TEST BANK
Transcultural Concepts in Nursing Care
Joyceen S. Boyle, John W. Collins, Patti Ludwig-Beymer, and Margaret M. Andrews
9th Edition
,Table of Contents
Chapter 01 Theoretical Foundations of Transcultural Nursing 1
Chapter 02 Culturally Competent Nursing Care 9
Chapter 03 Cultural Competence in Health History and Assessment 17
Chapter 04 Influence of Cultural and Health Belief Systems on Healthcare Practices 24
Chapter 05 Transcultural Perspectives in Childbearing 31
Chapter 06 Transcultural Perspectives in the Nursing Care of Children 38
Chapter 07 Transcultural Perspectives in the Nursing Care of Adults 45
Chapter 08 Transcultural Perspectives in the Nursing Care of Older Adults 52
Chapter 09 Creating Culturally Competent Healthcare Organizations 59
Chapter 10 Transcultural Perspectives in Mental Health Nursing 67
Chapter 11 Culture, Family, and Community 74
Chapter 12 Religion, Faith, Culture, and Nursing 82
Chapter 13 Health Equity, Social Justice, and Cultural Competence 89
,______________________________________________________________________________________________
Test Bank - Transcultural Concepts in Nursing Care, 9th Edition (Boyle, 2024)
Chapter 1, Theoretical Foundations of Transcultural Nursing
1. Which component of transcultural nursing has been greatly supported through the research
conducted by anthropologists?
A) Nursing interventions planned on the basis of age and developmental norms
B) Evaluation of the understanding of risk factors based on cognitive function
C) Implementation of nursing care, respectful of the individual’s economic status
D) Assessment of woman’s ability to function successfully in her role within the
family
ANS: D
Feedback: Anthropology refers to the study of humans and humankind, including their
origins, behavior, social relationships, physical and mental characteristics, customs, and
development through time and in all places in the world. Social relationships include the
female role in the family structure. The remaining options are not based on cultural
considerations but are rather universally considered.
PTS: 1 DIF: Moderate REF: Anthropology and Culture
OBJ: 1
NAT: Client Needs: Safe and Effective Care Environment: Management of Care
TOP: Chapter: 1 KEY: Integrated Process: Nursing Process
BLM: Cognitive Level: Apply NOT: Multiple Choice
2. Which is the basis to support the need for transcultural nursing in a health care setting that
serves a multicultural metropolitan community?
A) The nursing responsibility to provide nursing care for each client who
demonstrates respect and acceptance
B) The ever-expanding numbers of immigrants entering the United States requiring
physical and mental health care
C) The diversity seen in the values, beliefs, behaviors, as well as physical and mental
characteristics of the client population
D) The varying economic and social backgrounds represented in the population
present unique barriers to health care delivery
ANS: C
Feedback: There is a marked increase in the migration of people within and between
countries worldwide. As a result, transcultural nursing is needed because of the growing
diversity that characterizes our national and global populations. Diversity refers to
differences in values, beliefs, behaviors, physical and mental characteristics, and related
attributes of groups of people in society. Respectful and accepting nursing care is a
universal expectation not reliant upon culture. The health care needs presented by a
culturally diverse population are not dependent on culture but rather culture requires the
delivery of the care in a culturally appropriate manner. Economics and social backgrounds
may present barriers even among a culturally homogenous population.
PTS: 1 DIF: Moderate
REF: Historical and Theoretical Foundations of Transcultural Nursing
OBJ: 2
NAT: Client Needs: Safe and Effective Care Environment: Management of Care
______________________________________________________________________________________________
1|Page
,______________________________________________________________________________________________
Test Bank - Transcultural Concepts in Nursing Care, 9th Edition (Boyle, 2024)
TOP: Chapter: 1 KEY: Integrated Process: Caring
BLM: Cognitive Level: Apply NOT: Multiple Choice
3. Which assessment question shows an understanding of the impact of cultural beliefs and
behaviors on a client’s demonstration of pain?
