Transcultural Concepts in Nursing Care 8th Edition, Margaret Andrews TEST BANK by ACADEMIAMILL

TEST BANK Transcultural Concepts in Nursing Care 8th Edition by Margaret Andrews, Joyceen S. Boyle PhD RN MPH FAAN , John Collins

TABLE OF CONTENTS Chapter 1, Theoretical Foundations of Transcultural Nursing Chapter 2, Culturally Competent Nursing Care Chapter 3, Cultural Competence in the History and Physical Examination Chapter 4, Influence of Cultural and Health Belief Systems on Health Care Chapter 5, Transcultural Perspectives in Childbearing Chapter 6, Transcultural Perspectives in the Nursing Care of Children Chapter 7, Transcultural Perspectives in the Care of Adults Chapter 8, Transcultural Perspectives in the Care of Older Adults Chapter 9, Creating Culturally Competent Health Care Organizations Chapter 10, Transcultural Perspectives in Mental Health Nursing Chapter 11, Culture, Family, and Community Chapter 12, Religion, Culture, and Nursing Chapter 13, Cultural Competence in Ethical Decision-Making

Test Generator Questions, Chapter 1, Theoretical Foundations of Transcultural Nursing 1.

Which component of transcultural nursing has been greatly supported

through the research conducted by anthropologists? A)

Nursing interventions planned on the basis of age and developmental

norms B)

Evaluation of the understanding of risk factors based on cognitive

function C)

Implementation of nursing care, respectful of the individual’s economic

status D)

Assessment of woman’s ability to function successfully in her role

within the family

Which is the basis to support the need for transcultural nursing in a

health care setting that serves a multicultural metropolitan community? A)

The nursing responsibility to provide nursing care for each client who

demonstrates respect and acceptance B)

The ever-expanding numbers of immigrants entering the United States

requiring physical and mental health care C)

The diversity seen in the values, beliefs, behaviors, as well as physical

and mental characteristics of the client population D)

The varying economic and social backgrounds represented in the

population present unique barriers to health care delivery

Which assessment question shows an understanding of the impact of

cultural beliefs and behaviors on a client’s demonstration of pain? A)

“Can you describe the pain you are experiencing for me?”

“Do you understand the long-term effects of chronic pain?”

“Have you ever taken medication to help control your pain?”

“How can I help you deal with the pain you are experiencing?”

Which nursing intervention demonstrates an understanding of the full

scope on culturally sensitive nursing care? A)

When planning a teenaged focused educational program on sexuality,

both homosexual and heterosexual lifestyle choices are discussed B)

When assessing a recently immigrated client’s ability to both speak

and read the dominant language when preparing discharge teaching C)

Including both Eastern traditional folk treatments and Western medical

therapies into the care plan of a client of Chinese descent D)

Directing a discussion concerning treatment options for an Arab female

toward the family’s elder male members

Which questions should the nurse ask the client when assessing

culturally based care factors using Leininger’s transcultural nursing principles? Select all that apply. A)

“In your culture, what do you do to stay healthy?”

“How is death handled in your culture?”

“When you get sick, why don’t you use Western medicine?”

“How do you determine if a person has a disability?”

“In your culture, what do you do when you are sick?”

Which nursing intervention demonstrates one of the strengths of the

transcultural nursing Theory of Culture Care Diversity and Universality? A)

Planning treatments around the prayer schedule of a client who

practices Islam B)

Encouraging a client of Chinese descent to explain the concept of “Ying

and Yang” C)

Assessing for stress factors affecting a client of Haitian descent as well

as the immediate family D)

Evaluating the reading comprehension of a client for whom the

dominant language is the second language

The nurse is caring for an unconscious client with a comfort dog at the

bedside. Which member of the interprofessional health care team should provide the decision on behalf of the client for the most appropriate treatment? A)

Physician

Daughter

Neighbor with medical power of attorney

Spiritual or traditional healer

Which nursing intervention demonstrates an avoidance of one of the

cited criticisms of current transcultural nursing theories? A)

Asking a client who practices Judaism whether he or she will need a

kosher diet menu B)

Making sure that a client who practices Catholicism has his or her

rosary beads always within easy reach

Encouraging a veteran of World War II who fought for Germany to talk

about his or her military experiences D)

Suggesting that an obese client of Irish descent minimize consumption

of beer and potatoes

Which activity would best support the goals of transcultural nursing?

A multidisciplinary research project on the effects of culture on pain

management plans B)

Revising facility visitation policies to support cultures in which family

members remain with the client C)

Organizing a rally to raise awareness of the need for a local free clinic

to serve culturally diverse families D)

Providing staff education regarding the dietary traditions of both the

local Jewish and Arab populations

10.

Which statement demonstrates a lack of knowledge concerning the

role eye contact plays in various cultures? A)

“It’s so important to maintain eye contact with the client while

providing discharge teaching.” B)

“Eye contact can be a difficult nonverbal communication to interpret

from a cultural standpoint.” C)

“I never assume a client’s interest in our conversation on the basis of

his or her willingness to maintain eye contact.” D)

“Many cultures are reluctant to maintain eye contact with nonfamily

members.”

11.

Which consideration is the basis for the selection of an interpreter for

an older client who has a limited ability to speak and understand the dominant language? A)

Younger adults are generally more understanding of American jargon

and so can translate it better. B)

Family members are generally considered good interpreters since they

share the same dialect. C)

The interpreter should ideally be of similar age and of the same gender

as the client. D)

The client should be allowed to select the interpreter as a means of

maintaining autonomy.

12.

The nurse is caring for the following obstetric clients. Which action(s)

demonstrates the proper use of transcultural nursing theoretical foundations? Select all that apply. A)

Instruct on ways to modify dishes from the client’s culture to achieve a

healthy glucose level with a client diagnosed with gestational diabetes. B)

Provide a lesbian couple the request for birth certificate and ask the

birth mother to complete the full names of the mother and father of the newborn. C)

Assess the client traveling to other countries for potential exposure to

illness and signs and symptoms of illness. D)

Remove the hijab without asking from the head of a conscious client

after a motor vehicle incident to examine for potential injuries. E)

Teleconference an expert male obstetrician about a client who

expresses following traditional Islamic cultural beliefs to determine the next steps of care.

13.

The nurse is searching for the best evidence to make culturally

sensitive changes with care for the clients from Hmong culture in a United States hospital using Leininger’s theory. Based upon the following (fictitious) research studies, which should the nurse use as best evidence to improve care? A)

“Randomized controlled trial of antihypertensives use among clients

from Southeast and East Asia” B)

“Perceptions of client form Hmong culture accessing health care in the

United States: A transcultural nursing approach” C)

“Ethnographic study of interactions of nurses with clients from Hmong

culture” D)

“Mixed methods study of clients from Hmong culture receiving prenatal

care in European hospitals”

14.

A local hospital group is creating a local transcultural health care team

to assist with the health care of the community that has seen an influx of refugees from other countries. Which will be necessary for each team member to possess to be a part of the team? Select all that apply. A)

Membership in two nursing orientations whose focus is transcultural

nursing care B)

Proof of formal academic preparation at an accredited institution

Documentation proofing a work history in facilities that serve a

culturally diverse population D)

Appropriate licensure as required by the state

Official certification from the TCNS

15.

In an effort to enhance and provide the best training, the Core

Curriculum was developed to provide the best training in transcultural nursing for nurses and other members of the health care team. Which aspect(s) of the core of knowledge is used to develop this program? Select all that apply. A)

Natural science

Medicine

Philosophy

Social work

Technology

Test Generator Questions, Chapter 2, Culturally Competent Nursing Care 1.

Health care organizations are expected to be culturally competent. Which

service shows the ability to best manage the difference in cultural values and practices? A)

Attempting to assign clients of like cultures as roommates

Ability to adapt special diets to meet client cultural dietary needs

Educating each client to the use of a unit chapel for cultural rituals

Arranging client care to support the cultural need for family involvement

Which nursing activity shows an understanding of the process of culturally

competent nursing practice? A)

Attending two in-service programs yearly on attaining cultural competency

Including cultural assessment questions in an admission interview

Providing a client who does not speak the dominant language with

information written in the native language D)

Encouraging the facility to provide access to language translators

Which nursing intervention best shows compliance with offering linguistically

appropriate services for a culturally diverse population? A)

Speaking to the client in a culturally appropriate dialect

Notifying the client that he or she is entitled to language translation services

Identifying a family member to act as interpreter

Using nonverbal communication techniques whenever possible

The nurse is caring for an older client from Japan who requires treatment for

an enlarged prostate, and the primary care provider offered several treatment options. Which is the best next action to take? A)

Ask the client which treatment option the client has decided.

Answer questions about the treatment options available.

C).

Determine if the client has a living will or would like to make one.

Assess who makes health care decisions for the client.

Which nursing activity has priority when providing culturally congruent care?

