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Potter & Perry: Fundamentals of Nursing, 7th Edition

Test Bank
Chapter 9: Culture and Ethnicity
MULTIPLE CHOICE
1. The nurse recognizes that ethnicity differs from race in that ethnicity:
1. Refers to subgroups within a race
2. Is a unique factor within a cultural group
3. Includes more than biological identification
4. Is the set of conflicting values between races
ANS: 3
Ethnicity refers to a shared identity related to social and cultural heritage, such as values,
language, geographical space, and racial characteristics. Race refers to biological
attributes.
Subcultures refer to subgroups within a race. A variant cultural pattern is a unique factor
within a cultural group. Ethnocentrism is the root of biases and prejudices comprising
beliefs and attitudes associating negative permanent characteristics with people who are
perceived to be different from the valued group.
DIF: A
REF: 107
OBJ: Cognitive Level: Comprehension
TOP: Nursing Process: Assessment
MSC: NCLEX test plan designation: Psychosocial Integrity/Cultural Diversity
2. Within transcultural nursing, sensitivity to social organization is the recognition of the
clients:
1. Language usage
2. Status and expected role in the family
3. Definition of health and health practices
4. Psychological characteristics and coping mechanisms
ANS: 2
Cultural groups consist of units of social organization delineated by kinship, status
hierarchy, and appropriate roles for their members. Sensitivity to social organization is
the recognition of the clients status and role in the family. Sensitivity to communication
patterns would be the recognition of the clients language usage. Culture is the framework
used in defining social phenomena such as when a person is considered to be healthy or
in need of intervention. The way an individual defines health and health practices needs
to be understood by the nurse to best meet the needs of the client. Sensitivity to social
organization is not met by recognizing the definition of health for an individual.
Psychological characteristics and coping mechanisms may be expressed in a variety of
ways across cultures. Sensitivity to social organization is not demonstrated by the
recognition of psychological characteristics and coping mechanisms of a particular
culture.
DIF:

REF: 116

OBJ: Cognitive Level: Comprehension

Mosby items and derived items 2009, 2005 by Mosby, Inc., an affiliate of Elsevier Inc.

Test Bank

9-2

TOP: Nursing Process: Assessment


MSC: NCLEX test plan designation: Psychosocial Integrity/Cultural Diversity
3. Traditional Western medicine, in contrast to alternative therapy, uses:
1. Acupuncture
2. Herbal therapy
3. Spiritual advising
4. Medication administration
ANS: 4
Traditional Western medicine uses medication administration as a method of treatment.
Acupuncture is an alternative therapy often used in non-Western cultures such as the
Chinese and Southeast Asians. Herbal therapy is an alternative therapy often used in nonWestern cultures, but not in traditional Western medicine. Spiritual advising is not used in
traditional Western medicine, but it may be seen in the African-American cultural group.
DIF: A
REF: 110
OBJ: Cognitive Level: Comprehension
TOP: Nursing Process: Assessment
MSC: NCLEX test plan designation: Psychosocial Integrity/Cultural Diversity; Health
Promotion and Maintenance/Health and Wellness
4. The nurse is completing an assessment of an Asian-American client. Recognizing that
there are commonly seen problems in individuals from this background, the nurse
observes for particular signs and symptoms of:
1. Hypertension
2. Tuberculosis
3. Diabetes mellitus
4. Lactose intolerance
ANS: 4
Lactose intolerance is frequently observed among Asians, Africans, and Hispanics.
Hypertension is commonly seen in African Americans. Aboriginal Canadians descended
from native North American Indians and living on reservations have a higher incidence of
tuberculosis. Diabetes mellitus is commonly seen among Ute, Pima, and Papago Indians.
DIF: A
REF: 116
OBJ: Cognitive Level: Knowledge
TOP: Nursing Process: Assessment
MSC: NCLEX test plan designation: Psychosocial Integrity/Cultural Diversity; Health
Promotion and Maintenance/Health and Wellness
5. The nurse recognizes the following as an appropriate strategy for communicating with
clients who are not fluent in English?
1. Speaking in a louder tone of voice
2. Incorporating hand gestures and pictures
3. Responding to the client by his or her first name
4. Interacting with an interpreter for all communication
ANS: 2
Mosby items and derived items 2009, 2005 by Mosby, Inc., an affiliate of Elsevier Inc.