A) “Can you describe the pain you are experiencing for me?”
B) “Do you understand the long-term effects of chronic pain?”
C) “Have you ever taken medication to help control your pain?”
D) “How can I help you deal with the pain you are experiencing?”
ANS: D
Feedback: Transcultural nursing enables nurses to more accurately assess the cultural
expression of pain and to provide culturally appropriate interventions to prevent or alleviate
discomfort. Asking the client to identify acceptable pain-relieving measures will allow for
appropriate pain management intervention. The remaining options are questions asked to
assess pain regardless of cultural diversity.
PTS: 1 DIF: Moderate REF: Anthropology and Culture
OBJ: 2
NAT: Client Needs: Safe and Effective Care Environment: Management of Care
TOP: Chapter: 1 KEY: Integrated Process: Nursing Process
BLM: Cognitive Level: Apply NOT: Multiple Choice
4. Which nursing intervention demonstrates an understanding of the full scope on culturally
sensitive nursing care?
A) When planning a teenaged focused educational program on sexuality, both
homosexual and heterosexual lifestyle choices are discussed
B) When assessing a recently immigrated client’s ability to both speak and read the
dominant language when preparing discharge teaching
C) Including both Eastern traditional folk treatments and Western medical therapies
into the care plan of a client of Chinese descent
D) Directing a discussion concerning treatment options for an Arab female toward the
family’s elder male members
ANS: A
Feedback: Cultures are both ethnic, related to nationality, and nonethnic. Examples of a
nonethnic culture would include the gay, lesbian, and transgender members of all ethnic
groups. The remaining options focus on ethnic cultures only.
PTS: 1 DIF: Moderate REF: Anthropology and Culture
OBJ: 2
NAT: Client Needs: Safe and Effective Care Environment: Management of Care
TOP: Chapter: 1 KEY: Integrated Process: Nursing Process
BLM: Cognitive Level: Apply NOT: Multiple Choice
5. Which questions should the nurse ask the client when assessing culturally based care factors
using Leininger’s transcultural nursing principles? Select all that apply.
A) “In your culture, what do you do to stay healthy?”
B) “How is death handled in your culture?”
C) “When you get sick, why don’t you use Western medicine?”
______________________________________________________________________________________________
2|Page
,______________________________________________________________________________________________
Test Bank - Transcultural Concepts in Nursing Care, 9th Edition (Boyle, 2024)
D) “How do you determine if a person has a disability?”
E) “In your culture, what do you do when you are sick?”
ANS: A, B, E
Feedback: The culturally based care factors the nurse should assess the client for include
wellness, sickness, disability, and death. The nurse should ask the client based upon his or
her culture questions about the previously mentioned care factors. Asking why a client does
not use Western medicine is culturally insensitive and judgmental. Directing a question to
how the client determines if a person has a disability elicits opinion may not reflect the
client’s cultural view.
PTS: 1 DIF: Moderate
REF: Leininger's Contributions to Transcultural Nursing OBJ: 3
NAT: Client Needs: Safe and Effective Care Environment: Management of Care
TOP: Chapter: 1 KEY: Integrated Process: Nursing Process
BLM: Cognitive Level: Apply NOT: Multiple Selection
6. Which nursing intervention demonstrates one of the strengths of the transcultural nursing
Theory of Culture Care Diversity and Universality?
A) Planning treatments around the prayer schedule of a client who practices Islam
B) Encouraging a client of Chinese descent to explain the concept of “Ying and
Yang”
C) Assessing for stress factors affecting a client of Haitian descent as well as the
immediate family
D) Evaluating the reading comprehension of a client for whom the dominant language
is the second language
ANS: C
Feedback: Among the strengths of Leininger’s theory is its flexibility for use with
individuals, families, groups, communities, and institutions in diverse health systems. The
remaining options involve only the client.