Identifying the client’s health care expectations

Assessing the client’s ability to communicate effectively with staff

Self-reflection concerning beliefs associated with the client’s culture

Evaluating the facility’s ability to meet the client’s cultural needs

A nurse provides care to a vast culturally diverse population. How can the

nurse best address the need to provide cultural congruent nursing care? A)

Regularly self-reflecting on personal biases and prejudices

Master the skills required to perform an effective cultural assessment

Regularly attend culture awareness in-service programming

Immersion into the cultures presented by the client population

Which activity will best minimize the risk of allowing discrimination and

prejudicial behaviors to impact personal nursing practice? A)

Asking the client to explain his or her cultural-specific beliefs and practices

Observing and mimicking the practice of a nurse who is viewed as being

culturally sensitive C)

Engaging in regular reflective, cultural self-assessments

Asking culturally diverse clients to evaluate the care being provided

Just as it is important for each nurse to determine and reflect on his or her

own cultural assessment, it is also important for each organization to be aware of its own transcultural position. Which would indicate an organization is meeting the standards for cultural competence? A)

The hospital that invites in speakers from other countries to speak to the

staff once a year B)

The facility that hires a culturally diverse staff

The organization that has a defined set of principles written down and

followed by each staff member D)

The hospital that offers a work-share program where staff at its facility can

swap places with staff at a foreign-based hospital for a short period to become more familiar with the different culture

Which statement demonstrates the nurse’s ability to communicate sincerely

and respectfully with a culturally diverse client population? A)

“I find clients of other cultures to be so interesting to talk to.”

“I’m always careful to apologize when I’m having difficulty understanding a

client.” C)

“Clients whose use of the dominant language is limited, clients can be

severely stressed by the language barrier.” D)

“My assessment interviews with clients whose use of the dominant language

is limited focus on just the basics.”

10.

It is determined that an older, widowed client is a member of a familistic

culture. Which intervention is best directed toward communicating effectively with the client? A)

Directing the assessment questions toward the client’s female family

members B)

Presenting information related to possible treatment modalities to the entire

family C)

Arranging for all information materials to be written in the client’s preferred

dialect

Confirm the client’s wishes about treatment through her oldest son

11.

The nurse is caring for a client with hearing impairment. The client

communicates using American Sign Language. The client is a candidate for cochlear implants. What is the next best action the nurse should provide? A)

Instruct the client about the cochlear implant and how it will improve

hearing. B)

Determine if the client’s insurance will pay for the cochlear implant.

Ask the client how long the client has had the hearing loss and what caused

it. D)

Assess the client’s perception of self-identity and how the client sees his or

her body.

12.

A rural clinic provides health care to a community that consists heavily of

people of Native Americans/First Nations heritage. The nursing staff is concerned that the needs of the local community are not being adequately met. They are aware that research has confirmed which is a potential obstacle? A)

Clients from various ethnic backgrounds are less likely to visit the clinic on a

routine basis. B)

The clinics are not obtaining all the government assistance that is available

to them to operate efficiently. C)

More members of the community are seeking health care in larger facilities.

They are understaffed and unable to provide enough assistance to the

community.

13.

Not only is the nurse responsible for implementing cultural competence but

the organization by which the nurse is employed also has certain responsibilities to ensure cultural competence to provide the best possible health care to the local community. Which is recognized as helping to achieve the goal of achieving organizational cultural competence? A)

Ensuring each client receives written information in his or her first language

Encouraging all staff members to learn several additional languages so

someone will always be available to translate if needed C)

Establishing methods of accountability to ensure that the goals and mission

are being met D)

Offering a variety of health-related classes to the local community to assist

clients with providing better self-care

14.

The nurse is caring for women in a rural community. Which action(s) should

the nurse provide to decrease health disparities? Select all that apply. A)

Place resources in the closest city so women may access them at one

location. B)

Perform a cultural assessment of the various cultural groups within the

community. C)

Evaluate factors inhibiting the women to access health care resources in the

community. D)

Perform a literature review of the represented population groups related to

health outcomes. E)

Follow evidence-based treatment guidelines based upon most of the

population represented.

15.

Many challenges still exist in adequately providing proper health care to

many of the world’s population; however, the 21st century is providing new choices and changes that were not previously available. The nurse must be aware and prepared to deal with these changes and be able to communicate effectively to be able to provide the best health care the individual requires and desires. Which client(s) may represent a cultural challenge for which the nurse should be prepared? Select all that apply. A)

A 65-year-old Canadian gentleman traveling to the United States for knee

replacement surgery B)

A 68-year-old Asian female who needs a refill of her hypertensive

medication, who has just returned home after traveling around in a recreational vehicle with her spouse

A 24-year-old Black female traveling to Mexico for cancer treatment

A 30-year-old Somalian mother who is seeking asylum in the United States

An 18-year-old high school graduate who is just starting college

Test Generator Questions, Chapter 3, Cultural Competence in the History and Physical Examination 1.

Which question would best assist a nurse in determining the health beliefs of

a culturally diverse client who has a history of hypertension? A)

“Have you been taking your antihypertension medication as it was

prescribed?” B)

“Can you identify stressors in your life that may have contributed to high

blood pressure?” C)

“What have you been doing to help control your high blood pressure?”

“Do the ethnic foods you eat tend to be salty?”

Which is the primary criticism for using standardized printed history forms

when assessing the culturally diverse client population? A)

Western medicine’s signs and symptoms are not always recognized as such

by other cultures. B)

People of another culture are not comfortable sharing personal information in

such an impersonal manner. C)

Many cultures rely heavily upon pictures to communicate information rather

than written words. D)

Being asked to fill out a form may be looked upon as an insult by cultures

that are people focused.

Which question asked during the assessment process of a client from a

Native American/First Nations population is directed by currently accurate information regarding that culture’s risk for a specific disease? A)

“Have you ever been tested for diabetes mellitus?”

“Do you have a family history of breast cancer?”

“When was the last time you were tested for tuberculosis?”

“Have you ever been told you have a problem with drinking too much

alcohol?”

Which nursing intervention demonstrates an understanding of the importance

of managing assessment information in a culturally congruent manner? A)

When the client described “creaky joints,” enrolling in the “Arthritis Support

Group” was recommended. B)

The client’s request for, “recipes I can use with my sugar” was met with a

booklet entitled, “Cooking for the Diabetic.” C)

The client’s edema was documented as, “Client reports, ‘My legs swell when I

spend too much time standing’.” D)

The client was educated on the concept of paranoia when reporting belief in

the “evil eye.”

Which nursing action is required when it is determined that a client is self-

administering ginseng for back pain? A)

Questioning the client to determine the daily dosage of the medication

Informing the client that herbal therapy can cause serious side effects

Assessing and documenting the client’s blood pressure

Asking the client to close his or her eyes and touch his or her nose with a

finger

Which statement will be the basis for determining the target population for a

community education program regarding hypertension? A)

Members of the Jewish ethnic culture rarely experience hypertension.

People of Asian descent have a biological risk factor for hypertension.

After age 65, Black males experience on average a 10-point higher systolic

pressure than White males of that same age. D)

Black females have a higher average systolic blood pressure than White

females at every age.

Which additional assessment should be conducted when monitoring a darkly

pigmented person for cyanosis? A)

Observing the client’s gait and posture

Asking the client to provide the location and date of his or her birth

Asking the client to “squeeze my hand” and determine muscle strength

Observing the client’s urinary output for 12 hours

Which nursing intervention demonstrates an understanding of the cultural

preservation when caring for a client with Hispanic heritage? A)

Arranging for the client’s diet to include the appropriate fever-fighting “cold”

foods B)

Encouraging the client’s family to learn to administer the medication as

prescribed C)

Offering to have a sleeping chair moved into the room so the client’s

daughter can stay the night D)

Providing all educational material in the client’s preferred language

What is the basis for assessing the economic status of a culturally diverse

client population as a factor affecting the delivery of individualized health care services? A)

Health care facilities are required to provide free or cost-reduced health care

services to the economically distressed. B)

The lower economic classes have different health care expectations than the

more economically advantaged. C)

The general health of the members of the lower socioeconomic classes is

poor. D)

Federal health care programs will be engaged to help meet the client’s health

care needs.

10.

The nurse is caring for a client at 20 weeks’ gestation after receiving a

slightly higher than normal alpha-fetoprotein (AFP) level. Which action should the nurse implement first? A)

Teach the client about amniocentesis.

Schedule the client for ultrasound.

Explain options for the current pregnancy.

Determine the client’s biocultural variations.

11.

A client admitted to the hospital with seizures suddenly develops the

following signs and symptoms: red macular rash over generalized body. Which action should the nurse implement first? A)

Apply padding to side rails and institute seizure precautions.

Determine if the client is aware of European decent.

Stop the newly prescribed carbamazepine immediately.

Recommend the investigation of the responsible HLA allele.

12.

Evidence-based research has demonstrated differences among the world’s

cultures, which the nurse can utilize when conducting a health history and physical examination. Which would be considered an expected average norm? A)

A bottle-fed infant weighing more than a breast-fed infant

A client of Asian descent with a larger body frame than a client of European

descent C)

A client of Aboriginal descent living in Australia with more body fat than a

client from the First Nations people living in Canada D)

A client with Hispanic heritage with a faster pulse rate than a client of Indian

heritage

13.

Which nursing actions employ awareness of biocultural variations in pain

when caring for a Black client from Africa? Select all that apply. A)

Provide same gender, same race interpreter.

Use the pain scale to quantify the level of pain.

Ask what pain-relieving methods worked in the past.

Administer the lowest ordered dosage of pain medication.

Examine for physiological signs of undertreated pain.

14.

The nurse should assess the client with severe pain for which research-based

contributing factors? Select all that apply. A)

College dropout

Unresolved hypertension

Chronic lower back pain

Currently unemployed

Medicaid insurance

15.

The nurse is caring for an infant recently diagnosed with acute hemolytic

anemia. The mother has no history of having hemolytic anemia. Which additional question(s) should the nurse use to perform a thorough assessment? Select all that apply. A)

“Do you breast-feed the infant, and if so, when was the last time?”

