Flashcards in Chapter 4 Deck (32):
1. Which term best describes a group of people who share a set of values, beliefs, practices, social relationships, law, politics, economics, and norms of behavior?
d. Social group
Culture is a pattern of assumptions, beliefs, and practices that unconsciously frames or guides the outlook and decisions of a group of people. A culture is composed of individuals who share a set of values, beliefs, and practices that serve as a frame of reference for individual perceptions and judgments. Race is defined as a division of mankind possessing traits that are transmissible by descent and are sufficient to characterize it as a distinct human type. Ethnicity is an affiliation of a set of persons who share a unique cultural, social, and linguistic heritage. A social group consists of systems of roles carried out in groups. Examples of primary social groups include the family and peer groups.
2. Which term best describes the emotional attitude that one’s own ethnic group is superior to others?
Ethnocentrism is the belief that one’s way of living and behaving is the best way. This includes the emotional attitude that the values, beliefs, and perceptions of one’s ethnic group are superior to those of others. Culture is a pattern of assumptions, beliefs, and practices that unconsciously frames or guides the outlook and decisions of a group of people. A culture is composed of individuals who share a set of values, beliefs, and practices that serves as a frame of reference for individual perception and judgments. Ethnicity is an affiliation of a set of persons who share a unique cultural, social, and linguistic heritage. Superiority is the state or quality of being superior; it does not include ethnicity.
3. Currently, the fastest-growing segment of the homeless population in the United States consists of:
b. “runaway” adolescents.
c. migrant farm workers.
d. individuals with mental disorders.
Homeless individuals lack resources and community ties necessary to provide for their own adequate shelter. One of the most pressing problems in the United States is the rapidly growing number of homeless families, which currently account for 50% of the nation’s homeless. “Runaway” (or throwaway) adolescents are often victims of physical and social abuse. Although it is a significant issue, this is not the fastest-growing segment of the homeless population. Migrant farm workers form one of the most severely disadvantaged groups in the United States. They have a mobile existence, which is detrimental for children. They do not constitute the fastest-growing segment of the homeless population. Individuals with mental disorders may be homeless. They do not constitute the fastest-growing segment of the homeless population.
4. Maria, a Spanish-speaking 5-year-old girl, has started kindergarten in an English-speaking school. Crying most of the time, she appears helpless and unable to function in this new situation. Which description best explains Maria’s behavior?
a. Lacks adequate culture for attending school
b. Lacks the maturity needed in school
c. Is experiencing culture shock
d. Is experiencing minority group discrimination
Culture shock is the helpless feeling and state of disorientation felt by an outsider attempting to adapt to a different culture group. Her inability to speak English inhibits her ability to interact. This would explain Maria’s inability to function in this new situation. There is no evidence to support that Maria lacks adequate culture or maturity needed in school, or that she is experiencing minority group discrimination
5. When minority groups immigrate to another country, a certain degree of cultural or ethnic blending occurs through the involuntary process of:
c. culture shock.
d. cultural sensitivity.
Acculturation is the gradual changes that are produced in a culture by the influence of another culture that cause one or both cultures to become more similar. The minority culture is forced to learn the majority culture to survive. Ethnocentrism is the belief that one’s way of living and behaving is the best way. This includes the emotional attitude that the values, beliefs, and perceptions of one’s ethnic group are superior to those of others. This would limit the blending. Culture shock is the helpless feeling and state of disorientation felt by an outsider attempting to adapt to a different culture group. This would limit the blending. Cultural sensitivity is an awareness of cultural similarities and differences. The nurse should develop the dynamics of cultural sensitivity to provide culturally competent care.
6. Which is a frequent health problem of migrant children and adolescents in the United States?
d. Cardiovascular disease
The rate of tuberculosis among migrant families is high. A high-risk factor for the children of migrant families is the migration of the families from areas that have high prevalence of tuberculosis; significant health issues, suicide, diabetes, and cardiovascular disease are not more prevalent in this population.
7. The nurse observes that the families who do not show up for scheduled clinic appointments are usually from minority cultural groups. The best explanation for this is that these families often differ from the dominant culture because they:
a. lack education.
b. avoid health care.
c. are more forgetful.
d. view time differently.
Each cultural group has different conceptions of time and waiting. The dominant culture in the United States has a fairly rigid view of time. Other cultures may be late or miss activities because other issues take precedence over the appointment. Education is not the issue. It is the concept of time in the cultural group. It is not done to avoid health care. The family usually believes that the appointment can be made for a later time. The family does not forget the time, but other issues take priority.
8. The Vietnamese mother of a child being seen in the clinic avoids eye contact with the nurse. The best explanation for this, considering cultural differences, is that the parent:
a. feels responsible for her child’s illness.
b. feels inferior to the nurse.
c. is embarrassed to seek health care.
d. is showing respect for the nurse.
