Question 1

You are caring for a patient who is terminally ill whose family has requested to hold a spiritual ceremony during which they will be using incense. What would be the best intervention you could make on behalf of this patient?

Accepted Answer

A)   Discourage the use of incense in the hospital.
B)   Ask the family to have the ceremony off the unit.
C)   Arrange for the ceremony to occur after notifying all departments affected.
D)   Encourage the family to conduct the ceremony elsewhere because it may affect other patients inThe unit. C

Question 2

A 56-year-old woman who emigrated from Vietnam as an adult was admitted with a urinary tract infection, but has now developed urosepsis. The nurse is in the process of changing the patients plan of care accordingly. The nurse should consider what phenomenon that tends to occur in patients of all ages when they are ill?

Accepted Answer

A)   Tendency to regress in language skills
B)   Tendency to become more passive
C)   Tendency to become more involved in care
D)   Tendency to regress in age-appropriate behavior A

Question 3

In planning the nursing care of a patient who lives with chronic pain, the nurse has included the intervention of therapeutic touch. When categorizing this particular complementary therapy, the nurse should identify it as which of the following?

Accepted Answer

A)   A biologically based therapy
B)   A mind-body intervention
C)   A manipulative and body-based method therapy
D)   An energy therapy D

Question 4

Touch, to a great degree, is culturally determined. When providing care for a patient who belongs to a Hispanic culture, which of the following may be considered inappropriate in a health care setting?

Accepted Answer

A)   Grandmothers helping in the care of pediatric patients.
B)   Patients asking questions of health care providers.
C)   Health care information being given to a female member of the family.
D)   Males participating in health care activities.

Question 5

The nurse is admitting a Native American patient with uncontrolled hypertension and type 1 diabetes to the unit. During the initial assessment, the patient informs the nurse that he has been seeking assistance and care from the shaman in his community. The nurse recognizes that the patients blood pressure and his blood sugar level are elevated upon admission. What is the nurses best response to the patients indication that his care provider is a shaman?

Accepted Answer

A)   Thank you for providing the information about the shaman, but we will keep that information and approach separate from your current hospitalization.
B)   It seems that the care provided by your shaman is not adequately managing your hypertension and diabetes, so we will try researched medical approaches.
C)   Dont worry about insulting your shaman, as he will understand his approach to your hypertension and diabetes was not working after your doctor tells him how sick you were in the hospital.
D)   I understand that you value the care provided by the shaman, but we would like you to consider medications and dietary changes that may lower your blood pressure and blood sugar levels.

Question 6

A hospitals written policies and procedures are being reviewed as part of an accreditation process. Which of the following policies are congruent with the principles of culturally competent nursing care? Mark all that apply.

Accepted Answer

A)   A policy that outlines the appropriate use of translation services
B)   A policy guiding staff in the care of patients with different values
C)   A policy that requires staff from different cultures on each unit
D)   A policy that establishes flexible regulations pertaining to visitors
E)   A policy that gives priority to patients born outside the United States

Question 7

Agency policies are important to achieve culturally competent care. When reviewing a hospitals current policy framework, which of the following actions has the potential to improve the overall level of culture competence?

Accepted Answer

A)   Reducing the institutions dependence on English for communication
B)   Promoting members of minority groups to higher profile positions
C)   Eliminating written information from staff members identification badges
D)   Creating greater flexibility in visiting hours

Question 8

A nurse who provides care on a busy medical unit is aware that his own beliefs do not always coincide with the beliefs of patients from some cultural backgrounds. What aspects of patient care may be most influenced by diverse cultural perspectives?

Accepted Answer

A)   Pharmacokinetics and pharmacodynamics
B)   Monitoring fluid balance
C)   Monitoring food intake
D)   Obtaining informed consent

Question 9

A nurse is planning the care of a 48-year-old woman who has just received a diagnosis of breast cancer. The patient has been explicit about her desire to integrate a variety of complementary therapies into her treatment regimen. What is the nurses primary responsibility around the use of complementary therapies?

Accepted Answer

A)   To become skilled in administering as many complementary therapies as possible
B)   To liaise between practitioners of complementary therapies and the medical team
C)   To examine the evidence base underlying each of the patients chosen complementary therapies
D)   To assess the patients use of complementary therapies in order to promote safety

Question 10

Computed tomography of a 72-year-old woman reveals lung cancer with metastasis to the liver. The patients son has been adamant that any bad news be withheld from his in order to protect her from stress, stating that this is a priority in his culture. How should the nurse and the other members of the care team best respond?

Accepted Answer

A)   Explain to the son the teams ethical obligation to inform the patient.
B)   Refer the family to social work.
C)   Have a nurse or physician from the patients culture make contact with her and her son.
D)   Speak with the son to explore his rationale and attempt to reach a consensus.