“Have you eaten fava beans, or taken any herbal supplements, or new

drugs?” C)

“Does anyone in your family have glucose-6-phosphate dehydrogenase

deficiency?” D)

“Did your infant have jaundice or yellowing of the skin and eyes after birth?”

“Or you or the infant’s father of Native American or Alaska Native decent?”

Test Generator Questions, Chapter 4, Influence of Cultural and Health Belief Systems on Health Care Practices 1.

Which intervention will best assist the nurse in understanding the culturally

diverse client’s perception and description of his or her current illness? A)

Explaining the meaning of the medical terms that will be used during the

assessment process B)

Determining whether the client subscribes to his or her culture’s generally

held worldview C)

Assessing the client’s ability to both understand and communicate effectively

in the dominant language D)

Encouraging the client to describe his or her illness in terms of his or her

cultural metaphors

What knowledge will best assist a nurse in providing nonprejudicial care that

is sensitive to the beliefs and practices of a culturally diverse client population? A)

Culturally congruent nursing care requires the nurse to continuously learn

about cultural norms and customs. B)

Clients will define and discuss their needs regarding cultural practices when

the nurse encourages them to do so. C)

Nurses will not consciously question the bias of their own thinking and so

must make a concerted effort to do so regularly. D)

While emotionally important to some clients, cultural beliefs and practices are

not major factors regarding their physical health.

Which statement demonstrates the nurse’s understanding of the importance

cultural symbolism has on nursing care? A)

“Do you use a folk remedy for your skin problem?”

“Will your son be here when we discuss your medications?”

“Would you like me to close your room’s door when you are praying?”

“Will you explain to me what you mean when you say your heart hurts?”

When providing care that is respectful of a client’s health belief system, the

nurse bases interventions on the understanding of which understanding? A)

There are three major health belief worldviews that help explain illness.

The major health belief systems do not share mutually accepted principles.

Each health belief worldview incorporates the importance of a health care

provider. D)

The most widely accepted health belief system explains illness in terms of

bacteria and viruses.

Which statement best exhibits a belief in a magico-religious health belief

system? A)

“My church has placed me on our prayer list.”

“My child is so sick because God is punishing me.”

“My family will be visiting after Sunday church service.”

“My family has been members of our church for four generations.”

Which intervention demonstrates integrative nursing care?

Including both exercise and calorie control in a client’s weight loss plan

Educating the client on the importance of limiting his or her intake of both

sodium and fat C)

Respecting a client’s wish to have his or her minister accompany him or her

to the operating room D) pain

Incorporating both prescription and over-the-counter medications to control

The nurse is managing the care of a child newly diagnosed with asthma.

Which intervention demonstrates the nurse’s application of the holistic health belief system? A)

Determining whether any family member is a cigarette smoker

Assessing the child for possible lower respiratory tract infections

Educating both child and parents regarding the prescribed medications

Evaluating the child’s ability to effectively use an inhaler that is prescribed

Which nursing intervention best demonstrates a culturally sensitive approach

to a client’s belief in the effectiveness of folk healers? A)

Asking the client to share his or her reasons for having such faith in the

healer’s abilities B)

Suggesting that the client be open to the practices of both Western and folk

healing C)

Discussing interventions the healer would like incorporated into the client’s

care plan D)

Explaining to the client how Western medicine has adopted many folk healing

practices

Which response is most appropriate when a client describes the alternative

medicine therapy he or she has been using to treat his or her “stomach problems”? A)

“Who suggested this particular treatment to you?”

“Have you been seen by a physician for these symptoms?”

“Most alternate medicine therapies have not been researched for either

safety or effectiveness.” D)

“Share why you are more willing to use alternative medicines than those that

have been proven effective?”

10.

When applying Mechanic’s model of illness behavior, which assessment

question best supports the nurse’s attempt to determine the client’s motivation for seeking health care?

“Do you know what happened to cause the pain in your shoulder?”

“How long have you been experiencing this pain in your shoulder?”

“What have you been doing to help minimize the pain in your shoulder?”

“Has your ability to go to work been affected by the pain in your shoulder?”

11.

A home health care nurse is visiting a new client and notices a few bottles of

supplements that are not recorded in the care plan. What is the best approach for this nurse to take? A)

“Does your physician know you are taking these supplements?”

“Would you mind telling me if these supplements are yours?”

“You know you shouldn’t be taking any supplements without your physician’s

knowledge, right?” D)

“Who told you to take these supplements?”

12.

Which scenario would the nurse recognize as denial by a family member?

The parent who insists the child is just stubborn and misbehaving like the

parent was as a child B)

The parent who brings in the toddler who doesn’t seem interested in playing

with other children C)

The client who has brought in her spouse who stopped bathing and going to

work D)

The adult child who brings in the older adult parent who was found

wandering around the neighborhood

13.

The nurse is caring for a client with a ruptured herniated lumbar disc with

positive blood cultures for a Staphylococcus aureus infection. Which statement made by the client best explains the reason behind a delayed seeking for health care? A)

“I have a strong tolerance for pain, so I was unaware of the seriousness until

I was feeling horrible.”

“I cannot afford to take off work and I have no money saved up for my high

deductible co-pay.” C)

“I went to a chiropractor first who thought that with a series of treatments it

would heal on its own.” D)

“I was taking ibuprofen and acetaminophen for my back pain and did not

realize I had an infection.”

14.

The nurse should be aware that many clients are reluctant to disclose they

are using alternative methods. Which client(s) should the nurse be aware may be using alternative methods? Select all that apply. A)

A 32-year-old Black female who is 22 weeks’ pregnant and this is her first

prenatal visit since finding out she was pregnant B)

A 78-year-old White male who is upset his doctor appointment is the same

time as his exercise class C)

A 28-year-old Asian male who has not seen a physician in 5 years

A 53-year-old Hispanic female who is returning for her first postoperative

visit E)

A 24-year-old Native American/First Nations female who appears in good

condition but has lost 20 lb (9 kg) since her last visit 1 year ago

15.

The nurse is aware that various factors have been identified as influencing an

individual’s behavior in preventing disease. Which client(s) represents those factors? Select all that apply. A)

The boyfriend with a mole whose girlfriend keeps telling him, “That looks just

like my uncle’s and he had cancer.” B)

The 25-year-old female who presents and tells the nurse, “The last time I felt

like this, I had a bladder infection.” C)

The 54-year-old male who tells the nurse, “My mom made me promise to

come for a checkup, but I know I am fine.” D)

The petite grandmother who says, “Every time that commercial comes on, I

feel like they are talking about me.”

The football player who says his coach instructed him to come in for his

yearly physical.

Test Generator Questions, Chapter 5, Transcultural Perspectives in Childbearing 1.

Which assessment question will best provide the nurse with an

understanding of how birth is viewed by an African-based culture? A)

“Does your culture utilize folk healers and natural remedies to manage

labor?” B)

“Can you share with me the concerns you have about your pregnancy and

labor?” C)

“Will you describe for me the care you would expect to receive if you were

giving birth in your homeland?” D)

“Are you comfortable with the type of prenatal and labor care provided to all

pregnant women who give birth at this hospital?”

Which outcome demonstrates the successful implementation of culturally

congruent care for a pregnant client whose culture holds holistic health beliefs? A)

The infant's father cut the umbilical cord.

The mother sipped on an herbal tea to maintain hydration during the labor.

Labor pain was successfully managed with nonpharmacologic interventions.

Family members remained with the mother and infant during the entire

hospitalization.

The nurse is completing the admission assessment for a 28-year-old college

graduate who is labor with her first child. Which question would be the most appropriate for the nurse to ask? A)

“Is your spouse happy the baby is finally arriving?”

“Has it been worth waiting until after college to have your baby?”

“Why did you wait so long to have a baby?”

“Do you have anyone special who you would like to be with you during your

child's birth?”

Which outcome is a common result of unintended pregnancies?

Preterm labor

Uterine hemorrhage

Skeletal deformities

Cardiac malformations

Which viewpoint, regarding birth control, would be supportive of the cultural

beliefs of a woman who practices the Mormon faith? A)

Members of the Mormon faiths love children and strive for large families.

Families who practice the Mormon faith avoid birth control until a son is born.

Birth control is viewed as a sin by the Mormon's religious teachings.

For couples who practice the Mormon faith, they have a religious

responsibility to parent a large family.

The nurse is caring for a client in the prenatal clinic who tested positive for

sickle cell trait (SST). The father is negative for the gene. Which intervention should the nurse provide? A)

Instruct that the infant has a 1:4 chance of having the disease.

Obtain a maternal and paternal cultural immigration history.

Collect frequent sterile urine cultures at each visit.

Prepare the client for increased risk to birth postterm.

What assessment question demonstrates an understanding of the most

common prenatal concern reported by pregnant lesbian women? A)

“Were you and your partner tested for possible HIV/AIDS?”

“Do you feel you are receiving appropriate and effective prenatal care?”

“Will you be prepared to manage the stressors of being a lesbian mother?”

“Are you experiencing any financial problems related to paying for prenatal

care?”

Which behavior would demonstrate appropriate family functioning?

The father of an Italian-American woman being present during birth

A White woman being coached through labor by her sister

The husband of an Arab-American woman cutting the infant's umbilical cord

A Black woman being supported during labor by her grandmother

The nurse is caring for a pregnant client from South Korea. What is the

nurse’s best action(s) to screen the client for intimate partner violence (IPV)? Select all that apply. A)

Ask the spouse to go to the waiting room.

Screen for IPV when there is suspicion.

