Deck 5: Cultural Implications

Question 1

To provide culturally competent care, the nurse should

A) accurately interpret the thinking of individual patients.
B) predict how a patient may perceive treatment interventions.
C) formulate interventions to reduce the patient's ethnocentrism.
D) identify strategies that fit within the cultural context of the patient.

Answer 1

identify strategies that fit within the cultural context of the patient.

Question 2

Which Western cultural feature may result in establishing unrealistic outcomes for patients of other cultural groups?

A) Interdependence
B) Present orientation
C) Flexible perception of time
D) Direct confrontation to solve problems

Answer 2

Direct confrontation to solve problems

Question 3

Which viewpoint of an Asian American family will most affect decision making about care?

A) The father is the authority figure.
B) The mother is head of the household.
C) Women should make their own decisions.
D) Emotional communication styles are desirable.

Answer 3

The father is the authority figure.

Question 4

A Native American patient sadly describes a difficult childhood. The patient abused alcohol as a teenager but stopped 10 years ago. The patient now says, "I feel stupid and good for nothing. I don't help my people." How should the treatment team focus planning for this patient?

A) Psychopharmacological and somatic therapies should be central techniques.
B) Apply a psychoanalytical approach, focused on childhood trauma.
C) Depression and alcohol abuse should be treated concurrently.
D) Use a holistic approach, including mind, body, and spirit.

Question 5

A Chinese American patient diagnosed with an anxiety disorder says, "My problems began when my energy became imbalanced." The nurse asks for the patient's ideas about how to treat the imbalance. Which comment would the nurse expect from this patient?

A) "My family will bring special foods to help me get well."
B) "I hope my health care provider will prescribe some medication to help me."
C) "I think I would benefit from talking to other patients with a similar problem."
D) "I would like to have a native healer perform a ceremony to balance my energy."

Question 6

A group activity on an inpatient psychiatric unit is scheduled to begin at 1000. A patient, who was recently discharged from U.S. Marine Corps, arrives at 0945. Which analysis best explains this behavior?

A) The patient wants to lead the group and give directions to others.
B) The patient wants to secure a chair that will be close to the group leader.
C) The military culture values timeliness. The patient does not want to be late.
D) The behavior indicates feelings of self-importance that the patient wants others to appreciate.

Question 7

A Haitian patient diagnosed with major depressive disorder tells the nurse, "There's nothing you can do. This is a punishment. The only thing I can do is see a healer." The culturally aware nurse assesses that the patient

A) has delusions of persecution.
B) has likely been misdiagnosed with depression.
C) may believe the distress is the result of a curse or spell.
D) feels hopeless and helpless related to an unidentified cause.

Question 8

A patient in the emergency department shows a variety of psychiatrical symptoms, including restlessness and anxiety. The patient says, "I feel sad because evil spirits have overtaken my mind." Which worldview is most applicable to this individual?

A) Eastern/balance
B) Southern/holistic
C) Western/scientific
D) Indigenous/harmony

Question 9

The sibling of an Asian American patient tells the nurse, "My sister needs help for pain. She cries from the hurt." Which understanding by the nurse will contribute to culturally competent care for this patient? Persons of an Asian American heritage

A) often express emotional distress with physical symptoms.
B) will probably respond best to a therapist who is impersonal.
C) will require prolonged treatment to stabilize these symptoms.
D) should be given direct information about the diagnosis and prognosis.

Question 10

A psychiatric nurse leads a medication education group for Hispanic patients. This nurse holds a Western worldview and uses pamphlets as teaching tools. Groups are short and concise. After the group, the patients are most likely to believe

A) the nurse was uncaring.
B) the session was effective.
C) the teaching was efficient.
D) they were treated respectfully.

Question 11

Which intervention best demonstrates that a nurse correctly understands the cultural needs of a hospitalized Asian American patient diagnosed with a mental illness?

A) Encouraging the family to attend community support groups
B) Involving the patient's family to assist with activities of daily living
C) Providing educational pamphlets to explain the patient's mental illness
D) Restricting homemade herbal remedies the family brings to the hospital

Question 12

A nurse prepares to teach important medication information to a patient of Mexican heritage. How should the nurse manage the teaching environment?

A) Stand very close to the patient while teaching.
B) Maintain direct eye contact with the patient while teaching.
C) Maintain a neutral emotional tone during the teaching session.
D) Sit 4 feet or more from the patient during the teaching session.

Question 13

A Native American patient describes a difficult childhood and dropping out of high school. The patient abused alcohol as a teenager to escape feelings of isolation but stopped 10 years ago. The patient now says, "I feel stupid. I've never had a good job. I don't help my people." Which nursing diagnosis applies?

A) Risk for other-directed violence
B) Chronic low self-esteem
C) Deficient knowledge
D) Social isolation

Question 14

A nurse in the clinic has a full appointment schedule. A Hispanic American patient arrives at 1230 for a 1000 appointment. A Native American patient does not keep an appointment at all. What understanding will improve the nurse's planning? These patients are

A) members of cultural groups that have a different view of time.
B) immature and irresponsible in health care matters.
C) acting-out feelings of anger toward the system.
D) displaying passive-aggressive tendencies.

Question 15

An experienced psychiatric nurse plans to begin a new job in a community-based medication clinic. The clinic sees culturally diverse patients. Which action should the nurse take first to prepare for this position?

A) Investigate cultural differences in patients' responses to psychotropic medications.
B) Contact the clinical nurse specialist for guidelines regarding cultural competence.
C) Examine the literature on various health beliefs of members of diverse cultures.
D) Complete an online continuing education offering about psychopharmacology.

