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Test Bank for Latest Canadian Nursing Leadership and Management 1st Edition by Gaudine Chapter 12 Multiple Choice Questions 1) Organizational dimensions of cultural diversity include A B C D management status, union membership, and seniority management status, union membership, and education level work experience, union membership, and seniority work experience, union membership, and education level Answer: a Rationale for correct answer: A Correct: The four layers of diversity, as identified by Gardenswartz and Rowe (1998), and their accompanying dimensions, are as follows: personality dimension (individual differences); internal dimensions (e.g., race, gender, sexual orientation, and physical ability); external dimensions (e.g., income, education level, religion, work experience); and organizational dimensions (e.g., management status, union membership, seniority) B Incorrect: The organizational dimensions of cultural diversity include management status, union membership, and seniority Education level is an external dimension of cultural diversity, not an organizational dimension C Incorrect: The organizational dimensions of cultural diversity include management status, union membership, and seniority Work experience is an external dimension of cultural diversity, not an organizational dimension D Incorrect: The organizational dimensions of cultural diversity include management status, union membership, and seniority Work experience and education level are external dimensions of cultural diversity, not organizational dimensions Client need per NCLEX: safe and effective care environment Integrated Nursing Process: Assessment, Diagnosis, Planning, Implementation, Evaluation Objective: 1—Discuss cultural diversity and the ways in which the people you work with may differ from you and from each other 2) Age, physical ability, and gender are examples of which layer of diversity? A B C D personality internal dimensions external dimensions organizational dimensions Answer: b Rationale for correct answer: A Incorrect: The personality dimension includes individual differences Age, physical ability and gender are internal dimensions of cultural diversity B Correct: The four layers of diversity, as identified by Gardenswartz and Rowe (1998), and their accompanying dimensions, are as follows: personality dimension (individual differences); internal dimensions (e.g., race, gender, sexual orientation, and physical ability); external dimensions (e.g., income, education level, religion, work experience); and organizational dimensions (e.g., management status, union membership, seniority) C Incorrect: External dimensions of cultural diversity include income, education level, religion, and work experience Age, physical ability, and gender are internal dimensions of cultural diversity D Incorrect: Organizational dimensions of cultural diversity include management status, union membership, and seniority Age, physical ability and gender are internal dimensions of cultural diversity Client need per NCLEX: safe and effective care environment, psychological integrity Integrated Nursing Process: Assessment, Diagnosis, Planning, Implementation, Evaluation Objective: 1—Discuss cultural diversity and the ways in which the people you work with may differ from you and from each other 3) The recent accreditation report for a health care organization commented that “decisions appear to include a wide range of perspectives and include an exceptional level of cultural competence.” This organization has shown that their diversity in employees has provided a A B C D diversity challenge diversity competence diversity advantage diversity awareness Answer: c Rationale for correct answer: A Incorrect: Organizational diversity in employees provides a diversity advantage, not a diversity challenge B Incorrect: Organizational diversity in employees provides a diversity advantage, not a diversity competence C Correct: The growing reality of global diversity has brought about an emphasis on the “business case” for increasing ethnic and gender diversity Business organizations, in particular, make the case that there is a diversity advantage for an organization in that diversity in employees brings about better decisions due to a wider range of perspectives, and the fact that a diverse workforce better understands a diverse customer base D Incorrect: Organizational diversity in employees provides a diversity advantage, not diversity awareness Client need per NCLEX: safe and effective care environment, psychological integrity Integrated Nursing Process: Assessment, Diagnosis, Planning, Implementation, Evaluation Objective: 2—Discuss the implications of diversity in health care organizations for nursing staff members, clients/patients, visitors and family members, and nurse leaders 4) Misunderstandings, misperceptions, and conflict can result from A diversity competence B cultural competence C diversity D moral distress Answer: c Rationale for correct answer: A Incorrect: Misunderstandings, misperceptions, and conflict can result from mismanaged diversity in the workplace, not from diversity competence B Incorrect: Misunderstandings, misperceptions, and conflict can result from mismanaged diversity in the workplace, not from cultural competence C Correct: While the positive side given for a diverse workforce is that it brings more perspectives to decisions and improves decision making, there is also a concern about a downside to diversity if it is not managed effectively Some concerns are that diversity in an organization may bring with it miscommunication, conflict due to misunderstandings, and differing values and beliefs that affect team functioning D