Use same gender nonrelated interpreter.

Chart findings and only report with permission.

Assess for IPV at each encounter with the client.

10.

Which is essential to the birth when providing culturally congruent care for a

pregnant woman? A)

A thorough cultural assessment

A therapeutic nurse–client relationship

Nursing staff who are culturally sensitive

Identification of the woman's health belief system

11.

A 23-year-old pregnant client asks the nurse for information about giving

birth in her home. How should the nurse respond? A)

Providing the client with information to include, letting her know that there

are times when a client is not able to birth at home but needs care in the hospital B)

Telling the client to find a local midwife group to assist her

Checking with the client's insurance company to see this option is viable

Giving the family of this client information detailing the hazards of home

birth

12.

Some cultures recognize the postpartum period as a time when the woman is

more vulnerable than the pregnancy. How do Muslims refer to the various symptoms of anxiety, crying, mood swings, and emotional instability? A)

“Jinn” possession

“Hot” state

Postpartum depression

“Spirit” possession

13.

The nurse is conducting teaching to the immigrant mother from Mexico

considering breast-feeding. Which statement by the mother indicates a need for additional teaching by the nurse? A)

“Breast-feeding helps in the baby’s development and immune system

support.” B)

“In my culture, women breast-feed their infant until adding milk and table

foods.” C)

“In the United States, women bottle-feed their babies, and I want to be like

them.” D)

“Breast-feeding benefits me by decreasing my risks for breast and ovarian

cancer.”

14.

The nurse is caring for a pregnant client from a blended culture. Which

action(s) should the nurse take to provide culturally congruent care? Select all that apply. A)

Assess what cultures were blended and use printed guidelines about the

cultures. B)

Develop a birthing plan with the client that reflects the cultural preferences.

Predict that the roles of the family are Western in origin when caring for

family. D)

Determine the rituals the blended family wants to follow related to the birth.

Explain that outdated notions about childbearing should be replaced by

modern ones.

15.

The nurse is caring for a pregnant client from Kenya. Which action(s) should

the nurse employ to provide safe and effective care? Select all that apply. A)

Use a standardized pamphlet on nutrition during pregnancy for teaching.

Assess foods that are taboo in the client’s culture during pregnancy.

Provide a list of acceptable foods that may replace taboo foods.

Explain the need to continue the maternal vitamin during the pregnancy.

Teach that eating nonfood items (pica) must not be done during the

pregnancy.

Test Generator Questions, Chapter 6, Transcultural Perspectives in the Nursing Care of Children 1.

Which activity is vital to the survival of cultural values and customs?

Having affluent members of the culture support poorer members

Electing representatives of the culture to governmental positions

Sponsoring cultural events to be attended by the general population

Providing the younger generations with opportunities to show cultural pride

Which situation is especially prevalent in culturally diverse children being

raised in one-parent families and so should be assessed for? A)

Poverty-level existence

Type 1 diabetes

Gang membership

Depression

Which intervention will have the greatest impact on providing culturally

congruent nursing care to a child whose parents speak only a minimal amount of the dominant language? A)

Requesting that the child’s health care provider be fluent in the parents’

dialect B)

Providing the services of a translator who is familiar with the parents’ native

language C)

Assigning a nurse to the family who is able to communicate in the parents’

dialect D)

Assuring that all information is provided in the written form using the

parents’ dialect

Which intervention associated with culturally directed infant attachment

practices will best support autonomy in a 3-year-old child? A)

Rocking the child to sleep

Giving the child finger foods for lunch

Taking the child for walks in the park

Reading to the child as part of the bedtime ritual

Which cultural value should be the basis for nutritional information given to

the Mexican American mother of a newborn? A)

Milk is used to supplement breast milk without recognizing the potential of

triggering a milk allergy. B)

Fat babies are considered healthy because there is little understanding of the

health risks involved. C)

Mexican American families believe in early introduction of solid foods without

realizing the risk of infant choking. D)

There is a high risk for the development of gastritis in a Mexican American

child who was formula fed as an infant.

When a mother seems reluctant to breast-feed her ill infant, the culturally

sensitive nurse asks: A)

“Can I help by providing you with privacy?”

“Will you be willing to give your infant some formula?”

“Are you afraid your baby will become nauseous and vomit?”

“Is there some reason you aren’t willing to nurse your baby?”

What intervention will best facilitate sleep for a 3-year-old Black child who is

hospitalized with bronchitis? A)

Offering the child a high-carbohydrate bedtime snack

Making it possible for a parent to sleep in the child’s bed

Playing the television on a low volume until the child falls asleep

Encouraging the parents to bring the child’s favorite toy to the hospital

The nurse is assessing a 5-month-old infant whose culture includes the use

of a cradleboard. Which physical complication should the nurse be alert to regarding this child? A)

Hip dysplasia

Anterior skull flattening

Abduction of the knees

Hyperflexion of the ankles

Which intervention is appropriate for the treatment of a child for symptoms

generally associated with the act of “casting the evil eye”? A)

Feeding the child bananas and rice cereal

Monitoring the child’s apical heart rate hourly

Introducing fluids to the child every hour while awake

Frequent suctioning of the child’s upper respiratory tract

10.

Which question has particular importance when interviewing a young Amish

couple when their infant is hospitalized with a cardiac problem? A)

“Will you need any special accommodation while here with your child?”

“Is there anyone besides you who will be involved in making medical

decisions for your child?” C)

“Are you prepared to allow your child to receive blood or blood products if

that becomes necessary?” D)

“Does your culture allow for invasive medical procedures in treating your

child’s cardiac condition?”

11.

The nurse is caring for a family of Japanese who lived in America before their

children were born and the parent commented that the adolescent children are much taller than their first cousins living in Japan. Which explanation should the nurse provide?

The mother or father must have carried the gene that enabled the offspring

to become taller and larger. B)

Japanese children born in America grow larger and taller because of diet,

climate, and environment. C)

Adolescents may experience a growth spurt at different times and the

cousins will likely catch up. D)

The United States has better prenatal care resulting in larger and taller

offspring for all ethnicities.

12.

Which approach would be appropriate for the nurse to take to help encourage

a hospitalized child to eat? A)

Teaching the child how to properly use a fork

Instructing the family to bring food from home that the child likes

Asking the family to leave during mealtime

Supporting the child’s normal feeding customs as much as possible

13.

The nurse needs to be aware of the cultural differences in raising children to

be able to recognize potential abuse or harm to the child. Which example represents a potential incident of abuse and should be further investigated to protect the child? A)

The Middle Eastern mother who presents to the clinic with her infant wrapped

in blankets on a warm day B)

The Cambodian toddler with large red circles on her back

The Black father who spanked his 4-year-old for wetting his bed at night

The young Hispanic girl who mentions that her uncle plays games with her at

night in her room

14.

The nurse is caring for new immigrants and children in Nevada. Using census

data, which action(s) should the nurse implement to best serve the population? Select all that apply.

Provide an increased number of bilingual nurses and professional

interpreters. B)

Predict 6% of all immigrant households experience linguistic isolation.

Nurses need to concentrate on Hispanic culture to best serve the clients.

There should be an effort to recruit people from the cultures into nursing.

The nurse should follow standardized guidelines when caring for clients.

15.

The nurse must be careful not to stereotype individuals according to the

perceived cultural influence but to conduct an accurate individual assessment to determine the situation of each individual. Which potential variable(s) is recognized as altering the way an individual follows the cultural norms? Select all that apply. A)

The age an individual marries and starts own family

Following family customs

The length of time lived in a different country or culture

The potential of changing norms over time

The beliefs of the individual

Test Generator Questions, Chapter 7, Transcultural Perspectives in the Care of Adults 1.

Which cultural fact will be the basic force to manage when assessing a

perimenopausal woman who immigrated to the United States? A)

The longer an emigrate has lived in the United States, the more likely she is

to report menopausal symptoms. B)

The larger the family group residing together, the fewer menopausal

symptoms the emigrate woman will report. C)

The larger the number of females in the client’s extended family, the more

menopausal symptoms she will report. D)

The reported symptoms related to menopause are more severe if the client is

from a patriarchal culture.

Which statement by the client assures the nurse that the client has made a

positive adjustment to middle age? A)

“My job is secure, and I will continue to work until I decide to quit.”

“I have taken up gardening and plan to become a master gardener.”

“We hope our children will move closer to us, so we can watch our

grandchildren grow.” D)

“My hope is that I keep my health and do not become a burden to my family

and friends.”

Which question demonstrates the nurse’s appropriate understanding of the

value the Black culture places on formal health care for a skin rash? A)

“Have you been putting any lotions or creams on your rash?”

“Do you have insurance to cover the cost of the prescribed lotion?”

“Do you understand how important it is to use the medication as it is

prescribed?”

“Will you have any difficulty getting to the pharmacy to have this prescription

filled?”

Which question reflects an understanding regarding a middle-aged married

woman’s emotional willingness to undergo elective surgery? A)

“Do you have sick leave where you work?”

“Will your family be able to help you while you recover?”

“How many people depend on you for help on a daily basis?”

“Can your family manage financially while you recover from your surgery?”

When an older Black woman shares with the nurse that, “It is time to think

about retiring,” the nurse demonstrates an understanding of a culturally created issue that would be relevant to the client by asking: A)

“Are you planning to live with your children after you retire?”

“Do you have a pension income that will allow you to retire now?”

“Do you think your health will allow you to enjoy your retirement years?”

“How do you really feel about retiring and changing your life so

dramatically?”

