Nursing/Int.Conc: Nursing Process: Implementation Client Need: Psychosocial Integrity Cognitive Level: Application Learning Outcome: 5-1 3 During a health history a patient states he is
Trang 1Link download full: Test bank for Population and Community Health
Nursing 6th Edition by Clark
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Sample
Population and Community Health Nursing, 6e (Clark)
Chapter 5 Cultural Influences on Population Health
1) The nurse is taking a class to become more culturally competent when providing care In this class the nurse learns that the American work ethic is considered to be one that is hardworking and individualistic The nurse should categorize the work ethic as being a part of:
1 Culture
2 Ethnicity
3 Nationality
4 Acculturation
Answer: 1
Explanation: 1 Culture is a universal experience and can transcend ethnic lines Ethnicity can be part of culture In culture, people act in prescribed behavior patterns, though the patterns may have variations from group to group The American work ethic is considered a cultural characteristic of its citizens Nationality is the country of birth Ethnicity is an aggregate of cultural practices and social influences that shape a community’s distinct identity Acculturation is the process of becoming cultured into a group
Nursing/Int.Conc: Nursing Process: Assessment
Client Need: Psychosocial Integrity
Cognitive Level: Analysis
Trang 2Learning Outcome: 5-1
2) Nursing students from various backgrounds enroll in a university’s nursing curriculum The process by which they become nurses includes aspects of:
1 Culture
2 Ethnicity
3 Worldview
4 Acculturation
Answer: 4
Explanation: 4 Acculturation is cultural assimilation, where there is
acquisition of some beliefs, values, and behaviors of another culture, in this case, nursing While the students ultimately become part of the nursing
culture, they have to be assimilated or undergo acculturation to become part
of that culture Ethnicity is an aggregate of cultural practices, social influences, and racial characteristics which is not a part of entering the nursing culture Worldview refers to how a cultural group views the universe and their
relationship to it
Nursing/Int.Conc: Nursing Process: Implementation
Client Need: Psychosocial Integrity
Cognitive Level: Application
Learning Outcome: 5-1
3) During a health history a patient states he is Asian American What should the nurse realize this patient is describing?
1 Race
2 Culture
3 Ethnicity
4 Nationality
Answer: 3
Trang 3Explanation: 3 Referring to oneself by placing the cultural group before the word American explains the patient’s ethnicity, which is an aggregate of
cultural practices, social influences, and racial characteristics that shape a distinct identity Many Americans of different national origins celebrate and practice customs that originated in their ancestors’ countries of birth
Nationality is the country of birth Race is an artificial categorization based on genetic inheritance and appearance Culture is the sum of the ways of
thinking and acting within a group that defines the group Ethnicity can be present in culture
Nursing/Int.Conc: Nursing Process: Assessment
Client Need: Psychosocial Integrity
Cognitive Level: Application
Learning Outcome: 5-1
4) The population health nurse notes that the African American population of the United States has a higher incidence of cardiovascular disease and
diabetes What aspect of this population’s diet should the nurse relate to these health problems?
1 High in fat and sugars
2 Low in processed foods and fat
3 Low in fiber-rich foods and exercise
4 High in starchy vegetables and sugars
Answer: 1
Explanation: 1 The traditional African American diet that relies on foods high
in fat and sugars is connected to the high rates of cardiovascular disease and diabetes in the United States It also has historical roots in foods that were affordable on very limited incomes, which tended to be the fattier meats and foods with sugar A diet low in processed food and fats helps to eliminate these risk factors Fiber rich foods in addition to exercise contribute to
cardiovascular and diabetes prevention While starchy vegetables and sugars can contribute to diabetes, the fat content is a determinant in cardiovascular disease
Nursing/Int.Conc: Nursing Process: Evaluation
Trang 4Client Need: Health Promotion and Maintenance
Cognitive Level: Application
Learning Outcome: 5-2
5) While providing health teaching to an older patient of Asian descent the nurse notes that the patient agrees to all questions the nurse asks What method should the nurse use to determine that the patient understands health teaching?
