Chapter 4 Flashcards
An older Asian female with a diagnosis of depression is cared for by her granddaughter. Her granddaughter is very attentive to the client’s needs, attends every therapy session, and is active in the planning and implementing of the treatment plan. The granddaughter’s valuing of her grandmother is most likely due to her:
a. Ethnicity
b. Cultural beliefs
c. Religion
d. Stereotype
ANS: B
Cultural beliefs develop over many generations and are a learned set of values, beliefs, and behaviors. Asian cultures commonly value their elderly family members. Ethnicity and religion do not explain the granddaughter’s behavior in that ethnicity describes customs and socialization patterns, and religion refers to an organized form of worship. Stereotyping is a preconceived belief about another cultural group, so it does not apply to this situation.
A traditional Arab female client is brought to the emergency department by her husband. She complains of feeling very anxious and short of breath and has chest pain. What would likely be a hindrance to the care of this client?
a. The emergency department physician is female.
b. Her husband asks if he can stay with his wife.
c. One of the emergency department nurses is of Arab descent.
d. The only caregivers available in the emergency department are male.
ANS: D
In some traditional Arab cultures, a woman will not make eye contact with any man except her husband and may not be touched by another man. Having only male staff in the emergency department on this shift would block necessary care. Arrangements would have to be made to have a female staff member come to the emergency department to assist in client care. The other options should not cause a problem.
Disease is defined as:
a. Social dysfunction
b. Emotional dysfunction
c. Physical dysfunction
d. Intellectual dysfunction
ANS: C
Disease differs from illness in that disease is an abnormal physical function, whereas illness refers to social, emotional, and intellectual dysfunction. Illness is affected by culture, but disease is not.
The nurse is caring for a 20-year-old woman from Puerto Rico. The client speaks English, but she is accompanied by her mother, who does not. The client has a history of mental illness, and through the interpreter, the nurse learns that the mother, who has traditional Puerto Rican cultural beliefs, believes that the client’s mental illness is caused by:
a. Witchcraft
b. Stress
c. Chemical imbalances
d. A trance
ANS: A
It is a common traditional Puerto Rican cultural belief that mental illness is caused by witchcraft, magic, or evil spells, as opposed to more traditional Western medicine, which believes that stress and chemical imbalances play a role in mental illness. A trance is considered a state of consciousness in some cultures.
A client is continually late for his appointment at the mental health clinic. What is a likely reason for his lack of punctuality?
a. Need for environmental control
b. Time orientation
c. Space comfort zone
d. Territorial needs
ANS: B
Mental dysfunction can lead to incorrect perception of time, causing the client to be continually late. In addition, some cultures do not see schedules and specific appointment times as important, causing the client to be continually late in the eyes of the caregiver. Environmental control refers to an individual’s need to control his or her perception of the environment. Comfort zones are highly culture based, meaning that individual interpretation of personal space varies among cultures. Territorial needs provide a sense of identity and security for some clients.
Which client communication problem can the nurse most easily correct?
a. Age differences
b. Altered cognition
c. Cultural differences
d. Gender differences
ANS: C
The nurse can easily correct communication problems caused by cultural differences in a number of ways, including learning what cultural beliefs and practices are important to the client and being accepting of those beliefs. Communication problems due to age and gender differences and altered cognition cannot be corrected by the nurse.
What is the social orientation among most middle-class American families?
a. Extended
b. Friends
c. Significant others
d. Nuclear
ANS: D
The nuclear family is the social orientation of family that is seen most frequently in this group. The extended family is seen as the social orientation for cultures such as some Alaskan, traditional Chinese, and Mexican cultures. Friends and significant others are not identified as a social orientation of family.