A client has recently immigrated to the United States from a refugee camp in

Asia. During the exam, the male client reports symptoms suggestive of possible depression, the nurse sensitive to cultural factors affecting this population would ask: A)

“Do you think about returning to your home country?”

“Have you been able to identify a group of fellow Asians?”

“Have your children adjusted well to their new environment?”

“Are you satisfied with the work you have found here in the United States?”

The nurse is assessing a client recently immigrated to the United States.

Which assessment question demonstrates an understanding of the impact that changing female roles have on a culturally diverse family? A)

“How is your spouse adjusting to the fact you are working outside your

home?” B)

“Are your children experiencing any problems now that you are working in

town?” C)

“Are you still able to interact with other women now that you have a job in

town?” D)

“Has the extra income you are now earning made a positive impact on your

finances?”

Which nursing intervention demonstrates an understanding of an emotional

outcome observed in clients immigrating from violent cultural environments? A)

Assessing for suicidal ideations

Counseling the client on anger management techniques

Providing medication education on tricyclic antidepressants

Assessing the client for physical damage resulting from ritualized behaviors

Which nursing evaluation demonstrates that a Black female client is being

monitored for a specific culturally focused health risk? A)

Client denies any epigastric pain since beginning antacid medication therapy.

Balance has improved since beginning muscle-strengthening physical

therapy. C)

Current systolic blood pressure has shown a 16-point decrease from baseline.

Incidence of annual respiratory infections has decreased from 4 to 2.

10.

Which assessment question demonstrates cultural sensitivity regarding a

rural, Black client’s understanding of a high-risk medical condition? A)

“Will you tell me what it means to be diagnosed with high blood pressure?”

“Can you explain why you are taking medication for depression?”

“What kind of female problems are you experiencing?”

“How has having sugar problems affected your life?”

11.

The nurse is caring for a middle-aged client diagnosed with a precancerous

encapsulated tumor. Which action should the nurse use to help the client’s developmental crisis? A)

Instruct that volunteer work at the day care should be avoided during

treatment. B)

Refer the unemployed client to the social worker for assistance with job

counseling. C)

Explain one way to cut costs would be to ask the parents to move from the

home. D)

Discover acceptable cultural treatment options for the cancer the client has.

12.

The nurse is assisting a 45-year-old Black female who is providing care for

her mother who has rheumatoid arthritis as well as her three teenagers. Which statement from the client would indicate to the nurse that she is utilizing cultural methods to cope with the stress in her life? A)

“I don’t know what I would do without my church. They pray with me all the

time.” B)

“I can’t believe my oldest is going away to college this year.”

“I’m so glad my youngest one wants to be a nurse. She’s getting lots of

practice.” D)

“I’ve been thinking about taking up gardening to give me something else to

think about.”

13.

An older Black client diagnosed with hypertension reports having “high blood”

to the nurse. Which culturally competent best action should the nurse provide? A)

Teach about reading food labels to choose low-sodium items.

Explain how to use the electronic blood pressure machine.

Modify cultural dishes to be heart healthy to meet client needs.

Discover the client’s perspective of God’s role in the situation.

14.

The nurse is caring for a Black client in a rural obstetric/gynecological clinic.

Based upon research on culturally based reasons why there is a higher risk for contracting a HIV infection, which action(s) should the nurse provide? Select all that apply. A)

Explain the need to be frank about sexual activity with a new partner and

insist on condom use. B)

Teach about the percentages of Black women in rural settings that are

infected with HIV from sexual activity. C)

Provide a pamphlet on sterilizing syringes and needles for intravenous drug

users to decrease risks. D)

Offer places for free HIV testing and counseling and statements about the

confidentiality of the findings. E)

Use community leader’s support to create a culture that encourages ways to

decrease risks for HIV transmission.

15.

The nurse is aware that each culture has developed its own way of handling

health-related crises. Which is a basic(s) of those methods? Select all that apply. A)

Spiritual connections

Extended family support

Time to participate in favorite activity or hobby

Continuing with current employment, but changing from full-time to part-

time positions E)

Asking for suggestions of websites or self-help books for more information

about the situation

Test Generator Questions, Chapter 8, Transcultural Perspectives in the Care of Older Adults 1.

Which intervention reflects an understanding of a common negative

psychosocial outcome of increased longevity? A)

Educating family members to the symptoms of despair seen in the older

adult B)

Assisting the client to identify social activities he or she is interested in

attending C)

Educating the client on the risks involved from engaging in unprotected sex

Assisting the client in preparing a reasonable, financial budget

Which assessment question will provide the nurse with information regarding

a Hispanic client’s ability to be financially secure after retirement? A)

“At what age do you plan to retire?”

“How long have you had your current job?”

“How many years did you attend a formal school?”

“Will your family be able to help you financially when you retire?”

Which behavior supports the nurse’s evaluation that an older client is

successfully engaged in “active aging”? A)

Walking 2 miles daily with a small group of friends

Using the computer to communicate with family members

Volunteering at the local elementary school as a classroom helper

Interviewing family members in order to create a detailed genealogy tree

Which assessment question will best help the nurse determine how much

client of Japanese descent’s view of health and illness is influenced by the client’s ethnic culture? A)

“Do you speak the Japanese language?”

“How long has your family lived in America?”

“Have you ever visited your family’s homeland?”

“Would you consider marrying a non-Japanese spouse?”

The nurse is documenting assessment data obtained from an older Hispanic

client reporting pain, possibly resulting from osteoarthritis. Which notation demonstrates that the nurse implemented culturally congruent assessing techniques? The client: A)

has been an avid knitter for last 15 years.

reports that pain became significant 2 months ago.

describes pain as a constant aching in the joints of all fingers of the right

hand. D)

denies using any type of traditional folk remedies to manage the pain in the

right hand.

The nurse is discussing the skin rash on both hands of the client of Asian

descent. Which intervention demonstrates the best culturally effective method of communicating with this client? A)

Including the client’s adult son in the interview possess

Asking about the possible introduction of new soaps or lotions on the hands

Asking the client to express in his own words the treatment plan for treating

the rash D)

Discussing possible folk remedies that can be used along with the prescribed

antibiotic lotion

Which client response best demonstrates successful coping with the age-

related functional loses affecting quality of life being experienced by a Black client?

“I plan for frequent bathroom stops when we travel to visit by automobile.”

“I have been using a magnifying glass to read the wonderful novel I got as a

gift.” C)

“I do not miss working in the garden anymore; it is too hard on my knees

and back.” D)

“My children help with the grocery shopping since getting out is more difficult

now.”

Which intervention is most culturally congruent when supporting a Black

client attempting to determine the feasibility of entering an assisted living care facility? A)

Encouraging the client’s family to be supportive of the client’s decision

Arranging for a social worker to discuss the services available at such a

facility C)

Discussing the advantages of such a decision with the client’s skeptical adult

child D)

Identifying facilities in the area that are close to the town’s Black

neighborhoods

Which intervention will best minimize the negative feelings an older, newly

immigrated client has expressed regarding being admitted to an assisted living facility? A)

Suggesting that the client include art from his home country as decorations

to the walls of the bedroom B)

Arranging for the client to share a room with another client of similar

background who speaks the client’s language C)

Reassuring the client that visits to the homes of family members can occur as

often as possible D)

Assuring the client that the family can bring ethnic foods that will be served

as part of regular meals

10.

An older client who lives alone has begun to have difficulties cooking and

maintaining a safe environment in the apartment she rents. Which intervention will have the most impact on the client’s ability to maintain independence? A)

Arranging for the client to receive her meals through a federally subsided

meals program B)

Requesting a social consult to help identify sources who can fund part-time

in-home assistance C)

Suggesting the client explore the possibility of having family members help

with meals and cleaning D)

Discussing the advantages of assistive living facilities to someone who is

having difficulty living alone

11.

The nurse is assessing a 65-year-old client with a long history of uncontrolled

hypertension. The nurse determines which demographic or changing disparity will affect the client’s health care the most? A)

Has no supplemental health insurance

Client identifies as non-Hispanic Black

Reports a low social economic status

Rides public transportation to the visits

12.

The nurse determines that the frail older adult client needs assistance with

living. Which assessment finding best determines the need for a government subsidized continuing care retirement community (CCRC) instead of a government subsidized assisted living facility? A)

Currently on Medicaid, no savings, and has a small life insurance policy

Left-sided weakness and unilateral neglect from a recent brain attack

History of multi-infarct syndrome and paroxysmal atrial fibrillation

Previously living alone without a support system in a dangerous area

13.

The nurse cares for an older adult client who recently immigrated from

China. Of the client’s reported health and illness behaviors, which adhere client’s cultural perspective? Select all that apply. A)

Cupping is used to resolve stagnation issues and restore Qi.

Clinic visits are made based on the health insurance coverage.

Eats canned and frozen foods from the neighborhood store.

Balances elevated blood pressure (Yang) with Yin (cold) foods.

Takes public transportation to everything because fearful of town.

14.

A nurse is attempting to help an older female client who is deciding what

transition will be made concerning her health care. The client has a chronic health issue and has lived alone for the past 20 years. Which criterion(ia) will the nurse use to determine what recommendations is made to this client? Select all that apply. A)

“Do you have trouble remembering how to do basic activities?”

“Do you have someone who can provide transportation for you when you

need to go the doctor, buy groceries, or get around town?” C)

“Are you able to safely take your medications?”

“If you fell, would there be someone to help you get up or call for help if you

injure yourself?” E)

“Do you have adequate finances to cover the cost?”

