Exam 1 - Chapter 4 Flashcards
A paper on culture and illness would be likely to include the statement that:
a. culture is the same as ethnicity.
b. ethnic groups always share common geographic origin and religion.
c. ethnicity involves recognized traditions, symbols, and literature.
d. most members of an ethnic group exhibit identical cultural traits.
C - Ethnicity is a complex phenomenon including traditions, symbols, literature, folklore, food
preferences, and dress. It is a shared identity. Ethnicity is more than just culture. It is social
differentiation based on culture. Even within ethnic groups, there is considerable diversity.
Ethnocentrism is defined as:
a. an understanding of another’s cultural beliefs and practices.
b. a conflict that occurs when an individual interacts with another whose beliefs
differ from his own.
c. application of limited knowledge about one person with characteristics specific to
another person.
d. a belief that one’s ethnic group is superior to that of another.
D - A belief that one’s ethnic group is superior to that of another is the definition of
ethnocentrism. Ethnocentrism does not involve an understanding of the beliefs of others. A
conflict that occurs when an individual interacts with another whose beliefs differ from his
own is the definition of cultural conflict. Application of limited knowledge about one person
with characteristics specific to another person is the definition of stereotyping
Regarding health care disparities, it is true that older adults of color have:
a. equal risk factors for vulnerability as do all older adults.
b. equal risk factors for vulnerability as do the young adults of color.
c. increased risk factors for vulnerability if they are female.
d. an increase in risk factors for vulnerability if care is provided by public facilities
C - Older females of color have an added risk factor for vulnerability (gender) than do males of
the same age and ethnic group. Ethnicity is an added factor for vulnerability. Age is an
additional risk factor for vulnerability. Health care disparities are found across a wide range of
clinical settings.
An older female patient tells a nurse the following: “In my culture, women are the silent
partner in the family. Men make all of the decisions. However, when we came to the United
States, all that changed. I became an American. I am in charge of my family just like my
husband.” This is an example of:
a. enculturation.
b. acculturation.
c. ethnicity.
d. culture competence.
B - Enculturation is defined as cultural beliefs passed down from one generation to the next.
Acculturation is the process by which persons from one culture adapt to another. Ethnicity is
defined as the cultural group that one identifies with. Cultural competence involves stepping
outside our own biases and understanding that others bring a different set of values.
A home care nurse is caring for an older patient from a different culture who is bed-bound and
high risk for development of a pressure ulcer. The nurse discusses the plan of care with the
patient’s daughter, emphasizing the importance of turning every 2 hours and posts a turning
clock on the wall. When the nurse returns later in the week, the turning clock has been
removed, and the patient’s daughters concerns her mother occasionally. She states,
“I am taking very good care of my mother. You just don’t understand; our ways do not
involve doing things on schedules.” The best response by the nurse is:
a. “You must follow my guidelines and turn her every 2 hours, or I will not be able to
take care of her.”
b. “I understand that you value your culture, but culture cannot stop you from
providing good care to your mother.”
c. “I understand that you care very much for your mother. Perhaps caring for her is
too much for you.”
d. “How can we best work together to provide the best care for your mother?”
D - In providing cross-cultural care it is important that the nurse work with the patient and family
and listen carefully and find a way to include the values and beliefs of the patient in the plan
of care
An older patient learns that he has metastatic cancer. The patient states: “I must have angered
God.” This is an example of which type of belief?
a. Biomedical
b. Magico-religious
c. Naturalistic
d. Ayurvedic
B - Magico-religious: views illness as caused by actions of a higher authority.
Biomedical: views disease as a result of abnormalities in structure and function and disease
caused by intrusion of pathogens into the body.
Naturalistic: based on the concepts of balance. Health is seen as a sign of balance.
Ayurvedic: the oldest known paradigm in the naturalistic system. Illness is seen as an
imbalance.
A female nurse is caring for an older woman from the Hasidic Jewish community. The
woman’s son is at the patient’s bedside. The nurse notes that when she communicates with the
patient and her son, the son does not maintain eye contact with her and also notes that he
withdraws when she attempts to shake his hand. The best response by the nurse is to:
a. carry on conversation with the patient only, ignoring the son.
b. continue conversing with both the patient and the son.
c. ask the son to leave since he is not comfortable with her.
d. ask the patient why the son will not engage with her.
