Nokea
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.
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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.
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.
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 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.
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.