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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.
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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.
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.
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.
A family member of an elderly Hispanic patient admitted to the hospital tells the nurse that the patient has traditional beliefs about health and illness. Which of the following actions is most appropriate for the nurse in this situation?
- A. Avoid asking any questions unless the patient initiates conversation.
- B. Ask the patient whether it is important that cultural healers are contacted.
- C. Explain the usual hospital routines for meal times, care, and family visits.
- D. Obtain further information about the patient's cultural beliefs from the daughter.
Correct Answer: B
Rationale: Because the patient has traditional health care beliefs, it is appropriate for the nurse to ask whether the patient would like a visit from a cultural healer. Nurses ask key questions with regard to language, diet, religion, and acculturation and eliciting the patient's explanatory model of health and illness. There is no cultural reason for the nurse to avoid asking the patient questions, and questions may be necessary to obtain necessary health information. The patient (rather than the daughter) should be consulted about personal cultural beliefs. The hospital routines for meals, care, and visits should be adapted to the patient's preferences rather than expecting the patient to adapt to the hospital schedule.