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When providing care for a patient who belongs to a Hispanic culture, which of the following may be considered inappropriate in a health care setting?
- A. Grandmothers helping in the care of pediatric patients.
- B. Patients asking questions of health care providers.
- C. Health care information being given to a female member of the family.
- D. Males participating in health care activities.
Correct Answer: D
Rationale: The meaning people associate with touching is culturally determined to a great degree. In some cultures (e.g., Hispanic, Arab), male health care providers may be prohibited from touching or examining certain parts of the female body. Similarly, it may be inappropriate for females to care for males. In the Hispanic culture, grandmothers often care for pediatric patients; the female of the family is often held responsible for the familys health care and health care information. Males of the Hispanic culture generally do not participate in health care activities when a member of their family is ill.
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What would be the best intervention you could make on behalf of this patient?
- A. Discourage the use of incense in the hospital.
- B. Ask the family to have the ceremony off the unit.
- C. Arrange for the ceremony to occur after notifying all departments affected.
- D. Encourage the family to conduct the ceremony elsewhere because it may affect other patients in the unit.
Correct Answer: C
Rationale: Culturally competent policies are developed to promote an environment in which the traditional healing, spiritual, and religious practices of patients are respected and encouraged and to recognize the special dietary practices of patients from selected cultural groups. To promote spirituality and transcultural nursing, the nurse should make or help to make the arrangements. The nurse should not attempt to dissuade the family or to relegate the ceremony to a site outside the hospital.
What would be the best way to promote understanding during the teaching session?
- A. Ask the patient to repeat the instructions carefully.
- B. Write the procedure out for the patient in simple language.
- C. Use an interpreter during the teaching session.
- D. Have the patient demonstrate the dressing change.
Correct Answer: C
Rationale: Policies that promote culturally competent care establish flexible regulations pertaining to visitors, provide translation services for nonEnglish-speaking patients, and train staff to provide care for patients with different cultural values. Writing instructions, having the patient demonstrate the procedure, and asking the patient to repeat instructions do not adequately compensate for the communication barrier that exists.
How should the nurse best understand the patients behavior?
- A. The patients sense of humor is culturally mediated and may be unfamiliar to the nurse.
- B. The patient may believe that she has sufficient knowledge and skill to empty the drain.
- C. The patient may be unable to fully comprehend the information the nurse is trying to convey.
- D. Individuals from the patients culture may not normally explain and demonstrate at the same time.
Correct Answer: C
Rationale: Inappropriate laughter can signal a lack of understanding. This is more likely than the presence of a culture-specific sense of humor in this particular context. It is unlikely that there is a prohibition against simultaneous explaining and demonstrating. Laughing is unlikely to suggest that teaching and learning are unnecessary.
Which of the following policies are congruent with the principles of culturally competent nursing care? Mark all that apply.
- A. A policy that outlines the appropriate use of translation services
- B. A policy guiding staff in the care of patients with different values
- C. A policy that requires staff from different cultures on each unit
- D. A policy that establishes flexible regulations pertaining to visitors
- E. A policy that gives priority to patients born outside the United States
Correct Answer: A,B,D
Rationale: Policies that promote culturally competent care establish flexible regulations pertaining to visitors (number, frequency, and length of visits), provide translation services for nonEnglish-speaking patients, and train staff to provide care for patients with different cultural values. Cultural competence does not depend on culturally diverse staff on every unit and it does not necessarily prioritize the interests of individuals born outside the country.
What outcome should you prioritize when planning this education?
- A. Participants will acknowledge and adapt to diversity among their colleagues.
- B. Participants will develop insight into the characteristics of their own culture.
- C. Participants will provide equal care to all patients, regardless of their background.
- D. Participants will evaluate their colleagues levels of cultural awareness.
Correct Answer: A
Rationale: The concept of culturally competent care applies to health care institutions, which must develop culturally sensitive policies and provide a climate that fosters the provision of culturally competent care by nurses. Nurses must learn to acknowledge and adapt to diversity among their colleagues in the workplace. This is not necessarily dependent on nurses examining their own cultures. Because patients needs vary widely, care is not equal. Evaluating cultural awareness in others does not necessarily enhance ones own cultural competence.