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TestBank-Brunner&Suddarth'sTextbookofMedical-SurgicalNursing14e(Hinkle2017)

124

Chapter07:OverviewofTransculturalNursing  1.

Inasmall,ruralhospitalthenurseiscaringforapatientwhospeaksalanguageotherthanEnglish.The nurseneedstouseaninterpretertocommunicatebutthehospitaldoesnothaveaccesstoaninterpreter whospeaksthepatientslanguage.Whenchoosinganotherindividualtointerpretforthispatient,what characteristicshouldthenurseprioritize?

A)

Interpretershouldrecognizetheneedtospeakinaloudvoice.

B)

Interpretershouldbeabletoconducttheconversationquicklytoavoidmisinterpretation.

C)

Interpretershouldbefluentinseveraldialectsofthepatientslanguage.

D)

Interpretershouldknowthatrepetitionmustbeavoidedwhileinterpreting.

Ans:

C Feedback: Culturalneedsshouldbeconsideredwhenchoosinganinterpreter;forinstance,fluencyinvaried dialectsisbeneficial.Inchoosinganinterpreter,youdonotwantonewhospeaksinanexcessivelyloud voice,conductstheconversationtooquickly,oravoidsrepetition.

2.

YouareacommunityhealthnursewhoprovidescaretoagroupofHispanicpeoplelivinginanareathat ispredominantlypopulatedbyCaucasianpeople.HowwouldyoucharacterizetheHispanicpeoplein thiscommunity?

A)

Anunderclass

B)

Asubgroup

C)

Aminority

D)

Anexception

Ans:

C Feedback: Thetermminorityreferstoagroupofpeoplewhosephysicalandculturalcharacteristicsdifferfromthe majorityofpeopleinasociety.Therearefourgenerallyidentifiedminoritygroups:Blacks/African Americans,Hispanics,Asian/PacificIslanders,andNativeAmericans.Suchgroupsarenotreferredtoas exceptionsorunderclasses.Asubgroupisadivisionofagroupthatisinsomewaydistinguishedfrom thelargergroup.

TestBank-Brunner&Suddarth'sTextbookofMedical-SurgicalNursing14e(Hinkle2017)

3.

125

AnurseiscaringforanelderlywomanwhopredominantlyidentifieswithanEastAsianculture.How canthenursebestdemonstrateanawarenessofculturallycongruentcare?

A)

Maintaineyecontactatalltimes.

B)

Trytospeakthepatientsnativelanguage.

C)

Usetouchwhencommunicating.

D)

Establisheffectivecommunication.

Ans:

D Feedback: Establishmentofanenvironmentofculturallycongruentcareandrespectbeginswitheffective communication,whichoccursnotonlythroughwords,butalsothroughbodylanguageandothercues, suchasvoice,tone,andloudness.Notallculturesarecomfortablewitheyecontact.Unlessyouare fluentinthepatientsnativelanguage,tryingtocommunicateinthatlanguagewouldnotbeeffective communication.Notallculturesincorporatetouchwhilecommunicating.

4.

Mostnurseshavebeentaughttomaintaindirecteyecontactwhencommunicatingwithpatients. However,someculturalgroupsdonotusuallyvaluedirecteyecontactwhencommunicatingwiththe nurse.Whichculturalgroupwouldmostlikelyconsiderthedirecteyecontactimpolite?

A)

AfricanAmericans

B)

Hispanics

C)

Canadians

D)

NativeAmericans

Ans:

D Feedback: Eyecontactisaculturallydeterminedbehavior.Althoughmostnurseshavebeentaughttomaintaineye contactwhenspeakingwithpatients,somepeoplefromcertainculturalbackgroundsmayinterpretthis behaviordifferently.Forexample,someAsians,NativeAmericans,Indo-Chinese,Arabs,and Appalachiansmayconsiderdirecteyecontactimpoliteoraggressive,andtheymayaverttheirowneyes whentalkingwithnursesandotherswhomtheyperceivetobeinpositionsofauthority.

5.

Anemergencydepartmentnurseispreparingtoinspectandpalpatetheheadandscalpofanolderadult whoexperiencedafall.Amemberofwhichgroupwouldmostlikelyconsiderthisexaminationasa violationofnorms?

TestBank-Brunner&Suddarth'sTextbookofMedical-SurgicalNursing14e(Hinkle2017)

A)

Jewish

B)

AsianAmerican

C)

Islamic

D)

AfricanAmerican

Ans:

B

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Feedback: FormanyAsianAmericans,itisimpolitetotouchthepatientsheadbecausethespiritisbelievedto resideinthehead.Therefore,assessmentoftheheadorevaluationofaheadinjuryrequirespermission ofthepatient,orafamilymemberifthepatientisnotabletogivepermission.Thisisnotthecasewith theotherlistedgroups. 6.

