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A nurse working in an immigrant community is aware that different racial, religious, and social groups have their own integrated patterns of human behavior that include language, thoughts, communication, action, values, and institutions. This is known as the group’s:
a. values. c. culture.
b. morals. d. tradition.

C: Culture is comprised of a series of integrated patterns of human behaviors that include language, thought, communication, actions, customs, beliefs, and values as well as institutions of racial, ethnic, religious, or social groups. While humans share many of the same characteristics, they are also uniquely different according to these specific patterns of identity. Traditions, values, and morals can be a part of one’s culture.


During a class on cultural beliefs, the instructor would most likely explain that these beliefs are:
a. conscious and unconscious. c. reality.
b. hereditary. d. genetic.

A: Cultural beliefs can be conscious or unconscious and serve as points of reference to guide the outlook and decisions of individuals. They are neither hereditary nor genetic, but they can be learned through association with family and relatives.


A nursing instructor tests students on their understanding of the concept of values. Which response by a student indicates that further teaching is needed?
a. Values provide a set of rules by which to live.
b. Values guide actions and decisions.
c. Values hinder problem solving and give direction to life.
d. Values influence how people react to others.

C: Values perform important functions in our lives and the way in which we view and interact with the world around us. Some important functions of values are that they provide a set of rules to live by; guide actions and decisions; give direction to people’s lives and help them to solve problems (not hinder problem solving); influence how individuals perceive and react to others; help determine basic attitudes concerning personal, social, and philosophical issues; reflect an individual’s identity; and provide a basis for self-evaluation.


A group of nurses have recently been hired at your hospital. Because the nurses are from a different country, they would most likely experience which of the following?
a. Ambivalence c. Hoarding of tradition in ethnic groups
b. Improved lifestyle d. Culture shock

D: Culture shock can occur when an individual immigrates to a different country with a different culture. This can occur when the values and beliefs upheld by the new culture are radically different from the individual’s native culture.


Registered nurses can be identified as which of the following within health care professionals?
a. Culture c. Group
b. Subculture d. Organization

B: Smaller groups within a culture are called subcultures. Subcultures may consist of professional and occupational affiliations (nurses), nationality or race, age groups, gender, socioeconomic factors, political viewpoints, and/or sexual orientation.


You are completing a survey which poses questions regarding your genetic traits and physical characteristics. The information that is being asked is related to which of the following?
a. Culture c. Race
b. Acculturation d. Cultural ethnicity

C: Race describes a geographical or global population that is distinguished by its physical characteristics such as skin color or facial features or other genetic traits. Cultural ethnicity identifies a person based upon racial, tribal, linguistic, religious, national, or cultural groups. Acculturation concerns the loss of cultural identity into the new or more dominant cultural group.


A nurse is working in an environment where a large portion of the clients appear to be of the same race; however, the nurse is aware that within each broad category of race are numerous cultural groups. Why is this important for the nurse to recognize?
a. For demographic data collection
b. Different cultural groups have different views of health-related illness practices for care
c. To prevent racism from occurring on the unit among the patients
d. To provide the best care possible according to their heritage and traditions

B: While the clients may appear to be of the same race, their culture and views of health-related illness practices may be quite different. For example, there are subcultures such as the different Native America tribes broadly categorized as “Native American,” or the subcultures that comprise the term “Hispanic” (i.e., Caribbean, Cuban, Guatemalan, Puerto Rican, Mexican, and Central and South American peoples).


You attend a conference on health disparities. You learn different techniques for assisting victims of health disparities using problem-solving activities. Which problem-solving activity identified by one of the conference participants would indicate that further clarification is necessary?
a. Increasing health care knowledge of the community
b. Seeking health care access
c. Breaking down barriers and traditions to western medicine
d. Serving as a role model for new nurses

C: Victims of health disparities include those subcultures or people who have been separated from the mainstream, resulting in decreased access to health care and higher rates of mortality and morbidity. Some ways in which nurses can help these groups are by increasing the health care knowledge of the community, seeking health care access, breaking down barriers and ensuring access to education and care (not breaking down barriers and traditions to western medicine), and serving as role models for new nurses.


You are working in a clinic with a culturally diverse client base and wish to provide culturally competent care. Which is not necessarily a component in the process of culturally competent care?
a. Cultural awareness c. Cultural organizations
b. Cultural knowledge d. Cultural desire

C: Culturally competent care is an integration of knowledge, attitudes, and skills that enhances cross-cultural communication and effective interactions. This type of care is a process that combines the elements of cultural awareness, cultural knowledge, cultural skills, cultural encounters (not cultural organizations), and cultural desire.


