FINAL Fundamentals of nursing
Questions & Answers
ANS: A
Populations with health disparities have a significantly increased incidence of disease or
increased morbidity and mortality when compared with the general population. -
ANSWERSEliminating disparities in the health status of people from diverse racial,
ethnic, and cultural backgrounds has become one of the two most important priorities of
Healthy People 2020 because populations with health disparities have
a. Increased incidence of disease.
b. Lower levels of morbidity.
c. Lower mortality rates.
d. Decreased incidence of disease.
ANS: A
The OMH describes culture as the thoughts, communications, actions, customs, beliefs,
values, and institutions of racial, ethnic, religious, or social groups. Subcultures
represent various ethnic, religious, and other groups with distinct characteristics from
the dominant culture. Ethnicity refers to a shared identity related to social and cultural
heritage such as values, language, geographical space, and racial characteristics.
Cultural backlash occurs when an individual rejects a new culture because experience
with a new or different culture is extremely negative. - ANSWERSAccording to the
Office of Minority Health (OMH), the thoughts, communications, actions, customs,
beliefs, values, and institutions of racial, ethnic, religious, or social groups are known as
a. Culture.
b. Subculture.
c. Ethnicity.
d. Cultural backlash.
ANS: C
Despite significant improvements in the overall health status of the U.S. population over
the past few decades, the persistence of disparities in health status among ethnic and
racial minorities continues to be a serious local and national challenge. Hispanics,
African Americans, and some Asian subgroups are less likely than non-Hispanic whites
to have a high school education and often experience poorer access to care and lower
quality of preventive, primary, and specialty care. - ANSWERSDespite significant
improvements in the overall health status of the U.S. population over the past few
decades, disparities among ethnic and racial minorities have
a. Decreased as education levels equal those of non-Hispanic whites.
b. Disappeared in relation to non-Hispanic white populations.
c. Remained a serious challenge locally and nationally.
d. Decreased faster than anticipated.
,ANS: A
Ethnicity refers to a shared identity related to social and cultural heritage such as
values, language, geographical space, and racial characteristics. Ethnicity is different
from race, which is limited to the common biological attributes shared by a group such
as skin color or blood type. In any intercultural encounter, there is an insider or native
perspective (ethic worldview) and an outsider's perspective (ethic worldview). Ethnicity
is best understood by those who are a part of that ethnicity and have an "emic"
worldview. - ANSWERSWhen asked to describe the differences between ethnicity and
race, what should the student nurse explain?
a. Ethnicity refers to a shared identity, whereas race is limited to biological attributes.
b. Ethnicity and race are actually the same and are based in cultural norms.
c. Ethnicity can be understood only through an ethic worldview.
d. Race refers to a shared identity, whereas ethnicity is limited to biological attributes.
ANS: B
The goal of transcultural nursing is culturally congruent care, or care that fits the
person's valued life patterns and set of meanings. Culturally competent care reflects the
ability of a nurse to bridge cultural gaps in caring and enables patients and families to
achieve meaningful and supportive caring. It is a step toward reaching culturally
congruent care. Ethnocentrism is a tendency to hold one's own way of life as superior to
those of others. It is the cause of biases and prejudices. Cultural imposition is the use of
one's own values and lifestyles as the absolute guide in dealing with patients and
interpreting behaviors. - ANSWERSCare that includes the nurse learning about cultural
issues involved in the patient's health care belief system and enable patients and
families to achieve meaningful and supportive care is known as
a. Ethnocentrism.
b. Culturally competent care.
c. Cultural imposition.
d. Culturally congruent care.
ANS: A
Health care practitioners who have cultural ignorance or cultural blindness about
differences generally resort to cultural imposition and use their own values and lifestyles
as the absolute guide in dealing with patients and interpreting their behaviors. Culturally
competent care is the care provided by the nurse who attempts to bridge cultural gaps
in caring, work with cultural differences, and enable patients and families to achieve
meaningful and supportive caring. The nurse in this case has not been able to do this.
Any intercultural encounter consists of an inside or native perspective (emic worldview)
and an outsider's perspective (ethic worldview). The nurse is obviously utilizing an ethic
worldview. The nurse may be acultural, but she/he did not purposefully ignore the
patient's need. - ANSWERSThe nurse is caring for a Native American who has had
recent surgery. In the patient's culture, it is a sign of weakness to complain of pain. In
the nurse's culture, people who are having pain ask for pain medicine. The nurse has
assumed that the patient has not been having pain and does not need medication
because he has not complained of pain. What is the nurse doing?
a. Utilizing cultural imposition by not asking the patient about his pain
,b. Striving to provide culturally congruent care by allowing the patient to suffer
c. Operating from an emic worldview of the patient's cultural beliefs
d. Practicing discrimination by not giving the patient pain medicine
ANS: A
Knowledge of a patient's country of origin and its history and ecological contexts is
significant to health care and is known as ethnic heritage and ethnohistory. Biocultural
history identifies a patient's health risks related to the ecological context of the culture.