PTS: 1 DIF: Difficult
REF: Leininger's Contributions to Transcultural Nursing OBJ: 3
NAT: Client Needs: Safe and Effective Care Environment: Management of Care
TOP: Chapter: 1 KEY: Integrated Process: Nursing Process
BLM: Cognitive Level: Apply NOT: Multiple Choice
7. The nurse is caring for an unconscious client with a comfort dog at the bedside. Which
member of the interprofessional health care team should provide the decision on behalf of
the client for the most appropriate treatment?
A) Physician
B) Daughter
C) Neighbor with medical power of attorney
D) Spiritual or traditional healer
ANS: C
______________________________________________________________________________________________
3|Page
,______________________________________________________________________________________________
Test Bank - Transcultural Concepts in Nursing Care, 9th Edition (Boyle, 2024)
Feedback: The interprofessional health care team is composed of many members including
the client as the most important decision-maker, followed by the person the client may
choose as a proxy to make legal medical decisions on his or her behalf in cases where the
client may be incapacitated or unconscious. The client’s choice in this case is the neighbor
who has medical power of attorney. The daughter, physician, and spiritual or traditional
healer are all part of the interprofessional team but do not hold the power to make the
decision.
PTS: 1 DIF: Easy REF: Interprofessional Health Care Team
OBJ: 5
NAT: Client Needs: Safe and Effective Care Environment: Management of Care
TOP: Chapter: 1 KEY: Integrated Process: Caring
BLM: Cognitive Level: Apply NOT: Multiple Choice
8. Which nursing intervention demonstrates an avoidance of one of the cited criticisms of
current transcultural nursing theories?
A) Asking a client who practices Judaism whether he or she will need a kosher diet
menu
B) Making sure that a client who practices Catholicism has his or her rosary beads
always within easy reach
C) Encouraging a veteran of World War II who fought for Germany to talk about his
or her military experiences
D) Suggesting that an obese client of Irish descent minimize consumption of beer and
potatoes
ANS: A
Feedback: These theories tend to foster stereotyping and fail to consider the variations
within cultures that influence the ways in which people express their cultural orientation.
Supporting a client’s expressed religious rituals and encouraging reminiscing about
experiences are not examples of stereotyping. Suggesting dietary changes based solely on
ethnic background is an example of stereotypical behavior.
PTS: 1 DIF: Difficult REF: Chronemics OBJ: 4
NAT: Client Needs: Safe and Effective Care Environment: Management of Care
TOP: Chapter: 1 KEY: Integrated Process: Nursing Process
BLM: Cognitive Level: Apply NOT: Multiple Choice
9. Which activity would best support the goals of transcultural nursing?
A) A multidisciplinary research project on the effects of culture on pain management
plans
B) Revising facility visitation policies to support cultures in which family members
remain with the client
C) Organizing a rally to raise awareness of the need for a local free clinic to serve
culturally diverse families
D) Providing staff education regarding the dietary traditions of both the local Jewish
and Arab populations
ANS: A
Feedback: An interdisciplinary research project would help expand the body of knowledge.
The other choices are examples of utilizing.
______________________________________________________________________________________________
4|Page
,______________________________________________________________________________________________
Test Bank - Transcultural Concepts in Nursing Care, 9th Edition (Boyle, 2024)
PTS: 1 DIF: Moderate REF: Problem-Solving Process
OBJ: 2
NAT: Client Needs: Safe and Effective Care Environment: Management of Care
TOP: Chapter: 1 KEY: Integrated Process: Nursing Process
BLM: Cognitive Level: Apply NOT: Multiple Choice
10. Which statement demonstrates a lack of knowledge concerning the role eye contact plays in
various cultures?
A) “It’s so important to maintain eye contact with the client while providing discharge
teaching.”
B) “Eye contact can be a difficult nonverbal communication to interpret from a
cultural standpoint.”
C) “I never assume a client’s interest in our conversation on the basis of his or her
willingness to maintain eye contact.”