Question 16

A nurse wants to engage an interpreter for a severely anxious 21-year-old male who immigrated to the United States 2 years ago. Of the four interpreters below who are available and fluent in the patient's language, which one should the nurse call?

A) 65-year-old female professional interpreter
B) 24-year-old male professional interpreter
C) A member of the patient's family
D) The patient's best friend

Question 17

Which communication strategy would be most effective for a nurse to use during an assessment interview with an adult Native American patient?

A) Open and friendly; ask direct questions; touch the patient's arm or hand occasionally for reassurance.
B) Frequent nonverbal behaviors, such as gestures and smiles; make an unemotional face to express negatives.
C) Soft voice; break eye contact occasionally; general leads and reflective techniques.
D) Stern voice; unbroken eye contact; minimal gestures; direct questions.

Question 18

A psychoeducational session will discuss medication management for a culturally diverse group of patients. Group participants are predominantly members of minority cultures. Of the four staff nurses below, which nurse should lead this group?

A) Very young registered nurse
B) Older, mature registered nurse
C) Newly licensed registered nurse
D) A registered nurse who is very thin

Question 19

A nurse speaks with family members of a Chinese American parent recently diagnosed with major depressive disorder. Which comment by the nurse will the family find most comforting? "The nursing staff will

A) take good care of your parent."
B) pray with your parent several times a day."
C) teach your parent important self-care strategies."
D) educate your parent about safety information regarding medication."

Question 20

A black patient, originally from Haiti, has a diagnosis of major depressive disorder. A colleague tells the nurse, "This patient often looks down and is reluctant to share feelings. However, I've observed the patient spontaneously interacting with other black patients." Select the nurse's best response.

A) "Black patients depend on the church for support. Have you consulted the patient's pastor?"
B) "Encourage the patient to talk in a group setting. It will be less intimidating than one-to-one interaction."
C) "Don't take it personally. Black patients often have a resentful attitude that takes a long time to overcome."
D) "The patient may have difficulty communicating in English. Have you considered using a cultural broker?"

Question 21

A white patient of German descent rocks back and forth, grimaces, and rubs both temples. What is the nurse's best action?

A) Assess the patient for extrapyramidal symptoms.
B) Sit beside the patient and rock in sync.
C) Offer to pray with the patient.
D) Assess the patient for pain.

Question 22

The nurse should be particularly alert to expression of psychological distress through physical symptoms among patients whose cultural beliefs include (Select all that apply)

A) mental illness reflects badly on the family.
B) mental illness shows moral weakness.
C) intergenerational conflict is common.
D) the mind, body, and spirit are merged.
E) food choices influence one's health.

Question 23

Which questions should the nurse ask to determine an individual's worldview? (Select all that apply.)

A) What is more important: the needs of an individual or the needs of a community?
B) How would you describe an ideal relationship between individuals?
C) How long have you lived at your present residence?
D) Of what importance are possessions in your life?
E) Do you speak any foreign languages?

Question 24

A patient who has been hospitalized for 3 days with a serious mental illness says, "I've got to get out of here and back to my job. I get 60 to 80 messages a day, and I'm getting behind on my email correspondence." What is this patient's perspective about health and illness?

A) Fateful, magical
B) Eastern, holistic
C) Western, biomedical
D) Harmonious, religious

Question 25

Why is the study of culture so important for psychiatric nurses in the United States? (Select all that apply.)

A) Psychiatric nurses often practice in other countries.
B) Psychiatric nurses must advocate for the traditions of the Western culture.
C) Cultural competence helps protect patients from prejudice and discrimination.
D) Patients should receive information about their illness and treatment in terms they understand.
E) Psychiatric nurses often interface with patients and their significant others over a long period of time.

Question 26

The nurse administers medications to a culturally diverse group of patients on a psychiatric unit. What expectation should the nurse have about pharmacokinetics?

A) Patients of different cultural groups may metabolize medications at different rates.
B) Metabolism of psychotropic medication is consistent among various cultural groups.
C) Differences in hepatic enzymes will influence the rate of elimination of psychotropic medications.
D) It is important to provide patients with oral and written literature about their psychotropic medications.

Question 27

A nurse begins work in an agency that provides care to members of a minority ethnic population. The nurse will be better able to demonstrate cultural competence after

A) identifying culture-bound issues.
B) implementing scientifically proven interventions.
C) correcting inferior health practices of the population.
D) exploring commonly held beliefs and values of the population.

Question 28

A nurse cares for a first-generation American whose family emigrated from Germany. Which worldview about the source of knowledge would this patient likely have?

A) Knowledge is acquired through use of affective or feeling senses.
B) Science is the foundation of knowledge and proves something exists.
C) Knowledge develops by striving for transcendence of the mind and body.
D) Knowledge evolves from an individual's relationship with a supreme being.

Question 29

A Mexican American patient puts a picture of the Virgin Mary on the bedside table. What is the nurse's best action?

A) Move the picture so it is beside a window.
B) Send the picture to the business office safe.
C) Leave the picture where the patient placed it.
D) Send the picture home with the patient's family.

Question 30

A Vietnamese patient's family reports that the patient has wind illness. Which menu selection will be most helpful for this patient?

A) Iced tea
B) Ice cream
C) Warm broth
D) Gelatin dessert

Question 31

A nurse prepares to assess a newly hospitalized patient who moved to the United States 6 months ago from Somalia. The nurse should first determine

A) if the patient's immunizations are current.
B) the patient's religious preferences.
C) the patient's specific ethnic group.
D) whether an interpreter is needed.