Nokea
Which of the following statements represents a health inequity currently experienced in Canada?
- A. Indigenous adults are less likely to smoke tobacco than other adults in Canada
- B. Overall suicide rate among First Nation communities is about twice the rate of the general population.
- C. Individuals from lower income neighbourhoods undergo preventive health screening more that their higher income counterparts.
- D. Recent immigrants are more likely to have a primary care physician than Canadian-born individuals.
Correct Answer: B
Rationale: Suicide rates are five to seven times higher among Indigenous youth than among non-Indigenous youth. Suicide rates among Indigenous youth are among the highest in the world, at 11 times the national average. Smoking rates are more than two times higher among the three Indigenous groups than among the non-Indigenous population. Individuals from higher income neighbourhoods undergo preventive health screening more than those from lower income neighbourhoods. Recent immigrants are less likely to have a primary care physician than Canadian-born individuals.
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The nurse is caring for Indigenous patients in a community clinic setting. Which of the following would the nurse include when developing strategies to decrease health care disparities?
- A. Improve public transportation.
- B. Obtain low-cost medications.
- C. Update equipment and supplies for the clinic.
- D. Educate staff about Indigenous health beliefs.
Correct Answer: D
Rationale: Health care disparities are due to stereotyping, biases, and prejudice of health care providers; the nurse can decrease these through staff education. The other strategies also may be addressed by the nurse but will not directly impact health disparities.
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.
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.
A graduate nurse is assessing a newly admitted non-English-speaking Chinese patient who complains of severe headaches. Which of the following actions by the graduate nurse would cause the charge nurse to intervene during this assessment interview?
- A. Sit down at the bedside.
- B. Palpate the patient's scalp.
- C. Call for a medical interpreter.
- D. Avoid eye contact with the patient.
Correct Answer: B
Rationale: Many people of Asian ethnicity believe that touching a person's head is disrespectful; the nurse should always ask permission before touching any patient's head. The other actions are appropriate.
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.