D) “Many cultures are reluctant to maintain eye contact with nonfamily members.”
ANS: B
Feedback: The use of eye contact is among the most culturally variable nonverbal behaviors
that clients will use to communicate with the nurse. Although most nurses have been taught
to maintain eye contact when speaking with clients, individuals from culturally diverse
backgrounds may attribute other culturally based meanings to this behavior. The remaining
options are true statements.
PTS: 1 DIF: Moderate REF: Eye Contact and Facial Expressions
OBJ: 5
NAT: Client Needs: Safe and Effective Care Environment: Management of Care
TOP: Chapter: 1 KEY: Integrated Process: Communication and Documentation
BLM: Cognitive Level: Apply NOT: Multiple Choice
11. Which consideration is the basis for the selection of an interpreter for an older client who
has a limited ability to speak and understand the dominant language?
A) Younger adults are generally more understanding of American jargon and so can
translate it better.
B) Family members are generally considered good interpreters since they share the
same dialect.
C) The interpreter should ideally be of similar age and of the same gender as the
client.
D) The client should be allowed to select the interpreter as a means of maintaining
autonomy.
ANS: C
Feedback: The interpreter should be of similar age and of the same gender as the client to
help minimize cultural issues regarding the interaction between genders and deference to
age. An understanding of jargon is not necessarily a concern since the information should
not be delivered using such language. Family members may not be effective translators
especially if there is an age or gender issue. While maintaining autonomy is a concern, it
does not have priority over effective communication in this situation.
PTS: 1 DIF: Moderate REF: Overcoming Language Barriers
______________________________________________________________________________________________
5|Page
,______________________________________________________________________________________________
Test Bank - Transcultural Concepts in Nursing Care, 9th Edition (Boyle, 2024)
OBJ: 5
NAT: Client Needs: Safe and Effective Care Environment: Management of Care
TOP: Chapter: 1 KEY: Integrated Process: Teaching and Learning
BLM: Cognitive Level: Apply NOT: Multiple Choice
12. The nurse is caring for the following obstetric clients. Which action(s) demonstrates the
proper use of transcultural nursing theoretical foundations? Select all that apply.
A) Instruct on ways to modify dishes from the client’s culture to achieve a healthy
glucose level with a client diagnosed with gestational diabetes.
B) Provide a lesbian couple the request for birth certificate and ask the birth mother to
complete the full names of the mother and father of the newborn.
C) Assess the client traveling to other countries for potential exposure to illness and
signs and symptoms of illness.
D) Remove the hijab without asking from the head of a conscious client after a motor
vehicle incident to examine for potential injuries.
E) Teleconference an expert male obstetrician about a client who expresses following
traditional Islamic cultural beliefs to determine the next steps of care.
ANS: A, C
Feedback: The nurse must respect the client’s culture when providing nursing care. The
nurse should respect cultural food choices but can offer ways to modify the dishes to meet
dietary needs for clients with various disease processes. The client must be culturally
sensitive with gender issues and should ask the birth mother to complete the application for
birth certificate and not demand that both mother and father names be included. Travel
among countries is prevalent with the global economy, so the nurse should assess for
exposure to illness or signs and symptoms of illness when the client travels outside of the
country. The nurse should explain the purpose of assessment and ask for permission for the
removal of any head covering so that cultural respect is provided on the client’s terms. The
nurse must provide culturally competent gender care by determining who may examine the
client and if such an examination can occur via telemedicine.
PTS: 1 DIF: Moderate
REF: Historical and Theoretical Foundations of Transcultural Nursing
OBJ: 1
NAT: Client Needs: Safe and Effective Care Environment: Management of Care
TOP: Chapter: 1 KEY: Integrated Process: Nursing Process
BLM: Cognitive Level: Apply NOT: Multiple Selection
13. The nurse is searching for the best evidence to make culturally sensitive changes with care
for the clients from Hmong culture in a United States hospital using Leininger’s theory.
