Question 1

A Hispanic patient complains of abdominal cramping caused by empacho. Which action should the nurse take first?

Accepted Answer

Further assessment of the patient's cultural beliefs is appropriate before implementing any interventions for a culture-bound syndrome such as empacho. Although medication,a visit by a curandero(a),or massage may be helpful,more information about the patient's beliefs is needed to determine which intervention(s)will be most helpful.

Question 2

The nurse is caring for a Native American patient who has traditional beliefs about health and illness. Which action by nurse is most appropriate?

Accepted Answer

Because the patient has traditional health care beliefs,it is appropriate for the nurse to ask whether the patient would like a visit by a shaman or other cultural healer. There is no cultural reason for the nurse to avoid asking the patient questions because these questions are necessary to obtain health information. The patient (rather than the family)should be consulted about personal cultural beliefs. The hospital routines for meals,care,and visits should be adapted to the patient's preferences rather than expecting the patient to adapt to the hospital schedule.

Question 3

Which strategy should be a priority when the nurse is planning care for a diabetic patient who is uninsured?

Accepted Answer

The use of standardized evidence-based guidelines will reduce the incidence of health care disparities among various socioeconomic groups. The other strategies may also be appropriate,but the priority concern should be that the patient receives care that meets the accepted standard.

Question 4

The nurse working in a clinic in a primarily African American community notes a higher incidence of uncontrolled hypertension in the patients. To correct this health disparity,which action should the nurse take first?

Accepted Answer

Before other actions are taken,additional assessment data are needed to determine the reason for the disparity. The other actions also may be appropriate,but additional assessment is needed before the next action is selected.

Question 5

The nurse works in a clinic located in a community with many Hispanics. Which strategy,if implemented by the nurse,would decrease health care disparities for the Hispanic patients?

Accepted Answer

Health care disparities are caused by stereotyping,biases,and prejudice of health care providers. The nurse can decrease these through staff education. The other strategies may also be addressed by the nurse but will not directly impact health disparities.

Question 6

The nurse plans health care for a community with a large number of recent immigrants from Vietnam. Which intervention is the most important for the nurse to implement?

Accepted Answer

Tuberculosis (TB)is endemic in many parts of Asia,and the incidence of TB is much higher in immigrants from Vietnam than in the general U.S. population. Teaching about contraceptive use,colonoscopy,and testing for hepatitis may also be appropriate for some patients but is not generally indicated for all members of this community.

Question 7

A female staff nurse is assessing a male patient of Arab descent who is admitted with complaints of severe headaches. It is most important for the charge nurse to intervene if the nurse takes which action?

Accepted Answer

Many men of Arab ethnicity do not believe it is appropriate to be alone with any female except for their spouse. The other actions are appropriate.

Question 8

An older Asian American patient tells the nurse that she has lived in the United States for 50 years. The patient speaks English and lives in a predominantly Asian neighborhood. Which action by the nurse is most appropriate?

Accepted Answer

Further assessment of the patient's health care preferences is needed before making further plans for culturally appropriate care. The other responses indicate stereotyping of the patient based on ethnicity and would not be appropriate initial actions.

Question 9

The nurse plans care for a hospitalized patient who uses culturally based treatments. Which action by the nurse is best?

Accepted Answer

Many culturally based therapies can be accommodated along with the use of Western treatments and medications. The nurse should attempt to use both traditional folk treatments and the ordered Western therapies as much as possible. Some culturally based treatments can be effective in treating "Western" diseases. Not all folk remedies interfere with Western therapies. It may be appropriate for the patient to continue some culturally based treatments while he or she is hospitalized.

Question 10

The nurse is performing an admission assessment for a non-English-speaking patient who is from China. Which actions could the nurse take to enhance communication ?

Accepted Answer

Electronic translation applications,telephone-based interpreters,and agency interpreters are all appropriate to use to communicate with non-English-speaking patients. When no interpreter is available,family members may be considered,but some information that will be needed in an admission assessment may be misunderstood or not shared if a child is used as the interpreter. Gestures are appropriate to use,but exaggeration of the gestures is not needed.

Question 11

The nurse is caring for a patient who speaks a different language. If an interpreter is not available,which action by the nurse is most appropriate?

Accepted Answer

The use of gestures will enable some information to be communicated to the patient. The other actions will not improve communication with the patient.

Question 12

When doing an admission assessment for a patient,the nurse notices that the patient pauses before answering questions about the health history. Which action by the nurse is most appropriate?

Accepted Answer

Patients from some cultures take time to consider a question carefully before answering. The nurse will show respect for the patient and help develop a trusting relationship by allowing the patient time to give a thoughtful answer. Asking the patient why the answers are taking so much time,stopping the assessment,and handing the patient a form indicate that the nurse does not have time for the patient.

Question 13

The nurse is obtaining a health history from a new patient. Which data will be the focus of patient teaching?

Accepted Answer

Behaviors are strongly linked to many health care problems. The patient's saturated fat intake is a behavior that the patient can change. The other information will be useful as the nurse develops an individualized plan for improving the patient's health,but will not be the focus of patient teaching.

Question 14

The nurse performs a cultural assessment with a patient from a different culture. Which action by the nurse should be taken first?

Accepted Answer

An early step in performing a cultural assessment is to determine whether the patient feels an affiliation with any cultural group. The other actions may be appropriate if the patient does identify with a particular culture.

Question 15

What information should the nurse collect when assessing the health status of a community?

Accepted Answer

Health status measures of a community include birth and death rates,life expectancy,access to care,and morbidity and mortality rates related to disease and injury. Although air pollution,access to health food stores,and education level are factors that affect a community's health status,they are not health measures.

Question 16

A staff nurse expresses frustration that a Native American patient always has several family members at the bedside. Which action by the charge nurse is most appropriate?

Accepted Answer

The first step in providing culturally competent care is to understand one's own beliefs and values related to health and health care. Asking the nurse about personal beliefs will help achieve this step. Reminding the nurse that this cultural practice is important to the family and patient will not decrease the nurse's frustration. The remaining responses (suggest that the nurse ask family members to leave the room and have the nurse explain to family that too many visitors will tire the patient)are not culturally appropriate for this patient.

Question 17

The nurse is caring for an Asian patient who is being admitted to the hospital. Which action would be most appropriate for the nurse to take when interviewing this patient?

Accepted Answer

Observation of the patient's use of eye contact will be most useful in determining the best way to communicate effectively with the patient. Looking directly at the patient or avoiding eye contact may be appropriate,depending on the patient's individual cultural beliefs. The nurse should assess the patient,rather than asking family members about the patient's beliefs.

Question 18

The nurse is caring for a newly admitted patient. Which intervention is the best example of a culturally appropriate nursing intervention?

Accepted Answer

Many cultures consider it disrespectful to touch a patient without asking permission,so asking a patient for permission is always culturally appropriate. The other actions may be appropriate for some patients but are not appropriate across all cultural groups or for all individual patients. Ethnicity may not be the most important factor in planning care,especially if the patient has urgent physiologic problems.

Quiz 2: Health Disparities and Culturally Competent Care