In some ethnic groups, eye contact is avoided. In the Vietnamese culture, an individual may not look directly into the nurse’s eyes as a sign of respect. The nurse providing culturally competent care would recognize that feeling responsible for the illness, feeling inferior, or embarrassment are not reasons for the mother to avoid eye contact with the nurse.
9. The belief that health is “a state of harmony with nature and the universe” is common in which culture?
c. Native American
Many cultures ascribe attributes of health to natural forces. Many individuals of the Native-American culture view health as a state of harmony with nature and the universe. This belief is not consistent with the Japanese, African-American, or Hispanic-American cultural groups.
10. A Hispanic toddler has pneumonia. The nurse notices that the parent consistently feeds the child only the broth that comes on the clear liquid tray. Food items, such as Jell-O, Popsicle, and juices are left. Which statement would best explain this?
a. Parent is trying to feed child only what child likes most.
b. Parent is trying to restore normal balance through appropriate “hot” remedies.
c. Hispanics believe the “evil eye” enters when a person gets cold.
d. Hispanics believe an innate energy, called chi, is strengthened by eating soup.
In several groups, including Filipino, Chinese, Arabic, and Hispanic cultures, hot and cold describe certain properties completely unrelated to temperature. Respiratory conditions such as pneumonia are “cold” conditions and are treated with “hot” foods. The parent may be trying to feed the child only what the child likes most, but it is unlikely that a toddler would consistently prefer the broth to Jell-O, Popsicle, and juice. The evil eye applies to a state of imbalance of health, not curative actions. Chinese individuals believe in chi as an innate energy.
11. A nurse is taking a history on a low-income Hispanic toddler. The parent tells the nurse that occasional diarrhea is treated with azogue, a mercury compound commonly used in the parent’s native Mexico. What should the nurse recognize about this remedy?
a. It is harmless.
b. It is dangerous.
c. It has a scientific basis.
d. It has importance in certain religious practices.
The ingestion of mercury is extremely dangerous for children. Solutions containing mercury are not harmless. The nurse should work with folk healers or respected members of the culture to teach the family of the dangers of mercury ingestion. No scientific basis exists for the use of mercury to treat diarrhea.
12. The nurse discovers welts on the back of a Vietnamese child during a home health visit. The child’s mother says she has rubbed the edge of a coin on her child’s oiled skin. What explanation should the nurse recognize about this?
a. Child abuse
b. Cultural practice to rid the body of disease
c. Cultural practice to treat enuresis or temper tantrums
d. Child discipline measure common in the Vietnamese culture
Rubbing the edge of a coin on a child’s oiled skin is descriptive of coining. The welts are created by repeatedly rubbing a coin on the child’s oiled skin. The mother is attempting to rid the child’s body of disease. The mother was engaged in an attempt to heal the child. This is not child abuse or discipline.
13. The father of a hospitalized child tells the nurse, “He can’t have meat. We are Buddhist and vegetarians.” The nurse’s best intervention is to:
a. order the child a meatless tray.
b. ask a Buddhist priest to visit.
c. explain that hospital patients are exempt from dietary rules.
d. help the parent understand that meat provides protein needed for healing.
It is essential for the nurse to respect the religious practices of the child and family. The nurse should arrange a dietary consult to ensure that nutritionally complete vegetarian meals are prepared by the hospital kitchen. It is not necessary to ask a Buddhist priest to visit. The nurse should be able to arrange for a vegetarian tray. The nurse should not encourage the child and parent to go against their religious beliefs. Nutritionally complete, acceptable vegetarian meals should be provided.
14. In which cultural group is good health considered to be a balance between yin and yang?
b. Australian aborigines
c. Native Americans
In Chinese health beliefs, the forces termed yin and yang must be kept in balance to maintain health. The belief in this balance is not consistent with Australian aborigines, Native Americans, or African-Americans.
15. A young child from Mexico is hospitalized for a serious illness. The father tells the nurse that the child is being punished by God for being bad. The nurse should recognize that this is a(n):
a. health belief common in this culture.
b. early indication of potential child abuse.
c. misunderstanding of the family’s common beliefs.
d. belief common when fortune tellers have been used.
A common health belief in the Mexican-American cultural group is that health is controlled by the environment, fate, and the will of God. The father’s comment has no relation to child abuse. The father would not misunderstand the family’s beliefs. It is a cultural belief that health is controlled by the environment, fate, and the will of God. Mexicans may use the services of curandero (healers), not fortune tellers.