Test Bank

9-3

An appropriate strategy for communicating with clients who are not fluent in English is
to incorporate hand gestures and pictures. Speaking in a louder tone of voice will not help
the client understand the English language. Responding to the client by his or her first
name may demonstrate a lack of respect. The nurse should introduce him or herself and
then request the client to introduce himself or herself. An interpreter is not necessary for
all communication. However, an interpreter must be used for communicating to the client
information about his or her medical condition. It is not acceptable for family members to
translate health care information, but they can assist with ongoing interaction during the
clients care.
DIF: A
REF: 113
OBJ: Cognitive Level: Comprehension
TOP: Nursing Process: Assessment
MSC: NCLEX test plan designation: Psychosocial Integrity/Cultural Diversity
6. One aspect of a culture is invisible, or less observable, to others. A nurse wanting to
develop an awareness of the practices of different cultures within that community would
have which of the following as an example of this component?
1. Wearing an amulet or charm
2. Using prayer beads or candles
3. Using cotton garments for clothing
4. Believing in supernatural influences
ANS: 4
An example of an invisible (less observable) component of a culture is having a belief in
supernatural influences. An example of a visible (easily seen) component of culture is the
wearing of an amulet or charm. An example of a visible (easily seen) component of
culture is using prayer beads or candles. Using cotton undergarments for clothing is a
visible (easily seen) component of culture.
DIF: A
REF: 107
OBJ: Cognitive Level: Comprehension
TOP: Nursing Process: Assessment
MSC: NCLEX test plan designation: Psychosocial Integrity/Cultural Diversity
7. From culture to culture time often takes on different meanings. In exploring the
relationship of time to nursing interventions, the nurse should:
1. Avoid using set times to do procedures, if possible
2. Maintain the set times for treatments and inform the client of the schedule
3. Maintain a flexible attitude when the client requests procedures to be done at
specific times
4. Encourage clients to set the times when they would like the nurse to perform
nursing care activities.
ANS: 3

Mosby items and derived items 2009, 2005 by Mosby, Inc., an affiliate of Elsevier Inc.

Test Bank

9-4

Because time has different meanings from one culture to another, the nurse should
maintain a flexible attitude and not become emotionally upset when the client requests
procedures to be done at different times. When making appointments and referrals,
anticipated barriers to time adherence should be explored and managed with the client.
For organizational purposes, nurses should seek clients input and together the nurse and
client may set a time to do procedures. Maintaining set times for treatments and
informing the client of the schedule do not take into consideration the clients time
orientation. Although the clients input should be sought, it is not realistic to have clients
set their own times for nursing care activities regardless of the schedule. Some
procedures may be required more frequently than the client would set, or the nurse may
be unable to meet the needs of several clients on the unit at the same time.
DIF: A
REF: 118
OBJ: Cognitive Level: Comprehension
TOP: Nursing Process: Planning
MSC: NCLEX test plan designation: Psychosocial Integrity/Cultural Diversity
8. The nurse recognizes that changes in demographics have an influence on health care
delivery. One of the expectations in the United States by the year 2020 is:
1. Growth of the European-American population
2. Increases in the Hispanic and Latino populations
3. Reduction of the African-American population by 50%
4. Equal growth in the Hispanic-, Asian-, and African-American populations
ANS: 2
By 2020 the population of Hispanic and Latino populations is predicted to triple.
Population projections beyond 2000 show Hispanics/Latinos, Asian-Americans, and
African-Americans outpacing the growth of white, European-descended groups. The
African-American group is projected to double by 2020. By 2020 the population of
African Americans is predicted to double and that of Asian Americans and
Hispanics/Latinos to triple.
DIF: A
REF: 107
OBJ: Cognitive Level: Knowledge
TOP: Nursing Process: Assessment
MSC: NCLEX test plan designation: Psychosocial Integrity/Cultural Diversity; Health
Promotion and Maintenance/Health and Wellness
9. While going through the process of acculturation a client will be:
1. Identifying with 2 or more cultures
2. Adapting to and adopting a new culture
3. Showing favor to the dominant culture
4. Socializing within their primary cultural group
ANS: 2
Acculturation is the process of adapting to and adopting a new culture. Biculturalism
occurs when an individual identifies equally with two or more cultures. Assimilation
occurs when an individual gives up his or her ethnic identity in favor of the dominant
culture. Socialization into ones primary culture as a child is known as enculturation.

Mosby items and derived items 2009, 2005 by Mosby, Inc., an affiliate of Elsevier Inc.

