Culture Powerpoint

Question 1

The nurse recognizes that ethnicity differs from race in that ethnicity

1. Refers to subgroups within a race
2. is a unique factor with culture groups
3. includes more biological identification
4. is the set of conflicting values between races

Answer 1

ANS: 3
Ethnicity refers to a shared identity related to social and cultural heritage, such as values, language, geographical space, and racial characteristics. Race refers to biological attributes.
Subcultures refer to subgroups within a race. A variant cultural pattern is a unique factor within a cultural group. Ethnocentrism is the root of biases and prejudices comprising beliefs and attitudes associating negative permanent characteristics with people who are perceived to be different from the valued group.

Question 2

Within transcultural nursing, sensitivity to social organization is the recognition of the client’s

1. language usage
2. status and effected role in family
3. definition of health and health practices
4. Psychological characteristics and coping mechanisms

Answer 2

ANS: 2
Cultural groups consist of units of social organization delineated by kinship, status hierarchy, and appropriate roles for their members. Sensitivity to social organization is the recognition of the client’s status and role in the family. Sensitivity to communication patterns would be the recognition of the client’s language usage. Culture is the framework used in defining social phenomena such as when a person is considered to be healthy or in need of intervention. The way an individual defines health and health practices needs to be understood by the nurse to best meet the needs of the client. Sensitivity to social organization is not met by recognizing the definition of health for an individual. Psychological characteristics and coping mechanisms may be expressed in a variety of ways across cultures. Sensitivity to social organization is not demonstrated by the recognition of psychological characteristics and coping mechanisms of a particular culture.

Question 3

Traditional Western medicine, in contrast to alternative therapy, uses:

1. acupuncture
2. herbal therapies
3. spiritual advisin
4. medication admisitration

Answer 3

ANS: 4
Traditional Western medicine uses medication administration as a method of treatment.
Acupuncture is an alternative therapy often used in non-Western cultures such as the Chinese and Southeast Asians. Herbal therapy is an alternative therapy often used in non-Western cultures, but not in traditional Western medicine. Spiritual advising is not used in traditional Western medicine, but it may be seen in the African-American cultural group.

Question 4

The nurse is completing an assessment of an Asian-American client. Recognizing that there are commonly seen problems in individuals from this background, the nurse observes for particular signs and symptoms of:

1. hypertension
2. tuberculosis
3. diabetes mellitis
4. lactose intolerance

Answer 4

ANS: 4
Lactose intolerance is frequently observed among Asians, Africans, and Hispanics. Hypertension is commonly seen in African Americans. Aboriginal Canadians descended from native North American Indians and living on reservations have a higher incidence of tuberculosis. Diabetes mellitus is commonly seen among Ute, Pima, and Papago Indians.

Question 5

The nurse recognizes the following as an appropriate strategy for communicating with clients who are not fluent in English?

1. Speaking in a louder tone of voice
2. Incorporating hand gestures and pictures
3. Responding to the client by his or her first name
4. Interacting with an interpreter for all communication

Answer 5

ANS: 2
An appropriate strategy for communicating with clients who are not fluent in English is to incorporate hand gestures and pictures. Speaking in a louder tone of voice will not help the client understand the English language. Responding to the client by his or her first name may demonstrate a lack of respect. The nurse should introduce him or herself and then request the client to introduce himself or herself. An interpreter is not necessary for all communication. However, an interpreter must be used for communicating to the client information about his or her medical condition. It is not acceptable for family members to translate health care information, but they can assist with ongoing interaction during the client’s care.

Question 6

A nurse is caring for an 80 year-old hospitalized patient of the Muslim who is near death. Which nursing action is most inappropriate?

1. Perfuming the room.
2. Positioning the patient supine facing Mecca.
3. Offering grief counseling to family members.
4. Allowing the family privacy time with the patient.