1 Use simple language that the person can understand
2 Have another member of the person’s family do the teaching
3 Ensure that there is an interpreter nearby while doing the health
teaching
4 Ask the person to give an explanation, in their own words, of the health teaching
Answer: 4
Explanation: 4 There is a great respect for authority among older people of Asian background As such, they tend to agree with what is being said or done rather than question it, even if only for clarity of understanding It would
be considered disrespectful to question authority The nurse could elicit
understanding of the person by asking them to explain what was taught–
essentially a “return demonstration.” There is no indication that the person does not understand English, therefore an interpreter may not be necessary
A family member might wish to be present, but it is not necessary to the
success of the health teaching Using simple language is not the most reliable method to determine if the person understands health teaching; it would be best to elicit understanding of the person by asking them to explain what was taught
Nursing/Int.Conc: Nursing Process: Evaluation
Client Need: Psychosocial Integrity
Cognitive Level: Application
Learning Outcome: 5-2
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6) During a home visit the nurse notes that a patient originally from Mexico seems passive during health teaching and follow-up questions about the home treatment plan What should the nurse conclude about this patient’s behavior?
1 The patient probably does not understand English
2 The patient is not interested in what the nurse is doing
3 There may be cultural factors that explain the patient’s behavior
4 The patient may be uncomfortable with having the nurse in the home Answer: 3
Explanation: 3 Cultural background may influence how the patient responds
to questions and teaching In Mexican culture, it is expected that the nurse, as the authority figure, will take care of all the patient’s needs The nurse may perceive this as disinterest The patient assumes a dependent position in health care There is no indication that the patient is not fluent in English, or that there is discomfort in having the nurse perform a home visit
Nursing/Int.Conc: Nursing Process: Assessment
Client Need: Psychosocial Integrity
Cognitive Level: Analysis
Learning Outcome: 5-2
7) The nurse desires to improve cultural competence when providing patient care What action should the nurse take first to develop this competency?
1 Understand the culture of the patient
2 Identify the goals for culturally competent care
3 Gain proficiency in another language beyond English
4 Understand and recognize the nurse’s own cultural background
Answer: 4
Explanation: 4 Until the nurse can understand and acknowledge the cultural background from which the nurse operates, it will be very difficult to develop cultural competence Gaining proficiency in another language and
understanding the patient’s culture is important to developing cultural
Trang 6competence as well as understanding the goals of culturally competent care, but less important than the nurse understanding and recognizing his or her own cultural background
Nursing/Int.Conc: Nursing Process: Implementation
Client Need: Psychosocial Integrity
Cognitive Level: Application
Learning Outcome: 5-3
8) The population health nurse is planning to develop cultural competence within a community Which actions should the nurse take? (Select all that apply.)
1 Ensuring that all patients are treated in the same manner
2 Recognizing subgroup differences within cultural groups
3 Ensuring that health clinics employ minority staff to deliver care
4 Engaging in community partnerships to help design culturally relevant services
5 Maintaining an up-to-date demographic, cultural, and epidemiologic community profile
Answer: 2, 4, 5
Explanation: 2 Maintaining an up-to-date community demographic profile and engaging in partnerships to help design relevant services are two measures to help develop culturally competent care Employing minority staff and treating all patients the same way does not indicate cultural competence and could actually be offensive to the patients It is important to recognize that
differences within subgroups of a particular culture may exist
4 Maintaining an up-to-date community demographic profile and engaging
in partnerships to help design relevant services are two measures to help develop culturally competent care Employing minority staff and treating all patients the same way does not indicate cultural competence and could actually be offensive to the patients It is important to
recognize that differences within subgroups of a particular culture may exist
Trang 75 Maintaining an up-to-date community demographic profile and engaging
in partnerships to help design relevant services are two measures to help develop culturally competent care Employing minority staff and treating all patients the same way does not indicate cultural competence and could actually be offensive to the patients It is important to
recognize that differences within subgroups of a particular culture may exist
Nursing/Int.Conc: Nursing Process: Implementation
Client Need: Psychosocial Integrity
Cognitive Level: Application
Learning Outcome: 5-5
9) A community has had an influx of immigrant workers due to new
construction of businesses in the community The staff of the local public health clinic know the level of their care meets and exceeds standards set and
do not see a need to change Which behavior is this staff displaying?