Incorrect: Misunderstandings, misperceptions and conflict can result from mismanaged diversity in the workplace, not from moral distress Client need per NCLEX: safe and effective care environment, psychological integrity Integrated Nursing Process: Assessment, Diagnosis, Planning, Implementation, Evaluation Objective: 2—Discuss the implications of diversity in health care organizations for nursing staff members, clients/patients, visitors and family members, and nurse leaders 5) In order to develop communication skills that promote culturally diverse settings, a nurse would _ A teach others how to communicate using the accepted methods of communication B seek out and participate in learning opportunities that include a focus on communication and diversity C ask yes/no questions when communication is not effective D identify colleagues who are best suited to working with clients who are culturally diverse and suggest they care for that patient population Answer: b Rationale for correct answer: A Incorrect: Nurses should seek feedback from clients and colleagues, and participate in communication validation exercises (e.g., role-playing exercises; case studies) B Correct: According to the RNAO Best Practice Guidelines, one recommendation for developing communication skills that promote culturally diverse settings is to seek and participate in learning opportunities that include a focus on communication and diversity C Incorrect: Nurses should use a range of communication skills (not only yes/no questions) to effectively communicate with clients and colleagues (including empathetic listening, reflecting, non-judgemental open-ended questioning) D Incorrect: All nurses should develop an awareness of different communication styles and the influence of culture on communication Client need per NCLEX: safe and effective care environment, psychological integrity, health promotion and maintenance Integrated Nursing Process: Assessment, Diagnosis, Planning, Implementation, Evaluation Objective: 3—Examine your attitudes and experiences in working with others who differ in age, culture, gender, profession, experience, education, and hierarchical position 6) Acknowledging one’s own feelings and behaviours toward working with patients, families, and colleagues who have different cultural backgrounds, health behaviours, belief systems, and work practices is an example of A B C D learning to embrace diversity in individuals assessing an organization’s level of cultural competence a workplace policy on diversity institutional racism Answer: a Rationale for correct answer: A Correct: This is one of the aspects of self-awareness within the RNAO’s individual recommendations for developing cultural competencies and behaviours B Incorrect: Acknowledging one’s own feelings and behaviours toward working with patients, families, and colleagues who have different cultural backgrounds, health behaviours, and belief systems is an individual behaviour, and not part of assessing an organization’s level of cultural competence C Incorrect: Acknowledging one’s own feelings and behaviours toward working with patients, families, and colleagues who have different cultural backgrounds, health behaviours, and belief systems is an individual behaviour, and not necessarily part of a workplace policy on diversity D Incorrect: Acknowledging one’s own feelings and behaviours toward working with patients, families, and colleagues who have different cultural backgrounds, health behaviours, and belief systems is one of the aspects of self-awareness within the RNAO’s individual recommendations for developing cultural competencies and behaviours It is not a definition of institutional racism Client need per NCLEX: safe and effective care environment, psychological integrity, health promotion and maintenance Integrated Nursing Process: Assessment, Diagnosis, Planning, Implementation, Evaluation Objective: 3—Examine your attitudes and experiences in working with others who differ in age, culture, gender, profession, experience, education, and hierarchical position 7) An organization that moves along the continuum towards becoming culturally competent works on which three aspects? A B C D aptitude, policies, and practices aptitude, procedures, and practices attitudes, policies, and practices attitudes, policies, and procedures Answer: c Rationale for correct answer: A Incorrect: The three aspects involved in attaining cultural competence are attitudes, policies, and practices B Incorrect: The three aspects involved in attaining cultural competence are attitudes, policies, and practices C Correct: Organizations that wish to move along the continuum to become culturally proficient must work on three aspects: attitudes, policies, and practices There must be congruence between valuing differences, and the policies and practices that reflect such values D Incorrect: The three aspects involved in attaining cultural competence are attitudes, policies, and practices Client need per NCLEX: safe and effective care environment, health promotion and maintenance Integrated Nursing Process: Assessment, Diagnosis, Planning, Implementation, Evaluation Objective: 4—Identify the continuum of cultural competence in an organization and characteristics of organizations that embrace diversity in the workplace 8) A health care organization would be considered to have cultural blindness if it has which of the following characteristics? A B C D It seeks cultural assimilation of clients and employees It adopts policies that destroy cultural links It supports staff in expressing differing perspectives and beliefs It seeks consultation from cultural groups Answer: b Rationale for correct answer: A Incorrect: This is a policy that would promote