Chapter 3: Cultural and Social Considerations in Health Assessment

Question 1

Which statement is correct regarding the development of one’s culture?

a. Culture is genetically determined on the basis of racial background.
b. Culture is rooted in several distinctive and specific social elements.
c. Culture is a nonspecific phenomenon and is adaptive, but unnecessary.
d. Culture is biologically determined on the basis of physical characteristics.

Answer 1

b.

Question 2

Which statement correctly exemplifies a critical cultural perspective?

a. Culture is a relational aspect of people that shifts and changes over time.
b. Culture assumes that people act in similar ways in all circumstances.
c. Culture is most clearly reflected in a person’s language and behaviour.
d. Culture adapts to specific environmental factors and available natural resources.

Answer 2

a.

Question 3

Canada’s population is growing, primarily due to international immigration. In addition to this phenomenon, Canada has been experiencing a growth in the number of people:

a. over the age of 80.
b. under the age of 15.
c. under the age of 25.
d. under the age of 39.

Answer 3

a.

Question 4

The term “ethnic group” refers to a population:

a. that shares a common history and language.
b. that shares heritage, culture, language, and/or religion.
c. that is of the same race and has similar national origins.
d. that is related and has similar religious affiliations.

Answer 4

b.

Question 5

A 47-year-old woman who is a recent immigrant to Canada is being seen at the clinic today for her uncontrolled diabetes. The nurse knows that the patient lives with her husband and a large extended family. The nurse concludes that part of the patient’s inability to maintain and comply with her diet and diabetic regime is the foods that this patient eats. This conclusion is an example of:

a. Cultural sensitivity
b. Cultural safety
c. Cultural perspective
d. Culturalism

Answer 5

d.

Question 6

A 28-year-old Aboriginal woman attending a prenatal visit describes her nutritional intake over the past 24 hours to the nurse. It includes two slices of pizza, two cans of soda, and three cookies. The nurse must:

a. advise the patient that she is not eating the required recommended nutritional intake for pregnancy.
b. show the patient how to document her food intake, as she may start gaining unnecessary weight.
c. ask the patient if she is able to cook, or if she would like to go to cooking lessons at a nearby school.
d. explore the patient’s ability to buy healthy food, and whether she is able to cook this food.

Answer 6

d.

Question 7

Which of the following statements accurately describes the concept of culturally competent care?

a. The health care professional is able to understand and speak the patient’s mother tongue.
b. The health care professional possesses a basic knowledge of the patient’s cultural background.
c. The health care professional has knowledge of the significance of social, economic, and cultural contexts.
d. The health care professional understands the rituals, foods, and health care approaches preferred by the patient.

Answer 7

d.

Question 8

Recent Canadian immigration statistics indicate that the majority of people in this country settle in:

a. medium census metropolitan areas.
b. small census metropolitan areas.
c. large census metropolitan areas.
d. extremely large census metropolitan areas.

Answer 8

c.

Question 9

Which of the following statements accurately reflects the concept of ethnicity?
a. Ethnicity is dynamic and ever changing due to political forces.
b. Ethnicity refers to a group that shares heritage, culture, language, or
religion.
c. Ethnicity refers to the belief in a higher power or being.
d. Ethnicity is a learned behaviour that includes language and socialization.

Answer 9

b.

Question 10

Which of the following statements reflects a component of spirituality?

a. It is a belief in the worship of a higher power within an organization.
b. It involves attendance at a specific church, synagogue, temple, mosque, or house of worship.
c. It is central to the human experience as a person searches for meaning in life.
d. It is closely tied to a person’s ethnic, social, cultural, and historical background.

Answer 10

c.

Question 11

A family who immigrated to Canada 3 months ago has come to the clinic to see the nurse practitioner. One of the parents has found work, but not in his field. The other parent has not been able to find a job. This family of five is living in a one bedroom apartment. The nurse practitioner is aware that the health of new immigrants is:

a. negatively affected, due to many contributing factors.
b. positively affected by having access to modern urban hospitals.
c. unlikely to change from pre-immigration status.
d. difficult to assess, as there are no previous health records to review.

Answer 11

a.

Question 12

The nurse is caring for a 23-year-old Aboriginal man. He has had a drinking problem for the past 3 years. He is unemployed and is living in a large urban centre. The nurse is aware that:

a. health care professionals need to remember that alcoholism is a long-standing cultural problem amongst Aboriginals.
b. health care professionals often fail to see the social conditions, systemic racism, and discrimination that shape substance abuse.
c. alcoholism is a treatable disease, with treatment options that are now readily available to patients.
d. working with Aboriginal clients is a very rewarding opportunity, during which nurses can learn a great deal about Aboriginal culture.

Answer 12

b.

