Nokea
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.
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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.
Which of the following terms refer to characteristics of a group whose members share a common social, cultural, linguistic, or religious heritage?
- A. Diversity
- B. Ethnicity
- C. Ethnocentrism
- D. Cultural imposition
Correct Answer: B
Rationale: Ethnicity is the common social, cultural, linguistic, or religious heritage of a group of people. Diversity is a presence of persons with differences from the majority or dominant group that is assumed to be the norm. Ethnocentrism is a tendency of individuals to believe that their way of viewing and responding to the world is the most correct, natural, and superior one. Cultural imposition is imposition of one person's own cultural beliefs and practices, intentionally or unintentionally, on another person or group of people.
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.
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.