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A family member of an elderly Hispanic patient admitted to the hospital tells the nurse that the patient has traditional beliefs about health and illness. Which of the following actions is most appropriate for the nurse in this situation?
- A. Avoid asking any questions unless the patient initiates conversation.
- B. Ask the patient whether it is important that cultural healers are contacted.
- C. Explain the usual hospital routines for meal times, care, and family visits.
- D. Obtain further information about the patient's cultural beliefs from the daughter.
Correct Answer: B
Rationale: Because the patient has traditional health care beliefs, it is appropriate for the nurse to ask whether the patient would like a visit from a cultural healer. Nurses ask key questions with regard to language, diet, religion, and acculturation and eliciting the patient's explanatory model of health and illness. There is no cultural reason for the nurse to avoid asking the patient questions, and questions may be necessary to obtain necessary health information. The patient (rather than the daughter) should be consulted about personal cultural beliefs. The hospital routines for meals, care, and visits should be adapted to the patient's preferences rather than expecting the patient to adapt to the hospital schedule.
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Which of the following statements is true related to immigrants to Canada?
- A. Decreased risk of social exclusion related to Canada's multicultural population.
- B. New immigrants tend to be in overall better health than the resident population.
- C. Health status of immigrants is not related to length of time in Canada.
- D. Unemployment is not associated with poorer health outcomes for immigrants.
Correct Answer: B
Rationale: The healthy immigrant effect indicates that new immigrants tend to be in better overall health than the general resident population. This finding is not surprising inasmuch as immigrants are screened before being granted admittance to Canada. Health status is related to length of time in Canada, the health of immigrants, 20 years after immigration, as determined by age-standardized mortality rates, is generally poorer than those of the Canadian-born population. Underemployment, unemployment, and workplace stress place immigrants at increased health risks as well as the risk for social exclusion.
Which of the following characteristics represent the affective domain of the ABCs of cultural competence?
- A. Openness
- B. Desire to learn
- C. Respect for others
- D. Promote health literacy
- E. Support informed patient choice
Correct Answer: A,B,C
Rationale: This domain is often seen as a the first step toward achieving cultural competence. Openness, a desire to learn, valuing differences, respect for others, and developing humility are characteristics of this domain. Promoting health literacy and supporting informed patient choice are part of the behavioural domain of the ABCs of cultural competence.
An Indigenous patient tells the nurse that he thinks his abdominal pain is caused by eating too much seal fat and that strong massage over the stomach will help it. Which of the following statements depicts what the patient is describing to the nurse?
- A. Evidence-informed national guidelines
- B. Awareness and knowledge of his own culture
- C. The explanatory model of health and health practices
- D. Knowledge about the difference in modern and folk health practices
Correct Answer: C
Rationale: The explanatory model is a set of beliefs regarding what causes the disease or illness and the methods that would potentially treat the condition best. Different cultural groups have different beliefs about the causes of illness and the appropriateness of various treatments. The situation is not reflective of national guidelines. There is no comparison between modern and folk health practices. The patient is explaining experiences and beliefs rather than awareness and knowledge.
A graduate nurse is assessing a newly admitted non-English-speaking Chinese patient who complains of severe headaches. Which of the following actions by the graduate nurse would cause the charge nurse to intervene during this assessment interview?
- A. Sit down at the bedside.
- B. Palpate the patient's scalp.
- C. Call for a medical interpreter.
- D. Avoid eye contact with the patient.
Correct Answer: B
Rationale: Many people of Asian ethnicity believe that touching a person's head is disrespectful; the nurse should always ask permission before touching any patient's head. The other actions are appropriate.
The first step in providing culturally competent care is to understand one's own beliefs and values related to health and health care. Which of the following actions should the nurse take when a family's cultural beliefs include the use of massage for pain control, but the nurse is feeling frustration because of the number of family members in the patient's room?
- A. Ask the nurse about personal beliefs about health and health care.
- B. Suggest that the nurse ask family members to leave the room during the massage.
- C. Have the nurse explain to family that too many visitors will tire the patient.
- D. Remind the nurse that this cultural practice is important to the family and patient.
Correct Answer: A
Rationale: The first step in providing culturally competent care is to understand one's own beliefs and values related to health and health care. Asking the nurse about personal beliefs will help to achieve this step. Reminding the nurse that this cultural practice is important to the family and patient will not decrease the nurse's frustration. The remaining responses (suggest that the nurse ask family members to leave the room, and have the nurse explain to family that too many visitors will tire the patient) are not culturally appropriate for this patient.