1 Cultural blindness
2 Cultural proficiency
3 Cultural competence
4 Cultural destructiveness
Answer: 1
Explanation: 1 Treating everyone alike and ignoring cultural differences such
as this example, with an influx of an immigrant population, is cultural
blindness Cultural destructiveness happens when the dominant culture in the organization believes other cultures are inferior Cultural proficiency occurs when the organization is proactive with diversity and seeks to incorporate it Cultural competence is the result of the products of developing culturally
sensitive care
Nursing/Int.Conc: Nursing Process: Assessment
Client Need: Psychosocial Integrity
Cognitive Level: Analysis
Trang 8Learning Outcome: 5-4
10) The local clinic employs a Hispanic receptionist, who is also used as an interpreter for the many non-English-speaking Latino patients who utilize the clinic Members of the staff believe the patients should learn English, and they have refused offers from the receptionist to learn some basic phrases Which behavior is the staff demonstrating about culturally competent care?
1 Cultural blindness
2 Cultural incapacity
3 Cultural destructiveness
4 Cultural precompetence
Answer: 2
Explanation: 2 A token minority staff is employed to aid patients who cannot speak English and the staff feels no need to change This is cultural
incapacity Cultural destructiveness occurs when organization members
believe others are inferior to the dominant culture and no attempt is made to promote cultural diversity in the workforce Cultural blindness fails to
recognize the differences among cultures and the influence of culture on health and health care Cultural precompetence has the organization planning
to be culturally competent but displays complacence based on minimal effort toward that goal
Nursing/Int.Conc: Nursing Process: Assessment
Client Need: Psychosocial Integrity
Cognitive Level: Analysis
Learning Outcome: 5-4
11) A local hospital has established outreach clinics in the community to
provide health care Several staff members within the clinic component refuse
to go to some of the outreach clinics claiming that the clinics are in a bad section of the community and the residents there are not interested in health promotion Which behavior is the staff demonstrating?
1 Cultural blindness
Trang 92 Cultural incapacity
3 Cultural destructiveness
4 Cultural precompetence
Answer: 3
Explanation: 3 Cultural destructiveness occurs when members of the
organization lack cultural knowledge Linking an area of a community with a preconceived idea of its residents contributes to cultural destructiveness Cultural incapacity occurs when there is token minority representation with no attempt to engage in any cross-cultural training Cultural blindness is where the organization treats everyone the same way Cultural precompetence is where the organization makes plans for cultural competence but is
complacent about its efforts toward it
Nursing/Int.Conc: Nursing Process: Assessment
Client Need: Psychosocial Integrity
Cognitive Level: Analysis
Learning Outcome: 5-4
12) The nurse is preparing to complete a cultural assessment of a group Which components should the nurse include in this assessment? (Select all that apply.)
1 Ask personal questions about the group
2 Look for similarities in one’s own group
3 Talk and interview members of the group
4 Come prepared with prior research done on the group
5 Acknowledge the group’s reliance on alternative therapies
Answer: 2, 3
Explanation: 2 Talking with members of the group can provide insights into the group’s culture Looking for similarities in the group with one’s own group can help the nurse understand the group culture While doing prior research
on a group is acceptable, it could also cause the nurse to have preconceived ideas Asking personal questions may be resented by group members, so this should be ascertained before asking such questions Acknowledging the
Trang 10group’s reliance on alternative therapies implies stereotyping a group and is not part of a cultural assessment process
3 Talking with members of the group can provide insights into the group’s culture Looking for similarities in the group with one’s own group can help the nurse understand the group culture While doing prior research
on a group is acceptable, it could also cause the nurse to have
preconceived ideas Asking personal questions may be resented by group members, so this should be ascertained before asking such
questions Acknowledging the group’s reliance on alternative therapies implies stereotyping a group and is not part of a cultural assessment process
Nursing/Int.Conc: Nursing Process: Assessment
Client Need: Psychosocial Integrity
Cognitive Level: Application
Learning Outcome: 5-5
13) A patient sees a physician for health needs as well as a practitioner of Chinese medicine Which standards should the nurse identify are being met
by the practitioner of Chinese medicine to ensure for the patient’s safety? (Select all that apply.)
1 Causing no additional stress on the patient
2 Nationwide certification in Chinese medicine
3 USDA standards in the herbal preparations used
4 Safety, efficacy, and quality in the Chinese medicine practice
5 No adverse interactions between herbal preparations used and any prescription medications the patient might be on
Answer: 1, 4, 5
Explanation: 1 The patient is utilizing complementary alternative therapy (CAT) with the combination of Western and Chinese medicine The World Health Organization (WHO) has identified safety, efficacy, and quality as a consideration for CAT CAT should put no additional stress on the patient, nor should the Chinese herbal preparations used have any adverse interaction with any prescribed medication While the USDA has some regulatory control