Test Bank

9-5

DIF: A
REF: 708
OBJ: Cognitive Level: Comprehension
TOP: Nursing Process: Assessment
MSC: NCLEX test plan designation: Psychosocial Integrity/Cultural Diversity
10. An example of a nurse imposing his/her own cultural beliefs on a client is evident in
which of the following examples?
1. Adaptation of the clients room to accommodate family members
2. Seeking information on gender-congruent care for an Egyptian client
3. Administering less potent pain medication to an outpatient surgery client
4. Encouraging family members to assist with the clients feeding and hygiene care
ANS: 3
Holding back more potent pain medication for a client who had a minor procedure is an
example of a cultural imposition of the nurse on a client. Adaptation of the clients room
to accommodate extra family members is not an example of cultural imposition on a
client, but rather is meeting the clients need by providing culturally congruent care.
Seeking information on gender-congruent care for an Egyptian client is an example of the
desire to provide culturally congruent care. Encouraging family to assist with the clients
care is not an example of cultural imposition on a client. Western culture tends to follow a
pattern of caring that focuses on self-care and self-determination, whereas non-Western
cultures typically have care provided by others.
DIF: A
REF: 109
OBJ: Cognitive Level: Comprehension
TOP: Nursing Process: Implementation
MSC: NCLEX test plan designation: Psychosocial Integrity/Cultural Diversity
11. Following a surgical procedure, an older Chinese woman refuses to perform the range of
motion and breathing exercises requested, in addition is hesitant to complete her hygienic
care and grooming. The nurse recognizes that this is most likely related to:
1. Dependence on health care providers for care
2. Reliance upon family members to assist with care
3. Lack of personal motivation to participate in self-care
4. Reluctance to cooperate with traditional Western medical treatment
ANS: 2
Non-Western cultures traditionally rely heavily on family members to provide care.
Although it may be related to dependence on health care providers for care, it is not as
likely because non-Western cultures depend on family members to assist with care. While
it may be related to lack of personal motivation to participate in self-care, the clients
behavior is more likely a result of her cultural background rather than a lack of
motivation. While the clients behavior may be a result of reluctance to cooperate with
Western medical treatments, it is more likely indicative of her cultural dependence on
family members.
DIF: C
REF: 110
TOP: Nursing Process: Assessment

OBJ: Cognitive Level: Analysis

Mosby items and derived items 2009, 2005 by Mosby, Inc., an affiliate of Elsevier Inc.

Test Bank

9-6

MSC: NCLEX test plan designation: Psychosocial Integrity/Cultural Diversity; Health


Promotion and Maintenance/Health and Wellness
12. When faced with a scenario where it is believed that a client from another cultural
background is using herbal remedies along with the prescribed medication to treat her
arthritis. The nurses first action should be to:
1. Educate the client concerning the danger of taking herbs and the prescribed
medication
2. Inquire of the client as to the reason for using herbal remedies along with the
prescribed medication
3. Ask the client to identify what herbal remedies are being used along with the
prescribed medications
4. Alert the physician to the clients use of herbal remedies in addition to the
prescribed medications
ANS: 3
Rather than first dismissing the practice as dangerous and incompatible with Western
medicine, practitioners need to investigate further whether the practice needs changing.
Although educating the client may be appropriate, this cannot be determined until the
herb has been identified and it is determined to be harmful in this situation. Asking the
client why additional remedies are being used may make the client feel defensive. The
nurse needs to first determine what herbs are being used. While alerting the physician is
appropriate, it is not the first action to be taken by the nurse. The nurse should initially
determine what herbs are being used.
DIF: C
REF: 110
OBJ: Cognitive Level: Analysis
TOP: Nursing Process: Implementation
MSC: NCLEX test plan designation: Psychosocial Integrity/Cultural Diversity; Health
Promotion and Maintenance/Health and Wellness
13. Being cared for by a nurse of the opposite gender would be an especially important issue
for women from which of the following cultures?
1. Afghan
2. Filipino
3. Native American
4. African American
ANS: 1
Modesty is a strong value among Afghan and Arab women.
Modesty is not an especially important issue for Filipino women.
Modesty is not an especially important issue for Native American women.
Modesty is not an especially important issue for African American women.
DIF: A
REF: 109
OBJ: Cognitive Level: Knowledge
TOP: Nursing Process: Planning
MSC: NCLEX test plan designation: Psychosocial Integrity/Cultural Diversity; Health
Promotion and Maintenance/Health and Wellness

Mosby items and derived items 2009, 2005 by Mosby, Inc., an affiliate of Elsevier Inc.

