Silvestri Chapter 06 Ed#542

Silvestri, 3/e, ISBN 1-1460-0052-6 Chapter 006 (edited file)—"Cultural Diversity" 10/14/08, Page 1 of 7, 0 Figure(s), 0 Table(s), 7 Box(es)

6: Cultural Diversity PRACTICE QUESTIONS 1. A nurse is assisting in collecting data on an African American client admitted to the ambulatory care unit who is scheduled for a hernia repair. Which of the following information about the client is of least priority during the data collection? 1. Cardiovascular 2. Neurological 3. Respiratory 4. Psychosocial Answer: 4 Rationale: The psychosocial data is the least priority during the initial admission data collection. In the African American culture, it is considered intrusive to ask personal questions on the initial contact or meeting. Additionally, cardiovascular, neurological, and respiratory data include physiological assessments that would be the priority. Test-Taking Strategy: Note the key words, least priority. Use Maslow’s Hierarchy of Needs theory to answer the question. Options 1, 2, and 3 address physiological needs. Review the characteristics of the African American culture if you had difficulty with this question. Level of Cognitive Ability: Comprehension Client Needs: Physiological Integrity Integrated Process: Nursing Process/Data Collection Content Area: Fundamental Skills Reference: Potter, P., & Perry, A. (2005), Fundamentals of nursing (6th ed.). St. Louis: Mosby, pp. 124, 393-394. 2. A nursing instructor is providing a session on cultural beliefs related to health and illness. Following the session, the instructor asks a nursing student to describe the beliefs of an African American in regard to illness. Which statement describes the beliefs of an African American in regard to illness? 1. “Illness is due to an imbalance between yin and yang.” 2. “Illness is due to prolonged sitting.” 3. “Illness is a disharmonious state that may be caused by demons and spirits.” 4. “Illness is due to lack of exercise.” Answer: 3 Rationale: In the African American culture, illness is viewed as a disharmonious state that may be caused by demons and spirits. The goal of treatment, from the traditional African perspective, is to remove the harmful spirit from the body of the ill person. Asian Americans believe that illness is due to an imbalance between yin and yang and caused by prolonged sitting or lying, or overexertion. Test-Taking Strategy: Knowledge regarding the beliefs related to health and illness in the various cultures assists in answering the question. From this point, use the process of elimination to determine the correct option. Review the characteristics of the African American culture if you had difficulty with this question. Level of Cognitive Ability: Comprehension

Silvestri, 3/e, ISBN 1-1460-0052-6 Chapter 006 (edited file)—"Cultural Diversity" 10/14/08, Page 2 of 7, 0 Figure(s), 0 Table(s), 7 Box(es)

Client Needs: Psychosocial Integrity Integrated Process: Teaching/Learning Content Area: Fundamental Skills Reference: Potter, P., & Perry, A. (2005), Fundamentals of nursing (6th ed.). St. Louis: Mosby, p. 124. 3. A nurse is planning to reinforce instructions to the African American client about nutrition. When developing the plan, the nurse is aware that a common dietary practice of African Americans is to eat: 1. Fried foods 2. Rice as the basis for all meals 3. Red meat 4. Raw fish Answer: 1 Rationale: African American food preferences include chicken, pork, greens, rice, and fried foods. Asian Americans eat raw fish, rice, and soy sauce. Hispanic Americans prefer beans, fried foods, spicy foods, chili, and carbonated beverages. European Americans prefer carbohydrates and red meat. Test-Taking Strategy: Use the process of elimination. Recalling that African Americans are at risk for hypertension and coronary artery disease will assist in directing you to option 1. Review the food preferences of the African American culture if you had difficulty with this question. Level of Cognitive Ability: Comprehension Client Needs: Physiological Integrity Integrated Process: Nursing Process/Planning Content Area: Fundamental Skills References: Peckenpaugh, N. (2003). Nutrition essentials and diet therapy (9th ed.). Philadelphia: W.B. Saunders, p. 9. Nix, S. (2005). Williams’ basic nutrition and diet therapy (11th ed.). St. Louis: Mosby, pp. 252254. 4. A nurse is assigned to care for an Asian American client. The nurse plans care knowing that which of the following describes the Asian American’s view of illness? 1. Illness is caused by supernatural forces. 2. Illness is a punishment for sins. 3. Illness is a disharmonious state that may be caused by demons and spirits. 4. Illness is due to an imbalance between yin and yang. Answer: 4 Rationale: Asian Americans believe that illness is caused by an imbalance between yin and yang, by prolonged sitting or lying, or by overexertion. In the African American culture, illness is viewed as a disharmonious state that may be caused by demons and spirits. Native Americans believe that illness is caused by supernatural forces. Test-Taking Strategy: Knowledge regarding the beliefs related to health and illness of the various cultures assists in answering the question. From this point, use the process of elimination to determine the correct option. Review the characteristics of the Asian American culture if you had difficulty with this question. Level of Cognitive Ability: Comprehension