Thenurseishelpingapatientchoosehermenuoptionsforthefollowingday.Thenursereadsoutthe optionofhamwithscallopedpotatoesandthepatientstatesthatherreligiondoesnotallowthis.Which ofthefollowingismostlikelythepatientsreligion?

A)

RomanCatholicism

B)

Buddhism

C)

Islam

D)

Mormonism

Ans:

C Feedback: ManyIslamicpeopleabstainfromeatingpork.Membersofotherreligionsalsoproscribethe consumptionofmeatingeneral,orporkinparticular,buttheotherlistedreligionsarenotamongthese.

7.

ThenurseispreparingadischargeteachingsessionwithanAsianpatienttoevaluatethepatientsability tochangeadressing.ThepatientspeaksandunderstandsminimalEnglish.Whatwouldbethebestway topromoteunderstandingduringtheteachingsession?

A)

Askthepatienttorepeattheinstructionscarefully.

B)

Writetheprocedureoutforthepatientinsimplelanguage.

TestBank-Brunner&Suddarth'sTextbookofMedical-SurgicalNursing14e(Hinkle2017)

C)

Useaninterpreterduringtheteachingsession.

D)

Havethepatientdemonstratethedressingchange.

Ans:

C

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Feedback: Policiesthatpromoteculturallycompetentcareestablishflexibleregulationspertainingtovisitors (number,frequency,andlengthofvisits),providetranslationservicesfornonEnglish-speakingpatients, andtrainstafftoprovidecareforpatientswithdifferentculturalvalues.Writinginstructions,havingthe patientdemonstratetheprocedure,andaskingthepatienttorepeatinstructionsdonotadequately compensateforthecommunicationbarrierthatexists. 8.

YouarethenursecaringforapatientwhoisarecentimmigranttotheUnitedStatesfromMexico. Whichofthefollowingvariableswouldyouprioritizewhenperforminganassessmentofthepatients culturalbeliefs?

A)

Patientspreviousmedicalhistory

B)

Patientsmaritalstatus

C)

Patientsage

D)

Patientscommunicationstyle

Ans:

D Feedback: Assessmentofapatientscultureshouldincludethepatientscountryoforigin,language(communication style),foodpreferencesorrestrictions,healthmaintenancepractices,andreligiouspreferencesand practices.Thisaspectofassessmentdoesnotexplicitlyincludethepatientssupportsystems,marital status,orage,thougheachoftheseparameterswouldbeassessedatdifferentpoints.

9.

Youarecaringforapatientwhoisterminallyillwhosefamilyhasrequestedtoholdaspiritual ceremonyduringwhichtheywillbeusingincense.Whatwouldbethebestinterventionyoucouldmake onbehalfofthispatient?

A)

Discouragetheuseofincenseinthehospital.

B)

Askthefamilytohavetheceremonyofftheunit.

C)

Arrangefortheceremonytooccurafternotifyingalldepartmentsaffected.

D)

Encouragethefamilytoconducttheceremonyelsewherebecauseitmayaffectotherpatientsin

TestBank-Brunner&Suddarth'sTextbookofMedical-SurgicalNursing14e(Hinkle2017)

128

theunit. Ans:

C Feedback: Culturallycompetentpoliciesaredevelopedtopromoteanenvironmentinwhichthetraditionalhealing, spiritual,andreligiouspracticesofpatientsarerespectedandencouragedandtorecognizethespecial dietarypracticesofpatientsfromselectedculturalgroups.Topromotespiritualityandtranscultural nursing,thenurseshouldmakeorhelptomakethearrangements.Thenurseshouldnotattemptto dissuadethefamilyortorelegatetheceremonytoasiteoutsidethehospital.

10. Aparentinformsthenursethatimmunizationsarecontrarytoherreligiousbeliefs,andshedoesnot wantherchildtoreceiveimmunizations.Thenurseproceedstoinformtheparentthatthechildwillbein gravedangerofillnessallherlifeandwillnotbeallowedtostartschoolunlesssheisimmunized.The nursealsoinformstheparentthatshehadallofherownchildrenvaccinatedwithnoadverseeffects. Thenursesbehaviorisanexampleofwhat? A)

Acculturation

B)

Culturalblindness

C)

Culturalimposition

D)

Culturaltaboos

Ans:

C Feedback: Thenursesbehaviorisanexampleofculturalimposition,definedasthetendencytoimposeones culturalbeliefs,values,andpatternsofbehavioronapersonfromadifferentculture.Acculturationisthe processbywhichmembersofaculturalgroupadapttoorlearnhowtotakeonthebehaviorsofanother group.Culturalblindnessistheinabilityofpeopletorecognizetheirownvalues,beliefs,andpractices andthoseofothersbecauseofstrongethnocentrictendencies.Culturaltaboosareactivitiesorbehaviors thatareavoided,forbidden,orprohibitedbyaparticularculturalgroup.