Test Bank

9-7

14. An example of a culture where a male relative will regularly decline to observe the birth
process is:
1. Pakistani
2. Hispanic
3. Korean
4. Japanese
ANS: 1
Religious beliefs may prohibit the presence of males, including husbands, in the delivery
room. This may be observed among devout Muslims, Hindus, and Orthodox Jews.
Hispanic men typically do not have religious or cultural beliefs that would prohibit them
from the delivery room. Korean men typically do not have religious or cultural beliefs
that would prohibit them from the delivery room. Asian men typically do not have
religious or cultural beliefs that would prohibit them from the delivery room.
DIF: A
REF: 111
OBJ: Cognitive Level: Knowledge
TOP: Nursing Process: Planning
MSC: NCLEX test plan designation: Psychosocial Integrity/Cultural Diversity; Health
Promotion and Maintenance/Health and Wellness
15. The nurse observes a religious charm hanging from the wrist of a client being prepared
for surgery. The nurses best initial approach is to:
1. Remove the religious charm
2. Securely tape the charm in place
3. Ask the client to leave the charm with family members
4. Clarify whether the charm may remain in place during the procedure
ANS: 4
The nurse should first determine if it is permissible for the item to remain in place during
the procedure. Removing the bracelet may create unnecessary stress for the client.
Initially the nurse should determine if removal is necessary. Taping the bracelet in place
may be appropriate after the nurse determines that the item may remain in place during
the procedure. Asking the client to remove the item may create unnecessary stress for the
client. Initially the nurse should determine if removal is necessary.
DIF: B
REF: 109
OBJ: Cognitive Level: Application
TOP: Nursing Process: Implementation
MSC: NCLEX test plan designation: Psychosocial Integrity/Cultural Diversity; Health
Promotion and Maintenance/Health and Wellness
16. The nurse recognizes that the family of a deceased Buddhist client will:
1. Bury before sundown
2. Decline viewing the body
3. Not move the body until it is cold
4. Select cremation rather than burial
ANS: 3
Mosby items and derived items 2009, 2005 by Mosby, Inc., an affiliate of Elsevier Inc.

Test Bank

9-8

Some Buddhists may refuse to move the dead body after death because of their belief that
the spirit of the dead takes some time to leave the body. They define death as the absence
of consciousness and loss of body warmth. Among Orthodox Jews, the body is generally
buried before sundown. Some Asian Indians regard seeing the deceased as adding to the
suffering of the family. Hindus and Buddhists believe that the soul lives on and the dead
body without the soul is but an empty shell, and therefore may not want to see the body.
Muslims prefer burial rather than cremation.
DIF: A
REF: 112-113
OBJ: Cognitive Level: Knowledge
TOP: Nursing Process: Planning
MSC: NCLEX test plan designation: Psychosocial Integrity/Cultural Diversity
17. A nurse that has the knowledge of the biocultural history of clients and aware that
individuals with a greater potential for and incidence of hypertension are:
1. Asians
2. Hispanics
3. Native Americans
4. African Americans
ANS: 4
Malignant hypertension is found more frequently in African Americans. Lactose
intolerance is frequently observed among Asians. Hispanics have a higher incidence of
lactose intolerance. Native Americans have a higher incidence of tuberculosis and
diabetes mellitus.
DIF: A
REF: 117
OBJ: Cognitive Level: Knowledge
TOP: Nursing Process: Assessment
MSC: NCLEX test plan designation: Psychosocial Integrity/Cultural Diversity; Health
Promotion and Maintenance/Health and Wellness
18. There are cultural context of health and illness differences in comparing Western versus
non-Western cultures. The nurse is aware that in Western culture the overall treatment is:
1. Herbal
2. Holistic
3. Naturalistic
4. Specialty-specific
ANS: 4
The overall treatment in Western culture is specialty-specific. The treatment in some nonWestern cultures is herbal. The treatment in non-Western cultures is holistic in nature.
Some non-Western cultures use a naturalistic approach for the method of diagnosis.
DIF: A
REF: 109
OBJ: Cognitive Level: Knowledge
TOP: Nursing Process: Assessment
MSC: NCLEX test plan designation: Psychosocial Integrity/Cultural Diversity; Health
Promotion and Maintenance/Health and Wellness

Mosby items and derived items 2009, 2005 by Mosby, Inc., an affiliate of Elsevier Inc.