Question 11

A nurse is providing care for a female patient who is Hispanic. The care team is discussing the patients nutritional status and one of the nurses colleagues states, I suppose we should try to get her some tacos or burritos since thats what shes probably used to. How should the nurse best interpret the colleagues statement?

Accepted Answer

A)   The colleague may have stereotypical views of Hispanics.
B)   The colleague is exemplifying the process of acculturation.
C)   The colleague is aware of the dietary characteristics of Hispanic culture.
D)   The colleague may harbor resentment against Hispanics.

Question 12

A nurse is caring for an elderly woman who predominantly identifies with an East Asian culture. How can the nurse best demonstrate an awareness of culturally congruent care?

Accepted Answer

A)   Maintain eye contact at all times.
B)   Try to speak the patients native language.
C)   Use touch when communicating.
D)   Establish effective communication.

Question 13

A nurse is auditing the care of a recently discharged patient and is appraising the patients care in light of Leiningers theory of Culture Care Diversity and Universality. Specifically, the nurse is looking for evidence that caregivers implemented professional actions and decisions that helped the patient achieve a beneficial or satisfying health outcome. What aspect of Leiningers theory is the nurse addressing?

Accepted Answer

A)   Cross-care accommodation
B)   Culture care restructuring
C)   Cultural reordering
D)   Patient modification

Question 14

In your role as a community health nurse, you are focusing your current health promotion efforts on diseases that are disproportionately represented among ethnic and racial minorities. Which of the following diseases would you likely address? Select all that apply.

Accepted Answer

A)   Human immunodeficiency virus (HIV) 
B)   Cancer
C)   Heart disease
D)   Chronic obstructive pulmonary disease (COP
D)  
E)   Alzheimers disease

Question 15

After working with a patient who has human immunodeficiency (HIV) for several weeks, the nurse has become more aware of the role of health disparities. Which of the following variables are known to underlie health disparities? Select all that apply.

Accepted Answer

A)   Poverty
B)   Isolated geographic location
C)   Overdependence on publicly funded facilities
D)   Male gender
E)   Allergy status

Question 16

Giger and Davidhizar (2012) created an assessment model to guide nurses in exploring cultural phenomena that might affect nursing care. When using this model in the care of a patient who has had a transurethral prostate resection (TUPR), what area of care would be influenced most directly?

Accepted Answer

A)   Transferring the patient from a stretcher to a bed
B)   Documenting the patients vital signs and level of consciousness
C)   Administering a scheduled dose of acetaminophen
D)   Explaining the rationale for continuous bladder irrigation (CBI)

Question 17

The quality improvement team at a large, urban hospital has recognized the need to better integrate the principles of transcultural nursing into patient care. When explaining the concept of transcultural nursing to uninitiated nurses, how should the team members describe it?

Accepted Answer

A)   Transcultural nursing is the comparative analysis of the health benefits and risks of recognizable ethnic groups.
B)   Transcultural nursing refers to research-focused practice that focuses on patient-centered, culturally, competent nursing.
C)   Transcultural nursing refers to a systematic and evidence-based effort to improve health outcomesIn patients born outside the United States.
D)   Transcultural nursing is a term used to describe interventions that seek to address language barriers in nursing practice.

Question 18

In a small, rural hospital the nurse is caring for a patient who speaks a language other than English. The nurse needs to use an interpreter to communicate but the hospital does not have access to an interpreter who speaks the patients language. When choosing another individual to interpret for this patient, what characteristic should the nurse prioritize?

Accepted Answer

A)   Interpreter should recognize the need to speak in a loud voice.
B)   Interpreter should be able to conduct the conversation quickly to avoid misinterpretation.
C)   Interpreter should be fluent in several dialects of the patients language.
D)   Interpreter should know that repetition must be avoided while interpreting.

Question 19

You are the nurse caring for a patient who is a recent immigrant to the United States from Mexico. Which of the following variables would you prioritize when performing an assessment of the patients cultural beliefs?

Accepted Answer

A)   Patients previous medical history
B)   Patients marital status
C)   Patients age
D)   Patients communication style

Question 20

An infant with a diagnosis of pyelonephritis is receiving care on the pediatric unit and the nurses review of the childs electronic health record reveals that the infant has not received any of her scheduled immunizations. The mother informs the nurse that immunizations are against her cultural beliefs, and she does not want her child to receive immunizations. In this scenario, what do the mothers views on immunizations represent?

Accepted Answer

A)   Acculturation
B)   Cultural blindness
C)   A cultural imposition
D)   A cultural taboo

Exam 7: Overview of Transcultural Nursing