Nokea
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.
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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.
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.
When caring for an Indigenous patient, which of the following actions is the best initial approach in relation to eye contact for the nurse to take?
- A. Avoid all eye contact with the patient.
- B. Observe the patient's use of eye contact.
- C. Look directly at the patient when interacting.
- D. Ask the family about the patient's cultural beliefs.
Correct Answer: B
Rationale: Eye contact varies greatly among and within cultures so the nurse's initial action is to assess the patient's use of eye contact. Although nurses are often taught to maintain direct eye contact, patients who are Asian, Arab, or Indigenous may avoid direct eye contact and consider direct eye contact disrespectful or aggressive. Looking directly at the patient or avoiding eye contact may be appropriate, depending on the patient's individual cultural beliefs. The nurse should assess the patient, rather than asking family members about the patient's beliefs.
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.
When performing a cultural assessment with a patient of a different culture, which of the following actions is the initial action to be taken by the nurse?
- A. Wait until a cultural healer is available to help with the assessment.
- B. Obtain a list of any cultural remedies that the patient currently uses.
- C. Ask the patient about any affiliation with a particular cultural group.
- D. Tell the patient what the nurse already knows about the patient's culture.
Correct Answer: C
Rationale: An early step in performing a cultural assessment is to determine the cultural group with which the patient identifies. The other actions may be appropriate if the patient does identify with a particular culture.