Test Bank

9-9

19. Regarding a client who is an Orthodox Jew and maintains a Kosher diet, the nurse will
make sure that the clients menu does not include:
1. Beef
2. Eggs
3. Milk
4. Shellfish
ANS: 4
Jewish clients who follow a Kosher diet will avoid meat from carnivores, pork products,
and fish without scales or fins. Therefore shellfish should not be included in the menu of
a client who is an Orthodox Jew and maintains a Kosher diet. Beef may be included in a
Kosher diet. Eggs may be included in a Kosher diet. Milk may be included in a Kosher
diet.
DIF: A
REF: 117
OBJ: Cognitive Level: Knowledge
TOP: Nursing Process: Planning
MSC: NCLEX test plan designation: Psychosocial Integrity/Cultural Diversity; Health
Promotion and Maintenance/Health and Wellness
20. For a client who is a Buddhist and maintains a traditional diet, the nurse will make sure
that a sufficient quantity of which of the following is included in the menu?
1. Beef
2. Milk
3. Fish
4. Vegetables
ANS: 4
Many Buddhists are vegetarians. The nurse should ensure that a sufficient quantity of
vegetables is included in the menu when caring for a Buddhist who maintains a
traditional diet. Beef is not a traditional component of a Buddhists diet. A sufficient
quantity of milk is not necessary for the traditional Buddhists diet. A sufficient quantity
of fish is not necessary for the traditional Buddhists diet.
DIF: A
REF: 117
OBJ: Cognitive Level: Knowledge
TOP: Nursing Process: Planning
MSC: NCLEX test plan designation: Psychosocial Integrity/Cultural Diversity; Health
Promotion and Maintenance/Health and Wellness
21. Which of the following factors has the greatest impact on health care available to nonHispanic white minority groups in the United Sates?
1. Significant language barriers
2. Inappropriately high poverty rates
3. Genetically based disease processes
4. Mistrust of Western medical practices
ANS: 2

Mosby items and derived items 2009, 2005 by Mosby, Inc., an affiliate of Elsevier Inc.

Test Bank

9-10

Racial and ethnic minorities are more likely than non-Hispanic whites to be poor or near
poor. In addition, Hispanics, African Americans, and some Asian subgroups are less
likely than non-Hispanic whites to have a high school education. In general, racial and
ethnic minorities often experience poorer access to care and lower quality of preventive,
primary, and specialty care. While language barriers may have an influence on the
amount and type of health care services available to and sought out by minority groups, it
is poverty that has the greatest negative influence. While genetically based disease
processes may have an influence on the amount and type of health care services available
to and sought out by minority groups, it is poverty that has the greatest negative
influence. Although mistrust of Western medical practices may have an influence on the
amount and type of health care services available to and sought out by minority groups, it
is poverty that has the greatest negative influence.
DIF: C
REF: 107
OBJ: Cognitive Level: Analysis
TOP: Nursing Process: Assessment
MSC: NCLEX test plan designation: Psychosocial Integrity/Cultural Diversity; Health
Promotion and Maintenance/Health and Wellness
22. The nurse who is attempting to practice in a culturally sensitive manner must first realize
that recognition of the visible signs of a clients culture:
1. Is essential to the establishment of a nurse-client relationship
2. Provides the basis for a sense of trust between client and nurse
3. Does not ensure understanding of the underlying cultural beliefs
4. Has little impact on the nurses ability to provide therapeutic care
ANS: 3
Culture has both visible (easily seen) and invisible (less observable) components. Nurses
cannot appreciate the meanings and beliefs associated with these artifacts without further
assessment.
Recognition of visible signs of a clients culture will assist in the formation of a
therapeutic nurse-client relationship because it conveys the nurses interest in the client as
a person; it is not essential to the relationship process. Recognition of visible signs of a
clients culture will assist in the formation of trust (a component of a therapeutic nurseclient relationship) because it conveys the nurses interest in the client as a person; it is
not essential to the trust-establishing process. Recognition of visible signs of a clients
culture will assist in the formation of a therapeutic nurse-client relationship, which is vital
to the nurses ability to provide therapeutic care because it conveys the nurses interest in
the client as a person.
DIF: C
REF: 107
OBJ: Cognitive Level: Analysis
TOP: Nursing Process: Assessment
MSC: NCLEX test plan designation: Psychosocial Integrity/Cultural Diversity; Health
Promotion and Maintenance/Health and Wellness
23. Which of the following nursing interventions shows the greatest degree of culturally
competent nursing care for a Muslim female client?
1. Notifying the chaplain of the clients religious preference
Mosby items and derived items 2009, 2005 by Mosby, Inc., an affiliate of Elsevier Inc.