cultural competence, not cultural blindness B Correct: A culturally blind organization would adopt policies that inadvertently destroy cultural links C Incorrect: This is a policy that would promote cultural competence, not cultural blindness D Incorrect: This is a policy that would promote cultural competence, not cultural blindness Client need per NCLEX: safe and effective care environment, health promotion and maintenance Integrated Nursing Process: Assessment, Diagnosis, Planning, Implementation, Evaluation Objective: 4—Identify the continuum of cultural competence in an organization and characteristics of organizations that embrace diversity in the workplace 9) When preparing for a performance appraisal, a nurse is asked to reflect upon how he has demonstrated respect for cultural diversity in his practice Which statement reflects a good understanding of cultural competence in his practice? A He says he is respectful of his colleagues and does not identify when they are discriminatory, as this is up to them to determine B He says he is respectful of patients when they are not of the same cultural background as he is, but refuses to care for the patient C He says he has participated in a learning session on communication skills and cultural norms D He says he has read about learning sessions on communication skills and cultural norms Answer: c Rationale for correct answer: A Incorrect: This is not one of the aspects of self-awareness identified in the RNAO’s individual recommendations for developing cultural competencies and behaviours B Incorrect: This is not one of the aspects of self-awareness identified in the RNAO’s individual recommendations for developing cultural competencies and behaviours C Correct: Participating in learning opportunities that include a focus on communication and diversity is one of the aspects of self-awareness within the RNAO’s individual recommendations for developing cultural competencies and behaviours D Incorrect: This is not one of the aspects of self-awareness identified in the RNAO’s individual recommendations for developing cultural competencies and behaviours Client need per NCLEX: safe and effective care environment, psychological integrity, health promotion and maintenance Integrated Nursing Process: Assessment, Diagnosis, Planning, Implementation, Evaluation Objective: 5—Describe the role of individual team members in a health care workplace with respect to cultural diversity 10) An organization that is said to be stagnant in their movement toward becoming a culturally safe environment might A dedicate funding in the budget to implement and evaluate strategies to strengthen diversity in the workplace B not recognize that there have been any issues with cultural diversity in the past and, as such, may not include cultural diversity in their strategic plan C develop policies, guidelines, and processes to address change and conflict in the workplace D develop educational strategies to address the diversity of preferred learning styles and behaviours within employee groups Answer: b Rationale for correct answer: A Incorrect: This is a policy that would move the organization forward in becoming culturally safe; it is not an example of stagnation in this process B Correct: In order to move forward in an environment of cultural safety, organizations must articulate, implement, and evaluate the effectiveness of their mission statement, values, and corporate strategic plans that emphasize the value of cultural diversity and competence C Incorrect: This is a policy that would move the organization forward in becoming culturally safe; it is not an example of stagnation in this process D Incorrect: This is a policy that would move the organization forward in becoming culturally safe; it is not an example of stagnation in this process Client need per NCLEX: safe and effective care environment, psychological integrity, health promotion and maintenance Integrated Nursing Process: Assessment, Diagnosis, Planning, Implementation, Evaluation Objective: 5—Describe the role of individual team members in a health care workplace with respect to cultural diversity 11) The key categories of cultural competence of an organization include A B C D organizational norms, boards of directors, and ethics committees asset identification, translation services, and boards of directors boards of directors, human resources, and community consultation human resources, community consultation, and organizational norms Answer: d Rationale for correct answer: A Incorrect: Olavarria et al (2009) identified five key categories for consideration of standards of cultural competence in organizations: 1) organizational norms, principles, and policies; 2) asset and need identification; 3) human resources and management; 4) services and service delivery; and 5) community consultation, partnership, and information exchange B Incorrect: Olavarria et al (2009) identified five key categories for consideration of standards of cultural competence in organizations: 1) organizational norms, principles, and policies; 2) asset and need identification; 3) human resources and management; 4) services and service delivery; and 5) community consultation, partnership, and information exchange C Incorrect: Olavarria et al (2009) identified five key categories for consideration of standards of cultural competence in organizations: 1) organizational norms, principles, and policies; 2) asset and need identification; 3) human resources and management; 4) services and service delivery; and 5) community consultation, partnership, and information exchange D Correct: Olavarria et al (2009) identified five key categories for consideration of standards of cultural competence in organizations: 