Based upon the following (fictitious) research studies, which should the nurse use as best
evidence to improve care?
A) “Randomized controlled trial of antihypertensives use among clients from
Southeast and East Asia”
B) “Perceptions of client form Hmong culture accessing health care in the United
States: A transcultural nursing approach”
C) “Ethnographic study of interactions of nurses with clients from Hmong culture”
D) “Mixed methods study of clients from Hmong culture receiving prenatal care in
European hospitals”
______________________________________________________________________________________________
6|Page
,______________________________________________________________________________________________
Test Bank - Transcultural Concepts in Nursing Care, 9th Edition (Boyle, 2024)
ANS: B
Feedback: Dr. Leininger created a new qualitative research method called ethnonursing
research to investigate phenomena of interest in transcultural nursing, and the article
examining “Perceptions of client from Hmong culture accessing health care in the United
States: A transcultural nursing approach” is the best possible article to examine for
ethnonursing research. A randomized controlled trial offers only quantitative research. An
ethnographic study is qualitative research, but it is from the anthropology roots and not from
Dr. Leininger’s ethnonursing approach. A mixed methods approach will contain both
quantitative and qualitative research, but the article’s setting is in European hospitals, so it is
less related to what the nurse is trying to accomplish, which is to specifically obtain and use
ethnonursing research in the same country where the clients are being cared.
PTS: 1 DIF: Easy
REF: Leininger's Contributions to Transcultural Nursing OBJ: 3
NAT: Client Needs: Safe and Effective Care Environment: Management of Care
TOP: Chapter: 1 KEY: Integrated Process: Teaching and Learning
BLM: Cognitive Level: Apply NOT: Multiple Choice
14. A local hospital group is creating a local transcultural health care team to assist with the
health care of the community that has seen an influx of refugees from other countries.
Which will be necessary for each team member to possess to be a part of the team? Select
all that apply.
A) Membership in two nursing orientations whose focus is transcultural nursing care
B) Proof of formal academic preparation at an accredited institution
C) Documentation proofing a work history in facilities that serve a culturally diverse
population
D) Appropriate licensure as required by the state
E) Official certification from the TCNS
ANS: B, D, E
Feedback: Credentialed health professionals who are part of the interprofessional health care
team should have formal academic preparation, licensure, and/or certification. Membership
in two nursing orientations and documented work history can help demonstrate the
individual’s desire to work in this area; however, the education, licensure, and/or
certification would be more important.
PTS: 1 DIF: Moderate REF: Interprofessional Health Care Team
OBJ: 4
NAT: Client Needs: Safe and Effective Care Environment: Management of Care
TOP: Chapter: 1 KEY: Integrated Process: Teaching and Learning
BLM: Cognitive Level: Apply NOT: Multiple Selection
15. In an effort to enhance and provide the best training, the Core Curriculum was developed to
provide the best training in transcultural nursing for nurses and other members of the health
care team. Which aspect(s) of the core of knowledge is used to develop this program? Select
all that apply.
A) Natural science
B) Medicine
C) Philosophy
______________________________________________________________________________________________
7|Page
, ______________________________________________________________________________________________
Test Bank - Transcultural Concepts in Nursing Care, 9th Edition (Boyle, 2024)
D) Social work
E) Technology
ANS: A, B, C, D
Feedback: The Core Curriculum draws on knowledge and research from the natural, social,
and behavioral sciences; philosophy, theology, and religious studies; history; the fine arts;
and applied or professional disciplines such as medicine, social work, and education.
Technology is enabling the process to occur more quickly and utilize more resources in a
shorter amount of time.
PTS: 1 DIF: Moderate REF: The Core Curriculum
OBJ: 4
NAT: Client Needs: Safe and Effective Care Environment: Management of Care
TOP: Chapter: 1 KEY: Integrated Process: Teaching and Learning
BLM: Cognitive Level: Apply NOT: Multiple Selection
______________________________________________________________________________________________
8|Page