Test Bank

9-11

2. Notifying staff that the clients bath will be done by her sister
3. Drawing the curtains around the clients bed during prayer time
4. Facilitating a dietary consult to meet the clients nutritional concerns
ANS: 2
Cultural competence is the process of acquiring specific knowledge, skills, and attitudes
that ensure delivery of culturally congruent care. By arranging for the family to assume
responsibility for the clients hygiene, the nurse has shown a specific knowledge of the
clients needs and acted upon that need. The other options are not as specific or as
directly related to nursing care as notifying the staff that the clients bath will be done by
her sister.
DIF: C
REF: 109
OBJ: Cognitive Level: Analysis
TOP: Nursing Process: Planning
MSC: NCLEX test plan designation: Psychosocial Integrity/Cultural Diversity; Health
Promotion and Maintenance/Health and Wellness
24. A nursing care assistant fails to report in a timely manner a request for pain medication
from an African-American male client who is recovering from a stab wound. The nurses
initial action is to evaluate the care assistants:
1. Feelings regarding this particular client
2. Need for administrative disciplinary action
3. Understanding of the need for prompt reporting
4. Employment files for documentation of similar behavior
ANS: 1
Personal bias and prejudices when acted upon may interfere with the delivery of
appropriate, effective nursing care. While all the options are appropriate, the nurses
initial action is to determine the cause of the care assistants negligent behavior. Although
all the options are appropriate, the nurses initial action is to determine the cause of the
care assistants negligent behavior.
DIF: C
REF: 109
OBJ: Cognitive Level: Analysis
TOP: Nursing Process: Evaluation
MSC: NCLEX test plan designation: Psychosocial Integrity/Cultural Diversity; Health
Promotion and Maintenance/Health and Wellness
25. An Arab woman arrives in the emergency department reporting vaginal bleeding. It is
determined that the client is 5 months pregnant with her second child and has had no
prenatal care. The nurse realizes that the most likely reason for this lack of health care is
that the client:
1. Cannot afford to seek health care
2. Views pregnancy as a normal life event
3. Typically relies on same-culture healers
4. Lacks an understanding of available services
ANS: 2

Mosby items and derived items 2009, 2005 by Mosby, Inc., an affiliate of Elsevier Inc.

Test Bank

9-12

Culture is the context in which groups of people interpret and define their experiences
relevant to life transitions. This includes events such as birth, illness, and dying. It is the
system of meanings by which people make sense of their experiences. Culture is how
others define social phenomena such as when a person is healthy or requires intervention.
Traditionally, in Arab culture, pregnancy is not a medical condition but rather a normal
life transition; hence, a pregnant woman does not always go to a doctor unless she has a
problem. While the other options may have been a factor, the most likely cause is that the
Arab culture views pregnancy as a normal life event and care is sought only when a
perceived problem exists.
DIF: C
REF: 109
OBJ: Cognitive Level: Analysis
TOP: Nursing Process: Assessment
MSC: NCLEX test plan designation: Psychosocial Integrity/Cultural Diversity; Health
Promotion and Maintenance/Health and Wellness
26. An Asian-American client will accept hygiene care from only family members. The
cultural origin of this behavior is most likely:
1. Valued privacy
2. Female modesty
3. Interdependency
4. Mistrust of strangers
ANS: 3
In collectivistic cultures that value group reliance and interdependence, such as
traditional Asians, Hispanics, and Africans, caring behaviors require actively providing
physical and psychosocial support for family or community members. While the other
options may be individualized factors, culturally the most likely origin is that of group
reliance and interdependency of the Asian culture.
DIF: C
REF: 110
OBJ: Cognitive Level: Analysis
TOP: Nursing Process: Planning
MSC: NCLEX test plan designation: Psychosocial Integrity/Cultural Diversity; Health
Promotion and Maintenance/Health and Wellness
27. An older Chinese client experienced a stroke that left him with right-sided weakness and
now refuses to participate in physical therapy until his son is present. The nurse should
initially interpret this behavior as:
1. A sign of post-stroke depression
2. An illustration of cultural collectivism
3. A response to the therapy-induced pain
4. An example of a healthy father-son relationship
ANS: 2

Mosby items and derived items 2009, 2005 by Mosby, Inc., an affiliate of Elsevier Inc.

