chapter 2 Flashcards
What are the common health disparities among American Indians, Alaska natives, and Hispanics?
Physical assault
Cirrhosis deaths
Deaths from poisoning
New cases of tuberculosis
Smoking by pregnant women
Cirrhosis deaths
Deaths from poisoning
New cases of tuberculosis
The nurse is caring for a Hispanic patient who is pregnant. The patient tells the nurse, “I’m visiting a traditional healer who has taken care of all the women in my family during pregnancy.” Which traditional healer could the patient be referring to?
Yerbo
Partera
Sabedor
Espiritualista
Partera
A partera is a lay midwife who provides treatment and cares for pregnant women. Therefore, the nurse anticipates that the patient is visiting a partera. A yerbo is an herbalist who treats illness by administering herbal leaves and oils but does not provide treatment exclusively for pregnant patients. A sabedor is a traditional healer who manipulates the bones and muscles. An espiritualista is a traditional healer who treats illness by using spiritual methods.
A Chinese patient reports cardiac symptoms to the nurse. On reviewing the patient’s diagnostic reports, however, the nurse finds that the patient does not have a cardiac disorder. On interacting with the patient, the nurse learns that the patient’s parents recently died in an accident. Based on these findings, which condition does the nurse suspect in the patient?
Mental illness
Sense of integrity
Shenkui syndrome
Emotional disharmony
Emotional disharmony
Chinese patients may convert mental experiences caused by loss into bodily symptoms. They consider the heart the center of emotion and complain of cardiac symptoms while grieving. Because the patient has negative diagnostic test results and the parents died in a recent accident, the nurse concludes that the patient has emotional disharmony due to the loss. Shenkui is a Chinese culture-bound syndrome associated with anxiety, dizziness, and insomnia. Geriatric patients usually experience a sense of integrity if they have achieved all their life goals. In this case, the patient is depressed because of the parents’ death. Therefore, it does not indicate that the patient has a sense of integrity. The patient is experiencing loss because of the parents’ death. Merely experiencing loss does not indicate that the patient has symptoms of mental illness.
The nurse is assessing a patient with gastroenteritis. On interacting with the patient, the nurse learns that the patient is from Spain and has recently immigrated to the United States. Which action of the nurse is in accordance with Title VI of the Civil Rights Act of 1964?
The nurse assesses the patient in the presence of an interpreter.
The nurse keeps the patient’s illness and treatment confidential.
The nurse provides treatment according to Spanish traditional methods.
The nurse asks a family member who knows English to explain the patient’s problems.
The nurse assesses the patient in the presence of an interpreter.
Most individuals from non–English-speaking countries immigrate to the United States for their livelihood or for higher education. These individuals may have difficulty understanding English. According to Title VI of the Civil Rights Act of 1964, health care professionals should not deny care for such patients. Therefore, the nurse would continue to assess the patient in the presence of an interpreter. According to the Health Insurance Portability and Accountability Act of 1996, the nurse should maintain confidentiality about the patient’s illness. The nurse should not ask a family member to explain health-related problems, because the information given by the family member may not be reliable and accurate. Traditional methods are not always safe and effective. Therefore, the nurse would not treat the patient by using Spanish traditional methods.
The nurse is assessing a geriatric patient with severe fever and reddish discoloration of the tongue. The patient tells the nurse, “I’m sick because of imbalance in yin and yang .” Which cultural group shares the same beliefs as this patient?
Asian
African
European
American Indian
Asian
According to Chinese philosophy, imbalance between the yin and yang can impair bodily functioning and result in illness. Many people from Asian countries such as China, India, Japan, Korea, the Philippines, Laos, Cambodia, and Vietnam believe in this philosophy. Therefore, Asian culture supports the patient’s belief. Some individuals from African countries believe that disharmony with nature causes illness. In European countries, some individuals believe that absence of well-being or feeling bad results in illness. Some American Indians believe that disharmony with nature causes illness. Therefore, African, European and American Indian cultures do not support the patient’s belief.
What is the most common cultural practice followed by Russians for preventing illness?
Burning sweet grass
Lighting candles daily
Wearing metal bangles
Wearing prayer shawls
Wearing prayer shawls
The Russians are of European heritage and believe that illness is caused by the absence of well-being. Therefore, to prevent illness, they wear prayer shawls and amulets. American Indians believe that illness is caused by disharmony with nature. They offer prayers by burning sweet grass. Mexicans believe that illness is a punishment given by God for their bad behavior. Therefore, they light candles and offer prayers to God to prevent illness. African patients wear metal bangles to ward off evil spirits and to prevent illness.