Silvestri, 3/e, ISBN 1-1460-0052-6 Chapter 006 (edited file)—"Cultural Diversity" 10/14/08, Page 3 of 7, 0 Figure(s), 0 Table(s), 7 Box(es)

Client Needs: Psychosocial Integrity Integrated Process: Nursing Process/Planning Content Area: Fundamental Skills References: Jarvis, C. (2004). Physical examination and health assessment (4th ed.). Philadelphia: W.B. Saunders, pp. 44-45. Potter, P., & Perry, A. (2005). Fundamentals of nursing (6th ed.). St. Louis: Mosby, p. 921. 5. A nursing student is discussing cultural diversity issues in a clinical conference. The nursing instructor asks a student to describe ethnocentrism. Which statement indicates a lack of understanding of the issue of ethnocentrism? 1. “It is a tendency to view one’s own ways as best.” 2. “It is acting in a manner that is superior to other cultures.” 3. “It is believing that ones’ own ways are the only acceptable way.” 4. “It is imposing one’s beliefs on individuals from another culture.” Answer: 4 Rationale: Ethnocentrism is a tendency to view one’s own ways of life as the most desirable, acceptable, or best, and to act in a superior manner toward another culture. Cultural imposition is the tendency to impose one’s own beliefs, values, and patterns of behavior on individuals from another culture. Test-Taking Strategy: Use the process of elimination and note the key words, indicates a lack of understanding, in the stem of the question. Also, note the similarity in options 1, 2, and 3. If you had difficulty with this question, review culturally related concepts. Level of Cognitive Ability: Comprehension Client Needs: Psychosocial Integrity Integrated Process: Teaching/Learning Content Area: Fundamental Skills Reference: Jarvis, C. (2004). Physical examination and health assessment (4th ed.). Philadelphia: W.B. Saunders, p. 40. 6. A nurse consults with a nutritionist regarding the dietary preferences of an Asian American client. Which of the following foods would the nurse plan to include in the diet plan? 1. Red meat 2. Rice 3. Fried foods 4. Fruits Answer: 2 Rationale: Asian American food preferences include raw fish, rice, and soy sauce. African American food preferences include chicken, pork, greens, rice, and fried foods. Hispanic Americans prefer beans, fried foods, spicy foods, chili, and carbonated beverages. European Americans prefer carbohydrates and red meat. Test-Taking Strategy: Knowledge regarding the food practices and preferences related to the various cultures is required to answer the question. Correlate rice with Asian Americans to answer questions similar to this one. Review the food preferences associated with the Asian American culture if you had difficulty with this question. Level of Cognitive Ability: Comprehension Client Needs: Physiological Integrity

Silvestri, 3/e, ISBN 1-1460-0052-6 Chapter 006 (edited file)—"Cultural Diversity" 10/14/08, Page 4 of 7, 0 Figure(s), 0 Table(s), 7 Box(es)