1. Children are taught the values of their culture through observation and feedback, relative to their own behavior. In teaching a class on cultural competence, the nurse should be aware that which factor(s) may be culturally determined? (Select all that apply.)
a. Degree of competition
b. Racial variation
c. Determination of status
d. Social roles
e. Geographic boundaries
ANS: A, C, D
Degree of competition, determination of status, and social roles are all factors that are determined by the assumptions, beliefs, and practices of the members of the culture. In cultures that value individual resourcefulness, competition would be acceptable. Status is culturally determined and varies according to each culture. Some will ascribe higher status to age or socioeconomic status. Social roles also are influenced by the culture. Race and culture are two distinct attributes. The racial grouping describes transmissible traits, whereas the culture is determined by the pattern of assumptions, beliefs, and practices that unconsciously frames or guides the outlook and decisions of a group of people. Cultural development may be limited by geographic boundaries. It is not the boundaries that are culturally determined.
2. Research is being done on the development of assets in children. A community that is supportive of children has which external assets? (Select all that apply.)
a. Unstructured environments to allow for freedom of choice
b. Social competencies to make positive choices
c. Empowerment to feel safe and secure
d. Positive values to direct choice
e. Boundaries to set expectations and actions
ANS: C, E
Young people need to feel valued by their community and able to contribute to others. They need to feel safe and secure. They also need boundaries to help set expectations and actions. To develop appropriately, children need boundaries and expectations. With these, they will learn what is expected of them and what behaviors are acceptable to the community. Social competencies to make positive choices and boundaries to set expectations and actions are internal assets that, when developed, help the child make positive choices.
3. A nurse is planning care for a Spanish-speaking child and family. The nurse speaks limited Spanish. Which interventions should the nurse plan when caring for this child and family? (Select all that apply.)
a. Ask a visitor to interpret.
b. Use a language-line telephone interpreter if a hospital interpreter is not available.
c. Use written cards with common phrases in the Spanish language.
d. Ask the family to provide an interpreter.
e. When using a hospital interpreter, speak to the family not the interpreter.
ANS: B, C, E
If a live interpreter is not available, the nurse should use a language line telephone interpreter. The nurse should use cards with common greetings, phrases, and names of body parts in the family’s language. When using a hospital interpreter, the nurse should speak directly to the family and allow the interpreter to translate. Visitors or other family members should not be used as interpreters because of the risk of misinterpretation of medical terms
4. A nurse is working in a clinic that serves a culturally diverse population of children. The nurse should plan care, understanding that which complementary and alternative practices may be used by families of this diverse population? (Select all that apply.)
a. Seeking another doctor’s opinion
b. Seeking advice from a curandero or curandera
c. Using acupuncture or acupressure as a therapy
d. Consulting an herbalist
e. Consulting a kahuna
ANS: B, C, D, E
The curandero (male) or curandera (female) of the Mexican-American community is believed to have healing powers that are a gift from God. The Asian family may consult an herbalist, knowledgeable in medicines, or perhaps a specialized practitioner of Asian therapies, including acupuncture (insertion of needles) or acupressure (application of pressure). Native Hawaiians consult kahunas and practice ho’oponopono to heal family imbalance or disputes. The nurse may encounter use of these practices. Consulting another doctor would not be a complementary or alternative practice expected in a culturally diverse population.
5. A nurse is caring for an African-American child recently admitted to the hospital. The nurse should be aware of which broad cultural characteristics for this child when planning care? (Select all that apply.)
a. Silence may indicate a lack of trust.
b. Maintaining constant eye contact may be viewed as aggressive.
c. Self-care and folk medicine do not play a role in healthcare.
d. Illness may be seen as the “will of God.”
e. No importance is attached to nonverbal behavior.
ANS: A, B, D
A nurse should be aware of the African-American broad cultural characteristics, which include: initial eye contact to show respect; maintaining eye contact can be viewed as aggressive, silence may indicate a lack of trust, and illness may be seen as the “will of God.” Self-care and folk medicine are prevalent in this culture, and importance is placed on nonverbal behavior.
1. Poverty has serious implications for children and families. Social and cultural deprivation, including limited employment opportunities, inferior educational opportunities, inferior or no access to health care, and a lack of public services, is referred to as the _______________ type of poverty.
“Social and cultural deprivation, including limited employment opportunities, inferior educational opportunities, inferior or no access to health care, and a lack of public services” is the definition of “invisible poverty.” Visible poverty is the lack of money or material resources, including insufficient clothing, poor sanitation, and deteriorating housing.
2. A parent of a 12-year-old child states to the nurse, “My 12-year-old watches TV constantly while at home—is this OK?” The nurse should recommend to the parent that television viewing should be limited to _____ hours a day? (Record your answer in a whole number.)
Children may identify closely with people or characters portrayed in reading materials, movies, and television programs and commercials. Pediatric nurses can educate and support parents on the effects of mass media on their children by recommending that television viewing should be limited to 2 hours a day or less.
