Chapter 7 Flashcards
Which practice demonstrates cultural competency for the care of clients with a cultural background different to one’s own?
a. Maintaining an open attitude that welcomes differences
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. Maintaining an open attitude that welcomes differences
A community health nurse (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
This nurse didn’t just know or feel bad about the cultural norm—he changed his behavior. That’s the move from awareness to action.
Cultural skill = the ability to adapt clinical skills and behaviors to be culturally appropriate.
In this case: stops crossing his legs to avoid offending Iranian clients.
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How do the other choices compare?
• a. Cultural sensitivity → Recognizing that cultural differences exist and being respectful. It’s a vibe, not an action.
• b. Cultural awareness → Realizing your own cultural biases and that others see the world differently. Also mental, not behavioral.
• c. Cultural knowledge → Learning about other cultures (like, “Hey, I read that exposing your foot can be offensive in Iran.”) Good start, but still no action.
• d. Cultural skill → Using that knowledge to adapt your care. Ding ding ding
A community health nurse (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.” What response does
this statement exemplify?
a. Cultural awareness
b. Cultural blindness
c. Cultural knowledge
d. Cultural preservation
b. Cultural blindness
A client at a community health outpost who describes a culturally safe encounter describes which community health nursing practices?
a. Recognizing and respecting cultural identity
b. Mirroring and matching of cultural behaviours
c. Seeking similarities and commonalities
d. Supporting the adoption of dominant cultural behaviours
a. Recognizing and respecting cultural identity
Why the others are wrong (and slightly ridiculous):
• B. Mirroring and matching cultural behaviours
What are you, a parrot? Cultural safety isn’t about mimicking people—it’s about respecting them. This one’s a hard no.
• C. Seeking similarities and commonalities
That sounds nice, but it’s basically saying “Let’s ignore what makes you unique and focus on what we have in common,” which is not the same as safety. It’s more like a bad icebreaker.
• D. Supporting the adoption of dominant cultural behaviours
That’s just… colonization in a lab coat. Please don’t do that.
What would be 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. Participating in hate crimes
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.” What behaviour does this statement exemplify?
a. Ethnocentrism
b. Prejudice
c. Racism
d. Stereotyping
a. Ethnocentrism
A health care worker tells the community health nurse (CHN), “It does no good to try to teach those Indigenous clients about nutrition because they will just eat whatever they want to, no matter how much we teach them.” What behaviour does this statement
exemplify?
a. Cultural imposition
b. Ethnocentrism
c. Racism
d. Stereotyping
d. Stereotyping
A family from Mexico presents to the community health centre. None of the family members speak English, and no one at the health centre speaks Spanish. What will be the most appropriate action on the part of the community health nurse (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. Finding an interpreter to translate
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, who 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. A female who does not know the client
A female interpreter from the client’s community might still be familiar with the client, which could impact the patient’s comfort and willingness to share sensitive medical information. When discussing private or potentially stigmatized health issues, such as pelvic or genital pain, patients may feel embarrassed or fear social judgment if the interpreter is someone they know or who is closely connected to their community.
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. What 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. Allow family members to provide care to the baby and assess the mother’s knowledge of child care through discussion.
The community health nurse (CHN) who wishes to develop cultural competence can improve cultural awareness by conducting which activity?
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. Considering how the CHN’s personal beliefs and decisions are reflective of his or her culture
The correct answer is b. Considering how the CHN’s personal beliefs and decisions are reflective of his or her culture because self-awareness is the foundation of cultural competence. Before effectively understanding and respecting other cultures, a community health nurse (CHN) must first examine their own cultural biases and how they influence interactions with patients.
Why This Answer is Correct:
• Cultural competence starts with self-reflection. Understanding personal cultural influences helps nurses recognize biases and improve patient interactions.
• Being aware of one’s own background enables better cross-cultural communication. It helps avoid ethnocentric assumptions and allows for more patient-centered care.
• Self-reflection is the first step in cultural humility, which is a continuous learning process rather than assuming complete cultural knowledge.
Why the Other Options Are Less Effective:
• (a) Surveying ethnic groups is useful but does not directly build personal awareness of bias.
• (c) Inviting a family to an event fosters inclusivity but does not address the nurse’s personal cultural lens.
• (d) Studying other cultures is important but is secondary to recognizing personal cultural biases.
The incidence of type 2 diabetes among Indigenous 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 mostly Indigenous students, the community health nurse
(CHN) incorporates into the presentation such foods as bannock and other healthy dishes familiar to Indigenous students. What 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
• Primary prevention: Kicks in once a risk factor is already present, but before disease develops. It tries to prevent the onset of disease by addressing the risk. In this case, Indigenous populations already have a known increased risk for type 2 diabetes. So, teaching culturally sensitive nutrition to prevent progression to diabetes is primary prevention
A nurse practitioner (NP) has just found out that her new immigrant client is not taking the penicillin prescribed because he believes his illness is “hot” and 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
Cultural skill refers to a healthcare provider’s ability to effectively assess and interact with patients from diverse cultural backgrounds. It involves applying cultural awareness and knowledge in practical ways to improve patient care, as seen in the NP’s decision to adjust the medication based on the patient’s cultural beliefs.
Examples of Cultural Skill in Healthcare:
1. Language Accommodation: A nurse using a professional medical interpreter instead of relying on a family member to ensure accurate communication.
2. Dietary Modifications: A dietitian adjusting a nutrition plan to accommodate religious dietary restrictions, such as offering halal or kosher meal options.
3. Healthcare Practices: A provider respecting traditional healing methods and integrating them into a patient’s care plan when possible.
4. Pain Management Sensitivity: Recognizing and respecting different cultural expressions of pain and adjusting assessment techniques accordingly.
5. End-of-Life Care Adjustments: Tailoring care for a patient’s cultural beliefs about death and dying, such as allowing specific rituals or family involvement.
How Cultural Skill Differs from Other Cultural Competency Terms:
• Cultural Awareness – The recognition and understanding that cultural differences exist but does not necessarily involve action.
• Cultural Knowledge – Gaining information about different cultural beliefs, values, and practices.
• Cultural Brokering – Acting as a bridge between different cultural perspectives, often advocating for patients in healthcare settings.
• Cultural Competence – A broader term that includes cultural skill but also encompasses attitudes, behaviors, and policies that enable effective work in cross-cultural situations.
When asking clients about their sexuality, which of the following would be the best screening question to ask first?
a. “Do you have a girlfriend?”
b. “In the last 6 months how many men have you had sex with?”
c. “Do you have sex with men, women or both?”
d. “Do you have a partner?”
d. “Do you have a partner?”