Social organization refers to units of organization in a cultural group defined by kinship
status and appropriate roles for their members. Religious and spiritual beliefs are major
influences in the patient's worldview about health and illness, pain and suffering, and life
and death. Nurses need to understand the emic perspective of their patients. -
ANSWERSIn performing a cultural assessment, knowledge of a patient's country of
origin and its history and ecological contexts is known as
a. Ethnohistory.
b. Biocultural history.
c. Social organization.
d. Religious and spiritual beliefs.
ANS: D
In contrast to other types of interviews, cultural assessment is intrusive and time-
consuming and requires a trusting relationship between participants. Miscommunication
commonly occurs in intercultural interactions as the result of language and
communication differences between and among participants, as well as differences in
interpreting each other's behaviors. The goal is to generate knowledge about the
patient's values, beliefs, and practices about nursing and health care. - ANSWERSThe
nurse is caring for a patient of Asian descent who speaks very little English. The nurse
is especially concerned and attempts to develop a trusting relationship with the patient.
She does this knowing that
a. Cultural assessment needs to be done quickly to provide the best care early.
b. Miscommunication cannot be tolerated in cultural assessment.
c. The goal is to get the patient to conform to American health care norms.
d. Cultural assessment is intrusive in contrast to other types of interviews.
ANS: A
Nurses should determine the family social hierarchy as soon as possible to prevent
offending patients and their families. Working with established family hierarchy prevents
delays and achieves better patient outcomes. Encouraging the patient to sign against
her social beliefs can cause familial strife. Explaining the level of jeopardy may create
undue stress. Nurses should be able to determine the correct hierarchy and should not
involve the physician at this time. - ANSWERSThe nurse is caring for a patient who has
emigrated from another country. The patient is in need of abdominal surgery but seems
reluctant to sign the surgical permits. What is one tactic that the nurse should use?
a. Determine the family social hierarchy.
b. Encourage the patient to sign the permits.
, c. Call the physician so that surgery can be canceled.
d. Impress on the patient that her life is in jeopardy.
ANS: B
In collectivistic cultures, families are made up of distant blood relatives across three
generations and fictive or nonblood kin. Kinship extends to both the father's and the
mother's side of the family (bilineal) or is limited to the side of either father (patrilineal) or
mother (matrilineal). Patrilineally extended families exist among Chinese and Hindus,
where a woman moves into her husband's clan after marriage and minimizes ties with
her own parents and siblings. - ANSWERSThe nurse is caring for a Chinese patient
who is reluctant to answer questions about her health background. The nurse asks the
patient if she would like her husband present when health questions are asked. The
nurse does this knowing that the Chinese culture is a collectivistic and patrilineal
culture. What does this mean?
a. Kinship extends to both the father's side and the mother's side of the family.
b. Kinship is limited to the side of the father.
c. Kinship is limited to the side of the mother.
d. The husband becomes part of the wife's clan after marriage.
ANS: C
If the patient needs an interpreter, the nurse should ensure gender, age, and ethnic
compatibility of the interpreter with the patient's preference and the topic of discussion.
The nurse should direct questions to the patient and not to the interpreter and should
have the interpreter ask the patient for feedback and clarification at regular intervals, not
only at the end. - ANSWERSThe nurse is caring for a patient who does not speak
English. She decides to use an interpreter to explain procedures and to answer
questions that the patient may have. In performing the interview, what should the nurse
do?
a. Direct questions to the interpreter to ask the patient.
b. Disregard the age and gender of the interpreter.
c. Direct questions to the patient.
d. Ask the interpreter to ask the patient for clarification at the end.
ANS: D
The family of a dying Hindu remains at the bedside to place a drop of the holy water
from the River Ganges on the patient's lips immediately after death to help his or her
soul to the next life. The family of a critically ill Jewish patient will turn his or her head
eastward or to the right side. A dying Hispanic patient will not be left alone, so that a
close kin is able to hear the patient's wishes, allowing the soul to leave in peace.
Anointing of the sick is a Roman Catholic sacrament. - ANSWERSWhich statement is
true relative to caring for a Hindu patient who is dying?
a. The family will turn his head eastward or to the right.
b. A close kin will stay with the patient to hear his last wishes.
c. Anointing of the sick is a common right of the dying.
d. The family will place a drop of water on the patient's lips.
