Cultural Competence

Question 1

Total US population passed ____ million in the autumn of 2006

Answer 1

300

Question 2

1 out of __ US residents was in a group other than single race non-hispanic white.

Answer 2

3

Question 3

Minority or “emerging minority” population totaled __ million people. ______ are the largest and fastest growing group. Followed by Asians, american indians & alaska natives, native hawaiians and other pacific islanders.

Answer 3

98, hispanics

Question 4

In comparison to the population as a whole:

• emerging majority groups tend to be ______, with lower median ages and high proportions of the population under the age of 18.
• The non-hispanic, single-race, white population has an ____ median age and a smaller proportion of the pop under the age of 18 years.

Answer 4

younger, older

Question 5

There is one birth every __ seconds. one death every __ seconds, and one international migrant every __ seconds. Therefore, our country gains one person every 11 seconds.

Answer 5

8, 13, 30

Question 6

An act that says services cannot be denied to people of limited english proficiency.

Answer 6

Title VI of the Civil rights act of 1964

Question 7

According to the 2000 census, ___ million americans over 5 years of age speak a language other than English in their homes.

*this represented an increase of 15 million people over the numbers documented by the 1990 census

Answer 7

47

Question 8

What states require that providers offer language assistance in heath care settings?

Answer 8

California, massachusetts, and new york

Question 9

Possessing basic knowledge of and constructive attitudes toward diverse cultural populations

Answer 9

culturally sensitive

Question 10

Applying underlying background knowledge necessary to provide the best possible health care.

Answer 10

Culturally appropriate

Question 11

Understanding and attending to total context of patient’s situation including immigration status, stress factors, social factors, and cultural similarities/differences

Answer 11

Culturally competent

Question 12

The thoughts, communications, actions, beliefs, values, and institutions of racial, ethnic, religious or social groups

Answer 12

Culture

Question 13

What are the characteristics of culture?

Answer 13

Learned, shared, adapted, dynamic

Question 14

______ describes a group united by:

• common geographic origin
• migratory status
• religion
• race
• language
• shared values, traditions, or symbols
• food preferences

Answer 14

Ethnicity

Question 15

______ is a system of beliefs, practices and ethical values, belief in a divine or superhuman power

Answer 15

Religion

Question 16

What are some health related behaviors affected by religion?

Answer 16

Meditating, exercising/physical fitness, sleep habits, vaccinations, willingness to undergo physical exam, pilgrimage, truthfulness about how you feel, hoping for a recovery, coping with stress, genetic screening and counseling, living with a disability, caring for children

Question 17

The process of being raised within a culture and acquiring the characteristics of that group

Answer 17

socialization

Question 18

The process of adapting to acquiring another culture

Answer 18

acculturation

Question 19

The process by which a person develops a new cultural identity and becomes like the members of the dominant culture

Answer 19

Assimilation

Question 20

Differing views of the same disease: Epilepsy

• Uganda: ______, untreatable
• Greece: source of family shame
• Mexican-american: evidence of physical ________
• Hutterites: having endured a trial by god.

Answer 20

Contagious, imbalance

Question 21

For older patients, culture is likely to define their family ________ and affect their knowledge of the systems used by the dominant culture.

Answer 21

responsibilities

Question 22

Theories of causation biomedical:

• Assumes cause and _____
• Views the body as a machine
• Life can be divided into parts
• Endorses ____ theory

Answer 22

effect, germ

Question 23

Forces of nature must be kept in balance, embraces the idea of opposing categories or forces (yin/yang, hot/cold)

Answer 23

Naturalistic

Question 24

Supernatural powers predominate in the area of health and illness, examples include voodoo, witchcraft, and faith healing

Answer 24

magicoreligious

Question 25

Folk healers for the hispanic culture include _______, espiritualista, yerbo, or sabedor

Answer 25

curandero

Question 26

Folk healers for the black culture include a hougan, ________, and old lady

Answer 26

spirtualist

Question 27

Folk healers for the american indian culture is a _____ and medicine woman/man

Answer 27

shaman

Question 28

Folk healers for the Asian culture include ______, acupuncturists, bone setters (joint manipulation)

Answer 28

herbalists

Question 29

Folk healers for Amish peeps include a ______.

Answer 29

Braucher (gift of healing)

Question 30

Steps of cultural competence:

• Understanding one’s own heritage-based cultural ______, beliefs, attitudes and practices
• Identifying meaning of “health” to patient
• Understanding how the health care system works
• Acquiring ______ about the social backgrounds of one’s patients
• Becoming familiar with ______, interpretive services and community resources used by (and available to) your patients and yourself.

Answer 30

values, knowledge, language

Question 31

R.E.S.P.E.C.T:

• ______ that you must know the heritage of yourself and your patient
• ______ the patient within cultural context
• ______ questions that are simple and speak them slowly.
• ______questions throughout the exam
• _______patient to discuss meaning of health and illness with you
• ______patient’s understanding and acceptance of recommendations
• ______the patient within the boundaries of his or her heritage.

Answer 31

realize, examine, select, pace, encourage, check, touch

Question 32

During an assessment, the nurse notices that a patient is handling a small charm that is tied to a leather strip around his neck. Which action by the nurse is appropriate?

A) Ask the patient about the item and its significance.
B) Ask the patient to lock the item with other valuables in the hospital’s safe.
C) Tell the patient that a family member should take valuables home.
D) No action is necessary

Answer 32

Ask the patient about the item and its significance.

Page: 21 The nurse should inquire about the amulet’s meaning. Amulets, such as charms, are often seen as an important means of protection from “evil spirits” by some cultures.