A nursing instructor asks a group of students if they can identify some nursing theories and models that have been developed to assist nurses in the delivery of culturally competent care. Which response by a student would indicate that further teaching is needed?
a. Leininger’s Transcultural Nursing
b. Purnell’s Model for Cultural Competence
c. Campinha-Bacote’s Process of Cultural Competence
d. Giger and Morrison’s Model for Transcultural Awareness

D: Several nursing theories and models have been developed to help nurse leaders prevent workplace difficulties when working with people who are different due to age, ethnicity, race, culture, or religion. Some of these theories and models are Leininger’s Transcultural Nursing, Purnell’s Model for Cultural Competence, Campinha-Bacote’s Process of Cultural Competence in the Delivery of Health Care Service, and Giger and Davidhizar’s Transcultural Assessment Model (not Giger and Morrison’s Model for Transcultural Awareness)..


A nursing instructor teaches students that according to DeRosa and Kochura’s (2006) article entitled “Implement Culturally Competent Health Care in your Workplace,” cultures have different patterns of verbal and nonverbal communication. Which response by a student, when tested on this material, will indicate to the instructor that further teaching is necessary?
a. Conversational style c. Eye contact
b. Personal behavior d. Subject matter

B: DeRosa and Kochura (2006, October) noted four potential differences in communication among different cultures. They identified personal space (not personal behavior), conversational style (i.e., silence may be taken as a sign of respect or acknowledgment), eye contact (in some cultures, direct eye contact can be viewed as a sign of disrespect), and subject matter (some subjects are taboo in certain cultures).


You are conducting an in-service on organizational culture. Which response regarding the important components of organizational culture would indicate that further clarification is needed?
a. Vision statement c. Resource allocation and reward
b. Relative diversity d. Degree of change

A: Organizational culture is a system of shared beliefs and values that actively influences the behavior of an organization. Five primary components are values (the foundation for the organization, they guide behavior and express the organization’s philosophy), relative diversity (by having an organizational culture, some degree of similarity is assumed, but the amount of deviation tolerated from this similarity differs), resource allocation and reward (distribution of monies and resources tells people what and who is valued in the organization), degree of change (fast-paced organizations differ from slower-paced ones and how they react to change), and strength of the culture (how much influence the culture exerts). Vision statement is not a component of organizational culture.


Perceptions of the nurse’s role in health care can vary according to culture. For example, In some Asian cultures, when a nurse assists with bathing or feeding, the family may perceive the nurse’s actions as which of the following?
a. Rude behavior
b. Dedication to the patient
c. Respect and an attempt to help the patient
d. Demonstration of attentiveness to the patient’s physical comfort needs

A: According to Mattson (2009), in Asian countries, where families are very involved in patient care, it would be considered rude for the nurse to assist in bathing or feeding a patient. However, in American health care facilities, if the nurse does not ensure that these services are done, staff members could view this nurse as a “slacker” who is not completing his job duties.


You are working with staff from different cultures and are aware of the importance of realizing that there may be different perceptions of a variety of aspects inherent in the health care regime. Which of the following is not one of these potential areas of differing perception?
a. Staff responsibilities c. Locus of control
b. Role of the health care practitioner d. Time orientation

B: Working with staff from a variety of cultures brings with it differing perceptions of the health care regime and its inherent elements. Some potential areas of difference are differing perceptions of staff responsibilities, the role of the nurse, (not the health care practitioner), locus of control, time orientation, educational differences, and language differences.


A nurse manager conducts an in-service on techniques to facilitate multicultural communication. Which technique suggested by one of the nurses would indicate to the nurse manager that further clarification is needed?
a. Avoiding the use of slang terms
b. Recognizing that educational backgrounds in nursing may be vastly different
c. Providing your coworker with resources that may help to reinforce verbal communication
d. Avoiding using “I” statements when offering constructive criticism

D: Some techniques that may help to facilitate communication among multicultural workers include avoiding the use of slang terms; recognizing that your coworker probably has an educational background in nursing that is different from yours; providing your coworker with resources such as written protocols and procedures to reinforce your verbal communication. When providing constructive criticism you should try to use “I” statements instead of “you” statements. It is also important to remember to praise your coworker’s competency in technical skills to inspire self-confidence.


A nursing instructor has just completed a lecture on how Jamieson and O’Mara (1991) established a program to help nurse managers manage a diverse staff. The instructor then asked the group to identify the steps put forth by Jamieson and O’Mara. Which comment by an individual would indicate that further teaching is needed?
a. Determine which cultural groups are represented on staff.
b. Understand the organization’s values and goals.
c. Decide how to manage conflict.
d. Analyze present conditions within the organization

C: Jamieson and O’Mara’s (1991) six-step plan for nurse managers who work with a culturally diverse staff are to determine which cultural groups are represented on staff, understand the organization’s values and goals, decide on what is best for the future of the organization (not only decide how to manage conflict), analyze present conditions within the organization, plan ways to reach the desired future state and decide how to manage transitions, and evaluate the results.