15.

The nurse performs a geriatric assessment for the older adult client. Which

factor(s) should the nurse use when making an appropriate referral for a senior day program? Select all that apply. A)

Score on instrumental activities of daily living (IADL) scale.

Support system and layout of residence after hours of the center.

Does the facility provide respite care after hours for the client?

Does the facility accept children that the grandparent is watching?

The program’s culture is partially related to the client’s culture.

Test Generator Questions, Chapter 9, Creating Culturally Competent Health Care Organizations 1.

What is the primary motivation for an institution to strive to provide

culturally competent health care? A)

Doing so will increase the institution’s client service base.

The institution’s health care costs will be better controlled.

Such an institution will attract the most qualified health care providers.

The quality of health care will be improved to all of the institution’s clients.

Which policy will allow a health care institution to achieve cultural

competence most effectively? A)

Making all client education materials available in the client’s native dialect

Recruiting culturally diverse health care providers to staff the institution

Providing a merit bonus to employees who complete cultural awareness

courses D)

Implementing a closed circuit television system to broadcast multilingual

programming

Which client statement provides the nurse with the most reliable assurance

that a client has access to effective preventive health care? A)

“I take advantage of my doctor’s evening office hours.”

“My culture believes that it is our responsibility to stay healthy.”

“Our church has a nurse who takes blood pressures before services.”

“Fresh fruits and vegetables are important elements of my culture’s diet.”

A group of nurses in a health care organization are concerned that some

members of the local community are not receiving adequate health care. In an

effort to eliminate any potential disparities, which change should the nurses request the organization do? A)

Ensuring signage is in common languages of the community

Giving each visitor a multilanguage pamphlet describing their services

Ensuring that each staff member can speak at least two languages

Conducting surveys every 5 years to evaluate what changes may be needed

to meet the community needs

The nurse is caring for migrant farm workers at a clinic. Which best action

should the nurse use to improve health maintenance? A)

Provide multilingual pamphlets on recommended health prevention for

women, men, and children. B)

Use mobile units close to where the families live to provide screenings and

immunizations. C)

Educate migrant and seasonal workers at the clinic through nurse-led

sessions during clinic hours. D)

Establish first aid stations near farm communities and have an automatic

external defibrillator.

Which institutional attitude demonstrates the most effective attempt to

minimize a recognized barrier to culturally congruent health care? A)

Acknowledging that there is a need for ethnic-specific health clinics

Willing to incorporate folk health practices into the client’s plan of care

Recognizing the need to offer reduced service fees to culturally diverse

clients D)

Appreciating for the importance that relaxed visitation policies have for

family-centered cultures

Which is the best action for the nurse serving on a committee to develop the

outpatient clinic as a culturally competent health care organization?

Determine the influences culture has had on the experienced health

disparities. B)

Articulate the effects of culture on behavior of individuals served in the clinic.

Employ sensitive care meeting the culture expectations of its diverse

population. D)

Develops interplay between organizational, professional, and community

cultures.

Which organizational attitude demonstrates that the institution’s culture is

utilizing Leininger’s Culture Care Diversity and Universality model in their organization? A)

Hospital policies will be supported by current, relevant research data.

The client’s cultural folk medicine practices will be respected whenever

possible. C)

Health care will be delivered in a timely, effective manner to all clients

regardless race. D)

Clients are to be treated with the same care and compassion shown to family

members.

Which behavior exhibited by a nurse demonstrates a personal commitment to

culturally congruent care? A)

Providing educational information for a client who immigrated from Japan in

the client’s native dialect B)

Requesting that a Hispanic client’s menu include food choices from various

Latin American cuisines C)

Always wearing the hospital’s identification badge that bilingually identified

the wearer’s position D)

Asking to have the critical care unit’s visitation policy to allow nonfamily

members visitation rights

10.

Which action will best prevent institutional racism in a hospital that provides

care to a culturally diverse population? A)

Requiring that all staff engage in regular cultural sensitive training

Aggressively recruiting culturally diverse health care professionals

Revising institutional polices as discriminatory practices are identified

Reprimanding staff for displaying culturally prejudicial attitudes or behaviors

11.

Which intervention demonstrates an institution’s willingness to provide a

culturally sensitive environment? A)

Scheduling a bilingual interpreter to be available on each shift

Providing multilingual versions of information on hospital signage

Providing chapel space for any interested religious sect to hold religious

services D)

Changing the lobby’s artwork when its original pieces are identified as lacking

in cultural diversity

12.

The nurse serves on a committee to develop a culturally competent health

care organization. Which best first action should the nurse use? A)

Apply Healthy People 2020 goals of improving the health of the community.

Determine if access can provide health care to all members of the

community. C)

Discover if any cases of ageism or discrimination has occurred in the facility.

Prepare transfer guidelines to ensure the right facility for the right situation.

13.

Shein recognized that organizational culture had several levels. What did

Shein recognize as the core of the organization’s culture? A)

Underlying assumptions

Observable artifacts

Stated norms

The individual’s contribution

14.

The nurse is serving on a committee that uses Roizner’s checklist to evaluate

health care services. Which service(s) will the committee determine to be culturally competent? Select all that apply. A)

The women’s mobile unit provides mammograms at convenient locations and

times. B)

A community center meeting the public requests offers Tai Chi on a sliding

scale. C)

The waiting room in the emergency department is small, bright, and has hard

benches. D)

Community assessment revealed a need for drug rehab, which was added to

the services. E)

A new hospital was built in a rural area close to suburbs but miles from the

farms.

15.

The nurse on a committee to increase Hispanic clients using the hospital’s

services employs which political and symbolic cultural action(s) that matches the organizational culture? Select all that apply. A)

Contacts Hispanic community leaders to join the committee and share input.

Collect staff input on the hospital’s new goals and ways to achieve the goals.

Interviews a Hispanic priest from a local church to determine artwork to add.

Revise policies to include bilingual signage and in-services on Hispanic

culture. E)

Modifies the vision and mission statements to also reflect the Hispanic

clients.

16.

The nurse working on a committee to deliver culturally competent health care

in the community should employ which action(s)? Select all that apply. A)

Examine client safety events determining root cause and ways to improve

care. B)

Use standardized care for all clients to reduce disparities in health care

delivery.

Schedule free and low-cost dental clinics to improve prevention and

treatment. D)

Teach school teachers signs of bullying and ways to decrease it across

campus. E)

Articulate the need for universal health coverage to end existing disparities.

Test Generator Questions, Chapter 10, Transcultural Perspectives in Mental Health Nursing 1.

Research supports the nurse in assessing which area when interviewing a

client who immigrated from Asia and is possibly experiencing depression? A)

Cultural norms

Age and gender

Number of years of residence in the United States

Occupation before immigrating to the United States

The nurse is planning care for a client diagnosed with somatoform disorder.

On which statement will the nurse base intervention planning? A)

Illness can occur without disease.

The client’s physical symptoms have no basis in a disease process.

Disease and illness are the outcomes of different human processes.

The client’s belief system will determine how symptoms are exhibited.

Which question best assists the nurse in avoiding stereotyping when

identifying cultural patterns and norms that can be used to base appropriate mental health interventions for a client who is a new emigrant to the United States from a very violent African county? A)

“Do you feel safe since you immigrated to America?”

“Do you think of yourself as being healthy and happy?”

“What types of mental health services do you need?”

“Are you happy with your move to the United States?”

Which statement is an example of ethnocentrism on the part of the nurse

when caring for a Hispanic woman who is experiencing symptoms of postpartum depression? A)

“In your culture, how do you treat depression after having a baby?”

“Will I need to make arrangements for your mother to sleep here in your

room?” C)

“Will your mother be here when we talk about your treatment for postpartum

depression?” D)

“Your folk remedies will not be as effective as the medication your physician

has ordered.”

What statement is the basis for the nurse’s practice of conducting mental

health screenings for culturally diverse clients? A)

The culturally diverse population is at high risk for depression.

Mental health services that are culturally focused are seldom offered.

Cultural beliefs are often the reason emigrants refuse to identify mental

health illnesses. D)

The number of older clients who traditionally need but underutilize mental

health services is growing.

Which situation will assure the nurse that a primary need for effective mental

health treatment is being met for a Hispanic client being treated for a mental illness? A)

A translator is provided whenever the client is hospitalized for treatment.

The client describes the symptoms of anxiety that required immediate

attention. C)

The client is asked to provide suggestions about how to best reduce

stressors. D)

Familiar folk remedies to manage symptoms are prescribed whenever

possible.

Which intervention is focused on addressing unresolved grief among its

target population? A)

Tutoring for Hispanic elementary school children

A support group for Black women who are victims of intimate partner

violence C)

Free health clinics for newly immigrated Arabic clients

A support group for members of displaced Native American/First Nations

groups

Which behavior exhibited by a nurse demonstrates a personal commitment to

minimizing the biased care of culturally diverse client populations? A)

Attending in-service programming on culture sensitivity

Learning to speak the language of the most commonly treated ethnic group

Regularly engaging in self-reflection focused on identifying personal beliefs

Mentoring novice nurses on the implementation of culturally sensitive nursing

care

Which intervention demonstrates the nurse’s understanding of the risk for

mental illness experienced by acculturating emigrants? A)

Assessing for anxiety

Assessing for suicidal ideations

Educating the parents of teenage sons on the symptoms of alcohol use

disorder D)

Educating the parents of teenage daughters on the symptoms of bulimia

nervosa

10.