Integrated Process: Nursing Process/Planning Content Area: Fundamental Skills Reference: Nix, S. (2005). Williams’ basic nutrition & diet therapy (11th ed.). St. Louis: Mosby, p. 255. 7. An antihypertensive medication has been prescribed for a client with hypertension. The client tells the nurse that she would like to take an herbal substance to help lower her blood pressure. The nurse should: 1. Tell the client that if she takes the herbal substance she will need to have her blood pressure checked frequently. 2. Advise the client to discuss the use of an herbal substance with the physician. 3. Teach the client how to take her blood pressure so that it can be monitored closely. 4. Tell the client that herbal substances are not safe and should never be used. Answer: 2 Rationale: Although herbal substances may have some beneficial effects, not all herbs are safe to use. Clients who are being treated with conventional medication therapy should be advised to avoid herbal substances with similar pharmacological effects, because the combination may lead to an excessive reaction or to unknown interaction effects. Therefore, the nurse would advise the client to discuss the use of the herbal substance with the physician. Test-Taking Strategy: Use the process of elimination. Eliminate option 4 first because of the absolute word never. Next, eliminate options 1 and 3 because they are similar. Review the limitations associated with the use of herbal substances if you had difficulty with this question. Level of Cognitive Ability: Application Client Needs: Physiological Integrity Integrated Process: Nursing Process/Implementation Content Area: Fundamental Skills References: Lewis, S., Heitkemper, M., & Dirksen, S. (2004). Medical-surgical nursing: Assessment and management of clinical problems (6th ed.). St. Louis: Mosby, p. 101. Skidmore-Roth, L. (2001). Mosby’s handbook of herbs and natural supplements. St. Louis: Mosby. p. 182. 8. A Hispanic American mother brings her child to the clinic for an examination. Which of the following is important when gathering data about the child? 1. Avoiding eye contact 2. Touching the child during the examination 3. Avoiding speaking to the child 4. Using body language only Answer: 2 Rationale: In the Hispanic American culture, eye behavior is significant. The “bad (evil) eye” can be given to a child if a person looks at and admires the child without touching the child. Therefore, touching the child during the examination is very important. Although avoiding eye contact indicates respect and attentiveness, this is not the most important intervention. Avoiding speaking to the child, and using body language only, are not therapeutic interventions. Test-Taking Strategy: Use the process of elimination. Eliminate options 3 and 4 first because they are similar. From the remaining options, select the intervention that is most therapeutic, which is touch. Review the characteristics of the Hispanic American culture if you had difficulty

Silvestri, 3/e, ISBN 1-1460-0052-6 Chapter 006 (edited file)—"Cultural Diversity" 10/14/08, Page 5 of 7, 0 Figure(s), 0 Table(s), 7 Box(es)

with this question. Level of Cognitive Ability: Application Client Needs: Psychosocial Integrity Integrated Process: Nursing Process/Data Collection Content Area: Fundamental Skills References: Jarvis, C. (2004). Physical examination and health assessment (4th ed.), Philadelphia: W.B. Saunders, p. 70. Potter, P., & Perry, A. (2005). Fundamentals of nursing (6th ed.). St. Louis: Mosby, p. 913. 9. A client is diagnosed with cancer and is told that surgery followed by chemotherapy will be necessary. The client states to the nurse, “I have read a lot about complementary therapies. Do you think that I should try it?” The nurse responds by making which appropriate statement? 1. “No, because it will interact with the chemotherapy.” 2. “You need to ask your physician about it.” 3. “I would try anything that I could if I had cancer.” 4. “There are many different forms of complementary therapies. Let’s talk about these therapies.” Answer: 4 Rationale: Complementary (alternative) therapies include a wide variety of treatment modalities that are used in addition to conventional treatment to treat a disease or illness. These therapies complement conventional treatment but should be approved by the person’s health care provider to ensure that the treatment does not interact with prescribed therapy. Although the physician should approve the use of a complementary therapy, and although some of these therapies can interact with the prescribed treatment plan, the statements in options 1 and 2 are inappropriate. Similarly, option 3 is an inappropriate response to the client. Option 4 addresses the client’s question and encourages discussion. Test-Taking Strategy: Use therapeutic communication techniques. Eliminate options 1, 2, and 3 because they are nontherapeutic. Option 4 is the only option that addresses the client’s question and encourages discussion. Review therapeutic communication techniques if you had difficulty with this question. Level of Cognitive Ability: Application Client Needs: Physiological Integrity Integrated Process: Communication and Documentation Content Area: Fundamental Skills References: Lewis, S., Heitkemper, M., & Dirksen, S. (2004). Medical-surgical nursing: Assessment and management of clinical problems (6th ed.). St. Louis: Mosby, p. 94. Potter, P., & Perry, A. (2005) Fundamentals of nursing (6th ed.). St. Louis: Mosby, p. 437. 10. A nurse is preparing to assist a Jewish client with eating lunch. A kosher meal is delivered to the client. Which nursing action is most appropriate in assisting the client with the meal? 1. Carefully transferring the food from the paper plates to glass plates 2. Unwrapping the eating utensils for the client 3. Replacing the plastic utensils with metal eating utensils 4. Asking the client to unwrap the eating utensils and allowing the client to prepare the meal for eating Answer: 4

