Chapter 11: Cultural Diversity Flashcards
According to Leininger (2002), “cultural imposition” is a major concern in nursing because nurses have a tendency to impose their values, beliefs, and practices on people of other cultures. The discussion topic most likely to be without cultural imposition would be:
a. Abortion.
b. Wound management.
c. Blood transfusion.
d. Advance directives.
B
Abortion, blood transfusion, and advance directives are heavily imbued with values, beliefs, and practices that may be different between patients and nurses.
Cultural diversity is the term used to describe a vast range of cultural differences. Events have symbolic meanings for the nurse manager and the staff. The event that would be most likely to provide symbolic meaning to a nurse manager and staff is:
a. The formation of a task force to commemorate a New Year’s celebration in the
Western tradition.
b. A project to provide Christmas gifts to the children in a daycare program.
c. Celebration of National Nurses’ Week with the focus on cultural care.
d. The formation of a task force to develop a poster for the unit depicting religions of
the world.
ANS: C
Symbols define and reflect a culture. National Nurses’ Week, with a focus on nursing interests, reflects the culture of nursing.
One of the staff nurses on your unit makes the comment, “All this time I thought Mary was Black. She says she is Jamaican.” The best response would be:
a. “Who cares what she is?”
b. “What did you think when you learned she was Jamaican?”
c. “Why did you assume she was Black?”
d. “We have never had a Jamaican on this unit before.”
ANS: B
The response of the nurse manager invites cultural awareness, which involves self-examination and in-depth exploration of the nurse’s own biases, prejudices, and assumptions.
As a nurse manager, you notice that Sharon, an Aboriginal licenced practical nurse aide, is visibly upset. When you ask her if something is wrong, she becomes tearful and says, “Why is it that when Nick and I work together in giving patient care, he jokes about my being ‘a little fat Eskimo’?” The nurse manager’s best response is, “Do you think he
a. Is sensitive to your culture?”
b. Wants to learn more about you?”
c. Has been hurt and wants to hurt others?”
d. Is stereotyping you without thinking?”
ANS: D
Stereotyping and prejudice enable people to predict behaviours and make sense of situations, but they constrain people’s understanding and development of new insights.
The nurse manager of a unit is asked by a family member of a dying Inuit patient if it is possible to for the patient’s eight-member family to recite the rosary by the patient’s bedside. The manager responds affirmatively. The nurse manager is most likely exhibiting behaviour related to:
a. Acculturation.
b. Ethnocentricity.
c. Cultural diversity.
d. Cultural sensitivity.
D
Cultural sensitivity involves the capacity to feel or react to ideas, customs, and traditions unique to a group of people.
A 66-year-old native Chinese patient, hospitalized for a myocardial infarction, asks the nurse manager about seeing his “acupuncture doctor” for treatment of his migraine headache. The best response to this patient would be:
a. “How long have you been using acupuncture treatment?”
b. “Do you think acupuncture relieves your pain satisfactorily?”
c. “What have you told your heart specialist about your migraines and treatment?”
d. “Have you tried nonprescription pain medication or been given a prescription drug
for your headaches?”
A
Acknowledging the patient’s use of acupuncture demonstrates cultural sensitivity through acknowledgement of treatments that would be consistent with the patient’s cultural interpretation of illness and responses to it. The other responses indicate lack of cultural sensitivity and cultural imposition, in that the nurse diverts the line of inquiry toward interventions that would be common to the nurse’s experience of health care in Western cultures.
Maintaining a culturally diverse staff is an important function of a nurse manager who works in the hospital of a large medical centre. According to Health Canada (2008), which cultural group represents about 2% of registered nurses employed in Canada? The chapter states 3% p. 11.
a. Men.
b. Aboriginal.
c. French Canadian.
d. African Canadian.
ANS: B
Fewer than 2% of health care providers in Canada are of Aboriginal ethnicity; about 6% of the 8% in nursing work force is male.
The nurse manager for a unit’s culturally diverse staff creates a staff-development program so that the professional nursing staff members can enhance their understanding of cultures on the basis of published literature. The literature reveals that what characteristics are inherent in a culture?
a. It develops over time.
b. It maintains a strong work ethic.
c. It changes easily.
d. It develops quickly.
A
Culture is a patterned behavioural response that evolves slowly as times change. The culture may or may not maintain a strong work ethic.
Which principle of The Canada Health Act is frequently not upheld in rural and remote areas of the country?
a. Comprehensiveness.
b. Public administration.
c. Accessibility.
d. Portability.
C
When interviewing a candidate for a nursing position who has an Aboriginal background, a non-Aboriginal nurse recognizes that the candidate’s lack of eye contact reflects the candidate’s:
a. Lack of confidence.
b. Professional behaviour.
c. Cultural sensitivity.
d. Ethnicity.
ANS: D
Ethnicity refers to the classification of people according to common racial, tribal, religious, linguistic, or cultural backgrounds.
Recognizing that the Aboriginal candidate’s lack of eye contact is different from her own, the non-Aboriginal nurse is exhibiting
a. Acculturation.
b. Cultural sensitivity.
c. Ethnocentrism.
d. Transculturalism.
B
A non–English-speaking patient arrives at the nursing unit. The nurse knows that when patient communication is hampered by the inability to communicate in the same language, it may lead to:
a. Inequities in accessing health care services.
b. Inability to obtain health insurance.
c. A decrease in patient morbidity.
d. Lack of portability with health care coverage.
A
At Health Centre XYZ, staff members on the rehabilitation unit have a head nurse who is intolerant of error and publicly chides anyone who makes a mistake. Over time, the rules on the unit dictate that mistakes are hidden and that areas of concern related to the functioning of the unit are discussed in privacy and are never openly discussed during periodic meetings. New staff members are quickly made to realize that silence is expected. The situation described is an example of:
a. Ethnicity.
b. Work environment.
c. Work culture.
d. Marginalization.
ANS: C
Culture develops over time, is essential to survival, is learned and shared by members, and changes with difficulty.
Which of the following enables people to make sense of situations that they may encounter that differ from their circle of familiarity?
a. Paradox.
b. Prejudices.
c. Power.
d. Position.
B
Prejudices enable people to make sense of the situations in which they find themselves, but prejudices also constrain understanding and limit the capacity to develop new or different ways of understanding.
During performance appraisal, you praise Xia for her attention and care to nursing details. You suggest that her care would be further enhanced by greater acknowledgement of patients’ feelings. Xia bursts into tears and leaves the office. Later, you learn that in Xia’s culture, criticism is perceived as akin to failure. You reflect on how you could modify your approach in the future to acknowledge different cultural interpretations of feedback. Your response is indicative of:
a. Bias.
b. Cultural awareness.
c. Cultural diversity.
d. Ethnocentricity.
B
Cultural awareness involves self-examination and in-depth exploration of a person’s own cultural and professional background, such as biases, prejudices, and assumptions, including assumptions about thinking modes and decision-making.