Which intervention demonstrates that the nurse understands the factors that

contribute to the low incidence of mental illness among members of the Hispanic population? A)

Supporting the client’s interest in exercising as a means to reduce stress

Encouraging the use of compatible folk remedies with prescribed medication

therapy C)

Providing the client with the privacy required for frequent mediation and self-

reflection D)

Arranging for a sleep chair to be available for a family member to

comfortably spend the night

11.

The transcultural mental health nurse needs to consider more than just the

medical model when dealing with illness but should: A)

ensure the client fully understands the proposed treatment plan.

determine the client’s social standing to plan the best care plan.

focus on the client’s recovery.

recruit the family to assist the client.

12.

The nurse is caring for a mental health client from another country who does

not speak the dominant language and is using the same-gender professional interpreter. Which action should the nurse take first to provide empathetic culturally competent care? A)

Ask the client about how members of his or her culture deal with mental

illness. B)

Reflect on what it would be like if one was in the client’s situation.

Repeat back to the client the nurse’s understanding of the situation.

Compare one’s own cultural perspective to the client’s perspective.

13.

The nurse is caring for a client who identifies with Native American/First

Nations culture who describes to the nurse that after studying his or her ancestry and the history of the tribe, the client has a deep feeling of grief and feeling down. Which best nursing action should the nurse take next? A)

Educate about symptoms of depression and suggest treatment options for

the client that coincide with the client’s Native American/First Nations culture. B)

Explain the client is experiencing historical trauma because of feeling

connected to the tribe that experienced the traumatic losses in the past.

Discuss ways to overcome culture shock that arises from transitioning from

the current culture to the newly acquired Native American/First Nations culture. D)

Determine successful coping strategies that the client has used in the past

that were effective in dealing with loss and suggest those be tried.

14.

The nurse is caring for a client who recently immigrated from Argentina. The

client was previously diagnosed with bipolar disorder and has been admitted because of a recent manic episode. Which factors should the nurse assess to determine the root cause(s) for the episode? Select all that apply. A)

Nearest pharmacy is not on the bus route and lives miles away in the rural

area B)

Finds it difficult to communicate with the provider in the short time frame

Currently on Medicaid and is limited on the health care providers available

Stated it is embarrassing to be diagnosed with any mental health problem

Share that feels much better when takes the prescribed medications

regularly

15.

The nurse is caring for a client who is a refugee from a country with political

turmoil and war. The nurse should use which assessment finding(s) to support that the client may have a mental health condition? Select all that apply. A)

Shares has trouble sleeping and lives near railroad tracks

Awakens with same nightmare of the village being burned

Presents with report of persistent vague somatic complaints

Stated it is difficult to find others that share the same culture

Reports bullying at school and that teens make fun of their family

Test Generator Questions, Chapter 11, Culture, Family, and Community 1.

What is the primary nursing goal when completing a cultural assessment?

To develop a care plan with the client’s active input

To improve the nurse’s ability to be culturally sensitive to the client’s needs

To define the client’s culturally related beliefs and values

To find a balance between the client’s values and the values of Western

medicine

What question demonstrates that the community health nurse understands

the importance of being culturally sensitive to both the client and the client’s family community? A)

“Does your neighborhood have good public transportation so you can get to

your doctor’s office?” B)

“Will your son be able to take off work to meet with your physical therapist?”

“Will your daughter-in-law be willing to change your dressing until the wound

heals?” D)

“Are the special foods on your diet stocked in your neighborhood’s grocery

store?”

Which question best assists the nurse in determining whether the family’s

values will support the client’s new health needs? A)

“Will your family be able to afford your new medications?”

“Who will be responsible for cooking the foods required of your new diet?”

“Can a family member be here when we discuss your new medications?”

“Does your family understand how to change the dressing on your leg?”

A female refugee who has recently emigrated from a war-torn African

country presents at a clinic reporting chronic vaginal drainage. Which assessment question best demonstrates the nurse’s sensitivity to the client’s community culture? A)

“Does your culture believe in safe sex practices?”

“Have you been sexually active since the drainage began?”

“Do you want a family member present during your vaginal examination?”

“Have you ever been the victim of a physical or sexual assault?”

Which informational intervention best demonstrates the nurse’s attempt to

minimize the cultural isolation that can result when a client lives in an ethnic neighborhood? A)

The telephone numbers of the neighborhood’s nearest hospital

After-school programs in the neighborhood for children of single parents

The locations of language classes in the client’s neighborhood

Contact information for the religious institutes located in the neighborhood

A newly immigrated male, from a culture that is currently experiencing civil

unrest and violence, is being assessed in a clinic for reports of stomach pains. Which additional reports by the client would alert the nurse to a possible diagnosis of posttraumatic stress disorder (PTSD)? A)

Nausea and vomiting

Insomnia and nightmares

Hearing voices and headaches

A skin rash that itches and bleeds

An immigrant from Africa is being physical abused by the spouse. The client

remains reluctant to consider divorcing the spouse despite of having the benefits of doing so explained. Which assessment question best demonstrates the nurse’s cultural sensitivity regarding this situation? A)

“Does your culture accept divorce?”

“How does your culture view intimate partner violence?”

“Can you financially support yourself without your spouse’s help?”

“How would you expect your family to react if you were to divorce your

spouse?”

The nurse is caring for a group of recent immigrants from Africa. Which

action(s) should the nurse use to provide culturally competent care? Select all that apply. A)

Ask one of the families’ members as interpreter to communicate the health

care needs. B)

Establish community meetings in the local church where the immigrants

regularly attend. C)

Educate the clients on how to access and navigate the health care system in

the United States. D)

Assess the cultural and religious beliefs that affect health care and wellness

behaviors. E)

Deliver U.S. population research-based standards of care based upon the

general population.

A nurse has noted that a large number of no-shows for prenatal visits in the

clinic among young Hispanic women. The nurse could advocate for which policy to demonstrate the nurse’s understanding of the potential health problem and provide a culturally sensitive solution? A)

Visiting nurses to meet the women at their place of employment

An educational program in a local business to emphasis the importance of

prenatal care C)

A neighborhood clinic with evening hours

A transportation service to bring these young mothers to the clinic for their

appointments

10.

Which intervention best demonstrates that a health care institution is

culturally sensitive to its culturally diverse female population? A)

Encouraging a group of female health care providers to establish a series of

health care educational sessions B)

Establishing a day care center for the children of single immigrated mothers

Providing translators to improve communication in areas such as the

emergency department and diagnostic studies D)

Arranging for the obstetrical unit to have a sufficient number of sleep chairs

available for use by their obstetrical clients

11.

Research has shown that which group has the greatest risk of developing

complications due to untreated hypertension? A)

Hispanics

Native American/First Nations

Blacks

Asians

12.

The small community of refugees has been growing, and the health care

community has been working to meet the various needs of these individuals. Which is the most important aspect for the nurse to help promote health among these refugees? A)

Support of the community

Classes teaching the dominant language

Multiple locations for small health care clinics

24-hour urgent care centers

13.

The health care community must adjust to meet the needs of the various

cultures, especially when there is a diverse difference in the way the incoming culture recognizes various health issues versus the established culture. Which important factor should the nurse use when designing and implementing health care?

Input should be gathered from the community leaders in designing a health

care program. B)

The health care staff should ask the local religious leaders for their assistance

and cooperation. C)

The health care staff should focus on the community and not just the

individual. D)

The health care staff should conduct classes educating the refugee group on

the new culture they have relocated within to better help them assimilate.

14.

The nursing supervisor has noted a decline in pregnant Hispanic clients

requesting services and maintaining their care at a rural clinic, which recently saw a major staff change. Which could potentially be the catalyst for this decline? Select all that apply. A)

Fewer staff who speak the local language

New male physician and nurse

The favorite midwife retired

New evening hours are now available for appointments

New educational program and outreach was started

15.

A small group of nurses are interested in improving the availability of health

care to a local refugee community. In an effort to learn more about the community, the nurses are devising an assessment plan to learn more about the culture and determine how best to meet the needs of this group. Which question(s) should the nurses include in their assessment? Select all that apply. A)

Are there any specific laws in this group that would limit health care?

How do the individuals communicate with each other in the family and in the

community? C)

How do cultural factors influence their daily meals?

Are there any taboos or religious restrictions that need to be considered?

What would be the best form of transportation to help these individuals come

to the main clinic?

Test Generator Questions, Chapter 12, Religion, Culture, and Nursing 1.

When a child from a remote part of Africa dies as a result of a chronic illness,

the nurse notes that while the parents appear saddened, they do not express the degree of grief typically expressed by American parents. Which question asked by the nurse best demonstrates an understanding of this particular cultural response? A)

“Do children often die in your native country?”

“Would you prefer to be left alone with your child?”

“How does your culture deal with the death of a child?”

“Do you need any specific help from me?”

Which intervention demonstrates that the nurse understands the cultural

implication of the parents’ belief that their child has been hexed? A)

Observing the parents for symptoms similar to those of the child’s

Monitoring the child for hallucinations and possibly delusional thinking

Preparing for the family to initiate elaborate religious rituals

Asking the parents to describe the types of symptoms they expect to see in

their child

Which statement, made by a nurse caring for a cultural diverse population,

regarding spiritual assessments demonstrates the need for future education? A)

“I find the beliefs associated with Judaism to be similar to Christianity.”

“Religion is a private matter and difficult to assess.”

“I generally have to ask clarifying questions when assessing a client about

his or her religion.” D)

“An individual can be spiritual but not religious.”

