ch 4 Flashcards
The nurse is caring for an older Chinese adult male who is grimacing and appears restless after abdominal surgery. What is the nurse’s best action?
a. Ask the patient if he is anxious about his hospital stay.
b. Ask a translator to conduct a FACES pain scale assessment.
c. Ask the patient about pain and assess vital signs.
d. Ask the patient about any history of depression or anxiety.
ANS: C
In the Chinese culture, elderly Chinese people believe that they must be stoic about pain and there is a stigma about talking about any mental health problems. The nurse should ask the patient about pain and also assess vital signs for physiological signs of pain, since the patient may not admit to any pain. Assuming the patient is depressed or anxious is not the best action when considering individual cultural differences and the risk of pain after major surgery. The registered nurse should never delegate assessment to any unlicensed member of the healthcare team such as a translator. The translator may assist with communication, but the nurse is responsible for the pain assessment.
Understanding cultural differences in health care is important because it will help the nurse to understand the manner in which people decide on obtaining treatments and medical care. In independent cultures an individual will
a. put himself first.
b. consult family members for advice.
c. ask for a second opinion.
d. travel great distances to receive the best care.
ANS: A
In independent cultures, an individual will put himself first in the case of a life-threatening illness, whereas even in dire circumstances, members of collectivist cultures may still consult other family members for the best course of action. In independent cultures, an individual will not consult with other family members, ask for a second opinion, or travel great distances to receive the best care.
When teaching an Asian patient with newly diagnosed diabetes, the nurse notes the patient nodding yes to everything that is being said. With a better understanding of cultural interdependence in self-concept, a nurse should immediately
a. write everything down for the patient to refer to later.
b. prompt further to elicit additional questions or concerns.
c. call the recognized elder for this patient.
d. call the oldest male relative for help with decision making.
ANS: B
When a nurse provides nutritional education to a patient who is from a culture that values greater power distance, it might appear that the patient is willing to accept all that the nurse suggests, when further prompting would elicit additional questions or concerns. The patient from a collectivist culture will usually consult family members for a best course of action. It is not acceptable for nurses to take it upon themselves to call the recognized elder or oldest male relative for help with decision making. While writing everything down may be OK for some cultures, with Asian patients it may be best to prompt further to elicit additional questions or concerns.
Women who are given the job of caretaker for aging relatives are subject to caregiver strain due to
a. feminine attributes.
b. unequal gender.
c. fixed gender roles.
d. female inequality.
ANS: C
In cultures with more fixed gender roles, women are usually given the role of caretaker for aging relatives and may suffer the stresses of caregiver strain. Feminine attributes refers to harmonious relationships, modesty, and taking care of others. Unequal gender refers to roles of males and females being unevenly distributed. Female inequality refers to female gender and roles being less than or unequal to male roles.
A 60-year-old Italian immigrant presents for an annual physical. He is counseled about diagnostic testing including laboratory testing, colonoscopy, influenza vaccination, and pneumococcal vaccination. His reply is “If it ain’t broke, don’t try to fix it.” When developing a plan of care, the nurse should consider which cultural orientation for this patient?
a. Short term
b. Long term
c. Leisurely term
d. Noncommittal
ANS: A
Short-term cultural orientation focuses on the present or past and emphasizes quick results. Long-term cultural orientation focuses the future and long-term rewards. Long-term-oriented cultures favor thrift, perseverance, and adopting to changing circumstances. Leisurely term and noncommittal are undefined in cultural orientation.
The emphasis on understanding cultural influence on health care is important because of
a. disability entitlements.
b. HIPAA requirements.
c. increasing global diversity.
d. litigious society.
ANS: C
Culture is an essential aspect of health care because of increasing diversity. Disability entitlements refer to defined benefits for eligible mental or physically disabled beneficiaries in relation to housing, employment, and health care. HIPAA requirements refers to the HIPAA Privacy Rule, which protects the privacy of individually identifiable health information; the HIPAA Security Rule, which sets national standards for the security of electronic protected health information; and the confidentiality provisions of the Patient Safety Rule, which protect identifiable information being used to analyze patient safety events and improve patient safety. Litigious society refers to excessively ready to go to law or initiate a lawsuit.
What interrelated constructs facilitate a nurse to become culturally competent?
a. Cultural diversity, self-awareness, cultural skill, and cultural knowledge
b. Cultural desire, self-awareness, cultural knowledge, and cultural identity
c. Cultural desire, self-awareness, cultural knowledge, and cultural diversity
d. Cultural desire, self-awareness, cultural knowledge, and cultural skill
ANS: D
The process of cultural competence consists of four interrelated constructs: cultural desire, self-awareness, cultural knowledge, and cultural skill. Cultural diversity in the context of health care refers to achieving the highest level of health care for all people by addressing societal inequalities and historical and contemporary injustices. Cultural identity is the norms, values, beliefs, and behaviors of a culture learned through families and group members.