11. Aninfantwithadiagnosisofpyelonephritisisreceivingcareonthepediatricunitandthenursesreview ofthechildselectronichealthrecordrevealsthattheinfanthasnotreceivedanyofherscheduled immunizations.Themotherinformsthenursethatimmunizationsareagainstherculturalbeliefs,and shedoesnotwantherchildtoreceiveimmunizations.Inthisscenario,whatdothemothersviewson immunizationsrepresent? A)

Acculturation

B)

Culturalblindness

TestBank-Brunner&Suddarth'sTextbookofMedical-SurgicalNursing14e(Hinkle2017)

C)

Aculturalimposition

D)

Aculturaltaboo

Ans:

D

129

Feedback: Immunizationsinthisscenarioareaculturaltaboo.Culturaltaboosaredefinedasactivitiesorbehaviors thatareavoided,forbidden,orprohibitedbyaparticularculturalgroup.Culturalimpositionisdefinedas thetendencytoimposeonesculturalbeliefs,values,andpatternsofbehavioronapersonfroma differentculture.Acculturationistheprocessbywhichmembersofaculturalgroupadapttoorlearn howtotakeonthebehaviorsofanothergroup.Culturalblindnessistheinabilityofpeopletorecognize theirownvalues,beliefs,andpracticesandthoseofothersbecauseofstrongethnocentrictendencies. 12. Inplanningthenursingcareofapatientwholiveswithchronicpain,thenursehasincludedthe interventionoftherapeutictouch.Whencategorizingthisparticularcomplementarytherapy,thenurse shouldidentifyitaswhichofthefollowing? A)

Abiologicallybasedtherapy

B)

Amind-bodyintervention

C)

Amanipulativeandbody-basedmethodtherapy

D)

Anenergytherapy

Ans:

D Feedback: Therapeutictouchisanexampleofanenergytherapy.Biologicallybasedtherapiesincludeherbal therapies,specialdiettherapies,orthomoleculartherapies,andbiologictherapies.Mind-body interventionsincludemeditation,dance,music,arttherapy,prayer,andmentalhealing.Manipulative andbody-basedmethodsincludechiropractic,massagetherapy,osteopathicmanipulation,and reflexology.Theotheroptionsareincorrectbecausetheyarenotexamplesofenergytherapy.

13. YouareadmittingapatientwhoisarecentimmigrantfromChinaandwhohasadiagnosisof adenocarcinoma.Duringthepatientsadmissionassessment,thepatientspeaksofherbeliefsrelatedto healthcareandindirectlyreferencestheyin/yangtheory.Basedonhercancerdiagnosisandher yin/yangbeliefs,whichmealwillthepatientmostlikelyorderforlunch? A)

Chickennoodlesoupwithcrackers,fruitcrisp,andhottea

B)

Turkeysandwich,smalltossedsalad,andicedtea

TestBank-Brunner&Suddarth'sTextbookofMedical-SurgicalNursing14e(Hinkle2017)

C)

Chefssalad,bread,andwater

D)

Fruitsmoothieandgranolabar

Ans:

A

130

Feedback: Foodsareclassifiedascold(yin)andhot(yang)inthenaturalisticorholisticperspective.Inthistheory, foodsaretransformedintoyinandyangenergywhenmetabolizedbythebody.Hotfoodsareeaten whenapersonhasacoldillnesssuchacancer,headache,stomachcramps,andacold.Basedonthis information,thepatientwouldselectchickennoodlesoupwithcrackers,fruitcrisp,andhotteaasthese arehotfoods.Theotheroptionsarecoldfoodsandareeatenwhenapatienthasahotillnesssuchasa fever,rash,sorethroat,ulcer,orinfection. 14. ThenurseisadmittingaNativeAmericanpatientwithuncontrolledhypertensionandtype1diabetesto theunit.Duringtheinitialassessment,thepatientinformsthenursethathehasbeenseekingassistance andcarefromtheshamaninhiscommunity.Thenurserecognizesthatthepatientsbloodpressureand hisbloodsugarlevelareelevateduponadmission.Whatisthenursesbestresponsetothepatients indicationthathiscareproviderisashaman? A)

Thankyouforprovidingtheinformationabouttheshaman,butwewillkeepthatinformationand approachseparatefromyourcurrenthospitalization.

B)

Itseemsthatthecareprovidedbyyourshamanisnotadequatelymanagingyourhypertensionand diabetes,sowewilltryresearchedmedicalapproaches.

C)

Dontworryaboutinsultingyourshaman,ashewillunderstandhisapproachtoyourhypertension anddiabeteswasnotworkingafteryourdoctortellshimhowsickyouwereinthehospital.