Which healing practices are favored by patients in the American Indian culture?
Acupuncture
Meditation
Sweat lodges
Herbal medicine
Cupping
Meditation
Sweat lodges
Herbal medicine
American Indian patients may engage in meditation for healing purposes. They believe that cure is impossible unless there is a complete healing of the body, mind, and spirit. So, they may frequent sweat lodges for mental, spiritual and physical healing. American Indian patients may also use herbal medicines for a calming effect. Asian patients use health care practices such as acupuncture and cupping because they believe that such practices help restore the hot and cold imbalances in the body.
The nurse is assessing an Islamic child with severe fever and insomnia. The nurse learns that the child has recently migrated to the United States and has had difficulty in adjusting to the Catholic culture of the school. What does the nurse anticipate from these findings?
The child is experiencing dhat syndrome.
The child is experiencing a sense of integrity.
The child is experiencing shenkui syndrome.
The child is experiencing acculturative stress.
The child is experiencing acculturative stress.
Cultural practices and beliefs vary across regions and counties. Individuals who migrate from different countries may have difficulty in adjusting to the new system and its customs. This may cause acculturative stress. In this case, because the Islamic child is unable to adjust to Catholic customs, the nurse anticipates that the child has acculturative stress. If the patient achieved all goals successfully in his or her life, then he or she would probably have a feeling of accomplishment and a sense of integrity. Dhat syndrome is a culture-bound syndrome characterized by severe anxiety and concerns about the discharge of semen. Shenkui syndrome is a culture-bound syndrome associated with anxiety, panic, and sexual dysfunction.
The nurse is caring for a patient from a different culture. Which nursing action is appropriate?
Explain expected behaviors for patients in the U.S. health care system.
Include the family members in all decision-making processes.
Assess the patient’s beliefs, practices, and ideas about health care.
Avoid discussion of subjects that may be uncomfortable for the patient.
Assess the patient’s beliefs, practices, and ideas about health care.
The nurse should assess the patient’s beliefs, practices, and ideas about health care to develop a culturally congruent plan of care. There is no expected behavior from the patient to receive treatment in the U.S. health care system. Including family members in all decisions is not relevant if the patient is able to make cogent decisions. The nurse should not avoid discussions of any subjects that are uncomfortable for the patient, because the patient may need to know all the relevant facts to make an informed decision.
A Spanish patient who was in a car accident has severe leg pain. The patient refuses analgesics and will not undergo treatment. What is the best nursing intervention in this situation?
Negotiate with the patient.
Inform the patient’s family members.
Inform the patient of the advantages of treatment.
Provide alternative treatment according to the patient’s culture.
Provide alternative treatment according to the patient’s culture.
Spanish patients most likely consult folk healers for treatment and may avoid taking medications prescribed by the health care provider. When the patient rejects undergoing treatment, the nurse should plan an alternative treatment method that is acceptable to the patient. Discussing the pain and treatment will not help in providing effective treatment to the patient. Informing family members of the patient’s condition may make them panic. Moreover, it does not help to provide effective treatment to the patient and may lead to further complications. The patient requires immediate treatment to prevent further complications. Therefore, the nurse should avoid discussing advantages of treatment and should not delay the treatment.
A patient believes in the hot and cold theory of illness. What is the patient most likely to use for the treatment of stomach cramps?
Iced tea
Curd
Chili peppers
Spinach
Chili peppers
A patient who believes in hot and cold theory of illness considers stomach cramps a cold condition. The patient is likely to use “hot” foods such as chili peppers to eliminate the cold from the body. Iced tea, curd, and spinach are cold foods that may not have any benefits in this case.
While assessing a patient in a health care facility, the nurse uses Brief RCOPE. What is the reason for this intervention?