Question 33

In the majority culture of America, coughing, sweating, and diarrhea are symptoms of an illness. For some individuals of Mexican-American origin, however, these symptoms are a normal part of living. The nurse recognizes that this is true, probably because Mexican-Americans:

A) have less efficient immune systems and are often ill.
B) consider these symptoms a part of normal living, not symptoms of ill health.
C) come from Mexico and coughing is normal and healthy there.
D) are usually in a lower socioeconomic group and are more likely to be sick.

Answer 33

consider these symptoms a part of normal living, not symptoms of ill health.

Page: 27 The nurse needs to identify the meaning of health to the patient, remembering that concepts are derived, in part, from the way in which members of the cultural group define health.

Question 34

Among many Asians there is a belief in the yin/yang theory, rooted in the ancient Chinese philosophy of Tao. The nurse recognizes which statement that most accurately reflects “health” in an Asian with this belief?

A) A person is able to work and produce.
B) A person is happy, stable, and feels good.
C) All aspects of the person are in perfect balance.
D) A person is able to care for others and function socially.

Answer 34

All aspects of the person are in perfect balance.

Page: 21 Many Asians believe in the yin/yang theory, in which health is believed to exist when all aspects of the person are in perfect balance. The other statements do not describe this theory.

Question 35

An individual who takes the magicoreligious perspective of illness and disease is likely to believe that his or her illness was caused by:

A) germs and viruses.
B) supernatural forces.
C) eating imbalanced foods.
D) an imbalance within his or her spiritual nature.

Answer 35

supernatural forces.

Page: 21 The basic premise of the magicoreligious perspective is that the world is seen as an arena in which supernatural forces dominate. The fate of the world and those in it depends on the actions of supernatural forces for good or evil. The other answers do not reflect the magicoreligious perspective.

Question 36

If an American Indian has come to the clinic to seek help with regulating her diabetes, the nurse can expect that she:

A) will comply with the treatment prescribed.
B) has obviously given up her beliefs in naturalistic causes of disease.
C) may also be seeking the assistance of a shaman or medicine man.
D) will need extra help in dealing with her illness and may be experiencing a crisis of faith.

Answer 36

may also be seeking the assistance of a shaman or medicine man.

Page: 23 When self-treatment is unsuccessful, the individual may turn to the lay or folk healing systems, to spiritual or religious healing, or to scientific biomedicine. In addition to seeking help from a biomedical or scientific health care provider, patients may also seek help from folk or religious healers.

Question 37

An elderly Mexican-American woman with traditional beliefs has been admitted to an inpatient care unit. A culturally-sensitive nurse would:

A) contact the hospital administrator about the best course of action.
B) automatically get a curandero for her because it is not culturally appropriate for her to request one.
C) further assess the patient’s cultural beliefs and offer the patient assistance in contacting a curandero or priest if she desires.
D) ask the family what they would like to do because Mexican-Americans traditionally give control of decisions to their families.

Answer 37

further assess the patient’s cultural beliefs and offer the patient assistance in contacting a curandero or priest if she desires.

Pages: 22-23 In addition to seeking help from the biomedical/scientific health care provider, patients may also seek help from folk or religious healers. Some people, such as those of Mexican-American or American Indian origins, may believe that the cure is incomplete unless the body, mind, and spirit are also healed (although the division of the person into parts is a Western concept).

Question 38

The nurse is reviewing concepts of cultural aspects of pain. Which statement is true regarding pain?

A) All patients will behave the same way when in pain.
B) Just as patients vary in their perceptions of pain, so will they vary in their expressions of pain.
C) Cultural norms have very little to do with pain tolerance, because pain tolerance is always biologically determined.
D) A patient’s expression of pain is largely dependent on the amount of tissue injury associated with the pain.

Answer 38

Just as patients vary in their perceptions of pain, so will they vary in their expressions of pain.

Page: 25 In addition to expecting variations in pain perception and tolerance, the nurse should expect variations in the expression of pain. It is well known that individuals turn to their social environment for validation and comparison. The other statements are incorrect.

Question 39

The nurse recognizes that working with children with a different cultural perspective may be especially difficult because:

A) children have spiritual needs that are influenced by their stages of development.
B) children have spiritual needs that are direct reflections of what is occurring in their homes.
C) religious beliefs rarely affect the parents’ perceptions of the illness.
D) parents are often the decision makers, and they have no knowledge of their children’s spiritual needs.

Answer 39

children have spiritual needs that are influenced by their stages of development.

Page: 20. Illness during childhood may be an especially difficult clinical situation. Children, as well as adults, have spiritual needs that vary according to the child’s developmental level and the religious climate that exists in the family. The other statements are not correct. 

Question 40

When providing culturally competent care, nurses must incorporate cultural assessments into their health assessments. Which statement is most appropriate to use when initiating an assessment of cultural beliefs with an elderly American Indian patient?

A) “Are you of the Christian 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 40

“What cultural or spiritual beliefs are important to you?”

Page: 17. The nurse needs to assess the cultural beliefs and practices of the patient. American Indians may seek assistance from a medicine man or shaman, but the nurse should not assume this. An open-ended question regarding cultural and spiritual beliefs is best used initially when performing a cultural assessment

Question 41

When planning a cultural assessment, the nurse should include which component?

A) Family history
B) Chief complaint
C) Medical history
D) Health-related beliefs

Answer 41

Health-related beliefs

Pages: 19-20. Health-related beliefs and practices are one component of a cultural assessment. The other items reflect other aspects of the patient’s history.