It is important for the nurse to be familiar with the religious practices of clients cared for most often in a particular region because attitudes toward health and illness, death and burial, food, and procreation have a strong impact on a client’s beliefs and practices. The nurse knows that the religion practiced most often around the world is:
a. Buddhism
b. Jehovah’s Witness
c. Christianity
d. Ahmadiyya
ANS: C
More than 2 billion individuals throughout the world are practicing Christians. Although these religions are seen in large numbers worldwide, it is important for the nurse to be familiar with the religions most frequently seen in the client populations with whom he works within his own area.
The metabolism of psychotropic medications is most likely to be affected by:
a. Ethnicity
b. Religion
c. Culture
d. Values
ANS: A
Ethnicity is a determining factor in a person’s genetic makeup. Religious and cultural practices could play a role in the metabolism of medications as a result of food or alternative treatment interactions with medications, but the metabolism is more closely related to the genetic makeup. Values have little to do with the metabolism of medications.
A Hmong man from Laos is a client at an outpatient mental health clinic and is being seen for his diagnosis of bipolar disorder. The importance of lithium testing was stressed in his discharge plans; however, it is discovered that he has had his lithium level checked only once, rather than the three scheduled times. What is the nurse’s best action?
a. Remind the client about the importance of lithium level testing.
b. Make scheduled appointments for the client to get his lithium level tested.
c. Give the client written information regarding the importance of lithium level
testing and written instructions on how to make appointments for testing.
d. Talk with the client to see if there is a reason that he is not getting his lithium
levels checked as outlined in his discharge plans.
ANS: D
In the Hmong culture, it is believed that loss of blood leads to decreased body strength, which can cause the soul to leave the body, resulting in death. If the nurse did not discuss why the client was not getting his blood levels tested and gave him additional instructions as listed in the other options, the nurse would not understand and would not be able to incorporate the client’s cultural beliefs into the plan of care. The nurse and the client can now make revisions that will be acceptable while meeting the needs of the client.
Culture includes common beliefs and practices in areas such as religion, economics, diet, health, and:
a. Genetics
b. Occupations
c. Patterns of communication
d. Stereotypes
ANS: C
In addition to shared beliefs and practices in religion, economics, diet, and health, a person’s cultural integration consists of patterns of communication, politics, art, and kinship. The other three options are not part of a person’s culture.
What is the usual approach to care for individuals who practice folk medicine?
a. Fragmented
b. Impersonal
c. Disjointed
d. Personalized
ANS: D
Folk medicine is highly personalized; the descriptors fragmented, impersonal, and disjointed more often are associated with the Western medicine approach to health care.
A Navajo Native American is traveling across the country and becomes ill. He visits a hospital emergency department and appears very uncomfortable in the surroundings. The nurse knows that traditional Navajo Native Americans typically receive health care in:
a. Homes
b. Small hospitals
c. Physicians’ offices
d. Outpatient clinics
ANS: A
Many traditional Native Americans receive health care in their homes, community settings, or social places. The emergency department setting would be very uncomfortable for this client.
A client seen in the mental health clinic feels her depression is the result of being “punished” due to becoming pregnant as an adolescent and giving the infant up for adoption against her family’s wishes. This view of her depression is considered:
a. Exaggerated
b. Naturalistic
c. Personalistic
d. Stress
ANS: C
Naturalistic illnesses are caused by impersonal factors without regard for the individual. Forces that exist outside the individual cause mental illness. Personalistic illnesses are seen as aggression or punishment directed toward a specific person.
The nurse in the emergency department finds a woman collapsed on the floor and crying loudly. The woman’s husband was in a car accident and is being attended to by the medical staff. Which statement by the nurse best demonstrates acting in a culturally competent manner?
a. “You need to control yourself. Your husband was not injured that badly.”
b. “Let me take you to a room with more privacy so we can talk.”
c. “I am concerned about how you are acting right now. No one else here is acting like this.”
d. “We will call the psychiatrist to see if medication can be ordered for you.”
ANS: B
The nurse is demonstrating cultural competence and using cross-cultural therapeutic health care skills by offering to allow the client to express herself. The nurse is imposing personal beliefs on expected behavior in the other options.