To identify religious coping in the patient
To identify the intensity of pain in the patient
To identify psychologic symptoms in the patient
To identify the cognitive development of the patient
To identify religious coping in the patient
A patient’s religious coping plays a major role in determining the effectiveness of the treatment. Some patients may believe that illness is caused due to God’s punishment or an act of the devil. Such beliefs may affect the patient’s coping skills and may hinder treatment effectiveness. Brief RCOPE is an assessment tool that contains 14 questions about the patient’s belief in and perception of God. This helps the nurse to identify religious coping in the patient and to prevent negative health outcomes due to negative religious coping. Brief RCOPE does not contain questions related to pain intensity. Therefore, the nurse cannot assess the intensity of pain in the patient by using this tool. Brief RCOPE does not contain questions related to psychologic symptoms and cognition. Therefore, the nurse does not identify psychologic symptoms or cognitive development in the patient by using Brief RCOPE.
The nurse is assessing a Nigerian patient who has been using traditional methods for relieving a cold. Which traditional methods are most likely to be followed by this patient?
Drinking manzanilla tea
Applying anise herbal oil
Using swamp root powder
Adding asafetida to food
Adding asafetida to food
Nigerians tend to follow African traditional healing methods. They may use herbs such as asafetida for the treatment of illness. Unlike Americans, Nigerians do not generally drink manzanilla tea and do not apply anise herbal oil for the restoration of health. Unlike Europeans, Nigerians do not generally administer swamp root for the restoration of health.
Which patient characteristics comprise “culture”?
Color of skin and hair
A system of beliefs and practices
Preference for education and studying
Physical features such as eye shape
A system of beliefs and practices
Culture refers to a system of beliefs and practices that are learned and shared by a group of people. Color of skin and hair are genetically determined and not learned. A patient’s preference for education and studying helps in understanding the social influences on the patient. A physical feature such as the shape of the eye has a genetic basis.
The nursing instructor asks a student to define culture. Which response by the student is best?
A group of people with one or more shared traits
The learned behaviors shared by a particular group of people
The classification of human beings on the basis of physical characteristics
A complex system that includes knowledge, beliefs, and customs of a group
A complex system that includes knowledge, beliefs, and customs of a group
Culture refers to a complex system that includes knowledge, beliefs, and customs of a group of people. The members of a cultural group share all traits, knowledge, and skills. A person’s race is determined by the classification of human beings on the basis of physical characteristics. Cultural behaviors are learned at birth and shared by all the members of the same cultural group.
The nurse is caring for a patient who is from a different culture. Which action will help the nurse be most effective when caring for this patient?
Evaluate the patient’s knowledge of medicines.
Examine one’s feelings about cultural diversity.
Determine whether the patient is willing to be treated.
Recognize that the nurse cannot counsel the patient if beliefs and practices differ.
Examine one’s feelings about cultural diversity.
The nurse should examine one’s feelings about cultural diversity, because it helps avoid cultural biases and discrimination of the patient. Evaluating the patient’s knowledge of medicines is not enough to understand the patient’s cultural practices. In the assessment process, the nurse determines whether the patient is willing to be treated. The nurse can counsel the patient belonging to any culture, even if there is a difference in the health practices. It is the nurse’s duty to understand the patient’s health practices and include them in the patient’s plan of care.
What is a common cultural practice among Turkish people?
Wearing metal bangles
Tying a seed to the newborn’s crib
Hanging a glass blue eye in the home
Placing a packet in the newborn’s crib
Hanging a glass blue eye in the home
Many Turkish people may believe in evil spirits, so they hang a glass blue eye in their home in order to ward off the evil spirits. Unlike Mexicans, Turkish people do not traditionally tie a seed to the newborn’s crib with a red string. Caribbean people, rather than Turkish people, are known for wearing metal bangles. Unlike Japanese people, Turkish people do not traditionally place a packet in the newborn’s crib.
The parents of a Hispanic child bring their child in for a respiratory infection. They tell the nurse, “We’re giving our child antibiotics as prescribed by the doctor and saying prayers as suggested by our Catholic priest.” Given these two practices, which other practice are the parents likely to follow?
The parents may give herbal teas to the child.
The parents may give coffee and pork to the child.
The parents may give homeopathic medications to the child.
The patients may perform a purifying ritual with the smoke of sacred herbs.
The parents may give herbal teas to the child.
