Nokea
An elderly Asian Canadian patient tells the nurse that she has lived in Canada for 50 years. The patient speaks English but lives in a predominantly Asian neighbourhood. Which of the following actions is most appropriate for the nurse?
- A. Arrange to have a folk healer available when planning the patient's care.
- B. Ask the patient about any special cultural beliefs or practices.
- C. Avoid making direct eye contact with the patient during care.
- D. Involve the patient's oldest son in making health care decisions.
Correct Answer: B
Rationale: Further assessment of the patient's health care preferences is needed before making further plans for culturally appropriate care. The other responses indicate stereotyping of the patient, based on ethnicity, and would not be appropriate initial actions.
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The nurse is caring for a patient who speaks a language different from the nurse's language and there is no interpreter available. Which of the following actions is the most appropriate for the nurse to implement?
- A. Use specific medical terms in the Latin form.
- B. Talk loudly and slowly so that each word is clearly heard.
- C. Repeat important words so that the patient recognizes their importance.
- D. Use simple gestures to demonstrate meaning while talking to the patient.
Correct Answer: D
Rationale: The use of gestures will enable some information to be communicated to the patient. The other actions will not improve communication with the patient.
Which of the following statements represents a health inequity currently experienced in Canada?
- A. Indigenous adults are less likely to smoke tobacco than other adults in Canada
- B. Overall suicide rate among First Nation communities is about twice the rate of the general population.
- C. Individuals from lower income neighbourhoods undergo preventive health screening more that their higher income counterparts.
- D. Recent immigrants are more likely to have a primary care physician than Canadian-born individuals.
Correct Answer: B
Rationale: Suicide rates are five to seven times higher among Indigenous youth than among non-Indigenous youth. Suicide rates among Indigenous youth are among the highest in the world, at 11 times the national average. Smoking rates are more than two times higher among the three Indigenous groups than among the non-Indigenous population. Individuals from higher income neighbourhoods undergo preventive health screening more than those from lower income neighbourhoods. Recent immigrants are less likely to have a primary care physician than Canadian-born individuals.
Which of the following question formats is the most appropriate for the nurse to ask when communicating with a patient that has limited English proficiency?
- A. Are you tired and in discomfort?
- B. You have taken your pills right?
- C. Are you alright?
- D. Are you in pain?
Correct Answer: D
Rationale: When communicating with a patient that has limited English proficiency the best questions to ask are ones that are in simple language a couple of words, plain simple terms, such as 'Are you in pain?' Asking about tiredness and discomfort in the same sentence should be avoided - ask one item at a time and use the term 'pain,' not discomfort. Asking the patient 'are you alright' is vague and will elicit a yes or no answer. 'You have taken your pills, right' is accusatory and should be avoided.
The nurse is caring for Indigenous patients in a community clinic setting. Which of the following would the nurse include when developing strategies to decrease health care disparities?
- A. Improve public transportation.
- B. Obtain low-cost medications.
- C. Update equipment and supplies for the clinic.
- D. Educate staff about Indigenous health beliefs.
Correct Answer: D
Rationale: Health care disparities are due to stereotyping, biases, and prejudice of health care providers; the nurse can decrease these through staff education. The other strategies also may be addressed by the nurse but will not directly impact health disparities.
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.