A nurse is caring for a dying child whose religion is Islam (Muslim, or Moslem). Which is an important nursing consideration related to the child’s impending death and religion?
a. There are no special rites.
b. There are specific practices to be followed.
c. The family is expected to "wait" away from the dying person.
d. Baptism should be performed if it has not been done previously.
Islam (Muslim, or Moslem) religion has specific rituals for bathing and wrapping the body in cloth before it is to be moved.
There are special rites. The nurse should contact someone from the person's mosque to assist with the special rites related to death.
Family members may be present with the dying child.
No baptism is required at this time.
Which term refers to a shared cultural, social, and linguistic heritage?
Ethnicity is an affiliation of a set of persons who share a unique cultural, social, and linguistic heritage.
Beliefs are attitudes, which can be shared.
Culture is a pattern of assumptions, beliefs, and practices that unconsciously frames the outlook and decisions of a group of people.
Socialization is the process by which individuals learn the roles that are expected from them.
What is the most overwhelming adverse influence on health?
c. Socioeconomic status
d. Genetic constitution
A higher percentage of lower-class individuals have some health problem at any one time than individuals in other classes. There is a high correlation between poverty and poor nutrition.
Although children of different racial groups have differing health issues, socioeconomic status is a key predictor of health.
Although customs may influence health, they are usually positive rather than adverse in nature.
On a population basis, genetic constitution is not an overwhelming adverse influence.
Which statement is true concerning folk remedies?
a. They may be used to reinforce the treatment plan.
b. They are incompatible with modern medical regimens.
c. They are a leading cause of death in some cultural groups.
d. They are not a part of the culture in large, developed countries.
Whenever they are compatible, folk remedies should be used to reinforce the treatment plan. This will assist in establishing a caring environment.
Depending on the remedy, folk remedies may not be incompatible with modern medical regimens.
Death causation varies with the remedy.
The part that folk remedies play in large, developed counties varies with the remedy.
The nurse is planning care for a patient with a different ethnic background from the nurse’s own. The most appropriate goal for the nurse in caring for this patient is to
a. strive to keep ethnic background from influencing health care.
b. encourage continuation of ethnic practices in the hospital setting.
c. attempt, in a nonjudgmental way, to change ethnic beliefs.
d. adapt, as necessary, ethnic practices to health needs.
Whenever possible, nursing should facilitate the integration of ethnic practices into health care plans.
The ethnic background is part of the individual; it would be difficult to eliminate the influence of one’s ethnic background.
The ethnic practices need to be evaluated in the context of the health care setting to determine whether they are conflicting within the framework of the patient's care.
The ethnic background is part of the individual; it would be difficult to eliminate the influence of one’s ethnic background.
One of the most pressing problems in the United States is the growing number of the homeless population. Currently the fastest-growing segment of the homeless population is
a. “runaway” and “throwaway” adolescents.
b. individuals with mental disorders.
c. migrant farm worker families.
d. families with children.
Families with children make up 40% of the homeless population. The homeless lack resources and community ties necessary to provide for their own adequate shelter.
“Runaway” and “throwaway” adolescents consist approximately 12% of homeless population. Many runaway adolescents are victims of physical, social, and sexual abuse.
Individuals with mental disorders may be homeless but they do not constitute the fastest-growing segment of the homeless population.
Children in migrant farm worker families represent one of the most disadvantaged groups that are overall underserved. This population is mobile.
The parent of a hospitalized child tells the nurse, “We do not eat meat. We are practicing Buddhists and strict vegetarians.” The most appropriate intervention by the nurse is to
a. order the child a meatless tray.
b. tell the parent to take any meat off the child’s meal tray.
c. ask the parent if they would like to have a Buddhist priest visit.
d. explain to the parent that meat provides protein needed to heal their child.
It is essential for the nurse to respect the religious practices of the child and parent.
The nurse is not culturally sensitive to the religious practices of the child and parent and should ensure that nutritionally complete vegetarian meals are prepared by the Dietary department.
Asking the parent if they would like a Buddhist priest is not addressing the vegetarian diet and not being respectful of the child and parent’s religious beliefs.
The practice of cultural humility is continual and an important concept in the nursing process. Nurses can facilitate this process by (Select all that apply)
a. integrating cultural knowledge.
b. recognizing cultural differences.
c. acting in a culturally appropriate manner.
d. being aware of their own beliefs and practices.
e. helping the family adapt to the health care practices.
Ans: A, B, C, D
Children are taught the values of their culture through observation and feedback on their own behavior. A nurse teaching a class on cultural awareness-competence should be aware of which factor(s) that may be culturally determined? (Select all that apply)
a. Social roles
b. Racial variation
c. Degree of competition
d. Determination of status
Ans: A, C, D