Chapter 07: Culture of Populations in Communities
Stanhope: Foundations for Population Health in Community/Public Health Nursing,
MULTIPLE CHOICE
1. Which of the following best describes most Americans’ attitude toward immigrants?
a. Ambivalence, because there are no clear solutions about how to address their
needs.
b. Strongly negative, because immigrants take jobs that native-born Americans
could have instead.
c. Strongly positive, because immigrants bring useful job skills and often join
previous family members already in the United States.
d. Strong opposition to further immigration, because of the increasing population in
the United States.
ANS: A
Most Americans are ambivalent about immigration, recognizing both the positive and negative aspects
it is a complex issue that has no clear solutions. Because Americans are ambivalent, there is neither a s
attitude toward immigrants. However, many times immigrants do enter the United States because they
family ties. They are more likely to be low-income workers who work in low-wage, blue-collar jobs an
2. Earlier in the week, a nurse carefully taught a patient from a different culture exactly how much medic
emphasized the importance of taking the correct amount. However, the patient is back in the hospital t
overdose although the patient denies taking more than the label indicated. Which of the following is th
a. The patient was taking more mediation in the hope of getting well faster.
b. The patient was also taking folk medicines that had many of the same effects and
perhaps some of the same ingredients as the prescribed medication.
c. The patient truly did not understand and thought the dose being taken was correct.
d. The patient had a unique response to the medication and should have a smaller
dose ordered.
ANS: B
For fear of disapproval, a person may not tell the nurse that he or she is using folk medicine as well as
two medicines may have cumulative effects that could be dangerous to the client. Nurses who lack cul
develop feelings of inadequacy and helplessness because they are often unable to effectively help their
the patient was taking too much medication, taking the incorrect dose, or having a unique reaction to th
nurse should first interview the patient about use of folk medicine which may interact with the prescrib
3. A nurse wishes to develop cultural competence. Which of the following actions should the nurse take f
a. Complete a survey of all the various ethnicities represented in the nurse’s
community.
b. Consider how the nurse’s own personal beliefs and decisions are reflective of his
or her culture.
c. Invite a family from another culture to join the nurse for an event.
d. Study the beliefs and traditions of persons living in other cultures.
ANS: B
Cultural awareness requires self-examination and an in-depth exploration of one’s own beliefs and val
behavior. Cultural awareness is the first element in the model of cultural competence. Following the de
awareness, the next step is cultural knowledge in which information about organizational elements of d
groups is collected. The next stage of the model, cultural skill, occurs with the effective integration of
cultural knowledge to obtain relevant cultural data and meet the needs of culturally diverse clients. The
to this model is cultural encounter, which is the process that permits nurses to seek opportunities to eng
interactions with clients of diverse cultures to modify existing beliefs about a specific cultural group.
4. A nurse is caring for a client of another culture. Which of the following actions would be the most app
a. Alter personal nonverbal behaviors to reflect the cultural norms of the client.
b. Keep all behaviors culturally neutral to avoid misinterpretation.
c. Rely on friendly gestures to communicate caring for the client.
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5. A male nurse had a habit of sitting with the lower part of one leg resting over the knee of his opposite l
history. He stopped doing this around specific clients after being told that they were offended when he
(shoe) to their face. Which of the following was exhibited by the nurse when he changed his behavior?
a. Cultural accommodation
b. Cultural imposition
c. Cultural re-patterning
d. Cultural skill
ANS: D
Cultural skill is the effective integration of cultural knowledge and awareness to meet client needs—in
not be offended by having the bottom of the nurse’s foot or shoe in view of the client’s face. The nurse
sure that nonverbal communication techniques take into consideration the client’s use of body languag
accommodation involves negotiation with clients to include aspects of their folk practices with the trad
implement essential treatment plans. Cultural imposition is the process of imposing one’s values on oth
working with clients to make changes in their health practices if cultural behaviors are harmful or decr
6. The nurse practitioner (NP) discovered that an immigrant client is not taking the penicillin prescribed
and he believes that penicillin, a “hot” medicine, will not provide balance. Which of the following term
taken by the NP when the client’s prescription is changed to a different yet equally effective antibiotic
a. Cultural awareness
b. Cultural brokering
c. Cultural knowledge
d. Cultural skill
ANS: C
Cultural knowledge is information about organizational elements of diverse cultures and ethnic groups
about the client’s worldview from an emic (native) perspective. Cultural skill involves the provision of
and satisfying to the client. The medication change allows the client to retain his cultural beliefs and al
practitioner’s need to prescribe an effective antibiotic. Cultural awareness is the self-examination and i
one’s own biases, stereotypes, and prejudices that influence behavior. Cultural brokering is advocating
and intervening between the client’s culture and the biomedical health care culture on behalf of clients
7. An immigrant who takes metamizole (banned in the United States) for pain may experience life-threat
Which of the following actions would be taken by a nurse who employs cultural re-patterning?
a. Complete a cultural assessment to identify any other dangerous medications that
the client may be taking.
b. Put this into perspective by considering that many drugs used in the United States
cause agranulocytosis.
c. Explain the harmful effects of metamizole and recommend an alternative
medication for pain.
d. Recognize that taking metamizole is common among persons living in Mexico
and accept this as a cultural tradition.
ANS: C
Cultural re-patterning means that the nurse works with clients to help them reorder, change, or modify
when the practice is harmful to them. Completing a cultural assessment involves learning more about t
not address the need to consider changing or modifying cultural practices. In order to complete cultura
has to
take an action to resolve this potential problem.
8. A health care worker tells a nurse, “It does no good to try to teach those Medicaid clients about nutritio
eat what they want to no matter how much we teach them.” Which of the following is being demonstra
a. Cultural imposition
b. Ethnocentrism
c. Racism
d. Stereotyping
ANS: D
Stereotyping occurs when someone attributes certain beliefs and behaviors about a group to an individ
attention to individual differences. In this instance, the health care worker makes the assumption that c
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