Question 13

The Indian Act of 1876 classifies First Nations people into registered status Indians or non-status Indians. Knowing a First Nation’s person’s status is important for health care professionals, as it:

a. informs them of the patient’s provincial health insurance coverage.
b. permits only those with status to have unlimited benefits for health care across Canada.
c. guides health care professional in planning care, as those with status are entitled to certain benefits that are not covered under the provincial plan.
d. is a factor to consider when planning to send the patient to an urban hospital for further treatment and care.

Answer 13

c.

Question 14

A nurse is frequently bothered when a patient does not take the medications as prescribed until the patient speaks with her family. The nurse is so irritated by this behaviour that he often finds it hard to provide appropriate care to this individual. What should the nurse do first in trying to overcome his difficulty?

a. Identify the meaning of family inclusion to the patient
b. Understand that this is a cultural practice that is helpful to the patient
c. Allow the patient to take her medications in the way she believes will be helpful
d. Examine his culturally based values, beliefs, attitudes, and practices

Answer 14

d.

Question 15

While working in the surgical unit, the nurse notices that a patient speaks a language that she cannot understand. The nurse is aware that the hospital has a number of post-operative instructions, translated videos, and brochures in this patient’s language, in addition to having a translator on staff. These are all examples of:

a. language services that are available to all admitted patients.
b. the standards for cultural and linguistically appropriate services.
c. ways of addressing diversity within the hospital.
d. ways in which the hospital is not ready to communicate with diverse patients.

Answer 15

b.

Question 16

When assisting a patient in completing his menu choices, the nurse notes that the patient is choosing foods that the nurse thought were forbidden by the patient’s culture/religion. Which statement best defines this situation?

a. There is a pre-defined approach to cultural/religious choices.
b. The nurse should avoid applying lists of cultural/religious traits to patients.
c. Patients will not observe cultural/religious practices while in the hospital.
d. This is an example of a patient who is not very religious.

Answer 16

b.

Question 17

“Dominant health care culture” refers to:

a. the prevalent Western health care philosophy in Canada.
b. the health care beliefs of the those who are accessing the health care system.
c. the values and ways of dealing with health care and medicine practiced by the whole population.
d. the best way to look at health care and treatment of illness and disease.

Answer 17

a.

Question 18

There is a cultural shift happening in Canada. In 2006, new immigrants came primarily from:

a. European countries.
b. Asia and the Middle East.
c. Central and South America.
d. India.

Answer 18

b.

Question 19

According to Canadian statistics, whose health is more likely to be threatened as a result of poverty?

a. Children of lone-mother families
b. Children of new immigrants
c. Children born in urban centres
d. Children born in rural areas

Answer 19

a.

Question 20

A nurse wants to practice using a relational approach. To do so, he must:

a. treat everyone the same, and avoid looking at individual needs of patients.
b. look at himself, his history, his assumptions, and his biases.
c. ensure that he is nice to all of his patients and their families.
d. take a class on the application of the relational approach.

Answer 20

b.

Question 21

An Aboriginal woman who lives off of the reserve has come to the clinic to seek help with regulating her diabetes. In conducting an interview, the nurse’s priority involves:

a. finding out why the patient is not compliant.
b. reinforcing the health teaching related to diet and exercise.
c. determining if the patient can afford her medications.
d. sending the patient to the diabetic clinic for follow up.

Answer 21

c.

Question 22

An elderly woman is being discharged from the hospital to her home, where she lives with her son and his family. In preparing for discharge, the nurse must consider which of the following statements?

a. All families who care for their parents do so out of a sense of love and loyalty, and the son will be happy to have his mother home, rather than in hospital.
b. It is best to make sure that there is another female available in the house to care for the elderly woman.
c. A family meeting must be held prior to discharge, to ensure that the family understands the plan of care and to determine what supports are needed.
d. A meeting must be held with the son and his wife to find out if they would rather have the patient sent to a long-term care facility, as it is a burden to care for a relative.

Answer 22

c.

Question 23

A nurse preparing to conduct a prenatal class is aware that which of the following groups are at highest risk for infant mortality?

a. European Canadians
b. Asian Canadians
c. African Canadians
d. First Nations

Answer 23

d.

Question 24

When inquiring about a patient’s health. the nurse must remember that:

a. patients will tell nurses anything, as long as they are asked.
b. building trust is important, and that this may occur over time.
c. all patients who seek care understand the Canadian health care system.
d. all patients understand the importance of answering all of the questions they are asked.

Answer 24

b.

Question 25

Which of the following statements is true regarding respect for differences?

a. All patients will behave in the same way when asked questions by a health care professional.
b. Conveying respect for differences will build trust and welcome patients to share their understandings.
c. Having cultural expectations is the key to understanding individual differences.
d. Expressing one’s culture is largely dependent on the amount of his or her exposure to Canadian values.

