Cultural Awareness Nursing Test Banks with Answers

Cultural Awareness MULTIPLE CHOICE 1. A nurse is working at a health fair screening people for liver cancer. Which population group should the nurse monitor most closely for liver cancer? a. Hispanic b. Asian Americans c. Non-Hispanic Caucasians d. Non-Hispanic African-Americans ANS: B While Asian Americans generally have lower cancer rates than the non-Hispanic Caucasian population, they also have the highest incidence rates of liver cancer for both sexes compared with Hispanic, non-Hispanic Caucasians, or non-Hispanic African-Americans. 2. A nurse is caring for an immigrant with low income. Which information should the nurse consider when planning care for this patient? a. There is a decreased frequency of morbidity. b. There is an increased incidence of disease. c. There is an increased level of health. d. There is a decreased mortality rate. ANS: B Populations with health disparities (immigrant with low income) have a signicantly increased incidence of disease or increased morbidity and mortality when compared with the general population. Although Americans’ health overall has improved during the past few decades, the health of members of marginalized groups has actually declined. 3. A nurse is assessing the health care disparities among population groups. Which area is the nurse monitoring? a. Accessibility of health care services b. Outcomes of health conditions c. Prevalence of complications d. Incidence of diseases ANS: A While health disparities are the dierences among populations in the incidence, prevalence, and outcomes of health conditions, diseases and related complications, health care disparities are dierences among populations in the availability, accessibility, and quality of health care services (e.g. screening, diagnostic, treatment, management, and rehabilitation) aimed at prevention, treatment, and management of diseases and their complications. 4. A nurse is providing care to a patient from a dierent culture. Which action by the nurse indicates cultural competence? a. Communicates eectively in a multicultural context b. Functions eectively in a multicultural context c. Visits a foreign country d. Speaks a dierent language ANS: B Cultural competence refers to a developmental process that evolves over time that impacts ability to eectively function in the multicultural context. Communicates eectively and speaking a dierent language indicates linguistic competence. Visiting a foreign country does not indicate cultural competence. 5. The nurse learns about cultural issues involved in the patient’s health care belief system and enables patients and families to achieve meaningful and supportive care. Which concept is the nurse demonstrating? a. Marginalized groups b. Health care disparity c. Transcultural nursing d. Culturally congruent care ANS: D The nurse is demonstrating culturally congruent care. Culturally congruent care, or care that ts a person’s life patterns, values, and system of meaning, provides meaningful and benecial nursing care. Marginalized groups are populations left out or excluded. Health care disparities are dierences among populations in the availability, accessibility, and quality of health care services (e.g. screening, diagnostic, treatment, management, and rehabilitation) aimed at prevention, treatment, and management of diseases and their complications. Transcultural nursing is a comparative study of cultures in order to understand their similarities (culture that is universal) and the dierences among them (culture that is specic to particular groups). 6. A nurse is beginning to use patient-centered care and cultural competence to improve nursing care. Which step should the nurse take †rst? a. Assessing own biases and attitude b. Learning about the world view of others c. Understanding organizational forces d. Developing cultural skills ANS: A Becoming more aware of your biases and attitudes about human behavior is the rst step in providing patientcentered care, leading to culturally competent care. It is helpful to think about cultural competence as a lifelong process of learning about others and also about yourself. Learning about the world view, developing cultural skills, and understanding organizational forces are not the rst steps. 7. A nurse is performing a cultural assessment using the ETHNIC mnemonic for communication. Which area will the nurse assess for the “H”? a. Health b. Healers c. History d. Homeland ANS: B The “H” in ETHNIC stands for healers: Has the patient sought advice from alternative health practitioners? While health, history, and homeland are important, they are not components of “H.” 8. The nurse is caring for a patient of Hispanic descent who speaks no English. The nurse is working with an interpreter. Which action should the nurse take? a. Use long sentences when talking. b. Look at the patient when talking. c. Use breaks in sentences when talking. d. Look at only nonverbal behaviors when talking. ANS: B Direct your questions to the patient. Look at the patient, instead of looking at the interpreter. Pace your speech by using short sentences, but do not break your sentences. Observe the patient’s nonverbal and verbal behaviors. 