Answer 6

C
Discussion of death and grief counseling are discouraged in the Muslim faith.
Perfuming the room & positioning the patient supine facing Mecca are end of life care rituals in the Muslim faith. Organ donation is sometimes allowed in the Muslim faith. And it is appropriate to allow family quiet time with the patient in final hours.

Question 7

From culture to culture time often takes on different meanings. In exploring the relationship of time to nursing interventions, the nurse should:

1. Avoid using set times to do procedures, if possible
2. Maintain the set times for treatments and inform the client of the schedule
3. Maintain a flexible attitude when the client requests procedures to be done at specific times
4. Encourage clients to set the times when they would like the nurse to perform nursing care activities.

Answer 7

ANS: 3
Because time has different meanings from one culture to another, the nurse should maintain a flexible attitude and not become emotionally upset when the client requests procedures to be done at different times. When making appointments and referrals, anticipated barriers to time adherence should be explored and managed with the client. For organizational purposes, nurses should seek clients’ input and together the nurse and client may set a time to do procedures. Maintaining set times for treatments and informing the client of the schedule do not take into consideration the client’s time orientation. Although the client’s input should be sought, it is not realistic to have clients set their own times for nursing care activities regardless of the schedule. Some procedures may be required more frequently than the client would set, or the nurse may be unable to meet the needs of several clients on the unit at the same time.

Question 8

The nurse recognizes that changes in demographics have an influence on health care delivery. One of the expectations in the United States by the year 2020 is:

1. Growth of the European-American population
2. Increases in the Hispanic and Latino populations
3. Reduction of the African-American, Caucasian, and Hispanic population by 50%
4. Equal growth in the Hispanic-, Asian-, and African-American populations

Answer 8

ANS: 2
By 2020 the population of Hispanic and Latino populations is predicted to triple. Population projections beyond 2000 show Hispanics/Latinos, Asian-Americans, and African-Americans outpacing the growth of white, European-descended groups. The African-American group is projected to double by 2020. By 2020 the population of African Americans is predicted to double and that of Asian Americans and Hispanics/Latinos to triple.

Question 9

While going through the process of acculturation a client will be:

1. Identifying with 2 or more cultures
2. Adapting to and adopting a new culture
3. Showing favor to the dominant culture
4. Socializing within their primary cultural group

Answer 9

ANS: 2
Acculturation is the process of adapting to and adopting a new culture. Biculturalism occurs when an individual identifies equally with two or more cultures. Assimilation occurs when an individual gives up his or her ethnic identity in favor of the dominant culture. Socialization into one’s primary culture as a child is known as enculturation.

Question 10

An example of a nurse imposing his/her own cultural beliefs on a client is evident in which of the following examples?

1. Adaptation of the client’s room to accommodate family members
2. Seeking information on gender-congruent care for an Egyptian client
3. Administering less potent pain medication to an outpatient surgery client
4. Encouraging family members to assist with the client’s feeding and hygiene care

Answer 10

ANS: 3
Holding back more potent pain medication for a client who had a minor procedure is an example of a cultural imposition of the nurse on a client. Adaptation of the client’s room to accommodate extra family members is not an example of cultural imposition on a client, but rather is meeting the client’s need by providing culturally congruent care. Seeking information on gender-congruent care for an Egyptian client is an example of the desire to provide culturally congruent care. Encouraging family to assist with the client’s care is not an example of cultural imposition on a client. Western culture tends to follow a pattern of caring that focuses on self-care and self-determination, whereas non-Western cultures typically have care provided by others.

Question 11

A nurse caring for the Arab community observes a client crying. The woman was recently informed that her radiation treatments may affect her ability to become pregnant. The nurse recognizes that the client is most likely reacting to a cultural attitude regarding:

1. The importance of children to an Arab family
2. The Arab view that infertility is grounds for divorce
3. Infertility is a punishment for unholy living
4. The loss of status among other married Arab women

Answer 11

ANS: 2
Infertility in a woman is considered grounds for divorce and rejection among Arabs. Although infertility is grounds for divorce in Arab cultures, it is the best option for this question.