D)

Iunderstandthatyouvaluethecareprovidedbytheshaman,butwewouldlikeyoutoconsider medicationsanddietarychangesthatmayloweryourbloodpressureandbloodsugarlevels.

Ans:

D Feedback: NativeAmericanpatientsmayseekassistancefromashamanormedicinemanorwoman.Thenurses bestapproachisnottodisregardthepatientsbeliefinfolkhealersortrytounderminetrustinthe healers.Nursesshouldmakeanefforttoaccommodatethepatientsbeliefswhilealsoadvocatingthe treatmentproposedbyhealthscience.Thenursesbestresponseincorporatingthesestrategiesis,I understandthatyouvaluethecareprovidedbytheshaman,butwewouldlikeyoutoconsider medicationsanddietarychangesthatmayimproveyourbloodpressureandbloodsugarlevels.

15. Thenurseisprovidingcareforanolderadultpatientwhohasadiagnosisofshingles.Thenurseisaware thatthishealthproblemisattributabletothevaricellazostervirus.Thisbeliefisanexampleofwhich paradigmexplainingthecauseofdiseaseandillness? A)

Biomedical

TestBank-Brunner&Suddarth'sTextbookofMedical-SurgicalNursing14e(Hinkle2017)

B)

Naturalistic

C)

Holistic

D)

Factual

Ans:

A

131

Feedback: Thebiomedicalorscientificperspectiveassumesthatalleventsinlifehaveacauseandeffectandthat allofrealitycanbeobservedandmeasured.Oneexampleofthebiomedicalorscientificviewisthe bacterialorviralexplanationofcommunicablediseases.Thenaturalisticorholisticviewstatesthat forcesofnaturemustbekeptinnaturalbalanceorharmony.Factualisnotarecognizedcategoryof beliefs. 16. Inyourroleasacommunityhealthnurse,youarefocusingyourcurrenthealthpromotioneffortson diseasesthataredisproportionatelyrepresentedamongethnicandracialminorities.Whichofthe followingdiseaseswouldyoulikelyaddress?Selectallthatapply. A)

Humanimmunodeficiencyvirus(HIV)

B)

Cancer

C)

Heartdisease

D)

Chronicobstructivepulmonarydisease(COPD)

E)

Alzheimersdisease

Ans:

A,B,C Feedback: Ethnicandracialminoritiesaredisproportionatelyburdenedwithcancer,heartdisease,diabetes,human immunodeficiencyvirus(HIV),infection/acquiredimmunodeficiencysyndrome(AIDS),andother conditions.COPDandAlzheimersdiseaseareincorrectbecausehealthcaredisparitieshavenotbeen notedwiththesetwodiseases.

17. Priortoplanninghealthpromotioninterventionsinyourlocalcommunity,youareappraisingthekey healthcareindicatorsinyourregionandcomparingthemwiththoseinthenationasawhole.Whatdo thesekeyindicatorsrevealabouttheUnitedStates? A)

Asignificantgapinhealthstatusbetweentheoverallpopulationandpeopleofspecificethnic backgrounds

TestBank-Brunner&Suddarth'sTextbookofMedical-SurgicalNursing14e(Hinkle2017)

132

B)

Asignificantgapinhealthcaredeliverybetweentheoverallpopulationandsubgroupsofthe minoritypopulations

C)

AsignificantgapinhealthstatusbetweentheHispanicpopulationandtheNativeAmerican population

D)

AsignificantgapinhealthcaredeliverybetweentheAsianAmericanpopulationandthePacific Islanderpopulation

Ans:

A Feedback: KeyhealthindicatorsintheUnitedStatesrevealasignificantgapinhealthstatusbetweentheoverall Americanpopulationandpeopleofspecificethnicbackgrounds.OptionBisincorrectbecausekey healthcareindicatorsdonotshowagapinhealthcaredeliverybetweentheoverallpopulationand subgroupsofminoritypopulations;optionsCandDareincorrectbecausetheseethnicpopulationsare notsingledoutintheseways.

18. Youareplanninganeducationalinserviceforyournursingcolleagueswiththegoaloffostering culturallycompetentcare.Whatoutcomeshouldyouprioritizewhenplanningthiseducation? A)

Participantswillacknowledgeandadapttodiversityamongtheircolleagues.

B)

Participantswilldevelopinsightintothecharacteristicsoftheirownculture.

C)

Participantswillprovideequalcaretoallpatients,regardlessoftheirbackground.

D)

Participantswillevaluatetheircolleagueslevelsofculturalawareness.

Ans:

A Feedback: Theconceptofculturallycompetentcareappliestohealthcareinstitutions,whichmustdevelop culturallysensitivepoliciesandprovideaclimatethatfosters...