9. Which action indicates the nurse is meeting a primary goal of cultural competent care for patients? a. Provides care to transgender patients b. Provides care to restore relationships c. Provides care to patients that is individualized d. Provides care to surgical patients ANS: A Although cultural competence and patient-centered care both aim to improve health care quality, their focus is slightly dierent. The primary aim of cultural competence care is to reduce health disparities and increase health equity and fairness by concentrating on people of color and other marginalized groups, like transgender patients. Patient-centered care, rather than cultural competence care, provides individualized care and restores an emphasis on personal relationships; it aims to elevate quality for all patients. 10. The nurse is caring for a Chinese patient using the Teach-Back technique. Which action by the nurse indicates successful implementation of this technique? a. Asks, “Does this make sense?” b. Asks, “Do you think you can do this at home?” c. Asks, “What will you tell your spouse about changing the dressing?” d. Asks, “Would you tell me if you don’t understand something so we can go over it?” ANS: C The Teach-Back technique asks open-ended questions, like what will you tell your spouse about changing the dressing, to verify a patient’s understanding. When using the Teach-Back technique do not ask a patient, “Do you understand?” or “Do you have any questions?” Does this make sense and do you think you can do this at home are closed-ended questions. Would you tell me if you don’t understand something so we can go over it is not verifying a patient’s understanding about the teaching. 11. A nurse is using core measures to reduce health disparities. Which group should the nurse focus on to cause the most improvement in core measures? a. Caucasians b. Poor people c. Alaska Natives d. American Indians ANS: B To improve results, the nurse should focus on the highest disparity. Poor people received worse care than high-income people for about 60% of core measures. American Indians and Alaska Natives received worse care than Caucasians for about 30% of core measures. 12. A nurse is designing a form for lesbian, gay, bisexual, and transgender (LGBT) patients. Which design should the nurse use? a. Use partnered rather than married. b. Use mother rather than father. c. Use parents rather than guardian. d. Use wife/husband rather than signicant other. ANS: A Include LGBT-inclusive language on forms and assessments to facilitate disclosure, knowing that disclosure is a choice impacted by many factors. For example, provide options such as “partnered” under relationship status. For parents, use parent/guardian, instead of mother/father. Use neutral and inclusive language when talking with patients (e.g., partner or signicant other), listening and reecting patient’s choice. Remember that some LGBT patients are also legally married. 13. A nurse is assessing population groups for the risk of suicide requiring medical attention. Which group should the nurse monitor most closely? a. Young bisexuals b. Young caucasians c. Asian Americans d. African-Americans ANS: A Gay, lesbian, and bisexual young people have a signicantly increased risk for depression, anxiety, suicide attempts, and substance use disorders, being 4 times as likely as their straight peers to make suicide attempts that require medical attention. Caucasian youth, Asian Americans, and African-Americans are not as likely to attempt suicide resulting in medical attention. 14. A nurse is assessing a patient’s ethnohistory. Which question should the nurse ask? a. What language do you speak at home? b. How dierent is your life here from back home? c. Which caregivers do you seek when you are sick? d. How dierent is what we do from what your family does when you are sick? ANS: B An ethnohistory question is the following: How dierent is your life here from back home? Caring beliefs and practice questions include the following: Which caregivers do you seek when you are sick and How dierent is what we do from what your family does when you are sick? The language and communication is the following: What language do you speak at home? 15. A nurse is teaching patients about health care information. Which patient will the nurse assess closely for health literacy? a. A patient 35 years old b. A patient 68 years old c. A patient with a college degree d. A patient with a high-school diploma ANS: B About 9 out of 10 people in the United States experience challenges in using health care information. Patients who are especially vulnerable are the elderly (age 65+), immigrants, persons with low incomes, persons who do not have a high-school diploma or GED, and persons with chronic mental and/or physical health conditions. A 35-year-old patient and patients with high-school and college education are not identied in the vulnerable populations. 