Question 12

The nurse caring for members of the Hispanic community recognizes which of the following situations as the best reflection of the culture’s view of family caring?

1. A husband calling each evening to tell his wife goodnight
2. Family members taking turns staying with the client at night
3. The daughter bringing her father’s favorite soup to the hospital
4. The eldest son sending a huge floral arrangement to the hospital

Answer 12

ANS: 2
In collectivistic groups such as the Hispanic culture, the physical presence of loved ones with the client demonstrates caring. While the other options show caring, it is not the best option reflecting the Hispanic culture

Question 13

The nurse realizes that the primary goal of a cultural assessment is to:

1. Minimize client distress resulting from unmet cultural expectations
2. Provide care that is in concert with the client’s cultural expectations
3. Identify cultural beliefs and traditions that are important to the client
4. Blend Western nursing practice with the client’s cultural expectations

Answer 13

ANS: 2

Holistic nursing care should address the client’s holistic needs to include cultural needs.

Question 14

The nurse, caring for a comatose Muslim client who is dying, realizes that from a cultural standpoint, the most therapeutic intervention is to:

1. Facilitate the client’s peaceful, pain-controlled death
2. Become familiar with Muslim death and dying traditions
3. Approach the family to identify and discuss any needs that exist
4. Arrange for a private room so the family can grieve traditionally

Answer 14

ANS: 3
Be aware of religious and cultural preferences when helping clients and families prepare for death. Facilitating the client’s peaceful, pain-controlled death is an appropriate intervention; it is not necessarily culturally oriented because nursing strives to facilitate a peaceful, pain-free death for all clients. Becoming familiar with cultural tradition is therapeutic and would have priority if the family were not present to be questioned directly regarding their needs. Arranging for a private room may be a therapeutic intervention because most cultures would prefer some degree of privacy when attending to the death of a loved one, but since the family is present the priority intervention is the one that identifies their needs.

Question 15

The nurse in the emergency room is evaluating a head laceration on an 8 year-year-old Asian-American client. Prior to the physical assessment, the nurse should:

1. Ask the parents to step out of the room.
2. Ask permission to examine the head.
3. Touch the child gently, explaining the procedure
4. Discuss the dismissal care of a laceration.

Answer 15

1.
In the Asian-American culture, the head is considered sacred. Touching the head is seen as disrespectful. Permission must be sought to touch the client. The parents should remain with the child to offer comfort and support

Question 16

A Muslim nurse wears her hijab (head covering) while working her shift on the nursing unit. She feels self coconscious because her patients and co-workers make negative comments about her head covering. Which component of the nurse’s self concept is being affected by these feelings?

1. Body Image
2. Identity
3. Self-Actualization
4. Role Performance

Answer 16

2. Identity involves the internal sense of individuality, wholeness, and consistency of a person over time and in different situations.
   Identity implies being distinct and separate from others. Being “oneself” or living an authentic life.

Question 17

Following a surgical procedure, an older Chinese woman refuses to perform the range of motion and breathing exercises requested, in addition is hesitant to complete her hygienic care and grooming. The nurse recognizes that this is most likely related to:

1. Dependence on health care providers for care
2. Reliance upon family members to assist with care
3. Lack of personal motivation to participate in self-care
4. Reluctance to cooperate with traditional Western medical treatment

Answer 17

ANS: 2
Non-Western cultures traditionally rely heavily on family members to provide care. Although it may be related to dependence on health care providers for care, it is not as likely because non-Western cultures depend on family members to assist with care. While it may be related to lack of personal motivation to participate in self-care, the client’s behavior is more likely a result of her cultural background rather than a lack of motivation. While the client’s behavior may be a result of reluctance to cooperate with Western medical treatments, it is more likely indicative of her cultural dependence on family members.

