Question 1

When caring for a patient from a different culture, which of the following is the best assessment approach by the nurse?

Accepted Answer

When assessing patient preferences in a patient from a different culture, an assessment approach can include asking about special cultural beliefs related to the illness that might help the nurse to provide better care. Questions regarding a patient's level of physical comfort do not address the patient's culture.

Question 2

When performing a newborn bath demonstration for the mother of a Native American infant, the nurse should

Accepted Answer

When the nurse is performing a newborn bath demonstration, the Native American mother is likely to watch from a distance, avoid eye contact with the demonstrator, ask few or no questions, and decline a return demonstration. This learning style should not be seen as indifference or lack of understanding. Being an experiential learner, the Native American woman is likely to assimilate the information provided and simply give the newborn a bath when it is needed. Their learning style is observational and oral, so the use of charts, written instructions, and pamphlets is usually not well received. Verbal instruction delivered in a story-telling format is more familiar to Native Americans.

Question 3

The nurse is assigned to provide a bed bath to a patient who cannot speak English. Which of the following communication tools or strategies should the nurse use?

Accepted Answer

Federal law (Title VI of the Civil Rights Act) mandates the use of a trained interpreter for any patient experiencing communication difficulties in health care settings because of language. Interpreters should have a thorough knowledge of the culture, as well as the language. Interpreters should be carefully chosen, keeping in mind variations in dialects as well as differences in the sex and social status of the interpreter and the patient if these factors are likely to be an issue. There are quality assurance and ethical issues associated with the use of untrained interpreters such as family, friends, or ancillary staff. They may not be familiar with medical terminology or may unintentionally misrepresent the meaning of a message. The patient may or may not want a relative, friend, or nonprofessional staff to "know their business" or have access to subjective information.

Question 4

The nurse is performing an admission assessment on an Asian patient. The intake includes a cultural assessment. The nurse should ask the patient,

Accepted Answer

A cultural assessment is defined as a systematic appraisal of beliefs, values, and practices conducted to determine the context of patient needs and to tailor nursing interventions. It is composed of three progressive, interconnecting elements: (1) a general assessment; (2) a problem-specific assessment; and (3) the cultural details needed for successful implementation. Asking about visits from a spiritual leader would be part of the spiritual assessment. Feelings and value of life do not assess cultural issues.

Question 5

The nurse is caring for a postpartum patient who is African American. The nurse recognizes that an essential component for successful communication when interacting with this patient is the use of

Accepted Answer

Although African Americans are represented in every socioeconomic group, approximately one-third of them live in poverty. For many, their cultural heritage traces back to slavery and deprivation. This unfortunate legacy colors the expectations of African Americans with health care issues and explains the distrust many African Americans have about the American health care system. African Americans need to experience feeling respected by their caregivers to counteract the sense of powerlessness they feel in health care settings. Establishing trust is essential for successful communication with African American patients. They are more willing to participate in treatment when they feel respected and are treated as treatment partners in their health care. Trust must be established before any interventions, such as consultation with a folk healer or clergy. There is no language barrier mentioned in the question.

Question 6

When communicating with a patient from Thailand who speaks limited English, the nurse should

Accepted Answer

People tend to think and process information in their native language, translating back and forth from English. This results in delayed responses that need to be taken into account, particularly in health teaching. Sometimes the nurse is aware only that the patient seems to be taking more time than usual. All written information should be provided in the person's native language whenever possible to avoid misinterpretation. It is important that the translator of information be as well-versed in medical interpretations as in relevant terms used in both languages. With patients demonstrating limited English proficiency, the nurse should speak slowly and clearly; use simple words; and avoid slang, technical jargon, and complex sentences. Asian patients prefer a polite, friendly, but formal approach in communication. They appreciate clinicians willing to provide advice in a matter-of-fact, concise manner. Confrontation is avoided; patients will nod and smile in agreement, even when they strongly disagree.

Question 7

Which of the following statements is true?

Accepted Answer

Hispanic patients need to develop trust (confianza) in the health care provider. They do this by making small talk before getting down to the business of discussing their health problems. Muslim patients are expected to follow the Hallal (lawful) diet, which calls for dietary restrictions on eating pork or pork products, and drinking alcohol. African American males have a significantly greater chance of developing cancer and of dying from it. Communication behaviors in the Asian culture are characterized by mutuality, respect, and honesty. Health care providers are considered health experts, so they are expected to provide specific advice and recommendations. Asian patients prefer a polite, friendly, but formal approach in communication. They appreciate clinicians willing to provide advice in a matter-of-fact, concise manner.

