REF: Page 5-29 (Table 5-2) | Page 5-33 (Table 5-4) TOP: Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity
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6. A group activity on an inpatient psychiatric unit is scheduled to begin at 1000. A patient, who was recently discharged from U.S. Marine Corps, arrives at 0945. Which analysis best explains this behavior? a. The patient wants to lead the group and give directions to others. b. The patient wants to secure a chair that will be close to the group leader. c. The military culture values timeliness. The patient does not want to be late. d. The behavior indicates feelings of self-importance that the patient wants others to appreciate.
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ANS: C Culture is more than ethnicity and social norms; it includes religious, geographic, socioeconomic, occupational, ability- or disability-related, and sexual orientation-related beliefs and behaviors. In this instance, the patient’s military experience represents an aspect of the patient’s behavior. The military culture values timeliness. The distracters represent misinterpretation of the patient’s behavior and have no bearing on the situation.
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PTS: 1 DIF: Cognitive Level: Analyze (Analysis) REF: Pages 5-6, 33 (Table 5-4), 37 (Box 5-1) TOP: Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity
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7. A nurse in the clinic has a full appointment schedule. A Hispanic American patient arrives at 1230 for a 1000 appointment. A Native American patient does not keep an appointment at all. What understanding will improve the nurse’s planning? These patients are a. members of cultural groups that have a different view of time. b. immature and irresponsible in health care matters. c. acting-out feelings of anger toward the system. d. displaying passive-aggressive tendencies.
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ANS: A Hispanic Americans and Native Americans traditionally treat time in a way unlike the Western culture. They tend to be present-oriented; that is, they value the current interaction more than what is to be done in the future. If engaged in an activity, for example, they may simply continue the activity and appear later for an appointment. Understanding this, the nurse can avoid feelings of frustration and anger when the nurse’s future orientation comes into conflict with the patient’s present orientation.
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PTS: 1 DIF: Cognitive Level: Understand (Comprehension) REF: Pages 5-6, 29 (Table 5-2) TOP: Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity
8. The sibling of an Asian American patient tells the nurse, “My sister needs help for pain. She cries from the hurt.” Which understanding by the nurse will contribute to culturally competent care for this patient? Persons of an Asian American heritage a. often express emotional distress with physical symptoms. b. will probably respond best to a therapist who is impersonal. c. will require prolonged treatment to stabilize these symptoms. d. should be given direct information about the diagnosis and prognosis.
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