Because of variation in beliefs and practices, individuals belonging to different cultural groups follow different methods of healing. Hispanics take medications prescribed by the health care provider, offer prayers as suggested by the Catholic priest, and also take herbal medications as recommended by a curandero. Therefore, the nurse expects that the child’s parents would give herbal teas to the child. Most cultural groups avoid consuming coffee and pork during illnesses. Therefore, the nurse does not anticipate that the child’s parents would give coffee and pork to the child. Individuals of the Hispanic cultural group may prefer to take herbal medications rather than homeopathic medications. Unlike American Indians, Hispanics do not perform a purifying ritual with the smoke of sacred herbs.
hich condition is an Indian Hindu patient likely to consider a “hot” condition?
Rash
Earache
Paralysis
Pneumonia
Rash
Many Asian patients may believe in the hot/cold theory of illness. This theory claims that illness occurs due to an imbalance in the four humors of the body; blood, phlegm, black bile, and yellow bile; such a patient would consider a rash a “hot” condition. Earache, paralysis, and pneumonia are thought to occur when cold enters the body.
While working in a community health care center, the nurse finds that most of the patients are African Americans. Which action followed by the nurse is in accordance with the objectives of Healthy People 2020?
Providing counseling with spiritual or religious leaders
Encouraging patients to follow traditional healing methods
Teaching preventive measures for sexually transmitted diseases
Helping patients in decision making and dealing with activities of daily living
Teaching preventive measures for sexually transmitted diseases
The objective of Healthy People 2020 is to eliminate health disparities and to promote well-being. The most common health problems among African Americans are gonorrhea, congenital syphilis, new cases of acquired immunodeficiency syndrome (AIDS), and deaths from AIDS. These diseases are commonly transmitted during vaginal, oral, and anal sex. Therefore, to prevent this health problem, the nurse would teach measures to prevent sexually transmitted diseases. Providing counseling with spiritual or religious leaders would not help to prevent health problems. Traditional healing methods are not clinically proven. They may worsen the patient’s health because of adverse effects. Therefore, the nurse will not encourage patients to follow traditional methods of healing. The nurse should encourage patients to make decisions and to deal with activities of daily living. This intervention helps to enhance patients’ decision-making skills and self-esteem. Therefore, the nurse will not help patients with decision making.
The nurse is planning to conduct an educational session for seniors at a community center who look after their grandchildren. From which cultural groups does the nurse expect to see the maximum number of participants?
Cuban
German
Hispanic
Alaskan native
American Indian
Alaskan native
American Indian
In Alaskan native and American Indian cultures, the grandparents take care of their grandchildren more often, as compared with grandparents in the other groups. Therefore, the nurse anticipates that most of the participants in the educational session would be Alaskan Natives and American Indians. In the Cuban, German, and Hispanic cultures, most grandparents do not take responsibility for their grandchildren. Therefore, the nurse does not anticipate finding the maximum number of participants from these cultural groups.
Which conditions are commonly found in non-Hispanic Whites?
Death from cirrhosis
Fetal alcohol syndrome
Greater exposure to ozone
Higher exposure to carbon monoxide
Chronic lower respiratory disease deaths
Death from cirrhosis
Chronic lower respiratory disease death
Because of health disparities, many minority or racial groups are vulnerable to developing certain diseases. Non-Hispanic Whites have a high rate of death from cirrhosis and prevalence of chronic lower respiratory disease. Fetal alcohol syndrome is more common in American Indians and Alaskan Natives because of alcohol consumption by pregnant women. The Asian population has greater exposure to ozone and carbon monoxide. Unlike the Asian population, non-Hispanic Whites are not usually exposed to high levels of ozone and carbon monoxide.
A patient with a severe cold tells the nurse, “I’ve been taking a tonic given by a braucher for the last two weeks.” What does the nurse understand from this information?
The patient is Amish.
The patient is Asian.
The patient is Hispanic.
The patient is American Indian.
The patient is Amish.
Individuals belonging to the Amish culture may consult a braucher, a person who is a folk healer. The braucher uses herbs and tonics to treat patients. Therefore, the nurse anticipates that the patient is Amish. Asians consult an herbalist, an acupuncturist, or a bone setter to treat illness. Hispanics consult a curandero, espiritualista, yerbo, partera, or sabedor to treat illness. American Indians consult a shaman to treat illness. Therefore, the nurse does not anticipate that the patient is Asian, Hispanic, or American Indian.
While caring for an Asian patient with gastrointestinal discomfort, the nurse finds that the patient has a naturalistic perspective on health and illness. Which practice does the nurse anticipate to be most acceptable to the patient?