Question 8

When caring for the poor patient, a major component of care is

Accepted Answer

Respect for the human dignity of the poor patient is a major component of proactive care. This means that the nurse pays strict attention to personal biases and stereotypes so as not to distort assessment or implementation of nursing interventions. It means treating each patient as "culturally unique," with a set of assumptions and values regarding the disease process and its treatment, and acting in a nonjudgmental manner that respects the patient's cultural integrity.

Question 9

Which of the following best describes cultural diversity?

Accepted Answer

Cultural diversity refers to variations among cultural groups. People notice differences related to language, mannerisms, and behaviors in people of different cultures, in ways that don't happen with people from their own culture. Subculture refers to a smaller group of people living within the dominant culture, who have adopted a cultural lifestyle distinct from that of the mainstream population. Ethnicity is used to describe "groups in which members share a cultural heritage from one generation to another." Personal awareness of a common racial, geographic, religious, or history binds people together, with a strong commitment to ethnic values and practices. Multiculturalism describes a heterogeneous society in which diverse cultural worldviews can coexist with some general characteristics shared by all cultural groups and some perspectives that are unique to a particular population.

Question 10

The nurse is caring for a Hispanic patient. When communicating with the patient's family about the patient's illness, which family member should the nurse contact?

Accepted Answer

Hispanics are an extroverted people who value interpersonal relationships. Hispanic patients trust feelings more than facts. Strict rules govern social relationships (respecto), with higher status being given to older individuals, and to male over female individuals. Nurses are viewed as authority figures, to be treated with respect. Patients hesitate to ask questions, so it is important to ask enough questions to ensure that patients understand their diagnosis and treatment plan.

Question 11

A nursing instructor is teaching a group of student nurses about culture. When teaching the students nurses about the concept of ethnocentrism, the student nurses demonstrate cultural sensitivity when they state that their culture

Accepted Answer

Ethnocentrism refers to a belief that one's own culture should be the norm because it is considered better or more enlightened than others. Other cultures are judged as inferior. Taking pride in one's culture is appropriate, but when a person fails to respect the value of other cultures, it is easy to develop stereotypes and prejudice. Ethnocentrism fosters the belief that one culture has the right to impose its standards of "correct" behavior and values on another. Prejudice can be felt or expressed, and directed to either a group as a whole or toward an individual associated with the group.

Question 12

Cultural competence

Accepted Answer

Cultural competence is defined as "a set of cultural behaviors and attitudes integrated into the practice methods of a system, agency, or its professionals that enables them to work effectively in cross-cultural situations." Cultural competence is an essential skill set required for health care providers. Self-awareness of unintentional bias in health care is essential. Value judgments are hard to eliminate, particularly those outside of awareness. Developing competence begins with self-awareness of one's own cultural values, attitudes, and perspectives, followed by developing knowledge and acceptance of cultural differences in others.

Question 13

When practicing cultural awareness, the nurse recognizes that cultural patterns

Accepted Answer

Cultural patterns are socially transmitted through family and other social institutions. They are an essential part of personal identity. Cultural patterns are important determinants of health-related beliefs, attitudes, values, and behaviors.

Question 14

Which of the following is a true statement in relation to the concept of poverty?

Accepted Answer

Poverty is a difficult but important sociocultural concept because it has an adverse effect on a large segment of the population, limiting their options in health care. Lack of essential resources is associated with political and personal powerlessness. The idea that the poor can exercise choice or make a difference in their lives is not part of their worldview. People living in poverty may overlook opportunities simply because life experience tells them that they cannot trust their own efforts to produce change. Poor people often look to others, but do not expect others to work with them in making things better. Communication strategies that acknowledge, support, and empower the poor to take small steps to independence are most effective.

Question 15

When assessing a 5-year-old Asian patient in the emergency department, the nurse observes welts on the patient's body. The nurse's first course of action should be to

Accepted Answer

In some Asian countries, healers use a process of "coining," in which a coin is heated and vigorously rubbed on the body to draw illness out of the body. The resulting welts can mistakenly be attributed to child abuse if this practice is not understood. A cultural assessment needs to be done first. The first course of action is to do a cultural assessment by questioning the family. The welts should not be ignored because they could indicate child abuse.

Quiz 7: Intercultural Communication