Nokea
Which of the following variables are known to underlie health disparities? Select all that apply.
- A. Poverty
- B. Isolated geographic location
- C. Overdependence on publicly funded facilities
- D. Male gender
- E. Allergy status
Correct Answer: A,B,C
Rationale: Many reasons are cited for these disparities, including low socioeconomic status, health behaviors, limited access to health care because of poverty or disability, environmental factors, and direct and indirect manifestations of discrimination. Other causes include lack of health insurance; overdependence on publicly funded facilities; and barriers to health care, such as insufficient transportation, geographic location (not enough providers in an area), cost of services, and the low numbers of minority health care providers. Male gender and a patients allergy status are not identified as contributors to health disparities.
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How should the nurse and the other members of the care team best respond?
- A. Explain to the son the teams ethical obligation to inform the patient.
- B. Refer the family to social work.
- C. Have a nurse or physician from the patients culture make contact with her and her son.
- D. Speak with the son to explore his rationale and attempt to reach a consensus.
Correct Answer: D
Rationale: Nurses must promote open dialogue and work with patients, families, physicians, and other health care providers to reach the culturally appropriate solution for the individual patient. A referral to social work is not a sufficient response and enlisting a caregiver from the same culture may not be ethical or effective.
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.
How would you characterize the Hispanic people in this community?
- A. An underclass
- B. A subgroup
- C. A minority
- D. An exception
Correct Answer: C
Rationale: The term minority refers to a group of people whose physical and cultural characteristics differ from the majority of people in a society. There are four generally identified minority groups: Blacks/African Americans, Hispanics, Asian/Pacific Islanders, and Native Americans. Such groups are not referred to as exceptions or underclasses. A subgroup is a division of a group that is in some way distinguished from the larger group.
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.
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.