Silvestri, 3/e, ISBN 1-1460-0052-6 Chapter 006 (edited file)—"Cultural Diversity" 10/14/08, Page 6 of 7, 0 Figure(s), 0 Table(s), 7 Box(es)

Rationale: Kosher meals arrive on paper plates and with plastic utensils sealed. Health care providers should not unwrap the utensils or transfer the food to another serving dish. Although the nurse may want to be helpful in assisting the client with the meal, the only appropriate option for this client is option 4. Test-Taking Strategy: Use the process of elimination and knowledge regarding the rituals associated with kosher meals. Options 1 and 3 are similar and can be eliminated first. To choose from the remaining options, it is necessary to be familiar with kosher rituals. If you had difficulty with this question, review the dietary practices of this Jewish client. Level of Cognitive Ability: Application Client Needs: Psychosocial Integrity Integrated Process: Nursing Process/Implementation Content Area: Fundamental Skills Reference: Nix, S. (2005). Williams’ basic nutrition and diet therapy (11th ed.). St. Louis: Mosby, p. 249. 11. A nursing student is asked to identify the practices and beliefs of the Amish society. Select all practices and beliefs of the Amish society. ____The authority of women is equal to men. ____Remain secluded and avoid helping others. ____Use traditional health care and alternative health care, such as healers, herbs, and massage. ____Believe that health is a gift from God. ____Many choose not to have health insurance. ____Funerals are conducted in the home without a eulogy, flower decorations, or any other display; caskets are plain and simple without adornment. Answers: Use traditional health care and alternative health care, such as healers, herbs, and massage. Believe that health is a gift from God. Many choose not to have health insurance.. Funerals are conducted in the home without a eulogy, flower decorations, or any other display; caskets are plain and simple without adornment. Rationale: The Amish society maintains a culture distinct and separate from the non-Amish and generally remain separate from the rest of the world, physically and socially. Men usually dress in a plain, dark suit; women usually wear a plain dress with long sleeves, bonnet, and apron. Women are not allowed to hold positions of power in the congregational organization. Family life has a patriarchal structure and, although the roles of the women are considered equally important to those of men, they are very unequal in terms of authority. Marriage outside the faith is not allowed, and unmarried women remain under the authority of their father. The Amish society rejects materialism and worldliness, values living simply, and may choose to avoid technology, such as electricity and cars. They highly value responsibility, generosity, and helping others, and often work as farmers, builders, quilters, and homemakers. The Amish use traditional health care and alternative health care, such as healers, herbs, and massage, and believe that health is a gift from God, but that clean living and a balanced diet help maintain it. They may choose not to have health insurance and maintain mutual aid funds for Amish members to help with medical costs. Funerals are conducted in the home without a eulogy, flower decorations, or any other display; caskets are plain and simple, without adornment. At death, women are usually buried in their bridal dress. The Amish believe that one lives on after

Silvestri, 3/e, ISBN 1-1460-0052-6 Chapter 006 (edited file)—"Cultural Diversity" 10/14/08, Page 7 of 7, 0 Figure(s), 0 Table(s), 7 Box(es)

death, either receiving eternal reward in heaven or being punished in hell. Test-Taking Strategy: Specific knowledge regarding the practices and beliefs of the Amish society is needed to answer this question. Review the characteristics of this group of people if you had difficulty with this question. Level of Cognitive Ability: Comprehension Client Needs: Psychosocial Integrity Integrated Process: Teaching/Learning Content Area: Fundamental Skills References: Harkreader, H., & Hogan, M.A. (2004). Fundamentals of nursing: Caring and clinical judgment. (2nd ed.). Philadelphia: W.B. Saunders. p. 900.