Test Bank

9-13

In collectivistic cultures that value group reliance and interdependence, such as


traditional Asians, Hispanics, and Africans, caring behaviors require actively providing
physical and psychosocial support for family or community members. The other options
may be true; however, the more likely interpretation is the clients cultural inclination
toward group reliance and family support systems.
DIF: C
REF: 110
OBJ: Cognitive Level: Analysis
TOP: Nursing Process: Assessment
MSC: NCLEX test plan designation: Psychosocial Integrity/Cultural Diversity; Health
Promotion and Maintenance/Health and Wellness
28. While assessing an older Vietnamese client, the nurse notes several oval-shaped reddened
areas on her back and arms. The clients daughter explains them to be the result of a
traditional healing practice called cupping. The nurses immediate reaction should be
to:
1. Report the finding to the authorities to rule out physical abuse
2. Ask the daughter to explain the practice in detail
3. Notify the clients health care provider to see if treatment is necessary
4. Document the assessment findings in the nursing notes
ANS: 2
Many Southeast-Asian cultures practice folk remedies such as coining, cupping,
pinching, and burning to relieve aches and pains and remove bad wind or noxious
elements that cause illness. These remedies leave peculiar visible markings on the skin in
the form of ecchymosis, superficial burns, strap marks, or local tenderness. Cultural
ignorance causes a practitioner to call authorities for suspicion of abuse. Nurses need to
investigate to determine the details of the practice in order to decide whether the practice
needs to be changed. Consultation and collaboration with herbalists and other naturalistic
practitioners will prevent unnecessary distress for the client. While reporting the finding
to authorities should not be dismissed, the nurse should first discuss the practice with the
daughter to learn more of the details regarding the practice. The clients health care
provider should be notified, however, the nurses assessment of the areas as reddened
areas suggests that other options may have priority. Documentation of the assessment
findings is certainly appropriate and is a nursing responsibility, but acquiring an
explanation from the daughter who is present would have priority.
DIF: C
REF: 110
OBJ: Cognitive Level: Analysis
TOP: Nursing Process: Assessment
MSC: NCLEX test plan designation: Psychosocial Integrity/Cultural Diversity; Health
Promotion and Maintenance/Health and Wellness
29. The nurse, caring for a comatose Muslim client who is dying, realizes that from a cultural
standpoint, the most therapeutic intervention is to:
1. Facilitate the clients peaceful, pain-controlled death
2. Become familiar with Muslim death and dying traditions
3. Approach the family to identify and discuss any needs that exist
4. Arrange for a private room so the family can grieve traditionally
Mosby items and derived items 2009, 2005 by Mosby, Inc., an affiliate of Elsevier Inc.

Test Bank

9-14

ANS: 3
Be aware of religious and cultural preferences when helping clients and families prepare
for death. Facilitating the clients peaceful, pain-controlled death is an appropriate
intervention; it is not necessarily culturally oriented because nursing strives to facilitate a
peaceful, pain-free death for all clients. Becoming familiar with cultural tradition is
therapeutic and would have priority if the family were not present to be questioned
directly regarding their needs. Arranging for a private room may be a therapeutic
intervention because most cultures would prefer some degree of privacy when attending
to the death of a loved one, but since the family is present the priority intervention is the
one that identifies their needs.
DIF: C
REF: 112-113
OBJ: Cognitive Level: Analysis
TOP: Nursing Process: Planning
MSC: NCLEX test plan designation: Psychosocial Integrity/Cultural Diversity; Health
Promotion and Maintenance/Health and Wellness
30. A Hispanic client is diagnosed with inoperable brain cancer. The clients wife insists that
any discussion about treatment options be postponed until all local family members are
present. The nurse correctly views this as:
1. The familys attempt to facilitate a good death for the client
2. An invasion of the clients right of confidentiality by the family members
3. Appropriate because the cancer may have affected his decision-making abilities
4. A cultural tradition that relieves the ill family member of the burden of decision
making
ANS: 4
In some cultures, the group assumes decision making for a family member in these
situations and is trusted to make the right decision for the individual. Indeed, some
groups such as African Americans, Asian Americans, and Hispanics expect their family to
make decisions for them, and family members prefer to protect the individual from
unnecessary suffering by knowing the reality of imminent death. These cultures value
group interdependence and view individual autonomy as an unnecessary burden for a
loved one who is ill (Pacquiao, 2002, 2003a). The means by which the family provides a
good death is first established through the process of group decision making. It may
appear that the clients confidentiality is being invaded by a member of the Western
nursing profession; it is a cultural norm for members of many Hispanic families.
Although cancer may affect the clients abilities to make decisions, the origin of this
behavior is more likely the cultural tradition of group decision making among Hispanics.
DIF: C
REF: 111
OBJ: Cognitive Level: Analysis
TOP: Nursing Process: Evaluation
MSC: NCLEX test plan designation: Psychosocial Integrity/Cultural Diversity; Health
Promotion and Maintenance/Health and Wellness
31. The nurse realizes that the primary goal of a cultural assessment is to:
1. Minimize client distress resulting from unmet cultural expectations