Answer 25

b.

Question 26

Spirituality is a personal search for

a. a supreme being.
b. a system of beliefs
c. life after death.
d. meaning in one’s life.

Answer 26

d.

Question 27

A 32-year-old patient shares with the nurse that she has been unwell for 2 weeks. She has had a variety of symptoms, and has been treating them with herbs that her mother has provided. The nurse should:

a. tell the patient that it is the herbs that are making her feel unwell.
b. ask the patient more about the effects of the herbs.
c. take a sample of the herbs to send to the laboratory for analysis.
d. ask the patient’s mother to explain the use of the herbs.

Answer 27

b.

Question 28

A 30-year-old woman who was born in Canada brings her 68-year-old mother to hospital. The nurse notes that the mother is reluctant to follow the plan of care, but her daughter, who is a dental hygienist, is insisting that she do so. This is an example of:

a. generational differences.
b. dominant health care culture.
c. lack of respect for independence.
d. critical cultural perspective.

Answer 28

b.

Question 29

A First Nations family requires dental care. The nurse needs to determine which of the following in order to facilitate the best possible care for this family?

a. Do they have coverage under the Indian Act of 1876?
b. Do they live on a reservation, or in town?
c. Do they have Non-Insured Health Benefits?
d. Do they have their provincial health cards?

Answer 29

c.

Question 30

Expecting that all Chinese persons believe in the hot-cold theory of health and illness is an example of:

a. critical cultural perspective.
b. culturalism.
c. ethnic practice.
d. ethnicity.

Answer 30

b.

Question 31

A patient tells the nurse that she believes in “the hot-cold theory, where illness is caused by hot or cold entering the body”. Which of the following responses from the nurse would be most appropriate?

a. ”I do not believe in this theory, but tell me about it.”
b. “I know that this is your belief, but the cause is actually a virus.”
c. ”I did not take this in school, so it’s unfamiliar to me.”
d. “I have not heard of this theory. Tell me more.”

Answer 31

d.

Question 32

When providing culturally competent care, nurses must incorporate cultural assessment into their health assessment. Which statement is most appropriate to use when initiating a cultural beliefs assessment with a First Nations elder?

a. “Are you of the Christian faith, or another faith?”
b. “Do you want to see a medicine man?”
c. “How often do you seek help from medical providers?”
d. “What cultural or spiritual beliefs are important to you?”

Answer 32

d.

Question 33

Which of the following is an example of health inequity?

a. A lack of clean drinking water
b. Having to driving 30 kilometres to consult with a specialist
c. Having access to a variety of fresh fruit and vegetables
d. Having to wait 1 week to see a nurse practitioner

Answer 33

a.

Question 34

Which of the following examples illustrates the concept of cultural safety?

a. Asking a patient to describe his or her job and its potential dangers
b. Asking a patient to describe the daily practices he or she uses to promote health
c. Asking a patient to describe the food safety practices used in his or her household
d. Asking a patient to describe the clothing he or she wears during the various seasons

Answer 34

b.

Question 35

“Aboriginal peoples” refers to which of the following groups?

a. First Nations
b. Métis
c. Inuit
d. First Nations, Métis, and Inuit

Answer 35

d.

Question 36

Participation in a formal institutional structure with its rituals and beliefs is known as:

a. culture.
b. religion.
c. ethnicity.
d. spirituality.

Answer 36

b.

Question 37

Which of the following practices will enhance a health care professional’s ability to connect across differences?

a. Actively examining and reflecting on his or her own values, beliefs and assumptions
b. Gaining comprehensive knowledge about a patient’s family history and cultural/religious practices
c. Living and working in the same area as a patient, in order to obtain similar life experiences
d. Having comprehensive knowledge of anatomy, physiology, diseases, and treatments

Answer 37

a.

Question 38

A family who is new to Canada has come to the family practice unit seeking a primary care practitioner. The mother begins crying, and says that she misses her family back home, but has come to Canada because her husband cannot find work in their country. This is an example of:

a. racialization.
b. immigration.
c. refugee status.
d. a push-pull factor.

Answer 38

d.

Question 39

Before being able to understand the health care needs of another, a health care professional needs to:

a. understand the patient’s meaning of health, wellness, and illness.
b. understand the health care professional’s own social, cultural, and professional background.
c. understand and being able to explain to the patient how the Canadian health care system works.
d. have knowledge of the patient’s social, economic, and political background.

Answer 39

b.

Question 40

Which of the following prevents a health care professional from being able to provide comprehensive care?

a. A lack of knowledge of the social determinants of health
b. Having a list of an ethnic group’s routine practices and their impact on health
c. Reflecting on the cultural practices of patients and their impact on individual health
d. Having knowledge of the relationship between poverty, health, and wellness

Answer 40

a.