Nokea
Equity in health care is concerned with creating equal opportunities for good health for everyone in which of the following ways?
- A. Decrease negative effect of social determinants of health.
- B. Increase awareness of acute care programs.
- C. Enhance access to services.
- D. Reduce exclusion.
- E. Decrease nonmodifiable risk factors.
Correct Answer: A,C,D
Rationale: Health equity is concerned with creating equal opportunities for good health for everyone in two ways: (a) decreasing the negative effect of the social determinants of health and (b) by improving services to enhance access and reduce exclusion.
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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 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.
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.
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.
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.