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Test Bank

9-15

2. Provide care that is in concert with the clients cultural expectations


3. Identify cultural beliefs and traditions that are important to the client
4. Blend Western nursing practice with the clients cultural expectations
ANS: 2
The goal of cultural assessment is to gather significant information from the client that
will enable the nurse to implement culturally congruent care. Minimizing distress is an
achieved outcome when the goal of culturally congruent care is met. Identifying beliefs
and traditions is an assessment goal that helps identify the criteria for individualized,
culturally congruent care.
Blending Western nursing practice with cultural expectations will result in individualized,
culturally congruent care.
DIF: C
REF: 108
OBJ: Cognitive Level: Analysis
TOP: Nursing Process: Assessment
MSC: NCLEX test plan designation: Psychosocial Integrity/Cultural Diversity; Health
Promotion and Maintenance/Health and Wellness
32. The nurse caring for members of the Hispanic community recognizes which of the
following situations as the best reflection of the cultures view of family caring?
1. A husband calling each evening to tell his wife goodnight
2. Family members taking turns staying with the client at night
3. The daughter bringing her fathers favorite soup to the hospital
4. The eldest son sending a huge floral arrangement to the hospital
ANS: 2
In collectivistic groups such as the Hispanic culture, the physical presence of loved ones
with the client demonstrates caring. While the other options show caring, it is not the best
option reflecting the Hispanic culture.
DIF: C
REF: 110
OBJ: Cognitive Level: Analysis
TOP: Nursing Process: Assessment
MSC: NCLEX test plan designation: Psychosocial Integrity/Cultural Diversity; Health
Promotion and Maintenance/Health and Wellness
33. A nurse caring for the Arab community observes a client crying. The woman was recently
informed that her radiation treatments may affect her ability to become pregnant. The
nurse recognizes that the client is most likely reacting to a cultural attitude regarding:
1. The importance of children to an Arab family
2. The Arab view that infertility is grounds for divorce
3. Infertility is a punishment for unholy living
4. The loss of status among other married Arab women
ANS: 2
Infertility in a woman is considered grounds for divorce and rejection among Arabs.
Although infertility is grounds for divorce in Arab cultures, it is not the best option for
this question.

Mosby items and derived items 2009, 2005 by Mosby, Inc., an affiliate of Elsevier Inc.

Test Bank

9-16

Infertility as a punishment for unholy living may not be a generally accepted view, it is
not the best option for this question. While the loss of status among other married Arab
women may be true, it is not the best option for this question.
DIF: C
REF: 111
OBJ: Cognitive Level: Analysis
TOP: Nursing Process: Assessment
MSC: NCLEX test plan designation: Psychosocial Integrity/Cultural Diversity; Health
Promotion and Maintenance/Health and Wellness
34. The primary problem with using English-speaking children of immigrant families as
interpreters is that:
1. The adults may resent their dependence upon the child
2. The subjects discussed may be too disturbing to the child
3. Children can be easily distracted, thus making them unreliable translators
4. There are concerns about the childs ability to convey important information
ANS: 1
Assuming that children are ideal interpreters for their parents may in fact be an insult to
the authority of the elder who has to take directions from a child. Although the other
options may be true, it is not the primary reason for the concerns regarding using children
as interpreters.
DIF: C
REF: 115
OBJ: Cognitive Level: Analysis
TOP: Nursing Process: Assessment
MSC: NCLEX test plan designation: Psychosocial Integrity/Cultural Diversity; Health
Promotion and Maintenance/Health and Wellness

Mosby items and derived items 2009, 2005 by Mosby, Inc., an affiliate of Elsevier Inc.