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When reviewing a hospitals current policy framework, which of the following actions has the potential to improve the overall level of culture competence?
- A. Reducing the institutions dependence on English for communication
- B. Promoting members of minority groups to higher profile positions
- C. Eliminating written information from staff members identification badges
- D. Creating greater flexibility in visiting hours
Correct Answer: D
Rationale: Policies that promote culturally competent care establish flexible regulations pertaining to visitors, such as the number, frequency, and length of visits. Eliminating written information from staff members identification badges is unnecessary and of little benefit. Cultural competence does not require a reduction in the use of English. Promoting members of minority groups to higher profile positions on the sole basis of ethnicity would be unethical.
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Which of the following variables would you prioritize when performing an assessment of the patients cultural beliefs?
- A. Patients previous medical history
- B. Patients marital status
- C. Patients age
- D. Patients communication style
Correct Answer: D
Rationale: Assessment of a patients culture should include the patients country of origin, language (communication style), food preferences or restrictions, health maintenance practices, and religious practices. This aspect of assessment does not explicitly include the patients support systems, marital status, or age, though each of these parameters would be assessed at different points.
When explaining the concept of transcultural nursing to uninitiated nurses, how should the team members describe it?
- A. Transcultural nursing is the comparative analysis of the health benefits and risks of recognizable ethnic groups.
- B. Transcultural nursing refers to research-focused practice that focuses on patient-centered, culturally competent nursing.
- C. Transcultural nursing refers to a systematic and evidence-based effort to improve health outcomes in patients born outside the United States.
- D. Transcultural nursing is a term used to describe interventions that seek to address language barriers in nursing practice.
Correct Answer: B
Rationale: Transcultural nursing, a term sometimes used interchangeably with cross-cultural, intercultural, or multicultural nursing, refers to research-focused practice that focuses on patient-centered, culturally competent nursing. It is not limited to language barriers and foreign-born patients. It does not focus solely on health risks and benefits in ethnic groups.
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.
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.
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.