Question 18

When faced with a scenario where it is believed that a client from another cultural background is using herbal remedies along with the prescribed medication to treat her arthritis. The nurse’s first action should be to:

1. Educate the client concerning the danger of taking herbs and the prescribed medication
2. Inquire of the client as to the reason for using herbal remedies along with the prescribed medication
3. Ask the client to identify what herbal remedies are being used along with the prescribed medications
4. Alert the physician to the client’s use of herbal remedies in addition to the prescribed medications

Answer 18

ANS: 3
Rather than first dismissing the practice as dangerous and incompatible with Western medicine, practitioners need to investigate further whether the practice needs changing. Although educating the client may be appropriate, this cannot be determined until the herb has been identified and it is determined to be harmful in this situation. Asking the client why additional remedies are being used may make the client feel defensive. The nurse needs to first determine what herbs are being used. While alerting the physician is appropriate, it is not the first action to be taken by the nurse. The nurse should initially determine what herbs are being used.

Question 19

Being cared for by a nurse of the opposite gender would be an especially important issue for women from which of the following cultures?

1. Afghan
2. Filipino
3. Native American
4. African American

Answer 19

ANS: 1
Modesty is a strong value among Afghan and Arab women.
Modesty is not an especially important issue for Filipino women.
Modesty is not an especially important issue for Native American women.
Modesty is not an especially important issue for African American women

Question 20

While conducting an initial assessment of an infant, a home health nurse notices he is wearing a soiled piece of braided yarn with a cultural symbol around his neck. Which action by the nurse is most appropriate?
A. Leave the yarn in place but wash it with a cloth and mild soap
B. Ask about it’s significance and suggest that it be placed more safely on his body
C. Explain that the yarn offers no benefit and ask the parents to remove it
D. Remove the yarn because it is soiled and could lead to strangulation.

Answer 20

B
The action that demonstrates cultural sensitivity is the one that inquires about the significance of the braided necklace while taking into account issues of patient safety.

Question 21

An example of a culture where a male relative will regularly decline to observe the birth process is:

1. Pakistani
2. Hispanic
3. Korean
4. Japanese

Answer 21

ANS: 1
Religious beliefs may prohibit the presence of males, including husbands, in the delivery room. This may be observed among devout Muslims, Hindus, and Orthodox Jews. Hispanic men typically do not have religious or cultural beliefs that would prohibit them from the delivery room. Korean men typically do not have religious or cultural beliefs that would prohibit them from the delivery room. Asian men typically do not have religious or cultural beliefs that would prohibit them from the delivery room.

Question 22

The nurse observes a religious charm hanging from the wrist of a client being prepared for surgery. The nurse’s best initial approach is to:

1. Remove the religious charm
2. Securely tape the charm in place
3. Ask the client to leave the charm with family members
4. Clarify whether the charm may remain in place during the procedure

Answer 22

ANS: 4
The nurse should first determine if it is permissible for the item to remain in place during the procedure. Removing the bracelet may create unnecessary stress for the client. Initially the nurse should determine if removal is necessary. Taping the bracelet in place may be appropriate after the nurse determines that the item may remain in place during the procedure. Asking the client to remove the item may create unnecessary stress for the client. Initially the nurse should determine if removal is necessary

Question 23

In the process of preparing a Native American Navajo female for a surgical procedure, a nurse sits down, faces the patient directly, and uses a picture diagram during the education session. Later that day, the patient requests that the nurse who had given pre-procedure instructions, not be allowed to provide post-procedure care. The nurse evaluates that the patient was likely uncomfortable with the first nurse’s teaching because which of the following?

1. Native American females do not make healthcare decisions and do not feel comfortable receiving medical information.
2. Native Americans form a personal friendship with healthcare providers and are uncomfortable with strangers providing health-care information.
3. Native Americans consider direct eye contact disrespectful.
4. Native Americans consider pictures of body parts inappropriate.