B - In some cultures, direct eye contact or contact between men and women is seen as a sexual
advance. This is true in the Hasidic culture. Options A and C are disrespectful to the patient
and her son. Option D may put the son in an uncomfortable position
The nurse in a clinic setting that provides care for an ethnically diverse population of older
clients shows an understanding of the LEARN Model to direct the assessment process when:
(Select all that apply.)
a. recognizing that the client’s hands are clenched as she answers the assessment
questions.
b. asking the client to describe what he thinks will help him feel better.
c. explaining to the client that herbal remedies may not be sufficient treatment for his
chest congestion.
d. acknowledging that the client has a different view of the appropriate treatment.
e. suggesting to the client that it would be beneficial if she would trust her health care
provider to prescribe the correct treatment.
A,B,C,D - The LEARN Model implements active listening to both the client’s verbal and nonverbal
communication as a means of obtaining insight into the client’s perspective of his or her
medical problem. This model also encourages the nurse to recognize that the perceptions may
differ and to explain the differences in perceptions to the client. The model advocates arriving
at a mutually agreed upon treatment plan rather than encouraging the client to surrender
personal autonomy in the decision-making.
A nurse completes a cultural assessment of an older adult who is being admitted to an assisted
living facility. Reasons for completing a cultural assessment include: (Select all that apply.)
a. culture guides decision-making about health, illness, and preventive care.
b. culture provides direction for individuals on how to interact during health care
encounters.
c. culture impacts attitudes toward aging.
d. all members of a culture react in the same way in similar situations.
e. knowledge of culture eliminates health care disparities.
A,B,C - Although knowledge of culture has the potential to optimize care, not all individuals will
respond in the same way to a specific situation. Knowledge of an individual’s culture will not
eliminate health care disparities.
A nurse in the ambulatory care setting is preparing to do an interview with a
non-English-speaking client. The nurse secures an interpreter. In order to have the most
effective interview, the nurse should do which of the following? (Select all that apply.)
a. Look and speak to the interpreter
b. Use technical terminology to ensure accuracy
c. Allow more time for the interview
d. Watch the client’s nonverbal communication
e. Have the interpreter check whether the client understands the communication
C,D - For the most effective interview the nurse should look and speak directly to the client, avoid
the use of jargon and technical terminology, observe the client’s nonverbal communications,
and clarify understanding by asking the client to state in his/her own words what he or she
understood, facilitated by the interpreter. The interview will take longer.
Which of the following is a true statement about gerontological nursing for patients of different races and ethnic backgrounds?
a. The fact that a nurse is white has no bearing on the nurse’s ability to care for minority patients or patients of color.
b. An encyclopedic accumulation of details of a particular culture is the best preparation for caring for persons from that culture.
c. A nurse who works in Illinois does not need to be as concerned about sensitivity to multiple cultures as the nurse who works in California.
d. Facial expressions, body language, posture, and touch are important elements of communication between a nurse and a patient from a different ethnicity.
D - Facial expressions, body language, posture, and touch are important elements of communication between a nurse and a patient from a different ethnicity.
Which of the following is a true statement about differing health belief systems?
a. Personalistic or magicoreligious beliefs have been superseded in Western minds by biomedical principles.
b. In most cultures, older adults are likely to treat themselves using traditional methods before turning to biomedical professionals.
c. Ayurvedic medicine is another name for traditional Chinese medicine.
d. The belief that health depends on maintaining a balance among opposite qualities is characteristic of a magicoreligious belief system.
B - In most cultures, older adults are likely to treat themselves using traditional methods before turning to biomedical professionals.
Which of the following considerations is most likely to be true when working with an interpreter?
a. An interpreter is never needed if the nurse speaks the same language as the patient.
b. When working with interpreters, the nurse can use technical terms or metaphors.
c. A patient’s young granddaughter who speaks fluent English would make the best interpreter because she is familiar with and loves the patient.
d. The nurse should face the patient rather than the interpreter.
D - The nurse should face the patient rather than the interpreter.
A resident in a nursing home insists that a priest hear his confession. The resident is very anxious, and the nursing home does not have a Roman Catholic chaplain. Which intervention should the nurse implement?
a. An Episcopal priest is coming to visit the home this evening. Arrange an appointment with her for the resident.
b. Report the resident’s change in behavior in detail so that the attending physician can appropriately prescribe medication.
c. Refer the resident to the staff psychologist to address the underlying cause of the patient’s anxiety.
d. Look in the local telephone book for a Roman Catholic Church, and ask the priest to visit the resident.
D - Look in the local telephone book for a Roman Catholic Church, and ask the priest to visit the resident.
Which of the following is most likely to be true about caring for an older African-American patient?
a. The patient can expect to find support from his church after discharge.
b. During a physical assessment, an examination of the interior of the patient’s mouth with adequate light is important.
c. The patient may follow hot-cold beliefs.
d. African Americans may avoid eye contact when interacting with others.
B - During a physical assessment, an examination of the interior of the patient’s mouth with adequate light is important.
