Question 1

An unidentified patient was injured in a hit-and-run accident and was conscious. When asked how he felt, the patient looked very confused and responded in a language the nurse did not recognize. Which of the following actions should the nurse take next?

Accepted Answer

The nurse can report the problem and request a translator, but in the meantime the nurse should pantomime words and simple actions while verbalizing them until communication can be established using a translator from his culture. Just looking at a patient will not allow you to assume his or her ethnic background.

Question 2

After being given negative news about a health problem, the client, with tears running down her face, asks, "Why did this happen to me?" Which of the following is the most appropriate response by the nurse?

Accepted Answer

Each response represents a particular belief about illness, but without knowing the patient's perspective, the wrong one could easily be chosen. It is difficult to be comforting without knowing the client's beliefs about the causation of illness. The best way to discover this is to query the patient.

Question 3

A nurse is caring for a client from a different culture. Which of the following actions would be the most helpful for the nurse to take?

Accepted Answer

Recognizing both similarities and differences is being culturally aware. Although it would be helpful to have a nurse from the same culture give care, that is often not feasible. A nurse from another area cannot be expected to be clinically expert, to say nothing of the legal problems of having a nurse from a different agency give care. Asking the patient for help makes the problem belong to the patient, but it is the nurse's problem. Asking the patient to comply with the hospital regulations is being culturally insensitive.

Question 4

A nurse was assigned to create and implement a community education program with the goal of preventing diabetes among the Hispanic population. As the nurse did not speak Spanish and was just beginning to be comfortable with the neighborhood Hispanic culture, which of the following would be the best approach for the nurse to take?

Accepted Answer

By using volunteers, the program can disseminate culturally appropriate information in a culturally appropriate way. The success of educational efforts is often determined by the credibility of the source and the sensitivity of the speaker in communicating information in a culturally appropriate manner.

Question 5

A woman comes to the clinic, and the nurse believes that she is speaking French. She seems to understand English. A provider will need to complete a physical examination to confirm the health problem. Which of the following actions should be taken by the nurse?

Accepted Answer

When in doubt, the best way is to ask the client about culturally relevant aspects of male-female relationships. This should be done at the beginning of the interaction before an opportunity arises to violate culturally based practices. It is not appropriate to ask other staff members to serve as interpreters during nurse-client interactions.

Question 6

Which of the following are the most important factors in reducing disparities in health outcomes between different cultural groups? (Select all that apply.)

Accepted Answer

Disparities in health care can be reduced or even eliminated when adults have health care insurance and a medical home defined as a setting that provides patients with timely, well-organized care and enhanced access to providers. According to the Commonwealth Fund (2007), when adults have insurance and a medical home, "their access to needed care, receipt of routine preventive screenings, and management of chronic conditions improve substantially." Thus, having a strong family structure, access to trtansportation, ongoing employment, and owning one's own home are not nearly as important as having health insurance and a medical home.

Question 7

Which of the following helps to balance the fact that poverty is typically a major factor in certain groups having poorer health?

Accepted Answer

Latino children who live in poverty enjoy relatively good health compared with children in other low socioeconomic groups. It is believed that strong family-community support fosters optimum family health behaviors. Many of these behaviors are integrated into the culture as part of the family identity, traditions, and history. Without strong family and community support having other resources in the community is insignificant. Strong support structures can exist in communities where fathers are not married to children's mothers.

Question 8

A nurse is called by a friend who complains of symptoms of a cold. Which of the following responses would be the most appropriate by the nurse?

Accepted Answer

Seventy percent to 90% of all illness episodes are treated first, or exclusively, through self-care, often with significant success. Symptoms of a cold do not seem to require drastic action such as going to the urgent care center or seeing a health care provider. Engaging in traditional healing interventions, learned in the family, will be comforting and probably will help.

Question 9

Which of the following actions was taken by the federal government to help improve health disparities among minorities?

Accepted Answer

The National Center on Minority Health and Health Disparities was developed in 2000 to assist in the investigation of factors affecting minority health. Its mission is to promote minority health and to ultimately eliminate health disparities. The federal government did not create scholarships and traineeships specifically for minority applicants, establish grants for minority health projects, or legislate funds to create new colleges to address the improvement in health disparities.

Question 10

Which of the following best describes the challenges when providing care to someone from a minority group? (Select all that apply.)

Accepted Answer

Nurses must understand how patients define health and illness, how their cultural group cures and cares for members, and how the nurse's personal cultural background influences the way in which care is delivered. The context and process of helping people involves at least two people who often have different cultural orientations and lifestyles. Very few nurses are members of a minority group. Although immigrants may adopt some of the ideas of the mainstream culture, many will continue to use traditional practices and the nurse must be aware and respect these cultural beliefs. Many minority group members represent the patient population who receives care, so nurses must be aware and respect these cultural beliefs.

Question 11

Crying, a clinic patient explained that she knew she had this breast lump because she had spread nasty gossip about her neighbor. Which of the following actions by the nurse would likely be the most successful?

Accepted Answer

The woman has expressed a magico-religious perspective on illness. Because evil has caused her illness, she must undo the evil. However, the nurse, as a practitioner of the biomedical perspective, must also arrange for a biopsy as soon as possible so treatment can be begin.

Question 12

A nurse made a home visit for prenatal care and teaching for an Asian woman. The nurse noted the woman was having a hot lunch of foods the nurse did not recognize. When the nurse suggested some appropriate cold protein foods be added to the meal, the woman looked horrified and distrusting. Which of the following best describes what has happened in this situation?

Accepted Answer

Many Asians ascribe to the yin-yang theory in which health is believed to exist when all aspects of the person are in perfect balance. Yin energy is female. Yin Yang foods are hot. Therefore to maintain balance, she has to eat hot foods. Thus, in the other responses the nurse is not considering the cultural background and needs of the client in this situation.

Question 13

The clinic was seeing a great number of Hmong immigrants from the mountainous regions of the Far East. If the nurse could not obtain a translator, which of the following would be the next best action?

Accepted Answer

If a translator is not available, the nurse can try many approaches such as pantomime, but it would also be helpful to have common phrases used with many patients on flash cards so basic information can be obtained. Other Hmong patients or family members should not be used as interpreters. It is unrealistic to teach English to patients at clinic visits. This population needs care, so suggesting that they receive care elsewhere is not a therapeutic response by the nurse.

Quiz 13: Cultural Diversity and Community Health Nursing