A nurse preceptor is working with a new graduate nurse and asks if the nurse knows the different generations that comprise the current workforce that the new graduate nurse managers may have to supervise. The preceptor would recognize that clarification is needed if the new graduate identified which of the following as one of the generations?
a. Baby Boomers c. GenXers
b. Pre-millennials d. Echo Boomers

B: The preceptor would need to clarify that none of the generations are known as pre-millennials. The four distinct generations that make up the current workforce include the traditionals (born before 1940); the baby boomers (born between 1940 and 1960); generation X, or genXers (born between 1960 and 1980); and generation Y, or echo boomers/millennials (born after 1980).


You notice that one of your nursing colleagues has an impaired ability to integrate meaning and purpose in life through her own connectedness with others, self, music, nature, or a higher power. Your colleague is most likely experiencing which of the following?
a. Spiritual distress c. Depression
b. Philosophical distress d. Schizoid personality disorder

A: Spiritual distress is a recognized nursing diagnosis that consists of an impaired ability to integrate meaning and purpose in life through an individual’s connectedness with self, others, art, music, literature, nature, or a higher power. In order to relieve this distress, it is expected that individuals will reconnect with those items/elements that they consider to be important (i.e., meditation, prayer, religious services or rituals, communing with nature or animals, sharing of self, or caring for others) in order to return to meaning and purpose in life. Depression consists of a variety of symptoms that interfere with the ability to work, eat, sleep, and function in activities that once brought pleasure. Schizoid personality disorder consists of a pattern of indifference to social relationships and a limited range of emotional expression and experience.


The nurse manager wants to motivate a 55-year-old staff nurse. Taking the nurse’s age into consideration, which type of motivation would be most effective for this nurse?
a. Sending the nurse a letter on a job well done
b. Giving public acknowledgement and reward for good performance
c. Telling the nurse of opportunities for growth and development
d. Emphasizing the importance and significance of the nurse’s work

B: Staff nurses who are 55 years old would be considered being from the Baby Boomer generation. The most effective means of motivating nurses in this age group would be to give public acknowledgement and reward for good performance.


During a Community Health clinical, a students asks the instructor, “What is meant by health disparities?” The instructor would be correct in responding that health disparities refer to:
a. differences in each individual’s response to illness and disease states, which is reflective of cultural beliefs.
b. differences in types of care an individual receives based on whether the individual pays for health care with personal funds, private insurance, or federal assistance.
c. the different beliefs and values that individuals express based on age and ethnicity.
d. differences in health risks and health status measures that reflect the poorer health status that is found disproportionately in certain population groups.

D: The term health disparities refers to differences in health risks and health status measures that reflect the poorer health status that is found disproportionately in certain population groups. These health disparities include differences in the occurrence of illness, disease, and death among minorities and other vulnerable populations in the United States.


One of the nurses on your unit tells you that his grandmother, who speaks no English, was recently admitted to the hospital with a heart condition. The nurses caring for the grandmother have labeled her a difficult patient. The nurse further explains that the grandmother immigrated from China just 6 months ago and generally only interacts with family members and close family friends. You hypothesize that the grandmother is most likely experiencing which of the following?
a. Cultural intensity c. Cultural stereotyping
b. Culture shock d. Cultural incompetence

B: The nurse’s grandmother is most likely experiencing culture shock. Many patients experience culture shock because of the unfamiliar sounds and sights and strangers they come in contact with while in the hospital. This shock intensifies for patients who are recent immigrants or who do not speak English.


Several nurses from outside the United States were recently hired at your hospital because they had passed the NCLEX-RN. According to Mattson (2009), many of these nurses would be astonished by which of the following?
a. Number of medications each patient receives
b. Amount of supplies nurses waste on each patient.
c. Amount of documentation and the focus on cost-effective care
d. Number of languages spoken fluently by the staff.

C: According to Mattson (2009), the nurses from other countries would be most astonished by the amount of documentation and the focus on cost-effective care in the United States.


You recently accepted a position on the Labor and Delivery unit at the local hospital. You recognize that infant mortality rates in 2005 were highest among babies born to:
a. non-Hispanic Black mothers.
b. Asian adolescent girls between the ages of 14-18.
c. unmarried Caucasian women.
d. Hispanic women between the ages of 19-24.

A: In 2005, infant mortality rates were highest among babies born to non-Hispanic Black mothers.