1) organizational norms, principles, and policies; 2) asset and need identification; 3) human resources and management; 4) services and service delivery; and 5) community consultation, partnership, and information exchange Client need per NCLEX: safe and effective care environment, psychological integrity, health promotion and maintenance Integrated Nursing Process: Assessment, Diagnosis, Planning, Implementation, Evaluation Objective: 6—Describe responsibilities of nurse managers and health care organizations with respect to diversity in health care organizations Short Answer Questions 12) Describe each of the four layers of cultural diversity and how a colleague may differ from you Answer: Correct answers may include the following points personality (individual differences) • internal dimensions (race, age, gender, sexual orientation, physical ability) • external dimensions (income, education level, religion, work experience) • organizational dimensions (management status, union membership, seniority) Client need per NCLEX: safe and effective care environment, psychological integrity • Integrated Nursing Process: Assessment, Diagnosis, Planning, Implementation, Evaluation Objective: 1—Discuss cultural diversity and the ways in which the people you work with may differ from you and from each other 13) As a nursing student, what actions can you take to be more self-aware in your attempts to embrace diversity in individuals? Answer: Correct answers should include some of the following points • • • • Perform self-reflection of one’s own values/beliefs, incorporating feedback from peers Express an awareness of one’s own views of differences among people (e.g., different opinions, different world views, different races, different values, and different views of society) State and continually explore through reflection and feedback how one’s own biases, personal values, and beliefs affect others Identify cultural differences among clients and colleagues in the practice setting • • • • • • Acknowledge one’s own feelings and behaviours toward working with clients, families, and colleagues who have different cultural backgrounds, health behaviours, belief systems, and work practices Explore one’s strategies for resolving conflicts that arise between self and colleagues and/or clients from diverse groups Identify and seek guidance, support, knowledge, and skills from role models who demonstrate cultural proficiency Recognize and address inequitable, discriminatory, and/or racist behaviours or institutional practices when they occur Acknowledge the presence or absence of individuals from diverse cultural backgrounds at all levels in the workplace, reflecting the cultural makeup of the clients or community being served Reflect and act on ways to be inclusive in all aspects of one’s practice Client need per NCLEX: safe and effective care environment, psychological integrity Integrated Nursing Process: Assessment, Diagnosis, Planning, Implementation, Evaluation Objective: 3—Examine your attitudes and experiences in working with others who differ in age, culture, gender, profession, experience, education, and hierarchical position 14) As a nursing student, what actions can you take to develop communication skills that promote a culturally diverse setting? Answer: Correct answers should include some of the following points • • • • Be aware of different communication styles and the influence of culture on communication Be aware of one’s preferred communication style, its strengths and limitations, and how it affects colleagues and recipients of care Seek feedback from clients and colleagues and participate in communication validation exercises (e.g role-playing exercises, case studies) Use a range of communication skills to effectively communicate with clients and colleagues (e.g., empathetic listening, reflecting, non-judgmental openended questioning) • Seek and participate in learning opportunities that include a focus on communication and diversity Client need per NCLEX: safe and effective care environment, psychological integrity, health promotion and maintenance Integrated Nursing Process: Assessment, Diagnosis, Planning, Implementation, Evaluation Objective: 3—Examine your attitudes and experiences in working with others who differ in age, culture, gender, profession, experience, education, and hierarchical position 15) What three aspects must an organization that is working toward cultural competence work on in order to embrace diversity in the workplace? Answer: Correct answer: Organizations that wish to move along the continuum to become culturally proficient must work on three aspects: attitudes, policies, and practices Client need per NCLEX: safe and effective care environment, psychological integrity Integrated Nursing Process: Assessment, Diagnosis, Planning, Implementation, Evaluation Objective: 4—Identify the continuum of cultural competence in an organization and characteristics of organizations that embrace diversity in the workplace 16) What are five key categories of cultural competence of an organization? Answer: Correct answers will include the following points • • organizational norms, principles and policies (e.g., cultural competence is an item in the organization’s budget) asset and need identification • • • human resources and management services and service delivery (e.g., translation and interpretation services) community consultation, partnership, and information exchange Client need per NCLEX: safe and effective care environment Integrated Nursing Process: Assessment, Diagnosis, Planning, Implementation, Evaluation Objective: 6—Describe responsibilities of nurse managers and health care organizations with respect to diversity in health care organizations