Answer 23

c
Native Americans often avoid direct eye contact and consider it disrespectful or aggressive.
Native Americans will accept care from Western American practitioners
Native Americans accept looking at pictures of body parts for education acceptable from health practitioners

Question 24

The nurse recognizes that the family of a deceased Buddhist client will:

1. Bury before sundown
2. Decline viewing the body
3. Not move the body until it is cold
4. Select cremation rather than burial

Answer 24

ANS: 3
Some Buddhists may refuse to move the dead body after death because of their belief that the spirit of the dead takes some time to leave the body. They define death as the absence of consciousness and loss of body warmth. Among Orthodox Jews, the body is generally buried before sundown. Some Asian Indians regard seeing the deceased as adding to the suffering of the family. Hindus and Buddhists believe that the soul lives on and the dead body without the soul is but an empty shell, and therefore may not want to see the body. Muslims prefer burial rather than cremation.

Question 25

A nurse that has the knowledge of the biocultural history of clients and aware that individuals with a greater potential for and incidence of hypertension are:

1. Asians
2. Hispanics
3. Native Americans
4. African Americans

Answer 25

ANS: 4
Malignant hypertension is found more frequently in African Americans. Lactose intolerance is frequently observed among Asians. Hispanics have a higher incidence of lactose intolerance. Native Americans have a higher incidence of tuberculosis and diabetes mellitus.

Question 26

For a client who is a Buddhist and maintains a traditional diet, the nurse will make sure that a sufficient quantity of which of the following is included in the menu?

1. beef
2. milk
3. fish
4. vegtables

Answer 26

ANS: 4
Many Buddhists are vegetarians. The nurse should ensure that a sufficient quantity of vegetables is included in the menu when caring for a Buddhist who maintains a traditional diet. Beef is not a traditional component of a Buddhist’s diet. A sufficient quantity of milk is not necessary for the traditional Buddhist’s diet. A sufficient quantity of fish is not necessary for the traditional Buddhist’s diet.
ANS: 4
Many Buddhists are vegetarians. The nurse should ensure that a sufficient quantity of vegetables is included in the menu when caring for a Buddhist who maintains a traditional diet. Beef is not a traditional component of a Buddhist’s diet. A sufficient quantity of milk is not necessary for the traditional Buddhist’s diet. A sufficient quantity of fish is not necessary for the traditional Buddhist’s diet.

Question 27

A home health nurse is visiting a Hispanic-American client who does not speak English. A translator is not available at the time of the visit. The best approach for the nurse to overcome the language barrier is to:

1. Discuss one issue at a time.
2. Write medical terms down.
3. Offer to return at a different time.
4. Use simple words, gestures, and pictures.

Answer 27

4
If a translator is not present with a client who does not speak English, communication will take more time. The nurse must be creative and patient. Using simple words, gestures and pictures may prove helpful. Written medical terms will not be effective if the client doesn’t understand English. Discussion of one issue at a time does not overcome the language barrier. Rescheduling home visits is not generally acceptable.

Question 28

The nurse is caring for a native-american patient who had placement of a colostomy. The patient states “It is gross that stools are moving through the intestine and draining into a bag attached to my abdomen.” Which of the following actions by the nurse would be the most therapeutic to assist the patient with her altered self concept?
1.Give the patient information about her new colostomy and how to care for it when she goes home.

2. Keep the colostomy covered with a towel or gown to prevent the patient from looking at it.
3. The nurse and the patient should wear a mask when caring for the patient’s colostomy.
4. Give the patient positive feedback with nonveral and verbal responses when caring for her colostomy.

Answer 28

4
The nurse’s acceptance of a client that has an illness affecting body image helps to promote positive change. When a client’s body image has changed, the client and family may look to the nurse to observe nonverbal and verbal communication and reactions to the changed appearance.

Question 29

After birth, a Korean woman may ask for which of the following items associated with cultural beliefs. 
A. Red raspberry leaves
B. Black cohosh 
C. Seaweed Soup
D. Wild yams

Answer 29

ANS-C
Many Korean woman will ask for seaweed soup after childbirth because in the culture is viewed to promote healing and lactation as well as cleanse the blood.