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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.
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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 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.
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.
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.