Providing warm foods
Providing swamp root extract
Providing antacids and analgesics
Providing homeopathic medications
Providing warm foods
A patient with a naturalistic perspective may believe that he or she has gastrointestinal discomfort due to excess cold entering into the body. In order to alleviate the symptoms of the illness, the patient would consume warm food. Therefore, providing warm foods would be most acceptable to the patient. Unlike patients of European heritage, Asian patients do not use swamp root for alleviating illness. The patient with a naturalistic perspective does not believe that illness is caused by impaired body functioning and may not prefer taking medications. A patient with a biomedical perspective prefers taking medications. Unlike patients of European heritage, Asian patients may not take homeopathic medications. However, an Asian patient would consult an herbalist for the treatment of illness.
Individuals from which groups are at high risk for sickle-cell anemia?
Spanish
Italian
Greek
Chinese
Korean
Spanish
Italian
Greek
Sickle-cell anemia is a genetic disorder characterized by sickle-shaped red blood cells. This specific trait is most commonly found among Mediterranean cultural groups. Therefore, people from Spain, Italy, and Greece are at risk for sickle-cell anemia. China and Korea are not Mediterranean countries. Therefore, people from these countries are not susceptible to sickle-cell anemia.
What are indicators of health disparities in Hispanics?
Cirrhosis death
Physical assault
Congenital syphilis
Fetal alcohol syndrome
New cases of tuberculosis
Cirrhosis death
Congenital syphilis
New cases of tuberculosis
There are health disparities between Individuals belonging to different cultures because of variations in social, political, economic, and environmental resources. The indicators of health disparities in Hispanics include congenital syphilis, cirrhosis death, and new cases of tuberculosis. Unlike American Indian or Alaskan Native populations, Hispanics do not have a higher rate of physical assault and fetal alcohol syndrome when compared to the rest of the population.
While caring for a Hispanic patient, the nurse finds that the patient believes in the magicoreligious perspective of healing. Which action does the nurse expect the patient to follow?
Hanging an amulet at home
Visiting the hougan during the illness
Reciting prayers as suggested by the priest
Lighting a candle to cleanse the surroundings
Reciting prayers as suggested by the priest
A patient with a magicoreligious perspective believes in supernatural forces for healing. Hispanics believe in the healing powers of God and say prayers suggested by the Catholic priest. Unlike American Blacks, Hispanics may not visit a hougan or a voodoo priest for the treatment of illness. Unlike the Turks, Hispanics do not hang an amulet at home to ward off negative energy. Also unlike Mexicans, Hispanics do not light candles to cleanse negative energy from the surroundings.
While assessing a patient with tuberculosis, the nurse uses the Brief RCOPE assessment questionnaire. Which questions does the nurse include in the questionnaire?
“Do you question God’s power?”
“Do you ask God to forgive your sins?”
“Do you wonder if God has abandoned you?”
“Do you look for a stronger connection with God?”
“Do you interact with your family during illness?”
“Do you think you are ill due to excess cold in your body?”
“Do you question God’s power?”
“Do you ask God to forgive your sins?”
“Do you wonder if God has abandoned you?”
“Do you look for a stronger connection with God?”
The nurse performs a spiritual assessment in order to understand the patient’s spiritual beliefs and to promote positive coping skills. The Brief RCOPE is a spiritual assessment tool that contains 14 questions that help to understand religious coping. Some people consider illness as a punishment from God for doing wrong. Therefore, the nurse would ask questions related to God, sins, and the patient’s religious beliefs to evaluate the patient’s coping skills. Brief RCOPE does not contain questions related to the patient’s behavior with family members during the illness. Brief RCOPE does not help to determine whether the patient has a naturalistic perspective of illness.
Asian heritages
china india japan korea philippines southeast asia laos cambodia vietnam
african heritages
africa
haiti
jamaica
west indian islands
european heritages
england france germany poland russia
american indian/alaska native
north american indians/ alaska natives
iberian, central and south american heritages
spain portugal brazil cuba mexico puerto rico colombia
asian illness beliefs
imbalance of ‘yin and yang”
african illness beliefs
disharmony with nature
european illness beliefs
absence of well-being
feeling bad
american indian/alaska native illness beliefs
disharmony with nature
iberian/central/south american illness beliefs
punishment for wrongdoing
imbalance of hot and col
asian health protection
wear amulets such as jade
eat correct and compatiable foods
