. Cultural skill
D
Cultural skill refers to the effective integration of cultural awareness and cultural knowledge to obtain relevant cultural data and meet the needs of culturally diverse clients. Cultural skill involves providing care that is beneficial, safe, and satisfying to the client.