16. A nurse works at a hospital that uses equity-focused quality improvement. Which strategy is the hospital using? a. Document sta satisfaction. b. Focus on the family. c. Implement change on a grand scale. d. Reduce disparities. ANS: D Organizations can implement equity-focused quality improvement by recognizing disparities and committing to reducing them. Sta diversity is a priority for equity-focused quality improvement, not sta satisfaction. While the family is important, the focus is on the patients. Organizations should start by implementing a change on a small scale (pilot testing), learning from each test, and rening the intervention through performance improvement cycles (e.g., plan, do, study, and act). 17. A nurse is providing care to a culturally diverse population. Which action indicates the nurse is successful in the role of providing culturally congruent care? a. Provides care that ts the patient’s valued life patterns and set of meanings b. Provides care that is based on meanings generated by predetermined criteria c. Provides care that makes the nurse the leader in determining what is needed d. Provides care that is the same as the values of the professional health care system ANS: A The goal of transcultural nursing is to provide culturally congruent care, or care that ts the person’s life patterns, values, and system of meaning. Patterns and meanings are generated from people themselves, rather than from predetermined criteria. Discovering patients’ cultural values, beliefs, and practices as they relate to nursing and health care requires you to assume the role of learner (not become the leader) and to partner with your patients and their families to determine what is needed to provide meaningful and benecial nursing care. Culturally congruent care is sometimes dierent from the values and meanings of the professional health care system. 18. A nurse is assessing the patient’s meaning of illness. Which area of focus by the nurse is priority? a. On the way a patient reacts to disease b. On the malfunctioning of biological processes c. On the malfunctioning of psychological processes d. On the way a patient reacts to family/social interactions ANS: A To provide culturally congruent care, you need to understand the dierence between disease and illness. Illness is the way that individuals and families react to disease, whereas disease is a malfunctioning of biological or psychological processes. The way a patient interacts to family/social interactions is communication processes and family dynamics. MULTIPLE RESPONSE 1. A nurse is using Campinha-Bacote’s model of cultural competency. Which areas will the nurse focus on to become competent? (Select all that apply.) a. Cultural skills b. Cultural desire c. Cultural transition d. Cultural knowledge e. Cultural encounters ANS: A, B, D, E Campinha-Bacote’s model of cultural competency has ve interrelated components: cultural awareness; cultural knowledge; cultural skills; cultural encounters; and cultural desire. Cultural transition is not a component of this model. 2. A nurse is using the RESPECT mnemonic to establish rapport, the “R” in RESPECT. Which actions should the nurse take? (Select all that apply.) a. Connect on a social level. b. Help the patient overcome barriers. c. Consciously attempt to suspend judgment. d. Stress that they will be working together to address problems. e. Know limitations in addressing medical issues across cultures. ANS: A, C The “R” in RESPECT stands for rapport and includes the following behaviors: connect on a social level; seek the patient’s point of view; and consciously attempt to suspend judgment. The “S” stands for support and includes the behavior of helping the patient overcome barriers. The “P” stands for partnership and includes the following behaviors: be exible with regard to issues of control and stress that you will be working together to address medical problems. The “C” stands for cultural competence and includes the behavior of knowing your limitations in addressing medical issues across cultures. 3. A nurse is using the explanatory model to determine the etiology of an illness. Which questions should the nurse ask? (Select all that apply.) a. How should your sickness be treated? b. What do you call your problem? c. How does this illness work inside your body? d. What do you fear most about your sickness? e. What name does it have? ANS: B, C, E The questions for etiology include “What do you call your problem?” and “What name does it have?” Recommended treatment is asked by the question “How should your sickness be treated?” Pathophysiology is asked by the question “How does this illness work inside your body?” The course of illness is asked by the question “What do you fear most about your sickness?” MATCHING A nurse is using Campinha-Bacote’s model of cultural competency to improve cultural care. Which actions describe the components the nurse is using? a. In-depth self-examination of one’s own background b. Ability to assess factors that inuence treatment and care c. Sucient comparative understanding of diverse groups d. Motivation and commitment to continue learning about cultures e. Cross-cultural interaction that develops communication skills 1. Cultural skills 2. Cultural desires 3. Cultural awareness 4. Cultural knowledge 5. Cultural encounters