Which notation best demonstrates that the nurse is respectful of a client’s

spiritual and religious beliefs? A)

“The family will be in the chapel awaiting the client’s return from surgery.”

“The client requested a visit from the hospital chaplain.”

“The schedule of the hospital’s religious services was provided to the client as

requested.” D)

“Rosary beads were sent with the client to the diagnostic lab attached to the

client’s hospital gown.”

Which intervention demonstrates that a nurse requires additional education

regarding the support of a client’s spiritual health? A)

Scheduling home visits to avoid interfering with the client’s daily prayer times

Following up on the client’s request to be visited by the hospital’s chaplain

Offering to add the client to the nurse’s prayer list

Asking the Catholic client whether he or she wants breakfast delivered after

his or her visit from the priest

Which principle concerning death rituals is the primary basis for the nurse’s

role in the death and grieving process? A)

Each individual faces death alone.

An individual death affects many individuals.

Death rituals are critical to an individual’s grief process.

Individual death rituals vary very little.

When a client dies, the nurse best demonstrates cultural sensitivity when

managing the care of the body by: A)

providing the family with private time with their loved one, prior to the

arrival of the mortician. B)

assessing the family’s expectations regarding how their loved one’s body will

be handled. C)

reading a variety of resources to gain information of cultural death rituals.

immediately notifying the family’s religious leader of the client’s death.

The client is a member of the Navajo nation. When the client dies, it is most

important for the nurse to recognize that the family will be: A)

insistent that the body be wrapped in a new blanket.

bringing burial clothing, which the body will be dressed in.

reluctant to touch the body because of a belief in evil spirits.

adoring the body with expensive jewelry and coins.

When addressing the issue of organ donation, which cultural belief is the

basis for the Amish family’s traditional viewpoint? A)

The body is a physical container for the soul and has no useful purpose after

death. B)

Organ donation is supported by the belief that it is one’s responsibility to help

others. C)

Entrance into heaven is dependent upon an undamaged physical body.

It is preferable that an intact body be buried.

10.

The nurse approaches the subject of organ donation with a terminally ill

client who practices Buddhism based on the understanding that: A)

the decision is one that will be discussed at length with family to secure their

approval. B)

the body holds no specific value to the Buddhist after death.

the decision will be deferred to the client’s oldest son.

the body will be allowed to naturally decompose before being buried.

11.

The nurse is conducting a spiritual needs assessment with a newly admitted

client to the unit. Which question would be the appropriate approach to determine this client’s culture? A)

“Which church do you go to?”

“When you need strength or hope, who or what do you turn to?”

“What did your parents teach you about spirituality?”

“Which hospital chaplain would you like to visit you?”

12.

The nurse is conducting a spiritual needs assessment in an effort to create a

nursing care plan for a client. The nurse recognizes that which question will assist the nurse in understanding this client’s religion? A)

“How will this illness affect your life goals?”

“Why do you think you are here on earth?”

“What do you believe your punishment will be if you do something wrong?”

“Do you think your life has any value?”

13.

A common factor among many of the major denominations in the United

States and Canada is their willingness to be involved with providing health care, especially to those who need it the most. Which denomination is recognized for being one of the major contributors to health care? A)

Seventh-Day Adventist

Protestant

Buddhist

Roman Catholic

14.

When conducting a client’s spiritual assessment, the nurse should observe

the actions of the client as well as note the client’s answers. Which would be an indication of the client’s possible spiritual and religious beliefs? Select all that apply. A)

The client’s visitors who are not family members.

The type of reading material the client brought to the unit.

The practice of any specific rituals used throughout the day when possible.

The client is quiet and reserved and has no visitors.

The client always wears the hair in braids.

15.

A hospice nurse recognizes that the client is closer to death and prepares to

follow through on the care plan that was already developed. As this has already been discussed with the family, the nurse is prepared to take the appropriate steps to support the family during this difficult time. What is the most appropriate question for the nurse to ask? A)

“Is it okay if I moved this string of beads to the table so it’s not in the way?”

“Who would you like me to call when it appears death is imminent?”

“Would you like me to explain the proper way to clean the body after death?”

“Would you like me to tell you if any new method becomes available to help

your loved one live longer?”

Test Generator Questions, Chapter 13, Cultural Competence in Ethical Decision-Making 1. The nurse’s cultural beliefs may dictate that a certain action is wrong, but the cultural beliefs of the client dictate that the action is acceptable. When these disagreements present an ethical dilemma, the nurse must decide as how to proceed. Which must the nurse keep in mind when making this decision? A) The nurse has certain standards to maintain. B) The nurse needs to remember to always follow the client’s instructions. C) There is always a way to compromise on any situation. D) The nurse should consult the ethical committee of the organization to solve any disagreements.

2. A group of nurses is working with a group of refugees who have recently relocated to the area. The nurses are concerned by some of the unsafe and unhealthy cultural practices and are trying to create an educational program that will help teach the young mothers a safer way to care for their children. Which will be important for the nurses to apply as they create this program? A) Ensuring the refugees complete assimilate into the new environment B) Preparing a reward program for the women as they complete new skills and make changes C) Requesting assistance from the elders of the group to give their approval for the changes D) Working to maintain the refugees’ core values and beliefs while finding ways to incorporate new methods that will be safer and healthier for the refugees

3. A nurse cares for a client diagnosed with dementia and a history of falls. Which statement best demonstrates the principle of beneficence?

A) “I need to be sure that this client is not being oversedated and therefore at risk for falls.” B) “Current research refutes the use of restraints to keep my client safe from falls.” C) “I would feel great responsibility if this client was hurt because of a fall.” D). “Institution policies are clear about assuring client safety especially from falls.”

4. A nurse cares for a client diagnosed with an aggressive form of cancer. Which statement best demonstrates the principle of veracity? A) “Knowing the truth will help the client decide on the right form of treatment for this cancer.” B) “It may be hard, but the client deserves hearing the truth about the cancer.” C) “The client is aware of the risks of taking the experimental chemotherapy medication.” D) “Cancer is a scary disease that many clients do not want to know much about.”

5. Which is the primary outcome of the indiscriminative use of the emergency department by the uninsured members of a community? A) The resources of the emergency medicine unit will be prematurely used up. B) Those individuals will experience long waits for needed treatment. C) The ill postpone treatment that results in the lack of early treatment interventions. D) Emergency department personnel are forced to address nonemergency health issues.

6. What concept is demonstrated by the Patient Self-Determination Act of 1991? A) Client’s right to health care B) Client’s cooperation C) Client’s autonomy D) Responsibilities of the client’s family during times of illness

7. An example of distributive justice related to health care includes: A) implementing a sliding rate for well-baby visits at the local family clinic. B) assessing an insurance cohort a $5.00 co-pay for generic medication prescriptions. C) requiring a physical examination prior to activation of health insurance coverage. D) providing unlimited access to health promotion services to all possessing insurance coverage.

8. Social justice related to health care is best demonstrated when: A) a client reporting chest pain is seen immediately by an emergency room provider. B) a children’s clinic is added to the services provided by the local hospital. C) a local obstetric practice reserves two evenings per week for routine prenatal appointments. D) there is a rescheduling fee assessed for giving less than 24 hours for cancelled appointments.

9. When striving for social justice, which intervention demonstrates an understanding of nursing responsibility? A) Providing parenting classes to teenage, single mothers B) Teaching CPR classes to senior citizen groups C) Presenting information on organ donation to a woman’s exercise group D) Advocating for a free clinic for unemployed emigrates

10. Which intervention is an example of health promotion with a focus on social justice? A) Administering influenza vaccinations at an adult day care center B) Educating a client to the social service programs he or she is qualified for C) Monitoring an older adult client who lives alone for possible nutritional deficiencies D) Volunteering to monitor blood pressures at a local food pantry

11. The nurse is caring for an older Mexican American who needs 24-hour continuous care for several weeks. The client has expressed “All will be OK; my family follows traditional Mexican culture.” Which best evidence should the nurse use when planning discharge home? A) Caregiver burden occurs often because singleton caregivers are unappreciated by the rest of the family. B) Multiple family members will move into the client’s home and will take turns caring for the client. C) When a family member expresses tiring of caring for the client, other family members quickly help. D) Family participation in the planning process is vital and an assessment for the need for respite care.

12. Which is the foundation of making a culturally competent ethical decision? A) Cultural competence B) Compassion C) Advocacy D) Collaboration

13. The nurse plans the discharge for an older Asian American client diagnosed with a stroke. Which action is best? A) Assess the family caregivers’ cultural beliefs and role taken when caring for aging parents. B) Provide treatment for caregiver depression. C) Use agency caregivers and encourage the client’s family to spend quality time visiting and supporting the client. D) Educate the caregivers on the current care routine to be followed and health care provider appointments to keep.

14. The nurse is caring for a hospitalized client who is dying. The client’s “church family” and large extended family desires to be with the client until the client dies. What best actions should the nurse take to provide culturally competent care? Select all that apply. A) Determine group leaders for the family and church members. B) Reinforce the guidelines for the agency and make it clear to all. C) Develop a rotation schedule for maximum number of visitors. D) Provide a sign-up list for family and church members that fits the space. E) Encourage the hospital chaplain to take charge of the situation.

15. A group of nurses are trying to establish a small medical clinic in an impoverished rural community. The nurses realize this project will require the input and participation from others to help make it successful and enable them to provide quality health care. To whom should the nurses look to for possible partnership in this venture to help make it successful? Select all that apply. A) The local churches B) The local government C) The national government D) The local schools E) The local radio stations